No abstract available.
Craniosynostoses*

Thromboembolism is the most common serious complication following total hip arthroplasty and most common cause of death after total hip arthroplasty. A prospective randomized study in 170 cases of elective cementless total hip arthroplasty was carried out to examine the incidence of deep vein thrombosis and pulmonary embolism after cementless total hip arthroplasty from Aug. 1993 to May 1995. Laboratory study, clinical symptoms and signs, chest roentgenograph and precipitating factors were analysed. Venography and lung perfusion scan using radionuclide scan were used for this study. The weight, height, sex, habitus of alcohol and smoking, hypertension, diabetes mellitus, previous operation history of ipsilateral lower extremity, etiology of hip joint disease, and transfusion of blood were not precipitating factors, but the age over 40 and previous history of pulmonary embolism had a significant effect on the incidence of deep vein thrombosis. There was no significant relationship between the incidence of deep vein thrombosis and the laboratory assay, clinical symptoms and signs. Deep vein thrombosis was detected in 29 cases(17.0%), pulmonary embolism in 22 cases(12.9%), and fatal pulmonary embolism in 1 case(0.6%). The most common location of deep vein thrombosis was the popliteal area.
Arthroplasty, Replacement, Hip* ; Cause of Death ; Diabetes Mellitus ; Hip Joint ; Hypertension ; Incidence ; Lower Extremity ; Lung ; Perfusion ; Phlebography ; Precipitating Factors ; Prospective Studies ; Pulmonary Embolism* ; Smoke ; Smoking ; Thorax ; Thromboembolism ; Venous Thrombosis*

We evaluated the results of twelve total elbow arthroplasties that had been performed from Feb. 1986 to Mar. 1993 in ten patients. The duration of follow-up averaged three years two months(range, one year to seven years one month). There were six females and four males. Two females had bilateral procedures. The average age at the time of the operation was 35.3 years(range, 22 to 53). Five patients had severe rheumatoid arthritis, four patients had fracture sequelae around elbows and one patient had sequele of tuberculous arthritis. Total elbow arthroplasty had been performed for improving the range of motion and relief of pain. Total elbow arthroplasties had been performed in six cases of total ankylotic elbows and in six cases who complained severe painful limitation of motion of the elbow joints. Preoperatively, ankylotic group were fixed by 30 degrees of flexion on an average. In painful elbow group, the average total range of motion was 68 degrees. The prosthesis which were used in total elbow arthroplasties were semiconstrained type in nine cases and noncostrained in three cases. Most of the patients had relief of pain. Postoperative complications were permanent ulnar nerve palsy in one case, superficial infection in one case and dislocation in one case. Total gain of range of motion(ROM) was 17 degrees in painful elbow group and 102 degrees in ankylotic elbows. Total elbow arthroplasty was effective method for improvement of range of motion in ankylotic elbows and relief of pain in elbows which had painful limitation of motion.
Ankylosis ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Dislocations ; Elbow Joint ; Elbow ; Female ; Follow-Up Studies ; Humans ; Male ; Methods ; Postoperative Complications ; Prostheses and Implants ; Range of Motion, Articular ; Ulnar Neuropathies

Fibular fractures that begin proximal to the tibial plafond are assumed to include an injury of the syndesmosis. Many surgeons have treated this injuries by rigidly repairing the medial and lateral malleoli with trans-syndesmotic fixation. However, recently, some demonstrated that a trans-syndesmotic screw places biomechanical restrictions on the tibiotalar joint and is not required to maintain the integrity of the distal tibiofibular joint in cadava models. Thirty eight patients of ankle fracture with syndesmotic injury treated at Sun General Hospital from January 1989 to June 1994 week analyzed in clinical and radiologic aspect. The results obtained from this study were as followings. 1. If rigid anatomic medial and lateral joint fixation was obtained, syndesmotic screw fixation was not required to maintain the integrity of the syndesmotic. 2. Repairting the deltoid ligament did not enhance treatment results when fibular fracture and syndesmotic had been fixed anatomically. Therefore, we believe that syndesmotic screw fixation was indicated only when medial and lateral stabilization could not be achieved adequately.
Ankle Fractures ; Ankle Injuries ; Ankle ; Hospitals, General ; Humans ; Joints ; Ligaments ; Solar System ; Surgeons

Osteonecrosis of the femoral head is a destructive joint disease requiring early hip arthroplasty. The polyethylene-metal design using a 22-mm femoral head component, introduced by Charnley in 1950, has been widely used for over half a century. Since then, different materials with the capacity to minimize friction between bearing surfaces and various cement or cementless insert fixations have been developed. Although the outcome of second and third generation designs using better bearing materials and technologies has been favorable, less favorable results are seen with total hip arthroplasty in young patients with osteonecrosis. Selection of appropriate materials for hip arthroplasty is important for any potential revisions that might become inevitable due to the limited durability of a prosthetic hip joint. Alternative hip arthroplasties, which include hemiresurfacing arthroplasty and bipolar hemiarthroplasty, have not been found to have acceptable outcomes. Metal-on-metal resurfacing has recently been suggested as a feasible option for young patients with extra physical demands; however, concerns about complications such as hypersensitivity reaction or pseudotumor formation on metal bearings have emerged. To ensure successful long-term outcomes in hip arthroplasty, factors such as insert stabilization and surfaces with less friction are essential. Understanding these aspects in arthroplasty is important to selection of proper materials and to making appropriate decisions for patients with osteonecrosis of the femoral head.
Arthroplasty* ; Arthroplasty, Replacement, Hip ; Friction ; Head* ; Hemiarthroplasty ; Hip ; Hip Joint ; Humans ; Hypersensitivity ; Joint Diseases ; Osteonecrosis*

