External fixation was improved in its devices and techniques as a specific method of fracture treatment. It was possible to immobilize the fractures firmly with the use of Vidal modified Hoffmann external fixation and could be used effectively in difficult fractures with severe soft tissue injury. From October 1981 to December 1983, 28 patients of tibial fracture who had been treated with Hoffman external fixation at Severence Hospital, Yonsei University College of Medicine were studied. The results are summerized as follows: 1. The age of patients varied from 14 to 66 years old, the majority (53.6%) being between 20 to 39 years old and males comprized 89.3%. 2. Traffic accidents and machinary injuries comprized 96.4%. 3. Average duration with Hoffmann frame was 16.6 weeks and average time of bone union was30.1 weeks. 4. Many complications were noticed but majority were related to personalities of the fractures, not due to Hoffmann external fixation itself. 5. Hoffmann device was relatively easy and quick to apply: sufficient stability was obtained: reasonable anatomic reduction of major fragments was possible: facilitated treatment and care of polytr- aumatized patients. 6. Secondary operations, e,g., bone grafting and even plastic surgery, had been possible without necessitating removal of the device. 7. It was useful in open fractures with severe soft tissue tissue injury and also in taking care of further necessary managements.
Accidents, Traffic ; Bone Transplantation ; Fractures, Open ; Humans ; Male ; Methods ; Soft Tissue Injuries ; Surgery, Plastic ; Tibia ; Tibial Fractures

No abstract available.
Animals ; Cautery* ; Cryosurgery* ; Dogs* ; Femur* ; Phenol*

OBJECTIVES: The definite cause of obsessive-compulsive disorder (OCD) is still unknown. Evidences from familial, twin and segregation studies support the role of a genetic factor. There also are growing evidences indicating that OCD has specific neurochemical and neuroanatomical basis. Derived from the effectiveness of serotonin reuptake inhibitors in OCD treatment, several candidate genes related to serotonin regulation have been hypothesized to play on important role in the development of OCD. One of them is the serotonin transporter gene. The aim of this study was to investigate the association between serotonin transporter gene and OCD. METHODS: 124 OCD patients and 119 normal controls participated in this study. Genomic DNA was extracted from their blood. The genotypes and allele frequencies of the 5-HTTLPR polymorphism between OCD group and control group were compared. And we investigated the association between 4 factors derived from YBOCS checklists and 5-HTTLPR polymorphism. RESULTS: In this case-control study, we could not find any association between 5-HTRLPR polymorphism and development of OCD. In OCD group, patients with L (l/s+s/s) genotype had higher scores for the religious/somatic factor than those with S genotype. CONCLUSION: In this study, there was no difference in genotype distributions of 5-HTTLPR between OCD and control groups. But, L genotype of 5-HTTLPR polymorphism had negative effects on some factors of the obsessive-compulsive symptoms.
Case-Control Studies ; Checklist ; DNA ; Gene Frequency ; Genotype ; Humans ; Obsessive-Compulsive Disorder* ; Serotonin Plasma Membrane Transport Proteins* ; Serotonin Uptake Inhibitors ; Serotonin*

OBJECTIVES: The definite cause of obsessive-compulsive disorder (OCD) is still unknown. Evidences from familial, twin and segregation studies support the role of a genetic factor. There also are growing evidences indicating that OCD has specific neurochemical and neuroanatomical basis. Derived from the effectiveness of serotonin reuptake inhibitors in OCD treatment, several candidate genes related to serotonin regulation have been hypothesized to play on important role in the development of OCD. One of them is the serotonin transporter gene. The aim of this study was to investigate the association between serotonin transporter gene and OCD. METHODS: 124 OCD patients and 119 normal controls participated in this study. Genomic DNA was extracted from their blood. The genotypes and allele frequencies of the 5-HTTLPR polymorphism between OCD group and control group were compared. And we investigated the association between 4 factors derived from YBOCS checklists and 5-HTTLPR polymorphism. RESULTS: In this case-control study, we could not find any association between 5-HTRLPR polymorphism and development of OCD. In OCD group, patients with L (l/s+s/s) genotype had higher scores for the religious/somatic factor than those with S genotype. CONCLUSION: In this study, there was no difference in genotype distributions of 5-HTTLPR between OCD and control groups. But, L genotype of 5-HTTLPR polymorphism had negative effects on some factors of the obsessive-compulsive symptoms.
Case-Control Studies ; Checklist ; DNA ; Gene Frequency ; Genotype ; Humans ; Obsessive-Compulsive Disorder* ; Serotonin Plasma Membrane Transport Proteins* ; Serotonin Uptake Inhibitors ; Serotonin*

No abstract available.

