Two cases of epidermal nevi treated with systemic etretinate are presented. Case 1, a 21-year-old female, had been suffered from brownish verrucous papules and plaques on the left inguinal area, thigh, lower leg and dorsum of the foot since her first month of life; and case 2, a 4-year-old boy, had been suffered from brownish verrucous papular plaques on the left chest, axilla and back since birth. In both cases, there was no family history of similar disease. On histopathological examination, case 1 showed the findings of epidermolytic. hyperkeratosis but case 2 did not, with the exception of clumping of keratohyaline granules. In the treatment with systemic etretinate, we observed marked clinical improvement in case 1, but not in case 2. Any particular side effects of etretinate were not observed during treatment. We consider that etretinate therapy is useful in treating epidermal nevus with epidermolytic hyperkeratosis histopathologically.
Acitretin* ; Axilla ; Child, Preschool ; Etretinate* ; Female ; Foot ; Humans ; Hyperkeratosis, Epidermolytic ; Leg ; Male ; Nevus* ; Parturition ; Thigh ; Thorax ; Young Adult

Regular hemodialysis has been established as a way of treatment for end stage renal failure. In adults, hemodialysis 5 hours each time, three times weekly with one square meter hemodialyzer is now widely accepted as a standard, and there are many reports on long term follow up studies. Quite a large difference are present, however, in our community mainly originated from patient's poor compliance in frequent dialysis with short interdialysis interval. The author analyzed 200 cases of chronic renal failure who have received hemodialysis treatments during the 5 year period from July 1976 to June 1981 at the hemodialysis unit of the hanyang University Hospital and the following results are obtained; 1. Actual one year survival rate was much higher in thrice(87.1%) than one(35.1%) or twice(54.1%) weekly dialysis. 2. Long term(more than 6 months) complications were also more frequent in once(85.7%) or twice(70.2%) weekly treatments than in thrice(22.2%). The predominant complications were congestive heart failure, pericarditis, and infections. 3. Those who recieved three times weekly dialysis had better rehabilitation grades than the patients groups of twice or once weekly treatment. 4. Of peridialysis distressful symptoms, nausea, vomiting dizziness were less frequent in the group three times a week dialysis. In contrast, headache, hypotension, muscle cramps, and weakness were not significantly related with frequency of hemodialysis. 5. Those who voided a large amount of urine output had better survival and less frequent requirement of blood transfusions. 6. Main causes of death were due to patient poor compliance, hyperkalemia and cerebrovascular acidents. 7. Economic problems were the major cause of dialysis interruption.
Adult ; Blood Transfusion ; Cause of Death ; Compliance ; Dialysis ; Dizziness ; Follow-Up Studies ; Headache ; Heart Failure ; Humans ; Hyperkalemia ; Hypotension ; Kidney Failure, Chronic* ; Kidneys, Artificial ; Muscle Cramp ; Nausea ; Pericarditis ; Rehabilitation ; Renal Dialysis* ; Renal Insufficiency ; Survival Rate ; Vomiting

The medial collateral ligament is the most commonly injured ligamentous structure of the knee and it has been demonstrated that this ligament is the prime static stabilizer of the medial side of the knee joint. The management of the medial collateral ligament injuries were divided into surgical and conservative treatment. Many investigators reported consistently good to excellent results following surgical treatment. More recently, other investigators reported that isolated medial collateral ligament injuries did equally well under non-operative as operative treatment. For accurate diagnosis, arthroscopic examination of the knee to rule out other intraarticular pathologic conditions such as cruciate ligament injuries, maniscal tears and bony injuries is essential. From October 1988 to January 1991, we treated 76 cases of isolated medial collateral ligament injuries which was confirmed by diagnostic arthroscopy. Among them, we analyzed 31 cases that minimum follow-up was over 1 year and could be re-examed, 20 cases were treated with surgery and 11 cases were not. With comparision between initial and final follow-up stress X-ray, 5.45 ± 3.17mm in non-operative group had improved in medial laxity(P < 0.05). The Marshall scores which checked at final follow-up, averaged 40.3 ± 7.299 in operative and 37.364 ± 6.485 in non-operative group (P>0.05). In conclusion, medial stability was improved in operative than in non-operative group, however functional score was equally well under non-operative as operative treatment.
Arthroscopy ; Collateral Ligaments ; Diagnosis ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Ligaments ; Research Personnel ; Tears

