The radial head forms articulation with radial head fossa of proximal ulna and capitellum, and it ditectly contributes pronation and supination of forearm and also flexion and extension of elbow. There were debates in treatment of radial head fracture especially in displaced or communited fracture. From January 1982 to February 1992, we experienced and analysed 29 cases of radial head fracture. They were treated with conservative treatment or operative treatment according to type The results were as follows; 1. We could get better results with open reduction and internal fixation with miniscrew than radial head excision in type 11 radial head fracture. 2. There were unfavorable results of valgus instability, weakness in all cases of radial head excision.
Elbow ; Forearm ; Head ; Pronation ; Supination ; Ulna

Horseshoe kidney is a nonfatal anomaly of renal development characterized by fusion of one poles of both kidneys. Most clinical problems are caused by hydronephrosis and renal calculi. A case of horseshoe kidney with multiple renal stones and hydronephrosis in a 53 year-old woman is reported and literatures are reviewed. This case was diagnosed easily radiologically and treated successfully by pyelolithotomy & pyeloplasty.
Female ; Humans ; Hydronephrosis* ; Kidney Calculi ; Kidney* ; Middle Aged

Retinal vein occlusion(RVO)is the second most common form of retinal vascular disease next to diabetic retinopathy. Systemic risk factors such as hypertension, diabetes, cardiovascular disease, blood dyscrasia and ocular risk factors such as short axial length, glaucoma, papilledema, thyroid ophthalmopathy have been shown to be associated with RVO. It is usually unilateral disease, and bilateral occurrene of RVO is relatively uncommon. CRVO rarely occurs bilaterally with a short interval between two eyes. Having experienced a case of bilateral CRVO within one month in a 75-year-old female with short axial length, primary open angle glaucoma, hypertension and hypercholesterolemia, we report this case with literature review.
Aged ; Cardiovascular Diseases ; Diabetic Retinopathy ; Female ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Hypercholesterolemia ; Hypertension ; Papilledema ; Retinal Vein* ; Retinaldehyde ; Risk Factors ; Thyroid Gland ; Vascular Diseases

PURPOSE: To evaluate the effect of the excision of redundant skin and pretarsal orbicularis muscle without tarsal fixation on the correction of the congenital epiblepharon. METHODS: We performed the surgery on 115 patients, 220 eyes from January 1996 to December 1999, and evaluated the functional, and cosmetic result. Surgical treatment included excision of redundant skin and pretarsal orbicularis muscle without tarsal fixation and simple skin suture technique. RESULTS: The mean age of the group was 7.2+/-6.8 years. There were 45 males and 70 females. Following the average follow up period of 18.4+/-4.5 months (minimum was 12 months), 212 eyes (96.4%) showed satisfactory result in functional and cosmetic aspect with of 8 eyes (3.6%) showed undercorrection early postoperativey but none underwent reoperation due to recurrences. CONCLUSIONS: This operative technique resulted in a good cosmetic and functional result.
Female ; Follow-Up Studies ; Humans ; Male ; Recurrence ; Reoperation ; Skin* ; Suture Techniques

No abstract available.

PURPOSE: To report a case of Klebsiella pneumoniae endogenous endophthalmitis secondary to renal or urinary tract infection such as emphysematous pyelonephritis. METHODS: A-56-year-old woman with diabetes mellitus and emphysematous pyelonephritis was reterred to us in consultation for visual loss in her right eye for 5 days. Ophthalmologic evaluation and intervention were performed. RESULTS: Culture revealed Klebsiella pneumoniae from vitreous tap of the right eye. Systemic antibiotics, intravitreous antibiotics injection and vitrectomy were performed, but the eye showed progressive worsening to phthisis. CONCLUSIONS: A high index of suspicion of Klebsiella pneumoniae endogenous endophthalmitis must be carried in patients with renal or urinary tract infection such as emphysematous pyelonephritis as well as hepatobiliary disease such as pyogenic liver abscess.
Anti-Bacterial Agents ; Diabetes Mellitus ; Endophthalmitis* ; Female ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess, Pyogenic ; Pyelonephritis* ; Urinary Tract Infections ; Vitrectomy

PURPOSE: Proctitis is one of acute complications encountered when radiotherapy was applied to the pelvis. Radiation-induced proctitis represents similar microscopic findings that are observed in inflammatory bowel disease (IBD). Nitric oxide (NO) plays an important role in the inflammatory process and many data suggest a close relationship between NO production and gastrointestinal inflammation. This study was aimed to establish the optimal radiation dose for radiation-induced proctitis in rat and to find a relationship between radiation proctitis and NO production. MATERIALS AND METHODS: Female Wistar rats, weighing from 150 to 220 g, received various doses(10-30 Gy) of radiation to the rectum. On the 5th and 10th day after irradiation, rectal specimens were evaluated grossly and microscopically. In addition, the degree of NO production by irradiation dose was evaluated by study with NOS expression and nitrite production in the irradiated rectal tissue. To evaluate relationship between radiation proctitis and NO, we administered aminoguanidine, iNOS inhibitor and L-arginine, substrate of NOS to rats from 2 days before to 7 days after the irradiation. RESULTS: There were obvious gross and histological changes after 17.5 Gy or higher radiation dose but not with 15 Gy or less radiation dose. Twenty Gy or higher dose of radiation caused Grade 4 damage in most of rectal specimens which were more likely to be related to the late complications such as fibrosis, rectal bleeding and rectal obstruction. A single fraction of 17.5 Gy to the rat rectum is considered to be an optimal dose to produce commonly experienced proctitis in the clinic. The result demonstrated that severity of microscopic damage of rectal mucosa from irradiation significantly correlated with iNOS overexpression. However, administration of iNOS inhibitor or substrate of iNOS did not influence the degree of rectal damage. CONCLUSION: A single fraction of 17.5 Gy irradiation to the rat rectum considered to be an optimal dose for radiation induced proctitis model. These results indicated that an excess production of NO contributes to pathogenesis of radiation-induced proctitis in part but was not the direct cause of rectal damage.
Animals ; Arginine ; Female ; Fibrosis ; Hemorrhage ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Models, Animal ; Mucous Membrane ; Nitric Oxide Synthase ; Nitric Oxide* ; Pelvis ; Proctitis* ; Radiotherapy ; Rats* ; Rats, Wistar ; Rectum

