Poliomyelitis was first described in medical literature in 1789 by Underwood, an English physician. In 1909, Landsteiner and Popper confirmed the etiology of the poliomyelitis from a virus. Thereafter with clinical application of Salk and Sabin vaccinations, and marked improvements in control of poliomyelitis, the incidence of this disease has markedly decreased in developed nations. In Korea, Miyoshi was the first to report an epidemic of poliomyelitis in Dae Goo in 1939. Statistical analysis is presented of 752 cases of the late effects of the poliomyelitis who were admitted to Orthopedic Department of the Severance Hospital during the ten year period from Jan. 1961 to Dec. 1971. Results of this study are as follows: 1. The incidence in males was greater than in females (males 59.3%, females 40.7%). 2. 95.3% of the 752 cases were found to occur under the age of four years, and highest peak by age occurred between 12 and 24 months (38.7%) 3. The peak duration of deformities was from 3 years to 5 years (29.1%) 4. Difference between the incidences of the city and of the rural areas was not determined. There was no difference between the age distribution of the onset in Seoul, in the medium-sized cities and in rural areas. 5. Paralytic poliomyelitis was observed even in vaccinated children 2.5% of total cases after one injection of Salk vaccine, 1.6% after two injections of Salk vaccine, and 1.3% after three injections of Salk vaccine, and 0.2% followed a combination of Salk and Sabin vaccination. 6. Deformity of the upper extremity was only 1.2% of that of the total body. But deformity of the lower extremity was 93.9% of the total. There was no difference between the deformities in both sides. In deformities of the lower extremities, deformities of the foot were most common (29.3% of the total), those of the knee 21.3%, those of the hip 10.9%, those of the toes 8.6% and those of the legs were 8.0% Deformities of the spines were 4.4% and those of the pelvis were 0.5%. In individual deformities, discrepancy in leg length was most common (15.8% of the total), equinovalgus 7.9%, external tibial torsion 7.7%, claw toe 6.8%, equnovarus 6.2%, knock knee 5.6% and combination of flexion, abduction and external rotation of the hip was 5.4%. 7. The locations of the paralyses were found to be 90.7% in the lower extremities, 7.6% in the upper extremities, 1.5% in the trunk and 0.2% in the neck. In involvement of the upper extremities, the most frequent were in the Triceps brachii (0.5% of involvements of the total body muscles), Deltoideus (0.5%) & Biceps brachii (0.4%). In the involvement of the lower extremity, Tibialis anterior was found to be the most frequent (6.1% of invelvements of the total body muscles), Iliopsoas 6.1%, Quadriceps 6.1% and Tibialis posterior was 6.0%. Generally, the muscles of the upper extremity were more frequently affected in mild involvement than in severe involvement except that the Opponens pollicis was slightly more frequently affected in severe involvement than in mild involvement. However the muscles of the lower extremities were slightly more frequently affected in severe involvement than in mild involvement. Especially the Tibialis anterior, Quadriceps, Tibialis posterior, and hip adductors were more frequently affected in severe involvement than in mild involvement. Generally in the muscles of the upper and lower extremities, the proximal muscles were involved more frequently than that of the distal. There was no difference between the frequencies of the invelvements of right and left sides. 8. Taking associated paralysis into account it was shown that certain muscles that receive nerve supply from the same segment were paralysis or weakened together. Tibialis anterior and Tibialis posterior, Quadriceps and hip adductors, Quadriceps and hip flexors were the most numerous combinations of the associated paralysis. 9. Looking at spinal segment innervation in relation to miId affection of muscles, the highest incidence was found in the first lumbar segment. In segment incidence of severe paralysis the highest incidence was found in the second and third lumbar segments.
Age Distribution ; Child ; Congenital Abnormalities ; Daegu ; Developed Countries ; Female ; Foot ; Genu Valgum ; Hammer Toe Syndrome ; Hip ; Humans ; Incidence ; Knee ; Korea ; Leg ; Lower Extremity ; Male ; Muscles ; Neck ; Orthopedics ; Paralysis ; Pelvis ; Poliomyelitis ; Poliovirus Vaccine, Inactivated ; Seoul ; Spine ; Statistics as Topic ; Toes ; Upper Extremity ; Vaccination

