The most common fracture about the elbow joint in chilren is a supracondylar fracture. The displaced fracture is difficult to manage due to the potential danger of Volkmann's ischemia, nerve injury, and malunion, During the period of 6 years from June, 1979 to June, 1985, 63 children with supracondylar fractures of the humerus were treated at Pusan Paik Hospital, Inje Medical College, and analyzed. The results are summarized as follows: 1. The average age was 7.1 years, ranged from 1 year to 14 years, and the male and female ratio was 2.5: l. 2. In type of fracture, extension type was 92% and flexion type was 8%. In displacement of fracture, Grade I was only 2 cases, Grade III and IV were 87.3%. Posteromedial displacement was 42.8% (27 cases). 3. At the time of admission, 15cases(23.8%) accompanied nerve injury, of these median nerve injury (9 cases) was most common. All the patient with nerve injury were completely recovered within 14 months after reduction. 4. Severe cubitus varus was 14.2%, and severe limitation of elbow motion was 1.6%. 5. Of 61 displaced fractures, 37 patients were treated with closed reduction and percutaneous pin fixation. By Flynn's criteria, satisfactory results were obtained in 36 of the 37 patients(97.3%) treated with percutaneous pinning. 6. In the displaced fractures, closed reduction and percutaneous pinning is a satisfactory method for obtaining and maintaining reduction while preserving vascular function, if acute flexion is necessary for stable reduction.
Busan ; Child ; Clinical Study ; Elbow ; Elbow Joint ; Female ; Fractures, Closed ; Humans ; Humerus ; Ischemia ; Male ; Median Nerve ; Methods

We found a mistake in our recently published article.

We expierenced two cases of intradural verteral artery dissecting aneurysms. The presenting symptom was subarachnoid hemorrhage in one case and ischemic symptom in the other. The preoperative angiographic finding typically showed fusiform dilatation and proximal and/or distal narrowing of the affected artery. In one case, the vertebral artery was clipped distal to the PICA and in the other case trapping was performed through the extreme lateral transcondylar approaches. This approach permits a control of the aneurysm through the direct view of whole length of the vertebral artery, lower cranial nerves and ventral brain stem. In order to obtain ample view and to save the lower cranial nerves and perforating vessels, jugular tubercle should be sufficiently drilled out. Postoperitive neurological outcomes were favorable except mild hoarseness for some period in trapping case.
Aneurysm ; Aneurysm, Dissecting* ; Arteries ; Brain Stem ; Cranial Nerves ; Dilatation ; Hoarseness ; Pica ; Subarachnoid Hemorrhage ; Vertebral Artery

BACKGROUND: Influenza is a highly contagious respiratory disease. Influenza virus, which causes epidemics every winter season, has the high possibility of appearing with new virus types every year due to antigen variation. Therefore, we intended to analyze the data on the epidemiology of influenza that had been acquired by laboratory surveillance in Incheon during the 2003/2004 and 2004/ 2005 seasons and to apply the knowledge to the control and prevention of influenza in Korea. METHODS: Specimens were inoculated into Madin-Darby canine kidney (MDCK) cells and, when cytopathic effect (CPE) was seen, culture supernatants were tested by mutiplex RT-PCR for typing and subtyping of influenza viruses. RESULTS: The first virus of the season was isolated at week 47 (3rd week on November) in 2003 during 2003/2004 and at week 43 (4th week on October) in 2004 during 2004/2005, which was about 4 weeks earlier than in the 2003/2004 season. From 532 specimens cultured for influenza virus during the 2003/2004 season. 330 (62.0%) viruses were isolated: 161 (48.8%) A/H3N2, 1 (0.3%) A/H1N1, and 168 (50.9%) B. During 2004/2005 season, 457 specimens were tested and 278 (60.8 %) were positive for influenza virus: 232 (83.5%) A/H3N2, 5 (1.8%) A/H1N1, and 38 (13.7%) B. The incidence of influenza was the highest in the school-age children and young adults of 7 to 19 years age group in both seasons. CONCLUSION: Influenza virus was isolated at a high rate (more than 60%) by the laboratory influenza surveillance system in Incheon during the 2003/2004 and 2004/2005 seasons: the predominant strain was influenza A/H3N2 subtype.
Antigenic Variation ; Child ; Epidemiology ; Humans ; Incheon* ; Incidence ; Influenza, Human* ; Kidney ; Korea ; Orthomyxoviridae ; Seasons ; Young Adult

No abstract available.

