To evaluate the effect of a new topical anesthetic cream (EMLA : Eutectic mixture of local anesthetics) on reducing pain associated with DPT vaccination, we conducted a clinical observation on eighty infants who were brought to well baby clinic of Yeungnam University Hospital for DPT vaccination. 80 Infants, who were between 2 months and 8 months in age, were divided into two groups. EMLA treated group and control group. Male to femle sex ratio was 1.4 to 1. EMLA cream was applied 60 minutes before DPT vaccination, the effect of reducing pain was assessed by using McGrath's face scale, Oucher pain scale and modified behavioral pain scale (MBPS) and also evaluated by measuring the duration and time of crying (the time of the first crying after iniection, duration of the first crying, total duration of crying). The scores of those scales were lower in EMLA treated group than in control group significantly (P<0.01 in McGrath's face scale. MBPS and p<0.05 in Oucher pain scale). There was no difference in the time of the first crying after vaccination in both groups. The duration of the first crying was shorter in EMLA treated group than control group of crying was also shorter in EMLA treated group (EMLA treated group 9.0±12.5 sec, p<0.05). Transient skin erythema was noted in 5 infants after EMLA application, but no other adverse effects were observed. We conclude that the application of EMLA cream before vaccination seems to be an effective and safe way to reduce the pain from vaccination, but it takes usually 60 minutes to get the anesthetic effect of EMLA and it is expensive, so EMLA cream can not be recommended in routine vaccination in infants now.
Anesthetics ; Crying ; Erythema ; Humans ; Infant ; Male ; Sex Ratio ; Skin ; Vaccination* ; Weights and Measures

Pyriform sinus fistula (PSF) is a persistent embryologic third or fourth pharyngeal pouch, which typically presents as a congenital sinus tract that originates from the pyriform sinus. PSF is among the most uncommon congenital malformation of the neck. The usual clinical manifestations are either acute thyroiditis or abscess, usually on the left side of the neck. We report a case of PSF in a 9-year old female with a left cervical abscess who had been diagnosed by barium esophagogram and treated endoscopically by injection of histoacryl.
Abscess ; Barium ; Child ; Enbucrilate* ; Female ; Fistula* ; Humans ; Neck ; Pyriform Sinus* ; Thyroid Gland ; Thyroiditis

No abstract available.
Hazardous Substances* ; Occupations* ; Skin*

Fixed pelvic obliquity refers to a composite deformity induced by contractures both above and below the pelvis and the elements of this deformity are frequently interrelated during the period of growth. From the functional standpoint, leg length discrepancy is caused by deformities of the pelvis and lower extremities, such as pelvic obliquity and acetabular dysplasia, as well as by inequality of true limb bone length, and these deformities either aggravate or compensate functional discrepancy. During fhe fourteen years period, from August 1968 to August 1982, at the Department of Orthopaedic Surgery, Seoul National University Hospital, we treated 35 cases of fixed pelvic obliquity and acetabular dysplasia associated with true or functional limb length discrepancy by means of lumbodorsal fasciotomy or pelvic osteotomies such as Salters innominate osteotomy or Steels triple osteotomy, combined, if necessary, with contralateral abductor fasciotomy to gain functional limb length as well as to improve posture and balance. In many cases of residual poliomyelitis, epiphysiodesis was also performed when indicated. These cases were reviewed and following observations were made: 1. Of the 35 cases, residual poliomyelitis with 29 cases (83%) was by far the main cause of leg length discrepancy. Cerebral palsy (2cases), Legg-Perthes disease (2 cases), and fibrous ankylosis secondary to septic hip (2 cases) comprised the remainder. 2. The male-to-female ratio was about equal, being 17 to 18. 3. The average age at the time of operation was 17.9 years, the youngest being 7 years and the oldest being 30 years. The average age at the time of current follow-up was 18.8 years. 67% of those followed was skeletally mature. 4. An average of 1.35cm of bone length was gained radiographically by pelvic osteotomies. Steels triple osteotomy was more effective in gain than Salters innominate osteotomy. 5. An average of 2.43cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy alone. 6. An average of 2.61cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy and combined contralateral Soutters or Campbells fasciotomy. 7. An average of 3.57cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy and combined ipsilateral Steel's triple osteotomy. 8. An average of 1.73cm of functional lengthening when standing was corrected radiographically by ipsilateral Soutter's fasciotomy. 9. When lumbodorsal fasciotomy and Steel's triple osteotomy were combined with contralateral Soutter's or Campbell's fasciotomy, the average radiographic gain in standing length was 3.77cm. 10. Leg length discrepancy in terms of true bone length is conventionally corrected either by epiphysiodesis or bone shortening on the longer limb, or by bone lengthening on the shorter limb. We believe that when leg length discrepancy is associated with fixed pelvic obliquity, frequently aggravating the disability functionally, lumbodorsal fasciotomy and/or pelvic osteotomies on the shorter side and, combined if necessary, Soutters or Campbells fasciotomy on the longer side, can, in many instances, successfully correct or reduce functional limb discrepancy and improve balance, posture and function. Any residual discrepancy, true or functional, may then be corrected by conventional methods.
Acetabulum ; Ankylosis ; Bone Lengthening ; Cerebral Palsy ; Congenital Abnormalities ; Contracture ; Extremities ; Follow-Up Studies ; Hip ; Leg ; Legg-Calve-Perthes Disease ; Lower Extremity ; Osteotomy ; Pelvis ; Poliomyelitis ; Posture ; Seoul ; Socioeconomic Factors ; Steel

