The authors carriod out lumbodorsal fasciotomy on six cases of paralytic scoliosis with pelvic obliquity. In our experience, in those older children and adolescents with paralysis in whom scoliotic curve is not severe and is more or less static, correction and maintenance of the correction can be achieved by lumbodorsal fasciotomy without resorting to spine fusion. While it is a common practice to leave a mild and static curve uncorrected, even a mild degree of scoliosis, when associated with pelvic obliquity, abduction contracture of the hip, instability of the other hip and leg length discrepancy, is a major problem in paralytic patients. Initial results indicate that lumbodorsal fasciotomy, combined with contralateral Soutters or Campbells fasciotomy if necessary, is a simple and effective method in correcting these deformities and restoring balance and function.
Adolescent ; Child ; Congenital Abnormalities ; Contracture ; Health Resorts ; Hip ; Humans ; Leg ; Methods ; Paralysis ; Scoliosis ; Spine

During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complication. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-up in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examination in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examination in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis(n=5) and perforated appendicitis(n=1). Our results show that high-resolution, real-time US is an accureate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complication.
Abscess ; Adenocarcinoma ; Appendicitis* ; Appendix ; Diagnosis* ; Diverticulitis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography*

An intra-articular fracture of the distal tibia or a fracture of the tibial plafond is a relatively uncommon but the most difficult fracture to manage. There are many treatment options and many authors have reported good results after open reduction and rigid internal fixation to restore the length with articular surface and bone-graft followed by early motion and prolonged non-weight bearing. But in the fractures with severe comminution or with severe soft tissue injury, tries for internal fixation with plate and screws in the distal tibia will result in extensive soft tissue stripping of the wound with precarious blood supply, high rates of wound breakdown, superficial and deep infection, and osteomyelitis. The purpose of this study is to evaluate the results of treatment of severely open (open type III-A and more by Gustilo and Anderson) or comminuted plafond fractures (fracture type III and more by Ovadia and Beals) with an Ilizarov method with a minimum follow up of one year (average: 27.9 months) and we have reviewed 12 cases from December 1990 to October 1995. The results were as follows. 1. The average time of bone union were 17.5 weeks (range: 6-42weeks). 2. The radiological results of the treatment were excellent in 4 patients (33.3%), good in 4 patients (33.3%) and poor in 4 patients (33.3%) by radiological assessment of Crutchfield and the clinical results of the treatment were excellent in 4 patients (33.3%), good in 5 patients (41.7%) and poor in 3 patients (25.0%) by functional rating scaie of Crutchfield. 3. It seems that prognosis depends on severity of comminution at the time of injury. 4. The complications were bony collapse of the distal tibia in 2 patients, nonunion in 1 patient, degenerative arthritis of the ankle joint in 2 patients and chronic osteomyelitis in 2 patients. 5. Ilizarov technique is an useful method in the management of severely open or comminuted plafond fracture of the tibia and it would be preferable to apply buttress plate or bone graft after improvement of skin condition to prevent the late collapse.
Ankle Joint ; Follow-Up Studies ; Humans ; Ilizarov Technique* ; Intra-Articular Fractures ; Osteoarthritis ; Osteomyelitis ; Prognosis ; Skin ; Soft Tissue Injuries ; Tibia ; Transplants ; Wounds and Injuries

STUDY DESIGN: We classified adult isthmic spondylolisthesis based on the findings of postmyelographic CT scanning. OBJECTIVES: To propose a new classification that could be used as a useful guideline when evaluating the patient with adult isthmic spondylolisthesis. SUMMARY OF LITERATURE REVIEW: Morphologic changes of the spinal canal and its neural contents in the adult patient with isthmic spondylolisthesis and their relations to radiological variables have not been well described in literature. MATERIALS AND METHODS: 32 adult patients with one level isthmic spondylolisthesis underwent myelography followed by CT scanning. Based on these findings, we classified each patient with four morphologic criteria; 1. dural station I or ll by the location of dural sac, 2. non-compression or compression type by the existence of lateral compression of dural sac. 3. root station I or ll by the location of nerve root, 4. hook or smooth type by the shape of spinal canal. Subsequent statistical analyses to assess the relationships between our newly developed classification and clinical variables were tested by SPSS software. RESULTS: Dural station correlated positively with percent slip(rpb=0.39; p=0.026). Patient age was closely related to the lateral compression(rpb=0.54, p<0.01) which consequently decreased transverse diameter of dural sac(rpb=-0.68, p<0.01). Both dural station and lateral compression were important in the prediction of the extent of the dural involvement. Root station of the smooth type correlated positively with percent slip(reb=0.47: p=0.038), while that of the hook type did not. Consequently, nerve root of the hook type entered neural foramen under the pedicle, whereas that of the smooth type entered at various locations depending on the degrees of percent slip. Depth of lateral recess was significantly less in the hook type than in the smooth type(p<0.01). Stretching of the nerve root, produced by posterior migration of the nerve root, was observed only in the smooth type. CONCLUSIONS: We strongly recommend the use of our classification because it is easy to apply and has a high correlation with radiological variables.
Adult* ; Classification* ; Humans ; Myelography* ; Spinal Canal* ; Spondylolisthesis* ; Tomography, X-Ray Computed*

