A case of dysplasia eplphyseaalis hemlmelica (Fairbank, 1956) in a 8 years old boy, showlng typical clinical and roentgenographical appearance, is reported together wlth a brief review of literature in this paper. This condition is a rare developmental disorder of childhood in which there is a asymmetrical cartilaginous overgrowth of one or more than one epiphysis, or of a tarsal or carpal bone. Thls disorder is usually Iimited to elther the medial or lateral half of a single extremity. The disease is characterised radiographically by delay in the appearance of the epiphyseal nucleus, which is mottied and of irregular density. The most common deformities were genu valgum or varum and valgus or equinus deformity of the ankle. These deformities tended to increased wlth growth but the size of the lesion increased in proportion to the growth of the normal bone. Concomitant involvement of the knee and ankle is the rule, and in those cases the affected limb Is usually longer than Its mate. The lesion Is often microscopically indistingulshable from an osteochondroma.
Ankle ; Carpal Bones ; Congenital Abnormalities ; Epiphyses ; Equinus Deformity ; Extremities ; Genu Valgum ; Humans ; Knee ; Male ; Osteochondroma

Seventeen patients with classical rheumatoid arthritis have been treated with gold sodium thiomalate(G.S.T) injection and followed up for 1.7 years on average. The results obtained are as follows: 1. Clinical improvement was obtained in 12(70.3%) out of 17 cases, but only in 5 cases(29.3%) marked and persisting improvement was obtained. Such improvement was first noticed when the total dose of the gold sodium thiomalate reached 500mg or more, and also noticed about 10 weeks after initiation of G.S.T therapy. 2. Changes in laboratory parameters such as hemoglobin, hematocrit, eosinophilia, titers of rheumatoid factor and C-reactive protein, and proteinuria began to appear at the time of the clinical improvement. 3. Adverse reaction consisted mostly of mucocutaneous lesions. The main causes of drop-out during therapy also are severe skin rashes and pruritus. Most of the adverse reactions appeared when the total dose of G.S.T. administered reached over 500mg. In two severe cases skin rashes terminated the gold therapy. Our findings suggest, because of high incidence of adverse reaction during G.S.T therapy, repeated careful clinical and laboratory examination of the patient are mandatory especially when the total dose of G.S.T is reached 500mg. In spite of the well documented reports of the maintenance gold therapy for rheumatoid arthritis it is felt that the maintenance gold therapy should be studied further before it can be safely used as a routine in daily rheumatology practice because of its toxicity.
Arthritis ; Arthritis, Rheumatoid ; C-Reactive Protein ; Eosinophilia ; Exanthema ; Gold Sodium Thiomalate ; Hematocrit ; Humans ; Incidence ; Proteinuria ; Pruritus ; Rheumatoid Factor ; Rheumatology ; Sodium

No abstract available.
Bursitis*

No Abstract Available.
Rupture* ; Tendons*

Juvenile myoclonic epilepsy(JME) of Janz is a syndrome of generalized age related epilepsy with increasing incidence and probable autosomal recessive trait. We have experienced 2 female patients who had awakening myoclonus in both arms, which had started in their early 10th. The patterns of seirures and electroencephalographic findings were consistent with those of JME which had been first described as impulsive petit mal by Janz. We report these cases with brief review of literatures.
Arm ; Epilepsy ; Female ; Humans ; Incidence ; Myoclonic Epilepsy, Juvenile* ; Myoclonus

Anthracycline drugs are chemotherapeutic agents highly effective against a wide range of neoplasms. However, its administration may be complicated by cardiotoxic reactions. There is a continuum of increasing risk with increasing total dose of drug rather than an absolute cutoff point for total dose drug of that should not be exceeded under any circumstances. At the present time it appears that a potentially important clinical application of Doppler echocardiography would be the noninvasive evaluation of global ventricular function. To assess the value of serial Doppler echocardiography in detecting early signs of anthracycline cardiotoxicity in children, we studied 50 patients (35 male and 15 female children, age range 1.6 to 20 years) admitted to the Department of Pediatrics in the Kyungpook National University Hospital for treatment of neoplasia between July 20, 1988 and April 20, 1991 prospectively. Eight three Doppler echocardiograms were performed prior to and at intervals after receiving varying doses of anthracycline and aortic velocity, acceleration time (AT), ejection time (ET), ratio at AT to ET (AT/ET), acceleration and velocity time integral, and mitral velocity of E and A waves and velocity time integral were measured. Pretreatment parameters were not differ from those of normal age matched control children. The aortic AT/ET showed significant increase with increase in anthracycline dosage, being a mean (+/-SD) of 0.30+/-0.07 in the pretreatment group, 0.33 (+/-0.09) after 100 mg/M2 (p<0.001) but the mitral E/A peak velocity ratio showed significant decrease, being a mean (+/-SD) of 1.47 (+/-0.26) in the pretreatment group and 1.36 (+/-0.09) after 400mg/M2(p<0.05). We could not reliably ascertain the relationship between Doppler echocardiographic changes and development of anthracycline cardiomyopathy but these preliminary data show that Doppler echocardiography may detect incremental changes in left ventricular function in anthracycline cardiomyopathy. It is hoped that further study at higher dose levels in large populations for a sufficient follow up time will identify those patients with a risk of developing cardiomyopathy and then manage them appropriately.
Acceleration ; Cardiomyopathies ; Child* ; Echocardiography* ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Gyeongsangbuk-do ; Hope ; Humans ; Male ; Pediatrics ; Prospective Studies ; Ventricular Dysfunction, Left* ; Ventricular Function ; Ventricular Function, Left

