Kawasaki disease is described by fever lasting five days or more, bilateral conjunctival injection, changes of lips and oral cavity, polymorphous exanthema, acute non-purulent cervical lymphadenopathy, and changes of extremities. Atypical Kawasaki disease is defined as fewer than 4 of 6 criteria described above including coronary artery abnormalities. Especially, atypical clinical manifestations of Kawasaki disease appear in infants younger than 6 months old of age. Thus we recommend echocardiography in early infancy who has prolonged fever in order to diagnose atypical Kawasaki disease and treat early. We have experienced three cases of atypical Kawasaki disease with coronary aneurysm who were admitted because of fever and revealed coronary aneurysm on echocardiography.
Coronary Aneurysm* ; Coronary Vessels ; Echocardiography ; Exanthema ; Extremities ; Fever ; Humans ; Infant ; Lip ; Lymphatic Diseases ; Mouth ; Mucocutaneous Lymph Node Syndrome*

No abstract available.

Gastrointestinal stromal tumor (GIST) is known as considerable controversal tumor about it's histogenesis, differentiation and biologic behavior. It is traditionally regarded as smooth muscle tumor. To evaluate and clarify the origin of tumor, we performed immunohistochemical study of 23 cases of GIST on CD34 antigen, alpha-smooth muscle actin, S-100 protein, and compared the result with 4 cases of typical leiomyoma of GI tract. The results were as follows. CD34 antigen expression was noted in 21 cases (91.3%) of GIST, while typical leiomyoma was all negative. There were no difference of CD34 expression according to the biologic behavior. However, it's staining pattern was significantly different (p<0.05). Focal or multifocal expression was dominant in benign GIST (58.3%), while diffuse expression was dominant in malignant GIST (80%). Actin was expressed in 5 cases of benign GIST (38.5%) and 1 of malignant GIST (16.7%) focally. All typical leiomyoma showed diffuse strong positivity on alpha-smooth muscle actin. S-100 protein was expressed in 2 cases of benign GIST (16.7%) only. The pattern of CD34 expression was focal in the actin or S-100 protein positive cases. In conclusion CD34 antigen is useful marker in the separation of GIST, from typical smooth muscle tumor. Also it suggest that most GISTs are histogenetically primitive mesenchymal cell origin. However, CD34 expression was unrelated with biologic behavior of GIST.
Actins ; Antigens, CD34* ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Leiomyoma ; S100 Proteins ; Smooth Muscle Tumor

Subacute osteomylitis is far less common than acute osteomyelitis, characterized by insidious onset of the symptoms of mild local pain or discomfort without any acute systemic illness. Radiographic findings are not infrequently confused with benign or malignant bone tumors. From Jan, 1983 to Dec. 1991, we experienced twelve patients with subacute osteomylitis of long bones. Our clinical observations were as follows. 1. There were 11 boys and one girl with an average age of 9.7 years(range, 30months-16years). 2. The involved sites were proximal in 1, distal radius in 3, midshaft of femur in 3, distal femur in 2, proximal tibia in 1, and distal tibia in 2 cases. 3. All patients had insidious onset of mild to moderate pain. ESR was increased in 9 cases(75%) with a mean value of 44 mm/hr, but leukocytosis was not found. 4. According to the Green and Edwards' classification, there were type 1 in 1, type 2 in 3, type 3 in 3, and type 6 in 5 cases. 5. Eleven patients had operative treatment. The remaining one patient was treated by antibiotic treatment. 6. Primary treatment was successful in 11 patients who were followed for and average 9.5 months. One patients was lost to follow-up.
Child ; Classification ; Clinical Study ; Female ; Femur ; Humans ; Leukocytosis ; Lost to Follow-Up ; Osteomyelitis ; Radius ; Tibia

No Abstract Available.
Allografts* ; Posterior Cruciate Ligament*

The herniation of intervertebral disc is possibly diagnosed through the myelography, electromyography, discography or computerized tomography. Among them, the myelography is regarded as the popularized method that helps accurate analysis on the location and pattern of the lesion. The authors have studied 363 cases of herniated intervertebral disc with respect to the diagnostic accuracy of myelographic examination from January, 1982 to December, 1985 at the Department of Orthopedic Surgery and Radiology, National Police Hospital. The results were as follows; 1. The most common age group was 21 to 30 years old and ratio of male and female was 9.7: l. 2. The most common site of the lesion was between L4 and L5 vertebra in myelography. 3. Of the 363 cases which underwent the myelography, 305(84.0%) represented positive findings. 4. Myelographic accuracy was coincided with the clinical diagnosis regarding the location of herniation of intervertebebral disc in 262 cases(72.1%).
Diagnosis ; Electromyography ; Female ; Humans ; Intervertebral Disc ; Male ; Methods ; Myelography ; Orthopedics ; Police ; Spine

