Thirteen Polio patients with leg length inequality were undergone Ilizarov lengthening procedures and have been followed along for an average two years(range, 1-3.8 years) after removal of the fixator. The age of patients(M:F=7:6) ranged from 18.0 to 32.2 years(average 26.4 years). The difference of true leg length averaged 2.1cm with the tibia being 3.3cm the femur, 1.2cm. The corticotomy was done at the proximal tibia and distal fibula in all case. The fixation period of the Ilizarov apparatus averaged 9.3 months. The length gain averaged 3.0cm for an average 3.8cm inequality. The healing index averaged 3.1mon/cm. Two out of thirteen patients complained of pain in the operated leg. The limping gait was improved in all patients except one. According to Paley's classification, there were ten cases of problems, one obstacle and four true complications. The problems were pin site infection controled with local antibiotics injection. There was one case of obstacle; tibial valgus deformity developed during lengthening. True complications included peroneal nerve injury, aggravation of preexsiting equinovalgus and claw toe deformities, aggravation of preexsiting valgus deformity of ankle and tibial valgus deformity. The complications execpt in one case of peroneal nerve palsy were solved out by the secondary procedures. In summery, the bone healing by distraction osteogenesis with the Ilizarov technique was relatively delayed in polio patients and it seems necessary to modify the technique to shorten the prolonged external fixation period.
Ankle ; Anti-Bacterial Agents ; Classification ; Congenital Abnormalities ; Femur ; Fibula ; Gait ; Hammer Toe Syndrome ; Humans ; Ilizarov Technique ; Infection Control ; Leg Length Inequality ; Leg ; Osteogenesis, Distraction ; Paralysis ; Peroneal Nerve ; Poliomyelitis ; Socioeconomic Factors ; Tibia

Rhinocerebral mucormycosis, which is a fulminant and progressive disease often seen in debilitated hosts! Requires a high degree of clinical suspicion to promptly diagnose and an aggressive medical and surgical therapy. The prognosis is grave, especially in case of bilateral cavernous sinus thrombosis. We report a case of 69-year-old female patient with bilateral cavernous sinus thrombosis caused by rhinocerebral mucormycosis, who showed orbital swelling and lateral bulging of bilateral cavernous sinus in orbital CT, and large branching nonseptate hypae in biopsed specimen of the left periorbital necrotic tissue.
Aged ; Cavernous Sinus Thrombosis ; Cavernous Sinus* ; Female ; Humans ; Mucormycosis* ; Orbit ; Prognosis

Thrombotic thrombocytopenic purpura(TTP) is characterized by fluctuating neurologic signs, microangiopathic hemolytic anemia, thrombocytopenia, fever and renal abnormalities. Neurologic involvement occurs in over 90% of patients with TTP. TTP is rarely associated with large intracerebral hemorrhage and peripheral neuropadiy. The authors report a case of TTP associated with large intracerebral hemorrhage confirmed by brain MRI and peripheral neuropathy diagnosed electrophysiologic findings and sural nerve biopsy.
Anemia, Hemolytic ; Biopsy ; Brain ; Cerebral Hemorrhage* ; Fever ; Humans ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Peripheral Nervous System Diseases ; Purpura, Thrombotic Thrombocytopenic* ; Sural Nerve ; Thrombocytopenia

No abstract available.
Child* ; Epilepsy* ; Humans

BACKGROUND: Although lack of exercise is well known to be a risk factor of osteoporosis, it is unclear whether weight-bearing exercise has different effects on bone mineral density compared to non weight-bearing exercise, and the amount of exercise needed to prevent osteoporosis is not clearly defined. This study was performed to clarify the relations between the type and the amount of exercise with BMD. METHODS: This was a cross-sectional study of 3,661 women who had undertaken health screening including BMD measurement at Health Promotion Center of SNUH between May 1997 and March 1999. Information on sociodemographic characteristics, menarche, childbirth andexercise were gathered by means of self-reported questionnaire, and BMD was measured using DEXA. RESULTS: The number of women with lumbar osteoporosis were 601 (16.4%) and femoral neck osteoporosis 372 (10.2%). Lumbar osteoporosis occurred more frequently with increasing age and age at menarche, and in menopausal women, but less frequently with increasing fat-free mass in multiple logistic regression analysis. When adjusted for age, age at menarche, menopause and fat-free mass, lumbar osteoporosis was less common in women who exercised, but the type and the amount of exercise had no bearing. Especially, lumbar osteoporosis was least common in women engaging in moderate amount of exercise. Femoral neck osteoporosis decreased significantly only in weight-bearing exercise group and in women engaging in high amount of exercise. CONCLUSION: The results of this study suggest that lumbar osteoporosis can be prevented through exercise regardless of its type and amount, and high amount or weight- bearing exercise is most effective to prevent femoral neck osteoporosis.
Adult* ; Body Composition ; Bone Density* ; Cross-Sectional Studies ; Female ; Femur Neck ; Health Promotion ; Humans ; Logistic Models ; Mass Screening ; Menarche ; Menopause ; Osteoporosis ; Parturition ; Risk Factors ; Weight-Bearing ; Surveys and Questionnaires

No abstract available.
Spondylolisthesis*

No abstract available.

