Additional two cases of Klinefelter's syndrome with a literatural review was presented Two cases were revealed characteristics of Klinefelter's syndrome such as small testes, hyalinization of seminiferous tubules, azoospermia, increased FSH, normal 17-ketogteroid and positive sex chromatin. One case was associated with left inguinal crytorchidism.
Azoospermia ; Hyalin ; Klinefelter Syndrome* ; Seminiferous Tubules ; Sex Chromatin ; Testis

It is essential to define the accurate location and extent of bony bridge in relation to the epiphyseal plate for operation of partial epiphyseal plate closure by bony bridge resection. Since magnetic resonance imaging(MRI) provides excellent tissue contrast and multiplaner image, it could be applied to the diagnosis and mapping of bony bridge of epiphyseal plate. A thirteen year old female with post-traumatic epiphyseal injury of ankle was diagnosed by MRI. We could assess the bony bridge accurately by direct sagittal and coronal images and excellent tissue contrast of MRI.
Ankle ; Diagnosis ; Female ; Growth Plate ; Humans ; Magnetic Resonance Imaging

During the period from January 1980 to September 1988, 59 patients suffering from brachial plexus injury, have admitted to Seoul National University Hospital. Fifty-four patients were male and 5 patients were female, and age ranged from 6 to 58 years (mean:26.8 years). The most common cause of injury was traffic accident accounting for 66% (39patient), and among them 24 patients(62%) had the motor cycle accident. Birth injury, stab or gun shot wound, fall down and industrial hazard were following causes. Fracture and dislocation of involved limb accompanied in 19 patients(32%) and 2 patients of arterial injury were also found. EMG and cervicsl myelography with or without CT were performed in almost all the patients and MRI was performed in selected patients. Forty-five patients(76%) had supra-clavicular lesion and 14 patients (24%) had infra-clavicular lesion. In supra-clavicular lesion, upper roots or whole roots were involved in most of cases. Forty-nine cases were treated with conservative treatment for more than 8 months and operative procedures were performed in 36 cases. In operative cases, 30 patients were followed up for more than 1 year (average 24.3 months). Signs of root avulsion were found in 25 out of 31 cases of cervical myelography. MRI was performed in 7 cases, but it was inconclusive in diagnosis of root involvement. Infra-clavicular lesion showed better prognosis than supra-clavicular lesion. In supra-clavicular lesion, upper root involvement had the best prognosis. A pseudocyst detected by myelography usually precluded recovery in the root at the level of pseudocyst. Result of reparative treatment was better than that of conservative treatment. Overall satisfactory result in reparative treatment was 36%. However, if we include neurological improvement, positive result was 53%. Complete recovery was gained in half cases of neurolysis and other half showed no recovery, but all the cases of neurotization showed poor result. Reconstructive surgery including arthrodesis or muscle transfer can be effective treatment method, if it is performed properly on a selective patient.
Accidents, Traffic ; Arthrodesis ; Birth Injuries ; Brachial Plexus ; Diagnosis ; Dislocations ; Extremities ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Methods ; Myelography ; Nerve Transfer ; Prognosis ; Seoul ; Surgical Procedures, Operative ; Wounds and Injuries

