The treatment of supracondylar fracture of humerus in children has so many pitfalls as to be once called "supracondylar dilemma". The authors analyzed the follow-up results of fifty-six displaced extension type supracondylar fractures treated by percutaneous pinning and by open reduction from 1982 to 1989. The mean age was 7.6 years, ranging from three years to fifteen years. Forty three fractures were treated by percutaneous pinning and thirteen by open reduction. According to the modified Flynn's criteria, the results of the treatment by percutaneous pinning were excellent 36%, good 32%, fair 25% and poor 7%, while those of open reduction were 8%, 42%, 8% and 42% , respectively, on average follow up of 1.4 years. Post-operative complications were found in seven cases (16.7%) of percutaneous pinning, and in five cases(38.5%) of open reduction. Poorly chosen surgical approach for open reduction was appeared to be related with unsatisfactory results. We believe that percutaneous pinning was a simple, effective method for treatment of displaced supracondylar fractures of the humerus. We agree, however, that open reduction is still indicated if manipulative reduction before pinning is unacceptable, or if the fracture is complicated by neurovascular or open injury.
Child ; Follow-Up Studies ; Humans ; Humerus ; Methods

BACKGROUND: The hypereosinophilic syndrome(HES) represents a leukoproliferative process likely caused by a number of disorders, all of which are marked by sustained over-production of eosinophils. OBJECTIVES: The purposes of this study were aimed at evaluating the clinical and histopathological characteristics of HES. METHODS: The medical records and hist opathological slides of patients with HES who had skin biopsies performed in our department were reviewed. Criteria for the diagnosis of HES include (1) peripheral blood eosinophilia with eosinophil counts greater than 1,500/L for at least 6 months; (2) no evidence of parasitic, allergic, or other known causes of eosinophilia; and (3) presumptive signs and symptoms of multiple organ involvement. RESULTS: Four male and three female patients were included. HES developed in adulthood or old age (mean, 43.4 years). Because only the patients with cutaneous involvement were included, all the patients showed skin lesions. Heart, liver, stomach, nervous system, lymph nodes, and lung were involved organs in decreasing order of frequency. At the onset of HES, 40 to 80% of white blood cells were eosinophils in peripheral blood. White blood cell count and serum IgE level were elevated in all the tested patients. In six patients (85.7%), the level of serum erythrocyte sedimentation rate was elevated. Persistent hypereosinophilia (>1,500/L) was present for longer than 6 months in all patients. Stool examination and skin test for parasitic infestation all gave negative results. All the patients were not taking any medication. Histopathological examinations revealed perivascular mixed inflammatory cell infiltration; predominantly eosinophils in the stomach, liver, and nerve as well as in the skin. Interestingly, two patients who were presented with skin lesions showed the findings of eosinophilic vasculitis. In these patients, the skin lesions were consisted of Raynaud's phenomenon, digital gangrene, and several erythematous plaques. The most common cutaneous manifestations were papules and nodules on the extremities. The main treatment modality was systemic steroid. Except for one patient presented with central nervous system involvement of HES, all the patients were in a well-controlled state. In one patient with the typical clinical and hematologic features of HES, Hodgkin's disease followed. After the complete remission of Hodgkin's disease with chemotherapy, HES subsided. CONCLUSIONS: HES is a heterogenous collection of disorders marked by hypereosinophilia and organ damage. Most common cutaneous manifestations were papules and nodules on the extremities. Raynaud's phenomenon and digital gangrene can be the primary manifestation of HES in which cases cutaneous lesions showed eosinophilic vasculitis. Five patients (71%) responded well to systemic steroids. HES may be a herald of malignancy such as Hodgkin's disease. Further investigation will be mandatory ro elucidate the etiology and pathogenesis of HES.
Biopsy ; Blood Sedimentation ; Central Nervous System ; Diagnosis ; Drug Therapy ; Eosinophilia ; Eosinophils ; Extremities ; Female ; Gangrene ; Heart ; Hodgkin Disease ; Humans ; Hypereosinophilic Syndrome* ; Immunoglobulin E ; Leukocyte Count ; Leukocytes ; Liver ; Lung ; Lymph Nodes ; Male ; Medical Records ; Nervous System ; Skin ; Skin Tests ; Steroids ; Stomach ; Vasculitis

The objective of this investigation was to evaluate the influence of gestational age at exposure on the prenatal effects of gamma-radiation. Pregnant ICR mice were exposed to a single dose of 2.0 Gy gamma-radiation at a gestational 2.5 to 15.5 days post-coitus (p.c.). The animals were sacrificed on day 18 of gestation and the fetuses were examined for mortality, growth retardation, change in head size and any other morphological abnormalities. The only demonstrable effect of irradiation during the preimplantation period was an increase in prenatal mortality. Resorptions were maximal on post-exposure day 2.5 after conception. The pre-implantation irradiated embryos which survived did not show any major fetal abnormalities. Small head, growth retardation, cleft palate, dilatation of the cerebral ventricle, dilatation of the renal pelvis and abnormalities of the extremities and tail were prominent after exposure during the organogenesis period, especially on day 11.5 of gestation. Our results indicate that the late period of organogenesis in the mouse is a particularly sensitive phase in terms of the development of the brain, skull and extremities.
Abnormalities, Radiation-Induced/*pathology ; Animals ; Bone and Bones/abnormalities/radiation effects ; Female ; Fetal Death ; *Gamma Rays ; *Gestational Age ; Mice ; Mice, Inbred ICR ; Pregnancy ; Pregnancy, Animal/*radiation effects ; Prenatal Exposure Delayed Effects

