Since 1856, Mayer13) coined the term “osteotomy” for a tibial resection for an angular deformity, various shapes and designs of osteotomies in long bone or pelvis have been popularized to treat the malunion, osteoarthritis of hip and knee, bow leg, L.C.P., or C.D.H. etc. The purpose of corrective osteotomy for tibia is so different from that of upper extremity because it must be restored the weight bearing alignment, and equalize or minimize the leg length discrepancy. We respectively reviewed 14 cases with various angular deformities on tibia who were treated at Dept. of Orthopaedic Surgery, Catholic Medical College from Jan. 1976 to Dec. 1984. The results obtained were as follows: 1. Causes of angular or rotational deformities of tibia were malunion in 11, bow leg in 2 and partial closure of distal tibial epiphysis in l. 2. Ten cases of tibial deformities exceeded over the 10° of medial or lateral angulation and 15° of anterior or posterior bowing were corrected for normal weight-bearing alignment in lower leg. And a rotational deformity may be so disabling to walk as to require surgery. So four cases of tibial angular deformities combined with more than 20° of external rotation and 5° of internal rotation were corrected for normal good looking walks. 3. The maximum length that can be gained by an opening wedge osteotomy was near the point of maximum angluation, but it could be changed by the cause of deformity and patient's age. We've done 4 cases of opening and 10 cases of closing wedge osteotomy. 4. Angular deformity in one plane due to fracture in children under 10 years of age may be corrected spontaneously by growth, but deformities due to bow leg or epiphyseal injury cann't be expected any spontaneous correction of deformity by growth. So three cases of tibial deformities due to bow leg or epiphyseal injury in children were corrected in earlier after recognition of that deformities because of possible damage to articular cartilage and the combined rotational deformities. 5. A slight deformity if the angulation involves near a joint, knee or ankle could be seriously disabling and so must be correctcd earlier. 6. Functional results of the corrective wedge osteotomy in angular and rotational deformities of tibia were excellent, good, fair in 4, 7 and 3, respectively.
Ankle ; Cartilage, Articular ; Child ; Congenital Abnormalities ; Epiphyses ; Genu Varum ; Humans ; Knee ; Knee Joint ; Leg ; Numismatics ; Osteoarthritis, Hip ; Osteotomy ; Pelvis ; Tibia ; Upper Extremity ; Weight-Bearing

No abstract available.
Polymethyl Methacrylate*

The exact etiologies and mechanisms of ischemia in avascular necrosis of femoral head are still under investigation. But this condition seems to be increasing during a few decades with increasing use of steroid and alcohol abuse in Korea. The treatment modalities have been based on the stages of the disease by simple radiographic findings that do not describe the accurate pathological extent or localization. Therefore more sophisticated study is needed to treat the AVN of the femoral head well. Magnetic resonance images, simple radiographs, scintigraphs of 13 patients(22 femoral heads), who were admitted and treated at Seoul National University Hospital from April, 1989 to December, 1989 were correlated, to characterize the type of AVN by extent and location regardless of its stage and reveal the relationship between types and stages. It is the result of this study that the type of AVN as well as stage should be considered in determining the treatment modality.
Alcoholism ; Classification ; Head ; Ischemia ; Korea ; Magnetic Resonance Imaging ; Necrosis ; Seoul

Of 29 scoliotic patients treated by Harrington and Dwyer instrumentation, fourteen patients were taken of preoperative cnrrection by halo-femoral skeletal traction for the last two years from June 1974 to June 1976 at the Department of Orthopedic Surgery, Seoul National University Hospital. The correctability of scoliosis by the use of halo-femoral traction was evaluated with roentgenogram study and the following result was obtained. 1. Of the 14 cases, five cases were male and eight were female, and they were between the age of 13 and 29. 2. The etiology of the 14 scoliosis was idiopathic in three, paralytic in eight, congenital in one, and associated with neurofibromatosis in two. 3. The average initial curve was 108 degress with the flexibility of 32.1% on side bending. 4. The average preoperative curve with halo-femoral traction for one week was 75. 1 (30.5% correction), and the end of two week was 68 (37% correction). 5. The average immediate postoperative curve was 58.5 (46.5% correction). 6. The result of traction in the different etiologic type showes no significant difference.
Female ; Humans ; Male ; Neurofibromatoses ; Orthopedics ; Pliability ; Scoliosis ; Seoul ; Traction

From July 1989 to August 1991, we performed 146 cases of endoscopic sphincterotomy(EST). In our series, 9 early complications occurred in 146 cases(morbidity rate: 6.2%), and no fatalities were recognized(mortality rate:0). Four cases with late complications consisted of 2 cases of acute cholecystitis, one case of chalaagitis and restenosis. There were 36 with the gallbladder with stone(11 cases) or without stone(25 cases). Two cases with chalecystitis after EST occurred in the patients with gallbladder stones. EST gives the sufficient result in diagnosis and treatment for various disease of biliary tract. Furthermore, EST was found to be a safe procedure from low rates of complications and fatalities.
Biliary Tract ; Cholecystitis, Acute ; Diagnosis ; Gallbladder ; Humans ; Sphincterotomy, Endoscopic*

