No abstract available.
Blood Pressure*

Of 43 scoliotic patients treated by Harrington instrumentation and posterior spinal fusion, 38 patients were taken of preoperstive correction by Risser localizer cast, turn buckle cast. Cotrel traction or halofemoral traction from April 1969 to June 1978 at the Department of Orthopaedic Surgery, Seoul National University Hospital. The correctaibility of scoliosis by preoperative correction were evaluated with its methods, etiology, age, severity of the curve and curve pattern. and following results were obtained: 1. Age distribution was from 8 years to 39 yeara of age and mean age was 17. 2 years. 2. The etiology of the 43 cases was idiopathic in 15 (34.9%), paralytic in 10(23.3%). congenital in 9 (20.9%), neurofibromatosis in 5(11.6%) and others in 4, 3. The most common curve pattern was thoracic curve in 20 cases (40. 8%), and thoraco-lumber curve in 13, lumbar curve in 9, double curve in 5. 4. The average initial curve was 80.7 degrees with the flexibility of 36.9% on side bending; preoperative correction 31.3 degrees (38.3%) and immediate postoperative correction 40.6 degrees (50.3%). 5. As preoperative correction, Risser localizer cast was applied in 23 cases (53.5%) with 28.8 degrees (37.4%) of correction, turn buckle cast in 1 case with 80. 0 degrees (54.1%) Cotrel traction in 5 case with 27.5 degrees (40.7%) and halofemoral traction in 9 cases with 36.9 degrees (38.2%). 6. The best correction was obtained in idiopathic type and then followed with paralytic and congenital type. 7. Halofemoral traction was effectively applied in cases of rigidand severe, curve, mostly in older patients; the initial curve 96.5 degrees with 28.5% of flexibility. 8. The best correction was obtained in thoracic curve (39%) and then followed with thoracolumbar and lumbar curve. Halofemoral traction was effectively applied in tho racic curve. 9. Duration of preoperative correction was 5.1 days in Risser localizer cast, 7 days in turn buckle cast, 6.4 days in Cotrel traction and 13.3 days in halofemoral traction. 10. Most of preoperative correction were obtained in a few days of traction; 92% in half week with Cotrel traction and 83% in half week and 91% in one week with halofemoral traction.
Age Distribution ; Humans ; Neurofibromatoses ; Pliability ; Scoliosis ; Seoul ; Spinal Fusion ; Traction

Early detection of spine deformities by school screening has proven to be valuable for early diagnosis and prevention of severe deformities. Authors screened 1,620 middle and high school male students Seoul who were chosen arbitrarily, to determine the incidence rates of scoliosis. Authors diagnosed scoliosis on a combination of at least one positive physical sign and a lateral curvature more thar 5 degrees on an antero-posterior standing X-ray. According to this criteria 12 students were diagnosed as having scoliosis. They were analyzed for positive physical signs, etiology, degree of curvature. distribution of size of curvature, patterns of curvature, direction of curvation, and following results were obtained. 1. The overall incidence of scoliosis was 0.74%. 2. Idiopathic scoliosis was found in 10 students, congenital scoliosis in 1, and paralytic scoliosis in 1. 3. Rib humps, whose right to left ratio was 5, were found in 6 students, lumbar humps, whose right to left ratio was 0. 2. in 6 students, and shoulder elevation, whose direction were all to right, in 4 students. 4. Close observations were required for all the 12 students and treatment was required in 2 students who had more than 20 degrees, one for Milwaukee brace, and the other for surgical correction. 5. The most common pattern of curvature was thoracic curve. 6. in single curve right to left ratio was 2.7.
Braces ; Congenital Abnormalities ; Early Diagnosis ; Humans ; Incidence ; Korea ; Male ; Mass Screening ; Ribs ; Scoliosis ; Seoul ; Shoulder ; Spine

