Letterer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma of the bone are merely different clinical expressions of one disease. Lichtenstein grouped these three clinical syndromes and proposed that this disease be termed histiocytosis X. This grouping was based on the histologic similarities and the possibility of transformation of one syndrome into another. The cause of histiocytosis X remains unknown. Histiocytosis X is a condition that presents single or multiple lesions, distributed in the soft tissue, lymph nodes, various organ and bones, especially in the areas of marked reticuloendothelial activity. The authors reviewed the clinical findings, radiographs and the treatment of the twenty-six patients with histiocytosis X diagnosed on the base of pathologic findings at Severance Hospital, between January, 1971 and December, 1980. Among the twenty-six patients, twenty-one patients could be followed, ranging from one month to six years, with an average follow-up of 1.6 years. The results obtained were as follows: 1. There was a slight male predominance (61.6%). The age ranged from 2 months to 42 years (average 8.2 years). Sixty-five percents of patients were the child under 4 years of age. 2. Hand-Schuller-Christian disease (50%) was the most common form of this disease. Letterer-Siwe disease developed in the youngest (average 1.2 years) and eosinophilic granuloma in the eldest (average 20.4 years). 3. The common manifestations were hepatomegaly, skin rashes and anemia in Letterer-Siwe disease; palpable mass, pain and exophthalmos in Hand-Schuller-Christian disease; pain and mass in eosinophilic granuloma. 4. The common sites of the skeletal lesions were skull, spine and femur, etc. 5. The patients with single skeletal lesion improved regardless of the methods of treatment. 6. Vinblastine, methotrexate and/or prednisone were valuable agents for the multiply involved patients. 7. Prognosis was poor for the patients who were young at onest, or who had multiple systemic involvements, but in case only with skeletal involvement the prognosis was good. Eosinophilic granuloma is the most benign variant, while Letterer-Siwe disease is the most malignant type.
Anemia ; Child ; Clinical Study ; Eosinophilic Granuloma ; Exanthema ; Exophthalmos ; Femur ; Follow-Up Studies ; Hepatomegaly ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Lymph Nodes ; Male ; Methotrexate ; Prednisone ; Prognosis ; Skull ; Spine ; Vinblastine

The os calcis is fractured more frequently than any other tarsal bone. Fractures involving subtalar joint can, be associated with prolonged and severe disability. So there is no universal agreement in the treatment of these fractures. Calcaneal fractures of 64 feet in 56 patients who were treated at Severance Hospital, Yonsei University College of Medicine from Jan. 1971 to Dec. 1980 were analyzed in clinical and radiological aspects. The results obtained from this study were as follows; 1. Of 56 patients, 46 patients were male and 10 female. 2. The main cause of fractures of calcaneus was a fall from a height in 71.4 percents of cases, and spine injury was associated in 15 patients (26.8%) with calcaneal fractures. 3. The fractures were almostly closed (89.1%). 4. Fractures involving subtalar joint were in 52 feet (81.3%) and Rowe's type 5 were 38 fractures (39.4%). Of these type 5 fractures, 31 fractures were treated by closed reduction and axial pin fixation and then favourable results were obtained. 5. The most common complication after treatment was persistant foot pain. Pain beneath the lateral malleolus was the most common (8 feet), and correlated with the decrease of Bohler's angle.
Calcaneus ; Clinical Study ; Female ; Foot ; Humans ; Male ; Spine ; Subtalar Joint ; Tarsal Bones

