We reviewed twelve cases of congenital dislocation of the knee(CDK) which treated at Keimyung University from January 1992 to January 1997. All case were type II dislocation according to classification suggested by Ferris and reduced with minimal treatment. Dislocation were reduced within 4 days in minimum after treatment and 3 weeks in maximum. The period of follow up ranged from 6 months to 5 years. Clinical results were good. Early diagnosis followed by conservative treatment is important and enough to treatment of the type II congenital dislocation of the knee.
Classification ; Dislocations* ; Early Diagnosis ; Follow-Up Studies ; Knee*

To define the effectiveness of surgical management of the mallet finger deformity due to extensor tendon injury in children, we analyzed 9 patients who had operative treatment of mallet finger deformity in children from Jan. 1994 to Mar. 1997. The types of tendon injury in this series were as follows: 7 cases with tendon laceration, 1 case with crushing injury and 1 case with unknown injury The average period of follow up were ranged 2 years and 1 month. The clinical results were evaluated hy Kanies seale12) and Crawford scale5). An excellent result was obtained in 4 cases(44%), a good result in 5 cases(56%) according to Crawford scale and excellnt result in 9 cases(I00%) in Kanies scale, consecutively. Meticulous surgical repair of the lacerated tendon provided good result.
Child* ; Congenital Abnormalities* ; Fingers* ; Follow-Up Studies ; Humans ; Lacerations ; Tendon Injuries* ; Tendons*

There are many difficult problems and various methods in the treatment of difficult fractures of the femur. We reviewed the records of twelve patients who had been managed with circular external fixation using the llizarov apparatus for difficult fractures of the femur at Keimyung University. Dongsan rnedical center from October 1993 to April l996. There were ten males and two females with an average age of 42 years (range, 16-74 years). Si.x of twelve patients were severely comminuted supracondylar and intercondylar fractures of the femur associated with severe soft tissue injury (including four open fractures). These patients were treated initially by closed reduction with Ilizarov external fixator and followed by compression-distraction techniques. Four of the remaining six ptients developed infected non-unions after internal fixation of the femur without shortening or bone defect. These infected non-unions were treated by curettage, irrigation and Ilizarov application. After the control of infection, compression - distraction techniques were applied. One of the remaining two patients had severe open comminuted fracture of the supra-intercondyle region of femur associated with diaphyseal segmental bone defect (5cm in length). This patient was treated with closed reduction and internal bone transportation usipg llizarov external fixator. One patient with varus deformity (20 degree) was treated by correction of the deformity and simple compression technique. In three patients, additional autogenous cancellous iliac bone graft was done. The union of the fracture site was obtained in ten patients and the duration of llizarov external fixation was an average of 10 months (range 6-14 months). We experienced several complications; there were twelve patients of limitation of motion of knee, ten patients of pin tract infection, one patient of fracture site non-union, one patient of re-fracture and one patient of femoral artery injury. We concluded that the Ilizarov external fixation technique is one of the effective methods for the treatment of difficult fractures of the femur in spite of its complexity and high incidence of complications.
Congenital Abnormalities ; Curettage ; External Fixators* ; Female ; Femoral Artery ; Femur* ; Fractures, Comminuted ; Humans ; Incidence ; Knee ; Male ; Soft Tissue Injuries ; Transplants ; Transportation

The purpose of this study is to evaluate the effectiveness of Ilizarov external fixator in the treatment of difficult tibial fractures. We analyzed 37 cases with closed or open comminuted tibial fractures and unstable segmental fractures, treated with Ilizarov external fixator between August 1993 and August 1997. Among them, 21 cases were treated with simple application of Ilizarov external fixator. A compression of the fracture site (6 cases), translation (2 cases) and internal transportation technique (2 cases) were applied, and bone graft was applied in 5 cases. We obtained bony union in all cases with Ilizarov method except one case converted to intramedullary nailing due to delayed union. The average time required for bone union were 21 weeks in closed fractures, 26.2 weeks in open fractures. The complications developed were as follows; pin irritation in 14 cases, pin tract infection in 9 cases, adjacent joint contracture in 3 cases, delayed union in 1 case and malunion in 1 case. According to Tuckers classification, the results were graded as excellent in 18 cases, good in 14 cases, fair in 3 cases, poor in 2 cases. In conclusion, Ilizarov external fixation is one of the useful treatment option in closed or open comminuted tibial fractures and unstable segmental fractures.
Classification ; Contracture ; External Fixators* ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Ilizarov Technique ; Joints ; Tibia ; Tibial Fractures* ; Transplants ; Transportation

Spondylometaphyseal dysplasia(SMD) is very rare disease characterized with platyspondyly and metaphyseal changes in the long bone. Shrot status and later abnormal gait associated with coxa vara are common clinical feature. A 6 years 4 months old boy progressive bilateral coax vara were transferred with abduction limitation of the hip. With the skeletal survey, multiple dysplastic changes of the metaphysic of the long bone including knee, shoulder, ankle, and flatterning of the body of lower thoracic and upper lumbar spine(T11,12,L1) were noted. A corrective valgus osteotomy on the both hip were followed with improvement of the range of motion.
Ankle ; Coxa Vara ; Gait ; Hip ; Humans ; Knee ; Male ; Metaphysics ; Osteotomy ; Range of Motion, Articular ; Rare Diseases ; Shoulder

