Deformities of the leg and ankle may result from growth abnormalities of the tibia and fibula. The appearance of the secondary ossification center and growth plate closure of the tibial and fibular epiphyses, and the pattern of closure of the epiphyses, were observed in a different age. Normal radiographs were reviewed in one hundred and fifty patients at age from two days after birth to 20 years, who were injured on the contralateral leg, at Wonju Medical College, Yonsei University from Feb., 1980 to May, 1984. The results were as follows: 1. The time of the appearance of secondary ossification center and the closure of growth plates; The proximal tibial epiphysis usually forms secondary ossification center at birth to second postnatal months, the physeal closure occurs from 13 year and 11 months to 18 year 3 months in male, from 13 year 4 months to 15 year 5 months in female. The secondary ossification center of the distal tibial epiphysis appears from 8th postnatal months to one year, and physeal closure occurs from 15 years to 17 year and 4 months in male, from 15 year 2 months to 16 year 8 months in female. The secondary ossification center of the tibial tuberosity appears from 9 year 3month to 12 year 2 months, and closure occurs from 16 year 3 months to 18 year 7 months inmale, from 14 year 10 months to 19 year 1 months in female. The proximal fibular epiphysis forms secondary ossification center from 2 year 5 months to 5 year 4 months, closure occurs from 15year 8 months to 17 year 4 months in male, from 14 year 9 months to 16 year 9 months in female. The secondary ossification center of the distal fibular epiphysis appears from 2 year 5 months to 3rd years, and closure occurs from 13 year 11 months to 17 year 6 months in male, from 13 year 4 months to 16 year 7 months in female. 2. The growth and the pattern of the closure of growth plates of the tibia; The proximal tibial epiphysis is elliptic for the first 3 years of life. The epiphysis is slightly conical centrally as it extends toward the tibial spines, and becomes more prominent from 8 years to adolescence. The closure of the proximal tibial growth plate occurs initially along the anteromedial aspect of the tibia and tibial tuberosity during 12 years and proceeds posterolaterally. Complete closure of the proximal tibial physis occurs about from 13 years to 18 years. The secondary ossification center of the distal tibial epiphysis is oval in shape initially, becomes thicken medially by 3rd year of life, then the tibial plafond is valgoid, and becomes horizontal at age 10 approximately. The distal epiphysis of tibia unites first at about 13 years, starting centrally and proceeding toward anteromedial portion. And the posterolateral portion unites finally by about 15 to 17 years. The tibial tuberosity develops a secondary ossification center by 7 to 9 years, usually in the most distal region, and gradually elongates and extends toward the secondary ossification center of the proximal tibia.From about 12 years, the tuberosity epiphyseal center fuses with the proximal tibial center, and the fusion with the tibial metaphysis extends distally, the tuberosity physis closes completely from about 15 to 19 years. 3. The growth and development of the tibia, fibula and ankle; The growth of the proximal tibial and the distal fibular epiphyses play an important role of the growth rate in lower extremities unber ten years. The distal tibial growth plate inclines laterally and distally prior to the first year of life, the inclination is on the decrease and it finally horizontal at about 12 years. The distal tibia talus angle is about 90° prior to the age one year, becomes mildly valgoid by 12 years.
Adolescent ; Ankle ; Congenital Abnormalities ; Epiphyses ; Female ; Fibula ; Gangwon-do ; Growth and Development ; Growth Plate ; Humans ; Leg ; Lower Extremity ; Male ; Parturition ; Spine ; Talus ; Tibia

