A case of aneurysmal bone cyst is reported in a 23 years old male, who complained of pain and tenderness on the right lateral aspect of thigh, This case had been treated with radical curettage and autogenous bone graft, but eight months later the radiological evidence of recurrence was present. So he was reoperated and he has been recovered relatively gradually, Roensgenograms of 7 montbs duration after reoperation showed abundent new bone formtion and no evidence of recurrence.
Aneurysm ; Bone Cysts ; Curettage ; Femur ; Humans ; Male ; Neck ; Recurrence ; Reoperation ; Thigh ; Transplants

Ewing's Sarcoma is a rapidly growing malignant neoplasm that arises from primitive cells of the bone marrow in young persons. This case, a seventeen year-old male, complained of pain and swelling on the both knee. He had been treated under the impression of osteomyelitis at several local clinics. Clinically, malaise and high fever were continued during admission period. Microspically it was confirmed as Ewing's Sarcoma and then he was discharged. Presently he is under the radiation therapy.
Bone Marrow ; Fever ; Humans ; Knee ; Male ; Osteomyelitis ; Sarcoma, Ewing

No abstract available.
Child* ; Humans ; Neurons*

The purpose of this study is to introduce the patients with bilateral cleft lip nose have lots of distinctive anatomical features such as short columella, inferior displacement of the medial crura of alar cartilage, lowering of the alar dome, flattened tip of the nose, widened nostril sill and prominent vestibular skin web. Although millard, Kaplan and Wray have introduced columellar lengthening by fork flap, it was difficult to achieve satisfying results without reconstructing the nasal skeletal framework of the cleft lip nose deformity for their anatomical distinctiveness. We have performed rhinoplasty on 7 patients with bilateral cleft lip nose from January. 1995 to August. 1997, using onlay calvarial bone graft and suture suspension technique. Operation was performed on basic anatomical structure, skeletal framework using outer table of calvarial bone pushed into the nasal tip area and suspension suture was applied to the framework with anteroinferior projection of nasal tip projection vector by cantilever effect of the calvarial bone which carried out nearly normal anatomical nasal structure. We have obtained satisfying results without complication in all seven cases. In conclusion the method which authors have used shows several advantages. First, it was possible to obtain the substantial skin lengthening in anterior and inferior direction by "Tent-Pole effect" in which creating bony structure projected into nasal tip and traction suturing of the deformed alar cartilages. Secondly, columellar lengthening and close to normal nostril shape was obtained and thirdly, re-deformation of corrected structure was prevented. An expected problem in above method is resorption of grafted calvarial bone which expected to maintain its position under influence of alternation and reformation by reaction between chondroblast and chondroclast results in fibrous tissue replacement, yet long term follow up is necessary for futher evaluation.
Cartilage ; Chondrocytes ; Cleft Lip* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Inlays ; Nose* ; Rhinoplasty ; Skin ; Sutures* ; Traction ; Transplants*

Since May 1981, the standard method of treatment of the femoral shaft fractures at the Daejeon EuIji Deneral Hospital has been the closed intramedullary nailing technique of Kuntscher. We performed intramedullary nailing on thirty-five fractures of femoral shaft in 35 patients. Closed intramedullary nailing was used in twenty-eight femora and open intramedullary nailing with cerclage wiring in seven fractures, in which large butterfly fragment was present, precluding control of rotation or length, or both. The overall rate of union was 97 percent. The range of motion of the knee at follow up was good in 80%, fair in 14%, poor in 6% (Good Full extension; loss of flexion less than 10 degrees. Fair Any loss of extension;loss of flexion of 10 to 50 degrees, Poor Loss of more than 10 degrees of extension; range of flexion-extension less than 90 degrees). The advantages of this technique include the negligible risk of infection, the rapid stabilization of fracture, thus facilitating management of other associated injuries, the rapid return of function of the knee, and early union of fracture and return to work. It is authors' opinion that when proper equipment and expertise are available, than closed intramedullary nailing is the treatment of choice not only for simple uncomminuted fracture of the femoral shaft but also for open comminuted fractures.
Butterflies ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Humans ; Knee ; Methods ; Range of Motion, Articular ; Return to Work

Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as therapeutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Drainage ; Endoscopes ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Ligaments ; Needles ; Sphincterotomy, Endoscopic

No abstract available.
Immunocompromised Host* ; Kluyvera* ; Sepsis*

PURPOSE: Recently, indirect lymphangiography has been developed as a relatively good and noninvasive imaging modality of the lymphatic system at extremities. But the disadvantage of the indirect lymphangiography is a low contrast ratio between the surrounding tissues and the contrast media in lymphatic vessels, because dimeric nonionic contrast media is water soluble and diluted in the proximal leg lymphatic vessels. We could have relatively better image than previously published images for the leg lymphatic system, when we injected contrast media with adequate high pressure in intradermal space of the interdigital areas at the foot dotsum. So, we would like to report the results. MATERIALS AND METHODS: We could study all 9 lymphedemas(primary :6, secondary: 3) from April 1990 to May 1993 on outpatient base. They were diagnosed as lymphedema clinically and radiologically. Ten ml of dimeric nonionic aget, iotrolan(Isovist 300 ) was injected into intradermal space with five 30-gauge needles The injection speed was more than 0.2mi/min. We have done one side pedal lymphangiogram in 30 minutes. The evaluation of the anterior superficial lymphatics was accordig to the criteria of the Weissleder(2). RESULTS: The results were as follows:1. All lymphatic vessels from foot to inguinal area could be visualized. 2. Two or three inferior inguinal lymph nodes could be visualized about 42%. 3. The most common abnormal finding of the lymphedma was the neovascularization of the lymphatics on indirect pedal lymphangiogram. CONCLUSION: If we use adequate technique relatively high pressure injection, correct intradermal needle insertion, adequate soft tissue exposure technique indirect lymphangiography is considered to be a safe and noninvasive imaging modality for the evaluation of the lymphedema of lower extremity lymphatics including inferior inguinal lymph nodes.
Contrast Media ; Extremities ; Foot ; Humans ; Leg ; Lower Extremity ; Lymph Nodes ; Lymphatic System ; Lymphatic Vessels ; Lymphedema ; Lymphography* ; Needles ; Outpatients

There is room for debate in appropriate diagnosis and treatment due to physiological and anatomical differences in pediatric facial bone fractures from that of adult's. The objectives of this article is to analyze for our clinical cases and to suggest the appropriate management of facial bone fracture in children. The study included 56 children who had treatment for the craniofacial fractures form March, 1990 to February, 1998. Their ages ranged from 3 to 15. There were 38 males and 18 females. Physical examination, simple x-rays, ultrasonograms and routine CT scans were used for diagnosis. Materials were classified into 28 nasal bone fractures, 4 nasoethmoidal fractures, 6 orbital fractures, 8 mandible fractures, and 10 zygoma fractures. Patients were treated with conservative treatment in 9 cases, with closed reduction in 28 cases and open reduction only, and 14 patients with open reduction and internal fixation using microplates and screws. 3 patients needed autogenous calvarial bone graft. Plates and screws were removed in postoperative 3-6 months. All patients had successful union of fractured bones without no specific complications, and normal bony growths were noticed during the 7 years follow up. We conclude that surgeons should be careful in diagnosis and management for the pediatric facial fracture due to anatomical variations and differences in fracture aspects. First, it is mandatory for surgeous to get accurate diagnosis and identify children's fracture and displacement through routine CT check up along with physical examination. Second, it is important to perform the minimally invasive technique or conservative treatment for the children with mild displacement so that it reduces the incidence of growth retardation which may be caused by extensive operation. However, application of rigid fixation is necessary in case of extensive bony displacement or bony defects because of poor coorporation in postoperative care. Third, plates and screws which were used for the internal fixation should be removed at 3-6 months after the surgery. Fourth, if bone graft is needed, it is better to use autogenous graft than allogeneous graft. Fifth, care for dentition and follow up for growth are necessary for growing children.
Child ; Dentition ; Diagnosis ; Facial Bones* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mandible ; Nasal Bone ; Orbital Fractures ; Physical Examination ; Postoperative Care ; Tomography, X-Ray Computed ; Transplants ; Ultrasonography ; Zygoma

No abstract available.
Female ; Pregnancy ; Pregnancy in Adolescence*