Vnrus deformity is a common finding in patients who are candidates for toial knee replacement arthropiasty. To obtain excellent clinical results and to maintain well-aligned and stable prosthetic components in patients who have such a deformity, adequate ligament balancing as well as accurate cone.ction of bony alignment is required. But many technical problems are encountered. Especially the bony defect on the medial aspect of the tibia after adequate bone cutting and ligament imbalance with laxity in the lateral side and contracture in the medial side. Total knee replacement arthroplasty with 43 patients(56 cases) to be mcre than 10 degrees of varus of tibio-femoral angle was done by a single surgeon and reviewed retrospectively. The diagnosis was osteoarthritis in 46 cases, rheumatoid arthritis in 9 cases. The average follow up period was average 33 months(l-7 years). Preoperative varus deformity of average 13.5 degree., was corrected to valgus 6.69 degrees at last follow-up. Postoperative range of motion was 122.5 degree. And the mean knee society score improved from 24.8 to 87.2 postoperatively and the function score improved from 23.6 to 83.9 postoperatively. At self-assements, 88.2% of the patients was very satisfied or somewhat satisfied. Total knee replacement ;u1hroplasty in the patients with vaus deformity is effective procedure to corri.ct deformity and improve clini- c;1 and functional status, but long-term follow up period is required for changing alignment.
Arthritis, Rheumatoid ; Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Congenital Abnormalities* ; Contracture ; Diagnosis ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Osteoarthritis ; Range of Motion, Articular ; Retrospective Studies ; Tibia

Atrial septal defect is one of the most common congenital heart diseases in adult, of which absolute causes is not confirmed, but explained by multifactorial inheritance. In Korea, there has been no case report of atrial septal defect in identical twins in spite of some reports of atrial septal defect in relatives and twins in other countries. We present a first case of atrial septal defect in identical twins whose mother had no infection or medication history during pregnancy.
Adult ; Heart Diseases ; Heart Septal Defects, Atrial* ; Humans ; Korea ; Mothers ; Multifactorial Inheritance ; Pregnancy ; Twins ; Twins, Monozygotic*

Metacercariae of a kind of Levinseniella species were found from a brackish water crabs, Macrophthalmus japonicus de Haan, in the brackish area of Hyungsan river of Kyungpook province. Habitats were the epigastric and progastric regions of Macrophthalmus japonicus. One hundred and seventy five crabs out of 178 examined (98.3 per cent) were infested with metacercariae of Levinseniella species. The infested number of metacercariae in each crabs was average 100 ea. The excystation of metacercaria has not developed in vitro (both saline and tyrode's solution). Many eggs were observed in the metacercariae maintained for 24 or 48 hours in the water-bath. No differences were observed between semi-adult fluke from rat host and those maintained for 24 or 48 hours in vitro.
parasitology-helminth-trematode ; Levinseniella ; Macrophthalmus japonicus ; crab ; epidemiology ; tyrode's solution ; saline

OBJECTIVE: The laparoscopic appendectomy was developed as an alternative procedure to be used in acute appendicitis. Some surgeons dispute the advantages of laparoscopic procedures for acute appendicitis. Specifically, there are many controversies associated with perforated appendicitis. We reviewed the results of appendectomies to assess the feasibility of a laparoscopic appendectomy in acute appendicitis that included perforated appendicitis. METHODS: Three hundred thirty-nine consecutive patients with laparoscopic appendectomies, which include 27 patients with perforated appendicitis, were analysed. This study considered the lengths of the operation and the hospital stay. Differences in complications between non-perforated and perforated appendicitis were also evaluated. RESULTS: A total of 388 patients underwent appendectomies, 339 patients with laparoscopy and 49 patients with conventional open appendectomies, from April 1994 to June 1996. The mean duration of laparoscopic appendectomies was 48.9 minutes. This was slightly longer than that of open appendec tomies (44.9 minutes) in the same hospital. The duration of hospital stay was on the average of 4.9 days. Six patients (1.8%) were converted to conventional surgery because of difficult mobilization in 4 patients and uncontrollable bleeding in the remaining two. The surgeries on patients who were converted to conventional surgery were performed by rotating residents without staff supervision. Minor complications developed in eight patients (2.4%). In comparing the results between non-perforated and perforated appendicitis, durations of operation (47.3 vs. 78.3 minutes) and the hospital stay (4.6 vs. 8.6 days) were longer in perforated appendicitis. However, the complication rate (2.6 vs. 0%) was unexpectedly found to be lower in perforated appendicitis. CONCLUSIONS: The laparoscopic appendectomy is a safe, feasible procedure for acute appendicitis. It is an excellent procedure for perforated appendicitis and has minor complications compared to an open appendectomy with its large incision that is followed by a high rate of wound infection and/or post operative adhesion. There aree various reports on prospective randomized studies evaluating the benefits of a laparoscopic appendectomy compared to a conventional open appendectomy. The reports by laparo scopic surgeons in various centers are different with regard to operative time, postoperative recovery, morbidity, and postoperative complications. For complicated appendicitis, most surgeons are not in agree ment with the laparoscopic approach. We obtained excellent results with laparoscopic appendectomies in perforated appendicitis which included periappendiceal abscesses.
Abscess ; Appendectomy* ; Appendicitis ; Dissent and Disputes ; Hemorrhage ; Humans ; Laparoscopy ; Length of Stay ; Operative Time ; Organization and Administration ; Postoperative Complications ; Prospective Studies ; Wound Infection

