With the advancement of shoulder arthroscopy, use of biodegradable suture anchors in the surgical repair of rotator cuff tears has increased. Because of the radiolucency of these anchors, radiography is not appropriate for early detection of anchor failure. Ultrasonography is an advantageous modality in visualizing biodegradable, radiolucent anchors on a real-time basis without risk of radiation exposure. We report on two cases of displacement of a biodegradable suture anchor diagnosed on ultrasonography during the postoperative follow- up, which has not been previously reported. Because this displacement could be missed in the postoperative follow up ultrasonography, we describe the ultrasonographic features of the displaced biodegradable anchors. Surgeons and radiologists should pay special attention to the possibility of displacement of the suture anchor in patients who underwent rotator cuff repairs using suture anchors.
Arthroscopy ; Follow-Up Studies ; Humans ; Radiography ; Rotator Cuff* ; Shoulder ; Suture Anchors* ; Sutures* ; Tears ; Ultrasonography*

PURPOSE: The purpose of this study was to evaluate clinical manifestation, etiology and prognosis of hypocalcemic infants who were admitted with seizure. METHODS: We reviewed medical records of 32 infants admitted at the Asan Medical Center with hypocalcemic seizure retrospectively. We classified patients into vitamin D deficiency group(n=7, 21.9%), transient hypoparathyroidism group(n=4, 12.5%), relative hypoparathyroidism with hyperphosphatemia group(n=16, 50%), and others(n=5, 15.6%) according to the laboratory results. RESULTS: Of the 32 patients, 29 patients were improved. There were no differences in gestational age and birth weight among the three groups. In the vitamin D deficiency group, age of onset was later than those of the transient hypoparathyroidism group and relative hypoparathyroidism with hyperphosphatemia group(51.6+/-2.7 vs 8.3+/-.5, 8.2+/-.6 days). In the age when all laboratory results were normalized, transient hypoparathyroidism group was younger than those of vitamin D deficiency group and relative hypoparathyroidism group(33.2+/-4.6 vs 93.6+/-8.5, 77.1+/-2.4 days). In the total treatment period, relative hypoparathyroidism with hyperphosphatemia group was longer than those of vitamin D deficiency group and transient hypoparathyroidism group(68.9+/-3.5 vs 42.0+/-5.0, 25.0+/-4.3 days). Others included two 22q11.2 deletion syndrome patients, a congenital hypoparathyroidism, a pseudohypoparathyroidism, and an early neonatal hypocalcemia. CONCLUSION: Transient hypoparathyroidism and hyperphosphatemia were major causes of neonatal hypocalcemia. And high calcitonin and peripheral organ resistance to parathyroid hormone act on hypocalcemia. In infants after one month, vitamin D deficiency was also an important cause of hypocalcemia. Most of the patients were improved within 1-2 months after proper management, but relative hypoparathyroidism with hyperphosphatemia group needed longer treatment. So, it is necessary to perform a systematic study for several complex causes that explain above fact.
Birth Weight ; Calcitonin ; Chungcheongnam-do ; DiGeorge Syndrome ; Gestational Age ; Humans ; Hyperphosphatemia ; Hypocalcemia ; Hypoparathyroidism ; Infant* ; Medical Records ; Parathyroid Hormone ; Prognosis ; Pseudohypoparathyroidism ; Retrospective Studies ; Seizures ; Vitamin D Deficiency

Systemic lupus erythematosus is a connective tissue disease which can affect every organ system. Neurologic abnormalities are common, occuring in approximately half of all patients at some time during the course of their illness. But symptoms of nervous system as the sole presenting symptoms occur in less than 1% of lupus patients. In patients initially presenting with neurologic symptoms and signs, differential diagnosis is difficult and sometimes it may be misdiagnosed. Therefore extensive laboratory investigations should be carried out in all patients with unusual neurological symptoms, since early diagnosis of lupus can help in providing effective treatment. We report a patient with systemic lupus erythematosus who presented with dysarthria and dysphagia resembling multiple sclerosis.
Connective Tissue Diseases ; Deglutition Disorders ; Diagnosis, Differential ; Dysarthria ; Early Diagnosis ; Humans ; Lupus Erythematosus, Systemic* ; Multiple Sclerosis* ; Nervous System ; Neurologic Manifestations