BACKGROUND: Few studies have investigated magnetic resonance (MR) characteristics of traumatic posterosuperior rotator cuff tears involving the supraspinatus and infraspinatus. We hypothesized that traumatic rotator cuff tears may have MR characteristics distinguishable from those of non-traumatic tears. METHODS: Preoperative MR arthrography and intraoperative tear size measurements were compared in 302 patients who underwent MR arthrography and subsequent arthroscopic rotator cuff repairs for traumatic (group T, 61 patients) or non-traumatic (group NT, 241 patients) tears. The inclusion criteria for both groups were posterosuperior full-thickness rotator cuff tear and age between 40 and 60 years. For group T, traumas were limited to accidental falls or slips, or sports injuries, motor vehicle accidents; injuries were associated with acute onset of pain followed by functional shoulder impairment; and time between injury and magnetic resonance imaging (MRI) was 6 weeks or less. RESULTS: In group T, 72.1% of shoulders (44 patients) had tendon tears with blunt edges while 27.9% of shoulders (17 patients) had tears with tapering edges. In contrast, 21.2% of patients in group NT (51 patients) had blunt-edge tears, while 78.8% (190 patients) of tears had tapering edges. These results were statistically significant (p<0.001) and estimated odds ratio was 9.6. The size of tear did not vary significantly between groups. CONCLUSIONS: We found no exclusive MR characteristic to define traumatic tears. However, oblique coronal MRI of traumatic tears showed a significant tendency for abrupt and rough torn tendon edges and relatively consistent tendon thicknesses (without lateral tapering) compared to non-traumatic cuff tears.
Accidental Falls ; Arthrography* ; Arthroscopy ; Athletic Injuries ; Humans ; Magnetic Resonance Imaging ; Motor Vehicles ; Odds Ratio ; Rotator Cuff* ; Shoulder ; Tears* ; Tendons

Intramedullary nailing has become the most popular fixation method in the treatment of the shaft fractures of long bones especially of tibia and femur because it affords most rigid fixation of fracture via closed method which makes early rehabilitation possible. Nowadays intramedullary nailing of the humeral shaft is being performed by many surgeons with good results. Newer implants and better surgical techniques are being developed, which suggests application of this method can be widened. Purpose of this study was aimed to define whether intramedullary nailing could be an effective method or not in the treatment of humeral shaft fractures by documenting the practical points in the application of intramedullary nailing of humerus, effectiveness in fracture healing, any complications or obstacles. We managed thirteen humeral shaft fractures with closed locked intramedullary nailing with distal fanning devices(Seidel nail) from March 1993 to April 1994. Average follow-up period was 14 months(12 months-18 months). The results were as follows; 1, Union of the fracture was obtained at average 12.9 weeks(9 weeks-20 weeks) postoperatively except one case of nonunion, in which case, union was obtained at postoperative 10 months finally. 2. Among the 13 cases, painful limitation of shoulder motion remained in 6 cases. This complication was more common in the cases with protruded proximal end of the nail. Above results suggest that locked intramedullary nailing seemed to be one of the useful method in the treatment of the humeral shaft fractures. However, destruction and irritation of shoulder by the nail was found to be a grave problem, and we found that further investigations should solve this problem.
Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Fracture Healing ; Humerus ; Methods ; Rehabilitation ; Shoulder ; Surgeons ; Tibia

No abstract available.
Porokeratosis

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that is characterized by inflammation of the synovial tissue and deterioration of the joint and bone. A recent study reported a potential gene-environment interaction between HLA-DR and smoking. The present study investigated whether a specific gene was related to the association between smoking and the severity of RA (rheumatoid factor levels > 20 IU/ml). We used the resources of the NARAC family collection of GAW 15 databases, and 1139 subjects with RF > 20 IU/ml were included in the current analysis. The linkage panel contained 5858 SNP markers, and 5744 SNPs passed quality control criteria. Linear regression analyses, using PLINK software and generalized estimating equation regression models, were used to test for associations between the SNPs and the severity of RA according to smoking groups. Two major findings were established. First, the severity of RA in smokers was associated with rs703618 (p=6x10(-5)), which lies in the intronic region of the stabilin 2 (STAB2) gene on chromosome 12. Second, there were significant differences in the levels of RF between 'ever smokers' and 'never smokers' according to the rs703618 genotype (G/G, A/G, A/A). We investigated whether a specific gene acts as a mediator between smoking and the severity of RA and found that the STAB2 gene could affect this relationship. Our finding indicates that smoking may mediate RA severity by affecting the expression level of a specific gene.
Arthritis ; Arthritis, Rheumatoid ; Chromosomes, Human, Pair 12 ; Gene-Environment Interaction ; Genotype ; HLA-DR Antigens ; Humans ; Hyaluronic Acid ; Inflammation ; Introns ; Joints ; Linear Models ; Polymorphism, Single Nucleotide ; Quality Control ; Smoke ; Smoking