Immunization is the most effective and cost-beneficial means to prevent infectious diseases. So it has been regarded as one of the most important public health interventions in many countries and taken seriously in the aspect of national security related to smallpox and avian influenza. A variety of fields including production and distribution of vaccines, quality control of immunization, immunization registry, control of adverse events following immunization, and control of vaccine-preventable diseases should be considered for making and conducting the immunization policy. Korea has a long history of immunization since smallpox vaccination had been introduced in 1882, and many immunization strategies, including measles elimination program, have been carried out successfully. But there are still some problems to be solved for improving public health through immunization. KCDC (Korea Centers for Disease Control and Prevention) is making every effort to analyze and solve the problems, especially in the area of evidence-based policy-making, improving immunization coverage by supporting cost for vaccination, promoting public trust in immunization, laying the foundation for vaccine production, and eliminating vaccine-preventable diseases through immunization.
Animals ; Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Immunization ; Influenza in Birds ; Korea ; Measles ; Public Health ; Quality Control ; Security Measures ; Smallpox ; Vaccination ; Vaccines

Immunization is the most effective and cost-beneficial means to prevent infectious diseases. So it has been regarded as one of the most important public health interventions in many countries and taken seriously in the aspect of national security related to smallpox and avian influenza. A variety of fields including production and distribution of vaccines, quality control of immunization, immunization registry, control of adverse events following immunization, and control of vaccine-preventable diseases should be considered for making and conducting the immunization policy. Korea has a long history of immunization since smallpox vaccination had been introduced in 1882, and many immunization strategies, including measles elimination program, have been carried out successfully. But there are still some problems to be solved for improving public health through immunization. KCDC (Korea Centers for Disease Control and Prevention) is making every effort to analyze and solve the problems, especially in the area of evidence-based policy-making, improving immunization coverage by supporting cost for vaccination, promoting public trust in immunization, laying the foundation for vaccine production, and eliminating vaccine-preventable diseases through immunization.
Animals ; Centers for Disease Control and Prevention (U.S.) ; Communicable Diseases ; Immunization ; Influenza in Birds ; Korea ; Measles ; Public Health ; Quality Control ; Security Measures ; Smallpox ; Vaccination ; Vaccines

Trigeminal neurinomas are relatively rare tumors that arise from the sheath of Schwann and constitute 2.9% of intracranial neurinomas and 0.26% of all brain tumors. The most cases are confined to the middle fossa and arising from the Gasserian ganglion. In slight fewer cases the tumor occupy the cerebellopontine angle. In minority it is an hourglass form both situations. By reason of their rarity, the complex clinical problems which may present and the difficult technical aspects involved in their removal, neurinomas of the Gasserian ganglion are of extreme interest. We are reporting a case of trigeminal neurinoma which was arised from the right Gasserian ganglion and located in both situations of middle and posterior cranial fossas. A 37 year-old female was admitted to our department with characteristic symptoms and signs involving many cranial nerves, cerebellum and cerebral peduncle. We chose temporal craniotomy and approached to and exposed the mass by extradural and intradural techniques. Complete removal of the tumor occupying the middle and posterior cranial fossas are accomplished satisfactorily.
Adult ; Brain Neoplasms ; Cerebellopontine Angle ; Cerebellum ; Cranial Fossa, Posterior ; Cranial Nerves ; Craniotomy ; Female ; Humans ; Neurilemmoma* ; Tegmentum Mesencephali ; Trigeminal Ganglion

PURPOSE: We performed a retrospective study to compare the accuracy between conventional CT staging and intraoperative staging for advanced gastric cancer. MATERIALS AND METHODS: Sixty patients with advanced gastric cancer were included in this study during the recent 2 year-period. All were pre- and posto- peratively diagnosed as advanced gastric cancer. CTwas performed with G E 9800 and Somatom DR3 under conventional technique in 50 and with others in 10 referred patients. The CT staging for T and N category with emphasis on incurable factor, if not resacted, were performed. And we compared the accuracy between conventional CT and intraoperative staging. The final histo-pathologic staging was used as a gold standard. RESULTS: Accuracy of CT and operation for T4(n=l7) factor is 76.9 % and 86.2 % respectively. Overestimation rate for T4 was 9.3 % by CT and 6.1% by operation, and underestimation rate for was 13.8 % and 7.7 % respectively. Accuracy of CT and operation for N (n=60) factor was 50 % and 60 % respectively. Overestimation rate for N factor was 18.3 % by CT and 18.3 % by operation, and underestimation rate for N factor was 31.7 % and 21.7 % respectively. Correct Tand IM staging was possible only in 33% by CT and 38% by intraoperative assessment. CONCLUSION: Conventional CT and intraoperative staging for incurable T/N factor in advanced gastric cancer have a potential limitations, especially for N factor. Therefore, more reliable modality or technique such as dynamic scanning by spiral CT, transabdominal or endoscopic ultrasonography should be preoperatively performed to complement infrequent errors in intraoperative staging. Furthermore, a histology-oriented surgical approach seems essential in selecting the most appropriate surgical procedure.
Complement System Proteins ; Endosonography ; Fibrinogen ; Humans ; Retrospective Studies ; Stomach Neoplasms* ; Tomography, Spiral Computed

