In general, satisfactory results can be obtained by nonoperative means in the management of proximal femoral shaft fracture in children. Howerver, it is sometimes difficult to maintain the fracture alignment by the nonoperative means because of different muscle pulls in the thigh. The proximal fragment tend to be displaced and roentgenograms are difficult to be taken during traction. These problems have led some authors to advocate open reduction and internal fixation which facilitate overall care. We report our experiences on nonoperative and.operative treatment for proximal femoral fracture at the Chon-ju Presbyterian Medical Center from February 1987 to January 1991. The results are as follows ; 1. There were 20 cases in male, 7 cases in female. Average age at injury was 6.9 years (range, 6 months to 12 years and 8 months). Traffic accident was the most common cause (70.3%). 2. Average immobillization time was 9.2 weeks (range, 6.0 weeks to 12.1 weeks) in the nonoperative treatment group(17 cases), while 8.1 weeks(range, 6.1 weeks to 11.4 weeks) in the operative treatment group (10 cases). 3. Average bony union time was 9.6 weeks (range, 6.3 weeks to 12.5 weeks) in the nonoperative treatment group(17. cases) and 11.2 weeks (range, 9.0 weeks to 13.4 weeks) in the operative treatment group (P < 0.05). 4. Average overgrowth of femur was 3.3mm(range,
Accidents, Traffic ; Child ; Clinical Study ; Female ; Femoral Fractures ; Femur ; Humans ; Jeollabuk-do ; Male ; Protestantism ; Thigh ; Traction

To know the prevalence of the diabetes mellitus and associated diseases, we analyzed the date of the 3,088 subjects who were examined with the Computed Automated Medi-Screening Test System which consisted of 65 parameters including blood glucose determination fasting and one hour after 100 g of oral glucose load. We grouped the subjects by the modified criteria of National Diabetic Data Group. Followings are the results of the various analysis: 1. The prevalence of diabetes mellitus and impaired glucose tolerance in 2.27% and 18.26% respectively. 2. The prevalence of diabetes mellitus is 2.63% in male and 1.66% in female. There is no statistically significant difference between male and female. 3. There in tendency of increasing prevalence of diabetes mellitus as the age increases. From second to eighth decade, the prevalence of diabetes mellitus increases as 0.0, 0.45, 0.67, 2.28, 3.47, 5.36, 10.00% respectively. 4. There is no statistically significant difference of prevalence of obesity between normal and diabetes: that is, 18.03%, 22.86% respectively (P≥0.1). 5. There is no statistically significant difference of prevalence of impaired glucose tolerance and diabetes between non-obese and obses group (P≥0.1). 6. There is statistically significant increases of frequency of proteinuria, azotemia, hypertension as the glucose tolerance decreases (P≤0.05).
Azotemia ; Blood Glucose ; Diabetes Mellitus* ; Fasting ; Female ; Glucose ; Humans ; Hypertension ; Male ; Obesity ; Prevalence* ; Proteinuria

The recurrent rate after pterygium surgery is about 30 to 50%and mitomycin-C has been used as soaking method during surgery or as instillation after surgery for reduction of the recurrence. To determine the effective concentration of mitomycin-C in soaking method during pterygium surgery, we reviewed 87 patients(95 eyes)who were divided into three groups with different concentrations of MMC. The application time was 5 minute and concentration of MMC was 0.1 mg/ml(n=31), 0.2 mg/ml(n=35), and 0.4 mg/ml(n=29), respectively. During the mean follow-up period of 8 months, recurrent rate was 16.1%(5eyes)in 0.1mg/ml group, 14.3%(5 eyes)in 0.2 mg/ml, and 13.8%(4 eyes)in 0.4 mg/ml group. This difference was not statistically significant(p>0.05). Complication rate was 6.5%(2 eyes)in 0.1 mg/ml group, 8.6%(3 eyes)in 0.2 mg/ml group, and 10.3%(3 eyes)in 0.4 mg/ml group;these results were also not statistically significant(p>0.05). In conclusion, it is desirable to use lower concentration of MMC in soaking method for prevention of the recurrence of primary pterygium surgery.
Follow-Up Studies ; Mitomycin* ; Pterygium* ; Recurrence

