The managements of fractures of femoral shaft in children differ in many ways from those in adults. Fourty eight cases of fractures of femoral shaft in children who were treated at Masan Korea General Hospital from March 1981 to February 1984 were analyzed both clinically and radiologically and the following results were obtained. l. Among 48 cases, the ratio of male and female was about 2.7:1 and the highest incidence was between the age of 3 and 8 years(52.1%). 2. The main cause of fracture was traffic accident(66.7%) and the other was falling or slip down injury. 3. Middle 1/3 of femoral shaft was most commonly injured(45.8%) and transverse type was common (41.7 %). 4. The common associated injuries were head injuries, fracture of the lower extremities and fracture of pelvis. 5. 43 cases were treated with traction method and 5 with open reduction and internal fixation. 6. In general, angulation at fracture site was under 10 degrees and no clinical deformity was resulted in. 7. Among 48 cases, overring of fractured fragment was occured in 28 cases and the average length of overring was 7.5mm.
Accidental Falls ; Adult ; Child ; Congenital Abnormalities ; Craniocerebral Trauma ; Female ; Hospitals, General ; Humans ; Incidence ; Korea ; Lower Extremity ; Male ; Methods ; Pelvis ; Traction

The purpose of the study was to analyze the risk factors of school accidents. The study subjects were 408 students of a middle school in a municipal city. Among them, 204 students who met with an accident and received first-aid treatment in school health room at any time from March 2 to July 15, 1999, were selected as the school accident group. And the remaining 204 students were cases' matched control, who had never been experienced any school accident from elementary school days to July 15, 1999, For data collection, the structured questionnaire, and interview were adopted. The findings of this study were as below: There were significant differences personal and familial characteristics residential form(p=0.04); active disposition (p=0.02); impatient disposition(p=0.02); family environment(p=0.01); and father image(p=0.00), and the school life characteristics; achievement(p=0.00); observance of school order(p=0.00); school adjustment(p=0.00), the health characteristics; school health room(p=0.00); medical institute they usually used(p=0.00); sleeping hours(p=0.03); bath or shower(p=0.01); hand washing(p=0.04), and wearing glasses(p=0.02), and the characteristics of accident disposition; accident experience(p=0.00); the characteristics of accident disposition(p=0.00). Multiple logistic analysis were showed that religion, adaption to school life and school accomplishment were the significant predictors to school accident prevalence. To reduce school accident, accident-prevention program should be developed practically and concretely in consideration of student's personal characteristics. In addition, accident-prevention education should be implemented under the link between home and school, so that students could prevent accident for themselves.
Baths ; Case-Control Studies* ; Data Collection ; Education ; Fathers ; Hand ; Humans ; Prevalence ; Risk Factors* ; School Health Services ; Surveys and Questionnaires

PURPOSE: has been reported that benign rolandic epilepsy of childhood (BRE) does not always show benign nature in a clinical course. We hypothesized that children with atypical feature showed different characteristics of dipole sources of rolandic spikes. METHODS: Twenty-nine children with BRE were enrolled. Twenty patients showed typical features of BRE (typical BRE group). Nine patients were classified as atypical BRE, because each met one or more of the following criteria:(i) neurodevelopmental abnormalities such as mental retardation or delayed development;(ii) abnormal neuroimaging findings; and (iii) poor seizure control. Routine waking and sleep EEG recordings were obtained for at least 30 min from each patients, using a 32-channel digital EEG machine. Centrotemporal spikes were averaged which was used to do dipole source localization. The source location was estimated within a four-shell ellipsoidal model of the head. Voltage topography, orientation and propagation pattern of dipole source, as well as clinical characteristics were compared between two groups. RESULTS: The clinical characteristics such as age, sex, seizure onset age, and seizure outcome were same in both groups. The negative maximum of spikes was mainly on the central and temporal electrodes in both groups. Two thirds of patients in each group demonstrated dipole sources with tangential orientation. 40% of the typical BRE revealed two sources indicating propagation of spikes around rolandic areas, which was not observed in atypical group. The pattern of propagation was mostly from tangential to radial in anterior direction. CONCLUSIONS: These results suggest that the pathophysiological mechanism generating centrotemporal spikes of atypical BRE is different from that of typical ones.
Age of Onset ; Child ; Electrodes ; Electroencephalography ; Epilepsy, Rolandic* ; Head ; Humans ; Intellectual Disability ; Neuroimaging ; Seizures

Special idiopathic female pseudohermaphroditism with urinary tract, m llerian duct, and lower gastrointestinal tract anomalies, in addition to masculinization of the external genitalia, is rare phenomenon. Masculinization of external genitalia and other anomalies occur in the absence of a recognized exposure to androgen or other teratogenic factors. We report a case of a female pseudohermaphroditism with m llerian agenesis, bilateral multicystic dysplastic kidney, urethral agenesis, left double ureter, rectovesical fistula, imperforate anus, single umbilical artery, detected after therapeutic abortion at 23+5 weeks of gestational age. The final diagnosis is based on autopsy.
46, XX Disorders of Sex Development* ; Abortion, Therapeutic ; Anus, Imperforate* ; Autopsy ; Diagnosis ; Female* ; Fistula ; Genitalia ; Gestational Age ; Humans ; Lower Gastrointestinal Tract ; Multicystic Dysplastic Kidney ; Pregnancy ; Single Umbilical Artery ; Ureter ; Urinary Tract*

