No abstract available.
Alcoholics* ; Female* ; Hospitals, Psychiatric* ; Humans

Congenital kyphoscoliosis is an abnormal curvature of spine that is due to presence of vertebral anomalies which cause an imbalance in the longitudinal growth of the spine. Congenital kyphoscoliosis is often rigid and its correction can be difficult. It is often resistant to conservative treatment and more patients require surgical treatment than those with idiopathic curvature. The indication for the conservative treatment with Milwaukee brace is much limited. Largely Milwaukee brace is a delaying tactic to correct the spinal curvature until its growth is further advanced and it is more amenable for fusion. This paper was aimed to review our experience with 49 patients with congenital scoliosis, kyphosis and kyphoscoliosis who were treated surgically with various methods of preoperative correction, from Jan. 1968 to Dec. 1983, in special reference to new classification, proposed for common application to both kyphosis and scoliosis, and following results were obtained. 1.The average age when scoliosis was observed was 6.9 years, but the average age of surgery was deferred until 15.2 years. 2. The distribution of curve pattems were 1 cervicothoracic, 24 thoracic, 12 thoracolumbar, 7 lumbar and 1 lumbosacral curve in 45 scoliotic curves and 13 thoracic, 13 thoracolumbar and 4 lumbar curves in 30 kyphotic curves. The average degrees of deformity were most severe in thoracolumbar curves both in kyphosis and scoliosis. 3. The new morphological classification, which could be applicable to both kyphosis and scoliosis, was proposed. The type of unsegmented bar with contralateral hemivertebra was most common both in kyphosis and scoliosis. 4. Preoperative average degrees of scoliosis was 58.7 degrees and final correction was 20.6 degrees (35.1%) with loss of comection of 3.7 degrees (6.3%). Preoperative average degrees of kyphosis was 63.7 degrees and final correction was 20.1 degrees (42.5%) with loss of correction of 7.0 degrees (11.0%). 5. The surgical method with anterior and posterior fusion was the best treatment of severe kyphoscoliossis, in the aspect of final correction and loss of correction. 6. The lumbar curve was most amenable to treatment with the best final correction and the least loss of correction.
Braces ; Classification ; Congenital Abnormalities ; Humans ; Kyphosis ; Methods ; Scoliosis ; Spinal Curvatures ; Spine

Congenital scoliosis is a disease characterized by its rigid and progressive curve. It is usually resistant to conservative treatment and early surgical fusion has been reommended. The indication for conservative treatment with brace is much limited but present mainly as a delaying tactic to maintain the spinal curvature until its growth is further advanced and it is more amenable for fusion. This paper was aimed to review our experience with 17 patients (18 curves) with congenital scoliosis who were treated with brace with average follow-up of 4.3years (at least 2 years) from Jan. 1968 to Dec. 1983 and the following results were obtained. 1. The interval from the time when scoliosis was observed to the time of brace application was less than 1 year in 10 patients (58.8%). 2. The average age was 6.6 years ranging from 0.2 years to 14.1 years. The average initial curve was 40.5 degrees. 3. The average final amount of correction was 3.6 degrees (8.7%). 4. The lumbosacral curve gave the best correction. The correction effect of brace treatment was less effective in the thoracic curves. 5. The correction was more effective in the patients younger than 10 years. 6. The shorter the curve, the more correction was obtained. 7. The type of failure of formation gave much more correction than the type of failure of segmentation. 8. The brace treatment was more effective in the patients whose curves were less than 50 degrees in younger age and with the anomaly of failure of formation. Bracing would delay spine fusion until more ideal time even in severe curves or anomalies of failure of segmentation. 9. Spine fusion should be done early regardless of age for progressive curves even with brace treament.
Braces ; Follow-Up Studies ; Humans ; Scoliosis ; Spinal Curvatures ; Spine

Nesidioblastosis, also known as persistent hyperinsulinemic hypoglycemia of infancy(PHHI) or familial hyperinsulinsm, is the most common cause of recurrent severe hypoglycemia in infancy. It is an autosomal recessive disorder characterized by irregular insulin secretion leading to inappropriately raised plasma insulin concentration compared to blood glucose levels. Recently, mutations in the sulfonylurea receptor(SUR) have been described in association with PHHI. The mainstay of medical treatment is glucose infusion and diazoxide or long acting somatostatin. If medical treatment fails in preventing hypoglycemia, near total pancreatectomy is recommended. We report one case of nesidioblastosis cured by near total pancreatectomy with brief review of literatures.
Blood Glucose ; Congenital Hyperinsulinism* ; Diazoxide ; Glucose ; Humans ; Hypoglycemia ; Infant, Newborn* ; Insulin ; Nesidioblastosis* ; Pancreatectomy ; Plasma ; Somatostatin

5 alpha-reductase deficiency resulting in male pseudohermaphroditism is a rare disease characterized by clitoral-like phallus, bifid scrotum, urogenital sinus, testis cited in labioscrotal folds. Evaluation of plasma T/DHT ratios in infancy, particularly after hCG stimulation of the testes and elevated urinary tetrahydrocortisol (THF) to 5 alpha-tetrahydrocortisol(5 alpha-THF) ratios provide a valuable dianostic test for 5 alpha-reductase deficiency. We report one case of 5 alpha-reductase deficiency who were presented with ambiguous genitalia and elevated T/DHT ratio before and after hCG stimulation.
46, XY Disorders of Sex Development ; Cholestenone 5 alpha-Reductase* ; Disorders of Sex Development ; Plasma ; Rare Diseases ; Scrotum ; Testis ; Tetrahydrocortisol

