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*

PURPOSE: This study was conducted to evaluate the association between H. pylori infection and socioeconomic status and to determine the current prevalence of H. pylori infection in Korean adolescents. METHODS: A structured questionnaire was sent to the children's parents to obtain demographic information on the parents and environmental information. Of the 532 questionnaires sent out, 375 (70.5%; 170girls and 205boys) were returned. Their ages ranged from 10 to 15 years (mean, 12.9 years). After collecting blood samples, we measured serum IgG antibody to H. pylori using ELISA method. The association of risk factors such as age, sex, socioeconomic class, type of house, and crowding index with H. pylori infection were analyzed by multiple regression analysis. Socioeconomic status was estimated from the parents'education and occupation using a modified Hollingshead index. RESULTS: The prevalence rate of H. pylori infection was 16.8% (63/375). It increased with age (10.3% at 10~11 years, 15.9% at 12~13 years, and 20.7% at 14~15 years). The H. pylori infection was inversely related to the socioeconomic class (6.3% for the upper class, 16.0% for the middle class, and 20.0% for the lower class). Crowding condition and type of house did not affect significantly on seroprevalence of H. pylori infection. After logistic regression, we found that the odds ratio for age was 2.2 (95% confidence interval 0.9~5.4), and for socioeconomic status, 3.6 (95% confidence interval 0.5~28.9). CONCLUSION: The prevalence of H. pylori infection in Korean adolescents was 16.8%. It related inversely to socioeconomic status but was not statistically significant. Socioeconomic status based on parents' education and occupation seemed to affect more on H. pylori seroprevalence than crowding or type of house did.
Adolescent* ; Crowding ; Education ; Enzyme-Linked Immunosorbent Assay ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G ; Logistic Models ; Occupations ; Odds Ratio ; Parents ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Seroepidemiologic Studies ; Social Class*

An increasing interest in intravenous anesthetic techniques has resulted from the availability of more efficacious intravenous agents, possible discomfor of the patient on endotracheal intubation and the concern over anesthetic pollution in the operating room. This study was done to investigate the effect of intravenous anesthesia with ketamine on the respiratory system by comparing arterial blood gas analysis before and after the procedure. Analysis of arterial blood for PCO2, PO2, pH, and excess were carried out. Heart rate and blood pressure were monitored on 15 patients in ASA class l for diagnostic or short procedures. Each patient was premedicated with atropine 0.01mg/kg and valium 0.2mg/kg intramuscularly 30 minutes before the procedure. ketamine was administered intravenously 1.0~1.5 mg/kg or intramuscularly 3~5mg/kg for induction of anesthesia. The anesthesia was maintained with ketamine 0.5~1.0mg/kg and valium 0.1mg/kg ever 5 to 10 minutes. The results of this study showed that ketmine anesthesia seemed not to cause any untoward effect on respiratory function. In other words, ketamine seems to be a safe and good intravenous anesthetic agent for diagnostic or short surgical procedures.
Anesthesia ; Anesthesia, Intravenous* ; Atropine ; Blood Gas Analysis ; Blood Pressure ; Diazepam ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Intubation, Intratracheal ; Ketamine* ; Operating Rooms ; Respiratory System

There are not many reports of a spontaneous acute subdural hematoma (ASDH) without the presence of a subarachnoid hemorrhage as a result of a ruptured aneurysm. A 66-year-old woman presented with acute subdural hematoma secondary to a ruptured intracranial aneurysm. She was admitted with an acute onset of bursting headache and nausea. There was no past history of head trauma. The CT scan demonstrated a left subdural hematoma with extension along the tentorium in the absence of subarachnoid or intraparenchymal hemorrhage. CT angiography revealed an aneurysm of the left posterior communicating aneurysm, which was directed posterolaterally. Uneventful clipping was performed without any neurological deficits. The possibility of aneurysmal subdural hemorrhage should be considered in all cases of ASDH that present with a sudden bursting headache without any history of trauma. Therefore, CT angiography can be an indispensable tool for detecting the aneurysm that has an unusual pattern of subdural hematoma.
Aged ; Aneurysm ; Aneurysm, Ruptured ; Angiography ; Craniocerebral Trauma ; Female ; Headache ; Hematoma, Subdural ; Hematoma, Subdural, Acute ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Nausea ; Subarachnoid Hemorrhage