OBJECTIVE: Endovascular treatment is one of the most important treatments along with open craniotomy for cerebrovascular surgery. The successful treatment of endovascular disease relies on appropriate instruments and the surgeon's skill. Endovascular treatment needs to provide safe and stable access to the catheter cavity. Additionally, it is important to maintain a round shape without changing to an oval shape. The catheter for endovascular treatment has to be flexible and accommodate at least 0.027 inches of inner diameter. The 6-Fr Navien™ Intracranial Support Catheter (formerly the ReFlex Intracranial Catheter; Covidien Vascular Therapies, Mansfield, MA, USA) provides 0.072 inches of inner diameter. MATERIALS AND METHODS: We reviewed 61 cases for 56 cases of endovascular treatment with a Navien catheter. A triaxial system was used for all procedures with femoral arterial access. The Navien catheter was placed in the petrous segment of the internal carotid artery or third segment of the vertebral artery. The patients had various shapes of intracranial arteries, including tortuous vessels. RESULTS: The Navien catheter was used for 61 cases of endovascular treatment. We had 59 cases of coil embolization at unruptured and ruptured aneurysms and two cases of stent insertion into the middle cerebral artery. All the cases were successful without any catheter-related complications. CONCLUSION: The Navien catheter is a recently developed catheter that has several strengths compared with previously developed catheters. It provides a more stable environment for endovascular treatment. It provides a cavity sufficient for endovascular treatment devices. Additionally, it is sufficiently flexible to approach tortuous vessels.
Aneurysm, Ruptured ; Arteries ; Carotid Artery, Internal ; Catheters* ; Craniotomy ; Embolization, Therapeutic ; Endovascular Procedures ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Reflex ; Stents ; Vascular Access Devices ; Vertebral Artery

OBJECTIVE: Researchers and clinicians have been unable to fully elucidate the natural course of and proper treatment for unruptured intracranial aneurysms (UIAs) smaller than or equal to 5 mm, particularly with regard to whether close observation or surgery is more appropriate. In this retrospective study, we evaluated the safety and efficacy of endovascular coil embolization of small (≤ 5 mm) asymptomatic UIAs by analyzing outcomes and complications associated with the procedure. MATERIALS AND METHODS: We analyzed data from 150 patients with small asymptomatic UIAs (≤ 5 mm) treated with coil embolization between January 2011 and December 2015. Three-dimensional angiography was used to measure aneurysm size. We evaluated procedure-related morbidity and mortality, immediate post-operative angiographic results, brain computed thomography follow-up results on post-operative day one, and clinical progress. RESULTS: UIAs occurred primarily in the anterior circulation area (142 cases, 94.67%), though eight patients exhibited UIAs of the posterior circulation. Following coil embolization, aneurysms with complete occlusion were observed in 137 cases (91.3%). Partial occlusion occurred in five cases (3.33%), while the procedure had failed in eight cases (5.33%). Procedure-related morbidity and mortality were five cases (3.33%) and zero cases, respectively. CONCLUSION: The endovascular treatment of small asymptomatic UIAs is associated with good short-term outcomes without permanent neurologic complications as well as low overall complication and morbidity rates. Thus, the procedure should be considered for patients with smaller asymptomatic UIAs.
Aneurysm ; Angiography ; Brain ; Embolization, Therapeutic* ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Mortality ; Retrospective Studies

