In order to clarify the changes of the venous circulation in normal and affected hip with Legg-Ca1ve-Perthes' disease(L.C.P.D.) and to assess the effect of intertrochanteric varus osteotomy on the venous circulation around the proximal femur in L.C.P.D., intra-osseous venography(I.O.V.) was performed before osteotomy and also 8 weeks later when K-wires or staples used at the time of osteotomy were removed. Results obtained were as follows: 1. The material was consisted of 13 normal and 17 hips with L.C.P.D.. There were 14 boys and one girl, with a mean age of 6.1 years ranged from 5 to 9 years; in two patients the disease was bilateral. 2. When the hips with L.C.P.D. were divided into four groups by the method described by Catterall, three hips were included in group II, ten in III and four in IV. 3. In I.O.V. of the proximal femoral metaphysis on 13 normal hips, the opaque medium disappeard rapidly through the local venous system around the proximal femur, and no regurgitation into diaphysis were noted. But gluteal and medial circumflex vein in each one case was not visualized. 4. Of 17 hips with L.C.P.D., an I.O.V. was carried out before and after the intertrochanteric osteotomy. The ligamentum teres and gluteal vein appeared in only 4(24%) and 7 hips (41%) before and after osteotomy. And the lateral and medial circumflex vein visualized in 12(71%) and 15 hips before osteotomy and in 17 hips, both after osteotomy. The diaphyesal regurgitation in 35 % and trochanteric venous pooling of the opaque medium in 47%, indicating venous congestion on the trochanteric region of femur, disappeared after the osteotomy. But no significant differences in their age and group of L.C.P.D. were found. All of these findings suggest that the impaired venous system around the proximal femur and increased intra-osseous pressure on proximal femur may act as one of the important role in pathophysiology of the L.C.P.D., and the intertrochanteric osteotomy might have some positive effect for the normalization of venous circulation and intra-osseous pressure in L.C.P.D..
Diaphyses ; Female ; Femur ; Hip ; Humans ; Hyperemia ; Legg-Calve-Perthes Disease ; Methods ; Osteotomy ; Round Ligaments ; Veins

A 2-month-old Korean boy presented with a solitary papule on the cheek which was noted at birth. Histopathologic findings were consistent with angiofibroma of fibrous papule of the face (FPF). FPF is known to affect adults, and congenital occurrence has not been reported to the best of our knowledge. We report a case of congenital FPF which showed a facial papule clinically and an angiofibroma histologically.
Adult ; Angiofibroma ; Cheek ; Humans ; Infant ; Male ; Parturition

The tracheostomy is increasingly being performed. In most cases, the tracheostomy sites are left to heal by secondary intention, so it leaves a depressed and wide scar that is cosmetically disfigured. Another problem os that the scar is also attached directly to the trachea itself and will move vertically with the trachea during the act of swallowing. Even though the tracheostomy scar is cosmetically acceptable, the mobility and retraction of the scar is a continual nuisance to the patient. We performed a retrospective study on 9 patients who had undergone revision of the depressed thracheostomy scar by the Renner Method from June, 1997 to February, 1999. The method includes transverse fusiform incision of the original scar and excision of the depressed portion of the scar to the level of the trachea itself. To prevent attachment of the skin and trachea, a bilateral subcutaneous flap and muscle flap were simply advanced to the midline and overlapped. Then the rest of scar that was not depressed was deepithelized and flipped to augment the soft tissue volume in the central depressed area. Satisfactory results were achieved in all patients without hematoma, infection, hypertrophic scar, and keloid formation. We believe this simple Renner method is one of the best ways of performing posttracheostomy scar revision.
Cicatrix* ; Cicatrix, Hypertrophic ; Deglutition ; Hematoma ; Humans ; Intention ; Keloid ; Retrospective Studies ; Skin ; Trachea ; Tracheostomy

