Stenosing peroneal tenosynovitis is one of the rather common causes of pain and disability following calcaneal fracture. In practice, however, attention is focused on fracture healing and the development of subtalar degenerative arthritis, and impingement or adhesion of the peroneal tendons within their sheaths due to bony protrusion or distorted anatomy resulting in disability and pain on weight bearing is too frequently overlooked. We diagnosed and treated four cases of stenosing peroneal tenosynovitis, three of which were associates with subtalar arthritis, in a relative short period of time. We proposed that orthopaedists treating calcaneal fractures be aware of this entity as distinct causes of pain.
Arthritis ; Fracture Healing ; Osteoarthritis ; Tendons ; Tenosynovitis ; Weight-Bearing

In Korea, owing to effective vaccination, occurences of poliomyelitis begen to decrease rapidly from 1964 and in recent years less than 10 cases of acute infection are being reported annually. However, patients crippled with poliomyeltis residua, mainly the legacy of the many epidemics of 1950s, and early 1960s, are many and pose a social and national problem as well as a personal and family ordeal. We reviewed 536 patients with residual poliomyelitis admitted and treated at Seoul National University Hospital during the past 18 years, from 1963 to 1980 They were divided into four chronological groups; the first, 1993 to 1968, the second 1968 to 1973, the third, 1974 to 1977, and the fourth, 1978 to 1980, In each group, based on in-patient records, and out-patient records, epidemology, deformities, and treatment were extensively reviewed. The followings are the outcome of this investigation 1. The male-to-female ratio was 53.7%: 46.3%, The male majority, distinct in the first group with 63. 7%, became less conspicuos in the fouth group with 50. 3%. 2. Average age oe admission, which was 10. 7 years in the first group, had increased decidedly to 17. 8 years in the fourth group. 3. The age of onset was most frequent between 1 to 2 years with 45.8% and next frequent between 7 to 12 months with 23. 5%. The ages below 5 years occupied 97. 6% of the cases. 4. The year of onset was most frequent from 1961 to 1963 with 28.7%. The incidence markedly and steadily decreased thereafter. 5. 94. 5% of the cases were unvaccinated. The remaining cases, except one, had had incomplete vaccination. 6. Fever, with 74. 0% was by far the most frequent initial symptom. Vomiting and diarrhea were the next frequent symptoms. 7. Of the 60% of the patients who had had any previous treatment, 25. 9% had operations and 20. 4% had braces and crutches. 8. Average number of admissions per patient were 1. 7 and average number of operations were l. 9. Average length of hospitalization was 39. 2 days. 9. 23. 6% of the patents had hip deformities, of which flexion defermity was most frequent with 4. 7%. Soutter fasciotomy or Campbell operation was employed in order to correct flexion deformity. In the earlier groups, Mustard operation, Sharrard operation, Ober-Barr operation, and pem-berton osteotmy were commonly practiced, whereas in the later groups, Thomas-Thompson-Straub operation, combined Thomas-Thompson-Straub and Ober-Barr operation, Salter osteotomy, Chiari osteotomy, Steel osteotomy were favored. 10. 45.2% of the patients had knee and leg deformities, of which flexion deformit; was most frequent with 14.5%. Flexion-valgus-external rotation deformity and flexion-valgus deformity with 4.6% and 4.5%, respectively, followed next. 11. 83. 9% of the patients had foot and toe deformities, of which equinovarus deformity occupied 6. 5% equinovalgus deformity 6.8%, and clawing of great toe 25. 2%. Triple arthodesis was done most frequently with 45. 9% of the cases, or 282 feet. Jone's operation or its modification, Tendo Achilles lengthening, plantar fasciotomy, and Peroneal tendon transfer were also frequntly performed. 12. There was leg length inequality in 90%. of the cases, Epiphysiodesis and femoral shortening were carried out, except for 4 cases of stapling in the earliest group, and femoral lengthening was done in 3 cases. 13. Spineal deformity was found in 19.7 % Of the cases, of which scoliosis was most freqent with 11. 5%. 7% of the cases had pelevic obliquity. Lumbodorsal fasciotomy, and postrior spinal fusion with Harrington instrument were carried out in order to ameliorate these deformities. 14. Deformities in the upper extremity were found in 3.6% of the patients. Procedures carried out inclulded shoulder fusion, Saha's operation, Steindler's flexorplasty, sternocleidomastold transfer, wrist fusion and opponensplasty, etc. 15. Generally, there was marked improvement of disability after treatment. The patients having moder.ate to severe limping decreased from 41.3%, preoperatively, to 25% after operation.
Age of Onset ; Animals ; Arterial Switch Operation ; Braces ; Clubfoot ; Congenital Abnormalities ; Crutches ; Diarrhea ; Fever ; Foot ; Hip ; Hoof and Claw ; Hospitalization ; Humans ; Incidence ; Knee ; Korea ; Leg ; Leg Length Inequality ; Male ; Osteotomy ; Outpatients ; Poliomyelitis ; Scoliosis ; Seoul ; Shoulder ; Spinal Fusion ; Steel ; Tendon Transfer ; Toes ; Upper Extremity ; Vaccination ; Vomiting ; Wrist

