No abstract available.
Fatty Liver* ; Obesity*

PURPOSE: This study was undertaken to compare the growth promoting effect between patients with idiopathic growth hormone deficiency(IGHD) and those with organic growth hormone deficiency(OGHD). METHODS: Seventeen children with GH deficiency were divided into two groups: 7 IGHD and 10 OGHD including craniopharyngioma(5), sella germinoma(1), prolactinoma(1), Langerhans cell histiocytosis(1) and postirradiation(1). Diagnosis of GHD was made on the basis of two growth hormone provocative tests, serum IGF-1 & IGFBP 3 level, and bone age. Both groups were treated with recombinant human growth hormone(0.6-0.8IU/Kg/week) for 2 years and auxological parameters (height velocity, height SDS CA(standard deviation score for chronologic age)) were analyzed during 2 years of treatment by using KIGS 4.0 software program. RESULTS :The mean pretreatment height velocity in both groups did not differ statistically(2.6+/-.8cm/yr in IGHD vs 2.5+/-.9cm/yr in OGHD: p>0.05). However, height velocity after 2 years of growth hormone treatment was significantly greater in IGHD group than in OGHD group(9.0+/-.3cm/yr in IGHD vs 7.2+/-.8cm/yr in OGHD: P<0.05). The height SDS for CA has improved remakably during 2 years of growth hormone treatment; -3.46 SDS before treatment to -1.53 SDS in IGHD group, -2.3 SDS to -0.5 SDS in OGHD group. CONCLUSION: Growth hormone replacement therapy has remakably improved height velocity and height SDS for CA in both groups during the 2 years of the treatment. However, the height velocity in OGHD group was significantly less than in IGHD, indicating that additional factors such as malnutrition, associated multiple hormone deficiencies, spinal irradiation and sexual precocity might significantly hamper the growth promoting effect in OGHD group during growth hormone treatment.
Child* ; Diagnosis ; Growth Hormone* ; Humans ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Malnutrition

Elderly patient with Genu Varus deformity is commonly treated by high tibial valgus osteotomy to unload the stress concentration medially. Most of these procedures were performed by closing wedge osteotomies and that revealed some problems. Most require a fairly large scar and later reoperation for implant removal. The Ilizarov apparatus and Ilizarov's principles of deformity correction seem to offer several advantages over other methods of high tibial osteotomy. With the Ilizarov method, distractional open wedge technique offers a biomechanically sound, predictably accurate, and reproducible method of correcting an extremity's mechanical axis deviation. From December 1991 to December 1993 at the department of orthopaedic surgery, Pusan National University Hospital, 5 patients(7 tibia) underwent the operation of correction of the genu varum using Ilizarov external fixator for osteoarthritis. The results were summarized as follows: l. All case were female, and the Mean age was 58 years old. 2. Preoperative mean varus angle were 20° and postoperative mean valgus angle were 6° at final follow-up. 3. The complication was not detected includes limb length descrepancy. 4. Mean Ilizarov external fixator fixation period was 5 months. 5. The results after average 1 year 1 month of follow-up were as follows: Excellent in 2 cases(29%), Good in 4 cases(57%), Fair in 1 case(14%), Poor in 0 case()%). 6. The early clinical and radiologic results were encouraging, although a longer follow-up period is necessary.
Aged ; Busan ; Cicatrix ; Congenital Abnormalities ; External Fixators ; Extremities ; Female ; Follow-Up Studies ; Genu Varum ; Humans ; Ilizarov Technique ; Methods ; Osteoarthritis ; Osteotomy ; Reoperation

Nine hips in eight patients had development of femoral endosteal cortical erosion after a cementless total hip arthroplasty. Serial anteroposterior and lateral radiographs of all of the affected femora were reviewed to determine the interval between the operation and the first recognition of the osteolytic lesion or lesion, as well as to evaluate the radiographic appearance and progression of the lesions. We reviewed the one hundred twenty hips in one hundred eleven patients had a cementless total hip arthroplsty at the department of Orthopaedic Surgery, Pusan National University Hospital from January 1985 to December 1991. The mean average follow up period was forty five months (twenty four to one hundred nine months). Osteolysis was first noted radiographically at forty four to eighty five months(mean, sixty three months) postoperatively; it occurred most frequently around the distal portion of the prosthetic stem. Three of the femoral components were shown to be loose. The remaining six hips had been judged to be stable when the endosteal erosion had first been identified. The osteolysis was more severe in the femora in which the component was loose than in those in which it was stable. Of the six stable hips and two unstable hips except revised one hip, who were followed, four hips had an increase in the size of osteolytic lesion with time. All two unstable hips and two stable hips among six stable hips had an increase in the size of osteolytic lesion with time. Therefore, close follow up in necessary for patients in whom osteolysis develops in association with a stable cementless femoral component.
Arthroplasty, Replacement, Hip ; Busan ; Femur ; Follow-Up Studies ; Hip ; Humans ; Osteolysis

