It is difficult to treat the children with the growing deformity of long bone due toepiphysealloss or absence, because resulting deformith and discrepancy of limb length is progressive. There were many conventional treating methods including the lengthening and shortening, corrective osteotomy, and epiphysiodesis. But these procedures result in inadequate results, and there are limitation in treatment of these children. We tried the free vascularized epiphyseal transplantation using the proximal fibular epiphysis in 3 patients with epiphyseal injury or loss due to old tauma, wide excision of multiple exostosis and congenital clubhand. The duration of follow-up was from 20 months to 57 months, and the lengthening of the transplantedepiphyses was evaluated by the scanogram inregular interval. As final radiologic check, each transplanted epiphyseal growth was 1cm for 24months in case 1, 0.9 cm for 10 months in case 2, 1 cm for 24 months in case 3 (av. 1.3cm for 24 months) and the adjacent joint function was good. There was no gross deformity.
Child ; Congenital Abnormalities ; Epiphyses ; Exostoses, Multiple Hereditary ; Extremities ; Follow-Up Studies ; Humans ; Joints ; Osteotomy ; Transplantation

Forry-two symptomatic hands of 29 patients with carpal tunnel syndrome operated during the period from Marth 1986 to December 1993 were analized in clinical aspect. Among 29 patients, 3(10.3%) were male and 26(89.7%)were female. The syndrome occured on the right side in 10(34.5%) patients, on the left in 6(20.7%) patients, and on both in 13(44.8%) patients. The causes of the syndrome were idiopathic(90.5%), trauma(7.1%), mass(2.4%). Paresthesia(57.1%) was the most common chief complanit, followed by numbness(35.7%), pain(21.4%), weakness(9.5%). Thenar muscie atrophy occured in 84.8%, positive Tinel sign in 83.3% and positive Phalen sign in 90.0%. Delay of motor conduction velocity of median nerve was noted in all cases and delay of sensory nerve conduction velocity in all cases. Denervation finding such as fibrillation or sharp waves were seen in all cases. The carpal tunnel release was performed in all cases, and 31 cases were treated by carpal tunnel tunnel release with internal neurolysis. 35 cases(83.3%) were excellent or good results. The cases were long duration were poorer results. No significant difference was found between the results in cases treated by carpal tunnel release alone and those in cases treated by carpal tunnel release with internal neurolysis of median nerve.
Atrophy ; Bryophyta ; Carpal Tunnel Syndrome ; Denervation ; Female ; Hand ; Humans ; Male ; Median Nerve ; Neural Conduction

No abstract available.
Dyskeratosis Congenita*

The authors performed the interfascicular nerve grafting in the gap of injured nerves using the microsurgical technique to obtain the accurate coaptation of the fascicles. The authors experienced the 33 cases(26 patients) of the interfascicular nerve grafting in the median(11), ulnar(9), radial(2), common peroneal(3) and digital(8) nerves at the Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University from Jan. 1980 to June 1984. The patients were followed up from 12 to 26 months (average 20 1/2 months). The following results were obtained; 1. The shorter the length of the donor nerve and the younger the age of the patients are, the better the recovery of the nerve function is. 2. The medial and lateral cutaneous nerves of forearm as donor nerve are suitable as well as the sural and superficial radial nerves. 3. The end result of each patient was evaluated by Seddon's classification. The excellent motor recovery was 72.0% (18/25) and the excellent sensory recovery was 81.8% (27/33). 4. The interfascicular nerve grafting is an excellent method in treating the widely separated,severed peripheral nerve injury.
Classification ; Forearm ; Humans ; Methods ; Peripheral Nerve Injuries ; Peripheral Nerves ; Radial Nerve ; Tissue Donors ; Transplants

