Diastematomyelia, a form of spinal dysraphism, is characterized by a division of the spinal cord or canda equina resulting the form a bony or cartilaginous spur which transfixes the neural elements and dura. The presence of a structure of neural crest origin in the subarachnoid space connecting the spicules suggested that the anomaly resulted from delayed closure of the neural tube and its investments. The cinical finding are presumed due to its restriction, tethering of the normal apward migration of the spinal cord. Congenital anomalies of one or both lower extremities and spine are frequently found with this condition. The surgical removal is recommended as a prophylactic measure against further progressive neurological damage. The purpose of this paper is to presented becanse it was associated with clubfoot and adds to understanding of teratogenesis of diastematomyelia.
Clubfoot ; Investments ; Lower Extremity ; Neural Crest ; Neural Tube ; Neural Tube Defects ; Spinal Cord ; Spinal Dysraphism ; Spine ; Subarachnoid Space ; Teratogenesis

A Clinical study was done on 90 cases of acute myocardial infarction admitted to Busan Wallace Memorial Baptist Hospital from January, 1977 to Febuary, 1983. The following results have been obtained. 1) The ratio of male to female was 2.2:1. The most age group were 5th decades(35.6%) and over 5th decades(5th decades and 6th decades) were two-thirds of all age group. And annual incidency were increasing tendencies, in 1980-1982 than 1977-1979. 2) Between the preceding diseases and the risk factors, the most common cause was the smoking (60%). And other associated diseases and factors were hypertension(54.4%), hypercholesterolemia (43.8%), hyperlipidemia(51.4%) and angina pectoris (34.4%). 3) The most common inducing factor was physical exertion(33.3%). And others were emotional stress(23.3%), alcohol drinking(10%), rest and sleeping(5.6%). 4) The major symptoms of acute myocardial infarction were precordial or epigastric pain(96.7%), dyspnea(53.3%), radiating chest pain (51.7%) and painless infarction(3.3%). 5) On laboratory data, there were leukocytosis in 50.5% increased SGOT in 68.6%, increased serum LDH in 75.9% and cardiomegaly in chest x-ray film were 82 percents. 6) The ratio between the anterior and inferior infarction on EKG was 1.9:1. 7) When admission, normal sinus rhythms on EKG were 59 percents. And the common associated electrocardiographic abnormalities were ventricular premature beat (23.6%), atrial fibrillation(15.7%), first degree A-V block (15.7%), left ventricular hypertrophy(15.7%). The most common abnormality was ventricular premature beat(23.6%). 8) The mortality rate of acute myocardial infarction was 10 percents. The causes of death were heart failure(33.3%), ventricular arrhythmia(33.3%), sudden death (22.2%) and cardiogenic shock(11.1%).
Angina Pectoris ; Aspartate Aminotransferases ; Busan ; Cardiac Complexes, Premature ; Cardiomegaly ; Cause of Death ; Chest Pain ; Death, Sudden ; Electrocardiography ; Female ; Heart ; Humans ; Hypercholesterolemia ; Infarction ; Leukocytosis ; Male ; Mortality ; Myocardial Infarction* ; Protestantism ; Risk Factors ; Smoke ; Smoking ; Thorax ; X-Ray Film