BACKGROUND: The value of serum lipid in children after recovery of Kawasaki disease may be important bacause of the predilection of this disease for the coronary artery. METHODS: To determine the alterations in serum total cholesterol(TC) and high density lipoprotein(HDL)-cholesterol levels in Kawasaki disease(KD), we measured serum HDL-cholesterol and TC in 35 patients(mean age 36.8+/-22.0 months, range 6 to 93 months) with Kawasaki disease(KD) during 10 days or less after the onset(group A) and 2 months later after recovery. TC and HDL-cholesterol were also measured in an acute febrile respiratory illness group(group B) and a nonfebrile respiratory illness group(group C) to compare with those of KD. RESULTS: HDL-cholesterol levels in group A were depressed(29.6+/-11.0mg/dl) compared with group B and C(47.3+/-13.3mg/dl and 45.1+/-12.4mg.dl, respectively, p<0.01). TC levels in group A(145.1+/-33.1mg/dl) were not significantly different from those of group B(146.8+/-33.4mg/dl) and C(157.1+/-29.6mg/dl). Also the level of serum HDL-cholesterol in the acute phase of KD was significantly lower when compared with that after recovery(30.2+/-13.2mg/dl vs 50.0+/-10.2mg/dl, p<0.05). In KD patients, TC levels were not significantly different between the acute & recovery phase(145.0+/-26.6mg/dl, 153.4+/-32.6mg/dl). Echo-cardiography confirmed coronary artery aneurysms in 11 patients(31.4%) and otherwise, normal findings(n=24) in the KD group. There were no significant difference in TC level(140.7+/-27.6mg/dl vs. 146.9+/-35.4mg/dl, p=NS) and HDL cholesterol level(30.1+/-12.5mg/dl vs. 29.2+/-10.7mg/dl, p=NS) between patients with and without coronary aneurysms. CONCLUSIONS: HDL-cholesterol levels were significantly depressed only in the acute phase of KD but TC levels did not change significantly. Both levels were not related to coronary artery aneurysm.
Aneurysm ; Child ; Cholesterol, HDL ; Coronary Aneurysm ; Coronary Vessels ; Humans ; Mucocutaneous Lymph Node Syndrome*

No abstract available.
Alcoholism*

Metaphyseal Chondrodysplasia is a disease characterized by metaphyseal ossification leading to shortening of stature. The extremities, especially lower, and mainly affected, resulting in a disproportionate drarfing which spares the trunk. The first case was reported in a patient with irregular metaphysis of lower extremities and hands, and severe shorteness of stature by Murk Jansen in 1934. A milder form of Metaphyseal Chondrodysplasia was noted in 1949 by Schmid, which is more common and transmitted in autosomal dominant. Mckusick recently reported another form of Metaphseal Chondrodysplasia, and other types were reported, but they are extremly rare, and of little clinical significance. In the Schmid type, patient is normal at birth, but characteristically shortness of stature, bowed leg, and waddling gait developed at biginning of walking. Ali labratory findings including serum calcium level, phosphorous, alkaline phosphatase, renal function test is normal in Metaphyseal Chondrodysplasia. The most difficult differential diagnosis is Vitamin D-resistant rickets in clinical and x-ray findings. The only treatment is careful observation and properly timed corrective surgery. Authors experienced on case of Schmid type of Metaphyseal Chondrodysplasia which had been treated with Vitamin D under impression of rickets for 1 year before the case was consulted to Orthopedic Department. Proximal tibial osteotomy and subtrochanteric valgus osteotomy were performed for the correction of genu varum and coxa vara deformity with satisfactory results for one year follow up.
Alkaline Phosphatase ; Calcium ; Congenital Abnormalities ; Coxa Vara ; Diagnosis, Differential ; Extremities ; Follow-Up Studies ; Gait ; Genu Varum ; Hand ; Humans ; Leg ; Lower Extremity ; Orthopedics ; Osteotomy ; Parturition ; Rickets ; Rickets, Hypophosphatemic ; Vitamin D ; Walking

