No abstract available.
Kidney Transplantation* ; Urinary Diversion*

One of a fairly common cause of painful hips in children is the transient synovitis which subcide in short time by bed rest. This transient synovitis is also called as observation hip, irritable hip, coxitis serosa seu simplex, transitory hip arthritis, transitory coxitis, acute transient epiphysitis, toxic synovitis, and intermittent hydrathrosis etc. It is not clear what is the exact cause of transient synovitis but many authors agree infection, trauma and allergic conditions can be cause of that disease. The disease is of interest, not because it is a disabling condition, but because of the difficulties encountered in differentiating it from more serious disease of the hip such as Legg-Calve-Perthes disease, tuberculosis, osteomyelitis and etc. Of the 67 cases so diagnosed at the catholic medical college from 1975 to, 1980, 30 were reviewed and reported. Following observation were made: 1. The main symptom was pain of sudden onset in the region of the hip joint with a limp on the: affected side. 2. The patients mean age was 7.4 yrs and the sex ratio of boy & girl revealed 1. 7:1. 3. Radiological abnormalities of the soft tissue shadow of the affected hip joint was noted at 24 cases (80%), among them the gluteal sign(50%) are more prominent than others Bone scanning with Tc was performed at 13 cases. Increased uptake density of radio-active isotopes found at 6 cases (46%). 4. The treatment was conservative including bed rest, skin traction on the affected leg, non weight bearing, antibiotics and anti-inflammatory drug. 5. Two hips among them revealed later as s Legg-Calve-Perthes disease and tuberculous arthritis of hip joint.
Anti-Bacterial Agents ; Arthritis ; Bed Rest ; Child ; Clinical Study ; Female ; Hip Joint ; Hip ; Humans ; Isotopes ; Leg ; Legg-Calve-Perthes Disease ; Male ; Osteomyelitis ; Serous Membrane ; Sex Ratio ; Skin ; Synovitis ; Traction ; Tuberculosis ; Weight-Bearing

No abstract available.
T-Lymphocytes* ; Transplantation*

No abstract available.
Child* ; Humans ; Leukemia*

No abstract available.
Spine*

The infradiaphragmatic type of Total Anomalous Pulmonary Venous Return(TAPVR) is a rare congenital cardiacanomaly which usually results in death during the period of early infancy. A two month-old baby boy with cyanosisand respiratory distress was suspected of having a TAPVR clinically and the two-dimensional echocardiographicfindings were compatible with the infradiaphragmetic type of TAPVR. The subsequent cardiac catheterization andcineangiogram revealed the common pulmonary vein connected with portal vein and inferior vena cava in theinfradiaphragmetic area with obvious obstruction. The surgery and the autopsy confiremd the preopeative diagnosis.Among infants presenting pulmonary venous congestion in the newborn period. TAPVR below the diaphragm shold be oneof the important diagnostic cosiderations.
Autopsy ; Cardiac Catheterization ; Cardiac Catheters ; Diaphragm ; Humans ; Hyperemia ; Infant ; Infant, Newborn ; Male ; Portal Vein ; Pulmonary Veins ; Scimitar Syndrome ; Vena Cava, Inferior

Local anesthetic systemic toxicity (LAST) refers to the complication affecting the central nervous system (CNS) and cardiovascular system (CVS) due to the overdose of local anesthesia. Its reported prevalence is 0.27/1000, and the representative symptoms range from dizziness to unconsciousness in the CNS and from arrhythmias to cardiac arrest in the CVS. Predisposing factors of LAST include extremes of age, pregnancy, renal disease, cardiac disease, hepatic dysfunction, and drug-associated factors. To prevent the LAST, it is necessary to recognize the risk factors for each patient, choose a safe drug and dose of local anesthesia, use vasoconstrictor , confirm aspiration and use incremental injection techniques. According to the treatment guidelines for LAST, immediate application of lipid emulsion plays an important role. Although lipid emulsion is commonly used for parenteral nutrition, it has recently been widely used as a non-specific antidote for various types of drug toxicity, such as LAST treatment. According to the recently published guidelines, 20% lipid emulsion is to be intravenously injected at 1.5 mL/kg. After bolus injection, 15 mL/kg/h of lipid emulsion is to be continuously injected for LAST. However, caution must be observed for >1000 mL of injection, which is the maximum dose. We reviewed the incidence, mechanism, prevention, and treatment guidelines, and a serious complication of LAST occurring due to dental anesthesia. Furthermore, we introduced lipid emulsion that has recently been in the spotlight as the therapeutic strategy for LAST.
Anesthesia, Dental ; Anesthesia, Local ; Arrhythmias, Cardiac ; Cardiovascular System ; Causality ; Central Nervous System ; Dizziness ; Drug-Related Side Effects and Adverse Reactions ; Heart Arrest ; Heart Diseases ; Humans ; Incidence ; Parenteral Nutrition ; Pregnancy ; Prevalence ; Risk Factors ; Unconsciousness

