We reviewed the records of thirty-four patients who had been managed with the Ilizarov technique for the comminuted intra- and extra-articular fractures and nonunion of the long bones with or with-out bone defect. The goal of this study is to analysis the clinical complications of the Ilizarov technique, and to find out the methods solving them. 1. This study comprises 34 patients who were treated by Ilizarov technique at the Chonbuk National University Hospital from March, 1992 to June, 1993. 2. Among 34 cases, 22 were comminuted intra- and extra-articular fractures, and 12 were nonunion of the long bones. 3. The complications were divided intd problem, obstacle and complication; problem in 16 cases, obstacle in 11 cases and complication in 6 cases. 4. We conclude that the Ilizarov technique is a useful method in management of the severe commi- nuted fractures and the nonunion of the long bones, but we have to consider the complication sincerely and endeavor to reduce them.
Fractures, Comminuted ; Humans ; Ilizarov Technique ; Jeollabuk-do ; Methods

Ultrasonic evaluation of the pylorus was performed in a group of 22 infants clinically suspected of having Congenital Hypertrophic Pyloric Stenosis (CHPS), from march 1990 to July 1991. In every case the diagnosis of CHPS was confirmed by surgery. Ten normal babies served as the control group. 1) In CHPS group, the mean age on admission was 36.7 +/- 16.4 days, and male to female ratio was 19.3. In control group, the mean age was 33.7 +/- 18.7 days, with the sex ratio of 8 : 2, male predominating. 2) In CHPS group, the mean age of symptom onset was 18.6 +/- 12.7 days, the majority occurring between 2 to 3 weeks (13 cases : 59%). 3) The ultrasonographic measurements showed that the pyloric muscle thickness of CHPS group was 4.94 +/- 1.35 mm (mean+/-S.D), nearly four times greater than that of the control group with 1.30 +/- 0.17mm, whereas the pyloric canal length of CHPS group (18.03 +/- 1.84mm) was increased significantly, but only by 50%, compared with the control group (11.54 +/- 1.70). 4) In CHPS group, operative measurements of pyloric muscle thickness was 5.20+/-1.23mm, not significantly differing from the sonographic measurement, while pyloric canal length measured 22.13 +/- 3.45mm, significantly larger than ultrasonographic measurement. This indicates that the pyloric muscle thickness measured on preoperative ultrasonogram may provide more significant diagnostic value than the pyloric canal length. 5) If the diagnostic criteria for CHPS were taken as pyloric muscle thickness above 4mm and pyloric canal length above 16mm, 21 out of 22 cases (99.4%) were diagnosed correctly.
Diagnosis* ; Female ; Humans ; Infant ; Male ; Pyloric Stenosis, Hypertrophic* ; Pylorus ; Sex Ratio ; Ultrasonics ; Ultrasonography

We experienced a case of congenital tuberculosis infected in utero, who had been found to have massive ascites and pleural effusion on routine ultrasonography at the 39 weeks' gestation. The emergency C-section delivered a male neonate weighing 2,050 g with poor condition and in severe respiratory distress. He was the first child born of a 27-year-old woman, who was diagnosed as having tuberculous pleurisy after delivery. Detection of acidfast bacilli in gastric aspirates obtained from the newborn as well as the clinical features and maternal history confirmed the diagnosis of congenital tuberculosis. Though rare, congenital tuberculosis requires early detection and treatment because of its severity and high mortality. A brief review of the relevant literature was made.
Adult ; Ascites* ; Child ; Diagnosis ; Emergencies ; Female ; Humans ; Infant, Newborn ; Male ; Mortality ; Pleural Effusion* ; Pregnancy ; Tuberculosis* ; Tuberculosis, Pleural ; Ultrasonography

The Zika virus, a flavivirus related to dengue and Japanese encephalitis was discovered in the Zika forest in Uganda, 1947. Since Zika virus was first reported in Brazil in May 2015, infections have occurred in at least 40 countries, especially in the Americas. Zika virus infection usually is asymptomatic or causes mild illness, but may be related to severe clinical manifestations, particularly microcephaly and Guillain-Barré syndrome. Although the possibility of autochthonous Zika virus transmission in South Korea is low, the imported cases and Zika virus-transmitting mosquito should be adequately monitored and promptly managed. In addition, enhancing preparedness for Zika virus infection are needed.
Americas ; Brazil ; Communicable Diseases* ; Culicidae ; Dengue ; Encephalitis, Japanese ; Flavivirus ; Guillain-Barre Syndrome ; Korea ; Microcephaly ; Specialization* ; Trees ; Uganda