This study was carried out in order to find out the pattern of the root resorption following maxillary incisor retraction after maxillary 1st bicuspid extration in maxillary protrusion patients. For this study, thirty two patient who received orthodontic treatment were chosen. The results were as follows; 1. Of the total 192 teeth, 61 teeth(31.77%) showed no apical root loss, 64 teeth(33.33%) fell into the class "slight", 46 teeth(23.96%) fell into the class "moderate". Only 21 teeth(10.94%) were classified as "excessive". 2. No correlation was noted between the amount of apical root loss and the types of tooth movement of the maxillary central incisors. 3. The patients who were treated with standard brackets had more changes in tooth axis and less movement of root apexes, but the patients with straight brackets had less changes in tooth axis and more movement of root apexes. 4. Comparing the degree of root resorption between bracket types, patients who had used standard brackets showed more apical root loss than patients who had used straight brackets. 5. The most frequent degree of root resorption observed in standard bracket patients was second degree, followed by first degree and third degree. The most frequent degree of root resorption observed in straight bracket patients was zero degree, followed by first, second degree and third degree.
Axis, Cervical Vertebra ; Bicuspid ; Humans ; Incisor* ; Root Resorption* ; Tooth ; Tooth Movement

We report a case of annular lichen planus occurred in the hands and feet area, which also showed nail dystrophy and annular or polycyclic plaques on the proximal and lateral nail folds. Annular lesions of lichen planus have been reported mainly in glans penis area of male patients, but predominantly annular variant occurred in other body sites is quite rare and was reported exclusively in black patients. Our case is interesting in that the patient had periungual lesions of lichen planus as well as its rare annular configurations localized to hands and feet.
Foot ; Hand ; Humans ; Lichen Planus* ; Lichens* ; Male ; Penis

Differential diagnoses showing Verocay body-like formation include schwannoma, palisading myofibroblastoma, palisading cutaneous fibrous histiocytoma, dermatofibroma with myofibroblastic differentiation, leiomyoma, palisaded encapsulated neuroma, and neuroma. A 60-year-old Korean man presented with a 10-year-history of an asymptomatic nodule on the right forearm. Histopathological examination revealed well-circumscribed multi-micronodules with prominent Verocay body-like formation consisted of spindle cells and extensive infiltrate of mutinous materials. The spindle cells were negative for S-100 protein and desmin, but positive for vimentin and a-smooth muscle actin by immunohistochemical staining. The micronodules were lined by CD34 and factor VIII positive endothelial cells. The mutinous materials were stained with alcian blue at pH 2.5, but not at pH 0.5. We diagnose it as myxoid myofibromatosis-type perivascular myoma showing Verocay body-like formation.
Actins ; Alcian Blue ; Desmin ; Diagnosis, Differential ; Endothelial Cells ; Factor VIII ; Forearm ; Histiocytoma, Benign Fibrous ; Humans ; Hydrogen-Ion Concentration ; Leiomyoma ; Middle Aged ; Myofibroblasts ; Myoma* ; Neoplasms, Muscle Tissue ; Neurilemmoma ; Neuroma ; S100 Proteins ; Vimentin

BACKGROUND: The association of Kaposi's sarcoma-associated human herpesvirus, or human herpesvirus 8 (HHV8) with various skin diseases has been described in many reports. However, only 3 human diseases: Kaposi's sarcoma, primary effusion lymphoma, and multicentric Castleman disease were proved to be associated with HHV8. In addition to Karposi's sarcoma, sarcoidosis and Kikuchi's disease were also described to be associated with HHV8. OBJECTIVE: The purpose of this study was aimed at the association of HHV8 with various skin diseases, such as Kaposi's sarcoma, sarcoidosis, and Kikuchi's disease. METHODS: We performed PCR to examine whether the 233-bp segment of the viral DNA of HHV8 was detected in Korean patients with Kaposi's sarcoma, sarcoidosis, Kikuchi's disease, angiosarcoma, and angiolymphoid hyperplasia with eosinophilia. The medical records and histopathological specimens of patients diagnosed at Asan Medical Center from 1989 to 1999 were reviewed. RESULTS: HHV8 DNA sequences were identified in 9 (69%) of sarcoid tissues from 12 patients with sarcoidosis and in all (100%) of from 8 patients with Kaposi's sarcoma but not in 2 tissues from 2 patients with Kikuchi's disease, in 3 tissues from 2 patients with angiosarcoma and 2 tissues from 2 patients with angiolymphoid hyperplasia with eosinophilia. CONCLUSION: HHV8 may be strongly associated with the pathogenesis of Kaposi's sarcoma and sarcoidosis. However, the association with Kikuchi's disease, angiosarcoma, and angiolymphoid hyperplasia with eosinophilia was denied in this study. Further extensive study will be needed.
Angiolymphoid Hyperplasia with Eosinophilia ; Base Sequence ; Chungcheongnam-do ; DNA, Viral ; Giant Lymph Node Hyperplasia ; Hemangiosarcoma ; Herpesvirus 8, Human* ; Histiocytic Necrotizing Lymphadenitis ; Humans* ; Lymphoma, Primary Effusion ; Medical Records ; Polymerase Chain Reaction* ; Sarcoidosis ; Sarcoma ; Sarcoma, Kaposi ; Skin Diseases

