Of 43 scoliotic patients treated by Harrington instrumentation and posterior spinal fusion, 38 patients were taken of preoperstive correction by Risser localizer cast, turn buckle cast. Cotrel traction or halofemoral traction from April 1969 to June 1978 at the Department of Orthopaedic Surgery, Seoul National University Hospital. The correctaibility of scoliosis by preoperative correction were evaluated with its methods, etiology, age, severity of the curve and curve pattern. and following results were obtained: 1. Age distribution was from 8 years to 39 yeara of age and mean age was 17. 2 years. 2. The etiology of the 43 cases was idiopathic in 15 (34.9%), paralytic in 10(23.3%). congenital in 9 (20.9%), neurofibromatosis in 5(11.6%) and others in 4, 3. The most common curve pattern was thoracic curve in 20 cases (40. 8%), and thoraco-lumber curve in 13, lumbar curve in 9, double curve in 5. 4. The average initial curve was 80.7 degrees with the flexibility of 36.9% on side bending; preoperative correction 31.3 degrees (38.3%) and immediate postoperative correction 40.6 degrees (50.3%). 5. As preoperative correction, Risser localizer cast was applied in 23 cases (53.5%) with 28.8 degrees (37.4%) of correction, turn buckle cast in 1 case with 80. 0 degrees (54.1%) Cotrel traction in 5 case with 27.5 degrees (40.7%) and halofemoral traction in 9 cases with 36.9 degrees (38.2%). 6. The best correction was obtained in idiopathic type and then followed with paralytic and congenital type. 7. Halofemoral traction was effectively applied in cases of rigidand severe, curve, mostly in older patients; the initial curve 96.5 degrees with 28.5% of flexibility. 8. The best correction was obtained in thoracic curve (39%) and then followed with thoracolumbar and lumbar curve. Halofemoral traction was effectively applied in tho racic curve. 9. Duration of preoperative correction was 5.1 days in Risser localizer cast, 7 days in turn buckle cast, 6.4 days in Cotrel traction and 13.3 days in halofemoral traction. 10. Most of preoperative correction were obtained in a few days of traction; 92% in half week with Cotrel traction and 83% in half week and 91% in one week with halofemoral traction.
Age Distribution ; Humans ; Neurofibromatoses ; Pliability ; Scoliosis ; Seoul ; Spinal Fusion ; Traction

No abstract available.

BACKGROUND: The aim of this study was to investigate the correlation between the type of subscapularis tendon tears diagnosed during arthroscopy and the outcomes of physical tests and of isokinetic muscle strength tests. METHODS: We preoperatively evaluated physical outcomes and isokinetic muscle strength of 60 consecutive patients who underwent an arthroscopic rotator cuff repair and/or subacromial decompression. We divided the patients into five groups according to the type of subscapularis tear, which we classified using Lafosse classification system during diagnostic arthroscopic surgery. RESULTS: When we performed a trend analysis between the outcomes of the physical tests and the severity of subscapularis tendon tear, we found that both the incidence of positive sign of the collective physical tests and that of individual physical tests increased significantly as the severity of the subscapularis tear increased (p<0.001). Similarly, the deficit in isokinetic muscle strength showed a tendency to increase as the severity of subscapularis tear increased, but this positive correlation was statistically significant in only the deficit between those with Lafosse type II tears and those with Lafosse type III tears. CONCLUSIONS: Although no single diagnostic test surpasses above others in predicting the severity of a subscapularis tear, our study implies that, as a collective unit of tests, the total incidence of the positive rate of the physical tests and the extent of isokinetic strength deficit may correlate with severity of subscapularis tears.
Arthroscopy ; Classification ; Decompression ; Diagnostic Tests, Routine ; Humans ; Incidence ; Muscle Strength* ; Physical Examination ; Rotator Cuff ; Shoulder ; Tears* ; Tendons

No abstract available.
DNA*

Metaphyseal Chondrodysplasia is a disease characterized by metaphyseal ossification leading to shortening of stature. The extremities, especially lower, and mainly affected, resulting in a disproportionate drarfing which spares the trunk. The first case was reported in a patient with irregular metaphysis of lower extremities and hands, and severe shorteness of stature by Murk Jansen in 1934. A milder form of Metaphyseal Chondrodysplasia was noted in 1949 by Schmid, which is more common and transmitted in autosomal dominant. Mckusick recently reported another form of Metaphseal Chondrodysplasia, and other types were reported, but they are extremly rare, and of little clinical significance. In the Schmid type, patient is normal at birth, but characteristically shortness of stature, bowed leg, and waddling gait developed at biginning of walking. Ali labratory findings including serum calcium level, phosphorous, alkaline phosphatase, renal function test is normal in Metaphyseal Chondrodysplasia. The most difficult differential diagnosis is Vitamin D-resistant rickets in clinical and x-ray findings. The only treatment is careful observation and properly timed corrective surgery. Authors experienced on case of Schmid type of Metaphyseal Chondrodysplasia which had been treated with Vitamin D under impression of rickets for 1 year before the case was consulted to Orthopedic Department. Proximal tibial osteotomy and subtrochanteric valgus osteotomy were performed for the correction of genu varum and coxa vara deformity with satisfactory results for one year follow up.
Alkaline Phosphatase ; Calcium ; Congenital Abnormalities ; Coxa Vara ; Diagnosis, Differential ; Extremities ; Follow-Up Studies ; Gait ; Genu Varum ; Hand ; Humans ; Leg ; Lower Extremity ; Orthopedics ; Osteotomy ; Parturition ; Rickets ; Rickets, Hypophosphatemic ; Vitamin D ; Walking

