BACKGROUND: There is a long-standing controversy whether melanocytes in vitiligo of more than 1 year duration are actually lost or still present. Resolving this matter is essential in understanding the underlying pathology and for the development of the treatment. On previous immunohistochemical and ultrastructural studies of vitiligo lesions, damage of melanocyte and keratinocyte in early lesions were reported and complete absence of melanocyte in long standing lesions were known. OBJECTIVE: This study aimed to determine the existence of the differences in pathologic changes in melanocytes according to the duration of the lesion. METHODS: We investigated the vitiliginous skin samples from 31 patients with early(less than 1 year duration) vitiligo and 30 patients with long standing(l to 5 years duration) vitiligo under the electron microscopy. RESULTS: Multiple degenerative changes in melanocytes were observed in the early and long standing lesions. In long standing lesions, degeneration of melanocytes including pyknotic, in-dented nuclei, vacuolated cytoplasms and blunted dendrites were more pronounced than early lesions. Even in long standing lesions, definite or presumptive melanocytes were observed in 16(53.3%) of 30 cases. CONCLUSION: Our results suggest that the melanocytes of vitiligo lesions were damaged and that the percentage of degenerative changes increase in accordance with the duration of the lesion. However, in long standing lesions as well as in early lesions, some residual melanocytes can be observed ultrastructurally.
Cytoplasm ; Dendrites ; Humans ; Keratinocytes ; Melanocytes ; Microscopy, Electron ; Pathology ; Skin ; Vitiligo*

Fractures of the zygoma are rarely encountered in pediatric patients. This report presents a case of a 3-year-old child who presented with a vertically split fracture of the marginal tubercle of the zygoma. The marginal tubercle, a bony portion present on the posterior border of the frontal process, assists in attaching the temporalis fascia. This patient was treated surgically with bony fixation using tissue glue. To the best of our knowledge, no cases of fracture of the marginal tubercle of the zygoma have been reported in the literature. Fractures of the marginal tubercle of the zygoma in pediatric patients may be overlooked because of their anatomic location and the musculoskeletal characteristics of these patients. Here, we discuss the clinical features of marginal tubercle fractures of the zygoma.

To evaluate the platelet activation in vivo in the patients with coronary artery disease Indium-111 labeled autologus platelet survival time was measured. Platelet survival determinations were made according to a modified method for radioisotope platelet survival studies recommended by the Panel on Diagnostic Application of Radioisotopes in Hematology of the International Committee for Standardization in Hematology. Autologous platelets were labeled with 111 In-oxine utilizing a similar method used at the Mallinckrodt Institute of Radiology. The results are summarized as follows : 1) In the patients with coronary artery disease, especially acutemyocardial infarction, the mean platelet survival time was significantly shorter than that of the normal controls(P<0.05). 2) The mean platelet survival time did not differ significantly between patients with acute myocardial infarction and angina pectoris. 3) The mean platelet survival time did not differ significantly between nonsmoker and smoker in the patients with coronary artery disease.
Angina Pectoris ; Blood Platelets* ; Coronary Artery Disease* ; Coronary Vessels* ; Hematology ; Humans ; Infarction ; Myocardial Infarction ; Platelet Activation ; Radioisotopes

PURPOSE: The majority of nasal bone fractures have been managed by routine procedure of closed reduction, intranasal packing or intranasal Kirschner wire (K-wire) splinting. But it leaves rooms for many complaints from patients such as pain, rhinorrhea and nasal obstructioon. Another option is, of course, no packing at all. The study was initiated to assess the necessity to pack or splint the nasal bone after routine closed reduction. METHODS: We analysed the medical records of 35 patients with nasal bone fracture who were operated by closed reduction in the last 2 years. We evaluated the postoperative CT scan scores and external deviation criterias 1 month after the operation. RESULTS: The postoperative deviation criteria and postoperative CT scan score were favorable and there were no serious complications using this technique. CONCLUSION: The present study demonstrates that the use of packing or splinting need not be routine in the majority of cases. The risks and discomforts associated with these procedures can often be avoided.
Humans ; Medical Records ; Nasal Bone ; Splints

No abstract available.
Aorta, Thoracic*

Recently, the Korean Medical Association (KMA) launched the KMA Policy system based upon the American Medical Association (AMA) Policy system. The KMA's official positions on health issues and medical ethics, as well as its constitution, bylaws, and directives, will be included in the KMA Policy system. The AMA's organizational structure and decision making process provided essential information for developing the KMA Policy system. Through the KMA Policy system, hereafter, the KMA should introduce a procedure not only to decide upon positions on various health issues but also a means to open them to the public. In addition, the KMA can expect the continuity and transparency of work, enhanced benefits to members, public credibility, and growth of its social reputation by means of KMA Policy. Furthermore, the system would be beneficial for both KMA members and the public, as they can easily access KMA Policy, and, in turn, access the healthcare systems of Korea and its medical knowledge. To achieve a successful KMA Policy system, the definite authority and responsibility should be granted to the organizational bodies of the KMA, for example, the House of Delegates and Board of Trustees, and the regional societies and other sections. These various groups must then efficiently divide up their work and cooperate systematically. Moreover, it is crucial that each individual member of the KMA pay much more attention to health issues and participate in the decision making process on KMA Policy.
American Medical Association ; Constitution and Bylaws ; Decision Making ; Delivery of Health Care ; Ethics, Medical ; Financing, Organized ; Humans ; Korea ; Power (Psychology)* ; Trustees

