No abstract available.

No abstract available.
Dislocations* ; Head*

Thirteen patients were operated for cubital tunnel syndrome and followed for an average of 26 months postoperatively. Ten patients had a history of relevant trauma and three patients had degenerative osteoarthritis of the elbow. The average duration of symptoms was 18 months (range, 2 to 96 months). Diagnosis was made by physical examination, electromyography and nerve conduction study. Among these, nerve conduction study was found to be the most valuable diagnostic method for the patients with atypical clinical findings. Most of the operations were performed by anterior transposition of the ulnar nerve. At the most recent follow-up, the result was excellent in two patients, good in eight, and fair in three; thus ten patients(77%) showed satisfactory results. The rating system for ulnar neuropathy based on sensory, motor dysfunction and pain was useful for evaluating the operative results. The postoperative gain of score for pain and sensory function were larger than that of motor function. Factors known to influence the result of the operation (age, duration of symptom, history of trauma, method of operation) did not effect the outcome in this study. For successful operation, the ulnar nerve must be thoroughly examined, all possible levels of compression must be released and new foci of compression must be created.
Cubital Tunnel Syndrome ; Diagnosis ; Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Methods ; Neural Conduction ; Osteoarthritis ; Physical Examination ; Sensation ; Ulnar Nerve ; Ulnar Neuropathies

BACKGROUND: The determination of serotype of enteroviruses is useful for the discrimination between sporadic and epidemic infections. The conventional serotyping method is time-consuming and labor-intensive. Recently, molecular method was introduced for the serotyping of enteroviruses. The aim of this study was to establish a method to isolate and analyze enteroviruses from various specimens utilizing molecular biological techniques and to determine which strains were phylogenetically related to clinical samples. METHODS: Clinical samples in this study included 164 cerebrospinal fluid (CSF), 136 stool, 15 sera, 6 throat swab, 5 urine, and 4 sputa, which were obtained from hospitalized patients, primarily infants or children presenting symptoms of aseptic meningitis in 1998. RD cells were used for enterovirus isolation. RT-PCR was performed with RD cell lysate showing CPE. The primers 011 and 012 were used for the VP1 region, and the primers EN1 and EN2 for 5'-UTR. The nucleotide sequences of VP1 region were determined and analyzed with BLAST program. RESULTS: Among 333 samples, only 23 samples produced CPE: 17 samples at first and six samples at the second blind passage. Fifteen isolates were related to coxsackievirus B2 two to echovirus 4, three to echovirus 6, and three to echovirus 18. All 23 viral isolates displayed a nucleotide sequence identity of 80-95%, compared with the reference serotypes. However, the identity was increased up to 93-100% when the VP1 region was translated into amino acids CONCLUSIONS: Since CB2 type was 55% among enteroviral isolates, the CB2 was determined as the major causative serotype of enteroviral meningitis in 1998. CB2 type was emerged between June and July, EC4 and EC6 was limited to July, and EC18 was in August.
Amino Acids ; Base Sequence ; Cerebrospinal Fluid ; Child ; Discrimination (Psychology) ; Echovirus 6, Human ; Enterovirus B, Human ; Enterovirus* ; Humans ; Infant ; Meningitis* ; Meningitis, Aseptic ; Pharynx ; Serotyping*

BACKGROUND: The determination of serotype of enteroviruses is useful for the discrimination between sporadic and epidemic infections. The conventional serotyping method is time-consuming and labor-intensive. Recently, molecular method was introduced for the serotyping of enteroviruses. The aim of this study was to establish a method to isolate and analyze enteroviruses from various specimens utilizing molecular biological techniques and to determine which strains were phylogenetically related to clinical samples. METHODS: Clinical samples in this study included 164 cerebrospinal fluid (CSF), 136 stool, 15 sera, 6 throat swab, 5 urine, and 4 sputa, which were obtained from hospitalized patients, primarily infants or children presenting symptoms of aseptic meningitis in 1998. RD cells were used for enterovirus isolation. RT-PCR was performed with RD cell lysate showing CPE. The primers 011 and 012 were used for the VP1 region, and the primers EN1 and EN2 for 5'-UTR. The nucleotide sequences of VP1 region were determined and analyzed with BLAST program. RESULTS: Among 333 samples, only 23 samples produced CPE: 17 samples at first and six samples at the second blind passage. Fifteen isolates were related to coxsackievirus B2 two to echovirus 4, three to echovirus 6, and three to echovirus 18. All 23 viral isolates displayed a nucleotide sequence identity of 80-95%, compared with the reference serotypes. However, the identity was increased up to 93-100% when the VP1 region was translated into amino acids CONCLUSIONS: Since CB2 type was 55% among enteroviral isolates, the CB2 was determined as the major causative serotype of enteroviral meningitis in 1998. CB2 type was emerged between June and July, EC4 and EC6 was limited to July, and EC18 was in August.
Amino Acids ; Base Sequence ; Cerebrospinal Fluid ; Child ; Discrimination (Psychology) ; Echovirus 6, Human ; Enterovirus B, Human ; Enterovirus* ; Humans ; Infant ; Meningitis* ; Meningitis, Aseptic ; Pharynx ; Serotyping*

