The coronary arteries of young individuals are histologically studied. Fourteen cases in pediatric age group and three adult hearts were used. No case had clinical and pathological evidences of heart disease. Inner circumference, thickness of tunicae intima, media and adventitia were measured at eight different sites of coronary arteries. The thickness of tunica media was used as a standard scale of cardiac growth, and the heart weight, body weight, height and age were compared with the medial thickness. The morphological changes were assessed in five groups by the heart weights. Group I ( less than 10 gm) showed single endothelial lining with cytoplasmic vacuolization or endothelial denudation. Group II (more than 10 but less than 20 gm) consisted of full term babies and showed first stigma of focal intimal thickening and intimal collagen fibers. Diffuse intimal thickening more than 1/1 of medial thickness was first seen in a case with 46 gm of heart weight. Elastic fiber was not seen in internal elastic laminae of groups I and II. Fragmentation of internal elastic lamina and smooth muscle proliferation as a form of musculoelastic layer were the major findings of intimal thickening in childhood and no case showed complicated atherosclerotic lesions.
Child ; Adult ; Male ; Female ; Humans

Meningioma of unusual age of onset, location, histogenesis and histologic type is reported. The patient, 4 year-old girl, had an intradural spinal meningioma arising from lumbar nerve root with no dural attachement. The meningioma revealed glycogen-rich, clear cell type with extensive and blocky hyalinization of the stroma. The tumor shared common fibrous sheath with attached lumbar nerve, and nerve fibers were scattered within the tumor. Ultrastructurally, the tumor cells had abundant glycogen particles, intermediate filaments and intercellular desmosomes. Hyalinized material revealed large amianthoid collagen fibers.
Child ; Male ; Female ; Humans ; Meningioma

No abstract available.
Skin* ; Tissue Expansion Devices* ; Transplants*

It is known that the toe-flexors exert some power generation in ankle plantar flexion. However, there has been no paper published in which the power generation was quantified. The purpose of this paper, therefore, is to quantify the amount of contribution of the toe-flexors to the ankle plantar-flexion in normal and rapid walking using the kinetic data of three dimensional gait analysis system. In order to restrict the action of the toe-flexors, we designed special braces which can be applied to the forefeet of the examinee during walking. We performed the gait analysis in ten normal adult volunteers with and without braces, and evaluated the moment and power of toe-flexors during terminal stance and pre-swing phase of gait cycle. Gait analysis was done with the VICON 3-dimensional motion analysis system (VICON, Oxford Metrics, Oxford, England) and 2 force plates (AMTI, Advanced Mechanical Technoiogy, Newton, MA, U.S.A,). The kinetic results are as follows: l. Average speeds of normal and rapid walking were 1.12m/sec and 1.41m/sec respectiveIy. 2. In normal walking, peak ankle plantar-tlexion moment decreased 5.5% with braces, and sum of ankle plantar-flexion moment decreased 12.3% with braces. Both of the results were not significant statistically (p>0.05). Peak ankle power generation decreased 11.0% with braces, and sum of ankle power generation decreased 10.4% with braces. These decreases were also insignificant statistically (p>0.05). 3. In rapid walking, peak ankle plantarflexion moment decreased 26.7% with braces. The decrease was horderline significant statistically (p=0.062). The sum of ankle plantar-tlexion moment decreased 26.6% with braces, but the decrease was not significant statistically (p>0.05). Peak ankle power generation decreased 40.2% with braces, and sum of ankle power generation decreased 37.9% with braces. These decreases showed borderline significance statistically (p=0.062). In conclusion, toe-flexors may contribute about 10% of the total ankle plantar-flexion power generation, and the contribution will be increased with increase of walking velocity. We must be very careful to sacrifice the toe-flexors in cases with weak triceps power.
Adult ; Ankle* ; Braces ; Gait ; Humans ; Toes* ; Volunteers ; Walking*

