Ex.traosseous osteogenic sarcoma is exceedingly rare although bone formation occurs commonly in different reactive processes or neoplasms. Most of this tumors occurred in the lower extremities of middle aged people. The overall prognosis is grave and local recurrence following simple local excision possibly contributes to the poor prognosis. An agressive surgical approach including major amputation is recommended as the primary form of treatment. We have experienced a case of extraosseous osteogenic sarcoma of left gluteal region at the site of therapeutic irradiation for cervical carcinoma 16 years previously.
Amputation ; Buttocks ; Humans ; Lower Extremity ; Middle Aged ; Osteogenesis ; Osteosarcoma ; Prognosis ; Recurrence

A 28-yr-old woman, weighing 61 kg with bleeding myoma of uterus was scheduled for total abdominal hysterectomy. There was no history of cardiac arrhythmia or syncope. She was not premedicated. The heart rate was 115 beats/min and arterial pressure was 155/95 mmHg, immediately before the induction of anesthesia. Under the preoxygenation, anesthesia was induced with IV injection of thiopental sodium 250 mg followed by succinylcholine 75 mg. About 20 seconds after the succinylcholine bolus, the ECG showed an abrupt change from sinus rhythm to asystole without any stimulus including laryngoscopy. After a precordial thump and atropine 0.5 mg IV, tracheal intubation and ventilation with 100% O2 were quickly accomplished. Normal sinus rhythm with heart rate of 87 beats/min returned during laryngoscopy and intubation. The interval from the sinus arrest to the reestablishment of normal sinus rhythm was only 15 seconds. Surgery proceeded uneventfully and the patient recovered without any complication.
Anesthesia ; Arrhythmias, Cardiac ; Arterial Pressure ; Atropine ; Electrocardiography ; Female ; Heart Arrest* ; Heart Rate ; Hemorrhage ; Humans ; Hysterectomy ; Intubation ; Laryngoscopy ; Myoma ; Succinylcholine* ; Syncope ; Thiopental ; Uterus ; Ventilation

Application of the Gracilis or Pectoralis Musculocutaneous Free Flap to restore finger fiexion after destruction of forearm flexors had been reported by a surgical team at the Six Peoples Hospital at Shanghi in 1976. Viability is maintained by microvascular anastomoses of the muscles artery and vein to a suitable artery and vein in the recipient site. Gracilis is suitable for obtaining the dynamic requirement of transplanted forarm flexors. We presented two cases of muscle transplantation using Gracilis Musculocutaneous Free Flap for the loss of function of the long flexors to digits due to Volkmanns ischemic contracture of which one was after supracondylar fracture and the other was infection after deep laceration on elbow. In both cases transplanted muscles survived but funtioning was well in one case and other case was not good due to the previous infection. In first case, excellent grip strength and nearly a full flexor finger movement was provided by transplanted muscles.
Arteries ; Elbow ; Fingers ; Forearm ; Free Tissue Flaps ; Hand Strength ; Ischemic Contracture ; Lacerations ; Microsurgery ; Muscles ; Transplantation ; Veins

Angiography has been playing important roles in diagnosis and treatment in the field of orthopaedic surgery. Conventional angiography is the most reliable and widely used method in diagnosis of peripheral arterial disease. But the clinical use of the conventional angiography has been limited by the risk of possible complications and time-consuming procedures. Radionuclide sngiography is rapidly performed, rapidly interpretable and time-saving procedure for the visualization of arterial tree prior to vascular intervention in the critically ill patient. We have analyzed and compared the 22 cases who had taken radionuclide angiography and conventional angiography simultaneously from November, 1986 to August, 1987 in Department of Orthopaedic Surgery, Hanysng University Hospital. The results were as follow 1. Radionuclide angiography is simple, non-invasive, accurste, reproducible method. It eliminstes the discomfort and morbidity of conventional angiography and can be done on an outpatient basis at a much lower cost. It is useful in the patients who may be allergic to the contrast medium. 2. In cases of arterial occlusion, radionuclide angiogrpahy is also useful in the evsluation of obstruction of major artery and can be substituted for conventionsl angiography. 3. For the purpose of evaluation of success in the cases of vascular reconstruction, radionuclide angiogrphy also demonstrate the vasculsr blood flow without any risk. 4. Although rsdionuclide angiography has limitstion in snatomic detsil, it could be psrtially substituted for conventionsl angiography in the diagnosis of vascular anomalies or tumors.
Angiography ; Arteries ; Critical Illness ; Diagnosis ; Humans ; Methods ; Outpatients ; Peripheral Arterial Disease ; Radionuclide Angiography ; Trees

