A case of congenital dislocation of the both knees in a newborn infant which is a very rare condition and difficult to treat, is reported together with the reviews of the literature and the discussion of the future therapeutic programme of the condition.
Dislocations ; Humans ; Infant, Newborn ; Knee

Cubitus varus and valgus is one of late complication of elbow fracture, and this deformity is caused usually by malunion in supracondylar fracture or epiphysial injury of the elbow joint. 40 supracondylar closed wedge osteotomies (on cubitus varus 25, cubitus valgus 15) were performed at the supracondylar level and were fixed with two K-wires or French method. The following results were obtained: 1. The frequency of deformity of cubitus varus was higher than that of cubitus valgus: cubitus varus, 25 cases and cubitus valgus, 15 cases. 2. Injury of the supracondylar of the humerus frequentry occured between the age of 6 and 15 (65%). 3. In cubitus varus the degree of deformity ranging from −11° to −30° was the most common whereas in cubitus valgus that ranging from 30° to 40°, 4. Incomplete ulnar nerve palsy was revealed in 15 postoperative cases of cubitus varus of which 3 cases were treated by anterior transposition. In all cubitus valgus, tardy ulnar nerve symptom was disappeared after correction. 5. Nerve damage could be avoid by performing the closed wedge osteotomy and upper connection combind with posterolateral incision in cubitus varus and medial incision in cubitus valgue. 6. Internal fixation associated with cross pinning with two K-wires or French method were performed and good result was obtained without complication even though older case.
Congenital Abnormalities ; Elbow ; Elbow Joint ; Humerus ; Methods ; Osteotomy ; Ulnar Nerve ; Ulnar Neuropathies

We have many unsolved problems about the femoral neck fracture, especially non-union of the fracture and avascular necrosis of the femoral head. It seems clear that underlying these are two basic problems; first, the mechanical difficulties in maintaining secure fixation; and second, biological factors interfering with union, paramount of which is damage to the blood supply of the femoral head. Intra-capsular fracture of the femoral neck heals in the same way as other intra-articular fractures-only by endosteal and not by periosteal repair. If the femoral head has an intact blood supply, repair appears early on both sides of the fracture. But if the femoral head is not viable, this repair appears only on the neck side of the fracture. It can migrate into the head and heal the fracture only if there is close apposition and rigid fixation of well reduced fracture fragments. Clearly the femoral neck fracture heals not by periosteal callus but by callus arising from the marrow supporting structure. Yet there is still no reliable clinical method of determining early the union of the femoral neck fracture and the viability of the femoral head. The femoral head intra-osseous venography, first described by Hulth (1953), to predict viability of the femoral head after fracture of the femoral neck has been carried by various previous authors (Hulth1953 1956 1958, Dahlgren 1959, Harrison 1962, Hulth and Johansson 1962, Nagai 1962). However, they did not mention healing process of fractures of the femoral neck in these studies. To observe the fracture healing and to predict the viability of the femoral head, authors adopted a femoral trochanteric intra-osseous venographic technique. The precedure was carried out under the control of a T-V image intensifier. Venous drainage of the femoral head parallels the arterial supply. There are several venous drainage routes in the hip region; the medial and lateral circumflex vein, gluteal vein, nutrient vein, femoral vein, vein of the ligamentum teres and obturator vein. With the aid of a T-V image intensifier, a bone marrow needle is driven 1 inch below the femoral greater trochanter. When the tip of the needle is in the marrow cavity, about 30cc, of 75% Urograffin is injected. Next X-rays are taken at intervals of 2 seconds, the last film at 5 minutes. A positive venography is one in which venous drainage is seen, and opaque fluid is seen in mottled distribution throughout neck region and part of the head. A negative venography is one in which no venous drainage is seen, on the contrary, opaque fluid pools within the trochanteric region are evident and remain for at least 5 minutes. A positive venography indicates that the head has an intact circulation, thus it may be predicted that the fracture can unite and the head is alive. Negative venography suggests that fracture union is not and will not take place and that the head may be dead. This study provided information about fracture heaIing processes and vascularities of the femoral head and its surrounding tissues during and after fractures healing. We have found that trochanteric intra-osseous venography is a useful diagnostic tool in hip injuries.
Biological Factors ; Bone Marrow ; Bony Callus ; Drainage ; Femoral Neck Fractures ; Femoral Vein ; Femur ; Femur Neck ; Fracture Healing ; Head ; Hip Injuries ; Hip ; Methods ; Neck ; Necrosis ; Needles ; Phlebography ; Round Ligaments ; Veins

