We have observed that the companion shadow of the upper rib may be misinterpreted as a small pnemothorax or pleural plaque associated with asbestosis. To observe the radiographic characteristics of the normal companion shadow, we analyzed, on the posteroanterior(PA) chest radiographs, the companion shadow of 50 normal cases. Factors such as occurrence on each rib, the sharpness of the margin, the relative position to the rib, the shape and the thickness were observed. Also, we analyzed the displaced pleura of 4 pneumothorax cases to differentiate their frndings from the findings of normal companion shadows. On 50 normal chest radiographs, 192 compaion shadows were observed on the first to fourth ribs. In 173 of those shadows, the visceral margin of the companion shadow on the second rib simulated pneumothorax more closely than those on any othe rivs due to its apical location and thinness. In six of 50 normal cases, the companion shadow on the first or second rib showed an inw rdly convex lower margin, mimicking pleural plaque. The compaion shadow was suggested on the plain chest radiograph by the following characteristics imultiplicity(47/50), thicker than normal pleura(3/4), persistent on serial filma with the same shape and specific location(4/4).
Asbestosis ; Friends* ; Humans ; Pleura ; Pneumothorax ; Radiography, Thoracic ; Ribs* ; Thinness

No abstract available.

Operative reduction is not essential for mild to moderate spondylolisthesis, but some authors agree that reduction of spondylolisthesis is beneficial for widening of intervertebral canal and consequently for decompression of neural tissue even though the degree of slippage is grade I or II. In our institute, we sometimes reduced the slippage for these reasons. But at follow up study we would find redisplacement and the degree of it seemed to be associated with the kind of instruments. So we analyzed redisplacement rate according to the kind of instruments in 59 cases of spondylolisthesis that were followed more than one year. The conclusions were as follow; 1. There was no significant correlation between reduction and redisplacement rate with pathologic type, lesion site, age,iscectomy and clinical result at least in grade I or II spondylolisthesis (P>0.05). 2. The pedicle screw system was more useful in reduction and its maintenance than the Luque ring system (P<0.001). 3. Redisplacement was occurred mainly within 2 months after operation, 4. The cause of redisplacement after reduction seems to be associated with mechanical insecurity before consolidation of the grafted bone takes place.
Decompression ; Follow-Up Studies ; Spondylolisthesis* ; Transplants

The Fracture of the os calcis is quite common in relation to fracture in other tarsal bone, and fractures involving the subtalar joint may cause serious and persistant disabilities. The treatment of these calcaneal fractures remains controversial So there is no universal agreement in the treatment of these fractures, especially involving the subtalar joint. Twenty displaced intraarticular fractures of calcaneus in 15 patients were treated by open reduction and internal fixation with a plate and screws and bone graft through a lateral approach to elevate the depressed lateral portion of the posterior facet at the Inchon Chritian Hospital from Jan., 1990 to Dec, 1991. Twenty feet in 15 patients of calcaneal fractures involving the subtalal joint were treated and were clinically analysed and following result were obtained. 1. The 20 cases were classified according to the Sanders classification, 9 in type II, 9 in type III and 2 in type IV. 2. The 20 cases were treated by open reduction andinteranl fixation with plate and screws and iliac bone graft through an Sanders lateral approach. The bone graft is packed under the elevated posterior to prevent late collapse of the central fragment and to supply structral stability. 3. The preoperative average Böhler's angle was 0.4°. The post operative average Böhler's angle was 23.4° which was increased significantly. 4. Based on assessment of result of Salama, excellenwas 6, good was 7, fair was 4 and poor was 3. 5. The most common complication after treatment was persistant pain, especially beneath the lateral malleolus.
Calcaneus ; Classification ; Foot ; Humans ; Incheon ; Intra-Articular Fractures ; Joints ; Subtalar Joint ; Tarsal Bones ; Transplants

Background: Riehl’s melanosis of the face and neck has been reported in middle-aged women who have darker skin types. Recently, cases of Riehl’s melanosis have been on the rise in Korea, which might reflect the increased use of various cosmetic products and procedures. Objective: This study was designed to analyze the clinicopathological characteristics and treatment outcomes of Riehl’s melanosis in Korean patients. Methods: We closely observed 80 patients with Riehl’s melanosis diagnosed in Asan Medical Center and Hanyang University Medical Center between 2005 and 2015. A skin biopsy was analyzed in 51 patients, and a patch test was carried out in 16 patients. Results: Patients with chronic Riehl’s melanosis (＞12 months) had an increased frequency of previous laser treatments. Patients with acute Riehl’s melanosis (＜3 months) reported a previous history of dry skin, itching, or irritation as a result of the use of hair dye. Patients older than 50 years, with darker skin type, and with a longer disease duration (＞12 months) had poor response rates. Chronic Riehl’s melanosis may be preceded by repeated irritation of barrier-compromised skin, and acute Riehl’s melanosis seems to be an allergic form of Riehl’s melanosis. Conclusion Riehl’s melanosis has different clinical manifestations according to disease duration and different treatment responses based on disease duration.