Gynecomastia is a proliferation of the glandular component of the male breast. Gynecomastia is the most common variant condition of the male breast and results from the effect of an altered estrogen-androgen balance on breast tissue or from the increased sensitivity of breast tissue to a normal estrogen level. We experienced a case of macrogynecomastia in a 16-year-old boy who had a normal male phenotype and was treated by reduction mammoplasty with breast tissue removal, which was effective and produced good cosmetic and psychologic results.
Adolescent ; Breast ; Estrogens ; Female ; Gynecomastia ; Humans ; Male ; Mammaplasty* ; Phenotype

No abstract available.
Glycogen Storage Disease*

PURPOSE: To assess the effect of gestational age and illness severity, and the effect of antenatal exposure to magnesium sulfate, glucocorticoids, and antibiotics, on the timing of the first stool in preterm infants. METHODS: Medical records of all preterm infants admitted to the neonatal ward at Kangnam Sacred Heart Hospital between March 1998 and August 1998 were reviewed. We studied the time of the first stool in 55 infants. RESULTS: The median age of the infant at the time of first stool was 18 hours, and 90% of the infants passed stool by 50 hours. Both the gestational age and the illness severity, as measured by the score for neonatal acute physiology(SNAP), correlated significantly with the timing of the first stool(r=0.47 and P<0.001 for SNAP; r=0.29 and P<0.05 for gestational age). An analysis of covariance showed that the relationship between SNAP and the timing of the first stool was significant even after adjustment for gestational age(P<0.01), but the relationship between the gestational age and the timing of the first stool was not significant after adjustment for SNAP (P=0.14). Antenatal exposure to magnesium sulfate for tocolysis, glucocorticoids for enhancing fetal lung maturity, and antibiotics, had no effect on the timing of the first stool. CONCLUSION: Delayed passage of first stool is a function of illness severity, not of gestational immaturity. Antenatal exposure to magnisium sulfate, dexamethasone, and antibiotics, does not affect the timing of first stool in premature infants.
Anti-Bacterial Agents ; Dexamethasone ; Gestational Age ; Glucocorticoids ; Heart ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Magnesium Sulfate ; Medical Records ; Tocolysis

PURPOSE: To assess the effect of gestational age and illness severity, and the effect of antenatal exposure to magnesium sulfate, glucocorticoids, and antibiotics, on the timing of the first stool in preterm infants. METHODS: Medical records of all preterm infants admitted to the neonatal ward at Kangnam Sacred Heart Hospital between March 1998 and August 1998 were reviewed. We studied the time of the first stool in 55 infants. RESULTS: The median age of the infant at the time of first stool was 18 hours, and 90% of the infants passed stool by 50 hours. Both the gestational age and the illness severity, as measured by the score for neonatal acute physiology(SNAP), correlated significantly with the timing of the first stool(r=0.47 and P<0.001 for SNAP; r=0.29 and P<0.05 for gestational age). An analysis of covariance showed that the relationship between SNAP and the timing of the first stool was significant even after adjustment for gestational age(P<0.01), but the relationship between the gestational age and the timing of the first stool was not significant after adjustment for SNAP (P=0.14). Antenatal exposure to magnesium sulfate for tocolysis, glucocorticoids for enhancing fetal lung maturity, and antibiotics, had no effect on the timing of the first stool. CONCLUSION: Delayed passage of first stool is a function of illness severity, not of gestational immaturity. Antenatal exposure to magnisium sulfate, dexamethasone, and antibiotics, does not affect the timing of first stool in premature infants.
Anti-Bacterial Agents ; Dexamethasone ; Gestational Age ; Glucocorticoids ; Heart ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Lung ; Magnesium Sulfate ; Medical Records ; Tocolysis

Mucoepidermoid tumor of the lacrimal sac is exteremely rare. To our knowledge, there have been 4 cases reported in the literature and no case was reported in Korea. We have experienced a 77-year-old male patient complaining of epiphora and medial canthal area mass of 5-month duration in the right eye. On biopsy findings, many cystic structures containing mucin were seen, of which wall consisted of neoplastic mucin-secreting cell components and small nests of epidermoid cells. The diagnosis of mucoepidermoid tumor was made.
Aged ; Biopsy ; Cellular Structures ; Diagnosis ; Humans ; Korea ; Lacrimal Apparatus Diseases ; Male ; Mucins ; Mucoepidermoid Tumor*