Diaphyseal fractures of the radius and ulna present high incidence of malunion and non-union because of difficulty in reduction and maintenance of two mobile, parallel bones in the presence of the pronating and supinating muscles which exert angulatory as well as rotational forces. Over the years various methods of open reduction and internal fixation or the closed method have been advocated, but open reduction, especially fixation with compression plate and screws resulted in more satisfactory results was proved recently by the major clinical reports. From March. 1977 to December. 1985, 59 cases of diaphysesl fractures of the forearm both bone in adult and children were managed in the Department of Orthopedic Surgery, Chonbuk National University Hospital and comparisions have been made between the conservative treatment group and operative group. The obtained results were as follows; 1. The most common csuse of injury was fallen on the outstretched hand in children and traffic accident in adult. 2. The most frequent site of the fracture was middle one-third(50.8%). 3. The most common pattern of the fracture was stable fracture(50.1%). 4. The applied methods for management of the fractures include cast immobilization after manual reduction or skeletal traction, K-wire fixation, compression plate and screws, intramedullary nailing, and combined. 5. Comparision of conservative treated group with operative treated group was as follows. 1) In roentgenologically, excluding those complicated by nonunion or infection, average bone union time of conservative group in children and adolescence was 10.2 weeks and in adult was 16.7 weeks, and of operative group was 13.9 weeks. 2) According to Grace and Eversmann's evaluation, Satisfactory results were shown in 80.0% of children and adolescence group treated by conservative method and 86.7% of adult group trested by compression plate and screws. 3) Among the various internal fixstion methods, compression plate and screws method was the best measure for rapid bone union and functional recovery in adult. 4) Any marked difference between each group was not seen in nonunion, but angulstory and rotational deformity were more common in conservative group and infection was developed 2 cases in operative group only. 6. There was no noticesble difference between each treatment in children and adolescence, but operative treatment, especially compression plate and screws, in adult was more superior to conservative treatment with. regard to bone union time and functional result.
Accidents, Traffic ; Adolescent ; Adult ; Child ; Clinical Study ; Congenital Abnormalities ; Forearm ; Fracture Fixation, Intramedullary ; Hand ; Humans ; Immobilization ; Incidence ; Jeollabuk-do ; Methods ; Muscles ; Orthopedics ; Radius ; Traction ; Ulna

Primary malignant lymphoma of the appendix is an unconnnon neoplasm although the gastrointestinal tract is the most common extranodal site of malignant lymphoma. We report a case of primary malignant lymphoma of the appendix in a 54-year-old male, who presented with pain in the right lower abdomen. An appendectomy was performed. The appendix measured 9.5 cm in length and 5.5 cm in diameter. Cut sections showed a solitary circumferential mass in the appendiceal lumen. Light microscopic features were compatible with malignant lymphoma of diffuse large cell type(Working Formulation) and the immunophenotype was B cell type.

Paragonimiasis caused by Paragonimus westermani is essentially a pulmonary disorder, but it is also known to cause ectopic parasitism at various sites in human host such as the brain, muscle, liver, spinal cord and spleen. Ectopic parasitism of the female genital tract, especially the ovary is relatively rare. We have experienced a case of a 62-year-old Korean woman with asymptomatic ectopic paragonimiasis in the salpinx , ovary, and cul de sac.
Female ; Humans

It is well known that increasing tendency of emergency surgery of congenital snomalies such as tracheoesophageal fistu1a, esophageal atresia, esophageal hiatal hernia, hypertrophic pyloric stenosis,intestinal obstruction, imperforated anus, omphalocele, and meconium ileus by virtue of improvement of pediatric surgical procedure, anesthetic agent, and anesthetic method. The possibility of a low gastric pH and the resultant pulmonary damage if aspirated must be considered in the initial care of the newborn with poor muscle tone or reflex activity as well as in the anesthetic management of neonates. We became interested in the factors determining neonatal gastric pH in this point of view, and have measured gastric pH in 75 unselected neonates, 55 of whom were born vaginally and 20 by cesarean section. In premature infants, pH was high regardless of mode of delivery. In mature infants, pH was 1) significantly lower after vaginal delivery than after cesarean section; 2) tended to be lower after section preceded by labor than after elective section; and 3) was lowest after precipitate delivery. There was no correlation between neonatal gastric pH and duration of rupture of membranes, birth weight, or Apgar score. It was concluded that the mature human fetus produces gastric acidity in response to stresses associated with labor and vaginal delivery.
Anal Canal ; Apgar Score ; Birth Weight ; Cesarean Section ; Emergencies ; Esophageal Atresia ; Female ; Fetus ; Gastric Acid* ; Hernia, Hiatal ; Hernia, Umbilical ; Humans ; Hydrogen-Ion Concentration ; Ileus ; Infant ; Infant, Newborn ; Infant, Premature ; Meconium ; Membranes ; Pregnancy ; Reflex ; Rupture ; Virtues

