We reviewed 40 cases of femoral shaft fractures in children treated with split Russel traction and initial fracture angulation above 10 degree. The treatment of femoral shaft fractures in children is various according to age. Satisfactory results have been reported with split-Russel traction. At an average follow-up of 33 months, we obtained following results about remodelling of fracture site & physeal site, possible acceptable angulation of fracture. 1. The average time of traction was 18 days, and hip spica cast was applied for 28 days. 2. Malunion within 25degrees in flexion & 23degrees in valgus & 24degrees in varus was well corrected spontaneously. 3. Average correction of initial angular deformity was 86% at last follow up. 4. Anterior angulation was corrected at 83%, varus 87%, valgus 88%. 5. Remodelling according to direction of deformity was no statistical correlation (P>0.05), and then spontaneous correction of angular deformity was same without relation to direction of deformity. 6. Remodelling according to site was statistical correlation (P<0.05), fracture site 26%, physes 74%. And proximal physes 36%, distal physes 38%.
Child* ; Congenital Abnormalities* ; Follow-Up Studies ; Hip ; Humans ; Traction*

Aneurysmal bone cyst uncommonly involves the pubic bone and tends to grow eccentrically and thin out overlying cortex. In the following case report, a 19-year-old male patient visited out hospital, because of dull pain in his left groin. He was diagnosed as aneurysmal bone cyst originated from the superior pubic ramus by CT guided needle biopsy. Transcatheter arterial embolization was effective in the treatment of this lesion such as complete consolidation after the procedure. At present, 2 years follow-up, no problem was noted at weight bearing as well as hip function or recurrence.
Aneurysm ; Biopsy, Needle ; Bone Cysts ; Follow-Up Studies ; Groin ; Hip ; Humans ; Male ; Pubic Bone ; Recurrence ; Weight-Bearing ; Young Adult

OBJECTIVE: This is a retrospective review of 22 surgically treated benign and malignant tumors of brachial plexus region to describe clinical presentation, the characteristics of brachial plexus tumor and clinical outcomes with a literature review. METHODS: Twenty-one patients with consecutive 22 surgeries for primary brachial plexus tumors were enrolled between February 2002 and November 2011 were included in this study. The medical records of all patients were reviewed. RESULTS: Eleven male and 10 female patients were enrolled. Mean age was 39 years. Three patients had brachial plexus tumor associated with neurofibromatosis (13.6%). Presenting signs and symptoms included parenthesis and numbness (54.5%), radiating pain (22.7%), direct tenderness and pain (27.2%), palpable mass (77.3%). Twelve patients presented preoperative sensory deficit (54.5%) and 9 patients presented preoperative motor deficit (40.9%). Twenty tumors (90.9%) were benign and 2 tumors (9.1%) were malignant. Benign tumors included 15 schwannomas (68.2%), 4 neurofibromas (18.2%) and 1 granular cell tumor (4.5%). There were 1 malignant peripheral nerve sheath tumor (MPNST) and 1 malignant granular cell tumor. Gross total resection was achieved in 16 patients (72.7%), including all schwannomas, 1 neurofibroma. Subtotal resection was performed in 6 tumors (27.3%), including 3 neurofibromatosis associated with brachial plexus neurofibromas, 1 MPNST and 2 granular cell tumor in one patient. CONCLUSION: Resection of tumor is the choice of tumor in the most of benign and malignant brachial plexus tumors. Postoperative outcomes are related to grade of resection at surgery and pathological features of tumor.
Brachial Plexus ; Female ; Granular Cell Tumor ; Humans ; Hypesthesia ; Male ; Medical Records ; Nerve Sheath Neoplasms ; Neurilemmoma ; Neurofibroma ; Neurofibromatoses ; Peripheral Nerves ; Retrospective Studies

