Medial gastrocnemius myocutaneous flap for soft tissue defect of anteromedial aspect of leg / 대한정형외과학회잡지

No abstract available.

A Case of Epilepsia Arithmetices

Activation of epileptic seizure or electroencephalographic epileptiform discharges by mental calculation is rare, not reported in Korea. We report a 10-year-old right handed school girl without previous seizure history who showed clinically absence seizures and generalized synchronous 3 to 3.5Hz spike-and-wave dlscharges only when she attempted to perform difficult mental arithmetic. No further seizure was provoked after Valproic acid intake.

A Case of Idiopathic Hypoparathyroidism with Albright's Hereditary Osteodystrophy

A 27 years old female patient who had some features of idiopathic hypoparathryoid manifestation such as hypocalcemica, hyperphosphatemia. Chronic tetany, no evidence of osteomalacia, rickets and renal insufficiency, also was found to have certain characteristic skeletal and developmental abnormalities :rounded face, short neck, thick-set stocky body habitus, brachymetatarsia and mental retardation, which are attributable to Albright's Hereditary Osteodystrophy. On the basis of a circulating immunoreative Parathormone level, this case could be considered as idiopathic hypoparathyrodism rather than psuedohypoparathyroidism, despite of Albright's Hereditary Osteodystrophy because the patient's circulating parathormone level is normal range in C-terminal radioimmunoassay system. Presumably, the suggested explanation about the patients normal range of immunoreative parathormone is that the hypoparathyroid state is not a deficiency of circulating parathormone but an ineffectiveness of acitve parathormone because of a defect in conversion of secreted proparatbyroid hormone into an active form as proposed by Nusynowitz et al.(l973) The similar concentrations in immunoreactive parathormone levels of patient's family in same radioimmunoassay systems support this hypothesis. We concluded this case as idiopathic hypoparathyroidism with Albright's Hereditary Osteodystrophy.

A Case of Primary Malignant Leptomeningeal Melanomatosis

Primary malignant melaomatosis of leptomeninges is uncommon, not reported in the Korea to this time. Primary melanomatosis of leptomeninges are not associated with any specific clinical or radiological symptoms. The diagnosis was made by ultrastructural demonstration of malignant melanoma cells from CSF. The patient is 23 years male, who has had meningeal irritating symptoms such as intermittent headache. Nausea, vomiting and disturbed consciousness. Brain CT and MRI showed no mass lesion but cytology of cerebrospinal fluid revealed malignant melanoma cells. There was no evidence of extracerebral melanoma.

Seperation of the vertebral end plate: a case report / 대한정형외과학회잡지

No abstract available.

Resection arthrodesis for giant cell tumor in distal femur: two cases using vascularized and neovascularized fibular(dual fibular) graft / 대한정형외과학회잡지

No abstract available.

Operative Treatment in Fractures of the Metacarpal and Phalanx in the Crushing Injury / 대한정형외과학회잡지

Fractures of the metacarpal and phalanx of the hand are common occurances and bony union usually occurs without difficulties. If complication of the metacarpal and phalangeal fracture of the hand occurred, it causes significant functional deficit. The authors have reviewed 92 patients, 121 cases of metacarpal and palangeal fracture of the crushed hand which were treated with internal fixation with/without open reduction in the deparment of orthopaedic surgery in Holy Family Hospital from Jan. 1985 to Dec. 1989. The authors obtained the following results ; 1. The incidence of nonunion and delayed union was 12.4% (15/121 cases). 2. The criteriae of nonunion and delayed union are progressive angulation at fracture site after removal of implant, lack of bony union evidence in the radiography more than 12 weeks after injury, tenderness and pain on motion at fracture site and gross pseudomotion. 3. Nonunion and delayed union occurred more commonly in phalangeal fractures, shaft fractures, severely traumatized fractures (open fractures, marked displaced fractures, comminuted fractures and fractures had associated injuries in the same hand) and under-reduced fractures after internal fixation. 4. Mean TAM (total active motion) range at last follow up was 94.5°in thumb and 186.6°in finger and that of nonunion and delayed union cases was 89°in thumb and 153.5°in finger.

