Grice extra-articular subtalar arthrodesis has been performed as either a temporizing or a definite procedure in young children to correct the dynamic hindfoot valgus deformity without affecting subsequent growth of the foot. Fifty eight extra-articular subtalar arthrodesis in thirty patients, performed at Seoul National University Children's Hospital from setpember 1985 to June 1989, were retrospectively reviewed to evaluate the clinical and radiographic results. There were 52 valgus feet in 26 patients and 6 varus feet in 4 patients secondary to cerebral palsy, meningomyelocele, congenital snomalies, and other neuromuscular diseases. In many instances, additional tendon surgeries were also required to correct deformities or achieve the muscle balance. The review consisted of personal interview, physical examination, and radiological assessment. On physical examination, preoperative hindfoot valgus deformty(mean: 14.3°clinically) was well corrected, postoperative hindfoot valgus ranging from neutral to valgus 5°clinically in 35 of 52 cases(67.3%). Correction of the lateral talocalcaneal angle on standing lateral radiographic view averaged 8.5 degrees(from 57.3 degrees preoperatively to 37.6 degrees postoperatively). In valgus feet, there were 3 cases with mild pain around the ankle joint. There were 5 cases of graft resorption and 2 cases of nonunion. Graft failure was more frequent when the proximal end of the graft was directed anterior to the weight bearing axis. With original Grice subtalar arthrodesis, satisfactory results were obtained in 34 of 52(65.4%) hindfoot valgus feet. In 6 varus feet, there were 1 undercorrection and 2 recurrence of varus deformity. We re-emphasize the importance of strict operative technique to obtain satisfactory results. We also believe that Grice procedure may be used for the correction of subtalar instability in selected cases of varus foot before muscle baancing procedures.
Ankle Joint ; Arthrodesis ; Cerebral Palsy ; Child ; Congenital Abnormalities ; Foot ; Humans ; Meningomyelocele ; Neuromuscular Diseases ; Physical Examination ; Recurrence ; Retrospective Studies ; Seoul ; Tendons ; Transplants ; Weight-Bearing

No abstract available.
Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Thyroid Function Tests* ; Thyroid Gland*

We experienced 150 cases of spontaneous intracerebral hematoma which were confirmed by CT scan in Gang Nam Sacred Heart Hospital from November 1980 to October 1982. The analysis is based on 110 patients with primary intracerebral hematoma on whom operation was performed in 44 cases and conservative treatment was done in 66 cases. The CT scan of brain allows the clinical diagnosis of intracerebral hematom, and size, location, extension, ventricular penetration and evolution of hemorrhage are accurately portrayed. The results of the treatment were affected by conscious level, location and volume of hematoma, ventricular penetration and blood pressure. The operative treatment was better than conservative management in followings : 1. semicomatose and drowsy mental state, 2. subcortical hemorrhage, 3. more than 20 cc in volume, 4. progressively deteriorating neurological function and consciousness. We have obtained the best results in operating cases between 4th and 7th day after the stroke.
Blood Pressure ; Brain ; Consciousness ; Diagnosis ; Heart ; Hematoma* ; Hemorrhage ; Humans ; Stroke ; Tomography, X-Ray Computed

We experienced 150 cases of spontaneous intracerebral hematoma which were confirmed by CT scan in Gang Nam Sacred Heart Hospital from November 1980 to October 1982. The analysis is based on 110 patients with primary intracerebral hematoma on whom operation was performed in 44 cases and conservative treatment was done in 66 cases. The CT scan of brain allows the clinical diagnosis of intracerebral hematom, and size, location, extension, ventricular penetration and evolution of hemorrhage are accurately portrayed. The results of the treatment were affected by conscious level, location and volume of hematoma, ventricular penetration and blood pressure. The operative treatment was better than conservative management in followings : 1. semicomatose and drowsy mental state, 2. subcortical hemorrhage, 3. more than 20 cc in volume, 4. progressively deteriorating neurological function and consciousness. We have obtained the best results in operating cases between 4th and 7th day after the stroke.
Blood Pressure ; Brain ; Consciousness ; Diagnosis ; Heart ; Hematoma* ; Hemorrhage ; Humans ; Stroke ; Tomography, X-Ray Computed

The traumatic false aneurysm of the vertebral artery, as distinct from arteriovenous fistula, is rare condition. The aneurysm of the extracranial vertebral artery is most frequently related to penetrating or perforating injury, such as gunshot or stab injury, and it is not true aneurysm but false aneurysm. We expected a case of false aneurysm in 52 years old man who had taken penetrating neck trauma by sharp steel rod at work. The vertebral angiogram disclosed an aneurysmal shadow and occlusion of the vertebral artery at the level of the axis and successfully treated by clipping of the artery and resection of the aneurysmal mass.
Aneurysm ; Aneurysm, False* ; Arteries ; Arteriovenous Fistula ; Axis, Cervical Vertebra ; Humans ; Middle Aged ; Neck ; Steel ; Vertebral Artery*

