We describe a case of xanthoma on the corneoscleral limbus in a 21-year-old man. It was characterized by a localized, round, elevated, yellowish mass on the right superonasal limbus with 6mm in size. There was no correlation with systemic or metabolic diseases such as hyperlipidemia and the microscopic examination revealed scanty fibrous element.
Humans ; Hyperlipidemias ; Metabolic Diseases ; Xanthomatosis* ; Young Adult

We describe a case of xanthoma on the corneoscleral limbus in a 21-year-old man. It was characterized by a localized, round, elevated, yellowish mass on the right superonasal limbus with 6mm in size. There was no correlation with systemic or metabolic diseases such as hyperlipidemia and the microscopic examination revealed scanty fibrous element.
Humans ; Hyperlipidemias ; Metabolic Diseases ; Xanthomatosis* ; Young Adult

BACKGROUND AND OBJECTIVES: Tarsal tunnel syndrome is a rare compressive neuropathy. Reported cases of the tarsal tunnel syndrome in Korea were diagnosed by conventional nerve conduction and EMG studies, so their sensitivity was low and the differentiation from similar disorder such as lumbosacral radiculopathy was difficult. We report the usefulness of the interdigital nerve conduction study by using needle recording electrodes in the tarsal tunnel syndrome. METHODS: Sensory compound nerve action potentials were recorded orthodromically using the near-nerve needle and signal averaging techniques. Active and reference recording electrodes were inserted behind the medial malleolus above the flexor retinaculum. When the great toe was contracting minimally with less than 3mA for a stimulus of 0.05ms duration, the needle was considered to be adequately positioned. The first and fifth digital nerves were stimulated with ring electrodes and various interdigital nerves with interdigital stimulating surface electrodes which were specially designed. Averaged sensory action potential were recorded 3 times and superimposed after 64 stimuli per each time of recording. Amplitude of sensory nerve action potential, sensory nerve conduction velocity, and the presence of the temporal dispersion were checked. The results were as follow, 1. The causes of the 775 were trauma in 3 cases, sprain in 2 cases, unknown in 5 cases. 2. Associated disease were radiculopathy in 6 cases, rheumatoid arthritis In 1 case, carpal tunnel syndrome In 1 case. 3. Clinical findings included pain on the in 5 cases, tingling sensation in 4 cases, hyperesthesia in 4 cases, numbness in 2 cases and Tinnel's sign in 2 4. Five cases showed absent potential, 5 cases low amplitude, 4 cases dispersion, 2 cases slow nerve conduction velocity and 2 cases low amplitude and slow nerve conduction velocity by Interdigital nerve condution study. 5. Five lumbosacral radiculopathy without tarsal tunnel syndrome showed normal results in interdigital nerve conduction test. We concluded that interdigital nerve conduction test using needle recording electrode is useful methods of diagnosing tarsal tunnel syndrome as well as differentiating to other disorders having similar symptoms.
Action Potentials ; Arthritis, Rheumatoid ; Carpal Tunnel Syndrome ; Electrodes ; Hyperesthesia ; Hypesthesia ; Korea ; Needles ; Neural Conduction ; Radiculopathy ; Sensation ; Sprains and Strains ; Tarsal Tunnel Syndrome* ; Toes

Fifty eight diabetic patients and 20 normal controls were studied by the method of nerve conduction studies(NCS) and sudomotor skin reponse(SSR), and the following results were obtained. 1. SSR was easily obtainable in all normal control. 2. The patients with abnormal NCV showed more numbers of abnormal SSR than the pat ients with normal NCV. 3. The patients with abnormal SSR were significantly older than the patient with normal SSR, but duration of disease was not different between the patients with normal SSR and with abnormal SSR. 4. The levels of sugar at fasting and postprandial 2 hours, and level of HbAlC in serum were not different between the patients of norrnal SSR and of abnormal SSR. 5. The incidence of autonomic symptoms, such as syncope, sweating abnormality, impotence in male, urinary disturbance, postural hypotension, was not different between the patient of norrnal SSR and of abnormal SSR. 6. Among the patients of diabets, the number of abnormal nerves in terminal latency motor and sensory nerve condcution velocity, and amplitude of compound motor and nerve action potentiaL were significantly correlated with the number of abnormal nerves in SSR. 7. The absolute values of motor terminal latency, motor and sensory conduction velocity and amplitude of compound motor and sensory action potential in the patient of abnormal SSR were significanly decreased thai. The patients with norrnal SSR. The values of terminal latency in abnormal SSR were significanly prolonged than the patients with normal SSR We concluded that the SSR test is a valuabe one for early detection of sympathetic nerve invasion in the diabetes' patients.
Action Potentials ; Asian Continental Ancestry Group ; Diabetic Neuropathies* ; Erectile Dysfunction ; Fasting ; Humans ; Hypotension, Orthostatic ; Incidence ; Male ; Neural Conduction* ; Skin* ; Sweat ; Sweating ; Syncope

