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

Although the ultrasonography is a useful imaging modality for evaluation of abdominal mass in an infant and child, CT has more advantages over te ultrasonography in assesssing anatomic detail, precise extent of tumor and differential diagnostic accuracy. The authors analyzed CT featurs of 85 cases of pathologically or clinicallyproven pediatric abdominal masses for recent 4.5 years at Keimyung University Dongsan Hospital. The reseults wereas follows: 1. The most common site was kidney (36 cases:42.4%), followed by nonrenal retroperitoneal masses(23cases:27.1%), hepatobiliary masses(15 cases:17.6%), gastrointestinal masses(9 cases: 10.6%), and genital massses(2cases: 2.3%) in order of frequency. 2. Hydronephrosis(17 cases:20%) and Wilms' tumor(17 cases:20%) were mostcommon and splenomegaly(8 cases:9.4%), neuroblastoma(5 cases: 5.9%), teratoma(4 cases:4.7%), rhabdomyosarcoma(4cases: 4.7%) were descending order of frequency. 3. The male to female ratio was 2;1, but female was predominantin teratoma, choledochal cyst and genital masses. Twenty three cases(27.1%) were under the age of one year. 4. Thediagnosis of hydronephrosis, assessment of its severity and localization of exact level of obstruction were easywith CT examination. 5. Characteristic CT features of Wilms' tumor were round or oval shaped, smooth marginated,large intrarenal mass with displaced or obstructed calyces, pseudocapsule and crescent sign; there were noevidence of retroperitoneal lymph node or contiguous extension, retrocrural lymph node enlargement, prevertebralmidline extension, or encasement of the aorta. 6. Typical CT findings of the neuroblastoma wre irregular shaped &marginated extrarenal mass with calcification frequently, accompained by retroperitoneal lymph node or contiguousextension, retrocrural lymph node enlargement, prevertebral midline extenstion and encasement of the aorta; therewere no evidence of pseudocapsule or crescent sign. 7. CT features of teratoma were characteristic, having atleast three or more of different tissue densities among fat, water, soft tissue and calcific densities. 8.Pathology and its extension of retroperitoneal space was demonstrated accurately by CT. 9. Mesenteric, omental andenteric cysts had similar CT appearance particularly very large cystic masses.
Aorta ; Child ; Choledochal Cyst ; Female ; Humans ; Hydronephrosis ; Infant ; Kidney ; Lymph Nodes ; Male ; Neuroblastoma ; Retroperitoneal Space ; Teratoma ; Ultrasonography ; Water ; Wilms Tumor

