Objective: Depending on the direction and degree of the septal deviation, the patient with malalignment-type VSD present with a variety of clinical syndrome. It is the purpose of this study to examine clinical characteristics of malalignment-type VSD, and to emphasize the clinical significance of septal malalignment in VSD and thus to increase the awareness for it. Methods: We analyzed echocardiographic or cardic catheterization and angiographic findings of 85 patients who were diagnosed as malalignment-type VSD at the department of pediatrics, Chonnam University Hospital between July 1990 and September 1992 Results: 1) Among 85 patients with malalignment-type VSD, there were 52 Cases (61. 2%) of Fallot-type VSD. 14 cases (16.5%) of Eisenmenger-type VSD, 19 cases (22.3%) of coarctation-type VSD. 2) All the 85 cases with malalignment-type VSD had the infundibular defects, and perimembranous infundibular VSD was most frequently associated with septal malalignment. 3) There was no prolapsing valve in all the cases with malalignment-type VSD. 4) Pulmonary hypertension was observed in all the cases with Eisenmenger-type and coarctation-type VSD. 5) Among the 19 cases with coarctation-type VSD, 8 cses (42.1%) were associated with coarctation of the aorth, and 3 cases (15.8%) with interrupted aortic arch. Conclusion: We conclude that septal malalignment in VSD has considerable clinical significance. Therefore, the authors believe that we should always consider the presence or absence of septal malalignment, in addition to the size and location of defect at the time of diagnostic evaluation of VSD, especially in the Koreans showing high incidence of infundibular VSD.
Aorta, Thoracic ; Catheterization ; Catheters ; Echocardiography ; Heart Septal Defects, Ventricular* ; Humans ; Hypertension, Pulmonary ; Incidence ; Jeollanam-do ; Pediatrics

Numerous surgical procedures have been advocated to correct the facial deformity in patients with hemifacial microsomia, including chondrocostal grafts, mandibular osteotomies combined with bone grafts, and maxillary osteotomies done at an early age after permanent dentition is completed. The standard treatment of these malformations consists of the application of bone grafts which can lead to unpredictable growth. Furthermore, these procedures often require intermaxillary fixation, blood transfusions and sometimes tracheostomies. Lengthening of the mandible by gradual distraction, according to the method of Ilizarov, opens new perspectives for interceptive therapy. Laboratory and clinical studies have shown that mandibular distraction is an effective and powerful reconstructive surgical technique. Lengthening of the mandible by gradual distraction was performed on five patients of hemifacial microsomia and one patient of Goldenhar syndrome using unidirectional or bidirectional extraoral device and intraoral device. In two patinets, simultaneous mandibular and maxillary distraction was performed with incomplete Le Fort I osteotomy. The amount of mandibular bone lengthening ranged from 8 to 21 mm, the patinets were maintained in fixation for an average of 12 weeks to allow ossification. There was no severe perioperative complication and the length of clinical follow-up ranged from 3 to 17 months. The skeletal change resulting from directional bone lengthening could be seen best by comparing the pre-and postoperative 3-D CT scans. There was also the potential for improvement in neuromuscular function (functional matrix), attendant growth and development of the affected jaw. Mandibular distraction is a simple procedure with minimal morbity and complications, so the results to date indicated that the technique can be applied to the correction of hemifacial microsomia. The development of new devices should permit multidirectional mandibular distraction and craniofacial distraction to allow early reconstruction of cranio-maxillofacial malformations. Distraction osteogenesis for reconstruction of the mandible in this subest of young patients was a safe and effective technique for improving the craniofacial skeletal form and appearance, with minimal associated morbidity.
Blood Transfusion ; Bone Lengthening ; Congenital Abnormalities ; Dentition, Permanent ; Follow-Up Studies ; Goldenhar Syndrome* ; Growth and Development ; Humans ; Jaw ; Mandible ; Mandibular Osteotomy ; Maxillary Osteotomy ; Osteogenesis, Distraction ; Osteotomy ; Tomography, X-Ray Computed ; Tracheostomy ; Transplants

A case of neonatal diabetes mellitus is described. The child presented with low birth weight but was normal in appearance. She was acidotic and ketonuria was observed. The HLA typing was DR1 and 3, and insulin autoantibodies were negative. Genetic analysis with polymorphic DNA markers for chromosome 6 indicated biparental inheritance. She required insulin therapy for the control of hyperglycemia, and insulin dependence continues after 8 months of age.
Autoantibodies ; Child ; Chromosomes, Human, Pair 6 ; Diabetes Mellitus* ; Genetic Markers ; Histocompatibility Testing ; Humans ; Hyperglycemia ; Infant, Low Birth Weight ; Infant, Newborn ; Insulin ; Ketosis ; Wills

No abstract available.
Aged, 80 and over* ; Humans ; Transurethral Resection of Prostate*

