Eighty three rickets could be diagnosed at our department during eight years from August of 1969 to July of 1977. Among them fourteen children, whose radiographs and clinical description were precise with well-documented follow-up study of more than one year, were subjected to this analysis. Evaluation of the healing and correction of the lower leg deformity in these rachitic children obtained the following results. 1. Among fourteen rachitic children, thirteen patients (26 legs) showed varus and one patient (2 legs) showed valgus deformity. 2. Mean mechanical tibio-femoral angle showed shift from the initial 16.1°±5.3° to 5.5°+4.0° at final visit, which indicated the gradual correction of the deformity with the advance of the ages of children. The follow-up study after three years in this series showed that the correction became almost complete. 3. At the epiphyseo-metaphyseal region of the distal femur, the initial angle showed two distinct trends of change. The initial varus angle more than 7 or 8 showed the decrease at the later follow-up study, while the initial angle less than 7 or 8 showed the increase. 4. The epiphyseo-metaphyseal region of the proximal tibia showed the minimum change of angle. Mean angle of deviation from the vertical line was 3.7°±2.9° at first visit and 2.6°± 2.4°at final visit. The least degree of varus and the trend toward valgus observed in this region may refiect its compensatory activity against the varus deformity of the leg as a whole. 5. The epiphyseo-metaphyseal region of the distal tibia showed the maximum degree of varus at both initial and final check although the greatest degree of correction was attained. The initial mean varus angle of 23.9°±9.2° became 12.9°±7.1° at final visit. 6. The results of this study have shown that the correct evaluation of the rcchitic leg deformity is possible with measurement of the mechanical tibio-femoral angle and that the deviation angle of each epipyseo-metaphyseal region is preferable.
Child ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Genu Varum ; Humans ; Leg ; Rickets ; Tibia

PURPOSE: To report a case of endophthalmitis associated with Vibrio vulnificus septicemia. METHODS: Vibrio vulnificus septicemia patient was referred to us in consultation for abrupt onset left visual loss, severe periorbital swelling and conjunctival injection. RESULTS: Left eye showed suppurative intraocular inflammation. With a clinical impression of V. vulnificus endogeneous endophthalmitis, culture for causative organisms and intravitreal antibiotics injection were done. Two days later, we performed pars plana lensectomy, pars plana vitrectomy, intravitreal antibiotics, SF6 gas injection. Intraocular inflammation was subsided after operation, and the anatomical structure of the eyeball was preserved CONCLUSIONS: Immediate ophthalmologic examination is mandatory for ruling out endophthalmitis when Vibrio species septicemia patient complains of ophthalmic symptoms, such as blurred vision or ocular pain. When clinicians diagnose endophthalmitis, make an effort to identify causative organisms. When bacterial infection is suspected, inject antibiotics intravitreously or vitrectomy must be done as faster as possible.
Anti-Bacterial Agents ; Bacterial Infections ; Endophthalmitis* ; Humans ; Inflammation ; Intravitreal Injections ; Sepsis* ; Vibrio ; Vibrio vulnificus ; Vitrectomy

PURPOSE: To report one case of neurilemoma of the bulbar conjunctiva with a review of the relevant literature. CASE SUMMARY: A 15-year-old girl presented with a bulbar conjunctival mass in the right eye. There were no other medical or ophthalmologic problems. The patient wanted to remove the mass for cosmetic reasons. We performed an excisional biopsy and simple wound closure. The mass was composed of bipolar spindle shaped cells that were arranged in bundles and fascicles in dense fibrous tissue. Immunohistochemical staining for the S-100 protein was positive. Two months after mass excision, there was no evidence of recurrence. CONCLUSIONS: We successfully treated a case of bulbar conjunctival neuriliemoma by simple excision.
Adolescent ; Biopsy ; Conjunctiva ; Cosmetics ; Eye ; Humans ; Neurilemmoma ; Recurrence ; S100 Proteins

PURPOSE: To investigate the change of the Beta adrenergic system in the rat visual cortex and superior colliculus after visual deprivation during a critical period of postnatal development. METHODS: The changes of beta 1 and beta 2 adrenergic receptor mRNA were investigated by using northern blot analysis in the rat visual cortex and superior colliculus. The right eyelid of visually deprived rat was sutured at the 10th postnatal days. After visual deprivation for 4 weeks, the rat were sacrificed and the visual cortex and superior colliculus tissues were removed for analysis. RESULTS: Beta 1 and beta 2 adrenergic receptor mRNA expression was decreased in the contralateral visual cortex to the deprived eye. In the superior colliculus, beta 2 adrenergic receptor mRNA expression increased in both sides, but a much greater increase was shown in the ipsilateral superior colliculus than the contralateral side. CONCLUSIONS: These results suggests that visual deprivation during a critical period of postnatal development influences the beta adrenergic system in the rat visual cortex and superior colliculus.
Animals ; Blotting, Northern ; Critical Period (Psychology) ; Eyelids ; Rats* ; Receptors, Adrenergic ; RNA, Messenger* ; Superior Colliculi* ; Visual Cortex*