We sudied, with echocardiography as a main tool, the natural processes of 211 patients with uncomplicated ventricular septal defect (VSD) (incidence, 5.33 per 1,000 live births); 146 (69.2%) had a perimenbranous VSD and 32 (15.2%) had a subarterial, 25 (11.8%) had a muscular type of VSD. Cumulative rate of spontaneous closure was 26.1%. In the closure processes, about three-fourth of perimembranous VSD showed a partial closure or tunnel formation by changes of septal leaflet of the tricuspid valve, remaining one-fourth showed a "functional" complete closure. Four of 58 neonates had a partially closed-perimembranous VSD. Rates of infundibular stenosis and Eisenmenger syndrome were 6.6% and 1.4% respectively. Aortic prolapse with insufficiency was detected in 6 patients who were over 6 years of age. Surgical closure was required in 27.5% of all studied patients and in 12% of infants (14 of 177). No natural deaths were observed during the study-periods of recent 3 years. But, 3 of 58 (5.2%) were dead postoperativel (two were early, one late). Doppler color flow mapping is a valuble aid in the diagnosis of VSD and may be on reason for the observed increase in the incidence of VSDs.
Constriction, Pathologic ; Diagnosis ; Echocardiography* ; Eisenmenger Complex ; Heart Septal Defects, Ventricular* ; Humans ; Incidence ; Infant ; Infant, Newborn ; Prolapse ; Tricuspid Valve

The expression of the c-fos and c-myc oncogenes was investigated by dot blot analysis of total RNA extracted from biopsies of normal skin and psoriatic lesions. Densitometric analysis revealed 6.3 fold and 8.6 fold evevation respectively of c-fos and c-myc oncogenes mRNA levels in severe psoriasis compared to normal skin, and 1.5 fold and 1.6 fold elevation respectively of c-fos and c-myc oncogenes mRNA levels in mild psoriasis compared to normal skin. The ratio of c-fos/c-myc transcripts in normal skin and mild psoriasis was constant compared to that in severe psoriasis. The maintenance of a constant ratio of c-fos/c-myc is believed to be closely related to ordered cell growth and the ratio of c-fos/c-myc transcripts in severe psoriasis suggests a disordered pattern of cellular differentiation. We be1ieve that overexpression of these oncogenes is related to the pathogenesis of psoriatic epidermal hyperplasia.
Biopsy ; Hyperplasia ; Oncogenes* ; Psoriasis ; RNA ; RNA, Messenger ; Skin

Wallerian degeneration is well known as the anterograde degeneration of axon and their accompanying myelin sheath from injury to the proximal portion of the axon or its cell body. The most common cause of wallerian degeneration is cerebral infarction. Authors experienced three patients with old hemispheric infarct with typical wallerian degeneration in the brain stem, which was demonstrated by magnetic resonance imaging (MRI) in two cases and CT in one case. This report demonstrates the wallerian degeneration in the corticospinal tract on the MRI and CT with the brief review of the literatures.
Axons ; Brain Stem ; Brain* ; Cell Body ; Cerebral Infarction ; Humans ; Magnetic Resonance Imaging* ; Myelin Sheath ; Pyramidal Tracts ; Wallerian Degeneration*

Mitral regurgitation (MR) was analyzed by Doppler echocardiography, preoperatively and postoperatively, in 59 patients with patent ductus arteriosus (PDA). The ratio of left atrial dimension and aortic root dimension (LAD/AOD) and the maximal velocity of the mitral valve (MVmax) were compared in pre, postop group. The degree of the regurgitation was given to the MR group. In preop MR group (13 of 59,22%), we compared the LAD/AOD by echo and the Qp/Qs by catheterization with non-MR group. The following results were obtained: 1) In preop MR group, about half of them had a grade 1 regurgitation, where as one fourth showed grade 2, remaining one fourth showed grade 3. The later were all changed to grade 2, postoperatively. The whiffle or mild MR (grade 1 or 2) shown preoperatively were slightly reduced in their degrees of regurgitation, but most were not disappeared and persisted to 7th postop day. 2) LAD/AOD and MVmax were significantly reduced at postop state of PDA. 3) In preop MR group (n=13), LAD/AOD was significantly increased. Qp/Qs was higher in MR grade 2 group (n=6). In conclusion, left atrial dilatation could be a factor causing mitral regurgitation in the PDA. The amount of the pulmonary blood flow also related to that. The size of the PDA itself, Rp/Rs and associated cardiac lesions were not related to the regurgitation.
Catheterization ; Catheters ; Dilatation ; Ductus Arteriosus, Patent ; Echocardiography, Doppler ; Humans ; Mitral Valve ; Mitral Valve Insufficiency*