Accidents have become one of the most important problem in the pediatric and child health field because of the recently observed high incidence of and mortality from accidents. Due to an improvement of the living standard in general and especially due to the wide application of vaccination and antibiotics, there has been a decline of incidence of infectious diseases in childhood. However, in contrast accidents have occurred increasingly involving childhood recently. Many accidents have been recognized as being preventible. Therefore, parental health education should be emphasized as one of the more important preventive measures against accidents. This clinical study was carried out for analysis on 1,297 cases which were diagnosed as accidents at the emergency room in Wonju Christian Hospital during the 5 years, from Jan. 1, 1975 to Dec. 31, 1979. The results were as follows: 1. The most common type of accidents was traffic accidents which accounted for 393 cases(30.4%) of the total accidents, followed by falls(233 cases, 18.0%), burns(209 cases, 16.1%), trauma(199 cases, 15.3%), poisoning(126 cases, 9.7%), foreign body aspiration(42 cases, 3.4%), dog bites(30 cases, 2.3%), drowning and near drowning(24 cases, 1.6%). 2. An absolute number of accident patients increased in each year compared with the previous year. However, the child accident case found in the emergency room showed only 30% annually. 3. Traffic accidents and falls showed the highest incidence in children between 4 and 7 years. On the other hand, however, burn and foreign body aspiration showed the highest incidence between 2and 5 years. 4. Accidents were found more in males than females. Falls, drowning, near drowning, and snake bites were prodominantly in males. 5. Accidents were shown higher in summer and autumn and relatively lower in winter. 6. Sedans among all the various vehicles were the most common cause of traffic accidents (25.4%), followed by trucks(20.4%) and autobicycles(15.8%). 7. Falls occurred mostly at the play ground(13.3%), stairs(10.3%), roofs(8.6%) and trees(3.9%). 8. Scalding burns(64.8%) were the most common cause, followed by flame burns(13.3%) and coal briquet(3.9%). 9. In trauma, violence(24.1%) was the most common cause. Accidental injuries caused by farmer's tools(12.0%), hitting with stone(11.2%) and injury with pieces of glass(9.5%) followed in that order. 10. In poisoning, carbon monoxide intoxication and insecticides were the most common 26.2% in each, followed by D.D.S.(16.7%) and pestides(9.5%). 11. The most common material aspirated was coins(78.6%), followed by pins(95%) and buttons(4.7%). 12. 1,024 cases(78.9%) among 1,297 cases showed improvement. 65 cases(5.0%) expired and 64 cases(4.9%) had some complications.
Accidents, Traffic ; Animals ; Anti-Bacterial Agents ; Burns ; Carbon Monoxide Poisoning ; Child ; Child Health ; Coal ; Communicable Diseases ; Dogs ; Drowning ; Emergencies* ; Emergency Service, Hospital* ; Female ; Foreign Bodies ; Gangwon-do* ; Hand ; Health Education ; Humans ; Incidence ; Infant* ; Insecticides ; Male ; Mortality ; Near Drowning ; Parents ; Poisoning ; Snake Bites ; Socioeconomic Factors ; Vaccination

In 1974, bipolar endoprosthesis was first introduced by Bateman & Giliberty. It has theoretical advantages including minimizing acetabular wear, possible reduction of incidence of stem loosening, lessening of dislocation and easy revision procedure. Various methods for the treatment of fracture of the femur neck have been developed & performed, but it is still called “the unsolved fracture” in certain situation. But the role of it as primary treatment of fracture of the femur neck continues to be controversial. Current clinical results encourage its continued use and expansion of indication. Authors reviewed and analysed 21 cases of bicentric endoprosthesis and 1 case of Giliberty endoprosthesis those have been operated at the Department of Orthopaedic Surgery, National Medical Center from 1981 to 1983. Following results were obtained, l. According to disorder distribution, 14 cases were neglected fracture of femur neck, 2 old fracture, 1 idiopathic femoral head necrosis and 2 avascular necrosis & 1 non-union complicated by femoral neck fracture. 2. Among 20 cases, 8 cases were operated within 1/2 1 month after injury and 6 cases within 1 3months 3. Harris lateral appmach was used in 16 cases (80%) and Modified Gibson approach in 4 cases (20%). There were no significant differences in morbidity during operation and postoperative complication. 4. We used femoral stems those head diameter was 22 and 32mm(Charnley & Miiller type) and head pieces those diameter was 48-51 mm in male and 44–48 mm in Ifemale. 5. 3 cases were stiff in inner bearing without acetabular erosion. 6. In 6 cases more than 2 years followup 1 degree CE angle of Wiberg was increased in 2 cases of youngage respectively without associated hip joint pain. 7. Although inclination of head piece was vertical in 8 cases, fracture and dislocation were not found. 8. The circumference of head piece and opposite femoral head was measured and compared. There were 12 cases (mean 12.6 mm) that of head piece larger than opposite femoral head and 3 cases smaller than opposite femoral head. 9. There was 4 cases of complication (3 patients) and still no reoperation and revision converted to T.H.R. 10. With regard to average 18 months of follow-up, 7 cases of 81–90 Harris hip-rating score, 6 of 91–100, 4 of 71–80 and 3 of 61–70.
Acetabulum ; Dislocations ; Femoral Neck Fractures ; Femur ; Femur Neck ; Follow-Up Studies ; Head ; Hip Joint ; Humans ; Incidence ; Male ; Neck ; Necrosis ; Postoperative Complications ; Reoperation

