BACKGROUND: Intussuseception is one of the most common diseases requiring abdominal emergency care in early childhood. The delay in diagnosis increases morbidity and, in particular, reduces the success rate of the non-surgical method of reduction. In this report, the authors determined the clinical characteristics of pediatric patients with intussusception, and the factors involved in delayed diagnosis and the efficacy of doppler ultrasonography in diagnosis. METHODS: The authors performed a retrospective study of 44 cases in 42 patients with intussusception who had visited the emergency room of SamSung medical center from January 1st to December 31, 1996. RESULTS: The sex ratio was equal and 64.3% of the patients were under 1 year of age. The prevalent complaints were vomiting(36.4%) and abdominal pain(33.8%). Ultrasonography was used in 11 cases, 3 of them were performed because of obscure symptoms and the rest were due to diagnostic delay. The average time past from visit to diagnosis was 4 hours and 20 minutes, and there were 4 diagnostic delays. Air enema reductions were unsucessful in 11 cases(25%) and that was related to hospital-visit delays and long time past from symptom onset to diagnosis. There were no motalities. CONCLUSION: To reduce delays in diagnosis and unnecessary operations, the use of doppler ultrasonography is recommanded in suspicious cases. And to reduce the hospital-visit delays, related to the failure on non-surgical reduction, the education about this disease is necessary.
Delayed Diagnosis ; Diagnosis ; Education ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Enema ; Humans ; Intussusception* ; Retrospective Studies ; Sex Ratio ; Ultrasonography ; Ultrasonography, Doppler

Background: Insulin is known to act as second effector that provides potassium transfer from extracellular fluid to intracellular fluid, thus causing hypokalemia and arrythmia. We evaluated the effect of magnesium sulfate treatment on hemodynamics and serum potassium concentration, induced by continuous infusion of regular insulin solution in rabbits. Method: Twenty-four rabbits were divided into four groups for the experiment. Group I was given intravenouse injection of 5 ml of normal saline and continuous dripping of 7.5 U of RI. Group II was pretreated with 30 mg/kg of magnesium sulfate, followed by continuous dripping of 7.5 U of RI. Group III was given 5 ml of normal saline and 15 U of RI. And Group IV was administered 15 U of RI after 30 mg/kg of magnesium sulfate pretreatment. Venouse blood sampling was done before pretreatment, and after 5, 30, 60 and 120 minutes respectively. Heart rate and arterial blood pressure were taken at the same intervals. Result: 1) There was no significant change in serum potassium concentration in groups injected with 7.5 units of RI respectively (groups I and II), regardless of magnesium pretreatment. But in groups injected with 15 units of RI, the group that was not pretreated with magnesium (Groups III) showed a decrease in serum potassium concentration from 3.39+/-0.57 Eq/L to 2.29+/-0.71 mEq/L, while the concentration in the pretreated group (Group IV) decreased more significantly from 3.35+/-0.50 mEq/L to 1.81+/-0.41 mEq/L. 2) Pulse rate did not change significantly in groups that received continuous infusion of 7.5 units of RI (groups I and II) regardless of magnesium pretreatment, but increased significantly in groups injected with 15 units of RI (groups III and IV), pretreated or not. The pretreated group (group IV) had a more significant rise in pulse rate compared with the group that was not pretreated (group III). 3) In all of the groups, those pretreated with magnesium (groups II and IV) and those not pretreated (groups I and III), there was no significant change in systolic and diastolic blood pressures. Nor was arrhythmia detected. Conclusion: The above results indicate that while magnesium sulfate pretreatment at 30 mg/kg with insulin infusion affects serum potassium concentration, has an antiarrhythmic effect, and may induce tachycardia, it does not have any significant effect on blood pressure.
Arrhythmias, Cardiac ; Arterial Pressure ; Blood Pressure ; Extracellular Fluid ; Heart Rate ; Hemodynamics* ; Hypokalemia ; Insulin ; Intracellular Fluid ; Magnesium Sulfate ; Magnesium* ; Potassium* ; Rabbits* ; Tachycardia

No abstract available.

