Early diagnosis and treatment of congenital dislocation of the hip is the only means of obtaining good results with consistent regularity. But a large number of congenital dislocation of the hip remain undiagnosed before the child begins to walk. One hundred and nine cases of congenital dislocation of the hip had been clinically diagnosed and 48 cases of them were treated conservatively or operatively at Department of Orthopedic Surgery, College of Medicine, Seoul National University from January, 1965 through September, 1975 with following results. 1. Among 109 cases of congenital dislocation of the hip, 48 cases were admitted and treated. In recent 10 years the number of the out-patient was increasing. 2. The preponderance of female to male (4:1) was found. 3. The age ranged between 3 months and 24 years, and 46 cases (42%) between 12 and 24 months. 4. In most cases the chief complaint was limping. 5. The associated congenital anomalies were observed in 3 cases of the series, comprising two cases of arthrogryposis multiplex congenita and one case of hydrocephalus. 6. The scetabular index was increased in affected hip. 7. The ratio of unilateral cases to bilateral ones was 100: 9, and right to left was 47: 53. 8. Closed reduction was satisfactory in 25 cases under 2 years of age. 9. Open reduction was necessary in 18 cases of failed closed reduction and 5 cases of redislocation. 10. Eleven cases of Salter's operation, 4 cases of Pembertons operation, 2 cases of Colonnas operation, and 8 cases of derotational osteotomy were performed to increase the stability of the hip joint.
Arthrogryposis ; Child ; Dislocations ; Early Diagnosis ; Female ; Hip Joint ; Hip ; Humans ; Hydrocephalus ; Male ; Orthopedics ; Osteotomy ; Outpatients ; Seoul

No abstract available.

No abstract available.
Aged* ; Bone Density* ; Female ; Femur* ; Humans ; Resistance Training* ; Thigh*

Atrial septal defect is one of the most common congenital heart diseases in adult, of which absolute causes is not confirmed, but explained by multifactorial inheritance. In Korea, there has been no case report of atrial septal defect in identical twins in spite of some reports of atrial septal defect in relatives and twins in other countries. We present a first case of atrial septal defect in identical twins whose mother had no infection or medication history during pregnancy.
Adult ; Heart Diseases ; Heart Septal Defects, Atrial* ; Humans ; Korea ; Mothers ; Multifactorial Inheritance ; Pregnancy ; Twins ; Twins, Monozygotic*

A clinical trial was done to evaluate the antihypertensive efficacy and side effects of manidipine, a new calcium antagonist, in 30 patients with mild to moderate essential hypertension. 1) The study patients consisted of 19 men and 11 women, and the mean age was 51.8 years. 2) Blood pressure dropped significantly in 2 weeks and in 4 weeks, and well maintained throughout the study period. The mean-pressure drop was 26.2/14.9mmHg after 10 weeks. 3) Heart rate did not change significantly with manidipine therpy. 4) Optimal dose for effective pressure-drop was between 10 and 20 mg in 86% of patients. Overall good antihypertensive effect was achieved in 83% of patients. 5) All of the laboratory parameters including blood chemistry, glucose, lipid and electrolytes did not change, but serum calcium increased from 9.2% mg/dl (p=0.001) in 10 weeks. 6) Side effects were mild in nature(palpitation in 3, dry mouth in 1, weakness in 1 and impotence in 1 patient). In conclusion, manidipine monotherapy with 10 to 20 mg once a day regimen is effective and well tolerated in the patients with mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Chemistry ; Electrolytes ; Erectile Dysfunction ; Female ; Glucose ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth

Supracondylar fracture of the humerus is the one of the commonest elbow fracture in children. There are much controversies surrounding the method of treatment for various and frequent complications such as cubitus varus and joint stiffness, etc. For the period of 2 years and 8 months from Jan. 1987 to Aug. 1989, 32 patients had undergone treatment at the Department of Orthopaedic Surgery, Choongang Gil Hospital. Ten cases among them were treated with close reduction and cast, 8 cases were treated with close reduction and pinning, and 14 cases were treated with open reduction and internal fixation. The results obtained are as follows; l. Of all fractures, extension type was 96.9%, and flexion type was 3.1%. According to the Holmberg classification, 5 cases belong to Group I (15.6%), 10 to Group II (31.3%), 7 to Group III (21.9%), and 10 to Group IV (31.3%). 2. Radial nerve injuries which now are thought to be neuropraxia were the most common form of concomitant injuries. 3. All fractures were found to obtain bone union with mean duration of bone union about 40.9 days. 4. There were 7 cases (21.9%) who had more than 10 degrees of elbow motion limitation. Three cases (9.4%) showed the change of carrying angle over 10 degrees in Group IV by Holmberg classification. 5. By the modified Mitchell and Adams' criteria for grading results, Excellent was 22 cases (68.7%), Good was 7 cases (21.9%), Fair was 2 cases (6.3%), and Poor was 1 case (3.1%). 6. In Holmberg classification, the higher severity, the longer mean duration of bone union and the higher joint stiffness made the prognosis worse.
Bone Cysts ; Child ; Classification ; Elbow ; Humans ; Humerus ; Joints ; Methods ; Prognosis ; Radial Nerve

Six hundred and fifty one cases of bone tumors diagnosed and operated at Department of Orthopedic Surgery, Seoul National University Hospital, from Jan., 1969 to Apr., 1989. were reviewed and analyzed with respect to the types of tumor, the age and sex distribution of the patients, the location of the lesions and the advances of diagnosis and treatment. 378 benign and 273 malignant bone tumors were identified. Osteochondroma(113 cases, 17.4%) was the most common bone tumor, followed by osteosarcoma(72 cases, 11.1%) and giant cell tumor(50 cases, 7.7%) Second decade was the most common age of bone tumors(216 cases, 33.2%) and male(379 cases, 58%) was more common than female. Femur(222 cases) was the most common site of bone tumors, followed by tibia and vertebra. For simple bone cyst, steroid injection was widely used recently. It was a simple and safe procedure and its results were similar to those of curettage and bone graft. Limb salvage operations were performed for malignant bone tumors increasingly. Neoadjuvant chemotyeraphy and limb salvsge operation using tumor prosthesis were performed in 5 patients of osteosarcoma and their results are so far promising. Of 7 cases of chondrosarcoma, the limb was salvaged by resection arthrodesis or resection arthroplasty. 7 cases of malignant fibrous histiocytoma were treated by radical ablative surgery and/or chemotherapy and radiation, but local recurrence or pulmonary metastasis were detected in all of them. So it was thought to be highly malignant bone tumors.
Arthrodesis ; Arthroplasty ; Bone Cysts ; Chondrosarcoma ; Curettage ; Diagnosis ; Drug Therapy ; Epidemiologic Studies ; Extremities ; Female ; Giant Cells ; Histiocytoma, Malignant Fibrous ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Orthopedics ; Osteosarcoma ; Prostheses and Implants ; Recurrence ; Seoul ; Sex Distribution ; Spine ; Tibia ; Transplants

