The elbow is the most frequent area of complaint in children and adolescent baseball players. The physical stresses associated with repetitive throwing create extra-ordinary forces, which may affect the normal osteochondral and soft tissue developmental process and are the important factors causing the decrease of competitive power and shortening of life as a baseball player in adolescents. We surveyed the 114 baseball players of middle & high school in Taegu in order to evaluate the prevalance of symptoms and radiologic findings of the elbow and correlation of these findings to career & position of the baseball game. The results were as follows. 1. Of 114 players, 83 were non-pitchers and 31 were pitchers. The mean career was 3.8 years (7 months to 6 years). 2. The 77 players (67.7%) had the pain on their elbow during or after daily exercise. Other clinical symptoms were locking (30.7%), limitation of motion (18.4%), swelling (16.6%) and clicks on motion (10.5%). 3. On the radiogram of the elbow, hypertrophy or separation of medial epicondyle were seen in 34% of players, loose bodies in 17%, hypertrophy of the humerus in 12% and cystic change of the capitellum in 11%. 4. The mean career of symptomatic players was 4.4 years but non-symptomatics was 2.7 years. The mean career of players who had abnormal radiologic findings was 5.1 years but 3.1 years in players who had no abnormal radiologic fingings. 5. Symptoms and pathologic changes were more common in the elbow of pitcher' s group due to throwing frequency & pitching style. 6. Among the 77 players who had any kinds of problem of the elbow, 49 players of them had no experience of visiting hospital. 7. To prevent these injuries of the elbow, the following recommendations were made. First, restrict the number of innings pitched per game. Second, avoid throwing the curve ball in this age group. Third, ensue an adequate warm up period before exercise or rest after games. Fourth, inform parents and coaches of possible harmful nature of excessive throwing.
Adolescent* ; Baseball* ; Child ; Daegu ; Elbow* ; Humans ; Humerus ; Hypertrophy ; Parents

Anatomically flexor pollicis longus is different from deep finger flexors. Flexor pollicis longus tendon is unique in that it may be advanced without disturbing its blood supply, since it has no vinculum. From January 1990 to December 1992, 17 cases of patients with laceration of the flexor pollicis longus tendon were treated at Kyungpook National University Hospital. The follow up period ranged from 3 to 36 months. The results were as follows; 1. agents causing the laceration were broken bottles in 10 cases(58.8%), knives in 3 cases(17.6%) and machinary like saw in 2 cases(11.8%). 2. Totally 17 cases, 9 cases of them were located at distal to metacarpophalageal joint. 3. As associated injuries, digital nerve injuries were 4 cases(23.5%) and the recurrent branch of median nerve injuries was 1 case. 4. The surgical treatment was direct suture with or without proximal lengthening in 13 cases(76%) as primary or secondary repair and distal advancement with or without proximal lengthening in 4 cases(24%) as secondary repair. 5. Distal to metacarpophalangeal joint, the surgical treatment was direct suture with or without proximal lengthening in 3 cases as primary or secondary repair and distal advancement with or without proximal lengthening in 4 cases as secondary repair. 6. The result by Urbaniak method was excellent in 8 cases(47.0%), good in 7 cases(41.2%) and fair in 2 cases(11.8%). 7. Based on the results in these patients, it was recommended that secondary treatment for lacerations distal to the metacarpophalangeal at the wrist, as needed is bettewr than free tendon graft.
Fingers ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Joints ; Lacerations ; Median Nerve ; Metacarpophalangeal Joint ; Methods ; Sutures ; Tendon Injuries ; Tendons ; Transplants ; Wrist

