Neurofibromatosis is an autosomal dominant abnormality that may affect multiple organ systems. The eyelids, the orbits, the adjacent tissues and bones may be involved with varying frequency and severity. The management of orbitotemporal neurofibromatosis depends very much on the type and severity of the orbital involvement and on the functional state of the eye. Experience with surgical management of orbitotemporal neurofibromatosis involved in the orbit, the temporal soft tissue and bone with blind eye is reported. The goal of surgery is tumor resection, reconstruction of the orbital socket, aesthetic eyelids, and insertion of the artificial prosthesis. A two stage approach is recommended. In the first stage, tumor is resected and the orbital socket is reconstructed with titanium mesh plate and cranial bone graft. After reconstruction of the orbital socket, galeal flap is rotated posteriorly to cover the mesh plate and canthopexy is accomplished. Mask lift is performed to enhance aesthetics. In the second stage, correction of the bulky eyelids is achieved and orbital space for insertion of the artificial prosthesis is reconstructed. Authors have managed a orbitotemporal neurofibromatosis with blind eye of a 41-year-old male using titanium mesh plate and bone graft with satisfactory results.
Adult ; Esthetics ; Eyelids ; Humans ; Male ; Masks ; Neurofibromatoses* ; Neurofibromatosis 1 ; Orbit ; Prostheses and Implants ; Titanium ; Transplants

No abstract available.
Anterior Cruciate Ligament* ; Autografts* ; Polyethylene*

PURPOSE: In addition to regulating calcium and phosphorus homeostasis and bone metabolism, vitamin D is known as an immune modulator. Recently, there has been increased worldwide interest in the association between low levels of vitamin D and allergic diseases. The purpose of this study was to assess the relationship between serum vitamin D levels and allergic/vasomotor rhinitis (AR/VR) in children. METHODS: This study included 164 patients. The sample included 59 patients with AR, 42 patients with VR, and 63 controls. Their ages ranged from 0 to 16 years. We examined the levels of 25-hydroxyvitamin D, Immunoglobulin E, specific IgE, and eosinophil cationic protein; peripheral blood eosinophil count; and the results of a skin prick test. RESULTS: Serum 25-hydroxyvitamin D levels were 19.0+/-8.5 ng/mL in the AR group, 25.5+/-10.9 ng/mL in the VR group, and 26.9+/-10.7 ng/mL in the control group. After adjustment for body mass index and season at the time of blood sampling, vitamin D levels in the AR group were lower than those of the VR group (P=0.003) and control group (P<0.001). Vitamin D levels were inversely correlated with Immunoglobulin E levels (r=-0.317, P<0.001). AR patients with food allergy or atopic dermatitis did not have lower levels of 25-hydroxyvitamin D than AR patients without these diseases. CONCLUSION: This study demonstrates a possible relationship between vitamin D levels and allergic rhinitis in Korean children.
Body Mass Index ; Calcium ; Child* ; Dermatitis, Atopic ; Eosinophil Cationic Protein ; Eosinophils ; Food Hypersensitivity ; Homeostasis ; Humans ; Immunoglobulin E ; Immunoglobulins ; Metabolism ; Phosphorus ; Rhinitis ; Rhinitis, Vasomotor* ; Seasons ; Skin ; Vitamin D* ; Vitamins*

Severe muscular rigidity is a rare but potentially serious side effect from the use of opioid, usually in high dose. However it has also been reported with the use of low to moderate dose of opioids in a few occasions. The age of the patients varied from newborn to old. These diverse and unpredictable natures of clinical manifestations seem to be related to the unknown mechanisms in the subcortical areas which are difficult to study. Now the author reports the case of severe muscular rigidity which occurred in the 5 year old child who received the usual analgesic dose of meperidine, notably in rapid injection. And after reviewing the related literatures,the author puts some emphasis regarding management of this problem.
Analgesics, Opioid ; Child ; Humans ; Infant, Newborn ; Meperidine ; Muscle Rigidity

