Polydactyly is the most common congenital anomaly of the upper limb. Polydactyly is classified as preaxial polydactyly(thumb), central polydactyly(index, middle and ring fingers), and postaxial polydactyly(little finger) by the site of the extra digit. A 3-day-old female newborn had a 1.5 * 1.0cm sized flesh color ed pedunculated sac like mass on the proximal phalanx of her right thumb since birth. A roentgenogram on the hand revealed no bony abnormalities of the digit and the mass contained no bony structures. The stalk of the mass was cut by the CO2 laser. On histopathological examination, a cartilage structure was found in the loosely arranged, edematous dermis and the overlying epidermis was flattened. The clinical and histological findings support the diagnosis of preaxial polydactyly. We report this interesting case of preaxial polydactyly with a review of the literature.
Cartilage ; Color ; Dermis ; Diagnosis ; Epidermis ; Female ; Hand ; Humans ; Infant, Newborn ; Lasers, Gas ; Parturition ; Polydactyly* ; Skin* ; Thumb ; Upper Extremity

No Abstract Available.
Trabeculectomy*

BACKGROUND/AIMS: Solid and papillary epithelial neoplasm (SPEN) of the pancreas is a rare malignant tumor with a characteristic female predominance. This tumor has a low- grade malignant potential biologically, and shows favorable prognosis with surgical treatment clinically. METHODS: Nine patients with SPEN of the pancreas who were pathologically confirmed at the Dong-A University Medical Center were analyzed retrospectively. Clinical data, including clinical manifestation, diagnostic maneuvers, surgical treatment modality, and prognosis were evaluated. RESULTS: Six out of nine patients were females with a mean age of 28 (range, 15~52) years. Except in 2 cases, all patients presented with either a palpable abdominal mass (5 cases) or abdominal pain (2 cases). The tumors ranged in size from 3.8 to 18 (average size, 11.4) cm. Five were located in the body, 3 in the tail, and 1 in the head. SPEN was diagnosed preoperatively in 6 patients by abdominal ultrasonography and/or CT. All patients underwent surgical resection, which included subtotal pancreatectomies (4 cases), distal pancreatectomies (4 cases, 1 by laparoscopically) and local excision (1 case). All patiests are survived without evidence of recurrence with a mean follow up of 53.1 (range, 26~69) months. CONCLUSION: SPEN of the pancreas is low-malignant in character, and complete surgical excision is the treatment of choice which warrants a long-term survival.
Abdominal Pain ; Academic Medical Centers ; Female ; Follow-Up Studies ; Head ; Humans ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancreatectomy ; Prognosis ; Recurrence ; Retrospective Studies ; Ultrasonography

PURPOSE: Various surgical approaches have been used for stress urinary incontinence. We used a suburethral patch sling operation using fascia lata for all patients with stress urinary incontinence and report our experience. MATERIALS AND METHODS: From November, 1996 to May, 1997, a total of 25 female patients with stress urinary incontinence underwent the sling procedure, and 22 patients were followed up postoperatively. A 1.5- x 3.5- cm rectangle of fascia lata was used with 1-0 prolene sutures attached to allow suspension and the fascia lata patch was fastened at the level of the bladder neck in the anterior vaginal wall. We used the Stamey needle to transfer the suspension sutures in a fashion identical to that used for bladder neck suspension. Median followup was 22 months(range 20 to 26). RESULTS: Mean age was 47.1 years and mean parity was 3.1. According to the symptom grading system by Stamey, grade I was 77.3%(17), grade II 18.2%(4), and grade III 4.5%(1). Valsalva leak point pressure was 60cmH2O or less in 27.3%(6), 61 to 90cmH2O in 27.3%(6), and more than 90cmH2O in 45.4%(10). Mean operation time was 124.0minutes and mean duration of postoperative indwelling catheter was 4.2 days. Among 22 patients, 18 patients(81.8%) were cured, 3(13.6%) improved, and 1(4.5%) failed. No statistically significant relationship existed between either symptom grade or VLPP and success rate, but maybe it would be due to low number of patients to be compared. Two patients(9.1%) with grade I suffered from prolonged voiding difficulty and they catheterized intermittently for 30 days and 64 days respectively before normal voiding. De novo urge incontinence developed in 1 patients(4.5%). Other minor complications were urinay tract infection(4 cases), weak stream(3 cases), bladder irritative symptom(2 cases), deviation of urine stream(2 cases), prolonged suprapubic pain(1 case), prolonged thigh pain(1 case), and dyspareunia(1 case). CONCLUSIONS: The suburethral patch sling operation using fascia lata was considered another useful option for the patients with stress urinary incontinence who want autologous tissue for sling material but can not use rectus fascia due to medical condition or previous abdominal operation or irradiation.
Catheters ; Catheters, Indwelling ; Fascia Lata* ; Fascia* ; Female* ; Follow-Up Studies ; Humans ; Neck ; Needles ; Parity ; Polypropylenes ; Sutures ; Thigh ; Urinary Bladder ; Urinary Incontinence* ; Urinary Incontinence, Urge

