STUDY DESIGN: Case report OBJECTIVES: To report a case of Brown-Séquard syndrome after blunt cervical trauma. SUMMARY OF LITERATURE REVIEW: Brown-Séquard syndrome is a rare disease characterized by hemisection of the spinal cord, and it shows the best prognosis of the various types of incomplete spinal cord injuries. MATERIALS AND METHODS: A patient with Brown-Séquard syndrome that occurred after a traffic accident was followed up for 2 years and 6 months. RESULTS: We observed normal recovery of motor strength, but sensory impairment and deep tendon hyperreflexia remained. CONCLUSIONS: Brown-Séquard syndrome is known to have a good prognosis, but in this case, the neurological abnormality did not fully recover; therefore, we report this rare case and present a review of the literature.
Accidents, Traffic* ; Cervical Vertebrae ; Female ; Humans ; Prognosis ; Rare Diseases ; Reflex, Abnormal ; Spinal Cord ; Spinal Cord Injuries ; Tendons

The goal of fracture treatment is to restore the patient to pre-injury function level. But the outcome assessment after orthopedic interventions has usually focused on physician-defined parameters of technical success, such as fracture union, alignment and range of motion rather than patient function and quality of life. However, the correlation among improvements in these parameters and functional status, psychosocial well being is inconsistent and weak in the elderly. Therefore authors assessed the functional status after surgical intervention of hip fractures in the elderly with functional recovery score(FRS). Independence in basic activities of daily living, in instrumental activities of daily living, in mobility, freedom from pain and intact memory were assessed in 133 hip fractures in the elderly. The hip fractures in the elderly resulted in 24.8% loss of function after the first year. The older the age, the more the loss of function after surgery of hip fractures. The more functional loss was observed in female patients and in patients with poor postoperative radiological results, but statistically insignificant (P>0.05). The more functional loss was observed in patients with underlying medical disease preoperatively and it was statistically significant (P<0.05). We recommend the evaluation of functional status in the elderly after hip fractures.
Activities of Daily Living ; Aged* ; Female ; Freedom ; Hip Fractures* ; Hip* ; Humans ; Memory ; Orthopedics ; Quality of Life ; Range of Motion, Articular

BACKGROUND: We assessed the effectiveness of arthroscopic capsular release for the treatment of adhesive capsulitis. Further, we tried to ascertain the clinical benefits, if any, of pancapsular release over selective capsular release, where the two differ by performing or not performing a posterior capsular release, respectively. METHODS: Thirty-five consecutive patients with either primary or secondary adhesive capsulitis who failed conservative treatment for more than 6 months were enrolled in the study. A total of 16 patients allocated in group 1 received a pancapsular release that comprises the release of the rotator interval, anteroinferior capsular, and the posterior capsular release, whereas 19 patients in group 2 received a selective capsular release that comprises only the release of the rotator interval release and anteroinferior capsular release. The clinical outcomes, visual analogue scale (VAS) score, Constant score, and range of motion, were assessed preoperative and postoperatively. RESULTS: In both groups, the preoperative VAS score, Constant score, and ROM showed a significant improvement by the 6-month follow-up. We found that the immediate postoperative internal rotation was significantly higher in group 1 than group 2. Despite significant differences seen between the two groups at the initial postoperative period, there were no significant differences in Constant score, VAS score, and the ROM at all the subsequent follow-ups between the two groups. CONCLUSIONS: Arthroscopic capsular release for the treatment of adhesive capsulitis is very effective. However, pancapsular release did not show any advantage over selective capsular release in terms of overall clinical outcome.
Bursitis* ; Follow-Up Studies ; Humans ; Joint Capsule Release* ; Postoperative Period ; Range of Motion, Articular

No abstract available.
Aged* ; Child* ; Dislocations* ; Hip* ; Humans

The 35 patients of femur neck fracture treated with bipolar hemiarthroplasty were followed up for an average of 18 months with the range of 12 months to 5 years after bipolar hemiarthroplasty from Jan. 1986 to Dec. 1992. 1. Mean age of the patient was 68 years old(25-93) and mean hospitalization period was 55 days. 2. Associated medical problems were diabetes mellitus in 6 cases, cerebrovascular disease in 5 cases, rectal cancer in 1 case and pulmonary tuberculosis in 1 case. 3. An anterior dislocation, one of the early complication occured in 1 case, and superficial infection in 3 cases(8.5%), a deep infection, one of the late complication occured in 1 case. 4. The clinical result was focus on the functional hip assessment of bipolar hemiarthroplasty after femur neck fracture, and the functional results evaluated by Lunceford's Method were excellent in 22 cases(63%), good in 5 cases(14.3%), fair in 5 cases(14.3%), poor in 3 cases(8.6%). 5. The bipolar hemiarthroplasty was satisfactory method for the displaced femur neck fracture in the elderly patients, but to return the patient's preinjury activity level, more active postoperative rehabilitation should be required.
Aged ; Cerebrovascular Disorders ; Diabetes Mellitus ; Dislocations ; Femoral Neck Fractures ; Femur Neck ; Femur ; Hemiarthroplasty ; Hip ; Hospitalization ; Humans ; Methods ; Rectal Neoplasms ; Rehabilitation ; Tuberculosis, Pulmonary

