Deformities of the leg and ankle may result from growth abnormalities of the tibia and fibula. The appearance of the secondary ossification center and growth plate closure of the tibial and fibular epiphyses, and the pattern of closure of the epiphyses, were observed in a different age. Normal radiographs were reviewed in one hundred and fifty patients at age from two days after birth to 20 years, who were injured on the contralateral leg, at Wonju Medical College, Yonsei University from Feb., 1980 to May, 1984. The results were as follows: 1. The time of the appearance of secondary ossification center and the closure of growth plates; The proximal tibial epiphysis usually forms secondary ossification center at birth to second postnatal months, the physeal closure occurs from 13 year and 11 months to 18 year 3 months in male, from 13 year 4 months to 15 year 5 months in female. The secondary ossification center of the distal tibial epiphysis appears from 8th postnatal months to one year, and physeal closure occurs from 15 years to 17 year and 4 months in male, from 15 year 2 months to 16 year 8 months in female. The secondary ossification center of the tibial tuberosity appears from 9 year 3month to 12 year 2 months, and closure occurs from 16 year 3 months to 18 year 7 months inmale, from 14 year 10 months to 19 year 1 months in female. The proximal fibular epiphysis forms secondary ossification center from 2 year 5 months to 5 year 4 months, closure occurs from 15year 8 months to 17 year 4 months in male, from 14 year 9 months to 16 year 9 months in female. The secondary ossification center of the distal fibular epiphysis appears from 2 year 5 months to 3rd years, and closure occurs from 13 year 11 months to 17 year 6 months in male, from 13 year 4 months to 16 year 7 months in female. 2. The growth and the pattern of the closure of growth plates of the tibia; The proximal tibial epiphysis is elliptic for the first 3 years of life. The epiphysis is slightly conical centrally as it extends toward the tibial spines, and becomes more prominent from 8 years to adolescence. The closure of the proximal tibial growth plate occurs initially along the anteromedial aspect of the tibia and tibial tuberosity during 12 years and proceeds posterolaterally. Complete closure of the proximal tibial physis occurs about from 13 years to 18 years. The secondary ossification center of the distal tibial epiphysis is oval in shape initially, becomes thicken medially by 3rd year of life, then the tibial plafond is valgoid, and becomes horizontal at age 10 approximately. The distal epiphysis of tibia unites first at about 13 years, starting centrally and proceeding toward anteromedial portion. And the posterolateral portion unites finally by about 15 to 17 years. The tibial tuberosity develops a secondary ossification center by 7 to 9 years, usually in the most distal region, and gradually elongates and extends toward the secondary ossification center of the proximal tibia.From about 12 years, the tuberosity epiphyseal center fuses with the proximal tibial center, and the fusion with the tibial metaphysis extends distally, the tuberosity physis closes completely from about 15 to 19 years. 3. The growth and development of the tibia, fibula and ankle; The growth of the proximal tibial and the distal fibular epiphyses play an important role of the growth rate in lower extremities unber ten years. The distal tibial growth plate inclines laterally and distally prior to the first year of life, the inclination is on the decrease and it finally horizontal at about 12 years. The distal tibia talus angle is about 90° prior to the age one year, becomes mildly valgoid by 12 years.
Adolescent ; Ankle ; Congenital Abnormalities ; Epiphyses ; Female ; Fibula ; Gangwon-do ; Growth and Development ; Growth Plate ; Humans ; Leg ; Lower Extremity ; Male ; Parturition ; Spine ; Talus ; Tibia