Being a rare disease entity, there have been few references about the cleft hand in Korea. We evaluated the postoperative cosmetic results of 17 cleft hands in 14 patients, who were treated surgically at the Department of Orthopedic Surgery of Seoul National University Hospital, from 1982 to 1993. Among 14 patients, 8 were males. Bilateral cleft hands were in five patients and unilateral in 9. Three of five patients who had bilateral cleft hands, were treated surgically on both hands. Remaining two patients had an operation on one hand which affected more severely. Average age at the time of operation was 2 years and 5 months(5 months-10years). Average duration of follow-up was 34 months(1 year 1 month-7years 5 months). By Lange's classification, typical patterns were 16 hands and atypical pattern one. By Flatt's classification, there were 8 hands of I b, 7 I c, 1 I a, 1 II. One patient had family history whose father had both cleft hands and feet. Congenital anomalies other than cleft hand were associated in 10 of 14 patients. Two patients had 3 associated anomalies, 4 patients 2, and 4 patients one. Syndactyly was the most common associated anomaly of affected cleft hand. Central cleft was closed by Snow-Littler technique in 4 hands(24%), Barsky method in 12(71%) and others in 1(6%). Metacarpal bone was treated by intermetacarpal ligament reconstruction in 1 hand(6%), excision only 7(41%), transfer of 2(rd) metacarpal to 3(rd) metacarpal base after excision 5(29%), and 2(rd) metacarpal corrective osteotomy 3(18%). Complications were in 2 hands; one wound dehiesence of cleft, and one partial necrosis of skin. The cosmetic results of surgical treatment were graded into good, fair or poor by the parents-Good ; when parents were satisfied with the result, Fair; improved cosmesis but not satisfied, and Poor; no improvement after surgery. Good was in 16 hands and fair in one.
Classification ; Fathers ; Follow-Up Studies ; Foot ; Hand ; Humans ; Korea ; Ligaments ; Male ; Methods ; Necrosis ; Orthopedics ; Osteotomy ; Parents ; Rare Diseases ; Seoul ; Skin ; Syndactyly ; Wounds and Injuries

Neurilemoma is benign never-sheath tumor which has been described as painless mass and is usually discovered incidentally. It is the most common tumor of peripheral nerve origin and may arise in any nerve where Schwann cells occur. There are few domestic reports which were clinically evaluated in tens of cases of neurilemoma so far. We evaluated on the 56 cases of neurilemoma confined to the trunk and extremities, in the aspect of clinical characteristics, radiology, pathology, EMG, surgical treatment and postoperative results, who were surgically treated at the Department of Orthopedic Surgery of Seoul National University from 1984 to 1994. Among 56 patients, male were 29 and female were 27, and there was no sexual difference. The average age at surgical intervention was 46.4 years (16–83yrs) and 46.4% of patients were in the age of fourties and fifties. The anatomical locations of the tumors were as followed: upper extremities in 22(39%) cases, neck and supraclavicular area in 15(27%) cases, sacrum and lower extremities in 14(25%) cases and trunk in 5(9%) cases. Symptoms were palpable mass in 55 cases, local tenderness in 14, radiating pain in 11, pain in 10, paresthesia in 11, motor weakness in 2 cases. The average follow up period was 19.1 months(13–56 month). Median nerve was involved most frequently(14%), then ulnar nerve(11%). There was no cases which occurred in multiplicity or associated with neurofibromatosis. Marginal excision was done in 51 cases(91%), incisional biopsy only in 4 cases(7%), wide excision in 1 case. The size of the tumors in the longest axis was smaller than 2cm in 9 cases, between 2 and 4cm in 31 cases, between 4 and 6cm in 13 cases and more than 6cm in 3 cases. Malignant change or recurrence was not found in all cases.
Biopsy ; Extremities ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; Male ; Median Nerve ; Neck ; Neurilemmoma ; Neurofibromatoses ; Orthopedics ; Paresthesia ; Pathology ; Peripheral Nerves ; Recurrence ; Sacrum ; Schwann Cells ; Seoul ; Transcutaneous Electric Nerve Stimulation ; Upper Extremity

