Recently, people living in a rapidly industrializing country such as Korea seems to have less opportunity to be exposed to Rhus and Ginkgo trees than before, which may cause a lower prevalence of sensitivity to such allergens than those reported in the past. To prove the prevalence of sensitivity in Koreans, we have tested 0. 002g and 0.0l%, Urushiols and 10% Ginkgo leaves produced by Torii company to 72 atients with or suggesting contact dermatitis. The results were as follows: 1) Twelve of 72 patients(13, 9%) showed positive reactions and two patients(2. 8 %) showed active sensitization to both 0. 002% and 0. 0l% Urushiols. Only one patient(]. 4%) reacted to 10g Ginkgo leaves, and she was also reacted to the Urushiols. 2) Age and sex distribution of the positive reactors were none under thirty, 2 in thirties, 3 in forties, 4 in fifties, one over sixty, and seven female patients outnumber three male patients. 3) Out of 5 patients having past history cf contact dermatitis to Rhus tree, only patients showed positive reactions. Out of 67 patients without past history of allergy to Rhus, 8(ll, 9%) showed positive reactions and 59(88. 1%) showed negative reactions.
Allergens ; Dermatitis, Contact ; Female ; Ginkgo biloba* ; Humans ; Hypersensitivity ; Korea ; Male ; Prevalence* ; Rhus* ; Sex Distribution ; Trees

This study was undertaken to observe the difference of patch test and prick test positive reactions in three groups, 20 atopic dermatitis patients, 20 chronic urticaria patients, and 20 normal controls, Twenty commercial antigens (ToriiCo.) and twenty three frozen and boiled antigens of fishes and shellfishes were used as test materials. The results were as follows: 1. No positive reaction was observed in all sixty subjects in patch test. 2 In prick test, difference in reactivity was observed among atopic dermatitis (14. 7%), chronic urticaria (8.7%), and normal control(1. 5%) 3. There was significant difference in reactivity between Torii and frozen antigens in atopic dermatitis group, but no significance in chronic urticaria and control groups. 4. Boiling altered the reactivity in tested materials in all three groups of subjects singificantly. 5. Patients with past or family history of allergic diseases showed double fold higher reactivity tban patients without any history.
Dermatitis, Atopic* ; Fishes ; Humans ; Patch Tests ; Shellfish* ; Urticaria*

The authors reviewed 85 knees in 59 patients(9 males, 50 females) who had preoperative flexion contracture(FC) greater than 20° and taken total knee arthroplasty(TKA) at the Seoul National University Hospital from Jan.1987 to Dec.1992. We reviewed the surgical methods according to preoperative FC, changes of postoperative FC and range of motion, and clinical and radiologic findings. In our series, 48 knees were degenerative arthritis(average FC: 26°), 34 knees, rheumatoid arthritis(average FC: 40°)and 3 knees, others(average FC:28°). The average follow-up period was 2 years(range, 1 to 4(+8) years). Seventy three knees with FC less than 45 (Group I)had been treated with TKA accompanied with adequete soft tissue release, removal of osteophyte and appropriate bone resection. Eleven knees with FC greater than 50° (Group II) had been treated with skin traction followed by TKA. One knee with 65° of FC(Group III)was treated with posterolateral and posteromedial release including tendon lengthening at first, and then TKA in second stage. Preoperative FC was significantly greater in RA group than in DA group. Flexion contracture improved until postoperative 3 years in DA group and improved until postoperative 2 years and slightly deteriorated after then in RA group, but statistically insignificant(p>0.05). There was no difference of FC at postoperative 2 weeks and final follow-up between Group I and II. Range of motion improved until postoperative 2 years in DA group significantly(p < 0.05). In RA group, range of motion improved until postoperative 2 years(p>0.05) and deteriorated after then(p < 0.05). With TKA, range of motion increased significantly in both Group I and II and there was no difference of range of motion between Group I and II at final follow-up. Postoperative HSS score and pain score improved in DA and RA groups significantly, and final HSS score with greater in DA group than RA group(p < 0.05). Preoperative HSS score and pain score of Group I were significantly higher than those of Group II, but final follow-up, there was no difference between two groups. There was no correlation between final FC and HSS score. There was no difference in score of radiolucency between two groups in which final FC was greater and lesser than 10°. We thought that in knees with fixed flexion contracture, successful correction of moderate to severe flexion contracture and satisfactory result of total knee arthroplasty can be achieved by adequate soft tissue release, appropriate bone resection, and/or preoperative management.
Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Male ; Osteophyte ; Range of Motion, Articular ; Seoul ; Skin ; Tenotomy ; Traction

No abstract available.
Clubfoot*

PURPOSE: The Singh index which is based on a plain radiograph has commonly used in assessing the grade of osteoporosis. We studied value of the Singh index in assessing the grade of osteoporosis by obtaining reliability of the Singh index and correlation between the Singh index and bone mineral density. MATERIALS AND METHODS: Six observers assessed radiographs of 60 patients suspected osteoporosis. The interobserver and intraobserver agreement of the Singh index were obtained by using kappa statistics. The bone mineral density of proximal femur was measured by dual energy X-ray absorptiometry in all patients, and then the results of bone mineral density were compared with those of Singh index by using percentage of variance. RESULTS: The kappa values of interobserver agreement ranged from 0.28 to 0.76 (mean value: 0.45) and the strength of the agreement was moderate. The percentage of variance of BMD which was explained by Singh index was 7.1%. CONCLUSIONS: The results of this study suggest that the Singh index has low clinical value in assessing the grade of osteoporosis
Absorptiometry, Photon ; Bone Density ; Femur ; Humans ; Osteoporosis*