Even though various kinds of diagnostic and therapeutic measures have been used for the detection and cure of the acute osteomyelitis, this disease is difficult to be eradicated in many clinical cases. However it is rather easy to treat once this disease can be detected in early stage. So far radiological examination and many kinds of maneuvers including blood culture, clinical laboratory, xeroradiography, computed tomography have been performed for the early detection of this disease but invalid in the most cases. Recently some authors reported that the bone scanning was useful for the early detection of acute osteomyelitis, but this method also had difficulty in differential diagnosis and uncertaninty of its activity. This study aims to try to find methods of early detection of acute osteomyelitis. Experimental osteomyelitis was developed by the inoculation of Staphylococcus aureus to proximal tibias of 39 young rabbits already sclerosed by solution of sodium morrhuate. By comparing the clinical, radiological, bacteriological and laboratory findings in sequence from 2 days to 7 weeks after inoculation, the following results were obtained. 1. The incidence of experimental osteomyelitis after inoculation of staphylococcus aureus SNUH-S-188 in suspension of 1×10(7) colony forming units was 84%, 74%, and 79% in radiological, blood culture and pathologic examination respectively. 2. The leucocytosis was noticed only in early stage and slight degree of anemia was found during the 1st and 2nd weeks after inoculation. The sedimentation rate was increased only in early acute stage and same was eosinophil count. The leucocyte alkaline phosphatase(LAP) and platelet count. showed no significant abnormal changes. 3. Lymphocyte and eosinophil turned over from normal and eosinophil was predominant in experimental osteomyelitis. 4. Serum calcium, phosphorus, total protein and albumin showed significant decrease in all stages and was conversely paralle1 to changes in groin temperature. The level of BUN was normal indicating normal kidney function in experimental osteomyelitis. 5. Even though the enzymes of which showed no significant changes enrolled alkaline phosphatase and serumgluiamicoxalic-transaminase(S-GOT), but some increa.e was attained to 27% and 44% respectively. 6. It is important and significant to find continuous increase of lactic dehydrogenase (LDH) and creatine phosphokinase (CPK) since 48 hours after inoculation and author, think these will be the reliable and sensitive indices in early detection of the development of osteomyelitis and efficacy of therapeutic measures.
Alkaline Phosphatase ; Anemia ; Calcium ; Creatine Kinase ; Diagnosis, Differential ; Eosinophils ; Groin ; Incidence ; Kidney ; Lymphocytes ; Methods ; Osteomyelitis ; Oxidoreductases ; Phosphorus ; Platelet Count ; Rabbits ; Sodium Morrhuate ; Staphylococcus aureus ; Staphylococcus ; Stem Cells ; Tibia ; Xeroradiography

Six cases of lunate dislocation were treated in the departments of orthopaedic surgery, Hangang Sacred Heart Hospital and Kangnam Sacred Heart Hospital, Hallym College during the period from March 1, 1978 to August 31, 1982. The results were as follows; l. Among the total 6 cases, two cases had lunate dislocation only and the other four had associated injuries of the same wrist joints. 2. Marupulative reduction was successful in only one case. Five cases were treated by open reduction, and for four of them internal fixation was tried. 3. Postoperative roentgenograms showed acceptable reductions in all cases except one which redislocation occurred. This case showed lunate dorsiflexion instability and was treated with extensor carpi radialis longus tenodesis. 4. The cases with pure lunate dislocation yielded better functional recovery than those with associated carpal injuries.
Dislocations ; Heart ; Tenodesis ; Wrist Joint

Congenital diverticulum of the left ventricle is a very rare disease. Ventricular diverticulum is usually associated with other anomalies including intracardiac and midline thoracoabdominal defect. We describe a case with congenital left ventricular diverticulum presenting as an isolated lesion. A 37-year-old man presented with 4-year history of chest pain. Diverticulum was diagnosed by echocardiography and left ventriculogram.
Adult* ; Chest Pain ; Diverticulum* ; Echocardiography ; Heart Ventricles ; Humans ; Rare Diseases

PURPOSE: The aim of this study was to assess the mid-term results of primary cementless total hip arthroplasty (THA) using Summit® stems. MATERIALS AND METHODS: One hundred twenty-eight arthroplasties in 121 patients who were performed THA from December 2004 to March 2013, were reviewed retrospectively a minimum of 4 years follow-up (mean age, 60.3 years; mean postoperative follow up period, 86.3 months). For a clinical evaluation, the Harris hip score (HHS) was used to assess outcome. Radiographic evaluation was done through spot welds, subsidence, stress shielding, canal filling. RESULTS: The mean HHS was 69.8 points preoperatively, and it improved significantly to 96.3 points at the final follow-up. Postoperatively, 10 patients experienced thigh pain and 7 patients showed a moderate limping gait. There was not only early stem subsidence but there was no more subsidence at last follow up. One hundred eighteen hips showed radiographic signs of stem bone ingrowth, and 10 hips showed fibrous ingrowth at the last follow-up. Stress shielding occurred in 85 hips and third degree stress shielding was observed in 6 hips. Complication arose in 10 hips due to dislocation. Although revisions due to recurrent dislocations led to acetabular component revision in one hip, no revisions arose due to isolated aseptic loosening of the femoral component. CONCLUSION: The clinical and radiological mid-term results of primary THA using Summit® stems revealed solid initial fixation and bone ingrowth stable fixation. Considering the satisfactory clinical results, Summit® stems may be a good treatment option in Korean patients who were required hip arthroplasty
Acetabulum ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Dislocations ; Femur ; Follow-Up Studies* ; Gait ; Hip ; Humans ; Retrospective Studies ; Thigh