PURPOSE: Prenatal diagnosis of congenital heart disease has been made by fetal echocardiography and its clinical impact on the outcome of CHD cases has been analysed. METHODS: A prospective study was performed for the fetal diagnosis of CHD for the standard risk pregnancy, confirmed postnatally or at second study and/or at autopsy and/or follow up at CHA hospital in 2001. Incidence of CHD has been calculated and compared to the incidence of CHD of the prescreening period(1992.3-1995.2). RESULTS: There were 66 cases of CHD prenatally during the study period. CHD consisted of 7 cases of ventricular septal defects(VSD), 7 cases of tetralogy of Fallot(TOF), 5 cases of heterotaxy, 5 cases of double outlet right ventricle(DORV), 5 cases of severe pulmonary stenosis(PS), 3 cases of hypoplastic left heart syndrome(HLHS), 3 cases of coarctation, 3 cases of critical aortic stenosis(AS), 3 cases of pulmonary atresia with intact ventricular septum(PA IVS). Among 66 fetal CHD cases, 30 cases of CHD has been terminated, 1 case died in utero and 23 cases has been delivered at cardiac center through planned delivery. The most common factors of termination were extracardiac and chromosomal anomaly. 17 cases of false negative diagnosis were small VSD and mild PS that couldn't be diagnosed in fetal stage. There was no false positive diagnosis. There were 30 cases of CHDs born in 2001 at CHA hospital. 28 cases were diagnosed postnatally. Among 30 cases of CHDs, there were 18 cases of VSD(17 small VSD), 6 cases of mild PS, 4 ASD, 1 PDA. Incidence rate of CHD in 2001 and period 1992.3-1995.2 were 5.95 and 10.15/1,000 livebirth respectively. CONCLUSION: The data suggested that all of the significant CHDs could be diagnosed prenatally accurately by fetal echocardiography. And the incidence rate of CHD has been decreased by 41.4%. And the most of the complex CHD has been transferred to the cardiac center for planned delivery or has been terminated. The rate of termination was 45.5%.
Autopsy ; Diagnosis* ; Echocardiography* ; Follow-Up Studies ; Heart ; Heart Defects, Congenital* ; Incidence ; Pregnancy ; Prenatal Diagnosis ; Prospective Studies ; Pulmonary Atresia

A murime monoclonal antibody (mAb) specific for the envelope glycoprotein gp120 of human immunodeficiency virus type-I (HIV-1) was chemically coupled to pokeweed antiviral protein (PAP) from Phytolacca americana. The immunotoxin was purified by FPLC using 5200 colum. The purified immunotoxin efficiently bound to HIV-infected T cells as evidenced by fluorescence-activated cell sorter analysis. The immunotoxin selectively killed human T lymphoid lines infected with HIV-lIIIB at less than 250 pM of the immunotoxin cells, while PAP or mAb alone did not have any significant effect on infected cells. The uninfected control T cell lines were not affected. Human cells infected with HIV-2 or other HIV-1 strains were not killed, suggesting that the killing depends completely on the antibody used for coupling. These in vitro results suggest that the PAP-mAb conjugate may be used to selectively remove cells expressing viral antigens from individuals infected with HIV.
Antigens, Viral ; Cell Line ; Glycoproteins ; HIV ; HIV-1 ; HIV-2 ; Homicide ; Humans* ; Immunotoxins ; Phytolacca americana* ; T-Lymphocytes*

