PURPOSE: Cerebral cortical dysplasias are one of the important causes for epileptic seizures and developmental disabilities in children, particularly in diffuse or bilateral cases. These developmental malformations are generally regarded as a group of neuronal migration disorders, however, the classification system and pathogenetic mechanisms of cortical dysplasias are not yet entirely clear. Even a novel entity, congenital bilateral perisylvian syndrome, characterized by speech delay, pseudobulbar Palsy, intractable seizures, and bilateral perisylvian abnormalities on imaging studies, have rather diverse figures on morphology and symptomatology than initially considered. We have studied the clinical features and correlations of clinical outcomes 3nd magnetic resonance imaging(MRI) findings of bilaterally involved cortical dysplasias. METHODS: 20 cases of bilateral cortical dyspalsias were grouped into three categories on the basis of MRI findings; centroparietal dysplasias(6 cases), diffuse dysplasias with (5) or without white matter lesions(4), and schizencephaly(5). EEGs, motor and language development, epilepsy, and outcomes were reviewed in each groups. RESULTS: Language delay(100%), motor developmental delay(94.7%), motor deficit(65%), epilepsy(40%) were the main reasons for their initial hospital visits. A meaningful word expression was possible at the mean age of 2 years and 2 months(1 to 4 years of age). Hypotonia and spastic motor paralysis were evident in all the cases of diffuse dysplasia with white matter lesions and the schizencephaly groups. All but one case of centroparietal dysplasia showed motor developmental delay. Epilepsies were developed in 8 cases at the mean age of 5 years and 5 months(2 months to 12 years of age) and the seizures were relatively well controlled with anticonvulsants. EEG findings were variable; normal, focal or diffuse abnormalities. High amplitude diffuse fast activities were only noted in the diffuse dysplasia group. CONCLUSION: The severity of neurological deficits and developmental delay had correlated to the size of cortical abnormalities. The epilepsies were relatively well controlled during childhood and the EEG finding of high amplitude diffuse fast activities was specific for the diffuse cortical dysplasias. Bilateral centroparietal dysplasias should be included on consideration of the causes for developmental aphasia.
Anticonvulsants ; Aphasia ; Child ; Classification ; Developmental Disabilities ; Electroencephalography ; Epilepsy ; Humans ; Language Development ; Language Development Disorders ; Magnetic Resonance Imaging* ; Malformations of Cortical Development* ; Muscle Hypotonia ; Muscle Spasticity ; Neuronal Migration Disorders ; Paralysis ; Pseudobulbar Palsy ; Seizures

No abstract available in English.
Congenital Abnormalities

No Abstract Available.
Fas Ligand Protein* ; Keratoconus*

Inflammatory pseudotumor of the liver is a relatively rare entity, and frequently misdiagnosed as a malignant tumor. We report a case of inflammatory pseudotumor involving the liver in a 53year-old man. The liver function test and serum alpha-fetoprotein level were within normal range. His preoperative diagnosis was as hepatocellular carcinoma by radiologic studies, and ultrasonography guided fine needle aspiration cytology and biopsy were done but confirmative diagnosis of malignancy or pseudotumor was not given. Grossly a relatively well marginated reddish brown soft mass with focal hemorrhage, measuring 5.0 cm in the largest diameter, was noted in the left lobe of liver. Surrounding hepatic parenchyma was yellowish brown in color without cirrhosis. Microscopically the mass showed typical findings of inflammatory pseudotumor and the ing liver tissue revealed diffuse fatty change and moderate chronic inflammatory cell on in the portal areas.
Biopsy ; Carcinoma, Hepatocellular

The authors have reviewed 16 cases of the fracture of the femoral neck in children which were treated at Pusan Gospel Hospital during the period of 5 years from March 1975 to January 1980. 12 of the 16 fractures of femoral neck had sustained the injury by automobile accidents. The ratio between boy and girl was 1.6:1. There were five Type-II (Transcervical), nine Type-III (Cervicotrochanteric) and two Type-IV (In-tertrochanteric) femoral fractures by Delbets classiflcation. 2. cases of undisplaced and displaced Type-IV were treated with abduction plaster spics cast. 14 cases, which were displced and had associated injury, were reduced by closed reduction and internal fixation with hagie pin, cortical screw and cancellous screw under general anesthesia. 11 of 16 cases were followed for 7 months to 29 months, average 14 months. The results were rated according to criterias of the Ratliff. Satisfactory results were obtained in 9 cases and those of 5 cases were treated by closed reduction and internal fixation wlth cancellous screw. Pain was developed in a Type-II and Type-II due to loosening of metal devices for internal fixation.
Anesthesia, General ; Automobiles ; Busan ; Child ; Female ; Femoral Fractures ; Femur Neck ; Humans ; Male ; Spine

