Authors had reviewed the results of 20 anterior cervical fusions performed between 1975 and 1980 to determine which factors were important to a successful result. There had been 18 single level fusions and 2 fusions at two levels, the majority at C and C. The indications for fusion operation were: firstly in acutely traumatized patient was the spine representing radiologically the signs of segmental instability, secondly was the chronic segmental instability in old traumatized spine representing the nuchal rigidity and severe cervicobrachial pain which. was not ceased by conservative treatments. The index of successful fusion was complete relief of pain, loss of cervical rigidity and radiologlcal stability of fused segment indicated by no-movement in flexion-extension lateral radiograms, and the bony bridges between the fused segments. The postoperative stability of spine was assessed by measuring the changes of disc space and kyphotic angle. The result obtained were as follows: 1. Pre-and post-operative immobilization with cervical traction played an immportant role for successful results after fusion: 4–6 weeks of pre-operative traction in acutely injured spine provided the torn soft tissue structures with sufficient time needed for its healing, and 6 weeks of postoperative traction also provided the bone graft with sufficient time needed for its cooperation with graft bed. 2. ln all cases succeasful fusion was obtained. In a case a adjacent level was incorrectly fused, but it was fused soundly in time, while the unstable unfused segment was not fused spontaneously. 3. The fused segment or segments of spine stabilized clinically in 6-8 weeks after fusion operation which was proven by serial radiograms, and solid bony fusion was obtained radiologically averaging in 12 weeks after fusion operation. 4. The average increase of kyphosis after interbody fusion till solid fusion was negligible, averaging 3.0 degrees. 5. The solid fusion occurred in one to 2 weeks earlier in the spines with wedge and axial conpression fractures than the spines with flexion-rotation and shear types of fractures. 6. No further neurogical damage developed after successful fusion.
Dislocations ; Humans ; Immobilization ; Kyphosis ; Muscle Rigidity ; Spine ; Traction ; Transplants

Authors clinically analysed the end results of the 56 elderly patients having fresh femoral neck fracture who were treated with osteosynthesis procedures and 23 endoprosthesis replacement surgery. All these 79 patients were treated between 1970 and 1979 at the St. Marys Hospital, Seoul. The indications of primary endoprosthesis replacement surgery in femoral neck fractured patients were in elderly patients over 65 years, displaced, comminuted sub capital or transcervical fractures, irreducible fractures, pathological fractures and patients having generalized diseases or senile psychosis. The results for the operated hip joints were assessed by duration of hospitalization, early and late post-operative complication. and the Jessels hip grading method at least post-operative one and half year later. The results obtained were as follows: 1. The average age of the patients were 65 years in 56 cases with initial osteosynthetic group, and 73 years in 23 cases of initial endoprosthesis group. 2. The slip down was the most common cause of injuries. The transcervical type of fracture was 54% of all cases. 3. The eligibility of ambulation was average 34 days after surgery in cases having initial osteosynthesis and 18 days in cases having endoprosthesis. 4. Early post-operative complications such as pneumonia and urethritis etc. were more common in cases of endoprosthesis than in osteosynthesis. But we think these complications were not related with surgery itself and transient. 5. Late post-operative complications in cases of osteosynthesis were avascular necrosis of head (16%), nonunion (9%), osteoarthritis (4%), and deep wound infection (2%), but in cases with endoprosthesis, leg length discrepancy (12%), acetabular erosion (4%) and loosening (4%) in order. 6. We performed the second operation in 12 cases among the 56 patients of osteosynthesis because of post-operative complications. 7. Good end results were obtained 90% in 56 osteosynthesis and 91% in 23 endoprosthesis. Conclusively, author's observation time was relatively short (11/2–3 years) and it is impressed that long term study for the prosthetic group is necessary for the more accurate evaluation of their hip function.
Acetabulum ; Aged ; Femoral Neck Fractures ; Femur Neck ; Fractures, Spontaneous ; Head ; Hip ; Hip Joint ; Hospitalization ; Humans ; Leg ; Methods ; Necrosis ; Osteoarthritis ; Pneumonia ; Psychotic Disorders ; Seoul ; Urethritis ; Walking ; Wound Infection

