The phenomenon of Myotonia consist in a failure of voluntary muscles to relax immediately when voluntary innervation ceases. The stiffness is accentuated by cold and relieved by exercise, while generalized muscle weakness and atrophy (or not commonly hypertrophy of muscle) is common. Myotonia is a feature of four principal clinical syndromes which have been classified myotonia congenita (Thomsens disease), myotonia atrophica (Steinerts disease), paramyotonia and myotonia and myotonia acquisita by Walton et al. We report here a forty six years old male of myotonia atrophica (Dystrophia myotonia, Steinerts disease) who presents bilateral cataracts, frontal baldness, gonadal atrophy, facial myopathy, sterno-cleidomastoid muscle atrophy and a progressive generalized myopathy of peripheral distribution in the limbs.
Alopecia ; Atrophy ; Cataract ; Extremities ; Gonads ; Humans ; Hypertrophy ; Male ; Muscle Weakness ; Muscle, Skeletal ; Muscular Atrophy ; Muscular Diseases ; Myotonia Congenita ; Myotonia ; Myotonic Dystrophy

Bornstein and plate (1911) and Bassoe (1913), followed by many European and American, described the radiographic appearance of avascular necrosis of the bone in compressed air worker. Divers bone lesions was described for the first time by Grutzmacher in 1941. There is not any report of information on the caisson disease and divers bone lesions in this country. Inview of these considerations, during the period from March to June 1981, 124 traditional civilian divers and 132 Naval divers, were observed in eight Korean coastal cities (In-cheon, Sam-chun-po, Sin-hae, Pu-san, Ul-san, Ku-ryung-po, joo-moon-jin and Sok-cho). For each divers, a record was made of his medical history, diving experiences and frequencies of bends attacks. The clinical examination included blood pressure, body weight, a chest radiograph and routine checks of the shoulders, hips and knees, but an X-ray examination extended to the spines, ankles, elbows when symptoms existed. The results were as follow: l. Out of 256 divers, 113 (44.2%) had bone lesions, seventy-five traditional divers (60.5%) had bone lesions out of 125 divers, but naval divers, only thirty eight (28.8%) of 132 had such lesions. 2. Divers bone lesion incidence is increased with diving experience especially over 10 years. 3. The most frequent bone lesions occured in the upper end of the humerus, the upper end of the femur, the lower end of the femur and proximal tibia. 4. The most frequent divers bone lesions in X-ray was dense areas (Bl). 5. There was a high incidence (93.1%) in man with a history of the bends and significantly relate between the sites of the bends and those of the lesions. 6. Divers bone lesions incidence was increased with the length of diving experiences, diving depth, diving time, ages and with bends experiences.
Ankle ; Blood Pressure ; Body Weight ; Compressed Air ; Decompression Sickness ; Diving ; Elbow ; Femur ; Hip ; Humerus ; Incidence ; Knee ; Korea ; Necrosis ; Radiography, Thoracic ; Shoulder ; Spine ; Tibia

No abstract available.
Female ; Ovary* ; Teratoma*

A cases is reported of congenital atlanto-occipital fusion in a 12-years-old girl. The lesion was treated by occipito-cervical arthrodesis by iliac bone grafting with wiring. The congenital atlanto-occipital fusion has not progressed in this 2 years of observation. This is presented with a review of literature.
Arthrodesis ; Bone Transplantation ; Female ; Humans

We review 66 patients with lower caliceal stones treated with extracorporeal shock wave lithotipsy. One of the major problems involved with extracorporeal shock wave lithotripsy is the high rate of residual stone fragments in the lower calices. We observed the influence of the presence of lower caliceal dilatation, hydronephrosis, and the size of alone on the passage of stone. Thirty-nine of the 66 patients with a lower caliceal stone and no stone fragments. The success rate was only 59 per cent. The stone was completely fragmented in 59 of 66 (89%) patients. Thirty-nine of 59 patients who had completely fragmented stones. had no residual fragments. The patients who had no lower caliceal dilatation and a relativgly small size stone (less than 1.5 x 1.0 cm). such as in group 4. had a high success rate of 70%. The patients with a large stone or the presence of caliceal dilatation. were expected to low success rate, therefore there was a need for repeated treatment with extracorporeal shock wave lithotripsy and combined treatment with percutaneous nephrostomy.
Dilatation ; Humans ; Hydronephrosis ; Lithotripsy* ; Nephrostomy, Percutaneous ; Shock*

