No abstract available.
Hydronephrosis*

PURPOSE: To determine the relation between clinical results and correction angle in proximal tibial osteotomy through the retrospective study. MATERIALS AND METHODS: Seventy-two valgus osteotomies of the tibia were performed in forty-nine patients from 1985 to 1992; average follow-up period was 7 year 11 months(range, 5 to 12 years). We classi- fied the patients into three groups according to the tibiofemoral angle measured at the last follow-up. Group I includes patients with less than valgus 6 degrees of tibiofemoral angle, Group II with from valgus 7 degrees to 9 degrees and Group III with more than valgus 10 degrees. RESULTS: The Insalls Hospital for Special Surgery knee score was gradually decreased in time as 95 at postoperative 2 years, 92 at 5 years and 82 at the last follow-up. The average preoperative tibiofemoral angle was varus 3.4 degrees and the average postoperative tibiofemoral angle was corrected as valgus 8.0 degrees, 7.9 degrees at two years, valgus 7.0 degrees at five years and valgus 5.4 degrees at the last follow-up. The group I, 40 cases(mean 9 year 7 month follow-up), showed postoperative valgus 6.4(3-15) degrees and val- gus 2.6 degrees at the last follow-up. Loss of correction was 3.8 degrees and knee score was 76 at the last fol- low-up. The group II, 21 cases(8 year 1 month), showed postoperative valgus 9.0(7-11) degrees and 7.6 degrees at the last follow-up. Loss of correction was 1.4 degrees and knee score was 83.5 at the last follow- up. The group III, 11 cases(7 year 7 month) showed postoperative valgus 11.4(10-15) degrees and 10.9 degrees at the last follow-up. Loss of correction was 0.5 degrees and knee score was 97 at the last follow-up. The group III showed better maintenance of postoperative correction angle and clinical results than the other gf OUpS. CONCLUSION: Deductively, it is essential to correct tibiofemoral angle more than 7, especially ranged from 10 to 15 degrees for the best long-term clinical results.
Follow-Up Studies ; Humans ; Knee ; Osteotomy* ; Retrospective Studies ; Tibia

No abstract available.
Child* ; Hand* ; Humans

No abstract available.
Fingers*

Bone injuries of the extremities can be found in 0.2-2% of all living newborns. The most common location of the fracture was clavicle, and followed by humerus, femur in orders. Fractures of the femur are relatively rare. Authors have analyzed 9 cases of the femoral shaft fractures in the newborns, treated at Severence Hospital from January 1985 to March 1992. Seven cases were born by Cesarean section, two cases were by normal spontaneous vaginal delivery. Vertex presentation were three cases, breech presentation were five cases, and transverse presentation was one case. The mean birth weight was 2.93kg and four cases were born in prematurity. The location of fracture were seven cases in proximal shaft, one case in mid shaft, and one case in distal shaft. The type of fracture were all spiral fracture except two fractures. Five cases were treated by splint and 4 cases were treated by traction method. No further immobilization was needed for 8 cases but two weeks long leg cast after splint was applied for one case. Two cases of complication were noted. Skin necrosis developed due to the traction to the popliteal fossa and minimal anterior angulation of femora, and no functional deficit were found, but bony protrusion of proximal femora were palpated.
Birth Weight ; Breech Presentation ; Cesarean Section ; Clavicle ; Extremities ; Female ; Femur ; Humans ; Humerus ; Immobilization ; Infant, Newborn ; Leg ; Methods ; Necrosis ; Parturition ; Pregnancy ; Skin ; Splints ; Traction

BACKGROUND: Surfactant protein A (SP-A) is important in the regulation of surfactant secretion, synthesis and recycling. SP-A has important roles in regulating surfactant metabolism as well as in determining surfactant's physical properties. Since systemic sepsis is one of the common causes of acute respiratory distress syndrome (ARDS) and abnormalities in surfactant function have been described in ARDS, the authors investigated the effects of endotoxemia on the accumulation of mRNA encoding SP-A and SP-A protein content. METHODS: Adult rats were given various doses of intraperitoneal endotoxin from Salmonella enteritidis and sacrificed at different times. SP-A mRNA was measured by filter hybridization method. Lung SP-A protein content was determined by double sandwich ELISA assay using a polyclonal antiserum raised in rabbits against purified rat SP-A. RESULTS: 1) The accumulation of SP-A mFNA in the endotoxin treated group 24 hours after 2mg/kg and 5mg/kg endotosin treatments was significantly increased 50.9% and 27.3%, respectively, compared to the control group (P<0.001, P<0.025). 2) The accumulation of SP-A mRNA 24 hours in the 5mg/kg endotoxin treated group was significantly increased by 26.5% compared to the control group (P<0.01). 3) Total amount of lung SP-A was not altered at 24 hours by various doses of treatment. Total lung Sp-A content 144 hours after endotoxin administration was significantly decreased by 51.4% compared to the control group (P<0.01) CONCLUSIONS: The specific regulation of SP-A by various time course in vivo is evident. The late decline in SP-A protein content was unexpected and suggests that SP-A may be differentially regulated during lung inflammation. The functional significance of these alterations remains to be clarified.
Adult ; Animals ; Endotoxemia ; Enzyme-Linked Immunosorbent Assay ; Gene Expression* ; Humans ; Lung ; Metabolism ; Pneumonia ; Pulmonary Surfactant-Associated Protein A* ; Rabbits ; Rats ; Recycling ; Respiratory Distress Syndrome, Adult ; RNA, Messenger ; Salmonella enteritidis ; Sepsis