Gas gangrene is a potentially lethal dissease, but fortunately uncommon. Profound toxicity and rapid progression are characteristic of this disease. Therefore the success of the treatment in this disease is largely depended on early diagnosis and treatment. The treatment includes debridement and decompression, amputation if ncessary, adequate entibiotic therapy, administration of antitoxin, hyperbarit oxygen therapy and general supportive therapy. The authors have reviewed 9 cases of gas gangrence, which were identified by bacteriologically out of 14 cases of suspicious gas gangrene. All cases were treated in our department from 1981 to 1985. The results are summarized as follows: 1. The culture studies of clostridium were specified in 5 cases of Cl. perfringens, 2 cases of Cl. septicum, 1 case of Cl. bifermentans and 1 case of Cl. sporogenes. 2. All 9 patients underwent debridement, antibiotic therapy, hyperbaric oxygen therapy and general supportive therapy. We had not used gas gangrene anti-toxin, beceuse of the value of antitoxin is uncertain and subjects the patient of the danger of hypersensitivity reactions. 3. In 7 patients involving only the extremities, amputations were inveitable on 3 patients due to irreversible gangrenous changes on the involved extremities. And one of them died due to septic shock. 4. In 2 patients involving the trunk, one of them died due to renal failure.
Amputation ; Clinical Study ; Clostridium ; Debridement ; Decompression ; Early Diagnosis ; Extremities ; Gas Gangrene ; Humans ; Hyperbaric Oxygenation ; Hypersensitivity ; Oxygen ; Renal Insufficiency ; Shock, Septic

We present 3 cases of congenital hyperplasia. Case lis a 5 year and 9 month old who is suffered from excessive salt craving and symptoms of precocious puberty. Case llis a 2 month old boy who has failure to thrive and frequent episode of dehydration. Case lll is a 5 year and 3 month old girl who has enlarged clitoris without salt craving since birth. All 3 cases have higher level of 17KS than normal but normal blood pressure. Serum 17 OH progesterone or urinary pregnanetriol were not checked. All patients were well responding with corticosteroid and 17 KS in 24 hour urine were decreased to normal. These patients are considered to have 21 hydroxylation defect type in congenital adrenal hyperplasia. Review of literature and references on congenital adrenal hyperplasia was attempted priefly.
Adrenal Hyperplasia, Congenital* ; Blood Pressure ; Clitoris ; Dehydration ; Failure to Thrive ; Female ; Humans ; Hydroxylation ; Hyperplasia ; Infant ; Male ; Parturition ; Pregnanetriol ; Progesterone ; Puberty, Precocious

OBJECTIVE: At present, gold-standard technique of cervical cord decompression is surgical decompression and fusion. But, many complications related cervical fusion have been reported. We adopted an extended anterior cervical foraminotomy (EACF) technique to decompress the anterolateral portion of cervical cord and report clinical results and effectiveness of this procedure. METHODS: Fifty-three patients were operated consecutively using EACF from 2008 to 2013. All of them were operated by a single surgeon via the unilateral approach. Twenty-two patients who exhibited radicular and/or myelopathic symptoms were enrolled in this study. All of them showed cervical cord compression in their preoperative magnetic resonance scan images. RESULTS: In surgical outcomes, 14 patients (64%) were classified as excellent and six (27%), as good. The mean difference of cervical cord anterior-posterior diameter after surgery was 0.92 mm (p<0.01) and transverse area was 9.77 mm2 (p<0.01). The dynamic radiological study showed that the average post-operative translation (retrolisthesis) was 0.36 mm and the disc height loss at the operated level was 0.81 mm. The change in the Cobb angle decreased to 3.46, and showed slight kyphosis. The average vertebral body resection rate was 11.47%. No procedure-related complications occurred. Only one patient who had two-level decompression needed anterior fusion at one level as a secondary surgery due to postoperative instability. CONCLUSIONS: Cervical cord decompression was successfully performed using EACF technique. This procedure will be an alternative surgical option for treating cord compressing lesions. Long-term follow-up and a further study in larger series will be needed.
Decompression* ; Decompression, Surgical ; Follow-Up Studies ; Foraminotomy* ; Humans ; Kyphosis ; Spinal Cord Compression ; Spondylosis

