There are few reports in the literature on how to care and manage bi!ateral congenital dislocation of the hip. Six patients have been encountered at this hospital from June 1979, of them four children had operative treat ment and the other two conservative. As a result of our experience about the management of bilateral congenital dislocation of the hip. The authors obtained the following conceptions; 1. The patient with bilateral dislocation was rather delayed in diagnosis. Therefore, in comp the treatment of bilateral cases was poorer than that of unilateral case. 2. In the case of the dislocated hip that might be easily reduced and maintained in the stab servative care was usually recommeded even in the older child. Unstable, unreduced hip,; hip in old children, the more definitive operation and internal & external rigid immobilization mandatory to get good result. 3. It might be beneficial to operate the more deformed and resistive hip first, and then to p with the same procedure 2 weeks after the first operation.
Child ; Diagnosis ; Dislocations ; Fertilization ; Hip ; Humans ; Immobilization

No abstract available.
Dislocations* ; Elbow*

The gout is a hereditary condition of disturbed uric acid metabolism. There are medical and surgical management in tophaceous gout for prevention of recurrence of acute attack and creation of a negative uric acid balance. The surgical management is removal of tophaceous material in the soft tissue and osseous structure. Aditionally, the resection of bone and joint, arthrodesis and bone graft improve the functional capacity of the gouty patients. A 53 years old man was managed by removal of tophaceous materials in both prepatellar area, left olecranon area and both feet and arthrodesis of left first metatarsophalangeal joint with autogenous iliac bone graft and supportive medication with probenecid and indomethacine, and was followed up from March, 1986 to April, 1987. There was no significant difference in duration between the union of nonpathologic fracture and the union of arthrodesis area in this gouty patient. We found the progressive recovery of normal trabeculation in previous destructive bone lesions with drug therapy, but there was no specific change in the soft tissue lesions.
Arthrodesis ; Drug Therapy ; Foot ; Gout ; Humans ; Indomethacin ; Joints ; Metabolism ; Metatarsophalangeal Joint ; Olecranon Process ; Probenecid ; Recurrence ; Transplants ; Uric Acid

No abstract available.
Endometriosis* ; Female ; Humans

Isolated tuberculosis of the coccyx is extremely rare. A 35-year-old man presented with a 3-month history of coccygeal and gluteal pain. Computed tomography and magnetic resonance imaging revealed osseous destruction and a large enhancing mass involving the coccyx with anterior and posterior extension. Pathologic examination of the surgical specimen revealed necrosis, chronic granulomatous inflammation, and multinucleated giant cells consistent with tuberculosis. This case highlights the importance of considering tuberculosis as a diagnosis even though unusual sites are involved.
Coccyx ; Giant Cells ; Inflammation ; Magnetic Resonance Imaging ; Necrosis ; Tuberculosis

OBJECTIVES: This study examined the influence of different sizes of spoons (normal spoon, 8.3 cc vs small spoon, 4 cc) on eating rate, energy intake and the satiety levels of female college students. METHODS: Twenty four healthy female college students participated in this study once a week for 2 weeks. Two hundred ten grams of cooked rice and 250 g of beef shank soup with a normal spoon and same amount of rice and soup with a small size spoon were served to the same participants over two consecutive weeks. After each lunch, the eating rate, energy intake, and the satiety levels were measured. RESULTS: Results showed that the subjects who were using a small spoon ate less beef shank soup (149.0 kcal) (p < 0.01) and had lower total energy intake (423.3 kcal) (p < 0.05) than using a normal spoon (178.7 and 461.1 kcal, respectively). Also, the meal time (15.7 min) (p < 0.01), a serving per one spoon (8.6 g) (p < 0.001), and eating rate (27.9 g/min) (p < 0.001) of those who used a small spoon were significantly different than that of those who used a normal spoon (13.6 min, 12.5 g and 35.7 g/min, respectively). However, despite consuming less energy at lunch, the level of satiety after eating from the small spoon was not significantly different from the normal spoon immediately after, 1 hour after and 2 hour after lunch. CONCLUSIONS: Our results revealed that students were able to control their eating rate by using a small spoon and they could feel full enough even though they eat less. In conclusion, eating rate decrease by using a small spoon may play an important role in food intake.
Eating* ; Energy Intake* ; Female* ; Humans ; Lunch ; Meals

