No abstract available.
Carcinosarcoma* ; Stomach*

There are many difficult problems and various methods in the treatment of difficult fractures of the femur. Form May 1991 to August 1994, 9 cases of difficult fractures of the femur were treated with Ilizarov external fixator. We obtained good result for all cases as follow : 1. There were 1 case of severely segmental and comminuted fracture with bone loss, 3 cases of infected nonunion after internal fixation(2 cases combined with bone loss), 2 cases of non-union after internal fixation and 3 cases of severely segmental and comminuted fractures. The traffic accident injury was in 6 cases and the falling down injury was in 3 cases. 2. The bone union was obtained in all cases and the duration of Ilizarov external fixator application was minimum 7.7 months up to 19 months with an average of 1.3 months and full weight bearing was possible in all cases after removal of the Ilizarov external fixator. 3. We experienced 9 complication; there were 6 cases of pin tract infection which were controlled by antibiotic injection at that site and there were three cases of limitation of motion of knee. So we conclude that the Ilizarov external fixation technique is one of the effective methods for the treatment of difficult fracture of the femur(ex. segmental, comminuted fracture, bone defect, osteomyelitis and nonunion) in spite of having experienced only few cases.
Accidental Falls ; Accidents, Traffic ; External Fixators ; Femur ; Fractures, Comminuted ; Knee ; Osteomyelitis ; Weight-Bearing

Leg length discrepancy or short stature is a significant problem to patient psychosocially, cosmetically, and there has been many efforts for limb lengthening. There are many report about lower limb lengthening since the first description of femoral lengthening by Codivilla in 1905. Although limb lengthening using external fixator was popularized by Anderson, the result was poor because of many difficulties in techniques and complications. Recently, a great progress in lower limb lengthening was made by distraction osteogenesis by llizarov and callotasis by De Bastiani. But as such exter- nal fixator has some problem in technique, cosmesis or complications. Therefore gradual elongation intrameduilary nailing(Albizzia) developed by Guichet in 1986 has gained attention for more stability and relatively less discomfort. We reviewed 18 cases in 11 patients(5 males and 6 females) who visited the department of Orthopedic Surgery of Severance Hospital at Yonsei University with limb leg length discrepancy due to sequeale of poliomyelitis, familial short stature and Turner syndrome. They all underwent lower limb lengthening using Albizzia technique between December 1995 and January l997. The average age at the time of the operation was 22.7 year. Famiiial short stature was in 12 cases(67%), Turner syndrome in 2 cases(11%), and leg length discrepancy due to the sequelae of poliomyelitis in 4 cases(22%). The site of lengthening were 5 cases of femur(28%) and l3 cases of tibia(72%). The latency period was average of 7 days. During the distraction period, 15 ratchetings per day(1 mm/day) were performed. In case of bilaterai femoral lengthenings, average length of gain(LG) was 6.0cm and percentage of increase(PI) l6.8%(16.2-17.4), lengthening index(LI) 1.2 month/cm(0.75-2.2). In case of unilateral femoral lengthening, LG was 3.8cm, Pl 7.8 %, Ll 1.3 month/ cm. In case of bilateral tibial lengthening, average LG was 5.5cm(3.5-6.0~) and Pl 18.8%(12.0-22.9), LI 1.3month/cm(0.67-2.3). In case of unilateral tibial lengthening, LG was 2.9cm(2.3-3.5), P1 9.4 %(7.7-11.7), LI 2.8 month/cm(2.2-3.1). Lengthening index in poliomyelitis by llizarov was 3.l month/cm, but it was 1.3 in femur and 2.8 in tibia hy Albizzia method. There are some advantages and disadvantages or contraindications and indications of the Albizzia technique. We suggest that the Albizzia technique is more stahle, more comfortable and no longer lengthening time compared to external fixator such as Ilizarov.
Albizzia ; External Fixators ; Extremities* ; Femur ; Humans ; Latency Period (Psychology) ; Leg ; Lower Extremity ; Male ; Orthopedics ; Osteogenesis, Distraction ; Poliomyelitis ; Tibia ; Turner Syndrome

We evaluated the results following the use of hinged Ilizarov and free tissue transfer to correct the eqinus deformity of the foot associated with extensive scarring of the leg and ankle in nine patients. The deformity was secondary to ischemic and neuropathic changes after trauma to the leg, ankle and foot. The average age of the patients was seventeen years (range, thirteen to thirty-four years). The average duration of follow-up was twenty-one months (range, twelve to thirty-eight months). Free tissue transfer was done in all cases, parascapular flap was done in seyen cases, groin flap was done in two cases. Among the nine cases, free tissue transfer and hinged Ilizaov were done at the same time in four cases, The average interval of the other five patients between free tissue transfer and hinged Ilizaov was three months (range, two to four months). The duration of distraction was four to six weeks, and the apparatus was kept in place for an additional two months after the desired position of correction had been achieved. The results were evaluated using two criteria, dorsiflexion and range of motion of ankle joint. Criteria on dorsiflexion of ankle, the results were good in seven cases, fair in two cases. Criteria on range of motion of ankle, one case being performed ankle fusion was not evaluated. Total eight cases were evaluated for range of motion of ankle. The results were good in six cases, fair in two cases. On the basis of our results, we believe that severe eqinus deformities of the foot associated with extensive scarring of the leg and ankle can be corrected with heel cord lengthening, free tissue transfer and hinged Ilizarov.
Ankle Joint ; Ankle* ; Cicatrix* ; Congenital Abnormalities ; Equinus Deformity* ; Follow-Up Studies ; Foot ; Groin ; Heel ; Humans ; Leg* ; Range of Motion, Articular

