No abstract available.
Bile Ducts* ; Bile* ; Gallbladder*

Since Luque introduced new posterior instrumentation by segmental sublaminar wiring for neuromuscular scoliosis in 1976, preliminary reports have been published regarding its use with Harrington rod or Luque rod for other types of scoliosis, traumatic lesions of the spine, and spondylolisthesis as well as for degenerative disorders and tumors. Its advantage includes rigid internal fixation which often obviates the requirement for postoperative immobilization and the significant correction of deformity. Disadvantages are longer operation time, increased blood loss and the risk of neurologic damage. Segmental spinal instrumentation was carried out using either Harrington rod or Luque rod in 30 cases of scoliosis; 16 in idiopathic scoliosis, 12 in paralytic scoliosis and 1 each in congenital scoliosis and neurofibromatosis, at the Department of Orthopedic Surgery, Seoul National University Hospital, for 3 years from January 1984 to December 1986, Twenty six cases had been followed for more than 1 year and following results were obtained. 1. In idiopathic scoliosis, average preoperative curve was 65.0 degrees and immediate postoperative curve was 27.9 degrees with 57.4% correction. There was 1.2 degrees loss of correction with an average follow-up of 19.5 months (14–28 months). 2. In papalytic scoliosis, average preoperative curve was 108.5 degrees and immediate postoperative curve was 55.5 degrees with 49.5% correction. There was little loss of correction with anaverage follow-up 24.5 months (13–38 months). 3. No neurological complication occurred as a result of sublaminar wiring. 4. Segmental spinal instrumentation is an effective method with an advantage of better correction, greater contouring of the spine to avoid flat back, and less external immobilization in the treatment of idiopathic or paralytic scoliosis without increased complication.
Congenital Abnormalities ; Follow-Up Studies ; Immobilization ; Methods ; Neurofibromatoses ; Orthopedics ; Scoliosis ; Seoul ; Spine ; Spondylolisthesis

Nineteen patients (twenty knees) with degenerative arthritis of knee treated by arthroscopic curettage were reviewed. Of the nineteen patients, there were eighteen females and one male ranging in age from 49 to 68 years (mean, 57 years). The mean follow up period was 18.2 months (range, 12 months to 21 months). Simple standing roentgenorgram and 99m-Tc bone scintigraphy were used to select the patients with medial compartment involvement only, less than 5 degree of varus deformity and sparing of patello-femoral joint. Knee scoring by Hospital for Special Surgery Formula showed improvement from the preoperative average 68 points to postoperative average 89.6 points (21.6 points increase) and 84.1 points (16.1 points increase) at 6 months and one year respectively. Arthroscopic curettage of knee, if done early in degenerative arthritis, not only can shorten hospital days and immobilization period but also can defer other major surgical treatments by promoting natural healing process and symptomatic relief.
Congenital Abnormalities ; Curettage ; Female ; Follow-Up Studies ; Humans ; Immobilization ; Joints ; Knee ; Male ; Osteoarthritis ; Radionuclide Imaging

With the advent of improyed external fixation device, femoral lengthening has gained renewed popularity in recent years in the treatment of unequal leg length. Wagner(1971) and De Bastiani et al(1987), among others, have made epochal contribution in this field. During the period from May 1984 to May 1987, 25 patients with leg length discrepancy underwent femoral lengthening using Wagner's or De Bastianis distractable external fixators at the Department of Orthopedic Surgery, Seoul National University Hospital. There were 6 patients below 16 years of age admitted to the Children's Hospital, and 19 patients were 16 years or older. The mean age was 18.2 years, ranging from 3 years to 36 years. The underlying etiology included residual poliomyelitis in 20 patients, epiphyseal injury in 2 patients, congenital short femur in 1 patient, septic hip residua in 1 patient, and cerebral palsy in 1 patient. The mean leg length discrepancy was 4.5cm, ranging from 1.3cm to 7.4cm. The mean length gained was 4.1cm, ranging from 1.8cm to 6.4cm. All except two patients had two stage procedures with iliac crest strut bone graft. The mean time required for radiological consolidation of bone graft was 4.8 months. The plate and screws used for osteosynthesis was removed after the medullary canal has been re-established. Six patients had removal of the plate and screws between 8 months and 25 months after the second stage osteosynthesis. Technical errors included 1 case of incomplete osteotomy which required manual clasis, and another case of faulty insertion of Schanz screws that required reinsertion. Five cases (33.3%) had the minor pin tract infection. Schanz screw breakage occurred in a case of one stage femoral lengthening. Loosening of plate and screws was seen in three cases. One case had delayed union requiring augmentation bone graft. Stiff knee with less than 90°of flexion was encountered in one case. One case sustained fracture of patella during physiotherapy. Despite of a long list of complication, the ultimate goal of leg length equalization was successfully achieved in all the cases.
Cerebral Palsy ; External Fixators ; Femur ; Hip ; Humans ; Knee ; Leg ; Orthopedics ; Osteotomy ; Patella ; Poliomyelitis ; Seoul ; Transplants

