No abstract available.
Urodynamics*

No abstract available.
Animals ; Humans ; Rats* ; Regeneration* ; Urinary Bladder*

A Paralytic hip with subluxation or dislocation may be treated by any of the ischial seat brace, hip fusion, muscle or tendon transfer, and more recently Pembertons or Salters osteotomy. 61 hips on 45 cases have been reconstructed, by one or combination of various procedures at Seoul National University Hospital during the 7 year period from October 1963 to October 1970. Follow-up results of these hips were evaluated by the reporters' according to the criteria of both functional and mechanical stability. Of the 43 cases with known results 9 rated Undetermined, 2 Fair, 5 Good, and 27 Excellent. Analysis of the 27 Excellent cases suggests that the most satisfactoy results can be obtained when the hips are attacked by concomitant functional(muscle or tendon transfer) and mechanical (Pembertons or Salters osteomy) stabilizations. In our experience, a combination of muscle or tendon transfer and an arthroplasty of Pemberton or Salter type can be carried out at the same setting, and at the same time results in better and more permanent rehabilitation of the hip than either muscle or tendon transfer or arthroplaty alone and often eliminates braces and the need for hip fusion, and thus a flail hip can be functionally salvaged. Our approach has become more aggressive in recent years, and we sometimes do not hesitate radical operations in children below 5 years of age or in convalescent stage of poliomyelitis in order to prevent further progression of hip deformities. More recently, Sharrards posterior transplantation of the iliopsoas tendon, originally described for reconstruction of paralytic hips in meningomyelocele, was carried out in 4 cases of residual poliomyelitis and we are satisfied with the initial results.
Arthroplasty ; Braces ; Child ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Hip ; Humans ; Meningomyelocele ; Osteotomy ; Poliomyelitis ; Rehabilitation ; Seoul ; Tendon Transfer ; Tendons

Background:Insulin dependent diabetes mellitus(IDDM) is known to be a disease characterized by a deficiency of insulin caused by destruction of the pancreatic beta-cells. It has been suggested that the clinical and immunological characteristics of IDDM in Korean are different from those of Caucasian. This study was undertaken to investigate the clinical characteristics and the prevalence of autoimmune markers in type I diabetic children and their prediabetic siblings in Korea. METHODS:Insulin autoantibody(IAA), antiglutamic acid decarboxylase(Anti-GAD) antibody, thyroid autoantibodies such as antithyroid antibody(ATA) and antimicrosomal antibody(AMA), and rheumatoid facter(RF) in 54 type I diabetic children have been measured. Diabetic autoimmune antibodies were also measured in 48 siblings. RESULTS: 1)Clinical characteristics of type I diabetic children were that age of onset was 8.6+/-4.4 years, duration of diabetes was 4.1+/-3.3 years. C-peptide at onset of diabetes was fasting 0.7+/-0.5ng/ml, and postprandial 1.2+/-0.5ng/ml, and HbA1c was 12.5+/-4.3%. 2)The positivity of IAA and anti-GAD antibody of type I diabetic children was 74% and 50% respectively. ATA and AMA positivity of type I diabetic children was 3.7% and 5.6%. however RF was not detected at all. Among the diabetic siblings, 48 persons for anti-GAD antibody, 21 for IAA, 27 for ICA were measured but 1 case was positive for IAA. 3)Clinical characteristics of type I diabetic children were not specific different between IAA and anti-GAD antibody positivity. But the mean age of onset of type I diabetic children was younger in case of both positivity of IAA and anti-GAD antibody than both negativity(7.8 vs 11.4 years old, P<0.05). 4)A case in whose brothers are diagnosed as IDDM has shown that autoantibody of elder brother was positive in both IAA and anti-GAD antibody, and younger brother was also strongly positive in IAA. Another case in whose sisters were IDDM, has shown that, while elder sister was positive in IAA, younger sister strongly positive in both IAA and anti-GAD antibody. 5)In a case of identical twin brother, the elder is type I diabetic child and the younger is normal, elder brother's onset of age was 6 years and 8 months old, and titer of anti-GAD antibody was measured as strong positive. Both ICA and anti- GAD antibody were negative in normal younger brother. First phase insulin release in IV GTT and the insulin levels in oral GTT showed reduction from the normal level in normal brother, and repeat check up showed normal ranges but on-going study is needed under observation. CONCLUSION: The prevalence of autoantibody positivity of type I diabetic children of Korea in this study were IAA 74%, and anti-GAD antibody 50%. Cases with both IAA and anti-GAD antibody positive were shown to be earlier onset. Though titers of auto-antibody in IDDM twins, brothers and sisters were strongly positive, auto-antibodies in siblings of IDDM patients were detected only one case with IAA positive(0.47%). We suggest that the pathogenesis of IDDM in Korean is different from foreign countries in terms of prevalence of autoimmune antibodies and more numbers of diabetic siblings should be tested for further study.
Age of Onset ; Antibodies* ; Autoantibodies ; C-Peptide ; Child* ; Diabetes Mellitus, Type 1 ; Fasting ; Humans ; Infant ; Insulin ; Korea ; Prevalence* ; Reference Values ; Siblings* ; Thyroid Gland ; Twins, Monozygotic