A total of 36 typical Krukenberg tumors of the ovary was obtained from the pathology file of the Department of Pathology, College of Medicine, Seoul National University during a period of 17 years from January 1968 to December 1984. By definition, all were characterized by the presence of mucin containg signet ring cells within the cellular, nonneoplastic ovarian stroma. The clinico-pathologic characteristics of 36 Krukenberg tumors were as follow: The Krukenberg tumors accounted for 16.3% of all ovarian malignancies. The age of the patient at the time of diagnosis of the Krukenberg tumor ranged from 28 to 69 years with an average of 43 years. A primary carcinoma of stomach (31 cases) of colon (1 case) was found in 32 (88.9%) of 36 patients. The primary carcinomas was not detected in four cases, and autopsy was not performed in any case. In 22 cases the primary carcinomas had been diagnosed before ovarian tumors were found. The ovarian and the primary carcinomas were identified synchronously in 6 cases, while in 8 cases the primary carcinomas were not discovered until after the ovarian tumors had been treated. The gross diameter of the ovarian tumor ranged from 1.5cm to 28cm with an average of 10.3cm. The largest weighed 4,550gm. The Krukenberg tumors typically formed rounded or reniform, solid mass that were coarsely lobulated or bosselated. The cut surface was yellow white and associated frequently with nodular, myxoid or gelatinous area and cystic changes of various size. Both ovaries were involved in 29(80.6%) of the cases and one ovary in 7(19.4%). Krukenberg tumors classified into the three major types on the basis of the characteristic morphologic patterns of signet ring cells. The first type was classic Krukenberg tumor(28 cases) represented by predominent components of typical signet ring cells. The second type was tubular Krukenberg tumor(5 cases) characterized by tubular structures resembling a Sertoli-Leydig cell tumor. The third type was re tiform Krukenberg tumor (3 cases) characterized by an irregular network of elongated, often slitlike tubules and cysts, which resembled the rete testis.

Three cases of angiosarcoma of the breast are described. One case in a 66 year old woman was a solid mass and histologically showed poor differentiation leading to a death 14 months after the diagnosis. Another two in 46 and 25 year old females were large vascular masses showing moderate differentiation with endothelial tufting and papillary projections, and abdominal and contralateral mammary, and liver metastasis occurred within postoperative 10 months and 6 months in each case. A radical mastectomy and adjuvant chemotherapy in case 2 were not lifesaving. Although histologic degree of differentiation seems prognosis-related, angiosarcoma is the most malignant tumor of the breast.
Female ; Humans ; Neoplasm Metastasis

Seventy five cases of squamous cell carcinoma of the uterine cervix, invasion depth of which was less than 5 mm from the basement membrane, were reviewed during a period of 9 years from 1975 to 1983 at SNUH and investigated clinicopathologically by the following items; 1) lymphnode metastasis 2) vascular invasion 3) recurrence 4) pattern of invasion 5) cell type. Following results were obtained. 1) Lmyphnode metastasis was demonstrated in 4 out of 75 cases (5.3%). One of them had stromal invasion to 1.3 mm and the other three to a depth of 3.1 to 5.0 mm. 2) Vascular invasion was seen in 5 among the cases (6.7%) and well related to the depth of invasion. Vascular invasion did not occur in tumors with 3 mm depth of stromal invasion. 3) Three patients were with recurrence, treated by postoperative radiation. The depth of stromal invasion was over 2 mm in all of them. 4) The pattern of invasion was confluent in 26 out of 28 cases (92%) whose stromal invasion were over 2 mm depth, while only 3 confluency of 27 cases (11%) invaded less than 1 mm depth. 5) There was no good relationship between the tumor cell type and the depth of stromal invasion. Based on the above results, it is concluded that diagnostic criteria of microinvasive squamous cell carcinoma of the uterine cervix is stromal invasion not exceeding a depth of 3 mm from basement membrane of surface or glandular epithelium.
Neoplasm Metastasis

