The ischial weight-bearing functional long leg brace is one of the new immobilization devices, which allows patients to walk using less energy than was required by other devices-e.g. cast, cast-brace, conventional long leg brace. It has advantages as minimal pain and irritation, more natural gait, convenience of free joint motion, and good skin hygiene. The brace consists of quadrilateral total contact thigh shell, bilateral up-rights, knee joint, tibial cuff band and ankle-foot section. The brace was applied to 10 patients with variable diseases treated at the Department of Orthopedic Surgery, Seoul National University Hospital, from Mar-74 to May-76. It was applied postoperatively to 4 cases of femoral shaft fractures and 1 case of fibrous dysplasia of the tibia and applied to 4 cases of Legg-Perthes' disease as one of conservative managements. The brace was modified into “abduction-internal rotation functional long leg brace” in cases of Legg-Perthes disease. In 1 cases of post-infectious subluxation of the hip, the stability was maintained by use of the brace. With this experience, it is expected that the ischial weight-bearing functional long leg brace may be applied to other pathologic conditions of the lower extremity in which weight-bearing is to be avoided or guarded.
Braces ; Gait ; Hip ; Humans ; Hygiene ; Immobilization ; Joints ; Knee Joint ; Leg ; Legg-Calve-Perthes Disease ; Lower Extremity ; Orthopedics ; Seoul ; Skin ; Thigh ; Tibia ; Weight-Bearing

Osteochondritis dissecans is a joint affection characterized by partial or complete detachment and necrosis of cartilage fragment and underlying bone from the articular surface. It is seen frequently in knee, elbow and ankle joints. Young males are most commonly affected. Also it develops not infrequently in children, but never in a child under 4 years of age. A case of osteochondritis dissecans which occurred in a 6-year-old boy is reported here. The patient had been sufferred from pain, swelling and progressive limitation of motion of the left knee. X-ray showed shadows like loose bodies on posteromedial aspect of the left knee. Clinically, possibility of tuberculous arthritis could not be rulled out. Loose bodies were removed, and almost detached ostechondral fragment was excised. At post-operative second week, crutch walking and physiotherapy were recommended.
Ankle Joint ; Arthritis ; Cartilage ; Child ; Elbow ; Humans ; Joints ; Knee ; Male ; Necrosis ; Osteochondritis Dissecans ; Osteochondritis ; Walking

No abstract available in English.
Scoliosis

No abstract available.
Blood Flow Velocity* ; Humans ; Infant, Newborn*

Dopamine receptors in the CNS and other several tissues were identified by physiological, biochemical and radioligand binding techniques. But previous morphological and biochemical studies have been unable to charaterize or determine the tissue distribution of dopamine receptor subtypes because no selective ligands are available yet. Furthermore, the cellular distribution of the dopamine receptor subtypes in the rat kidney is not demonstrated well. The present study utilizes specific antibodies to characterize the renal distribution of this dopamine receptor subtype using light microscopic immunohistochemistry in the rat kidney. In the rat kidney, D1 receptor protein was localized to proximal tubule, distal tubule, renal vessels, medullary collecting tubule, juxtaglomerular apparatus(JGA) and glomerulus. And D2 receptor protein was localized to distal tubule, Henle's loop, proximal tubule, medullary collecting tubules, juxtaglomerular apparatus(JGA) and renal vasculature. The D1 and D2 receptors, which present in the central nervous system, are now identified in the rat kidney. There are some differences in receptors expressing sites on the previous radioligand binding and pharmacologic studies, but these results suggest that at least some of the renal dopamine DA1 and DA2 receptors correspond structually to the central dopamine D1 and D2 receptors.
Animals ; Antibodies ; Central Nervous System ; Dopamine* ; Immunohistochemistry* ; Kidney* ; Ligands ; Rats* ; Receptors, Dopamine ; Tissue Distribution