The angiotensin I converting enzyme inhibitor (Captopril) has recently been studied extensively in various experimental models of radiation injury and has proven its protective effects in various organs, such as the lungs, gastrointestinal tract, and kidneys. Twenty-three Sprague-Dawley rats were divided into experimental and control group. The experimental group was divided into two large groups: the first one received a single dose of 18 Gy irradiation from an electron beam on the local field of the kidney region only, and the second group received captopril per oral continuously after the same doses of irradiation. The second experimental group was divided into four subgroups by captopril doses: 62.5 mg/l, 125 mg/l, 250 mg/l, and 500 mg/l, respectively. On light and electron microscopy, the kidneys of the irradiated rats with no captopril treatment showed diffuse glomerular contraction, congestion with occlusion and focal necrosis of the endothelial, and mesangial cells. The tubules showed ballooning degeneration, desquamation, and diffuse coagulation necrosis. Captopril treated rats, especially those given a high dose (more than 250 gm/l), revealed a marked reduction of the tubular and glomerular injuries. There was a statistically significant difference in the degree of renal injury among the experimental groups (p<0.05). The result of this study suggests that an administration of high dose captopril might prevent radiation-induced renal injury, especially in the early post-irradiation period.
Animals ; Captopril* ; Estrogens, Conjugated (USP) ; Gastrointestinal Tract ; Kidney ; Lung ; Mesangial Cells ; Microscopy, Electron ; Models, Theoretical ; Necrosis ; Peptidyl-Dipeptidase A ; Radiation Injuries ; Rats* ; Rats, Sprague-Dawley

Authors want to report that PTA was an out-standing therapeutic method in treatment of renovascular hypertension by renal artery stenosis due to Takaysu's arteritis in an 18-years-old Korean female. Abdominal aortogram and bilateral renal arteriogram showed mild smooth narrowing of the mid abdominal aorta of 4cm length from origin of renal arteries, complete occlusion of left renal artery from it's origin with a few small collateral arteries and severe stenosis of proximal right renal artery. PTA of right renal artery was performed with Gruntzign Balloon dialtation catheter, and the patient's blood pressure was down to 120/80 from 220/130,stable for 8 months follow-up examination. Takayasu's arteritis is one of the msot important cause of renovascular hypertension in Orenals. Multiple treatement modalities, such as steroid administration or variable surgical intervention, were attempted and limited response was presented. But PTA is a simple, cost-effective, repeated,and relatively complicaiton-free method in treatment of renovascular hypertension due ot Takayasu's arteritis, with an outstanding result, as authors case.
Angioplasty ; Aorta, Abdominal ; Arteries ; Arteritis ; Blood Pressure ; Catheters ; Constriction, Pathologic ; Female ; Follow-Up Studies ; Humans ; Hypertension, Renovascular ; Methods ; Renal Artery Obstruction ; Renal Artery ; Takayasu Arteritis