Treatment of Dislocation of distal Radio / 대한정형외과학회잡지

The distal ulnar resection, Darrach operation, has been used for several conditions such as fracture about wrist joint, rheumatoid arthritis or ulno-carpal impingement syndrome. But, this operation could be led to have excessive unphysiologic increase radial loading on the radio-carpal joint and early osteoarthritis is thought to be inevitable in long-term follow-up. So, we performed various kind of reconstruction for 19 cases with dislocated distal radioulnar joint, and compared their radiologic and clinical results with that of the group for total 13 cases with distal ulnar resection. Through this study, we could find out that the preservation of normal relationship of dislocated distal radioulnar joint is considered as more desirable than that of removal of ulnar head.

The Clinical Study of the Brain CT Patterns in the Seventeen Global Aphasic patients

The lesion of the global aphasia often involves both Broca's and Wernicke's speech area, and is shown as broad lesion in the Brain CT However, practically there were several reports about the Brain CT findings of the global aphasia, which suggested atypical patterns that did not involve both language centers, simultaneously. Therefore we subdivided the patterns of Brain CT finding of the 17 global aphasic patients into 4 subtypes according to whether or not the cortical language area was involved. We obtained the following results; 1. Type A : Involvement of the both language areas : 9 cases (53%) 2. Type B : Involvement of only Broca's area with sparing of Wernicke's area : 3 cases(17%) 3. Type C : Involvement of only Wernicke's area with sparing of Broca's area : 1 case (6%) 4. Type D : Involvement only of subcortical area with sparing of cortical language areas : 4 cases (24%).

A Case Report of Cerebral Embolism from a Left Atrial Myxoma

Transient ischemic attacks or embolic strokes caused by the cardiac myxoma are very rare in its freguency. To detect cardiac myxoma, as a source of cerebral embolism originating from the heart, has a great significance because of the occurrence and recurrence of the possible stroke can be prevented by surgical procedure. We present a patient who showed typical clinical symptoms and signs of the left atrial myxoma which was subsequently diagnosed by 2-dimensional real time echocardiography and confirmed by sugery. Following the successful removal of the left atrial myxoma, now, the patient is in stable neurological condition.

A Case of Musicogenic Epilepsy

In Patients subject to convulsions the attacks occur sporadically, and the factors reponsible for precipitation of a seizure at any given time are usually unknown. In a small number of patients certain sensory stimuli may consistently initiate an attack. The sensory modality involved varies in different patients: however, the entire group has been referred to by the term 'reflex epilepsy.' In certain rare instances, listening to music produces seizures and this subdivision of reflex epilepsy has been called "musicogenic epilepsy". By the Critchley, in 1937, several particular types of musical stimuli were reported, but frequency of such stmuli was much rare and there has been no report yet in Korea. This 40 years old fernale patient revealed a ternporal lobe seizure, which appeared whenever listened to old korean popular songs. The etiology was not known and the response to anti-epileptic drugs was good.

A Case Report of Facial Diplegia Associated with Acute Viral Hepatitis type B

The Neuropsychiatric complications in acute viral hepatitis are uncommon. Despite the wide spread occurrence of this disease. Various complications of central and peripheral nervous involvement may arise during the course of viral hepatitis. Encephalitis, meningitis, neuritis, myelitis and mental disturbances such as depression, euphoria and insomnia complicating viral hepatitis has been reported several literatures. Also, bilateral facial nerve palsy is seen very infrequently in clinical practice and has an annual incidence of approximately 0.01% per total facial nerve palsy. The isolated cranial nerve palsy, especially facial nerve. Complicated by viral hepatitis has been suggested very rarely. This combination of bilateral facial nerve palsy and viral hepatitis B seems to be two phases of same disease. However, there were no such reports in Korea until now. Therefore, We present a case of bilateral peipheral facial nerve palsy associated with acute viral hepatitis type B.

Two Cases of Reversible Leukoencephalopathy, Caused by 5-Fluorouracil, Presenting as Akinetic Mutism

We experinced 2 cases of reversible leukoencephalopathy, caused by 5-Fluorouracil derivatives(carmoful), presenting as akinetic mutism. Each patient was diagnosed as colon cancer and stomach cancer respectively and received operations. Their outcome was good without metastatic evidences, and carmoful was started orally 400mg in 1 case and 600mg in the other. Their clinical pictures were akinetic mutism, one and two months after the administration of carmoful. There were no metastatic lesions in the brain CT but bilaterally symmetric diffuse low densities of cerebral whites matter, predominantly in the frontal area, were noted. Carmoful was discontinued and replaced by conservative treatment. One and two months later, their clinical symptoms improved without specific treatment. Follow up brain CT was done in case 2, which revealed attenuation of the previous low densities.

