Oblique single-plane trochanteric osteotomy, in which an oblique cut is made through the femoral trochanteric area and the bony fragments are rotated at the face of the cut in direct contact with each other, allows simulatenous correction of the femoral neck-shaft angle, femoral anteversion as well as flexion/extension effect. Only approximate methods of calculating the correction effects of this procedure have been introduced. Considering unique spatial orientation of femoral neck, we developed a rigorous method to calculate preoperatively the obliquity of the single-plane osteotomy and the amount of rotation required to achieve the target femoral conformation, through geometric analysis. The correction effect by oblique trochanteric osteotomy on the geometry of proximal femur was dependent not only on the amount of change of the neck-shaft angle and femoral anteversion but also on the preoperative neck-shaft angle and femoral anteversion themselves. The flexion/extesion effect was determined by the direction of the correction and the preoperative neck orientation. Computer graphic simulation study confirmed the validity of this method. A program written in QBASIC was introduced to make this complex calculation method more useful in the clinical practice.
Computer Graphics ; Femur Neck ; Femur ; Methods ; Neck ; Osteotomy

This purpose of this study was to evaluate the possible prognostic factors of physeal bar resection in the treatment of partial physeal growth arrest. From January 1979 to October 1993, 23 skeletally immature patients (16 males, 7 females) underwent physeal bar resection and fat graft interposition. The age was ranged from 1 year 8 months to 16 years 9 months (average 8 years 9 months). The follow-up period was ranged from 12 months to 10 years 6 months (average 3 years 4 months). The results of the surgery were categorized into 4 groups on the basis of relative growth ratio (RGR), spontaneous angular correction after physeal bar resection, disappearance of converging growth arrest lines, and the viability & proximal migration of the interposed fat verified by follow-up MRI. The RGR was assessed as a percentage of the contralateral limb segment: change in length of operated limb segment divided by change in length of unoperated limb segment multiplied by 100. The angular correction was calculated as the difference of the degrees of angular deformity between the preoperative and the latest follow-up visit. In the sixteen cases which required concomitant operations (osteotomy, Ilizarov method of for lengthening or deformity correction), their contribution to the angular correction was excluded in the calculation. The etiology of partial physeal arrest consisted of fracture (17), infection (5), and leukemia (1). In 10 of 17 fracture cases in which initial radiographs were available, the Salter-Harris types were assessed. There were type II (2), type III (2) and type IV (6) fractures. Distal femur was the most common site of physeal arrest (13), followed by distal tibia (7), proximal tibia (2), and distal radius (1). There were peripheral (9), combined (6), central (5) and linear (3) types of physeal bar. The nine variables including preoperative limb length discrepancy and degree of angulation, age, onset, etioloty of physeal arrest, Salter-Harris type of epiphyseal injury, site of the arrested physis, type and size.
Congenital Abnormalities ; Extremities ; Femur ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Leukemia ; Magnetic Resonance Imaging ; Male ; Radius ; Tibia ; Transplants

We evaluated the scapular shape, dispiacement and rotation in 10 cases of Sprengel deformity using three-dimensional computed tomography in order to investigate its clinical usefulness. Standard views, including trunk posterior view, scapular true posterior view and medial view, were taken, and the 3-D image was rotated in three axes to visualize the omovertebral bony connection. In the trunk posterior view, the amount of superior displacement of the affected scapula was measured using the glenoid level as reference, and the rotational deformity by the tilting of the base of scapular spine. Scapular dysplasia was evaluated in the scapular true posterior and medial views. The presence, size, and anchoring points of omovertebral bone were assessed in various view points. There was a tendency of inverse correlation hetween superior displacement and rotational deformity of scapula. In most cases, the affected scapulae were convex at their medial borders and concave at their lateral borders, with increased width/height ratio. The anchoring point of omovertebral connection appeared to determine the scapular shape, level, and amount of rotation. Three-dimensional CT was helpful in preoperative planning.
Congenital Abnormalities* ; Imaging, Three-Dimensional ; Scapula ; Spine

No abstract available.
Mitral Valve*

No abstract available.
Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma*

No abstract available.

No abstract available.
Osteotomy*

Intraosseous lipoma is a very rare primary tumor of the bone. We report four cases of intraosseous lipoma. The patient ranged in age from 34 to 59-year-old (median age: 35 year-old). There were three men and one woman. All of four cases presented with pain. The involved bones were calcaneus in two cases, tibia in one case and ilium in one case, respectively. In all cases plain x-ray film revealed well-defined lytic lesion. Their size ranged 2 to 4.5 cm (mean size: 3.5 cm). Histologic examination showed mature adipose tissue. Three cases showed secondary changes such as atrophic bone, fat necrosis, fibrosis, dystrophic calcification, and reactive ischemic bone formation. The clinicopathologic and roentgenographic correlation are necessary in establishing correct diagnosis of this tumor.
Adipose Tissue ; Calcaneus ; Diagnosis ; Fat Necrosis ; Female ; Fibrosis ; Humans ; Ilium ; Lipoma* ; Male ; Middle Aged ; Osteogenesis ; Tibia ; X-Ray Film

A 28-year-old female devei,oped five rice-sized erythematous telaniectatic solid papules of her left side of cheek and numerous light brownish flat papules of her face two years before visiting our department of dermatology. Biopsy results of the erythematous papule vere dermal infiltration by well-differentiated, however, somewhat atypical and varying sized plasma cells involving epidermis, and the flat papule was that of verwca plana. Bone marrow aspirate was essentially normal. Primary cutaneous plasmacytoma is a rare disease. A significant proportion of patients with this ent on to develop systemic disease with a poor prognosis. Our patient was not treatead, bit only excised partially for biopsy. All skin lesions involuted two years later spontaneously and rema ns well until now six years later without recurring.
Adult ; Biopsy ; Bone Marrow ; Cheek ; Dermatology ; Epidermis ; Female ; Humans ; Plasma Cells ; Plasmacytoma* ; Prognosis ; Rare Diseases ; Skin

The occurrence of atrial fibillation during an electrophysiologic study or catheter ablation in patients with accessory pathways is a common problem and sometimes complicates the localization and ablation procedure of accessory pathways. In patients with sustained atrial fibrillation, it is often time-consuming to terminate atrial fibrillation by drugs or electrical cardioversion. We performed successful radiofrequency catheter ablation in a patient with right-sided accessory pathway during atrial fibrillation requiring repeated electrical cardioversion. The target site was determined by activation mapping and morphology of unipolar electrogram at a site of early ventricular activation.
Atrial Fibrillation* ; Catheter Ablation ; Electric Countershock ; Humans