No abstract available.
Femur Neck* ; Fractures, Stress*

No abstract available.
Ear* ; Replantation*

Fracuture-dislocation of the cuboid is an extremely rere injury compared with fracture-dislocation of other tarsal bones. We report a case of the fracture-dislocation of the cuboid treated by open reduction and internal fixation.
Tarsal Bones

The blood blister-like aneurysm (BBA) of the internal carotid artery (ICA) is a rare but clinically important cause of subarachnoid hemorrhage (SAH), which accounts for 0.5% of incidences of ruptured intracranial aneurysms. BBA is a thin-walled, broad-based aneurysm that lacks an identifiable neck and is one of the most difficult lesions to treat. In this paper, a case is presented of a 57-year-old woman with SAH. Her cerebral angiography demonstrated a small BBA on the dorsal wall of her right ICA. Endovascular treatment that consisted of a stent-within-a-stent was attempted, but the replacement of the second stent failed, and the aneurysm became bigger. Surgery was performed by clipping the BBA with a Sundt slim-line encircling graft clip. The patient completely recovered with no complications. This treatment may be a salvageable option for BBA, especially when endovascular treatment has failed.
Aneurysm ; Carotid Artery, Internal ; Cerebral Angiography ; Endovascular Procedures ; Female ; Humans ; Incidence ; Intracranial Aneurysm ; Middle Aged ; Neck ; Stents ; Subarachnoid Hemorrhage ; Transplants

Management of the impalpable testis is one of the controversial issues in cryptorchidism. So we studied to evaluate the usefulness of laparoscopy and surgical methods for impalpable testis. From January 1992 to December 1993, a total of 36 patients with impalpable cryptorchid was admitted to Seoul National University Children's Hospital. All the patients were examined by laparoscopy under general anesthesia. According to laparoscopic finding, in 15 patients with high abdominal testis, we performed 5 microscopic testicular autotransplantations and 10 testicular vessels transsections(Fowler-Stephens method). In other cases, We performed 9 standard orchiopexies and 6 orchiectomies. Complication of laparoscopy was not experienced. During mean follow up period of 12 months, success rate was 80% in microscopic testicular autotransplantation, 80% in testicular vessels transsection and 91% in standard orchiopexy. Therefore, we think that laparoscopy can be used safely to assess the accurate location of impalpable testis and that surgical methods including testicular autotransplantation are acceptable to high abdominal testis.
Anesthesia, General ; Autografts ; Cryptorchidism ; Follow-Up Studies ; Humans ; Laparoscopy ; Male ; Orchiectomy ; Orchiopexy ; Seoul ; Testis*

Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are 40~50's in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows; If the odds ratio of below 29 year of age is 1.0 then that of 30~39 is 1.74 (p=0.33), 40~49 is 2.47 (p=0.10), 50~59 is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of 0~9 is 5.08 (p<0.01), 10~19 is 12.37 (p<0.01), 20~29 is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of 100~120 is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below 29 micron/1 gamma-GT is 1.0 then that of 30~s59 is 2.11 (p<0.01), 60~90 is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then 150~199 is 1.49 (p=0.05), 200~250 is 1.09 (p=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and serum triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.
Alcoholism ; Alkaline Phosphatase ; Antigens, Surface ; Bilirubin ; Blood Glucose ; Cross-Sectional Studies* ; Diabetes Mellitus ; Diagnosis ; Early Diagnosis ; Fasting ; Fatty Liver* ; Female ; Hepatitis ; Humans ; Male ; Malnutrition ; Metabolism ; Obesity ; Odds Ratio ; Overweight ; Prevalence* ; Substance-Related Disorders ; Tetracycline ; Transferases ; Triglycerides ; Ultrasonography*

Glossopharyngeal neuralgia is a relatively rare condition characterized by severe, paroxysmal episodes of lancinating pain in the tongue, throat, ear, and tonsil. This disorder is assumed to be due to compression of the glossopharyngeal nerve by vascular structures. A 47-year-old woman complaining of sharp and lancinating pain in the right periauricular and submandibular areas visited our hospital. Swallowing, chewing, and lying on her right side triggered the pain. Her neurologic examination revealed no specific abnormalities. The results of routine hematologic and blood chemistry studies were all within normal limits. Carbamazepine and gabapentin were given, but her symptoms persisted. Her pain was temporarily relieved only by narcotic pain medication. MRI showed an arachnoid cyst located in the right cerebellomedullary cistern extending to the cerebellopontine cistern. Cyst removal was performed via a right retrosigmoid approach. Lateral suboccipital craniotomy was performed using the right park-bench position. After opening the dura and cerebellopontine angle, the arachnoid cyst was exposed. The arachnoid cyst was compressing the flattened lower cranial nerves at the right jugular fossa. Her symptoms resolved postoperatively. Two months after the operation, she was completely free from her previous symptoms.
Amines ; Arachnoid ; Carbamazepine ; Cerebellopontine Angle ; Cranial Nerves ; Craniotomy ; Cyclohexanecarboxylic Acids ; Deception ; Deglutition ; Ear ; Female ; gamma-Aminobutyric Acid ; Glossopharyngeal Nerve ; Glossopharyngeal Nerve Diseases ; Humans ; Mastication ; Middle Aged ; Neurologic Examination ; Palatine Tonsil ; Pharynx ; Tongue

