PURPOSE: To evaluate the US findings of soft tissue hemangiomas in extremities and to correlate the echo-pattern with MR signal characteristics of hemangiomas. MATERIALS AND METHODS: We retrospectively studied forty-two patients either with pathologically proven cases or with characteristic features of hemangiomas on MRI, US and plain film. Hemangiomas were divided into two types according to the locations;subcutaneous and intramuscular. Analytic points on US and MR findings were gross morphology of the mass, internal echo-pattern or signal characteristics. We correlated the echo-pattern with MR signal characteristics in hemangiomas. RESULTS: Subcutaneous hemangiomas revealed homogeneously anechoic mass on US, which were well correlated with MR signal characteristics' homogeneous low singnal intensity(SI) on Tl-weighted image(WI) and high SI on T2-WI. Intramuscular hemangiomas showed heterogeneously mixed echoic masses on US. An anechoic component on US corresponded to dilated vascular channels on MRI. The signal intensity of intramuscular hemangioma was less than that of subcutaneous fat on T1-WI and greater than that of fat on T2-WI. Both types of hemangiomas had tubular or lace-like appearance with interspersed fibrofatty septa. CONCLUSION: The echo-patterns in US were well associated with MR signal characteristics on MRI. Regarding US and MR features, intramuscular hemangiomas were different to subcutaneous hemangiomas.
Extremities* ; Hemangioma* ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Subcutaneous Fat

Fractures of the femoral neck in children are rare and usually occur as a result of severe trauma. They are one of the most challenging injuries to treat. Their complication rate is high and their anatomic and physiologic characteristics make treatment difficult. The commonly encountered complications are avascular necrosis, nonunion, coxa vara and premature fusion of epiphyseal plate. Treatment of these fractures remains an unsolved problem but accurate reduction held with adequate internal fixation would appear to offer the best chance for succesful results. We report our observations in the treatment of eighteen cases of fracture of the femoral neck in children. Included is a review of references. The results obtained are as follows: 1. Among 18 patients, 11 were boys and 7 were girls. the highest incidence was between the ages of 5 and 7 years. 2. The main causes of fractures were traffic accidents in 10 cases (55.5%), falling from a height, and slipping down. 3. The commonest type of fracture was the cervicotrochanteric type (47.4%). Twelve cases were displaced fractures (66.7 %). 4. The range of Pauwels angle varied from 20° to 70°. 5. The commonly associated injuries were pelvic bone fractures, extremity fractures, skull fractures and soft tissue injuries. 6. Nine cases were treated by skin traction and plaster cast. Five cases ere treated by closed reduction and internal fixation with K-wires or knowles pins. 7. In 13 of the 18 cases, follow-up studies were done for an average period of 18 months. 8. The results were analyzed according to the Ratliffs assessment. Among the 13 cases, 10 cases showed good results, two fair and one poor. 9. All cases treated by closed reduction and internal fixation showed good results without complications. 10. Complications developed in five cases (38.5%), three cases of avascular necrosis and two cases of coxa vara. Among these five cases, one case of avascular necrosis developed as a result of neglect of the fracture and the others as a result of too conservative a treatment. 11. Secondary treatment of trochanteric arthroplasty was required in only one neglected case. This was further by avascular necrosis and the results were poor. 12. As a result, we recommond closed reduction and internal fixation as the most favorable method of treatment for the fracture of the femoral neck in children.
Accidental Falls ; Accidents, Traffic ; Arthroplasty ; Casts, Surgical ; Child ; Clinical Study ; Coxa Vara ; Extremities ; Female ; Femur ; Femur Neck ; Follow-Up Studies ; Growth Plate ; Humans ; Incidence ; Methods ; Necrosis ; Pelvic Bones ; Skin ; Skull Fractures ; Soft Tissue Injuries ; Traction

Tonifying method has been used to treat various types of deficiency syndrome in traditional Korean medicine. Tonifying medicinal including ginseng and deer horns is one of the various methods of the treatments, but they are recognized as a representative of traditional Korean remedies nowadays in Korea. That is concerned with the new trends of medicine manifested at Naeuiwon(Royal Infirmary) in the late Chosun period. The period that manifested the tonifying method obviously was the reign of King Youngjo(r.1724-1776). King Youngjo who lived longest among Chosun kings considered tonifying yang very important in keeping him healthy. He had taken a large quantity of ginseng, he and others considered the reason for his longevity as taking ginseng. From that time, the method of tonifying yang became one of the principles in health care and treatment as well. In the 19th century, the theory of tonifying method had been changed, in that tonifying yin was considered more important among Naeuiwon physicians. Tonifying yang alone was thought to be harmful because of its warm and dry nature. The main cause of prevalence of tonifying method in Naeuiwon was the fact that it was safe and had little side effects. The method of health care and treatments of the kings was considered as an ideal model by the ordinary people at that time. The new trends of medicine manifested at Naeuiwon in the late Chosun period had a strong influence on traditional Korean medicine, which emphasized the importance of tonifying method.
Deficiency Diseases/history/therapy ; History, 18th Century ; History, 19th Century ; Humans ; Korea ; Medicine, East Asian Traditional/*history