Experimental studies suggest that captopril plays an important preventive role in radiation induced renal injury (RRI). To elucidate the pathogenesis of RRI and effect of captopril, one subgroup was irradiated with a single dose of 9 gray (Gy) total body irradiation and another subgroup with 17 Gy local irradiation in the right kidney. Twenty-four healthy looking Sprague-Dawley rats, weighing 200~250 g, were divided into one control and three experimental group (EG)s for this study. The control group, composed of 2 rats, was maintained on stock diet and drinking tap water. EG was divided into three. EG 1 composed of two subgroups, the first subgroup, 3 rats each, was sacrificed within 12 hours after 9 Gy and 17 Gy single dose irradiation only and the second subgroup, 2 and 1 rats each, was sacrificed 8 weeks after the same doses irradiation. EG 2 composed of subgroups of 2 and 3 rats was given 500 mg/L of captopril in the drinking water after irradiating them with 9 Gy and 17 Gy and sacrificed in the 8th week. EG 3 was subdivided into four subgroups by captopril doses given, 62.5 mg/L, 125 mg/L and 250 mg/L and sacrificed 20 weeks after 9 Gy and 17 Gy irradiation. On light microscopy proximal convoluted tubules showed cytoplasmic vacuolization and focal necrosis in the subcapsular region in EG 1 sacrificed within 12 hours after 9 Gy and 17 Gy irradiation only (sham) and very mild fibrosis in juxtamedullary regions in rats sacrificed 8 weeks after irradiation. In EG 3 these changes were severely increased with additional increased fibrosis in the juxtamedullary region in the group given captopril 62.5 mg/L. On transmission electron microscopy, there were various degenerative changes of organelle. Among the captopril administered EG 2 and EG 3, rats given a high dosage revealed milder degree of damage compared to that of rats given a low dosage, and thickening of basement membrane was remarkable in rats given a low dosage. There was a reduction in tubular damage related to the captopril dosage. According to the above findings, administration of a high dose of captopril might preserve the ultrastructure in RRI and the possible mechanism of captopril was discussed.
Animals ; Basement Membrane ; Captopril ; Cytoplasm ; Diet ; Drinking ; Drinking Water ; Fibrosis ; Kidney ; Microscopy ; Microscopy, Electron, Transmission ; Necrosis ; Organelles ; Rats* ; Rats, Sprague-Dawley ; Water ; Whole-Body Irradiation

No abstract available.
Antioxidants* ; Technetium Tc 99m Medronate*

Although the ultrasonography is a useful imaging modality for evaluation of abdominal mass in an infant and child, CT has more advantages over te ultrasonography in assesssing anatomic detail, precise extent of tumor and differential diagnostic accuracy. The authors analyzed CT featurs of 85 cases of pathologically or clinicallyproven pediatric abdominal masses for recent 4.5 years at Keimyung University Dongsan Hospital. The reseults wereas follows: 1. The most common site was kidney (36 cases:42.4%), followed by nonrenal retroperitoneal masses(23cases:27.1%), hepatobiliary masses(15 cases:17.6%), gastrointestinal masses(9 cases: 10.6%), and genital massses(2cases: 2.3%) in order of frequency. 2. Hydronephrosis(17 cases:20%) and Wilms' tumor(17 cases:20%) were mostcommon and splenomegaly(8 cases:9.4%), neuroblastoma(5 cases: 5.9%), teratoma(4 cases:4.7%), rhabdomyosarcoma(4cases: 4.7%) were descending order of frequency. 3. The male to female ratio was 2;1, but female was predominantin teratoma, choledochal cyst and genital masses. Twenty three cases(27.1%) were under the age of one year. 4. Thediagnosis of hydronephrosis, assessment of its severity and localization of exact level of obstruction were easywith CT examination. 5. Characteristic CT features of Wilms' tumor were round or oval shaped, smooth marginated,large intrarenal mass with displaced or obstructed calyces, pseudocapsule and crescent sign; there were noevidence of retroperitoneal lymph node or contiguous extension, retrocrural lymph node enlargement, prevertebralmidline extension, or encasement of the aorta. 6. Typical CT findings of the neuroblastoma wre irregular shaped &marginated extrarenal mass with calcification frequently, accompained by retroperitoneal lymph node or contiguousextension, retrocrural lymph node enlargement, prevertebral midline extenstion and encasement of the aorta; therewere no evidence of pseudocapsule or crescent sign. 7. CT features of teratoma were characteristic, having atleast three or more of different tissue densities among fat, water, soft tissue and calcific densities. 8.Pathology and its extension of retroperitoneal space was demonstrated accurately by CT. 9. Mesenteric, omental andenteric cysts had similar CT appearance particularly very large cystic masses.
Aorta ; Child ; Choledochal Cyst ; Female ; Humans ; Hydronephrosis ; Infant ; Kidney ; Lymph Nodes ; Male ; Neuroblastoma ; Retroperitoneal Space ; Teratoma ; Ultrasonography ; Water ; Wilms Tumor

