No abstract available.
Humans ; Liver Cirrhosis, Biliary* ; Male*

Long segmental fixation with TSRH posterior instrumentation for 19 patients who had unstable thoracolumbar fracture was performed between October 1992 and April 1995. The patients were followed for an average of 22 months. Measurements of the deformity angle, kyphosis, vertebral height, and the intervertebral angle were made. The patients were divided into 2 groups according to configurations of instruments for lower segmental fixation. For one group, only hooks were used, and for the others group pedicular screws and lateral offset hooks were used together at the same segment. Therefore, the purpose of this study is to anlyze the correctability following long segmental fixation and to compare one segmental fixation using both screws and lateral offset hook systems with two segmental fixation using hook systems for distal fixation. There was an overall correction of kyphosis at follow-up of 6.9degrees (27.1%) after a loss of 4.3degrees from operative correction. Overall correction of deformity angle was 8.2degrees (32.2%). Loss of vertebral height at final follow-up was 4.4%. And loss of intervertebral angle was 2.0degrees at follow-up. There was no difference of overall results between the hook group and the pedicular screw with lateral offset hook group. However, there was a significant improvement of the correction of kyphosis and restoration of vertebral height in patients who underwent operation within 7 days after injury, as compared to delayed operation. Therefore, the timing of surgery is the most important factor in order to correct the deformity caused by unstable thoracolumbar fractures. There was no significant loss of correction and no metallic failure. Therefore, rodding long with the method of one segment distal fixation using screws and lateral offset hook together can provide excellent correctability, maintenance of correction, preservation of distal lumbar joints, prevention of implant failure and complication.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints ; Kyphosis

Ultrasongraphy is a safe, noninvasive examination which should be the first procedure in the workup of apatient with a definite or suspected pelvic masses. The diagnostic schemes were derived from correlating the sonographic features with histomorphology in 230 surgically proven pelvic masses. Besides separating pelvic masses into the conventional categories of cystic, complex and solid, grayscale sonographic features of a pelvic mass canbe used to subcategorized these masses into a more useful differential diagnosis. The results are as follows; 1.The most characteristic finding of uterine myoma was midly to mederately echogenic uterine enlargement (90.7%)with a lobulated uterine margin (62.8%), and often less echogenic than the normal uterine echoes. 2. The typical ultrasonographic finding of H-mole was uterine enlargement with multiple small vesicular patterns of intrauterincontents(93%). 3. The most frequent finding of cystic teratoma was cystic mass with echogenic foci(48%), but the echogenic appearance of the lesions was extremely variable. 4. The ultrasonographic findings of ectopic pregnancywere adnexal mass(comlex or cystic), decidual proliferation of the uterus, enlargement of uterine size, fluid incul-de-sac, deveiation of uterus by adnexal mass, and psuedointrauterine appearance. 5. Ultrasound provided information leading to the correct diagnosis in 57% of cases, contributory data in 21.3%, and non-specific information in 10.4%. Errors occured in 3.9% and false-negative in 7.4%.
Diagnosis ; Diagnosis, Differential ; Leiomyoma ; Teratoma ; Ultrasonography ; Uterus

We examined a male infant with transient increase in alkaline phosphatase(ALP) activity. The 25-month-old infant was admitted to a local hospital because of pneumonia of unknown etiology. Initial laboratory investigation revealed a serum ALP of 11,260U/L, which was comparable to that of bone isoenzyme on the electrophoresis pattern, There was no evidence of hepatitis, skeletal or intestinal diseases. The hyperphosphatasemia disappeared 3 months later. We report a case of transient hyperphosphatasemia diagnosed inci- dentally in the course of management of pneumonia. (J Korean Pediatr Soc 2000;43:856-860)
Alkaline Phosphatase ; Child, Preschool ; Electrophoresis ; Hepatitis ; Humans ; Infant ; Intestinal Diseases ; Male ; Pneumonia

Chronic intestional pseudoobstruction syndrome is a rare clinical condition in which impaired intestinal peristalsis. Causes recurrent symptoms of bowel obstruction in the absence of a mechanical occlusion. This syndrome may involve variable segments of small or large bowel. And may be associated with urinary bladder retention. This study included 6 children(3 boys and 3 girls) of chronic intestinal obstruction. Four were symptomatic at birth and two were of the ages of one month and one year. All had abdominal distention and defication difficulty. Five had urinary bladder distention. Despite parenteral nutrition and surgical intervention(ileostomy or colostomy), bowel obstruction persisted and four patients expired from sepsis within one year. All had gaseous distention of small and large bowel on abdominal films. In small bowel series. Consistent findings were variable degree of dilatation. Decreased peristalsis(prolonged transit time) and microcolon or microrectum. This disease entity must be differentiated from congenital megacolon, ileal atresia and megacystis syndrome.
Dilatation ; Hirschsprung Disease ; Humans ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Parenteral Nutrition ; Parturition ; Peristalsis ; Sepsis ; Urinary Bladder