No abstract available.
Pancreaticoduodenectomy*

OBJECTIVES: Early diagnosis of intrauterine growth retardation is important to ensure optimal monitoring and delivery with the introduction of real-time and Doppler ultrasound systems, a noninvasive method of measuring human fetal blood flow has become available. The aim of this study is to compare blood flow velocity waveforms at the fetal descending aorta and umbilical artery in normal and in patients with pregnancy induced hypertension. METHODS: Using a combination of linear array real-time and pulsed Doppler ultrasound, blood flow velocity measurements were carried out at the fetal descending aorta and umbilical artery in 35 normal pregnancies and 18 cases of pregnancy induced hypertensive patients. RESULTS: The mean systolic/diastolic ratio of umbilical artery and aorta was significantly higher in PIH patients than in normal pregnancies(3.8 +/- 0.81 versus 2.97 +/- 0.52, p<0.05) and to predict perinatal morbidity, umbilical velocimetry is more sensitive than that of descending thoracic aorta. CONCLUSION: This study suggests that umbilical artery velocimetry could be used as a marker to predict adverse perinatal outcome.
Aorta ; Aorta, Thoracic* ; Blood Flow Velocity ; Early Diagnosis ; Female ; Fetal Blood ; Fetal Growth Retardation ; Humans ; Hypertension, Pregnancy-Induced ; Pregnancy ; Rheology* ; Ultrasonography ; Umbilical Arteries

To identify significant prognostic factors in patients undergoing simple hysterectomy in the presence of invasive cervical cancer, the records of 45 patients who had taken such a procedure between 1993 and 1997 were reviewed. Overall relapse-free survival and 5-year survival rates were 91.1 and 92.1%, respectively. Factors found to be significantly related to survival were the retrospectively determined stage(p=0.0000), the presence of residual disease(p=0.0001), and cell type(p=0.0000). By multivariate analysis, factor emerging as significantly detrimental to survival was the cell type. The presence of residual disease was a marginally significant factor(p=0.067). The expectations for survival of patients with residual tumor mass and/or with adenocarcinoma after simple hysterectomy appear to be markedly worse than those with others, so radical reoperation should be considered in those patients.
Adenocarcinoma ; Humans ; Hysterectomy* ; Multivariate Analysis ; Neoplasm, Residual ; Reoperation ; Retrospective Studies ; Survival Rate ; Uterine Cervical Neoplasms*

We herein describe a case of a 55-year-old healthy woman with localized primary thymic amyloidosis presented as a mediastinal mass, found incidentally by chest radiography. Computed tomography revealed a 4.1 cm soft tissue lesion with nodular calcification in the left anterior mediastinum. The resected specimen was a well-defined lobulating mass with calcification. Microscopically, the mass was consisted of amorphous eosinophilc hyalinized substances involving the thymus and intrathymic lymph nodes. These eosinophilic substances showed apple-green bi-refringence under polarized light after staining with Congo red. In immunohistochemical study, they were positive for kappa and lambda light chains and negative for amyloid A. There was no evidence of systemic amyloidosis in clinical investigations. A final diagnosis of localized primary thymic amyloidosis was made.
Amyloid ; Amyloidosis ; Congo Red ; Eosinophils ; Female ; Humans ; Hyalin ; Light ; Lymph Nodes ; Mediastinum ; Middle Aged ; Thorax ; Thymoma ; Thymus Gland

