It is well known the early diagnosis and early treatment is very important for the patient with congenital dislocation of the hip(CDH) to provide a favorable function in the whole life. However, despite screening programmes for the detection of CDH, children with dislocated hip continue to present late. While there has been general agreement as to the need for treatment of persistent acetabular dysplasia secondary to CDH, the appropriate treatment has been a matter of controversy for many years, and the surgical treatment of CDH in old children presents a more formidable technicalchallenge than in younger child. The author studied 26 cases in 23 patients of CHD aged between 6 years and 13 years at the Department of Orthopedic Surgery of Yonsei University during a 6 year period from January, 1979 to December, 1984. The aim of this study was to find out available surgical treatment for the old childhood with CDH and to assess the comparative results of age, degree of acetabular dysplasia and the station of femoral head displacement. The results of this study are are as follows; l. Among the 23 patients, female was 20 patients, male was 3 patients and 3 female patients show bilateral involvement. And among 26 cases, left hip involvement was 21 cases and right hip involvement was 5 cases. 2. Age at initial operation was 8 years and 10 months in average ranging from 6 years and 2 months to 13 years and 4 months, and average follow-up time was 3 years and 11 months ranging from 1 year 6 months to 5 years 2 months. 3. Attended type of surgery of the CDH in old childhood were 4 cases of Salter's innominate osteotomy, 5 cases of Sutherland's double innominate osteotomy, 5 cases of Salter's innominate osteotomy with femoral shortening and 12 cases of Klisic procedure. 4. Age of the patient as well as degree of acetabular dysplasia and station of femoral head displacement may influence on determination of type of the surgical procedure. 5. The older the age at initial operation and the more the displacement of femoral head, the results was less favorable. 6. As in young childhood, the clinical results of treatment are invariably better than the radiological results. 7. Overall final results of leg length discrepancy was 1.0cm in length and range of leg length discrepancy differs from type to type of surgical procedure. 8. Complications developed after treatment were avascular necrosis of femoral head in one case, fracture of the ipsilateral femure in 3 cases and wound infection in 1 case.
Acetabulum ; Child ; Dislocations ; Early Diagnosis ; Female ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Leg ; Male ; Mass Screening ; Necrosis ; Orthopedics ; Osteotomy ; Wound Infection

No abstract available.
Capillaries* ; Ischemia* ; Muscle, Skeletal* ; Tourniquets*

Aneurysmal bone cyst is an uncommon tumor-like lesion of the bone, containing distended channels or cavities filled with blood. This case, a eighteen years old female, complained of pain and swelling in the right lateral aspect of thigh. Roentgenograms showed a ballooned-out distension of the shaft of the femur, eccentric buldging of the cortex and soap-bubble appearance of interior of the lesion. The case was treated with radical curettage and autogenous bone graft with bone chips which were taken from the iliac wing. Pathological examination grossly and microscopically revealed an aneurysmal bone cyst. Patient made an uneventful recovery, and 11 months later she had no complaints and no evidence of recurrence.
Aneurysm ; Bone Cysts ; Curettage ; Female ; Femur ; Humans ; Recurrence ; Thigh ; Transplants

Amputation is an unpleasant affair, generating a very negative aura that must be consciously combated. For optimal care of amputation, the surgeon needs not only to be comprehensive trained in reconstructive surgery but also to be knowledgeable about prosthetics. The evolution of an artificial arm can be traced first from the cosmetic prosthesis, then to that with passive movements, and lastly to an artificial limb with active movement which made it possible to restore to some degree the lost function of the amputation limb. But the gap between basic requirement of function and cosmesis is still present in conventional prosthesis. Myoelectric prosthesis was introduced for upper extremity amputees since 1960 by Korbinski and his co-workers and was most exciting improvement in the field of prosthetics. Two patients of bilateral above-elbow and bilateral below-knee amputees with myoelectric prostheses and conventional prostheses were compared in their function, cosmesis and acceptability of patient. Myoelectric prosthesis shows not only favorable cosmesis but also excellent function in range of motion and coordination of mechanical joints. And myoelectric prosthesis provides superior pinch force and requires less energy expenditure than a body-powered conventional prosthesis. So, in spite of the high cost of the appliance and of continued maintenance and repair, improvement in comfort, cosmesis and function have had to good level of acceptance of patients. Further research will undoubtedly improve the appearance, function and durability of the present electrically powered myoelectric prosthesis, making them even more acceptable and useful to lower limb and upper limb amputees.
Amputation ; Amputees ; Artificial Limbs ; Energy Metabolism ; Epilepsy ; Extremities ; Humans ; Joints ; Lower Extremity ; Prostheses and Implants ; Range of Motion, Articular ; Upper Extremity