We performed ERCP manometry of Sphincter of Oddi(SO) before and after endoscopic sphincterotomy(EST) for evaluation of the effect af EST on the SO. The subjects were postcholecystectomized common bile duct stone patients(n=l2) and EST was performed by major incision. The pressure gradient between common bile duct and duodenum before EST (8.6 + 3.9 mmHg) decreased significantly after EST(2.4 +1.7 mmHg). The length of SO before EST(8.8 + 0.8mmHg) decreased significantly after EST(2.5 + 0.8mm). But in each patient, the pressure gradient between common bile duct and duodenum remained in spite of the major incision. In conclusion, EST alters the function of the sphincter of the Oddi, but does not destroy its all protective function. The positive pressure in the bile duct is preserved in contrast to the absolute loss of pressure following surgical transduodenal sphincteroplasty.
Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Duodenum ; Humans ; Manometry* ; Sphincter of Oddi* ; Sphincterotomy, Endoscopic* ; Sphincterotomy, Transhepatic

PURPOSE: To investigate prognostic factors influencing on local recurrence, distant metastasis and event-free survival of liposarcomas. MATERIALS AND METHODS: Fifty-two patients managed for liposarcomas since 1993 were analyzed respectively in the view of prognostic influence of patient age, tumor size, location, histologic type, histologic grade, resection type, surgical margin, chemotherapy and radiation therapy on local recurrence, distant metastasis and event-free survival. The mean follow up period was 39 months. The univariate and multivariate regression analysis were performed for statistical evaluation. RESULTS: The local recurrences occurred in 11 patients (21.2%) and distant metastasis in 4 patients (8%), Event-free survival rate at 4 year follow up was 67%. In univariate analysis, histologic grade, surgical margin, chemotherapy and radiation therapy were significant prognostic factors on local recurrence (p<0.05). However, histologic grade lost its significance in muitivariate analysis. Trunk location revealed higher rate of distant metastasis than extremity location. In univariate analysis on event-free survival. histologic grade and chemotherapy were significant factors (p<0.05). No factor remained significant in multivariate analysis. CONCLUSION: Considering selection bias, positive surgical margin was negative prognostic factor on local recurrence. Liposarcomas arisen in trunk revealed higher rate of distant metastasis. There was no independent prognostic factor on event-free survival of patients with liposarcomas.
Disease-Free Survival ; Extremities ; Follow-Up Studies ; Humans ; Liposarcoma ; Multivariate Analysis ; Neoplasm Metastasis ; Recurrence ; Retrospective Studies ; Selection Bias

Infantile fibrosarcoma is a rare malignant soft tissue tumor occurring especially in newborn and young children under 2 years. We experienced three cases of infantile fibrosarcoma presenting in the neonatal period. Case 1 presented with a multiseptated cystic mass on his left thigh at birth that was diagnosed as lymphangioma. After picibanil injection, we noted the size of the mass doubled and a solid lesion was prominent in the magnetic resonance image. Case 2 was found to have a reddish mass on his lower back mimicking hemangioma. Over 2 weeks, the mass grew rapidly with internal hemorrhaging. Case 3 was noted to have an encircling mass around the splenic flexure, which developed into congenital bowel obstruction. All of the tumors were resected completely, but microscopic resection margin was not clear in two patients. The two patients received adjuvant chemotherapy and all patients are well without evidence of recurrence.
Chemotherapy, Adjuvant ; Child ; Colon, Transverse ; Fibrosarcoma ; Hemangioma ; Humans ; Infant, Newborn ; Lymphangioma ; Magnetic Resonance Spectroscopy ; Parturition ; Picibanil ; Recurrence ; Thigh

Juvenile spring eruption(JSE) of the ears is an unusual type of photodermatosis, which develops on the light exposed areas of the ears of boys and young male adults in the early spring months. JSE has received little attention in the literature, and to our knowledge no cases have been reported in Korea until now. Herein we report a case of JSE occurring in a 17-year-old man who has suffered from a recurrent pruritic erythematous papulovesicular eruption of both helix, followed by crusting and healing without scarring within one to two months early each spring for six years.
Adolescent ; Adult ; Cicatrix ; Ear* ; Humans ; Korea ; Male

Moyamoya disease is a rare occlusive cerebrovascular disease characterized by stenosis or occlusion of the main cerebral arteries. It has a tendency for multifactorial inheritance and familial occurrence, although its pathogenesis is not clear. We observed this disease in two girls from the same family:one was eight years old and the other was 45 months. They presented with transient ischemic attacks. We performed cerebral angiography on both patients and magnetic resonance angiography (MRA) on the younger. Both approaches showed the typical features of moyamoya disease, and MRA successfully revealed abnormal findings specific for the disease in the second child. Both children received encephaloduroarteriosynangiosis (EDAS) and this produced good results. MRA is thus a powerful and noninvasive way of detecting individuals at high risk of developing this disease. Considering the reported familial incidence of moyamoya disease in Japan, a careful search for family members using MRA would probably reveal many more such cases in Korea.
Cerebral Angiography ; Cerebral Arteries ; Child ; Constriction, Pathologic ; Female ; Humans ; Incidence ; Ischemic Attack, Transient ; Japan ; Korea ; Magnetic Resonance Angiography ; Moyamoya Disease* ; Multifactorial Inheritance