Nonunion is extremely rare in children, Weber et al. concluded that considerable skill is required to induce nonunion in a child and its occurrence always results from a serious error in management. Twenty-six cases of delayed union and nonunion examined and treated at department of Orthopedic Surgery, Yonsei University, Wonju College of Medicine during the period of 1970 to 1988 was observed and analysed. 1. Of the 26 cases, there was 18 male and 8 female patients. The results showed more predominence of male over female patients. 2. Delayed union and nonunions commonly occurred over 5 year of age. 3. The causes of the fractures consisted of 12 Fell from heights, 5 Traffic accidents and others. 4. Of the 26 cases, there were 21 closed fractures and 5 open fractures. 5. Prior to admission to this hospital, 15 were treated conservatively and 10 treated operatively, and one received no treatment at all. 6. The sites of delayed union and nonunion were 10 phalanges, 6 tibia, and 3 ulna in order. 7. Probably causes of the delayed union and nonunion were unsatisfactory immobilization in 13 cases, infections in 6 cases, operative complications in 6 cases, interposition of the soft tissues in 2 cases in 2 cases, persistent seperation of the fragments in 1 case. 8. We are considered that the treatment of the nonunion must be individualizd but usually requires eradication of any infection, excision of the intervening fibrous tissue, bone grafting, and internal fixation.
Accidents, Traffic ; Bone and Bones ; Child ; Female ; Fractures, Closed ; Fractures, Open ; Gangwon-do ; Humans ; Immobilization ; Male ; Orthopedics ; Tibia ; Transplants ; Ulna

One case of congenital cutis aplasia is presented. The defect involved includes full-thickness skin defect of scalp and cranium. The patient was treated with debridement of dirty necrosed crust which covered exposed dura mater and with double opposing rotation flap including pericranium for bone regeneration. The donor site was covered with skin graft from right thigh. During operation, the superficial temporal artery was found to be short and weak. And after operation, the margin of flap were congested and finally necrotized. The necrotic wound was treated with conservative management. The vascular impairment is thought to be main course of congenital cutis aplasia. So we conclude that the treatment of choice is conservative management or careful flap surgery for coverage of defect area.
Bone Regeneration ; Debridement ; Dura Mater ; Estrogens, Conjugated (USP) ; Humans ; Scalp ; Skin ; Skull ; Temporal Arteries ; Thigh ; Tissue Donors ; Transplants ; Wounds and Injuries

BACKGROUND: Chemokines are molecules with chemotatic activities on selective leukocyte populations and are sub-grouped into alpha-chemokine acting primarily on PMNL (polymorphonuclear leukocyte) and beta-chemokines attracting mainly lymphocytes and monocytes. We conducted a prospective study to investigate the serum levels of interleukin (IL)-8, monocyte chemoattractant protein (MCP)-1, and macrophage inflammatory protein (MIP)-1 alpha in patients with acute ischemic stroke and carotid atherosclerosis. METHODS: Serum was sampled from patients with acute ischemic stroke (<24hrs), with persistent ischemic neurological deficits associated with atherosclerosis (>1 month), and from normal subjects without a history of vascular disease. Concentrations of chemokines were measured by enzyme linked immunosorbent assay ( ELISA ). RESULTS: Compared with carotid atherosclerotic patients and control subjects, the serum levels of IL-8 were significantly elevated in those with acute ischemic stroke. The serum levels of MCP-1 in patients with large artery disease were higher than those in patients with small vessel disease and cardioembolism. CONCLUSIONS: This study suggested that IL-8 can be involved in acute ischemic stroke and MCP-1 plays a role in the pathogenesis of atherosclerosis.
Arteries ; Atherosclerosis* ; Carotid Artery Diseases ; Chemokine CCL2* ; Chemokines ; Chemokines, CC ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Interleukin-8* ; Interleukins ; Leukocytes ; Lymphocytes ; Macrophage Inflammatory Proteins* ; Macrophages* ; Monocytes* ; Prospective Studies ; Stroke* ; Vascular Diseases

