BACKGROUND: Vitiligo is considered as an autoimmune disorder due to the generation and presence of autoantibodies directed against melanocyte antigens in the patients sera. Previous studies have revealed an increased incidence of organ-specific autoantibodies in vitiligo patients. A number of studies have demonstrated an increased frequency of thyroid autoantibodies in vitiligo patients and vitiligo is commonly seen in patients with clinical thyroid diseases. OBJECTIVE: The aim of this study is to investigate the incidence of antithyroid antibodies in vitiligo patients and to correlate the presence of these antibodies with factors such as sex, age, activity of the disease, duration of the disease and the type of vitiligo. Another aim of this study is to compare the incidence of abnormal thyroid function in those who have antithyroid antibody and those who don't. METHODS: One hundred and fifty seven vitiligo patients who visited vitiligo clinic in Samsung medical center from January of 1995 to November of 1996 were enrolled in this study. Detection and titration of antithyroid antibodies were performed by immunoradiometric assay. RESULTS: Among 157 patients tested, 17(10.8%) patients had antithyroglobulin antibodies and 10(6.4%) patients had antimicrosomal antibodies. Five patients had both antibodies. Statistically meaningful data are as follows; 1) Antimicrosomal antibody appeared less frequently in patients of childhood-onset. 2) Antithyroglobulin antibody was detected more frequently in active disease. Fifty nine out of 157 patients were examined for thyroid function. Four out of 22 patients with antithyroid antibody had abnormal thyroid function. None out of 37 patients without antithyroid antibody had abnormal thyroid function. CONCLUSION: The incidence of antithyroid antibodies according to onset age and activity is contradictory to previous reports, therefore large scaled study will be necessary to draw a conclusion.
Age of Onset ; Antibodies* ; Autoantibodies ; Humans ; Immunoradiometric Assay ; Incidence* ; Melanocytes ; Thyroid Diseases ; Thyroid Gland ; Vitiligo*

There are many problems in treatment of intertrochanteric fractures due to osteoporosis and unstable pattern of fractures in old ages and they are different from those in young ages, for example, type of fracture, degree of osteoporosis, and general condition, ect. Anthors studied about the prognostic factors of 42 cases among 88 patients with intertrochanteric fractures, who were treated and followed up from Jan. 1982 to Dec. 1987. 1. The patients under 50 years old were mainly males(94.4%) and its chief cause of injury was traffic accident or fall down(72.2%). The cause of injury over 50 years old was slip down on ground(62.9%). 2. The osteoporosis was increased according to increased age of patients and then the unstable type of fracture was increased. In yaung patients, the unstable intertrochanteric fracture was rare despite of high violent injury. 3. The bone union of the follow-up patients was gained at average 13.8 weeks. 4. The sliding degree of lag screw was increased with unstable fracture and the incidence of metal protrusion into joint cavity was increased in the patients of eccentric fixation of lag screw into femoral head. 5. The all cases of complication were occured in osteoporotic patients over 50 years old and their causes were inadequate fixation of unstable fracture. 6. The most important factors in prognosis of intertrochanteric fractures are initial pattern of fractures, degree of osteoporosis and adequacy of reduction state(postop.).
Accidents, Traffic ; Follow-Up Studies ; Head ; Hip Fractures ; Humans ; Incidence ; Joints ; Osteoporosis ; Prognosis

Expandable metallic stents(EMS) were implanted in 7 patients with malignant (4 cholangio- carcinnoma, 1 pancreatic cancer, 1 ampullary carcinoma and 1 lymph node metastasis) biliary stricutres and 17 patients with benign(13 intrahepatic strictures of primary intrahepatic stone patients, 2 postoperative stricutres, 1 ampullary stenosis followed by endoscopic sphineterotomy and 1 bilioenteric anastomosis) biliary stricutures. In the fifteen patients out of 17 patients with benign biliary stricture, relief of cholangitis, improvement of liver function or loss of pruritus was observed. But in the 2 patients with.biliary cirrhosis, no clinical improvement was noted. In the malignant strictures with cholangio-carcinoma, the occlusion of EMS occurred in 3 patients and the duration of stent patency was average 2 months in those patients.
Cholangitis ; Constriction, Pathologic ; Fibrosis ; Humans ; Liver ; Lymph Nodes ; Pancreatic Neoplasms ; Pruritus ; Stents*