No abstract available.
Methicillin Resistance* ; Methicillin* ; Staphylococcus*

Taeuiwon was in charge of the medical care of the royal family in the Chosun period of 1898. The Taeuiwon Ilgi is the document which was recorded by Taeuiwon officials. In this study, the authors studied the contents of Taeuiwon Ilgi of 1898 in order to understand the medical care of the royal family of Chosun Kingdom. In 1898, Taeuiwon took some careful measures to take good care of the royal family. Taeuiwon physicians made regular inquiry about their health through the format called Moonan. The Moonan was to check out the health conditions of them. When Taeuiwon carried out Moonan, Emperor Kojong was asked to take a medical examination called Ipjin by the court physicians of Taeuiwon, even if he were in good condition. Taeuiwon physicians also regularly prescribed Insamsokmium, when the royal family performed the religious service or went into mourning. Insamsokmium is a kind of restorative food containing ginseng. From the above, we could conclude that Taeuiwon provided the preventive care to them. It was considered the proper way to such kind of high personage in that period.
English Abstract ; *Famous Persons ; Government ; History, 19th Century ; Korea

PURPOSE: The purpose of this study was to analyze the radiologic findings of primary epiploic appendagitis, with particular attention to the correlation of ultrasonographic, clinical, CT, MR and surgical findings. MATERIALS AND METHODS: Among 14 patients with primary epiploic appendagitis who presented with the rapid onset of a very localized pain and tenderness, we performed ultrasonography in all, CT in eight, and MRI in four of these eight. Surgery was performed in two patients. Follow-up examinations were performed using US, CT and MRI (n=2), US and CT (n=2), US alone (n=2), and with regard to clinical features (n=12). RESULTS: US performed in 14 patients revealed the presence in all of small, well-defined, ovoid, noncompressible hyperechoic (n=12) or isoechoic (n=2) solid masses attached to the colonic wall, without bowel wall change and without communication with bowel lumen. CT performed in 8 patients showed varying hyperattenuating fatty lesions in the same location in the abdomen, without other inflammatory process. MRI findings of four patients were helpful for further evaluation of internal architecture. CONCLUSION: In primary epiploic appendagitis, US findings were sufficiently characteristic to allow accurate diagnosis and valuable for the differential diagnosis of other acute conditions of the abdomen.
Abdomen ; Colon ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Ultrasonography

PURPOSE: To evaluate the importance of two ancillary findings of anterior tibial plateau bruise/fracture and popliteus muscle strain on MR diagnosis of posterior cruicate ligament injury. MATERIALS AND METHODS: We retrospectively evaluated 48 patients with confirmed posterior cruciate ligament tear. We studied the incidence of anterior tibial plateau injury and popliteus muscle strain, and the specificity of popliteus muscle strain with or without bony injury. RESULTS: A complete tear of the posterior cruciate ligament was noted in 37 cases, a partial tear in 11. Anterior tibial plateau lesion was found in 21 of 48 cases (44%); This total was made up of 17/37 PCL complete tears (46%) and 4/11 partial tears (36%). The difference in the incidence of complete and partial tears is not statisticially significant. Popliteus muscle injury was found in 20 of 48 cases (42%), the total consisted of 19/37 PCL complete tears (51%) and 1/11 partial tears (10%). The incidence of 42% is relatively high, approximating that of bony injury. The difference in the incidence of complete and partial tears is statistically significant (p<0.006). Specificity for posterior cruciate ligament tear is 69% (20/29), and when concomitant with anterior tibial plateua injury is 94% (16/17). CONCLUSION: As in the case of anterior cruciate ligament injury, these documented ancillary findings of anterior tibial plateau and popliteus muscle injuries are very helpful when MR diagnosis of posterior cruciate ligament injury itself and differentiation of partial and complete rupture are doubtful.
Anterior Cruciate Ligament ; Diagnosis* ; Humans ; Incidence ; Ligaments ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament* ; Retrospective Studies ; Rupture ; Sensitivity and Specificity

