In general. femoral neck fracture in young adult presents poor prognosis due to the high velocity injury, high angle shear fracture, and poor candidate for arthroplasty. In addition to the relative rarity of the injury, the high incidence of aseptic necrosis and nonunion have been reported in the management of these fractures. 25 cases of femoral neck fracture in young adult were treated with multiple pinning and analyzed at Sung-Ae general hospital from 1987 to 1994 after 28 months follow up in average with review of charts, X-ray and clinical result. There were 18 male and 7 female, 5 cases of them had significant polytrauma to other organs or skeletal system, authors tried to treat them as soon as possible to decrease the interval time between fracture and fixation (the average time was 39.7 hours.) Union occurred in all of Garden stage I (4 cases) and II (4 cases), but in Garden stage III (7 among 8 cases) and IV (7 among 9 cases) the union rate was lower. Average union time was 16.5 weeks. The incidence of complications (12%, 3 among 25 cases) was higher in displaced fractures group (Garden stage III, IV) and also in poorly reduced group of Garden’s alignment index. In conclusion, the prognosis of femoral neck fractures in young adult was related with mainly initial reduction and rigid fixation than the initial injury.
Agriculture ; Arthroplasty ; Female ; Femoral Neck Fractures ; Femur Neck ; Follow-Up Studies ; Hospitals, General ; Humans ; Incidence ; Male ; Multiple Trauma ; Necrosis ; Prognosis ; Young Adult

PURPOSE: To evaluate the differential features of complete and partial-thickness tears of the anteriorcruciate ligament, as seen on magnetic resonance imaging(MRI). MATERIALS AND METHODS: We retrospectvely reviewedMR images of 36 patients with ACL injuries (complete tear 16, incomplete tear 20). In all cases, the presence ofan ACL tear was determined by arthroscopy or surgery. Primary and secondary signs of ACL injury and associatedinjuries were assessed. RESULTS: Ligamentous discontinuity of the ACL was observed in ten complete tears (63 %),but in only four (10%) of those that were partial (p=0.009). In addition, complete tears were more likely to showa low degree of ACL axis, less than 45 degree(11/16 : 2/20, p=0.001). There was, however, no statistically significantdifference between complete and partial tears with regard to signal intensity of ACL, PCL buckling or angle,anterior dis-placement of the tibia, uncovered meniscus sign, deep notch sign, empty notch sign, and associatedinjuries. CONCLUSION: Ligamentous discontinuity and the ACL axis are features which usefully differentiatebetween complete and partial tears of the ACL.
Anterior Cruciate Ligament* ; Arthroscopy ; Axis, Cervical Vertebra ; Humans ; Ligaments ; Tibia

OBJECTIVE: This study was conducted to measure radiographic joint space width and to estimate erosion in the hands of patients with rheumatoid arthritis. It showed that joint space width, homogeneity, and invariant moments are parameters to discriminate between the normal and the rheumatoid joint. METHODS: In order to measure the joint space width and to estimate erosion in the finger joint, 32 radiographic images were used - 16 images for training and 16 images for testing. The joint space width was measured in order to quantify the joint space narrowing. Also, homogeneity and invariant moments was computed in order to quantify erosion. Finally, artificial neural networks were constructed and tested as a classifier distinguishing between the normal and the rheumatoid joint. RESULTS: The joint space width of normal was 1.04+/-0.15 mm and the width of patients with rheumatoid arthritis was 0.94+/-0.15 mm. The Homogeneity of normal was 16568.83+/-2669.83 and invariant moments were 6843.45+/-2937.55. They were statistically difference (p<.05). Using these characteristics, artificial neural networks showed that they discriminate between normal and rheumatoid arthritis (AUC=0.91). CONCLUSION: Measuring joint space width, estimating homogeneity, and invariant moments provide the capability to distinguish between a normal joint and a rheumatoid joint.
Arthritis, Rheumatoid ; Finger Joint ; Hand ; Humans ; Joints

No abstract available.
Adult* ; Disseminated Intravascular Coagulation* ; Humans ; Multiple Organ Failure* ; Still's Disease, Adult-Onset*

