The diagnosis of a Battered Child Syndrome is made by the pediatrician, surgeon and the radiologist because almost parents deny the diagnosis or refuse to answer the doctor's questions. The imaging modalities play a key role in the investigation and documentation of the battered child syndrome, because of the high frequency of the typical skeletal lesion. Although physical abuse is denied by parents, the recognition of this entity is possible by the primary diagnostic imaging study in the suspected child abuse. The imaging studies are either a bone scan and x-ray series or a complete radiolographic skeletal survey by X-ray series. In an expected intracranial injury, a CT scan of the head is mandatory We experienced a case of Battered Child Syndrome in a 6 month-old male infant who had subdural hemorrhage and fractures of skull and ribs in different stages of healing and repair. The brief review of the literature was made.
Battered Child Syndrome* ; Child ; Child Abuse ; Diagnosis ; Diagnostic Imaging ; Head ; Hematoma, Subdural* ; Humans ; Infant ; Male ; Parents ; Ribs ; Skull ; Tomography, X-Ray Computed

Accelerated idioventricular rhythm(AIVR) describes ventricular rates slower than usual tachycardia rates but faster than the ventricular escape rhythm. Ventricular rates of 40- 120 beats/min are usual. Accelerated idioventricular rhythm probably represents enhanced automaticity in the ventricles and manifests itself when sinus rates slow. This arrhythmia has been reported in association with acute myocardial infarction, digitalis excess, cardiomyopathy, and rheumatic heart disease. Only rare case of AIVR without underlying heart disease has been described. It is transient and intermittent, with episodes lasting a few seconds to a minute, and does not appear to seriously affect the patient's clinical course or the prognosis. Suppressive therapy is rarely necessary. Recently, we have experienced four cases of AIVR in children without underlying heart disease with benign clinical course.
Accelerated Idioventricular Rhythm* ; Arrhythmias, Cardiac ; Cardiomyopathies ; Child* ; Digitalis ; Heart Diseases ; Heart* ; Humans ; Myocardial Infarction ; Prognosis ; Rheumatic Heart Disease ; Tachycardia ; United Nations

No abstract available.
Intervertebral Disc* ; Retrospective Studies*

No abstract available.
Spondylolysis*

No abstract available.
Ankle* ; Dislocations* ; Tendons*

No abstract available.
Muscular Dystrophy, Oculopharyngeal*

PURPOSE: To determine the characteristics of benign breast calcifications on mammogram. MATERIALS AND METHODS: Benign breast calcifications on mammograms of 25 patients, which were confirmed by needle localization and excisional biopsy(15 cases), cytology(1 case), or follow-up study(9 cases), were retrospectively analysed according to size, shape, number, distribution, and density. RESULTS: The size of benign breast calcifications was uniform in 4 cases (16%), and variable in 21 cases (84%). The shape of calcifications was round or oval in 18 cases(72%), linear or branching pattern in 6 cases (24%), and irregular in 1 case(4%). The number of calcifications was 2-5 in 7 cases(28%), and over 6 in 12 cases(48%). The distribution of calcifications was focal in 13 cases(52%) and diffuse in 12 cases(48%). The density of calcification was homogenous in all 25 cases(100%). CONCLUSION: Analysis of number, shape, size, and distribution is helpful for the diagnosis of benign breast calcifications. However the homogenous density of the calcification is suggested to be the most helpful criterion for the diagnosis of benign breast calcifications.
Breast* ; Diagnosis ; Follow-Up Studies ; Humans ; Needles ; Retrospective Studies