It is difficult to distinguish benign from malignant, pulmonary nodule by conventional roentgenologic examination. But CT makes it easier to evaluate adjacent parencymal invasion, pleural or mediastinal extenstion,or early metastasis to intra- or extrathoracic lymph node as well as distant organs, although only a solitaryperipheral pulmonary nodule is seen on plain radiograph. Authors reviewed CT of 22 cases of histopathologically confirmed primary lung cancer seen as a solitary peripheral pulmonary mass from May 1980 to Sep. 1984 at DongsanMedical Center, Keimyung University. The results are as follows: 1.The incidence was most common in the 6thdecade(36%). Male to female ratio was 10:1 and 2 females all had bronchioloalveolar cell carcinoma. 2. Thedistributions of histologic cell type were as follows: squamous cell carcinoma 40%, adenocarcinoma, small cellcarcinoma, bronchioloalveolar cell carcinoma and unclassified carcinoma 14% in each cases, and adenoid cysticcarcinoma 4% . 3. The CT findings were as follows: a) Superior and posterior basal segments of both lower lobeswere most frequently involved(68%). b) The mean diameter of the mass was 48mm, and most common in the range of30-49 mm in the greatest dimension(46%). c) The mean CT atttenuation value was 57 H.U., and most common in thegroup of 41-70 H.U. (64%). d) Lymph node metastasis was found in 13 (59%) of 22 cases, and the involved nodes wereas follows: hilar nodes 10 cases, paratracheal nodes 8 cases, subcarinal nodes 7 cases and extrathoracic nodes 3cases. In 2 of 3 cases with small cell carcinoma, diffuse multiple lymph nodes were involved. e) Distantmetastasis was seen relatively early in 3 cases; cerebral metastasis in 1 case of squamous cell carcinoma, rightaderenal metastasis without intrathoracic lymph node metastasis or invasion of adjacent structures in 1 case ofbronchioloalveolar cell carcinoma, and liver and bone metastases in 1 case of unclassified carcinoma. f) Adjacentpleural or mediastinal invasion was found in 7 cases(32%): pleural invasion along chest wall in 4 cases, andinvasion of adjacent mediastinal pleura in 3 cases of 2 squamous cell carcinoma and 1 unclassifed carcinoma. g)Calcifications witihin the mass were found in 5 cases (23%), and most common in squamous cell carcinoma(3 cases).In all cases, a few granular calcification were seen along the peripheral margin of the mass. h) Tumor necrosiswas seen in 4 cases(18%), and 3 cases were squamous cell carcinoma, and one of them showed irregular centralcavitation. i) The margins of tumor were irregularly lobulated with radiating spiculations in all except one ofadenoid cystic carcinoma, which revealed oval shaped, smooth clear margin. j) In 9(41%) of 22 cases, someenlargement of pulmonary vessels with perivascular linear infiltrations were found in the adjacent lungparenchymes of the mass, which were thought to be retrograde perivascular lymphangitic spread along pulmonaryvessels.
Adenocarcinoma ; Adenoids ; Carcinoma, Bronchogenic ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Epithelial Cells ; Female ; Humans ; Incidence ; Liver ; Lung Neoplasms ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Pleura ; Thoracic Wall

Although the ultlrasonography has been regarded as a main procedure in the diagnosis of bile duct andgallbladder diseases, a few reports concerning the ultrasonographic findings of biliary ascariasis appeared in theliterature. Seven cases of real-time ultrasonographic diagnosis of biliary ascariasis were made in our hospitalduring last 15 months. In six, the diagnosis was confirmed by surgery or radiographic examination. The resultswere as follows; 1. The characteristic long, thick, highly reflective echo without distal acoustic shadowing inthe extra and/or in tra-hepatic ducts were seen in all six proven cases. 2. The echogenic, nonshadowing images ofthe worms were seen as single stripe in five cases(containing a central longitudinal, anechoic tube, suggestingits digestive tract in three cases ) or multiple stripes in one case. But so-called coiled appearance or amorphousfragments were not seen in our cases. 3. Associated findings were as follows; mild to moderate dilatation of theextrahepatic duct in all six duct in 1 case, intrahepatic stone in 1 case, contracted gallbladder containingsingle stone in 1 case and evidence of cholecystitis in 4 cases. 4. One false positive diagnosis of ascariasis inthe gallbladder is considered due to reverberation artefact. No false negative was seen.
Acoustics ; Artifacts ; Ascariasis ; Bile Ducts ; Cholecystitis ; Diagnosis ; Dilatation ; Gallbladder ; Gastrointestinal Tract ; Shadowing (Histology)

No abstract available.