No abstract available.

A clinical study was performed on 940 cases of essential hypertension observed at Dept. of Internal Medicine of Seoul National University Hospital during a period of last seven years from 1971 to 1977. The followings were the results: 1. The incidence of hypertensive patients was 13.8% among all medical in-patients and 68.2% among all cardiac in-patients. 2. The highest occurence was observed in sixth decade and accounted for 34.2% of all cases and least occurence was in second decade of life which accounted for 0.6% of all cases. No difference was found in age distribution between both sexes. The male to female ratio was 1.2:1. 3. The mean value of blood pressure was 178.1+/-21.8/107.4+/-12.3 mmHg and tended to increase with age at least over the decades from second to seventh and there was tendency to decrease after the eighth decade. No paticular difference in blood pressure levels was found in both sexes. 4. The most outstanding symptom was headache which was found in 51.5% of all cases. Dizziness, dyspnea and palpitation were the next orders in frequency. There was a general trend of the the subjective symptoms which were more pronounced in younger than older patients. 5. Hypertensive retinopathy was found in 83.3% of all cases. Hypertensive retinopathy of K-W grade II was found in 36.1% of all cases and was the most frequent finding among the Keith-Wagener grades. Malignant hypertension of K-W grade IV was found in 4.2% of all cases and the largest numbers were between the fourth and fifth decade of life. 6. The abnormal retinal finding was found to be rather proportional to the blood pressure levels. 7. Albuminuria was detected in 56.2% of all cases and it was more frequent in male than in female patients. 8. The appearance of albuminuria seemed to have a close correlation with hypertensive retinal change and blood pressure levels. 9. Electrocardiographic abnormalities were associated in 71.9% of all cases. The most frequent association among electrocardiographic abnormalities was left ventricular hypertrophy which accounted for 45.2% of all cases. There was the reverse correlation between the normal electrocardiogram and degree of blood pressures. The finding of left ventricular hypertrophy and degree of blood pressures were closely correlated. 10. Cerebrovascular accident, renal failure, congestive heart failure and atrial fibrillation were four major complications. It was recorded in 26.5%, 10.4%, 5.4% and 2.0% of all cases respectively. The complications were common in men than in women. 11. Renal failure, congestive heart failure and myocardial infarction were closely corelated with hypertensive retinopathy.
Age Distribution ; Albuminuria ; Atrial Fibrillation ; Blood Pressure ; Dizziness ; Dyspnea ; Electrocardiography ; Female ; Headache ; Heart Failure ; Humans ; Hypertension* ; Hypertension, Malignant ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Incidence ; Internal Medicine ; Male ; Myocardial Infarction ; Renal Insufficiency ; Retinaldehyde ; Seoul ; Stroke

No abstract available.

Paget's disease is classified, according to location, as mammary or extramammary disease. Extramammary Paget's disease especially in the vulva is extremely rare. Several hundred cases have been described worldwide. Patients with Paget's disease of the vulva are usually white and postmenopausal. The cause of which remains elusive. A case of vulva Paget's disease is presented with brief review of literature.
Humans ; Paget Disease, Extramammary ; Vulva

In Korea, Kerion celsi caused by T. verrucosum was first reported by Kim et al in the Honam province in 1986. Since then three mare cases have been reported in the Young Nam province. Herein present a case of kerion celsi caused by T. verrucosum from Chungcheong province. The patient, a 7-year old female, showed a 4x 4cm sized, oval, yellow crusted and boggy patch with alopecia on the scalp. She was living on a farm in a rural area of Chungcheong province. Cows on the farm also exhibited similar skin lesions on the buttock. The same T. verrucosum was identified by a characteristic colony morphology on Sabourauds dextrose agar and chains of chlamydoconidia with mycologic stain from scales of lesions of patient and cows. This skin lesion was successfully treated with griseofulvin.
Agar ; Alopecia ; Buttocks ; Child ; Female ; Glucose ; Griseofulvin ; Humans ; Korea ; Scalp ; Skin ; Tinea Capitis* ; Weights and Measures

