Congenital high scapula, more commonly referred to as Sprengel's deformity, was first described by Eulenberg in 1863. Usually other congenital anomalies are associated such as absent or fused ribs, chest wall asymmetry, Klippel-Feil syndrome, cervical ribs, congenital scoliosis, cervical spina biffida was treated with the excision of the elongated acromion and the resection of prominent elongated acromion to be described is an extremely rare malformation. We experienced one case of congenital high scapula associated with anomaly of the acromion, which was treated with the excision of the elongated acromion and the resection of prominent supermedial border of the scapula for the purpose of the cosmetic and functional correction. After 1 year follow up, abduction was improved by only 10 degrees in the glenohumeral joint with the definite cosmetic improvement.
Acromion ; Cervical Rib ; Congenital Abnormalities ; Follow-Up Studies ; Klippel-Feil Syndrome ; Ribs ; Scapula ; Scoliosis ; Shoulder Joint ; Thoracic Wall

The juvenile Tillaux fracture and the triplane fracture of the distal end of the tibia in adolescents are considered uncommon injuries and the mechanism of both injuries has been uncertain. It has been postulated that both fractures probably are caused by external rotation of the foot. We atempted to evaluate the mechanism of injury as well as to conform the role of the external rotation of the foot for the juvenile Tillaux fracture and triplane fracture. From 1983 to 1988 at the department of orthopedic surgery, college of medicine, Hallym University, we evaluated the cases of nine adolescent patients with the juvenile Tillaux fracture and nine patients with the triplane fracture of the distal tibial epiphysis. We confirmed that external rotation force produced the triplane fracture as well as juvenile Tillaux fracture. And we could postulate that the triplane fracture needed further external rotation force, less closure of the distal tibial epiphysis, and more complicated mechanism of injury than the juvenile Tillaux fracture. The knowledge of these mechanism of injury enables us to use a rational manipulative approach to reduce these fractures.
Adolescent ; Clinical Study ; Epiphyses ; Foot ; Humans ; Orthopedics ; Tibia

The authors present a case of spontaneous discitis in a 1-year-old female who presented with fever and limping gait. The erythrocyte sediment rate was increased. The roentgenograms revealed normal appearnce, and radioactive bne scan showed increased uptake at the affected level. Discitis should be considered in any child with limping gait or leg pain, refusal to walk, or abdominal pain. Early recognition may avoid unnecessary diagnotic and treatment procedures.
Abdominal Pain ; Child* ; Discitis* ; Disulfiram ; Erythrocytes ; Female ; Fever ; Gait ; Humans ; Leg

A 74-year-old man presented with recurrent vomiting and aspiration pneumonia in the left lower lobe. He entered the intensive care unit to manage the pneumonia and septic shock. Although a percutaneous endoscopic gastrostomy tube was implanted for recurrent vomiting, vomiting and aspiration recurred frequently during admission. Subsequently, he complained of neck pain when in an upright position. A videofluoroscopic swallowing study showed compression of the esophagus by cervical osteophytes and tracheal aspiration caused by an abnormality at the laryngeal inlet. Cervical spine X-rays and computed tomography showed anterior cervical osteophytes at the C3-6 levels. Surgical decompression was scheduled, but was cancelled due to his frailty. Unfortunately, further recurrent vomiting and aspiration resulted in respiratory arrest leading to hypoxic brain damage and death. Physicians should consider cervical spine disease, such as diffuse skeletal hyperostosis as an uncommon cause of recurrent aspiration pneumonia.
Aged ; Bays ; Decompression, Surgical ; Deglutition ; Esophagus ; Gastrostomy ; Humans ; Hyperostosis ; Hypoxia, Brain ; Intensive Care Units ; Neck Pain ; Osteophyte* ; Pneumonia ; Pneumonia, Aspiration* ; Shock, Septic ; Spine ; Vomiting

