Since 1974, we had performed five cases of total elbow replacement; four cases of Coonrad type and one case of Stanmore type. There were done In three cases of comminuted fracture and dislocation of the elbow and two cases of ankylosis of the elbow. We could obtain useful range of motion in three cases and good stability without pain in all the cases. In one case of Coonrad type total elbow, we removed the prosthesis at five years and three months later due to infection of the Joint. In another case of Coonrad type total elbow, there was transitory tourniquet palsy of the arm.
Ankylosis ; Arm ; Arthroplasty, Replacement, Elbow ; Dislocations ; Elbow ; Fractures, Comminuted ; Joints ; Paralysis ; Prostheses and Implants ; Range of Motion, Articular ; Tourniquets

A neglected Monteggia fracture can pose a significant clinical problem because of decreased range of motion of the elbow, increased cubitus valgus, progressive damage and elbow instability. Factors leading to misdiagnosis include swelling of soft tissue, overlying of bones on radiographs and lack of inclusion of the elbow on the radiograph at the ulnsr fracture. Therefore, a radiograph that includes the elbow at the ulnar fracture should be taken. A line drawn through the shaft and head of the radius into the elbow should align with the capitulum in any projection, thereby assisting in the correct diagnosis. Three cases of neglected Monteggia fracture were treated by open reduction of the radial head with repair or reconstruction of the annular ligament and osteotomy of the ulna, and satisfactory results were obtained.
Child ; Diagnosis ; Diagnostic Errors ; Elbow ; Head ; Humans ; Ligaments ; Monteggia's Fracture ; Osteotomy ; Radius ; Range of Motion, Articular ; Ulna

No abstract available.
Alcoholism* ; Mass Screening*

The complications of herpes zoster ophthalmicus vary greatly among different patients. The major portion of the complications fall under four types; (1) keratitis, (2) iridocyclitis, (3) muscular palsies, and (4) optic neuritis. We have experienced a case of herpes zoster ophthalmicus complicated by abducens palsy, sectorial paralysis of iris sphincter, iritis, and transient increase of intraocular pressure. The case was reviewed and the pathogenesis of the complications were discus sed.
Herpes Zoster Ophthalmicus* ; Herpes Zoster* ; Humans ; Intraocular Pressure ; Iridocyclitis ; Iris ; Iritis ; Keratitis ; Optic Neuritis ; Paralysis*

13 cases of intracranial Aneurysm were obliterated intracranially with Heifetz clip under Halothane /O2 Deliberate Hypotensive anesthesia. Deliberate hypotension in the surgery of intracranial aneurysm is used to diminish bleeding and render an aneurysmal sac slack to make clipping easy. Herein is presented a review of clinical experience of deliberate hypotension in conjunction with postural drainage. Clinical investigation has shown that this method offers a wider margin of safety. All factors stressed again the needs for careful, adequate and ideal clippage of the neck of aneurysm preferably with the use of Heifetz clip. Deliberate hypotension and adequate clippage of the neck of aneurysm subsequently allowed a favorable clinical result with an operative mortality by 7.7%.
Anesthesia* ; Aneurysm ; Drainage, Postural ; Halothane ; Hemorrhage ; Hypotension ; Intracranial Aneurysm* ; Mortality ; Neck

Localized, water-suppressed in vivo 'H MRS was performed to evaluated the proton metabolic alterations in patients with acute cerebral infarction.Ten brain infarction patients(six males and four females; age range 53-77) participated in this study. GE Signa 1.5-T whole-body NMI/MRS system using STEAM pulse sequence was used. Voxels were selected from the cerebral infarcted region and contralateral normal region as control in the same patient. Proton metaboliteratiosrelativetocreatine (Cr) wereobtainedusingaMa-rquartalgorithm. The specific features in the cerebral infarcted regions demonstrated a significant decrease of N-acetyl aspartate (NAA)/creatine (Cr) ratio, compared with control regions. Markedly increased lactate (Lac) level was observed in areas of cerebral infarctioln in all patients. Our preliminary study showed that NAA/Cr ratio in the infarcted regions was substanially different from that in control regions.The signal intensity of Lac may be served as a metabolic criterion that can specify acuteness of infarction, and also evaluate the therapeutic effect. It is necessary to investigate the spectral alterations in various stages of cerebral infarction for further detail analysis.
Aspartic Acid ; Brain Infarction ; Cerebral Infarction* ; Female ; Humans ; Infarction ; Lactic Acid ; Male ; Metabolism ; Protons ; Steam

