No abstract available.
Anesthesia* ; Humans ; Outpatients*

Freeman-Sheldon Syndrome is one of the very rare genetic diseases which primarily affects face, hands and feet. At first, Freeman and Sheldon described this syndrome as cranio-carpo-tarsal dystrophy in 1938 and later Burian, as "whistling face" syndrome in 1963. There were 60 cases of reports in the world up to now, and only one paper with 5 cases in a family was reported in Korea. The authors report 2 cases of Freeman-Sheldon Syndrome associated with bilateral inguinal hernias and undescended tests in a family, briefly review the literature and alert orthopaedic surgeons to this condition.
Cryptorchidism ; Foot ; Hand ; Hernia, Inguinal ; Humans ; Korea ; Male ; Surgeons

BACKGROUND: In renal transplantation, a good HLA-DR match Is associated with successive graft outcome. But due to a number of technical problems, reliable serological DR typing cannot always be obtained. To compare the serological DR typing with DRBI DNA typing, we tested 103 specimens that had been frozen after serological typing, by PCR-SSOP typing method. METHODS: Serological DR typing was performed by complement-dependent microlymphocytotoxicity technique using commercial antisera kits, and DNA gyp ins was performed by PCR-SSOP, using one of the methods recommended by 12th International Histocompatibility Workshop. DNA amplification was done by DRBAMP-A and DRBAMP-B primers, and hybridization by 18 oligonucleotides labelled with digoxigenin.. RESULTS: The concordance rate between serologic typing and DNA typing was 76.7%. Most (79.0%) of discordant results were due to serological blanks turning out to be definable antigens by DNA typing and these antigens consisted of mainly DR5 splits but none of DR1, DR2, or DR7. CONCLUSIONS: In spite of technical improvement, serological typing method often can not define the accurate HLA-DR type. It is thought that combining serological typing with DNA typing Is necessary to achieve a higher success rate of graft outcome.
Digoxigenin ; DNA ; DNA Fingerprinting ; Education ; Histocompatibility ; HLA-DR Antigens* ; Immune Sera ; Kidney Transplantation ; Oligonucleotides ; Transplants

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as nausea, vomiting, respiratory depression, and pruritus. The purpose of this study was to evaluate the analgesic efficacy and side effects by combination use of epidural morphine and butorphanol. METHODS: Forty five patients were randomly divided into 3 groups. For group I, a bolus of 4.7 ml of saline and 3 mg of morphine were administered. For group II, a bolus of 4.2 ml of saline and 3 mg of morphine and 1 mg of butorphanol were administered. For group III, a bolus of 3.2 ml of saline and 3 mg of morphine and 3 mg of butorphanol were administered. Continuous epidural analgesia were administered for all groups; group I (saline 99.4 ml and morphine 6 mg), group II (saline 98.4 ml, morphine 6 mg, and butorphanol 2 mg), group III (saline 96.4 ml, morphine 6 mg, and butorphanol 6 mg) by two day infuser, 2 ml/hr. We compared the side effects and analgesic effect of the three groups for 2 days. RESULTS: The incidence of pruritus, nausea and vomiting was reduced significantly in the group II and III, but the incidence of somnolence increased in the group III. There were no significant differences in analgesic effect and the other side effects among the three groups. CONCLUSION: Above results suggest that the addition of butorphanol to morphine in epidural infusion reduce the incidence of pruritus, nausea and vomiting, but increase the incidence of somnolence.
Analgesia* ; Analgesia, Epidural ; Anesthesia, Epidural* ; Butorphanol* ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

BACKGROUND: Epidural morphine has been commonly used to provide postoperative pain relief, but it has many side effects such as nausea, vomiting, respiratory depression, and pruritus. The purpose of this study was to evaluate the analgesic efficacy and side effects by combination use of epidural morphine and butorphanol. METHODS: Forty five patients were randomly divided into 3 groups. For group I, a bolus of 4.7 ml of saline and 3 mg of morphine were administered. For group II, a bolus of 4.2 ml of saline and 3 mg of morphine and 1 mg of butorphanol were administered. For group III, a bolus of 3.2 ml of saline and 3 mg of morphine and 3 mg of butorphanol were administered. Continuous epidural analgesia were administered for all groups; group I (saline 99.4 ml and morphine 6 mg), group II (saline 98.4 ml, morphine 6 mg, and butorphanol 2 mg), group III (saline 96.4 ml, morphine 6 mg, and butorphanol 6 mg) by two day infuser, 2 ml/hr. We compared the side effects and analgesic effect of the three groups for 2 days. RESULTS: The incidence of pruritus, nausea and vomiting was reduced significantly in the group II and III, but the incidence of somnolence increased in the group III. There were no significant differences in analgesic effect and the other side effects among the three groups. CONCLUSION: Above results suggest that the addition of butorphanol to morphine in epidural infusion reduce the incidence of pruritus, nausea and vomiting, but increase the incidence of somnolence.
Analgesia* ; Analgesia, Epidural ; Anesthesia, Epidural* ; Butorphanol* ; Humans ; Incidence ; Morphine* ; Nausea ; Pain, Postoperative ; Pruritus ; Respiratory Insufficiency ; Vomiting

