Transient synovitis of the hip joint in children was first described by Lovett and More in 1892and is the commonest cause of painful hip in children. It is characterized by pain and limp of acute onset, generally shart-lived, unassociated with structural changes in the femoral capital epiphysis demonstrable roentgenographically.. The pathology is of interest, not because it is a disabling condition, but because of the difficulties in differentiating it from more serious disease of the hip such as Legg-Calve-Perthes disease, tuberculosis, osteomyelitis and etc. The 76 cases so diagnosed at the Han-II hospital from 1974 to 1983 were reviewed and reported as follows; 1. There was probably associated with predisposing factors such as infection, and trauma. 2. The diagnostic criteria were clinical symptoms, laboratory and radiological findings. 3. The treatment was bed rest, skin traction on the affected leg, non-weight bearing, antibiotics, sedatives and in a few cases, INH was administrated for the prevention of the tuberculosis. 4. Four hips among them revealed later as Legg-Calve-Perthes disease and tuberculous arthritis of the hip joint.
Anti-Bacterial Agents ; Arthritis ; Bed Rest ; Causality ; Child ; Clinical Study ; Epiphyses ; Hip Joint ; Hip ; Humans ; Hypnotics and Sedatives ; Leg ; Legg-Calve-Perthes Disease ; Osteomyelitis ; Pathology ; Skin ; Synovitis ; Traction ; Tuberculosis

Phacomatosis pigmentovascularis (PPV) is a rare syndrome characterized by concurrent nevus flammeus (capillary malformation) and pigmentary nevus. According to current research, the major pathophysiologic mechanism in PPV is venous dysplasia with resultant compensatory collateral channels and venous hypertension. Arterial involvement is rare. We herein report our experience on renovascular hypertension, intermittent claudication, and severe rhabdomyolysis due to diffuse stenosis of multiple arteries in a patient with PPV type IIb associated with SWS.
Arteries ; Constriction, Pathologic ; Humans ; Hypertension ; Hypertension, Renovascular ; Intermittent Claudication ; Intracranial Aneurysm ; Neurocutaneous Syndromes* ; Nevus ; Port-Wine Stain ; Rhabdomyolysis* ; Sturge-Weber Syndrome* ; Vascular Diseases

PURPOSE: This paper evaluate and classified the risk factors that could possibly cause ischemic stroke in children, and investigate whether TOAST classification could be applied to the ischemic stroke in children. METHODS: From March 1995 to February 2002, we retrospectively reviewed the medical record of 87 patients under the age 16 who had been registered to the Ajou Stroke Registry. We evaluated the risk factors of ischemic stroke according to the Ajou Stroke Registry Protocol, and classified the risk factors into 6 main subgroups. In addition, the risk factors were investigated according to the age distribution. TOAST classification had been applied to children with ischemic stroke. RESULTS: There was 64 ischemic stroke(73.6%) and 23 hemorrhagic stroke(26.4%) among the 87 patients. In children with ischemic stroke, there was three major peak age; 13 patients younger than 1 year old(15.3%), 26 patients in age 5 to 8 years old(40.6 %), 22 patients in 9 to 12 years old(34.3%). Vasculopathy(48.6%) was the most common risk factor of the ischemic stroke in this study. Other important risk factors in order of frequency were hypertensive encephalopathy(12.5%), infectious disease(7.8%), metabolic disease(7.8%), and hematologic disease(6.2%). Moyamoya disease was the most common cause of ischemic stroke due to vasculopathy. If we analyze the risk factors according to the age at the presentation of ischemic stroke, 90% of the ischemic stroke due to vasculopathy had been developed after 5 years of age. However, ischemic stroke due to infectious disease had been developed less than 4 years of age. Major stroke was the most common subtype of the ischemic stroke in children, but TIA had been found in 80% of the patients with ischemic stroke due to moyamoya disease. TOAST classification determined the subtype of the ischemic stroke only in 2 children. Risk factors of ischemic stroke in the remained 62 patients were extremely variable, and could not be applicable to the TOAST classification. CONCLUSION: Risk factor of ischemic stroke were found in the 90% of patients. Although risk factors of ischemic stroke were extremely variable in children, cerebral vasculopathy including moyamoya disease was the most common. However, inherited metabolic disorder, coagulopathy, and hypertensive encephalopathy were also relatively common risk factors of ischemic stroke especially in children older than 5 years old. Therefore, we must extensively evaluate all the possible risk factors of ischemic stroke in children. TOAST classification could not be applicable in children because the risk factors of ischemic stroke were extremely variable.
Age Distribution ; Child* ; Child, Preschool ; Classification ; Communicable Diseases ; Humans ; Hypertensive Encephalopathy ; Medical Records ; Moyamoya Disease ; Retrospective Studies ; Risk Factors* ; Stroke*

No abstract available.
Drug Therapy*

Acute cerebral infarctions are rare in children, however, they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient's survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokineinduced vascular inflammation.
Brain ; Cerebral Infarction* ; Child ; Child, Preschool ; Decompressive Craniectomy ; Diagnosis ; Enoxaparin ; Humans ; Immunoglobulins ; Inflammation ; Levofloxacin ; Magnetic Resonance Imaging ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia, Mycoplasma* ; Stroke ; Thrombophilia ; Thrombosis ; Vasculitis

