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.
Anemia, Aplastic*

There are several different methods of purifying Treponema pallidum(TP) from rabbit testicular tissue. Among them, we compared the use of differential centrifugation, which has been most widely used, to Percoll density gradient centrifugatian, a newly applied method, in purifying TP from rabbit testicular tissue by checking the protein concentration of the TP suspension, hemagglutination assay using sheep erythrocytes sensitized by TP, IgM-TP-enzyme-linked immunosorhent, assay(IgM-TP-ELISA) and eJect,ron microscopic observation. The protein concent,ration af TP antigen suspension (2x10(8)TP/ml) purified by Percoll density gradient centrifugation (lower band) was the lowest (129.0pg/ml) when compared to those purified by differential centrifugation (324.0pg/ml) and Percoll density gradient centrifugatian (upper band) (560.2pg/ml). Sheep erythrocytes sensitized by TP purified by Percoll density gradient centrifugation(lower band) showed the same resiilts as those using a commercii1 TPHA kit when tested with positive and negative control sera. The sensitivity and specificity of the IgM-TP-ELISA were 88.5%(23/26') and 86.4%(19/2Z) respectively using TP as an antigen purified by differential centrifugation. The rates were 96.29% (25/26) and 95.5%(2l/22) using TP purified by Percoll density gradient centrifugation. As shown by the electron microscopy, T. pizllida purified by clifferential centritugation and Percoll density gradient centrifugatiori were structurally unaltered, and Percoll-purified TP contained much less tissue debris than TP prepared by differ ential centrifugation. Therefor e, Percoll density gradient centrifugation is considered to be a better method of purifying TP from rabbit testicular tissue when compared to differential centrifugatian, as a matter of fact, Perrol1 density gradient centrifugation has been applieci successfully in the study of the physiology, recombinant DNA techniques, and antigenic structure of TP and to the preparation of the antigen for the FTA-ARS and TP-ELISA
Centrifugation ; Centrifugation, Density Gradient ; DNA, Recombinant ; Erythrocytes ; Hemagglutination ; Microscopy, Electron ; Physiology ; Sensitivity and Specificity ; Sheep ; Treponema pallidum* ; Treponema*

Congenital stapes fixation showing normal finding of external auditory canal and tympanic membrane causes non-progressive conductive hearing loss in the range of 40 to 60 dB since childhood. It is a rare disease, but most commonly found among the isolated ossicular anomalies. Patients with this disease are very suitable candidates for stapes surgery, and successful hearing improvement can be expected by an appropriate surgical procedure. We report 2 cases of congenital stapes fixation which had been operated improperly. One case showed interposed homologous ossicle between the stapes head and the incus, and the other case showed transposed incus between the malleus handle and the stapes head along with the anterior crus fracture. They showed hearing improvements of more than 30 dB after stapedotomy with placement of the Fisch type stapes prosthesis. We are reporting two cases of misdiagnosed congenital stapes fixation with a discussion.
Ear Canal ; Head ; Hearing ; Hearing Loss, Conductive ; Humans ; Incus ; Malleus ; Prostheses and Implants ; Rare Diseases ; Stapes Surgery ; Stapes* ; Tympanic Membrane

The antiphospholipid antibodies are characterized by prolonged phospholipid-dependent coagulation test (known as APTT or Russel viper venom), thrombosis, thrombocytopenia, and fetal loss. The association of antiphospholipid antibodies with one or more of these characteristic clinical features has been termed the i antiphospholipid syndrome. We have experienced a case of successful live birth after treated a woman with heparin and aspirin who has experienced spontaneous abortion four times with antiphospholipid antibodies and present it with the review of literature.
Abortion, Spontaneous ; Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Aspirin ; Female ; Heparin ; Humans ; Live Birth* ; Pregnancy ; Thrombocytopenia ; Thrombosis

