No abstract available.
Anaphylaxis* ; Histamine Release* ; Histamine* ; Mast Cells*

Acute tubular necrosis has been rarely reported as a complication of typhoid fever in the literature. We experienced four cases of acute tubular necrosis associated with typhoid fever in children. Patients showed significant titer of widal reaction associated with acute renal failure and one of them rised in 2 months after onset of clinical symptoms. Renal biopsy findings were compatible with acute tubular necrosis and immune complexes were not deposited in the glomeruli. Clinical and urinary findings were normalized by hemodialysis and antibiotic therapies. In conclusion, close longterm follow up of widal titer is mandatory in acute tubular necrosis, especially when associated with high fever.
Acute Kidney Injury ; Antigen-Antibody Complex ; Biopsy ; Child ; Fever ; Follow-Up Studies ; Humans ; Necrosis* ; Renal Dialysis ; Typhoid Fever*

The human hand is a highly sophisticated tool of sensibility and prehension, and the reconstruction of injured hands are essential to not only reconstruct of hand function but also reconstruct of body. Seven cases of tendocutaneous flap, a case of osteocutaneous flap, nine cases of thumb reconstruction with a free neurovascular wrap-around flap from the big toe, two cases of second toe-to-index trander, and a case of left ring finger to right index finger transfer were performed at the Department of Orthopedic Surgery of Hanyang University Hospital, and satisfactory results were obtained both comsmetically and functionally.
Fingers ; Hallux ; Hand ; Humans ; Microsurgery ; Orthopedics ; Thumb

No abstract available.
Adolescent* ; Arteries* ; Humans ; Male*

No abstract available.

PURPOSE: To evaluate the extrahepatic spread of peripheral cholangiocarcinoma with CT. MATERIALS AND METHODS: We retrospectively reviewed CT findings of extrahepatic spread in thirty-six patients with peripheral cholangiocarcinoma confirmed adenocarcinoma at surgery(n=5) or percutaneous biopsy(n--31) without primary leion in other organs, and analysed the frequency and distribution of enlarged lymph nodes, direct invasion of adjacent solid organs, and thrombosis of major vessels. RESULTS: Among the 36 cases, enlarged metastatic lymph node was noted in twenty-four(66.7%), direct invasion into adjacent organs in six(16.7%), portal and inferior vena caval thrombosis in five(13.9%). Enlarged lymph nodes were seen in hepatic nodes(n=16, 44.4%), portocaval nodes(n=15, 41.7%), interaortocaval nodes (n=10, 27.8) and celiac nodes in two(5.6%). Direct invasion was detected in the greater omentum(n=6), gallbladder(n:3) and stomach(n=2). Portal vein thrombosis(n:5) and thrombosis of inferior vena cava(n=2) were noted. CONCLUSION: Lymph node metastasis was seen in 67% in patients with peripheral cholangiocarcinoma. Direct invasion to adjacent organs and thrombosis in portal vein or inferior vena cava were occasionally associated.
Adenocarcinoma ; Cholangiocarcinoma* ; Humans ; Lymph Nodes ; Neoplasm Metastasis* ; Portal Vein ; Retrospective Studies ; Thrombosis ; Vena Cava, Inferior

Infectious mononucleosis is a common systemic illness primarily invloving children and young adults and due apparently to the Epstein-Barr virus (EBV). Although the typical case is easily recogniged, unusual manifestations or serious complications occur frequently enough to pose problems in diagnosis and management. Neurologic complications are rare(1%). These nerologic complications may actually precede the full clinical picture or present as the sole manifestation of the illness, thereby causing a confusing clinical picture and delay in diagnosis. We have experienced a case of infectious mononucleosis associated with facial nerve palsy in a 22-months old female. She was admitted to the hospital with the fever, right facial nerve palsy and hepatosplenomegaly. The diagnosis was made on the clinical findings, immunologic findings and the typical findings of peripheral blood smear. On peripheral blood smear, atypical lympocytes with relative lympocytosis were seen. On Immunologic study EBV anti-VCA IgM titer was 1:20 and the IgG titer was 1:40. To our knowledge, this is the first report in Korea. So, we report this case and the brief literatures of infectious mononucleosis associated with neurologic complications and other viral diseases which caused facial nerve palsy.
Child ; Diagnosis ; Facial Nerve* ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant ; Infectious Mononucleosis* ; Korea ; Paralysis* ; Virus Diseases ; Young Adult

