The age of puberty represents a very critical time in the life history of every young woman. The menarche stands as primary indicator of the onset of sexual maturation in females. According to several studies, menarcheal age in Korean girls has dropped from about 15 years of age in 1960s to 13.5 years of age in 1980s. This findings show a pronounced secular trend to earlier maturation. The purpose of this study is to determine (1) the average age at menarche in Korea in present time, (2) the secular trend of menarcheal age, and (3) the geographic regional influence on menarche. The data sampling was obtained from the physical examination cards of women students in Yonsei University who entered from 1983 to 1991. The data which was obtained from the number of 7761 was analysed by dBase III plus and SAS program. The results are as follows: 1) The mean menarcheal age of the subjects was 13.7+/-1.2 years. 2) Age at menarche has been getting earlier by some 7.4 months during the period of recent II years. 3) Comparing to the decreasing secular trend of menarcheal age, the height and weight showed increasing trend. 4) There were significant differences in menarcheal age, height, weight among geographic regions. We conclude that the results indicate an accelerating secular trend in age of menarche in Korea.
Adolescent ; Female ; Humans ; Korea* ; Menarche ; Physical Examination ; Puberty ; Sexual Maturation

Among two groups of navy recruits undergoing training, one consisting of 500 enlisted men and another 100 newly enrolled midshipmen, 18 reported to Chinhae Naval Hospital with fatigue fractures during the period from February though September 1969. Following observations were made on these cases: 1. The incidence of fatigue facture was 1.4 percent among the enlisted men and 11 per cent among the midshipmen. 2. There were 6 cases of complete fraeture and 2 cases of incomplete fracture. In the remaining 10 cases, only periosteal reaction was evdent roentgenographically with no visible fracture line initially: fracture lines, however, became apparent on subsequent examinations in all the cases. 3. The fractures involved the femur in 4 cases and the tibia in 14 cases, a ratio of 1:3. 5 in latter s favor. 4. The site of predirection in the femur was the distal one third of the shaft, occurring in 3 of the cases. In the tibia the junction of the upper and middle thirds was most frequently affected, occurring in 10 of the cases. 5. All the cases in our series healed without any complications.
Fatigue ; Femur ; Fractures, Stress ; Humans ; Incidence ; Male ; Tibia

STUDY DESIGN: This study assessed the final functional results after treatment of thoracolumbar burst fractures and compared the relationship between the results and the parameters of reduction and state of the fractures. OBJECTIVES: To define prognostic factors affecting the final results and to present some precautions to minimize the treatment failure. SUMMARY OF LITERATURE REVIEW: In the treatment of the thoracolumbar burst fractures in which flexion loads are predominant, the sagittal contour is crucial to achieve permanent pain-free stability, but definitive therapeutic guidelines have remained a controversal topic. MATERIALS AND METHODS: We reviewed 37 thoracolumbar burst fractures with an average follow up period of 1.8 years: group 1 consisting of 20 cases treated conservatively and group 2 consisting of 17 cases treated surgically with posterior instrumentation. Finally functional results were analysed with the Denis'pain and work scores, and were compared between groups on anterior body height and local kyphosis. RESULTS: A satisfactory pain score less than or equal to P3 was in 15(75%) in group 1 and 15(88.2%) in group 2(p>0.05), but satisfactory work score less than or equal to W3 was in 12(60%) in group 1 and in 14(82.4%) in group 2(p<0.05). But, some loss of body height and local kyphosis in group 1 was not reversely related with functional outcomes. Eight cases in group 1 showing unsatisfactory result in work scores were analyzed as 4 osteoporosis(Jikei grade I, II/III), 3 associated compression fracture of the contiguous vertebra and one combined osteoporosis and compression fracture, showing significant loss of vertebral height and increase of kyphosis(p<0.01). CONCLUSIONS: Functional results of group 1 showing loss of vertebral height less than 50% and increased kyphosis less than 200 were comparable to those of group 2. The osteoporosis and associated compression fracture of adjacent vertebra were the risk group to develop posttraumatic kyphosis and might be added to the surgical indication of the thoracolumbar burst fractures.
Body Height ; Follow-Up Studies ; Fractures, Compression ; Kyphosis ; Osteoporosis ; Spine ; Treatment Failure

Adult intussusception is rare involving of only 1% of the causes of bowel obstruction. We report a case of a 39-year-old female with intussusceptions due to inverted Meckel's diverticulum. She visited our hospital for diffuse abdominal pain during 1 week and aggravated abdominal pain for 2 days. Vital signs were stable, and there was periumbilical tenderness. She had no history of abdominal operation. CT scan showed a 3.7x2.1 cm of fatty mass with focal intussusception in the distal ileum. When the emergency operation was performed, the patient was found to be suffering from ileocolic intussusception. A manual reduction of intussusception showed inverted Meckel's deverticulum at 65 cm proximal to the ileocecal valve, and the segmental resection of small bowel including a Meckel's diverticulum was performed. Pathologic examination revealed a Meckel's diverticulum containing a 0.6x0.6 cm sized aberrant pancreas.
Abdominal Pain ; Adult ; Emergencies ; Female ; Humans ; Ileocecal Valve ; Ileum ; Intussusception ; Meckel Diverticulum ; Pancreas ; Stress, Psychological ; Vital Signs