No abstract available.
Leukemia, Lymphocytic, Chronic, B-Cell*

PURPOSE:Several drugs such as insulin, propranolol, levodopa, glucagon and clonidine have been used for pharmacological growth hormone(GH) provocative test, and each medical center chooses different combinations of drugs during GH provocative tests. In this study, authors compared three drugs insulin(RI), clonidine(C), and propranolol-levodopa(P-L) in terms of GH secretory ability to select the most effective drug. METHODS:Study patients consisted of 63 children with idiopathic growth hormone deficiency, who were diagnosed 'H deficiency'in the department of pediatrics, Kyungpook National University Hospital between January, 1995 and December, 1995. Peak values of GH by each drug were analyzed and following results were obtained. RESULTS:Numbers of patients who showed peak GH values of < or = 5ng/mL, 6-9ng/ mL or > or = 10ng/mL were 23, 22 and 18 respectively in GH provocative test using RI, 48, 12 and 3, respectively in GH provocative test using P-L, 55, 8 and 0, respectively in GH provocative test using C. The numbers of patients showing peak growth hormone values over 6ng/mL were more significantly in GH provocative test using RI than those using P-L or C(P<0.05). CONCLUSION: Among drugs authors have been using in GH provocative tests, RI was more effective in stimulating growth hormone secretion than P-L or C. Authors feel that RI should be included in GH provocative tests for the diagnosis of growth hormone deficiency.
Child ; Clonidine* ; Diagnosis ; Glucagon ; Growth Hormone* ; Gyeongsangbuk-do ; Humans ; Insulin* ; Levodopa ; Pediatrics ; Propranolol

Osteochondromas are one of the most common benign bone tumors usually involving extraarticular metaphysis of long bone. Solitary intra-articular osteochondroma arising from the elbow joint has rarely been reported. We present a case of 23-year-old female who had pain and limited motion of the left elbow as a result of intraarticular osteochondroma of the distal humerus. Arthroscopic excision of the osteochondroma yielded complete relief of symptoms. Absence of recurrence was confirmed radiographically at two years after surgery. To the best of our knowledge, this is the first report of osteochondroma of the elbow successfully treated arthroscopically.
Arthroscopy ; Elbow Joint ; Elbow* ; Female ; Humans ; Humerus ; Osteochondroma* ; Recurrence ; Young Adult

BACKGROUND: Few studies have reported the results of arthroscopic coracoplasty concomitantly conducted with subscapularis tear. Therefore, this study was conducted to examine and compare the outcomes of arthroscopic subscapularis repair after arthroscopic coracoplasty using either the subacromial approach or rotator interval approach. METHODS: We retrospectively reviewed 51 patients who underwent coracoplasty with subscapularis repair. The patients were grouped according to whether the subacromial approach group (24 patients) or rotator interval approach group (27 patients) was used during coracoplasty. Preoperative and postoperative visual analogue scale scores, American shoulder and elbow surgeons scores, Korean shoulder scores, and range of motion (ROM) were assessed. Assessment of repaired rotator cuff tendon integrity was performed at 1 year after surgery using either magnetic resonance imaging or ultrasonography. RESULTS: At final follow-up, overall functional scores and ROM improved significantly in both groups when compared with preoperative values (p>0.05). The re-tear rates were not significantly different between groups; however, the rotator interval approach group showed a significant increase in ROM compared with that in the subacromial approach group (p<0.05). CONCLUSIONS: Arthroscopic coracoplasty conducted concomitantly with subscapularis repair can provide a satisfactory outcome. There were no significant differences between the two approach groups regarding final functional scores and re-tear rates. However, the rotator interval approach group showed a greater increase in ROM at final follow-up, especially in external rotation.
Arthroscopy ; Elbow ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Retrospective Studies ; Rotator Cuff ; Shoulder ; Surgeons ; Tears* ; Tendons ; Ultrasonography

Plasmid vectors with either RSV or CMV promoter are frequently used for DNA- mediated immunization due to the availability in commercial. Consequently, influence of the vector constituents, such as promoter, enhancer and transcription termination signal etc. on vaccination efficiency is not studied extensively. As an initial attempt to develop an efficient vector system for DNA-rnediated immunization, influence of promoter for antigen gene expression on vaccination efficiency has been analyzed. Initially, plasmids with either B-actin or muscle creatine kinase (MCK) promoter were constructed from the plasmid with prototype CMV promoter. In addition, ovalbumin (OVA) antigen gene has been cloned into each vectors to generate the plasmid vectors with different promoters for induction of the anti-OVA immune responses. Antigen protein expression in antigen gene transfected mouse muscle myoblast cells showed that the level from MCK promoter containing plasmid was slightly higher than those from either CMV or B-actin promoter containing plasmids. Also, the same plasmid turned out to be slightly more efficient than other plasmids in antibody imrnune response induction in vivo, when they were applied both through intramuscularly and intradermally. These results suggest that the commonly used CMV promoter containing plasmid vector could be further modified to develop an efficient vector for DNA-mediated immunization.
Animals ; Clone Cells ; Creatine Kinase, MM Form ; Gene Expression ; Immunization ; Mice ; Myoblasts ; Ovalbumin ; Plasmids* ; Vaccination*