Fractures of the shaft of the humerus due to muscle violence esp. from throwing hand grenades are uncommon. Even so there are reports from many authors documenting such fractures from throwing a javerin, baseball, hand grenade and arm wrestling. Fractures of this type are usually spiral in nature; located between the middle and distal third of the humerus. We have treated four such cases during activities in which hand grenades were thrown. These fractures were sustained by military recruits in the Department of Orthopaedic Surgery, Capital Armed Forces General Hospital from Jan. 1980 Dec. 1980.
Arm ; Baseball ; Hand ; Hospitals, General ; Humans ; Humerus ; Military Personnel ; Violence ; Wrestling

Holoprosencephaly is a rare and complex malformation affecting the cleavage of the developing forebrain and is usually associated with defects of the mid Face. We have experienced a case of holoprosencephaly, diagnosed prenatally by ultrasound examination at 31 weeks of pregnancy in a 31-year-old primigravida woman. This case is characterized by holoprosencephaly, cleft palate, cleft lip, left renal aplasia and right renal hypertrophy. The chromosomal study showed a deletion of the long arm of chromosome 7, 46, XX, del(7)(q32), We report with a terminal deletion of chromosome 7q associated with atypical clinical picture and holoprosencephaly.
Adult ; Arm ; Chromosome Aberrations* ; Chromosomes, Human, Pair 7 ; Cleft Lip ; Cleft Palate ; Female ; Holoprosencephaly ; Humans ; Hypertrophy ; Multicystic Dysplastic Kidney* ; Pregnancy ; Prosencephalon ; Ultrasonography

Tailgut cyst is a rare congenital anomaly arising in the retrorectal space. Malignancy arising from the tailgut cyst is very rare. We experienced a case of adenocarcinoma arising from the tailgut cyst. The findings of this rare tumor are bony destruction of the sacrum on plain radiograph, a cystic mass on ultrasound, a low attenuation mass with calcification and enhancement on CT, and a multiseptated cystic mass containing solid component on MRI.
Adenocarcinoma* ; Magnetic Resonance Imaging ; Sacrum ; Ultrasonography

Portal vein (PV) thrombosis (PVT) is a rare condition with development of thrombosis in the PV and its branches. Further extension to the splenic and superior mesenteric vein (SMV) causes intestinal infarction, with a reported mortality of up to 50%. A variety of treatments for PVT exist including anticoagulation, thrombolysis, surgical thrombectomy, insertion of shunts, bypass surgery, and liver transplantation. We experienced a case of successfully treated by surgical thrombectomy with direct thrombolysis into the thrombosed-PV and SMV. A 31-year-old male presented worsening abdominal pain for one week. Preoperative contrast enhanced computed tomography scan revealed complete PVT extending to splenic vein and SMV. The PV was accessed surgically and opened by thrombectomy; visual inspection confirmed proximal and distal flow. Urokinase was administered directly into the inferior mesenteric vein with successful decrease in thrombus burden. The complete angiography showed complete dissolution of thrombosis in PV and SMV.
Abdomen, Acute* ; Abdominal Pain ; Adult ; Angiography ; Humans ; Infarction ; Liver Transplantation ; Male ; Mesenteric Veins* ; Mortality ; Portal Vein ; Splenic Vein ; Thrombectomy* ; Thrombosis* ; Urokinase-Type Plasminogen Activator ; Venous Thrombosis

Renal artery aneurysm (RAA) is uncommon, and the coexistence of an abdominal aortic aneurysm (AAA) is an extremely rare condition with potentially high life-threatening mortality in case of rupture. Aneurysms can be treated by endovascular intervention or open surgery. Although most of aneurysms are treated by endovascular intervention, open surgery is often necessary for RAAs associated with the proximal renal bifurcation or the branches in the distal renal arteries. We report a rare case of coexisting RAA with AAA treated by hybrid method, consisting of endovascular aneurysm repair for AAA and open surgery for RAA located adjacent to the distal branches of the renal artery.
Aneurysm* ; Aortic Aneurysm, Abdominal* ; Gallbladder Neoplasms* ; Humans ; Mortality ; Renal Artery* ; Rupture

No abstract available.
Anal Canal*

No abstract available.