Achilles tendon is the most powerful tendon of the body and increases efficiency in weight bearing and walking capability. Since pares' report about the rupture of the Achilles tendon many authors have reported various causes, diagnostic and therapeutic methods. Most of the authors emphasized the early diagnosis and treatment resulted in good prognosis. There are many methods for the diagnosis of the Achilles tendon, roentgeography, angiography, electromyography, histologic examination and Thompsons test. The causes of the rupture of the Achilles tendon are direct and indirect injury. The two methods of treatment are conservative management and surgical treatment. Whether the cause of the injury is direct or indirect, restoration of function after treatment must be emphasized and the proper method of treatment must be determined by the degree of injury. Clinical analysis was done on 15 cases of Achilles tendon rupture treated at Orthopedic Department of Capital Armed Forces General Hospital from Oct. 1973 to Oct. 1978 with the following results. 1. In sex distribution, there were 13 male cases and 2 female cases and the age range of 20 to 30 years old was the most frequent (67%). 2. There was no difference In frequency between the right and the left side. 3. Achilles tendon rupture was two times more frequent in indirect cause than direct cause, especially after falling from heights and exercises. 4. The most frequent site of rupture was 2–5 Cm. above the insertion of the tendon (80%). 5. By means of a cost immobilization, good result was obtained in fresh partial rupture of the tendon. 6. Good results were obtained by end-to-end suture in fresh cases and reconstructive surgery in old cases. 7. Most of the patients returned to their jobs about 6 months after the operation.
Accidental Falls ; Achilles Tendon ; Angiography ; Arm ; Clinical Study ; Diagnosis ; Early Diagnosis ; Electromyography ; Exercise ; Female ; Hospitals, General ; Humans ; Immobilization ; Male ; Methods ; Orthopedics ; Prognosis ; Rupture ; Sex Distribution ; Sutures ; Tendons ; Walking ; Weight-Bearing

No abstract available.
Esophageal and Gastric Varices* ; Hypertension, Portal*

No abstract available.
Pancreaticoduodenectomy* ; Risk Factors*

PURPOSE: To investigate renal toxicity of high-dose intravenous immunoglobulin(IVIG) in children with Kawasaki disease and idiopathic thrombocytopenic purpura. METHODS: 23 children with Kawasaki disease and 7 children with idiopathic thrombocytopenic purpura who were treated with high-dose IVIG(2 g/kg) were evaluated for the change of urine output, blood urea nitrogen(BUN), serum creatinine(Scr), creatinine clearance(Ccr), tubular reabsorption of phosphorus(TRP), fractional excretion of sodium(FENa), 24hour urine b2-microg1obuin/creatinine(b2MG/cr) ratio and urine microalbumin/creatinine(MA/cr) ratio at post-IVIG 1 and 3 day. RESULTS: There was no significant change of urine output, BUN, Scr, Ccr, TRP, 24hour urine b2MG/cr and MA/cr ratio after high-dose IVIG treatment. Transient increase of FENa at post-IVIG 1 day was the only significant change. CONCLUSION: There was no significant renal toxicity of high-dose IVIG in children with Kawasaki disease and idiopathic thrombocytopenic purpura who had normal renal function.
Biopsy, Fine-Needle* ; Child ; Creatinine ; Humans ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome ; Purpura, Thrombocytopenic, Idiopathic ; Salivary Ducts* ; Urea

INTRODUCTION: The purpose of this study was to investigate the changes in the concern and attitudes of Nursing students toward the disabled before and after the disability experience program. METHOD: 151 Nursing students with clinical practice in National rehabilitation hospital were conveniently selected as the subject. All subjects had experience the disability program, and their attitudes toward the disabled were measured before and after the 3hours' program. Collected data were analyzed by SPSS 11.0 with paired t-test. RESULTS: 1. The concern toward the disabled after their disability experience program was more positive than before(t= -4.930, p= .000). 2. The attitudes toward the disabled after their disability experience program was more positive than before(t=5.892, p=.000). 3. The appreciation of daily life after their disability experience program was higher than before(t=- -8.563, p= .000). CONCLUSION: In summary, the disability experience program should be effective in order to promote the positive attitude toward the disabled. Therefore expansion of this program is of profound significant.
Humans ; Nursing* ; Rehabilitation ; Students, Nursing*

We examined the rates of postoperative neurologic complications, as recorded in the medical record department in Severance Hospital from 1989 through 1991 for patients who had had operations on the spine. There were 538 hospitalizations for procedures on the spine; 327(60.78%) of herniated disc, 120(22.30%) of spondylolisthesis, 64(11.90%) of infection, 27(5.02%) of spinal stenosis were included. Neurologic complications oecurred in 12(2.23%) patients; 3 cases in herniated disc, 4 in spinal stenosis, 4 in spondylolisthesis, and 1 in infection. Regarding techniques of the operation, 8 complications occurred in arthrodesis, among these, 2 were in anterior approach and 6 in posterior approach. Four cases of the complications occurred in laminectomy and discectomy procedure. Complications were more frequent in the patients who had had spinal stenosis when arthrodesis was performed than decompression procedure only. Possible causes of neurologic complication were postoperative hematoma formation, translation of the vertebral column due to instability after anterior debridement and forceful traction of the nerve root during the operation.
Arthrodesis ; Debridement ; Decompression ; Diskectomy ; Hematoma ; Hospitalization ; Humans ; Intervertebral Disc Displacement ; Laminectomy ; Medical Records ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Traction

Intraosseous Neurilemmomas are very rare tumor and most of them are arose in the mandibular bone. A case report is made on the intraosseous neurilemmoma in the distal shaft of tibia which belong very rarely seen in the area of bone. The case was a 23 year old male who had multicystic lesion on the distal shaft of right tibia with marginal this sclerotic change on the radiological examination. The lesion of intraosseous neurilemmoma was confirmed by the microscopic examination after surgical treatment of curettage and bone graft. Also a review of literature on the neurilemmoma was made and reported.
Curettage ; Humans ; Male ; Neurilemmoma ; Tibia ; Transplants