No abstract available.
Thyroid Gland* ; Thyroid Neoplasms*

The result of clinical survey of seventy-five children with supracondylar fractures of the humerus is presented. Sixty-eight fractures had gross displacement, and seven were undisplaced ones. Seven children with undisplaced fractures were treated with simple splinting. Twenty-one fractures with gross displacement were closedly reduced and immobilized by cast. Twenty cases treated with over-head skin traction or skeletal traction, and followed by cast immobilization, and twenty-seven were operatively reduced and were fixed with 2 K-wires. The results obtained were as follows: 1. The average age of children was 6.8 years, and the male and female ratio was 2.1:l. 2. 97.1% (66 cases) was the extension type and 2.9% (2 cases) was the flexion type. 3. Good end results were obtained in the well-reduced groups, such as undisplaced fractures and surgically reduced fractures. Of 27 operated cases, 19 who had early operation without manipulative trial or traction, had excellent results, while 8 who had surgery in delay developed limitation of flexion and/or extension motion of the elbow. Of these 19, two cases developed mild extension limitation as sequella. 4. As complications, incomplete ulnar nerve palsy developed in one case, but it spontaneously recovered in 3 weeks after open reduction. During treatment utilizing the olecranon pin traction, pin tract infection developed in 2 cases, but the infection was controlled by the antibiotic administration and wound dressing. Severe cubitus varus deformity developed in 4 cases among the conservatively treated group (manipulatively reduced group and skeletal traction group). These 4 children had corrective osteotomy. Mild deformity was the inevitable one when it is treated conservatively. Limitation of elbow motion developed in 23 cases (32%) as a sequella. 5. Fracture healed mostly in three weeks after reduction and immobilization. Average hospital stay for conservatively treated patients was 17.2 days, whereas that for surgically treated patients was 5.8 days in average. 6. Early anatomical reduction by any means whether it is surgical or nonsurgical, proved to be only the methods which bring the satisfactory results, and minimize the sequellae.
Bandages ; Child ; Congenital Abnormalities ; Elbow ; Female ; Humans ; Humerus ; Immobilization ; Length of Stay ; Male ; Olecranon Process ; Osteotomy ; Skin ; Splints ; Traction ; Ulnar Neuropathies ; Wounds and Injuries

Most cases of spondylolisthesis are asymptomatic and successfully managed with conservative treatment. Operation was performed in 20% of symptomatic cases having severe back pain, neurological symptoms and or progressive slipping. Although surgical treatments are divided into decompression and fusion, various methods were tried frorn simple Gill's resection to posterior and/or anterior fusion with instrumentation in case of severe slipping. The authors reviewed 49 cases of symptomatic spondylolisthesis, who were surgically treated, and well followed up at Kang-Nam St. Mary's Hospital during past 6 years from January, 1981, to June, 1987. l. Among 49 cases, 23 were isthmic type and 26 were degenerative in nature, and 40 were females. 24 patients(92.3%) of degenerative type were female over 4th decade. Mean age was 47.9 years. 2. The most common site of involvement was L4–5 intervertebral space(25 cases,; 51.0%). 17 cases(73.9%) of isthmic thpe were involved in L5-Sl intervertebral space, and 21 cases (80.8%) of degenerative type were involved L4–L5 intervertebral space. 3. The symptoms were low back pain, intermittent claudication and sciatica in order of incidence. 4. The average slipping measured by Taillard method was 19.5%, and Meyerding's grade I slipping(69.3%) was the highest in the percentile incidence. The average degree of slipping in isthmic type(23.6%) was greater than that of degenerative type(16.4%). 5. Myelogram mainly showed complete or near complete block in degenerative type and ventral indentation in isthmic type. C–T myelogram showed mainly central stenosis in degenerative type, and nerve root compression in isthmic type. 6. In 9 cases,anterior fusions were done ; 5 degenerative and 4 isthmic. In 37 cases, decompression and posteriolateral fusions were done with or without instrumentation ; instrumented in 11 cases. 7. Clinically, the results were judged as excellent in 16 cases(32.7%), good in 26 cases(53.1 %), fair in 6 cases(12.2%), poor in 1 case(2.1%). Thus, 42 cases(85.8%) were considered satisfactory. The satisfactory results were obtained in 77.8% of anterior interbody fusion cases, 88 5% of posterolateral fusion cases, 90.7% of decompression and posterolateral fusion with instrumentation cases. There was no appreciable difference in clinical results between isthmic and degenerative types. 8. There were no changes in slipping in 35 cases(71.5%), Partial reduction were possible in 13 cases(28.5%), and further splipping developed in a patient who had decompression surgery alone. Among 46 cases of vertebral fusion, complete fusion was obtained in 43 cases(93.5%) within one year. 9. Solid anterior spondylodesis was obtained in all the cases of degenerative type, while in 2 cases(50%) of the isthmic type, graft crumbled with redisplacement and delayed fusion. Through the results, it is concluded that posterior instrumentation may not be essential for the successful spondylodesis in cases of posterolateral fusion, since there was no statistical significance in the results between the instrumented and non-instrumented, and isthmic type and degenerative type, and that anterior interbody fusion is best indicated for the treatrment of the degenerative type and not for the isthmic type. Therefore, if anterior interbody fusion is chosen for the successful treatment of isthmic type, a certain type of internal fixator should be combined.
Back Pain ; Clinical Study ; Constriction, Pathologic ; Decompression ; Female ; Humans ; Incidence ; Intermittent Claudication ; Internal Fixators ; Low Back Pain ; Methods ; Radiculopathy ; Sciatica ; Spinal Fusion ; Spondylolisthesis ; Transplants

