The percutaneous pinning is a simple, effective method for the treatment of displaced supracondylar fractures of the humerus in children. But there is some controversy in the number of pins used and the method of pin insertion. The cross pinning method provides more stability at the fracture site but the risk of ulnar nerve damage is higher than in lateral pinning method, The senenty-one displaced extension type supracondylar fractures were treated by closed reduction and percutaneous cross pinning from January 1991 to October 1994. Among them, the medial pin was inserted in elbow extension in twenty-eight cases and in forty- three cases the medial pin was inserted in elbow flexion. Ulnar nerve injury occured postoperatively in six cases, in which the pin was inserted with the elbow in flexion position. These results may suggest that when percutaneous cross pinning method is selected to fix the supracondylar fracture of the humerus, it would be safer to insert one or two lateral pins with the elbow in full flexion position followed by one medial pin in extension position in order to reduce the risk of loss of reduction and ulnar nerve damage.
Child ; Elbow ; Humans ; Humerus ; Methods ; Ulnar Nerve

We present a case of medial malleolus and deltoid ligament loss with extensive overlying soft tissue defect from crushing injury. The resultant gross medial ankle instability necessitated deltoid ligament reconstruction using a bone-patellar tendon graft.
Ankle ; Child ; Humans ; Ligaments ; Patella ; Patellar Ligament ; Tendons ; Transplants

The adult trematodes, Fasciola hepatica, Eurytrema pancreaticum and Paramphistomum cervi, employed in this experiment were obtained from the cattle slaughtered at the local abbatoir. The worms selected and washed several times in normal sterilized saline solution. Each about ten of intact F. hepatica, fourty of E. pancreaticum, and twenty of P. cervi were incubated in 50 cc volume of special incubation flasks with incubation medium consisting of 10 cc. of Krebs-Ringer phosphate buffer(pH 7.4) The incubation medium was added C(14)-1-acetate and non-radioactive carrier Na-acetate so as to contain acetate concentration of 50 mg per cent . The worms were allowed to incubate for 5 hours in the Dubnoff metabolic shaking incubator at 38 C. After incubation period, respiratory CO(2) samples from central well of incubation flask were analysed for total CO(2) production rate and their specific activity of respiratory CO(2). The lactate and pyruvate appearance rates were determined by analyzing the lactate and pyruvate concentration in a medium after incubation. The glycogen samples isolated from worms were analyzed for the tissue concentration and their radioactivities in order to determine the turnover rate of glycogen pool. Radioactivities of these series of experiments were counted by an endwindow Geiger-Muller counter as an infinitely thin samples. The quantitative analysis of C(14)-acetate utilized by F. hepatica, E. pancreaticum and P. cervi were compared and discussed in this report. According to these data of the experiment, it is suggested that the fatty acid such as acetate may play a part of their oxidative process into the respiratory CO2 and the synthetic process into glycogen in the above species of trematodes.
parasitology ; helminth ; trematoda ; Fasciola hepatica ; Eurytrema pancreaticum ; Paramphistomum cervi ; acetate ; metabolism ; biochemistry ; CO(2) ; glycogen ; Krebs-Ringer phosphate buffer

Extensor digitorum brevis manus (EDBM) is a rare variation of the extensor muscle of the dorsum of the hand, which is found incidentally during surgery or magnetic resonance imaging (MRI). EDBM arises from the wrist capsule inferior to the extensor retinaculum, which frequently goes into the ulna side of the basis of the proximal phalanx between the 2nd and 3rd fingers. The aim of this report is evaluate to investigate the symptomatic mass on the dorsum of the hand and wrist using an image study (MRI or ultrasonography) to confirm whether it is a tumor or EDBM. Surgical excision was chosen as a treatment.
Fingers ; Hand ; Magnetic Resonance Imaging ; Ulna ; Wrist

Author requested to change the name of the last author. The correct name should be Tong joo Lee instead of Tong Ju Lee.

Approximately 5-30% of the ovarian cancers are metastatic malignancies. The prevalence of metastatic ovarian tumors varies with the incidence rates and spread patterns of primary malignancies. We evaluated the prevalence, pre- and postoperative characteristics of metastatic ovarian cancer in Korean women. We reviewed the records for 821 ovarian malignancies with pathological consultation from 1996- 2006 and recorded patient demographical, radiological, histopathological, and survival data. The study included 112 cases of histologically confirmed metastatic ovarian cancer. Metastatic ovarian cancer accounted for 13.6% of all ovarian malignancy, primarily arising from the gastrointestinal tract. The preoperative detection rate with imaging was 75%, and none of the radiological or serological features were useful for differential diagnosis. In multivariate analysis for prognostic variables, the only significant factor was the primary tumor site (p=0.004). Furthermore, extensive resection increased survival for some patients. The differential diagnosis of metastatic ovarian cancer can be problematic, so multiple diagnostic approaches are necessary. The extent of cytoreductive surgery for this type of tumor must be decided on a case-by-case basis.
Adenocarcinoma/*diagnosis/*secondary/surgery ; Adult ; CA-125 Antigen/blood ; Data Interpretation, Statistical ; Diagnosis, Differential ; Female ; Gastrointestinal Neoplasms/diagnosis/pathology ; Humans ; Medical Records ; Middle Aged ; Ovarian Neoplasms/*diagnosis/*secondary/surgery ; Ovariectomy ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Analysis

