No abstract available.
Femoral Fractures* ; Hip Dislocation* ; Hip*

Fractures of the shaft of the radius and ulna occur commonly in children and are usually treated by closed reduction and plaster cast immobilization. Anatomic reduction is seldom necessary because of the remodelling potential in the child under 10 years of age, whereas the bones of children older than 10 years of age have less capacity to remodel and the diaphyseal fracture is unstable. In case of either unacceptable reduction or unstable fractures in adolescent patients, an operative treatment is required. In five children older than 12 years of age for whom conservative treatment had hailed, we treated a closed intramedullary nailing using a distal radial and proximal ulnar approach, and followed up for 1 year or more. All fractures healed within 6 weeks. No nonunion, cross-union or refrature occured. Another advantages of this method are negliable cosmestic defect and easy removal of the internal fixation device under local anesthesia. We think that closed intramedullary nailing with rush pin is a safe and reliable method to treat unstable forearm fracture in children older than 12 years of age.
Adolescent ; Anesthesia, Local ; Casts, Surgical ; Child ; Forearm ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Internal Fixators ; Methods ; Radius ; Ulna

We reviewed 14 children with unilateral fractures of femoral shaft who had an angular deformity after union of 10° to 25°. At an average follow-up of 32 months(15 to 65), we measured remodelling of the proximal physis, the distal physis and the femoral shaft. The average correction was 83% of the initial deformity and there was no relation between the remodelling rate and degrees of malunion. Of the correction of angulation, only 27% had occurred at the fracture site and 73% at physis. The ability of physis to remodel better than that of fracture site. In children under 13 years of age, malunion as much as 25° in flexion deformity will remodel enough to get normal alignment of the joint surfaces.
Child ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints

No abstract available.
Humans ; Orthognathic Surgery*

No abstract available.
Neoplasm Metastasis* ; Neuroblastoma*

The incidences of posttraumatic avascular necrosis of the femoral head were variably reported. In 1980, Calandruccio reported its incidence of 14% in nondisplaced femoral neck fracture and 50% in displaced ones. In general, the prophylactic methods, such as core decompression, bone graft and trochanteric osteotomy were recommended for the treatment of early stages of femoral head avascular necrosis(Ficat-Arlet stage 1 or 2), while the primary replacement surgery for the advanced ones (Ficat-Arlet stage 3 or 4). One of our authors(Y.K. Chung) has performed five cases of corticocancellous bone grafts using combined autogenous free fibular graft and iliac cancellous bone graft, for the post-traumatic femoral head AVN from January 1985 to December 1989 at our hospital, and the following results are obtained: 1. Among the forty nine displaced adult femoral neck fractures, there were five eases of avascular necrosis(10. 2%). 2. There were three male patients and two female ones, and the average age of injury was 48 years old(30 to 57). 3. According to the type of fractures, there were four cases of subcapital fracture and one of transcervical fracture. All of the patients were performed closed reduction and internal fixation with compression hip screw system, including additional Knowles pinning in two cases. 4. Histological study with the excised femoral head, showed that there was no bony union between the grafted cancellous bone and the necrotic head, and the grafted bone has been changed to amorphous necrotic tissue. However, we found a solid consolidation of the grafted bone and the femoral neck portion.
Adult ; Decompression ; Female ; Femoral Neck Fractures ; Femur ; Femur Neck ; Head ; Hip ; Humans ; Incidence ; Male ; Necrosis ; Osteotomy ; Transplants

PURPOSE: Bone bruises of patients with acute traumatic knee injuries, that are not found on simple radiograph, can be found on magnetic resonance imaging (MRI). The purpose of this study is to evaluate the frequency and locations of bone bruises on MRI in acute traumatic anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) injury. MATERIALS AND METHODS: 25 and 19 MRls, in which acute traumatic ACL and PCL injury was pre sent and there was no abnormality in simple radiograph, were reviewed. MRI was taken within 51 days of injury. A bone bruise was determined as a geographic and nonlinear area of signal loss on T1 images and increased signal intensity on T2 images involving the subcortical bone. RESULTS: In 16 patients with bone bruises and acute ACL injury, bone bruises were found in the lateral compartment of the knee in 15 (93.8%) patients. The most common area was the lateral tibial plateau (11 cases, 68.8%) and the second was lateral femoral condyle (9 cases, 56.3%). In 5 patients with bone bruises and acute PCL injury, bone bruises were found in the lateral compartment of the knee in all 5 (100%) patients. The most common area was lateral tibial plateau (4 cases, 80%) and the second was lateral femoral condyle (2 cases, 40%). CONCLUSIONS: In patients with acute traumatic ACL or PCL injuries the bone bruises are often found on the lateral compartment of the knee, especially lateral tibial plateau and lateral femoral condyle on MRI.
Anterior Cruciate Ligament ; Contusions* ; Humans ; Knee ; Knee Injuries ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament

Myasthenia gravis(MG) is an autoimmune disorder characterized by the presence of anti-acetylcholine receptor antibody and weakness of voluntary muscles. The pathogenesis of MG is decreased numbers of acetylcholine receptors at postsynaptic membranes of neuromuscular junctions. It has been reported that MG often coexists with other autoimmune disorders. This is a case report of systemic lupus erythematosus coexisting with MG in a 23 year old female patient presenting with dysarthria, dysphagia, and limb weakness. We report the case with relevant literature review.
Deglutition Disorders ; Dysarthria ; Extremities ; Female ; Humans ; Lupus Erythematosus, Systemic* ; Membranes ; Muscle, Skeletal ; Myasthenia Gravis* ; Neuromuscular Junction ; Receptors, Cholinergic ; Young Adult

OBJECTIVES: Although human papillomavirus (HPV) infection is considered as a favorable prognostic factor in oropharyngeal cancer, the prognosis of HPV-associated tonsil cancer has rarely been studied especially when surgery was the main treatment. In this study, the authors investigated the effect of p16 over-expression (HPV infection) on tonsil cancer prognosis according to the type of treatment, HPV presence by PCR, and expression of p53 and epidermal growth factor receptor (EGFR) by immunohistochemistry (IHC). METHODS: Medical records of 33 tonsil cancer patients were reviewed. Using formalin-fixed and paraffin-embedded tumor specimens, PCR-based genotyping of HPV and IHC of p16, p53 and EGFR were performed. The effects of HPV presence and the expression of IHC markers were analyzed on the recurrence-free survival. Five-year disease-free survival (DFS) rates were evaluated according to p16 expression status. RESULTS: An over-expression of p16 was observed in 27 (81.9%) out of 33 cases. Surgery-based treatment was provided for 21 (63.6%) patients. There was no association between p16 immunoreactivity and HPV presence, nor with p53 and EGFR expression. Regardless of main treatment modalities, five-year DFS did not differ by p16 expression status (P=0.051). However, over-expression of p16 was associated with a lower recurrence in multivariable analyses (P=0.046). CONCLUSION: Regardless of main treatment modalities, an over-expression of p16 (HPV infection) is associated with a lower recurrence in tonsil cancers. However it is not associated with simple HPV presence or p53 and EGFR over-expression.
Disease-Free Survival ; Humans ; Immunohistochemistry ; Medical Records ; Oropharyngeal Neoplasms ; Palatine Tonsil ; Polymerase Chain Reaction ; Prognosis ; Receptor, Epidermal Growth Factor ; Recurrence ; Tonsillar Neoplasms

The purpose of this study was to provide basic biometric data on Korean adults through magnetic resonance imaging (MRI)-based measurements of the distances between the apex of sacral hiatus (SH) and the termination of dural sac (DS), and between SH and conus medullaris (CM) because they are critical to the performance of epidural neuroplasty. A total of 200 patients (88 males and 112 females) with back pain, who had no spine fracture, significant spinal deformity, and spondyloisthesis were selected for this study. The subjects were of mean age 54.3 (20~84) years and mean height 161.3 cm (135~187). T2-weighted MRI images were used for correlation analysis to evaluate the relationships between the distances, and variables such as sex and height. In all patients, the mean distance between SH and DS was 62.8±9.4 mm and the mean distance between SH and CM was 232.2±21.8 mm. The minimum distance and the maximum distance between SH and DS were 34.8 mm and 93.9 mm respectively, and the minimum distance and the maximum distance between SH and CM were 155.0 mm and 284.0 mm respectively. In female patients, both the distances between the SH and DS, and between SH and CM were shorter when compared to those of the male patients (p<0.05). Both the distances between SH and DS and between SH and CM showed a significant correlation with height (p<0.01). The results of this study will provide a useful biometric data on the distances between SH and DS and between SH and CM in Korean in ensuring clinical safety and in the development of more effective catheterization techniques for epidural neuroplasty in Korean.
Adult* ; Back Pain ; Catheterization ; Catheters ; Congenital Abnormalities ; Conus Snail* ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Spinal Cord* ; Spine