Posterior chamber intraocular lenses were implanted into 40 eyes with inadequate capsular or zonular support by securing both haptics of the lenses to the sclera at ciliary sulcus with 10-0 prolene sutures. Our follow-up of 36 eyes with scleral fixated posterior chamber intraocular lenses ranged from 2 months to 8 months(average 4.6 months). At the last follow-up visit. 31 eyes(86%) had a vision of 0.5 or better. Mean refractive error was -1.15 +/- 1.13D. which was -0.67 +/- 0.99D more myopic than predicted (p<0.05). Measurement of anterior chamber depth showed deeper than the control group of posterior chamber intraocular lenses without scleral fixation suture(4.18 +/- 0.42mm, 3.96 +/- 0.29mm, respectively), but which was not statistically significant(p>0.05). Additionally, the difference of postoperative axial length between two groups was not statistically significant(23.39 +/- 0.87mm, 23.42 +/- 0.75mm, respectively). In 4 eyes(ll %), minor intraoperative bleeding oceured but was absorbed spontaneously without any sequelae. One eye(3%) of minimal decentration of PCL, one eye(3%) of subluxation of PCL, and one eye(3%) of exposed scleral fixation suture were noted, but no serious postoperative complication, such as corneal edema, glaucoma, persistent uveitis, or retinal detachment was detected.
Anterior Chamber ; Corneal Edema ; Follow-Up Studies ; Glaucoma ; Hemorrhage ; Lenses, Intraocular* ; Polypropylenes ; Postoperative Complications ; Refractive Errors ; Retinal Detachment ; Sclera ; Sutures* ; Uveitis

The subject of ankle injuries has for a long time been embedded in controversy. The injuries to the ankle joint complex include not only injuries that cause disruption of the bone architecture of the ankle joint but often significant ligamentous and soft tissue components. Strong differences of opinion exist regarding the preferred method of treatment, the length of time immobilization is necessary, the postreduction management and the criteria of what constitutes an acceptable reduction. Follow up of 52 cases was possible which were admitted to the department of orthopedics, Kyung- pook University Hospital during the period of January, 1974 to december 1983. The results obtained from this study were as follows; 1. Among the 51 patient, male was 45 (88.2%) patients and female 6 (11.8%) patients. Most of the patient were in the ages between 20 and 30. 2. Of the 52 cases, the main cause of fractures were traffic accident 33 (63.5%) cases and the other causes were falling from a height 9 (17.5%), slipping down 3 (5.7%) and sport injury 1 (1.9%) in order. 3. Open fracture was 16 (31%) and closed fracture was 36 (69%). 4. According to the classification of Lauge-Hansen, the supination-external rotation type 18 (34.6%) was the commonest type. 5. Among the 52 cases, 32 cases were treated by open reduction and 20 cases by closed reduction. 6. The average peried of the cast immobilization after the open reduction was 6Wks. but the closed reduction was 8Wks. 7. According to clinical and radiological accessment of the result of treatment for bimalleolar Fx, internal fixation of both medial & lateral malleolus was better than medial malleolus only. 8. The fibular fracture involving lateral malleolus and the diastasis of the distal tibiofibular syndesmosis were very important in ankle stability and were treated by internal fixation for accurate anatomical reduction.
Accidental Falls ; Accidents, Traffic ; Ankle Fractures ; Ankle Injuries ; Ankle Joint ; Ankle ; Classification ; Clinical Study ; Female ; Follow-Up Studies ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Ligaments ; Male ; Methods ; Orthopedics ; Sports

Dislocation of the metacapophalangeal joint of the finger is apparently rare except thumb. The mecchanism of injury seems to be direct injury that produces hyperextension of metacapophalangeal joints. In 1957, Kaplan advocated the triple incision, that is release of the volar fibrocartilaginous plate, the natatory ligament, and the superficial transverse metacapal ligament, expose the operation field through palmar approach. In 1975. Becton advocate direct dorsal longitudinal incision. The advantages of this approach as compared with the volar approach are 1. There is full exposure of the fibrocartilaginous volar plate, the main structure blocking reduction. 2. Digital nerves are not as apt to be damaged. 3. Accurate reduction and fixation of the osteochondral fracture of the metacarpal head is possible. We exprenced 6 cases of index metacarpophalangeal dislocation and treated with dorsal approach.
Dislocations ; Fingers ; Head ; Joints ; Ligaments ; Metacarpophalangeal Joint ; Thumb

