The authors observed clinically typical case of unilateral coloboma of the optic disc. This patient, 5 years old Korean boy, visited to our clinic with the chief complaints of visual disturbance and intermittant exotropia of left defecting eye. The optic disc was enlarged about 2.5 times of normal optic disc diameter excavated about 7.0 Diopters in depth. The vision of colombomatous left eye was 20/50(n.c.) but the cause of defective vision was not evaluated certainely whether it might be due to coloboma itself or slight posterior subcapsular opacity of the lens.
Child, Preschool ; Coloboma* ; Exotropia ; Humans ; Male ; Optic Nerve*

10 cases of tuberculosis of the greater trochanter of the femur were treated at the Department of Orthopedic Surgery, Seoul National University Hospital from Jan. 1964 to Jun. 1971 with following results; 1) Duration of onset was more than 2 years in 7 cases and tuberculous foci of other organ were noted in 4 cases. 2) Bony destruction on the greater trochanter was observed in all cases and marked synovial thickening was combined in 4 cases. 3) Radical curettage or resection of bony focus of the greater trochanter were carried out in all cases with excellent result except 1 case in which reoperation was necessary 4 years later.
Curettage ; Femur ; Orthopedics ; Reoperation ; Seoul ; Tuberculosis

One case of bilateral congenital vertical talus was experienced, which was combined with multiple congenital anomalies on the elbows and hands. Open reduction and internal fixation was carried out in talonavicular and talocalcaeeal joints anatomically with satisfactory result.
Elbow ; Hand ; Joints ; Talus

The author analyzed 158 cases of intracranial aneurysm surgically treated in the Department of Neurosurgery, Yonsei University Medical College, from Jan. 1965 to Sept. 1976. Of the 158 cases 124 underwent direct intracranial approach (clipping, ligature, coating, wrapping, proximal vessel occlusion, and trapping) for the treatment of the aneurysms, and 33 cases underwent proximal carotid ligation in the neck as the choice of treatment. The aneurysms arising in the posterior communicating artery (46) are most common, followed by anterior communicating artery (43), middle cerebral artery M2 portion (22), and carotid bifurcation (12) in order. We also found cavernous aneurysm (2), ophthalmic artery aneurysms (3), anterior choroidal artery aneurysm (2), anterior cerebral artery A1 portion aneurysm (6), distal anterior cerebral artery aneurysm (2), middle cerebral artery M1 portion aneurysm (8), m3 portion aneurysm (2), posterior cerebral artery aneurysm (1) and basilar artery aneurysm (1). Multiple aneurysms were found in 8 cases. There was no significant difference according to sex. There were 18 cases over 60 years of age, of whom 2 were 75 years old. On this basis, we cannot consider ligation was 18.2%. If patients who were operated on in emergency because of large intracranial hematoma of repeated, or chain rupture of aneurysm are excluded, the mortality rate for purely elective cases using the intracranial approach drops to 4.3%. After introduction of the surgical microscope and newly designed temporary clipping system, 37 patients were operated on with only one death (2.7%), a patient who had repeated ruptures of the posterior communicating artery aneurysm and was operative on only 7 days after the last bleeding. So recently we have not had to pay much attention to the mortality rate of the intracranial attack for the aneurysms. There are instances when imperfection which cannot be seen by the naked eye are noticed only after the aneurysmal neck is magnified from 6 to 40 times with use of microscope. In these cases, it is obvious that correction of clipping as well as coating, which prevents rupture of the aneurysmal sac and reinforces or prevents slipping of the clip are inevitable. Various factors, such as grade of the patient's condition vasospasm, cerebral edema, presence of intracranial hematoma, state of intracranial pressure, preoperative management, timing of surgery, points of operative technique according to the sites of aneurysms, postoperative complications and their management, all of which affect the clinical and postoperative course, are discussed.
Aged ; Aneurysm ; Anterior Cerebral Artery ; Arteries ; Choroid ; Edema ; Emergencies ; Hematoma ; Hemorrhage ; Humans ; Intracranial Aneurysm* ; Intracranial Pressure ; Ligation ; Middle Cerebral Artery ; Mortality ; Neck ; Neurosurgery ; Ophthalmic Artery ; Postoperative Complications ; Rupture ; Vasospasm, Intracranial