This article consists of a clinical analysis of 221 cases of the Pediatric Inguinal Hernia treated in General Surgery of Pusan Adventist Hospital, from January 1990 to June 1996. The results were as follows ; 1) Patients with inguinal hernia were 37.5% of total operative patients in the division of pediatric surgery 2) Males predominated over females by the ratio of 5.5:1 3) Of 221 cases, 101(54%) were on the Rt side, 80(43.1%) on the Lt side and the remainder (6.4%) on both side in case of Male. 20(58.8%) were on the Rt side, 13(38.2%) on the Lt sid and the remainder (3.0%) on both side in case of Female. 4) The chief Complaints were inguinal protrusion in 131 cases(59.3%) and scrotal enlargement in 77 cases(34.9%) 5) Peak incidence age (32 Months) & Duration of history (20.2 Months) 6) Associated diseases were found in 10 cases(4.9%) and they were cryptorchidism (1.47%), hydroclele (0.98%), Umbilical hermia (0.49%), Heart anomaly (0.49%), cleft palate (0.49%), Teratoma (0.49%), and Jejunal atresia (0.49%). Family History was denied. 7) All were indirect hernia. 8) Incarcerated cases were 6(2.7%) and the ratio of male to female was 2:1, and the location of incarcerated hernia was Rt (66.6%), and Lt (33.3%) 9) There were 70 cases of strangulation. 10) Intraperitoneal organ in hernial sac was noted in 5 cases (2.26%), and they were ovary and fallopian tube in 3 cases (1.35%), small intestine in 1 case (0.45%), cecum and appendix in 1 case (0.45%). 11) 215 (97%) of all hernia were repaired only by highligation of sac and 6(3%) were inforced with Bassini's posterior wall repair. 12) Mean postoperative hospitalization were 5.2 days. 13) Postoperative complications occured in only 2 cases : hematoma and edema 1, wound infection 1.
Appendix ; Busan ; Cecum ; Cleft Palate ; Cryptorchidism ; Edema ; Fallopian Tubes ; Female ; Heart ; Hematoma ; Hernia ; Hernia, Inguinal* ; Hospitalization ; Humans ; Incidence ; Intestinal Atresia ; Intestine, Small ; Male ; Ovary ; Postoperative Complications ; Sudden Infant Death ; Teratoma ; Wound Infection

No abstract available.
Flow Cytometry* ; Humans* ; Leukocytes* ; Microscopy* ; Phagocytosis* ; Staphylococcus aureus* ; Staphylococcus*

No abstract available.
Flow Cytometry* ; Humans* ; Leukocytes* ; Microscopy* ; Phagocytosis* ; Staphylococcus aureus* ; Staphylococcus*