Sudoriparous angioma is an unusual form of angioma with pain and hyperhidrosis. We present two cases of typical sudoriparous angioma. Case 1: 9-year-old female showed 0. 8 to 2. 0cm multiple dark brownish tender palpable hypertrichotic masses on the right lower leg after birth. Muscular atrophy and flexion contracture was also developed on the right lower leg for 2 years. Case 2: 4-year-old rnale showed 3 * 3cm tender elevated mass on the left shin after birth. Marked hyperhidrosis was developed when even slight pressure applied on the lesion in these cases. On histologic examination, these two cases showed proliferation of varible sized blood veasels hyperplasia and dilated hyperplastic eccrine glandular and ectopic adipose tissue on the mid and deep dermis. Muscular biopsy from case 1 showed fibrotic and degenerative change. Electromicroscopic examination done from case 1. The secretory epithelial cell of eccrine gland showed cytoplastic degradation and slight dilated intercellular canaliculi (Fig. 11). The lumen of subepithelial capillaries were dilated and some of endothelial cells showed degenerative changes evidenced by RER dilation, mitochondrial swelling and detachment from underlying tissue(Fig. l2). The cutaneous nerve showed many non-myelinated axons enclosed in cytoplasm of Schwann cells.
Adipose Tissue ; Axons ; Biopsy ; Capillaries ; Child ; Child, Preschool ; Contracture ; Cytoplasm ; Dermis ; Eccrine Glands ; Endothelial Cells ; Epithelial Cells ; Female ; Hemangioma* ; Humans ; Hyperhidrosis ; Hyperplasia ; Leg ; Mitochondrial Swelling ; Muscular Atrophy ; Parturition ; Schwann Cells

Unilaterl frontal hyperhidrosis, a rare disorder of the sweat gland with localized hyperhidrosis, ia discribed. A 13-year-old female patient had increased sweating on the left half of the forehead, recurring in summer season for 2 years. Quantitative sweat collection demonstrated that the sweat glands responsive to those stimuli, which were thermal (direct and indirect heat), gustatory and cholinergic stimulation. A marked increase in sweat gland activity was noted on the affected areas as compared to the contaralateral normal sites, in thermal and gustatory effect. But, carbachol stimulation was not responsive. Biosy specimen which taken from the positive site of starch iodine technique showed increase number of sweat glands and ducts with somewhat dilated sweat ducts.
Adolescent ; Carbachol ; Female ; Forehead ; Humans ; Hyperhidrosis* ; Iodine ; Seasons ; Starch ; Sweat ; Sweat Glands ; Sweating

This survey was to elucidate the bacterial clearance time (BCT) among the patient of L-type and B-group leprosy who had been und.er chernotherapy and foll- ow up with bacterial examination 4 times every year more than 3 years at the Chronic Disease Laboratory of Catholic Medical College. The 99 patients, 53 L-type and 46 B-group, were slected for this study. These patients were classified again into 2 groups: 80 patients with negative bacterial index and 19 patient of posit.ive bacterial index. The patient with negative bacterial index was subdivided into 3 groups by BCT. 1. Rapid decrease group (RA group) BCT<(4years) 2. Standard decrease group (ST group) 4BCT<7 R. Slow decrease group (SL group) 7.
Chronic Disease ; Drug Therapy* ; Humans ; Leprosy* ; Leprosy, Borderline* ; Leprosy, Lepromatous* ; Prognosis*

Helicopter emergency medical services (HEMS) are a part of air medical services. The transportation of patients using helicopters or airplanes is a core element of the air medical services. HEMS have developed from militarybased transportation, which used helicopters on the battlefield. HEMS have played an important role in properly transporting critical patients before the golden time elapses. The optimal strategies for the operation of HEMS at any emergency medical system are dependent on the characteristics of the regional emergency medical system, diversitiy of HEMS organizations, and the legal background of each country. Therefore, every participant, including the government, medical personnel, and HEMS organizations, should concentrate their efforts toward the establishment of HEMS. Other than the factors related to patients, the key element in facilitating the establishment of HEMS is the safety of the flight and crew members.

Rotation-plasty procedure was first done by Borggreve, in 1930 for the congenital short femur. Recently this procedure was used for the malignant bone tumor at the distal femur by Kotz and Salzer in 1982. In spite of its cosmetic problem of the distal stump, this procedure has great functional advantage of converting the above-knee amputation to the below-knee amputation. The authors applied this procedure in case of severe soft tissue crushing and large bone defect from the distal femur to the proximal tibia by the rail-road accident. Conventional below-knee prosthesis with thigh corset gave him normal ambulation. The inverted foot was good to control the prosthesis as a below-knee stump and heel functioned as a patella to support the body weight.
Amputation ; Body Weight ; Femur ; Foot ; Fractures, Comminuted ; Heel ; Knee ; Patella ; Prostheses and Implants ; Thigh ; Tibia ; Walking