Total release of the hamstrings of the knee from their origin was performed In nine cerebral plasied children. Eighteen procedures were performed in nine patients whose age ranged from three to sixteen years with an average of ten years. The average follow-up period was twenty one months from ten to thirty-six months. The spastic knee flexion was correction adequately; in mest instances the crouch posture was corrected, gait was improved, and a long stride was possible. The power of the hamstrings was assessed in the fourteen limbs of the children who could walk or cooperate in musicle testing. The power was graded as good in six knees and as normal in one. Seven showed improvement in gait; six patients who had never walked were able to do so after hamstring release; and one patient was able to stand up for the first time in his life after the operation. Eight out of nine cases are now able to stand up with or without support of a brace, and to walk with a brace in five cases and without support in two. However, increased lumbar lordosis and genu recurvatum has occurred in two cases each.
Animals ; Braces ; Cerebral Palsy ; Child ; Extremities ; Follow-Up Studies ; Gait ; Humans ; Knee ; Lordosis ; Muscle Spasticity ; Posture

No abstract available.
Dental Porcelain* ; Resin Cements*

The Dowling-Meara type of epidermolysis bullosa simplex(EBS) is genetic disease that is transmitted as an autosomal dominant trait and is charscterized clinically by pherpetiform clustering of blisters and palmo-plantar keratoderma. The disease usually presents at with or in early infancy. Although serious and hemorrhagic Wers may occur on any part of the body, the lesions heal without scaning in general. The disease shows a tendency to improve by progressian of age and it usually follows a relatively benign course. Microecopically, there are intraepidermal bli.ter s forming as a result of cytolysis of basal cells. In addition, the is a highly characteristic clumping of tonofilaments of keratinocytes in the lower epidermis, which is not seen in any other form of EBS. We report a case of Dowling-Meara type of EBS that is first destribed in Korean medical literatures.
Blister ; Epidermis ; Epidermolysis Bullosa Simplex* ; Epidermolysis Bullosa* ; Intermediate Filaments ; Keratinocytes

The most frequently used serodiagnostic test for syphilis in Korea is VDRL test, which is one of several flocculation tests utilizing cardiolipin-lecithin as antigen. This test remains popular because it is easily performed, inexpensive, is standard for screening purposes, and is useful for following the serologic response to treatment. A common problem is weakly reactive (or 'rough' result) VDRL test or reactive VDRL in the absence of definite evidence of present or past syphilis; the diagnosis of syphilis in these cases should be confirmed by using the specific treponemal antigen tests. The Fluorescent Treponemal Antibody-Absorption (FTA-ARS) test is the result of continued attempts to improve the original FTA procedures. This test uses virulent T. pallidum (Nichols strain) as antigen and uses fluorescein-tagged antihuman globulin as reaction indicator. The FTA-ABS test is very sensitive in all stage of syphilis, especially in early syphilis. The FTA-ABS test was carried out on 448 persons with reactive and weakly reactive VDRL tests and divided the groups of routine physical check and out patients. (countinued..)
Diagnosis ; Flocculation Tests ; Fluorescent Treponemal Antibody-Absorption Test ; Humans ; Korea ; Mass Screening ; Outpatients ; Syphilis*

Hip arthroscopy is technically demanding procedure and it is difficult to inspect the entire joint space. But with the development of instruments and the accumulation of results of research, the indications of hip arthroscopy are expanding. The operative arthroscopy of 18 joints was performed during the past four years. We used the supine position on the fracture table and anterolateral and lateral portals. Removal of traumatic loose bodies and synovial chondromatosis, lavage of pyogenic arthritis are excellent indications for the arthroscopic surgery of the hip joint. The results of the partial synovectomy and debridement for rheumatoid arthritis and other arthritis are satisfactory. The hip arthroscopy is beneficial to the diagnosis and treatment for the unexplained hip pain.
Arthritis ; Arthritis, Rheumatoid ; Arthroscopy ; Chondromatosis, Synovial ; Debridement ; Diagnosis ; Hip Joint ; Hip ; Joints ; Supine Position ; Therapeutic Irrigation

Recently we performed arthrography in 10 cases of ankle injuries and obtained abnormal findings roentgenographically suspected to be ligamentous injury in only 8 cases. In two cases surgical exploration was done. Although two arthrographys is not completely reliable and sufficiently specific to justify the use of this technique in elucidating injuries to the lateral ligament complex, it has value in the diagnosis of diastasis (hidden sprains of the anterior or posterior tibio-fibular ligament), in distinction between old and recent lesions and in diagnosing some sprains of the deltoid and lateral ligaments of the ankle.
Ankle Injuries ; Ankle Joint ; Ankle ; Arthrography ; Collateral Ligaments ; Diagnosis ; Ligaments ; Sprains and Strains