Treatment of Rupture of Achilles tendon was first reported by Pare, 1575 and thereafter the various causes, diagnostic & therapeutic method of the ruptured tendon have been described by many authors. The two options of treatment are conservative management and surgical treatment and currently surgical intervention has been more popular. There are various surgical techniques which have been reported by many surgeons to treat the acute rupture of the Achilles tendon. In this report, 18 cases ( 11 male & 7 female ) of injuried Achilles tendon had been treated by the modified Lindholm method and follow-up study of 18 cases had been made during 28 months from august. 1993 to december, 1995. The results as follows; 1. After repair by the modified Lindholm method, a long leg cast was applied, and then aweight bearing was started average 8 weeks postoperatively. It can be demonstrated to shorten hospitalization and early ambulation compared to other surgical techniques 2. Postoperative power of triceps surae muscle was improved to normal in 15 patients ofthe 18 patients, and muscle power was good in 3 patients, but, all cases was improved to nearly normal whithin the last follow up. 3. Heel to floor distance was 0.6cm less on the operated side than on the normal side, and the difference decreased to 0.2cm at the last follow up. 4. The calf atrophy was minimal, and active range of motion of ankle was within normal limit. 5. We suggest that the procedure is recommended for one of the methods of the treatment of acute rupture of the Achilles tendon, because it is easy to do and permits early weight bearing and the complication is less.
Achilles Tendon* ; Ankle ; Atrophy ; Early Ambulation ; Female ; Follow-Up Studies ; Heel ; Hospitalization ; Humans ; Leg ; Male ; Range of Motion, Articular ; Rupture* ; Tendons ; Weight-Bearing

It is important to follow strict indications for surgery and recognize prognostic factors in order to get good results in the surgical treatment of herniated nucleus pulposus. 55 patients with herniated nucleus pulposus were studied who had had laminectomy and discectomy and were followed up for more than 1 year in order to analyze the correlation between various factors including history, physical examination and radiologic finding and surgical results. Age, sex, symptom duration, location of the herniation, smoking, occupation, physical examination, disc height change, MRI findings, operation time and bleeding volume were evaluated as prognostic factors that seemed to influence surgical result. The results are as follow 1. Female had significantly better surgical results than male (P<0.05). 2. Non-smokers had significantly better surgical result than smokers (P<0.01). 3. In MRI finding, protruded disc had significantly better surgical result when it had involved spinal canal posterolaterally than centrally (P<0.01). 4. The less bleeding volume, the better surgical result (P<0.05).
Diskectomy ; Female ; Hemorrhage ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Male ; Occupations ; Physical Examination ; Smoke ; Smoking ; Spinal Canal

Albendazole binds to parasite's tubulin inhibiting its glucose absorption. Its common adverse effects are nausea, vomiting, constipation, thirst, dizziness, headache, hair loss and pruritus. Although mainly metabolized in the liver, abnormal liver function tests were a rare adverse effect during clinical trials and we found no literature about albendazole-induced hepatitis requiring admission. This patient had a previous history of albendazole ingestion in 2002 resulting in increase of liver function tests. And in 2005, the episode repeated. We evaluated the patient for viral hepatitis, alcoholic liver disease, and autoimmune hepatitis, but no other cause of hepatic injury could be found. Liver biopsy showed periportal steatosis and periportal necrosis. The initial abnormal liver function test improved only with supportive care. These findings and the Roussel Uclaf Causality Assessment Method of the Council for International Organizations of Medical Sciences (RUCAM/CIOMS) score of 9 are compatible with drug-induced hepatitis so we report the case of this patient with a review of the literature.
Albendazole/*adverse effects ; Antiprotozoal Agents/*adverse effects ; Eosinophils/metabolism ; Glucose/metabolism ; Hepatitis, Toxic/*diagnosis ; Humans ; Liver/drug effects ; Liver Function Tests ; Male ; Middle Aged ; Necrosis