PURPOSE: To evaluate the radiologic findings of granulomatous colitis on double contrast barium enema and changes on follow-up studies. MATERIALS AND METHODS: Serial double contrast barium enemas of six patients with granulomatous colitis confirmed by endoscopic biopsy were reviewed. We analyzed the radiologic findings and their follow-up changes, including aphthous ulcers, lymphoid hyperplasia, deep ulcers, cobble stone appearance, geographic ulcers, asymmetric involvement of ulcers, skip lesions, sinus tract, fistula formation, pseudosacculation, focal stricture, and small bowel involvement. RESULTS: Pretreatment double contrast baruim enema findings were aphthous ulcers in five patients, deep ulcer in six, cobble stone appearance in five, longitudinal geographic ulcers in two, fistulas in one, pseudo-sacculations in two, focal stricture in one, and pseudopolyps in six. Also, anal ulcers were observed in two patients, asymmetric involvement of ulcers in three, skip lesions in four, and small bowel involvement in five in five patients proved to have inactive disease after treatment, aphthous ulcers and deep ulcers disappeared. Geographic ulcers of two patients and anal ulcer of one patients decreased in size or depth. Pseudosacculation in one patient disappeared. Pseudopolyps decreased in two patients, increased in one, and decreased after increase in two. One patient whose disease remained active after treatment showed maintenance or increase of ulcers or fistula. And their pseudosacculation or focal stricture unchanged and pseudopolyps decreased. CONCLUSION: The major radiologic findings of chronic granulomatous colitis on double contrst barium enema are aphthous ulcer, deep ulcer, cobble stone appearance, discontinuity of the lesion, and coexistence of ulcers and pseudopolyps. And, double contrast barium enema is good follow-up modality because its findings correlate with clinical course of the granulomatous colitis after treatment.
Barium* ; Biopsy ; Constriction, Pathologic ; Crohn Disease* ; Enema* ; Fissure in Ano ; Fistula ; Follow-Up Studies* ; Humans ; Hyperplasia ; Stomatitis, Aphthous ; Ulcer

PURPOSE: To evaluate the radiologic findings of granulomatous colitis on double contrast barium enema and changes on follow-up studies. MATERIALS AND METHODS: Serial double contrast barium enemas of six patients with granulomatous colitis confirmed by endoscopic biopsy were reviewed. We analyzed the radiologic findings and their follow-up changes, including aphthous ulcers, lymphoid hyperplasia, deep ulcers, cobble stone appearance, geographic ulcers, asymmetric involvement of ulcers, skip lesions, sinus tract, fistula formation, pseudosacculation, focal stricture, and small bowel involvement. RESULTS: Pretreatment double contrast baruim enema findings were aphthous ulcers in five patients, deep ulcer in six, cobble stone appearance in five, longitudinal geographic ulcers in two, fistulas in one, pseudo-sacculations in two, focal stricture in one, and pseudopolyps in six. Also, anal ulcers were observed in two patients, asymmetric involvement of ulcers in three, skip lesions in four, and small bowel involvement in five in five patients proved to have inactive disease after treatment, aphthous ulcers and deep ulcers disappeared. Geographic ulcers of two patients and anal ulcer of one patients decreased in size or depth. Pseudosacculation in one patient disappeared. Pseudopolyps decreased in two patients, increased in one, and decreased after increase in two. One patient whose disease remained active after treatment showed maintenance or increase of ulcers or fistula. And their pseudosacculation or focal stricture unchanged and pseudopolyps decreased. CONCLUSION: The major radiologic findings of chronic granulomatous colitis on double contrst barium enema are aphthous ulcer, deep ulcer, cobble stone appearance, discontinuity of the lesion, and coexistence of ulcers and pseudopolyps. And, double contrast barium enema is good follow-up modality because its findings correlate with clinical course of the granulomatous colitis after treatment.
Barium* ; Biopsy ; Constriction, Pathologic ; Crohn Disease* ; Enema* ; Fissure in Ano ; Fistula ; Follow-Up Studies* ; Humans ; Hyperplasia ; Stomatitis, Aphthous ; Ulcer