Clear cell sarcoma of tendon and aponeurosis is a rare malignant tumor. It occurs chiefly in young adults, predominates in women and is most common in the regions of the foot and ankle. We report a case of clear cell sarcoma of tendon and aponeurosis in s 22-year-old man. he pstient had had a asymptomatic, normal skin colored, relativerly hard, dome shsped nodule on the anterior chest for 6 months. Histopsthologic findings revealed uniform pattern composed of compact nests of round or fusiform cells which had clear cytoplasm and were surrounded by delicate framework of fibrocollagenous tissue, and the individual tumor cell had a fairly regular appearance of possessing round to avoid vesicular nucleus with prominent basophilic nucleolus. One year after surgical excision and post operative radiotherapy, there was no recurrence.
Ankle ; Basophils ; Cytoplasm ; Female ; Foot ; Humans ; Radiotherapy ; Recurrence ; Sarcoma, Clear Cell* ; Skin ; Tendons ; Thorax* ; Young Adult

PURPOSE: To evaluate the effects of silicone tube intubation in patients showing common canalicular obstruction in dacryocystography. METHODS: We conducted a retrospective chart review of 136 eyes of 93 patients who underwent silicone tube intubation and who were followed for more than 6 months. The patients were divided into 2 groups: the normal canaliculus group (112 eyes of 72 patients) and the common canalicular obstruction group (24 eyes of 21 patients). The demographic characteristics, degree of nasolacrimal duct obstruction on probing, and functional and anatomical success rates of silicone tube intubation were compared between the two groups. Surgery success was noted when the patient was satisfied with the 'improved' tearing symptom and the tear meniscus height decreased. RESULTS: On probing, 17 (70.8%) of 27 eyes revealed definite obstructive feeling at nasolacrimal duct in the common canalicular obstruction group, and there was no significant difference compared to the normal canaliculus group (p = 0.639). The anatomical success rate of silicone tube intubation was 91.1% in the normal canaliculus group and 83.3% in the common canalicular obstruction group, and the functional success rate was 85.7% in the normal canaliculus group and 75.0% in the common canalicular obstruction group. There were no significant differences in success rates between the two groups (p = 0.271, p = 0.161, respectively). CONCLUSIONS: Silicone tube intubation can be considered as a primary treatment option for management of common canalicular obstruction.
Humans ; Intubation* ; Nasolacrimal Duct ; Retrospective Studies ; Silicon* ; Silicones* ; Tears

OBJECTIVES: Hemophilia B has been known to result from more than 500 kinds of mutations. And it is difficult to find out a mutation specific for each family. Therefore, linkage analysis of DNA polymorphism within or near the factor IX gene has been frequently used in the clinical practice for molecular genetic diagnosis of hemophilia B. But the ethnic variation makes more difficult to apply useful markers in Caucasian population. To investigate the usefulness of the MseI and HhaI polymorphism in Korean population, we analysed the MseI and HhaI polymorphism. METHODS: Forty-five normal Korean and thirteen parents of the hemophilia B patients, using PCR and restriction enzyme analysis. RESULTS: The heterozygosity rate of MseI polymorphism was 49.7% and that of HhaI polymorphism was 25.5%. CONCLUSION: These data indicated that PCR-based analysis of MseI and HhaI polymorphism of factor IX was useful in molecular genetic diagnosis of hemophilia B in Korean population.
Diagnosis* ; DNA* ; Factor IX* ; Hemophilia A* ; Hemophilia B* ; Humans ; Molecular Biology* ; Parents ; Polymerase Chain Reaction ; Prenatal Diagnosis ; Restriction Mapping

The precise diagnosis of internal derangement of the knee is difficult, since the signs and symptoms are frequently obscure. For this reason, diagnostic aids have long been sought, and arthrogrphy has been widely used as a means to improve diagnostic accuracy. Recently, post-arthrographic high resolution computed tomogrphy has been added to the diagnostic techniques for the evaluation of the knee. Arthrography and post-arthrographic high resolution computed tomography were carried out in 97 cases of clinically suspicious meniscal tear from January 1986 to October 1987. Among them, 40 cases were confirmed by arthroscopic surgery and following results were obtained. l. Arthorgraphy resulted in a diagnostic accuracy of 92.5% and 72.5% for medial and lateral meniscal lesion. Post-arthrographic high resolution computed tomography resulted in that of 95.0% and 90.0% for each meniscal lesion. 2. 16 cases of them were discoid meniscus. 13 cases(92.5%) were detected by arthrography and 16 cases(100%) by post-arthrographic high resolution computed tomography. 3. The sensitivity of arthrography was proved to be 100% and 65.4% for medial and lateral meniscal lesion, and thst of post-arthrographic high resolution computed tomography to be 100% snd 88.5% for each meniscal lesion. The specificity of arthrography was 90.0 and 85.7% in each meniscal lesion and that of post-arthrographic high resolution computed tomography was 93.3% and 92.9% in each meniscal lesion. 4. Post-arthrogrsphic high resolution computed tomography was proved to show better diagnostic accuracy, and good visualization of the relationship and extent of torn meniscal lesions. The meniscal anatomy that was displayed by high resolution computed tomography more accurately depicted the anatomical findings that were seen at arthroscopy. With this additional information, arthroscopists could plan more appropriate surgical approach.
Arthrography ; Arthroscopy ; Diagnosis ; Knee ; Sensitivity and Specificity ; Tears

No abstract available.
Neurofibromatoses* ; Scoliosis*

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