Behcet disease is a multisystemic disorder characterized by a chronic relapsing triple symptom complex of recurrent oral ulceration, genital ulceration, and ocular inflammation. The onset of Behcet disease is rare in old age as is whole colon involvement. We recently saw a 78-year-old female patient examined to have intestinal Behcet disease with diffuse colon ulcers. She was admitted due to multiple oral ulcers, genital ulcers, low abdominal pain, and hematochezia. Colonoscopy showed multiple well-demarcated, large, deep, bleeding ulcers from the cecum into the descending colon. The patient was diagnosed with Behcet disease and treated with steroid, colchicine, and mesalazine. This paper describes a case of Behcet disease with unusual intestinal distribution.
Abdominal Pain ; Aged ; Behcet Syndrome ; Cecum ; Colchicine ; Colon ; Colon, Descending ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Inflammation ; Mesalamine ; Oral Ulcer ; Ulcer

The percutaneous endoscopic gastrostomy is used for nutritional support in patients requiring prolonged tubal feeding. Unfortunately, numerous complications, such as infection, stomal leak, fever, local pain, ileus and tube occlusion, have been reported since its introduction. The buried bumper syndrome is a rare but well-recognized long-term complication. The tight anchorage between the internal and external bumpers leads to gastric mucosal erosion and embedding of the internal bumper into the gastric wall, obstructing feeding. Our case involves an elderly patient with a buried bumper syndrome complicated by an abdominal wall abscess. A similar case has not been reported in Korea before. This article reports our findings and management with a review of the literature.
Abdominal Wall ; Abscess ; Aged ; Fever ; Gastrostomy ; Humans ; Ileus ; Korea ; Nutritional Support

Foreign bodies in the gastrointestinal tract often cause serious complications, such as perforation, obstruction, abscess formation, or hemorrhage. This is a case in which a patient visited our hospital and complained of a vague lower abdominal pain that had been present for three months. She had an intrauterine device (IUD) inserted five years earlier. The abdominal X-ray, computed tomography and colonoscopy revealed that the IUD had penetrated into the descending colon. We tried to remove the IUD by colonoscopy but failed due to pain, so we removed the IUD surgically. Thus, we report a case in which a previously inserted IUD had penetrated into the descending colon and was surgically removed. We also present a brief review of the literature.
Abdominal Pain ; Abscess ; Colon, Descending ; Colonoscopy ; Foreign Bodies ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intrauterine Devices

Hyperkalemic periodic paralysis is characterized by episodic flaccid paralysis of the skeletal muscles due to an increase in serum potassium concentrations. Primary hyperkalemic periodic paralysis is caused by point mutations in SCN4A, encoding a voltage-gated skeletal muscle sodium channel. However, hyperkalemia-related diseases, such as renal failure, adrenal insufficiency, hypoaldosteronism, and chronic diuretic use, can induce secondary hyperkalemic periodic paralysis. Diagnosis of this disease is based on clinical features, nerve conduction studies, and a DNA sequence analysis. In cases of diagnostic uncertainty, a provocation test can be used to ensure the correct diagnosis. Here, we report a case of secondary hyperkalemic periodic paralysis with hyperkalemia that was induced by diabetic nephropathy, and review the relevant literature.
Adrenal Insufficiency ; Diabetic Nephropathies ; Dietary Sucrose ; Hyperkalemia ; Hypoaldosteronism ; Muscle, Skeletal ; Neural Conduction ; Paralysis ; Paralysis, Hyperkalemic Periodic ; Point Mutation ; Potassium ; Renal Insufficiency ; Sequence Analysis, DNA ; Sodium Channels ; Uncertainty

OBJECTIVE: To obtain information on the growth inhibition effect of arsenic compounds and gene expression profiles using cDNA microarray technique in SiHa cell lines. METHODS: We cultured 103 SiHa cell in 96 well plate and we investigated growth inhibition effects using MTT assay and also we performed gene expression profile experiment using 384 cDNA chip in SiHa cell after exposure of arsenics (As2O3, As4O6 - 1 (micro)M) for 48 hrs. RESULTS: Arsenics (As2O3, As4O6) inhibit the growth of SiHa cells (As2O3: 0.5, 1, 2, 3, 4, 5 (micro)M - 9.2, 56, 89, 93, 96, 96%, As4O6: 0.5, 1, 2, 3, 4, 5 (micro)M- 54, 84, 84, 85, 85, 87%) in 4 days culture. As2O3 and As4O6 induced apoptosis in SiHa cells. After exposure of As2O3, 47 genes were changed more than 2 times (eg, thymidylate synthetase, cyclin B1, CDC 20). In case of As4O6, 78 genes were changed more than 2 times (eg, CDC 20, cyclin B1, primase, proliferating cell nuclear antigen). CONCLUSION: we observed arsenic compound (As2O3, As4O6) inhibit the growth of SiHa cell. In gene expression profiling experiment, 78 genes was changed the expression level 2 times more than that of reference RNA after treatment of As4O6 and 47 genes after treatment of As2O3. Through these result, we thought more study need in functional genomics after arsenic treated cervical cancer cells.
Apoptosis ; Arsenic* ; Arsenicals ; Cell Line ; Centers for Disease Control and Prevention (U.S.) ; Cyclin B1 ; DNA Primase ; DNA, Complementary* ; Gene Expression Profiling ; Gene Expression* ; Genomics ; Oligonucleotide Array Sequence Analysis* ; RNA ; Thymidylate Synthase ; Transcriptome* ; Uterine Cervical Neoplasms