It is well known that double contrast knee arthrography is useful in diagnosis of meniscal lesions and other knee pathology, But intra-articular structures become less well delineated shortly after injection into the kneejoint with water soluble contrast media because of rapid absorption and dilution of the injected media. This limits the time when sharply detailed arthrograms are obtainable and precludes repeat delayed arthrogram withougreinjection of contrast media. In order to overcome this major disadvantage, the authors used epinephrine which has vasoconstrictive effect and is expected to reduce fluid movement across the synovial membrane temporarily. The authors attempted to compare epinephrine inhanced double contrast arthrographic group, einephrine(+) group, to thedouble contrast arthrographic group withoug epinephrine, epinephrine(-) group, by statistical evaluation. Eachgroup consisted of 35 cases and 7 lateral films of knee joint were taken sequentially 2,6,10,15,10,20,30, and 60 minutes after injection of contrast media, and were assessed by 5 certified radiologists. The resuls were as follows; 1. The difference of mean score of quality between epinephrine(+) group and epinephrine(-) group was statistically significant at every time interval (p value<0.01 at 2 minutes, p<0.01 at all other time intervals).Epinephrine(+) group was superior to the epinephrine(-) group in quality of film. 2. Numbers of cases above scoreof 2 which was considered to be of diagnostic quality in evaluating meniscal lesions were larger in epinephrine(+)group than epinephrine(-) group in quality of film. 3. Only 43% of cases was above score of 2 at 10 minutes inepinephrine (-) group, but 97% at 10 minutes and 80% at 20 minutes respectively in epinephrine(+) group. Therefore duration for adequate study of arthrogram is prolonged more than two times in epinephrine(+) group. 4. At 30 minuts, 57% of cases was above score of 2 in epinephrine(+) group while at 15 minuts, 80% of cases was below scoreof 2 in epinephrine(-) group. This makes it possible to repeat study without additional injection of contrast media or postponing of the examination in half of cases, if necessary. 5. The use of epinephrine in kneearthrography results in significant enhancement of radiographic quality initially (p<0.01). Therefore we can fluoroscope in good condition and obtain films of fine quality.
Absorption ; Arthrography ; Contrast Media ; Diagnosis ; Epinephrine ; Knee Joint ; Knee ; Pathology ; Synovial Membrane ; Water

The auther analysed 29 patients who were treated with prednisolone, including nephrotic syndrome (13 cases), acute leukemia(10 cases), bronchial asthma (2 cases), juvenile rheumatoid arthritis (2 cases) and ulcerative colitis (1 cases) patients in childhood, after remission induction, pro9longed alternate or interrupted treatment was used. The auther observed patterns of height velocity of these patients from 1.6 to 10.3 years. The results were as follow 1) Of the total 29 patients who were treated with prednisolone, most of them showed normal height velocity within the percentile channels, but 4 cases (13.8%) of them showed delay in height velocity. 2) The 4 cases who delayed in height velocity, including 2 cases of bronchial asthma and 2 cases of juvenile rheumatoid arthritis patients, received prednisolone daily about 0.4~1.5mg/kg from 3 to 6 years alternatively or interruptedly. Height velocity was decreased from bet ween 3 and 25 percentile channel at first to below 3 percentile channel at last contiously. 3) In these 4 cases, height velocity was inversely proportion to dosage of prednisolone.
Arthritis, Juvenile ; Asthma ; Colitis, Ulcerative ; Humans ; Nephrotic Syndrome ; Prednisolone ; Remission Induction

Legg-Calve-Perthes disease is a hip disorder of undetermined etiology, occurring in children and charaterized by necrosis and repair of the proximal femoral epiphysis. Its etiology and treatment continue to command intense interest among orthopaedic surgeons. It is the purpose of this paper to evaluate the result of our experience in the selected patients with Legg-Calve-Parthes disease treated by innominate osteotomy, In this study, six cases of Legg-Calve-Perthes disease treated at Severance Hospital from March 1976 to November 1978 were analysed clinically, and gratifying results were obtained.
Child ; Epiphyses ; Hip ; Humans ; Legg-Calve-Perthes Disease ; Necrosis ; Osteotomy ; Surgeons

Many procedures of quadricepsplasty were reported by Thompson (1944), Judet (1959), van Nes (1962), Nicoll (1963) and Hesketh (1963) in confining the indication of them for the strictly extra-articular origin of their causes. During the period of January 1979 to August 1979, 5 cases of stiff knee joints were surgically treated by means of arthrolysis and quadriceps release. The result were gratifying. The average gain of flexion was 119 degrees, and extension lag was absent except a case which had compression fracture of femoral condyle.
Fractures, Compression ; Knee Joint ; Knee

It is the purpose of this article to determine various normal anatomic measurements of temporomandibular joint and normal range of condylar movement using relatively simple X-ray equipment and radiographic technique in consideration of popular clinical application. Author's cases condisted of 100 clinically normal adult males and temporomandibular joint radiographs of 3 serial position so condylar head were taken by transcranial obliquelateral pojection in each case. The serial positions are centric occlusion, 1 inch opening and maximal opening position. The results were as follows; 1. In cetric occlusion, the length between the condylar head and glenoidfossa was 2.23±0.58mm in anterior part, 3.55±0.80mm in upper part and 2.76±0.72mm in posterior part. 2. Incentric occlusion, the angle (alpha) between the horizontal standard line(AB) and anterior slope (BC) was 37.22±3.87 degrees. 3. In 1 inch opening position, the distance between the summit of condylar head from thestandard point of articular eminence (B) was
Adult ; Head ; Humans ; Male ; Mandible ; Reference Values ; Temporomandibular Joint

