Avascular necrosis of the femoral head is generally localized in the anterosuperior aspect of the head. The posterior part of the head often retains a normal, smooth contour containing healthy cartilage even in much advanced cases. Because of this anatomical localization of the lesion, Y. Sugioka has devised a transtrochanteric rotational osteotomy in young and middle-aged person, which reduces the weight-bearing force on the necrotic area, and transfers shearing forces to the healthy posterior cartilage of the femoral head to prevent progressive collapse of the articular surface and improve alignment when articular collapse followed femoral head subluxiation. The authors reviewed 13 cases of Sugioka operation, performed at the Department of Orthopedic Surgery, Seoul National University Hospital during the period from December 1983 to Feburary 1986 and the following results were obtained. 1. There were 11 males and 1 female. The average age of the 13 cases was 33.3 years. 2. In all the cases of Grade I and Grade II hips, there was not progressiveness of necroticarea of femur heads. 3. By U.C.L.A. hip rating system, preoperative mean scores of pain, walking ability, function and activity were 2.5, 5.7, 4.8 and 4.3, respectively, while postoperative scores of these were increased to 7.7, 9.5, 8.4 and 7.8, respectively. 4. Average ranges of motion of hip joint were increased more postoperatively than preoperatively.
Cartilage ; Female ; Femur Head ; Head ; Hip ; Hip Joint ; Humans ; Male ; Necrosis ; Orthopedics ; Osteotomy ; Seoul ; Walking ; Weight-Bearing

Antihypertensive and beta-adrenoceptor blocking effect of long-acting propranolol were observed in the outpatient department, Department of Internal Medicine, National Medical Center during the period between December, 1981 and May, 1982. The clinical effects of long-acting propranolol were compared with those of conventional propranolol and following results were obtained. 1) Direct cross-over from conventional propranolol 20mg three times a day for several days to long-acting propranolol 160mg once daily was not accompanied by appreciable side effect and there was fairly good antihypertensive effect either in systolic or diastolic pressure. 2) Antihypertensive and bata-adrenoceptor blocking effect of long-acting propranolol 160mg once daily were comparable to those of conventional propranolol 40mg three or four times a day. The compliance of the patients to long-acting propranolol once daily was naturally better than that to conventional propranolol which must be taken three to four times daily. 3) In several cases of trial, the patients who tolerated the long-acting propranolol 160mg per day also well tolerated the regimen of long-acting propranolol 320mg per day, 4) The regimen of long-acting propranolol once daily was recommendable to those patients who were on beta-blocking agents for prolonged period of time for their indications such as hypertension and other chronic cardiovascular diseases, in view of the aspects of good patient compliance, good antihypertensive and beta-blocking effect.
Blood Pressure ; Cardiovascular Diseases ; Compliance ; Humans ; Hypertension ; Internal Medicine ; Outpatients ; Patient Compliance ; Propranolol*

Trichorhinophalangeal syndrome (TRPS) was first described in 1966 by Giedion. It is a rare genetic disease and divided into two groups : TRPS type I and TRPS type II. TRPS type I is an autosomal dominant inherited disorder, defined by three characteristic findings : first, sparsely distributed brittle and slow-growing scalp hair, second, a bulbous pear-shaped nose with an elongated philtrum, third brachydactyla with angular deformities. The characteristic radiological features of the hands include cone shaped epiphysis of the proximal interphalangeal joints. Most TRPS type II is sporadic and shows multiple exosteosis, mental retardation and microcephaly in addition to the three chracteristic findings of TRPS type I . A 20-year-old female visited our department for the evaluation of her sparse, slow-growing scalp hair. She also had a bulbous pearshaped nose, ulnar deviated fingers and shortened both hallux. Some relatives of patients show similar symptoms of scalp hair. A Radiologic aly, histopathologic aly and chromosomal study were done, and we established the diagnosis, TRPS type I.
Congenital Abnormalities ; Diagnosis ; Epiphyses ; Female ; Fingers ; Hair ; Hallux ; Hand ; Humans ; Intellectual Disability ; Joints ; Lip ; Microcephaly ; Nose ; Scalp ; Young Adult

No abstract available.
Child* ; Humans ; Pneumonia*

No abstract available.
Animals ; Diuresis* ; Heat-Shock Proteins ; HSP70 Heat-Shock Proteins* ; Rats* ; Urinary Bladder*

