BACKGROUND: Keloids may occur at any age, but tend tend velop between the ages of 10 and 30. The incidence and median age of onset are equal for both sexes. Keloids are common among the darker pigmented rices, but there have been a few clinia studies of keloids in Korea. OBJECTIVE: The purpcse of this study was to evaluate the variable clinical characteristics of keloids in Korea. METHODS: This clinical investigation was made with 223 of patients of keloid who had visited the Department of Derrnatology, Chonnam University Hosptal from January 1984 to December 1993. RESULTS: 1.The annual incidenie averaged over 10 years was 0.831 (361 cases of total 43,752 outpatients). 2.The ratio of male to female was 1: 0.94(Male. 115, Feila 108). 3.The mean age of the onset and at the first visit to our hospital were 24.5years and 29.2 years respectively. 4.In our series tte presternal area was the most commor saes, the shouder region next. Most keloids on the shoulder were related to BCG vaccination in ifoncy or chilhood. 5.The precipitating fa ctors associated with keloid were riaeeding dermatologic diseases(33.2 %), unknown(17.9%) rejection & vaccination(15.2%), operation(13.9%), burn(13.9%) and laceration(5.8%) in descending order. 6.Among preceeding as, iociated dermatologic diseases, acne w s the most common. 7. A positive family history is more likely in cases of mitile keloidal (p<0,001), and severe keloidal formation. 8.Most patients did not. complain of any symptorns(45.3%) nd a symptom of pain or tenderness(40.8%) was piesert rather than pruritus(13.9%). 9.The most prevaent tr eatment modality was intralesional injection with triamcinolone acetonide (84.3%). CONCLUSION: According, to this study, usually keloids occore in patients between 10 and 29 years of age, and most keloids were located on the antetio partion of the chest, shoulders, and face and scalp. A positive family history is more likely in as of multiple, severe keloidal for mation.
Acne Vulgaris ; Age of Onset ; Female ; Humans ; Incidence ; Injections, Intralesional ; Jeollanam-do ; Keloid* ; Korea ; Male ; Mycobacterium bovis ; Scalp ; Shoulder ; Thorax ; Triamcinolone Acetonide ; Vaccination

Osteoporosis causes a decrease in bone mineral density. To overcome the decrease in fixation strength, a variety of techniques and devices have been developed, including cement augmentation of pedicle screws. Polymethyl methacrylate (PMMA), is commonly known as bone cement, and is widely used for implant fixation in various orthopaedic and spine surgery. In general, PMMA augmentation of pedicle screws is simple and safe if performed with technical precautions. PMMA is a safe agent, but it may rarely lead to significant foreign body reactions. In this report, we present a patient who developed bone cement-related epidural space foreign body granuloma
Osteoporosis

The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO) has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.
Brain Death* ; Brain Injuries* ; Brain* ; Extracorporeal Membrane Oxygenation* ; Humans ; Kidney ; Liver ; Tissue and Organ Procurement ; Tissue Donors*

No abstract available.
DiGeorge Syndrome*

OBJECTIVE: The purpose of this study was to evaluate of course of delivery & perinatal outcomes for postterm pregnancy compared with fullterm pregnancy. METHODS: This study included 360 cases of postterm pregnancy out of 16,992 cases delivered at Department of Obstetrics and Gynecology from January 1, 1993 to December 31, 1997. 16,143 cases of full term deliveries of 38 to 42 gestational weeks conducted in same period were used as the control group. Postterm pregnancy was defined as a pregnancy that it exceeds 295 days calculated from first day of the last menstrual period. RESULTS: The incidence of postterm pregnancy was 2.13% with the highest incidence occurring in the 26 ~30 years age group. This study group was significantly different from the control group in the incidence of fetal distress (10.28% vs. 2.20%), large fetus (10.83% vs. 6.95%), perinatal death (1.67% vs. 0.27%). CONCLUSIONS: Adverse perinatal outcomes were increased markedly as the gestational weeks to be prolonged. Therefore, careful prenatal care, accurate determination of delivery date is very important.
Fetal Distress ; Fetus ; Gynecology ; Humans ; Incidence ; Obstetrics ; Pregnancy* ; Prenatal Care