Avulsion fracture of ischial tuberosity which usually occurs in a young athelete is often undiagnosed early, and therefore is treated after a considerable time elapsed. And it causes a lot of discomfort to the athelete because of subsequent tumorous enlargement of tuberosity with fibrous union, and hamstring dysfunction as a late sequela. Two cases of this sort that required excision of the ununited enlarged fragment are presented. The present authors feel that widely displaced avulsion fracture of ischial tuberosity should be treated operatively and that even minimally displaced one also has to be protected from another injury.

The developement of squamous cell carcinoma from the draining sinus of chronic osteomyelitis has long been recognized as a rare and late complication. The mode of developement of carcinoma at the site of chronic osteomyelitis is not well understood. This, however, is chiefly a disease of middle aged men, and tibia is the most common site. There are two types in this carcinoma; superficial and deep types. In the superficial type obvious presence of fungaiing growth makes diagnosis simple and easily confirmed by biopsy. In the deep type the diagnosis is difficult clinically, but the features most frequently described are an increase in pain and discharge with swelling and hemorrhage. Amputation at the adequate level is the treatment of choice. Three cases of the disease involving one left femur, and two left tibiae are reported with review of literature.
Amputation ; Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Epithelial Cells ; Femur ; Hemorrhage ; Humans ; Male ; Middle Aged ; Osteomyelitis ; Tibia

The management of fractures of the intercondylar eminence of the tibia is uncomplicated when the fracture has minimal displacement(type I) or when only anterior one-third or half of the eminence is elevated(type II)(Meyers and Mckeever 1959, 1970). The treatment of complete separation(type III) has been controversial. Many authors however recommended conservative treatment even for the completely separated fracture if the fracture fragment is not rotated. Two cases of non-union of the tibial spine fracture we experienced were; one in type IIl, and the other type II. They were treated conservatively by cast immobilization. One patient had severe anterolateral rotatory.instability and had lateral meniscal tear, and the other had transverse ligament impingement at the fracture gap which interfered the reduction of the fragment and also bony union. Through the clinical experience and the two listed non-union cases, we drafted a therapeutic plan for the avulsed tibial spine fractures. The authors recommend open reduction and internal fixation of the avulsion fracture of the tibial spine in following circumstance; 1) all of the type K complete separation injuries 2) tibial spine fracture with positive Lachman test and soft end point 3) fracture with associated ligament injury. We applied the above surgical indications for 13 cases. The authors reviewed 25 cases of the anterior tibial spine fracture patients treated at the Department of Orthopaedic Surgery, Catholic Unviersity Medical College during the period from October 1982 to August 1986 and the following results were obtained. 1. The cases were classified into 3 different categories according to the Meyers and Mckeever classification; Type I(7 cases, 29%), Type II(10 cases, 40%), Type III(8 cases, 31%). 2. Associated ligament injuries on the same knee were rupture of LCL for 7 cases(28%) and MCL for 6 cases(24%). 3. Twelve out of thirteen open reduction and internal fixation cases had excellentresult in minimum 6 months follow-up period.
Classification ; Follow-Up Studies ; Humans ; Immobilization ; Knee ; Ligaments ; Rupture ; Spine ; Tears ; Tibia

With the increasing use of pedicular system to fix the spine, many complications are being reported. Recently many systems are available to fix the spine. However, each system has own advantages and disadvantages. The causes of metallic failure of Modular Segmental Spinal (MOSS) instrumentation on 42 consecutive patients undergone in Kang-Nam St. Mary's hospital since 1989 were reviewed. The specific aim of this investigation was to assess causes of metallic failure and loosening of this system on various spinal disorders. Of these, 8 cases had metallic failure and loosening. Breakage of screw and rod developed in 6 cases and dislodgement of rod from screw in 2 cases. In case of degenerative spondylolisthesis (unstable phase) with stenosis, however, the complications were closely correlated to expansile decompressive laminectomy to widen the narrowed spinal canal and the instrumental distraction to gain normal intervertebral disc space at the operation. Bony union and back pain were not correlated to metallic failure and loosening. Therefore, the main causes of metallic failure and loosening were (1) preoperative instability undergone expansile decompressive laminectomy including total bilateral facetectomy that aggravated preoperative instability, and (2) forceful instrumental dis traction. In cases needed these requirements, combined anterior interbody fusion or posterior interbody fusion should be added, heavier rods and screws larger than 3.5mm, 4.0mm in diameter, respectively, should be used. In addition to postoperatively sufficient bed rest and immobilization using rigid braces should be recommended to reduce these complications.
Back Pain ; Bed Rest ; Braces ; Constriction, Pathologic ; Humans ; Immobilization ; Intervertebral Disc ; Laminectomy ; Spinal Canal ; Spine ; Spondylolisthesis ; Traction