No abstract available.
Thanatophoric Dysplasia*

BACKGROUND: Infantile Hypertrophic Pyloric Stenosis (IHPS) is one of the most common surgical problems of early infancy and one for which an eminently successful surgical treatment has been available since the work of Ramstedt in 1912. A clinical study was begun to access further the accuracy of ultrasonography in identifying hypertrophic pylorus. METHODS: This study is a retrospective clinical analysis of 31 cases of IHPS treated at the Department of Surgery of Pohang St. Mary's Hospital from Jan. 1990 to Dec. 1997. RESULTS: (1) The most prevalent age group was between 3 weeks and 8 weeks in 24 cases (77.4%), and the ratio of males to females was 5.2:1. (2) Among the 31 cases, new born babies were 21 cases (67.7%). (3) In 30 cases (96.8%), the gestational age was between 37 weeks and 42 weeks, and the birth weight was more than 3.5 kg in 21 cases (67.7%). The body weight percentile at admission was lower than the 50 percentile in 31 cases. (4) Among the 31 cases, breast-fed infants were 15 cases (48.4%), milk-fed 13 cases (41.9%), and mixed-fed 3 cases (9.7%). B type blood group was 23 cases (74.2%), and O type was 4 cases (12.9%). (5) In 4 cases (12.9%), an inguinal hernia was noted as an associated anomaly. (6) The onset of symptoms was neonatal (1 week-12 weeks) in all 31 cases, and the duration of the symptoms was between 1 week and 2 weeks in 18 cases (58.1%). (7) Non-bile stained, projectile vomiting was noted in all 31 cases (100.0%), an olive-shaped mass in right upper quadrant of the abdomen was felt in 27 cases (87.1%), and visible peristalsis on the epigastrium was noted in 25 cases (80.6%). (8) On laboratory tests, 17 patients had leukocytosis, and anemia was observed in 2 cases. Hypokalemia was observed in 9 cases (29.0%), hypochloremia in 4 cases (12.9%), and moderate to severe alkalosis (CO2 content > 25 mEq) in 7 cases. (9) Among the 25 cases, for which an the ultrasonographic evaluation was performed, the length of the stenotic canal was from 16 mm to 20 mm in 23 cases (92.0%), and the thickness of the stenotic portion was from 5 mm to 6 mm in 21 cases (84.0%). (10) All 31 cases were surgically treated by using a Fredet-Ramstedt pyloromyotomy, and the mortality was nil. The average hospitalization was 9.4 days. (11) There was 1 case of duodenal perforation and 1 case of intermittent non-projectile vomiting after the operation. CONCLUSIONS: We conclude that early accurate diagnosis, adequate preoperative preparation of the fluid & electrolyte imbalance, immediate surgical correction, and scheduled careful oral feeding are important in treatment of IHPS. Ultrasonographic determination of pyloric muscle length and thickness is the most accurate of the currently available techniques. A Fredet-Ramstedt pyloromyotomy is a safe and successful surgical procedure.
Abdomen ; Alkalosis ; Anemia ; Birth Weight ; Body Weight ; Diagnosis ; Female ; Gestational Age ; Gyeongsangbuk-do ; Hernia, Inguinal ; Hospitalization ; Humans ; Hypokalemia ; Infant ; Leukocytosis ; Male ; Mortality ; Peristalsis ; Pyloric Stenosis, Hypertrophic* ; Pylorus ; Retrospective Studies ; Ultrasonography ; Vomiting