PURPOSE: We investigated the direct labeling method of antibody with 99mTc and 188Re and examined the stability and function of these labeled compounds in in vitro and in vivo. MATERIALS AND METHODS: Disulfide bond of nonspecific human IgG was reduced to -SH group by 2-mercaptoethanol. Stannous ion was used to reduce 99mTc and 188Re. The stability of 99mTc-IgG and 188Re-IgG was estimated upto 24 hrs. Biodistribution was evaluated in abscess bearing rats at 4 and 24 hr post-injection of 99mTc or 188Re labeled IgG. RESULTS: The number of -SH group per reduced IgG molecule was 2.34. The labeling yield of 99mTc-IgG and 188Re-IgG were 90% and 95%, respectively. The stability of 99mTc-IgG at 1, 4, 6 and 24 hr was 91%, 83%, 78%, 7% and that of 188Re-IgG, high uptake was found on kidney, blood, stomach and abscess (9.42+/-0.68, 1.43+/-0.24, 0.86+/-0.18, 0.72+/-0.10 %ID/g, respectively). The uptakes at 24 hr were kidney, abscess, stomach, and blood in descending order. In case of 188Re-IgG, high uptake at 4 hr post injection appeared on kidney, blood, abscess and stomach (3.92+/-0.62, 1.32+/-0.08, 0.88+/-0.01, 0.26+/-0.06, respectively). The upatkes at 24 hr were kidney, abscess, blood abd stomach in descending order. The abscess to blood uptake ratio of 99mTc-IgG was 0.5 at 4 hr and 2.02 at 24 hr and that of 188Re-IgG was 0.67 and 1.29. CONCLUSION: 99mTc-IgG and 188Re-IgG and 188Re-IgG canbe labeled efficiently with direct labeling method. However, 99mTc-IgG and 188Re-IgG, labeled with direct method, was unstable. Further study in needed to enhance the stability of the antibody labeling.
Abscess ; Animals ; Humans ; Immunoglobulin G ; Kidney ; Mercaptoethanol ; Rats ; Stomach

No abstract available.
Adult ; Autoantibodies/*blood ; Gangliosides/blood/*immunology ; Humans ; Male ; Ophthalmoplegia/blood/*diagnosis/immunology ; Recurrence ; Syndrome

No abstract available.
Twins, Conjoined*

Radiographic measurement of cervical spine is very important in cervical spine injury especially those without fracture. Authors measured the retropharyngeal space, retrotracheal space, lordortic curve and sagittal diameter of cervical spinal canal in 148 cases of normal adult male. The results are as follows: 1 . In normal Korean adult male maximum retropharyngeal space is 7mm in C, level and Smm in Cs level. Maximum retrotracheal space is 16mm in C, level. 3. Loss of normal lordotic curve is shown in 21 cases(14.2%), 4. Average sagittal diameter of C, level is 21.27mm-it's the largest of all the cervical spinal cana1s, and that of C, level is 16.15mm-it's the smallest.
Adult ; Humans ; Male ; Spinal Canal ; Spine

There are many experiences and principles about posterior approach in the spine as surgical procedure in the treatment of the patients with low back pain. And the anterior approach to the disc with its excision and bone graft, less known to others, has become a relatively safe procedure with the increasing experience. The greatest advantage of anterior lumbar interbody fusion is that the reduction of lumbar vertebral slipping is possible, the distance between the involved bodies is well maintained and the rate of fusion increases by spreading the vertebral bodies and putting into the measured bone bloc especially in the patients with severe segmental instability or spondylolisthesis. We analysed 48 patients having anterior interbody fusion by using a specially designed reduction-spreader during eight years, from January 1.978 to December 1985. The results were as follows: 1. Among 48 cases, 20 cases were male and 28 cases were female; 12 cases were in the fourth decade and 19 cases were in the fifth decade-most common in the fifth decade. 2. 28 cases were at the level of L4–L5, 16 cases were L5–S1, and 4 cases were two levels(L3–L4 L4–L5 and L4–L5 LS–Sl). 3. Retroperitoneal approach was used for the L3–L4 and L4–L5, and transperitoneal approach was used for the L5–S1. 4. After distraction between the involved vertebral bodies using an effective device, reduction-sprea-der, a pair of full thickness iliac bone grafts were impacted into the interspace, maintaining the reduction after removal of the reduction-spreader. 5. Fusion was achieved between 3 months and 6 months in 46 cases except 2 cases. 6. Overall clinical results were as follows: good in 42 cases, fair in 6 cases. 7. The anterior interbody fusion using the reduction-spreader is found to be useful method in the treatment of low back pain with spinal instability diagnosed by lumbar flexion-extension lateral roentgenograms.
Clinical Study ; Female ; Humans ; Low Back Pain ; Male ; Methods ; Spine ; Spondylolisthesis ; Transplants

The pubic bone is an unusual site for an aneurysmal bone cyst. This case, a 15year old male patient, was diagnosed as an aneurysmal bone cyst in the superior ramus of the right pubic bone. He was treated by complete excision of the superior ramus and on five years follow up no problems were noted in terms of weight bearing as well as hip function or evidence of recurrence.
Aneurysm ; Bone Cysts ; Follow-Up Studies ; Hip ; Humans ; Male ; Pubic Bone ; Recurrence ; Weight-Bearing