STUDY DESIGN: Sixteen patients with congenital kyphoscoliosis were evaluated the clinical and radiological results according to the treatment method. OBJECTIVES: To provide a guideline for surgical treatment of congenital kyphoscoliosis SUMMARY OF LITERATURE REVIEW: Congenital kyphoscoliosis is an abnormal coronal and sagittal curvature of spine that is caused by the presence of vertebral anomalies, which causes a significant deformity and disability. Correction of the deformity is challenging and accompanied by high risk of complications. Many methods of operative treatment were recommended with various results. MATERIALS & METHODS: We reviewed 16 patients of congenital kyphoscoliosis who were operated from 1984 to 1997, and follow-up periods were over 12 months in all. The average age of surgery was 12 years (ranged from 4 to 20 years). Nine cases were operated by excision of quadrant hemivertebra through combined anterior & posterior approach and 6 cases were treated only by posterior instrumentation and one underwent posterior on bloc spondylectomy. RESULTS: The type of curves were thoracic in 5, thoracolumbar in 9, lumbar area in 2 patients. Average angle of kyphosis was 55 degree preoperatively, 25 degree postoperatively, and 39 degree at the follow up study. Average angle of scoliosis was 48 degree, 22 degree, and 27 degree, respectively. In 9 cases corrected by excision of quadrant hemivertebra; kyphotic angle was changed from 62degrees preoperatively, to 22degrees postoperatively and to 36 degree at the end of follow up study, while scoliotic angle was changed from 47degrees, to 12degrees and to 21degrees, respectively. In 6 cases corrected by posterior instrumentation kyphotic angle was changed from 52degrees preoperatively, to 33degrees postoperatively and to 48degrees degree at the follow up study, while scoliotic angle was changed from 53degrees, to 33degrees and to 37degrees, respectively. CONCLUSION: Excision of quadrant hemivertebra through combined anterior and posterior approach or posterior instrumentation were resulted in significant loss of correction during the remaining growth period due to the secondary change of adjacent vertebrae. So, to obtain better correction and to reduce the recurrence of deformity, more aggressive approach including the concept of three dimentional osteotomy involving the upper and lower adjacent curve may be considered.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Osteotomy ; Recurrence ; Scoliosis ; Spine

No abstract available.
Ureaplasma urealyticum* ; Ureaplasma*

No abstract available.
Allopurinol* ; Animals ; Liver* ; Rats* ; Reperfusion Injury* ; Verapamil*

Vitamin D deficient ricket is now a rare disease in the developed countries because of the generally improved nutrition and medical awareness but occasional cases are found in the special susceptible populations. The ricket is characterized pathophysiologically by a failure of the normal mineralization of bones and epiphyseal cartilages and is susceptible to the fractures because of the weakness and increased plasticity of bones. The fractures occurred in rickets are known to be delayed in union but it should be normal if the ricket is effectively treated. Authors reviewed 7 cases of fractures occurred in the vitamin D deficient rickets which were managed at Daegu Fatima Hospital during the years from 1980 to 1986 and the following results were obtained. 1. The cases were 4 boys and 3 girls having ages from 6 to 11 years who were all in the same group of restricted population of poor nutrition. 2. 10 fractures noted in 7 cases including two cases of multiple fractures and a case of refracture and most of the fractures occurred in femurs except for a humerus and a forearm bones. 3. The causes of fractures were uncertain because the definite histories were unable to obtain but any violent trauma was not suggested. 4. The fractures were treated by the usual methods of skin tractions or cast immobilizations and daily doses of 2,000 U. or 5,000 U. of vitamin Dwere given as soon as the rickets are recognized. 5. The normal healing of the fractures and rickets occurred in the cases who were given vitamin D initially when the diagnosis of rickets were made. 6. The healing of fractures were very delayed in 2 cases who were missed to recognize the rickets initially and vitamin D was not given.
Daegu ; Developed Countries ; Diagnosis ; Female ; Femur ; Forearm ; Fractures, Multiple ; Growth Plate ; Humans ; Humerus ; Miners ; Plastics ; Rare Diseases ; Rickets ; Skin ; Traction ; Vitamin D ; Vitamins