Ketamine hydrochloride(ketamine) is a non-barbiturate anesthetic agent chemically designated as dl-2-(0-chlorophenyl)2-(methylamino)-cyclohexanone hydrochloride. Ketamine anesthesia has been found distinctively different from that induced by conventional anesthetic agents, as it provides profound analgesia without significant impairment of respiratory function or stimulation of cardiovascular activities thus avoiding hypotension and are preserved the protective pharyngeal and laryngeal reflexes. In addition, ketamine appears to have muscle relaxation properties. This latter clinical finding, however has not been experimentally substantiated since few reports have appeared on the effect of ketamine on muscle relaxation. The present study therefore, was undertaken to determine whether this agent affects the muscle activity during d-tubocurarine block. The experiment was performed on sixteen rabbits weighing 1.8 to 2.5kg and these were divided into two groups; eight rabbits for control and eight for th study group. All animals were intubated through a tracheostomy under general anesthesia with nembutal 40mg/kg given intravenously. Respiration was controlled by means of a Harvard animal respirator. The body temperature was kept at 35 degrees C to 36 degrees C with a thermo-blanket. The common peroneal nerve and anterior tibial muscle was exposed and the nerve stimulator was applied to the nerve muscle preparation. The twhitch height of the muscle contraction was recorded on a biophysiograph through the force displacement transducer. The common peroneal nerve was stimulated supramaximally using a single twitch, square wave of 0.2 msec duration at a frequency of 0.1Hz once every 10 seconds. The degree of neuromuscular block following intravenous injection of d-tubocurarine 1mg/kg was measured in the control group. And in the study group ketamine 5mg/kg was administered intravenously when 25% of twitch height of muscle contraction was obtained spontaneously after the intravenous injection of d-tubocurarine 1mg/kg. The changes of the twitch height of muscle contraction and the time of spontaneous recovery in the study group were compared with those of the control group. The results were as follows: 1) The times and degree of maximal single twitch depression were obtained at 194.8sec and 87.3% in the control group and were at 197.5 sec and 87.8% in study group. No significant difference was observed. 2) Recovery index of the control group was 1,560.0 sec and recovery index of the study group was markedly prolonged to 2,387.5 sec(53.0% prolongation). 3) Mean decrease of single twitch height was 8.8% soon after the intravenous ketamine 5mg/kg when 25% of twitch height was obtained after the intravenous d-tubocurarine 1mg/kg in the study group.
Rabbits ; Animals

BACKGROUND: The external jugular vein (EJV) is a useful intravenous (IV) cannulation site for anesthesiologists, although it has a relatively high failure rate. Unlike other central veins, visualization of the EJV is important during IV cannulation, and the Valsalva maneuver distends the jugular venous system. However, the relationship between the maneuver and EJV visibility remains unknown. This study compared EJV visibility before and after the Valsalva maneuver. METHODS: This was a prospective observational study that included 200 participants. After the induction of anesthesia, EJV visibility grade, depth from the skin to the EJV superficial surface (EJV depth), and EJV cross-sectional area (CSA) before the Valsalva maneuver were measured. The same parameters were measured after the Valsalva maneuver was performed. The EJV visibility grade was defined as grade A: good appearance and good palpation, grade B: poor appearance and good palpation, and grade C: poor appearance and poor palpation. RESULTS: Patient body mass index and EJV depth affected the EJV visibility grade before the Valsalva maneuver (p < 0.05), although EJV CSA did not. The Valsalva maneuver distended EJV CSA and reduced EJV depth, although these changes were not correlated with EJV visibility grade. With regard to EJV visibility, 34.0% of grade B cases and 20.0% of grade C cases were improved by the Valsalva maneuver. CONCLUSIONS: Although the Valsalva maneuver improved EJV CSA and EJV depth, it did not greatly affect EJV visibility grade.
Anesthesia ; Body Mass Index ; Catheterization ; Humans ; Jugular Veins* ; Observational Study ; Palpation ; Prospective Studies ; Skin ; Ultrasonography ; Valsalva Maneuver* ; Veins

No abstract available.
Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Hot Temperature* ; Humans ; Intellectual Disability*

No abstract available.
Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Hot Temperature* ; Humans ; Intellectual Disability*