Strumal carcinoma of the ovary is rare tumor of germ cell origin characterized by intimate mixture of thyroid tissue and carcinoid. We report a strumal carcinoid tumor associated with ipsilateral follicular cyst and contralateral mature cystic teratoma of the ovary in a 47-year-old woman. Histologically it was composed largely of trabeculae partly of insular carcinoid and focally of individual thyroid follicles. Many cells in the carcinoid areas and even some follicular areas contained abundant argyrophile granules, and they also, in the corresponding areas, demonstrated thyroglobulin. Electron microscopic findings revealed abundant neurosecretory granules and colloid material in the same cell. We agree that this tumor is derived from hybrid showing thyroid and neuroendocrine differenciation.
Female ; Humans ; Cysts

INTRODUNTION: The objective of the present study was to investigate bedtime, rise time and time-in-bed of Korean college students, separately on weekday and on weekend and to compare them. In addition, this study also aimed to evaluate the influence of gender, age and grade on the above sleep parmeters in Korean college students. METHODS: Information regarding bedtime and rise time, separately on weekday and on weekend, of Korean college students were obtained by self-administered questionnaire. Questionnaires of 1,825 students (1,416 females and 409 males, age 18-30 ; mean age 21.1+/-2.2) were used for statistical analyses. RESULTS: Korean college students retired to bed 50 minutes later (00 : 49 on weekday ; 01 : 40 on weekend ; t=39.67, p<0.001), rose 1 hour 58 minutes later (07 : 52 on weekday ; 09 : 50 on weekend ; t=39.46, p<0.001), and slept 1 hour 8 minutes longer (t=13.33, p<0.001) on weekend. Compared to male students, female students had earlier rise time (t=8.96, p<0.01 ; t=3.89, p<0.01) and earlier bedtime both on weekday and weekend (t=7.10, p<0.01; t=6.04, p<0.01), and shorter time-in-bed on weekday (t=1.99, p<0.01). In addition, rise time delay and time-in-bed increase on weekend were more prominent in female students than in male students (t=3.41, p<0.01 ; t=3.68, p<0.01). Grade was correlated with bedtime and rise time on weekday (beta=0.1022, p<0.01 ; beta=0.1009, p<0.01), bedtime and time-in-bed on weekend (beta=0.1096, p<0.01 ; beta=-0.0990, p<0.01), and differences between weekday and weekend of the rise time and the time-in-bed (beta=-0.0906, p<0.01 ; beta=-0.1115, p=0.02). CONCLUSIONS: In this study, Korean college students had earlier bedtime/rise time and shorter time-in-bed on weekday than on weekend. These findings suggest that weekday sleep-wake schedule of Korean college students may be advanced relative to their biological sleep-wake cycle and that this discrepancy may be associated with weekday sleep deprivation. In addition, differences of sleep patterns between weekday and weekend were more prominent in female students and students with lower grade. Therefore, discrepancy between weekday sleep-wake schedule and biological sleep-wake cycle, as well as weekday sleep deprivation, might be more serious in female or lower-grade students.
Appointments and Schedules ; Female ; Humans ; Male ; Surveys and Questionnaires ; Sleep Deprivation

The slipped capital femoral epiphysis is characterized by a growth disturbance of the capital physi. resulting in weakening of this structure and a subsequent displacement of the femoral head on the fe moral neck. It is a rare entity in Korea and only six cases have been reported so far1-5). One of ou cases was a bilateral mild acute slips in 13 yearold boy which were treated by Hagie pinning. Th other case, a 17 year-old boy, who suffered from a moderate acute on chronic slip in his left hip an showed a typical Pistol grip deformity. He was treated by gentle closed rcduction and Knowles pi fixation with good result.
Congenital Abnormalities ; Epiphyses ; Hand Strength ; Head ; Hip ; Humans ; Korea ; Male ; Neck ; Slipped Capital Femoral Epiphyses