BACKGROUND: TSH stimulates both the adenyl cyclase and phospholipase C (PLC) pathways by binding to a single cell surface receptor that is coupled to G protein, and we examined crosstalk between these two signaling pathways. METHODS: FRTL-5 rat thyroid cells were grown in 6H medium, then incubated with 5H medium before the stimulation. Then cells were incubated for 24 hours with 5H mix containing 1 mCi/L myo-(2-N-3H) inositol. After pretreatment of 100 microM Rp-cAMP, 100 microM forskolin, 50 nM staurosporine, or 100 nM PMA (phorbol-12-myristate-13-acetate), TSH were added in different experiments. After 30 min at 37 degrees C, cells were disrupted and IP formation was determined. RESULTS: Stimulation with 100 microU/mL TSH resulted in a 1.65 fold increase in IP generation. In pursuing the possibility that the two post-receptor events might be linked in some way, we examined the effect of exogenously administrated Rp-cAMP, protein kinase A antagonist, and forskolin, a direct stimulant of protein kinase A, on IP generation achieved at a dose of 100 microU/mL TSH. The pretreatment of 100 M Rp-cAMP at a concentration sufficient to inhibit protein kinase A enhanced TSH-induced IP production. This effect of Rp-cAMP was dose-dependent. Forskolin attenuatedTSH-stimulated increases in phosphatidylinositide turnover. PMA, a protein kinase C (PKC) activator and staurosporine, a PKC inhibitor did not affect TSH-induced IP generation. CONCLUSION: These data suggested that activation of adenylate cyclase/cAMP post-receptor signalling casacde, which results in the protien kinase A activation, has an inhibitory effect on IP turnover activated by TSH.
Adenylyl Cyclases ; Animals ; Colforsin ; Cyclic AMP-Dependent Protein Kinases ; GTP-Binding Proteins ; Inositol ; Phosphotransferases ; Protein Kinase C ; Rats ; Receptors, Thyrotropin* ; Signal Transduction* ; Staurosporine ; Thyroid Gland ; Type C Phospholipases

OBJECTIVE: Nitric oxide(NO) is implicated in a wide range of biological processes in tumors and is produced in glioma. To investigate the role of NO and its interaction with the tumoricidal effects of anticancer drugs, we study the antitumor activities of NO donors, with or without anticancer drugs, in human glioma cell lines. METHODS: U87MG and U373MG cells were treated with the NO donors sodium nitroprusside(SNP) and S-nitroso-N-acetylpenicillamine(SNAP), alone or in combination with the anticancer drugs 1, 3-bis(2-chloroethyl)-1-nitrosourea(BCNU) and cisplatin. Cell viability, cell proliferation, DNA fragmentation, nitrite level, and the expression of Bcl-2 and Bax were determined. RESULTS: NO was markedly increased after treatment with SNP or SNAP; however, the addition of the anticancer drugs did not significantly affect NO production. NO donors or anticancer drugs reduced glioma cell viability and, in combination, acted synergistically to further decrease cell viability in a dose- and time-dependent manner. Cell proliferation was inhibited and apoptosis were enhanced by combined treatment. Bax expression was increased by combined treatment, whereas Bcl-2 expression was reduced. The antitumor cytotoxicity of NO donors and anticancer drugs differed according to cell type. CONCLUSION: BCNU or cisplatin can inhibit cell viability and proliferation of glioma cells and can induce apoptosis. These effects are further enhanced by the addition of a NO donor which modulates the antitumor cytotoxicity of chemotherapy depending on cell type. Further biological, chemical, and toxicological studies of NO are required to clarify its mechanism of action in glioma.
Apoptosis ; Biological Processes ; Carmustine ; Cell Line ; Cell Proliferation ; Cell Survival ; Cisplatin ; DNA Fragmentation ; Drug Therapy ; Glioma* ; Humans ; Nitric Oxide Donors* ; Nitric Oxide* ; Sodium ; Tissue Donors