No abstract available.
Bulimia* ; Gastric Dilatation* ; Ischemia* ; Portal Vein*

PURPOSE: The purpose of this study was to investigate the characteristics of the patients who had undergone vasovasostomy and to analyze the reasons for an increase in the number of these operations. MATERIALS AND METHODS: From January 1999 to April 2007, 105 patients were analyzed by examining their medical records and conducting telephone surveys. The patients were divided into two groups before and after insurance payments for a vasovasostomy. Analysis of the differences between the two groups was performed by grouping the patients who had a vasovasostomy before July 2004 and those who had a vasovasostomy after July 2004. RESULTS: Among the 105 patients, 35 patients (0.58/month) had a vasovasostomy before receiving their insurance payment. However, the number of operations increased by more than 4 times (70 patients, 2.33/month) after insurance repayment (p<0.05). After the payment, the proportion of patients willing to have a vasovasostomy due to changing their mind increased, whereas the proportion of patients willing to have a vasovasostomy for remarriage and loss of a child decreased (p<0.05). The overall patency and birth rates were 87.6% and 76.1%, respectively (43 boys and 37 girls). Among such factors as the age of the patient and his spouse, the duration of ligation and the presence of seminal fluid and sperm, the duration of ligation was the only factor that showed relevance to the anatomical patency (p<0.05). There were no variables that showed significant relevance to the pregnancy rate. CONCLUSIONS: The main reason of vasectomy reversal was to have another child. The numbers of vasovasostomies were influenced by the medical insurance payment. The duration of ligation affected the anatomical patency rate. The overall patency rate was 87.6% and the birth rate was 76.1% in this study.
Birth Rate ; Child ; Humans ; Insurance ; Ligation ; Marriage ; Medical Records ; Parturition ; Pregnancy Rate ; Spermatozoa ; Spouses ; Telephone ; Vasovasostomy

BACKGROUND: Observation on the hemodialysis treatment; whether there are any different effects on mortality rate, side effects, or effectiveness of the treatment depending on patients' age. METHODS: Chronic renal failure patients who started hemodialysis treatment between 2002 and 2003 were separated in two groups, 33 patients of 60 and older and 76 patients under 60. We investigated mortality rate difference, A-V shunt re-operation, and total protein and albumin level. Also, comparing and analyzing the urea reduction ratio, we examined whether effectiveness is different depending on the patients' age. RESULTS: The 3 year survivor rate of patients who initially started hemodialysis treatment over 60 was 66.7%, and that of the patients under 60 resulted as 73.1%. The average total protein lefel for over 60 was 6.48g/dL and for under 60 was 6.80g/dL, and albumin for over 60 was 3.15g/dL and under 60 was 3.46g/dL. We identified that the patients who repeated shunt operation in over 60 group was 4(12%) and in under 60 group was 4(5.2%). Effectiveness of the treatment, Urea Reduction Ratio(URR), for both groups was 71%. CONCLUSION: The 3 year survivor rate of patients who initially started hemodialysis treatment over 60 was lower than the control group, but considering the remaining life expectancy, it seems to be no significant difference between the groups; and the treatment effectiveness was same in both groups.
Humans ; Kidney Failure, Chronic ; Life Expectancy ; Prognosis ; Renal Dialysis ; Survivors ; Treatment Outcome ; Urea

