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*

A patient had total occlusion of the left main coronary artery that was proved by coronary arteriography. Patients with total occlusion of the left main coronary artery have a varying clinical presentation and may have prolonged survival. In patients with good collaterals, left ventricular function may be preserved. This report reveiws the clinical and angiographic findings of a patient with occlusion of the left main coronary artery with symptoms of unstable angina pectoris but without congestive heart failure or EKG evidence of myocardial infarction.
Angina, Unstable ; Angiography ; Coronary Vessels* ; Electrocardiography ; Heart Failure ; Humans ; Myocardial Infarction ; Ventricular Function, Left

PURPOSE: To analyze the MR imaging features of multiple sclerosis (MS) in spinal cord. MATERIALS AND METHODS: Nine MR (magnetic resonance) images of six patients with suspected MS were retrospectively evaluated in active phase (n=6) and inactive phase (n=3) before and after Gadolinium-DTPA administration. RESULTS: In all patients with clinically active phase, plaques of spinal cord appeared as high signal intensity on T2-weighted image with isointense cord swelling on Tl-weighted images. All lesions were enhanced on Gd-DTPA enhanced Tl-weighted images. The patterns of enhancement were nodular, circumferential rim-like, and segmental. On follow-up images in 3 patients who became clinically stable, all enhancing lesions disappeared. CONCLUSION: MR is a good modality in detection of spinal MS, and Gd-DTPA-enhanced MR is valuable in differentiating active MS from stable MS.
Follow-Up Studies ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Multiple Sclerosis* ; Retrospective Studies ; Spinal Cord*