No abstract available.
Antipsychotic Agents* ; Biomarkers*

Two cases of traumatic bilateral anterior and posterior dislocation of hip are reported. Dislocations were developed by a traffic accident as a passenger injury in truck. In both cases, the fractued femoral heads appeared posteriorly dislocated on x-ray examination and one of them was removed through posterior approach. Primary arthroplasty for operated hip was not attempted because the patient was young and the defect seemed to be unrelated to weight bearing surface. Extreme rarity of its incidence and curious uncertain mechanism of injury urge to report these cases.
Accidents, Traffic ; Arthroplasty ; Dislocations ; Head ; Hip ; Humans ; Incidence ; Motor Vehicles ; Weight-Bearing

Wegener's granulomatosis is a disease of unknown etiology that is characterized by the clinicopathologic complex of necrotixing granulomatous vasculitis of the upper and lower respiratory tract, glomerulonephritis, and variable degrees of small vessel vasculitis. Recently Antineutrophil Cytoplasmic Antibody (ANCA) has been reported to be a highly specific test for the diagnosis of Wegener's granulomatosis. We have experienced a patient of Wegener's granulomatosis in a 11 year old girl who was admitted with complaints f arthralgia, hematuria, convulsion and associated with otitis media and sinusitis. Serologic test of C-ANCA was positive and histologic findings of the kidney showed crescentic glomerulonephritis with sclerosis and surrounding infiltration of multinucleated giant cells. Patient was treated with pulse methylprednisolone without improvement. The clinical course progressed rapidly and expired due to the renal failure, gastrointestinal bleeding and status epilepticus. A brief review of literatures was made.
Antibodies, Antineutrophil Cytoplasmic* ; Arthralgia ; Child ; Diagnosis ; Female ; Giant Cells ; Glomerulonephritis ; Hematuria ; Hemorrhage ; Humans ; Kidney ; Methylprednisolone ; Otitis Media ; Renal Insufficiency ; Respiratory System ; Sclerosis ; Seizures ; Serologic Tests ; Sinusitis ; Status Epilepticus ; Vasculitis ; Wegener Granulomatosis*

PURPOSE: To assess the role of blood vessels in the formation of peritumoral abnormal signal intensity which exaggerates the size of malignant tumor on MR images. MATERIALS AND METHODS: We performed MR-microangiographic-pathologic correlation using implanted VX-2 carcinoma in 16 rabbit thighs 1-28 days after tumor implantation. The shape and distribution of abnormal vessels were analyzed on microangiography and on histologic examination in correlation with peritumoral abnormal signal intensity on MR images. RESULTS: Dilated peritumoral blood vessels gave rise to irregular, tortuous tumor vessels penetrated into the tumor. With the tumor growth, hypervascular tumor vessels in peritumoral area and central avascular areas were increased. These hypervascular areas on microangiography were corresponded with abnormal signal intensity on MR images. CONCLUSION: Hypervascularity could be a cause of peritumoral abnormal signal intensity which exaggerates the size of experimentally induced malignant musculoskeletal tumors on MR images.
Blood Vessels* ; Thigh

Brachycephaly is a kind of craniosynostosis. Because of premature closure of the coronal suture, the skull is shorter in the anteroposterior diameter but is widened with a high vault and the occiput and forehead are flattened. Diabetes insipidus had been reported in oxycephaly. We have experienced a case of central diabetes insipidus associated with brachycephaly. A brief review of related literatures is included in this report.
Craniosynostoses* ; Diabetes Insipidus ; Diabetes Insipidus, Neurogenic* ; Forehead ; Skull ; Sutures

