From January 1988 to December 1991, 39 fractures of the lateral condyle of humerus in children were treated at the Department of Orthopaedic Surgery, Sung-Ac General Hospital. It was possible to follow up from one year to four years and eleven months. The authors have analyzed the method of treatment on the basis of the degree of displacement in the change of Carrying angle and Baumann's angle. The results were as follows; 1. Of the 39 cases, the age incidence was confined to 2 to 12 years of age and the average age of the patients were 5 years. 2. Most fractures were Milch type II (29 cases) in contrast to Milch type I (10 cases). 3. According to the initial displacement of the fracture, 8 cases were Jokob's stage I, 21 cases of stage II & 10 cases of stage III. 4. There were no significant difference in the range of change of Carrying angle and Baumann's angle according to initial displacement of fracture site. However, significant difference in outcome were noticed from open reduction and internal fixation in comparison to closed reduction and percutaneous pinning. 5. In all 39 cases, lateral condylar overgrowth (10 cases), cubitus varus (1 cases) and cubitus valgus (3 cases) were noticed as complications but clinical significance was not noted. 6. The above results suggest that internal fixation is recommended for firm fixation although displacement is not severe. In case of Jakob's stage III, anatomical reduction is required in order to reduce additional damage on articular surface and epiphyseal plate caused by excessive manipulation.
Child ; Clinical Study ; Follow-Up Studies ; Growth Plate ; Hospitals, General ; Humans ; Humerus ; Incidence ; Methods

BACKGROUND: Pulmonary complications following bonemarrow transplantation(BMT) are common and associated with a high mortality rate, We investigated the yield, safety, and impact of fiberoptic bronchoscopy(FOB) for diagnosis of postBMT pneumoniae. METHODS: From May 1997 to April 2000, 56 FOBs were performed in 52 post BMT patients for clinical pneumoniae. BMT patients with repiratory symptoms and/or pulmonary infiltrates had a thoracic HRCT(high resolution computed tomography) and bronchoscopic examination including BAL(bronchoalveolar lavage), TBLB(transbronchial lung biopsy), PSB(protected specimen brush). RESULTS: The characteristics of the subjects were as follows:37 males, 15 females, mean age of 31.3 years(17-45), 35 sibling donor allogenic BMTs, 15 nonrelated donor allogenic BMTs, and 2 autologous BMTs. Fiftynine percent of FOBs (33 FOBs, 31 patients) were diagnostic. Isolated pathogens included the following:12 cytomegalovirus(CMV) (21.4%), 7 pneumocystis carinii(PC) (12.5%), 11 CMV with PC (19.6%), 2 Mycobacaterium tuberculosis (3.6%), and 1 streptococcus (1.8%). Most of the radiographic findings were diffuse interstitial lesions. CMV pneumoniae had mainly diffuse interstitial nodular lesion, and PC pneumoniae had diffuse, interstitial ground glass opacity(GGO). When CMV was accompanied by PC, a combined pattern of nodular and GGO was present. Of the 56 cases(23.2%), 13 died of CMV pneumoniae(n=2), PCP(n=2), mixed infection with CMV and PC(n=3), underlying GVHD(n=1), underlying leukemia progression(n=1), or respiratory failure of unknown origin(n=4). There was no major complication by bronchoscopy. Only 3 cases developed minor bleedig and 1 episode temporary hypoxemia. CONCLUSION: Based on our findings, CMV and PC are the major causes of postBMT pneumoniae. In addition, BAL can be considered a safe and accurate procedure for the evaluation of pulmonary complications after BMT.
Anoxia ; Bone Marrow Transplantation* ; Bone Marrow* ; Bronchoscopy* ; Coinfection ; Diagnosis* ; Female ; Glass ; Humans ; Leukemia ; Lung ; Male ; Mortality ; Pneumocystis ; Pneumonia* ; Respiratory Insufficiency ; Siblings ; Streptococcus ; Tissue Donors ; Tuberculosis

We describe a 27-year-old man who developed gait disturbance and dysarthria 2 years after the onset of cardinal symptoms of Behcet's disease. Positron emission tomography with 18F-fluorodeoxyglucose revealed severe hypometabolism in the cerebellum, in accordance wih cerebellar symptoms and sign of the patient. However, single-photon emission tomography with Tc-99m-HMPAO and Tc-99m-ECD did not disclose significant perfusion abnormalities in the brain. Routine brain magnetic resonance imaging did not show signal abnormalities. The findings of imaging studies compared with neurological manifestations of the patient are discussed.
Adult ; Brain ; Cerebellum ; Dysarthria ; Gait ; Humans ; Magnetic Resonance Imaging* ; Neurologic Manifestations ; Perfusion ; Positron-Emission Tomography ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Antibodies* ; Fetus* ; Heart Block* ; Heart*

