Hereditary theory was first proposed by Joachimsthal in 1905. However, a family history of congenital muscular torticollis is uncommon. This is a report of two female children who are interrelated and have congenital muscular torticollis. They are sisters. No environmental factor could be identified that would predispose the the children to congenital muscular torticollis. In this family, it is apparent that genetic factors are influencing the development of this condition. The cause of congenital muscular torticollis is unknown, but heredity may play a more important role than has previously been supected.
Child ; Female ; Heredity ; Humans ; Siblings ; Torticollis

Supracondylar fracture of the humerus is the most common fracture about the elbow in children, and frequently accompanies neurovascular complications. It is one of the most difficult to manage and is frequently associated with significant residual complications. In the treatment of supracondylar fracture of the humerus, prompt and accurate reduction without additional trauma is mandatory. 114 patients with supracondylar fracture of the humerus who were admitted and treated at the Department of Orthopedic Surgery of Hanyang University Hospital from May, 1972 to May, 1981 have been reviewed. The results obtained are as follows: 1. Supracondylar fractures of the humerus frequently occurred between the ages of 5 and 12 years (77.2%), and the sex ratio was 2.5:1 in male to female. 2. Of all fractures, 96.5% were the extension type and 3.5% were the flexion type. According to the Holmberg classification, type IV fractures were most common. 3. In the injuries associated with fracture, there were 6 ipsilateral forearm fractures, 6 neural injuries, 4 vascular injuries, and 2 neurovascular injuries. In 8 traumatic neuropathies, median nerve was involved most commonly, and they were recovered spontaneously within 6 week except 1 case, which was repaired surgically. 4. Most cases were treated successfully by early manipulative reduction, but in the presence of neurovascuiar signs and symptoms, continuous traction or open reduction was indicated. 5. The result of treatment of the conservative treatment group was better than that of the operative treatment group.
Child ; Classification ; Clinical Study ; Elbow ; Female ; Forearm ; Humans ; Humerus ; Male ; Median Neuropathy ; Orthopedics ; Sex Ratio ; Traction ; Vascular System Injuries

Thumb reconstruction with a free neurovasculsr wrap around flap from the great toe by microsurgery had been first reported by O'Brien, Macleod and Morrison in 1980. We have performed one case of thumb reconstruction with psrtial first metstarsus for loss of thumb except pulp and one digital vessel by microsurgery. The results were summerized as followings ; 1. This one stage procedure has the unique advantage to reconstruct a thumb almost identical to the origin. 2. This technique allows preservstion of the toe and the secondary defect results in no significant morbidity.
Free Tissue Flaps ; Microsurgery ; Thumb ; Toes

A microvascular osteocutaneous free flap is totally detached from its origin and reattached at a distant site, in one stage, by the use of microvascular anastomosis to maintain its viability. The advantages of microvascular osteocutaneous free flap trsnsfer are more rapid healing, greater resistance to infection, less risk of absorption than conventional bone grafts, and shortened hospitalization. Two cases of microvascular osteocutaaeous free flap transfer were performed at the department of Orthopaedic surgery of Hanyang University Hospital, and satisfactory results were obtained.
Absorption ; Free Tissue Flaps ; Hospitalization ; Transplants

Oil granuloma develops mainly after injection of oil substances such as paraffin, silicone, etc, but there have been reports of oil granuloma after topical application of lipid substance to the body. A 22-year-old woman developed oil granuloma after the application of squalene on both lower eye-lids. Histopathologic findings ahowed acanthosis and dyskeratosis of the hair follicles. Lipid suketances staining with oil-red-O stain were found mainly on the hair follicles. and partly on the epidermis. We report a case of oil grinulorna caused by squalerie that may have penetrated through the hair follicles and partly through the epidermis resulting in chronic granulous changes in the dermis.
Dermis ; Epidermis ; Eyelids* ; Female ; Granuloma* ; Hair Follicle ; Humans ; Paraffin ; Silicones ; Squalene* ; Young Adult

Most of malignant melanoma of skin had occurred in transformation from benign nevi(Webster, 1944), especially most frequently from junctional nevi of them. which was characterized by flat surface, dark-brown color and hairlessness(Ackermen, 1948) Blumberg (1972) introduced five levels of hietologic invasion of malignant melanoma described by Clark et al. Morton(1970) reported various measures of treatment such as surgery combined with radiotherapy or with chemotherapy or with recent immunotherapy with good result. The authors recently experienced 24-yeas old male soldier patient with malignant melanoma on hypothenar region of right palm. The pathologic investigation including electronmicroscopical aspect was carried out and are presented. Treatment consisted of the resections of right axillary lymph nodes and the lesion in situ on the hypotherar region of right hand, pedicle skin graft to right hand from abdomen, and immediate postoperative immunotherapy with intradermal injection of 1.0 cc. of B.C.G. daily on extensor surface of both thighs in turn, which lasted for about 3 months duration to find good result.
Abdomen ; Drug Therapy ; Hand ; Humans ; Immunotherapy ; Injections, Intradermal ; Lymph Nodes ; Male ; Melanoma ; Military Personnel ; Nevus ; Radiotherapy ; Skin ; Thigh ; Transplants