The MR images of 13 patients with brain abscesses were retrospectively reviewed. The abscesses were solitary in 11 patients and multiple in 2 patients. They were located in the corticomedullary junction of the cerebral hemispheres(11) and cerebellum (2).: The sizes of the abscesses were variable, ranging from 1 cm to 5 cm in diameter. They were round (5), oblong (4) or multilobulated (4) in shape. Massive surrounding edema was found in 12 patients. The signal intensity of the abscess contents was hypointense to gray matter and hyperintense to CSF on T1-weighted images, and hyperintense to gray matter on both proton-density-and T2-weighted images. In 5 patients the abscess contents were heterogeneous on both T1-and T2-weighted images. The signal intensity of the abscess walls was isointense(11), slightly hyperintense (1) or hypointense (1) relative to gray matter on T1-weighted images, whereas they were isointense (4) or hypointense (9) on T2-weighted images. Of 10 patients with Gd-enhanced-T1-weighted images, 5 patients(50%) showed thin, smooth, rim enhancement, while the other 5 patients revealed somewhat irregular thick wall enhancement Satellite or daughter abscesses were found in 6 patients. Meningeal or ventricular wall enhancement suggesting meningitis or ventriculitis was associated in 3 and 1 patient, respectively. In conclusion, the characteristic morphology and intensity of the abscess capsule, massive surrounding edema, satellite abscess and associated meningitis or ventriculitis are characteristics of the brain abscess, even though they are not entirely specific to allow for accurate diagnosis in all patients.
Abscess ; Brain Abscess* ; Brain* ; Cerebellum ; Diagnosis ; Edema ; Gray Matter ; Humans ; Magnetic Resonance Imaging* ; Meningitis ; Nuclear Family ; Retrospective Studies

The principal cause of avulsion fracture of anterior superior iliac spine is sudden powerful contraction of sartorius muscle in strenuous sporting activities. The condition usually occurs in young people in whom the apophysis has still not firmly united to the ilium. We presented the three cases of avulsion fracture of anterior superior iliac spine which occurred during sprinting in Physical Fitness Test.
Ilium ; Physical Fitness ; Spine ; Sports

Dislocation of the elbow joint is so frequent an injury, and its treatment so standardized, that most of the recent orthopaedic study devoted to the subject has focused on neurovascular complication or recurrent dislocation. Some authors reported minimal period of disability and better range of extension after three to five days short-term immobilization in simple acute dislocation. We, authors, had analyzed clinically 17 cases of acute dislocation of elbow joint who were treated at orthopaedic department of Catholic Medical College from Jan., 1978 to Dec., 1981. The results obtained were as follows: 1. The most prevalent age were second and third decades (76.5%). Males predominated by a ratio of 13:4. 2. The major mode of injury was slip down accident (58.8%). All cases were acute simple dislocation without open wound. 3. Posterolateral, dislocations were 13 cases (76.5%) and posterior dislocations were 3 cases (17.6%). These two type of dislocation were 94.1% of all cases. No anterior dislocation was noted. 4. Four fractures of radial head and one fracture of lateral epicondyle of humerus were seen. Associated fractures were noted in 29.4% of all cases. 5. Severe complication was none except one recurrent habituai dislocation and limitation of elbow extension, averaging 10.5 degrees, 6. In 9 cases which were immobilized for 3 to 5 days had an average loss of extension of 6 degrees and an average of 7 weeks of disability. In 7 cases which were immobilized for 3 weeks had an average loss of extension of 18 degrees and an average of 18.3 weeks of disability. Therefore, immediate reduction and 3 to 5 dhys of immobililization is excellent treatment for uncomplicated dislocations.
Clinical Study ; Dislocations ; Elbow Joint ; Elbow ; Head ; Humans ; Humerus ; Immobilization ; Male ; Wounds and Injuries

Subluxation of hip is a disease commonly experienced in orthopaedic field, which is classified into primary subluxation and secondary subluxation. Generally, secondary subluxation of the hip in children who once suffered from infected hips, Legg-Calve-Perths disease and also as sequellae of incompletely treated congenital dislocation of the hip can be often seen in Korea. Especially in Korea, subluxation of the hip with some destruction of the affected femoral head frequently arose from late complication of the tuberculous or septic hip in children. But, no definite treatment for the condition was established and no satisfactory results were obtained with various operative methods. Authors experienced satisfactory result by combining the intertrochanteric varus osteotomy and administration of crystalline glucosamine sulphate (Viatril, Rotta pharmaceuticals, Italy) in subluxated burnt-out tuberculous hip of 6 years old male.
Child ; Crystallins ; Dislocations ; Glucosamine ; Head ; Hip ; Humans ; Korea ; Male ; Osteotomy ; Tuberculosis