Cryptococcosis of the central nervous system if highly fatal, if unteated, but we experienced a case of cryptococcal meningitis that took a rather benign course with a marked hydrocephalus with deafness and visual disturbance simulating tuberculous meningitis clinically. A 31 year old Korean man was admitted to the department of Neurosurgery, Seoul National University Hospital, with the chief complaints of sudden visual disturbance and bilateral deafness of 4 years' duration. Simple skull films showed a sellar changes that was due to chronically increased intracranial pressure. Carotid angiogram revealed marked hydrocephalic changes and vertebral angiogram showed a 4th ventricle dilatation. On pneumoencephalogram, we could observe air trapping only below the tentorium. Conray ventriculogram showed marked dilatation of all ventricles. The 3rd ventricle was herniated into the sella and irregular filling defect at the posteroinferior portion of the 4th ventricle was observed. Lumbar CSF showed the finding compatible with tuberculous meningitis. India ink staining of CSF for fungus study gave a negative result. Posterior fossa exploration was performed to rule out possible mass lesion. Arachnoid membrance was thickened and adhered, so we couldn't separate tonsils and explore the 4th ventricle. And there was no CSF in the cisterna magna. We found a mass of yellowish and caseous material in the dorsal aspect of lower medulla. Ventriculo-operational shunt for hydrocephalus was done. Microscopic findings of the lesion revealed diffuse infiltration of many cryptococci with scattered neutrophils and monocytes. We report a case of cryptococcal meningitis that took and unusual benign course.
Adult ; Arachnoid ; Central Nervous System ; Cisterna Magna ; Cryptococcosis ; Deafness ; Dilatation ; Fungi ; Humans ; Hydrocephalus ; India ; Ink ; Intracranial Pressure ; Meningitis, Cryptococcal* ; Monocytes ; Neurosurgery ; Neutrophils ; Palatine Tonsil ; Seoul ; Skull ; Tuberculosis, Meningeal

BACKGROUND: Congenital cystic adenomatoid malformation (CCAM) is a congenital abnormality of branching morphogenesis of the lung. Thyroid transcription factor-1 (TTF-1) is detected in human respiratory epithelial cells from 11 weeks of gestation, and at full term, TTF-1 expression is confined within type II epithelial cells and in some respiratory nonciliated bronchiolar epithelial cells. Immunoexpression of bcl-2 is intimately related to apoptosis during the development. METHODS: To elucidate the nature of the lesion, TTF-1 expression was evaluated in twenty-four cases of CCAM (eight cases of type 1 and sixteen cases of type 2) along with immunostaining for bcl-2. For the control group, four cases of fetal lungs (19 week-, 21 week-, 27 week- and 40 week-gestational age) were also evaluated. In all cases of CCAM, TTF-1 was detected in the nuclei of epithelial cells lining the cysts. RESULTS: TTF-1 was expressed in the majority of the bronchiolar-like epithelial cells of the cysts in CCAM types 1, and 2, where almost 100% of the lining cells of the cysts were TTF-1 positive with variable intensity, while negative TTF-1 expressions were found in the alveolar-like epithelium of the adjacent alveoli or distal nonciliated bronchi. For bcl-2 immunostaining, no lining epithelial cells of the cysts were stained except for the infiltrating lymphocytes. In the control group, strong immunoreactivities found in early fetal stages were absent in the full-term aged lung (40 gestational weeks). CONCLUSION: These results support the hypothesis that CCAM types 1 and 2 reflect the abnormalities in lung morphogenesis and differentiation that are distinct from those for normally developed alveolar epithelium or adjacent bronchial epithelium, thus retaining the abnormal TTF-1 immunoreactions. Though restricted to CCAM types 1 and 2 in this study, CCAM might be related to TTF-1 rather than apoptosis in the morphogenesis of the developing lung.
Apoptosis ; Bronchi ; Congenital Abnormalities ; Cystic Adenomatoid Malformation of Lung, Congenital* ; Epithelial Cells ; Epithelium ; Humans ; Lung ; Lymphocytes ; Morphogenesis ; Pregnancy ; Thyroid Gland*

