The use of a pneumatic tourniquet is potentially associated with injury to underlying muscles, vessels, and nerves if excessive pressure occurs beneath the toumiquet. In order to minimize the risk of soft tissue injury, the lowest tourniquet pressure that maintains a bloodless operative field should be used. A clinical study was undertaken to evaluate the pneumatic tourniquet setting required for adequate hemostasis in upper extremity surgery. From March to September in 1984, the subcutaneous soft tissue pressure of the 20 upper extremities beneath a pneumatic toumiquet in the arm were measured directly and the following results were obtained. 1. The underlying subcutaneous soft tissue pressure was not affected by adult, age, arm circumference, and blood pressure of normal range. 2. The underlying subcutaneous soft tissue pressure showed direct correlation with the tourniquet pressure respectively. 3. A tourniquet preasure of more than 250 mmHg was not rarely required in a normotensive individual.
Adult ; Arm ; Blood Pressure ; Clinical Study ; Hemostasis ; Humans ; Muscles ; Reference Values ; Soft Tissue Injuries ; Tourniquets ; Upper Extremity

A synophthalmia, another form of cyclopia, in which the element of the two eyes are partially fused to form an apparently single eye in the middle of the forehead. The synophthalmia is a result of complex, neural plate misdevelopment syndrome involving the eye, brain, skull and face. It is well known that synophthalmia is due to heterogenous causes, most of which chromosomal imbalances. We experienced a case of synophthalmia associated with proboscis, alobar holoprosencephaly and chromosomal anomaly 46, XX, -15,t (15 q, 21 q). Diagnosis was confirmed by brain MRI and autopsy, The patient died about 20 hours of age and autopsy was done. A brief review of the literatures was also presented.
Autopsy ; Brain ; Diagnosis ; Forehead ; Holoprosencephaly ; Humans ; Magnetic Resonance Imaging ; Neural Plate ; Skull

Candidiasis is an acute or chronic infection caused most commonly by Candida albicans and occasionally by other species of the genus Candida. The superficial cutaneous candidiasis is varied; oral Candidiasis, perieche, candidal vulvovaginitis, candidal balanitis, candidal intertrigo, erosio interdigitalis blastomycetica, perianal candidiasis, candidal paronychia, candidal onychia, chronic mucocutaneous candidiasis, congenital cutaneous candidiasis, and candidid. Diagnosis can be made by typical appearance of the clinical lesions and the presence of satellite vesicopustules. This can be confirmed by KOH examination and culture of skin scrapings. Treatment is the correction of predisposing factors, topical therapy of imidazoles and/or systemic administration of itraconazole or fluconazole.
Balanitis ; Candida ; Candida albicans ; Candidiasis ; Candidiasis, Chronic Mucocutaneous ; Candidiasis, Cutaneous* ; Candidiasis, Oral ; Causality ; Diagnosis ; Fluconazole ; Imidazoles ; Intertrigo ; Itraconazole ; Male ; Paronychia ; Skin ; Vulvovaginitis

Two patients with moyamoya disease are reported whose initial and predominant manifestations were choreic movements. Choreic movements were recurrent and were often tnggered by excitement, emotional tension, or insomnia There were occurred unilaterally Moyamoya disease must be considered in the differential diagnosis of acquired chorea in young adults.
Chorea* ; Diagnosis, Differential ; Humans ; Moyamoya Disease* ; Sleep Initiation and Maintenance Disorders ; Young Adult

BACKGROUND: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. METHODS: Study subjects were drawn from male members of seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hundred per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. RESULTS: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. CONCLUSION: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.
Adult* ; Case-Control Studies ; Cohort Studies ; Drinking ; Follow-Up Studies ; Humans ; Insurance ; Korea ; Liver Diseases* ; Liver* ; Logistic Models ; Male* ; Obesity ; Odds Ratio ; Pharmacoepidemiology ; Postal Service ; Surveys and Questionnaires ; Seoul ; Smoke ; Smoking

PURPOSE: Angiopoietin-1 (Ang-1) plays a crucial role in vascular and hematopoietic development, mainly through its cognate receptor, Tie-2. Increased levels of Ang-2 have been shown to be correlated with abnormal tumor angiogenesis in several malignancies. Hence, we estimated the increased expression of Ang-2 relative to Ang-1 in patients with colorectal cancer and correlated our finding with prognosis in order to investigate the relationships between the expressions of Ang-1/Ang-2/Tie-2 receptor and the clinical parameters or overall survival of such patients. METHODS: We retrospectively analyzed 114 tissue samples from patients with colorectal cancer by using immunohistochemistry (IHC) to examine Ang-1, Ang-2, and Tie-2 expressions and to investigate the relationship between those expressions and clinical parameters or overall survival of such patients. A Western blot analysis was used for Ang-2 expression. RESULTS: IHC staining showed a link between Ang-1 and Tie-2 (P = 0.018), as well as meaningful correlations between Ang-2 and Tie-2 receptor (P = 0.022) and between lymph-node metastasis and Ang-2 (P = 0.025). The stronger the IHC staining for Ang-2 expression was, the shorter the cumulative survival was (P = 0.016). CONCLUSION: A relationship was found to exist between Ang-2 and Tie-2 expressions. The Ang-2 was correlated with lymph-node metastasis, and high expression of Ang-2 was indicative of poor overall survival. These findings suggest that Ang-2 is a useful prognostic marker in the management of patients with colorectal cancer. In addition, we suggest that Ang/Tie-2 signaling plays an important role in the progression of colorectal cancer.
Angiopoietin-1* ; Angiopoietin-2* ; Angiopoietins ; Blotting, Western ; Colorectal Neoplasms* ; Humans ; Immunohistochemistry ; Neoplasm Metastasis ; Prognosis ; Receptor, TIE-2* ; Retrospective Studies