PURPOSE: To evaluate CT findings of internal hernia. MATERIALS AND METHODS: Three patients with internal hernia had abdominal CT scans and two of them had small bowel follow through examinations. The CT features of two patients with retroanastomotic and one patient with left paraduodenal hernia were evaluated and correlated with small bowel follow through examinations, and surgical findings. Two patients with retroanastomotic hernia had a history of subtotal gastrectomy with antecolic gastrojejunostomy. The diagnosis of internal hernia was made on the basis of surgical find ings in two patients of retroanastomotic hernia, and characteristic barium study findings in one patient of left paraduodenal hernia. RESULTS: The small bowel follow through examination showed small bowel loops gathered in a circumscribed mass in the left mid abdomen, and delay in passage through these loops. In case of left paraduodenal hernia, abrupt narrowing of the distal duodenum could be identified. The characteristic CT findings of all three patients were whorling of the mesentery and mesenteric vessels in the left mid-abdomen. In the patient with left paraduodenal hernia, after resolution of the gastrointestinal symptoms, a follow-up CT scan showed spontaneous disappearance of whorling of the mesentery and mesenteric vessels suggesting spontaneous resolution of the hernia. In the other two cases, upon exploration of the abdomen, dilatation of afferent duodenum caused by adhesion between ligament of Treitz and adjacent bowel walls, and retro- anastomotic herniation of the efferent loops were found. CONCLUSION: The usual diagnosis of internal hernia is based on the appearance of the small bowel follow through examination. However, we consider that the whorling appearance(we call it whorling sign) of the mesentery and mesenteric vessels on CT scan is also suggestive of internal hernia in patients under clinical suspicion.
Abdomen ; Barium ; Diagnosis ; Dilatation ; Duodenum ; Follow-Up Studies ; Gastrectomy ; Gastric Bypass ; Hernia ; Humans ; Ligaments ; Mesentery* ; Tomography, X-Ray Computed

This study was conducted to investigate the status of pregnancy and delivery and relationship among knowledge, attitude and practice about pregnancy and delivery in poor country, Nepal. A questionnaire survey by interviewer was conducted to examine the general characteristics, knowledge about pregnancy and delivery, attitude about pregnancy and delivery, the rate of prenatal care and delivery condition of women who had an experience of delivery during last year(1994. 4. 13~1995. 4. 12) at a rural area, nepal(Dolakha Bazar Area). The major findings are as follows; Among respondents, 87.5 percentage never had health education and the degree of knowledge about pregnancy and delivery was low. Among respondents, 56.6 percentage had the attitude that they didn't want antenatal care, 42.8% of respondents answered that they wouldn't visit hospital or health center when vaginal bleeding occurred and 82.9% thought that the delivery itself was dirty. The proportion of women who experienced antenatal care was 28.3%, the proportion of health facilities delivery was 5.3%, which was very low and 82.6% of home delivery case didn't sanitate the tool to cut the umbilical cord. The women who had positive attitude about antenatal care and health facility utilization experienced more antenatal care and health facilities delivery. On consideration of above findings, health education for pregnancy and delivery is required to improve mother-child health status in poor country. To make efficient health education, the target population group, such as the uneducated, inhabitants far from health center or medical facility, must be chosen. To help the poor countries in medical field, the study on health status and its related factors on these countries like this article would be required.
Surveys and Questionnaires ; Female ; Health Education ; Health Facilities ; Health Services Needs and Demand ; Humans ; Nepal ; Pregnancy* ; Prenatal Care ; Surveys and Questionnaires ; Umbilical Cord ; Uterine Hemorrhage