We studied 600 normal lower extremities of Korean students of elementary school in order to establish normal values for the rotational profile and to define any differences between ethnic groups. Rotational profile examined at this study included medial and lateral rotation of the hip and thighfoot angle. The mean value of medial rotation of the hip was 48 degrees with a range of 35 to 64 degrees in male subjects, and 50 degrees with a range of 35 to 60 degrees in female subjects. The mean value of lateral rotation of the hip was 57 degrees with a range of 43 to 75 degrees, and 53 degrees with a range of 40 to 72 degrees in female subjects. Unlike medial rotation, lateral rotation of the hip was greater in male than in female subjects by a mean difference of 4 degrees(T-test, p<0.05). The mean value of thigh-foot angle was 10 degrees with a range of -2 to 23 degrees in male subjects, and 12 degrees with a range of 0 to 21 degrees in female subjects. The total range of hip rotation was slightly greater in Korean than in Caucasians or in Chinese, but, to conclude this, more large study by the same methods will be needed in other areas of Korea.
Asian Continental Ancestry Group ; Ethnic Groups ; Female ; Hip ; Humans ; Korea ; Lower Extremity* ; Male ; Reference Values

No abstract available.

E-cadherin is a calcium-dependent epithelial adhesion molecule which plays a role in the initial step of invasion of cancer cells. The step that follows the migration of separated tumor cells is a proteolytic lysis of basement membrane and extracellular matrix by protease of epithelial and endothelial cells such as matrix metalloproteinase (MMP). Vascular endothelial growth factor (VEGF) is known to be an endothelial cell-specific powerful mitogen as well as a vascular permeability factor. This study is aimed to evaluate the correlation between expression of these factors and pathologic or clinical variables and the roles and prognostic significance of those factors in squmous cell carcinoma and adenocarcinoma of the lung. Immunohistochemical stains were performed for E-cadherin, MMP-2, and VEGF in surgically resected specimens from 90 patients with squmous cell carcinoma and adenocarcinoma of the lung. Mean age of the patients was 59.7 years. Histologic type was categorized into 56 cases of squamous cell carcinoma and 34 cases of adenocarcinoma. Mean survival period of the 35 patients was 54 months. The immunohistochemical stains for E-cadherin, MMP-2, and VEGF revealed positive reaction in 67 cases (74.4%), 43 cases (47.8%), and 34 cases (37.8%), respectively. The expression of E-cadherin was higher in adenocarcinoma (82.4%) than in squamous cell carcinoma (69.6%). MMP-2 was expressed in the tumor cells, especially those invading into the surrounding stroma. The expression of MMP-2 was significantly correlated with the survival rate (p<0.05). The expression of VEGF in the tumor cells was significantly higher in cases with lymph node metastasis (p<0.05). In conclusion, these findings suggest that the expression of MMP-2 and VEGF predict poor prognosis of patients with squmous cell carcinoma and adenocarcinoma of the lung and that VEGF may play a role in tumor metastasis.
Adenocarcinoma* ; Basement Membrane ; Cadherins* ; Carcinoma, Squamous Cell* ; Coloring Agents ; Endothelial Cells ; Extracellular Matrix ; Humans ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Survival Rate ; Vascular Endothelial Growth Factor A*

No abstract available.
Bacteria* ; Bivalvia*

PURPOSE: Bone involvement is known to develop in 40-70Yo of pediatric acute leukemia. We aimed to analyze the clinical course and result of therapy in pediatric acute leukemia with bone involvement. METHODS: Twenty-seven patients diagnosed as pediatric acute leukemia at Dong San Medical Center from Jan. 1996 to Aug. 1998 were evaluated. According to bone X-ray and whole body bone scan, the patients were divided into two groups. RESULTS: Twenty-seven patients were enrolled in this study with 14 patients(52Yo) showing definite bone involvement on simple X-ray or bone scan. Mean age of patients with bone involvement was 5.5 years. Regarding the type of leukemia, 9 patients(64%) were acute lymphocytic leukemia. Ten patients(71%) out of 14 with bone involvement complained of bone pain at the involved bony site. Site of involvement was most frequent in the lower extremity. On simple X-ray, osteolytic lesion was found in 7 patients(50%), diffuse osteopenia in 2 patients(14%) and pathologic fracture in 2 patients(14%). In bone scan, radioactivity was increased in whole cases of patients with bone involvement. Thirteen patients(93%) were completely remitted by chemo-therapy, but, one AML patient died due to induction failure. CONCLUSION: Bone involvement occured in 52% of pediatric acute leukemia. Bone involvement was more frequent in male patients in the lower extremity, and osteolytic lesion was the most frequent finding on simple X-ray. There was no relevence between bone involvement and prognosis. Further study will be needed to evaluate long-term survival and prognosis. (J Korean Pediatr Soc 2000;43:806-813)
Bone Diseases, Metabolic ; Fractures, Spontaneous ; Humans ; Leukemia* ; Lower Extremity ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis ; Radioactivity