No abstract available.
Subclavian Artery* ; Thoracic Outlet Syndrome* ; Thromboembolism*

Isolation of Microsporum canis from home environment was carried out for 30 tinea capitis patients infected by M, canis. M. canis was isolated in 84.2-100% of patients caps, mattresses, clothes and pillows and families' clothes. The greatest mean number of M. canis colonies per petri dish was found in the patients pillows and followed by caps, mattresses, outerwear, and underwear. Mean number of M. canis colonies in the clothes of mothers, grandmothers, brothers, sisters and roommates of patients was smaller than that of the M. canis colonies in the clothes of patients but greater than that isolated from the clothes of other family members. Frequency of isolation and mean number of colonies decreased drarnatically after 2 weeks therapy and rarely isolated after 6 weeks therapy. M. canis was isolated in 100% of the house dust of patients. Isolation index was greater in the house dust of patients with concomittant infection of other family members and with lesions of scaly and inflammatory type. M. canis was isolated from cats and goat of patients by the hair brush technique.
Animals ; Beds ; Cats ; Dust ; Fungi* ; Goats ; Hair ; Humans ; Microsporum* ; Mothers ; Siblings ; Tinea Capitis* ; Tinea*

The Palmaris longus tendon is important not because of its function but because of its usefulness as a donor tendon. Variations in the palmaris longus muscle ar elfrequent and the most common variation of the muscle is its absence. The incidence of absence of this muscle varies in different racial groups. Reinmann and his coworkers found the palmaris longus muscle absent in 12.9% of in their 1,600 limbs surgery. We have experiened 307 cases of palmaris longus graft surgery and found that there were 4 cases of absence of the palmaris longus tendon. We examined 2,000 limbs of Korean to see the presence of the palmaris longus muscle. Among 1,000 persons, the muscle was absent bilaterally in 11 persons(1.1%). It was absent unilaterally in 32 persons(3.2%). The probability that the muscle is absent in any single limb is 2.7%. There was no significant differences in the incidence of absence by sex or right and left side.
Extremities ; Humans ; Incidence ; Tendons ; Tissue Donors ; Transplants

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

Peripheral nerve injury occurs mostly in company with tendon and muscle injuries, fractures, or dislocations. Because of the disabilities and socioeconomic loss caused by such injuries, much attention must be paid to the initial treatment, and later to the reconstruction and rehabilitation. At department of Orthopedic Surgery, Seoul National University Hospital, 336 patients of nerve lesion were treated from Jan, 1980 to Dec, 1988. Among them 128 patients were nerve compression syndrome (carpal tunnel 52 patients, cubital tunnel 40 patients, thoracic outlet 16 patients, others 20 patients), and 50 patients were brachial plexus injury, and 168 cases were peripheral nerve injury. 50 patients of the peripheral nerve injury were treated with reconstruction and 118 patients were treatred with neurorrhaphy, nerve graft, and neurolysis. Of the 118 patients, 94 patients were followed up for more than one year, and the results of neurorrhaphy, nerve graft and neurolysis were analyzed. In 46 patients (73.0%) of the patients treated with neurorrhaphy, 7 patients (58.3%) with nerve graft, and 15 patients (78.9%) with neurolysis, good or excellent results were obtained.
Brachial Plexus ; Dislocations ; Humans ; Nerve Compression Syndromes ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Rehabilitation ; Seoul ; Tendons ; Transplants

No abstract available.

