No abstract available.
Mandible* ; Osteoblastoma*

No abstract available.
Mandible* ; Osteoblastoma*

Recurrent dislocation of the patella is a relatively uncommon disease, which is most commonly seen in females in late adolescence. The condition is usually spontaneous and only rarely fallows traumatic dislocation. Dislocation is nearly always lateral and about one thirdis bilateral. The theoretical rationale of the treatment of the recurrent dislocation and subluxation of the patella is the realignment of the extensor mechanisms. We experienced with recurrent dislocation and subluxation of the patella on 22 knees in 18 patients at Seoul National University Hospital from July 1981 to Oct. 1987 and obtained the following results. 1. The age at operation ranged from 4 to 33 years and its mean was 15.8 years. Among 18 patients thirteen were female and five, male. 2. The most common presenting symiptom was pain (11 knees) and the most common presenting sign was quadriceps muscle atrophy (11 knees). 3. The prominent radiologic finding was patella alta in 6 knees (27.3%), genu valgum in 10 knees (45.3%), and hypoplasia of the lateral condyle of the femur in 2 cases (9%). 4. In two knees supracondylar osteotomy were performed and followed by proximal extensor mechanism realignment. In twelve knees only proximal reconstruction was performed. Four knees were treated by Hauser's technique and three knees with Roux-Gold-thwait technique. And these distal reconstruction procedures were performed with other procedures. 5. Mean follow up period was 1 year and 5 months. And the results are excellent in 8 knees, good in 12 knees and fair in 2 knees.
Adolescent ; Atrophy ; Dislocations ; Female ; Femur ; Follow-Up Studies ; Genu Valgum ; Humans ; Knee ; Male ; Osteotomy ; Patella ; Quadriceps Muscle ; Seoul

The author analyzed 177 consecutive cases of saccular, ruptured intracranial aneurysms admitted to the Department of Neurosurgery in Korea University Hospital during the period from August 1983 to July 1987. the results of analysis were summarized as follows. 1) Mean age of the patients was 50.4 years. 2) Incidence of clinical vasospasm was 27.2%(46/177) and of rebleeding was 10.7%(19/177). 3) Surgery was done for patients which accounts for 57.6% of all patients. Functional recovery was noted in 84 of the these surgically treated patients(84.6%). 4) The prognostic factors are age, hypertension, size of aneurysm, site of aneurysm, preoperative neurological state, vasospasm, hydrocephalus, rebleeding, timing of operation, multiplicity. 5) The mean size of aneurysms was 6.9mm. The direction of aneurysms was variable, but most of them pointed in the direction of blood flow in afferent arteries.
Aneurysm ; Arteries ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Intracranial Aneurysm* ; Korea ; Neurosurgery

The author analyzed 177 consecutive cases of saccular, ruptured intracranial aneurysms admitted to the Department of Neurosurgery in Korea University Hospital during the period from August 1983 to July 1987. the results of analysis were summarized as follows. 1) Mean age of the patients was 50.4 years. 2) Incidence of clinical vasospasm was 27.2%(46/177) and of rebleeding was 10.7%(19/177). 3) Surgery was done for patients which accounts for 57.6% of all patients. Functional recovery was noted in 84 of the these surgically treated patients(84.6%). 4) The prognostic factors are age, hypertension, size of aneurysm, site of aneurysm, preoperative neurological state, vasospasm, hydrocephalus, rebleeding, timing of operation, multiplicity. 5) The mean size of aneurysms was 6.9mm. The direction of aneurysms was variable, but most of them pointed in the direction of blood flow in afferent arteries.
Aneurysm ; Arteries ; Humans ; Hydrocephalus ; Hypertension ; Incidence ; Intracranial Aneurysm* ; Korea ; Neurosurgery

