No abstract available.
Diagnosis* ; Echocardiography*

OBJECTIVE: To examine a normal range for nuchal translucency thickness between 9 and 14 weeks' gestation in normal fetuses. METHODS: Nuchal translucency was measured prospectively in 124 fetuses between 9 and 14 weeks' gestation resulted in normal pregnancy outcome. The nuchal translucency measurement was expressed as the median and the 5th, 25th, 75th, and 95th percentiles according to complete weeks of gestation based on ultrasound measurement. RESULTS: The median nuchal translucency thickness was 1.8 mm at 9 weeks' gestation and it declined to 1.6 mm at 10 weeks. But the median thickness increased from 1.95 mm at 11 weeks to 2.3 mm at 12 weeks, after which it slightly declined to 2.25 mm at 13 weeks. And then it increased to 2.5 mm at 14 weeks. A nuchal translucency thickness greater than 2.5 mm was not found at 9 and 10 weeks' gestation, but found in 21.8% of fetuses from 11 weeks to 14 weeks. CONCLUSION: In normal fetuses, there is a physiologic variation in the thickness of nuchal translucency between 9 and 14 weeks' gestation. The calculation of risk for trisomies based on this thickness should take this variation into account. The adoption of a gestational age-dependent cutoff point, based on the deviation of a given measurement from the median, may reduce the invasive procedure for karyotyping. And this study suggest that if the nuchal translucency measurement is greater than 2.5 mm before 10 weeks, it may advise the karyotyping.
Female ; Fetus* ; Karyotyping ; Nuchal Translucency Measurement* ; Pregnancy ; Pregnancy Outcome ; Prospective Studies ; Reference Values ; Trisomy ; Ultrasonography

No abstract available.
Acetabulum*

No abstract available.
Appendicitis* ; Humans

Acromelanosis progressiva is a peculiar progressive pigmentary disorder characterized by intensely dark and sharply demarcated hyperpigmentation over the dorsa of fingers and toes, and the pigmentation rapidly spread proximally. A 19-year-old female had sharply demarcated symmetric dark aroarn macules on the dorsa of her hands and feet, forearms, lower legs, face and neck. These pigmentations at first appeared at the age of 5 on the dorsa of her fingers and toes, thereafter these pigmertatons spread progressively to the proximal portion of her body. Histologically, a proliferation of mela biocyte at the epidermal-dermal junction was seen, associated with mild hyperkeratosis. She was othervise normal on physical examination and had no family historv of consanguinity.
Consanguinity ; Female ; Fingers ; Foot ; Forearm ; Hand ; Humans ; Hyperpigmentation ; Leg ; Neck ; Physical Examination ; Pigmentation ; Toes ; Young Adult

No abstract available.
Appendicitis* ; Barium* ; Enema*

Hypertensive encephalopathy is characterized by an acute, severe rise in blood pressure associated with headache, nausea, vomiting, altered mental status, and focal neurologic deficits, and rapid improvement after control of blood pressure. An eight-year old boy had been admitted with symptoms of red urine, fever, headache, convulsion, and visual blurring of vision. Blood pressure was 140/90mmHg, and CSF exam revealed WBC 8/mm3, glucose 83mg/dL, protein 106mg/dL. Serum C3 was 8mg/dL, C4 17mg/dL, ASO 1,024 Todd units. Brain CT showed non specific findings, however, MRI revealed symmetric high signal intensity lesions on T2WI over the parieto-occipital areas bilaterally. These lesions had been completely resolved on the following MRI 4 weeks later.
Blood Pressure ; Brain* ; Fever ; Glomerulonephritis* ; Glucose ; Headache ; Humans ; Hypertensive Encephalopathy* ; Magnetic Resonance Imaging* ; Male ; Nausea ; Neurologic Manifestations ; Seizures ; Vomiting

