The leprous involvement of the ankle joint and the upper surface of the talus is said to be a rare entity and this is in sharp contract to the Charcot joint of other causes in which the ankle involvement is relatively common. This can partly be explained by the concept that the articular branch of tibial nerve to the ankle joint is usually spare din leprosy, although the fibular nerve is affected around the knee level. During the survey of nearly 3000 leprous patients in the National Leprosy Center we selected 26 cases with obvious bone change of the ankle joint and the clinical study on these 26 cases was made with the following results. 1. The 26 cases consisted of 15 males and 11 females 2. Average age of the patients was 56 years and those over 50 years numbered 20(77%)and undre 39 years of age there was only one involvement. 3. Ankle destruction can be classified according to the causative factors attributable to its occurrence as follows: destruction of ankle joint following fracture of which four were Potts type and eight hyperdorsif-lexion injury: those following idiopathic arthritis in four, and those following subtalar incongruity due to calcaneal flattening in ten. 4. The results of this study which clarify the pathogenesis of ankle involvement in leprous patients may offer reliable preventive measures for each case of ankle destruction.
Ankle Joint ; Ankle ; Arthritis ; Arthropathy, Neurogenic ; Clinical Study ; Female ; Humans ; Knee ; Leprosy ; Male ; Peroneal Nerve ; Talus ; Tibial Nerve

The authors report a clinical experience of 95 patients (98 hips) with congenital dislocation of hip under the age of 2 years who were followed up at least 1 year at Chonnam University Hospital between 1979 and 1988. The result of clinical analysis are as follows; 1. The most patients were girls, comprising 87 girls (89 hips) and 8 boys (9 hips). 2. The age at treatment were under the age of 6 months in 49 hips, 7 to 12 months in 5, 13 to 18 months in 30 and 19 to 24 months in 14. 3. The initial treatment of the 98 hips were Pavlik harness in 49 hips, closed reduction in 18, and open reduction in 31. 4. Pavlik harness was applied to the patients under the age of 7 months and the results were acceptable in 37 hips (76%), uncertain in 4 (8%) and unacceptable in 8 (16%). The 8 unacceptable hips were retreated by closed reduction in 6 hips and open reduction in 2. 5. Closed reduction was applied to the patients ranging from the age of 4 months to 21 months and the results were acceptable in 14 hips(78%), unacceptable in 4 (22%). The 4 unacceptable hips were retreated by open reduction in 3 hips and Salter innominate osteotomy in l. 6. Open reduction was applied to the patients ranging from the age of 7 months to 20 months, and the results were acceptable in 26 hips (84%), uncertain in 3 (10%) and unacceptable in 2 (6%). The one of 2 unacceptable hips was retreated by Salter innominate osteotomy. 7. The overall results of 98 hips following initial treatment were acceptable in 77 hips (79%), uncertain in 7 (7%), and unacceptable in 14 (14%). The final results after secondary treatment were acceptable in 89 hips (91%), uncertain in 7 (7%), and unacceptable in 2 (2%).
Child ; Dislocations ; Female ; Hip ; Humans ; Jeollanam-do ; Osteotomy

No abstract available.
Evoked Potentials* ; Spinal Cord* ; Spine*

Calcaneus is very important in weight bearing and maintaining the normal contour of the foot. Many diseases can cause the cyst-like destructive changes of the calcaneus. In most cases, histological confirmation and bacteriological examination are necessary for the final diagnosis. In recent years, four cases of the cyst-like destructive lesions of the calcaneus were treated and had satisfactory results. They were confirmed with biopsy and bacterial culture as followings; acute osteomyelitis, chronic osteomyelitis, tuberculous osteomyelitis and simple bone cyst. Operations on the osteomyelitis were curettage with or without sequestrectomy and the simple bone cyst the curettage and bone graft. After operations, proper antibiotics and plaster immobilization followed routinely.
Anti-Bacterial Agents ; Biopsy ; Bone Cysts ; Calcaneus ; Curettage ; Diagnosis ; Foot ; Immobilization ; Osteomyelitis ; Transplants ; Weight-Bearing

Remarkable improvement in control of malignant tumor was achieved by combined surgery and postoperative radiation therapy. In Past, radiation therapy had been recommended after 4-6 weeks from operation because of worry about increased complication rate of surgical wound by post-operative irradiation. Nowadays, early surgical extirpation and early post-operative irradiation is recommended for better therapeutic effect. To evaluate the relationship between surgery-radiation interval and healing of surgical wound, an experimental study was undertaken using a total of 132 mice. A single dose of 2000 rads irradiation was delivered immediate after and on 1,3,5,10,14days after incision and suture on the skin of hind limbs of mice. Tensile strengths of the wounds were measured after removal of stitches on 1st, 3rd, 5th, 7th, 10th, 14th and 21st post-operative days. The results are summarized as follows; 1. Wound healing was delayed by irradiation delivered within 3 days from operation. 2. No significant delay of wound healing was observed by irradiation on 5 or more days after operation. 3. Normal wound strength was attained at 21st post-operative day in any surgery-radiation interval. 4. More severe delay of wound healing by irradiation at 24 hrs after operation than by immediate post-operative irradiation although statistical significance is not confirmed. In conclusion, early post-operative irradiation delays healing of the surgical wound though ultimately tensile strength reaches the value of non-irradiated wound.
Animals ; Extremities ; Mice ; Radiation Effects ; Skin ; Sutures ; Tensile Strength ; Wound Healing ; Wounds and Injuries