PURPOSE: To determine the place and the limit of the arthroscopic management of septic gonitis. MATERIALS AND METHODS: Twenty-five patients were treated for pyogenic gonitis. The duration of symptoms prior to arthroscopic debridement was 10.2 days(range, one to 45 days). The surgical treatment consisted in a arthroscopic irrigation with debridement of infected necrotic tissue, and the medical treatment consisted in a intravenous antibiotics for an average duration of 10.3 days, followed by oral treatment for 3 weeks. RESULTS: The average follow up was 23.7 months(15 to 37). Twenty-three out of 25 patients had regained their activity as painless full range of motion. CONCLUSION: Arthroscopic drainage is a valuable procedure for the treatment of the septic gonitis. Arthroscopic drainage is a method that has proved effective, with minimal morbidity, in attempts to cure septic arthritis of the knee.
Anti-Bacterial Agents ; Arthritis, Infectious ; Arthroscopy ; Debridement ; Drainage ; Follow-Up Studies ; Humans ; Knee ; Range of Motion, Articular

We Studied the sport injuries of 135 Korean dissbled athletes who were going to Seoul Paralympics from 15th September 1988 to 30th September 1988. The results were as follows.1. The mean age was 23.3years, male and female ratio was 7 to l. 2. The type of disability were as follows ; Poliomyelitis, Cerebral Palsy and Blindness and transition rate of below 5 years of age was 71.6%. 3. The most common age of begining exercise of the disabled athletes were 16-20 years and composed of 77.4%. 4. The most common cause and process of athletic injuries were heavy training and excessive exercise. 5. The most common athletic injury was soft tissue injury and the most common site was hand and the most common type of injury was blindness and the most common causative sport was baseball and fencing. 6. The protects were used in 41% of athletes and they were globes and glassed as follows. 7. Over 77% of the disabled athletes were answered as “Necessary” to the question about scientification of disabled sport.
Athletes ; Athletic Injuries ; Baseball ; Blindness ; Cerebral Palsy ; Female ; Glass ; Hand ; Humans ; Male ; Poliomyelitis ; Seoul ; Soft Tissue Injuries ; Sports

PURPOSE: The purpose of this study was to investigate the frequency, site and characteristics of motion artifact of ascending aorta mimicking dissection. MATERIALS AND METHODS: The authors evaluated postcontrast CT scans of 60 cases in 60 patients without symptoms of aortic dissection or aortic disease. A Toshiba 900S scanner was used, with 1 cm slice thickness and 1 sec scan time. Streak artifacts, and those relating to extra-aortic vascular structure or pericardial effusion were excluded from this study. RESULTS: Crescent-shaped motion artifacts were seen in 54 cases (90%), and occurred from 1 cm to 4 cm above the level of the aortic valve; between men and women, there was no significant difference in frequency. In each case, the artifact was seen at 1 to 5 (mean 2.9) levels. Its pattern was symmetric in 31 of 60 cases (51%), and at 15 other sites, symmetric artifacts were seen between the SVC and ascending aorta. At the margin of the aortic circumference, the direction of the artifact was left anterior-right posterior in 23.9% of cases, and anterior median-posterior median in 20.8%. CONCLUSION: On CT, motion artifact of ascending aorta occurs frequently. Findings relating to location, symmetric pattern and characteristic direction of artifact may be helpful in the differential diagnosis of aortic dissection and aortic motion artifact.
Aorta* ; Aortic Diseases ; Aortic Valve ; Artifacts* ; Diagnosis, Differential ; Female ; Humans ; Male ; Pericardial Effusion ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Previous studies have demonstrated an association between several single nucleotide polymorphisms and atrial fibrillation (AF). We hypothesized that the phenotypes of AF patients were associated with common AF susceptibility alleles. SUBJECTS AND METHODS: A total of 659 patients (57±9 years, 76% male) with AF who underwent catheter ablation and 659 age, and sex-matched controls were genotyped for the common AF susceptibility alleles rs2200733 and rs6843082 at 4q25, rs2106261 at ZFHX3, and rs13376333 at KCNN3. The phenotypes of AF patients, including electroanatomical characteristics of the left atrium and recurrence after ablation, were compared. RESULTS: The rs2200733 variant allele carriers have larger left atrium volume (128.5±40.7 vs. 113.5±29.2 mL, p=0.020), longer PR interval (185.9±32.6 vs. 174.8±21.9 ms, p=0.018), and higher amplitude of negative P-wave terminal force in Lead V₁ (0.07±0.04 vs. 0.05±0.04 mV, p=0.015) on electrocardiography than those without the variant allele. When the patients were assigned to three groups according to the number of variant alleles (Group A: no variant, n=15; Group B: 1 variant, n=158; Group C: 2 variants, n=439), incremental prognostic value, according to the number of variant alleles, was demonstrated (Log Rank p=0.015). Multivariate Cox regression analysis showed that persistent AF (OR 1.677, 95% CI 1.176-2.381, p=0.004) and the number of variants (OR 1.552, 95% CI 1.099-2.222, p=0.015) were independent predictors for recurrence of AF. CONCLUSION: This study showed the common AF susceptibility alleles at 4q25 and ZFHX3 are associated with electroanatomical characteristics of the left atrium and the clinical outcomes of catheter ablation in Korean patients with AF.
Alleles ; Atrial Fibrillation* ; Catheter Ablation* ; Electrocardiography ; Heart Atria* ; Humans ; Phenotype ; Polymorphism, Single Nucleotide* ; Recurrence

