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

OBJECTIVES: Anticardiolipin antibody (ACA) and lupus anticoagulant (LA) are acquired antiphospholipid antibodies (APAs), which are regarded as important risk factors far vascular thrombosis and recurrent fetal loss. Although the clinical relevance of APAs in dialysis patients is uncertain, recent studies have suggested that APAs are involved in bioincompatibility and thrombogenic complications in hemadialysis (HD) patients. METHOD: We performed a cross sectional study of ACA and LA in 50 stable HD patients and their 68 vascular accesses (52 native arteriovenous fistulae and 16 synthetic arterovenous grafts), with the analysis of factors associated with the presence of APAs and the retrospective evaluation of vascular access occlusion (VAO). LA was assessed by platelet neutralization method whereas IgG-ACA was measured by a solid phase ELISA. Values higher than 23GPLU/ml (IgG phospholipid units) were considered to be positive for IgG-ACA and positive values for LA was more than 8 seconds in prolongation of the clotting time with human platelet lysate. Vascular access survival was assessed by Kaplan- Meier method, RESULTS: The mean age of the subject (M:F 21:29) was 46 years and the mean duration of hemodialysis was 49 months. The frequency of VAO in entire subjects was 0.45+/-0.98 episodes/patient year. The median value of IgG-ACA was 16.0 GPLU/ml with a distribution from 2.7 to 46.1GPLU/ ml. The median titer of I.A was 4.5 (3.1-45.6) seconds. Fourteen patients (28%) were found to have at least one episode of VAO. In spite of comparable clinical and biochemical data according to the presence of VAO, the titers of IgG-ACA (13.6+/-7.7 vs, 20.3+/-8.7GPLIJ/ml, P<0.05) and LA (4.5+/-2.9 vs. 11.7 +/-12.6sec, P<0.05) were significantly higher in VAO group. Six out of 50 patients(12%) had an increased titer of IgG-ACA and LA was found in 11 patients(22%). No patients were positive for ACA and LA simultaneously. There was no significant difference in sex, etiology of ESRD, diabetic status, the dosage of heparin during HD or the amount of erythropoietin administered according to the presence of APAs. We could not find any significant correlation between the titer of APAs and age, duration of dialysis, blood pressure, platelet count and biochemical parameters. In the patients with positive ACA, the frequency of VAO was 1.05+/-0.12 episodes/patient year, which was significantly higher than patients without ACA (0.33+/-0.17 episodes/ patient year, P<0.05). In the patients with the presence of LA(1.06+/-0.43 vs. 0.12+/-0.06 episodes/ patients year, P<0.01). The median vascular access survival time in IgG-ACA positive patients (32.7 months) was significantly decreased compared to 66.8 months in IgG-ACA negative group. CONCLUSION: Our data suggest that the presence of APAs (ACA and/or LA) affects the event-free vascular access survival in HD patients. Therefore the evaluation of APAs status have to be included in the diagnostic strategies for the patients with recurrent VAO. Further studies are necessary to explore the pharmacologic intervention method to decrease APAs and prevent VAO in HD patients.
Antibodies, Anticardiolipin* ; Antibodies, Antiphospholipid ; Arteriovenous Fistula ; Blood Platelets ; Blood Pressure ; Dialysis ; Enzyme-Linked Immunosorbent Assay ; Erythropoietin ; Heparin ; Humans ; Kidney Failure, Chronic ; Lupus Coagulation Inhibitor* ; Platelet Count ; Renal Dialysis* ; Retrospective Studies ; Risk Factors ; Thrombosis

Erythrasma is a chronic, superficial bacterial skin infection involving the body folds and toewebs, and sametimes it may be generalized. The causative organism of this disease is Corynebacterium minutissimum. But, in Korea, there are few reported case about this common condition. We experienced a case of erythrasma on 39-year-old male who have had well defined, brownish fine scaly patches on both crural areas for 15 years. We had treated this patient with topical antifungal agent for 1 month under impression of tinea cruris, But skin lesion was not improved. So, we reexamined the lesion and diagnosed it as genitocrural form of erythrasma with it's clinical appearance, red fluorescence under Wood's light. And we treated it with oral erythromycin.
Adult ; Corynebacterium ; Erythrasma* ; Erythromycin ; Fluorescence ; Humans ; Korea ; Male ; Skin ; Tinea

Acropustulosis of infancy is an uncommon, but not rare syndrome established as a new disease entity by Kahn and Rywlin(1976), which is characterized by recurrent, intensely pruritic vesicopustules on the distal extremities. We'd like to report a case of acropustulosis of infancy. Our patient was 19 month old girl who had been suffering from her skin disease since the age of 12 months. Intensely pruritic, 1 to 2 mm vesicopustules erupted on the palms, soles and the ventral aspects of the fingers. There were no bacteria, fungus and parasites(Sarcoptes scabiei) on the pustular lesions. Histopathologically, biopsy specimen of the left sole revealed large, well circumscribed intraepidermal pustule which was filled wth polymorphonuclear leukocytes. We confirmed our case as typical case of acropustulosis of infancy by it's characteristic clinical features and histopathologic findings. Severity of the skin lesions seems closely related to the dosage of dapsone. The eruptions were unresponsive to topical steroid, antibiotics and antihistaminics. But we observed that dapsone has dose dependent relationship with acropustulosis of infancy.
Anti-Bacterial Agents ; Bacteria ; Biopsy ; Dapsone ; Extremities ; Female ; Fingers ; Fungi ; Humans ; Infant ; Neutrophils ; Skin ; Skin Diseases

