In the Dept. of Thoracic Surgery, Korea University Hospital, Preoperative diagnosis as Ebstein anomaly was made on the 11-year old female through the preoperative examination including right cardioangiography and the Glenn Operation was performed to this patients as palliative treatment. During closure of the thoracic wall just after the anastomosis of S.V.C. and right pulmonary artery, sudden cardiac arrest developed. One day later after death, autopsy was performed in order to confirm the pathologic anatomy of the cardiac anomaly and to clarify the cause of death. Pathologic anatomy of the heart revealed the huge dilatation of right atrium, Patent Foramin Ovale, and the deformed and descended posterior and the septal leaflets of tricuspid value by which right ventricle was devided into the atrialized and the functional portion. The diagnosis of the autopsy showed (1) Ebstein Anomaly (2) bilateral total atelectasis of the lung, (3) multiple petechial hemorrhage and edema of the myocardium, brain and liver due to acute hypoxia, (4) fibrocaseous tuberculosis of the liver and tuberculous pericholangitis.
Anoxia ; Autopsy ; Brain ; Cause of Death ; Child ; Death, Sudden, Cardiac ; Diagnosis ; Dilatation ; Ebstein Anomaly* ; Edema ; Female ; Heart ; Heart Atria ; Heart Ventricles ; Hemorrhage ; Humans ; Korea ; Liver ; Lung ; Myocardium ; Palliative Care ; Pulmonary Artery ; Pulmonary Atelectasis ; Thoracic Surgery ; Thoracic Wall ; Tuberculosis

In this report, 20,536 new outpatients who have visited the Department of Dermatology of Wonju Christian Hospital from Jan. 1st, 1980 to Dec. 31st, 1984 were analized. The results suggest that the age, sex, monthly and yearly distribution patterns of dermatoses in Wonju area are similar to those of other areas in Korea except that infective dermtoses(40.3%), especially scabies(9.8%) and herpes zoster(1.6%) are more common.
Dermatology ; Gangwon-do* ; Humans ; Korea ; Outpatients ; Prevalence ; Skin Diseases* ; Statistics as Topic*

An electron microscopic study was conducted in order to investigate the healing and maturation process of central one third of donor site patellar tendon which was used for endoscopic anterior cruciate ligament reconstruction. 17 patients among 118 consecutive series, which underwent ACL reconstruction from January 1990 to March 1995, were involved in this study according to various followup periods. At 6 months follow-up, hypercullular and randomly arranged fibrohlasts had abundant cytoplasm with marked irregular cytoplasmic borders and short cytoplasmic extensions. Thc, nuclei of fibroblasts had prominent nuclear indentation with chromatin condensation along the nuclear mernbrane and prominent nucleolus. The cytoplasm contained irregularly dilated rough endoplasmic reticulum, Golgi complex, and pinocytic vesicles. Intercellular space were occupied by newly-formed, immature col)agen fibrills without distinct parallel arrangement, and the diameter of collagen fibrils was unifoimly small. At 12 months, fibroblast and collagen fibrils showed a little matured findings except the small diameter of collagen fibrils. At 24 months, irregular-shaped fibroblasts were still present, which contained folded nuclei, ahundant cytoplasm with large amount of rough endoplasmic reticulum and Golgi complex. Collagen fihril showed also a unimodal distribution pattern with small diameter, however had a tendency to have a regular parallel arrangement. These finding suggest that the donor site of a patellar tendon was still quite different from normal patellar tendon in electron microscopic morphology even at 24 months postoperative follow-up regardless of considerable maturation of regular parallel arrangement pattern of collagen fibril.
Anterior Cruciate Ligament Reconstruction ; Chromatin ; Collagen ; Cytoplasm ; Dronabinol ; Endoplasmic Reticulum, Rough ; Extracellular Space ; Fibroblasts ; Follow-Up Studies ; Golgi Apparatus ; Humans ; Patellar Ligament* ; Tissue Donors*

