Congenital high scapula, more commonly referred to as Sprengel's deformity, was first described by Eulenberg in 1863. Usually other congenital anomalies are associated such as absent or fused ribs, chest wall asymmetry, Klippel-Feil syndrome, cervical ribs, congenital scoliosis, cervical spina biffida was treated with the excision of the elongated acromion and the resection of prominent elongated acromion to be described is an extremely rare malformation. We experienced one case of congenital high scapula associated with anomaly of the acromion, which was treated with the excision of the elongated acromion and the resection of prominent supermedial border of the scapula for the purpose of the cosmetic and functional correction. After 1 year follow up, abduction was improved by only 10 degrees in the glenohumeral joint with the definite cosmetic improvement.
Acromion ; Cervical Rib ; Congenital Abnormalities ; Follow-Up Studies ; Klippel-Feil Syndrome ; Ribs ; Scapula ; Scoliosis ; Shoulder Joint ; Thoracic Wall

The juvenile Tillaux fracture and the triplane fracture of the distal end of the tibia in adolescents are considered uncommon injuries and the mechanism of both injuries has been uncertain. It has been postulated that both fractures probably are caused by external rotation of the foot. We atempted to evaluate the mechanism of injury as well as to conform the role of the external rotation of the foot for the juvenile Tillaux fracture and triplane fracture. From 1983 to 1988 at the department of orthopedic surgery, college of medicine, Hallym University, we evaluated the cases of nine adolescent patients with the juvenile Tillaux fracture and nine patients with the triplane fracture of the distal tibial epiphysis. We confirmed that external rotation force produced the triplane fracture as well as juvenile Tillaux fracture. And we could postulate that the triplane fracture needed further external rotation force, less closure of the distal tibial epiphysis, and more complicated mechanism of injury than the juvenile Tillaux fracture. The knowledge of these mechanism of injury enables us to use a rational manipulative approach to reduce these fractures.
Adolescent ; Clinical Study ; Epiphyses ; Foot ; Humans ; Orthopedics ; Tibia

The distal tibial physes begins its closure about 18 months prior to complete cessation of the tibial growth, closing first in its midportion, then medially, and finally, laterally. So the patterns of the ankle fracture during this period would be different from those of the adult or the children before this period. During the six year period from 1983 to 1988 at the department of orthopedic surgery, college of medi-cine, Hallym University, we found and analysed 54 adolescent patients with the ankle fracture which developed before the closure of the distal tibial growth plate, which were followed up more than 1 year. The results were as follows 1. During the 6 year period of this study, the adolescent ankle fracture comprise 4.4% (54 cases) of all the ankle fractures(1158 cases). Injury occurred more often in male than in female(44 versus 10). The mean age was 13.7 years. 2. The most common cause of injury was traffic accident being in 26 cases(48.1%), the next was slip down accident in 11 cases, and the third was sports activity in 10 cases. 3. The incidence of the adoescent ankle fractures using the Salter-Harris classification revealed 20 (37%) type II, 7 (13%) type III, 5 (9.3%) type IV, and 4 (7.4%) type I and that using the Dias and Tachdjian classification revealed 14 (25.9%) Supination-Inversion, 10 (18.5%) Supination-External rotation, 7 (12.7%) Pronation-Eversion-External rotation, and 1 (1.9%) no adjustable fracture. There were 9 (16.7%) Tillaux and 9 (16.7%) triplane fractures, which were belonged to both classifications 4. The treatments performed were closed reduction and cast immobilization for 28 cases (51.9 %), open reduction and internal fixation for 20 cases (37%), and closed reduction and percutaneous pinning for 6 cases. 5. There were complications experienced in 9 cases, which were 3 premature epiphyseal closure, 3 joint surface incongruity, 2 angular deformity, and 1 leg shortening. 6. For the prevention of the complication, the treatment of the adolecsent ankle fracture should be treated like as adult fracture.
Accidents, Traffic ; Adolescent ; Adult ; Ankle Fractures ; Ankle ; Child ; Classification ; Clinical Study ; Congenital Abnormalities ; Growth Plate ; Humans ; Immobilization ; Incidence ; Joints ; Leg ; Male ; Orthopedics ; Sports