In man the epiglottis is a thin lamella of yellow elastic cartilage. The upper part is free and is known asleaf and lower part participates in the formation of the anterior wall of the vestibule of the larynx. Theipithelial covering extends forwards onto the base of the tongue over the medial glossoepiglottic folds. The sidesof epiglottis are connected with the cartilages of Wrisberg and arytenoid cartilage by the aryepiglottic fold. Inview of these anatomical complexities, the function and physiology of the epiglottis have been debated sinceMagendi(1815), who proposed the theory that the epiglottis acts as a flap valve to prevent food entering thewindpipe, and who found that he could remove the free part of the epiglottis in dog without spoiling the dog.Follwoing the introduction of laryngoscopy(Garcia, 1815; Liston, 1840; Czermark, 1861) and modern cineradiographicequipments in 1950's, the anatomy and physiology of epiglottis has become much clearrer. Age as it is seen on thelateral x-ray of the neck. In the present study we have made an attempt to systematically analyze aging changes ofthe epiglottis in the lateral x-ray of the neck in 245 healthy adults. The age ranged from 16 to 65 years old.Based on our observation the epiglottis was classified into type A, B, and C according to their curvatures. Thus,type A represented those with posterior curvature, type B those with straight epiglottis and type C anteriorcurvature. Type C was sudivided into I, II and III according to the degree of curvature. Thus, type C-I, C-II andC-III represented mild, moderated and marked anterior curvature, respectively. Type A epiglottis was found in thesecond, third and fourth decades and type C-III in the older age group. Type A was least comon and type C mostprevalent. It seems that the epiglottis inclines anteriorly with backward curvature with age (p<0.0001).
Adult ; Aging ; Animals ; Arytenoid Cartilage ; Cartilage ; Dogs ; Elastic Cartilage ; Epiglottis ; Humans ; Larynx ; Neck ; Physiology ; Tongue

In Langerhans cell histiocytosis, diabetes insipidus is the most common endocrinologic complication. We experienced a case of Langerhans cell histiocytosis, involving pituitary stalk and lung. The patient was a 43 year old male with complaint of polyuria and polydipsia. The water deprivation test was carried out to confirm the diagnosis of diabetes insipidus. We found multiple small cysts and nodules in HRCT of lung, and diagnosed Langerhans cell histiocytosis by transbronchial lung biopsy, The patient was managed conservatively with DDAVP nasal spray. The polyuria,polydipsia was relieved completely. After that, we follow up and observe closely the patients lung and pituitary lesion.
Adult ; Biopsy ; Deamino Arginine Vasopressin ; Diabetes Insipidus ; Diagnosis ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans ; Lung ; Male ; Pituitary Gland ; Polydipsia ; Polyuria ; Water Deprivation

OBJECTIVE: The aim of our study is to evaluate the clinical usefulness of transvaginal sonography (TVS) and saline infusion sonohysterography (SHG) in the evaluation of endometrial abnormality. METHODS: We retrospectively reviewed 370 patients with abnormal uterine bleeding or uterine cavity abnormalities confirmed by TVS. SHG was carried out by experienced gynecologist, on the same setting in an outpatient clinic after the performance of TVS. Two hundred nineteen patients aged between 23 and 69 years (mean age 41+/-8.2) had operative hysteroscopy (88.2%), hysterectomy (9.1%) and dilatation/curettage (2.7%) within 3 months which provided a detailed description of uterine cavity. Surgical-pathologic findings were compared with the results obtained from TVS and SHG. RESULTS: The sensitivity and specificity were 71.7% and 31.4% for TVS, and 98.4% and 67.6% for SHG respectively. The positive and negative predictive values were 84.6% and 17.5% for TVS, and 94.3% and 92.3% for SHG, respectively. Twenty one cases showed a discrepancy between the TVS and SHG, and 16 cases showed a discrepancy between SHG and the pathologic diagnosis. Fifty five cases (25%) in TVS were unconfirmed, but SHG showed 51 pathologic confirmed intracavitary lesion. CONCLUSION: SHG is a sensitive tool and is superior to TVS used alone for evaluation of endometrial abnormalities. SHG definitely enhances the diagnostic potential of TVS in assessment of endometrium and intracavitary pathologies.
Ambulatory Care Facilities ; Diagnosis ; Endometrium ; Female ; Humans ; Hysterectomy ; Hysteroscopy ; Pathology ; Retrospective Studies ; Sensitivity and Specificity ; Uterine Hemorrhage