BACKGROUND: Coronary artery diseases (CAD) are increasing in recent years among Korean due to change of socioeconomic status. Even though death rates due to CAD has increased in Korea, few epidemiologic studies have been done about risk factors of CAD. We conducted a case-control study to analyze risk factors for CAD among Korean. METHODS: The case series comprised 166 patients with angiographically confirmed CAD, who were admitted to Division of Cardiology in Asan Medical Center. The controls were 137 persons composed of patients with normal coronary arteriogram or patients with normal myocardial SPECT for chest pain. We surveyed life style habits, measured anthropometric variables, and analyzed biochemical markers among CAD patients and controls. RESULTS: In univariate analysis adjusted for age and body mass index (BMI), age, obesity, abdominal obesity, hypertension, low HDL-cholesterol, low apolipoprotein A1, and high lipoprotein (a) were associated with CAD in men and women. Smoking, diabetes, and hypercholesterolemia were associated with in men only. Exercise and high HDL-cholesterol were inversely associated with CAD both in men and women. In multivariate logistic regression analysis, smoking, abdominal obesity, low apolipoprotein A1, and high lipoprotein (a) were found as independent risk factors of CAD among men. Abdominal obesity, low apolipoprotein A1, and high lipoprotein (a) were found as independent risk factors among women. CONCLUSION: These finding suggest cessation of smoking and weight control for abdominal obesity are important for prevention of CAD among Korean. The detection of low apolipoprotein A1 and high lipoprotein (a) could be useful for prevention of CAD.
Apolipoprotein A-I ; Biomarkers ; Body Mass Index ; Cardiology ; Case-Control Studies* ; Chest Pain ; Chungcheongnam-do ; Coronary Artery Disease* ; Coronary Vessels* ; Epidemiologic Studies ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Korea ; Life Style ; Lipoprotein(a) ; Logistic Models ; Male ; Mortality ; Obesity ; Obesity, Abdominal ; Risk Factors* ; Smoke ; Smoking ; Social Class ; Tomography, Emission-Computed, Single-Photon

In a murine model system, enhancement of the total IgA and rotavirus-specific IgA of suckling mice was measured by ELISA with the intestinal fluid following oral administration of murine rotavirus EC (EDIM-Cambridge) strain. In the EC strain-administered group, the geometric mean titers (GMT) of total IgAs were 512 and 91 at 1 and 2 week postinfection, respectively. On the other hand, the GMTs of the rotavirus-specific IgAs were 108 and 3 at the same periods, respectively. Thus increase in the total IgAs was 64 folds and that in the rotavirus-specific IgAs was 43 folds compared with the negative control group. As the maximal titers of both the total and rotavirus-specific IgAs were observed at 1 week decreasing until 2 weeks after infection, it is evident that the GMT of the total IgA implies that of rotavirus-specific IgA. In our ELISA system, whose specificity was verified by Western blot analysis, the total IgA in the administered group was determined to be 40-400 ng per 1 ml of the intestinal fluid. Therefore it is concluded that determination of the rotavirus-specific IgA in murine models can be a sensitive indication of rotavirus infection, and will be another promising tool in viral challenge experiments in vaccine development.
Administration, Oral ; Animals ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Hand ; Immunoglobulin A* ; Mice ; Mice, Inbred ICR* ; Rotavirus Infections ; Rotavirus* ; Sensitivity and Specificity

From January 1988 to December 1991, 39 fractures of the lateral condyle of humerus in children were treated at the Department of Orthopaedic Surgery, Sung-Ac General Hospital. It was possible to follow up from one year to four years and eleven months. The authors have analyzed the method of treatment on the basis of the degree of displacement in the change of Carrying angle and Baumann's angle. The results were as follows; 1. Of the 39 cases, the age incidence was confined to 2 to 12 years of age and the average age of the patients were 5 years. 2. Most fractures were Milch type II (29 cases) in contrast to Milch type I (10 cases). 3. According to the initial displacement of the fracture, 8 cases were Jokob's stage I, 21 cases of stage II & 10 cases of stage III. 4. There were no significant difference in the range of change of Carrying angle and Baumann's angle according to initial displacement of fracture site. However, significant difference in outcome were noticed from open reduction and internal fixation in comparison to closed reduction and percutaneous pinning. 5. In all 39 cases, lateral condylar overgrowth (10 cases), cubitus varus (1 cases) and cubitus valgus (3 cases) were noticed as complications but clinical significance was not noted. 6. The above results suggest that internal fixation is recommended for firm fixation although displacement is not severe. In case of Jakob's stage III, anatomical reduction is required in order to reduce additional damage on articular surface and epiphyseal plate caused by excessive manipulation.
Child ; Clinical Study ; Follow-Up Studies ; Growth Plate ; Hospitals, General ; Humans ; Humerus ; Incidence ; Methods

