The onset of systemic scleroderma in the first. decade of lif occurs in less than 1.5% of instances. Systemic sclerodrma in childhood have been characterized by less severe visceral involvement and a benign course We report a boy, aged 7 years, with a history of Raynaid; phenomenon and dysphagia. He had a mask-like face, flexion contracture of hands and knee joints, digital pitting scars, ichthyosiform skin change on leg and hyperpigrnented induration on all extremities and trunk. Antinuclear antibodies were positive in nucleolar type and Scl-70 antiocy was also present. On radiologie study, the pattern of reflux esophagitis and resorption of the listal ends of all phalanges were nated. Histopathological findings were compatible with sclerodma. He was treated with Penicillamine-D and oral corticosteroic with good improvernent.
Antibodies, Antinuclear ; Cicatrix ; Contracture ; Deglutition Disorders ; Esophagitis, Peptic ; Extremities ; Hand ; Humans ; Knee Joint ; Leg ; Male ; Scleroderma, Systemic* ; Skin

In organophosphate intoxication, the neurotransmitter acetylcholine accumulates in synapses, causing excessive stimulation of nicotinic and muscarinic receptors, producing various signs and symptoms. Organophosphates are highly toxic compounds that are readily absorbed through the skin, mucous membranes, and gastrointestinal and respiratory tracts. Organophosphate intoxication leads to many well defined complications, including cholinergic crisis, intermediate syndrome, and acute pancreatitis. However, parotitis caused by organophosphate intoxication is very rare. We experienced such a case of a 55 year old woman who visited the emergency center because of organophosphate intoxication. The next day, she complained of left facial redness, swelling, and pain. We checked serum lipase, amylase, and amylase-isoenzymes, and found elevation of salivary type amylase only. The mechanism of parotitis due to organophosphate intoxication is assumed to be similar to that of pancreatitis caused by organophosphate. In patients with elevated amylase caused by organophosphate intoxication, the possibility of parotitis must be considered.
Acetylcholine ; Amylases ; Dichlorvos ; Emergencies ; Female ; Humans ; Lipase ; Mucous Membrane ; Neurotransmitter Agents ; Organophosphates ; Pancreatitis ; Parotitis ; Poisoning* ; Receptors, Muscarinic ; Respiratory System ; Skin ; Synapses

Staphylococcus aureus is one of many causative agents of the fu uncles. As the S. aureus strains resistant to penicillinase-repsistant penicillins (methicillin-resistant S. aureus, MRSA) are more frequently isolated, their accuiate identification became a very important step in selection of an appropriate therapeutic regimen. We report herein a case of multiple furunculosis caused by metkicillin-resistant S. aureus in a 11-year-old male patient, who was successfully treated with sulbactam/ampicillin and amikacin.
Amikacin ; Child ; Furunculosis* ; Humans ; Male ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus ; Penicillins ; Staphylococcus aureus

Pulmonary embolism is a devastating disease that causes significant morbidity and mortality, however, seizure as a presentation of pulmonary embolism is rare. We experienced two such cases of a 25- and a 59-year-old male who visited the emergency center because of new onset seizure activity with no structural lesions by MRI or CT. Despite having alert consciousness, they were found to have hypoxemia of unknown cause with EKG abnormality. Therefore, we performed bedside ultrasound and CT angiography; pulmonary embolism was then diagnosed. The patients had similar patterns-risk factors, deep vein thrombosis, abnormal EKG, hypoxemia, tachycardia, and seizure. Diagnosis of pulmonary embolism is very confusing, particularly in cases presenting with seizure. Therefore, we suggest that physicians should be more aware of the importance of considering pulmonary embolism within the differential diagnosis for unexplained new onset of seizure activity.
Angiography ; Anoxia ; Consciousness ; Diagnosis ; Diagnosis, Differential ; Electrocardiography ; Emergencies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mortality ; Pulmonary Embolism* ; Seizures* ; Tachycardia ; Ultrasonography ; Venous Thrombosis

Pulmonary embolism is a devastating disease that causes significant morbidity and mortality, however, seizure as a presentation of pulmonary embolism is rare. We experienced two such cases of a 25- and a 59-year-old male who visited the emergency center because of new onset seizure activity with no structural lesions by MRI or CT. Despite having alert consciousness, they were found to have hypoxemia of unknown cause with EKG abnormality. Therefore, we performed bedside ultrasound and CT angiography; pulmonary embolism was then diagnosed. The patients had similar patterns-risk factors, deep vein thrombosis, abnormal EKG, hypoxemia, tachycardia, and seizure. Diagnosis of pulmonary embolism is very confusing, particularly in cases presenting with seizure. Therefore, we suggest that physicians should be more aware of the importance of considering pulmonary embolism within the differential diagnosis for unexplained new onset of seizure activity.
Angiography ; Anoxia ; Consciousness ; Diagnosis ; Diagnosis, Differential ; Electrocardiography ; Emergencies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mortality ; Pulmonary Embolism* ; Seizures* ; Tachycardia ; Ultrasonography ; Venous Thrombosis