Accidents have become one of the most important problem in the pediatric and child health field because of the recently observed high incidence of and mortality from accidents. Due to an improvement of the living standard in general and especially due to the wide application of vaccination and antibiotics, there has been a decline of incidence of infectious diseases in childhood. However, in contrast accidents have occurred increasingly involving childhood recently. Many accidents have been recognized as being preventible. Therefore, parental health education should be emphasized as one of the more important preventive measures against accidents. This clinical study was carried out for analysis on 1,297 cases which were diagnosed as accidents at the emergency room in Wonju Christian Hospital during the 5 years, from Jan. 1, 1975 to Dec. 31, 1979. The results were as follows: 1. The most common type of accidents was traffic accidents which accounted for 393 cases(30.4%) of the total accidents, followed by falls(233 cases, 18.0%), burns(209 cases, 16.1%), trauma(199 cases, 15.3%), poisoning(126 cases, 9.7%), foreign body aspiration(42 cases, 3.4%), dog bites(30 cases, 2.3%), drowning and near drowning(24 cases, 1.6%). 2. An absolute number of accident patients increased in each year compared with the previous year. However, the child accident case found in the emergency room showed only 30% annually. 3. Traffic accidents and falls showed the highest incidence in children between 4 and 7 years. On the other hand, however, burn and foreign body aspiration showed the highest incidence between 2and 5 years. 4. Accidents were found more in males than females. Falls, drowning, near drowning, and snake bites were prodominantly in males. 5. Accidents were shown higher in summer and autumn and relatively lower in winter. 6. Sedans among all the various vehicles were the most common cause of traffic accidents (25.4%), followed by trucks(20.4%) and autobicycles(15.8%). 7. Falls occurred mostly at the play ground(13.3%), stairs(10.3%), roofs(8.6%) and trees(3.9%). 8. Scalding burns(64.8%) were the most common cause, followed by flame burns(13.3%) and coal briquet(3.9%). 9. In trauma, violence(24.1%) was the most common cause. Accidental injuries caused by farmer's tools(12.0%), hitting with stone(11.2%) and injury with pieces of glass(9.5%) followed in that order. 10. In poisoning, carbon monoxide intoxication and insecticides were the most common 26.2% in each, followed by D.D.S.(16.7%) and pestides(9.5%). 11. The most common material aspirated was coins(78.6%), followed by pins(95%) and buttons(4.7%). 12. 1,024 cases(78.9%) among 1,297 cases showed improvement. 65 cases(5.0%) expired and 64 cases(4.9%) had some complications.
Accidents, Traffic ; Animals ; Anti-Bacterial Agents ; Burns ; Carbon Monoxide Poisoning ; Child ; Child Health ; Coal ; Communicable Diseases ; Dogs ; Drowning ; Emergencies* ; Emergency Service, Hospital* ; Female ; Foreign Bodies ; Gangwon-do* ; Hand ; Health Education ; Humans ; Incidence ; Infant* ; Insecticides ; Male ; Mortality ; Near Drowning ; Parents ; Poisoning ; Snake Bites ; Socioeconomic Factors ; Vaccination

A 6-day-old female infant had generalized superficial pustules which evolved into pigmented maucles, many of which had a peripheral collarvtte of scale. Histopsthologic stadies showed intracormeal aggregates of neutrophils. The appearance of the lesions and histopathologic finding fitted transient neonal pustular melanosis.
Female ; Humans ; Infant ; Melanosis* ; Neutrophils

Os subfibulare is a accessory bone arround the lateral maleolus, but it is different from many other accessory bones in foot and ankle in its development related to trauma and frequent symptoms of ankle instability. Accessory bone is a developmental anomaly which fails to unite to main secondary ossification center and usually asymptomatic. But os subfibulare is developed by recurrent ankle sprains in younger age or non-union of avulsion fracture of anterior talofibular ligament and causes instability of ankle. We experienced two cases of symptomatic os subfibulare in adolecents and report them with review of literatures.
Ankle ; Ankle Injuries ; Foot ; Ligaments

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

Necrotizing colitis associated with carcinoma of the colon, Known also as obstructive colitis, is a disordercharacterized by anulceration and inflammation of the colon proximal to an obstructive lesion, especiallycarcinoma of the rectosigmoid colon, and in rare instances, leads to actual gangrene of the colon. The authorsanalysed radiologic findings in four cases of necrotizing colitis associated with carcinoma of the colon. Bariumenema disclosed mucosal edema, nodular filling defects, irregularity of the colonic controur and typicalthumbprinting appearance of involved colon proximal to an obstructing carcinoma of the colon. The mechanism ofnecrotizing colitis was briefly reviewed.
Colitis ; Colon ; Edema ; Gangrene ; Inflammation