No abstract available.
Vitamin K Deficiency* ; Vitamin K* ; Vitamins*

This experimental studies was to investigate the location of PNS and CNS labeled neurons following injection of 2% WGA-HRP and pseudorabies virus (PRV), beta-galactosidase inserted Bartha strain, into the epididymis of rats. After survival times 4~5 days following injection of 2% WGA-HRP and PRV-Ba-Gal, the rats were perfused, and their brain, spinal cord, sympathetic ganglia and spinal ganglia were frozen sectioned (30 mm). These sections were stained by HRP histochemical and beta-galactosidase histochemical staining methods, and observed with light microscope. The results were as follows : 1. The WGA-HRP labeled sympathetic ganglia projecting to the epididymis were observed in pelvic ganglion and L1-6 lumbar sympathetic ganglia. 2. The WGA-HRP labeled spinal ganglia projecting to the epididymis were observed in L1-6 spinal ganglia. 3. The beta-galactosidase labeled neurons projecting to the epididymis were observed in lamina VII of cervical segments. In thoracic segments, beta-galactosidase labeled neurons were observed in dorsomedial part of lamina I, II and III. Dense labeled neurons were observed in intermediolateral n. and dorsal commissural n.. In lumbar segment, labeled neurons were observed in lamina III, IV, V, dorsal commisural n. and superficial dorsal horn. 4. In the medulla oblongata, beta-galactosidase labeled neurons projecting to the epididymis were observed in the trigeminal spinal n., A1 noradrenalin cells/C1 adrenalin cells/caudoventrolateral reticular n., rostroventrolateral reticular n., area postrema, n. tractus solitarius, raphe obscurus n., raphe pallidus n., raphe magnus n., parapyra-midal n., lateral reticular n. and lateral paragigantocellular reticular n.. 5. In the pons, labeled neurons were observed in Kolliker-Fuse n., locus coeruleus, subcoeruleus n. and A5 noradrenalin cells. 6. In midbrain, labeled neurons were observed in periaqueductal gray substance, retrorubral n., substantia nigra and dorsal raphe n.. 7. In the diencephalon, labeled neurons were observed in paraventricular hypothalamic n., lateral hypothalamic nucleus., medial preoptic n. and retrochiasmatic n.. These results suggest that WGA-HRP labeled neurons of the spinal cord projecting to the rat epididymis might be the first-order neurons related to the viscero-somatic sensory and sympathetic postganglionic neurons, and beta-galactosidase labeled neurons of the brain and spinal cord may be the second and third-order neurons response to the movement of vascular smooth muscle in epididymis. These beta-galactosidase labeled neurons may be central autonomic center related to the integration and modulation of reflex control linked to the sensory and motor system monitoring the internal environment. These observations provide evidence for previously unknown projections from epididymis to spinal cord and brain which may be play an important neuroanatomical basic evidence in the regulation of epididymal function.
Animals ; Area Postrema ; beta-Galactosidase ; Brain ; Diencephalon ; Epididymis* ; Ganglia, Spinal ; Ganglia, Sympathetic ; Ganglion Cysts ; Herpesvirus 1, Suid* ; Horns ; Hypothalamic Area, Lateral ; Locus Coeruleus ; Male ; Medulla Oblongata ; Mesencephalon ; Muscle, Smooth, Vascular ; Neural Pathways* ; Neurons ; Periaqueductal Gray ; Pons ; Pseudorabies* ; Rats* ; Reflex ; Spinal Cord ; Substantia Nigra ; Wheat Germ Agglutinin-Horseradish Peroxidase Conjugate*

A 23-month-old male patient with treated bronchitis underwent a surgery for the repair of bilateral Hutch's diverticulum of bladder under general anesthesia. He treated bronchitis during 2 weeks since 3 weeks before operation. Arriving operating room, he had mild coughing with sputum. During anesthesia, he was well ventilated but endotracheal secretion was profuse. At ABGA of 2 hours after starting anesthesia, severe hypercapnea(PaCO2: 190.2 mmHg) and severe acidosis(PH: 6.746) were checked. Active treatment was done by suction of endotracheal secretion, hyperventilation, PEEP(5~10 cmH2O), increasing fresh gas flow rate(3.6 L/min --> 7 L/min), and administration of sodium bicarbonate, orciprenaline sulfate and methyl- prednisolone. After 3 hours of treatment, ABGA was normalized and symptoms including wheezing were relieved.
Anesthesia ; Anesthesia, General ; Bronchitis* ; Child* ; Cough ; Diverticulum* ; Humans ; Hypercapnia* ; Hyperventilation ; Infant ; Male ; Metaproterenol ; Operating Rooms ; Prednisolone ; Respiratory Sounds ; Sodium Bicarbonate ; Sputum ; Suction ; Urinary Bladder*