No abstract available.
Cystectomy*

In recent years, with the increasing use of ultrasonography and computed tomography (CT), a large number of renal cell carcinoma has been founded incidentally for a variety of occasions. We reviewed 107 cases of renal cell carcinoma treated surgically from 1988 to 1995, and compared symptomatically suspected group (62 cases) to incidentally detected group (45 cases). The groups were compared according to stage, grade, tumor size, age, sex, laterality and survival rate. The chief imaging methods of detection were ultrasonography (80%), IVP (11%), CT (9%). The main reasons for examination leading to the diagnosis in incidentally detected group were follow-up of other diseases (58%), general health check (31%), and follow-up of unrelated symptoms (11%). The frequency of incidentally detected renal cell carcinoma was increased from 29% (1988-1991) to 48% (1992-1995). The tumor stage and grade were lower in incidentally detected group than suspected group, and tumor size was smaller in incidentally detected group. The 2-year disease free survival rate in incidentally detected group tended to be better (95% vs 68%). So screening test with ultrasonography to detect renal cell carcinoma at an early stage, may be essential.
Carcinoma, Renal Cell* ; Diagnosis ; Disease-Free Survival ; Follow-Up Studies ; Mass Screening ; Survival Rate ; Ultrasonography

This study was designed for comparison of shear bond strengths and failure patterns of four experimental groups which combinated mesh-backed metal brackets and texture based ceramic brackets (Transcend series 2000((TM))) with chemically cured resin (Mono Lok2((TM))) and visible light cured resin (Transbond((TM))). Brackets were bonded on the extracted human bicuspids, after etching them by manufacturer's recommand, and the shear bond strengths were measured on the Instron machine after 24 hrs passed in the 37degrees C water bath. The results were as follows. 1. Ceramic brackets, transcend series 2000((TM)), bonded with MonoLok2((TM)) showed statistically higher shear bond strength than mesh-backed metal brackets bonded with MonoLok2((TM)). 2. There was no significant difference in shear bond strengths between metal and ceramic brackets bonded with Transbond((TM)). 3. Ceramic brackets bonded with both Transbond((TM)) and MonoLok2((TM)) showed primarily fractures bet?ween brackets adhesive interface. 4. Enamel crack was not found in anyone specimen.
Adhesives ; Baths ; Bicuspid ; Ceramics* ; Dental Enamel ; Humans ; Light ; Water

Environmental studies regarding Paragonimiasis have been done in Sulak-Myun, Kapyung-Goon (I district) and Yongmoon-Myun, Yangpyung-Goon (II district), both of which are considered "active" endemic areas, and in Byukje-Myun, Koyang-Goon (III district) an "arrested" area. 1. Paragonimiasis is still active in the Uhmos River, Sulak-Myun, Kapyung-Goon, where 49% of crayfish contained Paragonimus metacecaria. Snails which are the first intermediate host of Paragonimus westermani were moderately present. In the Oonke River, Yongmoon-Myun, Yangpyung-Goon, crayfish which are the second intermediate host of Paragonimus westermani, were found in every area of the river, but snails were not found in any area of either branch of the river. They were caught in areas which are located below the junction. In the Daeja river, Bykje-Myun, Koyang-Goon, crayfish were found only in the upper stream of the river and snails were not caught in any area of the river. 2. The results described above are attributed to the fact that snails, which have minimal mobility and vitality, were complete1y obliterated by the long, unprecedented drought in 1965. In contrust, crayfish with great mobility and vitality survived. Thus without the snail, the life cycle of Paragonimus western1ani become incomplete, and the clinical disease disappeared. 3. Rainfall is very important in maintaining water flow in the river, a necessary factor for the life cycle of Paragonimus westermani. Therefore we have charted tile amount of rainfall in the Seoul and Choonchun areas in 1965, compared with the average of the past 30 years, in order to ascertain the degree of drought which influnced the Paragonimus westermani hosts and cohabitants. 4. Geographic conditions which are also very important in maintaining water flow in small rivers was investigated. The conclusion was drawn, that a long river has an advantage over a short during drought; a tortuous river provides a better opportunity for miracidia of Paragonimus westermani eggs to migrate to snails, and for Pargonimus cercaria to invade crayfish than a straight rapidly flowing river. 5. We must conclude that man may ingest Paragonimus metacercaria by drinking water from shallow wells and streams in areas endemic to paragonimiasis, when we note that one crayfish of four caught in shallow wells in Kapyung-Goon contained many Paragonimus metacercaria. 6. Other factors are the increase in traffic due to the expanding population in Korean farm areas, and the increase in the use of farm chemicals, which seep into the rivers and reduce the number of snails, crayfish and crabs available as potential hosts. 7. In recent years, the wild fauna in the mountains, one of the important terminal hosts of Paragonimus westermani, have been markedly reduced in number. This may have contributed to decreasing paragonimiasis as directly infective to man. 8. Health education on paragonimiasis, informing the people of the dangers of eating raw or inadequately cooked crayfish and crabs, or those soaked less than 10 days in soysauce, and drinking the water from shallow wells and streams, is demonstrated to have decreased the incidence of this disease. 9. Because of the preceding facts, paragonimiasis in Kyunggi-Prvince is being decreased.
Animals ; Asian Continental Ancestry Group ; Crustacea ; *Disease Reservoirs ; *Disease Vectors ; Ecology ; Human ; Korea ; Paragonimiasis/*epidemiology ; Paragonimus/isolation & purification ; Snails

No abstract available.
Wernicke Encephalopathy*