The incidence, recurrence, and mortality of Clostridium difficile infection are increasing and the standard therapy is oral metronidazole or vancomycin. Since treatment failure with standard therapy is increasing, an alternative therapy is needed. Fecal microbiota transplantation is one effective method in patients with refractory or recurrent C. difficile infection, including pseudomembranous colitis. Here, we report two cases of refractory pseudomembranous colitis treated with fecal microbiota transplantation.
Clostridium difficile ; Enterocolitis, Pseudomembranous ; Humans ; Incidence ; Metagenome ; Metronidazole ; Recurrence ; Transplants ; Treatment Failure ; Vancomycin

Brunnera's gland hyperplasia is a benign tumor of the duodenum and it is rarely associated with clinical symptoms. We report on a 64-yr-old man with Brunnera's gland hyperplasia who had undergone a duodenocephalo-pancreatectomy. The reason is that he presented upper gastrointestinal obstructive symptoms and the esophagogastroduodenoscopic finding revealed the lesion to be an infiltrating type mass on the second portion of the duodenum with luminal narrowing. An abdominal computed tomography showed a 2.5 cm-sized mass in the duodenal second portion with a suspicious pancreatic invasion and 7 mm-sized lymph node around the duodenum. Duodenocephalopancreatectomy was successfully performed. Histological examination revealed a Brunnera's gland hyperplasia. The final diagnosis was the coexistence of Brunnera's gland hyperplasia and pancreatic heterotopia with a pancreatic head invasion. The literature on Brunnera's gland hyperplasia is reviewed.
Brunner Glands/*pathology/radiography ; *Choristoma ; Diagnosis, Differential ; Duodenal Neoplasms/*pathology/radiography/surgery ; Duodenum/pathology/radiography ; Endoscopy, Gastrointestinal ; Humans ; Hyperplasia ; Male ; Middle Aged ; Pancreatic Diseases/*pathology/radiography ; Pancreaticoduodenectomy ; Severity of Illness Index ; Tomography, X-Ray Computed

Follicular lymphoid hyperplasia is commonly seen when performing pediatric endoscopy. But in adults, these findings can imply an underlying gastrointestinal or systemic illness, besides the normal variant. On the other hand, colonic involvement of chronic lymphocytic leukemia (CLL) is seen in about 5% to 20% of autopsy cases. However, there have been few reports on the colonoscopic appearance that corresponds to colonic involvement by CLL, and the reported colonoscopic appearances have included polyps, ulcers, granularity, submucosal nodules, erythema, the red ring sign etc. We report here on a case of CLL neoplastic lymphocyte involvement of the terminal ileum and colon as a form of lymphoid hyperplasia, and this was seen when performing colonoscopy.
Adult ; Autopsy ; Colon ; Colonoscopy ; Endoscopy ; Erythema ; Hand ; Humans ; Hyperplasia ; Ileum ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphocytes ; Polyps ; Ulcer

Crohn's disease can cause intestinal strictures, perforations, fistulas, or abscesses. Although fistulas and abscesses are common complications of Crohn's disease, a presacral abscess with neuromuscular complications is very unusual. A delayed diagnosis and treatment may increase morbidity. The diagnosis is frequently delayed, because the clinical features of presacral abscess are variable and nonspecific. We experienced a case of a presacral abscess with bilateral sciatica in a 25-year-old male patient. He was diagnosed with Crohn's disease of the terminal ileum 2 months previously and has been managed with mesalazine. He visited our hospital due to pain in the buttocks and severe neuralgia in both thighs. We confirmed enteric fistulas, resulting in a presacral abscess, which extended symmetrically through both sciatic notches and the gluteus medius muscles. He was managed with antibiotics after a small bowel segmentectomy, right hemicolectomy, fistulectomy, and surgical drainage. The bilateral radicular pain resolved completely within 2 weeks of surgery. The patient has remained in remission and asymptomatic 1 year after surgery.
Abscess ; Adult ; Anti-Bacterial Agents ; Buttocks ; Constriction, Pathologic ; Crohn Disease ; Delayed Diagnosis ; Drainage ; Fistula ; Humans ; Ileum ; Male ; Mastectomy, Segmental ; Mesalamine ; Muscles ; Neuralgia ; Sciatica ; Thigh