A case of aneurysmal bone cyst is reported in a 23 years old male, who complained of pain and tenderness on the right lateral aspect of thigh, This case had been treated with radical curettage and autogenous bone graft, but eight months later the radiological evidence of recurrence was present. So he was reoperated and he has been recovered relatively gradually, Roensgenograms of 7 montbs duration after reoperation showed abundent new bone formtion and no evidence of recurrence.
Aneurysm ; Bone Cysts ; Curettage ; Femur ; Humans ; Male ; Neck ; Recurrence ; Reoperation ; Thigh ; Transplants

Ewing's Sarcoma is a rapidly growing malignant neoplasm that arises from primitive cells of the bone marrow in young persons. This case, a seventeen year-old male, complained of pain and swelling on the both knee. He had been treated under the impression of osteomyelitis at several local clinics. Clinically, malaise and high fever were continued during admission period. Microspically it was confirmed as Ewing's Sarcoma and then he was discharged. Presently he is under the radiation therapy.
Bone Marrow ; Fever ; Humans ; Knee ; Male ; Osteomyelitis ; Sarcoma, Ewing

No abstract available.
Child* ; Humans ; Neurons*

The purpose of this study is to introduce the patients with bilateral cleft lip nose have lots of distinctive anatomical features such as short columella, inferior displacement of the medial crura of alar cartilage, lowering of the alar dome, flattened tip of the nose, widened nostril sill and prominent vestibular skin web. Although millard, Kaplan and Wray have introduced columellar lengthening by fork flap, it was difficult to achieve satisfying results without reconstructing the nasal skeletal framework of the cleft lip nose deformity for their anatomical distinctiveness. We have performed rhinoplasty on 7 patients with bilateral cleft lip nose from January. 1995 to August. 1997, using onlay calvarial bone graft and suture suspension technique. Operation was performed on basic anatomical structure, skeletal framework using outer table of calvarial bone pushed into the nasal tip area and suspension suture was applied to the framework with anteroinferior projection of nasal tip projection vector by cantilever effect of the calvarial bone which carried out nearly normal anatomical nasal structure. We have obtained satisfying results without complication in all seven cases. In conclusion the method which authors have used shows several advantages. First, it was possible to obtain the substantial skin lengthening in anterior and inferior direction by "Tent-Pole effect" in which creating bony structure projected into nasal tip and traction suturing of the deformed alar cartilages. Secondly, columellar lengthening and close to normal nostril shape was obtained and thirdly, re-deformation of corrected structure was prevented. An expected problem in above method is resorption of grafted calvarial bone which expected to maintain its position under influence of alternation and reformation by reaction between chondroblast and chondroclast results in fibrous tissue replacement, yet long term follow up is necessary for futher evaluation.
Cartilage ; Chondrocytes ; Cleft Lip* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Inlays ; Nose* ; Rhinoplasty ; Skin ; Sutures* ; Traction ; Transplants*

Since May 1981, the standard method of treatment of the femoral shaft fractures at the Daejeon EuIji Deneral Hospital has been the closed intramedullary nailing technique of Kuntscher. We performed intramedullary nailing on thirty-five fractures of femoral shaft in 35 patients. Closed intramedullary nailing was used in twenty-eight femora and open intramedullary nailing with cerclage wiring in seven fractures, in which large butterfly fragment was present, precluding control of rotation or length, or both. The overall rate of union was 97 percent. The range of motion of the knee at follow up was good in 80%, fair in 14%, poor in 6% (Good Full extension; loss of flexion less than 10 degrees. Fair Any loss of extension;loss of flexion of 10 to 50 degrees, Poor Loss of more than 10 degrees of extension; range of flexion-extension less than 90 degrees). The advantages of this technique include the negligible risk of infection, the rapid stabilization of fracture, thus facilitating management of other associated injuries, the rapid return of function of the knee, and early union of fracture and return to work. It is authors' opinion that when proper equipment and expertise are available, than closed intramedullary nailing is the treatment of choice not only for simple uncomminuted fracture of the femoral shaft but also for open comminuted fractures.
Butterflies ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Humans ; Knee ; Methods ; Range of Motion, Articular ; Return to Work

Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as therapeutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
Cholangiography* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Drainage ; Endoscopes ; Gastrectomy* ; Gastroenterostomy* ; Humans ; Ligaments ; Needles ; Sphincterotomy, Endoscopic

A case of right ovarian vein syndrome is reported with a review of literature. The patient presented was a 29 year-old multipara and eighth month of pregnancy. The extirpation of entire right ovarian vein, including it's all tributaries produced a good result and has not caused interruption of pregnancy. The clinical situation due to aberrant right ovarian vein is probably more frequent than heretofore suspected, by reason of a frown of X-rays during pregnancy and also an unawareness of the condition. Therefore, if clinical observations and X-ray studies are performed, more cases of such a condition. will be expected.
Adult ; Humans ; Pregnancy ; Veins*

Service diversification is recognized as an important strategy against turbulent environmental change. This study is designed to find out the trend of service diversification in Korean health care organizations and also to identify factors associated with the degree of service diversification. Data were collected from 69 hospitals out of 71 hospitals with over 300 beds. Important findings are summarized below. 1. Types of diversification are closely related to hospital size. Large hospitals have a tendency to provide sophisticated service requiring specialized skills and equipment, while small hospital have concentrated their efforts on health screening programs. 2. The more competitive and bigger hospitals are, the greater number of services that provide. Also, hospitals operating rational management information systems provide more services. Contrary to the expectation, hospitals with a low performance during last 3 years showed more service diversification. 3. A trend of more diversification was observed in hospitals whose chief executive officer used a prospector strategy. 4. A multiple regression analysis revealed that bed size, competitive environment, degree of rational management, and the growth pattern were significantly associated with teh service diversification.
Delivery of Health Care ; Health Facility Size ; Hospital Bed Capacity ; Management Information Systems ; Mass Screening

There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on qPality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.
Delivery of Health Care ; Female ; Health Services ; Humans ; Inpatients ; Logistic Models ; Marketing ; Middle Aged ; Outpatients ; Patient Selection

All ceramic restorations have had a more limited life expectancy than metal ceramic crowns because of their lower strength. The relatively lower strength has limited the use of all-ceramic crowns to the areas where occlusal loads are lower. Therefore many researches have been done to increase the strength of all-ceramic crowns. IPS Empress 2 is a new type of lithium disilicate glass-ceramic with enhanced physical characteristics which has been in use clinically since 1998. Previous researches reported that the flexural strength of all-ceramic material was greater than 300MPa, and all-ceramic crowns can be used in staining or layering technique. The objective of this study was to investigate the influence of the thickness of IPS Empress 2 ceramic on fracture strength. Both staining technique and layering technique was investigated. Vita VMK was used as control. For all three groups, five specimens each of 0.8mm, 1.0mm, 1.4mm, 1.8mm, and 2.2mm thickness (a total of 75 specimens) were prepared. Control group: Vita VMK Porcelain specimens were prepared with dentine ceramic and liquid glazing was done. Group I: IPS Empress 2 were prepared with staining technique and stained twice and glazed once. Group II : IPS Empress 2 were prepared with layering technique and glazed after wash firing. The thickness and diameter of the specimen were measured and controlled after specimen preparation. Biaxial Flexure Test (ASTM Standard F394-78) was adopted as this test method produces results least affected by the edge condition of the specimens. Fracture strength was measured with Instron Universal Testing Machine. Conclusions are as follow : 1. The fracture strength was increase in order of control group, test group I, test group II. 2. Fracture strength of the group I(Empress 2 Staining) was 65.54 N in 0.8mm, 155.2 N in 1.0mm, 233.5 N in 1.44mm, 434.5 N in 1.8mm, and 600.1 N in 2.2mm. 3. Fracture strength of the group II (Empress 2 Layering) was 190.0 N in 0.8mm, 283.5 N in 1.0mm, 437.2 N in 1.4mm, 732.0 N in 1.8mm, and 1115.0 N in 2.2mm. 4. No statistical difference was found in flexural strengths according to thickness in a specified group(p>0.05).
Ceramics* ; Crowns ; Dental Porcelain ; Dentin ; Fires ; Life Expectancy ; Lithium