Cubitus varus is a complex three-dimentsional deformity. In addition to deformity on varus-valgus plane, internal torsion of distal humerus is frequently combined. Also limitation of flexion-extension could be associated in some patients. Surgical correction of the cubitus varus after skeletal maturity, could have some different clinical course from those of growing children. However there have been few papers dealing with the surgical treatment of cubitus varus in adults. From May 1988 to December 1993, 23 patients who were older than 17 years of age, had correc- tive osteotomy for cubitus varus considering its three planes of the deformity at Seoul National University Hospital. To prevent serpentine deformity medial displacement of distal fragment was also combined during operation. The avereage age was 26 years(17-47), and the average follow-up after the operation was 1 year and 6 months(6 months-3 years). The presumed diagnosis of initial injury deduced from history and preoperative radiograms, was supracondylar fracture in 19 cases(86.4%). Others were lateral condylar fracture of humerus in two, and fractures associated with elbow dislocation in two. The average age at the time of initial injury was 8 years(2-14), and average delay from occurrence of deformity to the operation, were 13 years. Tardy ulnar nerve palsy was associated in 3 cases(13.6%). The preoperative average angle of cubitus varus was 26 degrees(16-45), flexion contracture 11 degrees(-5
Adult ; Bony Callus ; Child ; Congenital Abnormalities ; Contracture ; Diagnosis ; Dislocations ; Elbow ; Follow-Up Studies ; Humans ; Humerus ; Myositis Ossificans ; Osteotomy ; Paralysis ; Radial Nerve ; Range of Motion, Articular ; Seoul ; Tourniquets ; Traction ; Ulnar Neuropathies

There has been a few articles dealing with the incidence of congenital anomalies of the hand in Korea. In this paper, we have analyzed patients who have visited the hand clinic of Seoul National University Children s Hospital from March 1993 to February 1995 to study the relative incidence of congenital anomalies of the hand. We regarded more than two visits of the same patients as one. They were categorized into two groups by our classification system. First group consisted of the patients who showed hand anomaly only. The other group consisted of the patients who had anomalies in the other sites as well as in the hand. The first group was divided into two subgroups; the patients who had single entity of hand anomaly, and those who had more than two entities of hand anomalies. From the clinical analysis based on above criteria, following results were obtained. There were 626 anomalies in 547 patients, 319 (58.3%) males and 228 (41.7%) females (1.4: 1). Unilateral involvements of hand anomaly were noted in 385 (70.3%) patients (229 in right, 156 in left) and bilateral in 162 (29.7%). As a whole, the most common anomaly was trigger thumb (16.5%) and the second was polydactyly (16.1%). Other anomalies, in order of frequency, were syndactyly, camptodactyly, hypoplasia, brachydactyly, cleft hand and so on. In the first group who had hand anomaly only, there were 407 patients who had single entity of hand anomaly. Among these, trigger thumb were 25.3%, and polydactyly 16.2%. There were 68 patients who had multiple entities of anomalies. Among these, the syndactyly was the most common anomaly (23.9%) and the polydactyly was the next (16.2%). Fifty eight (10.6%) patients had anomalies in the hand as well as in the other site. Among these, camptodactyly was the most commonly found (36.5%) and polydactyly was the next common variety (19.0%) in the hand. In the anomalies which occurred in other than hand, arthrogryposis multiplex congenita was the most common (30.0%). Syndactyly of the foot (22.9%) and polydactyly of the foot (18.6%) were the next common anomalies.
Arthrogryposis ; Brachydactyly ; Child ; Classification ; Female ; Foot ; Hand* ; Humans ; Incidence* ; Korea ; Male ; Polydactyly ; Seoul ; Syndactyly ; Trigger Finger Disorder

The purpose of this study was to evaluate the results of various types of opponensplasties which have been performed for the last 15 years. For the patients who had median nerve injury with or without ulnar nerve injury, we usually transferred the ECRL or ECRB to restore thumb opposition and Huber s procedure were usually done for thumb hypoplasia. With the criteria outlined by Sundararaj and Mani, postoperative function of 27 hands from 23 patients who underwent the opponensplasty from March 1981 to March 1995 were evaluated. The results from each etiology group were analyzed by the same criteria. Also subjective opinion of the patients about the scar were investigated by our own criteria. The analysis from overall 27 hands yielded 19 excellent (70.4%), 4 good (14.8%), 3 fair (11.1%), and 1 poor (3.7%) results with Sundararaj and Mani s criteria and 1 excellent (3.7%), 14 good (81.5%), 3 fair (11.1%), and 1 poor (3.7%) results about the scar. In 11 patients with nerve injury (median nerve with or without ulnar nerve injury), 7 excellent and 2 fair results were yielded by the ECRL or ECRB transfer, 1 excellent by Phalen-Miller's procedure, and 1 excellent by Burkhalter's procedure. In 8 patients with congenital hypoplastic thumb, 7 excellent results were yielded by Huber's procedure and 1 excellent by the ECRB transfer. In 8 patients with residual poliomyelitis or brachial plexus injury, the ECRB transfer yielded 3 excellent results. However, 2 good and 1 fair results were obtained by Bunnell's procedure; and l good, l poor by Camitz's procedure. In summary, the ECRL or ECRB transfer in the patients who had neuropathy, such as median with or without ulnar nerve injury, brachial plexus injury or residual poliomyelitis; and Huber's procedure in congenital hypoplastic thumb were thought to be one of the useful methods for the restoration of the thumb opposition.
Brachial Plexus ; Cicatrix ; Hand ; Humans ; Median Nerve ; Poliomyelitis ; Thumb* ; Ulnar Nerve