BACKGROUND: Spinal cord injury occurring as a result of surgical repair of thoracic and thoracoabdominal aortic disease remains a devastating complication. Excitatory amino acids have been known to cause neurologic injury after neuronal ischemia. The purpose of this study was to elucidate the effects of intrathecal bupivacaine or bupivacaine dextrose on neurologic outcome and to characterize NMDA receptor gene expression in transient spinal ischemia. METHODS: Rats were anesthetized with isoflurane, divided by 3 groups: Control (C group), Intrathecal 0.5% bupivacaine 40 microliter (B group) and Intrathecal 0.5% bupivacaine with 8.5% dextrose 40 microliter (D group). Spinal ischemia was produced by induced hypotension and thoracic aortic cross clamping. After spinal ischemia, neurologic scores were assessed at 1, 2, 3, 24, and 48 hours. After 3 hours rats (Sham, C, B, and D groups) were euthenized and spinal cords and cerebral cortexes were removed for to assay NMDAR mRNA. 48 hours after ischemia, rats (C and B groups) were euthenized and spinal cords were removed for histologic examination. RESULTS: The neurologic scores of B group were significantly lower than those of C group or D group. Rats of D group showed seizure 1 hour after ischemia and died about 3 hours after ischemia. There were no significant changes in the NMDAR mRNA expressions of the cerebral cortex and the spinal cord. C group showed more significant apoptosis by TUNEL staining than B group. CONCLUSIONS: Intrathecal bupivacaine, not bupivacaine dextrose, proved effective at preventing neurologic injury after transient spinal ischemia. Intrathecal dextrose might be involved in the induction of generalized tonic-clonic seizure after spinal ischemia.
Animals ; Aortic Diseases ; Apoptosis ; Bupivacaine* ; Cerebral Cortex ; Constriction ; Excitatory Amino Acids ; Gene Expression ; Glucose* ; Hypotension ; In Situ Nick-End Labeling ; Ischemia* ; Isoflurane ; N-Methylaspartate* ; Neurons ; Rats* ; RNA, Messenger* ; Seizures ; Spinal Cord ; Spinal Cord Injuries ; Spinal Cord Ischemia

Thoracic disc herniation is one of the spine disc herniations which has poor prognosis. It is rare in occurrence, as it is only about 0.15-1.7% of all spine disc herniations. Due to anatomical problems and degenerative processes occuring in the thoracic spine and spinal canal, pathophysiological problems and diagnostic difficulties are encountered. Several surgical techniques have been tried and modified but up to now no satisfactory surgical management had been reported. Recently the neurosurgical team, at the St. Paul's Hospital, encountered a patient with T7-8 disc herniation. After all diagnostic tests and examinations were done and the diagnosis verfied, a transthoracic anterior, anterolateral, lateral, posterolateral and posterior apporach was done with iliac bone graft microsurgical technique. The post-operative recovery was uneventful. As there was remarkable improvement during the clinical course as compared to the results done employing other surgical techniques, we wish to share with you our new experience.
Diagnosis ; Diagnostic Tests, Routine ; Humans ; Prognosis ; Spinal Canal ; Spine ; Transplants

OBJECTS: We developed the Korean version of Hasegawa Dementia Scale(HDS-K) by translating the revised Hasegawa Dementia Scale(HDS-R) which is known to be a useful brief screening instrument for dementia. MATERIALS AND METHODS: The translation was carried out keeping the basic structure of Revised Hasegawa Dementia Scale(HDS-R). HDS-K, along with MMSE-KC, SBT-K and CDR, were administered to 174 dementia patients and 160 elderly control subjects. Cronbach alpha coefficient, inter-rator reliability, and test-retest reliability of HDS-K were examined. The correlations of MMSE-KC, SBT-K and CDR with HDS-K were also examined to confirm the validity of HDS-K. Cut-off scores for dementia were estimated by Receiver Operator Characteristic(ROC) curve anslyses. By comparing Area Under Curve(AUC), the diagnostic efficiency of HDS-K was compared with those of MMSE-KC and SBT-K. RESULTS: 1) HDS-K was found to have significantly high internal consistency(Cronbach alpha coefficient=0.948, <0.01), inter-rater reliability(Pearson correlation coefficient=0.999, <0.01) and test-retest reliability(Pearson correlation coefficient=0.848, <0.01). 2) All the correlations of HDS-K with MMSE-KC, SBT-K and CDR were significant indicating that HDS-K has good concurrent validity. Its optimal cut-off point for dementia was estimated as 15/16, where the sensitivity and specificity were 0.950 and 0.902, respectively. 3) The ROC curve analysis indicated that the diagnostic efficiency of HDS-K(AUC=0.972) was comparable with MMSE-KC(AUC=0.951) and SBT-K(AUC=0.963). CONCLUSION: We conclude that HDS-K is a reliable, valid, and useful screening instrument for dementia.
Aged ; Dementia* ; Humans ; Mass Screening* ; Reproducibility of Results* ; ROC Curve ; Sensitivity and Specificity ; Translating