No abstract available.
Craniocerebral Trauma* ; Head* ; Humans ; Hypothermia*

OBJECTIVE: For the treatment of carotid cavernous fistula(CCF), transarterial detachable balloon occlusion(DBO) is the method of choice. When it has failed to occlude the fistula, various embolization methods are used to treat the fistula. Transvenous embolization through the superior ophthalmic vein(SOV) is another method of treatment. The venous approach through the SOV after surgical dissection and exposure of this vein has been recommended by some delete, but(here) delete delete(an) alternative treatment method by percutaneous puncture of the SOV without surgical dissection(is described). METHODS: A 19-year-old woman admitted to our hospital two months after accident, presented with proptosis, chemosis, occulomotor and abducens nerve palsies, and bruit of the right eye. The authors tried DBO via transarterial route in initial treatment and the fistula was occluded with subsequent disapearance of bruit. However, 2 weeks later, she complained of recurence of bruit. Transarterial approach was attempted again, but the fistula hole was too small for this approach. The venous approach via SOV by percutaneous puncture was then tried. Puncture was made at the medial one third of the superior orbital rim and the fistula was embolized with Guglielmi detachable coils (GDCs). RESULTS: The fistula was completely occluded and no early and late complications noted. The patient's clinical symptoms were improved within a few days. CONCLUSION: Treatment of CCF by percutaneous puncture of the SOV is an alternative and effective method when other approaches are not feasible.
Abducens Nerve Diseases ; Exophthalmos ; Female ; Fistula* ; Humans ; Orbit ; Punctures* ; Veins* ; Young Adult

Necrosis is, in general, an unnatural cell death that rapidly occurs in response to severe insults such as poisons, anoxia, infections and trauma. Apoptosis or programmed cell death, unlike necrosis, is a physiological cell death that causes cell deletion without inflammation, release of cellular contents. In apoptosis, individual cells separate from their neighbors and begin a characteristic sequence of structural and biological changes. These changes include cell shrinkage, condensation of chromatin, DNA degradation, activation of caspase cascade. Finally, the cell itself fragments to form apoptotic bodies that engulfed by nearby phagocytes. Apoptosis is distinguished from necrosis in that gene activation is a prominent mechanism regulating cell survival. It is an essential physiological process that plays a critical role in development and tissue homeostasis and cell population control. However, apoptosis plays an important role in the pathogenesis of a number of disease. In the anesthesiology, apoptosis may contribute to major organ damage associated with ischemic/reperfusion injury, it has long been considered to represent necrosis. Apoptosis remains the important clinical consequence of ischemic/reperfusion injury. Free radicals, tumor necrosis factor-a (TNF-alpha), protein kinase c (PKC), caspases, P53, bcl-2 family and calcium have been suggested and frequently cited as important mediators for apoptosis. In this review, I will describe the known mediators and mechanism underlying apoptosis in major organ exposed to ischemic/reperfusion injury, because the usefulness and effectiveness of any therapeutic interventions for cell deaths after ischemic/reperfusion injury depends on a clear understanding of mechanism of apoptosis.
Anesthesiology* ; Anoxia ; Apoptosis* ; Calcium ; Caspases ; Cell Death ; Cell Survival ; Chromatin ; DNA ; Free Radicals ; Homeostasis ; Humans ; Inflammation ; Necrosis ; Phagocytes ; Physiological Processes ; Poisons ; Population Control ; Protein Kinase C ; Transcriptional Activation

Exercise-induced anaphylaxis can be associated with ingestion of a specific food. We experienced a case of exercise-induced anaphylaxis followed by ingestion of parsely. A 22- year old female patient was presented with angioedema of the face and chest tightness induced by running after ingestion of parsley within 15 minutes. She had suffered from allergic rhinitis. She had positive reactions to mugwort pollen and parsely extract on skin prick test in a dose dependent manner. Although the oral provocation test with parsely could not induce bronchoconstriction, we could diagnosed as parsely dependent exercise induced anaphylaxis based upon skin prick test and history.
Anaphylaxis ; Angioedema ; Artemisia ; Bronchoconstriction ; Eating ; Female ; Humans ; Petroselinum ; Pollen ; Rhinitis ; Running ; Skin ; Thorax

