No abstract available.
Anniversaries and Special Events

This is an analysis of 1282 cases of poliomyelitis from patient records gathered over a 20 year period from the year of 1964. The results are as follows : 1. The most visits recorded in any one year were 301(23%) in 1965. The most visits recorded in a 5 year period were 961(67%) in the years of 1965–1969. 2 Of a total of 1158 cases whose year of onset was recorded, the earliest onset was in 1900: only one case. Since 1981 no new onsets have been recorded. However, the majority of cases : 1014(87%) showed an onset between 1955–1974. 3. Of a total of 1282 cases whose place of residence at primary examination was recorced, 891(70%) resided in Seoul and 391(30%) in the rural areas. 4. Of a total of 1282 cases whose sex was recorded, males comprised 777(61%) and females 505(39%). 5. Of a total of 883 cases whose season of onset were recorded: 526(60%) onsets occured in the warm, 272(31%) in the cool, and 85(9%) in the cold season of yesr. 6. Of a total of 1155 cases whose age at onset was recorded, the youngest was 4 months and the oldest 28 years of age. The largest group comprising 915 cases(79%) were two years of age or younger. 7. Of a total of 1146 cases whose period between onset and primary visit was recorded: 182(16%) were in acute, 414(36%) were within convalescent, and 732(64%) were in residual stage. 8. Of a total of 1268 cases whose age at initial examination was recorded, 233(18%) were two years or younger, 1021(81%) were 14 years or younger. 9. Of a total of 445 cases whose vaccination history was recorded, 234(53%) had been vaccinated prior to onset. Of those only 112(48%) had completed the required course of vaccincation. 10. Of the total of 1282 cases, deformities resulting from muscular paralysis were recorded in 1099(86%) cases. The number of deformities occuring in these cases totalled 3141: 189 deformities(6%) were in the trunk, 64(2%) were in upper extremity, and 2888(92%) were in lower extremity. Among the lower extremity, 1270(40%) were in the foot. The most frequent single deformity was knee flexion with the total of 464(15%). 11. Of a total of 798 cases whose leg length was verified, 394 were measured by scanogram and 404 cases by measurement of actual leg length. The greatest leg length discrepancy was 12cm in a 17 year-old male, and the most average discrepancy in those bone growth completing, age of 17–20 years, was 3.2cm. 12. Of a total of 1282 cases, 503(39%) cases had prescriptions for supportive devices, but only 316(25%) cases actually had made and wore them. Among those prescriptions, the most common type prescribed was the long-leg brace, which totalled 351. 13. Of the total of 1282 cases, 449(35%) received 1297 surgical procedures, an average of 2.9 per patient. The operations on soft tissue comprised 734(57%) procedures : 348 tendon transplantations with the most(170 procedures) on peroneals, 147 tendon lengthenings with the most(146 procedures) on Achilles tendon, and 234 fasciotomies with the most (117 procedures) on iliotibial band. The operations on bone and joint comprised 563(43%) procedures : 274 leg length equalizations with the most(172 procedures) of growth stimulation, 186 arthrodeses with the most(115 procedures) of triple arthrodesis of the foot, and 92 osteotomies with the most(41 procedures) on tibis. 14. Since problems remaining in the residual stage of poliomyelitis are almost always permanent, observation of these cases over a long period of time has generated invaluable experience from which we have gained considerable knowledge. 15. It has been a revelation to see the considerable degree of compensation in growing children such as a decrease in leg length discrepancy as the end of growth approached. Cases of so called hand-knee gait showing hypertrophy of fingers have lost this in a few years, following corrective measures. 16. We feel that all cases of leg length discrepancy do not need to be treated uniformly, considering the power of the ability of growing children to compensate without any inter vention. 17. Prediction of type of motion or deformities using physical examination of muscular paralysis is very difficult because the compounding factors of not only the paralysis of various muscles but the individual characteristics. The age, sex, lifestyle, motivation etc. have been shown to have an over-riding influence. 18. Decisions to brace or operate should not be made hastily but only after careful and thorough examination. We saw many quite severely disabled cases walk remarkably well without braces or surgery by their own means of compensation or device. 19. Cases with almost no lower extremity muscle power except for 20–30% hip rotators could walk surprisingly well using the sartorius muscle as a main controlling force. So we dubbed their manner of walking the sartorius gait. 20. Bracing can be very burdersome, and decisions to brace should not be made on the textbook alone. Some cases happily choose surgery over bracing. 21. For one time surgical procedure, it is better to choose bone over soft tissue for a better result. When the surgery is two stage, soft tissue surgery done after bone and joint surgery has healed will produce better results. 22. We must all realize that not only poliomyelitis, but also all chronic diseases need mental treatment as well as physical. Because, in rehablitation mental disablity is more harmful than physical in the final analysis.
Achilles Tendon ; Age of Onset ; Arthrodesis ; Bone Development ; Braces ; Child ; Chronic Disease ; Compensation and Redress ; Congenital Abnormalities ; Female ; Fingers ; Foot ; Gait ; Hip ; Humans ; Hypertrophy ; Joints ; Knee ; Leg ; Life Style ; Lower Extremity ; Male ; Motivation ; Muscles ; Osteotomy ; Paralysis ; Physical Examination ; Poliomyelitis ; Prescriptions ; Seasons ; Seoul ; Tendons ; Tenotomy ; Upper Extremity ; Vaccination ; Walking

