Femoral fractures are difficult to treat in the child with head or multiple injuries. Traction may fail due to spasticity and restlessness. Poor results after closed reduction have led some authors to advocate open reduction and internal fixation which facilitates overall care. Anatomical reduction with internal fixation leads to limb overgrowth. We report our experience in anatomical open reduction of femoral fracture which had head or multiple injuries or difficult to maintain traction in children at the Kang-Nam St. Mary's Hospital. The results are as follows : 1. Among the 28 cases, there were 20 cases in male and 8 cases in female. Average age was 9.4 years. 2. Plate fixation was used in 27 cases and Kuntscher Kuentscher nail was used in one case. 3. Average union period was 11.5 weeks. There was one delayed union which was completely united in 20 weeks. 4. Average overgrowth of femur was 5.2mm. The overgrowth was related with age and handedness but it was not related with fracture site. For children who have head or multiple injuries or difficult to maintain the skin traction, open reduction with plate fixation appears the most satisfactory treatment. The overgrowth of the femur after open reduction was not significant problems clinically.
Child ; Extremities ; Female ; Femoral Fractures ; Femur ; Functional Laterality ; Head ; Humans ; Male ; Multiple Trauma ; Muscle Spasticity ; Psychomotor Agitation ; Skin ; Traction

No abstract available.
Cytomegalovirus Infections*

BACKGROUND: Recently the Korean society has been challenged with the rapid growth of obese population due to the improved socioeconomic status and lifestyle changes over the past decades. Not only has obesity been known as one of major risk factors for various diseases including cardiovascular diseases(e.g. hypertension, coronary heart disease and stroke) and diabetes mellitus, but it has also increased the death from obesity-related diseases. It has been required, however, to establish our own obesity criteria adjusted for Korean since much difference is expected to exist in the degree of obesity between white and Asian people. Therefore, this study was designed to provide with primary data to help establish new criteria through identifying the distribution of Body Mass Index(BMI), and then analysing its relatian with some obesity-related diseases. METHODS: This study calculated BMI and related it to some obesity-related diseases by analysing data from 1995 National Health Interview Surveys, in which a random sample of 5,750 Korean at the age of 15-69 had self-reported their heights, body weights and diagnoses with obesity-related diseases by physicians. Variables under consideration include potential risk factors(e.g. alcohol intakes, smoking, exercise, etc.) as well as demographics of the sample population. RESULTS: Average BMI(kg/m(2)) were 21.6+/- 2.6 for male and 21.7+/-4.8 for female(mean+/-SD), which increased in direct proportion to the increase of age until the age reached the group of 40-59, and then followed by the inverse in its relation with the age at 60 and over. It was revealed, however, that prevalences of obesity-related diseases such as hypertension, diabetes mellitus etc. were the highest among the population group with their BMI of 23.8~35.6. In short, this study identified the proportional relation of BMI with the prevalence of obesity-related diseases. CONCLUSIONS: In this study, the prevalence for hypertension and diabetes mellitus was shown to be higher than the average among population with their BMI of 21.9~238, whose figure is much lower than both 26.4, the value of the 90th percentile proposed in MONICA prot and 25, the current WHO criteria of obesity. However, a Japanese study reported that the health risk began to increase at the BMI of 23 with risks for obesity-related diseases dramatically increased at the BMI of 26-27 and over, and concluded that because Asian has more body fats accumulated within the upper body part compared with the white, the Asian persons are more obese, though less in terms of BMI, than the white. Therefore, future works should be focused on establishing our own criteria for obesity with health risks through determining the association of BMI with prevalence of various diseases in Korea.
Adipose Tissue ; Asian Continental Ancestry Group ; Body Height ; Coronary Disease ; Demography ; Diabetes Mellitus* ; Diagnosis ; Humans ; Hypertension* ; Korea ; Life Style ; Male ; Obesity ; Population Groups ; Prevalence* ; Risk Factors ; Smoke ; Smoking ; Social Class ; Weights and Measures

The most common cause of orbital in/fection is a sinusitis, and if this orbital complication is not provided with appropriate and intensive treatments, serious status such as visual loss or life-threatening may occur. Osteomyelitis rarely results from sinusitis, and in cases where it happens, the frontal sinus is the most frequently involved site. However, zygomatic osteomyelitis has not been reported so far. We present a case of maxillary sinusitis which was initiated by oroantral fistula, and developed to preseptal and postseptal abscess, penetrating into the orbital septum. The case was complicated by zygomatic osteomyelitis. This case was successfully treated by draining pus by endonasal endoscopic sinus surgery, infraorbital incision, and was followed by antibiotic therapy for about 8 weeks.
Abscess* ; Frontal Sinus ; Maxillary Sinus ; Maxillary Sinusitis ; Orbit ; Oroantral Fistula ; Osteomyelitis* ; Sinusitis ; Suppuration