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

Although various animals have been used as models of cardiac valvular diseases in humans, the structural characteristics of cardiac valves in animals remain unclear. In this study, we investigated cardiac valves in representative animal models for the purpose of comparative anatomy. Adult hearts from three dogs, four goats, six rabbits, and six fowls were fixed with 10% neutral-buffered formalin and analyzed gross-anatomically. Cardiac appearance was spherical or oval in dogs, goats, and rabbits, whereas it had a long conical shape in fowls. Left atrioventricular (AV) valve was composed of membranous septal and parietal cusps connected to two papillary muscles in all animals. The right AV valve was composed of membranous septal, parietal, and angular cusps with three papillary muscles in dogs and goats, membranous septal and parietal cusps attached to four papillary muscles in rabbits, and a single muscular plate without any papillary muscles and chorda tendinae in fowls. Aortic valves with thin membranous right, left, and septal semilunar cusps in dogs, goats, and rabbits had a thick membrane with a bended free border in fowls. Pulmonary valve (PV) with membranous right, left, and intermediate semilunar cusps made a large central hole by being closely attached to the surrounding wall in dogs, goats, and rabbits, whereas it protruded into half of the lumen as a thick membrane in fowls. The membranous cusp of the PV was composed of several layers in dogs and goats but was a single layer in rabbits and fowls. These findings indicate that even if animals have two completely separated atria and ventricles each, cardiac valves have species-specific morphological characteristics, especially between mammals and fowls.
Adult ; Anatomy, Comparative ; Animals ; Aortic Valve ; Dogs ; Formaldehyde ; Goats ; Heart ; Heart Valves* ; Humans ; Mammals ; Membranes ; Models, Animal ; Papillary Muscles ; Pulmonary Valve ; Rabbits ; Rabeprazole

Fusiform aneurysms on the basilar artery (BA) trunk are rare. The microsurgical management of these aneurysms is difficult because of their deep location, dense collection of vital cranial nerves, and perforating arteries to the brain stem. Endovascular treatment is relatively easier and safer compared with microsurgical treatment. Selective occlusion of the aneurysmal sac with preservation of the parent artery is the endovascular treatment of choice. But, some cases, particularly giant or fusiform aneurysms, are unsuitable for selective sac occlusion. Therefore, endovascular coiling of the aneurysm with parent vessel occlusion is an alternative treatment option. In this situation, it is important to determine whether a patient can tolerate parent vessel occlusion without developing neurological deficits. We report a rare case of fusiform aneurysms in the BA trunk. An 18-year-old female suffered a headache for 2 weeks. Computed tomography and magnetic resonance image revealed a fusiform aneurysm of the lower basilar artery trunk. Digital subtraction angiography revealed a 7.1x11.0 mm-sized fusiform aneurysm located between vertebrovasilar junction and the anterior inferior cerebellar arteries. We had good clinical result using endovascular coiling of unruptured fusiform aneurysm on the lower BA trunk with parent vessel occlusion after confirming the tolerance of the patient by balloon test occlusion with induced hypotension and accompanied by neurophysiologic monitoring, transcranial Doppler and single photon emission computed tomography. In this study, we discuss the importance of preoperative meticulous studies for avoidance of delayed neurological deficit in the patient with fusiform aneurysm on lower basilar trunk.
Aneurysm ; Angiography, Digital Subtraction ; Arteries ; Basilar Artery ; Brain Stem ; Cranial Nerves ; Female ; Glycosaminoglycans ; Headache ; Humans ; Hypotension ; Intracranial Aneurysm ; Magnetic Resonance Spectroscopy ; Parents ; Tomography, Emission-Computed, Single-Photon

We aimed; 1) to determine the validity of the EuroQol 5D (EQ-5D) for the health-related quality of life (HRQOL) of Korean patients with type 2 diabetes, and 2) to identify associated factors of the HRQOL of these patients. Follow-up surveys were conducted for consecutive patients with type 2 diabetes. HRQOL was assessed using the EQ-5D and the Short Form-36 (SF-36). The validity of EQ-5D was assessed with the perspectives of known group, convergent and discriminant validity. Additionally, a linear mixed model using a backward elimination was used for identify associated factors. Of the 1,072 patients included in the first survey, 858 (80.0%) completed the questionnaires in the follow-up. In the known group validity, the problem rates in each EQ-5D dimension were highest among women, elderly people, and less-educated subjects. The Spearman's rho between the EQ-5D and the SF-36 scales were larger in the comparable dimensions than those in the less comparable dimensions. In the final model, we found that sex, age, education, body mass index, atrial fibrillation, stroke, and retinopathy were statistically significant. Our data suggest that the EQ-5D is a valid tool for Korean patients with type 2 diabetes and that various factors could affect their HRQOL.
Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus, Type 2/complications/*physiopathology/psychology ; Female ; Humans ; Male ; Middle Aged ; *Quality of Life ; Quality-Adjusted Life Years ; *Questionnaires ; Republic of Korea ; Young Adult