The effect of intranasal nifedipine drops in 20 randomly chosen patients with diethyl-ether induced hypertension by inhalation anesthesia was observed. Patients were placed in two groups: the first group received intranasal nifedipine at the time of induction and the second group received intranasal nifedipine at the time to skin incision. The change in mean arterial pressure in the first group was not significant, but in the second group, the increase in mean arterial pressure was significant immediately after intranasal administration of nifedipine at the time of skin incision. An increase in pulse rate was noted with the increase in mean arterial pressure and this is thought to result from the stimulation of catecholamine secretion and baroreceptor reflex. Since the difference in mean arterial pressure between the two groups was minimal at ten minutes and twenty minutes after skin incision, it is suggested that the onset of intranasal nifedipine is quite fast. Based on the authors' experience, intranasal administration of nifedipine is very useful in preventing or treating hypertension during inhalation anesthesia using diethyl-ether.
Administration, Intranasal* ; Anesthesia, Inhalation ; Arterial Pressure ; Baroreflex ; Ether* ; Heart Rate ; Humans ; Hypertension ; Nifedipine* ; Skin

Influenza virus culture was performed in 149 patients with influenza-like illness who were admitted or visited to the Department of Pediatrics, Asan Medical Center from january, 1991 to March, 1991. The results were as follows; 1) Of the 149 patients, influenza virus were isolated in the 15 cases. 15 isolates were characterized by the WHO Collaborating Center for influenza: 7 cases were very similar to influenza A/Taiwan/1/86 (H1N1), 1 case was A/Beijing/353/89 (H3N2), 7 cases were B/Guangdon-g/55/89. 2) The age of 15 patients who were confirmed by viral isolation was between 11 months to 10 years. 3) The most common clinical symptoms were fever, vomiting, cough, nausea in deceasing order. 4) Of the total 149 patients, Reye syndrome occured in two patients and myositis occured in one: Influenza A/Taiwan/1/86 (H1N1) virus was isolated in one Reye syndrome patient.
Chungcheongnam-do ; Cough ; Fever ; Humans ; Influenza, Human* ; Myositis ; Nausea ; Orthomyxoviridae ; Pediatrics ; Reye Syndrome ; Seoul* ; Vomiting

BACKGROUND: The prevalence of patients over the age of 25 years with acne has significantly increased over the past 10 years. Several etiologic factors such as genetic factor, hyperandrogenism, stress, and cosmetics have been studied. OBJECTIVES: The purpose of this study is to evaluate the differences between adolescent acne and post-adolescent acne, based on the clinical features, asoociated diseased and aggravating factors of 327 acne patients. METHODS: 327 consective patients, first visited to our hospital with clinical facial acne between March 2000 and February 2001, were enrolled. 220 adolescent patients(AP) were under the age of 25 and post-adolescent patients(PP) were over age of 25. RESULTS: 1. In the face, cheeks and forehead in adolescents, chin and cheeks in post-adolescents were predilection sites. The predominant type was a comedonal type in adolescents and a papulopustular type in post-adolescents(P<0.05). Severity of inflammatory type was not different between two groups. Familial factors were important in both groups, but more frequently found in post-adolescents with persistent acne(P<0.05). 2. Rosacea, chloasma, and hyperandrogenic features such as hirsutism and androgenetic alopecia were more frequently observed in post-adolescents. Seborrheic and atopic dermatitis were more frequent in adolescents. Four patients had all the features of chloasma, acne, rosacea, seborrheic dermatitis and hirsutism. 3. Aggravation by weason especially summer, sweating, stress, and cosmetics was more frequent in adolescents. In PP, acne was more frequently aggravated by sunlight, foods and menstrual period. CONCLUSION: Post-adolescent acne was mainly a papulopustular type predominantly located on the chin and cheeks with mild to moderated severity, and family history and hyperandrogenism were strong etiologic factors in persistent acne. Aggravating factors were not significantly different between two group, which suggested cosmetics and stress might not be important in post adolescent acne.
Acne Vulgaris* ; Adolescent* ; Alopecia ; Cheek ; Chin ; Dermatitis, Atopic ; Dermatitis, Seborrheic ; Forehead ; Hirsutism ; Humans ; Hyperandrogenism ; Melanosis ; Prevalence ; Rosacea ; Sunlight ; Sweat ; Sweating