No abstract available.
Stents*

Two cases of incomplete transverse vaginal septum with a small opening in the upper third of vagina were presented. One case was a patient presenting at 31 years of age for evaluation of primary infertility and oligomenorrhea. Diagnosis was made by hysterosalpingography, tranvaginal ultrasonography, MRI, and diagnostic pelviscopy for evaluation of abnormality of endopelvic organs. The patient was treated with surgical resection of septum (simple septectomy). Examination 3 months later demonstrated narrowing of the vaginal lumen. Another case was a patient presenting intrauterine pregnancy at 8 weeks and 2 days accompanying transverse vaginal septum with small opening. She had previous septotomy history and presented postoperative scarring. She had septectomy and anastomosis of the mucosa, and presented postoperative narrowing again about a month postoperatively. In this report we describe the two cases of transverse vaginal septum. We also reviewed the literature including diagnostic and treatment guidelines. Prevention of postoperative scarring is the most important factor in management of transverse vaginal septum. For that, first of all, initial septectomy should be done with approximation of the mucosa and postoperative dilatation is necessary. Importance of the initial accurate septectomy is too important to be over-emphasized.
Cicatrix ; Constriction, Pathologic* ; Diagnosis ; Dilatation ; Female ; Humans ; Hysterosalpingography ; Infertility ; Magnetic Resonance Imaging ; Mucous Membrane ; Oligomenorrhea ; Pregnancy ; Ultrasonography ; Vagina

Subglottic stenosis is more likely to develop secondary to endotracheal intubation if one or more traumarelated risk factors are involved. Subglottic stenosis have been dealt with many medicosurgical procedures such as dilatation, stent, laryngofissure with or without skin of mucosal graff, and segmental resection. We report longterm failure of expandable metallic stent in the treatment of subglottic tracheal steno$is in 4 cases which had been presented with respiration difficulty due to framework problem of subglottic trachea after surgical operation.
Constriction, Pathologic ; Dilatation ; Intubation, Intratracheal ; Respiration ; Risk Factors ; Skin ; Stents* ; Trachea ; Tracheal Stenosis*

No abstract available.
Brain Stem* ; Hyperthyroidism* ; Spinocerebellar Degenerations*

PURPOSE: Trauma has been recognized to be accompanied by alterations of leukocyte, functions such as cytokine release. The regulatory mechanisms involved in these changes are still poorly defined. The aims of this prospective clinical study are to evaluate serum concentrations of cytokines in trauma patients with high risk of developing multiple organ failure, to investigate early change, and to examine the possible prognostic value of these elements. METHODS: Thirty-two patients with multiple traumatic injuries were studied. Patients were classified by age, sex, vector, Injury Severity Score (ISS), Triage Revised Trauma Score (T-RTS), and Systemic Inflammatory Response Syndrome (SIRS). Patients were categorized into two groups, depending on the severity of injury. Group 1 (n=21) consisted of patients with severe injuries and an ISS equal to or greater than 17 points. Group 2 (n=11) consisted of patients with minor injuries and an ISS less than 17 points. Whole blood and serum were obtained immediately after admission to the emergency department, and on days 1 and 3 after trauma. The post-traumatic serum levels of TNF-alpha, IL-4, IL-6, IL-10, and IL-12 were monitored using an enzyme-linked immunosorbent assay technique (ELISA). RESULTS: The 32 severely injured patients had a mean Injury Severity Score of 19.28+/-7.35 points. SIRS developed in 24 patients. Serum levels of IL-6, IL-10, and TNF-alpha were increased immediately and at 1 day and 3 days after the trauma, but the levels of IL-4 and IL-12 were not changed. Serum levels of IL-4, IL-6, IL-10, IL-12, and TNF-alpha were not related to the severity of the injury. However, the serum level of IL-10 was significantly increased at admission and on day 1 in patients who died (p<0.05 ). CONCLUSION: Serum IL-6, IL-10, and TNF-alpha levels were affected by injury. However, their levels did not correlate with the degree of injury. The serum level of IL-10 was significantly increased at admission and on day 1 in patients who died.
Cytokines ; Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Humans ; Injury Severity Score ; Interleukin-10 ; Interleukin-12 ; Interleukin-4* ; Interleukin-6 ; Leukocytes ; Multiple Organ Failure ; Prospective Studies ; Systemic Inflammatory Response Syndrome ; Triage ; Tumor Necrosis Factor-alpha*

No abstract available.
Animals ; Epithelium* ; Guinea Pigs* ; Guinea* ; Muscle, Smooth, Vascular* ; Rats*