Sixteen patients who had radial head fractures were treated with open reduction and internal fixation using Herbert screws (10 patients), and with silastic prosthetic replacement (6 patients) from March, 1992 to December, 1994 in Chungnam National University hospital. The average duration of follow up was 19.5 months. The purpose of this study is to examine the role of Herbert screw fixation and silicone replacement arthroplasty and to asscess the clinical results of two groups functionally, radiologically in raidial head fractures. By functional rating index (modified After B.F. Morrey et al), the results were classified as excellent (9 patients), good (6 patients), fair (No patient) and poor (1 patient). Nine of the ten patients treated by open reduction and internal fixation using Herbert screws had resulted in excellent or good. All patients were inserted silastic implants were showed excellent or good results. Especially, in Mason Type III radial head fractures, three of four patients treated by Herbert screws and all 5 patients treated by silastic prosthesis were considered to excellent or good results. We concluded that Herbert screw fixation or silastic prosthetic replacement had satisfactorily appeared to be the alternative treatment option for Mason Type III radial head fractures.
Arthroplasty, Replacement ; Chungcheongnam-do ; Follow-Up Studies ; Head* ; Humans ; Prostheses and Implants ; Silicones

PURPOSE: To describe radiologic findings of burn-associated persistent candidemia of the thorax. MATERIALS AND METHODS: This study included 42 patients with major burns in whom blood culture had shown the presence for more than 24 hours of persistent candidemia. The duration of positive culture for candidiasis ranged from two to 67 days(mean, 15 days). Radiographic(n=42) and thin-section CT findings(n=13) were retrospectively analyzed. The onset, pattern, size, distribution and persistence of parenchymal abnormalities as well as the presence or absence of pleural effusions, mediastinal lymphadenopathy and cardiomegaly were assessed. RESULTS: On chest radiographs, positive findings were noticed in 61.9%(26/42) and on thin-section CT, in 76.9%(10/13). The most frequent radiographic finding was pulmonary nodule(s), observed in 14 patients(33.3%). in 13, these were bilateral. Bronchovascular bundle thickening(n=6, 14.3%), consolidation(n=4, 9.5%), cardiomegaly(n=6, 14.3%) and pleural effusion(n=4, 9.5%) were also observed. Those lesions appeared eight to 129 days(mean, 33days) after the burn. Radiographic abnormalities persisted for seven to 115 (mean, 35) days, regardless of the treatment. Thin-section CT showed parenchymal abnormalities in 10/13 patients(76.9%) and subpleural nodules of less than 1cm in diameter and without halo in all patients. Cardiomegaly, pleural effusion and mediastinal adenopathy were observed on CT in 5(38.5%), 4(30.8%) and 2(15.4%) of the 13 patients, respectively. CONCLUSION: In a high proportion of patients with burn-associated candidemia, chest radiograph and thin-section CT findings were positive. The most frequent radiographic parenchymal abnormality was multiple bilateral nodules.
Burns* ; Candidemia* ; Candidiasis ; Cardiomegaly ; Humans ; Lymphatic Diseases ; Pleural Effusion ; Radiography, Thoracic ; Retrospective Studies ; Thorax*

Secondary osteoarthritis of hip joints is a common disease and is frequently followed by chronic sublexation and dislocation. Twenty four case of the secondary osteoarthritis associated with chronic subluxation and dislocation of the hip joints were evaluated with plain radiography and computed tomography. We retrospectively analyzed 1) the ossification and calcification of the acetabular labrum, 2) the thickeness of the quadrilateral plate of the ilium, and 3) anteroposterior diameter of the acetabulum. The changes of the hip joints in subluxation (n=14) revealed ossification of the acetabular labrum in 12 cases (86%), thickening of the quadrilateral plate of the ilium in 11 cases (78%) but anteroposterior diameter of the acetabulum was not changed. The changes of the hip joints in dislocation (n=10) revealed no evidence of the ossification of the acetabular labrum, thickening of the quadrilateral plate of the ilium in 10 cases (100%) and decreased anteroposterior diameter of the acetabulum. We conclude that CT findings of subluxation and dislocation of the hip joints can be helpful in the evaluation of the secondary osteoarthritis of the hip joints.
Acetabulum ; Dislocations* ; Hip Joint* ; Hip* ; Ilium ; Joints ; Osteoarthritis ; Osteoarthritis, Hip ; Radiography ; Retrospective Studies