OBJECTIVE: Peripartum emergency cesarean hysterectomy of 28 cases at our hospital for 10years were reviewed that the clinical indication, history, and annual incidence change. METHODS: A retrospective descriptive analysis from January, 1988 to December, 1997 was carried out. RESULTS: There were 28 cases of emergency cesarean hysterectomy identified during this period among total 24, 689 deliveries. The annual incidence of emergency cesarean hysterectomy was significantly declined statistically(p<0.005). Cesarean hysterectomy was performed in 20 of 6, 671 cesarean section(0.30%) and in 8 of 18, 018 vaginal deliveries(0.04%), so more frequently after cesarean section than vaginal delivery. The cesarean hysterectomy rate was more frequent in multiparous women(0, 22%) than in nulliparous women(0, 02%). The most common indication of cesarean hysterectomy was 13 cases of uterine atony(46%), followed by 5 cases uterine rupture(18%), 5 cases of placenta previa with placenta accreta(18%), 3 cases of placenta previa(11%), 2 cases of uterine myoma(7%). No significant difference in length of operating time, amount of blood loss and operative complications were found between total abdominal hysterectomy and subtotal hysterectomy. The all patient who had cesarean hysterectomy recieved from 1200ml to 15840ml of blood transfusion with a mean of 3673ml. In aspect of fetal outcome, 3 cases of FDIU(Fetal death in utero) in uterine rupture and 1 case of stillbirth in preterm were found. The maternal complications were wound disruption, DIC, wound hematoma, ureter injury, vaginal stump bleeding, UTI(Urinary tract infection) and retroperitoneal bleeding, CONCLUSION: We conclude that the incidence of emergency cesarean hysterectomy declined with prediction of antenatal risk factor, preparing of sufficient fresh blood, prophylactic antibiotics, vigorous uterotonics and close observation after delivery.
Anti-Bacterial Agents ; Blood Transfusion ; Cesarean Section ; Dacarbazine ; Emergencies* ; Female ; Hematoma ; Hemorrhage ; Humans ; Hysterectomy* ; Incidence ; Peripartum Period* ; Placenta ; Placenta Previa ; Pregnancy ; Retrospective Studies ; Risk Factors ; Stillbirth ; Ureter ; Uterine Rupture ; Wounds and Injuries

A female newborn had the following characteristics; a congenital localized absence of skin over the lower extremities; blistering of the skin or mucous membrane, incited by trauma, which heals without scarring; and congenital absence or deformity of the nails. In respect to the characteristic manifestation, clinical course and electron microscopic features, our patient seems to fit well into Bart's syndrome. The inheritance pattern appears to be autosomal dominant but, as in this report, isolated cases have been recognized. As the review of the literatures, congenital localized absence of skin has been observed in various subsets of inherited E.B. But, we believe that the term Bart's syndrome should be used to identify patients with good prognosis as the Bart's initial description To the best of our knowedge, this is the first reported case of Bart's syndrome in the korean literature.
Blister ; Cicatrix ; Congenital Abnormalities ; Female ; Humans ; Infant, Newborn ; Inheritance Patterns ; Lower Extremity ; Mucous Membrane ; Prognosis ; Skin

A umbilical omphalomesenteric duct polyp is the result of incomplete closure of the omphalomesenteric duct, which connects the midgut with the yolk sac of the embryo. It may be associated with underlying embryologic anomalies such as Meckels diverticulum and umbilical enteric fistula, the complications of which may at times be fatal. This rare malformation should be clinically discerned from persistent granulation tissue or pyogenic granuloma. Histologically, it shows a polypoid lesion consisting of ectopic gastrointestinal epithelium with the appearance of gastric, intestinal, or colonic mucosa. We report a case of an umbilical omphalomesenteric duct polyp in an 8-year-old male patient, who had had a bright-red polyp on the umbilicus from the age of 1 month and had not had any other types of underlying abnormalities.
Child ; Colon ; Diverticulum ; Embryonic Structures ; Epithelium ; Fistula ; Granulation Tissue ; Granuloma, Pyogenic ; Humans ; Male ; Mucous Membrane ; Polyps* ; Umbilicus ; Vitelline Duct* ; Yolk Sac

Lead is one of the most widespread environmental toxins and its poisoning in children was considered a rarity, usually resulting from unique circumstances such as inappropriate use of leadbased body cosmetics or direct administration of lead-containing folk medicines. The increasing concern about children with lower levels of lead exposure has developed, but there are no data regarding the mean blood lead levels and the incidence of symptomatic or asymptomatic lead poisoning in Korean children. We analyzed the zinc protoporphyrine (ZPP) values and blood lead concentrations in 163 pediatric inpatients for a prospective study of lead exposure. The blood lead concentrations in all 163 children were 15~54 g/dl, of whom 111 children (68.1%) were 25~54 g/dl which needs decision to chelate based on the EDTA provocation test. Among 111 children whose blood lead concentrations are 25~54 g/dl, 59 children(53.2%) were between 7 months and 3 years of age, which revealed no significant higher incidence of lead exposure than any other age group. The ZPP values in 126 children (77.3%) were above 35 g/dl. The mean blood lead concentration and ZPP values are 27.8 g/dl and 48.8 g/dl, respectively. We conclude that there are many asymptomatic children with increased absorption of lead in the urban area of Korea, and we need further studies regarding lead poisoning. It is important that there must be a national counterplan and that pediatricians continue to pay attention to lead posioning in children.
Absorption ; Child ; Edetic Acid ; Humans ; Incidence ; Inpatients* ; Korea ; Lead Poisoning ; Poisoning ; Prospective Studies ; Zinc