It was reported that many adverse effects occurred to the growth areas of the adolescent player due to repititous strain. The injuries mainly involved in the shoulder and elbow, and named as little leaguers Shoulder and Little Leaguers: Elbow in boy baseball player. But the stress fracture of olecranon epiphyseal plate was rare and reported in a few cases. We reported a case observed in an adolescent Judo Player.
Adolescent ; Baseball ; Elbow ; Fractures, Stress ; Growth Plate ; Humans ; Male ; Martial Arts ; Olecranon Process ; Shoulder

Partial knee ankylosis is a recognized complication following open operative procedure, trauma and disease processes about the knee. It can result from the formation of intraarticular adhesion and contracture of the capsule as well as the shortening or adhesion of the quadriceps mechanism. Physical therspy and occasionally manipulation under the anesthesia may improve the results, but performed late, these methods will be useless. This is a review of 30 patients who had severe limitation of motion in the knee joint following open operative procedures or trauma about the knee and who were treated by the percutaneous release of adhesions under the arthroscopic control. The following results were obtained; There were 17 males and 13 females, and the age of release ranged from 23 to 69 years old (av. 42.8years old). The interval between arthroscopic adhesiolysis and the last follow-up evaluation ranged from 6 months to 5 years and 7 months(av. 23 months). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from 3 months to 4 years(av. 15 months). The average preoperative knee ROM was 38.8°the postoperative ROM was 121.1°and the average final knee ROM at follow-up was 102.6°So the average loss of ROM was 18.5°The arthroscopic adhesiolysis seems to be applied to the various conditions of the partial knee ankylosis and the results are better than the other surgical procedures when it was performed early enough.
Anesthesia ; Ankylosis ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Male ; Surgical Procedures, Operative

No abstract available.
Ceftizoxime* ; Humans

PURPOSE: Introduction of low osmolality contrast agent(LOCA) has allowed safer, more comfortable contrast-enhanced CT examination, but there has been significant increase in image degradation when evaluating the kidneys due to streaky artifact. The authors reviewed findings of contrast-enhanced abdominal and pelvic computed tomography(CT) to know the difference of renal streaky artifact between a high osmolality contrast agent (HOCA) and LOCA. MATERIALS AND METHODS: This study included two hundred contrast-enhanced CT in 200 patients, 100 performed with HOCA(meglumine ioglicate, 150ml) and 100 performed with LOCA (iopromide, 150ml). The severity of renal streaky artifact was compared between HOCA and LOCA groups. RESULTS: Of the scans performed with HOCA, 40 had no artifact, 52 had grade I artifact, 6 had grade II artifact, and 2 had grade III artifact Of the scans performed with LOCA, 23 had no artifact, 44 had grade I artifact, 29 had grade II artifact, and 4 had grade III artifact. There was significant difference in the degree of the streaky artifact depending upon the osmolality of the contrast media used(by {{{{x^2}}}}-test, P=.0001). CONCLUSION: The results of this study revealed a statistically significant increased incidence of artifacts and distortions of renal image with LOCA when compared with HOCA.
Artifacts* ; Contrast Media* ; Humans ; Incidence ; Kidney ; Osmolar Concentration* ; Tomography, X-Ray Computed

BACKGROUND: Long-term phototherapy can induce the changes of photoaging and it is reported that there is an increased chance of cutaneous squamous cell carcinomas in patients exposed to large amounts of UV radiation. OBJECTIVE: The main objective was to investigate the degree of photoaging and the presence of p53 mutations in normal skin in patients undergoing long-term phototherapy. METHOD: We performed hematoxylin-eosin and special stains, p53 and p21 immunohistochemical stains and polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) on the normal skin of patients subject to long-term UV therapy. RESULT: 1. The typical features of photoaging were not observed in patients undergoing long-term UV therapy. 2. In p53 immunohistochemical staining performed at 1 week after cessation of long-term PUVA treatment, the patient group with a culmulated UV dosage of more than 1,000J/cm2 demonstrated an increased number of p53 positive epidermal cells compared to exposed as well as unexposed normal skins. 3. The patterns of p21 immunohistochemical staining performed at 1 week after cessation of long-term PUVA and UVB treatments were similar to that of p53 immunohistochemical staining performed at 1 week after cessation of phototherapy. 4. In p53 immunohistochemical staining performed at 4 months after cessation of UV treatment, the number of p53 positive epidermal cells decreased significantly compared to that of p53 positive epidermal cells found at 1 week after cessation of UV treatment. 5. The mutation of p53 genes was not found in PCR-SSCP analysis of biopsied skins done at 1 week after cessation of long-term PUVA and UVB treatment. CONCLUSION: Long-term phototherapy did not induce the typical changes of photoaging and p53 overexpression in the epidermis of UV treated skin was a reactive process. Therefore, UV therapy can be a relatively safe treatment modality, although a closer observation for cutaneous malignancy is warrented in the patients whose cumulated UV dosage is much higher than 1,000J/cm2.
Aging* ; Carcinoma, Squamous Cell ; Coloring Agents ; Epidermis ; Genes, p53 ; Humans* ; Phototherapy ; Skin*

No abstract available.
Child* ; Humans ; Meningitis* ; Scrub Typhus*