PURPOSE: To analyze the enhancement patterns and morphology of peripheral cholangiocarcinomas (CCs), as seen on three-phase helical CT. MATERIALS AND METHODS: Three-phase helical CT scans of 25 cases of 24 patients with pathologically-proven CCs were retrospectively reviewed. After intravenous administration of contrast media, scans of the hepatic arterial phase (HAP) were obtained at 30 seconds, of the portal venous phase (PVP) at 70 seconds, and of the delayed phase (DP) at 3 minutes. RESULTS: Linear, dense, marginal enhancement was seen in 17 CCs (68%), mainly on HAP images (64%) while thick, band-like, peripheral enhancement was seen in 18 (72%), on either PVP (52%) or DP (44%). Internal enhancement was observed in 23 CCs (92%) on PVP (68%) and/or DP (88%), and 19 CCs (76%) among them showed incomplete enhancement of stippled and/or septated patterns. Most (76%) were seen throughout all three phases to be hypoattenuating, as compared to the surrounding parenchyma. On HAP, wedge-shaped parenchymal enhancement was demonstrated at the periphery of 19 CCs (76%) suggesting impaired portal flow. Associated morphologic findings were satellate nodules (n=15, 60%), lymphadenopathy (n=14, 56%), focal dilatation of intrahepatic ducts around the tumor (44%), umbilication of the liver surface (50%), and clonorchiasis (44%). CONCLUSION: On three-phase helical CT, peripheral cholangiocarcinoma showed linear marginal enhancement on HAP, thick peripheral enhancement on PVP and/or DP, stippled and septated enhancing foci on DP, and peritumoral wedge enhancement on HAP. Associcated findings such as satellite nodules, focal dilatation of the intrahepatic ducts, umbilication of the tumor, and clonorchiasis were helpful.
Administration, Intravenous ; Cholangiocarcinoma* ; Clonorchiasis ; Contrast Media ; Dilatation ; Humans ; Liver ; Lymphatic Diseases ; Retrospective Studies ; Tomography, Spiral Computed*

PURPOSE: To evaluate the predicted results of treatment and to decide the time of using parenteral antibiotics to oral medication in Acute Uncomplicated Pyelonephritis, the serum C-reactive protein (CRP), WBC counts and body temperature (BT) were compared. MATERIALS AND METHODS: Between May 2003 and August 2004, 59 female patients with acute uncomplicated pyelonephritis were enrolled. The serum CRP, WBC counts and BT were measured on the first, third, fifth and seventh day after admission, and on the seventh day following discharge. The durations and patterns of the serum CRP, WBC counts and BT were statistically assessed after the use of parenteral antibiotics. RESULTS: The serum CRP, WBC counts and BT were increased in all patients on the first hospital day, but only the serum CRP was statistically correlated with the clinical course, with an average level of 11.83mg/dl. After the use of parenteral antibiotics, the mean serum CRP decreased to 8.38, 4.00 and 1.92mg/dl on the third, fifth and seventh day after admission, respectively. There were no cases increased serum CRP level or recurrence of inflammation during the follow-up period. The initial serum CRP level was also correlated with the disease severity when over 15mg/dl, the longer use of parenteral antibiotics and the longer stay in hospital were needed. CONCLUSIONS: Clinically, the level of serum CRP was a better indicator in determining the therapeutic effect of parenteral antibiotics use in patients with acute uncomplicated pyelonephritis than either the WBC counts or BT. Especially, in patients whose serum CRP level was decreased below 2.00mg/dl during the early days of the hospital stay, a decreased use of parenteral antibiotics and decreased hospital stay were observed. The initial serum CRP level was also correlated with disease severity.
Acute-Phase Proteins ; Anti-Bacterial Agents ; Body Temperature ; C-Reactive Protein* ; Female ; Follow-Up Studies ; Humans ; Inflammation ; Length of Stay ; Pyelonephritis* ; Recurrence

PURPOSE: This study evaluated the clinical and radiological findings as well as the and effectiveness of a two-stage reconstruction using the PROSTALAC for an infected hip bipolar hemiarthroplasty. This reconstruction technique comprises of an initial procedure, the removal of the implant, the insertion of a selfmade PROSTALAC and, a reconstruction with cementless implants. MATERIALS AND METHODS: From November 1996 to October 2001, at our institution, an infection around a hip arthroplasty which had been performed elsewhere in 13 patients (13 infected hips) was treated with a two-stage reconstruction. Postoperatively, all the patients returned for a clinical and radiographic followup at 6 weeks, 3 months, 6 months, and every year after the reconstruction to examine the recurrence of the infection and to determine if there was any loosening of the component. The average follow-up duration was 41.6 months (range, 28 months to 89 months). RESULTS: At the latest follow-up, there were no recurrence of the infection nor was there any loosening of the implants and Harris hip score changed from 52.4 preoperatively, to 84.0 postoperatively. CONCLUSION: A two-stage reconstruction for infected hip arthroplasty with cementless implants showed excellent results, no recurrence of the infection or loosening of the implants, and it is believed that this technique is effective and safe.
Arthroplasty ; Follow-Up Studies ; Hemiarthroplasty* ; Hip* ; Humans ; Recurrence

Trauma is frequently implicated in the development of sarcomas, including rhabdomyosarcoma. Rare soft tissue sarcomas have been reported to arise in scar tissue following surgical procedures or thermal or acid burns, at fracture sites, and in the vicinity of plastic or metal implants, usually after a latent period of several years. The authors encountered a case of a rhabdomyosarcoma arising from the forearm crushed by a conveyor belt 11 years ago. Several possible etiological factors for sarcoma development were identified in this patient, including tissue damage and inflammation, as well as the presence of metal implants and the limb’s exposure to radiation during multiple imaging tests. After severe soft tissue damage, the occurrence of a sarcoma should be considered and more attention should be paid to the causative factors for sarcoma.