No abstract available.
Appendix* ; Intussusception*

Tuberculosis of the vertebral column is a slowly developing disease, characterized by pain, spinal deformity, and occasionally paralysis. The following varieties of vertebral tuberculosis are commonly recognized, such as a central variety, metaphysial tuberculosis (inter-vertebral articular type), an anterior or periosteal variety, appendiceal tuberculosis, and a true tuberculous arthritis. Among these appendiceal tuberculosis is rare. This form of Potts disease may be unilateral or bilateral and may be isolated or present at multiple levels. Disk space changes and deformity are minor features, but large paravertebral abscesses are invariable. Extradural extension may lead to the development of paraplegia. Two cases of destructive lesions at the neural arch of 10th. and 11th. thoracic vertebra were revealed to be appendiceal tuberculosis. All cases treated with antituberculous medication, radical curettage and body jaket casts and made recoveries. Patients had no complaints and no evidence of recurrence. A brief summary of the literature is submitted.
Abscess ; Arthritis ; Congenital Abnormalities ; Curettage ; Humans ; Paralysis ; Paraplegia ; Recurrence ; Spine ; Tuberculosis ; Tuberculosis, Spinal

Various methods have been described for surgical treatment of recurrent shoulder dislocation. Arthroscopic techniques for stabilizing the shoulder have the theoretical advantage of reduced complication, decreased discomfort, and improved motion. The arthroscopic Bankart procedure was performed in 23 cases at Department of Orthopaedic Surgery, Yonsei University College of Medicine, from January, 1991 to December, 1993. This study is an attempt to evaluate results of arthroscopic Bankart procedure by Caspari's technique. Results of this study were as follows: l. According to the clinical evaluation of Rowe, results were excellent in 18 cases, good in 2 cases, fair in 1 cases and poor in 2 case. The prognosis was related to the size of Hill-Sachs lesion. 2. Complication after treatment included 5 cases of knot problem, 1 case of subluxation, and 2 cases of redislocation. Redislocation was developed in one patient who played ice hockey at 2 months after operation and in one patient who played soccer at 8 months after operation. Subluxation was developed in one patient who had psychologic problem. Among 5 patients who had knot prob- lem, two patients had a operation of removal. In conclusion, Caspari's suture technique in arthroscopic Bankart procedure needs some modification on the insertion point of the guide pin and suturing technique. And arthroscopic Bankart procedure by Caspari's technique offers good cosmetic results, low perioperative morbidity, low complications except knot irritation, and excellent results by the Rowe's criteria for patients with anterior shoulder instability.
Arthroscopy ; Hockey ; Humans ; Prognosis ; Shoulder ; Shoulder Dislocation ; Soccer ; Suture Techniques

The coexistence of extraadrenal pheochromocytoma and renal artery stenosis is extremely rare. The mechanisms of renal artery stenosis with pheochromocytoma include direct compression of the tumor mass on the renal artery and catecholamine-induced vasospasm, fibromuscular hyperplasia, and fibrous adhesion. We report a rare case of renal artery stenosis caused by extraadrenal pheochromocytoma in a 29- year-old female. She was admitted to the hospital because of palpitation and headache. She had been treated for hypertension for 2 years. On admission, her plasma epinephrine and norepinephrine levels were elevated as were her plasma renin activity, urinary vanillylmandelic acid (VMA) and metanephrine levels. Through the use of abdominal computed tomography, 131I-MIBG scan, and renal arteriography, a mass was found in the hilus of the left kidney which affected left renal artery stenosis. Surgical removal of the mass and left kidney restored the catecholamine excretion, plasma renin activity, and blood pressure to normal. Electronmicroscopic examination of the mass confirmed the pheochromocytoma.
Angiography ; Blood Pressure ; Epinephrine ; Female ; Headache ; Humans ; Hyperplasia ; Hypertension ; Kidney ; Metanephrine ; Norepinephrine ; Pheochromocytoma* ; Plasma ; Renal Artery Obstruction* ; Renal Artery* ; Renin ; Vanilmandelic Acid

