In 1961, Salter had devised the innominate osteotomy in treating C.D.H, which has been one of the most popular methods in these days. 14 hips with 12 patients who have been admitted and received Salters innominate osteotomy in the department of orthopaedic surgery, National Medical Center, from Feb. 1974 to Dec. 1976, were evaluated as for the results. Clinical analysis and follow-up study were carried out in 14 hips with C.D.H. and the following results were obtained. The mean age of the cases was 34 months, and sex preponderance of female to male was 11: 1. The ratio of left to right was not significantly different. 2 cases of complication out of 12 cases was found; redislocation and subluxaiton respectively. The age of first detection of C.D.H., was surprisingly late around 18 months old. In addition, approximately 12 months has elapsed between the first detection of C.D.H. and the first consultation to doctor. Assesment of the result was carried out by Severine and Macays method respectively; Radiological evaluation was as followings: (Severine) Excellent: 4, Good: 8, Fair: 1, Poor: 1. Clineal evaluation was as followings: (Macay) Excellent: 4, Good: 7, Fair: 1, Poor; 1, Failure: 1.
Equidae ; Female ; Follow-Up Studies ; Hip ; Humans ; Male ; Methods ; Osteotomy

Widespread neurological disorders following herpes zoster are rare. These include radiculopathy, myelitis, contralateral hemiparesis, encephalitis and postherpetic neuralgia. Herpes zoster can be easily diagnosed by the a ppearance of the vesicular eruption following a dermatomal distribution, and the associated radiculopathy can be confirmed electromyography. We present clinical symptoms, sings and electrodiagnostic findings of two cases of radiculopathy related to herpes zoster infection.
Electromyography ; Encephalitis ; Herpes Zoster* ; Herpesvirus 3, Human* ; Myelitis ; Nervous System Diseases ; Neuralgia, Postherpetic ; Paresis ; Radiculopathy*

OBJECTIVE: To explore the effects of different recording electrodes on motor nerve conduction latencies. METHOD: Median motor conduction study was performed in 10 healthy subjects. Motor conduction latency was determined by placing different recording electrodes (surface disc, monopolar needle and concentric needle) at the motor point of the left abductor pollicis brevis muscle, and reference electrodes on the proximal interphalangeal joint of the thumb. Motor nerve conduction recording was performed by using a surface disc, monopolar needle, and concentric needle. For the intramuscular recordings, needles were inserted both superficially and deep. The stimulus electrodes were secured 8 cm proximal to the recording electrodes, and the same intensity was applied throughout the tests. RESULTS: Deep intramuscular monopolar and concentric needle electrodes recorded the shorter latencies, 3.0+/-0.4 ms and 3.0+/-0.3 ms, respectively. Superficial concentric needle electrode recorded the longest latency of 3.4+/-0.3 ms. Motor nerve conduction latencies using a surface disc and superficial monopolar electrode were 3.2+/-0.3 ms and 3.2+/-0.3 ms, respectively. CONCLUSION: We conclude that the distal motor nerve conduction latency is variable depending on the type of recording electrodes.
Electrodes* ; Joints ; Needles ; Neural Conduction* ; Thumb

OBJECTIVE: We tried to make real time observation of the ulnar nerve with elbows in an extended and flexed state at 100 degrees. METHOD: We examined 58 elbows of 29 healthy volunteers. The participants were symptomless and showed normal conduction across the elbow. The transducer was applied between the line connecting medial epicondyle and olecranon. We measured the distances between the center of nerve, medial epicondyle, olecranon, skin, and investigated the flattening ratio with elbows extended. Afterwards, we repeated the measurement with the elbows flexed at 100 degrees. We classified the position of the nerves into three groups according to the flexed position. We used the Okamoto classification. RESULTS: The distance between nerve and skin, between nerve and medial epicondyle was 0.57+/-0.11 cm, 0.83+/-0.15 cm, with the elbow extended. But with the elbow flexed, the distance decreased to a value of 0.45+/-0.11 cm, 0.64+/-0.25 cm, respectively. The flattening ratio was 0.52+/-0.13 at extension, and 0.31+/-0.11 at flexion. Subluxation and dislocation of the ulnar nerve were seen in 20.7% and 5.2% respectively. With the elbow flexed, the ulnar nerve moved anteromedially and superficially in the dislocated group. CONCLUSION: With the elbow flexed, the ulnar nerve moves superficially and medially, and the flattening ratio is greater when the elbow is extended.
Classification ; Dislocations ; Elbow Joint* ; Elbow* ; Healthy Volunteers ; Olecranon Process ; Skin ; Transducers ; Ulnar Nerve* ; Ultrasonography

