No abstract available.
Venous Thrombosis

Serum C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR) were measured in 46 patients treated with uncomplicated primary hip replacements, 39 total tip replacements and 7 bipolar hip replacements. In uncomplicated primary hip replacements, ESR levels were slightly elevated preoperatively and were variable postoperatively. But CRP was normal before surgery and elevated in postoperative course, but back to normal within three weeks in most cases. Early success of hip arthroplasty is in indicated by normalization of CRP within three weeks, regardless of ESR. Since ESR seems to react somewhat differently from the CRP, both methods are useful in the monitoring of complications after hip arthroplasty.
Arthroplasty* ; Blood Sedimentation* ; C-Reactive Protein* ; Erythrocytes* ; Hip* ; Humans

No abstract available.
Anti-Bacterial Agents* ; Sepsis*

PURPOSE: To examine the cardiac function, incidence and natural history of cardiac hypertrophy (CH) and the association of side effects with CH after pulse dexamethasone therapy in infants with bronchopulmonary dysplasia. METHODS: Twelve infants, gestational age 28.6+/-1.6(26-31)weeks, birth weight 1243+/-186 (1010- 1620)g, received a pulse course of dexamethasone, starting at 0.5mg/kg/d for three days and readministered ten days thereafter at a median of 19 days of age. Serial echocardiographic measurement of septal thickness(ST), left ventricular(LV) posterior wall thickness(PWT), LV diameter(LVD), LV length(LVL), LV mass, ejection fraction(EF) and acceleration time to right ventricular ejection time ratio(AT/RVET) were taken before, and 4, 11 days after starting dexamethasone. For infants diagnosed as CH, echocardiography was performed weekly until the parameters were normalized. Side effects of dexamethasone such as leukocytosis, hypertension, hyperglycemia and insulin therapy were recorded and compared. RESULTS: CH occurred in 5 of 12 infants(47%). ST, PWD, and AT/RVET increased significantly at 4 days and 11 days after starting dexamethasone than baseline. LVD decreased significantly at 4 days and 11 days after the administration of dexamethasone than before. Other parameter such as LVL, LV mass and EF were not changed and the evidence of left ventricular outflow obstruction was not observed. The incidence of hyperglycemia and insulin therapy were higher in CH group than in no CH group(p<0.05). Five infants with CH recovered until five weeks after starting dexamethasone on serial echocardiography, CONCLUSION: Infants receiving a pulse course of dexamethasone developed evidence of septal hypertrophy, thickened left ventricular wall and impaired filling of left ventricle immediately after starting dexamethasone but always resolved within five weeks Serial echocardiography is not probably routinely required in preterm infants with bronchopulmonary dysplasia receiving pulse dexamethasone therapy.
Acceleration ; Birth Weight ; Bronchopulmonary Dysplasia* ; Cardiomegaly ; Dexamethasone* ; Echocardiography ; Gestational Age ; Heart Ventricles ; Humans ; Hyperglycemia ; Hypertension ; Hypertrophy ; Incidence ; Infant* ; Infant, Newborn ; Infant, Premature ; Insulin ; Leukocytosis ; Natural History ; Ventricular Outflow Obstruction

Supracondylar fracture of the humerus is the most common fracture about the elbow in children and much has been written about its treatment and the prevention of both Volkmann's ischemia with contracture and the nerve injuries associated with these fractures. However, it is still one of the most difficult fractures to manage and is frequently associated with significant residual complications. Among these complications, the change in carrying angle is the most common one. In a retrospective survey of 102 children with supracondylar fractures of the humerus treated at the Department of Orthopedic Surgery of Kyungpook National University Hospital, 68 cases were found to have sufficient clinical and roentgenographic data to classify the fractures and to determine the carrying angles at end result. The results are as follows: 1. The mean age of the 102 patients at the time of fracture was 7.3 years (range, 2 to 17 years), and the fractures were on the left side in 67.6%, and male comprised 70.1%. 2, Of all fractures, 98% were the extension type, and the most common direction of initial displacement of the distal fragment was postero-medial. 3. According to Arnold et al classification, fractures with moderate varus or valgus displacement were the most common types in our series. 4. In the associated injuries with fractures, there were 5 nerve palsies and 5 fractures at the other sites. 5. In our series, the carrying angle of the opposite side of the fractured elbow ranged from 2 to 23 degrees of valgus angulation, with a mean of 9.2 degrees. 6. The decrease in carrying angle was most common in fractures with postero-medial displacement. 7, As far as the position of immobilization after reduction of the fracture is concerned, there was less tendency of decreasing the carrying angle in pronated group. 8. Most cases were treated by conservative method. There was no significant difference in change of carrying angle between the cases treated by closed reduction and those by skeletal traction.
Child ; Classification ; Clinical Study ; Contracture ; Elbow ; Gyeongsangbuk-do ; Humans ; Humerus ; Immobilization ; Ischemia ; Male ; Methods ; Orthopedics ; Paralysis ; Retrospective Studies ; Traction