BACKGROUND AND OBJECTIVES: Recently, canal down mastoidectomy tends to be more frequently selected for complete eradication of the lesion and prevention of recurrence. Therefore, the problems attendant to the open mastoid continue to be of concern. Although various techniques have been used to solve the cavity problems, no single procedure has yet been devised that entirely accomplished this purpose. We evaluated the effects of partial mastoid obliteration using inferior based musculoperiosteal flap and autogenous conchal cartilage chips. MATERIALS AND METHODS: Twenty four cases were performed with mastoid obliteration using inferior based musculoperiosteal flap and autogenous conchal cartilage chips obtained from meatoplasty. There were 11 cases for control which were performed with canal down mastoidectomy without obliteration. We compared these two groups in the duration of epithelialization, accumulation of debris, presence or absence of drainage, shape of remodeled canal and caloric response and evaluated survival or atrophy of flap and absorption of cartilage chips. RESULTS: Obliteration group showed more rapid healing and epithelialization and less accumulated epithelial debris. Atrophy of flap or absorption of cartilage was not observed. There was no draining ear but vertigo with nystagmus on caloric stimulation developed in both groups. CONCLUSION: This partial mastoid obliteration technique used easy and quick application instead of complete restoration of canal wall, and it may be also valuable in providing rapid epithelialization and reducing mastoid bowl volume with relatively round canal shape. Furthermore, epitympanic obliteration using cartilage chips may be an effective method to prevent formation of attic retraction pocket.
Absorption ; Atrophy ; Cartilage* ; Drainage ; Ear ; Methods ; Recurrence ; Vertigo

PURPOSE: The Dual-Energy Quantitative Computed Tomography(DEQCT) was compared with bone equivalent K2HPO4 standard solution and ash weight of animal cadaveric trabecular bone in the measurement of bone mineral contents(BMC). METHOD AND MATERIALS: The attenuation coefficient of tissues highly depends on the radiation energy, density and effective atomic number of composition.The bone mineral content of DEQCT in this experiments was determined from empirical constants and mass attenuation coefficients of bone,fat and soft tissue equivalent solution in two photon spectra.In this experiments, the BMC of DEQCT with 80 and 120kVp X rays was compared to ash weight of animal trabecular bone. RESULTS: We obtained the mass attenuation coefficient of 0.2409, 0.5608 and 0.2206 in 80kVp, and 0.2046, 0.3273 and 0.1971cm2/g in 120kVp X-ray spectra for water, bone and fat equivalent materials, respectively.The BMC with DEQCT was acomplished with empirical constants K1=0.3232, K2=0.2450 and mass attenuation coefficients has very closed to ash weight of animal trabecular bone. The BMC of empirical DEQCT and that of manufacturing DEQCT were correlated with ash weight as a correlation r=0.998 and r=0.996, respectively. CONCLUSION: The BMC of empirical DEQCT using the experimental mass attenuation coefficients and that of manufacture have showed very close to ash weight of animal trabecular bone.
Animals ; Bone Density* ; Cadaver ; Water

PURPOSE: To evaluate the loss of bone mineral contents(BMC) in lumbar spine within the radiation field for cervical cancer treatment, BMC in the irradiated patient group was compared with that of a normal control group. METHOD AND MATERIALS: Measurements of BMC in the trabecular bone in lumbar spines(L3-L5) were performed in the both patient and normal control groups. Investigators used dual-energy quantitative computerized tomography(DEQCT) using photon energy of 120 and 80kVp. The numbers of patient and control groups were 43 in each with age distribution of fifth to seventh decade of women. The numbers of control group were 22 in fifth, 10 in sixth, and 11 in seventh decade, those of patient group were 14 in fifth, 14 in sixth, and 15 in seventh decade of women. The radiation field was extended to L5 spine for pelvic irrdiation with 45-54Gy of external radiation dose and 30Gy of high dose rate brachytherapy in cervical cancer. RESULTS: The BMC is decreased as increasing age in both control and patient groups. BMC in lumbar spine of patient group was decreased by about 13% to 40% maximally. The BMC of L3 and L4 a region that is out of a radiation field for the patient group demonstrated 119.5+/-30.6, 117.0+/-31.7 for fifth, 83.3+/-37.8, 88.3+/-46.8 for sixth and 61.5+/-18.3, 56.2+/-26.6mg/cc for seventh. Contrasted by the normal control group has shown 148.0 +/-19.9, 153.2+/-23.2 for fifth, 96.1+/-30.2, 105.6+/-26.5 for sixth and 73.9+/-27.9, 77.2+/-27.2mg/cc for seventh decade, respectively. The BMC of patient group was decreased as near the radiation field, while the lower lumbar spine has shown more large amounts of BMC in the normal control group. In particular, the BMC of L5 within the radiation field was significantly decresed to 33%, 31%, 40% compared with the control group of the fifth, sixth and seventh decades, respectively. CONCLUSION: The pelvic irradiation in cervical cancer has much effected on the loss of bone mineral content of lumbar spine within the radiation field, as the lower lumbar spine has shown a smaller BMC in patient group with pelvic irradiation in contrast to that of the normal control groups.
Age Distribution ; Bone Density* ; Brachytherapy ; Female ; Humans ; Research Personnel ; Spine* ; Uterine Cervical Neoplasms*

