In the treatment of dislocations and subluxations of the hip in the older children, whether congenital or paralytic, orthopedic surgeons are blessed with a wide variety of commonly used surgical procedures; namely, Salters innominate osteotomy, acetabtloplasties, Pembertons pericapsular osteotomy, shelf operations, Chiaris pelvic displacement osteotomy. and Colonnas capsular arthroplasty. However, with increasing age and soft tissue contractures,these procedures become ineffective, leaving a wide range of age between older children and young adults subject to uncertain or unfavarable prognosis. Steels triple osteotomy (1973) is aimed at coverig this age group, when displacement or in nominate osteotomy is either technically infeasible or likely to fail. It consists of an open reduction with or without soft tissue release and skeletal traction, redirection of the acetabulum to cover the femoral head by osteotonmies of the pelvis that has lost its young cartilagenous resiliency, and preservation and physiological remodelling of the articular cartilage of the acetabulum. We performed Steels osteotomy on a 21-years-old female with a severe paralytic subluxation of the hip associated with pelvic obliquity and paralytized both lower extremities. One and a half year follow-up result was satisfactory with a stable and congruous joint despite paralysis and with the patient walking for the first time in her life.
Acetabulum ; Adult ; Arthroplasty ; Cartilage, Articular ; Child ; Dislocations ; Female ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Lower Extremity ; Orthopedics ; Osteotomy ; Paralysis ; Pelvic Bones ; Pelvis ; Prognosis ; Steel ; Surgeons ; Traction ; Walking ; Young Adult

No abstract available.
Cleft Lip*

A case of Down's syndrome in which transient myeloproliferative disorder developed is described. In hematologic findings of peripheral blood, high blast cell count on 1st day of birth had been found and after serial follow-up for several weeks, decrease in WBC counts from 22.6x10(9)/L to 7.5x10(9)/L and blast cell counts from 31% to 2% occurred. The karyotype of his patient was 45,XY, der (13;14) (q10;q10), der(14;21) (q10;q10), +21. Karyotyping of his father revealed 45,XY, der(13;14) (q10;q10). Without specific chemotherapy, hematologic and clinical recovery was occurred within several weeks. We deport a case of transient myeloproliferative disorder in Robertsonian translocatlon type of Down's syndrome accompanying another Robertsonian translocation, der (13;14) (q10;q10), inherited from his father.
Cell Count ; Down Syndrome ; Drug Therapy ; Fathers ; Follow-Up Studies ; Humans ; Karyotype ; Karyotyping ; Myeloproliferative Disorders* ; Parturition

No abstract available.
Myocutaneous Flap* ; Pressure Ulcer*

No abstract available.
Diagnosis* ; Ultrasonography* ; Varicocele*

During development of central nervous system, cell proliferation, cell migration, cell differentiation and cell death are required. It has been reported that a number of cells are dying during development in the mammalian retinae examined so far, but the pattern of cell death has not been clarified yet. In addition. little has been studied on cell proliferation after birth. This study was conducted to identify histogenesis, cell death and cell proliferation in the retinae of the developing rats by light and electron microscopic methods as well as by immunohistochemical method using anti-proliferating cell nuclear antigen [PCNA] antiserum. The results were as follows : 1. In the developing rat, from postnatal 0 through 7 days, retina consisted of ganglion cell layer, inner plexiform layer and neuroblast layer. Neuroblast layer could be subdivided into three sublaminae : sublamina a, sublamina b and sublamina p, from postnatal 3 through 7 days. 2. From postnatal 10 days, retina consisted of ganglion cell layer, inner plexiform layer, inner nuclear layer, outer plexiform layer and outer nuclear layer. 3. Cells undergoing degeneration were observed from postnatal 0 to 13 days, and patterns of cell death were apoptosis, cytoplasmic degeneration and autophagic degeneration. 4. PCNA-immunoreactivity was seen in the cells located in sublaminae b and p of the neuroblast layer at postnatal 0 and 1 days. From postnatal 3 days PCNA immunoreactivity decreased. At 7-day-old rat, PCNA-Immunoreactive cells scattered in the distal part of sublamina p of the neuroblast layer.No immunoreactivity was observed from postnatal 10 days. These results demonstrate that retinal cell proliferation ends at postnatal 7 days, and histogenesis of retina is completed at postnatal 10 days, and superfluous cells during retinal development are eliminated by apoptosis, cytoplasmic degeneration and autophagic degeneration.
Animals ; Apoptosis ; Cell Death* ; Cell Differentiation ; Cell Movement ; Cell Proliferation* ; Central Nervous System ; Cytoplasm ; Ganglion Cysts ; Parturition* ; Proliferating Cell Nuclear Antigen ; Rats* ; Retina* ; Retinaldehyde

Cardiac rupture following blunt thoracic trauma is rarely encountered, since it commonly causes death at the scene. With advances in critical care, blunt cardiac rupture has been successfully treated with well-organized team approach including an emergency physician, anesthesiologist, and cardiac surgeon. We encountered a patient with blunt cardiac rupture of the junction of the superior vena cava and right atrium that extended 7 cm to the right ventricular junction. The patient was successfully resuscitated after a closed thoracostomy and pericardiocentesis with fluid loading. Cardiac injury was repaired via mid-sternotomy without cardiopulmonary bypass. The patient recovered without complications and was discharged on the 7th day after surgery.
Cardiopulmonary Bypass ; Critical Care ; Emergencies ; Heart Atria* ; Heart Injuries ; Heart Rupture* ; Humans ; Pericardiocentesis ; Thoracostomy ; Vena Cava, Superior*

No abstract available.
Ectoderm* ; Ectodermal Dysplasia*

BACKGROUND: To review the experience that used both ventricular assist device(VAD) and extracorporeal membrane oxygenation(ECMO) for children with congential heart disease requiring postcardiotomy mechanical circulatory support. MATERIAL AND METHOD: Between March 1993 and May 1995, we applied mechanical assist device using centrifugal pump to the 16 patients who failed to be weaned from cardiopulmonary bypass(n=15) or had been in cardiogenic shock in intensive care unit(n=1). The diagnosis were all congenital heart diseases and the ages of patients ranged from 20 days to 10 years (mean age=2.5+/-3.5 years). RESULT: The methods of mechanical circulatory support were LVAD(n=13), BVAD (n=1), and ECMO(n=2). The mean assist times were 54.0+/-23.7 hours. Post-assist complications were in orders: bleeding, acute renal failure, ventricular failure, respiratory failure, infection, and neurologic complication. It was possible for 9 patients(56.3%) to be weaned from assist device and 5 patients(31.3%) were discharged from hospital. There was no statistical significant between hospital discharged group and undischarged group by age, body weight, cardiopulmonary bypass time, and assist time. CONCLUSIONS: The ventricular assist device is an effective modality in salvaging the patient who failed to be weaned from cardiopulmonary bypass, but multiple factors must be considered for improving the results of mechanical circulatory support ; such as patient selection, optimal time of starting the assist device, and prevention and management of the complications.
Acute Kidney Injury ; Body Weight ; Cardiopulmonary Bypass ; Child ; Diagnosis ; Extracorporeal Membrane Oxygenation ; Heart Defects, Congenital ; Heart Diseases* ; Heart* ; Heart-Assist Devices ; Hemorrhage ; Humans ; Critical Care ; Membranes ; Patient Selection ; Respiratory Insufficiency ; Shock, Cardiogenic

No abstract available.
Chylothorax* ; Lymphangiectasis*