No abstract available.
Staphylococcus aureus* ; Staphylococcus*

The angle of the femoral anteverison has been recognized as an important consideration in the orthopedic Geld. The angle of the femoral anteversion can be measured roentgenographically by 3 methods, such as fluoroscopic, biplanar and axial methods. It is the purpose of this study to investigate the comparative accuracy of the roentgenographic methods determining the angle of the femoral anteversion. The measurements by the fluoroscopic(Rogers), biplanar (Magilligan) and axial (Dunn) methods were compared with the direct measurement of 42 adult dried femora and the measured values were statistically analyzed. The results were as follows: l. Among fluoroscopic, biplanar and axial methods, the biplanar method using Magilligan technique was the statistically reliable method to determine the angle of the femoral anteversion. 2. The axial method showed tendency to underestimate the angle of the femoral anteversion. 3. Though the fluoroscopic method was not so accurate as the biplanar method statistically, the 2 methods showed no difference in the ratio of measurement error within ±5°and ±10° range.
Adult ; Humans ; Methods ; Orthopedics

No abstract available.
Orthognathic Surgery

PURPOSE: Hand-assisted laparoscopic live donor nephrectomy (HALDN) are being performed at our institution in an attempt to make live donor more attractive to the potential donor. We review the results of HALD N retrospectively and compare them with those obtained using the standard open approach. MATERIALS AND METHODS: 9 consecutive HALDN were performed from February 2000 through June 2000. The control group consisted of the 22 open donor nephrectomy at the same institution from January 1999 through December 1999 immediately before the initiation of HALDN. Live donors were considered candidates for HALDN if they possessed left normal renal anatomy with single renal vessels and ureter. Among 9 HALDN patients, one patient had two main renal arteries and another one patient had a polar artery. We evaluated sex, age, body weight, BMI (Body Mass Index) basically. And we evaluated renal ischemic time, operation time, to normal activities, postoperative serum creatinine level, and postoperative complications. RESULTS: There was no significant difference in male-female ratio, age distribution and weight-height ratio between two groups. Warm ischemic time for HALDN group was 3 to 4 min and it was not different with open surgery. Operation time was prolonged in HALDN group (284.4+/-72.8 min) compared to open group (193.1+/-26.7 min) (p Age Distribution ; Arteries ; Body Weight ; Chylous Ascites ; Creatinine ; Humans ; Kidney Transplantation ; Length of Stay ; Nephrectomy* ; Pneumothorax ; Postoperative Complications ; Renal Artery ; Retrospective Studies ; Tissue Donors* ; Ureter ; Warm Ischemia

PURPOSE: Caliceal diverticular calculi are mostly asymptomatic. In certain cases they may be associated with chronic or recurrent pain, recurrent urinary tract infections, progressive renal damage and hematur ia. The treatment of symptomatic caliceal diverticular calculi has evolved from open surgery to less invasive procedures, such as extracorporeal shock wave lithotripsy (SWL), percutaneous techniques, retrograde ureteroscopy and laparoscopy, but it remains controversial. Percutaneous techniques are frequently used to address the diverticular stone burden, to fulgurate the diverticular wall, to dilated the diverticular neck and improve drainage. For this reason, we reviewed 33 patients with caliceal diverticular calculi to determine whether they could be treated successfully by percutaneous nephrolithotomy (PCNL) as the initial treatment. MATERIALS AND METHODS: A total of 33 patients with caliceal diverticular calculi underwent PCNL between February 1990 and February 2000. The majority of diverticula were located at the upper pole. Access was gained via a direct target puncture. After sequential dilatation of the tract, stones were removed and the diverticular wall was fulgurated. The diverticular neck was dilated with the Amplatz dilator upto 24-30 Fr. and a 20 Fr. nephrostomy catheter was placed. RESULTS: PCNL was performed successfully in 30 patients (90.9%), but puncture was failed in 3. Mean operative time was 105 minutes and mean hospital stay was 4.5 days. All patients who were treated successfully with PCNL became stone-free without any complication. Mean follow-up was 20 months (ranged from 1 to 108 months). Of the 26 patients with symptoms preoperatively, 25 patients were rendered symptom-free (96.2%). Twenty-four patients were assessed with an intravenous urogram at 1 or 3 months and 6, 12 months and there was no stone recurrence. The diverticula were obliterated or had improved drainage in 95.8% (23/24) of assessable cases. CONCLUSIONS: We confirmed that PCNL is a safe, less invasive and effective procedure and should be considered an acceptable form of primary management of patients with caliceal diverticular stone.
Calculi ; Catheters ; Dilatation ; Diverticulum ; Drainage ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Lithotripsy ; Neck ; Nephrostomy, Percutaneous ; Operative Time ; Punctures ; Recurrence ; Shock ; Ureteroscopy ; Urinary Tract Infections