This is an analysis of 137 feet of triple arthrodesis over a period of 23 years.1964–1987. The average period of follow-up was 4 years and 2 months. The results are as follows. 1. The ratio of male to female was 64 to 68 cases, and right to left was 75 to 62 feet. 97 feet(70. 8%) were operated on between late 1960 and early 1970. 89 cases(67.4%) came for their initial examination when they were aged between 9–20 years. Age at the surgery was between 55/12–50 years, and among them 134 feet(97.8%) were operated after age of 8 years. 2. 128(93.4%) out of 132 cases were residual poliomyelitis, and 97(70.8%) out of 137 feet were equinovarus. 3. 100 out of 132 cases receiving triple arthrodesis also received a total of 179 additional procedures simultaneously to achieve better correction. The major additional procedure was. Achilles tendon lengthening in 81 cases followed by plantar fasciotomy in 49 cases. 4. Surgical approach was by Ollier's method, and arthrodesis by Lambrinudi's method. 5. 134 out of 137 feet required triple arthrodesis in order to correct the deformity. On this operative procedure it was utmost important to dissect the tarsal bones and surrounding soft tissues thoroughly to loosen and rearrange the joints. In this way even severe deformity was corrected satisfactorily. 6. At the time of Achilles tendon lengthening by Z-plasty deviding it longitudinally, on the tibial side the tendon was cut at the calcaneal attatchment, and on the fibular side at the proximal end. We think that this produced more efficient and satisfactory results especially in the correction of equinovarus. 7. Internal fixation was done by one staple on 110 feet and two staples on 7 feet. On one staple use, it was inserted connecting the talus and the cuboid. More firm contact between two bones as it progressing into bone was achieved by placing with slightly spread legged staple. 8. We could not find any pseudoarthrosis or delayed union. It is assumed the reason for this was good dissection of bone and joint, firm internal and external immobilization, and good postoperative management. 9. Talar and navicular necrosis occurred in 6 feet(4.4%), but did not affect the final fusion of the arthrodesis. In relatively severe necrosis, we found flattening of the talus and complaint of considerable pain but nevertheless, no special additional procedure was done. 10. We found some cases of postoperative degenerative hypertrophic osteoarthritis in tibio-talar and navicular-cuneiform joint. We feel this phenomenon is due to compensatory stress emanating from the fusion of three joint, and new contact of articular surfaces with changed biomechanical force. 11. When doing triple arthrodesis, the optimal age for surgery is 10-12 years, i.e., before the completion of bone growth, the reason is during the remaining period of bone growth, there is opportunity for the bone and other tissues to adjust to the newly formed stresses of weightbearing and joint motion. 12. Of a total of 137 feet receiving triple arthrodesis, excellent results were seen in 31(23%), good in 82(60%), fair 20(14%) and failed in 4(3%).
Achilles Tendon ; Arthrodesis ; Bone Development ; Clubfoot ; Congenital Abnormalities ; Female ; Follow-Up Studies ; Foot ; Humans ; Immobilization ; Joints ; Leg ; Male ; Methods ; Necrosis ; Osteoarthritis ; Poliomyelitis ; Pseudarthrosis ; Surgical Procedures, Operative ; Talus ; Tarsal Bones ; Tendons ; Weight-Bearing