BACKGROUND AND OBJECTIVES: Chronic sinusitis with nasal polyposis, asthma and aspirin sensitivity characterize Samter's triad. The sinusitis associated with the triad is often difficult to treat and aggravates the asthmatic symptoms. This study was conducted to evaluate the feature of the triad and the outcome of endoscopic sinus surgey (ESS) as a treatment for chronic paranasal sinusitis with nasal polyposis in patients with Samter's triad. MATERIALS AND METHOD: The study group contained 16 patients with the triad who were compared with the control group (60 patients). The study was conducted in retrospective fashion focusing clinical characteristics, recurrence and re-operation rate of sinusitis and severity of asthma. RESULTS: ESS in Samter's triad patients was effective on the improvement of nasal symptoms. Fourteen of 16 patients recurred after ESS. Seven patients of 14 patients received systemic steroid therapy. Four patients of 7 patients underwent revision surgery. Three patients had asthmatic attack after postoperative use of analgesics. There was no significant improvement of asthmatic symptoms after ESS. CONCLUSION: This study suggests that the surgical intervention was less effective on Samter's triad patients. The recurrence and reoperation rate of nasal polyposis in Samter's triad patients were high. The use of NSAID should be avoided after ESS in asthmatics with nasal polyposis.
Analgesics ; Aspirin ; Asthma ; Endoscopy ; Humans ; Recurrence ; Reoperation ; Retrospective Studies ; Sinusitis

As is well known, myxoma of the heart is very rare(incidence 0.03%), constituting nearly 50% of all primary cardiac tumors. It is important because it can be abolished by surgical removal but usually fatal if unrecognized or untreated. Recently a wider use of echocardiogram as the screening test of valve lesions can be expected to increase the number of myxomas found preoperatively. We have experienced a case of bilateral atrial myxoma which simulated mitral valvular disease clinically and had typical three cardinal manifestations such as obstructive, embolic and constitutional symptoms. The patients was 39 years old woman. The left atrial myxoma was diagnosed preoperatively by echocardiography and cardiac angiography and the remainder during open heart surgery under the E.C.C. Both of them were removed successfuly and confirmed as typical myxoma microscopically. This is the first case report of bilateral atrial myxoma in Korea to our knowledge.
Adult ; Angiography ; Echocardiography ; Female ; Heart ; Heart Neoplasms ; Humans ; Korea ; Mass Screening ; Myxoma* ; Thoracic Surgery

Clinical and bacteriologicaql studies on 133 cases of urinary tract infection who were admitted to the Dept. of Pediatrics, NMC during the period of Jan. 1974 to Jan. 1979 were subjected in this study. The resultes were as follows : 1. Among the total 133 cases, 100 cases(75.2%) were male and 33 cases(24.8%) were female with sex ratio of 3:1. 2. The highest incidence(42.1%) was in children below the age of one year. The rate then decreased with age. 3. Seasonal incidence was relatively high in summer months, but seasonal difference was not significant. 4. Edema, signs of URI, vomiting, hematuria, failure to thrive and feeding problem were common clinical features. 5. Urinalysis disclosed proteinuria in 43 cases(32.3%), hematuria in 36 cases(27.1%) and pyuria in 26 cases(19.6%). 6. Hematological findings showed low hemoglobin in 40 cases(30.0%), leucocytosis in 31 cases(23.3%) and elevated ESR in 42 cases(31.6%). 7. IVP was performed in 13 cases, and 3 cases of them showed abnormal findings. 8. Nephrotic syndrome, acute glomerulonephritis, hyperbilirubinemia and sepsis were the common concurrent illnesses. 9. E. coli predominated as the infecting organisms(36.8%). It was most sensitive to ;gentamycin(83.7%) and cefamezine(77.8%)
Child* ; Edema ; Failure to Thrive ; Female ; Glomerulonephritis ; Hematuria ; Humans ; Hyperbilirubinemia ; Incidence ; Male ; Nephrotic Syndrome ; Pediatrics ; Proteinuria ; Pyuria ; Seasons ; Sepsis ; Sex Ratio ; Urinalysis ; Urinary Tract Infections* ; Urinary Tract* ; Vomiting

Clinical and bacteriologicaql studies on 133 cases of urinary tract infection who were admitted to the Dept. of Pediatrics, NMC during the period of Jan. 1974 to Jan. 1979 were subjected in this study. The resultes were as follows : 1. Among the total 133 cases, 100 cases(75.2%) were male and 33 cases(24.8%) were female with sex ratio of 3:1. 2. The highest incidence(42.1%) was in children below the age of one year. The rate then decreased with age. 3. Seasonal incidence was relatively high in summer months, but seasonal difference was not significant. 4. Edema, signs of URI, vomiting, hematuria, failure to thrive and feeding problem were common clinical features. 5. Urinalysis disclosed proteinuria in 43 cases(32.3%), hematuria in 36 cases(27.1%) and pyuria in 26 cases(19.6%). 6. Hematological findings showed low hemoglobin in 40 cases(30.0%), leucocytosis in 31 cases(23.3%) and elevated ESR in 42 cases(31.6%). 7. IVP was performed in 13 cases, and 3 cases of them showed abnormal findings. 8. Nephrotic syndrome, acute glomerulonephritis, hyperbilirubinemia and sepsis were the common concurrent illnesses. 9. E. coli predominated as the infecting organisms(36.8%). It was most sensitive to ;gentamycin(83.7%) and cefamezine(77.8%)
Child* ; Edema ; Failure to Thrive ; Female ; Glomerulonephritis ; Hematuria ; Humans ; Hyperbilirubinemia ; Incidence ; Male ; Nephrotic Syndrome ; Pediatrics ; Proteinuria ; Pyuria ; Seasons ; Sepsis ; Sex Ratio ; Urinalysis ; Urinary Tract Infections* ; Urinary Tract* ; Vomiting