A case of osteochondritis dissecans of both knee joints is developed in 15 year old boy. Since the original articles of Paget, Koning and others were reported, many theories as to etiology and pathogenesis have been proposed but exact cause has been unknown. Many Joint may show evidence of osteochondritis dissecans but lateral aspect of medial femoral condyle of knee is by far the most frequent site. Under the diagnosis of osteochondritis dissecans of both knees with clinical symptoms and X-ray finding, the one was treated with excision of framents and curettage, and the other treated with drilling of fragments. In follow up study for one year, the result was good without any complaints.
Curettage ; Diagnosis ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Osteochondritis Dissecans ; Osteochondritis

Two cases report on osteogenesis imperfecta tarda and review of literature has been made. The rare genetic disorder, osteogenesis imperfecta tarda is familiar to most orthopedic surgeons because of management of fracture and skeletal deformities, espicially bowing of long bone. Its clinical manifestations are known as bony fragility, blue sclera and deafness less frequently ligamentous laxity but its etiological factor is obscure; The basic defect is thought to involvement some abnormality of collagen. Recently the bony weakness caused by increased bony turnover rate. One case of osteogenesis imberrfecta tarda in 8 year old male was belonged to tarda type 1. (Falvo-classification), who could not walk due to marked anterolateral bowing of right tibia and the another to tarda type II. in 13 year old male with fresh fracture of right femoral shaft. The former was performed corrective multible osteotomy, realignment and intramedullary rod fixation for correction of bowing deformity of right tibia, and the later was managed the fracture of right femoral shaft with Russels traction and hip spica cast. The result of reported therapeutic mesure was good.
Collagen ; Congenital Abnormalities ; Deafness ; Fibrinogen ; Hip ; Humans ; Ligaments ; Male ; Orthopedics ; Osteogenesis Imperfecta ; Osteogenesis ; Osteotomy ; Sclera ; Surgeons ; Tibia ; Traction

OBJECTIVES: To investigate the relationship between job stress and the variables associated with the organizational effectiveness of dental technicians. METHODS: The job stresses were divided into the following six components; somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and hostility. The organi-zational effectiveness variables in this study included job satisfaction, occupational commitment, organizational commitment and intent to leave. The sample used in this study consisted of 248 dental technicians working in hospitals and dental laboratories. The data were collected with self-administered questionnaires between March 16 and April 29 in 2002, and the results analyzed with ANOVA and multiple regression analysis. RESULTS: Firstly, job stress of dental technicians was found to be significantly different in relation to the number of workers at the workplace and the working hours. The level of job stress was the highest when the number of workers were more than 10, or when the daily working hours were over 12. Secondly, of the six variables of job stress, five variables of somatization, interpersonal sensitivity, depression, anxiety, and hostility were found to have significant negative correlations with job satisfaction. Thirdly, all six job stress variables were found to have significant negative correlations with the occupational and organizational commitments of the dental technicians. Finally, depression was the only job stress variable found to have a significant effect on the dental technicians' intent to leave. CONCLUSIONS: The results of this study indicate that personal and organizational efforts are very important to improve the organizational effectiveness in reducing work related stress. Organizational support, especially for managing the depression of dental technicians is recommended.
Anxiety ; Dental Technicians* ; Depression ; Hostility ; Humans ; Job Satisfaction ; Laboratories, Dental ; Questionnaires