Ankle arthrodesis has been regarded as a good operative treatment for post traumatic and rheumatoid arthritis of ankle, and ankle arthroplasty has been also developed with several types, from 1970, by Lord & Marotte. Ankle arthroplasty is more functional & less cosmetic troublesome than arthrodesis, and with more developed prosthesis design, more good result will come. The authors operated 6 cases of total ankle arthroplasty for posttraumatic and rheumatoid arthritis of ankle, which were also indications of arthrodesis, and introduce the results and operative problems of ankle arthroplasty.
Ankle ; Arthritis, Rheumatoid ; Arthrodesis ; Arthroplasty ; Prosthesis Design

Cyclopia is rare congenital craniofacial anomaly, in which the eyes are fused together and located in a single orbit. It is consistently associated with severe holoprosencephaly, which is the failure of cleavage of the prosencephalon with a deficit in the midline facial development. chromosomal study revealed 47, X( ), +13 (Patau syndrome).
Holoprosencephaly ; Orbit ; Prosencephalon ; Trisomy*

PURPOSE: To study the outcomes and complications of tension-free vaginal tape(TVT) operations, according to postoperative period, and compare our results with those in the literature. MATERIALS AND METHODS: 340 patients were followed up for at least 3 months, between March 1999 and September 2001. During the postoperative period, the objective and subjective success rate, along with the postoperative complications, were evaluated. The mean age was 50.6+/-10.1 years. Among the 340 patients, 279(81.8%) and 61(19.4%) were diagnosed with stress and mixed incontinences, respectively. The patients were classified according to their symptom grades; grade I(n=66, 19.4%), grade II (n=240, 70.6%) and grade III(n=34, 10.0%). RESULTS: 113, 117, 44 and 66 of the 340 patients were observed postoperatively for 1, 1-2, 2-3 and for over 3 years, respectively. Of these, 137 completed questionnaires for evaluation of the subjective outcome. The objective success rates were high, irrespective of the extent of the postoperative period. The 1, 1-2, 2-3 and over 3 years postoperative period objective success rates were 93.8, 87.5, 89.5 and 93.3%, respectively. The subjective success rates were also high, irrespective of the extent of the postoperative period; 87.5, 75.0, 84.3 and 90.0% 1, 1-2, 2-3 and beyond 3 years, respectively. Postoperative complications occurred in 15 cases, including 12 bladder perforation due to the TVT device, 2 cases of bladder injury due to guide wire and one of vessel injury. 13 cases developed de novo urgency, although, they were cured with anticholinergic medication. Other serious complications, such as wound infection, hemorrhage requiring transfusion and nerve injury, were absent. CONCLUSIONS: Both the short and long term results were excellent, regardless of the extent of the postoperative follow-up period. TVT should play a significant role in treating female urinary incontinence, due to its availability and stability.
Female* ; Follow-Up Studies ; Hemorrhage ; Humans ; Postoperative Complications ; Postoperative Period* ; Surveys and Questionnaires ; Suburethral Slings* ; Surgical Mesh ; Urinary Bladder ; Urinary Incontinence* ; Wound Infection

PURPOSE: This study evaluated the treatment effectiveness and proper radiation dose of helical tomotherapy (HT) in spine oligometastases from gastrointestinal cancers. MATERIALS AND METHODS: From 2006 to 2010, 20 gastrointestinal cancer patients were treated with HT for spine oligometastases (31 spine lesions). The gross tumor volume (GTV) was the tumor evident from magnetic resonance imaging images fused with simulation computed tomography images. Clinical target volume (CTV) encompassed involved vertebral bodies or dorsal elements. We assumed that the planning target volume was equal to the CTV. We assessed local control rate after HT for 31 spine metastases. Pain response was scored by using a numeric pain intensity scale (NPIS, from 0 to 10). RESULTS: Spine metastatic lesions were treated with median dose of 40 Gy (range, 24 to 51 Gy) and median 5 Gy per fraction (range, 2.5 to 8 Gy) to GTV with median 8 fractions (range, 3 to 20 fraction). Median biologically equivalent dose (BED, alpha/beta = 10 Gy) was 52 Gy10 (range, 37.5 to 76.8 Gy10) to GTV. Six month local control rate for spine metastasis was 90.3%. Overall infield failure rate was 15% and outfield failure rate was 75%. Most patients showed pain relief after HT (93.8%). Median local recurrence free survival was 3 months. BED over 57 Gy10 and oligometastases were identified as prognostic factors associated with improved local progression free survival (p = 0.012, p = 0.041). CONCLUSION: HT was capable of delivering higher BED to metastatic lesions in close proximity of the spinal cord. Spine metastases from gastrointestinal tumors were sensitive to high dose radiation, and BED (alpha/beta = 10 Gy) higher than 57 Gy10 could improve local control.
Disease-Free Survival ; Gastrointestinal Neoplasms ; Humans ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Radiotherapy, Intensity-Modulated ; Recurrence ; Spinal Cord ; Spine ; Treatment Outcome ; Tumor Burden