PURPOSE: The aim of this study was to identify the clinical features and natural history of dietary protein induced proctocolitis (DPIPC) and to detect the causative foods of DPIPC, and to evaluate the effect of elimination of the foods on the course of the disease. METHODS: Between March 2003 and July 2004, data from 30 consecutive patients with DPIPC who were followed for over 6 months, was reviewed. The diagnostic criterion used for DPIPC was an increase in the number of eosinophils in the lamina propria (> or =60 per 10 high-power fields). In breast feeding mothers, 5 highly allergenic foods were eliminated from the maternal diet for 7 days, namely, allergenic food groups such as dairy products, eggs, nuts and soybean, fish and shellfish, and wheat and buckwheat. We observed the disappearance or appearance of hematochezia after elimination or challenge with the offending foods. RESULTS: Before diagnosis infants were breast-fed (93.3%) or formula-fed (6.7%). Mean age at symptom onset was 11.5+/-5.1 (5~24) weeks, and mean age at diagnosis was 17.8+/-9.5 (8~56) weeks. Duration from symptom onset to diagnosis was 6.3+/-6.7 (0~36) weeks. Mean peripheral blood eosinophil count was 478+/-320 (40~1,790)/mm3 and eosinophilia (>250/mm3) was observedin 90.0% of patients. None of patients were found to have an increased serum IgE level. Of 15 patients that received sigmoidoscopy, nodular hyperplasia with erosion was observed in 93.3%. Of 27 patients whose mother ate the diet eliminated the 5 food groups, hematochezia diappeared in 74.1% of patients. Offending foods were identified as dairy products (37.5%), wheat and buckwheat (27.5%), fish and shellfish (20.0%), nuts and soybean (7.5%) and eggs (7.5%). A free maternal diet without patient's clinical symptoms was achieved at 29.4+/-8.7 (9~44) weeks of patient's age, and a free baby diet without blood in stools was achieved at 37.5+/-9.7 (12~56) weeks of age. CONCLUSION: DPIPC commonly occurs in exclusively breast-fed babies. Elimination of the above-mentioned 5 hyper-allergenic food groups from the maternal diet for 7days enables the detection of the offending foods. DPIPC is a transient disorder and 96.0% of patients can tolerate the offending foods at 12 months of age.
Breast Feeding ; Dairy Products ; Diagnosis ; Diet* ; Dietary Proteins* ; Eggs ; Eosinophilia ; Eosinophils ; Fagopyrum ; Gastrointestinal Hemorrhage ; Humans ; Hyperplasia ; Immunoglobulin E ; Infant ; Mothers ; Mucous Membrane ; Natural History* ; Nuts ; Ovum ; Proctocolitis* ; Shellfish ; Sigmoidoscopy ; Soybeans ; Triticum

OBJECTIVE: A 10-year retrospective lumboperitoneal(LP) shunt surgery was reviewed in order to verify the several prognostic factors including the etiology, the findings of brain computed tomography(CT) and/or magnetic resonance imaging(MRI), and the effect of lumbar drainage which have been implicated in the result of LP shunt. PATIENTS AND MEHTODS: A series of 32 patients who underwent LP shunt surgery between March 1988 and May 1998 for the management of communicating hydrocephalus was reviewed. RESULTS: The etiology of communicating hydrocephalus was subarachnoid hemorrhage(SAH) in 19 cases(59.4%), head trauma in 10 cases(31.2%), intracerebral hemorrhage in 2 cases(6.3%), meningitis in 1 case(3.1%), tumor in 1 case(3.1%), and idiopathic in 2 cases(6.3%). The mean follow-up period was 1.2 years(range, 2 week to 8.5 year). Among them, twenty four patients(75%) were clinically improved after shunt operation. The result of LP shunt was not related to the etiologies and many findings of brain CT/MRI such as ventricular index, Evan's index, periventricular low density, obliteration of cerebral sulci and cortical atrophy. However, the result of LP shunt was significantly related to the effect of preoperative lumbar drainage(p=0.0184). CONCLUSION: This result suggests that the effect of preoperative lumbar drainage has a significant role in predicting the result of LP shunt in patients with communicating hydrocephalus.
Atrophy ; Brain ; Cerebral Hemorrhage ; Craniocerebral Trauma ; Drainage ; Follow-Up Studies ; Humans ; Hydrocephalus* ; Meningitis ; Retrospective Studies