During the rehabilitation period, traumatic fracture of the lower extremity in chronic spinal cord injured patients may be occur frequently. In the past, conservative treatment with pillow or plaster splinting was advocated by many clinician, but its treatment is still controversial. This paper presents our experience with fracture of 20 patients(5.7%) of total 350 patients who had spinal cord injuries from Jan. 1980 to Mar. 1987 at Korea Veterans Hospital. The results were as follow. 1. The incidence of fracture was not related to age, sex, type and duration of spinal cord injury. 2. The most common cause of fracture was insignificant trauma(94%). 3. The distribution of fracture was in the following order of frequency;supracondyle of femur (20%), shaft of femur (20%), shaft of tibis (16%). 4. The methods of treatment-Twenty cases were treated by conservative treatment and eleven cases were treated by operative treatment in following order; paster splint with well padded; 9 cases (20%), pillow splint; 4 eases (13%), plate and screw; 3 cases (10%). 5. Total 11 cases of complications were 8 cases in conservative treatment and 3 cases in operative treatment. 6. The duration of bone union was average 10 weeks in nonoperative treatment and average 10.2 weeks in operative treatment. Treatment should strive to achieve fracture healing with minimal danger to the patient and should cause little or no interfrence with patient's daily routine.
Femur ; Fracture Healing ; Fractures, Bone ; Hospitals, Veterans ; Humans ; Incidence ; Korea ; Lower Extremity ; Rehabilitation ; Spinal Cord Injuries ; Spinal Cord ; Splints

The authors conducted an in-Vivo experimental study using sciatic nerve of 200-300 grammed rats to verify clinical applicability of Silicone cuffing method, by which scar adhesion of repaired nerve in crushed limb is assumed hopefully to be reduced. The following observations were obtainable. 1. Nerve conduction velocity was noted faster in Silicone cuff group than in control group significantly after 6 weeks postoperatively. 2. Adhesion of repaired nerve with surrounding scar tissue was far less present in Silicone cuff group than in control group when observed grossly. 3. The amount of scar formation and axonal degeneration were noted reduced remarkably in Silicone cuff group than in control group after 3 weeks postoperatively. 4. The intraneural vascularity was noted reduced either in Silicone cuff group and in control group, but definitely less reduced in the former than in the latter. Clinical relevance: Above results may be taken as an experimental basis supporting clinical applicability of Silicone cuff wrapping method for neurorraphy in crushed limb.
Animals ; Axons ; Cicatrix ; Extremities ; Methods ; Neural Conduction ; Peripheral Nerves ; Rats ; Sciatic Nerve ; Silicon ; Silicones

OBJECTIVES: The symptoms of attention-deficit/hyperactivity disorder (ADHD) can be treated with methylphenidate, a potent blocker of the dopamine transporter (DAT). The homozygosity of the 10-repeat allele at dopamine transporter gene (DAT1) seems to be associated with a poor response to methylphenidate (MPH) in children with ADHD. In present study, we investigated association between DAT density using I-123N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl)tropane ([123I]IPT SPECT) and the homozygosity for 10-repeat allele at DAT1, and response to MPH in children with ADHD. METHODS: Eleven drug-naive children with ADHD were included in the study and treated with MPH for about 8 weeks. After the genotyping and SPECT were performed, we compared DAT density between ADHD children with and without the homozygosity for the 10-repeat allele at DAT1 and investigated correlation between the homozygosity for the 10-repeat allele and response to MPH. RESULTS: ADHD children with 10/10 genotype (n=7) had a significantly higher DAT density in basal ganglia than the children without 10/10 genotype (n=4)(Right: z=-2.65, p=0.008; Left: z=-2.65, p=0.008). We found that while only 28.6% (2/7) of the subject with 10/10 genotype showed good response (> or =50% improvement) to MPH treatment, 100% (4/4) of the subjects without 10/10 genotype showed good response to MPH treatment (chi2 test: F=5.238, df=1, p=0.022). CONCLUSION: Our findings support an association between homozygosity for the 10-repeat allele at DAT1 and the DAT density assessed in vivo and correlation between the homozygosity for the 10-repeat allele and poor response to MPH.
Alleles* ; Attention Deficit Disorder with Hyperactivity* ; Basal Ganglia ; Child ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Genotype ; Humans ; Methylphenidate* ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: This study was performed to know the clinical profile and effectiveness of colonoscopic polypectomy in patients with solitary juvenile polyp. METHODS: This study included 19 children, aged 1.8 to 11.4 years, who underwent colonoscopic polypectomy and histologically proven solitary juvenile polyps between March 1998 and August 2002. We analyzed their detailed history, clinical manifestations, colonoscopic examination, method of anesthesia and results of colonoscopic polypectomy. RESULTS: The mean age of the 19 cases was 4.7+/-2.8 year. The male to female ratio was 1 : 1.1.Hematochezia, the main indication of colonoscopy, was present in all cases. Combined symptoms were mucoid stool or diarrhea(42%), abdominal pain(26%), constipation(11%) and anal fissure(11%). Anemia(Hb <10 g/dL) in four cases recovered spontaneously after polypectomy. Complications associated with premedication, sedation and colonoscopy itself did not occur. Bleeding developed in two cases(11%) after polypectomy. One of them was controlled with hemoclipping. The main site of polyps was the rectosigmoid colon in 15 cases(79%). The size of the polyps ranged from 0.5 to 3.5 cm. The interval between the onset of symptoms and polypectomy was from 0.1 to 42 months. CONCLUSION: Juvenile polyps are a common cause of benign, chronic and recurrent rectal bleeding. Colonoscopic polypectomy is a simple, safe and effective therapeutic method. So earlier colonoscopy might avoid uneffective treatment and prevent untoward problems such as fear of parents and anemia.
Anemia ; Anesthesia ; Child* ; Colon ; Colonoscopy ; Female ; Hemorrhage ; Humans ; Male ; Parents ; Polyps* ; Premedication