The subluxation of the femoral head is one of important prognostic factors in LCPD and current treatment of LCPD is based on the premise that adequate containment of the vulnerable femoral head within the acetabulum during the process of repair should result in a more spherical femoral head and a more congruous joint than if treatments were not provided.We analised the arthrographic findings of 18 hips in unilateral LCPD in order to determine the changes of the femoral head and acetabulum, degree of the subluxation and containment of the femoral head in various position of hip. The results were as follows: 1. According to the result of sphericity, the femoral head was deformed mainly in coronal plane in LCPD. 2. Average medial joint space of normal hip was about 3.8mm in the AP view of hip, but it was more increased in any position of LCPD. 3. In abduction with internal rotation, average subluxation ratio was 7.5% in normal hip and 10.9% in LCPD. In abduction with external rotation, it was 8.3% in normal hip and 12.4% in LCPD. 4. In normal hip, the containment ratio was more than 1.0 in any position of hip, but the containment ratio was 1.03 in abduction with internal rotation and 0.95 in abduction with external rotation of hip in LCPD. 5. On the basis of these results, efficacy of the Scottish Rite orthosis was doubtful in most hips of LCPD.
Acetabulum ; Arthrography ; Containment of Biohazards ; Head ; Hip ; Joints ; Legg-Calve-Perthes Disease ; Orthotic Devices

No abstract available.
Polyhydramnios*

No abstract available.
Infant, Newborn ; Meconium Aspiration Syndrome* ; Meconium*

No abstract available.

To determine the incidence of prenatal brain damage, and evaluate the clinical and neurosonographical characteristics, we prospectively examined 508 newborn infants with intracranial ultrasound within the first day of life who admitted to the NICU of Severance Hospital from June 1990 to January 1992 and reviewed maternal or neonatal medical records. We found 12 cases (2.4%) of fetal brain lesions and ten of which had antenatal periventricularintraventricular hemorrhage and posthemorrhagic hydrocephalus. One of 10 infants had focal parenchymal hemorrhage, 1 had diffuse parenchymal hemorrhage with a porencephalic cavity, 1 had multicystic periventricular leukomalacia with spongiform cerebromalacia, and 1 had multicystic periventricular leukomalacia. Another 2 infants showed multicystic periventricular leukomalcia and multicystic encephalomalacia with ventriculomegaly respectively. Of 12 infants with prenatal brain damage, 7 were full-term, 5 were preterm, 9 were appropriate-for-gestational age, 2 were small-for-gestational-age, 7 were male, and 9 were delivered vaginally. Ten of 12 infants had perinatal asphyxia and five of which showed severe asphxia. Ten of 12 cases had significant materanl histories (three of which had preterm labor, three had premature rupture of amniotic membrane, one had preeclampsia, one had frequent upper respiratory tract infection and influenza, one had herb medication, and one had mental retardation). Only one infant with prenatal brain damage was asymptomatic and ll infants exhibited a few clinical signs during the neonatal period (all 5 infants had respiratory distress symptom, 4 infants had multiple congenital anomalies, 2 infants showed janudice and one infant had seizure). Of 9 infants who were taken electroencephalogram, 7 infants showed abnormal findings and four of 9 infants taken brainstem auditory evoked potential test exhibited abnormal response. Cerebral palsy and mental retardation were documented in two infants, 5 infants were lost on follow-up examination, and 5 infants were discharged against doctor's advices and died. This study confirms that some drain damage is prenatal and these lesions are associated with the development of cerebral palsy. therefore, prenatal brain damage can not be attributed to obstetrical events and neonatal care, We recommend that a fetal neurosonographic examination should be done in the last trimester of all pregnancies, especially in the presence of significant obstetric history or suspected fetal malformations and neonatal brain sonogaraphy be done within the first week of life. These examination are justified because they would allow early intervention to help offset possible neurologic deficits, would help prepare parents and pediatricians for possible limitations, and would prevent lawsuits and protect against malpractice allegations. But, it is not clear that every newborn infants need an ultrasound scan, since detection of prenatal brain damage would be of little benefit to the patients and enormous cost of routinely examining all pregnancies would be required.
Amnion ; Asphyxia ; Brain* ; Cerebral Palsy ; Early Intervention (Education) ; Electroencephalography ; Encephalomalacia ; Evoked Potentials, Auditory, Brain Stem ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hydrocephalus ; Incidence ; Infant* ; Infant, Newborn ; Influenza, Human ; Intellectual Disability ; Leukomalacia, Periventricular ; Male ; Malpractice ; Medical Records ; Neurologic Manifestations ; Obstetric Labor, Premature ; Parents ; Pre-Eclampsia ; Pregnancy ; Pregnancy Trimester, Third ; Prospective Studies ; Respiratory Tract Infections ; Rupture ; Ultrasonography