No abstract available.
Genu Varum*

No abstract available.
Fingers* ; Toes*

No abstract available.
Ear*

No abstract available.
Humans ; Religion*

Primary aldosteronism is a disease that the stimulus for the excessive aldosterone production residues within the adrenal gland. It was first described by conn in 1955. And many cases were reported by physicians at present in the world. But it is relatively rare in Korea, probably due to lack of attention and medical facilities. Only about 13 cases have been reported at present. The clinical, biochemical feature in l case of primary aldosteronism caused by adrenal hyperplasia that was diagnosed at Yeungnam University Hospital was observed and the following result were obtained. 1. Clinical feature: The present case was 27-year-old woman who was admitted due to general weakness and easy fatigability. The above mentioned chief complaints occurred 8 months prior to admission when she delivered of second baby by cesarean section. Symptoms such as above chief complaints, intermittent muscle paralysis and cramping were noticed. Trousseau's sign was also present. The average blood pressure ranged from 170/90 to 200/120 2. Biochemical abnormalities: Severe hypokalemia lower than 2.5 mEq/L was presented and 24 hours urine potassium showed markedly increased urinary loss (228 mEq/day). Plasma rennin activity was decreased under normal range with furosemide administration. (Basal renin; 0.01 ng/ml/hr, stimulated rennin 0.12 ng/ml/hr). Saline suppression test revealed markedly elevated levels of aldosterone higher than normal range (Basal aldosterone; 320.68 pg/ml stimulated aldosterone; 451.86 pg/ml). And posture test showed decreased plasma rennin activity and increased plasma aldosterone level. 3. Adrenal CT scan revealed no abnormal findings. 4. Treatment and course: Spironolactione was given at OPD with regular follow-up. Her blood pressure ranged from 150/90 to 160/100 and symptoms were improved. The effect of treatment was satisfactory and further follow up would be performed.
Adrenal Glands ; Adult ; Aldosterone ; Blood Pressure ; Cesarean Section ; Chymosin ; Female ; Follow-Up Studies ; Furosemide ; Humans ; Hyperaldosteronism* ; Hyperplasia* ; Hypokalemia ; Korea ; Muscle Cramp ; Paralysis ; Plasma ; Posture ; Potassium ; Pregnancy ; Reference Values ; Renin ; Tomography, X-Ray Computed

No abstract available.
Mucin-1* ; Poroma*

Thirteen Polio patients with leg length inequality were undergone Ilizarov lengthening procedures and have been followed along for an average two years(range, 1-3.8 years) after removal of the fixator. The age of patients(M:F=7:6) ranged from 18.0 to 32.2 years(average 26.4 years). The difference of true leg length averaged 2.1cm with the tibia being 3.3cm the femur, 1.2cm. The corticotomy was done at the proximal tibia and distal fibula in all case. The fixation period of the Ilizarov apparatus averaged 9.3 months. The length gain averaged 3.0cm for an average 3.8cm inequality. The healing index averaged 3.1mon/cm. Two out of thirteen patients complained of pain in the operated leg. The limping gait was improved in all patients except one. According to Paley's classification, there were ten cases of problems, one obstacle and four true complications. The problems were pin site infection controled with local antibiotics injection. There was one case of obstacle; tibial valgus deformity developed during lengthening. True complications included peroneal nerve injury, aggravation of preexsiting equinovalgus and claw toe deformities, aggravation of preexsiting valgus deformity of ankle and tibial valgus deformity. The complications execpt in one case of peroneal nerve palsy were solved out by the secondary procedures. In summery, the bone healing by distraction osteogenesis with the Ilizarov technique was relatively delayed in polio patients and it seems necessary to modify the technique to shorten the prolonged external fixation period.
Ankle ; Anti-Bacterial Agents ; Classification ; Congenital Abnormalities ; Femur ; Fibula ; Gait ; Hammer Toe Syndrome ; Humans ; Ilizarov Technique ; Infection Control ; Leg Length Inequality ; Leg ; Osteogenesis, Distraction ; Paralysis ; Peroneal Nerve ; Poliomyelitis ; Socioeconomic Factors ; Tibia

There are many difficult problems and various methods in the treatment of difficult fractures of the femur. Form May 1991 to August 1994, 9 cases of difficult fractures of the femur were treated with Ilizarov external fixator. We obtained good result for all cases as follow : 1. There were 1 case of severely segmental and comminuted fracture with bone loss, 3 cases of infected nonunion after internal fixation(2 cases combined with bone loss), 2 cases of non-union after internal fixation and 3 cases of severely segmental and comminuted fractures. The traffic accident injury was in 6 cases and the falling down injury was in 3 cases. 2. The bone union was obtained in all cases and the duration of Ilizarov external fixator application was minimum 7.7 months up to 19 months with an average of 1.3 months and full weight bearing was possible in all cases after removal of the Ilizarov external fixator. 3. We experienced 9 complication; there were 6 cases of pin tract infection which were controlled by antibiotic injection at that site and there were three cases of limitation of motion of knee. So we conclude that the Ilizarov external fixation technique is one of the effective methods for the treatment of difficult fracture of the femur(ex. segmental, comminuted fracture, bone defect, osteomyelitis and nonunion) in spite of having experienced only few cases.
Accidental Falls ; Accidents, Traffic ; External Fixators ; Femur ; Fractures, Comminuted ; Knee ; Osteomyelitis ; Weight-Bearing