When the multiple myelographic defects at lumbosacral region are noted, the prudential effort for decision of appropriate area of surgical decompression would be needed. Fifty four patients who had been treated surgically for the deseases, such as HNP and spinal stenosis, from March in 1982 to Feb. In 1987 at Department of Orthopecdic Surgery, Soonchunhyang University Hospital, were analyzed in order to define the etiology, the level of the defect, indication for the operation and to assess the results of each level which had been operated. The results of the study were as follows. 1. The number of patients, which the multiple indentations were noted in the myelogrsphy, was 54 cases, 29 spinal stenosis, 15 HNP and 10 mixed types. 2. The most common defect levels in myelography were L3-4 snd L4-5, which were 19 cases (35.2%), the next levels were L4-5 and L5S1, which were 16 cases(29.6%), then L3-4, L4-5 and L5S1 were 7 cases(13%) and the other levels were 12 cases(22.2%). 3. The decision for the sppropriste operation area had not be done following to the size of the myelographic defect, but the clinical symptoms and physicsl exsminations. 4. The results were classified ss excellent or good in 79.7%, which was 80% at two levels snd 79.5% at one level. 5. The operation levels could be decressed for the reducing the spinal instability, operation time and possibility of the dangerous conditions and promotion of early restoration and, ambulation, if the severe differences between the results of one and two operation levels were not seen.
Decompression, Surgical ; Humans ; Lumbosacral Region ; Myelography ; Spinal Stenosis ; Walking

PURPOSE: To report a case of Wegener's granulomatosis misdiagnosed as ocular tuberculosis. METHODS: A 65-year-old man who was treated with anti-tuberculosis medications as suspected pulmonary tuberculosis was referred from the department of internal medicine for visual loss over months. His initial visual acuity was counting fingers at 30 cm in the right eye and there was a chorioretinal scar involving the macula on fundus examination. At that time, we thought that the lesion was a tuberculosis-related chorioretinal scar and so he was treated with anti-tuberculosis medications. There was a recurrent bilateral anterior uveitis during three months from the initial visit. RESULTS: After 14 months, he was examined by otorhinolaryngologist due to a saddle nose deformity and Wegener's granulomatosis was diagnosed based on positive Cytoplasmic antineutrophil cytoplasmic antibody (c-ANCA) and nasal mucosal biopsy. At that time, ocular examination revealed the necrotizing scleritis in both eyes and orbital CT showed bony destruction of medial and inferior orbital wall without proptosis in both eyes. We had treated with oral cyclophosphamide and prednisone. CONCLUSIONS: We experienced a case of Wegener's granulomatosis with chorioretinal scar misdiagnosed as ocular tuberculosis. In conclusion, we should differentially diagnose Wegener's granulomatosis from suspected ocular tuberculosis.
Aged ; Antibodies, Antineutrophil Cytoplasmic ; Biopsy ; Cicatrix ; Congenital Abnormalities ; Cyclophosphamide ; Cytoplasm ; Exophthalmos ; Fingers ; Humans ; Internal Medicine ; Nose ; Orbit ; Prednisone ; Scleritis ; Tuberculosis, Ocular* ; Tuberculosis, Pulmonary ; Uveitis, Anterior ; Visual Acuity ; Wegener Granulomatosis*

Kimura's disease is a granulomatous disease which develops in the skin, subcutaneous tissues and lymph nodes and is characterized histologically by the presence of lymphoid follicles, vascular proli- feration and infiltration with eosinophils. The disease shows geographical predilection to Japan, China and South East Asia. The exact etiology and pathogenesis remain uncertain. Some patients had proteinuria or nephrotic syndrome. We have recently experienced the superimposed oliguric acute renal failure associated with Kimura's disease in a male patient with chronic renal failure who had been managed conservatively. Inguinal lymph node biopsy revealed Kimura's disease. He recovered from acute renal failure after being treated with hemodialysis and prednisolone. Lymphadeno- pathy and fever subsided with steroid treatment. We report a case of Kimura's disease which was complicated by acute renal failure in the patient with chronic renal failure.
Acute Kidney Injury* ; Biopsy ; China ; Eosinophils ; Far East ; Fever ; Humans ; Japan ; Kidney Failure, Chronic* ; Lymph Nodes ; Male ; Nephrotic Syndrome ; Prednisolone ; Proteinuria ; Renal Dialysis ; Skin ; Subcutaneous Tissue

No abstract available.
Colorectal Neoplasms* ; Fluorouracil* ; Humans ; Interferon-gamma*