Congenitial elevation of the scapula, more commonly referred to as Sprengel's deformity, first was described by Eulenberg in 1963. After then, many authors have reported this abnormal condition and many surgical spproaches have been described. When evaluating a patient with congenital elevation of the scapula for surgical correction, cosmetic severity, functional impairment, associated congenital anomalies and the child's age should be consicdered. Since July, 1981, we have tried surgical correction in 8 patients with this deformity, and followed up for more one year except one patient. 6 patients between 3 years and 11 years of age were trested with Green's operation, and 2 patients, 22 years and 26 years of age were treated with supraspinous portion resection only. All of 7 patients, whose follow-up period is more than one year, gained more thsn 1 grade of cosmetic improvement, mean 17 of combined abduction and mean 1.6 cm of acspular lowering. Keloid formation was most common complication and was prevented by meticulous subcutsneous and subcuticular suture. Brschial plexus palsy was most serious complication and was prevented by avoiding overcorrection or by clavicular osteotomy or intraoperative EST.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Keloid ; Osteotomy ; Paralysis ; Scapula ; Sutures

No abstract available in English.
Clinical Study

The authors have reviewed 63 resistant clubfeet of 40 patients who were treated by modified Turco's operstion at the Department of Orthopaedic Surgery, Seoul National University Hospital during the eight years period from July, 1979 to June, 1987. The procedure performed by the senior author(D.Y.L.) is essentially similar to Turco's original technique, but with the following modifications :(a) A curvilinear skin incision instead of Turco's straight oblique incision. (b) Aponeurotic tenotomy of the abductor hallucis. (c) Medial capsulotomies of the first metatarso-medial cuneiform joint, medial cuneiformnavicular joint and release of the medial extension of the tibialis anterior insertion. (d) Z-plastic lengtening of the tibialis posterior tendon instead of tenotomy (e) Plantar fasciotomy The average age at the time of operation was 23.4 months, the youngest being 4 months and the oldest being 6 year and 7 months. The follow-up period was minimum 12 months and maximum 6 years, the average being 27.4 months. The cases were analysed radiologically and clinically, and following observations were made. l. AP and lateral talocalcaneal angles were corrected satiafactorily in 60 feet(95%) and 59 feet(94%), respectively. The Talocalcaneal indices were corrected satisfactorily to over 40 in 60 feet(95%). 2. The talo-first metatarsal angles, which reflect adduction of the fore-foot, were corrected satisfactorily to within +10°in 55 feet(87%). 3. Good and fair results were obtained in 54 feet(86%) in the radiological evaluation. 4. Adduction deformity of the forefoot was responsible in most cases of radiologically unsatisfactory results. 5. Among 40 feet of 26 pstients who were evaluated clinically by the Wynne-Davis method, 33 feet were rated good and 7 feet were rated fair. No poor results were found clinically. 6. Senior author's modification of additional forefoot medial release is an important addition to Turco's original technique and effectively reduced unsatisfacotory results.
Clubfoot ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Humans ; Joints ; Metatarsal Bones ; Methods ; Seoul ; Skin ; Tendons ; Tenotomy

No abstract available.
Communicable Disease Control* ; Communicable Diseases* ; Quarantine* ; Republic of Korea*

Gastrofiberscopic findings under direct vision were analysed in 248 patients who were diagnosed as gastric cancer from Feb. 1980 to March 1983 in Department of internal Medicine, Kang Nam Sacred Heart Hospital, Hallym Medical College, Seoul, Korea. (continue...)
Endoscopy* ; Heart ; Humans ; Internal Medicine ; Korea ; Seoul ; Stomach Neoplasms* ; Stomach*

