We are reporting a case of multiple dermatofibromas which occuired during the treatment of systemic lupus erythematous with prednisolone for 3 years in a 30-yenr-old woman, All of the 26 lesions were 0.5-2cm sized. and had the same appearanes ad usual dermatofibromas coccurring singly. Histopathologic examination showed typical findings of dermatofibroma which were characterized hy proliferation of fibroblasts intermingled with collagen in irregular arrangement and proliferation of small vessels and endothelial cells.
Collagen ; Endothelial Cells ; Female ; Fibroblasts ; Histiocytoma, Benign Fibrous* ; Humans ; Lupus Erythematosus, Systemic* ; Prednisolone

No abstract available.
Brain* ; Child* ; Humans ; Magnetic Resonance Imaging* ; Seizures*

Avascular necrosis of the femoral head has been recognized as one of the most serious and frequent complications following the initial treatment of congenital dislocation of the hip. It is now well accepted that this particular complication is iatrogenic and may be avoided by careful and adequate treatment. The reported incidence of avascular necrosis is variable because of various methods of treatment and different diagnostic criteria. We retrospectively reviewed 130 patients(144 hips) with congenital dislocation of the hip, who were treated at Seoul National University Hospital during 10 year-period from January 1974 to December 1983, and found 13 patients (13 hips) with avascular necrosis of the femoral head. We analyed avascular necrosis following treatment of congenital dislocation of the with respect to various methods of treatment, possible causes, types of avascular necrosis, to radiological findings, and to functional results. 1. The incidence of avascular necrosis following treatment of congenital dislocation of the hip in our series was 9.0%(13/144 hips). 2. The average age of the patients with avascular necrosis was 3 years, the youngest being 4 months and the oldest being 10 years. The average follow-up period was 2 year and 2 months. 3. The incidence of avascular necrosis in the closed reduction series was higher in those between 6 months to 18 months with 10.5%, as compared to 7.1% in those 6 months and under 6.7% in those 18 months and over. In the open reduction series, the incidence increased as the age increased, being 5.9%, 12.4%, 15% in the groups 18 months to 3 years, 3 to 6 years, and 6 years and over, respectively. 4. The incidence of avascular necrosis in those who had priliminary traction was 8.3%, where as that in those who had not was 16.6%, being twice as much. 5. The incidence of avascular necrosis decreased as the traction time prolonged, being 9.0% in 7 days or less, 7.7% in 8 to 14 days, 7.1% in 15 to 21 days and nil in 22 days or more. 6. The incidence of avascular necrosis in the skin traction group was 5 times as much with 11.5%, as in the skeletal traction group with 2.2%, despite older age in the latter. 7. The incidence of avascular necrosis in the open reduction group was slightly higher with 9.5%, than in the closed reduction group with 8.6%. 8. All 6 cases of avascular necrosis following closed reduction occurred when Lorenz or frog-leg cast was applied initially after reduction despite attention to avoid extreme abduction. Avascular necrosis were not encountered in those who had Lange or human position cast as the initial form of immobilization. 9. In the closed reduction, avascular necrosis occurred 8.1% in those who had adductor tenotomy and 10.0% in those who had not. In the open reduction, avascular necrosis occurred 7.9% in those who had adductor tenotomy and 18.1% in those who had not, suggesting significant role of adductor tenotomy in the prevention of avascular necrosis. 10. Avascular necrosis was attributable to excessive abduction in 7 hips, to undue pressure of femoral head in one hip, to open reduction in 3 hips, to post-operative infection in one hip, and to non-union of subtrochanteric osteotomy in one hip. 11. Of the 13 hips, following roentgenograms were available in 11. According to the classification of Bucholz and Ogden, type I, II, III, IV were 7, 0, 3, and 1 hips, respectively. 12. Functional results of the 13 hips of avascular necrosis, according to Kalamchi and MacEwen's criteria, were Good, Fair, Poor in 9, 3, and 1 hips, respectively.
Classification ; Dislocations ; Follow-Up Studies ; Head ; Hip ; Humans ; Immobilization ; Incidence ; Necrosis ; Osteotomy ; Retrospective Studies ; Seoul ; Skin ; Tenotomy ; Traction

