From May, 1971 to June, 1984, we performed extensive saucerization on the chronic osteomyelitis of long bones eradicating all pathologic foci; not only sequestra but sclerotic involocurum and necrotic original cortex embeded by new bone, which was different from the conventional methods such as sequestrectomy or guttering in its extensiveness. Clinical analysis on the base of radiologic evaluation after saucerization was done on the 16 patients; for average 5 years of follow-up. The results obtained were as follows; 1. The angulatory deformity of the long bones after pathologic fracture complicated by the chronic osteomyelitis was not corrected satisfactorily due to the bony sclerosis or hyperostosis at the fracture site, especially in cases of posterior or medial angulation. 2. The recurrence was closely related to the persisting non-sequestered original cortical lesion after incomplete saucerization, which was embeded by the new bone. So to prevent the recurrence the non-sequestered original cortical lesion must be removed completely. 3. The cortical defect after saucerization was restored completely in patients under the age of 14, but which was not the way in patients over the age of 16.
Congenital Abnormalities ; Follow-Up Studies ; Fractures, Spontaneous ; Humans ; Hyperostosis ; Osteomyelitis ; Recurrence ; Sclerosis

Between Jan. 1976 and May 1987, Sixteen supracondylar fractures of the femur were treated by interlocking nailing. Of the 16 cases, 7 cases were intercondylar, 12 cases were segmental fractures of the femur, 4 cases were open fractures in the type of wound. 1. The simple supracondylar fracture involving the distal 9cm of the femur can be treated by interlocking nailing which makes firm fixation and allows early ambulation. 2. If the supracondylar fracture is accompanied with intercondylar fracture, careful reduction and transcondylar fixation by means of tibial bolt or cancellous screws are essential before the insertion of the nail. 3. The shape of the bent nail must be depended on the type of the fracture. If the nail is to be inserted into the anterolateral aspect of the distal fragment, the degree of bending of the nail is 400cm, and posteromedial is 110cm in radius. 4. The authors made several sagittal holes the at dorsum of the nail. So the screw can be easily inserted to the nail perpendicularly or obliquely, when the insertion of the screw through the transverse holes is difficult. 5. Of the 15 cases treated by interlocking nailing, 5 cases were excellent, 4 cases were good, 2 cases were fair, 4 cases were failure by schatzker assessment.
Early Ambulation ; Femur ; Fractures, Open ; Radius ; Wounds and Injuries

The intramedullary nailing is a good method of treatment in femur shaft fracture but it is not available in some fracture pattern or fracture level. And it is very difficult with conventional Kiintscher nailing to prevent torsional stress and fix rigidly in unstable fracture of the femur shaft. The unstable fracture by comminuted fracture or segmental fracture, nonunion and pathologic fracture needed the rigid fixation. Interlocking Kuntscher IM nailing can provide antitorsional stability, good axial alignment and prevent shortening of the fracture site, also allow early ambulation and joint exercise. We analysed 51 patients 52 cases of interlocking Kiintscher IM nailing from May 1981 to March 1988. The interlocking Kuntscher IM nailing prevents the rotational and axial roading. The interocking Kuntscher IM nailing has expanded its application in fracture pattern and fracture site. The interlocking IM nailing provides rigid fixation in severe comminuted fracture. segmental fracture, long spiral fracture, and other several unstable fractures and eliminates splinting or external supports, so it is possible doing early joint exercise. The interlocking Kuntscher IM nailing was also considered best internal fixation method in pathologic fracture or sever osteoporosis. The static interlocking for rigid fixation and the dynamic interlocking method for axial compression to fracture site during weight bearing can be adapted appropriately to fracture pattern. Radiation hazard during the interlocking nailing is not considerable.
Early Ambulation ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Comminuted ; Fractures, Spontaneous ; Humans ; Joints ; Methods ; Osteoporosis ; Splints ; Weight-Bearing

PURPOSE: Bilateral high signal intensity in basal ganglia on Tl-weighted images is unusual. the purpose of this study is to describe the pattern of high signal intensity and underlying disease. METHODS AND MATERIALS: During the last three years, 8 patients showed bilateral high signal intensity in basal ganglia on Tl-weighted image, as compared with cerebral white matter. Authors analized the images and underlying causes retrospectively. Of 8 patients, 5 were male and 3 were female. The age ranged from 15 days to 79 years. All patient were examined by a 0.5T superconductive MRI. Images were obtained by spin echo multislice technique. RESULTS: Underlying causes were 4 cases of hepatopathy, 2 cases of calcium metabolism disorder, and one case each of neurofibromatosis and hypoxic brain injury. These process were bilateral in all cases and usually symmetric. In all cases the hyperintense areas were generally homogenous without mass effect or edema, although somewhat nodular appearence was seen in neurofibromatosis. Lesions were located in the globus pallidus and internal capsule in hepatopathy and neurofibromatosis, head of the caudate nucleus in disorder of calcum metabolism, and the globus pallidus in hypoxic brain injury. CONCLUSION: Although this study is limited by its patient population, bilateral hyperintense basal ganglia is associated with various disease entities. On analysis of hyperintense basal ganglia lesion, the knowledge of clinical information improved diagnostic accuracy.
Basal Ganglia* ; Brain ; Brain Injuries ; Calcium Metabolism Disorders ; Caudate Nucleus ; Edema ; Female ; Ganglia ; Globus Pallidus ; Head ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Male ; Metabolism ; Neurofibromatoses ; Retrospective Studies