PURPOSE: To describe soft-tissue radiographic and high-resolution CT findings of radiation-induced lung injury of rabbit over time and to correlate them with pathologic findings. MATERIALS AND METHODS: 15 rabbits were irradiated in the right lung with one fraction of 2000 cGy. After 4, 6, 12, 20, 24 weeks, 3 rabbits in each group were sacrificed and soft-tissue radiographs and high-resolution CT of their lung tissue were obtained. Radiological findings were correlated with pathologic findings. RESULTS: On soft- tissue radiogram, radiation pneumonitis shown as consolidation with air-bronchogram occurred in 3 cases after 6 weeks, and in 1 case after 12 weeks of irradiation. In addition, pneumonic consolidation with adjacent pleural contraction was seen in 2 cases after 12 weeks of irradiation. Fibrotic changes indicated by decreased volume occurred after 20 weeks and combined bronchiectatic change and bronchial wall thickening appeared after 20 weeks(N=1), and 24 weeks(N=3). HRCT findings of radiation pneumonitis were homogeneous, increased attenuation after 4 weeks(N=3), 6 and 12 weeks (each N=I), patchy consolidation after 6 and 12 weeks(each N=2), discrete consolidation after 12, 20 and 24 weeks(each N=I) and solid consolidation after 20 and 24 weeks(each N=2). Pathologically radiation pneumonitis and pulmonary congestion were seen after 4 and 6 weeks. After 6 weeks, collagen and reticulin fibers were detected along alveolar wall. Mixed radiation pneumonitis and fibrosis were detected after 12 weeks. 20 weeks after irradiation, fibrosis was well defined in interstitium and in 24 weeks, decreased number of alveoli and thickening of bronchial wall were defined. CONCLUSION: Radiation pneumonitis was provoked 4 weeks after irradiation on rabbit lung and progressed into radiation fibrosis 20 weeks after irradiation on soft-tissue radiographs and high-resolution CT. High-resolution CT is more precise in detecting early radiation pneumonitis and detailed pathologic findings.
Collagen ; Estrogens, Conjugated (USP) ; Fibrosis ; Lung Injury ; Lung* ; Rabbits ; Radiation Pneumonitis ; Reticulin

Authors reviewed clinical records of 92 patients with tetanus from January 1974 to December 1983 at Severance Hospital and the following results wre obtained. 1) There were about 2.2 times more cases of neonatal tetanus than that of nonneonatal. The admitted cases of tetanus decreased in 1980's compared to those of 1970's. 2) The male versus female ratio was 3 : 1 not only in nonneonatal but also in neonatal teanus. 3) There was a tendency of higher mortality when the site of injury was on the central part of the body than on the distal. 4) Most cases of tetanus developed after the injury with bactrial contamination as expected, but a few cases are due to only trivial injury such as acupuncture or injection without overt contamination. 5) There was a close relationship between the incubation period and mortality in neonatal tetaus but no such definite relationship in nonneonatal tetaus. 6) The duraton of admission was about 3 weeks and the majority of deaths occureed in less than one week of admission. 7) There was no statistically significant difference in mortality between the group who used tetanus antitoxin from animal and that who used human tetanus immuneglobulin.
Acupuncture ; Animals ; Female ; Humans ; Male ; Mortality ; Tetanus Antitoxin ; Tetanus*

OBJECTIVE:The purpose of this study is to evaluate the CT findings of the carcinoma of the ampulla of Vater and to differentiate from other periampullary carcinoma including the carcinoma of the distal common bile duct and pancreas head. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 13 cases of the carcinoma of the ampulla of Vater, 20 cases of the carcinoma of the distal common bile duct and 20 cases of the carcinoma of the pancreas head confirmed by pathology. Five millimeter consecutive settings of CT scan were performed in all cases on ampulla level with supine position. The CT findings were retrospectively evaluated in view of common bile duct dilatation, pattern of termination of bile duct, pancreatic duct dilatation, protruding mass in duodenal lumen, and regional lymph node metastasis. RESULTS: All case of the carcinoma of the ampulla of Vater(13/13) and distal common bile duct(20/20) showed common bile duct dilatation with abrupt termination. Among the 10 cases of the carcinoma of the pancreas head with common bile duct dilatation, five cases each had is abrupt termination(5/20) and gradual stenosis of bile duct(5/20). Five cases of the carcinoma of the ampulla of Vater(5/13) and four cases of the carcinoma of distal common bile duct(4/20) showed pancreatic duct dilatation and all cases of the carcinoma of pancreas head show pancreatic duct dialtation(20/20). Twenty cases of the carcinoma of the ampulla of Vater showed protruding mass in the medial wall of the second portion of the duodenum(12/13) but only one case of the carcinoma of the distal common bile duct(I/20) and five cases of the carcinoma of the pancreas head (5/20) had protruding mass in the duodenal lumen. Only one case of the carcinoma of the ampulla of Vater showed(1/13) regional lymph node metastasis but three cases of the carcinoma of the distal common bile duct(3/20) and 18 cases of the carcinoma of the pancreas head(18/20) showed regional lymph node metastasis. CONCLUSION: Common bile duct dilatation with abrupt termination, protruding mass in the duodenal lumen and rare lymph node metastasis in CT may suggest the carcinoma of the ampulla of Vater.
Ampulla of Vater* ; Bile ; Bile Ducts ; Common Bile Duct ; Constriction, Pathologic ; Dilatation ; Head ; Lymph Nodes ; Neoplasm Metastasis ; Pancreas ; Pancreatic Ducts ; Pathology ; Retrospective Studies ; Supine Position ; Tomography, X-Ray Computed