The present study was carried out to investigate the structure and the glycoconjugate properties of the apoptotic cells in the rat accessory sex glands (prostate gland, seminal vesicle and coagulating gland) after castration. After identifying the apoptotic cells by TUNEL method, the structure and the glycoconjugate property of these cells was observed with the light and electron microscopes, using nine kinds of lectins (PSA, UEA I, GSL I B4, ECL, DBA, SBA, DSL, GSL II or WGA). And also, the glycoconjugate properties of the apoptotic cells originated from the prostate epithelial cell culture were investigated. The apoptotic cells have condensed and fragmented nucleus, and also have degenerated and condensed cytoplasm. The numerous apoptotic cells were observed in the accessory sex gland at 2nd day after castration, and in the cultured prostate epithelial cell which were grown in the medium lacking growth factors for 12 hours. The cytoplasm and nucleus of the apoptotic cells induced by castration showed positive reaction with PSA, UEA I, SBA, DSL and WGA, which indicate apoptotic cells have the glycoconjugates contain alpha-D-mannose, alpha-L-fucose, terminal beta-N-acetyl-D-galactosamine and internal beta-1, 4-N-acetyl-D-glucosamine oligomer. But normal epithelial cells of the accessory sex glands showed different glycoconjugate property from the apoptotic cells. These facts suggest that the glycoconjugate property was changed by apoptosis. The apoptotic cells induced by culture showed positive reactions with the nine different lectins.
Animals ; Apoptosis ; Castration* ; Cytoplasm ; Epithelial Cells ; Glycoconjugates* ; In Situ Nick-End Labeling ; Intercellular Signaling Peptides and Proteins ; Lectins ; Prostate ; Rats* ; Seminal Vesicles

The presnt study was carried out to find out any difference in terms of the rate of rebleeding, mortality and of the occurrence of vasopasm and hydrocephalus between the two groups of patients with subarachnoid hemorrhage : a group of 225 cases which were administered with epsilon aminocaproic acid(EACA) (antifibrinolytic agent) and the other a group of 221 cases without EACA treatment. Both groups were chosen from 476 patients admitted to the Department of Neurosurgery, Kyung-Hee University Medical Center within 7 days after the onset of subarachnoid hemorrhage during a period from January 1982 to December 1987. The clinical observation was done during acute period following subarachnoid hemorrhage. The major findings obtained were as follows : 1) The occurrence of rebleeding was higher within 3 days after the onset of subarachnoid hemorrhage. The rate of rebleeding was 8.4% in treated group whereas the rate was 13.1% in control group. This may suggest that administration of EACA is effective to prevent rebleeding. 2) the occurrence of vasopasm was higher within on the 7th and 8th day after the onset of subarachnoid hemorrhage. The rate of vasospasm was 28.9% in treated group whereas the rate was 12.4% in control group. This means that the rate of occurrence of vasospasm was two times higer in EACA treated group. 3) the rate of occurrence of hydrocephalus was 18.3% in treated group whereas the rate lower in control group(11.6%). 4) Within-two-weeks mortality and within-one-month mortality were 14.7% and 22.2% respectively in treated group whereas the two rates in control group were 15.1% and 24.1% respectively. No significant difference between the two groups was observed. 5) The causes of death in treated group were found to be vasospasm(55.5%) and rebleeding(28.0%) in order, whereas in control group the causes of deaths were rebleeding(40.2%) and vasospasm(21.3%). In other words, the main cause of death was vasospasm in treated and that in control group was rebleeding.
Academic Medical Centers ; Cause of Death ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Subarachnoid Hemorrhage*

The Kniest syndrome is characterized by disproportionate dwarfism and Kyphoscoliosis which may be associated with flat facies with prominent eyes, cleft palate, hearing loss, myopia and limited joint motion. The skeletal abnormalities are recognizable at birth with shortening and deformity of the extremities and stiff joints. Marked lumbar lordosis and kyphoscoliosis develop in childhood, resulting in disproportionate shortening of the trunk. We experienced a case of kniest syndrome, confirmed by clinical features, radiological features, and histological examination of cartilage. A brief review of the related literature is presented.
Animals ; Cartilage ; Cleft Palate ; Congenital Abnormalities ; Dwarfism ; Extremities ; Facies ; Hearing Loss ; Joints ; Lordosis ; Myopia ; Parturition