PURPOSE: This study aimed to investigate and compare the micro-structural profiles of trabecular bone from different facets at the ankle joint. MATERIALS AND METHODS: In a fresh cadaver ankle, four cored 10 mm of diameter cylindrical specimens of trabecular bone were harvested from the distal tibia, the talar dome, the medial malleolus, and the lateral malleolus. Using a micro-computed tomography, two-dimensional and three-dimensional micro-structural indices of the trabecular bone were analyzed. RESULTS: Each specimen from the tibia, talus, medial malleolus, and the lateral malleolus showed unique micro-structural pattern. Tibia versus talus, the talus was seen a higher bone volume fraction and a wider supporting zone subchondrally whereas the tibia was seen a relatively lower bone volume fraction and a much narrower supporting zone subchondrally. Lateral malleolus versus medial malleolus, the lateral malleolus was seen the thicker but sparse trabeculae pattern whereas the medial malleolus was seen the thinner but more compact trabecular pattern. CONCLUSION: Each four locations from the different facet at the ankle joint have distinct own micro-structural patterns of the trabecular bone, suggesting different mechanical properties.
Ankle Joint* ; Ankle* ; Cadaver ; Talus ; Tibia

No abstract available.

PURPOSE: To evaluate the clinical findings, prognosis and treatment strategy of patients with neuroendocrine carcinoma of cervix. MATERIALS AND MEHTODS: Thirteen patients with neuroendocrine carcinoma of cervix were included in this study, as confirmed histologically and immunohistochemically at the Dongsan Medical Center, Keimyung University, between May 1944 and October 2001. The mean age of patients was 56 years with a range of 32 to 78 years of age. According to the FIGO staging system, there were 5 patients with stage IB carcinoma, 5 patients with IIA, and 3 patients with stage IIB. Four patients underwent radical hysterectomy with pelvic lymphadenectomy, 3 of these patients also received postoperative radiotherapy, and one patient underwent extrafascial hysterectomy after radiotherapy. Primary radiotherapy was done in 9 patients, and 3 were irradiated postoperatively. Nine patients received chemotherapy, 7 received neoadjuvant and 2 received concurrent chemoradiotherapy. The radical purpose of radiotherapy consisted of external irradiation to the whole pelvis (4,500~5,400 cGy) and intracavitary irradiation (3,000~3,500 cGy). RESULTS: The mean follow up duration was 36 months with a range of 3 to 104 months. The overall 5-year survival rate was 61.5% and the 5-year survival rates for stage IB, IIA, IIB were 60.0%, 60.0%, and 66.7% respectively (p=0.99). Eight patients are still alive without disease, and all of the 5 patients with recurrence are dead due to distant metastasis. CONCLUSION: Neuroendocrine carcinoma of cervix is highly aggressive, with early lymphatic dissemination and a high rate of distant recurrence. Therefore, an aggressive therapeutic strategy is required to obtain pelvic and distant disease control. Multimodal therapy should be considered at the time of initial diagnosis.
Carcinoma, Neuroendocrine* ; Cervix Uteri* ; Chemoradiotherapy ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Node Excision ; Neoplasm Metastasis ; Pelvis ; Prognosis ; Radiotherapy ; Recurrence ; Survival Rate

Cardiopulmonary depression of long-term constant rate infusion (CRI) administration of multiple analgesic drugs is important, especially in critically ill dogs. Therefore, this study was conducted to evaluate the effects of lidocaine, ketamine or combined lidocaine-ketamine combination CRI treatment on vital signs and left ventricular (LV) function in healthy dogs. Six adult Beagle dogs were administered either ketamine (initial loading dose of 0.5 mg/kg followed by 10 microg/kg/min CRI), lidocaine (initial loading dose of 2 mg/kg followed by 0.025 mg/kg/min CRI), or combined lidocaine-ketamine intravenously. Arterial blood pressure (BP), heart rate (HR), respiratory rate (RR), body temperature (BT) and echocardiographic LV dimensions were measured before administration of medications, immediately after administration of drugs, and then every 10 min for 2 h. There were no significant changes in HR, RR, BT and BP after the administration of either lidocaine CRI, ketamine CRI, or combined lidocaine and ketamine CRI. There were also no significant changes in LV dimensions and stroke volume. The results revealed that treatment with either lidocaine, ketamine or combined lidocaine-ketamine may not cause cardiopulmonary suppression in healthy dogs.
Adult ; Analgesia ; Analgesics ; Animals ; Arterial Pressure ; Body Temperature ; Critical Illness ; Depression ; Dogs* ; Echocardiography* ; Heart Rate ; Humans ; Ketamine* ; Lidocaine* ; Respiratory Rate ; Stroke Volume ; Ventricular Function, Left* ; Vital Signs*

Morel-Lavallée is a rare lesion caused by post-traumatic soft tissue injury. It usually occurs around the greater trochanter, and it occurs very rarely in the lumbar region. It is often difficult to be diagnosed in the emergency room. Delayed diagnosis may result in the need for open surgery. The authors report a patient with extensive multiple Morel-Lavallée lesions in the thoracolumbar, buttock, and thigh after trauma and provide a literature review.
Buttocks ; Delayed Diagnosis ; Emergency Service, Hospital ; Femur ; Humans ; Lumbosacral Region ; Soft Tissue Injuries ; Thigh