No abstract available.
Lasers, Gas* ; Microsurgery*

No abstract available.
Keratosis*

Bezoars are collection of indigestible materials in the gastrointestinal tract. Many endoscopic techniques for removal of bezoars have been reported recently, but these methods need much equipment. We treated a gastric bezoar with a distal attachment device easily available for an endoscope. A 74-year-old man with a history of diabetes mellitus was admitted to hospital with hematemesis. On the second endoscopic examination, a gastric bezoar (6x4x4 cm) was detected in the stomach. Then, using a distal attachment device, we injected Coca-Cola directly into the bezoar by an injector. With tension force, the bezoar was easily broken due to the impulse of the distal attachment device. The endoscopic technique used in our case can be easily performed and has fewer complications compared to those of other techniques. Therefore, we report here on this new treatment modality that uses a distal attachment device.
Aged ; Bezoars ; Diabetes Mellitus ; Endoscopes ; Gastrointestinal Tract ; Hematemesis ; Humans ; Stomach

PURPOSE: To evaluate the MR findings of septic thrombosis of the cavernous sinus. MATERIALS AND METHODS: Eleven MR images of six patients with septic cavernous sinus thrombosis obtained over a five-year period and proven clinically or radiologically were retrospectively reviewed. The contour and enhancement pattern of the cavernous sinus, changes in the internal carotid artery, orbit, pituitary gland and sphenoid sinus, and intracranial abnormalities were analyzed and compared with the findings of follow-up studies. RESULTS: In all six patients, contrast study revealed asymmetrical enlargement of the ipsilateral cavernous sinus and multiple irregular filling defects within it. Narrowing of the cavernous portion of the ipsilateral internal carotid artery was noted in five patients, upward displacement of the ipsilateral internal carotid artery in four, ipsilateral proptosis with engorgement of the superior ophthalmic vein in two, pituitary enlargement in five, and inflammatory change in the sphenoid sinus in six. Associated intracranial abnormalities included edema and enhancement in the meninx, temporal lobe, or pons adjacent to the cavernous sinus in four patients, hydrocephalus in one, and cerebral infarction in one. Follow-up MR imaging indicated that the extent of asymmetrical enlargement of the cavernous sinus, filling defects within it, as seen on contrast study, and enlarged pituitary glands had all decreased, without significant interval change. CONCLUSION: MR imaging is useful in the diagnosis of septic cavernous sinus thrombosis. Asymmetrical enlargement of the cavernous sinus, multiple irregular filling defect within it, as seen on contrast study, and changes in the internal carotid artery are characteristic findings.
Carotid Artery, Internal ; Cavernous Sinus Thrombosis* ; Cavernous Sinus* ; Cerebral Infarction ; Diagnosis ; Edema ; Exophthalmos ; Follow-Up Studies ; Humans ; Hydrocephalus ; Magnetic Resonance Imaging ; Orbit ; Pituitary Gland ; Pons ; Retrospective Studies ; Sphenoid Sinus ; Temporal Lobe ; Thrombophlebitis ; Thrombosis ; Veins

C1 esterase inhibitor deficiency with consequent angioedma is an uncommon condition. Nonhereditary C1 inhibitor deficiency includes underlying disorders; lymphoproliferative disorder, autoimmune disease, hypereosinophilia, drug-induced, allergic, and idiopathic forms. The as sociation of hereditary C1 esterase inhibitor deficiency with systemic lupus erythematosus has been previously described. We experienced a case with transiently decreased C1 inactivator activity and angioedema in lupus nephritis. This present case is a previously healthy 22-year-old woman, who developed intermittent facial angioedema and decreased urine amount. After steroid treatment, the C1 inactivator activity was recovered and angioedema was disappeared.
Angioedema* ; Angioedemas, Hereditary ; Autoimmune Diseases ; Female ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis* ; Lymphoproliferative Disorders ; Young Adult

Zenker diverticulum is a rare condition with a reported prevalence of 0.01% to 0.11% in the general population. Challenges that can arise when treating a Zenker diverticulum through flexible endoscopy include maintaining a stable position and avoiding hemorrhage or perforation. Nevertheless, this approach is associated with less morbidity and a shorter hospital stay than conventional treatment consisting of open surgery or rigid endoscopic treatment with diverticuloscopy. We report a case of transparent cap-assisted flexible endoscopic septoplasty using a needle knife.
Endoscopy ; Hemorrhage ; Length of Stay ; Needles ; Prevalence ; Zenker Diverticulum