Monteggia fracture-dislocation was described as a fracture of proximal third of the ulnar with a dislocation of radial head by G. Monteggia in 1814. Bado named Monteggia lesion as a fracture of ulnar at any level and a dislocation of radial head. The authors reviewed sixty-three patents of Monteggia fracture who were treated at department of orthopedic surgery, Yonsei university college of medicine from 1980. 1. to 1985. 12. We emphasis especially on cause of injury, classification, direction of radial head dislocation, level of ulnar fracture site, treatment and result. The results were as follows: 1. There were 22 children and 41 adults among 63 patients. 2. The male was affected more frequenty than female (49:14) . The ratio between male and female was 3. 5: l. 3. The most common cause of injury was falling down (54%) in children and car accident (51%) in adults. 4. According to Bado classification, type I was 68%, type II 11%, type III 18% and type IV 3%. 5. The partial posterior interosseous nerve injury was noticed in 12 cases and the superficial radial nerve injury was in 3 cases. The nerve injury was recovered spontaneously in all cases. Dislocation of radial head was as follows: Anterior dislocation was 38%, anterolateral 41%, lateral 8%, posterior 10% and posterolateral 3 % 7. Location of ulnar fracture site was as follows: Metaphysis was 22%, proximal 1/3 24%, junction of proximal 1/3 and middle 1/3 38%, middle 1/3 14% and distal 1/3 2%. 8. Closed reduction of radal head dislocation was done in 45 cases, open reduction in 10 cases and radial head excision in 6 cases. 9. Closed reduction of ulnar fracture was done in 26 cases and open reduction 35 cases. 10. We obtained 93% favorable results in children and 71% in adults. Not only the prognosis of ch ildren was better than adults but also the recovery time of children was shorter than adult's.
Accidental Falls ; Adult ; Child ; Classification ; Clinical Study ; Dislocations ; Female ; Head ; Humans ; Male ; Monteggia's Fracture ; Orthopedics ; Prognosis ; Radial Nerve

Leiomyosarcoma is a malignant tumor showing smooth muscle differentiation, and it accounts for 2% to 8% of soft tissue sarcoma. Clinically, substantial mortality and morbidity are related to the propensity for distant metastasis and local recurrence, respectively. Microscopic findings characteristically reveal intersecting bundles of spindle-shaped cells having fibrillar cytoplasm and blunt-ended nuclei. Immunohistochemistry for intermediate filaments is helpful in establishing a definitive diagnosis. We experienced a case of large protruding leiomyosarcoma that developed on an old burn scar of the medial calf of a 45-year-old man. On preoperative evaluation, we recommended amputation due to a distant metastasis to the lung(stage IV). As the patient refused amputation of his lower leg, the tumor was radically excised and immediate reconstruction was done using free latissimus dorsi muscle flap and skin graft. Four months after excision despite adjuvant chemotherapy, amputation was performed due to local recurrence.
Amputation ; Burns ; Chemotherapy, Adjuvant ; Cicatrix ; Cytoplasm ; Diagnosis ; Humans ; Immunohistochemistry ; Intermediate Filaments ; Leg ; Leiomyosarcoma* ; Middle Aged ; Mortality ; Muscle, Smooth ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Skin ; Superficial Back Muscles ; Transplants ; Ulcer*

To evaluate the effect of shortening the latent period for distraction osteogenesis, the authors experimented with distraction osteogenesis for a 24-hour latent period in the mandibles of rabbits. This study was carried out on 32 New Zealand white rabbits, each weighting 2000 to 2500 gm. Twenty animals were used for the control group and 12 for the experimental group. A unilateral external fixation device was applied to the left mandible. The mandibles were lengthened at 1 mm per 24 hours for 10 days. Five rabbits from the control group and three from the experimental group by random selection were sacrificed on the first day, and at the second, fourth and eighth week of the consolidation period. After lengthening bone densities at the site of the left mandibular bony lengthening were measured by quantitative computer tomography (QCT) and dual energy x-ray absorptiometry (DXA). As a result, the DXA value showed no difference compared to the control group after two week's consolidation. The trabeculae were thicker and had begun to be surrounded by lamellar bone both in the control and experimental groups histologically. In conclusion, the results of this study indicate that the osteogenetic effect in the experimental group was nearly the same as in the control group. If stable fixation and minimal periosteal dissection were performed during the procedure, the latent period would not be an important factor in distraction osteogenesis of membranous bone.
Absorptiometry, Photon ; Animals ; Bone Density ; External Fixators ; Mandible* ; Osteogenesis* ; Osteogenesis, Distraction ; Rabbits*