PURPOSE: Sleep disorder is common in childhood and adolescence with prevalence of 27-62%, and the patients could have trouble with their daily life due to fatigue and headache; and it can also cause developmental disability, learning disorder, anxiety disorder, and depressive disorder. We studied the prevalence of anxiety and depressive disorder in childhood and adolescence with sleep disorder. METHODS: We studied 34 cases of patients under twenty-year-old who took a sleep polysomnography test at Sleep Center of Keimyung University Dongsan Medical Center and who could answer sleep survey questionnaires; and we used testing methods of Questionnaire for insomnia, Epworth sleepness scale, Hospital Anxiety Depression Scale, and Back Depression Inventory. We studied sleep disorder as two categories of sleep apnea and other sleep disorders and also the relationships of sleep and anxiety and depressive disorder with chi-square test. RESULTS: 29.4% of sleep disorder patients had anxiety disorder, and 47.1% depressive disorder. Considering the two categories of sleep disorder, anxiety disorder was significantly higher(P<0.005) in sleep apnea group with 43.5% than in other sleep disorder group with 9.1%. Depressive disorder was also significantly higher(P<0.05) in sleep apnea group with 65.6% than in other sleep disorder group with 36.4%. CONCLUSION: The patients with sleep disorder also had a tendency of having mood disorder, with prevalence of 29.4% of anxiety disorder and 47.1% of depressive disorder; especially in the group of sleep apnea, mood disorders was significantly higher than other sleep disorder group, which means more aggressive diagnosis and treatment are needed for the combined condition of sleep and mood disorder.
Adolescent ; Anxiety ; Anxiety Disorders ; Depression ; Depressive Disorder ; Developmental Disabilities ; Fatigue ; Humans ; Learning Disorders ; Mood Disorders ; Polysomnography ; Prevalence ; Surveys and Questionnaires ; Sleep Apnea Syndromes ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders

Churg-Strauss syndrome (CSS) is a disorder characterized by pulmonary and systemic small- vessel vasculitis, extravascular eosinophilic infiltration and hypereosinophilia; it is rarely diagnosed in the pediatric age group. We experienced a case of CSS in a male infant who had repeated symptoms of asthma with hypereosinophilia and transitory non-fixed pulmonary infiltrates on chest radiographs. He also had rectal bleeding in early infancy and multiple erosions with extravascular eosinophilic infiltrations in the sigmoid colon. We report a rare case of CSS in a 14-month-old infant and review the medical literature.
Asthma ; Churg-Strauss Syndrome* ; Colon, Sigmoid ; Eosinophils ; Hemorrhage ; Humans ; Infant ; Male ; Radiography, Thoracic ; Vasculitis

PURPOSE: We performed this study to investigate the outcome of surfactant replacement therapy (SRT) in above nearterm neonates who were required mechanical ventilatory care due to meconium aspiration pneumonia (MAP), respiratory distress syndrome (RDS) or other severe pneumonia (PN). METHODS: 48 patients, gestational period 36 weeks, who were admitted in NICU of Dongsan Medical Center, Keimyung University between July 1999 and June 2004 were enrolled. They were divided into three groups, MAP group (15 cases), RDS group (27 cases) and PN group (6 cases). All patients were received SRT and evaluated several clinical data (gestational age, oxygen index, duration of ventilator care) and outcome (complications and mortality rate) between pre-SRT and post-SRT. The mean dose of surfactant (modified bovine surfactant, Newfacten, Yuhan Co., Seoul, Korea) was 120 mg/kg. RESULTS: Among each groups, mean pre-SRT OI was higher in MAP group (213.2) than other groups, mean duration (days) of ventilatory care and oxygen therapy were similar distributions. Compared with pre-SRT values, significant improvements (P<0.05) in mean values for FiO2 and oxygenation index were documented at 12 hours after SRT. Early complications (persistent pulmonary hypertension of newborm, pneumothorax) and survival rate were lower in MAP group. Within RDS group, earlier SRT (given before 12 hours of life) revealed significantly lower early complication rate than later SRT (given after 12 hours of life) (13.3% vs 58.3%, P<0.05) CONCLUSION: Our study suggested that SRT seems to be an effective therapy in above nearterm neonates with severe pulmonary disease, and earlier SRT tends to reduce complications in RDS group than later therapy.
Humans ; Hypertension, Pulmonary ; Infant, Newborn* ; Lung Diseases* ; Meconium Aspiration Syndrome ; Mortality ; Oxygen ; Pneumonia ; Seoul ; Survival Rate ; Ventilators, Mechanical