The carpal tunnel syndroms is the most common peripheral nerve entrapment syndrome. The typical symptom is pain, numbness and paresthesia in the median nerve territory of the hand and progressive thenar atrophy. When the symptom is mild and its duration is short, conservative treatment such as splinting or local steroid injection is considered, but when neurological deficit is promiment and conservative treatment is not effective, surgical decompression is indicated.Authors reviewed 15 patients (23 cases) of carpal tunnel syndrome treated with surgical decomression at the Department of Orthopedic Surgery, Kyung-pook National University Hospital from March 1983 to October 1988. The follow up results are as follows; 1. Preoperatively, Tinel sign was present in 17 cases. Phalen test was positive in 17 cases. Sensory disturbance was present in 8 cases. Thenar muscle atrophy was present in 19 cases. Motor weakness was present in 13 cases. 2. Preoperatively, delay of motor conduction velocity of median nerve was noted in 15 cases (65.2%) and sensory nerve conduction velocity in 20 cases (86.9%). Denervation findings such as fibrillation or sharp waves were seen in 15 cases (65.2%). 3. The operative findings were as follows; Synovial hypertrophy in 12 cases, hypertrophy of transcarpal ligament in 4 cases, pseudoneuroma in 3 cases, ganglion in 2 cases, neurilemmoma in 1 case, gout in 1 case. 4. As the operative findings, median nerve had evidence of compression beneath the transcarpal ligament, consisting of flattening. narrowing and decreased epineurial vascularity. 5. External neurolysis was performed in all cases. 6. In case of long duration and severe thenar atrophy, internal neurolysis would be recommendable. 7. Fllow up period was ranged from 7 months to 6 years. 8. 19 cases (82.6%) were excellent or good results.
Atrophy ; Carpal Tunnel Syndrome ; Decompression, Surgical ; Denervation ; Follow-Up Studies ; Ganglion Cysts ; Gout ; Hand ; Humans ; Hypertrophy ; Hypesthesia ; Ligaments ; Median Nerve ; Muscular Atrophy ; Neural Conduction ; Neurilemmoma ; Orthopedics ; Paresthesia ; Peripheral Nerves ; Splints

Transient hyperkalemia is well known to occur in man following intravenous administration of succinylcholine chloride. To study on change of the serum level of K+, Na+ & Cl- after injection of succinylcholine in healthy adults, physical status 1 or 2 adopted by the American society of Anesthesiologists, we studied in two groups: pentothal sodium-succinylcholine injection group (group 1) as control, flaxedil-pentothal sodium-succinylcholine injetion group(group 2) as experimental. The following results were obtained: 1. Serum K+ was slightly increased in both groups, 2mEq/L at 3rd minute in control group, 2mEq/L at 1st minute in experimental group after succinylcholine injection, but no statistical significance was noticed in either group. 2. Serum Na+ was decreased 3 mEq/L immediately after pentothal sodium injection and then sliyhtly increased until 10th minute in control group. In experimental group lower level than control was observed until 15th minute, with the maximum decrease of 7mEq/L at 5th minute. But no statistical significance was noticed in either group. 3. Serum Cl was slightly decreased until 10th minute with the maximum decrease of 4mEq/L at 5th minute in control group. In experimental group, it was slightly increased until 5th minute. But no significance was noticed in either group.
Administration, Intravenous ; Adult ; Humans ; Hyperkalemia ; Sodium ; Succinylcholine ; Thiopental

We have experienced one case of acute cardiac arrest occurred during removal of a foreign body in the esophagus in a 8 month old boy. We consider the cause of acute cardiac arrest in this patient as acute hypoxia and vagal reflex, and stress the importance of prompt diagnosis, extensive knowledge and correct and skillful resuscitation.
Anoxia ; Diagnosis ; Esophagus* ; Foreign Bodies* ; Heart Arrest* ; Humans ; Infant ; Male ; Reflex ; Resuscitation

Uterine didelphys is a congenital malformation characterized by the presence of two separated hemiuteri andhemivaginas, due to lack of midfusion of the Mullerian ducts. We report a case of UD-BHRA(uterine didelphys withblind hemivagina and ipsilateral renal agenesis), a rare type of uterine didelphys charaterized by symptomaticunilateral hematocolpos due to blind hemivagina after menarche and ipsilateral renal agenesis. The MRI findings in22-year-old woman with bilateral ovarian tumors demonstrated two separated uterine horns and cervical and vaginalcanals, with left hematocolpos and left renal agenesis.
Animals ; Female ; Hematocolpos* ; Horns ; Humans ; Magnetic Resonance Imaging ; Menarche ; Mullerian Ducts