From August 1976 to February 1997, we have experienced 29 cases of rapidly destructive coxarthrosis in 23 patients who represented severe hip pain and destruction of the femoral head more than 50% within one year. The retrospective analyses of clinical, radiographic and operative findings of 2090 hips in 1534 patients, who have been diagnosed as ischemic necrosis of femoral head were performed to investigate the correlation between ischemic necrosis of the femoral head and rapidly destructive coxarthrosis. The incidence of rapidly destructive coxarthrosis was 1 % of the overall ischemic necrosis of the femoral head. The average duration of hip pain was 9 months. The average age of the patients was 56 years old and most of them were male. The cultures of synovial fluid for bacteria were negative in all cases except one case of non-pathogenic organism. But, the erythrocyte sedimentation rate and C-reactive protein were elevated. The pathologic findings were not different from the ischemic necrosis except the destruction of articular cartilage. Therefore, we concluded that rapidly destructive coxarthrosis is a subtype of ischemic necrosis of the femoral head.
Bacteria ; Blood Sedimentation ; C-Reactive Protein ; Cartilage, Articular ; Femur Head Necrosis ; Head ; Hip ; Humans ; Incidence ; Male ; Middle Aged ; Necrosis ; Osteoarthritis, Hip* ; Retrospective Studies ; Synovial Fluid

Purpose: Post-fracture sleeping disorders can lead to a deterioration of mental and physical health and delay recovery to pre-fracture status. Here, an analysis was conducted to determine if sleep disturbance is a risk factor for delirium in patients older than 60 years of age with surgically treated proximal femoral fractures. Materials and Methods: This retrospective study included 316 patients with surgically treated proximal femoral fractures between January 2014 and December 2016; 33 patients were removed from analysis due to exclusion criteria. Confirmation of delirium was made by a neurologist upon consultation for cognitive impairment and sleeping disorders were confirmed by a doctor or nurse based on the Pittsburgh sleep quality index. Potential risk factors other than a sleep disorder (e.g., history of cognitive impairment, medical illness, preoperational levels of albumin and hemoglobin, transfusion) were also analyzed as variables for the development of delirium. Results: The sensitivity and specificity of a sleeping disorder as a risk factor for the development of delirium were 0.75 and 0.76, respectively; the positive and negative predictive values were 0.64 and 0.93, respectively. A sleeping disorder was significantly related to the development of the delirium (odds ratio adjusted for age, sex and body mass index was 5.78, P<0.01). In those with a history of cognitive impairment, the adjusted odds ratio for the development of delirium was 6.03 (P<0.01). Conclusion Sleeping disorders occurring after a surgically repaired proximal femoral fracture in patients 60 years of age or older could be an independent predictive factor of delirium.

PURPOSE: CTAP(CT during arterial portography) has been shown to be the most sensitive technique available for the detection of hepatic mass. But because of many false positive lesions, it is important to interpretate the findings correctly. So we tried to analyse the false positive findings in CTAP. MATERIALS AND METHODS: Materials were 47 patients that had (;TAP for the detection of hepatic lesions. After performing superior roesenteric artery (SMA) arterial portography for the detection of vascular variation, CT^P was done. 100 to 150 cc of 50% diluted nonionic contrast media was injected at 2--3ml/sec rate. Spiral CT was used with 8mm slice thickness and 8mm/sec table speed. We compared the findings of CTAP with CTHA(CT during hepatic arteriography), enhanced (;T, anglogram, US, Lipiodol CT and biopsy. RESULTS: Twenty nine false positive lesions were found. There were 11 peritumoral defects, 7 straight line signs, 5 perihilar defects, 2 periligamentous defects, 3 subcapsular defects and 1 defect by cirrhosis. CONCLUSION: When CTAP is used for the evaluation of hepatic lesion(esp, preoperative evaluation), understanding of the false positive findings and the characterization of the lesion through multi-modality approaches are needed for the correct diagnosis and the proper treatment.
Arteries ; Biopsy ; Contrast Media ; Diagnosis ; Ethiodized Oil ; Fibrosis ; Humans ; Portography ; Tomography, Spiral Computed*

Dynamic compression plate, used in the orthopedic surgery as internal fixation system, should have excellent biocompatibility, corrosion resistance, and adequate mechanical properties. The object of this research was test of its biocompatibility as compared with Osteo DCP and fabnfication of a KAIST" DCP with evaluation of its effect by animal experiment. The conclusions were follows: 1. The corrosion resistance of domestic DCP had no significant difference as compared with foreign made DCP. 2. The tissue responses to DCP were thought to be adequate. 3. The new-design DCP had less mobility at fracture site as compared with existing DCP, but there was no significant statistical differences. 4. In summary, it was concluded that KAIST DCP could be applied to the human body and it would be worth while to research the advantages of new-design DCP. DCP: Dynamic Compression Plate KAIST: Korea Advanced Institute of Science & Technology.
Animal Experimentation ; Animals ; Corrosion ; Human Body ; Korea ; Orthopedics

