No abstract available.

Opposition of the thumb is necessary for pinch-one of the three most important functions of the hand. Frequently, opposition is either partially or totally lost in poliomyelitis or median nerve palsy. Several types of operations have been devised for restoration of opposition, and in 1973, Burkhalter et al. announced extensor indicis proprius opponensplasty: the tendon of extensor indicis proprius is brought out in the area of the pisiform and then passed against subcutaneously across the palm to the thumb, being attached to the abductor pollicis brevis and extensor pollicis longus tendon. It is useful in the case of loss of opposition without available finger flexor or wrist motors. Of nine patients who underwent operation-one with Riordan and eight with Burkhalter type of opponensplasty-at National Medical Center, seven had excellent results: one had a fair, and another one had a poor result. Six patients were with low combined median and ulnar nerve injury: one with high combined median and ulnar nerve injury: one with brachial plexus injury: and one with myotmesis of the thenar muscles. From the results, we conclude that Burkhalter type of opponensplasty makes satisfactory result for the hand without opposition movement; it is indicated in high median nerve injury and any combined median and ulnar nerve injury6; early restoration of opposition to the thumb in median nerve injury and in those limbs with multiple tissue trauma adds immeasurably to the over-all early rehabilitative effort.
Brachial Plexus ; Extremities ; Fingers ; Hand ; Humans ; Median Nerve ; Muscles ; Paralysis ; Poliomyelitis ; Tendons ; Thumb ; Ulnar Nerve ; Wrist

Familial hypokalemic periodic paralysis (HOPP) is a rare autosomal-dominant disease characterized by reversible attacks of muscle weakness occurring with episodic hypokalemia. Mutations in the skeletal muscle calcium (CACNA1S) and sodium channel (SCN4A) genes have been reported to be responsible for familial HOPP. Fifty-one HOPP patients from 20 Korean families were studied to determine the relative frequency of the known mutations and to specify the clinical features associated with the identified mutations. DNA analysis identified known mutations in 12 families: 9 (75%) were linked to the CACNA1S gene and 3 (25%) to the SCN4A gene. The Arg528His mutation in the CACNA1S gene was found to be predominant in these 12 families. Additionally, we have detected one novel silent exonic mutation (1950C>T) in the SCN4A gene. As for a SCN4A Arg669His mutation, incomplete penetrance in a woman was observed. Characteristic clinical features were observed both in patients with and without mutations. This study presents comprehensive data on the genotype and phenotype of Korean families with HOPP.
Adolescent ; Adult ; Calcium Channels/*genetics ; Child ; Child, Preschool ; Genotype ; Humans ; Hypokalemic Periodic Paralysis/*genetics ; Infant ; *Mutation ; Phenotype ; Sodium Channels/*genetics

PURPOSE: Many recent studies have been performed to improve adult height in short normal girls with early puberty by arresting rapid pubertal progression. We evaluated the effect of combined therapy with growth hormone (GH) and gonadotropin releasing hormone agonist (GnRHa) on predicted adult height in girls with early puberty, comparing them with a group treated with GnRHa alone. METHODS: Twenty eight girls with early puberty were classified into two groups and treated for an average 18 months. Group I of 18 girls was treated with GnRHa alone (leuprolide acetate; dosage: 30-90 mcg/kg, s.c. every 28 days) and group II of 10 girls was treated in combination with GH (dosage: 0.1 IU/kg, s.c. 5-7 days/week). Two groups were compared in terms of bone age, height, sexual maturity, and predicted adult height at the start and after the treatment. RESULTS: Two groups were not significantly different from each other in chronologic age, bone age, weight, target height, and sexual maturity before and after treatment. After treatment, group I showed predicted adult height (157.1+/-6.2 cm) which was comparable to target height (157.1+/-3.7 cm) and was not significantly higher than predicted adult height before treatment (156.0+/-6.5). On the contrary, group II showed predicted adult height (158.5+/-4.6 cm) which was comparable to target height (156.2+/-3.6 cm), but significantly higher than predicted adult height before treatment (154.2+/-7.4 cm) (P<0.05). CONCLUSIONS: GH and GnRHa combination treatment is more effective than GnRHa treatment alone to improve predicted adult height in girls with early puberty.
Adolescent ; Adult* ; Female* ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Growth Hormone* ; Humans ; Puberty*

A 17-year-old-boy with a bilateral incomplete cervical rib, upon abduction of his left arm at 45 degrees, had immediately begun to show symptoms of severe tingling, claudication, pallor, and weakness of his left upper extremity. These symptoms were aggravated at 90 degrees, leaving him debilitated from his work in the printing office. Transfemoral positional subclavian arteriography revealed total occlusion of the subclavian artery immediately distal to a cervical rib during 90 degrees abduction. Resection of the anterior scalene and medial aspect of the middle scalene muscles, cervical and first ribs, and arteriolysis were performed via a combined supraclavicular and infraclavi cular approach. He has returned to work as a printer with marked relief of symptoms and has remained asymptomatic over follow-up periods of 10 months.
Angiography ; Arm ; Cervical Rib ; Follow-Up Studies ; Muscles ; Pallor ; Ribs ; Subclavian Artery ; Thoracic Outlet Syndrome* ; Upper Extremity

