Myelodysplastic syndrome is a heterogeneous disease complex which is basically a clonal disorder and has characteristics of cytopenia of one or more cell series in peripheral blood and of dyspoiesis of precursors in bone marrow. Since the nature of this disease in childhood is very different from that in adults, retrospective clinical study was performed with 17 confirmed patients who were admitted to the Department of Pediatrics, Seoul National University Children's Hospital from June 1986 till October 1992. The results were as follows: 1) Themost frequent occurrence was found in preschool age group (76.5%), and male predominance was noted. 2) Hepatosplenomegaly was the most frequent clinical finding, and in view of laboratory findings, anemia waas found in all cases, and leukopenia in 5 cases, thrombocytopenia in 13cases were observed. Bone marrow aspiration revealed dyspoiesis of 3 cell series in almost all cases. The percentage of myeloblasts more than 5% of total bone marrow nucleated cells was seen in 8 cases on bone marrow study. 3) Subtypes of the disease were found to be 3 cases of RA, 6 cases of RAEB, 3 cases of RAEB-T, 4 cases of JCML, and 1 case of monosomy 7 syndrome. Chromosomal study was performed in 8 cases, and 6 of them were detected to be abnormal. 4) Supportive management was performed for almost all cases, and combined therapy with prednisolone and one-alpha for 3 cases, combined chemotherapy with various anticancer drugs for 7 cases, and low dose cytarabine therapy (10 mg/m2/12 hr) for 6 cases were performed. 5) There were 3 cases of drop out, 8 cases followed up on not remitted state, 5 cases of death, and 2 cases followed up on complete remission state. Two cases in complete remission were one of RA patients, and one of JCML patients, to whom prednisolone with one-alpha, and combined chemotherapy with A-Triple-V regimen were applied as treatment modalities, respectively. 6) Average duration of follow up for 10 survival cases was 18.2 months and a significant difference of 2 year survival rate was found in between the group composed of RA, RAEB and the other group composed of remained subtypes.
Adult ; Anemia ; Anemia, Refractory, with Excess of Blasts ; Bone Marrow ; Child* ; Cytarabine ; Drug Therapy ; Follow-Up Studies ; Granulocyte Precursor Cells ; Humans ; Leukemia, Myeloid, Acute ; Leukopenia ; Male ; Monosomy ; Myelodysplastic Syndromes* ; Pediatrics ; Prednisolone ; Preleukemia ; Retrospective Studies ; Seoul ; Survival Rate ; Thrombocytopenia

No abstract available.
Constriction, Pathologic* ; Sutures* ; Trachea*

A 51-year-old man had small, tender, skin colored firm nodule on the helix of the both ears for eight months. He was found to have classic features of chondrodermatitis nodularis chronica helicis, namely, tender nodule less than 1 cm in length with central crusting, localization to helix, age, men, and histologic findings. The histologic examination of the biopsy specimen showed the presence of thinned epiderrnis on center. acanthosis on the adjacent epidermis, with hyperkeratosis and parakeratosis, and cleft between epidermis and dermis. In the dermis, highly vascularized connective tissue and chronic inflarnmatory infiltrate were visible with perichondrial fibrosis. Elastic tissue stain showed degeneration of elastic fibers. After complete excision, no recurrence was obsered until now.
Biopsy ; Connective Tissue ; Dermis ; Ear ; Elastic Tissue ; Epidermis ; Fibrosis ; Humans ; Hypertrichosis ; Male ; Middle Aged ; Parakeratosis ; Recurrence ; Skin

BACKGROUND: Interferon alpha-2a has already been shown to be effective in clinical use of virus-originated diseases such as hairy cell leukemia, condyloma acuminatum, and AIDS-related Kaposi's sarcoma. The use of recombinant alpha-interferon may allow common warts to be treated relatively atraumatically and with less incidence of recurrence. OBJECTIVE: We tried to determine the safety and effectiveness of intralesional injections of recombinant alpha-2a interferon in the treatment of patients with common warts. METHODS: A single wart on each patient was weekly injected with 0.75 to 1.5×10(5) IU/25mm2 of interferon for 8 weeks, and the response to treatment was followed up-to 6 months. RESULTS: Clearing of the treated wart at the end of treatment occurred in 5(71%) out of 7 patients and the rest showed no improvement. With evaluation for relapses up-to 6 months after treatment, warts relapsed in 2(40%) out of 5 patients. Therefore, 3(43%) out of 7 patients were completely free of warts 6 months after treatment. CONCLUSION: Intralesional recombinant interferon alpha-2a has a limited therapeutic effect, but may be considered as a therapeutic modality of recalcitrant verruca or when it can be anticipated that destructive techniques or blistering agents will not be tolerated.
Blister ; Humans ; Incidence ; Injections, Intralesional ; Interferon-alpha ; Interferons* ; Leukemia, Hairy Cell ; Recurrence ; Sarcoma, Kaposi ; Warts*