The use of pure titanium and titanium alloys have been increased recently in fixed, removable prosthodontics and implant fields as a framework. But when they were used for superstructures of implant of metal framework of removable prosthesis, welding is necessary to reconnect the fracture site to control the casting distortions. To overcome the difficulties in soldering the titanium due to high oxidation property, much effort have been devoted. In this study, some of mechanical properties were compared between pure titanium and Ti-6Al-4V alloy by usingl aser welding, electron beam welding technique and tungsten arc welding. Mechanical properties such as tensile strength, yield strength, elongation and microhardness were measured. And, in order to compare the effect of welding site and surrounding metal tissue according to the welding condition, SEM photographs were taken an element distribution was observed by Wave Dispersion Spectroscopy. Through analyses of the data, following results were obtained; 1. In items such as tensile strength, yield strength and elongation according to the welding techniques of pure titanium, only tungsten arc welded group showed significant lower value than other groups(P<0.05). 2. In items such as tensile strength and yield strength according to the welding techniques of Ti-6Al-4V alloy, control group and tungsten arc welded group showed significant difference among all the groups(P<0.05). 3. Ti-6Al-4V alloy exhibited significantly greater elongation than control group when the laser welding method and electron beam welding method were used, and elongation showed increasing tendency. 4. Pure titanium specimens exhibited increasing tendency of microhardness regardless of the welding technique applied, and especially tungsten arc welded group demonstrated a great increase of microhardness than parent metal. 5. There was no hardness change in laser welded group and electron bean welded group of Ti-6Al-4V ally, but in tungsten arc welded group, hardness changed greatly from parent metal to weld seam. 6. Through the metallographic examination and scanning electron microscopy, laser welding caused central fusion and recristallizations were formed and tungsten arc welding caused localized fusion to 0.3-0.7mm from the surface.
Alloys ; Hardness ; Humans ; Microscopy, Electron, Scanning ; Parents ; Prostheses and Implants ; Prosthodontics ; Spectrum Analysis ; Tensile Strength ; Titanium* ; Tungsten ; Welding*

Chronic osteomyelitis continue to be a therapeutic challenge. The osteomyelitis also implies chronic ischemia of the diseased bone ; thus systemic antibiotic treatment may not be as effective as we want. In 1972, Klemm developed a new procedure to supplement saucerization in the treatment of chronic osteomyelitis, alternative to irrigation and suction-drainage, i.e., Gentamicin-PMMA Beads. The authors analysed 35cases of the chronic osteomyelitis which were admitted and treated by sauceriztion and Gentamicin-PMMA Beads in Department of Orthopaedic Surgery, Korea Veterans Hospital from Aug. 1984 to Jan. 1988.
Gentamicins ; Hospitals, Veterans ; Ischemia ; Korea ; Osteomyelitis ; Polymethyl Methacrylate

Miller-Dieter syndrome consists of severe type I lissencephaly, abnormal facial appearance, and sometimes other birth defects. Lissencephaly is a brain malformation manifested by a smooth cerebral surface, thickened cortical mantle, and microscopic evidence of incomplete neuronal migration. It comprises the agyria-pachygyria spectrum of malformation, thus excluding polymicrogyria and other cortical dysplasia. Type I lissencephaly results from abnormal migration between about 10 and 14 weeks gestaion. The brain is often small, and the ventricle is enlarged posteriorly The corpus callosum may be small or absent. The structural pattern of the cerebral hemispheres and ventricles is distintly immature, reminiscent of fetal brain. The superficial cellular layer resembles an immature cortex, with some separation into zones similar to layers III, V, and VI of normal cortex, although the cell population is decreased. In 1963 Miller described a malformation syndrome in a brother and sister with postnatal growth deficiency, craniofacial defects, and serious abnormalities of neurologic function. Autopsy at 3 and 4month of age, respectively, revealed lissencephaly. Subsequently, Dieker reported four additional patients with this disorder and referred to it as the 'lissencephaly syndrome'. We have experienced a case with this syndrome. Then we report this rare case with brief review of literature.
Autopsy ; Brain ; Cerebrum ; Congenital Abnormalities ; Corpus Callosum ; Humans ; Lissencephaly ; Malformations of Cortical Development ; Neurons ; Siblings