PURPOSE: To evaluate the results of using minimally invasive reduction techniques in patients with femoral subtrochanteric fracture. MATERIALS AND METHODS: We retrospectively analyzed 40 patients (41 cases) with subtrochanteric fracture who underwent using minimally invasive reduction techniques. The mean age was 61.4 years (15-89 years), and the mean follow-up period was 32.7 months (12-66 months). Clinical results were assessed using the Parker-Palmer mobility score and the Salvati-Wilson hip functional score. Radiographic results were evaluated using bone union time and femur neck-shaft angle. RESULTS: No significant difference was observed in the pre- and postoperative Parker-Palmer mobility score. Salvati-Wilson hip functional score showed more than good grade in 37 cases (90%) at the last follow-up. Union was achieved in all 41 cases at an average of 22.5 weeks (18-30 weeks). The mean femoral neck-shaft angle immediately postoperatively was 128.8 degrees (120-140 degrees), and the mean difference versus contralateral sides was 2.5 degrees varus (-6-13 degrees). CONCLUSION: Fixation of femoral subtrochanteric fracture using minimally invasive reduction techniques showed excellent clinical and radiographic results and low complication rate.
Femur ; Follow-Up Studies ; Hip ; Humans ; Retrospective Studies

BACKGROUND: To assess the efficacy and safety of perindopril, a new angiotensin-converting enzyme(ACE) inhibitor, perindopril was compaired to nifedipine LP. METHODS: Perindopril(4mg q.d.) was compaired to nifedipine LP(20mg b.i.d.) in the double blind, parallel-group study involving total of 41 hypertensive patients with diatolic blood pressure(DBP) of 95-125mmHg. A 4-week single-blind placebo period preceeded 12 weeks of active tratment. Dose titration was at weeks 4 and 8 if the DBP was >90mmHg. The dose was doubled and, if necessary, a diuretic(hydrochlorthiazide 25mg) was added. The analysis of efficacy was performed on the 36 patients who completed the trial after 12 weeks; active treatment. The analysis of tolerance involved all 41 patients who entered the study. RESULTS: 1) The two groups were homogeneous prior to treatment. 2) The fall in blood pressure(BP) with perindopril was 22/11mmHg(from 160+/-14/101+/-6mmHg to 139+/-15/90+/-6mmHg) and 32/19mmHg(from 164+/-18/104+/-7 to 132+/-17/85+/-10mmHg) for nifedipine. 3) 65% of the perindopril group and 84% of the nifedipine group achived the target BP(diastolic BP< or =90mmHg). 4) The respone rate(DBP< or =90mmHg or the fall in DBP> or =10mmHg) was similar between two groups(88% cersus 89%). 5) Heart rate was not changed in the perindopril group. but increased in the nifedipine group. 6) Five patients withdrew from the study ; two were attributed to adverse events. one in the perindopril group and one in the nifedipine group. 7) The incidence of side effects in the perindopil group was less than that in the nifedipine group. Cough was reported by 10% of patients of the perindopril group. 8) Both groups did not induce changes in blood glucose and lipid profiles. 9) We could not find any significant relationship between the amount of blood pressure decline and 24 hour urine sodium excretion. 10) There were no clinically significant changes in laboratory parameters. CONCLUSION: Perindopril reduced blood pressure to slightly less extent than nifedipine, but had as similar efficacy as nifedipine. Perindopril had less side effects than nifedipine.
Blood Glucose ; Blood Pressure ; Cough ; Heart Rate ; Humans ; Incidence ; Nifedipine* ; Perindopril* ; Sodium