No abstract available.
Cerebral Palsy*

Many organic and nonorganic agents can cause chemical pneumonitis. Chemical pneumonitis induced by inhalation of acetic acid is a rare clinical condition. As acetic acid is a water soluble agent, it causes chemical irritation to respiratory tract and causes variable symptoms. We experienced a case of acute lung injury due to inhalation of acetic acid fume. A 56-year-old male patient was admitted due to dyspnea with vomiting for one day. After he inhaled acetic acid fume in occupational situation, he had chest tightness, chilling sense, and productive cough. Our case was good response to oxygen inhalation, antibiotics, and systemic steroids.
Acetic Acid* ; Acute Lung Injury ; Anti-Bacterial Agents ; Cough ; Dyspnea ; Humans ; Inhalation* ; Male ; Middle Aged ; Oxygen ; Pneumonia* ; Respiratory System ; Steroids ; Thorax ; Vomiting ; Water

BACKGROUND: The incidence of mycoplasmal pneumonia is predominantly at childhood and early adulthood, but in adults, its incidence is low and its symptoms and physical findings are nonspecific. The definite diagnosis of M. pneumoniae pneumonia can be made by sputum culture, but requires several weeks for positive results, and the early diagnosis must initially be based on the serologic tests and appropriate clinical findings. Thus, we evaluated the clinical aspects of M. pneumoniae pneumonia in the adults patients. METHOD: Among the admitted patients due to pneumonia, the definite diagnosis is anti-M. pneumoniae antibody titer of > 1:40 and a single cold agglutinin titer of > 1:64. The presumptive diagnosis is anti-M. pneumoniae antibody titer of > 1:40 or a single cold agglutinin titer of > 1:64 and the clinical characteristics or chest X-ray findings are compatible with M. pneumoniae pneumonia. We studied the age and sex distribution, seasonal distribution, clinical symptoms, physical findings, serologic test, chest X-ray findings, treatment and its progression. RESULTS: 1) The age distribution was even and the ratio of male to female was 1:1. 2) The monthly distribution was most common in January(16.7%) and the seasonal distribution in autumn and winter(autumn: 30%, winter: 33.3%). 3) The cold agglutinin titers were higher than 1:64 in 12 cases(40%), and reached the peak level around 2 weeks from onset and antimycoplasma antibody titers were higher than 1:160 in 5 cases(16.7%). 4) On the chest X-ray, pulmonary infiltration was noted in 28 cases(93.3%) among 30 cases and right lower lobe involvement was the most common(33.3%) and both lower lobe involvement was noted in 7 cases(23.3%). 5) The mean treatment duration was most common(33.3%) in 1 week to 2 weeks after admission and 26 cases(86.7%) were improved within 4 weeks. 6) On admission, there was fever(> or =38.9degreesC) in 17 cases(56.7%), and the fever subsided in 12 cases(70%) within 3 days after treatment using erythromycin. CONCLUSION: The mycoplasmal pneumonia in adults shows milder clinical patterns than that in childhood and can be completely recovered without complication by early diagnosis and treatment.
Adult* ; Age Distribution ; Diagnosis ; Early Diagnosis ; Erythromycin ; Female ; Fever ; Hospital Distribution Systems ; Humans ; Incidence ; Male ; Pneumonia* ; Seasons ; Serologic Tests ; Sex Distribution ; Sputum ; Thorax

BACKGROUND: Ichthyosis is the name of a group of disorders characterized by a generalized, persistent, non-inflammatory scaling disorder of the skin. Filaggrin is an intermediate filament associated protein which functions to aggregate keratin intermediate filaments in the stratum corneum of mamrnalian epidermis. It is synthesized as a large precursor protein, profilaggrin, that consists of multiple filaggrin units and is localized in keratohyalin granules(KHG). Some reports elucidated the pathogenetic role of filaggrin in ichthyosis, especially autosomal-dominant ichthyosis(ADI). OBJECTIVE: We conducted an immunohistochemical study in order to observe the relationship between clinical phenotypes of various ichthyosiform dermatoses and the exprassion of filaggrin. MATERIALS AND METHODS: Clinically and histopathologically proven ADI, lamellar exfoliation of the newborn, lamellar ichthyosis, epidermolytic hyperkeratosis, and acquired ichthyosis cases were included in this study. Using monoclonal mouse anti-human filaggrin antibodies, an immunohisto-chemical study was performed with formalin-fixed, parraffin-embedded involved skin tissues via the ABC technique. RESULTS: Filaggrin was staind linearly or in a punctuate pattern along the granular cell layer of the normal epidermis. The expression of the filaggrin was decreased or partly absent in the skin tissue of ADI in accordance with the changes of KHGs. Similar immunoreactivities with filaggrin antibodies were noted in the skin of acquired ichthyosis. In lamellar exfoliation of the newborn, filaggrin was staineil from the stratum granulosum to the mid-layer of the stratum corneum with basket-weave byperkeratosis. Filaggrin was intensely and focally labelled in the normal acrosyringium of the lamellar ichthyosis from the granular layer to the mid horney layer. A decreased positive immunorcactivity was observed in the interfollicular stratum granulosum. A strong immunoreactivity was noted in the area with relatively normal KHGs of epidermolytic hyperker atosis, and a decreased l membranous staning pattern was observed in the layer with degenerated vacuolar KHGs. CONCLUSION: It can be concluded that decreased expression of filaggin may play a causative role in the pathogenesis of ADI. However in lamellar exfoliation of the newborn, lamellar ichthyosis, epidermolytic hyperkeratosis, and acquired ichhtyosis, the altered expression of filaggrin must reflect the changes of KHGs in the stratum granulosum.
Animals ; Antibodies ; Epidermis ; Humans ; Hyperkeratosis, Epidermolytic ; Ichthyosis ; Ichthyosis, Lamellar ; Immunohistochemistry ; Infant, Newborn ; Intermediate Filaments ; Mice ; Phenotype ; Skin ; Skin Diseases*