One hundred and thirty trimethoprim-resistant R plasmids derived from of Escherichia coli isolated from clinical specimens and feces of healthy collegians were examined for incompatibility, EcoRI endonuclease restriction fragment pattern, and Southern hybridization with DHFR I, II, III, V, and VII probe. 1. Most trimethoprim-resistant R plasmids were resistant to ampicillin, tetracycline, chloramphenicol, gentamicin, and kanamycin, and showed multiple drug resistance and various antimicrobial resistance patterns. 2. Trimethoprim-resistant R plasmids ranged from 90 to 50 kilobase and 42.3% of R plasmids tested were classified to incompatibilty group Inc FI, Inc FII or Inc FIV, 3. Among 48 random selected R plasmids from various origin, 14 R plasmids (including 9 of 14 Inc FII plasmids and 3 of 14 Inc FI plasmids) hybridized with DHFR VII oligonucleotide probe but others did not respond to any of DHFR probes used. 4. Most R plasmids showed various EcoRI endonuclease fragments and different reaction sites by Southern hybridization. Six plasmids showed identical or nearly identical molecular weight, EcoRI endonuclease fragment patterns and different sites of Southern hybridization. But 2 Inc FII plasmids derived from urine and feces showed identical pattern. These findings, if confirmed by further studies, suggest that normal flora E. coli can act as reservoir of resistant genes and, consequently, as a factor in the dissemination of these genes among enteric pathogens and need to be examined further.
Ampicillin ; Chloramphenicol ; Deoxyribonuclease EcoRI ; Drug Resistance, Multiple ; Escherichia coli* ; Escherichia* ; Feces ; Gentamicins ; Immunodeficiency Virus, Feline ; Kanamycin ; Molecular Biology* ; Molecular Weight ; Plasmids ; R Factors ; Tetracycline ; Trimethoprim Resistance* ; Trimethoprim*

Congenital dislocations of the hip are all present at birth. Therefore if adequate examination of all newborn infants is done regularly, it should theoretically never be seen in adolescents or adults. Both the pathogenesis and management of congenital dislocation of the hip remain controversial topics. Closed reduction of simple congenital dislocations of the hip with retention in frog position was introduced by Lorenz. After this great efforts to receive these patients for treatment as early as possible were made by investigators. Also numerous surgical procedures and modifications have been used. Congenital dislocations of the hip were known to be uncommon in Korea. Nevertheless adolescents with untreated dislocations were not rarely met. The author studied congenital dislocation of the hip for sex incidence, X-ray findings, birth history, relation with combining anomaly and the results of treatment, In this study, 39 cases of congenital dislocation of the hip, treated at the Orthopedic Department of Severance Hospital during 7 years and 6 months from July, 1970 until December, 1977, were reviewed. The results of this study are as follows: 1. The annual number of the patients who were treated at Severance Hospital has not changed markedly. 2. The number of female patients was much greater than males. The ratio of female to male was 9 to 1. 3. The incidence of bilateral involvement was relatively low compared to the western coutries. 4. Congenital anomaly associated with congenital dislocation of hip occurred in about 7.8%. 5. The acetsbular index, C-E angle, Y-coordinate and height on affected hips are aggrevated according to the increment of age. 6. Closed reduction was satiafactory in 16 cases among 22 cases under the age of 3, but 4 cases were treated by operation. 7. Open reduction was performed in 8 cases, Salter's innominate osteotomy in 8 cases, Colonna's capsular arthroplasty in 2 cases, and supracondylar osteotomy in 2 cases.
Adolescent ; Adult ; Arthroplasty ; Clinical Study ; Dislocations ; Female ; Hip ; Humans ; Incidence ; Infant, Newborn ; Korea ; Male ; Orthopedics ; Osteotomy ; Parturition ; Reproductive History ; Research Personnel

The lumbosacral joint is an unstable area from an anatomical yiewpoint, while it is also a very mobile area in ordinary life, so that clinically major causes of low back pain originate in this joint The purpose of this study is to assess the differences in the efiicacy of the lumbosacral angles among low back pain patients. The following lumbosacial angles were measured and evaluated in 65 patients with only low back pain, in 70 patients with spondylolysis, and in 51 patients with spondylolisthesis. 1. Ferguson angle. 2. Sacrovertebral angle. 3. L-5 horizontal angle. 4. Meschan angle. 5. Line of weight bearing. 6. Wedging of the lumbar spine. 7. Interrelationship between slipping and wedging of the lumbar spine. The results are as follows: 1. The Ferguson angle was increased in spondylolisthesis, 2. The L-5 horizontal angle was increased in spondylolisthesis, meaning unstability of the lumbosacral joint. 3. There was no interrelationship between stability of the lumbosacral joint and the sacro-vertebral angle. 4. The Meschan angle indicated high sensitivity in spondylolisthesis, but the changes were also observed in some of the other back pain patients. 5. Most of the cases showed instability when judged by the line of weight bearing. This was especially true in spondylolisthesis. 6 The lumbar index was in 92.7% of simple low back pain patients, 82.2% in spondylolysis, and 80.2% in spondylolistheysis, The average wedging of the L-5 vertebra was significantly greater in spondylolysis and spondylolisthesis than in patients without slipping of the vertebral body. 7. The degrees of wedging and of slipping showed a statistically valid correlation, although their etiological relationship remains to be further investigated.
Back Pain ; Humans ; Joints ; Low Back Pain ; Spine ; Spondylolisthesis ; Spondylolysis ; Statistics as Topic ; Weight-Bearing