Infantile myofibromatosis with systemic involvement is a very rare disease and is characterized by numerous nodules composed of spindle cells of a myofibroblastic nature. There are often disseminated throughout the subcutis, muscle, skeleton and viscera. We report an autopsy case of infantile myofibromatosis in a stillborn female fetus of 32 weeks of gestation. The nodules, Imm to 2 cm, were found over the whole body and viscera. The involved viscera were the heart, tongue, esophagus, gastrointestinal tract, portal areas of the liver, spleen anc pancreas. There were also associated malformations, viz., frontal meningoencephalocele, flexion defer-mities, syndactyly, cleft palate, agenesis of corpus callosum, pachygyria, diaphragmatic hemia, renal hypoplasia, etc. Multiple basaloid follicular hamartomas of the skin were noted on the face and extremeties. There are no previous reports in the literature of infantile myofibromatosis in conjunction with the above skin lesion and congenital malformations.
Infant ; Male ; Female ; Humans ; Hamartoma

No abstract available.
Dermatitis, Allergic Contact* ; Fusidic Acid* ; Sodium*

No abstract available.
Adenocarcinoma* ; Rectum*

The significance of the posterior cruciate ligament (PCL) in the stability of the knee and the necessity for surgical repair of its tears are still controversial. The purpose of this study is to present the short term results of surgical repair and Kennedy LAD augmentation for 15 cases with PCL injury. In 14 patients (15 knees), the torn PCL was repaired with pullout suture technique and Kennedy LAD augmentation was done from june 1993 to june 1994. The follow-up period ranged from 12 months to 25 months (average, 18months). The main causes of injuries were traffic accidents in 12. Thirteen of the patients were men and one was a woman, ranging in age from 17 to 52 years(average, 35 years). 10 knees were acute injury and repaired at average 9 days after injury. There were 11 cases that had combined injuries(4 ACL injuries, 4 meniscus injuries, 3 MCL injuries etc). In eight knees, the tear was in mid substance area and in five it was near femoral attach site and in two it was near tibial attach site. Postoperative results were evaluated by roentgenographic evaluation of posterior sagging and Lysholm knee score. 11 knee were stable but 4 knees were unstable posteriorly during postoperative follow-up period. 3 chronic injuried knees were included in 4 posteriorly unstable knees. There are 7 combined knee injuries in 11 stable knees and no combined injuries in unstable knees and average Lysholm knee score was 89.7 in stable knees and 90 in unstable knees and there was no significant difference between two groups. On the based of this study, surgical repair with pollout suture technique and augmentation with Kennedy LAD in acute PCL injury is a one of the good method for preventing posterior sagging but more longer follow-up period and more cases must be needed to accept this method.
Accidents, Traffic ; Female ; Follow-Up Studies ; Humans ; Knee ; Knee Injuries ; Lysholm Knee Score ; Male ; Methods ; Posterior Cruciate Ligament ; Suture Techniques ; Tears

Purpose: To report the surgical skills needed, and the clinical results of, minimally invasive hip surgery with dynamic hip screws and the comparison with the classical technique in stable pertrochanteric fractures of the femur. Materials and Methods: Thirty-two patients with pertrochanteric fractures of the femur who were treated with dynamic compression hip screws between April 1999 and March 2004, and were evaluated retrospectively, and were followed up for more than 12 months. 16 cases were treated with a classical dynamic hip screw technique and 16 cases with a minimally invasive technique in random order. The mean age was 73.2 years, and there were 11 males and 21 females. The operative times, total hemovac bleeding loss, functional scores, and average hemoglobin decrease ratios were evaluated. The clinical assessments were performed with the Harris Hip Score (HSS) and bony union was evaluated with serial follow-up plain radiographs. Results: The average operative time was 63.9 minutes with the classical technique and 42.5 minutes with the minimally invasive technique. The total average hemovac blood loss was 640 cc with the classical technique and 143 cc with the minimally invasive technique. Clinically, the HHS was an average of 85.9 and 89.2 in groups 1 and 2, respectively, by the last follow-up and there were no statistically significant differences between the two groups (P <0.05) The hemoglobin decrease ratio was the same in both groups and there was no nonunion. Conclusion: Minimally invasive dynamic hip screw insertion was useful in stable pertrochanteric fractures, because it decreased blood loss and operative times; and there were no changes in fracture healing and functional outcomes.
Female ; Femur ; Follow-Up Studies ; Fracture Healing ; Hemorrhage ; Hip* ; Humans ; Male ; Operative Time ; Retrospective Studies ; Surgical Procedures, Minimally Invasive

For the chronic renal failure(CRF) patients arteriovenous fistula(AVF) is performed on the upper extremity. The primary site is usually the wrist including snuffbox where diameter of the vessels is small, usually one to three millimeters. The trainee of general surgery has been lack of experience of small vessel surgery. Here on the basis of experimental microsurgery, novel animal practice model of AVF was developed for the clinical application. Among several types of vascular anastomosis of AVF, side-to-side anastomosis with distal vein ligation were favored in this study. In brief, rats were anesthetized with intraperitoneal urethane injection and midline abdominal incision was made. Aorta and IVC below the left renal vein was exposed and seperated and mobilized carefully. Side-to-side and end-to-end anastomosis can be performed microsurgically. Loupe(x3.5-5) and experimental microscope may help to carry out vascular anastomosis confidently. The key-point of the procedure is that both corners of stomas were sutured for staying and from the one-end continuous sutures were done with total open-loop method.
Animals ; Aorta ; Arteriovenous Fistula* ; Humans ; Kidney Failure, Chronic* ; Ligation ; Microsurgery ; Rats* ; Renal Veins ; Sutures ; Upper Extremity ; Urethane ; Veins ; Wrist