OBJECTIVES: The objective of this study was to compare the parent-child relationship of adolescents with depression and those without depression, by using Parent-Child Relationship Instrument (PCRI), Family Relationship Scale (FRS), and Parenting Attitude Test-Youth (PAT-Y). We also investigated the association between the parent-child relationship and depressive symptoms. METHODS: Twenty-five adolescents with depression (age 15.0+/-2.1 years, 8 boys) and 24 adolescents without depression (age 13.7+/-1.3 years, 16 boys) completed the Adolescent-General Behavior Inventory (A-GBI), Adolescent-Mood Disorder Questionnaire (A-MDQ), Beck Depression Inventory (BDI), PCRI, and PAT-Y. The parents of subjects completed the Child Behavior Checklist, Parent-General Behavior Inventory 10-item Mania Scale (P-GBI-10M), Parent-Mood Disorder Questionnaire, and FRS. Independent t-tests, analysis of covariance, and partial correlation analysis were used. RESULTS: The Intimacy (p=.002) and Respect (p=.029) scores of the PCRI were significantly higher in adolescents without depression compared to those with depression. The Intimacy scores of the PCRI showed negative correlation with the BDI and P-GBI-10M and the Strictness scores of the PCRI showed positive correlation with the A-GBI, A-MDQ, and BDI. The Inconsistency, Punishment, and Excessive Expectation scores of the PAT-Y showed positive correlation with the A-GBI and BDI scores. CONCLUSION: Our results suggest a possible association of the parent-children relationship and parenting attitude with adolescents' depressive symptoms.
Adolescent* ; Bipolar Disorder ; Checklist ; Child ; Child Behavior ; Depression* ; Family Relations ; Humans ; Parent-Child Relations* ; Parenting ; Parents ; Punishment ; Surveys and Questionnaires

There are many advantages in treating long bone fractures with interlocking intramedullary nail and its advantages are well known. Although it is used widely, many major and minor complication can develop in spite of meticulous operation techniques. Frist fifty consecutive interlooking intramedullary nail of two different surgeon, total of 100 cases that were operated in Seoul Paik Hospital from January, 1991 to July, 1994, were reviewed and the complications were analyzed with various factors. 1. Among the 100 cases, a total of 30(30%) major and minor complications had developed. But only 4 major complications which needed reoperation or poor result occurred. 2. Among the complications that had developed, angulation and rotation deformity being 10 cases were the most common, other complications were delayed union in 5 cases, nonunion in 2 cases, problem of screw in 4 cases, metal failure in 2 cases, misentry point in 2 cases and others in 5 cases. 3. There were no remarkable difference between surgeon A and surgeon B. The complications decreased abruptly after 30th case for each surgeon and only a few complications, probably due to complex fracture pattern, occurred. In conclusion, complications after interlocking intramedullary nailing can be reduced by meticulous preoperative planning and learning process of surgeon.
Congenital Abnormalities ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Learning ; Reoperation ; Seoul

Small cell neuroendocrine carcinoma is a high-grade and poorly differentiated tumor typically presenting as primary pulmonary neoplasm. Extrapulmonary small cell carcinoma is rare. Primary small cell neuroendocrine carcinoma of the breast (SCNCB) is extremely rare, with an incidence of less than 0.1% of all breast cancers. Herein, we report imaging features of SCNCB incidentally diagnosed in a 58-year-old woman along with a literature review. The tumor was observed to be a round and circumscribed mass with rim enhancement, heterogeneous intra-tumoral enhancement, and peritumoral edema on MRI. The patient underwent breast-conserving surgery with adjuvant chemotherapy and radiation therapy. No tumor recurrence was observed during the 2-year follow-up visits after surgery.

Gelastic Seizure(Ictal laughter) is frequently associated with hypothalamic hamartoma that is congenital tumor composed of heterotrophic and hyperplastic tissue located in the hypothalamus near the interpeduncular cistern, tuber cinereum, and mamillary body. The seizure usually begins in infancy or childhood and may be accompanied with precocious puberty and cognitive decline. A 14 year-old boy visited to our hospital because of paroxysmal frequent involuntary laughing regardless of emotional change. Brain MRI showed nonenhancing hypothalamic mass that had isointensity with gray matter on T1W1 and hyperintensity on T2Wl. So it was suspected that he had a gelastic seizure accompanied with hypothalamic hamartoma.
Adolescent ; Brain ; Hamartoma* ; Humans ; Hypothalamus ; Magnetic Resonance Imaging ; Male ; Mamillary Bodies ; Puberty, Precocious ; Seizures* ; Tuber Cinereum

No abstract available.