A case of neonatal diabetes mellitus is described. The child presented with low birth weight but was normal in appearance. She was acidotic and ketonuria was observed. The HLA typing was DR1 and 3, and insulin autoantibodies were negative. Genetic analysis with polymorphic DNA markers for chromosome 6 indicated biparental inheritance. She required insulin therapy for the control of hyperglycemia, and insulin dependence continues after 8 months of age.
Autoantibodies ; Child ; Chromosomes, Human, Pair 6 ; Diabetes Mellitus* ; Genetic Markers ; Histocompatibility Testing ; Humans ; Hyperglycemia ; Infant, Low Birth Weight ; Infant, Newborn ; Insulin ; Ketosis ; Wills

No abstract available.
Alloys* ; Dental Porcelain*

The most important spinal disorders in childhood are malformations and mass lesions. High-resolution, real-time ultrasonography of the spine enables the differentation of intraand paraspinal structures in a significant way. This examination does not require sedation, does not use radiation, can be performed in the nursery or an incubator and is less expensive than computed tomography or magnetic resonance imaging. The sonographic appearence of the various kinds of spinal dysraphism is demonstrated and illustrated. Based on our preliminary experience spinal sonography appears to be useful in neonates and infants as the first imaging device for differentiation of cmplex malformation and as a screeing method for occult spinal dysraphism.
Humans ; Incubators ; Infant* ; Infant, Newborn* ; Magnetic Resonance Imaging ; Neural Tube Defects ; Nurseries ; Spinal Dysraphism* ; Spine ; Ultrasonography*

No abstract available.
Craniocerebral Trauma* ; Head*

Partial knee ankylosis is a recognized complication following open operative procedure, trauma and disease processes about the knee. It can result from the formation of intraarticular adhesion and contracture of the capsule as well as the shortening or adhesion of the quadriceps mechanism. Physical therspy and occasionally manipulation under the anesthesia may improve the results, but performed late, these methods will be useless. This is a review of 30 patients who had severe limitation of motion in the knee joint following open operative procedures or trauma about the knee and who were treated by the percutaneous release of adhesions under the arthroscopic control. The following results were obtained; There were 17 males and 13 females, and the age of release ranged from 23 to 69 years old (av. 42.8years old). The interval between arthroscopic adhesiolysis and the last follow-up evaluation ranged from 6 months to 5 years and 7 months(av. 23 months). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from 3 months to 4 years(av. 15 months). The average preoperative knee ROM was 38.8°the postoperative ROM was 121.1°and the average final knee ROM at follow-up was 102.6°So the average loss of ROM was 18.5°The arthroscopic adhesiolysis seems to be applied to the various conditions of the partial knee ankylosis and the results are better than the other surgical procedures when it was performed early enough.
Anesthesia ; Ankylosis ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Male ; Surgical Procedures, Operative

No abstract available.

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

The unstable pelvic fracture involving sacro-iliac joint produced by excessive force, is relatively rare but causes a multiplicity of complications and presents a major therapeutic problem. The clinical results were obtained as follows: 1. 9 patients out of 16 were in age group between 20 to 29 year, Male and female ratio was 5:3 2. 10 patients out of 16 were produced by traffic accident. 7 patients among 16 were included in vertical shear type and 5 in lateral compression type. 3. There were 44 associated injuries in 15 patients. Fractures in other region were the most common associated injury in 20 and injuries of the genito-uninary system in 8. 4. All of the cases were treated conservatively and their result were excellent or good except 1 patient in pelvic disruption type, who has had paraplegia due to fracture-dislocation of L4-5.
Accidents, Traffic ; Clinical Study ; Female ; Humans ; Joints ; Male ; Paraplegia

We reviewed 35 patients who received an operation for the Spondylolisthesis from July 1980 to July 1985. The follow-up period between operation and evaluation was at least 14 months and average 32 months. we obtained the following results. 1. The age distribution was from 23 years of age to 70 years of age and the prevalent decade was at the 5th. 2. Sex difference showed male 9 cases and female 26 cases, that is, female preponderance about 3 times. 3. 24 cases were isthmic type and 11 cases were degenerative type. The ratio between isthmic type and degenerative type was about 2: l. 4. Isthmic type was found at the 4th and 5th decades frequently and degenerative type was at 5th and 6th decade frequently. 5. The displacement between L4 and L5 was 21 cases and the displacement between L5 and sacrum was 14 cases. 6. In isthmic type, the displacement between L4 and L5 was 11 cases and the displacement between L5 and sacrum was 13 cases. In degenerative type, the displacement between L4 and L5 was 10 cases and the displacement between L5 and sacrum was 1 case. So the isthmic defect occurred at 2 levels almost equally and degonerative type occurred at L4-5 predominantly. 7. Overall results are excellent 2 cases(6%), good 29 cases(82%), fair 2 cases(6%), and poor 2 cases (6%).
Age Distribution ; Clinical Study ; Female ; Follow-Up Studies ; Humans ; Male ; Sacrum ; Sex Characteristics ; Spondylolisthesis

A clinical observation and comparision was carried out on 466 cases of meningitis in infancy and childhood : 135 cases of purulent meningitis ; 208 cases of aseptic meningitis, and 123 cases of tuberculous meningitis. They were admitted to Jeonju Presbyterian Medical Center from January, 1973 to December, 1979. The results were as follows; 1) Male to female ratio was 2.1:1 in purulent meningitis, 3.2:1 in aseptic meningitis, and 2.4:1 in tuberculous meningitis. 2) The seasonal peak incidence was Spring and Summer for purulent and tuberculous menigitis and Summer for aseptic meningitis. 3) The most predilectional age which resulted in meningitis was infancy in purulent meningitis, 4 to 12 years o fage in aseptic meningitis and 1 to 4 years of age in tuberculous meningitis. 4) Fever was the most frequent symptom ; and vomiting, convulsion, unconsciousness, and headache followed in that order in the three kinds of meningitis. The most frequent neurologic finding was stiff neck; and Kernig's sign, Brudzinski's sign, and Babinski's sign followed in that order in the three kinds of meningitis. 5) In CSF examination on admission, cell counts were most frequently under 1,000/mm3 in purulent meningitis(49.6%), under 50/mm3 in aseptic menigitis (35.6%) and 100 to 300/mm3 in tuberculous meningitis (52.0%). The sugar level in 74.1% of purulent meningitis and in 84.5% of tuberculous meningitis was under 50mg/dl. In aseptic meningitis the sugar level was over 50mg/dl in 72.6%. The protein level was most frequently 30 to 150mg/dl in all three kinds of meningitis. 6) The mortality rate was 14.1% in purulent meningitis, 0.5% in asepic meningitis and 10.6% in tuberculous meningits. 7) The younger the patient in purulent and tuberculous meningitis, the worse the prognosis. The mortality rate of tuberculous meningitis was 9.1% in stage II and 50% in stage III.
Cell Count ; Female ; Fever ; Headache ; Humans ; Incidence ; Jeollabuk-do ; Male ; Meningitis* ; Meningitis, Aseptic ; Mortality ; Neck ; Neurologic Manifestations ; Prognosis ; Protestantism ; Reflex, Babinski ; Seasons ; Seizures ; Tuberculosis, Meningeal ; Unconsciousness ; Vomiting