No abstract available.
Ankle*

A 18-month-old child admitted with neck pain, spasm and neck motion limitation after traffic accident. On C-spine lateral view, there was anterior angulation of odontoid process with anterior displacement of atlas. Neurologic examination showed no specific focal deficits. The patient was treated with Gardner-Wells tongs traction, skeletal traction with wiring, Halo vest for 2 months, Minerva cast for 2 months and cervical collar brace. Eight months after the trauma, follow-up dynamic C-spine lateral view showed bone fusion without false movement or growth retardation.
Accidents, Traffic ; Braces ; Child* ; Follow-Up Studies ; Humans ; Infant* ; Neck ; Neck Pain ; Neurologic Examination ; Odontoid Process* ; Spasm ; Traction

Thirty six conseutive patients with recurrent hypertensive intracerebral hemorrhage were identified in a retrospective review of 307 cases of hypertensive intracerebral hemorrhage(HICH) treated at the Fatima hospital between September, 1989, and August, 1992. The recurrence rate was 1.7%. There were 14 males and 22 females, aged 38 to 83 years. Only one patient had recieved regular antihypertensive therapy after initial hemorrhage. The mean volume of hemorrhage was 21.7cc at first attack and 19.5cc at recurrent attack. The site of recurrent hemorrhage was putamen in 18 cases, thalamus in 12 cases, cerebellum in 8 cases and lobar in 3 cases. The most common pattern of recurrence was "Ganglionic-Ganglionic"(10 cases). Recurrent hemorrhage occurred at the same side in 54.8% and same side & same wite in 16.7% of recurrent hemorrhage. Mean interval between the hemorrhage was 17.4 months and 55.8% of recurrent hemorrhage occurred within 1 year. Initial condition was worse at recurrent hemorrhage and outcome also was worse regardless of treatment methods. We concluded that recurrent intracerebral hemorrhage in HICH patients was not a rare condition and regular follow up and antihypertensive therapy was important in prevention of recurrent hypertensive intracerebral hemorrhage.
Cerebellum ; Cerebral Hemorrhage ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension ; Intracranial Hemorrhage, Hypertensive* ; Male ; Putamen ; Recurrence ; Retrospective Studies ; Thalamus

Actinomycosis is an oppoturnistic infection of actinomyces, which are relatively avirulent endogenous oral commensals. After trauma or infection, they breach the normally protective mucosal barriers to invade adjacent soft tissue structures. Lesions routinely contain other bacteria, the normal resident flora at the site of primary infection, which act synergistically with actinomyces species to provoke this unique infection, which range from an acute suppurative process to a chronic fibrotic process. According to epidemic studies about pelvic actinomycosis, it should be significantly related to IUD(intrauterine device). It is accounted that IUD cause chronic intrauterine infection, tissue injury and act as nucleus for parasitic infestation. Here we present a case of pelvic actinomycosis related to IUD with brief review of the concerned literature.
Actinomyces ; Actinomycosis* ; Bacteria

Teratoma is one of germ cell tumor, common neoplasm in women of reproductive age, but it can arise at any age. Its malignant transformation is rare, less than 2%, frequently at older age. Nearly all the cases are squamous, sarcomatous and adenomatous transformation. Here we present a case of mixed transformation, adeno-squamous cell carcinoma with brief review of the concerned literature.
Carcinoma, Squamous Cell* ; Female ; Humans ; Neoplasms, Germ Cell and Embryonal ; Teratoma*

Results of 170 total knee arthroplasties(TKAs) performed from 1986 to 1995, followed up for at least one year, were reviewed. Lateral retinacular release was performed in 76 knees(45%) and not performed in 94 knees(55%). We compared the results of TKAs combined with lateral retinacular release with those without lateral retinacular release. The clinical results of TKAs were evaluated by the Knee Scoring System of Hospital for Special Surgery(HSS). The average follow-up period was 34 months. The clinical results assessed by HSS score, pain score and range of motion improved postoperatively in both groups, but there was no significant difference between the two groups. There were 8(4.7%) with patellar subluxations in 170 TKAs, one(1.3%) in the group with lateral retinacular release and 7(7.5%) in the group without lateral retinacular release(t-test; p<0.05). Analysis of lateral tilt of patella on roentgenographs also showed a significant difference between the two groups. 7 knees(9.2%) with lateral tilt were observed in the group with lateral retinacular release and 22 knees(23.4%) with lateral tilt in the group without lateral retinacular release(t-test; p<0.05). There was no osteonecrosis or fracture of patella in either group. In summary, lateral retinacular release might improve the patellar tracking and lower the incidence of patellar subluxation and lateral tilt of patella. Lateral retinacular release alone did not seem to cause patellar osteonecrosis and subsequent patellar fracture which were detectable in plain roentgenographs. So, we suggest that lateral retinacular release can be performed without great risk of potential patellar complications in TKAs requiring lateral retinacular release for proper patellar tracking.
Arthroplasty* ; Follow-Up Studies ; Incidence ; Knee* ; Osteonecrosis ; Patella ; Range of Motion, Articular