Epinephrine ; Pulmonary Edema

BACKGROUND AND PURPOSE: Hemifacial spasm(HFS) is a chronic and often progressive disorder characterized by unilateral irregular clonic and tonic contractions of one or more muscles of facial expression. Many previous electrophysiologic studies showed characteristic features of HFS differentiating from other involuntary movements of the face. However, there has been no electrophysiologic study for estimating the clinical severity of HFS. This study was prospectively designed to evaluate the relationships between electrophysiologic findings and clinical severity of HFS. METHODS: The authors performed direct facial nerve stimulation, blink reflex, and lateral spread response in 62 patients with HFS, and compared the results of affected side with those of unaffected each other. Clinical severity was graded into seven groups (0-6) by questionnaire and confirmed by a neurologist. RESULTS: The results were as following. 1) The total number of subjects were 62, the number of patients in group 2 was 3 (4.8%), group 3 was 12 (19.3%), group 4 was 25 (40.3%), group 5 was 21 (33.9%), and group 6 was 1(1.6%). 2) The mean age was 54.5+/-9.1years old, the mean duration of the illness was 6.4+/-4.9years, male was 11(17.7%) and female was 51(82.3%), and involved sites were right in 26(41.9%) and left in 36(58.1%) patients. 3) Direct stimulation of facial nerve showed no differences between affected and unaffected sides in HFS. 4) The results of blink reflex showed more increased latencies and larger amplitudes of R1 & R2 responses in affected sides than in unaffected sides of HFS, but no differences among the groups. 5) The lateral spread responses were found in 45 of 62 (72.6%) patients by stimulation of zygomatic branch and recording in mentalis muscle, 26 of 62 (41.9%) patients by stimulation of mandibular branch and recording in orbicularis oculi muscle on affected side. 6) There was a linear correlation between the presence of lateral spread response with zygomatic or mandibular stimulation and the grade of clinical severity. CONCLUSION: We suspected that the lateral spread response was a significant electrophysiological test for estimating the clinical severity of HFS.
Blinking ; Dyskinesias ; Facial Expression ; Facial Nerve ; Female ; Hemifacial Spasm* ; Humans ; Male ; Muscles ; Prospective Studies ; Surveys and Questionnaires

Lymphomatous involvement of the heart, occurring at initial diagnosis and presentation, is extremely rare. We report here a case of 58 year old man who presented with generalized edema, pericardial effusion, and a large right atrial mass detected by transesophageal echocardiography. There is no other evidence of disseminated lymphoma in this patient. Tumor removal and pulmonary embolectomy was done. Pathologically, the mass was malignant lymphoma, diffuse large cell type. Unfortunately, we have no chance to perform the intensive chemotherapy. The patient discharged in moribund state.
Diagnosis ; Drug Therapy ; Echocardiography, Transesophageal ; Edema ; Embolectomy ; Heart ; Humans ; Lymphoma* ; Middle Aged ; Pericardial Effusion

OBJECTIVE: Although the use of cytology in screening has reduced morbidity and mortality from invasive cervical cancer, there has been limitation because of the low sensitivity and high false negative rate in the detection of preclinical or clinical disease of the cervix. This study was performed to explore the usefulness of Hybrid Capture System HPV DNA test as a diagnostic method of the cervical cancer. METHODS: Cervical cytology and Hybrid Capture System 1 (HCS1) HPV DNA test were performed in 1,023 women who visited Gynecologic Oncology Clinic in Guro Hospital, Korea University Medical Center. HPV DNA were retested by HCS1, HCS2 and Polymerase Chain Reaction(PCR), in randomly selected 200 women to compare these DNA tests. RESULTS: While the sensitivity and specificity of cervical cytology in detection of cervical lesion were 71.2% and 89.5%, those of HCS1 HPV DNA test were 63.0% and 86.9% respectively. There was significant difference in detection of cervical precancerous lesions between HCS1 and HCS2 (P<0.05), but not between HCS2 and PCR (P=0.14). And the sensitivity and specificity were improved with combining cytology and HCS1 HPV DNA test(82.2%, 86.9%~). CONCLUSION: HCS HPV DNA test may be considered as a useful adjunctive test with cervical cytology in cervical cancer screening.
Academic Medical Centers ; Cervix Uteri ; DNA ; Female ; Human Papillomavirus DNA Tests* ; Humans ; Korea ; Mass Screening* ; Mortality ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

Creutzfeldt-Jakob disease (CJD) is presumably caused by a slow infectious pathogen or prion. The principal clinical features of Creutzfeldt-Jakob disease are dementia, pyramidal and extrapyramidal symptoms and signs, cerebellar dysfunction, and myoclonus. The patient rapidly deteriorates, declines to a vegetative state, becomes comatous, and is ultimately dead within several months. The authors present a case of Creutzfeldt-Jakob disease, proved by clinical findings, typical serial EEG, and pathologic features.
Creutzfeldt-Jakob Syndrome/*diagnosis/pathology/radiography ; Electroencephalography ; Female ; Humans ; Middle Aged ; Tomography, X-Ray Computed