Forty-nine children between the ages of 2 and 10 years, treated conservatively for fomoral shaft fracture, were studied clinically and radiographically to access the complications and related factors. They had an average follow-up of 48.8months(range, 12 to 77months). 35 percent of the patients had significant associated injuries. Leg length discrepancies of 10mm to 20mm are observed in 5 cases(10%) of the patients. The average overlap of bone ends at union was 6.5mm. The average growth acceleration was 8.8mm regardless of sex, age, upper limb dominance, fracture site or shape, but was promoted by overriding of the fracture ends at union, There were 16 cases(32%) of excessive angular deformity of 10° to 25° after union. However all deformities were remodelled enough to give normal alignment of the joint surface. The growth plate played on important role in the remodelling process.
Acceleration ; Child ; Congenital Abnormalities ; Follow-Up Studies ; Growth Plate ; Humans ; Joints ; Leg ; Upper Extremity

Multiple symmetric lipomatosis is a rare disease and affects almost exclusively middle aged man, usually with a background of excessive a alcohol intake. The disease is characterized by progressive growth of subcutaneous fat masses which are located symmetrically at neck, shoulders, chest, abdomen and groin, and which subsequently penetrate deeply into the surrounding spaces and structures with symptomatic compression of deep organs, such as trachea. A recent survey revealed a high incidence of sometic and autonomic neuropathy. The exact cause of the disease is not known, but a hyperplastic mechanism has been postulated, with in vitro studies demonstrating a defect in adrenergic-stimulated lipolysis of lipomatous tissue. We have experienced two cases of multiple symmetric lipomatosis. Case 1 was a 59-year-old male, complaining of slowly enlarging doughunt ring-shaped mass at his neck. He had a habit of excessive alcohol intake for many years. The subcutaneous mass at the neck was excised. The pathology report described the specimen as "normal adipose tissue". Case 2 was a 49-year-old male, complanining of slowly enlarging multiple symmetric masses at the neck, shoulders, chest, abdomen, flank and groin over a period of 6 years. He also complained of mild muscular weakness. He had a habit of excessive alcohol intake for many years. The subcutaneous mass in the neck was excised. The specimen had a tendency to form globular masses and microscopically indistinguishable from mature adipose tissue.
Incidence

BACKGROUND: The blunted tip of a reusable with multiple uses can cause problems with the passing procedure in arthroscopic Bankart repair. This study assessed the advantage of Scorpion with a 70° arthroscope in arthroscopic Bankart repair compared to hook typed suture passer. METHODS: Scorpion in 19 patients, the hook type suture passer (conventional group) in 18 patients were used. All patients underwent the same procedure except for the type of suture passer used. Another different point of the procedure were telescopes and the number of portals used; three arthroscopic portals (posterior, anterorsuperiorlateral, and mid-anterior) and a 30° arthroscope in the conventional group, but two portals and a 70° arthroscope as well as the 30° one in the Scorpion group. The surgery time and the surgical complications including an iatrogenic axillary nerve injury were recorded. RESULTS: The Scorpion group showed a significant decrease in surgery time compared to the conventional group. In contrast to the conventional group, Scorpion provided an easy estimation of the exit of suture passing, no iatrogenic labral injury during the passing procedure with straight movement and the sharp tip of the knife installed. Iatrogenic supraspinatus injuries could be avoided when making an accessory anteosuperiorlateral portal due to the 70° arthroscope. CONCLUSIONS: In arthroscopic Bankart repair, the use of the Scorpion suture passer and a 70° arthroscope can reduce the surgery time, avoid unnecessary supraspinatus injury, and avoid iatrogenic axillary nerve damage through the relatively easy and precise suture passing and saving of the anterosuperior portal.
Arthroscopes* ; Arthroscopy ; Humans ; Scorpions* ; Sutures* ; Telescopes

The present study addressed the risk factors in early life for Korean preschool children that are associated with being overweight or obese.

Following on from diagnosis using ultrasound, hydrostatic reduction using saline enema under ultrasoundguidance was tried in 20 cases of childhood intussusception. The conclusions were as follows: 1. Success rates ofsaline enema under ultrasound guidance during a frist-8 month period(P1) and a second 10 month period(P2) were55.6%(5/9) and 54.5%(6/11) respectively. Average succes rate was 55%(11/20). 2. During the periods of P1 and P2,no case was reduced by barium enema in 6 cases of failed reduction with saline enema. 3. During the period of P2, 5 cases of successful redution with saline enema were confirmed by clinical follow-up without barium enema. 4.During the periods of P1 and P2, 9 cases of failed reduction with saline enema were operated, resulting in 6 casesof segmental resection and 3 cases of manual reduction. 5. The obvious advantages of this method are: 1. Noradiation hazard. 2. No fear of barium peritonitis. 3. Detection of leading point. 6. With above results, thismethod could completely replace barium enema. And ultrasonography should be the initial study in the evaluation ofintussusception in children and then if necessary, saline enema under ultrasound guidance should be done.
Barium ; Child ; Diagnosis ; Enema ; Follow-Up Studies ; Humans ; Intussusception ; Methods ; Peritonitis ; Ultrasonography

