In the instance wherein concentric reduction cannot be achieved by closed method, open reduction is indicated. Prolonged and forceful attempts to reduce the refractory hips are not without risk to the circulation of the femoral head and open reduction is certainly a less traumatic way to obtain reduction in these hips. The authors performed clinical analysis in 30 patients with congenital dislocation of hip who were treated by open reduction between 1978 and 1987, The results are as follows :1. The results of treatment in 30 patients were acceptable in 22(73.3%), uncertain in 4(13. 3%), and unacceptable in 4 patients(13.3%). 2. Comparing the results depending on the presence of prior treatment or not, acceptable results were obtained in 86.4%(19 out of 22) of patients without prior treatment and in only 37.5%(3 out of 8) of patients with prior theatment by such as Pavlik harness and closed reduction. 3. The surgical approaches for open reduction were medial and anterior routes. The approach was selected depending on the age of patients and the severity of dislocation. The medial approach was used in patients under the age of 18 months. In mild degree of dislocation, the age limit of medial approach was extended to 24 months of age. The anterior approach was used in patients over 19 months of age.
Dislocations ; Head ; Hip ; Humans ; Methods

No abstract available.
Child* ; Femoral Fractures* ; Humans

No abstract available.
Humans

No abstract available.

No abstract available.
Liver* ; Neoplasm Metastasis*

No abstract available.
Choledochal Cyst* ; Humans ; Infant, Newborn*

No abstract available.
Anterior Cruciate Ligament*

PURPOSE: This study was designed to evaluate diagnostic accuracy of serial electrocardiograms(ECG), myocardial band of creatinine phosphokinase(CK)(CK-MB/CK ratio) and two dimensional echocardiography(ECHO) for myocardial injury in patients with blunt chest trauma. METHODS: We prospectively investigated 54 patients(male : 38, female : 16, mean age : 41) with severe blunt chest trauma. Presence of myocardial injury was determined by increase(>0.1ug/L) of peak serum troponin T(TnT) concentration from serial mesurements. RESULTS: Among 54 patients with blunt chest trauma, 23 patients(43%) had increased peak TnT level which suggested of myocardial injury. Among 23 patients with increased TnT, abnormal ECG findings were found in 18(78%) and echocardiographic abnormalities were observed in 17(74%). Cardiovascular events in 9(39%) of 23 patients with increase Tnt. There was no cardiovascular events in patients with normal TnT. CONCLUSION: Significant proprotion of patients with blunt chest trauma had elevated TnT value which suggested of myocardial injury. We recommend echocardiagraphy and serial tracing of ECG to verify the clinical significance of elevated TnT in patients with blunt chest trauma.
Creatinine ; Diagnosis* ; Echocardiography ; Electrocardiography ; Female ; Humans ; Prospective Studies ; Thorax* ; Trinitrotoluene ; Troponin ; Troponin T

BACKGROUND: Cardiovascular injury is a potentially fatal complication of blunt chest trauma. The diagnosis of cardiovascular injury in blunt chest trauma is not easy because of concomittent injuries of thoracic cage or lungs and early death from cardiovascular injury. Diagnostic tools such as electrocardiography or cardiac enzyme studies are not specific to cardiovascular injury. Two-demensional echocardiography can visualize anatomic and functional disturbances from cardiovascular injuries in patients with blunt chest trauma. Purpose: This study was designed to evaluate the usefulness of echocardiography in detecting cardiovascular injury of patients with blunt chest trauma. METHODS: We performed echocardiography for detecting cardiovascular injury in 151 patients with significant blunt chest trauma including sternal fracture, multiple rib fractures or pulmonary contusion. Echocardiography was performed within 6 hours since patient arrived emergency department. Electrocardiography was traced on arrival and 24 hours after admission. Serial determinations of cardiac enzymes including MB fraction of creatinine phosphokinase were also performed every 8 hours after admission. RESULTS: 37(25%) patients had echocardiographic evidences of cardiovascular injury. Abnormal echocardiographic findings were 10 pericardial effusion, 9 regional wall motion abnormality(RWMA) outright ventricle, 5 aortic injuries, 4 reduced left ventricular ejection fraction, 3 RWMA of left ventricle, 2 right ventricular dilatation, 2 valve injuries, and 2 other cardiovascular injuries. Electrocardiographic abnormalities were associated with echocardiographic findings. However, CK-MB/CK ratio was not associated with echocardiographic findings. Significant proportion(65%) of patients with abnormal echocardiographic findings needed cardiovascular management during hospital stay. CONCLUSION: Two-dimensional echocardiography is useful for detecting cardiovascular injury. Echocardiographic abnormality in blunt chest trauma is associated with high probability of need of cardiovascular management.
Contusions ; Creatinine ; Diagnosis* ; Dilatation ; Echocardiography* ; Electrocardiography ; Emergency Service, Hospital ; Heart Ventricles ; Humans ; Length of Stay ; Lung ; Pericardial Effusion ; Rib Fractures ; Stroke Volume ; Thorax*

OBJECTIVE: To evaluate factor XII deficiency in patients with recurrent spontaneous abortion and its relation to aPTT. MATERIAL AND METHOD: Factor XII was analyzed by clotting method. RESULTS: Of 70 patients with recurrent spontaneous abortion, there were 35 cases of factor XII deficiency. Among them, there were only 3 cases of prolonged aPTT. CONCLUSIONS: It is still unclear whether factor XII deficiency is related to recurrent spontaneous abortion. Molecular approaches should be used to understand further the causal relationship. But based on this result, in the workup of patients with recurrent spontaneous abortion, factor XII should be included. aPTT is not likely to represent the abnormality of factor XII.
Abortion, Spontaneous* ; Factor XII Deficiency* ; Factor XII* ; Female ; Humans ; Pregnancy