BACKGROUND: The pathogenesis of atopic dermatitis is still unknown. Many reports have suggested that the house dust mite antigen may play a role in the pathogenesis of atopic dermatitis. The IgG4 allergen-specific subclass has been considered to be involved both in allergic reactions and associated with the appropriate response to allergen-specific immunotherapy. OBJECT: The purpose of this study was to evaluate the positive rate of the allergic prick test to D. farinae and the levels of D. farinae-specific IgE and Ig64. METHODS: We performed the allergy prick test, RAST for D. farinae-specific IgE and ELISA for D. farinae-specific IgG subclasses and compared the values between atopic dermatitis patients and normal controls. RESULTS: 1. D. farinae was the most common allergen in patients with atopic dermatitis and the positive rate of the allergic prick test was 61.0%. The positive rate of the allergic prick test and the positive rate to D. farinae increased as c]inical grading increased. 2. The Positive reaction rate of D. farinae-specific IgE(RAST) in those with atopic dermatitis was 68.8% and increased as the positive reactions of the allergic prick test to D. farinae and chnical grading increased. 3. Among the IgG subclasses, only the level of D. farinae-specific IgG4 was significantly higher in atopic dermatitis than normal controls. 4. The level of D. farinae-specific IgG4 showed a tendency to decrease in accordance with the clinical severity grades. CONCLUSION: These results suggested that D. farinae might play an important role in the development of atopic dermatitis and well-designed studies should continue to be performed in order to delineate the biological significance of IgG4.
Antibodies* ; Dermatitis, Atopic* ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Immunoglobulin G* ; Immunotherapy ; Pyroglyphidae*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

PURPOSE: We investigated the anti-inflammatory and anti-fibrotic effects of amniotic membrane(AM) ointment in filtering surgery of rabbits. METHODS: After filtering surgery was performed on both eyes of 10 rabbits, the AM ointment was applied over and under the scleral flap on one eye whereas base ointment excluding AM element was applied to the other as a control. The shapes of blebs were observed under slit-lamp biomicroscopy at postoperative 3 days, 1 week, 2 weeks and 4 weeks, and the tissues were excised for histologic studies. RESULTS: Serial changes of intraocular pressures had no significant difference. Slit-lamp biomicroscopy demonstrated that conjunctival blebs of AM ointment group were more elevated and cystic at 1 and 2 weeks. The heights of conjunctival blebs were significantly higher at 1, 2 and 4 weeks, and the width of scleral tracks was significantly wider at 1 and 2 weeks in AM ointment group. The number of inflammatory cells in the scleral track was significantly less at 3 days and 1 week, the number of fibroblasts in scleral track was significantly less at 2 and 3 weeks in AM ointment group. Masson s trichrome stain was less positive in AM ointment and the stain area of alpha-smooth muscle actin-positive fibroblasts was insignificant with image analysis system. Collagen type 3 appeared in scleral track from postoperative 1 week in control group, however, in AM ointment group, from 4 weeks. CONCLUSIONS: AM ointment is beneficial to suppress fibroblast differentiation, proliferation and inflam-matory reaction in filtering surgery and might be safe and effective adjunctive for enhancement of success in filtering surgery.
Amnion* ; Blister ; Collagen ; Fibroblasts ; Filtering Surgery* ; Humans* ; Intraocular Pressure ; Rabbits*