Mammary carcinoma was induced in rats by itravenous injection of N-methy-N-Nitrosourea. Microangiography was perfromed to evaluate the microvascular alterations in mammary carcinoma after irradiation. The tumors were givena single dose of 1.400 rads using Co-60 telethrapy unit with field size of 4 x 4 cm at 40 cm SSD. The dose ratewas 147.5 rads per minute. Microangiography was performed prior to irradiation and at one, two, and four weeksfollowing irradiation. The results are as follows: 1. Before irradiation, mammary carcinoma in rats tended to formlobules and the basic vasculature consisted of peripheral vascular pattern with central penetrating vessels. Theperipheral vascular pattern was always richer than that of the center. Irregular and tortuous vessles stretchedfrom the periphery into the center of lobule. 2. One week following irradiation, an increase in the number ofsmaller, tortuous vessels and decreased intervasular distance were obseved in the central portion of each lobule.This finding seems to be due to an improved filling of some previously existing but unfilled vessels. This maylead to improved metabolic changes and reoxygenation. 3. Later's changes of microvasculature after irradiation aretortuosity, irregularity, narrowing, abrupt tapering, fragmentation, and extravasation. These findings progressedafter a lapse of time. 4. The results can be considered as the microangiographic demonstration of the fact that reoxygenation after irradiation is mainly due to dilatation of the collapsed tumor vessels.
Animals ; Dilatation ; Microvessels ; Radiation Effects ; Rats ; Silver Sulfadiazine

The closed reduction has made an important contribution to the treatment of children under the age of 24 months. The authors report a clinical experience of 20 patients(21 hips) with congenital dislocation of hip who were treated by closed reduction at the department of Orthopaedic Surgery of Chonnam University Hospital. There were total 230 patients(237 hips) disgnosed as having congenital dislocated hip for 10 years from 1978 to 1987 and 20 patients of them were included in this study. The follow-up period ranged from 1 year to 10 years with an average 3 years. The results are as follows: l. All but one were girls, comprising 19 (20 hips) of 20 patients. 2. The age at closed reduction were under 6 months in 2, 7 to 12 months in 4, 13 to 18 months in 10 and 19 to 24 months in 4. 3. Of the 21 hips treated by closed reduction, 17 hips achieved a satisfactory result(81%). The other four hips had redislocation(2 hips) and subluxation(2 hips). 4. Four additional treatments were open reduction in 3 and Salter innominate osteotomy in l. 5. The acetabular and center-edge angle improved from the averge 36.1 and
Acetabulum ; Child ; Dislocations ; Female ; Follow-Up Studies ; Hip ; Humans ; Jeollanam-do ; Joints ; Methods ; Necrosis ; Osteotomy

PURPOSE: To evaluate CT features of metastatic ureteral tumors. MATERIALS AND METHODS: CT findings in 16 patients with ureteral metastases were evaluated retrospectively ;there were eight cases of bilateral ureteral involvement. Primary tumors metastatic to the ureter were advanced gastric cancer (n=13), breast cancer (n=l), colon cancer (n=l), or adenocarcinoma of unknown primary (n=l). We analysed CT findings with regard to the site of ureteral obstruction, configuration of obstructed sites of ureter, presence or absence of periureteral soft tissue density, and status in other organs. RESULTS: Among 24 ureters involved, ureteral wail thickening was noted in 15, periureteral soft tissue density in 13. Small nodular enhancing lesions less than lcm, within the retroperitoneal space around the involved ureters were noted in seven patients, and four of them were multiple lesions. CONCLUSION: Among various primary tumors, gastric cancer was the most common cause of ureteral metastasis. The common CT findings of ureteral metastases were thickening of ureteral wall, periureteral soft tissue density, and small periureteral enhancing nodular lesions. The constellation of these CT findings may be helpful in making the diagnosis of ureteral metastases.
Adenocarcinoma ; Breast Neoplasms ; Colonic Neoplasms ; Diagnosis ; Humans ; Neoplasm Metastasis* ; Retroperitoneal Space ; Retrospective Studies ; Stomach Neoplasms ; Ureter* ; Ureteral Obstruction

Angiographic findings were analysed in 11 cases of Behcet'sdisease which was diagnosed clinically in Seoul national University Hospital from July 1982 to June 1983. Arterial involvement was noted in 5 cases and venous involvement in 6 cases respectively. Arterial aneurysm and occlusion were arteriographic findings. Arterial aneurysm was noted at large arteries in all 5 cases and multifocal involvement was noted in 4 cases. Characteristic finding of arterial involvement was protruding saccular aneurysm. Venous involvement was thrombotic occlusion of deep veins in iliac, femoral and tibial areas in all 6 cases. Behcet's disease should be differentiated whenever these arterial or venous angiographic findings are revealed in a young adult.
Aneurysm ; Arteries ; Humans ; Seoul ; Veins ; Young Adult

Ocular rosacea is the eye manifestations of rosacea, which involves the lids, conjunctiva, and cornea. A recent study revealed that all patients with cutaneous rosacea had some degree of ocular involvement which is often undiagnosed. It is difficult to make a diagnosis of ocular rosacea because it lacks clinical or pathological hallmarks. However, early diagnosis and treatment are emphasized to decrease morbidity and prevent potential blindness. We report a case of ocular rosacea in a 49 year-old man who showed blepharoconjunctivitis, keratitis, and cutaneous manifestations of persistent erythema, telangiectasia, and papules. The ocular symptoms and signs had improved significantly with tetracycline therapy.
Blindness ; Conjunctiva ; Cornea ; Diagnosis ; Early Diagnosis ; Erythema ; Eye Manifestations ; Humans ; Keratitis ; Middle Aged ; Rosacea* ; Telangiectasis ; Tetracycline