Plasma levels of growth hormone(GH), luteinizing hormone(LH) and cortisol were determined by radioimmunoassay following radiofrequency(RF) stimulation or coagulation of various nuclei in thalamus and hypothalamus. RF stimulation or coagulation of many nuclei in thalamus and hypothalamus consisted of pulvinar and dorsomedial nucleus in thalamus and anterior and posterior hypothalamic nuclei in hypothalamus. Anterior thalamic stimulation resulted in highly significant increase of plasma LH, GH, cortisol and TH levels. However thalamic stimulation resulted no change in the level of various plasma hormones. Hypothalamic lesion produced significantly decreased plasma LH, GH and cortisol levels. Plasma cortisol and LH levels were highest 2 hours after stimulation while GH levels did not increased until 6 hours and TH until 72 hours respectively after stimulation. The significant difference in latency for beginning of hormone secretion suggests that GH, cortisol and LH may be controlled by several separate neuronal networks. Plasma GH and cortisol levels were lowest 72 hrs after coagulation of the anterior hypothalamic area, while GH, cortisol and LH levels did not change following stimulation or coagulation of posterior hypothalamic nucleus and thalamic nucldi. It was also noted that the anterior hypothalamic stimulation or coagulation caused increased or decreased in GH, cortisol, and LH than that observed from stimulation or coagulation of other hypothalamic and thalamic nuclei respectively.
Anterior Hypothalamic Nucleus ; Hydrocortisone ; Hypothalamus* ; Lutein ; Mediodorsal Thalamic Nucleus ; Neurons ; Plasma ; Pulvinar ; Radioimmunoassay ; Thalamic Nuclei ; Thalamus*

BACKGROUND: The aim of this study is to evaluate the influence of immunosuppressants on in-hospital mortality from sepsis. METHODS: Using data of the Health Insurance Review & Assessment Service, we collected data from patients who were admitted to the hospital due to sepsis from 2009 to 2013. Based on drugs commonly used for immunosuppression caused by various diseases, patients were divided into three groups; immunosuppressant group, steroid-only group, and control group. Patients with no history of immunosuppressants or steroids were assigned to the control group. To identify risk factors of in-hospital mortality in sepsis, we compared differences in patient characteristics, comorbidities, intensive care unit (ICU) care requirements, and immunodeficiency profiles. Subgroup analysis according to age was also performed. RESULTS: Of the 185,671 included patients, 13,935 (7.5%) were in the steroid-only group and 2,771 patients (1.5%) were in the immunosuppressant group. The overall in-hospital mortality was 38.9% and showed an increasing trend with age. The steroid-only group showed the lowest in-hospital mortality among the three groups except the patients younger than 30 years. The steroid-only group and immunosuppressant group received ICU treatment more frequently (p < 0.001), stayed longer in the hospital (p < 0.001), and showed higher medical expenditure (p < 0.001) compared to the normal group. Univariate and multivariate analyses revealed that age, male gender, comorbidities (especially malignancy), and ICU treatment had a significant effect on in-hospital mortality. CONCLUSIONS: Despite longer hospital length of stay and more frequent need for ICU care, the in-hospital mortality was lower in patients taking immunosuppressive drugs than in patients not taking immunosuppressive drugs.
Comorbidity ; Health Expenditures ; Hospital Mortality ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Insurance* ; Insurance, Health ; Intensive Care Units ; Korea* ; Length of Stay ; Male ; Mortality ; Multivariate Analysis ; Risk Factors ; Sepsis* ; Steroids

No abstract available.
Animals ; Epithelium* ; Gene Expression* ; Laser Capture Microdissection* ; Mice* ; Microarray Analysis* ; Phenobarbital*

