Osteogenesis imperfecta is a heterogenous group of inherited disorder, which has abnormalities in the synthesis of collagen. Among variable clinical manifestations, orthopaedic clinical features are laxity of ligament and deformities arising from frequent fractures or angulation due to skeletal fragility. We had managed 4 cases of osteogensis imperfecta, which were belonged to type IV-B in two cases, type I-A in one, and type I-B in remained one by Sillence classification and they had suffered from recent fractures or deformities due to previous fractures in the long bones of the lower extremities. These patients had been treated with various types of intramedullary nails, such as Bailey-Dubow extensile rod. Rush rod and Kuntcher nail, and the result of intramedullary nailing lead to improvement of walking ability.
Classification ; Collagen ; Congenital Abnormalities ; Fracture Fixation, Intramedullary ; Humans ; Ligaments ; Lower Extremity ; Osteogenesis Imperfecta ; Osteogenesis ; Walking

No abstract available.
Osteochondroma*

The characteristics of modern society's trauma is a propensity for multiple and severe trauma, specially, the fatal damage accompanied by facial bone fracture. We observed the malocclusion owing to delayed prompt treatment If the fractured fragments is crushed severely, it is difficult to make them positioned into the normal anatomical states and to fix them tightly. Post-traumatic malocclusion is usually caused by a delay in treatment and inadequate anatomic reduction. Inadequately treated facial bone fractures result in facial disfiguring and functional impairment of mastication and speech.We performed 27 cases of correction of post-traumatic malocclusion between April 1994 and June 1996. We used various operative techniques such as anterior segmental osteotomy, Le Fort osteotomy, maxillary segmental osteotomy and mandibular sagittal split osteotomy. If the malocclusion was due to disarrangement segmental osteotomy. If that malocclusion was attributed to a malpositioned skeletal bone, we take maxillary segmental osteotomy or mandibular sagittal split osteotomy. We acquired the desirable occlusion first followed by a fixation between the mandible and maxillary skeletal bones with the bite block. The aim in the correction of malocclusion was to create a harmony of centric relation and centric occlusion. After operation, intermaxillary fixation with bite block have many advantages in the treatment of malocclusion.
Centric Relation ; Facial Bones ; Malocclusion* ; Mandible ; Mastication ; Maxillary Osteotomy ; Osteotomy ; Osteotomy, Le Fort

BACKGROUND: Korea is, known to be an endemic area of viral hepatitis B, and 5-6% of population are carriers. Immunization can reduce the spread of hepatitis B infection. Hower, not all people respond to hepatitis B immunsation. 5-15% of primary vaccinees fail to be immunized. After revaccination, only 37.5 44% of the primary failures elicit antibody response. Recent studies have reported that it is effective to inject a double dose vaccination in immunocompromsed patients. In some country, they recommend that neonate whode mother is HBV carrier shoud receive double dose vaccination. This study documented the results of double dose vaccintion only once to nonrsponders toward the HBV immunzation. METHODS: Healthy nonresponders to Hepatitis B immunization were recuited from Sep. 1995 to Aug. 1996. Subjects with their AST/ALT level over 40, or over 65 years old were excluded. They were received 2ml of plasma-derived vaccine(Hepavax-B) intramuscularly in the deltoid muscle. Anti-HBs antibody testing were performed at 1 to 3 months after vaccintion. RESULTS: 17 healthy nanreponders to Hepatitis B immunization(male 10, female 7) were included. Their mean ages were 47(32 to64), AST/ALT level 20/19(16 to 28/11 to 35), smoking 4.3pys(1 to 7). Seroconversion occured in 13 of them(76.5%). CONCLUSIONS: Nonresponders to Hepatitis B vaccintion respond well to double dose vaccination once.
Aged ; Antibody Formation ; Deltoid Muscle ; Female ; Hepatitis B* ; Hepatitis* ; Humans ; Immunization ; Immunization, Secondary ; Infant, Newborn ; Korea ; Mothers ; Smoke ; Smoking ; Vaccination*

Mandibular prognathism was defined by Johe Hunter as follows : 'The lower jaw projecting too far forwards so that the foreteeth pass before those of upper jaw, therefore disfigurement and malocclusion are the two of facial main characteristics.' Mandibular ramus osteotomy by vertical osteotomy or sagittal splitting osteotomy recently has come into more common use. Although preoperative and postoperative orthdontic management is indispensable in surgery of this type, we occasionally encounter patients who are intolerant to a long duration of orthodontic treatment and intermaxillary fixation. We describe surgical refinement accomplishing mandibular anterior segmental osteotomy, recession genioplasty by horizontal osteotomies and decortication of the anterior portion of the bony bar for a minor degree of mandibular prognathism. In results, the amount of setback is limited to 4 to 5mm, no intermaxillary fixation is required and no orthodontic treatment, in this operation, is needed. This procedure can obtain a rapid aesthetic improvement. We used this preocedure in 8 patients (3 males and 5 females) with a mild mandibular prognathism. No major complications occurred throughout the follow-up period except transient paresthesia of the mental nerves, otherwise all patients were satisfied with the result.
Follow-Up Studies ; Genioplasty* ; Humans ; Jaw ; Male ; Malocclusion ; Osteotomy* ; Paresthesia ; Prognathism*