BACKGROUND: Smoking increases the risk of respiratory, cardiac diseases and cancer. This study is to ascertain the relationship between passive smoking, the modes of residence, its location and the immunoglobulin values as well as the eosinophil counts in relation to child patients suffering from bronchial or cardiac asthma. METHODS: The research was conducted at a general hospital with cooperation of 242 patients who had been hospitalized 1991 through 1995. We compared the average values of immunoglobulin between the groups of exposed and non-exposed to smoking by T-test. A same work for residential modes was done by T-tests, while the data regarding the residing locality were processed by ANOVA. RESULTS: Each values of TEC, IgE, IgA, and IgM in both groups has been analysed but spelling no significant differences. The group residing in apartments showed lower value of IgM than those of flats. CONCLUSIONS: The reason the IgM value of apartments is lower than that of flats is due to the difference of living quarters. This signifies the modes of residence may as well affect the IgE value.
Asthma ; Child* ; Eosinophils ; Heart Diseases ; Hospitals, General ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin M ; Immunoglobulins* ; Smoke ; Smoking ; Tobacco Smoke Pollution*

Heterotopic pancreas (HP) is defined as pancreatic tissue lacking anatomic and vascular continuity with the main body of the pancreas. Most are asymptomatic, but can cause ulcer, bleeding, intussusception, and mechanical obstruction. Herein, we presented one case of HP presented as duodenal tumor causing duodenal obstruction. A 7-year-old girl visited the emergency room for abdominal pain with vomiting for 24 hours. Computed tomography and upper gastrointestinal series revealed a polypoid mass with short stalk in the 2nd portion of duodenum. We attempted an endoscopic removal. However, the lumen was nearly obstructed by the mass and the stalk was too broad and hard to excise. The mass was surgically removed via duodenotomy. It was confirmed as a HP with ductal and acini components (type 2 by Heinrich classification). Postoperatively, the patient has been well without any complication and recurrence.
Abdominal Pain ; Child ; Duodenal Neoplasms ; Duodenal Obstruction ; Duodenum ; Emergency Service, Hospital ; Female ; Hemorrhage ; Humans ; Intussusception ; Pancreas* ; Recurrence ; Ulcer ; Vomiting

Colonoscopy is a safe procedure performed routinely worldwide. Splenic rupture is a rare complication of colonoscopy with several reported cases since 1974. We report the first case of a complication in the Republic of Korea. The literature on this rare complication is also reviewed here, with focus on the analysis of risk, diagnosis, and treatment. A 77-year-old patient receiving oral aspirin underwent colonoscopy with polypectomy. After 24 hours, the patient experienced dizziness and hypotension. Colonoscopy was performed to exclude intestinal bleeding, which could be diagnosed with hemoperitoneum. A computed tomography scan showed copious abdominal free blood and a splenic rupture. An urgent splenectomy was performed, which was the recognized procedure of choice. Physicians should have greater awareness of the possibility of splenic rupture following colonoscopy in order to avoid delay of diagnosis and treatment for this life-threatening complication.
Aged ; Colonoscopy/*adverse effects ; Hemoperitoneum/diagnosis ; Hemorrhage ; Humans ; Male ; Splenectomy ; Splenic Rupture/*diagnosis/etiology/surgery ; Tomography, X-Ray Computed