The compartment syndrome was described by von Volkmann in 1872 and numerous reports have since been published. The anterior tibial syndrome is well known, but the peroneal compartment syndrome is very rare and have some differences in it's etiology, diagnosis and treatment. We experienced a case of the peroneal compartment syndrome developed after playing foot-ball, and treated by fasciotomy with some delay, but obtained a satisfactory functional result.
Anterior Compartment Syndrome ; Compartment Syndromes ; Diagnosis

It is generally accepted that integrity of the posterior cruciate ligament plays a major role in knee stability. The potential disability resulting from disruption of the posterior cruciate ligament is sufficient to warrant aggressive operative management when the lesion is discovered. From August 1980 to July 1982, the authors treated the 8 cases of the posterior cruciate ligament injury at the department of orthopedic surgery, Chung Ang university hospital; primary repair(2 cases), reconstruction using the medial head of the gastrocnemius muscle(6 cases). In the operative procedure of reconstruction using gastrocnemius, we experienced the following obstacle and resolved it effectively. l. In the surgical approach, we choosed the separate incision on the anteromedial and posteromedial aspect of knee and satisfactory results were obtained. 2. In adequate length of the gastrocnemius tendon was resolved by releasing of gastrocnemius as closer to it's femoral condyle origin as possible or together with attached periosteum and bone chips, by fixation of gastrocnemius with pull through wire suture method. 3. In advancement of the gastrocnemius into the knee joint, we used No. 32 chest tube and achieved the smooth enterance. 4. Adequate position of the femoral condyle drill hole was achieved by using hip screw reamer and K-wire.
Chest Tubes ; Head ; Hip ; Knee ; Knee Joint ; Methods ; Orthopedics ; Periosteum ; Posterior Cruciate Ligament ; Surgical Procedures, Operative ; Sutures ; Tendons

Penicillamine is a component of the penicillin molecule which was identified in the urine of patients with chronic liver disease who were receiving penicillin for the treament of intercurrent infections. Walshe demostrated its effectiveness as copper chelating agent and introduced it into the treatment of Wilson's disease. In addition, it has been shown to be effective in treatment of cystinuria, heavy metal poisoning, and rheumatoid arthritis. Levamisole is a three-ringed molecule which has been used as broad-spectrum antihelminthic drug. Levamisole is capable of T cell immune enhancer and has variable effects on antibody production, Since immune enhancer may affect multiple cell types, either directly or indirectly, and may operate on the adenylcyclase-cAMP-prostaglandin system, the results of treatment may be complex. Levamisole has been shown to be effective in rheumatoid arthritis by several study. We analysed the 29 rheumatoid arthritis patients who were treated at Deartment of Orthopedic Surgery, Chung Ang University Hospital from June, 1978 to June, 1982; among them 17 recieving penicillamine and 12 recieving levamisole. The results were as follows: 1. There were statistically significant improvement in ESR. But there were decrease in mean WBC and platelet counts in patients recieving penicillamine or levamisole. Hemoglobin was not affected. 2. Side effects led to withdrawal of treatment in 8(47%) patients in the penicillamine group and 5(42%) in the levamisole group. 3. In 17 patients having penicillamine treatment, one patient had complete remission(8%).
Antibody Formation ; Arthritis ; Arthritis, Rheumatoid ; Copper ; Cystinuria ; Hepatolenticular Degeneration ; Humans ; Levamisole ; Liver Diseases ; Orthopedics ; Penicillamine ; Penicillins ; Platelet Count ; Poisoning

Dislocation of peroneal tendons are caused by forceful domifiexion of the foot accompanied by a powerful contraction of the peroneal muscles. This mechanism of injury tears the superior pemneal retinaculum and allows the tendons to snap anteriorly. It is an important, although infrequent, cause of disability of the ankle. The acute injury can be treated by immobilization in a plaster cast, but when there is chronic recurring dislocation, surgical reconstruction is necessary. Authors experienced two cases of dislocation of pemneal tendons which were treated by use of Sarmiento's and Platzgummer's(modified) operative procedures with good results.
Ankle ; Casts, Surgical ; Dislocations ; Foot ; Immobilization ; Muscles ; Surgical Procedures, Operative ; Tears ; Tendons

Restoration of the M-P joint of a damaged or lost joint by trauma, tumor and others is necessary for adequate function of the hand. Several procedure have been described for restoration of the M-P joint. We experienced a case of vascularized joint transter for a lost joint by trauma. After 1 year and 2 months follow-up, there have been no degenerative change and no pain.
Follow-Up Studies ; Hand ; Joints