PURPOSE: We evaluated the occurrence of renal scarring in children with unilateral vesicoureteral reflux (VUR), and the relationships between renal scar formation and risk factors such as VUR, duration of fever, acute-phase reactant, age, and sex. METHODS: We retrospectively analyzed the data of 35 children newly diagnosed with unilateral vesicoureteral reflux after urinary tract infection (UTI) in Wallace Memorial Baptist Hospital between January 1996 and December 2004. Ultrasonography, Erythrocyte sedimentation rate (ESR), and C- reactive protein (CRP) were performed initially. Voiding cystourethrography (VCUG) was performed 1 to 3 weeks after treatment with UTI. (99m) Tc-dimercaptosuccinic acid (DMSA) scan was performed 4 to 6 months after treatment. RESULTS: Scintigraphic renal damage was present in 29 percent of the refluxing and in 3 percent of the nonrefluxing kidneys (P< 0.05). The severity of VUR was significantly correlated with renal scar formation (P< 0.05). The duration of fever before treatmen (5.0+/-1.3 vs 2.6+/-1.3) and prolonged fever of over 5 days were significantly different between renal scar group and non-renal scar group (P< 0.05). ESR (56.3+/-23.8 vs 27.9+/-18.1 mm/hr, P< 0.05) and CRP (12.8+/-7.3 vs 3.9+/-3.8 mg/dL, P< 0.05) at the diagnosis of UTI in the renal scar group were higher, compared to those of the non-renal scar group. There were no significant differences in age and sex between the two groups. CONCLUSION: The presence and grade of VUR, the duration of fever before treatment, prolonged fever over 5 days, ESR, and CRP were risk factors for renal scarring, irrespective of age and sex. Diagnosis and management of VUR, in children with UTI, is important to prevent renal scars.
Blood Sedimentation ; Child* ; Cicatrix* ; Diagnosis ; Fever ; Humans ; Kidney ; Protestantism ; Retrospective Studies ; Risk Factors ; Ultrasonography ; Urinary Tract Infections ; Vesico-Ureteral Reflux*

BACKGROUND/AIMS: The prevalence of colonic diverticulosis in Korea is lower than in Western contries and the involved site is different. But, the recently increasing prevalence in Korea may be due to changing life style and advances in diagnostic approachs. We analyzed the annual incidence and clinical manifestations of colonic diverticulosis of the patients who underwent colonofibroscopy. METHODS: Medical records of 25,808 patients who underwent colonofibroscopy at Yeungnam University Medical Center from January 2000 to December 2007 were retrospectively reviewed. RESULTS: Overall prevalence was 5.5%. The mean age of the patients was 57.02+/-12.41 years (range 19-97 years) and the most frequent occurrence (28.8%) occurred in the 7th decade of life. Male to female ratio was 977:159. The annual incidence rate increased from 4.6% to 7.2% since 2000. Diverticulum occurred more frequently in the right side colon (997 cases) than the left side colon (159 cases), with involvement of both sides in 62 cases. The rate of left sided colon increased with age. In 516 patients, only one diverticulum was detected and the other 682 patients had multiple diverticuli. Complications were evident in 51 cases, consisting of diverticulititis in 35 cases and bleeding in 16 cases. CONCLUSIONS: According to this single center analysis, the annual incidence rate of colonic diverticulosis is increasing with right sided colon as the predominant site. But, the frequency in left-sided colon is increasing with age.
Academic Medical Centers ; Colon ; Diverticulosis, Colonic ; Diverticulum ; Diverticulum, Colon ; Female ; Hemorrhage ; Humans ; Incidence ; Korea ; Life Style ; Male ; Medical Records ; Population Characteristics ; Prevalence ; Retrospective Studies

We experienced a 41-year-old male patient with the recurrent painful nodular swelling of muscles in both lower limbs for 4 years. The mass did not accompanied other general symptoms of muscle weakness and spontaneously regressed. On pathologic finding, there is marked inflammatory cell infiltration with muscle fiber destruction and regeneration. Analyzing the literature, we proposed the diagnosis of recurrent localized myositis.
Adult ; Diagnosis ; Humans ; Lower Extremity ; Male ; Muscle Weakness ; Muscles ; Myositis* ; Regeneration