We evaluated abnormalities in medial portion of elbow in high-school weightlifter compared with the non weightlifter using a stress radiography and ultrsonography. The experimental group(G1) was 26 high school weightlifters with an average age of 17 years old (range, 16.18 years). The control group (G2) were comprised of 25 age matched general students. Both groups received physical examination, simple and valgus stress radiography and ultrasonography on both side of elbow. Physical examination showed 26.9% (14/52 elbows) tenderness and 19.2% (10/52 elbows) valgus laxity in G1, no tenderness and laxity in G2. There were no differences in medial joint gaps on simple radiography (G1, 3.3 mm, G2, 2.7 mm; p>0.05), but the valgus stress view showed 5.6+/-0.8 mm medial joint gap in G1 and 3.8+/-0.8 mm in G2 (p<0.001). Ultrasonography in G1, angular deformity was found in 67.3% (36/52) and G2 all in normal (p<0.01). The horizontal distance was an average 4.9+/-1.23 mm for the G1 and 3.1+/-0.78 mm for the G2 (p<0.001). Vertical distance of the proximal portion of the ulna was average 0.58+/-0.94 mm for the G1 and 1.59+/-0.49 mm for the G2 (p<0.001). In G1, angular deformity of male was 50% (15/30 elbows) and female was 95% (21/22 elbows) (p<0.001). Change of horizontal and vertical distance were larger in female (p<0.05). In conclusion, there were increased incidence of medial elbow joint laxity in high school weightlifter, especially in female, regardless of career. Sustained valgus laxity could be prone to ulnar collateral ligament injury and should be evaluated with ultrasonography-assisted dynamic study.
Collateral Ligaments ; Congenital Abnormalities ; Elbow Joint* ; Elbow* ; Female ; Humans ; Incidence ; Joints ; Male ; Physical Examination ; Radiography ; Ulna ; Ultrasonography

STUDY DESIGN: This is a retrospective study evaluating the efficacy of new surgical technique for treatment of fixed lumbosacral kyphosis. OBJECTIVES: To report a new method of vertebral column resection and to determine its efficacy in the treatment of fixed lumbosacral kyphosis. SUMMARY OF BACKGROUND DATA: The treatment of fixed severe spinal deformity is very difficult and only a few surgical methods are reported. The vertebral column resection from anterior and posterior is a radical method to treat the severe deformity but it has many problems with anterior and posterior approachs. MATERIALS AND METHODS: A new surgical method of vertebral column resection from posterior approach only(PVCR) was carried out in 5 patients of fixed lumbosacral Tb kyphosis from October 1997 to March 1998. The mean age was 43.4 years(range 35-61 years), and four were female and one male. The average postoperative follow-up period was 5.5 months(ranged from 2 months to 12 months). An average of 2.6 vertebrae was resected. The degree of sagittal curves was measured using the Cobb technique preoperatively and postoperatively. the rejional lumbosacral kyphotic angle and compensatory thoracic curvature from 74 to 712. The sagittal imbalance was measured by distance from C7 plumb line to postero-superior corner of 51 using 14 x 36 inch standing lateral radiograph. RESULTS: The sagittal deformities were corrected from an average of kyphosis 37.4 to lodosis 8.4 at lumbosacral level and from an average of lodosis 31.6 to lodosis 8.2 at thoracic level. The sagittal imbalance was improved from an average of +11.7cm to +2.2cm, for a posterior immigration of 9.5cm. The mean operating time was 334 minutes and with an average blood loss of 4338m1. Complication comprised of motor weakness with deep wound infection in one case and superficial wound infection in another case. The transient hip flexor weakness was seen in all the patients. The hip flexor power recovered in 3-4 weeks. The patient of motor weakness and deep infection showed partial motor improvement and complete wound healing at last 2 month follow-up. CONCLUSION: one-stage posterior vertebral column resection is a promising technique for treatment of the severe fixed lumbosacral kyphosis.
Congenital Abnormalities ; Emigration and Immigration ; Female ; Follow-Up Studies ; Hip ; Humans ; Kyphosis* ; Male ; Retrospective Studies ; Spine* ; Wound Healing ; Wound Infection