Congenital hand anomalies encompass a very broad spectrum of deformity, and precise classification of these deformities has always posed a major problem. We reviewed 50 cases of congenital hand deformities in 47 patients, managed at Department of,Orthopedic Surgery, Severance Hospital from Jan. 1980. to Jun. 1984 and the following results were obtained. 1. There were 26 males and 21 females in 47 patients and the ratio between male and female was 1.2: 1. Right hands were involved in 16 patients and both hands were in 14 patients. 2. The most commomn type of anomalies were polydactylysm(48%), next were syndactylysm (24%) and the follwing anomalies were found: camptodactyly, congenital constriction band syndrome, congenital ulnar deficiency, congenital clasped thumb, clinodactyly, congenital finger deficiency, symphalangism. 3. 9 associated congenital anomalias were found in 5 patients, in which, anomalies of the foot were most common. 4. Prenatal history such as drug ingestion, preeclampsia, breech delivery, prematurity, low birth weight were found and 2 cases of family history were found. 5. Treatment was stressed upon the function of hand and the improvement of the deformity.
Classification ; Clinical Study ; Congenital Abnormalities ; Constriction ; Eating ; Female ; Fingers ; Foot ; Hand Deformities, Congenital ; Hand ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Male ; Pre-Eclampsia ; Thumb

Management of subtrochanteric fractures of the femur is difficult because of the high mechanical stresses in this region; furthermore, the bone here is mainly cortical and comminution is frequent. These two factors, involvement of cortical bone tissue and concentration of stress, have been mentioned as reasons for the high incidence of complication in the treatment of these fractures, such as Relayed union, mechanical failure and rnalunion. Thirty cases of subtrochanteric fractures in twenty-nine patients were reviewed, which have been managed at the Department of Orthopedic Surgery, Severance Hospital, Yonsei University College of Medicine from Jan. 1980 to Dec. 1984 and the following results were obtained: l. Of the 29 patients reviewed, 22 were male and 7 were female. Mean age was 45.7 years in male and 67.3 years in female. 2. Traffic accidents were the most common cause of injury(44.8%) 3. Pelvic bone fractures(7 cases) and rib fractures(7 cases) were the most common associated injuries. 4. Fielding's type II (13 cases) fracture and Seinsheimer's type IV (10 cases) fracture were most common. 5. Of the 30 cases, 26(86.7%) were treated by open reduction and internal fixation. Of fixation devices, a Jewett nail was most commonly used in 13 cases (50.0%). 6. The mean duration of bony union was 20.4 weeks. There was no significant difference in union rate between fractures which were treated by operative means and fractures by conservative means. And more longer period was needed in union as fracture goes distally. 7. Weight bearing was allowed earlier in patients treated by operative means (average 10.5 weeks) than in patients by conservative means (average 18.0 weeks.). 8. Of the 30 cases, 8 complications (26.7%) occured, that is: delayed union(4 cases), mechanical failure (3 cases) and angular deformity(1 case). All of them occured in Fielding's type II and III fractures except 1 case. Loss of medial buttress and unstable reduction were considered to be causing factors. 9. Satisfactory result was obtained by stable anatomical reduction and internally fixed by Jewett nail and compression hip screw. In case of intramedullary nail, good result was expected when used in non-comminuted fracture of distal portion. Also, additional supplementary screw fixation, circlage wire and bone graft were recommended, when necessary.
Accidents, Traffic ; Bone and Bones ; Clinical Study ; Female ; Femur ; Hip ; Hip Fractures ; Humans ; Incidence ; Male ; Orthopedics ; Pelvic Bones ; Ribs ; Stress, Mechanical ; Transplants ; Weight-Bearing