C.T.Findings and Prognosis of 25 Cerebellar Infarction Cases

Cerebellar infarction (CbI) is rare but because of its location it can give vital influence on the neighbouring structures. Therefore, it is important to make correct diagnosis and know general clinical pictures including prognosis. We studied 25 cases of CbI about their C.T. findings and clinical pictures, and the following results were obtained. 1. Location of the CbI was in inferior cerebellum 20 cases, superior 4 cases. Prognosis was good in 17 inferior and 2 superior cases. 2. Size of the CbI was variable, but fatal cases showed more than 5-6cm in diameter. 3. Deformity of the 4th. Ventricle and slight hydrocephalus were seen in 12 among 20 acute cases. 2 cases expired. 4. Among the total 25 cases 20 cases showed clinically complete cure or improvement, 2 cases worse, 1 cases undetermined, and 2-cases expired.

Postoperative Rehailitation of Ligamentous Injury of Knee Using Limited Motion Brace / 대한정형외과학회잡지

The authors have reviewed 46 cases (38 males and 8 females) with ligamentous injuries of the knee in the Department. of Orthopaedic Surgery, St. Mary's Hostpital, Catholic Medical College and Center, during the period from Feb. 1983 to May 1985. The patients were divided into two groups according to the two different postoperative rehabilitation programs. In one group, rehabilitation was begun with limited motion brace from 2nd week postoperatively (Group I). In another group, a long leg circular cast was applied for 6 weeks postoperatively, followed by rehabilitation (Group II). All patients were allowed to bear full weight in 12 weeks postoperatively and were recommended to keep appling braces for at least 6 months postoperatively. Sports or other vigorous activities were allowed in one year postoperatively. Primary repair was performed in 14 cases in Group I (66.7%) and in 17 cases in Group II (68.0%). Reconstruction of ligament was performed in 7 cases in Group I (33.3%) and in 8 cases in Group II (32.0%). The results were analyzed in terms of range of motion, pain, instability and muscle power in each group according to O'Donoghue. The results were as follows: 1. Three months after operation, over 120 degrees in flexion was achieved in 18 cases in Group I (85.7%) and in 7 cases in Group II (28.0%). The recovery of range of motion was achieved earlier in Group I than in Group II. 2. Three months after operation, extension lag was seen in only 2 cases in Group I, all of which were below 10 degrees, and 13 cases in Group II of which 10 cases had extension lag of over 10 degrees. The recovery of muscle power was achieved earlier in Group I than in Group II. 3. Overall results showed “excellent” in 17 out of 21 cases in Group I (80.9%) and in 12 out of 25 cases in Group II (48.0%). In conclusion, the limited motion brace was effective in early recovery of range of motion and muscle power, without any significant loss of stability, after repair or even reconstruction of theligamenta of the knee, regardless of the type of injury, although the number of posterior cruciate ligament tears were too small to come to a concrete conclusion.

A Case of Invasive Thymoma with Metastasis to the Diaphragem in a Myasthenic Patient

Primary malignancy of the thymus gland in myasthenia gravis remains rare, especially metastasis of the malignancy to a distant organ. We have presented a case of myasthenia gravis with invasive thymoma and its meatastasis to the diaphragm. The literature concerned with this aspect is reviewed.

Clinical Analysis of Headache

Since opening of the Yeungnam University Hospital in May 1983 till September 1983, total 411 headache patients were treated at the Neurology clinic. It was found that considerable number of the cases had latent epilepsy and brain atrophy as the causes of the headache. In about 40% of the cases, EEG showed more than moderate abnormalities. These cases should not be sent to psychiatry directly as they are not indicated for surgery, but should be treated at neurology clinic primarily.

A Cases of Familial Spastic Paraplegia (FSP)

We present a family of FSP with review of literatures. Seeligmuller (1876) and Strumpell (1880) were the first to describe familial case of spastic paraplegia characterized by progressive weakness and spasticity of the lower limbs with little or no involvement of the upper extremities. This syndrome is heterogenous in inheritance, age of onset, severity and associated signs. A pure type without complications has been named "Strumpell's FSP". We have recently experienced a case of 17 years old male who had bilateral weakness and stiffness of lower extremities, and gait disturbance with family history. Differential diagnosis, particularly with familial amyotrophic lateral sclerosis, is discussed.