Seven patients with average age of 15years and 6 months (range: 8 years and 11 months 25 years and 6 months) underwent forearm lengthening by callotasis. The indications for lengthening were shortening and/or deformity of the forearm due to exostosis of the distal ulna in three cases, growth disturbance due to physeal injury of the distal radius in three, congenital radial dislocation in one. Three had lengthening of the radius, three of the ulna and one of both the radius and the ulna. The average lengthening achieved was 3.8 cm (3.5 - 4.0) in radius, 2.7 cm (2.3 - 3.0) in ulna. Complications encountered were pin tract infection in two cases, nonunion in one and temporary nerve palsy in one. All of these complications were recovered completely without any residua. Retrospective review after average 41 months of follow-up (range: 36 to 78) showed satisfactory improvement in appearance and function. Callotasis was considered as one of the safe and reliable treatment methods for bone lengthening and deformity correction of the forearm.
Bone Lengthening ; Congenital Abnormalities* ; Dislocations ; Exostoses ; Follow-Up Studies ; Forearm* ; Humans ; Osteogenesis, Distraction* ; Paralysis ; Radius ; Retrospective Studies ; Ulna

The percutaneous pinning is a simple, effective method for the treatment of displaced supracondylar fractures of the humerus in children. But there is some controversy in the number of pins used and the method of pin insertion. The cross pinning method provides more stability at the fracture site but the risk of ulnar nerve damage is higher than in lateral pinning method, The senenty-one displaced extension type supracondylar fractures were treated by closed reduction and percutaneous cross pinning from January 1991 to October 1994. Among them, the medial pin was inserted in elbow extension in twenty-eight cases and in forty- three cases the medial pin was inserted in elbow flexion. Ulnar nerve injury occured postoperatively in six cases, in which the pin was inserted with the elbow in flexion position. These results may suggest that when percutaneous cross pinning method is selected to fix the supracondylar fracture of the humerus, it would be safer to insert one or two lateral pins with the elbow in full flexion position followed by one medial pin in extension position in order to reduce the risk of loss of reduction and ulnar nerve damage.
Child ; Elbow ; Humans ; Humerus ; Methods ; Ulnar Nerve

Many authors have been reported that the abdominal trauma, especially injury of the liver and spleen, is frequently found with lower rib fractures, below the ninth rib fractures and the incidence was about 20 to 30%. In cases of rib fractures, Intra- abdominal organs may be injured in the higher rib fractures than the ninth because the diaphragm is elevated at the level of filth intercostal space in expiration period and the intra-abdominal lesions are often delayed evaluated due to the pain of the fractures and masked by the other injuries of the head and the extremities. So above reasons, we were often questioned what the level of rib fracture we must evaluate the intra-abdominal injury was? So we investigated 452 patients with rib fractures who visited our emergency medical center from 1995, January to 1996, December and divided into two groups according to the prescience of intra-abdominal organ injuries by each the level of rib fractures. The number of patients with intra-abdominal organ injuries were 75(16.6%) and the most frequently damaged organ was the liver(25 cases, 33.3%). We calculated the statistical values of each level of rib fractures by the Chi-Square method and got a result that the level of rib fracture we must evaluate the intra-abdominal injuries was the sixth rib fracture. Therefore, if we will meet the patients with rib fracture below the sixth, we must have attentions to the intra-abdominal injuries and evaluate the abdomen closely with various diagnostic methods.
Abdomen ; Attention ; Diaphragm ; Emergencies ; Extremities ; Head ; Humans ; Incidence ; Liver ; Masks ; Rib Fractures* ; Ribs* ; Spleen

No abstract available.
Metacarpophalangeal Joint* ; Palmar Plate*

Since CT scanning was introduced in the diagnosis of calcaneal fracture, we became to understand more clearly the pathoanatomy of the injury. However we have to determine if we would or would not take CT scanning by simple radiography in the acute setting and most of the surgeons still use simple radiography in evaluating postoperative result. And also we have to determine the accuracy of reduction and position of screws by simple radiography intraoperatively. The purpose of this report is to determine the accuracy of simple radiography in assessing the pathological anatomy of the intraarticular calcaneal fracture by experimental and clinical studies. This is a combined experimental and clinical studies using four below knee amputation specimens and 15 patients with 19 displaced intraarticular calcaneal fractures treated at Hanil General Hospital between Jan. 1996 and May 1997. The lateral view of the foot was the best radiographic view for visualizing the degree of depression of the posterior facet. With regard to the location of a fracture line, findings of Broden views correlated well with findings on CT in 17 of 19 fractures. With regard to gapping between fragments, the axial view was not satisfactory in the majority of cases(15 of 19 cases). There was no case which showed more than 2 mm of discrepancy between the findings on Broden view and CT. We conclude that we may obtain most of the important informations about the pathological anatomy of the intraarticular calcaneal fracture by simple radiography.
Amputation ; Depression ; Diagnosis ; Foot ; Hospitals, General ; Humans ; Knee ; Radiography* ; Tomography, X-Ray Computed