Forty-nine children between the ages of 2 and 10 years, treated conservatively for fomoral shaft fracture, were studied clinically and radiographically to access the complications and related factors. They had an average follow-up of 48.8months(range, 12 to 77months). 35 percent of the patients had significant associated injuries. Leg length discrepancies of 10mm to 20mm are observed in 5 cases(10%) of the patients. The average overlap of bone ends at union was 6.5mm. The average growth acceleration was 8.8mm regardless of sex, age, upper limb dominance, fracture site or shape, but was promoted by overriding of the fracture ends at union, There were 16 cases(32%) of excessive angular deformity of 10° to 25° after union. However all deformities were remodelled enough to give normal alignment of the joint surface. The growth plate played on important role in the remodelling process.
Acceleration ; Child ; Congenital Abnormalities ; Follow-Up Studies ; Growth Plate ; Humans ; Joints ; Leg ; Upper Extremity

Transitional vertebrae include lumbarization and sacralization of lumbosacral region. The prevalence of transitional vertebra was reported as 3 to 21%. It is known that transitional vertebra is related to herniated nucleus pulposus and spinal stenosis but there is no report in English literature about the relationship of transitional vertebra to spondylolysis or spondylolytic spondylolisthesis. The purpose of this study is to evaluate the relationship of transitional vertebra to spondylolysis or spondylolytic spondylolisthesis and to find out the clinical relevance for the treatment. The cases included 182 cases of spondylolysis or spondylolytic spondylolisthesis who were treated at Severance hospital from 1987 to 1993. There were 33 cases of transitional vetebra; 12 lumbarization and 21 sacralization. And there were remaining 149 cases of control group. The degree of anterior sippage was measured by Meyerding's grading and percentage of Taillard method. As the results, the degree of average anterior slippage of L4 was 14.5% in the cases of isthmic defect in L4 and sacralization. The average slippage of L4 was 11.4% in the control group. The degree of average anterior slippage of L5 was 12.5% in the cases of isthmic defect in L5 and lumbarization, and 9.5% in the cases of isthmic defect in L5 and sacralization. The average slippage of L5 was 16.2% in the control group. In summary and conclusion, the cases with isthmic defect in L4 and sacralization showed more anterior slippage than the cases with isthmic defect in L4 without transitional vertebrae, and the cases with isthmic defect in L5 and sacralization showed less anterior slippage than the cases with isthmic defect in L5 without transitional vertebrae. It is concluded that more aggressive treatment is recommended in the cases of isthmic defect in L4 and sacralization, whereas more conservative treatment is recommended in the cases of isthmic defect in L5 and sacralization.
Lumbosacral Region ; Methods ; Prevalence ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Spondylolysis

Following on from diagnosis using ultrasound, hydrostatic reduction using saline enema under ultrasoundguidance was tried in 20 cases of childhood intussusception. The conclusions were as follows: 1. Success rates ofsaline enema under ultrasound guidance during a frist-8 month period(P1) and a second 10 month period(P2) were55.6%(5/9) and 54.5%(6/11) respectively. Average succes rate was 55%(11/20). 2. During the periods of P1 and P2,no case was reduced by barium enema in 6 cases of failed reduction with saline enema. 3. During the period of P2, 5 cases of successful redution with saline enema were confirmed by clinical follow-up without barium enema. 4.During the periods of P1 and P2, 9 cases of failed reduction with saline enema were operated, resulting in 6 casesof segmental resection and 3 cases of manual reduction. 5. The obvious advantages of this method are: 1. Noradiation hazard. 2. No fear of barium peritonitis. 3. Detection of leading point. 6. With above results, thismethod could completely replace barium enema. And ultrasonography should be the initial study in the evaluation ofintussusception in children and then if necessary, saline enema under ultrasound guidance should be done.
Barium ; Child ; Diagnosis ; Enema ; Follow-Up Studies ; Humans ; Intussusception ; Methods ; Peritonitis ; Ultrasonography