Diffuse aspiration bronchiolitis is defined as a clinical entity characterized by a chronic inflammation of bronchioles caused by recurrent aspiration of foreign particles. Clinical symptoms are bronchorrhea, bronchospasm, and dyspnea, and chest radiographs show the presence of regional or disseminated srnall nodular shadows and hyperlucency. Chest CT should help in detecting diffuse nodular shadows of bronchiolitis. Pathologic findings of diffuse aspiration bronchiolitis are characterized by localization of chronic mural inflammation with foreign body reaction in bronchioles. Recurrence of small amounts of aspiration might play an important role in the pathogenesis of diffuse aspiration bronchiolitis. We report a case of diffuse aspiration bronchiolitis in a 4-month- old female infant who had recurrent aspiration due to dysphagia and presented with recurrent fever, dyspnea and wheezing. She showed typical radiologic and histologic findings compatible to diffuse aspiration bronchiolitis. She was improved with treatment of nasogastric tube feeding. We emphasize the importance of recognizing this disease entity and differentiating it from pulmonary diseases associated with bronchospasm. (J Korean Pediatr Soc 2000;43:842-845)
Bronchial Spasm ; Bronchioles ; Bronchiolitis* ; Deglutition Disorders ; Dyspnea ; Enteral Nutrition ; Female ; Fever ; Foreign-Body Reaction ; Humans ; Infant* ; Inflammation ; Lung Diseases ; Radiography, Thoracic ; Recurrence ; Respiratory Sounds ; Tomography, X-Ray Computed

The measurement of gastric emptying time is useful in differentiation of the hypochondriacal neurosis from the functional gastrointestinal disturbance, and also useful in searching the hidden gastro-intestinal disease in patients who are believed as the functional gastrointestinal disturbance. We confirmed in this study that the more delayed gastric emptying time was measured in functional gastrointestinal disturbance compared to normal group, and more shortened gastric emptying time was found after treatment with dopamine antagonist (cleboril) in this group.
Dopamine ; Gastric Emptying* ; Gastrointestinal Diseases* ; Humans ; Hypochondriasis

No abstract available.
Head* ; Neck*

No abstract available.
Arthroplasty* ; Hip Joint* ; Hip*

Birth injury is defined as any condition that affects the fetus adversely during the labor or delivery. Clavicle fracture during the delivery can be found in 0.49-0.95% if all living newborns. The objectives of this study were to identify and prevent the contribution facture during delivery. We obtained 98 patients of the clavicle fracture among the 13,698 neonates delivered at P.M.C from March. 1991 to Feb. 1994. We analysed the 98 patients of the clavicle fracture with 857 control group according to neonatal factors, maternal factors and methods of delivery. The results were as follows ; 1. Of all the cases of the clavicle fracture, the site of the fracture was middle 1/3 of the clavicle and majority of the fracture were displaced(82.5%). 2. Birth injuries which were associated with clavicle fracture were increased than those without clavicle fracture in brachial plexus injuries, scalp and intracranial hemorrhage, and skull fracture. 3. Contributing factors which were increased the fracture of the clavicle during the delivery were as follows; i) Maternal age over 37 years and below 24 years. ii) Gestational age over 40 weeks (especially over 42 weeks) iii) Birth weight over 3500kg. 4. The proportion of the vacuum extraction during the delivery was nearly double times in patient group than in control group.
Birth Injuries ; Birth Weight ; Brachial Plexus ; Clavicle ; Fetus ; Gestational Age ; Humans ; Infant, Newborn ; Intracranial Hemorrhages ; Maternal Age ; Scalp ; Skull Fractures ; Vacuum

