Supracondylar fracture of the humerus is the most common fracture of the elbow in children. Early accurate reduction is very important to obtain good results. Authors tried to reduce the fracture accurately under the concept of intact hinge mechanism. Forty-five displaced supracondylar fractures which were not able to be reduced by closed method were admitted for open reduction at our department from April 1981 to October 1985. They were analysed clinically. The result are as follows: 1. The patient age ranged from 3 to 14 years; 16.2% were between 7 and 8 years. 70.3% were boys Left humerus was affected in 70.3% of all cases. 2. The most common cause of fracture was falling down from height. 94.6% of fractures were extension type. The severity of displacement in 34 patients(90.2%) were grade III or 1V of Holmberg classification. 3. Only in 2 patients cubitus varus deformity was observed as residua and among the patients who were followed more than one year, only 2 had about 10 degrees of limitation of elbow motion. 4. In Holmberg's grade II, III, IV group, 22 cases(100.0%) of the both side pinned and 12 cases (80.0%) of one side pinned showed excellent or good results. Therefore, both side pinning could have contributed in obtaining more accurate reduction. 5. According to Mitchell and Adams' Criteria, 34 cases(91.9%) had satisfactory results.
Accidental Falls ; Child ; Classification ; Clinical Study ; Congenital Abnormalities ; Elbow ; Humans ; Humerus ; Methods

Cryptococcosis is a disease caused by the Cryptococcus neoformans, occcuring most frequently in immunocompromised hosts. Cutaneous involvement is seen in 10-15 % of disseminated cases and its manifestation is variable. A 52 year old man presented with a subcutaneous neck mass and severe headache which had lasted for 2 months and 1 month respectively. Initially cutaneous involvement was monomorphic and localized and a CSF study failed to reveal any organisms. After several weeks of herb medication, however, multiple skin lesions occurred with varied morphology and a CSF study confirmed cryptococcosis by culture. The Urine cortisol was markedly elevated, suggesting an exogenous intake of steroid.
Cryptococcosis* ; Cryptococcus neoformans ; Headache ; Humans ; Hydrocortisone ; Immunocompromised Host ; Middle Aged ; Neck ; Skin

No abstract available.
Sarcoma* ; Uterus*

PURPOSE: These case reports have been prepared to highlight the uncommon occurrence of anterior shoulder dislocation after an epileptic seizure, the recognition of which is important as this type of injury is associated with bony lesions and a high incidence of recurrence. MATERIALS AND METHODS: We report two cases of recurrent anterior dislocation of the shoulder due to grand mal epilepsy. These cases were treated as usual anterior dislocations of the shoulder, and were regularly followed to detect any recurrence of shoulder instability. RESULTS: Outcome of the surgery in the two cases was different because of the differences in seizure control. In the patient in whom seizures were well-controlled, there was no recurrence of instability, while the patient with poorly controlled seizures developed a recurrence of the dislocation following shoulder repair. CONCLUSION: The authors emphasize the need to control seizures in order to prevent injury recurrence in this subset of patients.
Dislocations ; Epilepsy ; Epilepsy, Tonic-Clonic ; Humans ; Incidence ; Recurrence ; Seizures ; Shoulder ; Shoulder Dislocation

PURPOSE:Differential diagnosis of sexual precocity has been aided by new imaging techniques and endocrine evaluation. Sexual precocity, defined as the appearance of secondary sexual characteristics before the age of 8 years in girls and 9 years in boys, was studied to evaluate the sex incidence and etiology of sexual precocity. METHODS:A total 95 children(87 girls and 8 boys) who were diagnosed with sexual precocity at St. Mary's Hospital, Catholic University Medical College from 1984 to 1996, were studied. All underwent standard anthropometric measures. They were assinged to diagnostic categories on the basis of clinical assessment, endocrine evaluation, radiologic imaging, and pelvic ultrasonography. RESULTS: 1) The most common cause of sexual precocity was premature thelarche, 50 cases(52.6%) of all children. 2) Central precocious puberty was noted in 7 girls and 3 boys(female to male ratio 2.3:1). The causes were not identified in 6 cases(85.7%) in girls, but the causes were not found in 1 cases(33.3%) in boys. The idiopathic central precocious puberty occurs at least two fold more frequently in girls than in boys. 3) Incomplete precocious puberty was noted in 29 girls and 5 boys(female to male ratio 5.8:1). In the causes of 29 girls with incomplete precocious puberty, congenital adrenal hyperplasia were found in 23 cases, autonomous functional ovarian cyst in 5 cases and McCune-Albright syndrome in 1 case. In the causes of 5 boys with incomplete precocious puberty, virilizing adrenal cortical tumor were found in 3 cases, congenital adrenal hyperplasia in 1 case, and hepatoblastoma in 1 case. CONCLUSION: Sexual precocity occurs at least ten fold more frequently in girls than in boys. Premature thelarche is the most common form of sexual precocity.
Adrenal Hyperplasia, Congenital ; Child ; Diagnosis ; Female ; Fibrous Dysplasia, Polyostotic ; Hepatoblastoma ; Humans ; Incidence* ; Male ; Ovarian Cysts ; Puberty, Precocious ; Ultrasonography