No abstract available.
Humans*

Fractures of the shaft of the radius and ulna occur commonly in children and are usually treated by closed reduction and plaster cast immobilization. Anatomic reduction is seldom necessary because of the remodelling potential in the child under 10 years of age, whereas the bones of children older than 10 years of age have less capacity to remodel and the diaphyseal fracture is unstable. In case of either unacceptable reduction or unstable fractures in adolescent patients, an operative treatment is required. In five children older than 12 years of age for whom conservative treatment had hailed, we treated a closed intramedullary nailing using a distal radial and proximal ulnar approach, and followed up for 1 year or more. All fractures healed within 6 weeks. No nonunion, cross-union or refrature occured. Another advantages of this method are negliable cosmestic defect and easy removal of the internal fixation device under local anesthesia. We think that closed intramedullary nailing with rush pin is a safe and reliable method to treat unstable forearm fracture in children older than 12 years of age.
Adolescent ; Anesthesia, Local ; Casts, Surgical ; Child ; Forearm ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Internal Fixators ; Methods ; Radius ; Ulna

We reviewed 14 children with unilateral fractures of femoral shaft who had an angular deformity after union of 10° to 25°. At an average follow-up of 32 months(15 to 65), we measured remodelling of the proximal physis, the distal physis and the femoral shaft. The average correction was 83% of the initial deformity and there was no relation between the remodelling rate and degrees of malunion. Of the correction of angulation, only 27% had occurred at the fracture site and 73% at physis. The ability of physis to remodel better than that of fracture site. In children under 13 years of age, malunion as much as 25° in flexion deformity will remodel enough to get normal alignment of the joint surfaces.
Child ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Joints

In order to study the clinical efficacy of the metallic stent of the treatment of iliac arterial stenosis, the clinical and arteriographic findings of the 8 patients were retrospectively reviewed. All 8 patients were males with an age of 51 to 79. The Fontaine class for the functional status of lower extremities was II in 4 patients, III in 3 patients and IV in 1 patients. Self expandable Gianturco stent was inserted in 7 iliac arteries and balloon expandable Palmaz stent was inserted in 2 iliac arteries in the 8 patients. The indications for the metallic stent application were localized dissection with significant residual stenosis in 6sites, recoiling due to calcification in one case and eccentricity of the stenotic lesion in 2 sites. The deployment of the metallic stent was successful in all the cases to maintain the patency of iliac arteries with residual stenosis less than 30%. The Fontaine class was improved to I in 6 patients, II a in 1 patients IIb in another one. During the follow-up period of 3 to 14 months, none except one developed recurrence of the symptom. On the basis of our experience, we believe that metallic stent is safe and effective for the treatment of iliac arterial stenosis. However, we think that it is a complementary measure to the percutaneous transluminal angioplasty. The comparative study between different types of metallic stent and the long-term effect should be investigated further.
Angioplasty ; Constriction, Pathologic* ; Follow-Up Studies ; Humans ; Iliac Artery ; Lower Extremity ; Male ; Recurrence ; Retrospective Studies ; Stents* ; Treatment Outcome

In order to study the clinical efficacy of the metallic stent of the treatment of iliac arterial stenosis, the clinical and arteriographic findings of the 8 patients were retrospectively reviewed. All 8 patients were males with an age of 51 to 79. The Fontaine class for the functional status of lower extremities was II in 4 patients, III in 3 patients and IV in 1 patients. Self expandable Gianturco stent was inserted in 7 iliac arteries and balloon expandable Palmaz stent was inserted in 2 iliac arteries in the 8 patients. The indications for the metallic stent application were localized dissection with significant residual stenosis in 6sites, recoiling due to calcification in one case and eccentricity of the stenotic lesion in 2 sites. The deployment of the metallic stent was successful in all the cases to maintain the patency of iliac arteries with residual stenosis less than 30%. The Fontaine class was improved to I in 6 patients, II a in 1 patients IIb in another one. During the follow-up period of 3 to 14 months, none except one developed recurrence of the symptom. On the basis of our experience, we believe that metallic stent is safe and effective for the treatment of iliac arterial stenosis. However, we think that it is a complementary measure to the percutaneous transluminal angioplasty. The comparative study between different types of metallic stent and the long-term effect should be investigated further.
Angioplasty ; Constriction, Pathologic* ; Follow-Up Studies ; Humans ; Iliac Artery ; Lower Extremity ; Male ; Recurrence ; Retrospective Studies ; Stents* ; Treatment Outcome