Of 62 supracondylar fractures of the humerus in children treated for 10 years, 27 cases are described with follow-up study of 2 years and 6 months on average. These patients were treated percutaneous K-wires fixation after closed reduction. This method takes advantage in stability of fixation, vascular safety with any permissible any position of the elbow, early ambulation and short hospital stay, and low incidence of varus deformity in follow-up. Complication included transient ulnar sensory change, pin-tract infection and inaccurate position of K-wires. We observed 1 case of clinical cubitus varus among 17 cases during more than one-year follow-up and concluded this unhappy result was associated with imperfect initial reduction rather than growth disturbance or initial displacement.
Child ; Congenital Abnormalities ; Early Ambulation ; Elbow ; Follow-Up Studies ; Humans ; Humerus ; Incidence ; Length of Stay ; Methods

Since 1957, multiple possible mechanisms have been suggested to explain the production of the osteonecrosis of the femoral head and it is now accepted that steroid medication is one of the etiologic factors producing osteonecrosis of the femoral head. Among the surgical procedures in ischemic osteonercrosis of the femoral head are bone grafting, core decom-pression, rotational osteotomy, angulation osteotomy, hemiarthroplasty and total hip replacement. The choice of surgical procedures in the management of idiopathic osteonecrosis of the femoral head is dependent on several factors. Most important are the etiology and stage of the lesion. Other considerations are the patients age, lifestyle, and demands on his hip, and the surgeons preference and expertise. We reviewed 32 total hip replacements in 22 patients, which had been performed to treat steroid-induced osteonecrosis of the femoral head at Department of Orthopaedic Surgery, National Medical Center from Jan. 1975 to Dec. 1981. The longest follow-up was 7 years and 6 months and the shortest, 1 year, the average being 2 years and 6 months. The results were as follows: 1. There were 13 males and 9 females and more than half were in 5th decade. 2. Principal causes to use oral corticosteroids were rheumatoid arthritis, arthralgia, and low back pain in the order of frequency. 3. Duration of corticosteroid medication was between 2 months and 12 years and 18 patients took more than 12 months. 4. Of 18 patients who had the bilateral involvement, the two also had osteonecrosis of the humeral head. 5. Roentgenographically, 30 hips were in stage IV and 2, in stage III according to the classification of Arlet and Ficat. 6. Types of the implants used were Charnely (28 cases), MQller (2 cases) and Trapezoidal-28 (3 cases). 7. The function of the each hip was evaluated preoperatively and postoperatively by the method of Wilson and Salvati and all improved from average poor to average good.
Adrenal Cortex Hormones ; Arthralgia ; Arthritis, Rheumatoid ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Classification ; Female ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Humeral Head ; Life Style ; Low Back Pain ; Male ; Methods ; Osteonecrosis ; Osteotomy ; Surgeons

The Halo-pelvic traction has been considered as a powerful and strong method for correction of the severely deformed rigid spine whether it is kyphotic or scoliotic. It also affords firm stabilization during the operation and postoperative management with immobilization for a long time. Ambulation with this instrument enhances the usefulness. We have succeeded in treating and correcting 6 cases of Tuberculous Kyphosis, and 3 of which accompanied paraplegia. Especially one case of severe kyphosis, 78 was corrected to 20 and anterior strut graft was accomplished with vascuiarized free fibular graft with aid of microvascular technique. The correction rate was 38% in average. No significant complications have developed except osteoporosis of the spine.
Congenital Abnormalities ; Immobilization ; Kyphosis ; Methods ; Osteoporosis ; Paraplegia ; Spine ; Spondylitis ; Traction ; Transplants ; Walking

We report, herein, a case of reactive perforating collagenosis in a 52-year-old man with diabetes mellitus and chronic renal failure on hemodialysis. He had multiple, pinhead to pea sized, round or oval shaped, central umbilicated papules on the face, trunk, and extremities for 3 months duration. The papules developed after scratching due to pruritus. Histopathologic examination showed a cup-shaped depression of the epidermis filled with parakeratotic material, necrobiotic collagen and inflammatory cells. At the base of the depression, the epidermis showed interruption through which basophilic bundles of collagen ex-tend in a vertical direction from the dermis. The skin lesions improved after treatment with oral antihistaminics:
Basophils ; Collagen ; Depression ; Dermis ; Diabetes Mellitus* ; Epidermis ; Extremities ; Humans ; Kidney Failure, Chronic* ; Middle Aged ; Peas ; Pruritus ; Renal Dialysis ; Skin