The new onset of acanthosis nigricans in an adult-especially when the lesions appear on mucosal membranes such as the lips, periocular areas, and anus-may be indicative of an underlying tumor. Adenocarcinoma of the gastrointestinal tract is the most common malignancy-most often cancer of the stomach. A 72 years old female had disseminated, symmetrically distributed, brownish black pigmentation and papillary hypertrophy on the intertriginous and flexural areas for 12 months, and gastric adenocarcinoma was confirmed during the evaluation of internal malignancy. The cutaneous finding of acanthosis nigricans was a significant cutaneous marker of internal malignancy in this case.
Acanthosis Nigricans* ; Adenocarcinoma* ; Aged ; Female ; Gastrointestinal Tract ; Humans ; Hypertrophy ; Lip ; Membranes ; Pigmentation ; Stomach Neoplasms

OBJECTIVE: Patient-controlled-analgesia (PCA) using intravenous (IV) opioids is recognized a safe and effective method for pain control. However, postoperative analgesia with opioids is associated with a high incidence of postoperative nausea and vomiting (PONV) exceeding 30%. The 5-hydroxytryptamine receptor 3 (5-HT3) antagonists alleviate nausea and vomiting. This study aims to compare the effectiveness of ramosetron and ondansetron in preventing PONV following laparoscopic hysterectomy for benign uterine diseases under general anesthesia. METHODS: The medical records of 1483 patients who underwent laparoscopic hysterectomy between January 2005 and May 2009 were reviewed. Of the 1483 patients, 1184 patients who received IVPCA with ramosetron 0.3 mg (n=761) or ondansetron 8 mg (n=423) were analyzed. Fentanyl-based IVPCA was administered for 48 hours after surgery. The overall incidence of postoperative nausea and vomiting, bowel ileus, Levin tube insertion for severe bowel ileus, additional usage of pain killers and discontinuation of the IVPCA infusion with PCA-related severe nausea and vomiting were assessed for 48 hours after surgery. The amount of time until bowel gas passage resumption after surgery was measured. RESULTS: There was a significant difference between the two groups regarding the duration until post-operative bowel gas passage resumption (1.78+/-0.79 days in the ramosetron group, and 2.23+/-0.83 days in the ondansetron group; p=0.005); however, there were no significant differences found in other aspects. CONCLUSION: Ramosetron is superior to ondansetron in terms of faster recovery in bowel mobility, with similar effects in preventing the incidence of PONV.
Analgesia ; Analgesia, Patient-Controlled ; Analgesics, Opioid ; Benzimidazoles ; Humans ; Hysterectomy ; Ileus ; Incidence ; Medical Records ; Nausea ; Ondansetron ; Postoperative Nausea and Vomiting ; Serotonin ; Uterine Diseases ; Vomiting

Bednar tumor was described by Bednar in 1957. The histologic pattern of this tumor shows similar to dermatofibrosarcoma protuberans (DFSP) but melanin pigments are scattered within the tumor, It's rare neoplasm accounting for approximately 1-5% of all case of DFSP. Clinically, this tumor is considered to be intermediated malignancy, because of slow growth and frequent local recurrence and lack of distant metastasis. The majority are located on the trunk and the upper and lower extremities, but extremely rate in the head and neck area. Microscopically, this tumor is characterized by tight storiform spindle cells and long slender cells that admixed with a small population of melanin containing dendritic cells. This dendritic cells are the primary features distinguising this lesion from conventional DFSP. Complete surgical excision and close follow-up case are necessany for this neoplasm because of probable intermediate malignancy. A patient was admitted to Our Department of Oral and Maxillofacial Surgery due to swelling on right parotid area and numbness of the right lower lip on September, 1994, By clinical examinations and C-T finding, we dignosed tentatively as myxoma or pleomorphic adenoma. Surgical excision of this tumor was performed with parotidectomy and mandibular osteotomy under the frozen biopsy. By final microscopic and electromicroscopic examination and immunohistochemical study, this tumor was diagnosed as Bednar tumor. So, we report a case of pigmented DFSP with review of literatures.
Adenoma, Pleomorphic ; Biopsy ; Dendritic Cells ; Dermatofibrosarcoma* ; Follow-Up Studies ; Head ; Humans ; Hypesthesia ; Lip ; Lower Extremity ; Mandibular Osteotomy ; Melanins ; Myxoma ; Neck ; Neoplasm Metastasis ; Recurrence ; Surgery, Oral

