In the chronic osteomyelitis of the ilium the infection is often so diffuse that removing all sequestra and small cavities are practically impossible. Either the partial or total resection of the ilium has been thought as a standard method of treatment in these situations. According to authors experience, the partial resection is not sufficient for removing such diffuse lesions, and all the patients that underwent the total resection of the ilium have been suffering from the instability with severe Trendelenburg gait because of the loss of the abductor origin. These results are far from a satisfactory one in modern orthopedic field in which many reconstructive surgeries have been done for the disabled patients. Removal of only one cortex followed with the closed suction irrigation technique are applied in three cases. The result of this operation is as good as that removing the total ilium in controlling the infection, and there are no patients who are suffering from the gait disturbance. The inner or outer cortex could be safely and widely removed without affecting the hip joint of the affected side.
Gait ; Hip Joint ; Humans ; Ilium ; Methods ; Orthopedics ; Osteomyelitis ; Suction

The authors investigated serial changes of bacillary and granularity indices from 49 previously non-treated lepromatous leprosy patients under DDS therapy during 24 month period, and the following results were obtained. 1) Pretreatment bacillary index was highest on eye brows, and chins, ear lobes, arms, legs, backs in decreasing order. The proportion of fall of B.I. during therapy showed similar tendencies in each site of smears, the average decrease being 1. 2 in the first year and 0. 8 in the second year. 2) The average granularity index before therapy was 2. 5, the rise of G.I. was rapid during first 12 months, slower during next 6 months, and no significant changes were seen during last 6 months. 3) The changes of G.I. were faster and more sensitive to therapy than that of B.I. Therefore, it. seems more valuable assesing the response of therapy, drug resistance, prognosis, etc 4) 300 mg of DDS per week appears to be sufficient for maintaining the therapeutic dosage.
Arm ; Chin ; Drug Therapy ; Ear ; Equidae ; Humans ; Leg ; Leprosy, Lepromatous ; Mycobacterium* ; Prognosis

No abstract available.
Blood Pressure* ; Child* ; Humans ; Seoul*

An anatomical reduction and maintainance of articular fracture is on of the basic principles In Orthopedic Surgery if good function is to ensue, especially in a major welght bearing joint such as hip knee ankle. In displaced articular fractures, excellent results can be achieved mainly by an open anatomical reduction and firm internal fixation. We performed an open reduction and internal flxation with plates and screws in a patient with the severely comminuted acetabular fracture, and a satisfactory result is obtained.
Acetabulum ; Ankle ; Hip ; Humans ; Joints ; Knee ; Orthopedics

Between 1984 and 1996, 8 patients who were suffered from stage g Kienbock's disease underwent interpositional arthroplasty using pronator quadratus pedicled bone. Patients comprised 2 males and 6 females, with an average age of 33 years(range 19-47). Range of motion of the wrist, residual pain, grip strength, and carpal height ratio of the patients were analyzed. The follow-up period was between 1.5 years and 12.5 years(average 5.5 years). The arc of flexion-extension of the wrist was increased from average 74 degrees preoperatively to 96 degrees postoperatively. Among eight patients, five were free of pain and three had intermittent pain during heavy work. None of eight patients had any discomfort in daily work and changed his or her occupation. The grip strength was average 83% of the normal side. Carpal height ratio was average 0.48 preoperatively and was not changed postoperatively. Clinical results, assessed by Lichtman-Evans criteria, showed 4 good and 4 fair. The interpositional arthroplasty using pronator quadratus pedicled bone was considered as a very effective method for the treatment of stage III Kienbock's disease.
Arthroplasty* ; Female ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Occupations ; Osteonecrosis* ; Range of Motion, Articular ; Wrist

The carpal injury is difficult to diagnose due to anatomical complexity and the like. So, in order to get radiological knowledge of normal wrist, the authors measured the values which will be described on the wrist PA and lateral roengenogram obtained from 440 normal wrists(male : 188 cases, female : 252 cases) in randomly selected patients. The following results were obtained. l. Ulnar variance(mm±standard deviation): Total 1.1±1.2 : negative variance : 9.3%, positive variance : 56.1%, 2. Scapholunate Gap(mm±standard deviation): Total 0.4±0.7, 3. Ulnar Tilt(degrees±standard deviation): Total 23.6±5.3, 4. Volar Tilt, 5. Carpal height rstio : Total 0.52±0.05 male 0.53±0.04 female 0.51±0.05 : Total 13.1±5.9, 6. Carpal ulnsr distance ratio Total 0.05±0.05, 7. Scapholunate Angle : Total 49.9'±10.1', 8. Capitatolunate Angle Total 17.5'±10.0', 9. Radiolunate Angle Total 8.8'±6.7', 10. Carpal width ratio Total 0.72±0.08 11. Carpal thickness ratio Total 0.49±0.07.
Female ; Humans ; Male ; Wrist

If one can measure the actual angle of the bowing and rotation of a long bone three-dimensionally, it will be a great help in fracture reductions, operative treatments of the congenital snomalies, determination of the fusion angles in arthrodeses, and so on. We developed a computer program that gives us the actual bowing and rotation angle when we input the angles from the two X-ray films with known angle between them. We measured anteversion and neck-shaft angle of the femur, the amount of bowing and rotation in fracture model, and the fusion angles in arthrodeses. The angles calculated from the computer program were same as those from another X-ray that showed the actual angle taken by derotating the subject.
Arthrodesis ; Femur ; X-Ray Film

No abstract available.
Child* ; Heart Defects, Congenital* ; Humans ; Plasma* ; Renal Veins* ; Renin* ; Veins*