A case of eavernous hemangiomatosis involving alI tendon sheath of flexors and median nerve of the right forearm is reported. This case was a 22 year old Korean male who complained of painful swelling of the flexor side of right wrist region, limited motion of wrist joint, loss of pinching and opposition with tingling sensation on the admission. Roentgenographic examination revealed fusiform swelling of the soft tissues in flexor aspect of the right wrist region, with phlebolith, 3mm. in diameter. The tumor mass looked like strawberry in shape, and was scattered into all tendon sheath of flexors of the forearm, median nerve, the distal half of pronator quadrtus and other surrounding soft tissues. The specimen was confirmed as cavernous hemangioma in microscopic examination. The right long arm splint was applied for 3 weeks, and then the patient was treated with physical therapy for 4 months. Pinching, opposition, and motion of the right wrist joint recovered almost completly, and no evidence of the recurrence of hemangiomatosis was seen until 8 months after surgery.
Arm ; Forearm ; Fragaria ; Hemangioma, Cavernous ; Humans ; Male ; Median Nerve ; Recurrence ; Sensation ; Splints ; Tendons ; Wrist ; Wrist Joint

PURPOSE: Direct injection of doxorubicin into the eyelids results in permanent loss of muscle fiber and it is considered an attractive nonsurgical method in essential blepharospasm therapy. However, necrosis of skin overlying orbicularis oculi muscle is the most serious side effect of this therapy. The purpose of this study is to determine the effect of doxorubicin delivered by osmotic pump which release doxorubicin slowly, and to evaluate the degree of overlying skin injury following chemical myectomy. METHODS: Thirty three rabbits were assigned to three groups according to the doxorubicin concentration. The first group received direct injections of 0.5 mg doxorubicin diluted in 0.1 ml of saline in the right lower eyelid. and osmotic pump was inserted into the left lower eyelid which contained 0.5 mg doxorubicin in 0.1 ml of saline. The second group received 1 mg doxorubicin and the third group received 2 mg doxorubicin. Eight weeks after injection, the eyelids were assessed for the degree of muscle fiber loss microscopically. For the evaluation of functional change of muscle, an EMG study was carried out. RESULTS: Skin necrosis developed in all rabbits except for one which received injection of 0.5 mg doxorubicin. Skin necrosis appeared earlier in the direct injection group. The duration of skin necrosis was shortened at lower concentrations(0.5 mg, 1.0 mg) with a pump delivery(P<0.05). But there was no statistical differences in the 2.0 mg concentration. The size of necrosis was much smaller in rabbits using pump delivery than those of direct injection group in high doxorubicn concentrations(1.0 mg, 2.0 mg)(P<0.05). The total size of muscle fiber was decreased after a doxorubicin injection. There was no statistical difference between the direct injection group and the pump group(P<0.05). The similar effect on the muscle was noted regardless of the slow release of the doxorubicin into the muscle. Light microscopic study demonstrated destructive change of muscle and it was replaced by connective tissues. Electron microscopic study showed destruction of micro-architecture of muscle fibers. Functionally, in EMG study, there was no motor activity in the injection area. But some motor unit potentials appeared in the periphery of skin necrosis site. CONCLUSIONS: These results suggest that the osmotic pump may be used as an effective adjuvant in preventing skin necrosis in blepharospasm treatment.
Blepharospasm ; Connective Tissue ; Doxorubicin* ; Eyelids* ; Motor Activity ; Necrosis* ; Rabbits ; Skin*

One hundred fifty-seven patients wha underwent radical hysterectomy and pelvic lymphadenectomy for FIGO stage IB and IIA carcinoma of the cervix between February l975 and May 1987 were retros-pectively analysed to identify specific risk factors associsted with treatment failures. Prognostic factors inciuded clinical stage, histologic cell type, degree of differentiation, size of primary tumor, depth of stromal invasian, lymph-vaseular space invasion, and lymph node metastasis. Treatment results were evaluated according to the recurrence rate and 2-year absolute recurrence-free survival(NED) rate by the prognostie faetors and treatment modalities. Patients with lymph node me tases had a significantly higher incidence of bulky primary(-> 4cm), depth of stromal invasion(> 60% thickness), and lymph-vascular invasion(P<0.005). There was significant difference in the recurrence rate and 2-year, NED rate between cervical carcinoma stage IB and I1A(P <0.005). The pat,ients who had bulky primary tum~or(>4cm) and/or depth of stromal invasion (>60% thickness) had a higher recurrence and lower 2-year NKD rate(P<0.025, P<0.005), Unfortunately, it was not possible to demonstrate that these detrimentel effects could be overeorne by postoperetive radiation. When adjoined for these risk group, traditionally reported poor prognostic factors such as nodal metatasis, cell type and differentiation, lyrnphi-vascular mvasion assume less importance in our studies. In this study, prognosis is most inf1ueneed by clinical stage, depth of stromal invasion, and size of primary tumor,
Cervix Uteri* ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Risk Factors ; Treatment Failure*