No abstract available.

In the treatment of DDH, generally we have used the acetabular index (AI) and the center-edge (CE) angle as diagnostic factors for hip dysplasia. However, it is sometimes difficult to mark the exact lateral edge of the acetabulum to measure these factors due to indistinct bony shadows on the image of the dysplastic hip. The purpose of this study was to evaluate the lateral edge of the acetabulum to determine the location of the most accurate marking point on the plain radiograph. Using plain radiograph, we studied 53 patients with DDH which were treated with closed reduction. 26 patients were studied using plain radiograph and another method: 16 patients with 3- DCT, 4 patients with MRI, and 6 patients with arthrograph. According to this study, the most lateral bony margin of the acetabular roof on the plain radiograph indicates the antero-lateral portion of the acetabulum. The lateral edge of the sourcil indicates the lateral margin of the centro-lateral (mid-superior) portion of the acetabulum. The marking point on the lateral end of the sourcil reflects a dysplastic condition of the acetabulum, especially in the mid-superior portion of the acetabulum.
Acetabulum* ; Hip ; Hip Dislocation ; Humans ; Magnetic Resonance Imaging

A 56-year-old man received subtotal gastrectomy for an early gastric carcinoma type IIa+IIc with submucosal invasion. The tumor was made up of mixed papillo-tubular adenocarcinoma and solid carcinomatous portion, the latter comprising approximately four-fifths of the total tumor mass. The solid portion was confined within the submucosa and revealed a mixture of trabecular, compact and pelioid patterns of large polyhedra cells, resembling hepatocellular carcinoma of the liver(Edmondson-Steiner grade 2). Sinusoid-like vascular stroma of classical trabecular hepatocellular carcinoma intervened the tumor cell nests but was not associated with endothelial-cell lining. Immunohistochemical stainings with alpha-fetoprotein and alpha1-antitrypsin gave a strong reactivity in those areas of hepatoid differentiation and in the adjacent minute portion of adenocarcinoma. The findings suggest that a portion of gastric carcinoma may transdifferentiate into cells with hepatoid features along the line of endodermal lineage.
Male ; Humans ; Adenocarcinoma ; Carcinoma, Hepatocellular

No abstract available.
Fractures, Malunited* ; Radius*

We analyzed neurodevelopmental outcome data of 36 selected studies. Data of individual studies were pooled by birth weight group: <800g, <1.000g, <1.500g and by time period of birth year: Period I (pre-intensive care era), 1960-67:Period II (beginning period of intensive care), 1968-76: and Period III (established period of intensive care), 1977-87. In all weight groups, survival and intact outcome rates based on live birth have progressively improved over the three period. The major neurodevelopmental handicap rate of the <1,500g decreased in Period III vs. Period I and Period II (66,70, and 45 per 1,000 live births in I, II, and III, respectively). However, the major handicap rate in the <800g and the <1,000g live births increased: in the <800g, from 48 per 1,000 live births in Period II to 101 in Period III and, in the <1000g, from 28 per 1,000 live births in Period I to 67 in Period II and 73 in Period III. Increases in major handicap rate in two lower weight groups were predominantly the effect of increasing number of survivors over these periods and had little to do with the change in handicap rates in the survivors. In the <1,500g, the magnitude of reduction in handicap rate in the survivors was sufficient to overwhelm the effect of increased survival, resulting in a reduction in the number of major handicapped children. We conclude that based on the currently avaiable reports, neonatal intensive care has provided very low birth weight infants with a reduction in mortality, an increase in intact outcome, and decrease in the number of major neurodevelopmentally handicapped children. We try to estimate the trend of major neurodevelopmental handicap and intactoutcome of infants with birth weights <1,500g in Korea and speculate that major handicap rate have progressively increased over the three period in spite of increase in intact outcome.
Birth Weight ; Disabled Children ; Humans ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal* ; Korea ; Live Birth ; Mortality ; Parturition ; Survivors

PURPOSE: Factors affecting the response to surfactant replacement therapy are considered as types of surfactant, and strategies of treatment including prophylactic vs rescue therapy, single vs multiple doses, methods of mechanical ventilation, and modes of surfactant delivery. Among those factors, response to surfactant replacement therapy according to the modes of surfactant delivery was rarely studied in the world. In preterm infants with RDS, we studied the efficacy and adverse effects of surfactant replacernent therapy according to the differences in the modes of surfactant delivery. METHOD: Preterm infant weighing 500-2,500g with RDS who required assisted ventilation were divided into two groups. One group is as follows five fractional doses with five positional changes after removal from ventilator by feeding tube technique. The other group is as follows; two fractional doses with two positional changes by side-port adaptor technique. Of the 30 infants enrolled, 15 were randomly assigned to each group. We compared the respiratory indices, chest radiologic response, clinical outcome after surfactant replacement, and adverse effects during dosing procedure. RESULT: There were no diffrences of patient profile between two groups. There were significant improvernent in FiO2, a/APO2, MAP, OI, and chest radiologic response following surfactant replacement therapy in both groups. No significant differences were noted in the adverse effects during dosing procedure and incidence of complication. CONCLUSION: In initial phase of RDS treatment with surfactant replacement therapy, two fractional doses with two positional changes by side-port adaptor technique improve respiratory indices, radiologic response without dernonstrable harmful effects as five fractional doses with five positional changes after removal from ventilator by feeding tube technique, however two fractional dosing procedure is more recommendable because of #more simple and convenient procedure.
Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Respiration, Artificial ; Thorax ; Ventilation ; Ventilators, Mechanical