There are a few reports on tarsal tunnel syndrome resulting from the intraneural ganglion. Although it can occur through a connection with the adjacent joint, there is no consensus on its pathogenesis and treatment method. This paper reports a case of tarsal tunnel syndrome resulting from the intraneural ganglion of the medial plantar nerve of the tibial nerve.
Consensus ; Ganglion Cysts* ; Joints* ; Methods ; Recurrence* ; Tarsal Tunnel Syndrome* ; Tibial Nerve*

OBJECTIVE: Large loop excision of transformation zone(LLETZ) is gaining popularity as an alternative to other ablative or cone methods for the treatment of cervical intraepithelial neoplasia(CIN). The optimal management of CIN after LLETZ, however, remains controversial and the reliable predictors of residual disease after LLETZ have not been consistently identified. This study was performed to identify factors to predict residual disease after LLETZ. METHODS: From August 1993 to July 1995, 133 patients who received subsequent hysterectomy after LLETZ in Department of Obstetrics and Gynecology at Seoul National University Hospital were retrospectively reviewed. Residual disease was defined as positive findings of CIN or further advanced findings in hysterectomy specimen. The age of patients, the severity of disease and the status of resection margin(RM) were analyzed for predictive values of residual disease. The Chi-square test, Fisher's exact test and Student t-test were used for statistical analysis. RESULTS: The residual disease after hysterectomy was negative in 85.7%(114/133) and positive in 14.3%(19/133). Among 19 cases with positive residual disease, 3 cases were revealed to be microinvasive cervical cancer. The mean age of patients with no residual disease was 42.5 years(range; 27-71) and that of patients with residual disease was 49.1 years(range; 33-72). Nine out of 94 cases(9.6%) with negative RM and 10 out of 39 cases(25.6%) with positive RM in LLETZ had residual disease. Two out of 14 cases(14.3%) with CIN II and 17 out of 119 cases(14.3%) with CIN III in LLETZ had residual disease. The success of LLETZ which means no residual disease was influenced by the age of patients(p=0.005) and the status of resection margin of LLETZ(p=0.032). CONCLUSION: The negative resection margin in LLETZ does not always guarantee that there is no residual disease. Close preoperative workup and more aggressive treatment plan(wide conization or hysterectomy) should be considered in patients who has higher possibility of positive residual disease such as old age and positive resection margin in LLETZ.
Cervical Intraepithelial Neoplasia* ; Conization ; Gynecology ; Humans ; Hysterectomy ; Obstetrics ; Retrospective Studies ; Seoul ; Uterine Cervical Neoplasms

OBJECTIVE: This study was performed to identify the prognostic factor for survival of patients with recurrent cervical cancer. METHODS: Sixty-eight patients were diagnosed as recurrent cervical cancer at the Seoul National University Hospital from January, 1988 to December, 1998. Recurrence was defined as new evidence of tumor after 6 months of disease free survival. Retrospective analysis was done in terms of clinical features and the Cox proportional hazard model was used to identify independent variables associated with an improved survival rate. Histopathologic types were distributed as follows; squamous cell carcinoma in 70.6%, adenocarcinoma in 11.8%, adenosquamous cell carcinoma in 11.8%, and small cell carcinoma in 1.5%. Distribution of FIGO stage was as follows; stage I in 25.0%, stage II in 66.2%, and stage III in 4.4%. Sites of recurrence were as follows; central pelvic recurrence in 44.1%, pelvic side wall recurrence in 11.8%, and distant metastasis in 44.1% and the most common site of distant recurrence was extrapelvic lymph nodes (29.4%). 29.4% of recurrences were observed within the first 12 months after initial therapy, 50.0% within 2 years and 64.7% within 3 years. RESULTS: Positive rate of SCC-Ag at initial diagnosis was 45.2% with cutoff value of 2.0 ng/ml. Positive rate of SCC-Ag at the diagnosis of recurrence was 60.0%. Overall response rate to the treatment was 29.1%. Complete response rate was higher in central pelvic recurrrence than pelvic side wall recurrence and distant metastasis (P = 0.002) and also higher in normal SCC-Ag level (< or = 2.0 ng/ml) at the diagnosis of recurrence than elevated level (P = 0.032). Cumulative survival rates of 1 year after recurrence was 66.8%, 2 year 36.7%, and 5 year 18.7%. Central recurrence showed higher cumulative survival rate than pelvic side wall or distant recurrence (P = 0.029). The patients with elevated SCC-Ag level at the time of diagnosis of recurrence showed lower cumulative survival rate than those with normal SCC-Ag level (P < 0.001). Cox proportional hazard model showed that SCC-Ag elevation at the time of diagnosis of recurrence retained significant values in predicting survival(OR = 2.56; 95% CI = [1.22-5.39]; P = 0.01). CONCLUSION: SCC-Ag elevation at the diagnosis of the recurrence is a strong independent prognostic indicator for survival of patients with recurrent cervical cancer.
Adenocarcinoma ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Disease-Free Survival ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Seoul ; Survival Rate ; Uterine Cervical Neoplasms*