In transtrochanteric rotational osteotomy to treat osteonecrosis of the femoral head, the necrotic superior anterior femoral head is rotated anteriorly around the longitudinal neck axis so that the weight bearing force is transferred to the intact posterior surface. The ratio of transposed intact articular surface of the femoral head to the weight-bearing surface of the acetabulum on postoperative anteroposterior view of the hip roentgenograph is the most important indicator of the prognosis. During the period from December 1992 to June 1994, we treated 31 hips in 28 patients who were indicated for the anterior rotational osteotomy among the patients of osteoncrosis of the femoral head. Among the patients, male were 27 and female was one. Age distribution was from 13 to 62 years old and mean age was 44.3. According to the Ficat and Arlet classification, II A was most in number as 16 II B was 7 and III was 8. As their etiolgic factors, alcohol was most in number as 18, steroid was 3, idiopathic was 5 and trauma was 2. The mean rate of the intact area of the posterior part of the femoral head to the total articular surface on the preoperative lateral view of the hip roentgenograph was 41.8%. The mean ratio of transposed intact articular surface of the femoral head to the weight bearing surface of the acetabulum was 53.8% Fixation devices were screws or dynamic hip screw.
Acetabulum ; Age Distribution ; Classification ; Female ; Head* ; Hip ; Humans ; Male ; Neck ; Osteonecrosis* ; Osteotomy* ; Prognosis ; Weight-Bearing

611 children (297 boys and 314 girls) of a primary school were determined under 2% cyclogyl. (1) Among 611 children, refractive error was 70.46 % and emmetropia. 29.54 %. (2) As to the distribution of refractive errors, 72.47 % were hyperopic and 27.53 % myopic Hyperopia was more common than myopia. (3) Hyperopic refractive error was increased until 7 years of age. Since then it has been decreased 8.74 % yearly. Myopic refractive error has been increased 8.14 % yearly since 8 years of age. (4) The refractive errors were more frequent in women (37.81) than men (32.65 %) (5) Refractive errors were numerous around the age of 11. (24.77 %). (6) The degree of refractive errors varied, but in the great majority was less than 3 diopters. (7) As to the type of astigmatism; 59.42 % were with the rule and 39.94 % were against the rule.
Astigmatism ; Child* ; Cyclopentolate ; Emmetropia ; Female ; Humans ; Hyperopia ; Male ; Myopia ; Refractive Errors

PURPOSE: To analyze the affecting factor of lens in pathogenesis of acute primary angle-closure glaucoma (APACG) and the effect of selected cataract extraction with intraocular lens (IOL) implantation. METHODS: A survey was conducted on 25 eyes of 21 patients with acute angle-closure glaucoma accompanied by senile cataract against 21 eyes of 16 age-matched normal persons. Biometric measurements were made in both groups in order to analyze an affecting factor of lens in APACG. Before and after selected cataract extraction, other clinical findings were also evaluated. RESULTS: Biometric measurements such as anterior chamber depth (ACD), lens thickness (LT), ACD/axial length (AXL), LT/AXL, and relative lens position (RLP) were significantly larger for the 25 eyes of the 21 patients with APACG than the 21 eyes of the 16 age-matched normal persons (P<0.05). After selecting cataract extraction with IOL implantation, improved biometric measurements and clinical findings revealed the effectiveness of that operation. CONCLUSIONS: Selected cataract extraction with IOL implantation could be successful as primary surgery in APACG accompanied by senile cataract over intraocular pressure control and visual acuity improvement for lens factor removal of APACG.