BACKGROUND AND OBJECTIVES: Although estrogen replacement therapy has been associated with reduction of cardiovascular events in postmeno-pausal women (PMW), the underlying mechanisms are pooly understood. Because the beneficial effect of estrogen on vasomotor function and production of vasoconstrictive endothelin-1 may be a mechanism by which cardiovascular disease events are reduced, we accessed the acute effect of estrogen on endothelial dependent, independent vasodilaton and plasma endothelin-1 level and investigated whether the acute effect of estrogen on vascular response is related to reduced circulating plasma endothelin-1 level. MATERIALS AND METHOD: The diameter of the brachial artery at rest, during reactive hyperemia (FMV) and to response to nitroglycerine (NMV) were measured using high resolution ultrasound. Twenty-one PMW, 523 years old, 8 of whom had hypercholesterolemia were included and randomized to receive placebo, conjugated estrogen 2.5 mg and 5.0 mg with one week between each investigation. FMV and plasma endothelin-1 were assessed before and 30 minutes after iv administration of each substance. Sublingual nitroglycerine (NG) was given at the end of each investigation and NMV was measured. RESULTS: FMV and plasma endothelin-1 were not changed after placebo administration. FMV increased sinigicantly only after administration of CE 5.0 mg in healhy PMW and both after administration of CE 2.5 and 5.0 mg in PMW with hypercholesterolemia. NG induced more significant vasodilation after administration of estrogen than placebo in only PMW with hypercholesterolemia. Plasma endothelin-1 level decreased significantly after administration of CE 5.0 mg in PMW with hypercholesterolemia. We could not find direct correlation between increase of FMV and decrease of plasma endothelin-1 level. CONCLUSION: IV administration of conjugated estrogen improves endothelium-dependent vasodilation in PMW and may improve endothelium-independent vasodilation in PMW with hypercholesterolemia. These finding may be partly originated by reduced plasma endothelin-1 level after estrogen administration.
Brachial Artery ; Cardiovascular Diseases ; Endothelin-1* ; Endothelium ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Hypercholesterolemia ; Hyperemia ; Menopause ; Nitroglycerin ; Plasma* ; Ultrasonography ; Vasodilation

BACKGROUND/AIMS: Treatmant for hepatolithiasis is characterized by high failure and recurrence rates. In the past, surgery played a major role in the management of this disease, but the development of percutaneous transhepatic cholangioscopy and lithotripsy has played an important role in the treatment of these patients. Therefore, we undertook this prospective study to assess the role of surgery in the treatment of bilateral intractable hepatolithiasis in new era of the endoscopy. METHODS: We evaluated our results of 12 patients with bilateral intrahepatic stones treated by preoperative percutaneous transhepatic cholangioscopic approach and new definitive surgical approach (suprahilar approach and hilar cholangiotomy). RESULTS: The rate of complete stone removal was 100%. There was no incidence of procedure and operative mortality. CONCLUSIONS: In this new endoscopic era, we carefully foresee that the major role of surgical treatment may be concentrated in the intractable cases of hepatolithiasis. Therefore, we suggest that more definitive surgery must be tried in the treatment of intractable bilateral hepatolithiasis.
Endoscopy ; Humans ; Incidence ; Lithotripsy ; Mortality ; Prospective Studies ; Recurrence

The shortage of available organ donors is a significant problem and various efforts have been made to avoid the loss of organ donors. Among these, extracorporeal membrane oxygenation (ECMO) has been introduced to help support and manage potential donors. Many traumatic brain injury patients have healthy organs that might be eligible for donation for transplantation. However, the condition of a donor with a fatal brain injury may rapidly deteriorate prior to brain death determination; this frequently results in the loss of eligible donors. Here, we report the use of venoarterial ECMO to support a potential donor with a fatal brain injury before brain death determination, and thereby preserve donor organs. The patient successfully donated his liver and kidneys after brain death determination.
Brain Death ; Brain Injuries ; Brain ; Extracorporeal Membrane Oxygenation ; Humans ; Kidney ; Liver ; Tissue and Organ Procurement ; Tissue Donors

No abstract available.
Prevalence* ; Ulsan*

BACKGROUND: Neurofibroma, the hallmark of neurofibromatosis, is a cutaneous or subcutaneous lesion, with a variable clinical presentation. Histologically, neurofibroma consists of proliferation of nerve derived cellular elements, together with an abundant, collagenous extracellular matrix. Specifically, neurofibroma has been shown to contain 30-50% collagen in its matrix. Objective 5. METHODS: We examined the expression of extracellular matrix genes (collagen, fibronectin, laminin), TGF-b mRNA and Ha-ras oncogene mRNA by using Northern and slot-blot hybridization and immunoperoxidase stains. Result: In Northern blot analysis, Ha-ras and TGF-b genes revealed respectively, 8.8kb and 2. 5kb sized mRNA transcripts in neurofibroma. These parameters were normal in the control. The expression of these genes were 1.9, 2.0 fold increased in neurofibroma. In slot-blot analysis, expression of type I collagen showed fibronectin genes to be 2,401+210, 540+43, respectively, in neurofibroma. So there were 3.7 fold, 2.1 fold, differences respectively, compared to the normal control. However, there were no significant changes of type IV collagen and laminin Bl mRNA levels between neurofibroma and normal skin tissues. Irnmunoperoxidase staining by rnonoclonal anti type IV collagen antibody in neurofibroma showed type IV collagen to be diffusely and weakly stained in tissue. On staining by monoclonal anti-laminin antibody, laminin was stained in a matrix and around vessels. CONCLUSION: The increased expression of extracellular matrix genes may suggest that there is a subpopulation of fibroic cells in neurofibroma which are stimulated by TGF-b. Ha-ras genes which might have accumulated with the differentiation of neural tissue may be related to the pathogenesis of neurofibroma tissue formation. Further studies are needed to determine whether the other factors are related to the pathogenesis of neurofibroma.
Blotting, Northern ; Collagen ; Collagen Type I ; Collagen Type IV ; Coloring Agents ; Extracellular Matrix* ; Fibronectins ; Genes, ras* ; Laminin ; Neurofibroma ; Neurofibromatoses* ; RNA, Messenger ; Skin