No abstract available.
Slipped Capital Femoral Epiphyses*

Legg-Calve-Perthes disease is a hip disorder of undetermined etiology, occurring in children and characterized by necrosis and repair of the proximal femoral epiphysis. Many methods of the treatment were reported with good result and the goals of them were prevention of deformity of femoral head and secondary osteoarthritis of femoral head with concept of containment. The purpose of this study is to determine the significance of soft tissue release operation in patient of Legg-Calve-Perthes disease, whose prognosis will be poor by clinical and rsdiological evaluation at diagnosis. Soft tissue release operation was carried out 21 hips of 19 patients of Legg-Calve-Perthes disease at Severance Hospital from January 1986 to October 1987 and satisfactory result was obtained. We consider our method as new, effective treatment modality and its significance is to reduce abnormal pressure to femoral head, to restore normal range of motion, to avoid recurrent ischemia, and, finally, to avoid progression of deformity by soft tissue release operation.
Child ; Congenital Abnormalities ; Containment of Biohazards ; Diagnosis ; Epiphyses ; Head ; Hip ; Humans ; Ischemia ; Legg-Calve-Perthes Disease ; Methods ; Necrosis ; Osteoarthritis ; Prognosis ; Reference Values

PURPOSE: To describe soft-tissue radiographic and high-resolution CT findings of radiation-induced lung injury of rabbit over time and to correlate them with pathologic findings. MATERIALS AND METHODS: 15 rabbits were irradiated in the right lung with one fraction of 2000 cGy. After 4, 6, 12, 20, 24 weeks, 3 rabbits in each group were sacrificed and soft-tissue radiographs and high-resolution CT of their lung tissue were obtained. Radiological findings were correlated with pathologic findings. RESULTS: On soft- tissue radiogram, radiation pneumonitis shown as consolidation with air-bronchogram occurred in 3 cases after 6 weeks, and in 1 case after 12 weeks of irradiation. In addition, pneumonic consolidation with adjacent pleural contraction was seen in 2 cases after 12 weeks of irradiation. Fibrotic changes indicated by decreased volume occurred after 20 weeks and combined bronchiectatic change and bronchial wall thickening appeared after 20 weeks(N=1), and 24 weeks(N=3). HRCT findings of radiation pneumonitis were homogeneous, increased attenuation after 4 weeks(N=3), 6 and 12 weeks (each N=I), patchy consolidation after 6 and 12 weeks(each N=2), discrete consolidation after 12, 20 and 24 weeks(each N=I) and solid consolidation after 20 and 24 weeks(each N=2). Pathologically radiation pneumonitis and pulmonary congestion were seen after 4 and 6 weeks. After 6 weeks, collagen and reticulin fibers were detected along alveolar wall. Mixed radiation pneumonitis and fibrosis were detected after 12 weeks. 20 weeks after irradiation, fibrosis was well defined in interstitium and in 24 weeks, decreased number of alveoli and thickening of bronchial wall were defined. CONCLUSION: Radiation pneumonitis was provoked 4 weeks after irradiation on rabbit lung and progressed into radiation fibrosis 20 weeks after irradiation on soft-tissue radiographs and high-resolution CT. High-resolution CT is more precise in detecting early radiation pneumonitis and detailed pathologic findings.
Collagen ; Estrogens, Conjugated (USP) ; Fibrosis ; Lung Injury ; Lung* ; Rabbits ; Radiation Pneumonitis ; Reticulin

No abstract available.
Foreign Bodies* ; Granuloma, Foreign-Body* ; Lipectomy*

BACKGROUND: Non ulcer dyspepsia(NUD) is a commonly encountered disease at the primary practice. The relations of functional gastrointestinal disorder and Irritable bowel syndrome with depression or stress were suggested by previous studies. But the contributions of the anxiety, depression and stress as a whole to the NUD were not assessed. In this study, we wanted to show the associations of the anxiety, depression and stress levels with NUD. METHODS: This study was performed by case and control method from Aug. 1 to Sep. 7 at the outpatient department of Family Medicine and at the Health Management and Service department in Pusan Paik Hospital. The both groups were matched by sex and age. The case was defined who has three or more symptoms among nine upper gastrointestinal symtoms like dyspepsia, epigastric pain and anorexia etc. frequently or alwalys and who has no ulcer at the gastrofibroscope. The anxiety, depression, stress levels were measured by questionnaire which was validated by previous studies. The questionnaire was composed of Trait-STAI, Jung's Self Depression Scale(SDS), Modified BEPSI, and Grobal Assessment of Recent Stress(GARS) Scale. RESULTS: The total subjects were 136 persons(NUD group : 86 persons/control group : 86 persons). There were. significant differances in regularity of diet(P<0.001), levels of education(P=0.009), and history of medications(P<0.001) between two groups. The two group had higher scores than the control group in the depression score, anxiety score and modified BEPSI score(P<0.001). All items in GARS showed higher scores in NUD group than in control group(P<0.001). CONCLUSIONS: NUD group had higher degree of anxiety and depression than the control group. It seems that the NUD may have streeful status. When we encounter the NUD in outpatiet department, we had better consider the underlying psychogenic or stressful conditions.
Anorexia ; Anxiety* ; Busan ; Depression* ; Dyspepsia* ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Outpatients ; Ulcer* ; Surveys and Questionnaires

No abstract available.
Constriction, Pathologic*