BACKGROUND: Beta-adrenergic receptor Kinase 1(betaARK1) is a serine/threonine kinase attached, which inhibits the coupling of beta-adrenergic receptor with G-protein. Myocardial betaARK1 level is usually elevated in heart failure and hypertrophy, but it is not known whether the circulating betaARK1 level is related with the degree of cardiac hypertrophy. This study was performed to evaluate the association of the betaARK1 level in circulating mononuclear leukocytes(MNL) in untreated hypertension with left ventricular mass in hypertensive patients. Method: Nineteen non-treated hypertensive patients were included for this study. High blood pressure was confirmed when systolic BP is over 150 mmHg or diastoli BP is over 95 mmHg. Echocardiography was performed to evaluate the degree of hypertrophy by measuring the left ventricular mass index(LVMI) and relative wall thickness(RWT), and test the LV function by measuring the ejection fraction(EF) according to ASE guideline. At the same time, blood was collected from each patient and MNL were isolated by gradient centrifuge with Ficoll-400. Total RNA was purified from MNL and semi-quantitative RT-PCR was performed. After reverse transcription, PCR was done with primers for human betaARK1 and GAPDH as external control. betaARK1 levels were expressed by ratio to GAPDH level and estimated the relations with clinical and Echocardiographic parameters. Result: We studied confirmed 19 hypertensive patients(10 men and 9 women, mean age of 50.6 years). Echocardiographically measured indices(mean+/-SD) were as follows; LVMI(137.3+/-30.6g/m2), PWT(0.53+/-0.09) and EF(54.6+/-8.5%). Ratio of betaARK1 levels to GAPDH was from 0.10 to 0.96 (0.62+/-0.25). betaARK1 levels were correlated with LVMI(correlation coefficient: r=.502, p=.029) and RWT(r=.627, p=.004). But Systolic BP(r=0.009, p=.93), diastolic BP(r=.07, p=.85) or EF(r=.045, p=.84) were not related to level of betaARK1. CONCLUSIONS: The betaARK1 level of circulating MNL was correlated well with the degree of the cardiac hypertrophy estimated by LVMI and RWT. This data suggests that activation of sympatho-adrenal system would exert a major role in developing cardiac hypertrophy and we can expect the decreased responsiveness to catecholamine in the heart of hypertensive patients. betaARK1 in circulating MNL might be used as a predictor or marker for LV hypertrophy in hypertensive patients.
beta-Adrenergic Receptor Kinases ; Cardiomegaly ; Echocardiography ; Female ; GTP-Binding Proteins ; Heart ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Leukocytes, Mononuclear* ; Male ; Phosphotransferases ; Polymerase Chain Reaction ; Reverse Transcription ; RNA

BACKGROUND: Nonrheumatic atrial fibrillation is common in elderly and associated with an increased risk for thromboembolism. Left atrial spontaneous echo contrast(SEC) and thrombus. which are easily detected by transesophageal echocardiography(TEE) in patients with rheumatic mitral valve disease and atrial fibrillation, have been known as markers of thromboembolism. However, most of the previous studies on left atrial SEC and thrombus were performed in rheumatic mitral valve disease or various conditions including rheumatic mitral valve disease. Therefore this study was underaken in order to investigatd 1) the prevalence of left atrial SEC and thrombus, and 2) clinical and echocardiographic variables related to left atrial SEC and thrombus in nonrheumatic atrial fibrillation. METHODS: In patients with estabished atrial fibrillation over 7 days, we examined the clinical gistory and performed transthoracic echocardiography(TTE) and TEE simultaneously. Enlisted patients were those without rheumatic mitral valve disease, prosthetic valves, previous thromboembolism, and recent anticoagulant therapy. RESULTS: 1) Left atrial SEC was detected in 32(62.7%) of 51 patients and left atrial thrombus in 10(19.6%). All thrombi were located in the left atrial appendage. 2) In univariate analysis, SEC positive group showed higher prevalence of congestive heart failure(CHF)(56.3% vs 0%, p<0.001), lower ejection fraction(42.2+/-14.1% vs 50.8+/-9.7%, p<0.05), lower left atrial appendage blood flow velocity(peak positive flow velocity ; 18.7+/-11.1cm/sec vs 32+/-12.4cm/sec, p<0.01, and peak negative flow velocity ; 21.4+/-12.4cm/sec vs 31.9+/-12.8cm/sec, p<0.01) than SEC negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial SEC(p=0.02, Odds ratio ; 2.38, 95% CI ; 1.18-4.82). 3) In univariate analysis. left atrial thrombus positive group showed higher prevalence of CHF(70% vs 26.8%, p<0.05), larger left atrial demension(34+/-3.4mm/m2 vs 30.6+/-4.6mm/m2, p<0.05) than thrombus negative group. Multivariate analysis identifed CHF as an independent variable related to left atrial thrombus(p=0.04, Odds ratio ; 4.30, 95% CI ; 1.11-16.68). 4) Left atrial thrombus is more frequent in SEC positive group than in SEC negative group(28.1% vs 5.3%), however, there was no statistical significance(p=0.07). CONCLUSION: 1) Left atrial SEC is common in nonrheumatic atrial fibrillation and significantly related to CHF. 2) Left atrial thrombus is frequently detected in SEC positive patients, however, it is more realted to CHF than left atrial SEC itself.
Aged ; Atrial Appendage ; Atrial Fibrillation* ; Echocardiography ; Estrogens, Conjugated (USP) ; Heart ; Humans ; Mitral Valve ; Multivariate Analysis ; Odds Ratio ; Prevalence ; Thromboembolism ; Thrombosis*