PURPOSE: Septic arthritis of the knee is a relative rare complication of the arthroscopic anterior cruciate ligament reconstruction, but inadequate treatment of this complication may lead to a devastating conse- quence of a chronic infection. Moreover, no guidelines have been proposed for the treatment of patients with knee infections after the anterior cruciate ligament reconstruction. To determine the optimal diagno- sis and treatment recommendation, we performed this study. MATERIALS AND METHODS: We performed retrospective study of the knee joint infections after the arthroscopic anterior cruciate ligament reconstruction between August 1993 and August 1998, Of the 420 patients who reviewed arthroscopic ACL reconstruction during this period from one surgeon, we experi- enced 4 cases(0.95%) of postoperative deep infections of the knee. RESULTS: All 4 patients were male, and the average age was 32 years(range from 19 to 43). Two patients had acute(< 2 weeks), two patients had subacute infections(2 weeks to 2 months). The acute cases had more severe symptoms, and positive cultures from knee joint aspirates. All patients underwent immediate open(1 case), or arthroscopic irrigation and debridement. One patient underwent repeat irriga- tion and debridement. The graft was removed from all patients in acute cases. CONCLUSION: The clinical symptoms, and the infected organism were more helpful than the peripheral blood counts in the diagnosis of a deep infection of the knee. Arthroscopic lavage, and debridement com- bined with intravenous antibiotics were effective treatment options. Clinical symptoms were more severe in acute cases, and early graft removal is an adequate method of surgical treatment.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Anti-Bacterial Agents ; Arthritis, Infectious* ; Debridement ; Diagnosis ; Humans ; Knee Joint ; Knee* ; Male ; Retrospective Studies ; Therapeutic Irrigation ; Transplants

The treatment of acutely torn anterior cruciate ligament(A.C.L) remains a controversial subject. The purpose of this paper is to show the arthroscopic technique of A.C.L. primary repair with or without augmentation with semitendinosus tendon. Twenty-one patients with acute A.C.L. tear were treated with repair or augmented repair under arthroscopic control from April 1989 to August 1993. Five A.C.L. torn at femoral attachment with intact distal stump were treated with arthoscopic repair alone & 16 A.C.L. torn at substance near the femoral attachment with arthroscopic repair & augmentation with semitendinosus tendon. The patient population included of 16 males and 5 females with an average age 28.3 years. Fifteen patients injuried during sports activity. Postoperative results were evaluated by Lysholm knee score & Hospital for Special Surgery knee scale in average 26 months (range from 12 months to 64 months). All patients were rated as good or excellent result except one patient who had fair result. At follow-up study, testing with KT1000 arthrometer revealed 17 patients had less than 3mm of side to side difference. Second look arthroscopy was performed in 15 patients from 4 to 29 months after repair or augmented repair. Eleven out of these 15 A.C.L. were well healed with good tension 8r. revascularization of graft. Remaining 4 A.C.L. were healed with scar tissue. On the based of this study, arthroscopic repair or augmented repair is very effective treatment for acutely torn A.C.L. near the femoral attachment.
Anterior Cruciate Ligament ; Arthroscopy ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Knee ; Lysholm Knee Score ; Male ; Sports ; Tears ; Tendons ; Transplants

We reviewed 24 patients who had performed arthroscopic meniscal repair for the treatment off discoid lateral meniscal tear between january 1989 and December 1992. The follow up ranged from 1 year 6 month to 4 year 6 month(average 32month). The mean age was 17.9(range,8-50)years, the patients under 20 years old were 17(cases,71%).Common preoperative clinical symptom was pain on the knee joint(21 cases,87.5%) and click(19 cases,79%).Positive McMurry test was the most common physical examination finding(19 cases, 79%). All the lateral discoid meniscal tears were confirmed by arthroscopy. The mean interval between symptom onset and operation was 18.7 months(range 1 month to 10 year). The types of tear were peripheral (14cases, 58%), complex tear(4cases), longitudinal tear(2cases), transverse tear(2cases), horizontal tear(2cases)and the most common location of tear was posterior horn(1 1cases, 45%). The mean number of suture was four. In operative method, Scases(33%) were performed only meniscorrhaphy and meniscorrhaphy combined with partial meniscectomy was done in 16 cases(67%). According to Ikeuchi's grading system, the result was satisfactory in 21cases, fair in three cases. Second look arthroscopy was done in eleven cases(46%) between post operative 4 months to 2 years(mean, 8.3 months). The arthroscopic examination revealed complete healing of repaired meniscus in eight cases(73%). The remained three cases which were not completely healed was fair result.
Arthroscopy ; Follow-Up Studies ; Humans ; Knee ; Methods ; Physical Examination ; Sutures ; Tears