BACKGROUND: The HER-2/neu proto-oncogene (also known as c-ErbB-2) encodes a 185 kD transmembrane glycoprotein with intrinsic tyrosine kinase activity. Many studies revealed the correlation between the aberrant overexpression of HER-2/neu oncogene and poor prognosis of the malignant tumors such as breast, stomach, colon, lung cancers. But the significance of HER-2/neu oncogene overexpression as a prognostic factor in ovarian cancer remains controversial. OBJECTIVE: The aims of this study were to assess the prevalence of HER-2/neu oncogene amplification by polymerase chain reaction(PCR) and to evaluate the prognostic significance of HER-2/neu oncogene overexpression in terms of chemo-responsiveness and survival rate. MATERIALS AND METHODS: This study included 32 patients with advanced ovarian cancers(24 epithelial ovarian cancers, 2 Brenner tumors, 2 malignant mixed miillerian tumors, 2 granulosa cell tumors, 1 struma ovarii, 1 Krukenberg tumor). All patients had underwent staging laparotomy, and postoperative adjuvant chemotherapy with platinum-based combination chemotherapy. PCR was performed using tissues preserved in liquid nitrogen at the time of debulking operation. Overexpression of HER-2/neu oncogene was defined as being equal to or greater than 1.5 a.u. We analyzed whether the HER-2/neu overexpression correlated with chemoresponsiveness and 5-year survival rate(5-YSR). RESULT: HER-2/neu oncogene amplification was present in all of the ovarian cancers(32/32). Significant overexpression[gene copy number(GCN) > or =1.5 a.u.] was present in 13 of 32 ovarian cancers(41%) and 12 of 24 epithelial ovarian cancers (50%). The clinical response rate to chemotherapy in high copy group(GCN > or = 1.5 a.u.) was 67%(8/12) and that of low copy group(GCN<1.5 a.u.) was 92%(11/12)(p>0.05). Pathologic response rate to chemotherapy was 0%(0/5) and 50%(3/6), respectively(p>0.05). 5-YSR was 8% in high copy group and 25% in low copy group, but this difference was not statistically significant(p=0.17). CONCLUSION: HER-2/neu overexpression might be a poor prognostic factor, but this difference was not definitely elucidated by satistical analytsis in this study. Larger scaled prospective randomized study is needed to define the prognostidc significance of the HER-2/neu overezpression in ovarian cancer.
Breast ; Brenner Tumor ; Chemotherapy, Adjuvant ; Colon ; Drug Therapy ; Drug Therapy, Combination* ; Glycoproteins ; Granulosa Cell Tumor ; Humans ; Laparotomy ; Lung Neoplasms ; Nitrogen ; Oncogenes* ; Ovarian Neoplasms* ; Polymerase Chain Reaction ; Prevalence ; Prognosis ; Protein-Tyrosine Kinases ; Proto-Oncogenes ; Stomach ; Struma Ovarii ; Survival Rate

OBJECTIVE: Cervical carcinoma can be adequately treated when diagnosed in early stage. However, the progsnosis of recurrent cervical carcinoma remains poor. The objective of this study is to analyze the prognostic factors affecting survial of recurrent cervical carcinoma patients. METHODS: The clinical characteristics of eighty-three patients who were diagnosed as recurrent cervical carcinoma from Jan 1988 to Apr 1999 were retrospecively analyzed, The initial FIGO stage of II (67.5%) was the most predominant. There were 9.6% of adenocarcinoma, 9.6% of adenosquamous carcinoma, and 1.2% of small cell carcinoma other than squamous cell carcinoma (77.1%). Diagnosis of recurrence was made by histopathologic examination, CT/MRI, Chest X-ray, intravenous pyelography. The recurrence was detected on routine follow-up in 41.0%. Comparison of Kaplan-Meyer survival curve was made with log-rank test, P-value less than 0.05 was regarded as statistically significant. RESULTS: Overall 2-year survival rate was 37.3% and median survival was 17 [13-21, 95%CI] months. Four patients survived more than 5 years. There was no significant difference among survival rates of histopathologic types, Survival rates of patients with central recurrence were significantly higher than those of lateral and distant recurrence (P= 0.009). 13 patients who did not receive any treatment after recurrence survived only for 9 [7-11] months and the survival of those were significantly lower than the survival of patients who received treatment of any kind (P<0.001). The treatment modalities after recurrence did not affect survival. CONCLUSION: We conclude that regular follow-up of cervical carcinoma patients is very important in detecting recurrence and that treatment after recurrence does affect survival of patients.
Adenocarcinoma ; Carcinoma, Adenosquamous ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Diagnosis ; Follow-Up Studies ; Humans ; Recurrence ; Survival Rate ; Thorax ; Urography