No abstract available.
Bursitis*

Fractures of the tibia are frequently encountered in mordern civilized society. Especially, those in distal 1/3 of the tibia have so many problems, such as angular deformity, osteomyelitis and nonunion because of anatomically scanty soft tissue. Many modalities of the treatment of fracture of distal 1/3 of the tibia were introduced. Among them, interlocking IM nailings were considered as one of the best modality. But, in interlocking IM nail, reaming of the medullary canal which destroys the endosteal circulation and causes thermal necrosis of the inner aspect of the cortical bone results in delayed union. And also, procedure for distal screw fixation is difficult and time-consuming. As for using flexible IM nails for fractures of distal 1/3 of the tibia, it was considered as not so satisfactory method due to lack of stability of fixation. However, the stability of fixation can be strengthened with fanning of the nails in distal fragment, using more than 3 nails and delay the protected weight bearing. Authors studied 25 cases of fractures of distal 1/3 of the tibia treated with closed flexible IM nailing at Sung Ae General Hospital, from July., 1987 to July., 1989, and obtained following results: 1. Among 25 cases, 4th decades were most common and males were more commonly involved. 2. Traffic accidents were the most common causes of injury and majority of 16 open fractures and 19 comminuted fractures, were caused by high energy mechanism. Among open fractures, type II were most common. 3. Two angular deformities less than 10 degrees, one proximal migration and one checkrein deformity were observed as complications, but, no clinically significant complications were noted. 4. The time for radiological union were 14.5 weeks in group without fibular fracture and 15.1 weeks in group with fibular fracture, and 14.0 weeks in closed fracture group and 17.2 weeks in open fracture group, and average in 15.6 weeks.
Accidents, Traffic ; Clinical Study ; Congenital Abnormalities ; Fractures, Closed ; Fractures, Comminuted ; Fractures, Open ; Hospitals, General ; Humans ; Male ; Methods ; Necrosis ; Osteomyelitis ; Tibia ; Weight-Bearing

PURPOSE: MRI is known to display the anatomy of the larynx in excellent detail with its remarkable soft tissue delineation and multiplanar imaging capability. We evaluate the accuracy of MRI in diagnosis and staging of laryngeal cancer MATERIALS AND METHODS: Sixteen cases with pathologically proved squamous cell carcinoma of the larynx were reviewed, retrospectively. The examination was performed with a 0.5 T superconductive MR system and C1 surface coil. Axial, sagittal and coronal plane with T1WI(TR/TE 450/20) and T2WI(TR/TE 18OO/80) were done. RESULTS: Eleven cases with glottic cancer(5 Tla, 3 Tlb, 1 T3 and 2 T4) and 5 cases with supraglottic cancer (1 T1, 1 T3 and 1 T4) were included. Cancer tissue showed intermediate signal intensity on TIWI and high signal intensity on T2Wl. Among 16 cases, 13 cases were correctly staged and 3 cases were overstaged due to edema caused by previous biopsy, partial volume averaging effect of abutted lesion, or surrounding inflammation. CONCLUSION: MRI is an useful modality for diagnosis of laryngeal cancer, especially in evaluation of paraglottic extention on coronal image and cartilage invasion.
Biopsy ; Carcinoma, Squamous Cell ; Cartilage ; Diagnosis ; Edema ; Inflammation ; Laryngeal Neoplasms ; Larynx ; Magnetic Resonance Imaging ; Retrospective Studies

A nineteen year-old boy with progressive enlargement of the joints and distal extremities, clubbing, coarse facial features and hyperhidrosis was investigated. In physical examination, thickening of the scalp with furrowing (cutis verticis gyrata) and greasy thickening of skin (pachyderma) was prominent. His endocrine profile was normal. Radiological studies demonstrated bilateral symmetrical periosteal new bone formation with acroosteolysis and incidental microadenoma of pituitay gland. After extensive investigation to exclude systemic and endocrine causes, the patient was diagnosed as pachydermoperiostosis (PDP). PDP is a rare syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. The pathogenesis of the disorder has not been clarified though few endocrine abnormalities were seen. To aware of these clinical phenotype would help to differentiate PDP from acromegaly.
Acro-Osteolysis ; Acromegaly ; Extremities ; Fingers ; Humans ; Hyperhidrosis ; Joints ; Male* ; Osteoarthropathy, Primary Hypertrophic* ; Osteogenesis ; Phenotype ; Physical Examination ; Scalp ; Skin ; Young Adult*

