BACKGROUND: The aim of this study was to assess demographics, clinical outcomes, and complications of classic floating elbow in adults. METHODS: Six patients with ipsilateral diaphyseal fractures of the humerus, radius, and ulna were reviewed retrospectively. All patients were treated operatively and available for follow-up at a minimum of 1 year after surgery. The average age of the patients was 45.2 years (22-64 years) and the average follow-up period was 37.0 months (14-103 months). They were evaluated with postoperative outcome measures, including a visual analog scale (VAS) for pain, Mayo elbow performance score (MEPS), and American Shoulder and Elbow Surgeons (ASES) shoulder score. Residual complications were also evaluated. RESULTS: Five patients (83.3%) had open fracture, and 4 patients (66.7%) presented with associated nerve injury. All fractures were united within postoperative 4 months, except 1 delayed union. The average VAS pain score, MEPS, and ASES shoulder score at the final follow-up examination was 2.5, 79.8, and 67.5 respectively. Three patients including 2 cases of joint stiffness with incomplete recovery from nerve injury and 1 case of complex regional pain syndrome had poor clinical outcome. CONCLUSIONS: Although the classic floating elbow is rare, these injuries potentially have associated problems such as open fracture or nerve injury. The presence of residual neurological symptoms predispose to poorer clinical outcomes.
Adult* ; Demography ; Elbow* ; Follow-Up Studies ; Fractures, Open ; Humans ; Humerus ; Joints ; Outcome Assessment (Health Care) ; Radius ; Retrospective Studies ; Shoulder ; Ulna ; Visual Analog Scale

Chromosomal abnormalities are higher in twin gestations than in the singleton population. Turner's syndrome(gonadal dysgenesis) variety may result from chromosome loss during gametogenesis in either parent or a mitotic error during one of the early cleavage divisions of the fertilized zygote. The vast majority of 45, XO conceptions result in first or second-trimester miscarriage. Fetuses with Tumer's syndrome commonly exhibit posterior nuchal cystic hygromas and generalized edema. Recently we experienced one fetal demise in twin pregnancy. The affected fetus was associated with Turner's syndrome which was diagnosed by amniocentesis and karyotyping. The fetus was associated with cystic hygroma which was antenatally diagnosed by ultrasonogram. The unaffected fetus had normal karyotype and was delivered through cesarean section without any abnormalities. we report this case with brief review of literatures.
Abortion, Spontaneous ; Amniocentesis ; Cesarean Section ; Chromosome Aberrations ; Edema ; Female ; Fertilization ; Fetus ; Gametogenesis ; Humans ; Karyotype ; Karyotyping ; Lymphangioma, Cystic ; Parents ; Pregnancy ; Pregnancy, Twin* ; Turner Syndrome ; Ultrasonography ; Zygote

No abstract available.
Child* ; Humans ; Infant, Newborn*

No abstract available.
Dandy-Walker Syndrome*

The ultrasound is also helpful to make the diagnosis of a variety of soft tissue tumors bacause of its safety, low cost, non-invasiveness and usefulness. We analysed ultrasonographic findings of 43 cases of soft tissue tumors which were histopathologically confirmed by biopsy and obtained the following results. The ultrasonography could effectively image not only the presence, size and location of the lesion, but also the relationship between the lesion and the adjacent structures. And this method could easily identify the consistency of the lesion, solid or cystic nature, be used to guide the percutaneous biopsy and aspiration without exposure to radiation, and afford the differentiation of malignant lesion from benign one. It could also define the eritities of soft tissue tumors by the nature of internal echo, margin of the lesion, internal echo homogeniety, post-acoustic enhancement, and so on.
Biopsy ; Diagnosis ; Methods ; Ultrasonography

The traditional treatment for the femoral shaft fractures in children is closed reduction by continuous traction, usually for 2–3 weeks, until the fracture has achieved partial stability, followed by spica cast immobilization. Fifty three cases, from 3 to 10 years of age, has been treated with closed reduction and immediate application of hip spica csst; all of them were closed fractures of femoral shaft and were not associated with head, abdominal, or vascular injuries. Any angulations in excess of acceptable ranges were corrected with wedging the cast; any overridings in excess of acceptable ranges were corrected by skeletal traction for 1 week, followed by incorporation of the pin to the cast. The resultant overriding and angulation of fragments were within acceptable ranges, and complications were not significant.This method of treatment not only is likely easy in nursing care and comfortsble to the patients but also has some advantages of short stay in the hospital, better utilization of hospital beds, and costsaving. This immediate hip spica cast immobilization seems to be a good method of treatment for the femoral shaft fracture in children.
Child ; Clinical Study ; Fractures, Closed ; Head ; Hip ; Humans ; Immobilization ; Methods ; Nursing Care ; Traction ; Vascular System Injuries

No abstract available.