BACKGROUND: The somatosensory evoked blink reflex(SBR) is a newly reported blink reflex elicited by electrical stimulation of peripheral nerves. Although it has been thought that SBR is a release phenomenon transmitted via brainstem reticular formation, the actual pathophysiological mechanism still remains unknown. In this study we investigated the correlation between the somatosensory evoked blink reflex and specific type of diseases where it was well documented. METHODS: SBR was examined on 118 patients, having various neurologic diseases; 39 cases with hemifacial spasm, 26 cases with parkinson's disease, 12 cases with dystonia, 19 cases with stroke, 17 cases with peripheral neuropathy, and 5 cases with other diseases. Somatosensory evoked blink reflex can be obtained by electrical stimuli on median nerves. Latency and amplitude of the SBR was measured by inspection of superimposed responses. RESULTS: Among the 118 patients, SBR was presented in 23 patients. The somatosensory evoked blink reflex was seen most often in hemifacial spasm, parkinson's disease and dystonia. CONCLUSION: We concluded that the somatosensory evoked blink reflex was not usually elicitable but it was relatively well presented in specific diseases which were known to have increased excitability of the blink reflex pathway.
Blinking* ; Brain Stem ; Dystonia ; Electric Stimulation ; Hemifacial Spasm ; Humans ; Median Nerve ; Parkinson Disease ; Peripheral Nerves ; Peripheral Nervous System Diseases ; Reticular Formation ; Stroke

No abstract available.
Animals ; Embryonic Development* ; Embryonic Structures* ; Endometriosis* ; Female ; Humans ; Mice* ; Pregnancy

Traumatic injuries of the distal radioulnar joint (DRUJ) is important problem that requires special consideration for treatment to prevent disability arising from failure to the diagnosis, treatment, and rehabilitation. Stability of the DRUJ is provided by a combination of bony and soft tissue architecture. The bony architecture of the DRUJ account for only 20% of the DRUJ stability and soft tissues including triangular fibrocartilage complex (TFCC), pronator quadratus, and interosseous membrane give major role on the stability. TFCC is generally accepted as the most essential soft tissue stabilizer of the DRUJ. Acute dislocation of DRUJ injury is commonly associated with forearm fractures but it occurs as an isolated injury even though it is relatively rare. DRUJ injury is the one of main source of chronic wrist pain, instability and the focus of this article is on acute dislocation injury of DRUJ and their management.
Diagnosis ; Dislocations* ; Forearm ; Joints* ; Membranes ; Rehabilitation ; Triangular Fibrocartilage ; Wrist

Purpose: To determine predictive factors for detecting renal parenchymal damages (RPDs) in infants with recurrent febrile urinary tract infection (fUTI). Methods: From January 2015 to December 2021, 102 infants with recurrent fUTI and who underwent 99mTc-dimercaptosuccinic acid (DMSA) renal scan in our hospital were included in this study. Controls included infants with normal DMSA results performed 3 months apart from the 2nd episode of fUTI. DMSA-positive group included infants with positive DMSA results performed 3 months apart from the 2nd episode of fUTI or at the 3rd episode of fUTI. The recurrence rate, causative bacteria, renal size discrepancy of both kidneys, and laboratory findings including C-reactive protein (CRP) and spot urine sodium-to-potassium ratio (uNa/K) were compared between both groups. Results: Only 3.8% of 79 infants with a 2nd episode of fUTI showed positive DMSA results. fUTI recurred more frequently within 12 months of follow-up in the DMSA-positive group than in the control group (69% vs. 13%, P=0.00). CRP values were significantly higher in the DMSA-positive group than in the control group (7.3 mg/dL vs. 3.7 mg/dL, P=0.00). Spot uNa/K were significantly lower in the DMSA-positive group than in the control group (0.6 vs. 1.1, P=0.00). Conclusions Congenital renal scar and RPDs on the DMSA scan were more frequently found in infants with recurrent fUTI than those in the control group. High CRP values and low spot uNa/K in acute infections were helpful in predicting the presence of RPD in infants with recurrent fUTI.

BACKGROUNDS: Recent experimental studies demonstrate massive leukocytes extravasation at sites of cerebral ischemia even with the first hours of disease. Leukocytes are now considered to potentiate ischemic neural damage by microvasculature obstruction and generation of neurotoxic substances. Adhesion molecules mediate adhesion between endothelial cells and leukocytes as a precondition for extravasation of leukocytes at sites of tissue injury. We conducted a prospective study to investigate the serum level of ICAM-1, P-selectin, and E-selectin in patients with acute ischemic stroke, and with atherosclerosis. METHODS: Serum was sampled from patients within 24 hrs of acute ischemic stroke(n=20), from patients with previous (> 1 month) transient or persistent ischemic neurologic deficit associated with atherosclerosis(n=22), and control patients without a history of vascular disease(n=20). Concentrations of soluble ICAM-1(sICAM-1), P-selectin(sP-selectin), and E-electin(sE-selectin) were measured by enzyme-linked immunosorbent assay(ELISA). RESULTS: Compared with control subjects, sICAM-1 and sE-selectin were significantly elevated in patients with acute ischemic stroke and in previous symptomatic atherosclerosis(p=0.0001 and p=0.004). The serum level of sP-selectin in patients with acute ischemic stroke was higher than that in patients with previous symptomatic atherosclerosis and control subjects(p=0.0004). CONCLUSIONS: The results suggest a chronic elevation of ICAM-1 and E-selectin in patients with previous symptomatic atherosclerosis and also acute changes of them in patients with acute ischemic stroke. These findings indicate that acute changes of serum P-selectin occurred in response to acute ischemic stroke.
Atherosclerosis ; Brain Ischemia ; Cell Adhesion Molecules ; E-Selectin ; Endothelial Cells ; Humans ; Intercellular Adhesion Molecule-1 ; Leukocytes ; Microvessels ; Neurologic Manifestations ; P-Selectin ; Prospective Studies ; Stroke*