OBJECTIVE: To investigate the patterns of the temperature effect on motor nerve conduction parameters according to various warming methods and to obtain the most valuable method of warming in clinical setting. METHOD: Twenty normal subjects were studied. After limb cooling in cold water, the cooled hands were warmed by hot pack, fan heater, and whirl pool. The median motor responses were recorded at abdnctor pollicis brevis after the stimulation at the wrist during warming at 1 min interval until the temperature increment reached plateau. We measured the temperature changes and conduction parameters were measured at each examination. RESULTS: The time constants for temperature increment and distal motor latency, duration, area of compound muscle action potentials showed shorter tendency by hot pack and whirl pool than by fan heater (p<0.05). For the measurement of distal motor latency, time constant of whirl pool (2.49 1.21 min) was shorter than that of fan heater (7.12 3.12 min) or hot pack (5.96 1.98 min) (p<0.05). CONCLUSION: These findings suggest that the use of whirl pool is the most effective method for warming of the cooled limb.
Action Potentials ; Extremities ; Hand ; Neural Conduction* ; Water ; Wrist

OBJECTIVE: Traumatic brain injury is related to the acute stress response, and this can be accompanied by an elevated serum glucose level. So we estimated the influence of hyperglycemia on neurologic, functional status and outcome. METHOD: We studied the 139 traumatic brain injured patients who had been admitted to the department of neurosurgery from 1996 to 2000, retrospectively. We reviewed initial serum glucose level, postoperative glucose level, and Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS). We compared these values with functional independence measure (FIM) scores. Patients were divided into two groups according to the initial serum glucose level, then we analyzed the correlation between glucose level and GCS, GOS, FIM. RESULTS: The correlations of early hyperglycemia with GCS, GOS, initial FIM scores were significant (p<0.01). But serum glucose levels were not correlated with plateau FIM scores (p>0.05). Patients with unfavorable neurologic outcome after 10 days from head injury had significantly high serum initial and postoperative glucose levels than those with favorable neurologic outcome (p<0.01). CONCLUSION: In patients who had received rehabilitation therapy with moderate or severe head injury, early hyperglycemia were significantly correlated with initial FIM scores, GCS, GOS, but not with the plateau FIM scores.
Blood Glucose ; Brain ; Brain Injuries* ; Craniocerebral Trauma ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Glucose ; Humans ; Hyperglycemia* ; Neurosurgery ; Rehabilitation ; Retrospective Studies

Aspergillosis of the spine has been reported infrequently. It has usually been attributed to hematogenous infection, spread from an adjacent pulmonary infection. Acute paraplegia developed in a 68 year old man with aspergillus infection. Histopathologic findings showed aspergillus hyphae and magnetic resonance imaging study revealed mid thoracic cord compression. Direct extension of aspergillus infection caused an epidural abscess, vertebral destruction, thoracic spinal cord compression, and paraplegia.
Aged ; Aspergillosis* ; Aspergillus ; Epidural Abscess ; Humans ; Hyphae ; Magnetic Resonance Imaging ; Paraplegia* ; Spinal Cord Compression ; Spine*