Background: Post-dural puncture headache (PDPH) is one of the well-known complication of spinal anesthesia. Epidural blood patch is the treatment of choice for PDPH but is rarely used for the prevention of PDPH after spinal anesthesia. The purpose of this study is to observe the effectiveness of epidural blood patch for prevention of PDPH and to evaluate the complications after epidural blood injection. Methods: Three hundred patients (ASA I or II) receiving spinal anesthesia were studied. They were randomly devided into two groups. Patients in Group I, the control group, were maintained in a supine position for 24 hour after spinal anesthesia. Patients in Group II, the study group, received 3 ml of autologous blood in the epidural space after spinal anesthesia. PDPH was evaluated for 5 days. The incidence, location, onset, and duration of headache in the patients presenting with PDPH were measured for 5 days, and the complications following epidural blood patch in Group II were observed for 2 weeks. Results: The incidence of PDPH in group I was 11%, but 0% in group II. There were no specific complications following epidural blood patch in Group II. Conclusions: This study suggest that the 3 ml epidural autologous blood patch is an useful method for the prevention of PDPH in patients with spinal anesthesia.
Anesthesia, Spinal* ; Blood Patch, Epidural ; Epidural Space ; Headache ; Humans ; Incidence ; Post-Dural Puncture Headache ; Punctures* ; Supine Position

Bony defect is one of the most common problems in craniomaxillofacial surgery. Although aurogenous bone graft is the best choice for the treatment of bone defect, it provides many problems such as donor site morbidity, irregular absorption, and limited amount of harvest. To overcome the shortcomings of autogenous bone graft many bone substitutes have been introduced. The ideal bone substitution is to have characteristics such as cheap, easy to obtain, rapid fusion to recipient bone, hard structure, long maintenance of shape and volume, low infection rate, and low exposure rate. Among those bone substitutes which have been widely used we chose lyophilized cartilage allograft because of low antigenecity, low resorption rate, easiness of carving and ling term preservation. From August 1993 to August 1997, 66 patients had been performed craniomaxillofacial reconstruction with lyophilized cartilage allograft. Orbital wall reconstruction and correction of enophthalmos were 24, correction of cleft lip and nose deformity were 19, temporal augmentations were 7, and others 16. Complications such as infection, exposure were not common. And partially removed cartilage was proved some calcification. Radiologic follow-up presented well positioned lyophilized cartilage allograft. Two radiologic works revealed haziness of bone density at the site of cartilage allograft. This suggests the ossification of lyophilized cartilage allograft. Together with liw infection rate, low exposure rate, and good framework for osteoconduction, lyophilized cartilage allograft are regarded as one of the good bone substitutes.
Absorption ; Allografts* ; Bone Density ; Bone Regeneration ; Bone Substitutes ; Cartilage* ; Cleft Lip ; Congenital Abnormalities ; Enophthalmos ; Follow-Up Studies ; Humans ; Nose ; Orbit ; Tissue Donors ; Transplants

We reviewed 178 patients with hypertensive intracerebral hematoma(HICH), which were treated with computed tomography(CT) guided stereotactic aspiration from Aug. 1986 to Dec. 1993(166 CT guided U-loop and 12 Leksell system). Our series consisted of 82 males and 96 females. The hemorrhages were located in putamen in 67.4%, thalamus in 20.2%, subcortex in 9% and cerebellum in 3.4%. Mean removal rate of hematoma was 55.3%. The results for the 178 cases who underwent stereotactic aspiration were good recovery in 45.5%, moderate disability in 28.0%, severe disability in 9.0% and vegetative state in 4.0%. The infection rate and rebleeding rate of all cases were 1.7% and 6.8% respectively. The mortality rate of all cases was 13.5%. We analysed the factors affecting the prognosis in 178 patients. Factors affecting good prognosis were high initial GCS, less amount of initial hematoma and no presence of intraventricular hemorrhage. Stereotactic aspiration by CT-guided U-loop and Leksell system is simple, safe and can minimize the brain damage. This method can e performed under local anesthesia.
Anesthesia, Local ; Brain ; Cerebellum ; Female ; Hematoma ; Hemorrhage ; Humans ; Male ; Mortality ; Persistent Vegetative State ; Prognosis ; Putamen ; Thalamus ; Urokinase-Type Plasminogen Activator

A total of 181 cases of industrial ocular injuries hospitalized and treated at the St. Mary's Hospital, Seoul during the 5-year period was studied on their epidemiological characteristics. Of there patients 96.7% were males, and 43.6% were in twenties, 49.7% of the cases were injured on left eyes. There were no statistically significant differences in frequencies of study subjects by day of the week and month of the year. Most common injury hour were between 10- < 12 AM(13.6%) and between 2- < 4 PM(20%). Of the total 101 cases, 37.6% were working less than 6 months, and 73.7%, less than 2 years. Of the total, 42.3% were involved in machinery work and 13.9%, in construction work. According to the American National Standard Method of recording basic facts relating to the nature and occurrence of work injuries, 62% among all source of injuries was metal item and the most common accident type was struck by flying objects(76.2%). Among 181 cases, only 2 cases wearing protective equipment when the accidents occurred.
Diptera ; Humans ; Male ; Seoul