PURPOSE: The purpose of our study was to describe the clinical and radiological mani-festations of tuberculosis in patients with end-stage renal disease. MATERIALS AND METHODS: The medical records, chest radiographs, and CT scans of 42 patients with tuberculosis among 871 consecutive patients with end-stage renal disease were reviewed. Patterns of initial chest radiographs were categorized as primary, postprimary, miliary, or atypical, according to the predominant radiologic findings. RESULTS: Chest radiographs and CT scans revealed pulmonary tuberculosis in 28 patients and extrapulmonary tuberculosis in 15. The pattern of chest radiographs indicative of pulmonary tuberculosis was primary in 12 cases, postprimary in 11, miliary in one, demonstrated atypical infiltrates in three, and was normal in one. Tuberculosis involved the extrathoracic lymph nodes in six cases, the peritoneum in four, the spine in three, and the bone marrow in two. The primary pattern, seen in 12 patients, manifested as pleural effusion or segmental consolidation, and in ten of the twelve the former was dominant. CONCLUSION: The radiological pattern of pulmonary tuberculosis in end-stage renal disease is often primary, and extrapulmonary involvement is frequent.
Bone Marrow ; Humans ; Kidney Failure, Chronic* ; Lymph Nodes ; Medical Records ; Peritoneum ; Pleural Effusion ; Radiography, Thoracic ; Spine ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Pulmonary

We reviewed 13 patients with testicular embryonal carcinoma from July 1982 to May 1994. Embryonal carcinoma accounted for about 25% of total testicular tumors(13/56) and about 34% of nonseminomatous germ cell tumors(13/38). Among the patients with embryonal carcinoma, about 85% were diagnosed in the 15-to-34 year age group. About seventy percent of the patients had metastatic disease at the time of diagnosis and 66.7% of these had distant metastasis including by lung, bone, retroperitoneal lymph node and cervical lymph node, attesting to the aggressiveness of embryonal carcinoma and its tendency to early hematogenous spread. Serum AFP was elevated in 10 patients(76.9%) and hCG in 6 patients(46.2%). All patients with stage I (4/13) were treated with radical orchiectomy only, and all patients with stage II(3/13) were treated with radical orchiectomy and retroperitoneal lymph node dissection(RPLND) followed by chemotherapy. Of the patients with stage III(6/13), 4 patients were treated with radical orchiectomy and chemotherapy, and 2 patients with radical orchiectomy and early chemotherapy, followed by RPLND. The pathologic findings of lymph node at the time of RPLND in stage III were 1 residual embryonal carcinoma and 1 fibrosis. In stage I and II, all patients were still alive. In stage III, 2 patients were still alive for 22 and 48 months. Among the 4 expired patients, 2 were from lung metastasis and the others from sepsis might caused by chemotherapy. These results suggest that the radical orchiectomy only with close clinical observation for stage l had a good survival, and long term survival in stage II patients treated with radical orchiectomy and RPLND followed by chemotherapy will be expected. And in stage III, if the side effects of the chemotherapy is reduced, the better survival may be obtained.
Carcinoma, Embryonal* ; Diagnosis ; Drug Therapy ; Fibrosis ; Germ Cells ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Orchiectomy ; Sepsis ; Testis

In anterior communicating artery aneurysm that accounts for about 30% of intracranial aneurysms, it has been pointed out that the hemodynamic factor plays a very important role in all stages such as initiation, growth and rupture of aneurysm. Based upon the relationship between the findings of brain CT and those of cerebral angigram, the authors reviewed 96 cases of ruptured anterior communicating artery aneurysms that were operated on at the Department of Neurosurgery of Hanyang University Hospital from Jan. 1985 to June 1990, to suggest a point referred to which carotid artery should be selected first when direct carotid angiography is inevitable. The results were summarized as followings: 1) Of 96 cases, hemorrhagic evidence was observed in 92 case(95.8%) and among them, subarachnoid hemorrhage accompanying intracerebral hematoma(37 cases, 38.5%) was the most common type of hemorrhage. 2) Of 96 cases, left A1 was operated as afferent artery in 61 case(63.5%), right A1 in 23 cases(24.0%), and both A1, in 12 cases(12.5%). And the direction of aneurysm was to the right in 49 cases(51.0%), to the left in 12 cases(12.5%) and to the midline in 35 cases(36.5%). 3) Of 53 cases which had intracranial hematoma, 28 cases showed unilateral predominance. Among them the predominance of hematoma was opposite to the afferent artery in 82.1%(23/28) and was ipsilateral to the direction of aneurysm in 64.3%(18/28). 4) Of 91 cases which had subarachnoid hemorrhage, 29 cases showed unilateral predominance. Among them the predominance of hemorrhage was opposite to the afferent artery in 72.4%(21/29) and was ipsilateral to the direction of aneurysm in 58.6%(17/29). 5) Above findings suggest that in the cases with suspicious ruptured anterior communicating artery aneurysms on brain CT and direct carotid angiography is inevitable, contralateral carotid angiography should be undertaken at first when intracranial hematoma or subarachnoid hemorrhage shows unilateral predominance on brain CT, and left carotid antiography is preferable than the right one if there is no predominance of intracranial hematoma or subarachnoid hemorrhage on brain CT.
Aneurysm ; Angiography ; Arteries ; Brain ; Carotid Arteries ; Cerebral Angiography ; Hematoma ; Hemodynamics ; Hemorrhage ; Intracranial Aneurysm* ; Neurosurgery ; Rupture ; Subarachnoid Hemorrhage