PURPOSE: Dermatolymphangioadenitis (DLA) is a common and serious complication of lymphedema which deteriorates lymphatic function. The purpose of this study was to assess the risk of DLA by lymphoscintigraphy in patients with lower extremity lymphedema. MATERIALS AND METHODS: The subjects were 59 edematous lower extremities of 50 patients without previous episode of DLA and 12 lower extremities of 6 controls. Whole body images were acquired 1 min and 2 hr after subcutaneous injection of 37 MBq of Tc-99m-antimony sulfide colloid into interdigital spaces of both feet before therapy for lymphedema. The lymphosintigraphic and clinical variables were compared between groups were or without occurrence of DLA during clinical follow up. RESULTS: Thre were 20 episodes of DLA in 12 extremities during clinical follow-up (19+/-6 months). On univariate analysis, there were significant differences in ilioinguinal lymph node uptake, uptake pattern of main lymphatic vessel, clinical stage and therapy compliance between the two groups. After multivariate analysis, only the uptake pattern of main lymphatic vessel and therapy compliance were confirmed to be independent variables. In other words, non-visualized main lymphatic vessel and poor compliance to therapy were more frequent in extremities with subsequent occurrence of DLA. CONCLUSION: Lymphoscintigraphy can be used to predict the risk of DLA and may thus be helpful for determining the initial therapeutic plan in patients with lower extremity lymphedema.
Body Image ; Colloids ; Compliance ; Extremities ; Follow-Up Studies ; Foot ; Humans ; Injections, Subcutaneous ; Lower Extremity* ; Lymph Nodes ; Lymphatic Vessels ; Lymphedema* ; Lymphoscintigraphy* ; Multivariate Analysis ; Risk Assessment*

PURPOSE: The goal of this study was the early diagnosis of ABCB11 spectrum liver disorders, especially those focused on benign recurrent intrahepatic cholestasis and progressive familial intrahepatic cholestasis. METHODS: Fifty patients presenting neonatal cholestasis were evaluated to identify underlying etiologies. Genetic analysis was performed on patients suspected to have syndromic diseases or ABCB11 spectrum liver disorders. Two families with proven ABCB11 spectrum liver disorders were subjected to genetic analyses to confirm the diagnosis and were provided genetic counseling. Whole exome sequencing and Sanger sequencing were performed on the patients and the family members. RESULTS: Idiopathic or viral hepatitis was diagnosed in 34%, metabolic disease in 20%, total parenteral nutrition induced cholestasis in 16%, extrahepatic biliary atresia in 14%, genetic disease in 10%, neonatal lupus in 2%, congenital syphilis in 2%, and choledochal cyst in 2% of the patients. The patient with progressive familial intrahepatic cholestasis had novel heterozygous mutations of ABCB11 c.11C>G (p.Ser4*) and c.1543A>G (p.Asn515Asp). The patient with benign recurrent intrahepatic cholestasis had homozygous mutations of ABCB11 c.1331T>C (p.Val444Ala) and heterozygous, c.3084A>G (p.Ala1028Ala). Genetic confirmation of ABCB11 spectrum liver disorder led to early liver transplantation in the progressive familial intrahepatic cholestasis patient. In addition, the atypically severe benign recurrent intrahepatic cholestasis patient was able to avoid unnecessary liver transplantation after genetic analysis. CONCLUSION: ABCB11 spectrum liver disorders can be clinically indistinguishable as they share similar characteristics related to acute episodes. A comprehensive genetic analysis will facilitate optimal diagnosis and treatment.
Biliary Atresia ; Choledochal Cyst ; Cholestasis ; Cholestasis, Intrahepatic ; Diagnosis ; Early Diagnosis* ; Exome ; Genetic Counseling ; Hepatitis ; High-Throughput Nucleotide Sequencing ; Humans ; Hyperbilirubinemia ; Jaundice ; Liver Transplantation ; Liver* ; Metabolic Diseases ; Parenteral Nutrition, Total ; Syphilis, Congenital

OBJECT: To find out the anatomical changes of adhesive capsulitis of the shoulder by the ultrasonography. METHOD: We examined 20 patients with a adhesive capsulitis of the shoulder. Ultrasonographic findings were analysed by a radiologist who measured the synovium thickness of anterior, posterior and axillary plane and coracohumeral ligament length of the shoulder. RESULTS: Synovium thickness of the shoulder was measured with a mean value of 1.4+/-0.3 mm in the anterior plane, 1.4+/-0.4 mm in posterior plane and 1.8+/-0.5 mm in axillary plane of the unaffected sides and a mean value of 1.7+/-0.5 mm in the anterior, 1.8+/-0.4 mm in posterior and 3.2+/-1.0 mm in axillary planes of the affected sides. Coracohumeral ligament length was measured with a mean value of 27.8+/-7.9 mm in the unaffected side and 26.3+/-8.1 mm in the affected side. CONCLUSION: The characteristic appearance of the adhesive capsulitis of the shoulder by ultrasonography was an increased synovium thickness in the axillary plane compared to the unaffected side. This study demonstrates that the ultrasonography is a valuable tool for the evaluation and follow up for the adhesive capsulitis of shoulder.
Adhesives* ; Bursitis* ; Humans ; Ligaments ; Shoulder* ; Synovial Membrane ; Ultrasonography*