The assessment of cerebral vasoreactivity provides information on the reserve capacity of cerebral circulation in patients with cerevrovascular disease. It also allows for the diagnosis of impending ischemia and control of the effect of initiated corrective measures. The authors had performed transcranial doppler(TCD) studies to measure the CO2 reactivity of the entire basal cerebral arteries in 30 cases of age-adjusted control group and 42cases of disease group and 42 cases of disease group between the 3rd and 7th day after insult. The disease group involved 14 cases of head injury, 10 cases of intraventricular hemorrhage, 10 cases of subarachnoid hemorrhage and 8 cases of hydrocephalus. All patients were examined by single photon emission computed tomography(SPECT) and results of the 2 groups were compared with respect to their CO2 reactivities. In the patient group, the mean blood flow velocity(MBFV), pusatility index(PI) and MI index(middle cerebral artery MBFV/internal cerebral artery MBFV) had not changed but the CO2 index was significantly lower than that in the same age group of normal control. The regions showing abnormal ROI(region of interest) on SPECT well corresponded with the regions showing decreased CO2 reactivity on TCD. Both the increase of MBFV and the decrease of Pl were noted in the cerebral arteries with decreased CO2 reactivity. This indicates that the very arterial walls were dilated. As for the relationships between the investigated variables, ROI increased as the clinical status worsen(r=-0.05, p=0.0008). The acute prognosis(prognosis after 3month of insult) had positive correlation with CO2 index(r=0.32, p=0.04) of clinical status, while on the other hand, its correlation with ROI index was negative(r=0.40, p=0.0094). Transcranial doppler CO2 test provides useful information for the understanding of hemodynamic status, prognosis and beneficial effects of specific therapy. It is concluded that CO2 index measured during the subacute stage of insult correlates well with the acute prognosis.
Cerebral Arteries ; Craniocerebral Trauma ; Diagnosis ; Hand ; Hemodynamics ; Hemorrhage ; Humans ; Hydrocephalus ; Ischemia ; Prognosis* ; Subarachnoid Hemorrhage ; Tomography, Emission-Computed, Single-Photon

Ten brain tumor patients underwent wide resection of the tumor followed by Intraoperative Radiation Therapy (IORT) at the first surgery or at the second salvage surgery after failure of conventional external beam irradiation. Two patients(1 meningioma, 1 glioblastoma multiforme) were treated at the first surgery and 8 patients(3 anaplastic astrocytoma, 3 glioblastoma multiforme, 1 meningioma, 1 gliosarcoma) were treated after salvage surgery. The IORT doses were ranged from 15-25 Gy depending on the tumor volume and previous radiation therapy. The neurological status(Karnofsky performance status) was improved in 4 cases, not changed in 6 cases after IORT. There were several complications after IORT; radiation necrosis, communicating hydrocephalus, wound infection, and abnormal CT findings such as diffuse low density area in an around operation site. The radiation necrosis was confirmed by operation in a recurrent meningioma patient 12 months after IORT. At follow-up, ranging from 1 to 16 months, there was no deaths. Based on our limited experiences, the IORT might be one of the adjuvant therapeutic modalities especially for the malignant brain tumors and unresectable huge meningioma.
Adult ; Astrocytoma/radiotherapy/surgery ; Brain Neoplasms/pathology/*radiotherapy/*surgery ; Combined Modality Therapy ; Female ; Glioblastoma/radiotherapy/surgery ; Gliosarcoma/radiotherapy/surgery ; Human ; Intraoperative Care ; Male ; Meningioma/radiotherapy/surgery ; Middle Age ; Salvage Therapy

Cerebral Vasospasm was produced experimentally by injecting normal cat's blood into the cisterna magna of the cat. Ultrastructural changes were observed sequentially from 24 hours to 15 days following subarachnoid hemorrhage(SAH). Twenty-four hours after SAH, endothelial cells in the intima were round shaped and their cellulrar surface was corrugated, these changes remained to 72 hours after SAH with intimal thickening and loss of tight intercellular junction. But since 7 days after SAH, the endothelial cells assumed a more normal spindle-shaped configuration with tight intercelluar junction and an increase in cytoplasmic filaments and vacuoles. The internal elastic laminae was thickened and somewhat more electron dense than normal. In the media, the smooth muscle cells were most consistently and severely affected showing degeneration of mitochondria, vacuoles containing fine particles and loss of complex internal structure, surrounded by increased amounts of intercellular collagen. These findings concluded that the ultrastructural changes in the cat's basilar arterisl wall observed after induction of subarachnoid hemorrhage with fresh autogenous blood occurred as a consequence of vasospasm.
Animals ; Cats ; Cisterna Magna ; Collagen ; Cytoskeleton ; Endothelial Cells ; Intercellular Junctions ; Mitochondria ; Myocytes, Smooth Muscle ; Subarachnoid Hemorrhage* ; Vacuoles ; Vasospasm, Intracranial

Deep infection of Achilles tendon is one of the serious complications that occur after open repair of the tendon. It sometimes leads to a very large tendon defect during the course of treatment. We report on a case of massive defect in Achilles tendon, which was successfully treated with Achilles tendon allograft and flexor hallucis longus tendon transfer.
Achilles Tendon* ; Allografts* ; Tendon Transfer ; Tendons*

Dermatofibrosarcoma protuberans is a slow-growing, but locally aggressive fibrous tumor that has a high rate of local recurrence after surgical resection. This tumor most commonly occurs in the trunk and proximal extremities. In this report we present a case of a 47-year-old woman with dermatofirbosarcoma protuberans in her breast, which is a very unusual site. Complete and careful resection is recommended for this type of tumor to prevent its recurrence.
Breast* ; Dermatofibrosarcoma* ; Extremities ; Female ; Humans ; Middle Aged ; Recurrence