Congenital pseudarthroses and non-unions have been recognized as some of the most challenging problems in orthopaedic surgery. with a standard surgical procedure, such as bone grafting, nailing, plating or a combination of these, it was frequently failed to unit. After repeated surgical failures, amputation has been the main course. With the advent of an electrical control of osteogenesis, however, this dismal outlook is brightening. The earliest report of the use of electrical energy to directly stimulate bone healing seems to be in 19th century, but it was not reliable. In this century, the electrical properties of bone were first described by Yasuda et al in 1953. After then, several investigators have shown that the application of small amounts of the electrical current to bone stimulates osteogenesis at the site of the cathode. Clinical trials using various froms in the treatment of delayed union, non-union, and congenital-pseudarthrosis began early in the 1970's. Constant direct current, pulsed current, and electromagnetically induced current have all been used clinically to heal bone defects with varying degrees of success. But, to-this date it is unknown what is the mechanism of stimulating bone healiag with electricity, and which from of electricity is most efficient in stimulating osteogenesis. We have experienced direct current stimulation to promote osteogenesis in 9 cases of non-union and 4 cases of congenital pseudarthses of the tibia from august, 1978 to december, 1980. Of 9 non-unions, 7 (77.8%) achieved solid bony union. We had obtained bony union in 4cases of non-union only with the electrical stimulation. In 4 cases of congenital pseudarthses of the tibia, all cases achieved solid bony union with the electrical stimulation and bone graft, but in 3 cases, refractures were occurred. At this moment, our conclusions from this study are as followa. I. Direct current stimulation is one of the reliable methods inducing ostengenesis. 2. Regular follows-up and determination of the stimulator integrity are essential steps in the electrical stimulation. 3. Combined treatment with the electrical stimulation and bone graft have markedly improved the success rate. 4. In direct current stimulation of congenital pseudarthsis, the mechanically sound bony alignment, massive bone graft and protection using long leg brace seem to be mandatory procedures.
Amputation ; Bone Transplantation ; Braces ; Electric Stimulation ; Electricity ; Electrodes ; Humans ; Leg ; Magnets ; Osteogenesis ; Pseudarthrosis ; Research Personnel ; Tibia ; Transplants

The metastasis of renal cell carcinoma is common, but ureteral metastasis is very rare. A 68-year-old woman was evaluated for painless total gross hematuria accompanied by a blood clot. The left upper pole mass was preoperatively proven as renal cell carcinoma by CT-guided fine needle biopsy, and left radical nephrectomy was performed. Two months post operation, she visited again with the same symptom. On the ureteroscopic biopsy, left ureteral cancer was diagnosed by frozen biopsy. Left ureterectomy with bladder cuff excision was done, and pathologic examination demonstrated ureteral metastasis of renal cell carcinoma. She has been in good condition without any signs of recurrence until now. We report ureteral metastasis of renal cell carcinoma with 7 years survival time.
Aged ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Renal Cell* ; Female ; Hematuria ; Humans ; Neoplasm Metastasis* ; Nephrectomy ; Recurrence ; Ureter* ; Ureteral Neoplasms ; Urinary Bladder

No abstract available.
Patella*

The electrical burns constitute a unique type of thermal injury and usually consist of a limited area of cutaneous burn, but associated with deep muscle damage of variable extent. The deep tissue destruction resulting from such injury leads to high incidence of amputation. So electrical burns are different from other types of injuries requiring individualized and varied methods of treatment, such as early fasciotomy, repeated debridement, wound coverage and technique of amputation. During 5 years from Jan. 1988 to Dec. 1992, we experienced 310 cases of electrical burn. We analyzed these cases on the aspects of functional result and necessity of amputation according to the treatment variability. The result showed the extent of burn in amputation group was 11.6%, salvage group 13.1%, with no difference of extent between 2 groups(p>0.05, by qui square test). When the fasciotomy was done earlier than 12 hours after injury showed 39.1% of more than good functional result, when later than 12 hours 7.7% of more than good, that is, earlier fasciotomy resulted in better function(p < 0.05, qui square test). The amputation rate was 23.9% during the last 5 years which was a marked improvment when compared to the previous ten years(32.4%). From these results we concluded that in order to reduce the rate of amputation and to improve the function of patients, early fasciotomy, early repeated debridement and wound coverage is necessary.
Amputation ; Burns ; Debridement ; Humans ; Incidence ; Wounds and Injuries

No abstract available.
Aneurysm*

No abstract available.
Growth Hormone* ; Thyroid Gland*