The inverted nipple presents many problems including both cosmetic and functional aspects and impairment in breast feeding. the histopathologic characters of inverted nipple are that inverted nipple has less fibromuscular tissue than normal nipple and has short lactiferous duct and dense fibrous tissue. Many surgical and non-surgical techniques have been designed for correction of the inverted nipple. But most of these techniques have produced unsatisfactory problems. especially undesirable recurrence is most important problem. We experienced 19 inverted nipples in 12 patients between March 1995 and January 1998. We combined modified Teimourian method, purse-string suture and Z-plasty. and had good result for 3weeks to 30months follow up. This method was effective for correction of the inverted nipple with low recurrence rate and simple techniques.
Breast Feeding ; Follow-Up Studies ; Humans ; Nipples* ; Recurrence ; Sutures

Ankle arthrodesis has been considered to be the standard operative treatment for end-stage ankle arthritis, nevertheless currently increasing arthroplasty. Indication for arthrodesis is painful ankle from global arthrosis regardless of the etiology. But it is hard to be carried out in the several circumstance such as infection states, poor vascularity, severe diabetes, prematurity, etc. So thorough evaluation should be done before the surgery, including adjacent joints status. The ideal position for fusion is neutral in flexion, functional valgus, and slightly external rotation. Methods of arthrodesis would be largely divided into two categories as in situ fixation and realignment procedure. The lateral and anterior longitudinal approaches are two common procedures, and fixation modalities are also variable. The long-term results of arthrodesis have been reported. Even the close follow-up have shown subsequent degeneration of adjacent joints, benefits such as reliable pain loss, easy correctability for deformity, and improved functional status with considerable durability can be expected in the most patients.
Animals ; Ankle ; Arthritis ; Arthrodesis ; Arthroplasty ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints

PURPOSE: The prognostic significance of peri-operative serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA)19-9 determination in patients with gastric cancer has been controversial. This study was performed to evaluate the significance of CEA and CA19-9 as clinical predictors of prognosis. MATERIALS AND METHODS: The correlations between peri-operative serum CEA/CA19-9 levels and clinicopathologic factors were evaluated retrospectively in gastric cancer patients who had undergone curative surgery during the period from January 1995 to December 1998 at the Department of Surgery, Yonsei University College of Medicine. RESULTS: The positive rates for CEA and CA19-9 were 17.9% and 18.4%, respectively. The CEA positivity was related to the depth of invasion (P=0.040), lymph-node metastasis (P=0.000), and stage (P=0.001). The CA19-9 positivity was significantly related to the depth of invasion (P=0.000), lymph-node status (P=0.000), and stage (P=0.000). The positive rate of combined assay of pre-operative CEA and CA19-9 was 30.0%. There were statistically significant correlations with stage, depth of invasion, or degree of lymph- node metastasis in the combined assay. The survival rates according to the positivity of CEA and to the positivity of CA19-9 were clearly different (P=0.000). CONCLUSION: It should be stressed that even a simple blood test prior to surgery could be useful in establishing the depth of invasion, the status of lymph-node involvement, and the prognosis. For improved survival, an aggressive lymphadenectomy and adjuvant chemotherapy should be considered for patients with positive levels of pre-operative CA19- 9.
Carcinoembryonic Antigen ; Chemotherapy, Adjuvant ; Follow-Up Studies* ; Gastrectomy* ; Hematologic Tests ; Humans ; Lymph Node Excision ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate ; Biomarkers, Tumor*

No abstract available.
Abscess* ; Bacteria, Aerobic* ; Quinolones* ; Virulence*

OBJECTIVE: The purpose of the present study was to assess the short term result of the reconstruction of forefoot deformity, commonly seen in rheumatoid patients. METHODS: 15 patients (20 feet) were evaluated and the average follow up period was 18.4 months. The reconstructive procedure included the arthrodesis of the first metatarsophalangeal joint of hallux, the lesser metatarsophalangeal resection arthroplasty, and extensor tenotomy of lesser toes. The subjective and the objective findings were studied, using the rating scale of The American Orthopaedic Foot and Ankle society, and the radiological measurement. RESULTS: Subjective assessment with respect to pain, function, alignment was excellent in ten feet (50%), good in ten feet (50%), and no fair and poor. The hallux valgus angle (HVA) and 1st intermetatarsal angle were improved from 48.4+/-4.23 and 16.5+/-2.08 to 13.5+/-1.96 and 11.0+/-1.28 degrees respectively. The average dorsiflexion angle was 18.95+/-2.20 degrees. All arthrodesis site were fused within average 8 weeks after operation. The overall complication of the procedure was few and reoperation was none. CONCLUSION: The reconstructive procedure, including the arthrodesis of the first metatarsophalangeal joint and the lesser metatarsophalangeal resection arthroplasty with extensor tenotomy was regarded as a good option for treating a rheumatoid forefoot deformity surgically.
Ankle ; Arthrodesis ; Arthroplasty ; Congenital Abnormalities* ; Follow-Up Studies ; Foot ; Hallux ; Hallux Valgus ; Humans ; Metatarsophalangeal Joint ; Reoperation ; Tenotomy ; Toes