Breast feeding is one of many factors that have been associated with the development of lower respiratory tract illnesses. To assess the relation between breast feeding and subsequent experience of lower respiratory tract illness, we performed this study, retrospectively, on 366 infants who had been admitted to the pediatric ward, St. Francisco General Hospital, or had been brought to the well baby clinic from November, 1992 to March, 1993. The results were as foolows: 1) Among 366 infants, the number of all first illnesses observed at each interval were 259 cases (70.8%), of which 198 (54.1%) were associated with wheezing illnesses and 61 (16.7%) with non-wheezing lower respiratory illnesses. 2) Duration of breast feeding regardless of-whether other foods were given, was categorized as 3 grups, i. e., none or for less than a month (group), one to 4 months (group B), and 4 or more months (group C). Incidences of wheezing illnesses in the first 4 months of life were lower in group B(10.1%) and group C (8.4%) than group A (27.3%), respectively (p<0.01). Wheezing illnesses beyond 4 months of life and non-wheezing illnesses in all intervals seemed to be unrelated to the duration of breast feeding. 3) Considering a variety of other fisk factors, including sharing a room, parental childhood reapiratory trouble, sex and maternal education, children who received minimal breast feeding (group A) had the greater risk of early wheezing illnesses in the simultaneous exposure to sharing a room than group B and C (p<0.005). Our results suggest that decreased breast feeding is associated with a higher incidence of wheezing illnesses in the first 4 months of life, particularly in combination with other risk factors, such as sharing a room.
Breast Feeding* ; Breast* ; Child ; Education ; Hospitals, General ; Humans ; Incidence ; Infant ; Parents ; Respiratory Sounds ; Respiratory System* ; Retrospective Studies ; Risk Factors

BACKGROUND AND PURPOSE: This study was undertaken to compare the sensitivity of the Repetitive Nerve Stimulation Test (RNST) between the upper and lower extremity muscles in myasthenia gravis(MG) patients. MATERIALS AND METHODS: The study population consisted of 20 normal persons(control group) and 10 MG patients(MG group). Using Stalberg's method. RNST was systemically performed in orbicularis oculi muscle. upper extremity muscles(flexor carpi ulnaris. abductor digiti quinti), and lower extremity muscles(tibialis anterior. extensor digitorum brevis. vastus medialis). RESULTS: There were statistical differences of decremental response(mean+/-SD) in orbicularis oculi and upper extremity muscles between the control and MG groups(p<0.05 or p<0.01). However, there was no statistical difference of decremental response(mean+/-SD) to RNST in lower extremity muscles between the control and MG groups. There were highersensitivity in orbicularis oculi and upper extremity muscles than lower extremity muscles. Although positive reponse were detected in the lower extremity muscles, the positive response rates of lower extremity muscles were lower than o.oculi and upper extremity muscles. CONCLUSIONS: When the response rates of RNST in facial and upper extremity muscles are normal, may not be required RNST in lower extremity muscles.
Humans ; Lower Extremity* ; Muscles* ; Myasthenia Gravis* ; Upper Extremity

No abstract available.
Animals ; Interleukin-4* ; Mice*

No abstract available.
Colorectal Neoplasms* ; Neoplasm Metastasis*

No abstract available.
Joints* ; Range of Motion, Articular* ; Spine*

The aim of present study was to determine the efficacy of immunotherapy with paternal lymphocytes for unexplained infertility. It has been apparent that reproductive success may be affected by the presence of abnormal autoantibodies. Unexplained infertility and repeated pregnancy wastage has been reported in the presence of abnormal autoantibodies. These data suffest that abnormal immune function may be an important pathologic entity contributing subfertility in patients with unexplained infertility. Therefore, immunotherapy may be a possible treatment modality for patients with unexplained infertility. Some investigators have reported that a proportion of infertile couples with repeatedly unsuccessful ET showed close histocompatibility similar to those of spontaneous recurrent abortion. Recently, it has been noted that immunotherapy with paternal lymphocytes achieves a high efficacy in preventing subsequent abortion in women with primary recurrent abortion of unknown cause, which was mediated by immune reaction including blocking antibody. To substantiate the hypothesis, we applied immunotherapy preceding Peritoneal Oocyte and Sperme transfer (POST) to 43 patients, 47 cycles of 82 patients, 89 cycles with at least three previous IUI failure from April, 1993 to February, 1995. There were no significant differences between treatment and control group in clinical response and hormonal response to controlled hyperstimulation. there was no significant difference between treatment and control group in pregnant rates per cycles (42.6% versus 28.6%), but a significantly lower abortion rate per pregnancy in treatment group, with 10.0% (2/20) compared with 50.03% (6/12) in control group. This study may suggest that immune therapy for patients with unexplained infertility with paternal lymphocytes might be beneficial.
Abortion, Habitual ; Abortion, Induced ; Autoantibodies ; Family Characteristics ; Female ; Histocompatibility ; Humans ; Immunotherapy* ; Infertility* ; Lymphocytes* ; Oocytes ; Pregnancy ; Research Personnel ; Spermatozoa