Bilateral coronary artery fistula is very uncommon congenital anomaly which occupy small percentage of all congenital coronary artery fistula. About 20% of the cases associated with additional congenital heart disease. And it may cause congestive heart failure, especially severely in neonate. We experienced a case of neonate who was 1 day-old-male with bilateral coronary artery-right ventricular fistula associated with atrial septal defect and congestive heart failure. The Patient was admitted because dyspnea, cyanosis since birth. 2D ecgicardiogram and cardiac catheterization revealed that a fistulous communicating ; forming a large aneurysm, was noted from bilateral coronary artery emptied into the right ventricle, and there was oxygen step-up in right ventricle.
Aneurysm ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Cyanosis ; Dyspnea ; Fistula* ; Heart Defects, Congenital ; Heart Failure ; Heart Septal Defects, Atrial* ; Heart Ventricles ; Humans ; Infant, Newborn* ; Oxygen ; Parturition

PURPOSE: This study was conducted to identify awareness levels in regard to preconception care and gender differences targeting single undergraduate students in their 20s. METHODS: The study participants were 867 single undergraduate students aged 20~29 (523 women, 344 men). This was a descriptive research, in which awareness levels of preconception care and pregnancy were identified the through questionnaire surveys. RESULTS: Gender differences in the awareness of reproductive care before conception were found. Generally, women's awareness of issues related to preconception care and pregnancy was higher than that of men. Women recognized risk factors in pregnancy (chi2=22.85, p<.001) and positive behaviors (chi2=10.91, p = .012) better than men. Women's awareness of preconception care was significantly higher than that of men (t=8.37, p<.001). The awareness levels of the students who completed a reproduction related class (t=3.16, p = .002) and the students who knew about folic acid (t=-10.78, p<.001) in preconception care were statistically significantly higher. CONCLUSION: The results indicate that the ways to educate and alert students to major risk factors before pregnancy and other reproductive care content before conception is to provide education both single women and single men.
Education ; Female ; Fertilization ; Folic Acid ; Humans ; Male ; Preconception Care* ; Pregnancy* ; Surveys and Questionnaires ; Reproduction ; Risk Factors

Fine needle aspiration cytology of the salivary lesions was performed on 221 patients at Soonchunhyang University Hospital for 10 years. Of 221 aspirates, 6 aspirates(2.7%) were inadequate, 116 cases(52.5%) were non-neoplastic lesions, 76(34.4%) cases were benign neoplasms and 23 cases(10.4%) were malignant neoplasms. The cytologic diagnoses could be correlated with histologic findings in 58 cases. FNAC correctly discriminated between neoplastic and nonneoplastic lesions in fifty-seven lesions and failed in a case, and overall accuracy, sensitivity, and specificity were 98.3%, 98.0%, and 100.0%. FNAC correctly discriminated malignant neoplasms from benign neoplastic/non- neoplastic lesions in fifty-three cases and failed in five cases, and overall accuracy, sensitivity, and specificity were 91.3%, 72.7%, and 95.7%. Among three false negative cases, two mucoepidermoid carcinomas were misdiagnosed as mucocele and benign neoplasm, and an acinic cell carcinoma were misdiagnosed as Warthin's tumor. Two false positive cases were a Warthin's tumor misdiagnosed as squamous cell carcinoma and a pleomorphic adenoma misinterpretated as suggestive of malignancy. In conclusion, diagnostic accuracy of FNAC of salivary lesions is high, and the possibilities of low grade mucoepidermoid carcinoma and acinic cell carcinoma should be considered on hypocellular smears with mucoid or fluidy background.
Adenoma