BACKGROUND AND OBJECTIVE: IgG subclass deficiency has been reported in patients with bronchial asthma and is associated with recurrent respiratory tract infections. This study was done to identify prevalence of IgG subclass deficiency and to evaluate the possible difference between atopic and non-atopic asthmatics. Subjects and METHODS: We measured serum levels of IgG and IgG subclass in 35 asthmatic patients and 50 healthy controls using nephelometry. Reference values of each IgG subclass was defined as cumulative percentile between 2.5% to 97.5% of controls. RESULTS: Total IgG, IgG1 and IgG2 of asthmatics were significantly lower than for those of controls(p<0.05, respectively). In atopic asthmatics, compared with non-atopic asthmatics, IgG4 level was significantly higher (p<0.05). The frequency of IgG subclass levels below the reference value was eight (22.9%) of 35 asthmatics. CONCLUSION: IgG, IgG1 and IgG2 were significantly lower in asthmatic patients. Some patients had IgG subclass levels below reference value. Further studies will be needed to evaluate their clinical significance.
Asthma* ; Humans ; Immunoglobulin G* ; Nephelometry and Turbidimetry ; Prevalence ; Reference Values ; Respiratory Tract Infections

The diagnosis of Hodgkin's disease is based on the morphologic identification of Reed-Sternberg (RS) cells and its variants in paraffin-embedded sections. The origin of RS cells remains a subject of controversy, and cells resembling RS cells are observed in some non-Hodgkin's lymphoma of T-cell lineage. In this study, eighteen cases of Hodgkin's disease (3 nodular sclerosis, 6 diffuse lymphocyte predominance, and 9 mixed cellularity) were studied with peanut agglutinin(PNA), anti-Leu-M1(CD15), LN2(CD74), Ber-H2(CD30) and bauhinia purpurea (BPA) by the avidin-biotin-peroxidase complex(ABC) method in paraffin-embedded sections. RS cells and their variants revealed positive reactions with one or more of the reagents in all examined cases. BPA staining was positive in 17 of 18 cases (94.4%), PNA staining was positive in 9 of 18 cases (50.0%), Leu MI was positive in 7 of 18 cases(38.9%), Ber-H2 was positive in 11 of 18 cases (61.1%), and LN2 was positive in 8 of 18 cases(44.4%). The staining properties of examined markers were recognized as paranuclear, diffuse cytoplasmic and cellular membranous patterns, but LN2 disclosed diffuse cytoplasmic staining in the positive cells. BPA also showed dense cytoplasmic staining reaction with macrophage-histiocytes. BPA reactivity was not affected by fortnalin fixation or paraffm embedding. Thirty six cases of non-Hodgkin's lymphomas(IO T-cell and 26 B-cell type) were also examined. The neoplastic cells of those cases did not stain positive with BPA, PNA, and Leu-Mi, but stained positively with LN2 in 3 cases of T-cell lymphomas and 14 cases of B-cell lymphomas, and BeT-H2 in T-cell lymphomas. In conclusion, to facilitate the detection of RS cells and related variants in paraffm sectionse of Hodgkin's disease, BPA can be used as a useful marker because of its high-detection rate, reproducible staining pattem, and resistance to fixative.

We report a case of catheter-related bacteremia due to Tsukamurella pulmonis. T. pulmonis is a rare cause of opportunistic infection in immunosuppressed patients and in cases of indwelling foreign materials. This infection was nearly impossible to identify using conventional phenotyping methods because of its similarities to the related genera Nocardia, Rhodococcus, Gordonia, Streptomyces, Corynebacterium, and Mycobacterium. This organism was initially misidentified as Mycobacterium aubagnense through PCR-RFLP analysis. We correctly identified this organism using 16S rRNA sequencing combined with phenotyping tests.
Bacteremia ; Catheters ; Corynebacterium ; Humans ; Korea ; Mycobacterium ; Nocardia ; Nontuberculous Mycobacteria ; Opportunistic Infections ; Rhodococcus ; Streptomyces

Vesicles and bullae are the primary lesions in many diseases. The histologic classification of bullous disorders is based on the level in the skin on which that cleavage developed. We report a 44-year-old man with vitiligo at dorsum of hand who has experienced spontanous bullae at recipient site after epidermal graft for the treatment of vitiligo. Histopathologic examination revealed a subepidermal bullae and moderate lymphocytes and eosinophil infiltration in the dermis. Direct immunofluorescence test was negative. There was a change of CD4/CD8 ratio in immunohistochemical staining for CD4 and CD8 monoclonal antibody. There were no clinical signs of infection and drug eruption, and friction did not seem to have been a contributing factor.
Adult ; Classification ; Dermis ; Drug Eruptions ; Eosinophils ; Fluorescent Antibody Technique, Direct ; Friction ; Hand ; Humans ; Lymphocytes ; Skin ; Transplants* ; Vitiligo*