Previously severe multiple injuries associating the segmental fractures of the femurs were reported to be rare, and as a rule were fatal when surgeons did not immediately give or provide excellent care. Recently many patients having those injuries are quite often encountered at the clinic. The reason is high incidence of the mass casualties by road accidents, mine accidents and accidents at the industrial complexes. Also as the other reason, the advanced resuscitative measures which could do many of these patients to survive can be listed. For those severely injured patients associating segmental fracture of the femur, the more positive and efficient diagnostic and therapeutic measures have to be sought. Authors analyzed the 18 cases of segmental fractures of the femurs who were treated at the Orthopedic department of Catholic Medical College & Center from Jan., 1974 to Dec., 1979. The results obtained were as follows: 1. The male patients outnumbered the female in ratio of 13/5, and the most were at their 4th and 5th decade of age. 2. Traffic accident was the main cause of the injury; 13 out of 18 cases. Remaining 5 cases sustained injury by industrial accident. 3. All but one were closed fracture, and segmental shaft fracture was the commonest type of them; 10 out of 18 cases. 4. Thirteen patients accompanied significant injuries to other vital organ and/or other musculoskeletal system. 5. In entire cases the average union time in the proximal fracture was 28.9 weeks, and in the distal one 17.5 weeks. 6. Fractures regardless of their group that needed late bone grafting procedure numbered 7; 6 in the proximal shaft fracture and one in the distal fracture. 7. In 10 cases of the segmental shaft fracture (Group III fracture), bony union in the proximal fracture was obtained at 29.6 weeks in average. Proximal fractures in 4 cases in this group needed late bone grafting. Through these results it is suggested that in the treatment of segmental fracture of the femur, primary bone grafting at the proximal fracture site is beneficial to promote fracture healing or to prevent delayed union or nonunion especially when the proximal fracture is located across mainly the cortical part of the bone. Methods of treatment necessarily have to be selected according to the site and shape of the fracture, and in cases of segmental shaft fracture Kuntscher nailing is preferably recommended although the distal fracture site is not ideal one for the Kiintscher nail fixation.
Accidents, Occupational ; Accidents, Traffic ; Bone Transplantation ; Female ; Femur ; Fracture Healing ; Fractures, Closed ; Humans ; Incidence ; Male ; Mass Casualty Incidents ; Multiple Trauma ; Musculoskeletal System ; Orthopedics ; Surgeons

The instability of the degenerative spondylolisthetic lumbar spine was clinically evaluated by patients symptoms and serial radiograms. With X-ray films of patients lumbar spine, the lumbosacral angle, the sacral angle, the vertebral height difference between anterior and posterior surface of the 5th lumbar vertebra and the level of intercristal line were analysed. And the results of treatment were analysed too. The Results were as follows: 1) In degenerative spondylolisthetic L3 and L4 spines, facets were arranged in sagittal plane and sacrum was vertically arranged, but in L5 facets were coronally arranged and sacrum and in horizontal plane. 2) The lumbosacral angle was 149.9 and the average difference between anterior and posterior height of L5 vertebral body was 3mm. These results revealed that sacrum was more vertical and the 5th vertebral body was more rectangular, so lumbar lordosis was decreased as a whole. 3) The intercristal line was passed at IA or L4–5 interspace in 72.1% of cases(normal:95.8%), so L4 vertebra was placed in higher level. 4) In group A posterolateral fusion was done in 2 cases. Among group B and C, operation was done in 9 cases;4 cases with laminectomy and 5 cases with laminectomy and posterolateral fusion. Two years after surgery, slipping and instability were far advanced in 2 laminectomized cases for whom posterolateral fusion was followed later. 5) Unstable group of degenerative spondylolisthesis with severe neurological symptoms and claudication must be treated by decompressive laminectomy and posterolateral fusion, especially in patients under 60 years of age. 6) Young woman having flattened lumbar curve without slipping, narrowed disc space of L4–5, high-seated L4 and vertical sacrum is thought to be in prespondylolisthetic stage of degenerative origin; therefore, intensive back muscle exercise to prevent the slipping should be performed and periodic X-ray examinations should be followed up to detect the progress of the disease.
Animals ; Back Muscles ; Female ; Humans ; Laminectomy ; Lordosis ; Sacrum ; Spine ; Spondylolisthesis ; X-Ray Film

Cysticercosis which very rarly involves spinal canal, may show symptoms similar to herniated nucleus pulposus and cord tumor, and even myelogram may not be helpful for the accurate diagnosis. In this paper, a case in which free floating larvae of taenia solium mimicking intradural tumor by myelogram and clinical symptoms were presented. The present authors feel that cysitcercosis has to be considered as a cause when there is central filling defect of contrast media in myelogram.
Contrast Media ; Cysticercosis ; Diagnosis ; Larva ; Spinal Canal ; Spine ; Taenia solium