PURPOSE: The purpose of this study was to investigate the ability of Mineral trioxide aggregate(MTA) to support osteoclastic differentiation from fetal rat calvarial cell. METHODS: In this study, response of IL-6, RANKL, and OPG in fetal rat calvarial cells stimulated with IL-1beta on MTA was evaluated by ELISA and RT-PCR. RESULTS: The results were as follows; there was no significant difference between glass and MTA at 5days. In ELISA analysis, Glass group and MTA group showed similar IL-6 expression, Glass+IL-1beta group and MTA+IL-1beta group showed similar IL-6 expression. In RT-PCR analysis, Glass group and MTA group showed similar IL-6, RANKL, OPG mRNA expression, MTA+IL-1beta group and Glass+IL-1beta group showed 3 fold increase of IL-6 and RNAKL mRNA expression when compared with MTA group. All groups showed similar OPG mRNA expression. CONCLUSIONS: MTA does not suppress cell proliferation and increase the proinflammatory cytokine that induce osteoclastogenesis. Thus, MTA is biocompatible material that could be used in various clinical conditions.
Aluminum Compounds ; Animals ; Biocompatible Materials ; Calcium Compounds ; Cell Proliferation ; Cytokines ; Drug Combinations ; Enzyme-Linked Immunosorbent Assay ; Glass ; Glutamates ; Guanine ; Interleukin-6 ; Osteoclasts ; Oxides ; Rats ; RNA, Messenger ; Silicates ; Pemetrexed

Age-related rotator cuff tendon degeneration is related to tenofibroblast apoptosis. Anthocyanins reduce oxidative stress-induced apoptotic cell death in tenofibroblasts. The current study investigated the presence of cell protective effects in cyanidin and delphinidin, the most common aglycon forms of anthocyanins. We determined whether these anthocyanidins have antiapoptotic and antinecrotic effects in tenofibroblasts exposed to H₂O₂, and evaluated their biomolecular mechanisms. Both cyanidin and delphinidin inhibited H₂O₂-induced apoptosis in a dose-dependent manner. However, at concentrations of 100 μg/ml or greater, delphinidin showed cytotoxicity against tenofibroblasts and a decreased antinecrotic effect. Cyanidin and delphinidin both showed inhibitory effects on the H₂O₂-induced increase in intracellular ROS formation and the activation of ERK1/2 and JNK. In conclusion, both cyanidin and delphinidin have cytoprotective effects on cultured tenofibroblasts exposed to H₂O₂. These results suggest that cyanidin and delphinidin are both beneficial for the treatment of oxidative stress-mediated tenofibroblast cell death, but their working concentrations are different.
Anthocyanins ; Apoptosis ; Cell Death ; Rotator Cuff ; Tendons

OBJECTIVE: The purpose of this study was to determine any differences in outcome and patient satisfaction between endoscopic release (ECTR) and open carpal tunnel release (OCTR) in patients with bilateral carpal tunnel syndrome who underwent both techniques. METHODS: Seven patients with confirmed bilateral idiopathic carpal tunnel syndrome were randomized to undergo endoscopic release using a single portal Agee technique to one hand and a minimal open release to the other. Subsequent assessments were made at 0, 3, and 12 months after operation using a modified Levin scale. We also analyzed subjective and objective outcomes retrospectively, including the time to return to full activity, patient preference, cosmetic satisfaction, scar tenderness, and pillar pain. The pain was assessed using a visual analogue scale from 1 to 10. RESULTS: Based on the Levin scale, there were no significant differences between hands at any follow-up interval. At the three-month follow up, mean scale scores were lower in the ECTR group; however, the differences did not reach statistical significance. Cosmetically, all patients were satisfied with their scar irrespective of the technique. There were no statistical differences in terms of scar tenderness and pillar pain. CONCLUSION:ECTR did not show any significant advantage over short-incision OCTR. Therefore, the operator's experience and skill in using a certain method is important, regardless of which technique is used.
Carpal Tunnel Syndrome ; Cicatrix ; Cosmetics ; Follow-Up Studies ; Hand ; Humans ; Imidazoles ; Nitro Compounds ; Patient Preference ; Patient Satisfaction ; Retrospective Studies

OBJECTIVE: Even in the patients with neurologically good outcome after intracranial aneurysm surgery, their perception of health is an important outcome issue. This study aimed to investigate the quality of life (QOL) and its predictors of patients who had a good outcome following anterior circulation aneurysm surgery as using the World Health Organization Quality of Life instrument-Korean version. METHODS: We treated 280 patients with 290 intracranial aneurysms for 2 years. This questionnaire was taken and validated by 99 patients whose Glasgow Outcome Scale score was 4 and more and Global deterioration scale 3 and less at 6 months after the operation, and 85 normal persons. Each domain and facet was compared between the two groups, and a subgroup analysis was performed on the QOL values and hospital expenses of the aneurysm patients according to the type of craniotomy, approach, bleeding of the aneurysm and brain injury. RESULTS: Aneurysm patients showed a lower quality of life compared with control patients in level of independence, psychological, environmental, and spiritual domains. In the environmental domain, there were significant intergroup differences according to the type of craniotomy and the surgical approach used on the patients (p<0.05). The hospital charges were also significantly different according to the type of craniotomy (p<0.05). CONCLUSION: Despite good neurological status, patients surgically treated for anterior circulation aneurysm have a low quality of life. The craniotomy size may affect the QOL of patients who underwent an anterior circulation aneurysm surgery and exhibited a good outcome.
Aneurysm ; Brain ; Craniotomy ; Glasgow Outcome Scale ; Hemorrhage ; Hospital Charges ; Humans ; Intracranial Aneurysm ; Quality of Life ; Surveys and Questionnaires ; World Health ; World Health Organization