PURPOSE: Treatment efficacy for children with speech and language delay has been the subject of considerable debate in recent years. We evaluated the clinical features of children with delayed speech and language and their prognoses according to their etiologies after 6 months of speech and language therapy. METHODS: From January, 2000 to March, 2004, we retrospectively reviewed 56 children with speech and language delay who were administered speech and language therapy for 6 months in Uijongbu St. Mary's Hospital. RESULTS: Of 56 cases, the proportion of developmental language disorder was 66.1 percent, structural malformation 19.6 percent, mental retardation 12.5 percent, hearing defect 1.8 percent. The ratio of male to female was 4.6: 1 and the most frequent age group was over 47 months. The mean age of first spontaneous words with useful meaning was 15.9 months. The mean gestational age of the subjects was 39.8 weeks. The proportion of full-term infants was 96.4 percent and of premature infants was 3.6 percent. As for the birth order, the proportion of the first baby was 51.8 percent, the one of second babies it was 42.9 percent, and percent of third babies it was 7.1 percent. After 6 months of language intervention, 32.4 percent of patients with developmental language disorder showed normal linguistic development. All the patients with mental retardation showed sustained language and speech delay. As for the patients with structural malformations, five out of 11 patients showed normal linguistic development. CONCLUSION: The relatively advanced old age of majority of participants in this study suggests the necessity of screening test for language delay in this local community.
Birth Order ; Child* ; Female ; Gestational Age ; Hearing ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Intellectual Disability ; Language Development Disorders* ; Language Therapy* ; Linguistics ; Male ; Mass Screening ; Prognosis ; Retrospective Studies ; Treatment Outcome

Mycobacterium celatum is a recently described nontuberculous mycobacterium. Even though pulmonary or lymphatic infection cases were reported previously in human, the clinical significance of the infection with M.celatum is not yet understood completely. Most infections with this species occurred in the patients with suppressed cell-mediated immunity such as AIDS, and there are only a few cases of pulmonary infection with M.celatum in immunocompetent adults or infants in the world. In Korea, mycobacterial pulmonary infection is a major problem of respiratory disease but, there has been no pulmonary infection with M. celatum reported. We report, to our knowledge, the first Korean case of pulmonary infection with M. celatum, which was identified by gamma poB genomic sequencing.
Adult ; Humans ; Immunity, Cellular ; Immunocompetence ; Infant ; Korea* ; Mycobacterium* ; Nontuberculous Mycobacteria

Malignant fibrous histiocytoma(MFH) is a deep-seated pleomorphic sarcoma, which occurs principally as a mass of the extremities, abdominal cavity, or retroperitoneum in adults. However, it only rarely occurs in the chest wall. An 85-year-old man had undeergone excision of a small mass on the right posterior chest wall under local anesthesia 14 months age. However, the lesion did not heal and the mass recurred. He was referred to our hospital after the mass had grown to a size of 10.5x8x4cm with a 3x3cm skin defect. Intraoperative frozen biopsy revealed MFH. An en-bloc wide resection and thin-thickness skin graft from his thigh were performed. Although distant metastasis to the lund developed 14 months later and the patient died 2 months later, there was no local recurrence. Thin-thickness skin graft is a simple method for a wide range skin defect, especially in the old age. He recovered in good condition without any physical disabilities.
Abdominal Cavity ; Adult ; Aged, 80 and over ; Anesthesia, Local ; Biopsy ; Extremities ; Humans ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Skin ; Thigh ; Thoracic Wall* ; Thorax* ; Transplants

Progressive dysphagia in a 53 year old man was caused by a giant polypoid tumor in the lower intrathoracic esophagus. Radical transthoracic esophagectomy and esophagogastrostomy were carried out. Microscopic examination of the tumor revealed a true carcinosarcoma, composed of a mixture of basaloid squamous cell carcinoma and chondrosarcoma with multiple cartilagenous productions. Carcinoma metastases were found in the subcarinal and perigastric lymph nodes. Immunohistochemically, squamous area displayed strong positive to cytokeratin, and basaloid area showed positive immunoreaction to high molecular weight cytokeratin (34beta E12). Spindle cell sarcoma reacted to vimentin and smooth muscle actin. Chondrosarcomatous area reacted to vimentin and S-100 protein. He received postoperative chemotherpy and radiotherapy. He has been free of disease for 11 months.
Actins ; Carcinoma, Squamous Cell ; Carcinosarcoma* ; Chondrosarcoma ; Deglutition Disorders ; Esophageal Neoplasms ; Esophagectomy ; Esophagus* ; Humans ; Keratins ; Lymph Nodes ; Middle Aged ; Molecular Weight ; Muscle, Smooth ; Neoplasm Metastasis ; Radiotherapy ; S100 Proteins ; Sarcoma ; Vimentin

In 1964, Abbott and Colleagues published the world's first heterotopic heart transplantation technique in the rat. Their method established circulation by end-to-end anastomoses of the graft's aorta and pulmonary artery to the recipient's abdominal aorta and Inferior Vena Cava (IVC), respectively. In 1966, Tomita et al altered Abbott's technique by employing end-to-side rather than end-to-end anastomoses, thus eliminating the hind leg paralysis that sometimes resulted from Abbott's technique. In order to prevent postsuture hemorrhage (since 7-0 silk suture was the finest available at that time), Tomita's aortic anastomosis was done with double up-and-down continuous suture technique. A single layer continuous anstomosis effected the pulmonary artery-IVC anastomosis. The availability of Nylon monofilament suture made it possible for Ono and Lindsey to use a single layer suture technique for the aortic end-to-side anastomosis in their modified rat heart transplantation. We observed survival time between control group and Immunosuppression (Cyclosporine administration, 10mg/Kgx4 times postoperatively) group after heterotopic heart transplantation in the rat model. The cyclosporine adminstration group survived longer than the control group, thus we concluded that cyclosporine was based on Immunosuppressive drugs.
Allografts ; Animals ; Aorta ; Aorta, Abdominal ; Cyclosporine ; Heart Transplantation* ; Heart* ; Hemorrhage ; Immunosuppression ; Leg ; Models, Animal* ; Nylons ; Paralysis ; Pulmonary Artery ; Rats* ; Silk ; Suture Techniques ; Sutures ; Vena Cava, Inferior