No abstract available.
Central Nervous System Infections* ; Central Nervous System*

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

BACKGROUND: There were many studies about the changes of cognitive or non-cognitive domain and behavioral and psychological symptoms with the progression of Alzheimer's disease. But they assessed the changes individually so could not explain comprehensively the global change of disease progression. Also they studied by clinical dementia rating scale(CDR) which could not successfully explain the latest stage. So we have evaluated the cognitive, non-cognitive domain and behavioral and psychological symptoms at the same time and evaluated the changes with the expanded clinical dementia rating scale. Also we evaluated the relationship of each scale and assessed sensitivity change at the different stage of disease. METHODS: Twenty-three mild cognitive impairment(MCI) subjects and eighty-seven patients with Alzheimer's disease were recruited. The Korean version of Mini-Mental State Examination(K-MMSE), the Korean version of the neuropsychiatric inventory(NPI), the Extended version of the Korean Clinical Dementia Rating Scale(CDR), the Activity of Daily Living(ADL), the Severe Dementia Scale(SDS) and the Short form of Samsung Dementia Questionnaire(S-SDQ) were performed. RESULTS: It was found that all of them were well correlated each other(r>-0.73 and p<0.05) except NPI. Physical activity of daily living(P-ADL) was most related to Korean version of instrumental activity of daily living(K-IADL) (r=0.86 and p<0.01), SDS to K-MMSE(r=0.93 and p<0.01) and S-SDQ to K-IADL(r=0.86 and p<0.01). P-ADL and S-SDQ revealed the ceiling effect at CDR 4 and K-IADL at CDR 3. CONCLUSION: The cognitive and non-cognitive function were declined according to disease progression. The changes of behavioral and psychological symptoms were relatively independent of cognitive function. SDS, P-ADL and CDR were proved to be more sensitive in advanced stage of dementia and K-IADL, S-SDQ were more adequate in milder stage of dementia or MCI.
Alzheimer Disease ; Dementia ; Disease Progression ; Humans ; Motor Activity

Lymphoma of the prostate is exceedingly rare. Much more common than primary lymphoma of the prostate id secondary involvement of malignant lymphomas originating at other sites. A variety of treatments have bee n used, including prostatectomy, radiotherapy or combinations of chemotherapy and radiotherapy. Generally, the prognosis is very poor, and there is currently no consensus regarding treatment. We report on a patient with T-cell lymphoma who presented with symptoms of bladder neck obstruction. The patient has been asymptomatic and under complete remission after completion of doxorubicin-based chemotherapy for 2 cycles.
Bees ; Consensus ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Lymphoma ; Lymphoma, T-Cell* ; Prognosis ; Prostate* ; Prostatectomy ; Radiotherapy ; T-Lymphocytes* ; Urinary Bladder Neck Obstruction

The 8 cases of left ventricular thrombus detected by the 2 D echocardiography or left ventriculography, after acute transmural anterior myocardial infarction were effectively lysed by the thrombolytic agents and heparin therapy. The thrombolytic agents were either urokinase or tissue plasminogen activator. Urokinase was infused intravenously at a dose of 1.0 million unit for three days. And tissue plasminogen activator was infused at a dose of 100mg for a day. In all cases, the thrombi were completely lysed. At follow up, no recurrence of left ventricular thrombus was found. We have experienced 2 cases of peripheral embolization in which, left ventricular thrombi were protruding nonmobile type. The one was the embolic cerebral infarction, the other was transient hoarseness and paresthesia on the left foot, which may be transient ischemic attack. These results show that left ventricular thrombi can be treated by intravenous thrombolytic agents without life-threatening complication. However, for the better establishment of the risk and benefit of therapy further investigation is needed.
Cerebral Infarction ; Echocardiography ; Fibrinolytic Agents ; Follow-Up Studies ; Foot ; Heparin ; Hoarseness ; Ischemic Attack, Transient ; Myocardial Infarction* ; Paresthesia ; Recurrence ; Thrombolytic Therapy* ; Thrombosis* ; Tissue Plasminogen Activator ; Urokinase-Type Plasminogen Activator

No abstract available.
Diabetes Insipidus, Nephrogenic* ; Humans ; Siblings*