The author analyzed 352 patients who had been admitted to P.M.C. with clinical signs and symptoms of occlussive stoke from 1973 to 1980. Cerebral angiography was performed on 250 patients and 126 patients of them were confirmed to have angiographical evidence of occlusion. We've analyzed these 126 patients in clinical point of view. As presented above, positive rate of angiography was 50%. The site of lesion was most common at MCA which was somewhat different from other reports, and the side of predelection was left. In majority of cases, the occlusive stroke was occurred in age group between 40 to 60, and man was about 3 times as common as woman. Risk factors, in our series, were hypertension, cardiac problems, diabetes and so on which were similar to other reports. Hypertension, the most common risk factor, correlated well to the peak age incidence but there was not any intimate relationship with the level of serum cholesterol. The outcome of medically treated group(112 patients) was somewhat better than surgery(14 patients). Among 12 of EIAB, TIA noted the best result compared to RIND and SIE. Meticulous selection of patient using CT scanning and measurement of rCBF would promote the benefit of surgery.
Angiography ; Cerebral Angiography ; Cholesterol ; Female ; Humans ; Hypertension ; Incidence ; Risk Factors ; Stroke ; Tomography, X-Ray Computed

A 65 year-old male patient presented with a large palpable mass beneath the areola of the right breast for 7 years. The resected breast tissue was almost totally replaced by a round large solid mass (9 6 cm) with a pink-gray to yellow firm, partly nodular cut surface. Microscopically, the tumor revealed the diagnostic biphasic cellular pattern of adenoid cystic carcinoma, which consisted of both cribriform pattern of myoepithelial cells and tubular pattern of epithelial cells. On immunohistochemistry, the tumor revealed immunoreactivities for alpha-smooth muscle actin and S-100 protein in the myoepithelial cells and for AE1/AE3 in the epithelial cells. Mitoses were scarce. Multifocal lymphatic permeation and foci of perineural invasion were also found. Underlying resection margins and overlying skin were invaded by the tumor. We diagnosed this tumor as grade II adenoid cystic carcinoma according to the system utilized for the salivary gland tumors.
Actins ; Adenoids* ; Aged ; Breast* ; Carcinoma, Adenoid Cystic* ; Epithelial Cells ; Humans ; Immunohistochemistry ; Male* ; Mitosis ; S100 Proteins ; Salivary Glands ; Skin

OBJECTIVE: It is debatable whether an anterior oblique fracture orientation is really a contraindication to anterior odontoid screw fixation. The purpose of this study was to investigate the feasibility of anterior odontoid screw fixation of type II and rostral shallow type III fracture with an anterior oblique fracture orientation. METHODS: The authors evaluated 16 patients with type II and rostral shallow type III odontoid fracture with an anterior oblique fracture orientation. Of these 16 patients, 8 (group 1) were treated by anterior odontoid screw fixation, and 8 (group 2) by a posterior C1-2 arthrodesis. RESULTS: Of the 8 patients in group 1, seven patients achieved solid bone fusion (87.5%), and one experienced screw back-out of the C-2 body two months after anterior screw fixation. All patients treated by posterior C1-C2 fusion in group 2 achieved successful bone fusion. Mean fracture displacements and fracture gaps were not significantly different in two groups. (p=0.075 and 0.782). However, mean fracture orientation angles were 15.3+/-3.2 degrees in group 1, and 28.6+8.1 degrees in group 2 (p=0.002), and mean fragment angulations were 3.2+/-2.1 degrees in group 1, and 14.8+/-6.7 degrees in group 2 (p=0.001). CONCLUSION: Even when the fracture lines of type II and rostral shallow type III fractures are oriented in an anterior oblique direction, anterior odontoid screw fixation can be feasible in carefully selected patients with a relatively small fracture orientation angle and relatively small fragment angulation.
Humans ; Odontoid Process ; Orientation