Failure of the urachus to regress completely results in anomalies that may be classified as patent urachus, urachal sinus, urachal cyst and bladder diverticula. The presenting symptoms of children with urachal anomalies are variable and uniform guidelines for diagnosis and treatment are lacking. The purpose of this study was to elucidate our conclusions regarding the presentation, diagnosis and treatment of urachal anomalies by reviewing our experiences. We retrospectively analyzed the records of 32 patients who were admitted for urachal anomalies from March 1995 to February 2005. The age distribution of these patients at presentation ranged from 1 day to 14 years old (median age 1 month) and they included 20 boys and 12 girls. The 32 cases comprised 13 cases of urachal sinus (40.6%), 10 urachal cyst (31.3%), and 9 patent urchus (28.1%). The presenting symptoms were umbilical discharge (14 patients), umbilical granuloma (8), abdominal pain and fever (3), fever (3), abdominal pain (2), and a low abdominal mass (2). In 30 patients ultrasonography was used for diagnosis and 2 patients with patent urachus were explored without using a diagnostic method. Twenty-three patients were confirmed by ultrasonography alone and 7 patients were examined using additional modalities, namely, computed tomography for 2 patients with an urachal cyst, magnetic resonance imaging for 1 patient with an urachal cyst, and fistulography for 3 patients with an urachal sinus. Excision was performed in 29 patients, and 3 patients were conservatively managed. Urachal anomalies in children most frequently presented in neonates, and the most common complaint was umbilical discharge with infection. Urachal anomalies can be diagnosed by a good physical examination and an appropriate radiographic test, and ultrasound was found the most useful diagnostic method. Complete surgical excision of an urachal anomaly is recommended to avoid recurrence, and even, though rare, carcinoma development.
Abdominal Pain ; Adolescent ; Age Distribution ; Child* ; Diagnosis ; Diverticulum ; Female ; Fever ; Granuloma ; Humans ; Infant, Newborn ; Magnetic Resonance Imaging ; Physical Examination ; Recurrence ; Retrospective Studies ; Ultrasonography ; Urachal Cyst ; Urachus ; Urinary Bladder

Clonorchiasis is known to be closely related with the development of recurrent pyogenic cholangitis and carcinoma of the bile ducts. In order to ascertain the cholangiographic signs for recurrent pyogenic cholangitis or carcinoma of the bile ducts arising in patients with clonorchiasis. we reviewed cholangiograms in 42 patients with proven clonorchiasis. The population consisted of 29 patients with clonorchiasis alone, six patients with clonorchiasis and recurrent pyogenic cholangitis, and seven patients with clonorchiasis and carcinoma of the bile ducts. Cholangiographic abnormalities in 29 patients with clonorchiasis alone, six patients with clonorchiasis and recurrent pyogenic cholangitis, and seven patients with clonorchiasis and carcinoma of the bile ducts. Cholangiographic abnormalities in 29 patients with clonorchiasis alone were intrahepatic multiple, oval, or elliptic filling defects measuring 2-10 mm in size, representing adult flukes (n=24). The peripheral bile duct were obstructed (n=18), and the margins were ragged (n=20) and hazy (n=12) the intrahepatic bile ducts were dilated diffusely (n=27), and the dilated peripheral small tributaries gave the impression of "too many ducts appearance" (n=7) and dilatation was mid (n=17) In six patients with clonorchiasis and recurrent pyogenic cholangitis, there were filling defects of stones, and the extrahepatic ducts and larger intrahepatic ducts were predominantly dilated. In seven patients with clonorchiasis and cholangiocarcinoma all the biliary tree proximal to the tumor was markedly and diffusely dilated In the latter two groups, filling defects of flukes and associated findings were less prominent, but there was disproportionately severe dilatation of too many intrahepatic ducts. In patients with recurrent pyogenic cholangitis or cholangiocarcinoma, clonorchiasis should be considered as a underlying cause when cholangiogram shows "disproportionately" severe dilatation of too many intrahepatic ducts. intrahepatic ducts.
Adult ; Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis* ; Dilatation ; Humans ; Trematoda

An unusual case of glroependymal cyst involving the lateral ventricle, 3rd ventricle, cerebellopontine angle cistern and prepontine cistern, simultaneously, is reported. The glroependymal cyst is benign developmental cyst that mainly occurs in the cerebrospinal axis in relation to ventricle, but occasionally occurs in relation to extraventricular system, such as subarachnoid space, brain stem and cerebral parenchyme. The histological characteristics of ependymal cyst wall are ependyma-like epithelium and neuroglial tissue.
Axis, Cervical Vertebra ; Brain Stem ; Cerebellopontine Angle ; Epithelium ; Lateral Ventricles ; Subarachnoid Space