BACKGROUND AND OBJECTIVES: Acute sinusitis is a mild, self-limiting disease. In children, however, sinusitis may lead to other severe, even life-threatening, conditions. Therefore, appropriate diagnosis and management are needed. Orbital complications from sinusitis are caused by expansion through natural suture lines, foramen, dehiscence of lamina bone and bony erosion due to acute infection and necrosis. The purpose of this study was to analyze the common types of orbital complications and to compare the symptoms, prognoses and treatments of children and of adults, respectively. Materials and Method: Twenty-one children under15 years of age and thirteen adults over 15 were enrolled in the study. Symptoms, durations of treatment, treatment modalities, prognoses, and CT findings were analyzed. RESULTS: Preseptal cellulitis was found in 6 children (28.6%) and 8 adults (61.5%) ; subperiosteal abscess in 9 children (42.9%) and 3 adults (23.1%) ; and orbital cellulitis in 6 children (28.6%) and 2 adults (15.4%). Eye lid swelling was found in all subjects, while diplopia and limitation of eye movement was found in 4 children (19%) and 2 adults (15.4%). Medical treatment was the first line of therapy for both children (76.2%) and adults (61.5%), with the remaining children (23.8%) and adults (38.5%) receiving surgical treatment. CONCLUSION: While generally more severe, orbital complications in children can be treated more conservatively than those arising in adults.
Abscess ; Adult ; Cellulitis ; Child ; Diagnosis ; Diplopia ; Eye Movements ; Humans ; Necrosis ; Orbit* ; Orbital Cellulitis ; Prognosis ; Sinusitis* ; Sutures

Endometriosis affects up to 5 million women in the united states. The number of cases observed at any time is 1 in 15(7%) women in the reproductive age range. Infertility occurs in as many as 30% to 40% of cases. Anatomical compromise with failure of oocyte capture and transport is an eviednt explanation for infertility in women suffering from advanced(stageIII/IV) endometriosis. In contrast, the pathophysiology in couples suffening from mild to moderate endometriosis as a sole infertility diagnosis is poorly understood. Research over the last decade indicates that women with endometriosis suffer from excessive activstion of immunocompetent cells within the pelvis. In experimental paradigms, adversd effects of a peritoneal fluid on the reproductive process of the endometriosis patients can be demonstrated and include:(1) Phagocytosis of sperm(2) Decreased sperm motility(3) Alteration of sperm-egg interactions(4) Failure of oocytes capture by the fimbria and(5) Impeded embryo development. These data raise the possibility that the intraperitoneal inflammatory process observed in women with endometriosis may be responsible for the associated infertility. The purpose of this study was to evaluate the effect of peritoneal fluid(PF) from patient with moderate endometriosis on mouse embryo development.PF was aspirated from the posterior cul-de-sac at laparoscopy and centrifuged, and the cell-free superantant was not heat-inactivated and not filtered. Fifty percent PF in human tubular fluid(HTF) media was prepared as a study group. The control group consisted of PF with a nonendometriosis and of 0.5% bovine serum albumin and HTF. The in vitro fertilization was performed with these culture media. We were observed distribution of embryo under the microscopy at 24 hours, 72 hours, 92 hours and 120 hours after insemination. The 2-cell embryonic stages in the study group(254 ovums) and those in the control group(247 ovums) at 24 hours were 50.4%, 70.4%, respectively. At 72 hours, the embryonic stages of both groups were reached the morula stage. At 72 hours, only 7.0% of the embryos in the study group reached the hatching, versus 55.7% in the control group. (p < 0.001). At the 120 hours, 100% of embryos in study group were degenerating, versus only 13.2% in the control group. As a result, the peritoneal fluid of the endometriosis patients exert an adverse influence on early reproductive performance, especially inhibiting embryo development. The peritoneal fluid may be as a mediator in the pathogenesis of endometriosis associated subfertility.
Animals ; Ascitic Fluid* ; Culture Media ; Diagnosis ; Embryonic Development* ; Embryonic Structures* ; Endometriosis* ; Family Characteristics ; Female ; Fertilization in Vitro ; Humans ; Infertility ; Insemination ; Laparoscopy ; Mice* ; Microscopy ; Morula ; Oocytes ; Pelvis ; Phagocytosis ; Pregnancy ; Serum Albumin, Bovine ; Spermatozoa ; United States