OBJECTIVE: To analyze the degree of injury and patterns of recovery according to the severity and degree of ischemia-reperfusion. METHOD: Fifty-three rats were divided into 2 groups by degree of ischemia using ultrasonography. Each group was subdivided into 1 and 3-hours ischemia groups. Baseline recordings were performed, and ligation of the femoral vessels were done. Reperfusion process was done. Nerve conduction study (NCS), Sciatic Function Index (SFI) and histologic study were used. RESULTS: NCS parameters of the less than 3 hours incomplete insult group showed normal value. More than 1 hour of complete insult induced peripheral nerve injury. On first day and week, amplitude of NCS was small in 3-hour group. Muscle fiber diameter was less in 3-hour group. Although NCS parameters did not reach normal values on 4th week, 3-hour group showed smaller amplitudes. SFI returned to normal level at 4th week. Reperfusion injury was observed by electromyography. CONCLUSION: Less than 3 hours of partial ischemia/ reperfusion did not result in any form of injury whereas more than 1 hour of complete insult resulted in peripheral nerve injury with greater injury seen in 3 hour insult group. Neurological recovery was not achieved at 4 th week, and the more severe the ischemia, the poorer was the recovery.
Animals ; Electromyography ; Ischemia ; Ligation ; Neural Conduction ; Peripheral Nerve Injuries ; Rats* ; Reference Values ; Reperfusion ; Reperfusion Injury ; Ultrasonography

In man the epiglottis is a thin lamella of yellow elastic cartilage. The upper part is free and is known asleaf and lower part participates in the formation of the anterior wall of the vestibule of the larynx. Theipithelial covering extends forwards onto the base of the tongue over the medial glossoepiglottic folds. The sidesof epiglottis are connected with the cartilages of Wrisberg and arytenoid cartilage by the aryepiglottic fold. Inview of these anatomical complexities, the function and physiology of the epiglottis have been debated sinceMagendi(1815), who proposed the theory that the epiglottis acts as a flap valve to prevent food entering thewindpipe, and who found that he could remove the free part of the epiglottis in dog without spoiling the dog.Follwoing the introduction of laryngoscopy(Garcia, 1815; Liston, 1840; Czermark, 1861) and modern cineradiographicequipments in 1950's, the anatomy and physiology of epiglottis has become much clearrer. Age as it is seen on thelateral x-ray of the neck. In the present study we have made an attempt to systematically analyze aging changes ofthe epiglottis in the lateral x-ray of the neck in 245 healthy adults. The age ranged from 16 to 65 years old.Based on our observation the epiglottis was classified into type A, B, and C according to their curvatures. Thus,type A represented those with posterior curvature, type B those with straight epiglottis and type C anteriorcurvature. Type C was sudivided into I, II and III according to the degree of curvature. Thus, type C-I, C-II andC-III represented mild, moderated and marked anterior curvature, respectively. Type A epiglottis was found in thesecond, third and fourth decades and type C-III in the older age group. Type A was least comon and type C mostprevalent. It seems that the epiglottis inclines anteriorly with backward curvature with age (p<0.0001).
Adult ; Aging ; Animals ; Arytenoid Cartilage ; Cartilage ; Dogs ; Elastic Cartilage ; Epiglottis ; Humans ; Larynx ; Neck ; Physiology ; Tongue

OBJECTIVE: Study was designed preliminarily to observe the accordance of caregivers strain and depression with other factors such as sex of the patient, caregiver, lesion side, Mini Mental Status Examination (MMSE) score and Beck's Depression Index (BDI). METHOD: We composed a questionnaire with BDI, and the Sense of Competence Questionnaire (SCQ) in order to evaluate the amount of stress and depression of caregivers. Evaluation of the patient was done by interviewing them along with reviewing their medical records and obtaining scores such as the MMSE, Functional Inependence Index (FIM) and the Geriatric Depression Scale (GDS). RESULTS: BDI of the caregivers showed a negative correlation with the patients' age. Lesion side nor age, nor the prevalence of hemiplegia of patients did not show statistical relevance with the strain that the caregiver felt. The first subscale of SCQ showed a positive correlation with the caregiving time that the caregiver gave. In accordance to the sex of the caregiver, females showed to spend more time with the patient, showed to be more unsatisfied with the patient but showed a tendency of lesser SCQ score. CONCLUSION: Depression, strain and burden that the caregivers went through showed to have slight correlation with the patient and caregiver factors.
Caregivers* ; Depression* ; Female ; Hemiplegia ; Humans ; Medical Records ; Mental Competency ; Prevalence ; Surveys and Questionnaires