We studied the effects of chronic hyperoxia (>95% oxygen for 14 days) in change of body weight, wet to dry lung weight ratio, and morphologic changes of lung tissue compared with that of room air (21% oxygen for 14 days) in Sprague-Dawley neonatal rat pups. The results were as follows: 1) In neonatal rat pups exposed to room air (normoxia group), body weight of initial 3 days of neonatal rat pups was 9.18 0.18g, and body weights of developing rat pups exposed to room air for 7, 10, 14 days were 14.07 1.90, 17.00 2.09, 23.07 1.93g respectively. In neonatal rat pups exposed to hyperoxia (hyperoxia group), body weight of initial 3 days of neonatal rat pups was 9.35 0.80 g, and body weights of developing rat pups exposed to hyperoxia for 7, 10, 14 days were 11.06 1.31, 12.64 1.77, 15,41 1.65 g respectively. These results suggest that changes of body weight in developing rat pups were stunted significantly in the hyperoxia group compared with normoxia group during 14days-experiment (p<0.01). 2) No appreciable difference of wet to dry lung weight ratio was noted at initial 3 days of neonatal rat pups between normoxia group and hyperoxia group, but considerably increased wet to dry lung weight ratio was noted significantly at 7 days of exposure in the hyperoxia group compared with the normoxia group (p<0.05). The difference of wet to dry lung weight ratio was not significant at 10, 14 days of exposure between normoxia group and hyperoxia group. These results suggested that relative water content of wet lung was at a peak at 7 days of exposure in hyperoxia group. 3) The lung from developing rat pups exposed to room air for 7 days had many small alveoli and numerous septal buds. However, in the lung from developing rat pups exposed to hyperoxia for 7 days, presence of pink staining material within the lumen of the air spaces (proteinaceous edema fluid) and increased interstitial cellularity due to infiltration by macrophages and neutrophils was observed, and these findings suggested acute exudative lung injury. 4) In most lungs from developing rat pups exposed to room air for 14 days, much increased alveolarization including the secondary septal bud formation was observed. However, in most lungs from developing rat pups exposed to hypeoxia for 14 days, increased septal and interstitial cellularity and thickness and interstitial fibrosis were observed significantly compared with normoxia group (p<0.01). In conclusion we could make a experimental animal model which had similar histopathologic finding of bronchopulmonary dysplasia in human infant and this model will be useful for research of pathogenesis of bronchopulmonary dysplasia.
Animals ; Body Weight ; Bronchopulmonary Dysplasia ; Edema ; Fibrosis ; Humans ; Hyperoxia* ; Infant ; Infant, Newborn ; Lung Injury ; Lung* ; Macrophages ; Models, Animal ; Neutrophils ; Oxygen ; Pulmonary Edema ; Rats* ; Rats, Sprague-Dawley

No abstract available.
Humans ; Infant, Newborn*

The Ilizarov technique has been used successfully in the treatment of nonunion of long bone accompanied by infection, severe bone and soft tissue defects, and deformity. We report the results of treatment of 21 cases of nonunion using the Ilizarov technique. There were 20 males and 1 female with an average age of 34.2 years (range, 8-72 years). The average follow up period was 45 months (range, 12-74months). Infected nonunion(15/21 cases) was the most common cause of nonunion. The treatment methods include simple compression method(4 cases) and internal and external bone transport method(17 cases). Bony union was achieved in 20 cases out of 21 cases. One case is still having difficulty in achieving union. The mean time to union was 7.3 months in femurs and 6.3 months in tibias. The amount of bone defect that developed after the removal of infected bone fragments and soft tissue averaged 3.8cm (range, 2.3-9cm). The healing index, in cases of bone transport, was an average of 45 days per cm (range, 30-62 days per cm). Complications developed in 17 cases out of 21 cases. Pin site infection occurred in 5 cases, premature consolidation in ~1 case, angulation deformity in 2 cases, LOM of the knee in 2 cases, equinus deformity in 2 cases, ankle stiffness in 3 cases, and nonunion in 1 case. The Ilizarov technique is thought to be effective in the treatment of complicated nonunion combined with shortening, deformity, bone defect and infection. However, in order to reduce complications caused by the Ilizarov method, accurate surgical techniques and postoperative care are necessary.
Ankle ; Congenital Abnormalities ; Equinus Deformity ; External Fixators* ; Female ; Femur ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Knee ; Male ; Postoperative Care ; Tibia

No abstract available.
Tibial Fractures*