An appreciation of the normal variation of the Talar Tilt angle under stress roentgenogram on the ankle joint may throw some light on the diagnosis and treatment in an ankle joint injuries. The purpose of this study is to show the normal range of the Talar Tilt angleof the ankle joint under various circumstances and has been to compare the results of each angle. The author have undertaken the neutral ankle mortise view and inversion and eversion stress roentgenogram in all ankles and measured its Talar Tilt angle. The data were based on study of free chosen 50 normal Korean adult male 25 and female 25 respectively. The results were summerized as follows; 1. Talar Tilt angle was O degree in neutral ankle mortise view. 2. In inversion stress roentgenogram, Talar Tilt angle ranged from 0 to 15 degrees, 97% of cases were less than 10 degrees. 3. In eversion stress roentgenogram, Talar Tilt angle ranged from 0 to 7 degrees. 4. In inversion stress roentgenoram, the difference between right and left of same male and female ranged from 0 to 7 degrees. 5. It is very important to check accurately Talar Tilt angle under the same method and same conditions.
Adult ; Ankle Joint ; Ankle ; Diagnosis ; Female ; Humans ; Male ; Methods ; Reference Values

No abstract available.
Anesthesia, Epidural* ; Radiculopathy*

No abstract available.

The injured tendon is thought to be healed by, extrinsic healing from tendon sheath and adjacent connective tissue, and intrinsic healing from epitenon and endotenon. About the factors influencing the healing of injured tendon, many authors reported the effects of mobilization, electricity, ultrasound and various druge. Especially, active or passive mobilization had been known to promote the healing process and to reduce adhesion. To investigate the influences of active limited mobilization, intrinsic and extrinsic healing process, right Achilles tendons of 30 New Zealand white rabbits were grouped according to the types of treatments (Group I; tenotomy of Achilles tendon only, Group II; Tenotomy and long leg cast, Group III; surgical repair after tenotomy and long leg cast). The tendon sheath was repaired in all the groups, and the left Achilles tendons were used as control. At six weeks after operation, the tendons were removed and analysed biomechanically using Instron 1000, and histologically. The following results were obtained: 1. There were significant decreased of break strength, in order of Group III, Group I and Group II(p < 0.05). But, no difference was found between control group and Group III. 2. Extension length to the rupture, was decreased significantly in the experimental groups than control group. But there was no difference among the experimental groups. 3. Histologically, dense proliferation of fibroblasts and hypertrophy of tendon was observed in Group I; and matured fibricytic tendon tissues in Group II and III. In Group II, the amount of matured tendon tissues and degree of maturity were less than in Group III. In summary, suture and active limited motion were considered as promoting factors on the tendon healing.
Achilles Tendon ; Connective Tissue ; Electricity ; Fibroblasts ; Hypertrophy ; Leg ; Rabbits ; Rupture ; Sutures ; Tendons ; Tenotomy ; Ultrasonography

During the period from January 1980 to September 1988, 59 patients suffering from brachial plexus injury, have admitted to Seoul National University Hospital. Fifty-four patients were male and 5 patients were female, and age ranged from 6 to 58 years (mean:26.8 years). The most common cause of injury was traffic accident accounting for 66% (39patient), and among them 24 patients(62%) had the motor cycle accident. Birth injury, stab or gun shot wound, fall down and industrial hazard were following causes. Fracture and dislocation of involved limb accompanied in 19 patients(32%) and 2 patients of arterial injury were also found. EMG and cervicsl myelography with or without CT were performed in almost all the patients and MRI was performed in selected patients. Forty-five patients(76%) had supra-clavicular lesion and 14 patients (24%) had infra-clavicular lesion. In supra-clavicular lesion, upper roots or whole roots were involved in most of cases. Forty-nine cases were treated with conservative treatment for more than 8 months and operative procedures were performed in 36 cases. In operative cases, 30 patients were followed up for more than 1 year (average 24.3 months). Signs of root avulsion were found in 25 out of 31 cases of cervical myelography. MRI was performed in 7 cases, but it was inconclusive in diagnosis of root involvement. Infra-clavicular lesion showed better prognosis than supra-clavicular lesion. In supra-clavicular lesion, upper root involvement had the best prognosis. A pseudocyst detected by myelography usually precluded recovery in the root at the level of pseudocyst. Result of reparative treatment was better than that of conservative treatment. Overall satisfactory result in reparative treatment was 36%. However, if we include neurological improvement, positive result was 53%. Complete recovery was gained in half cases of neurolysis and other half showed no recovery, but all the cases of neurotization showed poor result. Reconstructive surgery including arthrodesis or muscle transfer can be effective treatment method, if it is performed properly on a selective patient.
Accidents, Traffic ; Arthrodesis ; Birth Injuries ; Brachial Plexus ; Diagnosis ; Dislocations ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Methods ; Myelography ; Nerve Transfer ; Prognosis ; Seoul ; Surgical Procedures, Operative ; Wounds and Injuries

