No abstract available.

Dedifferentiated chordoma is a rare pathologic entity presenting an additional sarcomatous component in otherwise classical chordoma. It has been also emphasized that this neoplasm is classified as a distinct entity because of its different clinical settings and aggressive behavior. Dedifferentiation is a peculiar phenomenon but its histogenesis has remained controversial. A 50-yera-old man developed a huge tumor mass in the retrorectal, presacral area, featured with two histological components. The one was a typical chordoma accounted for approximately 60% of the mass and the other was made up of highly cellular, plemorphic, undifferentiated tumor cells, reminiscent partly to the cells of plemorphic malignant fibrous histiocytoma. Ultrastructural features and immunoreactivity against cytokeratin, S-100 protein and alpha-1-antichymotrypsin in both portions support that histologically different components of this neoplasm derive from the same origin. To our knowledge, this is the first case of dedifferentiated chordoma in Korea.
Male ; Humans

No abstract available.
Clonorchiasis*

No abstract available in English.
Femur Neck

No abstract available.
Intussusception*

No abstract available.
Protein-Losing Enteropathies*

BACKGROUND: Tetracaine has been the most commonly used long-acting spinal anesthetic agent. Recently, hyperbaric bupivacaine was introduced to be useful agent, and has been reported to produce the better quality of anesthesia. The aim of the present investigation was to compare the anesthetic effects of 0.5% hyperbaric bupivacaine and 0.5% hyperbaric tetracaine spinal anesthesia. METHODS: 40 ASA Class I patients undergoing lower extremity operation were randomly distributed to two groups. Group A (n=20) received 15mg, 0.5% bupivacaine in 8% glucose, while Group B (n=20) received 15mg, 0.5% tetracaine in 10% glucose in the lateral decubitus position (L3,4 interspace). We evaluated the sensory and motor blockade, cardiovascular effects and the incidence of tourniquet pain. RESULTS: The mean maximum cephalad spread of analgesia was higher in bupivacaine group (T5) than in tetracaine group (T6) and the spread time was more rapid in bupivacaine group (13.1 +/- 3.3min.) than in tetracaine group (15.8 +/- 4.3min.), but there were no statistical significances. Tetracaine group was earlier onset of motor block and the duration of complete motor block in tetracaine group was significantly longer than in bupivacaine group. The mean decrease in systolic and diastolic blood pressure was 10% to 25% in both groups and more marked in tetracaine group. The incidence of tourniquet pain was greater in tetracaine group than in bupivacaine group. CONCLUSIONS: The quality of anesthesia obtained with bupivacaine may be superior to that produced by tetracaine. We concluded that 0.5% hyperbaric bupivacaine was suitable for short orthopedic or lower abdominal surgery because of less incidence of hypotension, shorter duration of motor block and lower incidence of tourniquet pain.
Analgesia ; Anesthesia ; Anesthesia, Spinal* ; Anesthetics ; Blood Pressure ; Bupivacaine ; Glucose ; Humans ; Hypotension ; Incidence ; Lower Extremity ; Orthopedics ; Tetracaine* ; Tourniquets

[Objective] To determine the long term survivorship and establish the idea I correction angle in proximal tibial osteotomy for primary osteoarthritis. [Method] Seventy-nine patients suffering from primary osteoarthritis (111 knees) were performed with proximal tibial valgus osteotomy from 1985 to 1997, among which 74 women (106 knees) and 5 men (5 knees). The age ranged from 37 to 70 years (mean, 55 years). Postoperatively, hospital for Special Surgery knee score (HSS) was used for clinical assessment. The femorotibial angle (FTA) was measured to classifiy patients to group Ⅰ of 61 knees with less than 7 of valgus; group Ⅱ of 23 knees with 7～9 of valgus; group Ⅲ of 27 knees with over 10 of valgus. Closed wedge osteotomy was performed in all cases. HSS was assessed pre-and post-operatively. [Result] The average follow-up period was 9 years and 6 months (2 years and 4 months to 14 years and 1 month). The HSS knee score averaged 60 points preoperatively, 94 after 1 year and 87 at the last follow-up. Falure I was the need for conversion of a proximal tibial osteotomy to a total knee arthrop lasty, and Failure Ⅱ was the need for conversion of HSS knee score of less than 60 points. The 4 and 14 years survival rates were 99% and 85% using the first definition of failure, and 96. 4% and 75.1% using the second. [Conclusion] Proximal tibial osteotomy is reliable for treating unicompartmental osteoarthritis, providing that the postoperative femorotibial angle is corrected to more than 7° of valgus and falls in the range of 10°～15°.

PURPOSE: We wanted to identify the difference of the measured values between a navigation system and radiographs when performing open and closed wedge high tibial osteotomy (HTO) under the control of a navigation system. MATERIALS AND METHODS: Thirty-two open wedge HTOs and 51 closed wedge HTOs were performed using a navigation system. The postoperative mechanical axis percent, which was planned on the navigation system, was 62%. The mechanical axis (MA) was measured before osteotomy and after fixation on the navigation system, and these were compared with the measured values from the radiographs. The difference of the postoperative MA between the navigation system and the radiographs was compared according to the type of HTO. The alteration of the tibial posterior slope angle was also compared. RESULTS: For the open wedge HTO, the mean MA after fixation was valgus 2.7degrees on the navigation system and the postoperative MA was valgus 4.0degrees on the radiograph. For the closed wedge HTO, the mean MA after fixation was valgus 3.5degrees on the navigation system and the postoperative MA was valgus 1.6degrees on the radiograph (p=0.000). The mean tibial posterior slope angle was increased by 5.3degrees after the open wedge HTO and it was decreased by 1.8degrees after closed wedge HTO (p=0.000). CONCLUSION: Performing HTO with a navigation system could increase the surgical accuracy because the navigation system checked the intraoperative correction angle in real time. Weight bearing makes a difference for the postoperative MA between the navigation system and radiographs. This should be taken into account, according to the type of HTO.
Axis, Cervical Vertebra ; Knee ; Osteoarthritis ; Osteotomy ; Surgery, Computer-Assisted ; Weight-Bearing

Limb-Body Wall complex is a complicated with the essential features of neural-tube defects, body-wall disruption, and limb abnormalities. This complex should be distinguished from other body-wall defects including omphalocele and gastroschisis since the prognosis for limb-body wall is uniformly poor. We have experienced one case of limb-body wall complex in a 22-year-old primigravida, which is presented with a brief review of the literature.
Extremities ; Gastroschisis ; Hernia, Umbilical ; Humans ; Prognosis ; Young Adult