Fractures of the patella are intra-articular fractures of a sesamoid bone. The goal of treatment is to restore the function of the extensor mechanism and congtvity of the articular surface of the knee. So postoperative traumatic arthritis is minimized by an accurate reduction of the articular surfaces. We analyzed nine cases of the patella fractures which were treated by the use of arthroscopy to allow visualization of and working inside of joints, and the use of the image-intensifier fluoroscope to allow real-time vi.sualization of the skeleton. The results were as follows The fixation of patelia fractures using an arthroscopy could be applied to transverse or vertical fractures without comminution and severe osteoporosis. 2. In the treatment of two types of patella fractures (simple transverse e rnarginal vertical fractures without comminution), clinically satisfactory results were obtained through the accurate reduction of articular surface using an arthroscopy and image intensifier.
Arthritis ; Arthroscopy* ; Intra-Articular Fractures ; Joints ; Knee ; Osteoporosis ; Patella* ; Sesamoid Bones ; Skeleton

No abstract available.
Cholesterol*

PURPOSE: To evaluate the appropriate correction of predicted intraocular lens (IOL) power when sulcus implantation due to posterior capsular rupture was performed and to compare the anterior chamber angle of sulcus-implanted eyes with in-the-bag implanted eyes using anterior segment optical coherence tomography (Visante OCT). METHODS: Fifty-two eyes of 52 patients who had IOL implantation in the sulcus due to posterior capsular rupture during cataract surgery were retrospectively reviewed. A 0.5 lower diopter IOL than predicted IOL power using SRK-T formula was chosen. The difference between the predicted refractive error and the spherical equivalence at the 3-month time-point after sulcus implantation were evaluated. Among 52 patients, 16 patients whose fellow eye had an in-the-bag IOL implantation underwent Visante OCT and the anterior angle of affected eyes and normal fellow eyes were compared. RESULTS: The difference between the predicted refractive error using SRK-T formula and the spherical equivalence after sulcus implantation was a myopic shift of 0.597 +/- 0.879 diopter. The mean iridocorneal angles, angle opening distance (AOD), trabecular iris surface area (TISA) at 500 um and 750 um for both nasal and temporal sides in sulcus implantation were all significantly lower than in-the-bag implantation. CONCLUSIONS: A choice of a 0.5 lower diopter power IOL than the power for in-the-bag implantation may be considered because of greater myopic shift than predicted refractive error when sulcus implantation due to posterior rupture is performed. Anterior chamber angle in sulcus IOL implantation was shallower than in-the-bag IOL implantation.
Anterior Chamber ; Cataract ; Eye ; Humans ; Iris ; Lens Implantation, Intraocular ; Lenses, Intraocular ; Refractive Errors ; Retrospective Studies ; Rupture ; Tomography, Optical Coherence

A total of 150women with singleton pregnancies who were delivered between 37 and 42weeks gestation had ultrasound scans on elective cesarean section day. The biparietal diameter(BPD), head circumference(HC), abdominal circumference(AC) and femur length(FL) were measured in all cases. Equations of estimated fetal body weight(BWT) for Korean term fetuses using AC alone, BPD/AC, AC/FL, HC/AC/FL, BPD/AC/FL, BPD/HC/AC/FL were made by stepwise multiple regression analysis and were compared with foreign equations such as Campbell(AC), Shepard(BPD/AC), Hadlock I(AC/FL), Hadlock II(HC/AC/FL), Hadlock III(BPD/AC/FL), and Hadlock IV(BPD/HC/AC/FL). The results were as follows. 1. The equations of BWT by sonographic measurement were Equation1 (AC) logeBWT=6.105936+0.005957X(AC) (R=0.876) Equation2 (BPD,AC)logeBWT=6.53614548+0.00004963X(ACXBPD) (R=0.929) Equation3 (AC,FL) logeBWT=6.25336442+0.00751602X(FL)+0.00005155X(ACXFL) (R=0.950) Equation4(HC,AC,FL) logeBWT=6.39631346+0.00004823X(ACXFL)+0.00002023X(FLXHC) (R=0.953) Equation5(BPD,AC,FL) logeBWT=5.99934074+0.00871394X(BPD)+0.00005132X(ACXFL) (R=0.960) 2. When BPD, AC and FL were measured, the addition of HC didn,t affected to accuracy of EFW 3. The best results of all equations were obtained with our equation 5(Mean error=2.36gm, Mean absolute error=96.39gm, Mean deviation + SD(%)=0.07+0.37) and among foreign equations, the best results were with Hadlock III equation(Mean error=18.35gm, Mean absolute error=107.82gm, Mean deviation + SD(%)=-0.46+0.42) 4. The equations using AC/FL (our equation 3, Hadlock I) are more accurate than those using BPD/AC (our equatione 2, Shepard) when utilizing two parameters. Therefore, equation using AC/FL is recommended when the BPD is unobtainable at term or labor 5. The percentage of cases in which the EFW was within +5% and +200gm of the actual birth weight was highest at our equation 5 for 82% and 89%, Hadlock IV equation for 79%, 88%. 6. Our equations had relatively an equal tendency to under- and overestimate fetal weight, but foreign equations, especially Campbell and Hadlock II equations tended to underestimate. 7. Analysing according to actual birth weight, our all equations gave the most accurate estimates of fetal weigh for birth weight group between 3000-3499gm, but for birth weight group above 3500gm, that was not. At birthweight group above 3500gm, the equations depend on femur length are more accurate than the equations independ on fumr length.
Birth Weight ; Cesarean Section ; Female ; Femur ; Fetal Weight* ; Fetus ; Head ; Pregnancy ; Ultrasonography

