Talus is an important structure of the ankle joint and its function is critical for ambulation and weight bearing. The talus fracture is rare, but the complications of fracture and dislocation are serious and resulting in avascular necrosis, osteoarthritis. So its treatment is carefully considered at initial status. Authors reviewed 11 cases of fracture and dislocation of the talus treated at Yeungnam university hospital from 1984 to 1991. The longest follow up was 8 years and shortest, 1 years. The results were as follows. 1. There were all males, the average age was 30 years old. 2. The most common cause was fall down (8 cases), and next traffic accident (2 cases), sports injury (1 case). 3. According to Marti-Weber classification, 1 case was type I, 1 in type II, 4 in type III and 5 in type IV. 4. The method of treatment were open reduction and internal fixation in 6 cases, the others were closed reduction in 5 cases. 5. Final results (by Hawkins grading system) were as follows, 3 cases were excellent, 4 cases were good, 1 case was fair and 3 cases were poor. 6. Complications were AVN in 2 cases, degenerative arthritis in 8 cases, malunion in 1 case. 7. The range of motion of the ankle joint was relatively preserved (74%), but in the subtalar joint it was decreased (43%)
Accidents, Traffic ; Ankle Joint ; Athletic Injuries ; Classification ; Dislocations ; Follow-Up Studies ; Humans ; Male ; Methods ; Necrosis ; Osteoarthritis ; Range of Motion, Articular ; Subtalar Joint ; Talus* ; Walking ; Weight-Bearing

BACKGROUNDS: Percutaneous radiofrequency neurotomy of posterior primary ramus has been in use as a treatment for persistent, mechanical low back pain for two decades. However, there has been limited studies regarding to prognostic factors related to outcome. We report our experience with at least 2-year follow up with special aftention on prognostic factors. METHODS: Of total 228 patients who underwent percutaneous radiofrequency neurotomy (PRN) of posterior primary ramus for refractory low back pain during last 3 years, 128 patients whose pain was considered to be originated from facets joints or their surrounding soft tissue and responded to temporary blocks were assigned to a group II. All patients had more than 6 months of pain. These patients were compared with 100 patients to whom PRN were provided for chronic nonspecific low back pain without all inclusion criteria (Group I). RF procedures were done under local anesthesia with C-arm intensifier guidance. Pain reliefs were estimated at 1week, 1month, 6months and 2 years using visual analog scale(VAS). For patients with more that 50% reduction of previous pain was regarded as positive responder. Various clinical variables such as age, sex, symptom duration, types of pain, bilaterality, and previous surgery were studied for prognostic factors. RESULTS: Positive responders were 56% at 1week, 46% at lmonth, 18% at 6months, and 13% at 2years after PRN in group I, and 78.9% at lweek, 75.4% at lmonth, 62.5% at 6months, and 54.7% at 2years in group II. Some variables were found to be significantly related to outcome including prominent local tenderness, percussion tenderness, combination of symptoms with pain on gefting up, extension, transitional movement, pain radiating to buttock and/or posterior thigh, and good immediate response. Age, sex, symptom duration, bilaterality, imaging study results, previous lumbar surgery, and degrees of pain relief from diagnostic block were not related to outcome. CONCLUSIONS: These results indicate that PRN of posterior primary ramus has a moderate overall long-term beneficial effect, with no morbidity in our series. But, the long-term good results will be anticipated only in properly selected patients with low back pain originating from facet joints and surrounding structures.
Anesthesia, Local ; Buttocks ; Follow-Up Studies ; Humans ; Joints ; Low Back Pain* ; Percussion ; Thigh ; Zygapophyseal Joint

BACKGROUND: Tracheal intubation for general anesthesia often leads to trauma of the airway mucosa, resulting in postoperative sore throat and hoarseness. Numerous studies have investigated the factors as contributing causes, but the influence of method of anesthesia induction and time for extubation of the endotracheal tube has not been systematically examined. The aim of this study was to establish the effects of the methods of anesthesia induction and timing of extubation on postoperative sore throat and hoarseness. METHODS: Eighty patients with ASA physical status 1 or 2 were randomly divided into four groups. Group 1 patients (n=20) recieved succinylcholine 1.0 mg/kg for intubation and early extubated ; group 2 patients (n=20) recieved succinylcholine 1.0 mg/kg for intubation and lately extubated ; group 3 patients (n=20) recieved pancuronium 0.1 mg/kg for intubation and early extubated ; group 4 patients (n=20) recieved pancuronium 0.1 mg/kg for intubation and lately extubated. All patients were interviewed 6, 24, 48, and 72 hrs after operation by an anesthesiologist in a double-blind manner. RESULTS: The incidence of sore throat at postoperative 6 and 24 hrs were decreased in group 3 compaired with group 1, 2, and 4 (p<0.05), respectively. The severity of sore throat at postoperative 6 hrs were decreased in group 3 compared with group 1, 2 and 4 (p<0.05), and that of postoperative 24 hrs were decreased in group 3 compared with group 1 and 2 (p<0.05), respectively. The severity of hoarseness at postoperative 6 hrs were decreased in group 3 compared with group 2 (p<0.05). CONCLUSIONS: We suggest that postoperative sore throat and hoarseness may be developed more when extubation was perfomed lately than early. Therefore, early extubation provide advantage in terms of reducing sore throat and hoarseness in limited cases of anesthesia.
Anesthesia* ; Anesthesia, General ; Hoarseness* ; Humans ; Incidence ; Intubation ; Mucous Membrane ; Pancuronium ; Pharyngitis* ; Succinylcholine