PURPOSE: The objectives of this study was to evaluate the correlations between the indices of insulin sensitivity using fasting glucose and insulin level, and the body fat mass measured by bioelectrical impedance analysis (BIA) and dual energy X-ray absorptiometry (DEXA), and to determine the clinical usefulness of insulin sensitivity indices when obese children were followed up. METHODS: In this study, 28 simple obese children and adolescents were included. Anthropometric data including body weight, height, obesity degree (OD), body mass index (BMI), and waist-to-hip ratio were collected and then body fat mass was measured by using BIA and DEXA. For metabolic data, 12 hour fasting serum glucose, insulin and lipid profiles were measured and indices for insulin sensitivity (G/I ratio, loginsulin, HOMA-IR, logHOMA-IR, QUICKI) were calculated. RESULTS: BMI had a higher correlation with insulin sensitivity indices than OD (G/I ratio, -0.463 vs -0.209; loginsulin, 0.417 vs 0.196; HOMA-IR, 0.301 vs 0.238; logHOMA-IR, 0.403 vs 0.198; QUICKI, -0.451 vs -0.224). But OD had a higher correlation with body fat mass measured by BIA and DEXA than BMI (BIA, 0.612 vs 0.316; DEXA, 0.667 vs 0.512). The G/I ratio was correlated with body fat mass in BIA (r=-0.420, P< 0.05) and DEXA (r=-0.512, P< 0.01), percentage of body fat (percentage of fat) in BIA (r=-0.366, P< 0.05) and DEXA (r=-0.449, P< 0.01). HOMA-IR was only correlated with body fat mass in DEXA (r=0.341, P< 0.05). CONCLUSION: This study revealed that G/I ratios had a statistically significant correlation with anthropometric obesity indices (OD and BMI) and also had a correlation with both body fat mass and percentage of fat. These results suggest that G/I ratios could be used as useful index when obese children and adolescence are followed up.
Absorptiometry, Photon* ; Adipose Tissue* ; Adolescent ; Blood Glucose ; Body Mass Index ; Body Weight ; Child ; Electric Impedance* ; Fasting ; Glucose ; Humans ; Insulin Resistance* ; Insulin* ; Obesity ; Waist-Hip Ratio

PURPOSE: The presence and degree of fever in children is a useful indicator of illness. This project aimed to assess the accuracy and usefulness of infrared tympanic membrane (TM) & forehead feverscan thermometers for measuring children's temperatures. METHODS: Data were obtained from 1, 050 children with a median age of 4.5 years. They visited the pediatric clinics at Chung-Ang University Yongsan Hospital from January 2004 to December 2004. We measured body temperatures at axilla by mercury thermometer, at ear by infrared TM thermometer and at forehead by feverscan. Then we analyzed the correlation between these data. RESULTS: Mercury and TM thermometer, and Mercury and forehead feverscan thermometer very well correlated with each others (P< 0.05). And the sensitivity of infrared TM thermometer (right and left) to correctly identify febrile children was 81.1 percent and 82.4 percent, the positive predictive value to detect a fever was 81.8 percent and 73.6 percent. The sensitivity of forehead feverscan was 83.3 percent and the positive predictive value was 74.4 percent. CONCLUSION: The tympanic membrane temperature measured by the BRAUN IRT 3020 (R) and forehead arterial temperature measured by the HubDIC DOTORY (R) feverscan accurately reflects mercury axillary temperature, validly assesses the presence of fever in children, and is easy to use. The Braun IRT 3020 (R) & HubDIC DOTORY (R) therefore is an adequate tool to assess fever and may be used both in a clinical setting and for research purposes.
Axilla ; Body Temperature ; Child ; Ear ; Fever ; Forehead* ; Humans ; Thermometers* ; Tympanic Membrane*

The inverted nipple presents many problems including both cosmetic and functional aspects and impairment in breast feeding. the histopathologic characters of inverted nipple are that inverted nipple has less fibromuscular tissue than normal nipple and has short lactiferous duct and dense fibrous tissue. Many surgical and non-surgical techniques have been designed for correction of the inverted nipple. But most of these techniques have produced unsatisfactory problems. especially undesirable recurrence is most important problem. We experienced 19 inverted nipples in 12 patients between March 1995 and January 1998. We combined modified Teimourian method, purse-string suture and Z-plasty. and had good result for 3weeks to 30months follow up. This method was effective for correction of the inverted nipple with low recurrence rate and simple techniques.
Breast Feeding ; Follow-Up Studies ; Humans ; Nipples* ; Recurrence ; Sutures

