Fetal bilateral renal agenesis is a lethal congenital anomaly characterized by bilateral pulmonary hypoplasia, deformities and death due to severe oligohydramnios. This syndrome is associated with malformations of genitourinary tract, cardiovascular system, vertebral bodies or imperforated anus in more than half of the affected individuals. An early and reliable prenatal diagnosis is extremely important because it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, empty renal fossae. But poor sonographic resolution of severe oligohydramnios makes it difficult to diagnose the disease. We present a case of bilateral renal agenesis diagnosed at the 32nd weeks gestation by using color doppler and "lying down" adrenal sign.
Anal Canal ; Cardiovascular System ; Congenital Abnormalities ; Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

The purpose of this article is to present the clinical and laboratory procedures for single tooth restoration using "Combination Implant Crown". It is cemented on implant abutment and that abutment is screw-retained over implant body. This type of implant restorations has the advantages of cement-retained restoration while being antirotational and retrievable. And, more esthetic and functional result can be achieved by minimizing the size of access hole. The results were as follow : 1. Preparation of abutment below the cuffline should be avoided 2. Axial reduction of implant abutment should not be excessive because it may weaken the abutment 3. More esthetical and functional occlusal surface was achieved with a minimal access hole which is slightly larger than the diameter of hex driver to enable future total retrievability. 4. Combination Implant Crown has the advantages of both the cement-retained and screw-retained type implant restoration. 5. Cementation between implant crown and abutment reduces screw loosening through even force distribution.
Cementation ; Crowns* ; Tooth*

The purpose of this study was to develop and test the validity of standardized Korean nomenclature of the Home Health Care Classification(HHCC), developed by Saba at the University of Georgetown. The four phases of the study were : (1) Two professors and 15 graduate students, who were taking a nursing intervention course, translated the HHCC into Korean. (2)12 nurses with various clinical backgrounds reviewed each nomenclature taking into consideration of the definition and activities, and the Delphi method was used to determine the best appropriate nomenclature for each term; (3)20 academic and clinical experts in nursing were given a questionnaire to rate the validity of each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate; (4) Five members of the Korean Nurses Association Research Committee reviewed the survey results and determined the most appropriate Korean nomenclature for each term of the HHCC. Most of the nomenclatures had a score of more than 4.0, but several terms had a score lower than 4.0. They are Ambulation therapy(3.1.1), Anticipatory grieving(3.11), Sexual patterns alteration(3.17), Nursing care coordination(3. 22), Physical therapist service(3.22), Regular diet(3.33), and Instrumental activities of daily living(3.44). These research results will be included in the nursing vocabulary dictionary to be published by the Korean Nurses Association.
Classification* ; Delivery of Health Care* ; Humans ; Nursing ; Nursing Care ; Physical Therapists ; Vocabulary ; Walking ; Surveys and Questionnaires

Nursing Diagnosis has evolved in the guest to define nursing and its functions. But for the application to clinical practice an unified system of terminology that help nurses to assess selected data and identify potential or actual client problems is required. Consistent terminology that captures the real meanings of the nursing diagnosis makes oral and written communication more accurate and efficient. Already we had performed to deliver a Korean -translated version of the 98 nursing diagnoses through the process of content validity tests and translations, and additionally performed to deliver a Korean-translated version of another 17 nursing diagnoses. The list of 17 nursing diagnoses were reviewed by our research team and two linguists, one specialized in Korean and the other in English. 17 diagnoses were mailed to 719 subjects to test content validity from December 10, 1997 to January 24, 1998, Among 719 questionnaires, 185 were used for analysis. Total mean score of the diagnoses was 3.72 on the 5 point likert scale. The diagnoses that acquired less than 3.50 were 'Risk for altered parent/infant/child attachment'(3.28), 'Potential for enhanced organized infant behavior'(3.40), 'Potential for enhanced community coping' & 'Risk for disorganized infant behavior'(3.49). We suggest to conduct tests for validation of related factors and characteristics of these 17 Nursing Diagnosis.
Diagnosis ; Humans ; Infant ; Nursing Diagnosis* ; Nursing* ; Postal Service ; Translations ; Surveys and Questionnaires

Histiocytosis-X has several mode of presentation, from the mildest solitary eosinophilic granuloma of bone to the most severe, with multiple granulomata in bones and soft tissues. This disease previously described as eosinophilic granuloma, Hand-Schuller-Christian disease and Letterer-Siwe disease. Lichtenstein (1953) used the term histiocytosis-x to encompass the above three names. We experienced a case of histiocytosis-x which had occured at multiple site of bones. The patient has good general condition with complete subsidance of specific symtoms and signs in our thirty-eight months follow up treatment.
Eosinophilic Granuloma ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans

Older children with neglected ongenital dislocation of the hip is not easily reduced. Even if reduction is achieved, the overstretched muscle tends to resume its original length, provoking either a redilocation or a pressure necrosis with resultant stiffness of the hip joint and deformity. The authors treated 15 cases of the C.D.H. in older children by combined procedure of open reduction, Salter's innominate osteotomy, and femoral shortening with redirection of the femoral head. The results were obtained in 15 operated hips with follow-up from 1 to 5 and 3/12 years. l. We had good results in 11 among 15 cases(73%). 2. Femoral shortening was spontaneously correctd 1.3cm in 1 year, 2.1cm in 2 years follow-up. 3. The improvement of acetabular index following Salter's innominate osteotomy was about 12.4 degrees. 4. We had no serious complication such as avascular necrosis, stiffness, and redislocation, but 3 cases of mild limitation of hip joint motion were noted. 5. Two skin incision were more convenient in operative procedure and handling of instruments than one incision(Klisić).
Acetabulum ; Child ; Congenital Abnormalities ; Dislocations ; Femur ; Follow-Up Studies ; Head ; Hip ; Hip Joint ; Humans ; Necrosis ; Osteotomy ; Skin ; Surgical Procedures, Operative