Eight bacterial strains were examined whether they have phoP/phoQ genes which were known to be involved in the intracellular survival of Salmonella typhimurium. The phoP/phoQ operon were known to sense the stimuli of the genes involved in the adaptation of the environment. Using 514-basepairs EcoRV DNA fragment of phoP region of Salmonella typhimurium as a probe, dot blot hybridization were performed. Chromosomal DNAs of Klebsiella pneumonia, Pseudomonas aeruginosa, Serratia marscescens, Enterobacter cloacae, Salmonella typhimurium, Escherichia coli, Shigella dysenteriae, and Listeria monocytogenes were examined by DNA hybridization assay. Against our expectation, intracellular pathogen, L. monocytogenes, did not have similar DNA sequences to phoP/phoQ of S. typhimurium, while E, coli, S. dysenteriae, and E. cloacae showed the positive signal even though they were not intracellular pathogens. This result suggested that the phoP/phoQ operon was absent in intracellular pathogenic bacterias other than S. typhimurium. Rather it was found in phylogenetically closer bacterias to S. typhimurium, which were not able to survive in intracellular environment. Some different mechanism, which is not dependent on phoP/phoQ operon, could be involved in the intracellular survival of L. monocytogenes.
Bacteria* ; Base Sequence ; Cloaca ; DNA ; Enterobacter cloacae ; Escherichia coli ; Klebsiella ; Listeria monocytogenes ; Operon ; Pneumonia ; Pseudomonas aeruginosa ; Salmonella typhimurium ; Serratia ; Shigella dysenteriae

Generalized perforating granuloma annulare is a rare variant of granuloma. annulare, which was first described by Duncan et al 1) in 1973. A 21-year-old female had hundreds of 3 to 5mm papules over the whole body, which were mainly distributed in the extremities and trunk since three months ago. Individual papules developed a central umbilication with a peripheral collarette of scale. Histopathologic examination showed an epidermal perforation and transepidermal elimination of necrobiotic material. The epidermal perforation communicated with areas of necrobiotic collagen surrounded by palisading granulorna in the dermis. We treated her with oral prednisolone and dapsone, but there was no clinical improvement.
Collagen ; Dapsone ; Dermis ; Extremities ; Female ; Granuloma Annulare* ; Granuloma* ; Humans ; Prednisolone ; Young Adult

We report a case of papillary eccrine adenoma occurring in a 39-year-old male who had a walnut sized, firm nodule on the right knee without subjective symptoms. Histopathologic exammination revealed a well circumscribed, non-capsulated dermal nodule consisting of multiple ducts with various sizes. These ducts were composed of double layered epithelial cells in most areas, but in some areas severe intraluminal papillation snd pseudostratification into the lumen were seen and the lumina were filled with a homogenous eosinophilic substance and partially with calcium deposition. Immunohistochemical studies with S-100 antigen and csrcinoembryonic sntigen (CEA) were also performed. Positivity for these sntigens strongly supports the hypothesis that this unusual neoplasm differentiates toward the eccrine secretory coil.
Adenoma* ; Adult ; Calcium ; Eosinophils ; Epithelial Cells ; Humans ; Juglans ; Knee ; Male

The authors reviewed the medical records of 20 patients who were diagnosed as brain tuberculoma at Severance Hospital from 1980 to 1984. The 20 patients were presumptive cases based on clinical, roentgenological or laboratory findings without histologic proof were used, exept one. All cases were Korean, onset was between 3 to 59 years of age and there was no sexual preponderance. The initial clinical features were seizure, symptoms and signs of increased intracranial pressure, focal neurological signs, etc. Although a definite diagnosis is often not possible on CT scan, the method is of value in determining number, location and extent of lesions and in evaluating the effectiveness of antituberculous therapy. Fourteen of our 20 patients had single tuberculoma, six had mutliple or miliary tuberculoma and 18 cases were located on the cerebrum, two on the brainstem.
Brain Stem ; Brain* ; Cerebrum ; Diagnosis ; Humans ; Intracranial Pressure ; Medical Records ; Seizures ; Tomography, X-Ray Computed ; Tuberculoma*