Arthrography is an invaluable procedure in critically verifyging the concentricity of closed reduction and the optimum position of stability. And it is known to be the most accurate and certain way of demonstrating lesser degrees of incongruity. It can visualize the intrinsic obstructive fractors, such as capsular attachment, the labrum, the psoas tendon and its relationship to the joint, the pulvinar, ligamentum teres, the inferior transverse ligament, and the shape of the femoral head and acetabulum. We analyzed 20 cases of congenital dislocation of the hip in 17 patients, which had been evaluated by arthrography. The results are as follows: 1. We found the inferior approach very efficient among many kinds of arthrographic techniques. 2. Among 20 cases, 12 cases could be treated with closed reduction and 8 cases were treated by open reduction such as capsuloplasty, partial limbusectomy, and removal of space occupying lesion in acetabulum, including 2 cases of Salter's innominate osteotomy and 1 case of derotational osteotomy. 3. Among the intracapsular obstructive factors which played major role in hindering closed reduction, capsular constriction was shown in 8 case, inverted or hypertrophic limbus in 5 cases, and other space occupying lesions in 2 cases. 4. We performed combined operation including bone and soft tissue for severe extra- and intracapsular lesions and closed reduction for mild to moderate extra- and intracapsular lesions. 5. Arthrography of the hip joint was indispensable in evaluating the intracapsular osstructive lesions as well as detecting the subtle incongruent reduction.
Acetabulum ; Arthrography ; Constriction ; Dislocations ; Head ; Hip Joint ; Hip ; Humans ; Joints ; Ligaments ; Osteotomy ; Pulvinar ; Round Ligaments ; Tendons

Hand tumorsare many and varied, although benign tumors are common. The pathology and histology of these tumors are not unlike these characteristics of the tumor when it occurs elsewhere. Early diagnosis and proper treatment of all hand tumors have been emphasized since the growth of tumors and pain can cause disturbance of intrinsic function of the hand. For the period of 10 years from 1977 to 1986, 105 cases of hand tumor were treated surgically and the results of clinical observation were as follows ; l. Among 105 cases, benign tumor was 101 cases(96.2%) Bone origin tumor was 20 cases, in which enchondroma and enchondromatosis were 17 cases(70%). Soft tissue origin tumor was 85 cases, in which ganglion was 54 cases(63.5%). 2. Among 105 cases, 42 cases were male and 63 cases were female. In age distribution, it showed even distribution. 3. In the duration of wymptom, 51 cases were below 1 year(48.6%). 4. The tumor occured 85 cases in soft tissue, 14 in phalanx, 7 in metacarpal and 1 in carpal bone. 5. The tumors were treated by excision or curettage and bone graft with good improvement, but postoperatively recurred in 2 cases of Hemangioma. Ampuation was performed in 3 cases of malignant tumors without recurrence.
Age Distribution ; Carpal Bones ; Chondroma ; Clinical Study ; Curettage ; Early Diagnosis ; Enchondromatosis ; Female ; Ganglion Cysts ; Hand ; Hemangioma ; Humans ; Male ; Pathology ; Recurrence ; Transplants

Neurocutaneous melanosis is a very rare congenital syndrome characterized by the presence of large or multiple congenital melanocytic nevi and benign or malignant melanotic tumors of the central nervous system. We report herein a case of neurocutaneous melanosis with leptomeningeal melanosis and a malignant melanoma of the right temporal lobe in a 46-year old man. The case is exceptional as regards the late onset of symptoms and death. Even without a malignant melanoma, the symptomatic neurocutaneous melanosis has a fatal course. The syndrome is rare but lethal, so the dermatologist should be aware of this syndrome when evaluating the patients with large or numerous congenital melanocytic nevi so as to watch for the usual signs of increased intracranial pressure and to take prompt palliative measures.
Central Nervous System ; Humans ; Intracranial Pressure ; Melanoma ; Melanosis* ; Nevus, Pigmented ; Temporal Lobe