Distraction osteogenesis techniques have provided more than a clinical treatment of limb length discrepancies and bone deformities. The nature of this mechanical environment and the characteristics of the regenerate bone are not typical of that found elsewhere in the skeleton. The purposes of this study were to investigate the physical and mechanical properties of regenerate bone in different consolidation period (sacrificing at the period of 8, 12, 18, 20, 24, 26 weeks post surgery) and to find out the relationship between both properties. Two ring Ilizarov fixators were applied to the right tibia in 7 large, skeletally mature dogs. A subperiosteal osteotomy of tibia was performed. Postoperatively, after 7 days of latency period, distraction was begun. Distraction of 1mm daily, 3 times per day was continued until radiographic evidence of a 2.5 cm distraction. Sacrifice was at 8, 12, 18, 20, 22, 24, 26 weeks post surgery. Allof the specimens were obtained from regenerate bone and were cutted in the rectangular shape of approximately 8x4x4 mm. Specimens were tested in axial compression and displayed an average modulus of elasticity of 215(sd=184)Mpa, an average yield stress of 3.58(sd=2.54)MPa, an average apparent bone density of 0.399(sd=0.107)g/cc, and an average ash weight density of 0.164(sd=0.084)g/cc. A linear regression of yield stress on modulus of elasticity was significant(p < 0.001) with R-square=0.28, and a slope of 0.007. The radiographic bone densitometry was performed before sacrifice. The results of densitometry of regenerate bone was osteoporotic comparing with those of the opposite tibia which did not be operated in all of the animals. The linear regressions of mechanical properties on physical properties were significant, only 12-34% of the variance in mechanical properties could be explained by the physical properties. In conclusion, based on the observation of the low ash fraction, it would be expected that the relationship between physical properties and mechanical properties may not be strong. This study suggested that the regenerate bone was a composite of bone and non-mineralized tissue until 26 weeks of post surgery. For the more accurate information of material property, testing of real regenerate bone without non-mineralized bone may be necessary.
Animals ; Bone Density ; Congenital Abnormalities ; Densitometry ; Dogs ; Elastic Modulus ; Extremities ; Latency Period (Psychology) ; Linear Models ; Osteogenesis, Distraction ; Osteotomy ; Skeleton ; Tibia

Leg length discrepancy or short stature is a significant problem to patient psychosocially, cosmetically, and there has been many efforts for limb lengthening. There are many report about lower limb lengthening since the first description of femoral lengthening by Codivilla in 1905. Although limb lengthening using external fixator was popularized by Anderson, the result was poor because of many difficulties in techniques and complications. Recently, a great progress in lower limb lengthening was made by distraction osteogenesis by llizarov and callotasis by De Bastiani. But as such exter- nal fixator has some problem in technique, cosmesis or complications. Therefore gradual elongation intrameduilary nailing(Albizzia) developed by Guichet in 1986 has gained attention for more stability and relatively less discomfort. We reviewed 18 cases in 11 patients(5 males and 6 females) who visited the department of Orthopedic Surgery of Severance Hospital at Yonsei University with limb leg length discrepancy due to sequeale of poliomyelitis, familial short stature and Turner syndrome. They all underwent lower limb lengthening using Albizzia technique between December 1995 and January l997. The average age at the time of the operation was 22.7 year. Famiiial short stature was in 12 cases(67%), Turner syndrome in 2 cases(11%), and leg length discrepancy due to the sequelae of poliomyelitis in 4 cases(22%). The site of lengthening were 5 cases of femur(28%) and l3 cases of tibia(72%). The latency period was average of 7 days. During the distraction period, 15 ratchetings per day(1 mm/day) were performed. In case of bilaterai femoral lengthenings, average length of gain(LG) was 6.0cm and percentage of increase(PI) l6.8%(16.2-17.4), lengthening index(LI) 1.2 month/cm(0.75-2.2). In case of unilateral femoral lengthening, LG was 3.8cm, Pl 7.8 %, Ll 1.3 month/ cm. In case of bilateral tibial lengthening, average LG was 5.5cm(3.5-6.0~) and Pl 18.8%(12.0-22.9), LI 1.3month/cm(0.67-2.3). In case of unilateral tibial lengthening, LG was 2.9cm(2.3-3.5), P1 9.4 %(7.7-11.7), LI 2.8 month/cm(2.2-3.1). Lengthening index in poliomyelitis by llizarov was 3.l month/cm, but it was 1.3 in femur and 2.8 in tibia hy Albizzia method. There are some advantages and disadvantages or contraindications and indications of the Albizzia technique. We suggest that the Albizzia technique is more stahle, more comfortable and no longer lengthening time compared to external fixator such as Ilizarov.
Albizzia ; External Fixators ; Extremities* ; Femur ; Humans ; Latency Period (Psychology) ; Leg ; Lower Extremity ; Male ; Orthopedics ; Osteogenesis, Distraction ; Poliomyelitis ; Tibia ; Turner Syndrome