Biliary ascariasis is a rare complication of intestinal ascaris infestation. Retrograde migration of the adult worm through the papilla of Vater causes biliary colic, and may give rise to pancreatic and biliary obstruction, choledocholithiasis, cholecystitis, cholangitis, hemobilia, and if the worm lodges in intrahepatic bile ducts, to liver absceases. In the past, treatment of biliary ascariasis has usually involved the direct removal of ascaris throagh a surgical choledochatomy and subsequent saline lavage of the common duct through an indwelling T tube. Recently, the worm in the bile duct can be seen by ERCP and it can be removed during the endoscopic procedure. A 55-year-old woman with intermittent colicky right upper quadrant abdominal pain was admitted to out hospital. Abdominai sonogram disclosed an echogenic structure within a mildly dilated common bile duct and a high ehogenic structure with acoustic shadowing in the distal common bile duct(CBD), which suggests a CBD stone. ERCP after obtaining the sonogram revealed a thick, long, linear, smooth filling defect in the CBD with a distal CBD stone. A distal CBD stone was removed by sphinctetotomy and lithotripsy, then we directly extracted ascaris with a tripod forcep without any complication.
Abdominal Pain ; Acoustics ; Adult ; Ascariasis* ; Ascaris ; Bile ; Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Cholecystitis ; Choledocholithiasis ; Colic ; Common Bile Duct* ; Female ; Hemobilia ; Humans ; Lithotripsy ; Liver ; Middle Aged ; Shadowing (Histology) ; Surgical Instruments ; Therapeutic Irrigation

This study examined the protective effect of dexamethansone following bilateral forebrain ischemia in a rat model of two-vessel occlusion. Twenty rats were subjected to dexamethasone (1 mg/kg intravenously) before bilateral common carotid artery occlusion for 10 minutes. Carotid artery blood flow was restored and the rats were terminated by a perfusion-fixation method after 7 days. Ten minutes of two-vessel occlusion produced cellular ischemic change in the cerebral hemispheres of most rats. This region was studied mainly with light microscope, and it was noticed that the CA 1 neuron in the hippocampus is the most vulnerable to ischemia. Ischemic neuronal damage was graded in accordance with conventional neuropathological criteria. The grade had no statistical significance.
Animals ; Carotid Arteries ; Carotid Artery, Common ; Cerebrum ; Dexamethasone* ; Hippocampus ; Ischemia ; Models, Animal ; Neurons ; Prosencephalon* ; Rats

There were 21 cases of tibial pilon fractures in total: type I-2 cases, type II-14 cases, type III-5 cases according to Rued's classification. In type I and II, ring fixators were applied to tibia and foot and closed reduction was performed monitoring the quality of the reduction with an image intensifier. When the quality of the reduction was questionable, we rechecked it using arthroscopy and if neces- sary, the reduction was readjusted. Instead of using plate and screws, we used olive stop wires to achieve stable fixation. In type III, a limited open reduction was performed in the place of arthroscopy. Approximately at the eighth week after operation, we removed the fixation of calcaneus, metatarsal and foot mounting. Between 16 and 28 weeks, we removed the foot mounting after achieving bony union in all cases except one case(20 cases). In the follow-up cases of 2 years and more, we obtained the fine functional results of 15 good, 4 fair and 2 poor cases. Fewer major complications were observed except 8 cases of pin tract infection(grade 1) and 1 case of reduction loss. Using ring fixators and arthroscopy, we had fewer surgical complications.
Arthroscopy ; Calcaneus ; Classification ; Follow-Up Studies ; Foot ; Metatarsal Bones ; Olea ; Tibia