The authors retrospectively reviewed the high resolution computed tomographic scans of 19 patients who had hematogenous or lymphangitic metastatic lung lesions. In all patients, the histologic diagnosis for primary cancers and the radiographic manifestations of pulmonary metastasis were established. Certain characteristic findings of metastatic lung tumors on HRCT scans were evident: uneven thickening of bronchovascular bundles, multiple small nodules, thickening of interlobular septum, and the presence of polygonal lines. The nodules are more predominent in hematogenous metastasis. The prevalent site of nodules is cortical portion of lung.
Diagnosis ; Humans ; Lung ; Neoplasm Metastasis* ; Retrospective Studies

Authors report the radiologic findings of two cases of multiple bile-duct hamartoma in the liver. Ultrasonography and computed tomography of the liver were performed in two female patients. In one patient, ERCP was performed. Ultrasonography and computed tomography showed scattered multiple hypoechoic and low attenuated lesions, measuring up to 2cm in both lobe and ERCP showed communication of these lesions with the biliary system. Multiple bile-duct hamartoma should be included in the differential diagnosis of multiple small cystic lesions in the liver.
Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis, Differential ; Female ; Hamartoma* ; Humans ; Liver ; Ultrasonography

Rhabdomyosarcoma are reportedly the most common soft tissue sarcoma occuring in childhood, but the biliary tree is a rare site of origin for this tumor. Recently we experienced a case of embryonal rhabdomyosarcoma of the biliary tree in a 30-month-old child. UItrasonography showed hypoechoic mass filling the dilated left. intrahepatic & extrahepatic bile ducts, and CT showed hypodense mass with heterogeneous enhancement after contrast infusion. Intraoperative cholangiography showed filling defects within the dilated left. intrahepatic & extrahepatic bile ducts. Postoperative MRI showed residual mass within the left. intrahepatic duct which was hypointense on T1WI and hyperintense on T2WI.
Bile Ducts, Extrahepatic ; Biliary Tract* ; Child ; Child, Preschool ; Cholangiography ; Humans ; Magnetic Resonance Imaging ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal* ; Sarcoma

Rhabdomyosarcoma are reportedly the most common soft tissue sarcoma occuring in childhood, but the biliary tree is a rare site of origin for this tumor. Recently we experienced a case of embryonal rhabdomyosarcoma of the biliary tree in a 30-month-old child. UItrasonography showed hypoechoic mass filling the dilated left. intrahepatic & extrahepatic bile ducts, and CT showed hypodense mass with heterogeneous enhancement after contrast infusion. Intraoperative cholangiography showed filling defects within the dilated left. intrahepatic & extrahepatic bile ducts. Postoperative MRI showed residual mass within the left. intrahepatic duct which was hypointense on T1WI and hyperintense on T2WI.
Bile Ducts, Extrahepatic ; Biliary Tract* ; Child ; Child, Preschool ; Cholangiography ; Humans ; Magnetic Resonance Imaging ; Rhabdomyosarcoma ; Rhabdomyosarcoma, Embryonal* ; Sarcoma