Differentiation between benign and malignant hepatic lesions was attempted according to the shape of the lesion, internal architecture and characteristics of signal intensity on MR images. MR images. We retrospectively analyzed 20 cases of hemangiomas, 12 cases of hepatomas and 5 cases of cysts which were diagnosed by clinical, radiological and surgical methods (33 patients). On T1-weighted, proton weighted, and T2-weighted images, most hemangiomas (70%) and cysts (100%) had smooth margin and were round or oval in shape, while hepatocellular carcinomas had irregular (67%) or lobulated (33%) borders. Ninety percent of hemangiomas and 100% of cysts had homogeneous signal intensity, but 67% of hepatocellular carcinomas were inhomogeneous. Signal intensities of hepatocellular carcinomas were more variable. However, hemangionmas were isointense or hyperintense on proton weighted images, and markedly hyperintense on T2-weighted images . In conclusion, inhomogenous, irregular border, and variable signal intensity lesions had high likelihood of malignancy, while homogenous and markedly hyperintense lesions were more likely benign.
Carcinoma, Hepatocellular ; Diagnosis* ; Hemangioma ; Magnetic Resonance Imaging* ; Protons ; Retrospective Studies

Differentiation between benign and malignant hepatic lesions was attempted according to the shape of the lesion, internal architecture and characteristics of signal intensity on MR images. MR images. We retrospectively analyzed 20 cases of hemangiomas, 12 cases of hepatomas and 5 cases of cysts which were diagnosed by clinical, radiological and surgical methods (33 patients). On T1-weighted, proton weighted, and T2-weighted images, most hemangiomas (70%) and cysts (100%) had smooth margin and were round or oval in shape, while hepatocellular carcinomas had irregular (67%) or lobulated (33%) borders. Ninety percent of hemangiomas and 100% of cysts had homogeneous signal intensity, but 67% of hepatocellular carcinomas were inhomogeneous. Signal intensities of hepatocellular carcinomas were more variable. However, hemangionmas were isointense or hyperintense on proton weighted images, and markedly hyperintense on T2-weighted images . In conclusion, inhomogenous, irregular border, and variable signal intensity lesions had high likelihood of malignancy, while homogenous and markedly hyperintense lesions were more likely benign.
Carcinoma, Hepatocellular ; Diagnosis* ; Hemangioma ; Magnetic Resonance Imaging* ; Protons ; Retrospective Studies

No abstract available.
Choanal Atresia*

An unusual case of intraspinal peripheral neuroepithelioma arising from the cauda equina is reported. The patient, a 21-year old female, suffered from low back pain with radiation to the posterior aspect of both legs. Myelographic, computed tomographic scan and magnetic resonance imaging studies of lumbosacral spine showed the intradural extramedullary mass lesion on the L3-S1 level which was excised surgically, but recurred rapidly. It could be diagnosed by the histopathologic findings. The postoperative radiotherapy and chemotherapy were administered. We report this rare case with review of the literatures.
Cauda Equina* ; Drug Therapy ; Female ; Humans ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Neuroectodermal Tumors, Primitive, Peripheral* ; Radiotherapy ; Spine ; Young Adult

We studied 75 cases of conventional Kuntscher intramedullary nailing and 52 cases of interlocking intramedullary nailing from July 1980 to October 1988 for femur shaft fractures. The conventional Kuntscher intramedullary nailing was used for fresh fracture and the interlocking intramedullary nailing was used not only fresh fracture, but also unstable fracture, nonunion and pathologic fracture. The conventional Kuntscher intramedullary nailing was frequently used in middle one-third level, but the interlocking intramedullary nailing could be applied widely from subtrochanteric area to supracondylar level in femur. The average operation time in patient who had no associated injury was 3.6 hours in conventional Kuntscher intramedullary nailing and 3.25 hours in interlocking intramedullary nailing. Time period for union was much less in interlocking intramedullary nailing than conventional Kuntscher intramedullary nailing. Some kinds of immobilization was needed shortly in conventional Kuntscher intramedullary nailing but immediate postoperative ambulation was possible in interlocking intramedullary nailing. Interlocking intramedullary nailing can prevent the angulation, shortening and trochanteric bursitis due to migration of the intramedullary nail.
Bursitis ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous ; Humans ; Immobilization ; Walking

The experimental study for peripheral nerve reconstruction was performed using degenerated skeletal muscle and omentum. At the sciatic nerves of 26 rabbits, about 10mm gaps were made under ketamine anesthesia. Degenerated skeletal muscles were made through the procedure of freezing with liquid nitrogen and thawing in distilled water. And omenta were taken through midline abdominal incisions. On 14 rabbits of experimental group, the nerves were connected with the degenerated skeletal muscles and surrounded with the omenta. On 6 rabbits of control group, the nerve gaps were connected with the degenerated skeletal muscles without surrounding with the omenta. And the other 6 rabbits of control group, the gaps were lets without further treatment. After 3, 6, 9 and 12 weeks, the results were compared using light microscope and transmission electron microscope. There were contractions and fragmentations at the skeletal muscles during the freezing and thawing. There were nerve regenerations through the degenerated skeletal muscles. The nerve tissues of the experimental group were more abundant than the control group using the degenerated skeletal muscles only.
Anesthesia ; Freezing ; Ketamine ; Linear Energy Transfer ; Muscle, Skeletal ; Nerve Regeneration ; Nerve Tissue ; Nitrogen ; Omentum ; Peripheral Nerves ; Rabbits ; Sciatic Nerve ; Water