We present a study on hospital stay in 1000 consecutive head injuries. The mean hospital stay and standard deviation were calculated in a given condition according to some variables, such as sex, age, Glasgow Coma Score on admission, skull fracture, CT findings, and treatment. Usually, standard deviation was greater than the mean value in a given condition and hospital stay varied in a wide range, representing that the duration of treatment is related not only to the severity but also various individual properties. Since the associated injuries were variable in location, type and severity, they altered hospital stay greatly. Thus hospital stay was analyzed in patients without associated injuries. Hospital stay was largely dependant on three variables. Low Glasgow Coma Score on admission, presence of intracranial mass lesion or diffuse axonal injury, and operative treatment prolonged hospital stay. Skull fracture also lengthened hospital stay but only in patients without associated injuries. Duration of treatment should be recorded in all medical certificates related to the injury. For the proper estimation of duration of treatment, more reports are needed in this field.
Coma ; Craniocerebral Trauma* ; Diffuse Axonal Injury ; Head* ; Humans ; Length of Stay* ; Skull Fractures

PURPOSE: We wanted to report the our early experience with performing nephron-sparing radiofrequency ablation (RFA) of renal tumor. MATERIALS AND METHODS: Three percutaneous RFAs were performed under combined computed tomography (CT) and ultrasonogram guided, and two intraoperative ultrasonograpy-guided laparoscopic RFAs were performed since June 2004. The treatment indications were localized, small (<4cm), solid renal masses in elderly patients and also the same type masses in the patients with comorbid conditions. The follow-up studies included physical examination, CBC, serum creatinine, urine analysis and kidney CT, and these were performed at day 1, 1 week, 1 month, 3 months, 6 months and 1 year after ablation, and then semi-annually thereafter. The mean follow-up duration was 8.8 months (range: 5-12 months). RESULTS: All five patients underwent successful RFA without any serious events. One patient had a mild perinephric hematoma and another patients had mild gross hematuria postoperatively. With a mean follow-up of 8.8 months, none of the patients showed any residual tumor on follow-up contrast-enhanced CT after the final tumor ablation. Complete tumor ablation was achieved after a single treatment session in 80% of the patients and in 20% of patients after the subsequent ablation sessions. CONCLUSIONS: Percutaneous or laparoscopic RFA is a promising nephron-sparing treatment for selected patients with small renal mass. Contrast-enhanced CT performed immediately after ablation is a reliable method to exclude residual viable tumor. The ultimate role for this modality will continue to evolve and this warrants further studies.
Aged ; Catheter Ablation* ; Creatinine ; Follow-Up Studies ; Hematoma ; Hematuria ; Humans ; Kidney ; Laparoscopy ; Neoplasm, Residual ; Nephrons ; Physical Examination ; Tomography, X-Ray Computed ; Ultrasonography

No abstract available.
Compliance* ; Early Detection of Cancer* ; Family Practice* ; Humans

Double primary cancer is defined as the case of primary malignant tumors, which must be arise in different sites and have a different histologic appearences. The number of reported cases of double primary malignant tumors has increased in recent and the occurrence of multiple primary cancers in the same individuals is one of the interesting subjects for investigation and research in relation to the carcinogenic mechanism and/or genetic factors. We have experienced a case with double primary malignant tumors of different site origins such as stomach adenocarcinoma and rectal adenocarcinoma, which were diagnosed by biopsies with gastro and colono fiberscopy. For its great rarity, we report this case with review of literatures.
Adenocarcinoma ; Biopsy ; Rectum* ; Stomach*

PURPOSE: Tenosynovial giant cell tumors (TSGCT) can be classified into localized and diffuse types. To identify reliable diagnostic markers for these tumors, we compared clinicopathologic and immunohistochemical features in localized and diffuse type TSGCT. MATERIALS AND METHODS: Clinicopathologic and immunohistochemical studies were perfomed. Thirty cases which had been histologically diagnosed as TSGCT after surgery, at our hospital from 2000 to 2012, were analyzed. RESULTS: There was no statistically significant difference between the groups for gender, age, site, recurrence, symptom (p>0.05). Macrophage colony-stimulating factor (MCSF), CD68, and Ki67 expression was identified in localized and diffuse type TSGCT. But there was no statistically significant difference between the groups for MCSF, CD68, and Ki67 expression (p>0.05). CONCLUSION: This study shows that although the markers MCSF, CD68, and Ki67 are expressed by localized and diffuse type TSGCT, their lack of specificity limits their use as a subsidiary immunohistochemical marker in the differential diagnosis of localized and diffuse type TSGCTs.
Diagnosis, Differential ; Giant Cell Tumors* ; Giant Cells* ; Macrophage Colony-Stimulating Factor ; Recurrence ; Sensitivity and Specificity

Pseudoaneurysm of splenic artery may arise from a vascular erosion by the inflammatory processes around the splenic artery, particularly in acute pancreatitis and chronic pancreatitis, which may cause rupture of pseudoaneurysm and life threatening hemorrhage. Collective experience with this massive hemorrhage is attended by a high mortality rate even with prompt therapy, and conservative management is associated with an almost 100 per cent of mortality rate. Identification of the bleeding site at laparotomy may be exceedingly difficult, which makes the preoperative detection of bleeding source desirable. Peripancreatic vascular lesions can be identified by angiography, and in selected cases the risk of urgent operation to control massive hemorrhage may be obviated by embolization. The authors have recently experienced a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography were essential to confirm these complications of pancreatic pseudocyst. We managed this child successfully with an urgent procedure of transcatheter arterial embolization and another elective surgery of pancreatic pseudocyst.
Aneurysm, False* ; Angiography ; Child* ; Hemorrhage ; Humans ; Laparotomy ; Male ; Mortality ; Pancreatic Pseudocyst ; Pancreatitis ; Pancreatitis, Chronic ; Rupture ; Splenic Artery* ; Tomography, X-Ray Computed