Fracture of the proximal humerus metaphysis with coexistent dislocation of the shoulder in children is a rare injury. The injury often occurs as a consequence of high velocity trauma. Most fractures of the proximal humerus commonly associated with the epiphysis in children can be treated with closed reduction. We presented a case of 5-year-old girl who sustained this type of fracture- dislocation of the shoulder. Open reduction and internal fixation with multiple smooth K-wires was performed. At two years follow-up, the patient was pain free and regained full range of motion.
Child, Preschool ; Female ; Fracture Fixation, Internal ; Humans ; Shoulder Dislocation ; complications ; therapy ; Shoulder Fractures ; complications ; surgery

PURPOSE: To predict early risk of osteonecrosis of the femoral head by comparison of the bone marrow pattern of the proximal femoral metaphysis(PFM) in normal subjects and patients with osteonecrosis of the femoral head on T1-weighted magnetic resonance (MR) images. MATERIALS AND METHODS: The authors retrospectively reviewed T1 (TR525/TE 25 msec) weighted coronal MR images of 67 hips with osteonecrosis and 65 normal hips in 39 patients with osteonecrosis of the femoral head and in 27 normal subjects. On the basis of bright signal intensity of fat, the proportion of remaining hematopoietic marrow in PFM was subdivided into 4 grades (0 to 3) by two radiologists. No evidence of remaining hematopoietic marrow was assigned grade 0, and grades 1, 2 and 3 represented scanty, moderate, and prominent hematopoietic marrow, respectively. Grades 0 and 1 were collectively defined as "predominantly fatty", grades 2 and 3 as "predominantly hematopoietic". The frequency of the predominantly fatty marrow in PFM was analyzed in relation to three age groups(<25,25-50,50<) and both sexes. RESULTS: The overall frequency of predominantly fatty marro in PFM was higher in hips with osteonecrosis than in normal hips (p<0.001). Especially in the male population under the age of 50, the frequency was apparently higher in hips with osteonecrosis, compared with normal hips (p<0.001). However, the male population aged over 50 or female population showed no statistically significant difference in our series. CONCLUSION: In proximal femoral metaphysis with osteonecrosis of the femoral head, fatty marrow conversion occurs apparently earlier than in normal subject. T1-weighted MR imaging could therefore be useful in predictiong early risk of osteonecrosis of the femoral head because of early fatty marrow conversion of the proximal femoral metaphysis.
Bone Marrow* ; Female ; Head* ; Hip ; Humans ; Magnetic Resonance Imaging ; Male ; Osteonecrosis* ; Retrospective Studies

BACKGROUND: Lung cancer is frequently cited as an example of a disease caused solely by exposure to environmental caricinogens. However, there is a growing realization that the genetic constitution is also important in determining individual's susceptibility to lung cancer. This genetic susceptibility may result from functional polymorphims of the genes involved in carcinogen metabolism. In this study, the association between GSTM1 and CYP1A1 polymorphisms and the lung cancer risk in Korean males was investigated. MATERIALS AND METHOD: The study population consisted of 153 male lung cancer patients and 143 healthy male controls. The GSTM1 and CYP1A1 genotypes were determined by multiplex PCR and PCR-RELP analysis. RESULT: The were no significant differences in the frequency of the GSTM1 null genotype between the cases and the controls. When the cases were categorized by their histologic type, the frequency of the GSTM1 null genotype in the small cell carcinoma group was higher than those of the controls(67.2% vs 55.9%), but the difference was not statistically significant(OR=1.772 ; 95% CI=0.723-4.340). The distribution of the CYP1A1 MspI genotypes among the cases were similar to those among the controls. When the cases were grouped by their histologic type, the m1/m1, m1/m2, m2/m2 genotypes frequencies among the small cell carcinomas(23.0%, 38.5%, and 38.5%, respectively) were significantly different from those of the controls(36.4%, 46.2%, and 17.4%, respectively, p<0.05). When the m1/m1 genotype was used as a reference, the m1/m2 and m2/m2 genotypes were associated with an increased risk for small cell lung cancer(m1/m2 genotype : OR=1.337, 95% CI=0.453-3.947 ; m2/m2 genotype : OR=3.374, 95% CI=1.092-10.421). CONCLUSION: These results suggest that the GSTM1 and CYP1A1 genotypes may be a genetic determinant of the risk for lung cancer, particlulary small cell carcinoma. Further investigation is needed to confirm these results.
Carcinoma, Small Cell ; Constitution and Bylaws ; Cytochrome P-450 CYP1A1* ; Genetic Predisposition to Disease ; Genotype ; Humans ; Lung Neoplasms* ; Lung* ; Male* ; Metabolism ; Multiplex Polymerase Chain Reaction