With the advent of improyed external fixation device, femoral lengthening has gained renewed popularity in recent years in the treatment of unequal leg length. Wagner(1971) and De Bastiani et al(1987), among others, have made epochal contribution in this field. During the period from May 1984 to May 1987, 25 patients with leg length discrepancy underwent femoral lengthening using Wagner's or De Bastianis distractable external fixators at the Department of Orthopedic Surgery, Seoul National University Hospital. There were 6 patients below 16 years of age admitted to the Children's Hospital, and 19 patients were 16 years or older. The mean age was 18.2 years, ranging from 3 years to 36 years. The underlying etiology included residual poliomyelitis in 20 patients, epiphyseal injury in 2 patients, congenital short femur in 1 patient, septic hip residua in 1 patient, and cerebral palsy in 1 patient. The mean leg length discrepancy was 4.5cm, ranging from 1.3cm to 7.4cm. The mean length gained was 4.1cm, ranging from 1.8cm to 6.4cm. All except two patients had two stage procedures with iliac crest strut bone graft. The mean time required for radiological consolidation of bone graft was 4.8 months. The plate and screws used for osteosynthesis was removed after the medullary canal has been re-established. Six patients had removal of the plate and screws between 8 months and 25 months after the second stage osteosynthesis. Technical errors included 1 case of incomplete osteotomy which required manual clasis, and another case of faulty insertion of Schanz screws that required reinsertion. Five cases (33.3%) had the minor pin tract infection. Schanz screw breakage occurred in a case of one stage femoral lengthening. Loosening of plate and screws was seen in three cases. One case had delayed union requiring augmentation bone graft. Stiff knee with less than 90°of flexion was encountered in one case. One case sustained fracture of patella during physiotherapy. Despite of a long list of complication, the ultimate goal of leg length equalization was successfully achieved in all the cases.
Cerebral Palsy ; External Fixators ; Femur ; Hip ; Humans ; Knee ; Leg ; Orthopedics ; Osteotomy ; Patella ; Poliomyelitis ; Seoul ; Transplants

Serum thyroxine(T4), effective thyroxine index(ETI) and thyroid stimulating hormone(TSH) were measured in 60 albino rats following laminectomy and cord injury produced by weight drop method. Thyroid hormones were measured at one and 100 minutes and, at 1, 3 and 7 days after injury by radioimmunoassay method. At 1 and 100 minutes, T4 was significantly reduced in both laminectomy and cord injured groups. TSH at 1 and 100 minutes were also elevated significantly. Gradual normalization of T4 and TSH showed at 7 days. It appeared likely that the opimal time to the administration of exogenous thyroid hormone would be before the 7th day of cord injury.
Animals ; Laminectomy ; Radioimmunoassay ; Rats ; Spinal Cord Injuries* ; Spinal Cord* ; Thyroid Gland* ; Thyroid Hormones ; Thyroxine

BACKGROUND: Pharmacological stress tests for the diagnosis of GH deficiency are unpleasant, labor intensive and potentially dangerous. Reports on urinary GH measurement for the assessment of GH have been published after highly sensitive immunoassaies were developed. The aim of this study was to determine whether a 24- hour urine GH as an alternative method for GH assessment were reliable in predicting GH deficiency defined by L-dopa stimulation test. METHODS: Thirty women, ages 45 to 67, were studied. L-dopa stimulation tests were performed with an ingestion of 500 mg of L-dopa. Serum GH and IGF-1 were measured by a radioimmunoassay using commercially available reagents and uGH was estimated from the 24-hour urine. Then, the mean and its distribution of uGH values were compared according to the GH status defined by L-dopa stimulation test. RESULTS: The correlation between the uGH and the peak values after L-dopa stimulation test was significant (r=0.46; p<0.01). The mean value of uGH in the GH deficiency group was significantly lower than that of the normal group P<0.05). But because of the broad overlap of uGH in the two groups uGH showed no good separation GH deficiency from normal group although uGH reflects GH status significantly. CONCLUSION: uGH reflects GH status significantly, but because of broad overalp uGH couldn't separate GH deficiency form normal group defined by L-dopa stimulation test.
Diagnosis ; Eating ; Exercise Test ; Female ; Growth Hormone* ; Humans ; Indicators and Reagents ; Insulin-Like Growth Factor I ; Levodopa ; Radioimmunoassay