To elucidate the clinical avaiability of FNAB, we reviewed retrospectively medical records of 30 patients who had infiltrative pulmonary lesion or pulmonary nodule or mediastinal mass, and got percutaneous fine needle aspiration biopsy using Westcott needle, 20~22 gauge, at the department of Pediatrics, Hanyang university hospital from July, 1986 to June, 1993. The obtained results were as follows: 1) There were 30 patients, aged 6 months to 15 years. 2) There were 17 male patients and 13 female patients with sex ratio of 1.3:1 3) Among 30 cases, we discovered 16 cases of infiltrative lesions, 7 cases of pulmonary nodules and 7 cases of mediastinal mass lesions. In mediastinal there were 4 cases of anterior mediastinum and 3 cases of posterior mediastinum. 4) Overall success rate on fine needle aspiration biopsy was 60% (18/30). The success rate was 50% (8/16) in infiltrative lesions, 50% (8/15) in pulmonary nodules and 71% (5/7) in mediastinal mass lesions, respectively. 5) Eight infiltrative lesione were diagnosed as Pneumocystis carinii pneumonia. Five pulmonary nodules were diagnosed as aspergillosis (2 cases), tuberculosis (1 case), mucormycosis (1 case), lung metastasis of metastasis of neuroblastoma (1 case). Five mediastinal mass lesions were diagnosed as teratoma (2 cases), lymphoma (1 case), malignant neurogenic tumor (1 case), ganglioneuroblastoma (1 case). 6) The complications occured in 20% (6 cases) among 30 procedures. All cases were due to pneumothorax: 3 cases spontaneously resolved, and 3 cases needed chest tube insertion. There were no death related with this procedures.
Aspergillosis ; Biopsy* ; Biopsy, Fine-Needle* ; Chest Tubes ; Child* ; Diagnosis* ; Female ; Ganglioneuroblastoma ; Humans ; Lung ; Lymphoma ; Male ; Mediastinum ; Medical Records ; Mucormycosis ; Needles ; Neoplasm Metastasis ; Neuroblastoma ; Pediatrics ; Pneumonia, Pneumocystis ; Pneumothorax ; Retrospective Studies ; Sex Ratio ; Teratoma ; Tuberculosis

No abstract available.
Dermatomycoses* ; Humans

Retrospective clinicopathologic analysis of 15 patients with the phyllodes tumors(PT) of the breast, diagnosed at SNUH over 6 years period, was done. By light microscopy, 8 cases were diagnosed as benign, and 7 cases were diagnosed as malignant. Mean ages o the patients were 37 and 34 years in malignant and benign, respectively. Most of those cases were presented with a palpable mass of the breast. None of the patients with malignant PT had distant metastasis, Local recurrences were experienced in 3 patients among the malignant PT, and one patient among the benign PT. One of 7 malignant PT was coexisted with simultaneous ipsilateral infiltrating duct carcinoma. The clinical course was not well correlated with pathologic features. The prognostic significances of several histopathologic parameters were assessed for possible correlation with local recurrence, metastasis and death; stromal cellularity, stromal cellular atypism, mitotic activity, tumor contour, necrosis, tumor size and heterologous stromal elements. Immunohistochemistry using antibody to vimentin, proliferating cell nuclear antigen(PCNA) and epidermal growth factor receptor(EGF-R) were analysed. In the 5 cases of benign PT, the stromal cells stained diffusely positive for vimentin and 3 cases of malignant tumors show similar staining for vimentin. The percentage of PCNA-positive cells were higher in the malignant PT than in the benign ones; they were 3.5% to 60% in malignancy, while they were less than 60% in all benign PT. The results of EGF-R staining were correlated with the histologic classification; only 2 cases out of 8 benign PT show diffusely positive staining of EGF-R in the cytoplasm, but 6 cases out of 7 malignant PT show positive findings.
Neoplasm Metastasis

Some of the techniques for bone grafting for delayed union or nonunion of the long bone are used currently. In 1991, at arthroscopy workshop in Phoenix, Arizona, Lanny L. Johnson, M.D. reported a case of endoscopic bone grafting for the delayed union on the humerus. He suggested the possibilities of endoscopic bone grafting such as minimal incision, magnified visualization, accurate debridement, accurate graft placement, vascular preservation, outpatient surgery and reduced cost. The author performed endoscopic bone grafting and extra-articular adhesionlysis on the delayed union of femur with extra-articular ankylosis. The patient was a 28 year old housewife with blood type Rh(-). The duration after initial operation was more than 9 months. The result of the graft was satisfactory. In the future endoscopic bone grafting could be performed for nonunion, delayed union and congenital bone defect.
Ambulatory Surgical Procedures ; Ankylosis ; Arizona ; Arthroscopy ; Bone Transplantation ; Debridement ; Education ; Femur ; Humans ; Humerus ; Transplants