Syndromal acanthosis nigricans is associated with cellular resistance to the action of insulin and other endocrinopathies. In the insulin resistant state, increased insulin binds to the receptors of insulin-like growth factors (IGFs). IGFs are growth prompting peptides, which act as direct mitogens on cells containing the receptors. Through these actions, increased cellular growth and metabolism cause the skin lesions of acanthosis nigricans. Hyperandrogenism is also found in syndromal acanthosis nigricans patients. When associated with insulin resistance, these states are proportionally related. Increased insulin prompts the synthesis of androgen and conversely, increased androgen elevates the insulin resistance. We present three cases of syndromal acanthosis nigricans with hyperpigmented skin lesions and obesity. Laboratory findings demonstrated normal fasting blood suga levels with increased insulin and C-peptide levels and decreased insulin receptors. The oral glucose tolerance test was normal. We suggest that these patients were in an insulin resistant state. Skin biopsies from the axilla in all three cases showed hyperkeratosis, irregular acanthosis and upward projection of dermal papillae as finger like fashion. Thus all three cases represent syndromal acanthosis nigricans associated with an insulin resistant state based on clinical, histopathological, and laboratory findings. The three patients were treated with dietary control.
Acanthosis Nigricans* ; Axilla ; Biopsy ; C-Peptide ; Fasting ; Fingers ; Glucose Tolerance Test ; Humans ; Hyperandrogenism ; Insulin Resistance* ; Insulin* ; Metabolism ; Mitogens ; Obesity ; Peptides ; Receptor, Insulin ; Skin ; Somatomedins

We report a case of porokeratotic eccrine ostial and dermal duct nevus in a 28-year old man. The skin lesions, present since birth, were multiple keratotic papules and punctate pits on the palms, soles and heels bilaterally. Histopathologically, the lesion was characterized by dilatation and hyperplasia of the eccrine sweat ducts with parakeratotic plugs related to sweat gland pores. This entity should be considered the differential diagnosis of other types of porokeratosis and comedo-like keratosis on palms and soles.
Diagnosis, Differential ; Dilatation ; Heel ; Hyperplasia ; Keratosis ; Nevus* ; Parturition ; Porokeratosis ; Skin ; Sweat ; Sweat Glands

Authors experienced a 13-day-old boy who had suffered from walnut sized hard erythematous nodules on left axilla, anterior and posterior aspect of the neck which began to develop 9 days after birth. Histopathologic findings revealed subcutaneous fat necrosis and needle-shaped cleft in several fat cells. The skin lesions spontaneously resolved at 2 months of age. The clinical pattern, the skin manifestations, and the histologic appearance of the lesions were diagnostic of subcutaneous fat necrosis of newborn.
Adipocytes ; Axilla ; Humans ; Infant, Newborn* ; Juglans ; Male ; Neck ; Necrosis* ; Parturition ; Skin ; Skin Manifestations ; Subcutaneous Fat*

We report a case of multiple xanthogranuloma occurring ori the scalp in a 33 years old wornan. Multiple yellowish papules were developed on her scalp 3 months ago. Histopathologic findings showed massive granulomatous infiltrations of foamy histiocytes Touton giant cells in the dermis, and these cells were positive for lipid stain. This case was considered to be multiple xanthogranuloma in an adult, and treated by sur- gical excision.
Adult* ; Dermis ; Giant Cells ; Histiocytes ; Humans ; Scalp

A modern development of ambulatory ECG monitoring gave great advances in the diagnosis and evaluation of various cardiac conditions. Fifteen cases of ischemic heart disease, 11 cases of nonischemic heart disease, 5 cases of noncardiac disease and 9 cases of normal healthy subjects were studied from January 1980 to July 1981 in national Medical Center, with the following results: 1) The heart rate was decreased during night time, with less decreasing tendency in patients with ischemic heart disease. 2) Among 30 cases, including 12 patients with ischemic heart disease, who didn't show arrhythmia on routine 12 lead ECG, 12 cases, including 6 patients with ischemic heart disease, showed arrhythmia on Holter monitoring. 3) Among 5 cases with ischemic heart disease who showed premature ventricular contraction on day time monitoring, 2 cases didn't show premature ventricular contraction on nigh time monitoring. 4) The S-T segment and T wave were changed during night time in 2 cases with ischemic heart disease and in 2 normal subjects. From these results, we could assert that Holter monioring or ambulatory ECG tracing would be a good method for diagnosis and evaluation of ischemic heart disease, and other cardiac conditions. Several another studies with this equipment have to be performed and would give more distinctive outcomes.
Arrhythmias, Cardiac ; Diagnosis ; Electrocardiography ; Electrocardiography, Ambulatory* ; Heart Diseases ; Heart Rate ; Humans ; Myocardial Ischemia ; Ventricular Premature Complexes