PURPOSE: PCNA has been widely used because it is highly accurate, relatively simple and safe to administer. Regardless of its high diagnostic rate, PCNA has the difficulty in excluding malignancy in the cases of, negative for malignancy" results in PCNA cytologic reports. So, we analysed PCNA cases to evaluate the clinical outcome of "negative for malignancy" results in PCNA cytologic reports. MATERIALS AND METHODS: PCNA in 170 cases were done between January, 1991 and December, 1993 and the diagnosis was malignancy in 86 cases, specific benign disease in 30 cases, "negative for malignancy" in 45 cases and inadequate sample in 9 cases. We analysed 36 cases among 45 cases of "negative for malignancy" results in cytologic examinations. The final diagnosis was made on the basis of histopathologic examinations, radiologic findings and clinical courses. we compared the final diagnosis to the radiologic diagnosis. RESULTS: Of the 36 cases with initial "negative for malignancy" results, the final diagnosis was benign in 30 cases and malignant in 6 cases(17%). In radiologic diagnosis of the malignancy, "positive predictive value" was 42%, "negative predictive value" was 96%, and accuracy was 78%. CONCLUSION: In the cases of PCNA results of "negative for malignancy", malignancy can not be excluded because 17% of the cases are proved to be malignant. And if malignancy is highly suggested at radiologic examination, the possibility of malignancy is 42%, and so intensive follow-up examination is needed.
Biopsy, Fine-Needle* ; Diagnosis ; Follow-Up Studies ; Proliferating Cell Nuclear Antigen ; Thorax*

BACKGROUND: Since recent economic crisis(IMF) in Korea, the number of new homeless is increasing(that is, 'IMF style homeless'). There are only few studies on the health problem of this uniquely formed population. We have attempted to estimate the problem of health behavior and health status of this population. METHODS: Some homeless who agreed to enter the asylum during the winter were taken for medical check-up in Sungbuk Community Health Center from November to December, 1998. The participants filled up a self-reported questionnaire and physical examination, laboratory test, and chest x-ray were performed. RESULTS: Among 'IMF style homeless', the prevalence of hypertension(30.9% in primary screening, 7.3% in secondary screening), diabetes mellitus(9.4% in primary screening, 3.5% in secondary screening), syphilis(7.3%), and hepatitis B antigen carrier(5.3%) was higher than among the general population. But we could not find statistical difference according to the duration of homelessness. We found higher smoking rate and higher alcohol drinking amount per week in homeless than in the general population. The amount of alcohol drinking per week was larger among those who had been homeless for more than 3 months(p< 0.01). CONCLUSION: The prevalence of chronic diseases in homeless was higher than in the general population, but statistical difference according to the duration of homelessness could not be found. The longer the duration of homelessness, the larger the amount of alcohol drinkin was seeng.
Alcohol Drinking ; Chronic Disease ; Community Health Centers ; Health Behavior ; Hepatitis B ; Homeless Persons ; Humans ; Korea ; Mass Screening ; Physical Examination ; Prevalence ; Seoul* ; Smoke ; Smoking ; Thorax ; Surveys and Questionnaires

PURPOSE: Cyanotic congenital heart diseases patients are in a state of hypoxia since birth. In general, hypoxia delays atrioventricular conduction. The atrioventricular node in such a hypoxic condition would have a different function, and some possibility for arrhythmia. The authors studied atrioventricular nodal function during hypoxia to elucidate the relationship between hypoxia and arrhythmia, including atrioventricular node in terms of cardiac tissue level. METHODS: After extraction of an adult rabbit heart under pentobarbital anesthesia, the heart was retrogradely perfused through the aorta with graded hypoxic Krebs' solution(100, 70, and 50% oxygen). The intracardiac electrocardiograms were obtained by a custom-made programmed stimulation at basic cyde length 40ms antegradely and retrogradely. All the data was analysed at His-electrogram and conduction time. Refractory periods and Wenckebach cycling length were determined. RESULTS: During antegrade conduction, the fast AV nodal conduction was prolonged and the slow conduction shortened, resulting in decreased compliance of the AV nodal conduction with graded hypoxia. The His-Purkinje system also showed a similar result. Among the refractory periods, only the AV nodal effective refractory period was prolonged with hypoxia. Wenckebach cycle length was sensitive to hypoxia, especially for retrograde conduction. CONCLUSION: Because the AV conduction during hypoxia was characterized by decreased AV conduction compliance, prolonged AV nodal effective refractory period, and sensitive Wenckebach cyding length, hypoxia would not seem to be a special risk for arrhythmia, including AV node.
Adult ; Anesthesia ; Anoxia* ; Aorta ; Arrhythmias, Cardiac ; Atrioventricular Node ; Compliance ; Electrocardiography ; Heart Diseases ; Heart* ; Humans ; Parturition ; Pentobarbital