BACKGROUND: It has been reported that Cortex mori ( Morus alba L, Sangbaikpi ; CM ), the root bark of mulberry tree, plays a role in inhibiting mast cell activation. Human seminal plasma ( HSP ) modulates immune systems and activates rat peritoneal mast cells ( RPMC ). However, the inhibitory agents of HSP - induced mast cell activation have not been disclosed yet. OBJECTIVE AND METHOD: This study was undertaken to determine the effects of CM on HSP-induced mast cell activation by morphologic and functional methods. Morphological changes of RPMC by HSP alone or CM plus HSP were observed with the inverted light microscope. And the amounts of histamine and calcium were measured by radioisotopic enzymatic histamine and radioisotopic calcium assays. RESULTS: By inverted microscopy, HSP-induced RPMC degranulation occurred in a dose-dependent fashion. After pretreatment of RPMC with CM, there was no HSP-induced degranulation. Degranulation index (DI) of RPMC treated with Hanks balanced salt solution (HBSS), CM or HSP was 7.0+/-4.3, 9.0+/-6.2, 56.5+/-16.9, respectively. After pretreatment of RPMC with CM, HSP-induced DI was 11.0 +/-7.1. These results indicate that CM inhibited HSP-induced degranulation of RPMC. HSP-induced RPMC histamine release (HR) was dose-dependent. HR of RPMC treated with HBSS, CM or HSP was 0.18+/-0.10, 0.30+/-0.19, 4.48+/-0.86 ug/ml, respectively. After pretreatment of RPMC with CM, HSP-induced HR was 0.52+/-0.21 ug/ml. These results indicate that CM inhibited HSP-induced HR from RPMC. Intracellular calcium level ( ICL) of RPMC was also increased according to the concentration of HSP. ICL of RPMC treated with HBSS, CM or HSP was 6.1+/-1.0, 9.0+/-2.1, 30.2+/-6.5 pmole, respectively. After pretreatment of RPMC with CM, HSP-induced ICL of RPMC was 11.6 +/- 3.3 pmole. These results indicate that CM inhibited HSP-induced calcium uptake of RPMC. CONCLUSION: From these results, it is suggested that CM contains some substances which inhi-
Animals ; Calcium ; Histamine ; Histamine Release ; Humans* ; Immune System ; Mast Cells* ; Microscopy ; Morus ; Rats* ; Semen* ; Trees

Few cases of ichthyosis bullosa of Siemens(IBS) have been reported since 1939, as a distinct entity from bullous congenital ichthyosiform erythroderma(BCIE). IBS can be differentiated from BCIE by the absence of congenital erythroderma and a different distribution of involved skin area. It's characteristic features include blistering, superficial erosion or moulting of the outer skin. Histological features are tonofilaments aggregation confined to the granular and upper spinous layer of the epidermis. However, in BCIE these findings are present in the whole suprabasal compartment. The original reports of Siemens and cases from other authors showed an autosomal dominant inheritance. Our patient developed IBS sporadically without a familial background.
Blister ; Dermatitis, Exfoliative ; Epidermis ; Humans ; Ichthyosis Bullosa of Siemens* ; Ichthyosis* ; Intermediate Filaments ; Molting ; Skin ; Wills

BACKGROUND AND OBJECTIVES:Traditionally, down beat nystagmus is regarded as a sign of central nervous system dysfunction. But, several years has passed since Herdman et al reported the down beat nystagmus developed during treatment maneuvers for posterior semicircular canal benign paroxysmal positional vertigo(BPPV). We undertook this study to evaluate the character and clinical analysis of the positional or positioning down beat nystagmus, to discuss the clinical significance of positional or positioning down beat nystagmus as a diagnostic criteria of superior semicircular canal BPPV, and to propose the new treatment method. MATERIALS AND METHOD:From November 1999 to March 2004, we sampled the 103 patients with positional or positioning down beat nystagmus. Of these patients, we selected 16 patients except for the patients with central nervous system dysfunction, nonspecific or artifact result, idiopathic origin. RESULTS:All of 16 patients had no sign and radiologic result of central nervous system disorder. 10 patients was reported or suspected the diagnosis of posterior semicircular canal BPPV. Fatigability was reported in 9 patients and reversibility was reported in 1 patient. Average latency was checked less than 2 seconds. CONCLUSION:Although the diagnostic criteria of superior semicircular canal BPPV that we reported was not controversial, we expect that this criteria is useful in diagnosis for patients with atypical positional or positioning down beat nystagmus. And the new treatment method that we reported will has the better results than previous method.
Artifacts ; Central Nervous System ; Diagnosis ; Humans ; Semicircular Canals ; Vertigo*