PURPOSE: The prevalance rate of chronic hepatitis B viral infection in children is high in our contry. We performed a prospective study to evaluate the effectiveness of and the factors predictive of response to interferon-alpha therapy in children with chronic hepatitis B. METHODS: Thirty-two children with chronic hepatitis B werew admitted to the Department of Pediatrics, Yonsei University College of Medicine from Oct. 1992 to Apr. 1994, and liver biopsies were performed. They recieved interferon-alpha (Intermax-alpha: 3 million IU intramuscularly three times a week) for from 4 to 6 months and were followed for 19+/-7.5 months after treatment. The control group comprised forty children with chronic hepatitis B who had conservative or no treatment. The therapeutic effectiveness of IFN-alpha was evaluated, and factors predictive of response to treatment were analyzed. RESULTS: 1) Thirty two children in the treatment group comprised 22 males and 10 females. The mean age was 11.7+/-3.5 years at entry. The pathologic types were chronic lobular hepatitis in 4, chronic persistant hepatitis in 12 and chronic active hepatitis in 16 cases. The mean age of 40 children in the control group was 8.2+/-4.4 years. There were no differences in the clinical and laboratory data between the two group. 2) The serum ALT and AST levels normalized in 29 (91%) of 32 treated cases and 33 (88%) of 40 controls. The normalization of serum aminotransferases in control group, however, was thought to be meaningful because most controls were in healthy chronic carrier state with normal aminotransferases levels. The serum HBV-DNA was cleared in 25 (78%) of 32 treated cases and 7 (41%) of 40 controls, which showed statistically significant difference (P<0.005) between two groups. HBeAg was cleared in 24 (75%) of the treated cases and 10 (25%) of 40 controls (P<0.05). The positive seroconversion of anti-HBe was noted in 18 (56%) of 32 treated cases and 7 (18%) of 40 controls (P<0.05). 3) Normalization rate of AST and ALT levels, the clearance rate of HBV-DNA andHBeAg, and the seropositive rate to anti-HBe were 100%, 50%, 75% and 50% in CLH; 83%, 75%, 58% and 42% in CPH; 94%, 88%, 88% and 69% in CAH, respectively. 4) Children with higher pretreatment peak ALT level were more likely to clear HBeAg and HBV-DNA. The clearance of HBeAg and HBV-DNA were 6 (55%) and 5 (45%) of 11 children with pretreatment peak ALT level of less than 100IU/L; 6 (75%) and 7 (88%) of 8 children with pretreatment peak ALT level of 100-200IU/L; 12 (92%) and 13 (100%) of 13 children with pretreatment peak ALT level of greater than 200IU/L. 5) Children with lower pretreatment HBV-DNA level were more likely to clear HBeAg and HBV-DNA. The clearance of HBeAg and HBV-DNA were 13 (72%) and 14 (78%) of 18 children with pretreatment HBV-DNA level less than 100pg/ml; 2 (40%) and 2 (40%) of 5 children with pretreatment HBV-DNA level greater than 100pg/ml. 6) Children with higher post-treatment peak ALT level were more likely to clear HBeAg and HBV-DNA. The clearance of HBeAg and HBV-DNA were 8 (73%) and 7 (64%) of 11 children with posttreatment peak ALT level less than 100IU/L; 9 (69%) and 10 (77%) of 13 children with post-treatment peak ALT level of 100-200IU/L; 7 (88%) and 8 (100%) of 8 children with post-treatment peak ALT level greater than 200IU/L. 7) Normalization of serum ALT and AST level took 7.1+/-6.8 months. The clearance of HBV-DNA and HBeAg took 12.9+/-8.3 and 10.1+/-7.3 months, respectively. positive seroconversion to antiHBe was obserbed at 10.6+/-6.3 months after IFN-alpha treatment. CONCLUSION: These results suggest that interferon-alpha therapy can induce an increased clearance of HBV-DNA and HBeAg with an increased positive seroconversion to anti-HBe in children with chronic type B hepatitis. Factors that may help in in identifying those children with a better chance of responding, were higher pre- and post-treatment peak ALT levels and lower pretreatment peak HBV-DNA levels.
Biopsy ; Carrier State ; Child* ; Female ; Hepatitis ; Hepatitis B e Antigens ; Hepatitis B, Chronic* ; Hepatitis, Chronic* ; Humans ; Interferon-alpha* ; Liver ; Male ; Pediatrics ; Prospective Studies ; Transaminases

Cardiac myxoma is a rare but potentially treatable cause of stroke. The diagnosis is rarely made on typical triad of constitutional, embolic, and obstructive symptoms, and it is difficult because there is no specific history, physical examination, chest X-ray, or electrocardiographic findings, but with the development of echocardiography the correct diagosis is now usualy made. Neurologic manifestation is frequent(25-45%) and presented with embolic infarction, aneurysm formation, intracranial hemorrhage, and distant metastasis. We experienced five patients with cardiac myxoma who presented with these neurologic manifestations. Also we should be considered in the differential diagnosis of cerebral infarction, particularly when multiple cerebral infarction and constitutional or obstructive symptoms are conjoined in young age stroke. We describe five patients who presented with embolic infarction, cerebral metastasis and aneurysm formation.
Aneurysm ; Cerebral Infarction ; Diagnosis ; Diagnosis, Differential ; Echocardiography ; Electrocardiography ; Humans ; Infarction ; Intracranial Hemorrhages ; Myxoma* ; Neoplasm Metastasis ; Neurologic Manifestations* ; Physical Examination ; Stroke ; Thorax