PUPOSE: Through a survey on an Internet homepage, we conducted research concerning the need of patients and their families for information on gastric cancer. We also assessed their interest in gastric cancer. MATERIALS AND METHODS: We analyzed 619 inquiries presented from June 2002 to September 2003 and 524 replies submitted to a questionnaire survey delivered by the Internet homepage (www.gastriccancer.co.kr) from August to October 2003 to gastric cancer patients and their families. RESULTS: Analysis of Inquiries: The classified inquiries listed in order of frequency are as follows: treatment, prognosis, stages, symptoms, pathophysiology, diagnostic modalities, favorable food, etiology, follow-up, etc. Among the inquiries about treatment, the most frequent subgroup was about the scope of surgery or perioperative implications. Next came questions concerning chemotherapy. Among the questions from patients yet to be operated, on those about operability and the prognosis were most frequent. Among the patients who had undergone a resection, questions on complications and the corresponding prognosis were most frequent. The concern from patients with inoperable or recurrent cancers was related to terminal care and/or chemotherapy. Analysis of Questionnaires: The respondents acquired information on gastric cancer from the Internet (40%), doctors (32%), the mass media (15%) and acquaintances (13%). Only 6% of the respondents were sufficiently satisfied with the information provided by doctors. Among the respondents, 89.9% were interested in complementing treatment with folk remedies while only 5% were not. CONCLUSION: Patients and their families were eager to get information about gastric cancer. However, many of them found the doctors' information to be insufficient. Our suggestion is that the public health, academic societies, medical institutions, and public organizations should endeavor to provide through an activated Internet network correct information on gastric cancer.
Complement System Proteins ; Surveys and Questionnaires ; Drug Therapy ; Follow-Up Studies ; Friends ; Humans ; Internet* ; Mass Media ; Medicine, Traditional ; Prognosis ; Public Health ; Surveys and Questionnaires* ; Societies, Medical ; Stomach Neoplasms ; Terminal Care

BACKGROUND: Dyskinesia is a common side effect complicating long-term levodopa therapy for Parkinson's disease. However, the pathogenesis of dyskinesia has not been completely understood. In recent animal studies, it has been reported that a NMDA (N-methyl-D-aspartate) antagonist reduced levodopa-induced dyskinesia. These findings suggest that the hyperfunction of NMDA receptors on striatal efferent neurons contributed to the pathogenesis of dyskinesia. Amantadine has also been recently shown to antagonize central NMDA receptors. In the present study, we observed amantadine efficacy in levodopa-induced dyskinesia in parkinsonian patients. METHODS:Twenty-two parkinsonian patients with levodopa-induced dyskinesia participated in a placebo-controlled, cross-over study. We prescribed 100 mg amantadine daily as a starting dose, which was built up every four days and titrated up to 400 mg a day. After two weeks of a wash-out period, a placebo was given with the same schedule. The doses of levodopa and other antiparkinsonian drugs were unchanged during this period. We assessed the duration and disability of dyskinesia (UPDRS part IV, item 32 and 33) based on diary and interview. RESULTS: Amantadine was superior to placebo in reducing the duration of dyskinesia in 9 patients (42.9%) and the disability of dyskinesia in 11 patients (52.4%). The reduction of the duration and disability of dyskinesia was correlated with the dose of amantadine. CONCLUSIONS These findings suggest that amantadine can improve levodopa induced dyskinesia and supports the view that the hyperfunction of NMDA receptors contributes to the pathogenesis of levodopa induced dyskinesia.
Amantadine* ; Animals ; Appointments and Schedules ; Cross-Over Studies ; Dyskinesias* ; Humans ; Levodopa ; N-Methylaspartate ; Neurons, Efferent ; Parkinson Disease ; Receptors, N-Methyl-D-Aspartate