Fractures of the shaft of the radius and ulna occur commonly in children and are usually treated by closed reduction and plaster cast immobilization. Anatomic reduction is seldom necessary because of the remodelling potential in the child under 10 years of age, whereas the bones of children older than 10 years of age have less capacity to remodel and the diaphyseal fracture is unstable. In case of either unacceptable reduction or unstable fractures in adolescent patients, an operative treatment is required. In five children older than 12 years of age for whom conservative treatment had hailed, we treated a closed intramedullary nailing using a distal radial and proximal ulnar approach, and followed up for 1 year or more. All fractures healed within 6 weeks. No nonunion, cross-union or refrature occured. Another advantages of this method are negliable cosmestic defect and easy removal of the internal fixation device under local anesthesia. We think that closed intramedullary nailing with rush pin is a safe and reliable method to treat unstable forearm fracture in children older than 12 years of age.
Adolescent ; Anesthesia, Local ; Casts, Surgical ; Child ; Forearm ; Fracture Fixation, Intramedullary ; Humans ; Immobilization ; Internal Fixators ; Methods ; Radius ; Ulna

No abstract available.

O1igodendrocytes are known to be responsible for the synthesis and maintenance of myelin sheath in the central nervous system, and their functional disturbance leads to defect in myelination. But, the fine mechanism of myelination by oligodendrocytes is not yet known, and iron metabolism in central nervous system is suspected to be related with myelination process by oligodendrocytes. Carbonic anhydrase-II[CA-II], transfe-rrin, and ferritin are known to be present at oligodendrocytes and suspected to play a role in iron metabolism of central nervous system. In this study, demyelination and remyelination of ICR mouse brains were induced using cuprizone, the copper-chelating agent, and immunohistochemical changes of CA-II-, transferrin-, and ferritin-immunoreactive oligodendrocytes at corpus callosum were observed. During demyelination by cuprizone feeding, the numbers of CA-II- and transferrin-immunoreactive oligodendrocytes were decreased. Especially, the decrease ratio of CA-II-positive cells was great. In contrast, the number of ferritin-positive oligodendrocytes was increased during demyelination by cuprizone feeding. Cessation of cuprizone feeding leaded remyelination and the numbers of CA-II-, transferrin-, and ferritin-immunoreactive oligodendrocytes were returned to normal level. In conclusion, the derangement of iron metabolism in oligodendrocytes may be related to demyelination mechanism of central nervous system, and the CA-II is suspected to have an important role in iron metabolism of oligodenrocytes in relation to demyelination and remyelination induced with cuprizone.
Animals ; Brain ; Carbon* ; Central Nervous System ; Corpus Callosum ; Cuprizone* ; Demyelinating Diseases ; Ferritins ; Iron ; Iron-Binding Proteins* ; Metabolism ; Mice* ; Mice, Inbred ICR ; Myelin Sheath ; Oligodendroglia ; Transferrin

Angiofibroma and shagreen patches are common cutaneous manifestations of tuberous sclerosis complex (TSC) and have significant physical and psychological repercussions for patients. Several treatments have been proposed to improve lesions; however, clear treatment guidelines have not yet been presented. Thus, we introduce a case of angiofibroma and shagreen patch improved by application of pulsed dye laser, ablative fractional CO2 laser, and topical rapamycin, and present clinical implications for the treatment of angiofibroma and shagreen patch in TSC.

Laser riidectomy with combined application of the Argon and the Nd-YAG laser was performed on 25 eyes of 24 patients with primary narrow angle glaucoma(19 eyes) or pupillary block glaucoma(6 eyes). Patients were followed for from a minimum of one month to maximum of six months and were evaluated the postoperative intraocular pressure, the iridectomy patency, the number of burst and the postoperative complication. In our study, the results obtained are as follows: 1. Pantency rates of iridectomy site were 100%. 2. Postoperative intraocular pressure were well controlled except one eye. 3. Numbers of burst were obviously decreased. 4. The bleeding during the iridectomy was noted in one eye(4%). 5. Immediate postoperative intraocular pressure elevation was seen in one eye(4%).
Argon* ; Hemorrhage ; Humans ; Intraocular Pressure ; Iridectomy* ; Lasers, Solid-State* ; Postoperative Complications

Laser riidectomy with combined application of the Argon and the Nd-YAG laser was performed on 25 eyes of 24 patients with primary narrow angle glaucoma(19 eyes) or pupillary block glaucoma(6 eyes). Patients were followed for from a minimum of one month to maximum of six months and were evaluated the postoperative intraocular pressure, the iridectomy patency, the number of burst and the postoperative complication. In our study, the results obtained are as follows: 1. Pantency rates of iridectomy site were 100%. 2. Postoperative intraocular pressure were well controlled except one eye. 3. Numbers of burst were obviously decreased. 4. The bleeding during the iridectomy was noted in one eye(4%). 5. Immediate postoperative intraocular pressure elevation was seen in one eye(4%).
Argon* ; Hemorrhage ; Humans ; Intraocular Pressure ; Iridectomy* ; Lasers, Solid-State* ; Postoperative Complications