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

No abstract available.
Fetus* ; Humans ; Pregnancy, Twin* ; Twins*

There has been remarkable progress in the treatment of erectile dysfunction during last decade. We have analyzed 2,000 patients with erectile dysfunction who had been treated with a variety of treatment modalities during last 10 years to identify the annual changes in the proportion of the respective treatment modality. The most remarkable change was seen in the proportion of patients treated by vasoactive pharmacotherapy The proportion was 12.0% on 1984, which was gradually increased in time, and reached to 82.1% on 1994. Another remarkable change was found in the proportion of patients treated by surgery, especially vascular surgery : The proportion of patients treated by penile prosthesis implantation on 1985 and vein ligation on 1986 was 64.0% and 14.3%, respectively ; whereas, it was decreased to 1.8 % and 0% on 1994, respectively. In conclusion, we could find remarkable change of trend in the primary treatment modality for erectile dysfunction from invasive and costly surgical treatment to less invasive and cheap vasoactive pharmacotherapy. Nowadays, intracavernous self-injection of vasoactive agents plays a primary role in the treatment of impotence. Penile prosthesis implantation remains as the last treatment modality for erectile dysfunction. However, vascular surgery is rarely being performed nowadays because of its poor long-term outcome.
Drug Therapy ; Erectile Dysfunction* ; Humans ; Ligation ; Male ; Penile Implantation ; Veins

Appreciation of the normal variation of anterior and posterior diameter of the lumbar spinal canal under computerized axial tomogram may throw very important value on the diagnosis and treatment in lumbar spinal problems. The authers have measured the diameter of the lumbar spinal canal using EMI scanner CT 5005. The data was first based on the study of two cadaver lumbar spine and then the study of 268 normal Korean adults male 185, and female 83. The results were summerized as follows. 1. The diameter of the osseous segment was more narrow than articular segment in normal lumbar spinal canal, 2. The shape of lumbar spinal canal was oval in upper lumbar. but became triangular going down to the lower lumbar. There was no difference of diameter in sex. 4. The average diameter of anterior and posterior spinal canal was; L1 16.53± 0.18, L2 16.23± 0.215, L3 15.42± 0.26, L4 15.57± 0.43 and l% 17.7± 1.63mm respectively. 5. The average diameter of transverse spinal canal was; L1 23.31± 0.18, L2 23.76± 0.28, L3 24.78± 0.345, L4 26.07± 0.605 and L5 29.31± 1.19mm respectively. 6. It was more accurate to check out the pathology of the lumbar spinal canal using coinputerized axial tomogram than other method previously used.
Adult ; Cadaver ; Diagnosis ; Female ; Humans ; Male ; Methods ; Pathology ; Spinal Canal ; Spine

70 cases free fiap were performed from March 1978 to July 1985. The donor fiap were dorsalis pedis flap in 34 cases, groin flap in 8 cases, osteocutaeous flap in 3 cases, gracilis flap in 17 cases, and latissimus dorsi flap in 8 cases respectively. The success rate was 90% in total including partial success. The causes of failure were 2 cases infection necrosis, and 1 case kinking of drain vessel. The gracilis and latissimus dorsi myocutaneous flap were very satisfactory method for the reconstruction of the upper extremity flexion power, especially in the case of Volkmann's ischemic contracture. The neurovascular dorsalis pedis flap was regarded as excellent method for the heel pad reconstruction, and tactile sensation reconstruction of the hand.
Free Tissue Flaps ; Groin ; Hand ; Heel ; Humans ; Ischemic Contracture ; Methods ; Microsurgery ; Myocutaneous Flap ; Necrosis ; Sensation ; Superficial Back Muscles ; Tissue Donors ; Upper Extremity