Clinical study was carried out on the 64 hemodialysis patients(HD) with chronic renal failure who had been treated from December 1992 to July 1993 in Yeungnam University Hospital. The following results were obitained. In hematologic parameters, MCH was 28.8±2.0pg, and MCV was 92.4±4.7fl. Result revealed normochromic and normocytic anemia. Mean values of serum ferritin were 657.4±292.0ng/ml in men and 511.5±370g in women. Mean values of serum iron were 145.5±63.7µg/dl. Mean values of transferrin saturation was 61.6±28.4%. Serum frerritin, serum iron and transferrin saturation were higher in HD group than normal reference. In erythropoeitin treatment group, Hb and Hct were significantly higher than non-erythropoietin treatment group. Amount of transfusion was significantly higher in non-erythropoietin treatment group than erythropoeitin treatment group(p<0.05). Values of iron, transferrin saturation were significantly higher in abnormal liver function test(LFT0 hemodialysis group than normal LFT group(p<0.05). Transfusion amounts revealed positive correlation with ferritin(r=0.4675), transferrin satruation (r=0.3823) and iron(r=0.3386) (p<0.05).
Anemia* ; Clinical Study ; Erythropoietin* ; Female ; Ferritins ; Humans ; Iron ; Kidney Failure, Chronic ; Liver ; Male ; Renal Dialysis ; Transferrin

PURPOSE: To evaluate the radiologic findings of alimentary anthrax. MATERIALS AND METHODS: 19 patients with alimentary anthrax, which was caused by ingestion of contaminated beef, were included in this study. The diagnosis was made .b.y demonstration of Bacillus anthracis in smear and culture of the contaminated meat. We evaluated the clinical manifestations and the findings of thoracic, abdominal radiographs, cervical, abdominal ultrasonograms and abdominal CT scans. RESULTS: Out of the 19 patients with the alimentary infection, 9 had oropharyngeal form, 18 had abdominal form and 8 had combination of oropharyngeal and abdominal form. The patients had general symptoms and signs such as fever, chill, myalgia. Clinical symptoms and signs were sore throat, throat injection, throat ulcer and patch in oropharyngeal form, and nausea, vomiting, abdominal pain, diarrhea, and gross GI bleeding in abdominal form. Radiologic findings included enlarged cervical lymph nodes(36%) in oropharyngeal form, and paralytic ileus(26%), ascites(26%), hepatomegaly(21%), enlarged mesenteric lymph nodes(26%), small bowel wall thickening(5%) in abdominal form. In two patients, late complications occurred as intestinal obstruction due to ileal stricture with perforation, and inflammatory changes of pelvic cavity due to ileovesical fistula. CONCLUSION: Radiologic findings of alimentary anthrax are difficult in differentiation from those of other inflammatory bowel disease, but those radiologic findings with clinical manifestations may be helpful in diagnosis and evaluation of disease process in patients with alimentary anthrax.
Abdominal Pain ; Anthrax* ; Bacillus anthracis ; Constriction, Pathologic ; Diagnosis ; Diarrhea ; Eating ; Fever ; Fistula ; Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Intestinal Obstruction ; Meat ; Myalgia ; Nausea ; Pharyngitis ; Pharynx ; Tomography, X-Ray Computed ; Ulcer ; Ultrasonography ; Vomiting

We retrospectively analysed plain radiographs and MR imaging of 16 conventional osteosarcoma cases(8 children, 8 adults) which underwent amputations or limb salvage operations. Pathologic correlation was performed with gross and microscopic sections to evaluate 1) whether the open epiphyseal plate can function as a barrier against transphyseal spread of osteosarcoma and 2) the diagnostic value of MR imaging for the detection of the detection of the epiphyseal involvement of osteosarcoma. In children with open epiphyseal plates, conventional radiographs suggested transphyseal tumor growth in one of eight cases(12.5% and MR imaging in seven cases(87.5%). Pathologic examination confirmed epiphyseal involvement in six of seven cases noted with MR imaging(75%). On the the other hand, in adult patients with closed epiphyseal plates, conventional radiographs showed transphyseal tumor growth in six of eight cases(75%), while MR imaging and pathologic exam demonstrated tumor invasion in all cases(100%). We conclude that open epiphyseal plate does not function as and effective barrier against tumor extension, and MR imaging is an excellent method in detecting the extent of transphyseal tumor growth.
Adult ; Amputation ; Child ; Growth Plate ; Hand ; Humans ; Limb Salvage ; Magnetic Resonance Imaging* ; Methods ; Osteosarcoma* ; Retrospective Studies