Kimura's disease is an uncommon, chronic inflammatory disease of unknown etiology. It is an important category of reactive lymphadenopathy in the oriental population. The most common sites are the subcutis of the head and neck, and parotid gland. It's clinical course is benign nature. The treatment modalities for this disease are steroid therapy, radiation therapy and surgical excision. We experienced a case of soft tissue mass in the left arm. It was slightly tender and relatively movable. We excised the mass, which was turned out to be Kimura's disease on microscopic examination.
Arm ; Head ; Lymphatic Diseases ; Neck ; Parotid Gland

The lack of familiarity with vertebral actinomycosis by both clinicians and radiologists, may contribute to its frequent omission from the differential diagnosis of suspicious lesions, therefore the condition can be difficult to diagnose. We now present the first report of two cases of thoracic and lumbar vertebral actinomycosis resulting in a paraparesis due to epidural abscess which necessifated surgery.
Actinomycosis* ; Diagnosis, Differential ; Epidural Abscess ; Paraparesis ; Recognition (Psychology) ; Spine

STUDY DESIGN: In this study, 18 patients undergoing posterior lumbar interbody fusion for multilevel lumbar spinal stenosis associated with degenerative scoliosis were reviewed retrospectively. OBJECTIVES: To assess the effectiveness of the cage-instrumented posterior lumbar interbody fusion in multilevel lumbar spinal stenosis associated with degenerative scoliosis. SUMMARY OF LITERATURE REVIEW: Degenerative lumbar scoliosis with the problems of neurogenic claudication, mechanical back pain and spinal deformity present a challenge for treatment. MATERIALS AND METHODS: We reviewed 18 surgical cases of multilevel lumbar spinal stenosis with degenerative scoliosis from March 1995 to April 2000 with an average follow up period of 2.9 years. We assessed the radiographic results of scoliotic angle correction and sagittal angle correction of the maximum curve and fused segment and disc height restoration. Clinical results were evaluated according to the Kirkaldy-Willis criteria. RESULTS: Mean scoliotic angle at preoperative, postoperative and final follow-up (maximum curve/fused segment) was 17.7-6.1-7.3degree /15.0-5.8-6.1degree respectively. Mean sagittal angle corresponding to each period was 12.1-34.1-32.7degree /8.3-27.0-26.0degree respectively. Mean disc height corresponding to each period was 22.9-42.4-40.5% respectively. The clinical result was analyzed as 15 satisfactory (83.3%), 3 fair (16.7%) and no poor. Fusion success was achieved in all patients. There were no serious complications except one case of fusion extension distally and no significant curve progression within follow-up period. CONCLUSIONS: The cage-posterior lumbar interbody fusion in multilevel lumbar spinal stenosis with degenerative scoliosis was effective for correction of scoliotic and sagittal deformity and restoration of disc height with resultant foraminal patency, provided relatively high clinical success and in situ fusion success in all cases even over multiple fusion levels, and can be an alternative among surgical treatments of this complex disease.
Back Pain ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Retrospective Studies ; Scoliosis* ; Spinal Stenosis*

A plexiform fibrohistiocytic tumor is a low-grade malignant mesenchymal neoplasm of myofibroblastic origin, with the capacity for biphasic differentiation toward a fibroblastic or histiocyte-like morphology. We report a case of myxoid plexiform fibrohistiocytic tumor occurring on the left upper arm in a 34-year old man. The lesion was a yellowish-to-pinkish color, rounded, pedunculated tumor with a short pedicle, measuring 1x1x1.5cm. Histopathological examination revealed a multinodular biphasic proliferation of fibroblast- like and histiocyte-like cells with a few osteoclast-like giant cells. This case is notable for the rare myxoid changes. To the best of our knowledge, this is the first report of a plexiform fibrohistiocytic tumor in the Korean dermatological journals.
Adult ; Arm ; Fibroblasts ; Giant Cells ; Humans ; Myofibroblasts

Rectal burns caused by hot water enema have been reported only occasionally and the majority of them were treated in a conservative manner. Although intractable rectal stricture caused by rectal burn is rare, it may be treated by endoscopic intervention or surgery. A 52-year-old woman who had used various methods of enema to treat her chronic constipation eventually undertook a hot water enema herself. After that, anal pain and constipation became aggravated prompting her to visit our clinic. Although various nonoperative treatments including endoscopic stenting were performed, her obstructive symptom did not improve and endoscopic findings had not changed. Hence, we performed a laparoscopic proctosigmoidectomy and transanal coloanal anastomosis with ileal diversion to treat the disease, and as a result, her obstructive symptom improved well. Corrective surgery such as resection of involved segment with anastomosis may be beneficial in relieving obstructive symptoms of an intractable rectal stricture caused by hot water enema.
Burns ; Constipation ; Constriction, Pathologic ; Enema ; Female ; Humans ; Middle Aged ; Stents ; Water

Rectal burns caused by hot water enema have been reported only occasionally and the majority of them were treated in a conservative manner. Although intractable rectal stricture caused by rectal burn is rare, it may be treated by endoscopic intervention or surgery. A 52-year-old woman who had used various methods of enema to treat her chronic constipation eventually undertook a hot water enema herself. After that, anal pain and constipation became aggravated prompting her to visit our clinic. Although various nonoperative treatments including endoscopic stenting were performed, her obstructive symptom did not improve and endoscopic findings had not changed. Hence, we performed a laparoscopic proctosigmoidectomy and transanal coloanal anastomosis with ileal diversion to treat the disease, and as a result, her obstructive symptom improved well. Corrective surgery such as resection of involved segment with anastomosis may be beneficial in relieving obstructive symptoms of an intractable rectal stricture caused by hot water enema.
Burns ; Constipation ; Constriction, Pathologic ; Enema ; Female ; Humans ; Middle Aged ; Stents ; Water