PURPOSE: We evaluated the lateral release rate and the clinical results according to the intraoperative assessment of patellar tracking in total knee arthroplasty (TKA). MATERIALS AND METHODS: We analyzed 365 primary total knee arthroplasties in 278 patients. The knees showing good patellar tracking without tourniquet deflation were classified into group 1, those showing improved patellar tracking after tourniquet deflation were classified into group 2, those showing improved patellar tracking after the single stitch method were classified into group 3 and those showing persistent patellar maltracking, that resulted in lateral retinacular release, were classified into group 4. The postoperative patellar tilting angle was measured and the clinical results were evaluated for all the groups. RESULTS: We classified 176, 127, 57 and 5 knees into groups 1, 2, 3 and 4 respectively. Only 5 knees (1.4%) showed poor patellar tracking with the single stitch method after tourniquet deflation and this resulted in lateral retinacular release. The postoperative mean patellar tilting angle was 4.1degrees, 3.4degrees, 5.1degrees and 4.3degrees in each group, respectively, and no statistical differences were shown between the groups (p>0.05). Nine knees complained of anterior knee pain and there was no difference between groups. CONCLUSION: Lateral retinacular release in TKA may not be necessary if the patellar tracking is improved with the single stitch method after tourniquet deflation.
Arthroplasty ; Humans ; Knee ; Tourniquets ; Track and Field

Pseudoxanthoma elasticum (PXE) is an inherited disorder involving the connective tissues of skin, eye and cardiovascular system. Both a recessive and a dominant inheritance pattern have been engaged in it. The skin changes are characterized by the yellowish crepe-like, lax, redundant folds on neck, axilla and periumbilical area. In rare instances, perforating dermatoses such as keratotic erythematous papules are also accompanied in PXE and histologically characterized by transepideraml elimination of altered basophilic calcified elastic fibers, which are short, fragmented and curled in the middle portion of the reticular dermis. Now we report a case of 26 year-old female who had a typical hereditary systemic PXE showing transepidermal elimination on her neck without preceding trauma history.
Adult ; Axilla ; Basophils ; Cardiovascular System ; Connective Tissue ; Dermis ; Elastic Tissue ; Female ; Heredity ; Humans ; Inheritance Patterns ; Neck ; Pseudoxanthoma Elasticum* ; Skin ; Skin Diseases

BACKGROUND: It is important to recognize the independent prognostic factors of papillary carcinoma of thyroid in therapeutic and follow up planning. However, its good prognosis and its low prevalence make it difficult to analyze prognostic factors determining patients survival in a relatively short period of time. We retrospectively investigated the independent prognostic factors for determining disease recurrence after surgery which, in adults, are known to be closely related to the prognosis of cancer. METHOD: We retrospectively reviewed the clinical records of 456 patients (male 70, female 381, unknown 5, mean age of 43.9+-12.9 years) who had visited the thyroid clinic in Seoul National University Hospital and analyzed the data with statistical software program. RESULTS: 1) At initial visit, chief complaint of the patients was abnormal neck mass in 90 percent. 2) In preoperative thyroid scan study, 82% showed cold area and 16% showed diffuse enlargement. 3) Of the 50 recurrent cases after surgery (11.5% of the total cases), 39 cases (78%) had recurred disease in neck area and 11 cases (22%) had recurrences at distant sites. (Lung 9 cases, Brain I case, Mediastinum 1case) 4) Statistically significant risk factors for recurrence after surgery were male sex, size of tumor (above 4.5cm in this study), extrathyroidal invasion of cancer, involvement of resection margin and no remnant ablation of thyroid tissue using radioiodine. CONCLUSION: Through retrospective study, we presented some clinical characteristics of papillary thyroid cancer in Korea and independent risk factors of cancer recurrences after surgery.
Adult ; Brain ; Carcinoma, Papillary ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Mediastinum ; Neck ; Prevalence ; Prognosis ; Recurrence* ; Retrospective Studies ; Risk Factors ; Seoul ; Thyroid Gland* ; Thyroid Neoplasms*

During the course of evaluation and management of neck masses, consideration for Immunoglobulin G4-related disease (IgG4-RD) should be given. IgG4-RD is relatively a new growing entity of immune-mediated origin, characterized by a mass-forming lesion, the infiltration of IgG4-positive plasma cells and occasionally elevated serum IgG4. The most common manifestations are parotid and lacrimal swelling, lymphadenopathy and autoimmune pancreatitis. A previously healthy 72-year-old man was referred to our clinic with a 2-month history of left cervical lymph node enlargement without systemic manifestations . A cervical lymph node biopsy was planned because of elevated serum IgG4 levels. Pathological findings showed prominent infiltration of IgG4-postive plasma cells in the lymph node. After steroid therapy, a computed tomography scan revealed a decrease in the cervical lymph node size. This case illustrates the importance of including IgG4-RD in the differential diagnosis of a cervical lymph node enlargement.
Aged ; Biopsy ; Diagnosis, Differential ; Humans ; Immunoglobulin G ; Immunoglobulins ; Lymph Nodes* ; Lymphatic Diseases* ; Neck ; Pancreatitis ; Plasma Cells