We have treated three cases of bone abscesses, two in proximal tibia and one in os calcis, by radical excision and filling the remaining bone cavity with autogenous iliac bone graft. We have observed them postoperatively for one to six years. They have not shown any sign of recurrence and they are carrying out their normal daily activity without any restriction. Eventhough it is against the basic fundamental of surgery to lay bone grafts in an infected area, our treatment was successful. We believe that this was resulted from the administration of the broad spectrum antibiotics, complete excision of the diseased tissue, gentle handling of the tissue at the surgery, and relatively perfect postoperative care. When the remaining bone cavity after the surgery of the osteomyeIitis can not filled by the usual method such as muscle pedicle graft, especially in the proximal metaphyseo-epiphyseaI region of the tibia, fresh cancellous bone graft immediately after the radical excision, and primary closure of the operative wound may be tried. It seems that this method brings rapid and permanent heaIing of the chronic osteomyelitis. Thus the patient can leave hospital earlier, pays Iess expense, and returns to his work earlier.
Abscess ; Anti-Bacterial Agents ; Humans ; Methods ; Osteomyelitis ; Postoperative Care ; Recurrence ; Tibia ; Transplants ; Wounds and Injuries

From March 1992 to June 1994, we experienced five failed cases of anterior cruciate ligament reconstruction. Four out of five cases had reconstruction in other hospitals. Two of them had anterior cruciate ligament reconstruction using artificial ligament, one using bone-patellar tendon-bone auto- graft, and one using bone-patellar tendon-bone autograft augmented by artificial ligament. The remaining one case had arthroscopic anterior cruciate ligment reconstruction using bone-patellar ten- don-bone autograft in Asan Medical Center. We performed arthroscopic revision anterior cruciate ligament reconstruction using allograft in four cases and bone-patellar tendon-bone autograft in one case. All cases were treated with vigorous postoperative rehabilitation program including postoperative immediate range of motion(ROM) exercise and muscle strengthening exercise. Postoperative results were evaluated by Lysholm knee score in average 17.2 months(range from 12 months to 25 months). The average Lysholm score improved from 49.8 to 81.4. At follow-up study, anterior drawer test with Telos device revealed 2mm of average side to difference.
Allografts ; Anterior Cruciate Ligament Reconstruction ; Anterior Cruciate Ligament ; Arthroscopy ; Autografts ; Chungcheongnam-do ; Follow-Up Studies ; Ligaments ; Lysholm Knee Score ; Rehabilitation ; Transplants

No abstract available.

More than 100 surgical methods were described as the treatment of recurrent patella dislocation. These can be divided into two categories, the proximal, dynamic reconstruction and the distal, static reconstruction. We treated a case of recurrent patella dislocation with a new method, using gracilis. The tendon of gracilis was dissected and cut at the point about 7cm proximal to the insertion. A 'H' shaped slot was made subperiosteally in the anterior surface of patella. The both ends of cut gracilis tendon were imbedded into the 'H' shaped slot of patella and sutured. So the gracilis tendon could act as a static and dynamic stabilizer. The result was excellent at 1 year follow up.
Dislocations ; Follow-Up Studies ; Methods ; Patella ; Tendons