We evaluated the results following the use of hinged Ilizarov and free tissue transfer to correct the eqinus deformity of the foot associated with extensive scarring of the leg and ankle in nine patients. The deformity was secondary to ischemic and neuropathic changes after trauma to the leg, ankle and foot. The average age of the patients was seventeen years (range, thirteen to thirty-four years). The average duration of follow-up was twenty-one months (range, twelve to thirty-eight months). Free tissue transfer was done in all cases, parascapular flap was done in seyen cases, groin flap was done in two cases. Among the nine cases, free tissue transfer and hinged Ilizaov were done at the same time in four cases, The average interval of the other five patients between free tissue transfer and hinged Ilizaov was three months (range, two to four months). The duration of distraction was four to six weeks, and the apparatus was kept in place for an additional two months after the desired position of correction had been achieved. The results were evaluated using two criteria, dorsiflexion and range of motion of ankle joint. Criteria on dorsiflexion of ankle, the results were good in seven cases, fair in two cases. Criteria on range of motion of ankle, one case being performed ankle fusion was not evaluated. Total eight cases were evaluated for range of motion of ankle. The results were good in six cases, fair in two cases. On the basis of our results, we believe that severe eqinus deformities of the foot associated with extensive scarring of the leg and ankle can be corrected with heel cord lengthening, free tissue transfer and hinged Ilizarov.
Ankle Joint ; Ankle* ; Cicatrix* ; Congenital Abnormalities ; Equinus Deformity* ; Follow-Up Studies ; Foot ; Groin ; Heel ; Humans ; Leg* ; Range of Motion, Articular

Leg length discrepancy or short stature is a significant problem to patient psychosocially, cosmetically, and there has been many efforts for limb lengthening. There are many report about lower limb lengthening since the first description of femoral lengthening by Codivilla in 1905. Although limb lengthening using external fixator was popularized by Anderson, the result was poor because of many difficulties in techniques and complications. Recently, a great progress in lower limb lengthening was made by distraction osteogenesis by llizarov and callotasis by De Bastiani. But as such exter- nal fixator has some problem in technique, cosmesis or complications. Therefore gradual elongation intrameduilary nailing(Albizzia) developed by Guichet in 1986 has gained attention for more stability and relatively less discomfort. We reviewed 18 cases in 11 patients(5 males and 6 females) who visited the department of Orthopedic Surgery of Severance Hospital at Yonsei University with limb leg length discrepancy due to sequeale of poliomyelitis, familial short stature and Turner syndrome. They all underwent lower limb lengthening using Albizzia technique between December 1995 and January l997. The average age at the time of the operation was 22.7 year. Famiiial short stature was in 12 cases(67%), Turner syndrome in 2 cases(11%), and leg length discrepancy due to the sequelae of poliomyelitis in 4 cases(22%). The site of lengthening were 5 cases of femur(28%) and l3 cases of tibia(72%). The latency period was average of 7 days. During the distraction period, 15 ratchetings per day(1 mm/day) were performed. In case of bilaterai femoral lengthenings, average length of gain(LG) was 6.0cm and percentage of increase(PI) l6.8%(16.2-17.4), lengthening index(LI) 1.2 month/cm(0.75-2.2). In case of unilateral femoral lengthening, LG was 3.8cm, Pl 7.8 %, Ll 1.3 month/ cm. In case of bilateral tibial lengthening, average LG was 5.5cm(3.5-6.0~) and Pl 18.8%(12.0-22.9), LI 1.3month/cm(0.67-2.3). In case of unilateral tibial lengthening, LG was 2.9cm(2.3-3.5), P1 9.4 %(7.7-11.7), LI 2.8 month/cm(2.2-3.1). Lengthening index in poliomyelitis by llizarov was 3.l month/cm, but it was 1.3 in femur and 2.8 in tibia hy Albizzia method. There are some advantages and disadvantages or contraindications and indications of the Albizzia technique. We suggest that the Albizzia technique is more stahle, more comfortable and no longer lengthening time compared to external fixator such as Ilizarov.
Albizzia ; External Fixators ; Extremities* ; Femur ; Humans ; Latency Period (Psychology) ; Leg ; Lower Extremity ; Male ; Orthopedics ; Osteogenesis, Distraction ; Poliomyelitis ; Tibia ; Turner Syndrome

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Head* ; Hemiarthroplasty* ; Necrosis*