We experienced a case of split hand split foot(SHSF) anomaly in a male neonate who had a deficiency of the middle finger, syndactyly of the 1st and 2nd finger and a deep median cleft in both hands. He also had a deep median cleft between 2nd and 3rd toe, syndactyly of the 1st and 2nd, 3rd and 4th toe without deficiency of the middle toe in both feet. SHSF anomaly may occur either isolated or associated with other anomalies. In this case, it occurd sporadically without family history and showed an isolated type without any other specific anomalies except both posterior iris synechiae. The karyotype of patient showed 46,XY,t(7p:14q) which has not been reported yet. We reported the case with the review of the associated literatures.
Fingers ; Foot* ; Hand* ; Humans ; Infant, Newborn ; Iris ; Karyotype ; Male ; Syndactyly ; Toes

PURPOSE: This study was performed to evaluate the polymerase chain reaction (PCR) in the diagnosis of Mycoplasma pneumoniae pneumonia in comparison with the specific antibody test. METHODS: Five hundred and ten patients with pneumonia, ranging from the ages of 8 months to 15 years who were admitted in Sung-Ae and Kwangmyung Sung-Ae general hospitals from Nov. 1996 to Oct. 1997, were enrolled in this study. Specific antibody test of the serum using Serodia Myco II kit and PCR of the sputum or throat swab were performed on admission simultaneously, and follow-up antibody test was done during the convalescent stage if they showed sero-negative at first. Among the PCR positive patients, 40 were treated with erythromycin initially, and were followed with PCR on the 7th day of treatment. RESULTS: The sensitivity of PCR to the specific antibody test was 82.5%, and the specificity, 98.4%. The false positive and negative rates of PCR to the specific antibody test were 1.6% and 17.5%, respectively. Fifty-six (91.8%) of the 61 patients who showed sero-negative and PCR positive on admission were determined as sero-positive at the convalescent stage. Negative conversion of PCR at the convalescent stage was noted for 32 (80%) of 40 patients who were treated with erythromycin. CONCLUSION: The PCR was considered to be valuable due to its high sensitivity and specificity as a diagnostic method of Mycoplasma pneumoniae pneumonia. The effect of the method was more apparent than the specific antibody test in early diagnosis which is clinically important. In addition, it seems to be more useful in the appreciation of treatment and epidemiologic study than the culture method that shows low sensitivity and takes too much time.
Diagnosis ; Early Diagnosis ; Epidemiologic Studies ; Erythromycin ; Follow-Up Studies ; Hospitals, General ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pharynx ; Pneumonia* ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum

To estimate the incidence of uterine cervix cancer among Korean women, we have conducted a study using the claim data on the beneficiaries of Korea Medical Insurance Corporation(KMIC). All medical records of the potential cases with diagnosis of ICD-9 180, 181, 182, 199, 219, 233 in the claims sent by medical care institutions in the whole country to the KMIC from January 1988 to December 1989, were abstracted and Gynecology specialist reviewed the records to identify the new cases of uterine cervix cancer among the potential cases during the corresponding period. Using these data, the incidence of uterine cervix cancer among Korean women was estimated as of July 1, 1988 to June 30, 1989. The crude rate was estimated to be 17.34(95% CI: 16.76~17.92) per 100,000 and the cumulative rates for the ages 0~64 and 0~74 were 1.7% and 2.2%, respectively. The age-adjusted rate for the world population was 19.93 per 100,000 which was higher than those of other Asian countries including China and Japan in 1983~1987. The truncated rate for ages 35~64 was 52.05 per 100,000 which was one of the highest in the world. With increasing age, the incidence rate increased to 78.11 per 100,000 in women aged 55~59 years, then it decreased in the older groups. This finding suggests that detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to inadequate medical care seeking behavior. In the geographical area, the SIR of Jeju province was significantly low but it might be due to statistical unstability by small case numbers.
Asian Continental Ancestry Group ; Cervix Uteri* ; China ; Diagnosis ; Epidemiology ; Female ; Gynecology ; Humans ; Incidence* ; Insurance ; International Classification of Diseases ; Japan ; Korea ; Medical Records ; Specialization

OBJECTIVE: The goal of this study is to evaluate the surgical outcome of multiple aneurysms including distal anterior cerebral artery (DACA) aneurysms. MATERIAL AND METHOD: From May 1989 to March 2000, 12 patients with multiple aneurysms including DACA aneurysms, presented with subarachnoid hemorrhage, had been surgically treated. Their medial record and radiological studies were studied retrospectively. Of 12 patients, in 5 patients, all of the aneurysms were clipped through a single craniotomy extended from midline to pterion in one stage, in 5 patients, multiple aneurysms were treated through separate craniotomies in one stage and 2 patients were treated in staged operation. RESULTS: Two patients showed Glasgow Outcome Scale (GOS) 5-4, 2 patients showed GOS 3-2 and 1 patient showed GOS 1 in 5 patients treated through a single craniotomy in one stage, 2 patients showed GOS 5-4 and 3 patients showed GOS 3-2. All patients treated in staged operation showed favorable outcome. CONCLUSION: In surgical management of multiple aneurysms including DACA aneurysms surgery through separate bony windows in two stages seemed to show more favorable outcome.
Aneurysm* ; Anterior Cerebral Artery* ; Craniotomy ; Glasgow Outcome Scale ; Humans ; Intracranial Aneurysm* ; Retrospective Studies ; Subarachnoid Hemorrhage