An analysis of the joint fluid should be performed as part of the diagnostic evaluation in any patient with joint disease. It is an important role in the differential diagnosis of the joint disease such as pyogenic arthritis, traumatic arthritis, degenerative and rheumatoid arthritis and others. The authors examined synovial fluid analysis in 33 cases of rheumatoid arthritis at the Department of Orthopedic Surgery, Chosun University Hospital. The following results were obtained. 1. The age and sex distribution was 21 cases in the male and 12 cases in the female. The sex ratio between male and female was 1.8:l. 2. The gross appearance of synovial fluid was greenish-yellow with turbid in 29 cases, and 4 cases were transparent with clear and yellow colored. The range of specific gravity was 1.028, it was more higher than normal values. 3. The range of white blood cell count in the synovial fluid was 5955/cubic mililiter in its average and polymorphonuclear leukocytes found the major part of cell counts (63.6%). 4. The glucose content in the synovial fluid was 72.8 mg/100ml in the range of average. It was tended to decrease compared with increase leukocyte numbers. 5. The latex fixation test in the synovial fluid was positive reaction in 93.9%, and was more higher value than its serum reaction in the blood. 6. The protein content in the synovial fluid was 6.9 gm/100ml) in the range of average, and it was 1.7 times more higher value than the reported literature. The correlationship of protein content between the duration of disease and its prevalences could not found the clinical significance. 7. The relationship between the age and the clinical course in the synovial fluid analysis was not significant finding of its fluid content and others, but the more pronounced pattern was revealed in the acute stage of rheumatoid arthritis in the joint fluid.
Arthritis ; Arthritis, Rheumatoid ; Cell Count ; Diagnosis, Differential ; Female ; Glucose ; Humans ; Joint Diseases ; Joints ; Latex Fixation Tests ; Leukocyte Count ; Male ; Neutrophils ; Orthopedics ; Osteoarthritis ; Prevalence ; Reference Values ; Sex Distribution ; Sex Ratio ; Specific Gravity ; Synovial Fluid

Transitional vertebrae include lumbarization and sacralization of lumbosacral region. The prevalence of transitional vertebra was reported as 3 to 21%. It is known that transitional vertebra is related to herniated nucleus pulposus and spinal stenosis but there is no report in English literature about the relationship of transitional vertebra to spondylolysis or spondylolytic spondylolisthesis. The purpose of this study is to evaluate the relationship of transitional vertebra to spondylolysis or spondylolytic spondylolisthesis and to find out the clinical relevance for the treatment. The cases included 182 cases of spondylolysis or spondylolytic spondylolisthesis who were treated at Severance hospital from 1987 to 1993. There were 33 cases of transitional vetebra; 12 lumbarization and 21 sacralization. And there were remaining 149 cases of control group. The degree of anterior sippage was measured by Meyerding's grading and percentage of Taillard method. As the results, the degree of average anterior slippage of L4 was 14.5% in the cases of isthmic defect in L4 and sacralization. The average slippage of L4 was 11.4% in the control group. The degree of average anterior slippage of L5 was 12.5% in the cases of isthmic defect in L5 and lumbarization, and 9.5% in the cases of isthmic defect in L5 and sacralization. The average slippage of L5 was 16.2% in the control group. In summary and conclusion, the cases with isthmic defect in L4 and sacralization showed more anterior slippage than the cases with isthmic defect in L4 without transitional vertebrae, and the cases with isthmic defect in L5 and sacralization showed less anterior slippage than the cases with isthmic defect in L5 without transitional vertebrae. It is concluded that more aggressive treatment is recommended in the cases of isthmic defect in L4 and sacralization, whereas more conservative treatment is recommended in the cases of isthmic defect in L5 and sacralization.
Lumbosacral Region ; Methods ; Prevalence ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Spondylolysis

Osteogenesis imperfecta is a rare affection characterized by fragility of the bones, blue sclerae, and deafness, less freqently by hypermobility of the joints. The etiology is unknown, but it appears to be a mesenchymal defect. A case of osteogenesis imperfecta(tarda form). in a 8 ycar old girl, is presented with a review of the literatures. The chief complaints were bowing deformities of the right upper arm and both lower extremities, stunted growth, blue sclerae, dental defects, weakness of the muscles and pigeon breast. X-Ray showed multiple malunited fractures of the right humerus, both femurs, and bilaterally of tibiae and fibulae.
Arm ; Breast ; Columbidae ; Congenital Abnormalities ; Deafness ; Female ; Femur ; Fibula ; Fractures, Malunited ; Growth Disorders ; Humans ; Humerus ; Joints ; Lower Extremity ; Muscles ; Osteogenesis Imperfecta ; Osteogenesis ; Sclera ; Tibia

In 1953, Lichtenstein suggested to use “Histiocytosis X” as an unifying diagnostic term to represent Eosinophilic granuloma, Hand-Schiiller-Christian disease, and Letterer-Siwe disease. The author experienced a case of Hand-Schuller-Christian disease in six year old girl. She has been treated under the diagnosis of Calves disease. But later, it was confirmed as Hand-Schiiller-Christian disease by clinically and pathologically, involving multiple region of entire skeletal system, but sparing the musculocutaneous and nervous system. Clinically, anemia, malaise, high fever and hepatomegaly were present. Co60 isotope irradiation combined with antibiotics was done for 87 days twice weekly in a dose of 50 R at a time. At the time of discharge clinical symptoms were subsided. In X-Ray check, one year after treatment, bony defects were consolidated with new bone and the result was successful.
Anemia ; Anti-Bacterial Agents ; Diagnosis ; Eosinophilic Granuloma ; Female ; Fever ; Hepatomegaly ; Histiocytosis, Langerhans-Cell ; Humans ; Nervous System

No abstract available.
Nipples*