Freeman-Sheldon Syndrome is one of the very rare genetic diseases which primarily affects face, hands and feet. At first, Freeman and Sheldon described this syndrome as cranio-carpo-tarsal dystrophy in 1938 and later Burian, as "whistling face" syndrome in 1963. There were 60 cases of reports in the world up to now, and only one paper with 5 cases in a family was reported in Korea. The authors report 2 cases of Freeman-Sheldon Syndrome associated with bilateral inguinal hernias and undescended tests in a family, briefly review the literature and alert orthopaedic surgeons to this condition.
Cryptorchidism ; Foot ; Hand ; Hernia, Inguinal ; Humans ; Korea ; Male ; Surgeons

The nasal tips of Orientals are different from those of caucasians with are characterized by flat nose and bulbous nasal tip appearance because of its thick and tense skin, shory columella, flaring of nostrils, and restriction of nasal tip projection due to underdevelopement of medial crus of alar cartilage. For better nasal tip definition and projection, alar carilage must be realigned and tip might be augmented with autogenous cartilage onlay graft. Furthermore in patient with short columella, strut formation might be performed because the nostril comprises two-thirds of height of nasal tip. If the nasal tip is prjected without lengthening of columella, sometimes we noted unnaturally tented appearance of nasal tip may result. Also for the soft tissue lengthening in columella in proportion to the nasal tip projection, the short columella can be lengthened with columella based V-Y advancement. Surgical approach through alar rim incision or open rhinoplasty incision may be employed depending upon the severity of tip defomity. If flattening is severe to enough require lengthening of the columella, open rhinoplasty incision is the best choice. Through the incision, the alar cartilage is dissected freely from the skin and vestibulsr mucosa. Cartilage grafts are performed using carilage onlay graft or columella strut formation after transdormal fixation suture. This study presents clinical cases of various nasal tips in the view of nasal tip deformity which were corrected with various operative methods using combined technique of approximating the alar cartilage and a multilayered autogenous onlay cartilage graft on the nasal tip harvested from the auricular cartilage, also Silicone implant was used for augmetation of nasal dorsum and columella strut formation with columella base V-Y advancement. The ten years of our experience with nasal tip plasty in over one hundred patient showed excellent result and no complications were observed during post operative follow-up so we are reporting these cases with review of literature.
Cartilage ; Congenital Abnormalities ; Ear Cartilage ; Follow-Up Studies ; Humans ; Inlays ; Mucous Membrane ; Nose ; Rhinoplasty ; Silicones ; Skin ; Sutures ; Transcutaneous Electric Nerve Stimulation ; Transplants

We reviewed 23 patients of injury to the spine who were under 15 years of age and treated at Wonju Christian Hospital from January, 1978 to December, 1987. The patients were classified into 3 different categories, that were frsctures(17 cases), dislocations(3cases), and fracture-dislocation(3 cases). We analyzed the cause of injury, sexage distribution, treatment and neurological injuries. The results were as follows : l. Among the 23 cases, there were 16 boys(70%) and 7 girls(30%). The mean age was 11 years of age, and ages of active period, that is 10 to 15 years of age, were most common, 17 cases(74%). 2. The most common cause of injury was fall from a height, 13 cases(57%). The most common location of injury was cervicsl spine, 10 cases(43%) and among these cases, injury to upper cervical portion(C1–C3) was more common than lower cervical portion(C4–C7). 3. The cases of multiple compression fracture were 6 patients(26%), and all cases were located thoracic or thoraclumbar junction. 4. Most cases were stable spinal injury, 18 cases(78%), and the most common mechanism of injury were compreesion injuries due to hyperflexion, 15 cases(65%). 5. The most common associated injury was head injury, 9 cases(39%), and associated neurological complications were in 4 cases, 3 cases of these were recovered. We could ascertain that the prognosis of children spinal cord injury is better than that of adult. 6. Restoration of the height of the involved vertebral bocy occurred in all but one compression fractures of vertebral body. 7. There were 3 cases of epiphyseal injury, 2 of these were epiphyseal separations of odotoid process of atlas, the other was fracture of lumbar vertebral apphysis. 8. All but two were treated conservatively and the results were good. In stable spinal injury, we considerded that the duration of treatment was 4 to 6 weeks.
Adult ; Child ; Clinical Study ; Craniocerebral Trauma ; Fractures, Compression ; Gangwon-do ; Humans ; Prognosis ; Spinal Cord Injuries ; Spinal Injuries ; Spine