No abstract available.
Coronary Vessels* ; Myocardial Infarction* ; Perfusion*

To evaluate the significance of placental histology, a collaborative histological and cytogenetic study was performed on the products of 88 spontaneous abortions, and subsequently bcl-2 immunostaining was performed on 62 cases. The morphometric parameters included were DCIRCLE, FORMSHAPE, CPRATIO, and the expression of bcl-2 immunostainig was graded in four categories (I to IV). The results were as follows: 1) 40% (n=35) were chromosomally abnormal: trisomies predominated (57%, n=20) and was followed by triploidy (14%, n=5), double trisomy (6%, n=2), monosomy X (6%, n=2), inversion (9) (6%, n=2). 2) mean of DCIRCLE in chromosomally abnormal pregnancy was 40 micrometer larger than that in chromosomally normal pregnancy (p=0.012, one side t-test), while no difference was found in FORMSHAPE and CPRATIO between chromosomally abnormal and normal pregnancy. 3) bcl-2 expression was found in syncytiotrophoblast and cytotrophoblast. bcl-2 expression was weaker in chromosomally abnormal pregnancy with intensity I and II of 59% than chromosomally normal pregnancy with intensity I and II of 24%. 4) In comparison bcl-2 expression with DCIRCLE, in chromosomally normal abortion one (10%) in I & II and one (3%) in III & IV showed large DCIRCLE (above 360 micrometer), while 11 (85%) in I & II and 3 (33%) in III & IV in chromosomally abnormal pregnancy. It would mean that bcl-2 protein is necessary in preservation of pregnancy and placental morphology. Abnormal villous diameter and weak bcl-2 expression may be suggestive of chromosomal anomaly. Besides other histologic parameters, application of bcl-2 immunostaining and morphometric analysis probably give more sensitive and specific results in identifying chromosomally abnormal abortion.
Abortion, Spontaneous ; Cytogenetics ; Female ; Humans ; Placenta* ; Pregnancy* ; Triploidy ; Trisomy ; Trophoblasts ; Turner Syndrome

Peripheral primitive neuroectodermal tumor (pPNET), a rare, highly aggressive neoplasm of indetermined histogenesis, occurs typically in the soft tissues of the chest wall and the paraspinal region. Comprehensive diagnostic studies including histological, ultrastructural, immunohistochemical and molecular analyses have been stressed to diagnose this entity. We report a case of primary renal PNET which was incidentally found in a 59-year-old man who presented with generalized weakness for 4 months. He was diagnosed as a non-insulin dependent diabetes mellitus 15 years ago and has been made well by oral therapy. An ill-defined mass, measuring 3.5 3 cm, located in the left kidney and perirenal fat, was incidentally found by ultrasonogram during a renal diabetic examination. The mass was resected because of the unresponsiveness against one-year chemotherapy and radiation therapy. Grossly, a homogeneously solid, gray-white mass, measuring 2.8 1.8 cm, was noted in the mid portion of renal cortex. The mass showed severe adhesion to the perirenal fatty tissue. Microscopically, tumor cells were rather uniform, small round with scanty cytoplasm and often showed rosette formation. Ultrastructurally, they showed membrane-bound dense core granules, measuring 125~150 nm, intercellular junctions and microvillous cytoplasmic projections. The tumor cells were uniformly immunoreactive for neuron-specific enolase and were focally immunoreactive for CD99 (013), chromogranin, synaptophysin and cytokeratin. They were not reactive for S-100 protein, vimentin, Leu-7, leukocyte common antigen, desmin and smooth muscle actin. To our knowledge, this is the smallest renal PNET in literature.
Actins ; Adipose Tissue ; Antigens, CD45 ; Cytoplasm ; Desmin ; Diabetes Mellitus ; Drug Therapy ; Humans ; Intercellular Junctions ; Keratins ; Kidney* ; Middle Aged ; Muscle, Smooth ; Neuroectodermal Tumors, Primitive* ; Phosphopyruvate Hydratase ; Rosette Formation ; S100 Proteins ; Sarcoma, Ewing ; Synaptophysin ; Thoracic Wall ; Ultrasonography ; Vimentin