No abstract available.
Child* ; Fracture Fixation, Intramedullary* ; Humans

No abstract available.
Female ; Ovary* ; Theca Cells* ; Thecoma*

Rigid posterior fixation of the atlas to the third and fourth cervical spine was achieved in a patient in whom axis pedicle fracture and dislocation of axis on the third cervical spine. Althouth there was no evidence of neurologic disorder, marked instability of axis on the third cervical spine should inevitably be fused in any procedures. An anatomically contoured loop was secured to the posterior arch of the atlas and the laminae of the third and the fourth cervical spine by sublaminar wirings. The technique has the advantage over bone graft, either alone or with cement, in that it affords rigid stabilization, allows early mobilization and some flexion movement of atlanto-occipital joint.
Atlanto-Occipital Joint ; Dislocations ; Early Ambulation ; Humans ; Nervous System Diseases ; Spine ; Spondylolisthesis ; Transplants

Recently, the 5-year survival rate of rhabdomyosarcoma has been greatly increased by combining therapy with radical surgery, radiation and chemotherapy. But it still has poor prognosis and there are few case reports of rhabdomyosarcoma of head and neck with long term survival rate. Here, we treated a rhabdomyosarcoma patient with radical surgery, radiation and chemotherpy. The patient visited our hospital in 1990 with a complaint of left facial protruding mass, diplopia and exopthalmos. She was diagnosed as rhabdomyosarcoma involving maxillary sinus and orbit. In september 1990, she received left total maxillectomy and eyeball exentration. After the surgery, we applied a 5000 cGy neutron therapy, 2000 cGy external radiation and 9 cycle pulse, along with VAC chemotherapy. She remains free of disease as of her last follow-up in February 1998.
Diplopia ; Drug Therapy ; Follow-Up Studies ; Head ; Humans ; Maxillary Sinus* ; Neck ; Neutrons ; Orbit* ; Prognosis ; Rhabdomyosarcoma* ; Survival Rate

OBJECTIVE: Two-dimensional fluoroscopy-based computerized navigation for the placement of pedicle screws offers the advantage of using stored patient-specific imaging data in providing real-time guidance during screw placement. The study aimed to describe the accuracy and reliability of a fluoroscopy-based navigation system for pedicle screw insertion. METHODS: A total of 477 pedicle screws were inserted in the lower back of 96 consecutive patients between October 2007 and June 2012 using fluoroscopy-based computer-assisted surgery. The accuracy of screw placement was evaluated using a sophisticated computed tomography protocol. RESULTS: Of the 477 pedicle screws, 461 (96.7%) were judged to be inserted correctly. Frank screw misplacement [16 screws (3.3%)] was observed in 15 patients. Of these, 8 were classified as minimally misplaced (< or =2 mm); 3, as moderately misplaced (2.1-4 mm); and 5, as severely misplaced (>4 mm). No complications, including nerve root injury, cerebrospinal fluid leakage, or internal organ injury, were observed in any of the patients. CONCLUSION: The accuracy of pedicle screw placement using a fluoroscopy-based computer navigation system was observed to be superior to that obtained with conventional techniques.
Cerebrospinal Fluid ; Humans ; Surgery, Computer-Assisted

Right atrial metastasis occurs in 1 to 4% of patients with hepatoma. and the extention to intracavitary or metastasis of tumor as a large mass rare. However, the high risk of progressive heart failure and sudden death from the tricuspid valve obstruction necessitates prompt diagnosis of intracavitary extension, and adequate intervention is needed to prolong a patient's life. A 49 year-old female was referred to our hospital for further evaluation of a liver mass, which was identified at a local clinic. The liver mass was confirmed as hepatocellular carcinoma with CT and celiac angiographic finding. She was treated with transarterial chemoembolization. Thirty-four months after discharge, a low density right atrial mass was noted incidentally with chest computed tomography while investigating massive right pleural effusion for possible pulmonary metastasis. Echocardiography showed a huge inhomogenous echogenic mass at the right atrium. The present report describes a case of primary hepatocellular carcinoma with a intracavitary cardiac mass detected with two dimensional echocardiography.
Carcinoma, Hepatocellular* ; Death, Sudden ; Diagnosis ; Echocardiography ; Female ; Heart Atria ; Heart Failure ; Humans ; Liver ; Middle Aged ; Neoplasm Metastasis ; Pleural Effusion ; Thorax ; Tricuspid Valve

Intervertebral disc herniation is rare in adolescence, although several cases have been reported in the literature. We present three cases of lumbar disc herniation with low back pain and severe scoliosis (Cobb angle greater than 20 degrees). The patients had no prior history of trauma or collagen disease. Preoperative MRI scans showed L3-L4 (case 1), L4-L5 (case 3) and L5-S1 (case 2) disc herniations with no other bony or structural changes. Following discectomy, patient pain resolved, and scoliosis improved without further treatment. We conclude that severe scoliosis associated with disc herniation in young patients is likely secondary to pain and is not indicative of further structural changes.
Adolescent ; Collagen Diseases ; Diskectomy ; Humans ; Intervertebral Disc ; Low Back Pain ; Magnetic Resonance Imaging ; Scoliosis

Time to time, we face patients who missed the proper time for primary palatal repair. Although we do not have enough available documents, it is important to establish efficacy of palatal repair in patients more than 4 years old. From May 1995 to March 2005, we selected 14 patients who underwent palatal repair in more than 4 years old patients and they are able to tolerate speech articulation tests. Out of 14 patients 5 males an 9 females in sex, aged form 4 to 50 years old. 6 patients with incomplete cleft palate and 8 patients with submucous cleft palate. Double reversing Z-plasty(n=5), pushback palatoplasty(n=4), two flap palatoplasty(n=2), von Langenbeck palatoplasty(n=2), and intravelar veloplasty(n=1) were performed. Preoperative and postoperative speech articulation test, "Simple method of speech evaluation in Korean patients with cleft palate", were conducted. Satisfaction rate was sorted into 5 levels. There is no significant statistical correlation in the speech improvement, satisfaction rate, patients sex, cleft type and operative method. But there is significant statistical correlation between the speech improvement and patienet's age. There were better result in younger patient group than aged patients group.
Child, Preschool* ; Cleft Palate ; Female ; Humans ; Male ; Middle Aged ; Speech Articulation Tests

Epinephrine is frequently used to control local bleeding during surgery. However, it may be associated with complications, such as pulmonary edema, reversible cardiomyopathy, and cardiac arrest. We encountered a case of stress induced cardiomyopathy (SIC) after local epinephrine instillation. The SIC is manifested with typical left ventricular apical ballooning and clinical symptoms of a myocardial infarction without coronary stenosis. Although its prognosis is more favorable than a myocardial infarction, anesthesiologists need to be aware of the possible adverse effects of local epinephrine infiltration.
Cardiomyopathies ; Coronary Stenosis ; Epinephrine ; Heart Arrest ; Hemorrhage ; Myocardial Infarction ; Prognosis ; Pulmonary Edema

Vertebroplasty (VP) is a well-known therapeutic modality used to treat pain associated with vertebral compression fractures. Major complications such as cord or root compression, epidural and subdural hematomas (SDH) and pulmonary emboli, occur in less than 1% of patients who undergo VP after compression fracture. Spinal SDH is an extremely rare complication that usually happens a few hours after the procedure. We report a case of spinal SDH that developed at two weeks after a successful VP. We also reviewed related literatures and discussed its possible pathogenesis.
Fractures, Compression ; Hematoma, Subdural ; Hematoma, Subdural, Spinal ; Humans ; Spine ; Vertebroplasty