Respiratory syncytial virus (RSV) is a pathogen with a high burden of disease and social cost among infants worldwide, but the development of a vaccine has been delayed. The recent understanding of the pathogenesis of RSV, progress in reverse genetics, and successful implementation of other maternal immunizations have prompted the recent rapid development of monoclonal antibodies (mAbs) and vaccines for RSV prevention. Phase 3 clinical trials for two next-generation mAbs (nirsevimab and clesrovimab) and two maternal RSV pre-F vaccines are currently underway or have been recently completed. Soon, we might be able to protect young infants through long-acting mAbs and/or maternal immunization.Additionally, the development of live-attenuated vaccine candidates that are capable of avoiding enhanced RSV disease is ongoing. We need to gain familiarity with these newly developed strategies and collect epidemiological data on domestic RSV to adequately prepare for a new era of RSV prevention.

BACKGROUND: Healthcare-associated infections (HAIs) are among the most important threats to patient safety. When hospitalized children face these threats, there is morbidity, mortality, prolonged hospitalization, and increased healthcare costs. Research on local healthcare epidemiology is necessary to enhance collective knowledge and evidence formanaging this problem. METHODS: We performed a retrospective analysis of databases of patients who were diagnosed with HAIs at Chung-Ang University Hospital (CAUH) from 2007 through 2011. Cases were selected from the microbiology registry databases. The data on prevalence of HAIs in various wards and its annual trends were compared to previously reported nationwide data. Moreover, we analyzed the patterns of antibiotic susceptibility results for HAI pathogens. RESULTS: A total of 181 HAIs were identified in 122 patients. The HAI rate among pediatric patients at CAUH was 2.4/1,000 person-hospital days. Urinary tract infections (UTIs) (53 episodes, 29.3%) were the most common, followed by pneumonia (33 episodes, 18.2%). Staphylococcus aureus was found to be the most common gram-positive organism, whereas Escherichia coli was the most common gram-negative organism. Methicillin-resistant S. aureus (MRSA) comprised 84% of the S. aureus infections. Imipenem resistance was detected in 58.8% and 55.0% of Acinetobacter baumannii and Pseudomonas aeruginosa isolates, respectively. CONCLUSION: Between 2007 and 2011, UTIs were the most common type of HAIs, and MRSA was the most common pediatric HAI pathogen, both in the general ward and intensive care unit at the CAUH. Further research on the epidemiology and pathogenesis of HAIs is necessary and prevention measures should be implemented to prevent HAIs in children.
Acinetobacter baumannii ; Child ; Child, Hospitalized ; Delivery of Health Care ; Escherichia coli ; Health Care Costs ; Hospitalization ; Humans ; Imipenem ; Intensive Care Units ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Microbial Sensitivity Tests ; Patient Safety ; Patients' Rooms ; Pneumonia ; Prevalence ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus aureus ; Urinary Tract Infections

Zika virus infection is, typically, either asymptomatic or causes mild illness; however, it may present severe clinical manifestations in neonates. Zika virus can be transmitted from a pregnant woman to her fetus, subsequently causing microcephaly and serious brain anomalies. Recently, the full spectrum of anomalies in neonates congenitally infected by Zika virus has been delineated as congenital Zika syndrome. Five major features are unique to congenital Zika syndrome: severe microcephaly with a partially collapsed skull, thin cerebral cortices with subcortical calcifications, macular scarring and focal pigment mottling of the retina, congenital contractures, and extrapyramidal symptoms. Recognition of this phenotype in neonates and infants by clinicians can help ensure appropriate etiologic evaluation of Zika virus infection and determine the required duration of follow-up and clinical care. Neonates with congenital Zika virus infection should be evaluated by a team of multiple specialists within the first year of life; the evaluations should include assessments of vision, hearing, feeding, growth, and neurodevelopmental function. Moreover, it is recommended that infants who show laboratory evidence of congenital Zika virus infection without apparent abnormalities be continuously monitored and screened by the primary care provider; repeated hearing tests should be carried out for such infants.
Brain ; Cerebral Cortex ; Cicatrix ; Contracture ; Culicidae ; Female ; Fetus ; Follow-Up Studies ; Hearing ; Hearing Tests ; Humans ; Infant ; Infant, Newborn* ; Microcephaly ; Phenotype ; Pregnant Women ; Primary Health Care ; Retina ; Skull ; Specialization ; Zika Virus Infection* ; Zika Virus*