No abstract available.
Humans ; Male*

The patellar tendon is known as the strongest material for the substitution of anterior cruciate ligament. There are many technical difficulties in reconstruction of the ligament with this tendon since patellar aponeurosis is weak, and the length of the tendon is restricted, and the adquate insertion in proper place is difficult. Authors harvested the middle 1/3 of patellar tendon c bone block of tibial tubercle and patella with the superficial layer of the quadriceps tendon left attached. The large triangular tibial tubercle piece was impacted into the femoral tunnel from distally to proximally, of which the orifice is the very place of the middle of the original anterior cruciate ligament. Two bundles of 0-dexon sutures made at the tibial tubercle portion, were pulled through to different outlet of femoral condyle during this procedure and were tied over the cortical bone of lateral supracondylar region. The tendon twisted 180°(clockwise for the right knee and counter-clockwise for the left knee) to adapt to screwhome movement. The patellar piece was fixed at the isometric point in full flexion and extension, which is usually the middle point of original tibial insertion c one or two barbed staples made at the original position of tibial insertion of the ligament. We tried this methods in 26 knees (12 vascularized grafts and 14 free grafts) and was followed for more than one year and the results was compared with those of 12 knees of original McIntosh operation (follow up period: 16-72 months, average 34.3 months). The instability were evaluated c Lachman test and OSI sagittal knee tester. The knee of negative Lachman test & pivot shift test was defined as "normal" The results were as follows;l. In modified McIntosh operation group negative Lachman test was noted only in 6 knees (50.0 % ) and there were 2 knees (16.7% ) of GI, II & III, respectively. 2. In vascularized bone block patellar tendon graft group II out of 12 knees (91.7%) showed negative Lachman test and only one knee (8.3%) revealed G II. 3. In free bone block patellar tendon graft 13 out of 14 knees (92.9%) showed negative Lachman test and the other one knee (7.1%) revealed GI. 4, The overall success rate (normal) of bone block patellar tendon graft was 92.3%. The success rate of patellar tendon bone block operation was significantly higher than that of modified McIntosh operation (χ²=6.48, df=1, P=0.0109) and there was no statististical difference between vascularized and free graft group (χ²=0.39, df=l, P=0.5322).
Anterior Cruciate Ligament ; Knee ; Ligaments ; Patella ; Patellar Ligament ; Sutures ; Tendons ; Transplants

1. Fifty one cases of fractures of the shaft of the femur in children, treated at Seoul National University Hospital during the seven years, from August 1962 to July 1969, were analyzed. 2. In thirty eight of the cases fracture involved the middle third of the shaft, in eleven the upper third, and in two the lower third. 3. Bryant traction was employed in fifteen of the cases ranging from four months to six years of age. One case, five years old, was complicated by Volkmanns ischemic contracture on both legs. 4. Russell traction was employed in eleven of the cases ranging from six to fourteen years of age. Angulation and distraction must be watched especially in the younger age group, although we encountered no serious complications which required subsequent treatment. 5. Hoke traction was employed in twelve of the cases ranging from six to eleven years of age. Although this form of treatment is not particularly popular, we are of the opinion that it is the treatment of choice over two years of age and,under six years of age and that between six and twelve years of age it may be optionally employed along with Russell traction. We found it. particularly useful and convenient in selected cases in which Russell traction could not be effectively employed. 6. In some of the complicated cases, open reduction and internal fixation, closed reduction with pin and plaster immobilization, or skeletal traction was employed.
Child ; Femur ; Humans ; Immobilization ; Ischemic Contracture ; Leg ; Seoul ; Traction

Between January 1994 and February 1996 lumbar fusion was carried out in eight patients who had degenerative lumbar disease by a technique of translaminar facet screw fixation. The goal of instrumentation is to confer immediate stability to unstable segments and lower the pseudarthrosis rate. However, transpedicular systems can carry a risk of neural damage and require a high standard surgical skills. Therefore, the purpose of this study was to determine the efficacy and safety, and to introduce the simple fusion technique. We usually used this technique for the patients who had been planned single level fusion without definite preoperative instability. Preoperative diagnosis were isthmic spondylolisthesis in one, spinal stenosis in three and laterally herniated lumbar discs in four in which postoperative instability was expected without performing fusion. A single-level fusion was perfomed in all patients. Fusion levels were L2-3 in two, L3-4 in one, L4-5 in four and L5-Sl in one. The average follow-up period was 20 months, ranging from 12 to 36 months. Overall clinical satisfaction including excellent and good result was obtained in all cases. The fusion rate was evaluated radiographically and all were solidly fused. The time to fusion ranged from 3 to 10 months at an average of 5.4 months. There were no significant complications including nerve root injury, and screw loosening or breakage. Although this study was retrospective and the number of cases were small, translaminar facet screw fixation for degenerative lumbar disease is simple and readily available, and provides sufficient rigid stabilization.
Diagnosis ; Follow-Up Studies ; Humans ; Pseudarthrosis ; Retrospective Studies ; Spinal Stenosis ; Spine* ; Spondylolisthesis

Cavernous lymphangioma in mediastinum is a rare congenital malformation of lymphatic system and is caused by lack of adequate drainage from the sequestrated lymphatic vessels to the venous system due to insufficiency or atresia of the efferent lymphatic channels The authors experienced 10 month-old male patient with cavernous lymphangioma in mediastinum documented by chest CT and open biopsy The review of the literature was made briefly.
Biopsy ; Drainage ; Humans ; Infant ; Lymphangioma* ; Lymphatic System ; Lymphatic Vessels ; Male ; Mediastinum* ; Tomography, X-Ray Computed