Here, we report a rare case of an anaplastic astrocytoma masquerading as a hypertensive basal ganglia hemorrhage. A 69-year-old woman who had been under medical management for hypertension during the past 3 years suddenly developed right hemiparesis with dysarthria. Brain computed tomography (CT) scans with contrast and CT angiograms revealed an intracerebral hemorrhage (ICH) in the left basal ganglia, without an underlying lesion. She was treated conservatively, but underwent a ventriculoperitoneal shunt operation 3 months after the initial attack due to deteriorated mental status and chronic hydrocephalus. Three months later, her mental status deteriorated further. Magnetic resonance imaging (MRI) with gadolinium demonstrated an irregular enhanced mass in which the previous hemorrhage occurred. The final histological diagnosis which made by stereotactic biopsy was an anaplastic astrocytoma. In the present case, the diagnosis of a high grade glioma was delayed due to tumor bleeding mimicking hypertensive ICH. Thus, a careful review of neuroradiological images including MRI with a suspicion of tumor bleeding is needed even in the patients with past medical history of hypertension.
Aged ; Astrocytoma ; Basal Ganglia ; Basal Ganglia Hemorrhage ; Biopsy ; Brain ; Brain Neoplasms ; Cerebral Hemorrhage ; Dysarthria ; Female ; Gadolinium ; Glioma ; Hemorrhage ; Humans ; Hydrocephalus ; Hypertension ; Intracranial Hemorrhage, Hypertensive ; Magnetic Resonance Imaging ; Paresis ; Ventriculoperitoneal Shunt

PURPOSE: Recent studies show that chorioamnionitis has an important role in the pathogenesis of bronchopulmonary dysplasia(BPD) and it induces thymic involution. The purpose of this study is to test the usefulness of thymic size at birth as a predictor of BPD. METHODS: This study was conducted on 91 very low birth weight infants of <1, 500 g with mean gestational age of 29.3 weeks and mean birth weight of 1, 161 g who were admitted at NICU of Dong Kang General Hospital for past 4 years of whom 21 infants had BPD. Thymic size was measured on routine chest radiographs taken in the first 3 hours after birth and measured as the ratio between the width of the cardiothymic shadow at the level of the carina and that of the thorax at the costophrenic angles (CT/ T). RESULTS: Correlation of thymic size with gestational age was statistically significant (P=0.003). CT/T of BPD group was smaller than that of non-BPD group (0.27+/-0.06, 0.33+/-0.07, respectively, P<0.01). A significant positive correlation between small thymus at birth and BPD was detected (P=0.003, odds ratio, 21.7), but not in other disease groups. CONCLUSIONS: We concluded that a small thymus at birth on the chest radiograph could be used as an early predictive parameter of the BPD.
Birth Weight ; Bronchopulmonary Dysplasia* ; Chorioamnionitis ; Female ; Gestational Age ; Hospitals, General ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Odds Ratio ; Parturition* ; Pregnancy ; Radiography, Thoracic ; Thorax ; Thymus Gland

PURPOSE: Thallous-201 chloride produced at Korea Cancer Center Hospital(KCCH) is used in detecting cardiovascular disease and cancer. Thallium impurity can cause emesis, catharsis and nausea, so the presence of thallium and other metal impurities should be determined. According to USP and KP, their amounts must be less than 2 ppm in thallium and 5 ppm in total. In this study, the detection method of trace amounts of metal impurities in [201Tl]TlCl injection with polarography was optimized without environmental contamination. MATERALS AND METHODS: For the detection of metal impurities, Osteryoung Square Wave Stripping Voltammetry method was used in Bio-Analytical System (BAS) 50W polarograph. The voltammetry was composed of Dropping Mercury Electrode (DME) as a working electrode, Ag/AgCl as a reference electrode and Pt wire as a counter electrode. Square wave stripping method, which makes use of formation and deformation of amalgam, was adopted to determine the metal impurities, and pH 7 phosphate buffer was used as supporting electrolyte. RESULTS: T1, Cu and Pb in thallous-201 chloride solution were detected by scanning from 300 mV to -800 mV. Calibration curves were made by using TlNO3, CuSO4 and Pb(NO3)2 as standard solutions. Tl was confirmed at -450 mV peak potential and Cu at -50 mV. Less than 2 ppm of Tl and Cu was detected and Pb was not detected in KCCH-produced thallous-201 chloride injection. CONCLUSION: Detection limit of thallium and copper is approximately 50 ppb with this method. As a result of this experiment, thallium and other metal impurities in thallous-201 chloride injection, produced at Korea Cancer Center Hospital, are in the regulation of USP and KP. Polarograph could be applied for the determination of metal impurities in the quality control of radiopharmaceuticals conveniently without environmental contamination.
Calibration ; Cardiovascular Diseases ; Catharsis ; Copper ; Electrodes ; Hydrogen-Ion Concentration ; Korea ; Limit of Detection ; Metals, Heavy* ; Nausea ; Polarography* ; Quality Control ; Radiopharmaceuticals ; Thallium ; Vomiting