Clear cell sarcoma of tendon and aponeurosis is a rare malignant tumor. It occurs chiefly in young adults, predominates in women and is most common in the regions of the foot and ankle. We report a case of clear cell sarcoma of tendon and aponeurosis in s 22-year-old man. he pstient had had a asymptomatic, normal skin colored, relativerly hard, dome shsped nodule on the anterior chest for 6 months. Histopsthologic findings revealed uniform pattern composed of compact nests of round or fusiform cells which had clear cytoplasm and were surrounded by delicate framework of fibrocollagenous tissue, and the individual tumor cell had a fairly regular appearance of possessing round to avoid vesicular nucleus with prominent basophilic nucleolus. One year after surgical excision and post operative radiotherapy, there was no recurrence.
Ankle ; Basophils ; Cytoplasm ; Female ; Foot ; Humans ; Radiotherapy ; Recurrence ; Sarcoma, Clear Cell* ; Skin ; Tendons ; Thorax* ; Young Adult

OBJECTIVES: This study aimed to develop an effective and efficient obesity treatment and management service platform for obese children/teenagers. METHODS: The integrated smart platform was planned and established through cooperation with service providers such as hospitals and public health centers, obese children/teenagers who constitute the service's user base, and IT development and policy institutions and companies focusing on child-teen obesity management and treatment. RESULTS: Based on guidelines on intervention strategies to manage child-teen obesity, we developed two patient/parent mobile applications, one web-monitoring service for medical staff, one mobile application for food-craving endurance, and one mobile application for medical examinations. CONCLUSIONS: The establishment of the integrated service platform was successfully completed; however, this study was restrictively to the hospital where the pilot program took place. The effectiveness of the proposed platform will be verified in the future in tests involving other organizations.
Delivery of Health Care ; Humans ; Medical Staff ; Mobile Applications ; Obesity* ; Pediatric Obesity ; Public Health ; User-Computer Interface

We report a case of metastatic carcinoma of the skin in 62-year-old male who showed multiple nodules on the anterior chest, scalp, face and left axilla for 2 months duration. He suffered from lower abdominal discomfortness for 6 months. Histopathologic findings revealed atypical cell nests and some tubular or glandular formation in the dermis and subcutaneous fat tissue. Material in the lumen showed diastase resistant and PAS positive, and alcian blue positive at pH 2.4, but negative pH 0.4. So it represented sialomucin. We did not find primary site of malignant tumor. In view of clinical and histopathological findings, it was considered to be originated from the large intestine.
Alcian Blue ; Amylases ; Axilla ; Dermis ; Humans ; Hydrogen-Ion Concentration ; Intestine, Large ; Male ; Middle Aged ; Scalp ; Sialomucins ; Skin* ; Subcutaneous Fat ; Thorax

Early diagnosis of persistent abnormal reflexes may be of great significance to a more effective functioning of the cerebral palsied child. It is important to know the normal and abnormal reflex responses and their effect upon motor development for providing a basis for evaluation in the diagnosis and treatment of the cerebral palsied child. We studied 28 cerebral palsied children, between 1 to 12 years old, who were treated at Sam Yook Childrens Rehabilitation Center from May 1975 to December 1977. The pathologic reflexes were checked, and the relationship between pathologic reflexes and walking was compared. The following results were obtained. 1. The following were the most important pathologic reflexes in non-walking fgroup: a. Positive supporting reaction b. Protective extensor thrust c. Moro reflex 2. If they are present, the prognosis for walking ambulation was bad and surgery will not improve for the chances of walking.
Child ; Diagnosis ; Early Diagnosis ; Humans ; Prognosis ; Reflex ; Reflex, Abnormal ; Reflex, Startle ; Rehabilitation Centers ; Walking

Primary hyperparathyroidism is a rare endocrine disease in children. It involves bone and joint, urinary tract, gastrointestinal tract and cardiovascular system. The main cause of these involvement is high level of PTH in serum, resulting in hypercalcemia.An 11 years old male patient who had complained of limping gait since last 18 months, showed typical laboratory and radiological findings of primary hyperparathyroidism. At the ultrasonography, computed tomography and radionuclide scanning, a well defined mass(10 X 15mm) was found on the posterior aspect of the right thyroid lobe. The mass was confirmed histologically as adenoma of parathyroid gland. The patient was successfully treated with subtotal parathyroidectomy and temporal administration of calcium and vitamin D.We report this case of primary hyperparathyroidism with brief review of the literatures.
Adenoma ; Calcium ; Cardiovascular System ; Child ; Endocrine System Diseases ; Gait ; Gastrointestinal Tract ; Humans ; Hyperparathyroidism, Primary ; Joints ; Male ; Parathyroid Glands ; Parathyroidectomy ; Thyroid Gland ; Ultrasonography ; Urinary Tract ; Vitamins