The abnormalities in Hypothalamic-pituitary-adrenal(HPA) axis are associated with many psychiatric symptoms including depression. We present a report of a 71 year old man who was admitted to the psychiatric department presenting symptoms of headache, avolition, loss of energy, psychomotor retardation, poor appetite, insomnia, anxiety resulting from adrenal insufficiency and hypopituitarism. Hypothyroidism and electrolyte disturbance were managed and headache, insomnia, anxiety, GI symptoms were improved. But he remained in anergic state. After discharge, he was readmitted to infection department with high fever and drowsy mentality. Adrenal insufficiency was recognized and he was treated with corticosteroid replacement therapy. Finally his diagnosis was made as panhypopituitarism and overall symptoms were resolved. In this case, we showed how the atypical symptoms resulting from hypopituitarism develop and progress. Hypothyroidism, adrenal insufficiency, and growth hormone deficiency resulting secondarily from panhypopituitarism were associated with various nonspecific symptoms such as loss of energy, fatigue, insomnia, weight loss, decreased appetite etc. In clinical situation, differential diagnosis with depression is needed when clinicians were met a patient with these nonspecific symptoms. It is important that laboratory tests and differential diagnosis with endocrine diseases should be conducted, especially in geriatric patients with nonspecific symptoms like anergia, fatigue, poor appetite and so on.
Adrenal Insufficiency ; Anxiety ; Appetite ; Axis ; Depression ; Diagnosis, Differential ; Endocrine System Diseases ; Fatigue ; Fever ; Growth Hormone ; Headache ; Humans ; Hypopituitarism ; Hypothyroidism ; Sleep Initiation and Maintenance Disorders ; Weight Loss

PURPOSE: To evaluate CT findings of internal hernia. MATERIALS AND METHODS: Three patients with internal hernia had abdominal CT scans and two of them had small bowel follow through examinations. The CT features of two patients with retroanastomotic and one patient with left paraduodenal hernia were evaluated and correlated with small bowel follow through examinations, and surgical findings. Two patients with retroanastomotic hernia had a history of subtotal gastrectomy with antecolic gastrojejunostomy. The diagnosis of internal hernia was made on the basis of surgical find ings in two patients of retroanastomotic hernia, and characteristic barium study findings in one patient of left paraduodenal hernia. RESULTS: The small bowel follow through examination showed small bowel loops gathered in a circumscribed mass in the left mid abdomen, and delay in passage through these loops. In case of left paraduodenal hernia, abrupt narrowing of the distal duodenum could be identified. The characteristic CT findings of all three patients were whorling of the mesentery and mesenteric vessels in the left mid-abdomen. In the patient with left paraduodenal hernia, after resolution of the gastrointestinal symptoms, a follow-up CT scan showed spontaneous disappearance of whorling of the mesentery and mesenteric vessels suggesting spontaneous resolution of the hernia. In the other two cases, upon exploration of the abdomen, dilatation of afferent duodenum caused by adhesion between ligament of Treitz and adjacent bowel walls, and retro- anastomotic herniation of the efferent loops were found. CONCLUSION: The usual diagnosis of internal hernia is based on the appearance of the small bowel follow through examination. However, we consider that the whorling appearance(we call it whorling sign) of the mesentery and mesenteric vessels on CT scan is also suggestive of internal hernia in patients under clinical suspicion.
Abdomen ; Barium ; Diagnosis ; Dilatation ; Duodenum ; Follow-Up Studies ; Gastrectomy ; Gastric Bypass ; Hernia ; Humans ; Ligaments ; Mesentery* ; Tomography, X-Ray Computed

PURPOSE: To evaluate the radiologic findings of alimentary anthrax. MATERIALS AND METHODS: 19 patients with alimentary anthrax, which was caused by ingestion of contaminated beef, were included in this study. The diagnosis was made .b.y demonstration of Bacillus anthracis in smear and culture of the contaminated meat. We evaluated the clinical manifestations and the findings of thoracic, abdominal radiographs, cervical, abdominal ultrasonograms and abdominal CT scans. RESULTS: Out of the 19 patients with the alimentary infection, 9 had oropharyngeal form, 18 had abdominal form and 8 had combination of oropharyngeal and abdominal form. The patients had general symptoms and signs such as fever, chill, myalgia. Clinical symptoms and signs were sore throat, throat injection, throat ulcer and patch in oropharyngeal form, and nausea, vomiting, abdominal pain, diarrhea, and gross GI bleeding in abdominal form. Radiologic findings included enlarged cervical lymph nodes(36%) in oropharyngeal form, and paralytic ileus(26%), ascites(26%), hepatomegaly(21%), enlarged mesenteric lymph nodes(26%), small bowel wall thickening(5%) in abdominal form. In two patients, late complications occurred as intestinal obstruction due to ileal stricture with perforation, and inflammatory changes of pelvic cavity due to ileovesical fistula. CONCLUSION: Radiologic findings of alimentary anthrax are difficult in differentiation from those of other inflammatory bowel disease, but those radiologic findings with clinical manifestations may be helpful in diagnosis and evaluation of disease process in patients with alimentary anthrax.
Abdominal Pain ; Anthrax* ; Bacillus anthracis ; Constriction, Pathologic ; Diagnosis ; Diarrhea ; Eating ; Fever ; Fistula ; Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Intestinal Obstruction ; Meat ; Myalgia ; Nausea ; Pharyngitis ; Pharynx ; Tomography, X-Ray Computed ; Ulcer ; Ultrasonography ; Vomiting