BACKGROUND & OBJECTIVE: Magnetic resonance angiography is helpful noninvasive evaluation of intracranial arteries and, in some patients, may spare invasive angiography which has potentially serious complication. However, it's diagnostic value in vertebrobasilar artery disease has not yet been evaluated. METHODS: MRA and axial brain MRI of 47 patients with acute cerebellar and/or brainstem ischemia, 26 patients with middle cerebral artery territory infarction, and 40 age matched normal controls were reviewed. Patients wit potential risks of cardiac embolization were excluded. MR Angiography was performed by three dimensional time-of-flight gradient-echo technique. Th diagnosis of vessel stenosis was made only when the lumen diameter was reduced by less than 50% on 3-D images to avoid overestimation of MR angiography. RESULTS: Forty-seven patients had cerebellar and/or brainstem infarction: with signal hyperintensities in T2-weighted MRI sequences. Pons was the most common infarcted site(28/47), followed by medulla (17/47), and cerebellum (11/47). The sensitivity of MR angiography in detecting vascular occlusive lesions of vertebrobasilar artery was 57.5% (28/47) in cerebellar and/or brainstem infarction patients, while 7 of 26 (26.9%) in middle cerebral artery territory infarction, and 2 of 40 (5%) in age matched control subjects showed occlusion or stenosis. MR angiography detected vascular occlusive lesions more frequently on vertebral arteries (25/47, 53.2%) than basilar artery (13/47, 27.7%). And occlusive or stenotic lesions of vertebral arteries were ipsilateral to ischemic lesion sites in 12 of 17 patients(70.6%), There was no difference between deep small lacunar stroke and perforator occlusion in pons. Absence of flow void on axial T2W imaging was seen only in 9 of 47 patients (19.1%). CONCLUSIONS: The results in this present study suggest that MR angiography is moderately sensitive diagnostic tool in vertebrobasilar occlusive disease although it has limitation in detection of smaller branches occlusion. Except vertebral arteries occlusion, absence of flow void in axial MR imaging is not a reliable findings.
Angiography ; Arteries ; Basilar Artery ; Brain ; Brain Stem Infarctions* ; Brain Stem* ; Cerebellum ; Constriction, Pathologic ; Diagnosis ; Humans ; Imaging, Three-Dimensional ; Infarction ; Ischemia ; Magnetic Resonance Angiography* ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Pons ; Stroke, Lacunar ; Vertebral Artery

A synophthalmia, another form of cyclopia, in which the element of the two eyes are partially fused to form an apparently single eye in the middle of the forehead. The synophthalmia is a result of complex, neural plate misdevelopment syndrome involving the eye, brain, skull and face. It is well known that synophthalmia is due to heterogenous causes, most of which chromosomal imbalances. We experienced a case of synophthalmia associated with proboscis, alobar holoprosencephaly and chromosomal anomaly 46, XX, -15,t (15 q, 21 q). Diagnosis was confirmed by brain MRI and autopsy, The patient died about 20 hours of age and autopsy was done. A brief review of the literatures was also presented.
Autopsy ; Brain ; Diagnosis ; Forehead ; Holoprosencephaly ; Humans ; Magnetic Resonance Imaging ; Neural Plate ; Skull

BACKGROUND: Hypertension is one of the common diseases which family physicians encounter to manage. Various research proved that appropriate aerobic exercise had effect on lowering blood pressure efficiently. This study was to find out the status of exercise, the change of exercise according to time and its predicting factors in hypertensive patients. METHODS: A total of 193 of the followed-up hypertensive patients of family physicians in Seoul and kyoungkido from May 11, 2001 to June 10, 2001 were interviewed by doctor according to the previously designed structured questionnaire. RESULTS: Eighty two patients (42.57) were male and mean and was 57.4 +/- 9.9 fears. Using Kaplan-Meier's method, 8% of non-exercise group (N= 115) in diagnosing hypertension started exercise after 1 fear and 40%, after 5 years. Otherwise, 5% of exercise group(N=78) stopped exercise after 1 year and 30%, after 5 years. The characteristics of 5 exercise groups according to sex, age, level of education and adequacy of exercise showed significant difference. In average blood pressure, lately started group showed the lowest (137/84 mmHg) and non-exercise group, the highest (146/91 mmHg) In the degree of recommendation. sporadic group showed the highest and non-exercise group, the lowest which showed significant difference (p =0.0024) . CONCLUSION: I conclude that lately started group among non-exercise group and continuous exercise group were mainly affected by recommendation to exercise of physician. As well as exercise, other nonpharmacologic treatment should be promoted by physician as an important strategy for treatment of hypertension.
Blood Pressure ; Education ; Exercise ; Gyeonggi-do ; Humans ; Hypertension ; Male ; Physicians, Family* ; Seoul ; Surveys and Questionnaires

No abstract available.
Paragonimiasis*