Fixed pelvic obliquity refers to a composite deformity induced by contractures both above and below the pelvis and the elements of this deformity are frequently interrelated during the period of growth. From the functional standpoint, leg length discrepancy is caused by deformities of the pelvis and lower extremities, such as pelvic obliquity and acetabular dysplasia, as well as by inequality of true limb bone length, and these deformities either aggravate or compensate functional discrepancy. During fhe fourteen years period, from August 1968 to August 1982, at the Department of Orthopaedic Surgery, Seoul National University Hospital, we treated 35 cases of fixed pelvic obliquity and acetabular dysplasia associated with true or functional limb length discrepancy by means of lumbodorsal fasciotomy or pelvic osteotomies such as Salters innominate osteotomy or Steels triple osteotomy, combined, if necessary, with contralateral abductor fasciotomy to gain functional limb length as well as to improve posture and balance. In many cases of residual poliomyelitis, epiphysiodesis was also performed when indicated. These cases were reviewed and following observations were made: 1. Of the 35 cases, residual poliomyelitis with 29 cases (83%) was by far the main cause of leg length discrepancy. Cerebral palsy (2cases), Legg-Perthes disease (2 cases), and fibrous ankylosis secondary to septic hip (2 cases) comprised the remainder. 2. The male-to-female ratio was about equal, being 17 to 18. 3. The average age at the time of operation was 17.9 years, the youngest being 7 years and the oldest being 30 years. The average age at the time of current follow-up was 18.8 years. 67% of those followed was skeletally mature. 4. An average of 1.35cm of bone length was gained radiographically by pelvic osteotomies. Steels triple osteotomy was more effective in gain than Salters innominate osteotomy. 5. An average of 2.43cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy alone. 6. An average of 2.61cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy and combined contralateral Soutters or Campbells fasciotomy. 7. An average of 3.57cm of functional length when standing was gained radiographically by lumbodorsal fasciotomy and combined ipsilateral Steel's triple osteotomy. 8. An average of 1.73cm of functional lengthening when standing was corrected radiographically by ipsilateral Soutter's fasciotomy. 9. When lumbodorsal fasciotomy and Steel's triple osteotomy were combined with contralateral Soutter's or Campbell's fasciotomy, the average radiographic gain in standing length was 3.77cm. 10. Leg length discrepancy in terms of true bone length is conventionally corrected either by epiphysiodesis or bone shortening on the longer limb, or by bone lengthening on the shorter limb. We believe that when leg length discrepancy is associated with fixed pelvic obliquity, frequently aggravating the disability functionally, lumbodorsal fasciotomy and/or pelvic osteotomies on the shorter side and, combined if necessary, Soutters or Campbells fasciotomy on the longer side, can, in many instances, successfully correct or reduce functional limb discrepancy and improve balance, posture and function. Any residual discrepancy, true or functional, may then be corrected by conventional methods.
Acetabulum ; Ankylosis ; Bone Lengthening ; Cerebral Palsy ; Congenital Abnormalities ; Contracture ; Extremities ; Follow-Up Studies ; Hip ; Leg ; Legg-Calve-Perthes Disease ; Lower Extremity ; Osteotomy ; Pelvis ; Poliomyelitis ; Posture ; Seoul ; Socioeconomic Factors ; Steel

No abstract available.
Encephalitis* ; Encephalitis, Herpes Simplex*

Treatment of a paralysed or flail shoulder falls into two categories; arthrodesis and reconstructive surgery. Of these the latter is preferable in view of mobility. Most authors have tried to reconstruct the paralysed abductor by transferring the trapezius muscle only. The final result of these procedures were poor in severe paralysis of the deltoid muscle or combined paralysis of the deltoid and the rotator cuff muscles. Noting the importance of the action of the rotator cuff muscles in abduction of the shoulder, Saha, in 1967, recommended simultaneous reconstruction of tne paralysed deltoid and rotator cuff muscles. We treated a case of paralysed shoulder that followed poliomyelitis by the Saha meshod, i.e., transfer of the trapezius muscle for the paralysed deltoid, transfer of the levator scapulae muscle for the supraspinatus, transfer of the pectoralis minor muscle for the subscapularis, all in one stage. Duration of the follow up was 3 months and the initial result seemed to be good in view of stability, mobility, and abductor power.
Accidental Falls ; Arthrodesis ; Deltoid Muscle ; Follow-Up Studies ; Methods ; Muscles ; Paralysis ; Poliomyelitis ; Rotator Cuff ; Shoulder ; Superficial Back Muscles

No abstract available.
Ganglia* ; Hemolytic-Uremic Syndrome*

No abstract available.
Female ; Obstetric Labor, Premature* ; Pregnancy ; Ritodrine* ; Tocolytic Agents*

No abstract available.
Lung Neoplasms* ; Lung* ; Risk Factors* ; Spirometry*

No abstract available.
Anal Canal* ; Rectal Fistula*