We report our series of the Ilizarov surgery for lengthening and deformity correction in upper extremity at the Severance Hospital and the Yong-Dong Severance Hospital between February 1992 and October 1994. We performed the Ilizarov surgery in 12 limb segments, there were 3 humerus, 5 radius, 3 ulna and 1 metacarpal bone. The etiologies of the limb length discrepancies were 7 posttraumatic physeal injuires, 2 congenital deformities, 1 posttraumatic bone loss, 1 posttraumatic amputation and 1 postinfectious physeal injury. The goals of treatment were bone lengthening alone in 8 cases, bone lengthening and deformity correction including angular correction in 4 cases. The bone was lengthened between 1.0 cm and 9.2 cm (mean 3.7 cm) representing a 8.1% to 63.0% (mean 24.5%) increase in length. The healing index varies from 1.0 mos/cm to 10.5 mos/cm (mean 3.4 mos/cm) except three cases which need additional fixation with plate and screws add to wedge osteotomy. By radiologic appearance of the distraction callus, the straight type were 6 cases, the attenuated type were 4 cases and the pillar type were 2 cases. The healing indices of each type were 1/5 mos/cm, 7.7 mos/cm and 12.4 mos/cm, respectively. In conclusion, lengthening and deformity correction of the upper extremity can be successfully achieved by gradual mechanical distraction using the Ilizarov method. In case of pillar type, healing index was high and therefore control of the rate and the rhythm should be tried. If this control is of no use, early interventional procedure would be beneficial. The healing index of the straight type was much lower than that of the attenuated or the pillar type.
Amputation ; Bone Lengthening ; Bony Callus ; Congenital Abnormalities ; Extremities ; Humerus ; Ilizarov Technique ; Osteotomy ; Radius ; Ulna ; Upper Extremity

We studied two hundread cases of replantations-61 cases of major limb replantation and 139 cases of finger replantation. 53 of 179 patients had multiple amputation. The most common cause of amputation was cutting-machine injury and the next one was belt and roller injury. The patients were followed than 6 months, ranging 6 months to 5 years and 10 months, averaging 36 months. The success rate of replantation is 86.9%(53/61) in the amputated limbs and 80.6%(112/139) in the amputated digits. Main causes of failure were tissue crushing, vessel thrombosis, long ischemic time, and amputation wound infection. Common complications were infection (25 cases), delayed union(7 cases), nonunion(2 cases), bleeding tendency and hematoma formation due to systemic heparinization(5 cases). We used Seddon's classification to assess the recovery of the nerve function of the replanted limbs and digits. 84.6 % of success cases of limb replantation presented the excellent result in the motor fuction recovery and 89.1% also presented the excellent sensory recovery. 89.8% of the success cases of the digit replantation showed the excellent result in the sensory recovery. The factors influencing the functional recovery of the replantation surgery were mechanism of injury, ischemic time, surgical technique, numbers of anastomosed vessels, ratio between anastomosed artery and vein, and wound infection. This analysis demonstrated that strict selection of the indication or the replantation is the first step in the limb and digit replantation surgery.
Amputation ; Arteries ; Classification ; Extremities ; Fingers ; Hematoma ; Hemorrhage ; Humans ; Operative Time ; Replantation ; Thrombosis ; Veins ; Wound Infection

Dislocations or fractures of the limbs can arise from muscle contraction during epileptic seizures. Dislocation complication of the bilateral temporomandibular joint from seizures is reported very rarely. A 36-year-old woman, who had no history of epilepsy, presented recurrent dislocations of the bilateral temporomandibular joint and generalized tonic-clonic seizures. EEG showed intermittent generalized slow activity. We report a case of bilateral temporomandibular joint dislocation that occurred during generalized tonic-clonic seizures, which has not previously been reported in Korea.
Adult ; Dislocations* ; Electroencephalography ; Epilepsy ; Extremities ; Female ; Humans ; Korea ; Muscle Contraction ; Seizures* ; Temporomandibular Joint*