High tibial osteotomy is now an accepted procedure in the treatment of osteoarthritis of the knee. Since the effect of this procedure is to shift the line of weight bearing from one compartment of the other, the procedure is of value in knees with osteoarthritis only when there is predominant involvement of one compartment. The osteoarthritis of knee developed bilaterally in many case, so simultaneous bilateral high tibial osteotomy under one anesthetic was considered. Eight cases of osteoarthritis with genu varum deformity were treated by simultaneous bilateral high tibial osteotomy at the Department of Orthopaedic Surgery of NMC during the,period from January, 1984 to December, 1987. The results were as follows: l. All case were female, and the mean age was 56 years old. 2. Preoperative mean varus angle were 4° in right, 3.4° in left, and postoperative mean valgus angle were 8° in right, 6° in left at final follow-up. 3. The results after average 2.2 years of follow-up were as follows: good in 5 cases(63%), fair in 1 cases(12%), poor in 2 cases(25%) 4. The complications were one proximal tibial fracture, one displacement of distal fragment, and one transient peroneal nerve palsy. 5. Mean immobilization period was 7 wks and mean hospitalization period was 48 days. 6. More rigid internal fixation was recommended in simultaneous procedure to reduce the period of hospitalization and early ambulation.
Congenital Abnormalities ; Early Ambulation ; Female ; Follow-Up Studies ; Genu Varum ; Hospitalization ; Humans ; Immobilization ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Osteotomy ; Paralysis ; Peroneal Nerve ; Tibial Fractures ; Weight-Bearing

Acromioclavicular joint injuries are recently increased, but there are still controversies as to the proper choice of treatment. We treated thirty cases of acromioclavicular injuries, among these, twenty five cases were done by operative method and five cases conservatively from August 1979 to June 1988. The results were as follows, 1. The injuries were composed of one case of Type 1, 7 cases of Type 2 and 22 cases of Type 3. 2. The result of conservative treatment consisted of 2 cases of good, 1 case of fair and 2 cases of poor. 3. The final outcome of operative method was better than that of conservative one, which consisted of 16 cases of good and 9 cases of fair. 4. The cause of fair results in operative method was thought to residual lexity of the repaired coracoclavicular ligament. 5. The key point of operative treatment in acromioclavicular separation was firm and strong reconstruction of the coracoclavicular ligament. 6. Modified method of coracoclavicular ligament reconstruction using coracoacromial ligament with bone block has been tried.
Acromioclavicular Joint ; Ligaments ; Methods

No abstract available.
Pre-Eclampsia*

We report a case of neuroblastoma with multiple skin metastases as a chief complaint in a 2-month-old girl. the skin lesions were rnultiple, pea-sized, bluish, nontender, moable subcutaneous nodules on abdomen, back and scalp. Histopathology showed small round or poly gonal tumor cells which have deeply stained, basophilic, hyperchromatic nuclei with some mitoses. Th.se tumor cells showed clumping tendency which is one of early menifestations of rosette formation. Immunohistochemically positive reaction was demonstrated by anti-NSE(neuron specific enolase) antilody but negative reaction by anti-NFP (neurofilament proteiin ) antibody. She has been succesfully treated with combined chemotherapy for 10 months without relapse.
Abdomen ; Basophils ; Drug Therapy ; Female ; Humans ; Infant ; Mitosis ; Neoplasm Metastasis* ; Neuroblastoma* ; Phosphopyruvate Hydratase ; Recurrence ; Rosette Formation ; Scalp ; Skin*

PURPOSE: We designed a new osteotomy technique in order to get a consistent extension gap along with a tibial polyethelene insert in TKRA. The results were compared to the independent osteotomy technique. MATERIAL AND METHODS: Forty two patients were divided into an independent osteotomy group and a linked osteotomy group according to the technique adopted. In the linked osteotomy group, the extension gap was made by using a linker which was designed to provide a consistent gap between the distal femur and the proximal tibia during knee extension. The widths of the extension gap and the polyethylene thickness was compared between the two groups. RESULTS: The extension gap of the independent osteotomy group was 18.1 +/- 4.2 mm (2SD) and that of the linked femorotibial osteotomy group was 20.3 +/- 1.3 mm (2SD). The polyethylene thickness was 8.1 +/- 2.6 mm (2SD) in the independent group and 9.4 +/- 0.9 mm (2SD) in the linked group. CONCLUSION: This linked femorotibial osteotomy technique provided an improved method for obtaining a tibial insert matched extension gap in TKRA. This technique might also increase the longevity of the polyethylene insert.
Femur ; Humans ; Knee* ; Longevity ; Osteotomy* ; Polyethylene ; Tibia

No abstract available.
Heart Septal Defects, Atrial*

No abstract available.
Knee* ; Nevus* ; Organoids*