Antireflux surgery has been indicated in gastroesophageal reflux disease (GERD) that does not respond to medical treatments. Although the most commonly performed operation is Nissen fundoplication, Belsey Mark IV fundoplication is indicated for more complicated cases, such as, in cases of a failed Nissen operation or a long lasting hiatal hernia. Here, we report a case of Belsey Mark IV fundoplication for a failed Nissen fundoplication. The infant developed frequent times of aspiration pneumonia after initial Nissen for a hiatal hernia with GERD during the newborn period. At 15 months of age, a 2nd Nissen operation was attempted, but fundoplication was not available because of excessive mesenteric adherence to the liver and cardia. Therefore, Belsey Mark IV fundoplication was performed via trans-thoracic approach, which can provide full esophageal mobilization and better visualization of the herniated fundus and the surrounding tissues. Subsequently, she has shown an improved general condition without GERD.
Cardia ; Fundoplication* ; Gastroesophageal Reflux ; Hernia, Hiatal ; Humans ; Infant ; Infant, Newborn ; Liver ; Pneumonia, Aspiration

Rice allergen has low antigenicity, and thus, anaphylactoid reactions to rice are exceedingly rare. We experienced a case of isolated rice allergy in a 5 month-old girl who had been fed a milk formula without incident. However, after feeding a powdered weaning milk formula containing rice, she developed symptoms of projectile vomiting and diarrhea, at this time rice specific antigen tests were all negative. One month later a challenge test was performed using a rice gruel, and her symptoms recurred. Endoscopic and microscopic findings showed hyperemic mucosa in the duodenum and subtotal villous atrophy. Thereafter, she showed no adverse reaction to almost all foods appropriate for her age, but after feeding rice gruel at 10 months, she developed symptoms of cyanosis and vomiting. However, none of the allergic symptoms were demonstrated at 13 months upon repeated challenge test. Currently, she is 28 months old and tolerates all foods including rice.
Atrophy ; Child, Preschool ; Cyanosis ; Diarrhea ; Duodenum ; Female ; Humans ; Hypersensitivity* ; Infant ; Milk ; Mucous Membrane ; Respiratory Sounds ; Vomiting ; Weaning

PURPOSE: We proposed a new classification of pediatric intussusception based on clinical and radiologic findings. METHODS: Data from 88 consecutive patients with intussusception were reviewed. We retrospectively analyzed six factors; patient age, sites of intussusception, symptoms, therapeutic methods, existence of enlarged mesenteric lymph nodes, and ultrasonographic (US) findings from clinical records. RESULTS: 1) There was one neonatal case (1.1%), the others (98.9%) were infants and children. 2) These 87 infant and child cases consisted of 14 cases (16.1%) of small bowel intussusception (SBI) and 73 cases (83.9%) of ileo-colic intussusception (ICI). Of the 14 SBI cases, 12 cases were symptomatic and 2 cases were asymptomatic. The symptomatic group comprised 8 transient cases (66.7%), 3 operative cases (25.0%), and 1 enema-reduction case (8.3%). Two asymptomatic cases were incidentally captured by computed tomography. Of the 73 ICI cases, 19 cases (26.0%) required operation, and 54 (74.0%) enema-reduction. 3) When transient SBI cases were compared with operated SBI cases, enema-reduced and operated ICI cases, the age (38.0+/-22.9 months) of transient SBI cases were significantly higher than those of the others (p=0.003). Mean mass size (20.8+/-2.7 mm) in transient SBI was significantly smaller than in the others (p=0.0001). 4) No correlation was found between the existence of enlarged mesenteric lymph nodes and therapeutic method or concomitant illness. 5) Most of the target types observed by US were in transient SBI cases, the remainder were in the enema-reduced ICI cases. In terms of the doughnuts type, all 8 cases (34.8%) with an external hypoechoic rim thickness of >8.9 mm were treated surgically. CONCLUSION: Pediatric intussusception may be classified based on clinical and radiologic findings, which are likely to indicate appropriate therapies.
Child ; Classification* ; Humans ; Infant ; Intussusception* ; Lymph Nodes ; Retrospective Studies