We present a patient who developed a pseudolymphoma after ear piercing. A patch test showed gold sensitivity. Therefore, long standing dermal exposure to gold from a pierced-type earring might have produced the patient's disease. This patient did not respond to an intralesional steroid injection and was finally treated with a complete resection of the lesion. It is proposed that every patient with a hyperplastic lesion in the ear lobe should be taken a biopsy in order to rule out the possibility of a pseudolymphoma. When a pseudolymphoma develops in the ear lobe, a complete surgical excision could be the treatment of choice, especially for the prevention of recurrence.
Biopsy ; Body Piercing* ; Ear* ; Humans ; Patch Tests ; Pseudolymphoma* ; Recurrence

Phenytoin is useful medication in patients with seizure disorders. Hematologic side effects of phenytoin treatment are rare. Especially, isolated thrombocytopenia is very rare. This condition is presumably the result of an immune-mediated process caused by antiplatelet antibodies induced by a drug as a hapten. Thrombocytopenia as a side effect of the phenytoin treatment usually has been reported in adults. It generally occurs at 2 to 4 weeks after initiation of therapy and resolved at 2 to 28 days after discontinuation of the phenytoin. In our case, the thrombocytopenia developed on the 2nd day of therapy and resolved on the 4th day after discontinuation of the phenytoin. We report a 3-year-old girl who developed reversible thrombocytopenia during the phenytoin treatment.
Adult ; Antibodies ; Child, Preschool ; Epilepsy ; Female ; Humans ; Phenytoin ; Thrombocytopenia*

Chilaiditi's sign is a radiographic term used when the hepatic flexure of colon is seen interposed between the liver and right hemidiaphragm. Mostly asymptomatic, Chilaiditi's syndrome can present with abdominal pain, nausea, vomiting, anorexia, abdominal distension, tender hepatomegaly and change in bowel habits. Uncommon in childhood, the incidence seems to increase with age. We have experienced a case of Chilaiditi's syndrome presenting with vomiting in a 15-month-old boy. The patient recovered uneventfully.
Abdominal Pain ; Anorexia ; Chilaiditi Syndrome* ; Colon ; Hepatomegaly ; Humans ; Incidence ; Infant ; Liver ; Male ; Nausea ; Vomiting*

No abstract available.
Bupivacaine* ; Morphine* ; Prospective Studies*

A 12-year-old female with histiocytosis X accompanied by autoimmune hemolytic anemia. During the episode of hemolysis, the hemoglobin level fell to 5.2 g/dL. The direct antiglobulin test was weakly positive. The anti-C and anti-e were identified in her serum. The Rh subgroup of her family(father, mother and brother) including the patient, were all same as DCe. The antibodies which showed anti-C and anti-e specificity were confirmed autoanti-Ce(non-separable) using the serum absorbed with various known Rh phenotyped RBCs. Two packed RBCs phenotyped as DeE were transfused for correction of anemia. Acute and delayed hemolytic transfusion reactions were not noted after transfusion. Identification of blood group specific autoantibodies may be benificial in such case for blood transfusion.
Anemia ; Anemia, Hemolytic, Autoimmune* ; Antibodies ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Child ; Coombs Test ; Female ; Hemolysis ; Histiocytosis, Langerhans-Cell ; Humans ; Mothers ; Sensitivity and Specificity