Core decompression is still widely used in avascular necrosis of the femoral head but the results are unpredictable and the indications are not settled yet. The reparative process of the decompressed femoral head is poorly understood. Seven cases in 5 patients were undertaken THRA following failed decompression and these were studied for the radiological and pathological changes of the core tracts. The lesions of failed cases were involved more than 1/3 of femoral head on MRI and all cases were stage II A or B. The extent of the necrotic area in MRI was enlarged with crack, sclerosis and sometimes gas collection. Depression of the subchondral plates were also observed. Capillary ingrowth or neovascularization was not found at all and there were only fibrosis, inflammatory response and foreign body reactions.
Capillaries ; Decompression* ; Depression ; Fibrosis ; Foreign Bodies ; Head* ; Humans ; Magnetic Resonance Imaging ; Necrosis* ; Sclerosis

Three patients with complex partial seizures had dysembryoplastic neuroepithelial tumor (DNET) in temporal lobe. In all cases, longterm video-EEG monitoring showed epileptogenic focus in left temporal lobe where small mass lesion was located. For further seizure localization and functional mapping, subdural grids were placed on left temporal lobe including lesions. Lateral temporal lobectomy with lesionectomy was performed in two cases. Lateral temporal lobe resection and amygdalohippocampectomy was done in one case. The pathological findings of all lesions were characterized by intracortical location, multiple nodular architecture, foci of dysplastic cortical disorganization and the presence of a specific glioneuronal element. All patients have been seizure free.
Epilepsy, Temporal Lobe* ; Humans ; Neoplasms, Neuroepithelial* ; Seizures ; Temporal Lobe*

No abstract available.

Leiomyomatosis peritonealis disseminata is a rare benign condition characterised by the occurrence of multiple leimyomas scatterred throughout the peritoneal cavity, giving the clinical impression of a wide spread malignant tumor. The histopathology of leiomyomatosis peritonealis disseminata is that of a benign leiomyoma, probably originating from the multipotent subcoelomic mesenchymal cells. Three cases with malignant transformation were described among previous reported fifty cases. Many of the early reports described the disorder in premenopausal women, and now the histogenesis is considered to be a metaplastic change by abnormal tissue response to the relatively or absolutely elevated female sex hormone. We report a case of leiomyomatosis peritonealis disseminata, which was diagnosed by multiple scattered submucosal and subseroal leimyomas of stomach, small bowel and colon, combined with advanced gastric cancer in a 58 years old man, Multiple submucosal tumors of the stomach combined with advanced gastric cancer were demonstrated by fibergastroscopy, upper gastrointestinal barium study and abdominal ultrasonography. During radical subtotal gastrectomy multiple submucosal and subserosal tumors of stomach, and subserosal tumors of small bowel and colon were observed and these tumors were confirmed as leiomyoma without malignant potential.
Barium ; Colon ; Female ; Gastrectomy ; Humans ; Leiomyoma ; Leiomyomatosis ; Middle Aged ; Peritoneal Cavity ; Stomach ; Stomach Neoplasms* ; Ultrasonography

PURPOSE: Literature shows that low rectal cancer, that especially undergoing abdominoperineal resection (APR), is worse than mid or high rectal cancer. Two reasons have been proposed: diverse lymphatic channels in the low rectum, and technical difficulty in performing the APR. By comparison with the results reported in representative literature, we tried to find out whether low rectal cancer is really worse oncologically than high rectal cancer. METHODS: For 133 patients who underwent an APR from 1995 to 2005, we examined the pathological characteristics of the cancer, the recurrence, the metastasis, the survival rates, and the prognostic factors. RESULTS: The patient distribution according to stage was 15.9% in stage I, 33.6% in stage II, and 50.4% in stage III. The overall 5-year actuarial survival rate (5SR) of patients undergoing a curative resection (n=113) was 74.6%. Local pelvic recurrence was found in 11.5% of the patiennts, and systemic metastasis was noted in 14.2%. Among several prognostic variables, lymph node metastasis, the number of metastatic lymph nodes, adjuvant chemotherapy, and the distance between the tumor border and the dentate line were significant factors. In the multivariate analysis, lymph node metastasis was the most significant prognostic factor. CONCLUSIONS: It is true that a curative resection in low rectal cancer is difficult due to the anatomy of pelvis, so knowledge of the anatomic features of the pelvis and surgical skill are important. definitely, acceptable oncological results can be attamed if the rule of curative resection is obeyed. We also found that lymph node involvement was the most significant prognostic factor in low rectal cancer.
Chemotherapy, Adjuvant ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Pelvis ; Rectal Neoplasms* ; Rectum ; Recurrence ; Survival Rate