Osteogenesis imperfecta is a rare affection characterized by fragility of the bones, blue sclerae, and deafness, less freqently by hypermobility of the joints. The etiology is unknown, but it appears to be a mesenchymal defect. A case of osteogenesis imperfecta(tarda form). in a 8 ycar old girl, is presented with a review of the literatures. The chief complaints were bowing deformities of the right upper arm and both lower extremities, stunted growth, blue sclerae, dental defects, weakness of the muscles and pigeon breast. X-Ray showed multiple malunited fractures of the right humerus, both femurs, and bilaterally of tibiae and fibulae.
Arm ; Breast ; Columbidae ; Congenital Abnormalities ; Deafness ; Female ; Femur ; Fibula ; Fractures, Malunited ; Growth Disorders ; Humans ; Humerus ; Joints ; Lower Extremity ; Muscles ; Osteogenesis Imperfecta ; Osteogenesis ; Sclera ; Tibia

In 1953, Lichtenstein suggested to use “Histiocytosis X” as an unifying diagnostic term to represent Eosinophilic granuloma, Hand-Schiiller-Christian disease, and Letterer-Siwe disease. The author experienced a case of Hand-Schuller-Christian disease in six year old girl. She has been treated under the diagnosis of Calves disease. But later, it was confirmed as Hand-Schiiller-Christian disease by clinically and pathologically, involving multiple region of entire skeletal system, but sparing the musculocutaneous and nervous system. Clinically, anemia, malaise, high fever and hepatomegaly were present. Co60 isotope irradiation combined with antibiotics was done for 87 days twice weekly in a dose of 50 R at a time. At the time of discharge clinical symptoms were subsided. In X-Ray check, one year after treatment, bony defects were consolidated with new bone and the result was successful.
Anemia ; Anti-Bacterial Agents ; Diagnosis ; Eosinophilic Granuloma ; Female ; Fever ; Hepatomegaly ; Histiocytosis, Langerhans-Cell ; Humans ; Nervous System

No abstract available.
Uterine Prolapse*

Gastric volvulus is a rare surgical disorder in the pediatric population. We experienced a case of gastric volvulus. A 2-year-old boy was admitted to hospital with abdominal distension. An upper gastrointestinal series showed reversal of the greater and lesser curvatures. Surgical exploration revealed an organoaxial volvulus of the stomach, and anterior gastropexy was performed.
Child, Preschool ; Gastropexy ; Humans ; Intestinal Volvulus ; Male ; Stomach ; Stomach Volvulus*

Herpes zoster is a viral infection of the dorsal nerve root causing painful vesicular eruptions over the skin or mucous membrane of the affected nerve. It is less well known to the dermatologists that berpes zoster causcs bladder dysfunction when the zoster affects the lumbar and sacral spinal ganglia. The authors observed a case of herpes zoster involving the S 2~4 dermatomes, associated with bladder atony in a 58 year old male who had received rad.iotherapy and chemotherapy for his malignant Iymphoma of lymphocytic type. Conservative treatment with urinary catheterization and antibiotics resulted in complete recovery of the bladder function about 3 weeks later. He had also ichthyosiform skin lesions on his back and lower extremities which, by carefuI history and histopathological examination, proved to be acquired ichthyosis.
Anti-Bacterial Agents ; Drug Therapy ; Ganglia, Spinal ; Herpes Zoster* ; Humans ; Ichthyosis* ; Lower Extremity ; Lymphoma* ; Male ; Middle Aged ; Mucous Membrane ; Skin ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urinary Catheterization ; Urinary Catheters

Red blood cells that agglutinate with most normal adult sera but never with own sera are termed polyagglutinable and can be separated by patterns of lectin reactivity into various types. Among these polyagglutination, activation of the T cryptantigen occurs when carbohydrate structures on glycophorins A and B lose sialic acid and express the disaccharide Gal beta-l-3 GalNac which reacts with the peanut agglutinin, a lectin from Arachis hypogaea. T activation is a temporary condition due to exposure of the membrane antigen to the action of microbial neuraminidase. In T activated red cells, the following hazards, which are theoretically possible, are spontaneous polyagglutination of red cells in vitro, in vivo and severe blood transfusion reactions. We experienced a case of T activation in 6 month old girl with bacterial meningitis caused by Streptococcus pneumoniae. The reactivity to lectins indicated the patient's red cells were T activated. We report a case of T activation in an infant with the review of literature.
Adult ; Arachis ; Blood Transfusion ; Erythrocytes ; Female ; Glycophorin ; Humans ; Infant ; Lectins ; Membranes ; Meningitis, Bacterial ; N-Acetylneuraminic Acid ; Neuraminidase ; Peanut Agglutinin ; Streptococcus pneumoniae

No abstract available.