Recently, NAG activity has gained increasing importance as and aid in the diagnosis of renoparenchymal diseases. Elevation of urine NAG activity has been found to be an indicator of renoparenchymnal diseases. To evaluate the diagnostic value of the NAG activity test in the renal disease, we carried out clinical study on 31 cases of renal disease patients who had been admitted to the Department of Pediatrics, Chung-Ang University Hospital between March 1992 and February 1993. We analyese by two data: (1) Stastical Package for the Social Science. (2) Students'T test. The results were as follows 1) The urine NAG activity significantly increased (p<0.05) to 69.9+/-5165.69U/hr/mg Creatinine (U/hr/mg Cr) in the renal disease group compared to 3.6+/-1.91U/hr/mg Cr in the control group. 2) The serum NAG activity was 11.69+/-5.18U/L in the renal disease group and 10.58+/-4.04U/L in the control group. There was no significant difference in the serum NAG sctivity between two groups. 3) In the renal disease group, the serum NAG activity was 10.78+/-3.32U/L in male 12.53+/-6.47U/L in female. There was no significant difference between both sexes. In the renal disease, the urine NAG activity was 33.62+/-30.67U/hr/mg Cr in male and 114.05+/-241.62U/hr/mg Cr female. There was no significant difference between both sexes (p<0.05). 4) In the renal disease group, the urine NAG activity increased 314.73+/-420.39U/hr/mg Cr in the 2 years old group but there was no significant difference of urine NAG activity compared to above 2 years old group . 5) The urine NAG activities were 93.1+/-0193.04U/hr/mg Cr in the poteinuria subgroup and 13.3+/-47.62U/hr/mg Cr in the nonproteinuria subgroup and 3.66+/-1.91U/hr/mg Cr in the control group. There was no significant difference between the proteinuria subgroup and the nonproteinuria subgroup. but there was significant difference between nonproteinuria subgroup and control grouop(p<0.005).
Child, Preschool ; Creatinine ; Diagnosis ; Female ; Humans ; Male ; Pediatrics ; Proteinuria ; Social Sciences

PURPOSE: To evaluate effectiveness of oblique approach under biplane fluoroscopic guidance in transthoracic fine needle aspiration biopsy. MATERIALS AND METHODS: Fourteen consecutive patients underwent transthoracic fine needle aspiration biopsy for subcarinal lesions. Subcarina was the only accessible biopsy site in 13 patients. Subcarinal biopsy was performed to determine the presence of metastasis in an enlarged subcarinal lymph node in the remaining one patient. Before biopsy, we evaluated the size and location of the lesion on preliminary plain chest X-ray film and CT scan. Under dual projection fluoroscopic guidence, biopsy was performed through right posterior intercostal space with the patient prone by using oblique approach. On 15 degree LAO projection the needle was directed to the area anterior to the spine and advanced to the line extending through the posterior wall of the main bronchus. RESULTS: Cytologic diagnosis was made in 12 out of 14 patients(accuracy 85.7%). The final diagnosis consisted of 5 squamous cell carcinoma, 5 small cell carcinoma, 1 adenocarcinoma and 1 adenosquamous carcinoma. Pneumothorax developed in 2 patients(14%) and was managed by chest tube drainage. Mild hemoptysis was observed in 2. CONCLUSION: Transthoracic fine needle aspiration biopsy using oblique approach under biplane fluoroscopic guidance is a relatively safe and sensitive method for the histologic diagnosis of subcarinal lesion.
Adenocarcinoma ; Biopsy* ; Biopsy, Fine-Needle* ; Bronchi ; Carcinoma, Adenosquamous ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Chest Tubes ; Diagnosis ; Drainage ; Hemoptysis ; Humans ; Lymph Nodes ; Needles ; Neoplasm Metastasis ; Pneumothorax ; Spine ; Thorax ; Tomography, X-Ray Computed ; X-Ray Film