Multiple myeloma can usually be identified by non-traumatic vertebral fracture or signs of recurrent infection. Without these clinical signs, detection is unlikely. We briefly report a case of extraosseous multiple myeloma presenting as repeated intracranial bleeding and relapsing high fever. In doing so, we highlight the importance of subtle changes in laboratory findings. A 67-year-old man presented with spontaneous acute epidural hematoma, and hematoma evacuation was performed at the same site 3 times. A radiologic work-up failed to reveal any osseous lesions and he made a gradual recovery. In the meantime, he suffered unexplained fever up to 39oC despite normal chest and abdominal radiograms. Blood chemistry showed mild leukocytosis, high ESR and CRP, and a slightly elevated globulin. On his 15th hospital day, immunoglobulin studies confirmed the diagnosis of multiple myeloma. He was treated in the ICU for difficult breathing and uncontrolled fever. In spite of intensive critical care, his leukocyte count fell to below 2,000 and he died on postoperative day 28. Apparently normal laboratory and radiologic findings can hamper swift discovery and ultimate management of multiple myeloma. When there is unexplained repeated intracranial bleeding and accompanying fever, the possibility of hidden malignancy should be assessed to avoid delaying or missing treatment.
Aged ; Critical Care ; Fever ; Hematoma ; Hemorrhage ; Humans ; Immunoglobulins ; Leukocyte Count ; Leukocytosis ; Multiple Myeloma ; Respiration ; Respiratory Insufficiency ; Thorax

BACKGROUND: Laryngoscopy and tracheal intubation are associated with hemodynamic pressor responses, which can have adverse effects. During anesthesia induction with propofol target-controlled infusion (TCI), we aimed to determine the most appropriate dosage of alfentanil required for intubation, using a steady effect-site concentration of propofol and with the use of vecuronium. METHODS: Eighty ASA class 1 or 2 patients presenting for elective surgery were allocated at random to one of four groups. Anesthesia was induced in all patients with TCI of propofol target concentration 8 microgram /ml, followed by vecuronium (0.12 mg/kg). This was reduced to 5microgram/ml when the effect-site concentration had been 4microgram/ml. After the effect-site concentrations had reached to 5microgram/ml, control group received normal saline, group 1 received alfentanil 10microgram/kg, group 2 received alfentanil 20microgram/kg, and group 3 received alfentanil 30microgram/kg. Laryngoscopy and intubation were performed 90 s later. Heart rate was monitored continuously. Systolic blood pressure, diastolic blood pressure and mean arterial pressure were measured at pre-induction, post-induction (pre-intubation) and post-intubation, respectively. Complications such as hypotention and bradycardia were recorded until 5 minutes had elapsed after tracheal intubation. RESULTS: Control group showed significant increases associated with tracheal intubation in all hemodynamic variables (P < 0.05). Post-intubation values decreased significantly from pre-induction values in groups 1, 2 and 3 (P < 0.05). In groups 2 and 3, hypotension and bradycardia occurred (zero in group 1) but there were no significant differences in their incidences between the three groups. CONCLUSIONS: We suggest that alfentanil 10microgram/kg constitutes the optimal dosage to obtund the hemodynamic responses to tracheal intubation, using propofol TCI (5microgram/ml) and vecuronium for induction of anesthesia.
Alfentanil* ; Anesthesia* ; Arterial Pressure ; Blood Pressure ; Bradycardia ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension ; Incidence ; Intubation ; Intubation, Intratracheal* ; Laryngoscopy ; Propofol* ; Vecuronium Bromide