Since the independent reports of Charcot and Marie and of Tooth, in 1886, interest in this familial disease has centered largely in the genetic and diagnostic aspects, and yet references in the literature to Surgical management are rare and inexact. Our experience with Charcot-Marie-Tooth disease in 4 patients operated at Seoul National University Hospital during the last 3 years is reported. Of 6 cases of Charcot-Marie-Tooth disease which have been studied, 4 patients have undergone surgery for the correction or amelioration of the crippling foot deformity. The authors' operation has consisted of triple arthrodesis, medial release, lengthening of the Achilles tendon, tendon transfer which was available and present evidence that properly designed surgical treatment can correct, prevent, or materially reduce disability of the deformed feet. Of the 4 cases reported here, all have either been reviewed or the patients have been interviewed in the last year. On the basis of adequate follow-up observations, thesurgical procedure outlined have been shown to improve the crippled condition. In spite of progressive musele wasting, the operative treatment could prevent or ameliorate the deformity. Three cases of Charcot-Marie-Tooth disease were evaluated in a long-term follow-up after having undergone surgery to correct their foot deformity. Excellent results were achieved from three of them which were maintained at final follow-up, and one is being gollowed up.
Achilles Tendon ; Arthrodesis ; Charcot-Marie-Tooth Disease ; Congenital Abnormalities ; Follow-Up Studies ; Foot ; Foot Deformities ; Humans ; Seoul ; Tendon Transfer ; Tooth

No abstract available.
Child* ; Humans ; Testosterone*

In the treatment of dislocations and subluxations of the hip in the older children, whether congenital or paralytic, orthopedic surgeons are blessed with a wide variety of commonly used surgical procedures; namely, Salters innominate osteotomy, acetabtloplasties, Pembertons pericapsular osteotomy, shelf operations, Chiaris pelvic displacement osteotomy. and Colonnas capsular arthroplasty. However, with increasing age and soft tissue contractures,these procedures become ineffective, leaving a wide range of age between older children and young adults subject to uncertain or unfavarable prognosis. Steels triple osteotomy (1973) is aimed at coverig this age group, when displacement or in nominate osteotomy is either technically infeasible or likely to fail. It consists of an open reduction with or without soft tissue release and skeletal traction, redirection of the acetabulum to cover the femoral head by osteotonmies of the pelvis that has lost its young cartilagenous resiliency, and preservation and physiological remodelling of the articular cartilage of the acetabulum. We performed Steels osteotomy on a 21-years-old female with a severe paralytic subluxation of the hip associated with pelvic obliquity and paralytized both lower extremities. One and a half year follow-up result was satisfactory with a stable and congruous joint despite paralysis and with the patient walking for the first time in her life.
Acetabulum ; Adult ; Arthroplasty ; Cartilage, Articular ; Child ; Dislocations ; Female ; Follow-Up Studies ; Head ; Hip ; Humans ; Joints ; Lower Extremity ; Orthopedics ; Osteotomy ; Paralysis ; Pelvic Bones ; Pelvis ; Prognosis ; Steel ; Surgeons ; Traction ; Walking ; Young Adult

Fracture of the coracoid process are rare and those associating with a complete acromioclavlcular separation is even more rare. The mechanism of injury may be attributed to either direct or indirect trauma. Most coracoid fractures are minimally displaced because It is by maintained by the coracoclavicular ligament and coracoacromial ligaments. Usually good result is obtained In the coracoid fracture by non-operative treatment. On the other hand open reduction Is rarely Indicated. The case we are reporting was treated by open reduction and Internal fixation of the acromloclavicular joint using two Kirschner wires, and screw fixation was done for the fracture of the base of the coracoid process. Review of the literature ls also done.
Bone Wires ; Dislocations ; Hand ; Joints ; Ligaments

The present study is an observation of 678 cases of children's fractures; which was treated in the Dept. of Orthopedic Surgery, inchon Christian Hospital, for the past ten years, from 1968 to 1978. The peak age was in from 5 years to 6 years. The sex ratio was 2.9 male to 1 female. The ratio between the right and left extremity was nearly equal. The frequency of fracture of the upper extermity was silghtly dominant then lower extremity. The cause of fracture was fall down Injury in nealy 70% of all cases. The epiphyseal Injury was noted as 16.8% of total orthapedic cases. The most common type of Salter & Harris Classiflcation was type II or 56.1%. Mostly all of children's fractures were treated by closed method, and others were treated by open reduction. Complication Included 29 cases of changed carring angle 18 cases of traumatic arthritis and 8 cases of malunlted supracondylar fracture and 3 cases of postoperative Infections and 2 cases of radial nerve palsy and 3 cases of delayed ulnar nerve palsy of the elbow. In fractures of the femur, 3 cases of the peroneal nerve palsy and 2 cases of leg longth discrepancy was noted. Brief discussion and review of Iiterature is presented.
Arthritis ; Elbow ; Extremities ; Female ; Femur ; Humans ; Incheon ; Leg ; Lower Extremity ; Male ; Methods ; Orthopedics ; Paralysis ; Peroneal Nerve ; Radial Nerve ; Sex Ratio ; Ulnar Neuropathies