PURPOSE: Crouch gait is one of the common pathologic gaits in children with cerebral palsy. Hamstring lengthening for alleviation of knee flexion is often considered as a first choice for the treatment of crouch gait. However, there have been a variety of reports about the lengths of the hamstring muscle. The purpose of this study was to classify the crouch gait on the transverse plane and to suggest a guide line for hamstring lengthening by analyzing the length of these muscles. MATERIALS AND METHODS: The subjects for this study were selected in ambulatory spastic diplegia patients with crouch gait. A total of sixty-two patients (124 cases) were included. The gait parameters and the muscle lengths were compared. The range of +/-1 standard deviation of the normal middle stance hip rotation was considered as the normal range. The subjects were divided into three groups as hip external rotated (group I), normal (group II) and hip internal rotated (group III) according to the hip rotation. RESULTS: The flexion of the knee and hip was the greatest in group III and dorsiflexion of the ankle was the least in group I. On comparison of moment and power on the sagittal plane, there was no significant difference among the groups. In group III, the percent lengths of the adductor, biceps femoris and gracilis muscles were increased the most, whereas the percent length of the semimembranosus was decreased the most. There was no statistical difference between groups I and II and the normal control group. CONCLUSION: Irrespective of the hip rotation, the length of the hamstring muscle in patients with crouch gait did not differ compared to that of the normal control. But if rotational osteotomy is done for the correction of the increased femoral anteversion in group III, then we should consider lengthening the semimembranosus muscle.
Animals ; Ankle ; Cerebral Palsy ; Child ; Gait ; Hip ; Humans ; Knee ; Muscles ; Osteotomy ; Reference Values

To produce bioactive compound enriched yeast using medicinal Gugiga (Lycium chinensis Mill), several edible Saccharomyces species were cultured in Gugija extracts added yeast extract, peptone and dextrose medium (GE - YEPD medium) at 30degrees C for 24 hr, and their growth were determined. Growth of Saccharomyces cerevisiae K-7 and Sacchromyces cerevisiae ACTC 7904 were better than those of the other yeasts. Two yeasts were selected and then determined their some physiological functionalities after cultivated the yeasts in the GE - YEPD medium and compared those grown on YEPD medium. Antihypertensive angiotensin I-converting enzyme (ACE) inhibitory activity of S. cerevisiae K-7 grown on GE - YEPD medium was about 20% higher than that grown on YEPD medium. Superoxide dismutase-like activity of S. cerevisiae ACTC 7904 was also about 12% more high. However, the other physiological functionalities were almost same or lower. Optimal addition concentration of Gugija extract was 10%, and maximally growth and ACE inhibitory activity of S. cerevisiae K-7 were shown when the strain was cultured in 10% Gugija extracts containing YEPD medium at 30degrees C for 12 hr.
Angiotensins ; Glucose ; Peptidyl-Dipeptidase A ; Peptones ; Saccharomyces ; Saccharomyces cerevisiae ; Sprains and Strains ; Superoxides ; Yeasts

PURPOSE: The natural courses of prenatally diagnosed hydronephrosis(HN) are diverse. Our purpose was to determine if the findings of renal ultrasonography(USG) in patients with prenatal HN at 1 month of age can predict the 1 year follow-up results and determine the guideline of follow-up study. METHODS: Among 462 hydronephrotic patients registered between 1996 and 2004, 153 unilateral hydronephrotic renal units were enrolled in this study, bilateral HN, vesicoureteral reflux and other associated anomaly were excluded. These were classified into four groups respectively, according to anterior posterior pelvic diameter(APPD) or Society for Fetal Urology(SFU) grading by USG findings at 1 month after birth. Renal USG and Tc(99m)-mercaptoacetyl triglycerine(MAG3) scan were done according to a set protocol. RESULTS: Most cases improved or remained stationary. No one underwent an operation SFU grade 1,2 groups and only one case of SFU grade 3 group was operated. Thirty two cases(64 percent) were operated on among the 50 cases of SFU grade 4 group. 0/2(0 percent), 5/11(45.5 percent), 11/17(64.7 percent) and 16/20(80 percent) were operated on in each group with APPD <10, 10-19, 20-29, >30 mm, and the operation risk is higher as the APPD is increased. CONCLUSION: In group with SFU grade below 3 and APPD below 10 mm, we can delay the follow-up study beyond existing set protocol. Operations are recommended immediately if diuretic renogram show the obstructive pattern or decreased renal function in SFU grade 4 group with APPD over 10 mm.
Follow-Up Studies* ; Humans ; Hydronephrosis* ; Parturition ; Ultrasonography* ; Vesico-Ureteral Reflux