To obtain the useful information for the status of working environment and health management of workers in manufacturing industries, comparision of results on the status of working environmental and health management of workers for 32 manufacturing industries in Chunam area from 1988 to 1989 was carried out. The results were as follows: 1. The rate of over-PEL(Permissible Exposure Limit) to for hazardous factors decreased significantly 23.5% in 1988, 18.3% in 1989 (p<0.05) and, the highest rate of over-PEL was the stone and sand handling industry, the highest rate of over-PEL was the dusty worplace as 38.5% in 1988, 35.2% in 1989. 2. The rate of workers exposed to hazardous factors in 1988 and in 1989 was 22.4% respectively, the rate of workers checked up special health examination was 40.1% in 1988, 75.3% in 1989. In stone and sand handling an dmedicochemical industries, none of workers exposed to hazardous factors was subjected to special health examination in 1988, but 75% of workers exposed to hazardous factors had checked up in 1989. 3. The 6 industries appointed as part-time factory physician among 17 industries which were supposed to have factory physician according to the Safety and Healthy Act of Korea, 6 out of 24 industries only appointed industrial hygienist, furthermore 4 out of 6 hygienists had another duty in addition to occupational hygiene itself.
Hygiene ; Korea ; Silicon Dioxide

Paraffin injection has been widely used to improve body contouring or to augment various body parts, although it has now been abandoned owing to serious complications. Paraffin injection may lead to complications after a long latency period, ranging from several years to several decades. Here, we present the rare case of a 77-year-old woman who suffered from recurrent wound problems after a bilateral paraffin injection into her hands 40 years ago. Initially, conservative debridement was carried out due to the patient’s reluctance to undergo extensive surgery and cost concerns. However, this resulted in recurrent wound dehiscence and infection. After serial debridement procedures, a skin graft was performed on her right hand. The patient complained of a depressed contour and numbness at the skin graft site, and tightness and discomfort of her right hand during flexion of the metacarpophalangeal joint. Three years later, the patient presented with a highly similar wound on her left hand. Thorough excision of the soft tissue infiltrated by paraffin was performed, followed by reconstruction using a sensate free anterolateral thigh flap. The patient responded well postoperatively without complications, displaying a fair range of motion without discomfort, sensory restoration of the flap, and satisfaction with the contour of the dorsum. This case report highlights the importance of complete excision of soft tissues infiltrated by paraffin for definitive treatment. Among the various reconstruction options, a sensate free flap is a good choice for achieving favorable functional and esthetic outcomes in hand reconstruction after radical excision of a paraffinoma.

Paraffin injection has been widely used to improve body contouring or to augment various body parts, although it has now been abandoned owing to serious complications. Paraffin injection may lead to complications after a long latency period, ranging from several years to several decades. Here, we present the rare case of a 77-year-old woman who suffered from recurrent wound problems after a bilateral paraffin injection into her hands 40 years ago. Initially, conservative debridement was carried out due to the patient’s reluctance to undergo extensive surgery and cost concerns. However, this resulted in recurrent wound dehiscence and infection. After serial debridement procedures, a skin graft was performed on her right hand. The patient complained of a depressed contour and numbness at the skin graft site, and tightness and discomfort of her right hand during flexion of the metacarpophalangeal joint. Three years later, the patient presented with a highly similar wound on her left hand. Thorough excision of the soft tissue infiltrated by paraffin was performed, followed by reconstruction using a sensate free anterolateral thigh flap. The patient responded well postoperatively without complications, displaying a fair range of motion without discomfort, sensory restoration of the flap, and satisfaction with the contour of the dorsum. This case report highlights the importance of complete excision of soft tissues infiltrated by paraffin for definitive treatment. Among the various reconstruction options, a sensate free flap is a good choice for achieving favorable functional and esthetic outcomes in hand reconstruction after radical excision of a paraffinoma.