The most common fracture about the elbow joint in chilren is a supracondylar fracture. The displaced fracture is difficult to manage due to the potential danger of Volkmann's ischemia, nerve injury, and malunion, During the period of 6 years from June, 1979 to June, 1985, 63 children with supracondylar fractures of the humerus were treated at Pusan Paik Hospital, Inje Medical College, and analyzed. The results are summarized as follows: 1. The average age was 7.1 years, ranged from 1 year to 14 years, and the male and female ratio was 2.5: l. 2. In type of fracture, extension type was 92% and flexion type was 8%. In displacement of fracture, Grade I was only 2 cases, Grade III and IV were 87.3%. Posteromedial displacement was 42.8% (27 cases). 3. At the time of admission, 15cases(23.8%) accompanied nerve injury, of these median nerve injury (9 cases) was most common. All the patient with nerve injury were completely recovered within 14 months after reduction. 4. Severe cubitus varus was 14.2%, and severe limitation of elbow motion was 1.6%. 5. Of 61 displaced fractures, 37 patients were treated with closed reduction and percutaneous pin fixation. By Flynn's criteria, satisfactory results were obtained in 36 of the 37 patients(97.3%) treated with percutaneous pinning. 6. In the displaced fractures, closed reduction and percutaneous pinning is a satisfactory method for obtaining and maintaining reduction while preserving vascular function, if acute flexion is necessary for stable reduction.
Busan ; Child ; Clinical Study ; Elbow ; Elbow Joint ; Female ; Fractures, Closed ; Humans ; Humerus ; Ischemia ; Male ; Median Nerve ; Methods

Between July 1982 and July 1985, we treated thirty-one fractures of the tibial shaft by intramedullar ary Ender's nailing at the Department of orthopedic Surgery of Pusan Paik Hospital. Reductions of the fractures were achieved by closed method in 25 cases and open method in 6 cases. The results were as follows. 1. The average age was 34. 5 years and the most common cause of injury was traffic accident(67.7%) 2. Nineteen cases (61%) were closed fracture and 12 cases (39%) open. Seventeen cases (55%) were simple fracture and 14 cases (45%) comminuted. The most common level of the fracture was middle third of the tibial shaft. 3. Twenty cases (64.5%) had associated injuries and average interval from injury to operation was 11. 8 days. 4. The average healing time was 16.7 weeks and the time prolonged in comminuted fractures than in simple fractures. 5. Complications were one case of valgus deformity (11°), one case of delayed union with pseudoane urysm of anterior tibial artery on fracture site and one case of infected nonunion in Grade III open comminuted fracture. 6. Ender nails are relative ease of nailing, allow early weight bearing and decrease complication. Ender nailing is considered to be a good method in treating tibial shaft fracture especially for management of multiple injured patient and when other procedures have failed.
Busan ; Congenital Abnormalities ; Fractures, Closed ; Fractures, Comminuted ; Humans ; Methods ; Orthopedics ; Tibia ; Tibial Arteries ; Weight-Bearing

Development of acetabulum and epiphysis of the femoral head following reduction in seventy-four patients with ninty-one congenitally dislocated hips were assessed radiologically. Acetabular index, CE angle of Wiberg, neck-shaft angle of the femur and overgrowth of the pelvis and femur were measured according to the various treatment. To evaluate results, the method of treatment was divided into four groups; closed reduction, open reduction, open reduction combined with pelvic osteotomy and modified Klisic operation (open reduction, pelvic osteotomy, femoral osteotomy and so on). Each treatment was compared with three subgroups according to ages; first subgroup was belong to patients under one year of age, second from one year to three years, third over three years. This paper agrees to Harris (1976) and Lindstrom (1979) about improvement of acetabular index and CE angle of Wiberg that showed a rapid rate of repair in the first 6 months and thereafter slowly progressed to normal range of degree. Overgrowth of pelvis and femur was also noticed in cases of hips treated pelvic and/or femoral osteotomy, moreover even in cases of open reduction only. The goal of this preliminary investigation may be supposed to propose the idea which method of treatment to the first visiting patient will approach the most satisfactory final result.
Acetabulum ; Dislocations ; Epiphyses ; Femur ; Head ; Hip ; Humans ; Methods ; Osteotomy ; Pelvis ; Reference Values

It is generally accepted that posterior cruciate ligament is the prime stabilizer and perhaps the most importent ligament in the knee. We agreed that primary repair or reconstruction of ruptured posterior cruciate ligament is essential. Recently Clancy reported good results to correct knee instability due to rupture of the posterior cruciate ligament with a procedure that employes a free graft of one-third of the patella tendon with its tibial and patella attachments. The free patella tendon graft has been shown to revascularize readly, develop resonably high tensile strengh, allow bone to bone healing, have excellent static stability and not to deprive the knee of a significant stabilizer. So, we analized the 10 cases of the posterior cruciate ligament injuries who were admitted and treated reconstruction using free patella tendon graft in Busan Paik Hospital between May, 1984 to Dec, 1986 and obtained the following results. 1. In 8 cases, obtained satisfactory results. In 2 cases, obtained unsatisfactory results due to combined other compartment injuries, but improved posterior stability than preoperative status. 2. Reconstruction of posterior crucitae ligament using free patella tendon graft was excellent procedure for regaining of static stability of the knee.
Busan ; Knee ; Ligaments ; Patella ; Patellar Ligament ; Posterior Cruciate Ligament ; Rupture ; Transplants