Inflammatory myofibroblastic tumor(IMT) or inflammatory pseudotumor is a rare, solid tumor that most often affects children. This tumor is characterized by a spindle cell proliferation admixed with a variety of inflammatory cells. Although it has disputed nosology, a distinctive fibroinflammatory and even pseudosarcomatous appearance have been well appreciated. Herein, we report a case of IMT in the posterior mediastinum in a 19-year-old girl with clinical findings. The immunohistochemical and ultrastructural studies on the tumor cells are reported, and their distinctive characteristics are discussed in details.
Cell Proliferation ; Child ; Female ; Granuloma, Plasma Cell ; Humans ; Mediastinum* ; Myofibroblasts* ; Young Adult

No abstract available.
Glioblastoma* ; Keratosis, Seborrheic

No abstract available.
Diagnosis* ; Female ; Humans ; Polycystic Kidney Diseases*

Epithelium ; Humans ; Hyperplasia ; Lymphangiectasis ; Lymphangioma ; Lymphatic Vessels ; Male ; Molar, Third ; Salivary Glands ; Salivary Glands, Minor ; Tooth Extraction ; Young Adult

Acinar Cells ; Biopsy ; Carcinoma, Acinar Cell ; Diagnosis ; Humans ; Male ; Maxillary Sinus ; Middle Aged ; Odontogenic Tumors ; Recurrence

Chordoma is a relatively rare primary osseous tumor arising from the remnants of the primitive notochord and located along the axial skeleton. It is characterized by is slow growth, hight frequency to invade and destroy bone by direct extension, local recurrence after surgical excision and distant metastasis. It accounts for 1 to 4% of all malignant bone tumors. Approximately 50% of chordomas arise in the sacrococcygeal region, 35% at the clivus, and 15% in the vertebral column above the sacrum. The tumor tends to predominate in males, with roughly a 2 : 1 male-female ratio, and occurs predominantly in the fifth through seventh decades of life. Pain is the most common symptom in the chordomas of the spine, and symptoms of constipation, urinary frequency, or nerve root compression may appear before patients present to their physician. Many patients, therefore, are misdiagnosed as having degenerative disc disease, coccygodynia, or hemorrhoids. A firm, fixed presacral mass can usually be palpated on rectal examination. Surgical extirpation of the tumor is the only curative procedure and the indicated surgical procedure for sacrococcygeal chordoma is a high sacral amputation, maintaining a cuff of normal tissue over the tumor. Radiation therapy seems to be effective with adjuvant or palliative aims. We report a case of large sacral chordoma detected in a 60-year-old female in the course of a clinical examination, which was successfully treated by high sacral resection by a posterior approach and repair of the sacral bone defect with bone cement.
Amputation ; Chordoma* ; Constipation ; Cranial Fossa, Posterior ; Female ; Hemorrhoids ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Notochord ; Radiculopathy ; Recurrence ; Sacrococcygeal Region ; Sacrum ; Skeleton ; Spine

OBJECTIVE: We report our experience of percutaneous radiofrequency neurotomy(PRN) on the posterior primary ramus with at least two years follow up. METHODS: Two hundred and twenty-eight patients were underwent PRN on the posterior primary ramus for refractory low back pain during last three years. One hundred and twenty-eight patients were met all inclusion criteria indicating facetal originated pain(group II), and 100 patients were not(group I). Radiofrequency procedures were done in usual manner. Pain reliefs were estimated at 1 week, 1 month, 6 months and 2 years using visual analog scale. RESULTS: Positive responders were 56% at 1 week, 46% at 1 month, 18% at 6 months, and 13% at 2 years after PRN in group I, and 78.9% at 1 week, 75.4% at 1 month, 62.5% at 6 months, and 54.7% at 2 years in group II. Prominent local tenderness, percussion tenderness, pain on getting up, extension and transitional movement, radiating pain on buttock and/or posterior thigh, and good immediate response were found to be significantly related to outcome. And age, sex, symptom duration, bilateral symptoms, favorable imaging study results, previous lumbar surgery, and degrees of pain relief from diagnostic block were not. CONCLUSION: Percutaneous radiofrequency neurotomy on the posterior primary ramus has long-term beneficial effect, without any morbidity in our series. And the long-term good results will be anticipated after proper selection among patients with facet joints related low back pain.
Buttocks ; Follow-Up Studies ; Humans ; Low Back Pain ; Percussion ; Thigh ; Visual Analog Scale ; Zygapophyseal Joint