Tensor fascia lata myocutaneous flap is the most useful local flap in surgical treatment of greater trochanteric sore. But the small volume of muscle included in Tensor fascia lata myocutaneous flap makes the thickness of flap thinner and the rate of recurrence higher than any other muscle flap. To overcome this disadvantage, Scheflan(1981) used distal folded Tensor fascia lata myocutaneous flap in treating greater trochanteric sore. But Scheflan used this flap as an island flap, that made the blood supply unstable and unreliable, and required skillful technique. And he didn`t use distal part of the thigh which made the efficacy of flap bulk small. In order to thicken the flap bulk, we used the distal folded tensor fascia lata myocutaneous flap. We have treated 10 patients by using newly designed distal folded tensor fascia lata myocutaneous flap. All of them had previous systemic disease. Some had general paresthesia and others had heart failure, diabetic mellitus, neuralgia and so on. We drew V-shaped design, one wing was from the anterior superior iliac spine to the lateral condyle of the femur and the other wing was from the center of the greater trochanter to the lateral condyle of the femur. After design, we harvest the flap and fold the flap two or three times. Flap bulk is enough to prevent sore recurrence. We follow up the patients from 6 months to 35 months. No recurrence is occurred. Our newly designed flap has sufficient volume and reliable blood supply. The result is good and satisfactory.
Fascia Lata* ; Fascia* ; Femur* ; Follow-Up Studies ; Heart Failure ; Humans ; Myocutaneous Flap* ; Neuralgia ; Paresthesia ; Recurrence ; Spine ; Thigh

Tensor fascia lata myocutaneous flap is the most useful local flap in surgical treatment of greater trochanteric sore. But the small volume of muscle included in Tensor fascia lata myocutaneous flap makes the thickness of flap thinner and the rate of recurrence higher than any other muscle flap. To overcome this disadvantage, Scheflan(1981) used distal folded Tensor fascia lata myocutaneous flap in treating greater trochanteric sore. But Scheflan used this flap as an island flap, that made the blood supply unstable and unreliable, and required skillful technique. And he didn`t use distal part of the thigh which made the efficacy of flap bulk small. In order to thicken the flap bulk, we used the distal folded tensor fascia lata myocutaneous flap. We have treated 10 patients by using newly designed distal folded tensor fascia lata myocutaneous flap. All of them had previous systemic disease. Some had general paresthesia and others had heart failure, diabetic mellitus, neuralgia and so on. We drew V-shaped design, one wing was from the anterior superior iliac spine to the lateral condyle of the femur and the other wing was from the center of the greater trochanter to the lateral condyle of the femur. After design, we harvest the flap and fold the flap two or three times. Flap bulk is enough to prevent sore recurrence. We follow up the patients from 6 months to 35 months. No recurrence is occurred. Our newly designed flap has sufficient volume and reliable blood supply. The result is good and satisfactory.
Fascia Lata* ; Fascia* ; Femur* ; Follow-Up Studies ; Heart Failure ; Humans ; Myocutaneous Flap* ; Neuralgia ; Paresthesia ; Recurrence ; Spine ; Thigh

OBJECTIVE: The purpose of this study was to evaluate of course of delivery & perinatal outcomes for postterm pregnancy compared with fullterm pregnancy. METHODS: This study included 360 cases of postterm pregnancy out of 16,992 cases delivered at Department of Obstetrics and Gynecology from January 1, 1993 to December 31, 1997. 16,143 cases of full term deliveries of 38 to 42 gestational weeks conducted in same period were used as the control group. Postterm pregnancy was defined as a pregnancy that it exceeds 295 days calculated from first day of the last menstrual period. RESULTS: The incidence of postterm pregnancy was 2.13% with the highest incidence occurring in the 26 ~30 years age group. This study group was significantly different from the control group in the incidence of fetal distress (10.28% vs. 2.20%), large fetus (10.83% vs. 6.95%), perinatal death (1.67% vs. 0.27%). CONCLUSIONS: Adverse perinatal outcomes were increased markedly as the gestational weeks to be prolonged. Therefore, careful prenatal care, accurate determination of delivery date is very important.
Fetal Distress ; Fetus ; Gynecology ; Humans ; Incidence ; Obstetrics ; Pregnancy* ; Prenatal Care