BACKGROUND: We performed this stody to find out about antimicrobial effect of lidocaine which is commonly used local anesthetic, and thrombin and epinephrine used for hemostasis during bronchoscopic procedures. MATERIALS AND METHODS: The microorganisms that were cultured from specimens obtained during bronchoscopy were Staphylococcus aureus (n=42), Streptococcus pneumoniae (n=42), Klebsiella pneumoniae (n=42), and Pseudomonas aeruginosa (n=43) collected from St. Mary's Hospital, from March to Sep 2004 were used for susceptibity testing. Susceptibility to lidocaine, thrombin, and epinephrine were tested according to the National Committee for Clinical Laboratory Standards. RESULT: MIC50 and MIC90 of lidocaine for S. aureus, S. pneumoniae, P. aeruginosa were all 20,000 microgram/mL and that for K. pneumoniae were 10,000 microgram/mL. MIC50 and MIC90 of thrombin for both S. aureus and P. aeruginosa was 500 IU/mL and above 500 IU/mL, respectively; that for K. pneumoniae were all above 500 IU/mL and for S. pneumoniae they were 125 IU/mL, MIC50 and MIC90 of epinephrine for K. pneumoniae and S. pneumoniae were above 500 microgram/mL; that for S. aureus and P. aeruginosa were 500 microgram/mL. CONCLUSION: We observed possible antimicrobial effect of lidocaine, thrombin, and epinephrine in vitro against pathogens such as S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa, which are common respiratory microorganisms. The use of these agants could affect the result of bacterial culture.
Bronchoscopy ; Epinephrine* ; Hemostasis ; Klebsiella pneumoniae ; Lidocaine* ; Pneumonia ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Streptococcus pneumoniae ; Thrombin*

BACKGROUND: We performed this stody to find out about antimicrobial effect of lidocaine which is commonly used local anesthetic, and thrombin and epinephrine used for hemostasis during bronchoscopic procedures. MATERIALS AND METHODS: The microorganisms that were cultured from specimens obtained during bronchoscopy were Staphylococcus aureus (n=42), Streptococcus pneumoniae (n=42), Klebsiella pneumoniae (n=42), and Pseudomonas aeruginosa (n=43) collected from St. Mary's Hospital, from March to Sep 2004 were used for susceptibity testing. Susceptibility to lidocaine, thrombin, and epinephrine were tested according to the National Committee for Clinical Laboratory Standards. RESULT: MIC50 and MIC90 of lidocaine for S. aureus, S. pneumoniae, P. aeruginosa were all 20,000 microgram/mL and that for K. pneumoniae were 10,000 microgram/mL. MIC50 and MIC90 of thrombin for both S. aureus and P. aeruginosa was 500 IU/mL and above 500 IU/mL, respectively; that for K. pneumoniae were all above 500 IU/mL and for S. pneumoniae they were 125 IU/mL, MIC50 and MIC90 of epinephrine for K. pneumoniae and S. pneumoniae were above 500 microgram/mL; that for S. aureus and P. aeruginosa were 500 microgram/mL. CONCLUSION: We observed possible antimicrobial effect of lidocaine, thrombin, and epinephrine in vitro against pathogens such as S. aureus, S. pneumoniae, K. pneumoniae, P. aeruginosa, which are common respiratory microorganisms. The use of these agants could affect the result of bacterial culture.
Bronchoscopy ; Epinephrine* ; Hemostasis ; Klebsiella pneumoniae ; Lidocaine* ; Pneumonia ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Streptococcus pneumoniae ; Thrombin*

OBJECTIVE: The aim of this study was to compare the efficacy of sacrospinous colpopexy without hysterectomy and with hysterectomy for symptomatic uterine prolapse. METHODS: A retrospective chart review was performed in the women who underwent sacrospinous ligament suspension between March 1998 and March 2002. A hundred fifty five women with a symptomatic uterine prolapse were treated with either sacrospinous colpopexy without hysterectomy and/or anterior-posterior repair (83 cases=Group A) or sacrospinous colpopexy with hysterectomy and/or anterior-posterior repair (72 cases=Group B). RESULTS: The mean duration of surgery, hemoglobin change, catheter days and inpatient days were shorter in group A compared with group B. (Group A 102.5+/-33.4 min, 2.4+/-0.7 mg/dL, 5.2+/-1.4 days, 7.6+/-2.2 days vs. Group B 135.3+/-33.9 min, 2.9+/-0.8 mg/dL, 6.1+/-2.1 days, 9.4+/-3.7 days, p<0.05 respectively) Recurrent pelvic organ prolapse developed in 14.5% in group A and 12.5% in group B. Six patients (7.2%) in group A and 5 patients (6.9%) in group B required repeat operation for recurrent pelvic organ prolapse. CONCLUSIONS: Sacrospinous colpopexy without hysterectomy and with hysterectomy are equally effective surgical operation for uterine prolapse. This study shows that hysterectomy is not essential for the correction of uterine prolapse.
Catheters ; Female ; Humans ; Hysterectomy* ; Inpatients ; Ligaments ; Pelvic Organ Prolapse ; Retrospective Studies ; Uterine Prolapse*