PURPOSE: To evaluate the CT and MR findings of bronchial anthracofibrosis. MATERIALS AND METHODS: Forty-one patients with ronchoscopically confirmed bronchial anthracofibrosis were included in this study. Thirty-six were female and five were male, and all were aged between 53 and 89 (mean, 70) years. The CT (n=41) and MR findings (n=5) were retrospectively analysed with regard to bron-chostenosis, atelectasis, air-space consolidation, lymph node enlargement, calcified lymph node, mass and bronchial wall thickening, as seen on CT, and signal intensity of the mass and lymph nodes, as seen on MR. RESULTS: CT scans revealed the presence of bronchostenosis (n=34, 83%), atelectasis (n=24, 59%), pneumonic consolidation (n=26, 63%), enlarged mediastinal lymph node (n=39, 95%), calcified lymph node (n=22, 54%), mass (n=4,10%), and thickening of bronchial wall (n=1, 2.4%). Multifocal involvement of bron-chostenosis, atelectasis, and air-space consolidation occurred in 61%, 50% and 30% of cases, retrospectively. MR imaging showed low signal intensity of mass (n=3) and lymph nodes (n=10) on T1WI and T2WI. but in one case, mass and lymph node showed central high signal intensity on T2WI. CONCLUSION: A multiplicity of bronchostenosis, atelectasis, air-space consolidation and enlarged mediastinal lymph nodes were characteristic CT findings of bronchial anthracofibrosis. Most MR findings included relatively low signal intensity of masses and lymph nodes on T2WI, possibly indicating the benign nature of the diseases
Female ; Humans ; Lung ; Lymph Nodes ; Magnetic Resonance Imaging ; Male ; Pneumoconiosis ; Pulmonary Atelectasis ; Retrospective Studies ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES:In order to analyze and understand the oculomotor system completely, it is essential to measure horizontal, vertical, and torsional eye movements. We developed a new system of 3-dimensional videooculography that can accurately estimate the pupil center and measure torsional eye movement in real time while minimizing the errors caused by upper eyelid droop, eyelashes, corneal reflection, and eye blinking. MATERIALS AND METHOD:For accurate estimation of the center and diameter of the pupil, the edges of the pupil were searched by using a sector-form window and circle fitting was performed using the least square regression. Torsional eye movement was measured using polar cross-correlation technique with modification to lessen the errors produced by the change in pupil size. Calibrations were performed and to verify the proposed system, the linearity between the measured and actual eye movements was measured. Also, the results of the proposed system were compared with those of another commercialized system. RESULTS: The linearity between the measured and actual eye movements showed errors of less than 1%. The spatial resolutions of the system for horizontal, vertical, and torsional eye movements were 0.3, 0.4, and 0.2, respectively whereas the temporal resolution was 30 frames/sec. In comparison to the commercialized system, our system showed less artifact by eye blinking when measuring vertical eye movement. CONCLUSION:We proposed an algorithm and a system for measuring horizontal, vertical, and torsional eye movements which minimized the influence of partial eyelid closure, eyelashes, corneal reflections, and change in pupil size.
Artifacts ; Blinking ; Calibration ; Eye Movements* ; Eyelashes ; Eyelids ; Pupil

Adult-onset type II citrullinemia (CTLN2) is a disorder caused by an inborn error of metabolism affecting the liver. CTLN2 is an autosomal recessive disorder characterized by recurrent encephalopathy with hyperammonemia due to highly elevated plasma levels of citrulline and ammonia, caused by a deficiency of argininosuccinate synthetase in the liver. A small number of patients have undergone liver transplantation with favorable results. In Korea, the limitations of the deceased donor pool have made living donor liver transplantation a common alternative treatment option. We report the case of a patient with type II citrullinemia who was treated successfully with auxiliary partial orthotopic liver transplantation (APOLT) from a living donor. This is the first description of an APOLT for a patient with adult onset type II citrullinemia in Korea.
Adult ; Ammonia ; Argininosuccinate Synthase ; Citrulline ; Citrullinemia ; Humans ; Hyperammonemia ; Korea ; Liver ; Liver Transplantation ; Living Donors ; Plasma ; Tissue Donors

The repair of abdominal aortic aneurysm (AAA) in patients with functioning renal transplant is critical because it is important to avoid ischemic and reperfusion injury to the transplanted kidney. Endovascular aneurysm repair (EVAR) avoids aortic cross clamping and can prevent renal graft ischemia. Here we report the endovascular management and outcome of AAA in two renal transplant patients using a bifurcated aortic stent graft. One patient underwent EVAR using a small amount of contrast (30 mL) due to decreased renal function resulting from chronic rejection. Another patient had EVAR performed with iliac conduit because of the heavily calcified, stenotic lesion of external iliac artery. EVAR in patients with a renal transplant is a feasible option without impairing renal arterial flow.
Aneurysm ; Aortic Aneurysm, Abdominal ; Constriction ; Endovascular Procedures ; Humans ; Iliac Artery ; Ischemia ; Kidney ; Kidney Transplantation ; Rejection (Psychology) ; Reperfusion Injury ; Stents ; Transplants

No abstract available.
Intestinal Polyposis*