No abstract available.
Catheters* ; Embolism, Air*

Schizophrenia-like psychiatric symptoms in patients with MELAS are rarely reported. A 34-year-old male was admitted because of visual hallucinations, persecutory delusions and generalized seizure. He also presented with repeated headache, vomiting, and left homonymous hemianopsia. We report a 34-year-male with MELAS presenting psychiatric symptoms before the establishment of the diagnosis by gene analysis.
Adult ; Delusions ; Diagnosis ; Hallucinations ; Headache ; Hemianopsia ; Humans ; Male ; MELAS Syndrome* ; Schizophrenia ; Seizures ; Vomiting

BACKGROUND AND OBJECTIVES: Neurocardiogenic syncope is believed to be caused by a transient imbalance of autonomic nervous system. Actually, there were significant differences in heart rate variability (HRV) indices during head-up tilt test between patients with neurocardiogenic syncope and normal controls. But there was no definite evidence for it during daily activity. So, we tried to evaluate HRV during daily activity with 24-hour ambulatory electrocardiography monitoring. MATERIALS AND METHODS: 27 patients with neurocardiogenic syncope or presyncope (mean age 45+/-3) and 25 normal volunteers (mean age 47+/-2) comparable for age and sex underwent 24-hour ambulatory electrocardiography. Head-up tilt test was used to diagnose neurocardiogenic syncope or presyncope in patients group. HRV was analysed over the whole 24 hours, using time and frequency domain parameters. Student's t-test was applied. ResultsThere were no significant differences in HRV measures between two groups, over 24-hour period and day-time and night-time period. But the hourly HRV measures showed a transient decrease of LF, LFnorm and LF/HF ratio in patients group compared to normal control group. CONCLUSIONS: These results indicate that patients with neurocardiogenic syncope or presyncope suffer from temporarily decreased sympathetic tone with normal parasympathetic tone. So, transient additive change of autonomic nervous tone may cause syncope or presyncope in these patients. (Korean Circulation J 2000;30 (6):716-723)
Autonomic Nervous System ; Electrocardiography, Ambulatory ; Healthy Volunteers ; Heart Rate* ; Heart* ; Humans ; Syncope* ; Syncope, Vasovagal*

BACKGROUND AND OBJECTIVES: Heart rate variability(HRV) reflects the autonomic integration of heart. There were many reports that HRV in patients with myocardial infarction or heart failure is an independent prognostic factor to predict fatal arrhythmia and sudden cardiac death. But, the role of HRV is still controversial in stable angina patients without history of myocardial infarction. In this study, we tried to compare HRV indices between stable angina patients and normal subjects. MATERIALS AND METHODS: Twenty-one stable anginal patients without history of myocardial infarction (mean age : 57 +/- 2 years) and twenty-one relatively healthy persons without history of coronary heart disease (mean age : 53 +/- 2 years) were included in the study and underwent 24-hour ambulatory ECG monitoring. In patients group, all underwent coronary angiography after 24-hour ambulatory ECG monitoring. HRV was analyzed over the whole 24 hours, using time and frequency domain parameters, according to time phases and coronary angiographic severity. RESULTS: There were no significant differences in age, sex and cardiovascular risk factors, except hypertension (p=.001) between two groups. HRV indices such as rMSSD, pNN50, LF, HF, LFnorm and HFnorm were significantly decreased (p<0.05) in patients group. But the angiographic severity of coronary arteries did not show any significant effect on the HRV indices in patients group. CONCLUSIONS: We observed significantly reduced HRV indices in patients with stable angina without history of myocardial infarction.
Angina, Stable* ; Arrhythmias, Cardiac ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Death, Sudden, Cardiac ; Electrocardiography ; Heart Failure ; Heart Rate* ; Heart* ; Humans ; Hypertension ; Myocardial Infarction* ; Risk Factors

Spontaneous rupture of the kidney, Wonderlich syndrome, is a rare event but potentially life-threatening condition. The most comman causes are clear cell carcinoma, benign angiomyolipoma and vascular disease. Among this event, acute pyelonephritis is a very unusual cause. A 67-year-old diabetic woman was admitted with high fever and left flank pain due to acute pyelonephritis. She had uterine prolapse for 10 years with both renal hydronephrosis before this event. Abdominal ultrasonography and CT scan showed fluid collection around left kidney with a rupture of renal parenchyme at lower pole. The renal angiography showed displaced capsular artery due to subcapsular hematoma and decreased blood flow at lower pole. The percutaneous needle aspiration revealed blood collection around left kidney, which confirmed spontaneous rupture of the kidney. We report this case with a review of the relevant literature.
Aged ; Angiography ; Angiomyolipoma ; Arteries ; Female ; Fever ; Flank Pain ; Hematoma ; Humans ; Hydronephrosis ; Kidney* ; Needles ; Pyelonephritis* ; Rupture ; Rupture, Spontaneous* ; Tomography, X-Ray Computed ; Ultrasonography ; Uterine Prolapse ; Vascular Diseases