It is well known that the medullary carcinoma of the breast is one of the special types of breast carcinoma with a good prognosis. At present, the medullary carcinoma of the breast is subclassified into 3 types: typical medullary, atypical medullary and nonmedullary carcinoma. Among them, the former has the best prognosis. We reviewed the film mammographic and ultrasonomammographic findings of 13 patients according to the reevaluated histopathologic diagnosis. Typical medullary carcinoma shows a well circumscribed mass with surrounding halo on film mammogram, and well defined mass with central intermediate echogenicity and peripheral low echogenicity and posterior acoustic enhancement on ultrasonomammogram. Atypical medullary carcinoma shows relatively well circumscribed mass with partial marginal obliteration on film mammogram, and irregular bordered mass with inhomogeneous echogenicity due to focal necrosis in the mass and associated findings of thick boundary, asymetrical lateral shadowing on ultrasonomammogram. Nonmedullary carcinoma shows lobulated mass with surrounding parenchymal distortion and skin thickening on film mammogram, and relatively well defined lobulating mass with surrounding parenchymal distortion and marked heterogeneous internal echogenicity on ultrasonomammogram. Therefore, differentiation between typical medullary carcinoma with good prognosis and atypical medulary or nonmedullary carcinoma with poor prognosis, may be possible by various diagnostic imaging modalities preoperatively. But further collective study shall be needed in near future.
Acoustics ; Breast Neoplasms ; Breast* ; Carcinoma, Medullary* ; Classification* ; Diagnosis ; Diagnostic Imaging ; Humans ; Necrosis ; Prognosis ; Shadowing (Histology) ; Skin

It is well-known that the infection of bone and joints could produce the shortening by destroying the articuiar cartilage and growth plate, or the lengthening hy increased hlood circulation to the epiphyseal and metaphyseal regions of long bone. Since 1985, we have treated total l7 cases of children s pyogenic or tuberculous children s knee with early arthrotomy and continuous irrigation etc. and followed their long hone growth for average 53 months after surgical intervention. Five patients (group I ) were early treated within 2 weeks and twelve patients(group 3 ) were delayed to treat their knees for more than 2 weeks of symptom development. Total 11 patients out of 17 cases(64.7%) (2 cases of group 1 pyogenic arthritis, and 1 case of group l and 8 cases of group II tuberculous arthritis) revealed growth acceleration. Femoral lengthening was much more greater than that of tibial growth, and the size of patella, distal femoral and proximal tibial epiphysis which were measured by computerized digitizer were also significantly larger than that of opposite knee. The total limb length was increased hy average 7mm in 6 months, l4mm in 1 year and 3mm in 2 years after operation. These results suggest the pyogenic and tuberculous arthritis in children s knee should he treated as early as possible after symptoms developed, and followed them to trace their limh inequality for at least 2 years after surgery. That means the early arthrotomy for tuberculous knee or even in pyogenic arthritis can preserve normal articular cartilage and can also prevent the early epiphyseal closure hy infection. and can get the limh lengthening by increased blood circulation around the knee joint.
Acceleration ; Arthritis ; Blood Circulation ; Cartilage ; Cartilage, Articular ; Child* ; Epiphyses ; Extremities ; Growth Plate ; Humans ; Joints ; Knee Joint* ; Knee* ; Lower Extremity* ; Patella ; Socioeconomic Factors

A clinical review and analysis was carried out on 14 cases of ischemic myositis associated with carbon monoxide poisioning treated at S.N.U.H. during the 3 year period from 1968 to 1971 with following results. l. Among 14 patients, there were 8 males and 6 females. 8 cases were between the 20–30 years of age. None was observed under 20 years old. 2. Average duration of exposure to carbon monoxide gas was 9 hours, mostly between 8–12 hours. 3. Such systemic conditions are suggested as predisposing causes leading to ischemic myositis as pregnancy, postpartum, active pulmonary tuberculosis, obesity with hypertension, and hypnotic addiction. 4. In regard to the local factors, prolonged external pressure the body is subjected to in unconcious state as well as local burn is shown to be responsible for the myositis. And in this respect Korean mode of bed on On-Dol may deserve blame for myositis because of its hardness and much heat. 5. Complications associated with ischemic myositis were 3 cases of ischemic myocarditis, 2 cases of brain syndrome and 3 cases of acute renal failure. In 3 cases of renal failure, all terminated fatally inspite of the intensive care including hemodialysis. 6. Fasciotomy should be performed cautiously, as 4 cases of secandary infection were complicated after fasciotomy on 5 cases.
Acute Kidney Injury ; Brain ; Burns ; Carbon Monoxide Poisoning ; Carbon Monoxide ; Carbon ; Critical Care ; Female ; Hardness ; Hot Temperature ; Humans ; Hypertension ; Male ; Myocarditis ; Myositis ; Obesity ; Postpartum Period ; Pregnancy ; Renal Dialysis ; Renal Insufficiency ; Tuberculosis, Pulmonary