Many different myelographic contrast media have been employed for the radiographic visualization of the spinal cord. Unfortunately, none has fulfilled all the requirements of an ideal contrast medium-no toxicity, complete and rapid absorption, good radiographic contrast, and miscibility with the cerebrospinal fluid. Toxic reactions have been reported from the water soluble contrast media, which require the administration of a spinal anesthesia and have thus been employed clinically only in examination of the lumbosacral area. Some authors have advocated the use of new contrast media, Conray(Meglumine iothalamate), Dimer-X, for the lumbar myelography without a spinal anesthesia and obtained good results. The present work is an attempt to provoke and emphasize the toxicologic response and the pathologic changes by variation in amount of Conray and rate of injection. Each dog was prepared with a catheter in lumbar subarachnoid space under the light anest hesia. After recovery from the anesthesia, myelography was performed by lumbar subarachnoid injection of Conray by variations in amount of Conray and rate of injection under the control of a fluoroscope. The experimental conditions were varied as follows. 1. Conray was injected in variable amounts from the lumbosacral subarachnoid space to the high cervical and intracranial subarachnoid space. 2. Conray was injected in variable rate of injection. 3. Decadron was added to Conray in another group. 4. The brain and the spinal cord including the dura and the nerve roots were taken for the pathologic study in variable durations after myelography. The results were summarized as follows. 1. A large amount of Conray injection to the high cervical and intracranial subarachnoid space produced wevere toxic reactions followed by death. 2. Rapid injection of Conray was considered to elicit more toxic reactions. 3. The toxic reactions included changes in behavior and respiration, neck muscle spasms, paresis of forelegs and hindlegs, urination, defecation and epileptiform convulsions. 4. There was no difference in toxic reactions in adding Decardon. 5. Radiographic contrast densities were somewhat less than that of Pantopaque. Conray was freely miscible with the cerebrospinal fluid, thus providing total myeloraphy. 6. No recognizable reaction was noted in gross and histopathological examination.
Absorption ; Anesthesia ; Anesthesia, Spinal ; Animals ; Brain ; Catheters ; Cerebrospinal Fluid ; Contrast Media ; Defecation ; Dogs ; Iophendylate ; Myelography* ; Neck Muscles ; Paresis ; Respiration ; Seizures ; Spasm ; Spinal Cord ; Subarachnoid Space ; Urination

Since the first report on infective endocarditis by Rokitansky in 1985, this subject has been extensively dealt with in the world literature. Nowadays by use of echocardiography, there has been a high discovery rate of vegetation, and thus made it a valuable tool in diagnosis, treatment, and the evaluation of the patient. However in Korea, there have been only a few case reports and even fewer studies on infective endocarditis. This study is a clinical analysis of 87 infective endocarditis cases, which were admitted and treated at the department of Pediatrics and Internal medicine, diagnosed as infective endocarditis, during the period from january 1975 through February 1984. 1) The mean age was 24.8 years and male to female ratio was 1.49:1. 2) Annual incidence showed no increment during the period and it was 1:2500. 3) Underlying heart diseases consisted of rheumatic heart disease(52.3%), congenital heart disease(39.7%), no underlying heart disease(8%), previous infective endocarditis(4.6%), and prosthetic valve endocarditis(3.4%). 4) Frequent clinical manifestations on admission were high fever, heart murmur, congestive heart failure and frequent laboratory findings were positive blood culture results, anemia, positive C-reactive protein, and hematuria. 5) Blood culture was positive in 75.9% and the most common infecting organism was alpha-streptococcus, which represented 42.4% of total positive cases. S. aureus and S. epidermidis were next common and these three organisms consisted of 71.2% Culture positivity was not significantly related to the type and incidence of complications. 6) Antibiotics sensitivity of the major isolated organisms were performed. Alpha-streptococcus was sensitive to almost all antibiotics except Tetracycline. Group D-streptococcus was sensitive to Chloramphenicol and Cephalosporin. S. aureus and S. epidermidis showed same results, which showd sensitivity to Chloramphenicol, Cephalosporin and Methicillin and resistence to penicillin. 7) Echocardiography was performed in 55 cases and showed vegetation in 58.2%. Complications related to the echocardiographic identification of the vegetations showed difference only in the mortality rate, which was greater by 3 times in the positive cases than in the negative. 8) Peripheral embolizations occurred in 29.9% of cases, and by far the mostcommon site was the brain, where 63% of the embolism was localized. 9) Sufficient duration of hospitalization(4-6 weeks) and judicious antibiotics administration was done in 43.7%. The initial response to therapy was noted in 48.5% of total febrile cases. 10) The mortality rate of the cases was 13.8% of the patients died. However, as many patients were discharged against advice because of socio-economic factors, precise therapeutic results of these cases could not be obtained.
Anemia ; Anti-Bacterial Agents ; Brain ; C-Reactive Protein ; Chloramphenicol ; Diagnosis ; Echocardiography ; Embolism ; Endocarditis* ; Female ; Fever ; Heart ; Heart Diseases ; Heart Failure ; Heart Murmurs ; Hematuria ; Humans ; Incidence ; Internal Medicine ; Korea ; Male ; Methicillin ; Mortality ; Pediatrics ; Penicillins ; Tetracycline