The coronary artery fistula from right coronary artery to left ventricle is a rare disease among coronary artery anomaly. We experienced three cases of rare coronary fistula and report with literature review. Although symptoms of coronary artery fistula are associated with arteriovenous shunt and coronary steal phenomenon, many cases are asymptomatic. In this report, all patients had no symptom. but incidental murmur was noted (two are continuous, one is diastolic rumbling). The diagnosis was made by transthoracic or transesophageal echocardiogram and selective coronary angiography. Because patients were relatively young and the diameter of dilated coronary artery were huge, we perfomed operation on three patients.
Coronary Angiography ; Coronary Vessels* ; Diagnosis ; Fistula* ; Heart Ventricles* ; Humans ; Rare Diseases

BACKGROUND: There were many studies about the changes of cognitive or non-cognitive domain and behavioral and psychological symptoms with the progression of Alzheimer's disease. But they assessed the changes individually so could not explain comprehensively the global change of disease progression. Also they studied by clinical dementia rating scale(CDR) which could not successfully explain the latest stage. So we have evaluated the cognitive, non-cognitive domain and behavioral and psychological symptoms at the same time and evaluated the changes with the expanded clinical dementia rating scale. Also we evaluated the relationship of each scale and assessed sensitivity change at the different stage of disease. METHODS: Twenty-three mild cognitive impairment(MCI) subjects and eighty-seven patients with Alzheimer's disease were recruited. The Korean version of Mini-Mental State Examination(K-MMSE), the Korean version of the neuropsychiatric inventory(NPI), the Extended version of the Korean Clinical Dementia Rating Scale(CDR), the Activity of Daily Living(ADL), the Severe Dementia Scale(SDS) and the Short form of Samsung Dementia Questionnaire(S-SDQ) were performed. RESULTS: It was found that all of them were well correlated each other(r>-0.73 and p<0.05) except NPI. Physical activity of daily living(P-ADL) was most related to Korean version of instrumental activity of daily living(K-IADL) (r=0.86 and p<0.01), SDS to K-MMSE(r=0.93 and p<0.01) and S-SDQ to K-IADL(r=0.86 and p<0.01). P-ADL and S-SDQ revealed the ceiling effect at CDR 4 and K-IADL at CDR 3. CONCLUSION: The cognitive and non-cognitive function were declined according to disease progression. The changes of behavioral and psychological symptoms were relatively independent of cognitive function. SDS, P-ADL and CDR were proved to be more sensitive in advanced stage of dementia and K-IADL, S-SDQ were more adequate in milder stage of dementia or MCI.
Alzheimer Disease ; Dementia ; Disease Progression ; Humans ; Motor Activity

We present here, a case of pemphigus erythematosus developed in a 31-year-old woman, who had been suffering from repeated episode, of remission and exacerbation with several erythematous, and somewhat oozing patche accompanying a mild pruritus or her face, upper part of the back and anterior chest. In serological studies, she had antinuclear antiboc@lies at. a titer of 1:160. Histopathological finding showed subcorneal bullae. Immunofluorescent study revealed IgG and C, deposition in the intercellular space of the epidermis and along the de rmoepidermal junction.
Adult ; Epidermis ; Extracellular Space ; Female ; Fluorescent Antibody Technique ; Humans ; Immunoglobulin G ; Pemphigus* ; Pruritus ; Thorax

Rhinocerebral mucormycosis, which is a fulminant and progressive disease often seen in debilitated hosts! Requires a high degree of clinical suspicion to promptly diagnose and an aggressive medical and surgical therapy. The prognosis is grave, especially in case of bilateral cavernous sinus thrombosis. We report a case of 69-year-old female patient with bilateral cavernous sinus thrombosis caused by rhinocerebral mucormycosis, who showed orbital swelling and lateral bulging of bilateral cavernous sinus in orbital CT, and large branching nonseptate hypae in biopsed specimen of the left periorbital necrotic tissue.
Aged ; Cavernous Sinus Thrombosis ; Cavernous Sinus* ; Female ; Humans ; Mucormycosis* ; Orbit ; Prognosis

We report a case of classic Kaposi's sarcoma (KS) in a 67-year-old man, who had multiple cutaneous lesions of the feet and left hand as well as an internal involvement of the stomach. The histopathologic findings showed typical features of KS as a mid-dermal tumor composed of vascular proliferations, vascular slits, spindle cells, extravasated erythrocytes and deposits of hemosiderin. Analysis of T-cell subpopulations showed decreased T4 lymphocytes and in-creased T8 lymphocytes; the ratio of T4M lymphocytes was decreased. Natural killer cell activity was also decreased. These findings suggest a possible relationship between immunological abnormalities and the pathogenesis of this disease. The patient's serum was negative for antibodies to the human immunodeficiency virus (HM). This report describes a case of classic KS with immunological abnormalities and internal involvement and possible pathogenetic mechanisms are discussed.
Aged ; Antibodies ; CD4-Positive T-Lymphocytes ; CD8-Positive T-Lymphocytes ; Erythrocytes ; Foot ; Hand ; Hemosiderin ; HIV ; Humans ; Killer Cells, Natural ; Lymphocytes ; Sarcoma, Kaposi* ; Stomach ; T-Lymphocytes