PURPOSE: Cleidocranial dysostosis is a rare hereditary disorder affecting bones that develop by intramembranous formation. The typical features include excessive growth of transverse diameter of the skull, hypoplastic clavicles, low height and characteristic facial features. METHODS: A 28-year-old female patient visited by frontal area depression. The diagnosis was performed by computed tomographic study and radiographic imaging. The patient had widely opened anterior fontanelle, partial fused metopic suture, multiple wormian bone and supernumenary impacted teeth. Under the coronal incision, we exposed depressed frontal area and corrected with Medpor block carving. RESULTS: Postoperatively frontoparietal skull was aestheticlly improved and satisfied the patient. CONCLUSION: Authors report a case of cleiodocranial dysostosis who underwent correction of abnormal skull shape by Medpor(R) insertion.
Adult ; Clavicle ; Cleidocranial Dysplasia ; Cranial Fontanelles ; Depression ; Dysostoses ; Female ; Frontal Bone ; Humans ; Polyethylenes ; Skull ; Sutures ; Tooth, Impacted

BACKGROUND: Little is known concerning hair diameter variation within the safe donor area for hair transplantation surgery. Thicker or thinner hair may be needed, depending on the recipient area, hairline design, and the purpose of surgery. METHODS: Twenty-seven patients (7 men and 20 women; mean age, 28 years; range, 20–47 years) were included in this study. The midoccipital point was used as the reference point on the horizontal plane at the upper border of the helical rim. The target area width was 15 cm (7.5 cm to the right and left of the reference point) and the height was 8 cm (2 cm above and 6 cm below the reference point). The study area was divided horizontally into 3 5-cm sections (A, B, C) and vertically into 4 2-cm sections (1–4), creating a total of 12 zones. Ten anagen hairs were randomly obtained from each zone and their diameters were measured. RESULTS: Hair diameter in the 4 vertical sections varied significantly, gradually decreasing from sections 1 (superior) to 4 (inferior) in all 3 horizontal sections (A, B, and C). CONCLUSIONS: Our results suggest that sections 1 and 2 of the occipital safe donor area would be useful for obtaining thicker hair, such as in procedures to treat male- and female-pattern hair loss, whereas hair from zones 3 and 4 could be useful for transplantation surgery requiring thinner hair, such as eyebrows, eyelashes, and female hairline correction. Our results may be clinically valuable for planning hair transplant surgery and choosing the optimal donor region.
Eyebrows ; Eyelashes ; Female ; Hair Follicle ; Hair* ; Humans ; Male ; Tissue Donors* ; Transplant Donor Site ; Transplantation