Surgical treatment of compressive ulnar neuropathy at the elbow has been performed with a wide variety of techniques. Among these techniques, anterior submuscular transposition of the ulnar nerve has been regarded as the method of choice by many authors. It has many advantages including a low recurrence rate, scar-free vascular bed, and protection from repeated trauma to the nerve. However, anterior submuscular transposition is technically demanding and requires more extensive soft tissue dissection. On the other hand, anterior subfascial transposition is less invasive, requires a relatively shorter operation time than the submuscular technique, and also can be done safely even in patiensts with elbow arthritis. We evaluated the clinical results of anterior submuscular transposition compared with anterior subfascial transposition. Fifteen patients underwent anterior submuscular transposition and ten patients underwent anterior subfascial transposition of the ulnar nerve. The mean follow-up time was 15 months (range 10 to 38 months) in the anterior submuscular transposition group and 7 months (range 6 to 15 months) in the anterior subfascial transposition group. According to the outcome status determination algorithm devised by Mowlavi, 3 patients (20%) showed total relief, 10 patiensts (66.7%) improvement and 2 patients (13.3%) no changes in the anterior submuscular transposition group. In the anterior subfascial transposition group, 2 patients (20%) showed total relief, 7 patients (70%) improvement and 1 patient (10%) displayed no changes. Statistically there was no significant difference of the clinical results between the two surgical techniques. Therefore we would suggest anterior subfascial transposition of the ulnar nerve as a preferred method for treatment of cubital tunnel syndrome.
Arthritis ; Cubital Tunnel Syndrome ; Elbow ; Follow-Up Studies ; Hand ; Humans ; Recurrence ; Ulnar Nerve ; Ulnar Neuropathies

PURPOSE: The purpose of this study is to evaluate the clinical and radiographic results of internal fixation using multiple Kirschner wires (K-wires) for the fifth metatarsal base fracture. MATERIALS AND METHODS: We retrospectively reviewed 14 patients with a displaced fifth metatarsal base fracture. We measured the distance of fracture displacement on the foot oblique radiograph pre- and post-operatively. We evaluated the clinical results using the visual analog pain scale at six weeks and three months postoperatively and the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score at six months postoperatively. RESULTS: In our series, 10 cases were zone I fracture and four cases were zone II fracture. We achieved anatomical reduction and bony union in all of our cases. The average time to bone union was 43 days. The degree of pain around the fifth metatarsal base was significantly decreased after surgery. The average AOFAS score was 95 at six months postoperatively. CONCLUSION: Multiple K-wire fixation is a relatively simple fixation method for displaced fifth metatarsal base fractures. If we place a K-wire into the medial cortex of the fifth metatarsal, we could prevent proximal migration of the K-wire.
Ankle ; Bone Wires* ; Foot ; Humans ; Metatarsal Bones* ; Pain Measurement ; Retrospective Studies

PURPOSE: The purpose of this study is to evaluate the clinical and radiographic results of symptomatic bunionette treated with a diaphyseal oblique osteotomy. MATERIALS AND METHODS: We retrospectively reviewed 12 feet of nine patients diagnosed as symptomatic bunionette and treated with diaphyseal oblique osteotomy. All patients were female and the average age at the time of surgery was 48 years. We checked the foot standing anteroposterior, oblique, and lateral images pre- and post-operatively. We measured the fourth intermetatarsal angle and fifth metatarsophalangeal angle and evaluated the clinical results using the American Orthopaedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal-interphalangeal (MTP-IP) scale preoperatively and six months postoperatively. RESULTS: Of the nine patients, hallux valgus was combined with symptomatic bunionette in seven feet of five patients. In all of our cases, the average AOFAS lesser MTP-IP scale showed improvement after surgery. Painful callosity around the fifth metatarsophalangeal joint disappeared after surgery in all of our cases. The fourth intermetatarsal angle improved from 12.7degrees to 3.1degrees and the fifth metatarsophalangeal angle improved from 16.6degrees to 2.3degrees. CONCLUSION: Diaphyseal oblique osteotomy of the fifth metatarsal appears to be a safe and satisfactory surgical procedure for treatment of symptomatic bunionette.
Ankle ; Bunion, Tailor's* ; Callosities ; Congenital Abnormalities* ; Female ; Foot ; Hallux Valgus ; Humans ; Metatarsal Bones ; Metatarsophalangeal Joint ; Osteotomy* ; Retrospective Studies