PURPOSE: Tracheal transplantation is necessary in patients with extensive tracheal stenosis caused by trauma, congenital disease, benign or malignant tumor. Results with the cryopreserved vascular homograft have prompted us to evaluate cryopreserved trachea. When trachea is cryopreserved, it maintains viability of the cartilage and allogenicity decreased because epithelium of trachea whitch has major allogenicity (MHC class II Antigen) is exfoliated after some periods of cryopreservation. We assessed the proper duration of cryopreservation and probability of trachea allotransplantation. METHODS: The trachea were harvested from Mongrel dogs and frozen to 80degrees C for different length preservation (group 1: 1~10 week, group 2: 1 month, 2 months, 3 months, 6 months, 2 months). Ggoup 1 was thawed and tested epithelial viability, Group 2 was perfomed trachea transplantation with cryopreserved trachea allograft, after one months We checked gross appearance, viability of cartilage and grade of monocyte infiltration (rejection). RESULTS: In group 1, Exfoliation of epithelium was begun after four weeks cryopreservation, in group 2, when allograft was extracted, trachea of 4 dogs was stenosed, and six months preserved trachea was not seen due to total necrosis. Cartilage viability of 4 case of transplantation, three of 4 case were mild infiltration of monocyte. CONCLUSION: We conclude that more than 1 month cryopreservation for prevention of rejection and additional procedure (omentopexy) for graft vascular supply are needed for trachea transplatation. Although cryopreservation was performed, all case of transplantation happened some degree graft rejection. if trachea transplantation will be applied, immune suppress will be needed.
Allografts* ; Animals ; Cartilage ; Cryopreservation ; Dogs* ; Epithelium ; Graft Rejection ; Humans ; Monocytes ; Necrosis ; Trachea* ; Tracheal Stenosis ; Transplants

A hemothorax usually occur, due to injuries to the intercostal and great vessels, pulmonary damage, and sometimes fractured ribs. We report a case in which the hemothorax that occurred, neither intrathoracic injury nor injury to internal thoracic vessels and organs, via lacerated diaphragmatic and liver laceration due to a right upper part of anterior chest stab injury caused by a sharp object. The patient's general conditions gradually worsened, so chest and abdominal computed tomogram were taken. The abdominal computed tomogram revealed diaphragmatic injuries and bleeding from the lacerated liver. We performed an exploratory laparotomy to control the bleeding from the lacerated liver with simple primary sutures. In addition exploration was performed in the right pleural space through the lacerated diaphragm with a thoracoscopic instrument. There were no bleeding foci in the right pleural space, the vessels, or the lung on the thoracoscopic video. Closure of the lacerated diaphragm was achieved with simple, primary sutures. The postoperative course of the patient was uneventful, and the patient was discharged.
Diaphragm ; Hemorrhage ; Hemothorax ; Humans ; Lacerations ; Laparotomy ; Liver ; Lung ; Pleural Cavity ; Ribs ; Sutures ; Thoracoscopes ; Thorax ; Wounds, Stab