Experiences of 26 cases of electrical bone stimulation on normal adult rabbits was documented in this paper. The cathodic electrode was introduced longitudinally into the medullary cavity of the proximal tibia and the anodic electrode was introduced transversely in the distal femur of the same side. The contralateral tibia was used as the control, of which the Teflon coated Kirschner wire was introduced longitudinally into the medullary cavity. 10uA of direct current was passed continuously through the fixed wires between the proximal tibia and distal femur. At the second, fourth and sixth week, random bone scan with 99m-Tc was performed and the animals were sacrificed. The specimen X-rays of the tibia and femur were taken and the specimens were prepared for the microscopic study. The followings are obtained from this experimental study. 1. The rate of new bone formation is 69.2% in the stimulated group and 7.7% in the control group. There were also fibrosis and cartilage formation as well as the new bone formation. The fibrosis and cartrilage formation are observed only in the electrically stimulated side and their occurances are 69.2% and 11.1% respectively. So The new bone formation and fibrosis are definitely increased in the bones of the cathodic electrical stimulation than those of the control side. 2. The intramembraneous ossification is the predominent feature of this electrically stimulated new bone formation. 3. Bone and soft tissue necrosis was the main microscopic feature in the anode side. 4. Since new bone, fibrous tissue and sometimes new cartilage were observed in this study, it seems that the cathodic electrical stimulation is not specific for the new bone formation, but induce crude tissues such as bone, cartilage, fibrous tissue or vessels. Furthermore, it can be postulated that the 10uA electrical stimulation is only one of the best electrical environment for the formation of the crude tissues, especially for bone and fibrous tissue.
Adult ; Animals ; Cartilage ; Electric Stimulation ; Electrodes ; Femur ; Fibrosis ; Humans ; Necrosis ; Osteogenesis ; Polytetrafluoroethylene ; Rabbits ; Tibia

To evaluate the relationship between spontancous diuresis and improvement of pulmonary function in respiratory distress syndrome, 15 premature neonates requiring mechanical ventilation for RDS, who admitted in NICU of Wonkwang University Hospital from January 1990 to June 1992, were studied. The results were as follows (results are mean+/-SEM) 1) Mean birth weight of study infants was 1.82+/-0.08Kg, and mean gestational age was 32.80+/-0.54 weeks. 2) The onset of diuresis occured at a mean age of 29.1+/-2.48 hours with maximum diuresis at a mean age of 41.9+/-1.8 hours 3) Mean urine output increased from 2.25+/-0.43ml/Kg/hr at the stage of pre 12 hours-onset of diuresis (p<0.001), then decreased 3.5+/-0.2ml/Kg/hr at the stage of after maximum diuresis (p<0.05). 4) After maximum diuresis, inspired oxygen gradient, peak inflating pressure, peak end expiratory pressure, mean airway pressure, and respiratory rate were decreased significantly (p<0.05), and alveolar-arterial oxygen gradient was decreased more significantly (p<0,01). So, We conclude that the pulmonary function was rapidly improving after maximum diuresis and these changes reflect the general principle used in ventilatory management of infants with RDS.
Birth Weight ; Diuresis* ; Gestational Age ; Humans ; Infant* ; Infant, Newborn ; Oxygen ; Respiration, Artificial ; Respiratory Rate

BACKGROUND: Pharmacological stress tests for the diagnosis of GH deficiency are unpleasant, labor intensive and potentially dangerous. Reports on urinary GH measurement for the assessment of GH have been published after highly sensitive immunoassaies were developed. The aim of this study was to determine whether a 24- hour urine GH as an alternative method for GH assessment were reliable in predicting GH deficiency defined by L-dopa stimulation test. METHODS: Thirty women, ages 45 to 67, were studied. L-dopa stimulation tests were performed with an ingestion of 500 mg of L-dopa. Serum GH and IGF-1 were measured by a radioimmunoassay using commercially available reagents and uGH was estimated from the 24-hour urine. Then, the mean and its distribution of uGH values were compared according to the GH status defined by L-dopa stimulation test. RESULTS: The correlation between the uGH and the peak values after L-dopa stimulation test was significant (r=0.46; p<0.01). The mean value of uGH in the GH deficiency group was significantly lower than that of the normal group P<0.05). But because of the broad overlap of uGH in the two groups uGH showed no good separation GH deficiency from normal group although uGH reflects GH status significantly. CONCLUSION: uGH reflects GH status significantly, but because of broad overalp uGH couldn't separate GH deficiency form normal group defined by L-dopa stimulation test.
Diagnosis ; Eating ; Exercise Test ; Female ; Growth Hormone* ; Humans ; Indicators and Reagents ; Insulin-Like Growth Factor I ; Levodopa ; Radioimmunoassay

Intracranial vasculitis is a rare and disastrous complication of tuberculous meningitis if not treated properly. Focal neurologic deficits according to the vessels involved are common manifestation. Here, we report a 29-year-old man who suffered abrupt, bizarre behavioral changes caused by vasculitis complicating tuberculous meningoencephalitis. The diagnosis of tuberculous meningitis is based upon both the CSF findings and a chest X-ray. His systemic symptoms disappeared by after being administered antituberculous medication but various psychotic features such as hypersomnia, hyperphagia and aggressivebehavior continued. A brain MRI showed multiple small parenchymal tuberculous nodules, and the brain MR angiography revealed a narrowing of the proimal middle cerebral arteries and a reduced visualization of the cerebral vessels, suggesting widespread vasculitis. Intravenous dexamethasone successfully ameliorated his behavioral changes. In addition both the follow up brain MRI and angiography showed a normalization of the previous findings.
Adult ; Angiography ; Brain ; Dexamethasone ; Diagnosis ; Disorders of Excessive Somnolence ; Follow-Up Studies ; Humans ; Hyperphagia ; Magnetic Resonance Imaging ; Meningoencephalitis* ; Middle Cerebral Artery ; Neurologic Manifestations ; Thorax ; Tuberculosis ; Tuberculosis, Meningeal ; Vasculitis

The optic canal fracture has been recognized as a clinical entity for quite sometime, and is, by no means, a rare condition. We were aware of it for last several years, and have collected five radiographically proved cases from the records. Interestingly enough, two of these patients were involved in motor-cycle accidents and revealed abrasion over the lateral end of the homolateral eye brow. Only one of these five patients had partial recovery of his vision.
Humans