Infectious keratitis is the most common serious ocular infection, and may be caused by various bacteria, fungi, viruses and parasites. The authors performed prospectively an epidemiological study to identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis under the identical protocol from April 1995 to September 1997. Logistic regression analysis [univariate analysis and multivariate analysis] was used to evaluate possible risk factors. Six hundred sixty cases of infectious keratitis reported from 19 hospitals were studied. Two hundred eighty-three organisms[247 bacteria, 32 fungi, 4 acanthamoeba] were detected in 626 eyes with infectious keratitis excluding 34 pherpetic keratitis. The Pseudomonas aeruginosa, coagulase negative staphylococcus, Staphylococcus aureus and Serratia marcescens were the major orgnisms in bacterial keratitis. Aspergillus, Fusarium and Candida were the major isolates in fungal keratitis. Contact lens wear was a risk factor for bacterial keratitis. Female, age[less than 40 years] and occupation[student, house-wife, office worker, servise] were associated with bacterial keratitis. Risk factors in herpetic keratitis were age[between 40 and 59 years] and ocular adnexal diseases. Male was associated factor with herpetic keratitis.
Adnexal Diseases ; Aspergillus ; Bacteria ; Candida ; Coagulase ; Epidemiologic Studies ; Epidemiology* ; Eye Infections ; Female ; Fungi ; Fusarium ; Humans ; Keratitis ; Keratitis, Herpetic ; Logistic Models ; Male ; Parasites ; Prospective Studies ; Pseudomonas aeruginosa ; Risk Factors ; Serratia marcescens ; Staphylococcus ; Staphylococcus aureus

This study represents the first epidemiological study based on the national registry of primary immunodeficiencies (PID) in Korea. Patient data were collected from 23 major hospitals. A total of 152 patients with PID (under 19 yr of age), who were observed from 2001 to 2005, have been entered in this registry. The period prevalence of PID in Korea in 2005 is 11.25 per million children. The following frequencies were found: antibody deficiencies, 53.3% (n = 81), phagocytic disorders, 28.9% (n = 44); combined immunodeficiencies, 13.2% (n = 20); and T cell deficiencies, 4.6% (n = 7). Congenital agammaglobulinemia (n = 21) and selective IgA deficiency (n = 21) were the most frequently reported antibody deficiency. Other reported deficiencies were common variable immunodeficiencies (n = 16), X-linked agammaglobulinemia (n = 15), IgG subclass deficiency (n = 4). Phagocytic disorder was mostly chronic granulomatous disease. A small number of patients with Wiskott-Aldrich syndrome, hyper-IgE syndrome, and severe combined immunodeficiency were also registered. Overall, the most common first manifestation was pneumonia. This study provides data that permit a more accurate estimation PID patients in Korea.
Adolescent ; Agammaglobulinemia/congenital/epidemiology ; Age Distribution ; Child ; Child, Preschool ; Common Variable Immunodeficiency/epidemiology ; Female ; Genetic Diseases, X-Linked/epidemiology ; Humans ; IgA Deficiency/epidemiology ; IgG Deficiency/epidemiology ; Immunologic Deficiency Syndromes/*epidemiology ; Infant ; Infant, Newborn ; Job's Syndrome/epidemiology ; Male ; Prevalence ; Questionnaires ; Registries ; Republic of Korea/epidemiology ; Severe Combined Immunodeficiency/epidemiology ; Sex Distribution ; Wiskott-Aldrich Syndrome/epidemiology ; Young Adult

To identify risk factors and causative organisms, and to evaluate clinical manifestations, methods and results of treatment in infectious keratitis, an epidemiological study was performed prospectively under the identical protocol from April 1995 to March 2000.Logistic regression analysis was used to evaluate possible risk factors. The 1474 cases of infectious keratitis reported from 22 hospitals were studied. Five hundred forty-four organisms(442 bacteria, 82 fungi, 20 A c a n t h a m o e b a)were detected in 1320 eyes with infectious keratitis excluding 154 herpetic keratitis. The Pseudomonas aeruginosa was the most common organism in bacterial keratitis, and Fusariumspp. was the major isolate in fungal keratitis. Contact lens wear and occupation(industry, forester, miner, fisherman)were the risk factors for bacterial keratitis. Risk factors in fungal keratitis were fifth decade of age, farmer, and systemic diseases(diabetes mellitus etc.). Risk factors in herpetic keratitis were male and occupation(office worker, service, student, housewife). Risk factors in Acanthamoeba keratitis was contact lens wear.
Acanthamoeba Keratitis ; Bacteria ; Epidemiologic Studies ; Epidemiology* ; Fungi ; Humans ; Keratitis ; Keratitis, Herpetic ; Male ; Prospective Studies ; Pseudomonas aeruginosa ; Risk Factors