The first description on the discoid meniscus was made by Young in 1889 and was known as it affects only the lateral meniscus for a long time. However, Cave and Staples had reported the two cases of discoid changes on medial meniscus in 1941. Smillie(1948) had stated that the menisci exist as cartilagenous discs at an early stage of fetus and remain in discoid shape congenitally. Kaplan(1957) reported that the discoid meniscus is not caused by congenitally but acquired in relation of joint motion. A clinical analysis is made on the 22 discoid meniscus which were removed surgically and summarized as follows: 1. The click sound on walking, tenderness and positive McMurray test were important as diagnostic criteria and were present all of the cases. 2. The most of the discoid meniscus were found in first and second decade in 13 cases(76.5%) out of 22. The five cases were bilateral. 3. The discoid change of the meniscus had no sex defferences in their incidence but lateral involvement were far superior than in ten times. 4. The discoid meniscus shows degenerative change microscopically 17(77.3%). 5. The clinical result of surgical removal of discoid meniscus was satisfactory in resuming their full activities in six weeks.
Clinical Study ; Fetus ; Incidence ; Joints ; Menisci, Tibial ; Walking

Tooth is the most important element in esthetic consideration on facial area. Tooth alignment which is in harmony with gingiva, lips, and face is also key element. The purpose of this study was to give a clinical discipline for restoration of gingival contour, which contains a ratio of maxillary 6 anterior teeth, research for gingival contour etc., in case of rehabilitation of maxillary anterior teeth. 300 Dankook university dental school students ,who is their twenties and free from periodontitis, participate in this study. The result was from each 70 males and females who had normal occlusion and tooth alignment. Length, width and length/width ratio of maxillary 6 anterior teeth were 0.74-0.81 in male, 0.81-0.84 in female. There was significant difference between male and female. The most deepest position of gingiva in maxillary central incisor and canine was located in distal part of teeth and maxillary lateral incisor was middle portion. In maxillary central incisors, gingival line of the most deepest point appeared significant difference between male and female (p<0.01) whereas there was no difference in lateral incisors and canines. Distance between interdental papilla apex and the most deepest portion appeared significant difference beween male and female. Distance of the deepest positon of gingiva is statistically significant except maxillary central incisors and lateral incisors. Standard deviation and mean of the width of labio-lingual were measured in cervical area and there was a significant difference both male and female.(p<0.01) From this result, we could get the mean of maxillary anterior gingival line and these results have great value in clinical guidance in studying maxillary anterior teeth.
Female ; Gingiva ; Humans ; Incisor ; Lip ; Male ; Maxilla* ; Periodontitis ; Rehabilitation ; Schools, Dental ; Tooth

Removal of subgingival calculus is essential for the success in periodontal treatment. Subgingival instrumentation is used for the removal of all bacterial plaque and calculus. In this study, Gracey curet and Ultrasonic curet were used on single rooted teeth to conduct subgingival scaling and root planning. The remaining amount of calculus was evaluated according to type of instrument, depth of pocket, and tooth surface. 24 teeth were extracted from 14 patients being treated at department Periodontology Seoul Advantist dental hospital were used. Total 96 area(4 surface per teeth) were evaluated. 12 teeth treated with Gracey curet were used as the control group and the other 12 teeth treated with Ultrasonic curet were examined for experimental group. The 4 surfaces of the teeth(buccal, mesial, lingual or palatal, distal) were observed through the stereomicroscope and the images of the surface were captured and saved in CCD. The images were displayed on the monitor and the amount of calculus remained was evaluated by overlapping 10x10 grid pixel screen produced by Microsoft power point. The results evaluated were as follows 1. There was no statistically significant difference in residual calculus and tooth position following scaling and root planning of all group, but statistically significant correlation with residual calculus, probing depth, instruments and tooth surface. 2. There was statistically significant correlation between residual calculus and probing depth, but no statistically significant difference in residual calculus, tooth surface and tooth position on experimental(Ultrasonic curet) group. 3. There was no statistically significant difference in residual calculus according to the pre-treatment pocket depth and tooth position, but statistically significant correlation with tooth surface. The amount of residual calculus increase with mesial, distal, buccal and lingual(or palatal) surface on control(Gracey curet) group. 4. The Gracey curet showed better results than ultrasonic curet in mesial and distal surface, and there is significant difference. The results demonstrate that ultrasonic curet alone is inadequate for thorough subgingival debridement and suggest that Ultrasonic curet with Gracey curet should be more effective.
Calculi ; Debridement ; Dental Scaling* ; Humans ; Seoul ; Tooth ; Ultrasonics*