No abstract available.
Hydronephrosis*

So called pseudosarcoma of the esophagus is an extremely rare polypoid malignant tumor and a number of cases, totaling 19 cases have been reported in world literatures until 1985. The presenting case is an unique one of pseudosarcoma of the esophagus and we illustrated all microscopic features with mapping, immunoperoxidase stain for cytokeratin and electron microscopic findings to clarify the histogenesis of spindle cells. It is postulated that the spindle cells of pseudosarcoma are transformed from squamous carcinoma cells based on (1) morphological similarity between squamous epithelial cells and spindle cells, (2) positive reaction of immunoperoxidase staining for cytokeratin in the adjacent normal esophageal mucosa, squamous cell carcinoma, spindle cells and giant cells and (3) presence of transformation zone.

It is difficult to distinguish benign from malignant, pulmonary nodule by conventional roentgenologic examination. But CT makes it easier to evaluate adjacent parencymal invasion, pleural or mediastinal extenstion,or early metastasis to intra- or extrathoracic lymph node as well as distant organs, although only a solitaryperipheral pulmonary nodule is seen on plain radiograph. Authors reviewed CT of 22 cases of histopathologically confirmed primary lung cancer seen as a solitary peripheral pulmonary mass from May 1980 to Sep. 1984 at DongsanMedical Center, Keimyung University. The results are as follows: 1.The incidence was most common in the 6thdecade(36%). Male to female ratio was 10:1 and 2 females all had bronchioloalveolar cell carcinoma. 2. Thedistributions of histologic cell type were as follows: squamous cell carcinoma 40%, adenocarcinoma, small cellcarcinoma, bronchioloalveolar cell carcinoma and unclassified carcinoma 14% in each cases, and adenoid cysticcarcinoma 4% . 3. The CT findings were as follows: a) Superior and posterior basal segments of both lower lobeswere most frequently involved(68%). b) The mean diameter of the mass was 48mm, and most common in the range of30-49 mm in the greatest dimension(46%). c) The mean CT atttenuation value was 57 H.U., and most common in thegroup of 41-70 H.U. (64%). d) Lymph node metastasis was found in 13 (59%) of 22 cases, and the involved nodes wereas follows: hilar nodes 10 cases, paratracheal nodes 8 cases, subcarinal nodes 7 cases and extrathoracic nodes 3cases. In 2 of 3 cases with small cell carcinoma, diffuse multiple lymph nodes were involved. e) Distantmetastasis was seen relatively early in 3 cases; cerebral metastasis in 1 case of squamous cell carcinoma, rightaderenal metastasis without intrathoracic lymph node metastasis or invasion of adjacent structures in 1 case ofbronchioloalveolar cell carcinoma, and liver and bone metastases in 1 case of unclassified carcinoma. f) Adjacentpleural or mediastinal invasion was found in 7 cases(32%): pleural invasion along chest wall in 4 cases, andinvasion of adjacent mediastinal pleura in 3 cases of 2 squamous cell carcinoma and 1 unclassifed carcinoma. g)Calcifications witihin the mass were found in 5 cases (23%), and most common in squamous cell carcinoma(3 cases).In all cases, a few granular calcification were seen along the peripheral margin of the mass. h) Tumor necrosiswas seen in 4 cases(18%), and 3 cases were squamous cell carcinoma, and one of them showed irregular centralcavitation. i) The margins of tumor were irregularly lobulated with radiating spiculations in all except one ofadenoid cystic carcinoma, which revealed oval shaped, smooth clear margin. j) In 9(41%) of 22 cases, someenlargement of pulmonary vessels with perivascular linear infiltrations were found in the adjacent lungparenchymes of the mass, which were thought to be retrograde perivascular lymphangitic spread along pulmonaryvessels.
Adenocarcinoma ; Adenoids ; Carcinoma, Bronchogenic ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Epithelial Cells ; Female ; Humans ; Incidence ; Liver ; Lung Neoplasms ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Pleura ; Thoracic Wall