Metformin has been reported to increase the expression of the glucagon-like peptide-1 (GLP-1) receptor in pancreatic beta cells in a peroxisome proliferator-activated receptor (PPAR)-alpha-dependent manner. We investigated whether a PPARalpha agonist, fenofibrate, exhibits an additive or synergistic effect on glucose metabolism, independent of its lipid-lowering effect, when added to metformin. Non-obese diabetic Goto-Kakizaki (GK) rats were divided into four groups and treated for 28 days with metformin, fenofibrate, metformin plus fenofibrate or vehicle. The random blood glucose levels, body weights, food intake and serum lipid profiles were not significantly different among the groups. After 4 weeks, metformin, but not fenofibrate, markedly reduced the blood glucose levels during oral glucose tolerance tests, and this effect was attenuated by adding fenofibrate. Metformin increased the expression of the GLP-1 receptor in pancreatic islets, whereas fenofibrate did not. During the intraperitoneal glucose tolerance tests with the injection of a GLP-1 analog, metformin and/or fenofibrate did not alter the insulin secretory responses. In conclusion, fenofibrate did not confer any beneficial effect on glucose homeostasis but reduced metformin's glucose-lowering activity in GK rats, thus discouraging the addition of fenofibrate to metformin to improve glycemic control.
Animals ; Blood Glucose/metabolism ; Body Weight/drug effects ; Diabetes Mellitus, Experimental/*drug therapy/*metabolism ; Drug Therapy, Combination ; Feeding Behavior/drug effects ; Fenofibrate/*pharmacology/therapeutic use ; Glucagon-Like Peptide 1/agonists/metabolism ; Glucose/*metabolism ; Glucose Tolerance Test ; Homeostasis/*drug effects ; Immunohistochemistry ; Injections, Intraperitoneal ; Insulin-Secreting Cells/drug effects/metabolism/pathology ; Lipid Metabolism/drug effects ; Male ; Metformin/*pharmacology/therapeutic use ; Peptides/administration & dosage/pharmacology ; Rats ; Receptors, Glucagon/metabolism ; Venoms/administration & dosage/pharmacology

PURPOSE: To described the MR findings in the periodic changes of the size and signal intensity ofreconstructed anterior cruciate ligament (ACL) of the knee and the efficacy of oblique axial imaging in patientswho underwent arthroscopic ACL reconstruction using autogenous patellar tendon. MATERIALS AND METHODS: Twenty-onepatients who had undergone ACL reconstruction were evaluated by follow-up MRI at postoperative 1 week, 1, 2, 3 and6 months, and 1 year, Conventional Fast-Spin-Echo (FSE) sagittal and coronal images and oblique axial images(proton density and T2-WI; VEMP TR/TE, 2000/20/70) were obtained perpendicular to the ligament, and using an ROIcurve in the intra-articular area, periodic changes in the cross-sectional area were evaluated by proton densityimaging and signal intensity by T2WI imaging. Cross-sectional morphology was categorized as either smooth, andround or notch-shaped and periodic changes in configuration were observed. In three cases, we evaluated the retearof reconstructed ACL by comparing the oblique axizl image obtained by conventional sagittal and coronal imaging. RESULTS: The cross-sectional area and signal intensity of grafted ACL increased significantly (p<0.05) after 3months and at 1 year, respectively. Cross-sectional morphology was smooth and round in 86% of cases, and notchedin 14%, and during follow-up MR studies, no periodic changes were seen. Notch-shaped ACL and decreased perigraftsignal intensity, as seen on sagittal images, could lead to a misdiagnosis of partial tear ; on oblique axialimages, ACL and perigraft signal intensity were found to be normal. CONCLUSION: During the natural evolution ofgrafted ACL, cross-sectional area and signal intensity increased significantly after 3 months and at 1 year,respectively ; on follow-up MR studies, cross-sectional morphology did not change, however. Oblique axial imagingprovides important information for evaluating whether the reconstructed ACL is torn or not.
Anterior Cruciate Ligament* ; Cross-Sectional Studies ; Diagnostic Errors ; Follow-Up Studies* ; Knee* ; Ligaments ; Magnetic Resonance Imaging ; Patellar Ligament ; Prospective Studies* ; Protons ; Transplants*

Spontaneous cerebrospinal fluid (CSF) leak is a recognized cause of spontaneous intracranial hypotension (SIH). Subdural hematoma (SDH) is a serious but rare complication of SIH. An autologous epidural blood patch at the CSF-leak site can effectively relieve SIH. We report a case of bilateral SDH with SIH caused by a CSF leak originating at the C1-2 level. A 55-year-old male complained of orthostatic headache without neurological signs. His symptoms did not respond to conservative treatments including bed rest, hydration and analgesics. Magnetic resonance imaging showed a subdural hematoma in the bilateral fronto-parietal region, and computed tomography (CT) myelography showed a CSF leak originating at the C1-2 level. The patient underwent successful treatment with a CT-guided epidural blood patch at the CSF-leak site after trephination for bilateral SDH.
Analgesics ; Bed Rest ; Blood Patch, Epidural* ; Cerebrospinal Fluid ; Headache ; Hematoma, Subdural ; Hematoma, Subdural, Chronic* ; Humans ; Intracranial Hypotension* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Myelography ; Trephining