-D- is a very rare haplotype which determines D without C, c, E or e and exalted D activity. The extremely rare homozygote propositi(-D-/-D-) are usually ascertained through their immune antibodies which react with red cells of all common Rh phenotypes. Authors experienced a woman with -D- phenotype for the first time in Korea. She had a history of abortion and intrauterine fetal death. She delivered a baby with severe hemolytic disease of the newborn at the third pregnancy. In spite of intensive medical interventions, the baby died of hydrops fetalis. An immune antibody to high incidence Rh antigen, namely anti-Hro, was demonstrated in the woman's serum. Family study revealed that all of the family had -D- gene complex and one of her sisters also was -D-homozygote. The sister also had anti-Hro in the serum.
Antibodies ; Female ; Fetal Death ; Haplotypes ; Homozygote ; Humans ; Hydrops Fetalis ; Incidence ; Infant, Newborn* ; Korea ; Phenotype* ; Pregnancy ; Siblings

We present two patients with clinical features suggestive of a hyperkinetic form of encephalitis lethargica described by von Economo. While undergoing treatment for viral meningoencephalitis, they both developed comatose mentality, oromandibular dyskinesia, chorea, myoclonic jerk, oculogyric crisis, opistotonus, respiratory failure, and autonomic dysfunction. One patient died of autonomic failure while the other improved several months later. In both patients, cerebrospinal fluid exmamination revealed only pleocytosis. A brain MRI and EEG showed no specific findings. In order to control severe hyperkinetism and autonomic failure, medical treatments including L-dopa, clonazepam, and steroid pulse therapy were administereed in both cases while electroconvulsive therapy was tried in one of the cases. However, they all failed. These cases and previous reports informed us of the presence of sporadic form of encephalis.
Brain ; Cerebrospinal Fluid ; Chorea ; Clonazepam ; Coma ; Dyskinesias ; Electroconvulsive Therapy ; Electroencephalography ; Encephalitis* ; Encephalitis, Viral ; Humans ; Leukocytosis ; Levodopa ; Magnetic Resonance Imaging ; Meningoencephalitis ; Myoclonus ; Respiratory Insufficiency

Endometrial squamous cell carcinoma is extremely rare. In 1928 Fluhmann proposed three criteria to establish the diagnosis of endometrial squamous cell carcinoma: (1) no coexisting endometrial adenocarcinoma, (2) no connection between the endometrial tumor and the squamous epithelium of the cervix, and (3) no squamous cell carcinoma of the cervix present. More recently, the World Health Organization (WHO) updated Fluhmann's criteria by adding that the tumor must contain clear evidence of squamous differentiation, such as the presence of intercellular bridges and/or keratin. We presented a case of carcinoma in situ of endocervix and endometrial squamous cell carcinoma involving full thickness of whole endometrium with a review of literature.
Adenocarcinoma ; Carcinoma in Situ ; Carcinoma, Squamous Cell* ; Cervix Uteri ; Diagnosis ; Endometrium ; Epithelium ; Female ; World Health Organization

PURPOSE: This study evaluated the prognostic factors of modified Thompson quadricepsplasty for a stiff knee. MATERIALS AND METHODS: From February 1987 to February 2007, 38 knees of 38 patients were managed with modified Thompson quadricepsplasty for a stiff knee. Thirty three males and 5 females were enrolled with a mean age of 36 years. The average follow-up duration was 92 months (range, 18 to 133 months). The most common cause of the stiff knee was a fracture around the knee in 33 cases. Multivariate logistic regression analysis was performed to evaluate the prognostic factors. RESULTS: Multivariate analysis showed that the gain of ROM after surgery was negatively correlated with the ROM before surgery (p<0.0001), and flexion contracture at the last follow up was positively correlated with the initial flexion contracture (p<0.0001). CONCLUSION: In a stiff knee, modified Thompson quadricepsplasty should be considered as soon as possible if the patient cannot gain an acceptable ROM through conservative management. More improvement in the ROM can be obtained in those with a more severe limitation of motion.
Contracture ; Female ; Follow-Up Studies ; Humans ; Knee ; Logistic Models ; Male ; Multivariate Analysis