PURPOSE: This study investigated the effects of multiple drilling on the immature capital femoral epiphysis following ischemic injury in a piglet model. MATERIALS AND METHODS: Ischemic necrosis of capital femoral epiphysis was induced bilaterally in 12 piglets using a cervical ligation method. Three weeks later, medial, central, and lateral 3 drill holes were made on the left femoral head using 0.062" K-wire. At 3, 6, 9, and 12 weeks following the multiple drilling, femoral heads were harvested from each three piglets. On histologic examination, percent of revascularization, percent of osteoblast surface, capital femoral epiphyseal quotient and proximal femoral growth plate height were evaluated. Untreated right femoral heads served as control. RESULTS: While percent of revascularization of left capital femoral epiphysis with multiple drilling was significantly higher than untreated control side (p<0.001), percent of osteoblast surface, capital femoral epiphyseal quotient and proximal femoral growth plate height showed no significant difference. CONCLUSION: This study indicates that multiple drilling could promote revascularization of ischemic capital femoral epiphysis, and multiple drilling does not appear to produce bony physeal bars at short-term, if using small diameter drill. However, multiple drilling alone does not seem to prevent femoral head deformity or to promote new bone formation.
Animals ; Bone Remodeling ; Disease Models, Animal ; Epiphyses/*blood supply/pathology/*surgery ; Female ; Femur Head/*blood supply/pathology/*surgery ; Humans ; Ischemia/pathology/*surgery ; Legg-Calve-Perthes Disease/pathology/surgery ; Swine

PURPOSE: Pneumonia is rather common and benign disease in children but its course is various. Many clinicians used the empirical antibiotics to treat pneumonia without identification of causative organism. This study was performed to find the pathogenic organism from the fluid culture by bronchoscopy with BAL (bronchoalveolar lavage) in severe pneumonia patients. METHODS: We studied 21 cases (male 15, female 6) who were admitted with severe pneumonia in the Department of Pediatrics, Sunlin Hospital from March to October in 1999. These patients had no underlying disease such as immunologic deficiency. We took laboratory tests including CBC, CRP, ESR, PB smear, mycoplasmal antibody and blood culture at admission day. We performed bronchoscopy with BAL, and wet smear and culture of that fluid. RESULTS: Organisms were cultured in nineteen cases out of 21 cases. Seven cases of Streptococcus mitis, five of Stenotrphomonas maltophilia, five cases of Streptococcus oralis, two of Moraxella species, two of Acinetobacter junii, one of Acinetobacter spesies, one Staphylococcus hominus, one alpha-h-Streptococcus, one Klebsiella pneumoniae, one Pseudomonas aeruginosa, one Enterobacter cloacae. Two organisms were cultured in nine cases. CONCLUSION: The positive rate of BALF culture was very high (90.5%). But, further studies are necessary for the patients with severe pneumonia preceded the use of antibiotics.
Acinetobacter ; Anti-Bacterial Agents ; Bronchoalveolar Lavage* ; Bronchoscopy ; Child ; Enterobacter cloacae ; Female ; Humans ; Klebsiella pneumoniae ; Moraxella ; Pediatrics ; Pneumonia* ; Pseudomonas aeruginosa ; Staphylococcus ; Streptococcus mitis ; Streptococcus oralis

BACKGROUND: The Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH) is one of the most widely used questionnaires for assessing functional ability of the patients with upper extremity diseases. Carpal tunnel syndrome (CTS) is the most common neuropathic disease in the upper extremities. The aim of this study was to verify the validity, reliability, and responsiveness of Korean version of QuickDASH questionnaire (K-QuickDASH) in the patients with CTS. METHODS: In total, 83 subjects who underwent open carpal tunnel release (CTR) operation were selected. They fulfilled Korean version of Disabilities of the Arm, Shoulder and Hand questionnaire (K-DASH) and K-QuickDASH at two different time points: before and six months after the surgery. Both criterion-related and construct validities were evaluated using Pearson's correlation coefficient and factor analysis. Internal consistency was estimated using Cronbach's alpha, and test-retest reliability was assessed to verify the reliability of K-QuickDASH using intraclass correlation coefficient (ICC). The standardized response mean and the effect size were analyzed to confirm the responsiveness of the K-QuickDASH in CTS patients. RESULTS: Significant positive correlation was found between K-QuickDASH and K-DASH. All the questionnaire items were categorized into three factors. Acceptable internal consistency was confirmed in three categories of K-QuickDASH. A high test-retest reliability and responsiveness of K-QuickDASH were detected. CONCLUSION: K-QuickDASH in Korean patients with CTS was confirmed to have high degree of validity and reliability, and responsiveness after CTR. Therefore, the K-QuickDASH would be a good evaluation tool for evaluating clinical symptoms and determination of treatment outcomes in the patients with CTS.
Arm* ; Carpal Tunnel Syndrome* ; Hand* ; Humans ; Reproducibility of Results ; Shoulder* ; Upper Extremity