The association between choledochal cysts and pregnancy is unlikely to be etiological, but may rather be an aggravation or precipitation of a preexisting condition. Although choledochal cysts rarely occur in pregnancy, the aim of this study is to elucidate the condition associated with pregnancy because delayed or inappropriate therapy may be catastrophic for both mother and child. Authors reviewed 18 cases of choledochal cyst, of which 2 were aggravated during pregnancy, managed at the Department of Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, during the period from 1990 to 1995. The results were as follows: The ratio of female to male was 2.6:1 which revealed predominance in female and most frequent age group was above sixty years old(33%). In non-pregnant patients, the most common symptoms were abdominal pain(78%) and all pregnant patients had pain, jaundice, nausea and vomiting, and indigestion. Transaminase and bilirubin were elevated in all pregnant patients. In all patients, US(88%, 100%) was the most common preoperative diagnostic study and one case was diagnosed during explo-laparotomy. Pregnant patients have cholecystitis in two cases and nonpregnant patients had cholecystitis(19%), CBD stone(19%), and others. The operative procedures were performed in 9 cases and pregnant patients were operated by cyst excision and Roux-en-Y hepaticojejunostomy in one case, and also Roux-en-Y choledochocystojejunostomy in one case. According to Todani's classification, in non pregnant patients, type I was the most common(63%), in pregnant patients, two cases were type I. Postoperative complications occurred in 3 cases, wound infection(6%) and cholangitis(6%) in non pregnant patients, pleural effusion(6%) in pregnant patients. Two cases of choledochal cyst in pregnancy were 25 years old at 29.4 weeks and 36 years old at 16 weeks into pregnancy.
Adult ; Bilirubin ; Child ; Cholecystitis ; Choledochal Cyst* ; Classification ; Dyspepsia ; Female ; Heart ; Humans ; Jaundice ; Male ; Mothers ; Nausea ; Postoperative Complications ; Preexisting Condition Coverage ; Pregnancy* ; Surgical Procedures, Operative ; Vomiting ; Wounds and Injuries

In this study, the trypsin gene (bgtryp-1) from the German cockroach, Blattella germanica, was cloned via the immunoscreening of patients with allergies to cockroaches. Nucleotide sequence analysis predicted an 863 bp open reading frame which encodes for 257 amino acids. The deduced amino acid sequence exhibited 42-57% homology with the serine protease from dust mites, and consisted of a conserved catalytic domain (GDSGGPLV). bgtryp-1 was determined by both Northern and Southern analysis to be a 0.9 kb, single-copy gene. SDS-PAGE and Western blotting analyses of the recombinant protein (Bgtryp-1) over-expressed in Escherichia coli revealed that the molecular mass of the expressed protein was 35 kDa, and the expressed protein was capable of reacting with the sera of cockroach allergy patients. We also discussed the possibility that trypsin excreted by the digestive system of the German cockroach not only functions as an allergen, but also may perform a vital role in the activation of PAR-2.
Allergens/analysis/chemistry/*genetics ; Amino Acid Sequence ; Base Sequence ; Blattellidae/*genetics ; Blotting, Western ; Catalytic Domain/genetics ; DNA, Complementary/genetics ; Escherichia coli/metabolism ; Female ; *Genes, Insect ; Humans ; Male ; Molecular Sequence Data ; Molecular Weight ; Receptor, PAR-2/metabolism ; Recombinant Proteins/analysis/biosynthesis/chemistry ; Research Support, Non-U.S. Gov't ; Sequence Alignment ; Sequence Homology, Amino Acid ; Trypsin/analysis/chemistry/*genetics

No abstract available.
Child* ; Humans ; Seizures, Febrile*

Amniotic embolism is a fatal disease with an abrupt onset and rapidly deteriorating clinical course. Its clinical features are various and the prediction of its occurrence is very difficult. Understanding its pathogenetic mechanisms has increased over the past two decades. We report on a case of amniotic embolism along with its full clinical manifestations after a normal delivery in the young primigravida.
Embolism*

This study was conducted to understand health status by general characteristic, and to find out relationship between social support and worker's health status. Health status was measured using SF-36(Medical Outcome Study Short Form 36), a 36 item self administered Instrument. The finding of this study were as follow; Mean scores of health status by sex were higher in male. The younger worker reported good health on physical functioning and role limitation-physical than did the older worker, but the older worker reported good health on social functioning and mental health. Mean scores of health status were higher in high income and white worker. When the relationship between social support and health status, social functioning, role limitation-emotion, mental health, vitality, general health were significantly related. Therefore we reviewed the evidence that socio-economic condition are associated with health status in this study, and that the strength of the social support was a important to maintain health.
Humans ; Male ; Mental Health ; Outcome Assessment (Health Care)

This study is concerned with the classifcation of Korean adult mandibular condyles on the basis of the shape of their anteroposterior view. The results were as follows ; 1. Morphological variations are classified into 4 groups. The percentage of each group has been : flat, 7.7% ; convex, 47.2% ; angled, 14.8% ; round, 30.3%. 2. The location of the highest point were as follows : in the lateral third, 15.5% ; middle third, 80.3% ; medial third, 4.2%. 3. The maximum transverse diameter and greatest height were 20.3±2.4mm and 6.5±1.5mm, respectively.
Adult* ; Classification* ; Humans ; Mandibular Condyle*