BACKGROUND: This study was conducted to compare the clinical and radiological outcomes of the locking hook plate fixation (HP) technique and the single tight rope (TR) technique applied for acute high-grade acromioclavicular (AC) joint separations. METHODS: Between 2009 and 2014, 135 consecutive patients with acute AC joint separation Rockwood types III, IV, and V were subjected to surgical reconstruction. One hundred fourteen patients (84.4%) were available for retrospective evaluation. Of them, 62 and 52 were treated using the single TR group and clavicular HP group techniques, respectively. The visual analogue scale, Constant, American Shoulder and Elbow Surgeons (ASES), and Taft scores were used for clinical assessment. Postoperative shoulder range of motion was also assessed. An anteroposterior radiograph of the coracoclavicular distance (CCD) was obtained to evaluate the radiographic signs of recurrence. RESULTS: The TR group patients had better Constant, ASES, and Taft scores than the HP group patients. The loss of reduction in terms of the CCD did not differ between groups. Subacromial osteolysis was observed in 34.6% of the cases in the HP group. However, there were no significant differences in the clinical outcomes between the patients with and without osteolysis in the HP group. Subcoracoid osteolysis, drill tunnel widening, and metal displacement were observed in 3.2%, 22.6%, and 4.8% of the cases in the TR group, respectively. CONCLUSIONS: The single TR technique was relatively more effective at treating acute high-grade AC joint injuries than the HP fixation technique (level of evidence: therapeutic; retrospective comparative study, Level III).
Acromioclavicular Joint* ; Dislocations* ; Elbow ; Humans ; Joints ; Osteolysis ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Shoulder ; Surgeons

There is room for debate in appropriate diagnosis and treatment due to physiological and anatomical differences in pediatric facial bone fractures from that of adult's. The objectives of this article is to analyze for our clinical cases and to suggest the appropriate management of facial bone fracture in children. The study included 56 children who had treatment for the craniofacial fractures form March, 1990 to February, 1998. Their ages ranged from 3 to 15. There were 38 males and 18 females. Physical examination, simple x-rays, ultrasonograms and routine CT scans were used for diagnosis. Materials were classified into 28 nasal bone fractures, 4 nasoethmoidal fractures, 6 orbital fractures, 8 mandible fractures, and 10 zygoma fractures. Patients were treated with conservative treatment in 9 cases, with closed reduction in 28 cases and open reduction only, and 14 patients with open reduction and internal fixation using microplates and screws. 3 patients needed autogenous calvarial bone graft. Plates and screws were removed in postoperative 3-6 months. All patients had successful union of fractured bones without no specific complications, and normal bony growths were noticed during the 7 years follow up. We conclude that surgeons should be careful in diagnosis and management for the pediatric facial fracture due to anatomical variations and differences in fracture aspects. First, it is mandatory for surgeous to get accurate diagnosis and identify children's fracture and displacement through routine CT check up along with physical examination. Second, it is important to perform the minimally invasive technique or conservative treatment for the children with mild displacement so that it reduces the incidence of growth retardation which may be caused by extensive operation. However, application of rigid fixation is necessary in case of extensive bony displacement or bony defects because of poor coorporation in postoperative care. Third, plates and screws which were used for the internal fixation should be removed at 3-6 months after the surgery. Fourth, if bone graft is needed, it is better to use autogenous graft than allogeneous graft. Fifth, care for dentition and follow up for growth are necessary for growing children.
Child ; Dentition ; Diagnosis ; Facial Bones* ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mandible ; Nasal Bone ; Orbital Fractures ; Physical Examination ; Postoperative Care ; Tomography, X-Ray Computed ; Transplants ; Ultrasonography ; Zygoma