The postmortem stature was measured in 57 Korean adult males (age range: 20-86 years old, mean: 52.3 years old) in supine position. After dissection of the corpses, we measured the maximum length of the remaining limb-bones (humerus, radius, ulna, femur, tibia and fibula). The correlation coefficients between the stature and each limb-bone length were calculated. Simple regression equations for estimating stature from each limb-bone length and multiple regression equations from the combination of limb-bone lengths were also obtained.
Adult ; Aged ; Aged, 80 and over ; Body Height* ; Bone and Bones/anatomy & histology* ; Extremities/anatomy & histology* ; Human ; Male ; Middle Age ; Regression Analysis

To investigate the morphologic evidence of acute renal failure by folate, histological, histochemical (PAS), enzyme histochemical (Na-K-ATPase, G6PD, and ALP), and ultrastructural studies were performed. The results are as follows: l) Oliguria was most severe 3 hours after folate and the urine volume was 24.8% that of the control group. 2) Histologically, dilatation of tubules, degeneration and focal necrosis of the cortical tubules, and PAS(+) droplets in the tubular lumen were noted. And also frequent mitoses, mild interstital connective tissue proliferation, and neutrophilic infiltrates were observed in the late stage. 3) On enzyme histochemical examination, the activities of Na-K-ATPase and ALP were decreased, but G6PD activity was increased in comparison with the control group. 4) The ultrastructural studies revealed cytoplasmic vacuoles, apical cytoplasmic blebbing, dense bodies, mildly swollen mitochondria, dilated endoplasmic reticulum, loss bf brush border of the proximal tubules, and loss of microvilli of the thin limb of Henle's loop. Later, marked attenuation or loss of infoldings of basal plasma membrane of the cortical tubules was recognized. According to above results, the cause of acute renal failure by late is thought to be the injuries of tubular epithelial cells including sodium pump secondary to tubular obstruction.
Rats ; Animals

No abstract available.
Atrophy ; Pityriasis* ; Tinea Versicolor*

With the exception of Meckel's diverticulum, a small bowel diverticulum is an acquired disease due to high pressure in the small bowel lumen. The causes of the increase in the pressure of the lumen are usually a motility disorder of the small bowel, a luminal obstruction due to a tumor mass, or adhesion of the bowel loop. The prevalence of small bowel diverticulum increases with age, but the clinical manifestations are asymptomatic or nonspecific, such as vague abdominal pain, nausea, vomiting, indigestion, constipation, and diarrhea. Therefore, the disease is relatively difficult to diagnose until complications, such as perforation, obstruction, intussusception, or hemorrhage, develop. Because of its rarity, Physicians usually neglect to rule out small bowel diverticulitis. As the proportion of the elderly increases, the rate of small bowel diverticulitis will increase. If complications from small bowel diverticulitis develop in the elderly, mortality and morbidity may increase. To detect small bowel diverticulitis before complications develop, emergency physicians need to be aware of small bowel diverticulitis in elderly patients with abdominal pain of uncertain cause and need to evaluate it with multiple diagnostic tools. We report a case of perforation of a small bowel diverticulum due to intestinal obstruction caused by primary Non-Hodgkin's lymphoma of the terminal ileum.
Abdominal Pain ; Aged ; Constipation ; Diarrhea ; Diverticulitis ; Diverticulum* ; Dyspepsia ; Emergencies ; Hemorrhage ; Humans ; Ileum* ; Intestinal Obstruction ; Intestine, Small ; Intussusception ; Lymphoma, Non-Hodgkin* ; Meckel Diverticulum ; Mortality ; Nausea ; Phenobarbital ; Prevalence ; Vomiting