The effects and interactions of pipecuronium and atracurium with diltiazem and verapalmil on the electrically-evoked twitch response, train-of-four and tetanic stimulation were studied in the isolated rat phrenic-hemidiaphragm preparation. Pipecuronium (3X10(-7) -4X10(-6)) and atracurium (10(-6) -3X10(-5) M) decreased the electrically-evoked twitch response, train-of-four and tetanus ratio in a dose-related fashion and the pipecuronium was more potent than atracurium. The inhibitory effects of pipecuronium and atracurium were potentiated by pretreatment of 5 uM diltiazem and verapamil, Ca++-channel blokers, in which the concentration of diltiazem or verapamil has no obvious effect on the twitch response itself. Futhermore, it is noteworthy that the inhibitory effects of pipecuronium and atraeurium were markedly potentiated by 150 uM hemicholinium pretreatment. On the basis of these findings, the results of present study suggests that the muscle relaxation by pipecuronium and atracurium is mediated by pre- and post-junctional receptor blockade, and that diltiazem or verapamil intensifies neuromuscular blockade produced by these musele relaxants. The potentiating effect of diltiazem or verapamil may be due to blocking influx of calcium and/or release of acetylcholine from presynaptic nerve terminals.
Acetylcholine ; Animals ; Atracurium ; Calcium ; Diltiazem* ; Hemicholinium 3 ; Muscle Relaxation ; Neuromuscular Blockade* ; Pipecuronium ; Rats ; Tetanus ; Verapamil*

We experienced a 57-year-old male patient who have had multiple coin sized, erythematous, psinful, indurated ulcerations with purulent discharge on the right calf area since 10 years before. Previously he received injections of paraffin in the lesion site for correcting the thinning of right calf due to complication of pyoderma. Histopathologic examination showed "Swiss cheese" appearance of parsffinoma. Good result was obtained after treatment with surgical excision and split thickness skin graft.
Humans ; Male ; Middle Aged ; Numismatics ; Paraffin ; Pyoderma ; Skin ; Transplants ; Ulcer

A benign fibrous histiocytoma is a tumor with 6brohlastic and histiocytic differentiation, most commonly found in soft tissues or adult bones. Its occurrence in the ear is, however, extremely rare, and there hasn't been any report on the case originating from the middle ear. We experienced a case of 37-year old male patient who complained of intermittent otorrhea and hearing loss. The patient had an 1 x 1 cm-sized mass in the right mastoid antrum in the temporal bone CT. Under the impression of cholesteatoma or benign tumor, a mass removal was done. A histopathologic investigation of the resected tumor showed typical features of benign fibrous histiocytoma. We herein report along with a brief literature review a case of benign fibrous histiocytoma arising in the mastoid antrum.
Adult ; Cholesteatoma ; Ear ; Ear, Middle ; Hearing Loss ; Histiocytoma, Benign Fibrous* ; Humans ; Male ; Mastoid* ; Temporal Bone

Background/Aims: The objective of this study was to determine the more appropriate wound-closure method by comparing the effectiveness of two methods in a group of patients who underwent ileostomy repair. Methods: The study conducted after obtaining the approval of the Institutional Review Board (IRB) included 58 patients ≥19 years of age who underwent ileostomy at the Department of Surgery at the Presbyterian Medical Center. This was a retrospective, single-center trial. Patients who underwent ileostomy closure between January 2011 and September 2017 were assigned to the primary wound-closure (PC, n=25) group and the purse-string wound-closure (PSC, n=33) group. Post-repair complications, such as wound infection, delayed healing, and patient satisfaction related to wound management, were investigated and compared according to the wound-closure method. Results: The PSC group had a significantly lower surgical site infection rate than the PC group (0% vs. 44%, p<0.001). The wound-healing period was also significantly different between the PC and PSC groups (mean 27.18 days vs. 20.96 days, p=0.023). However, the postoperative wound-healing delay of >30 days was not significantly different (39% vs. 20%, p=0.114). In addition, there were no significant differences in the response to questionnaires on patient satisfaction between the two groups. Conclusions PSC has a lower surgical site infection rate and the wound-healing delay was not very different from that of PC. Therefore, if patients are at risk of wound infection, such as in severe wound contamination, long operating time, and immunocompromised conditions, we should consider PSC as a wound closure method of choice.