Gestational trophoblastic tumor is one of the curable disease, but metastatic trophoblastic tumor still shows high mortality rate because of resistance to the chemotherapy. Choriocarcinoma may occur after an any type of human pregnancy. The incidence of choriocarcinoma following term pregnancy is very uncommon, and such tumor appears to follow a more aggressive course with more extensive metastatic spread and is less responsive to chemotherapy resulting in a poorer prognosis. Choriocarcinoma presenting as postpartum hemorrhage, and spontaneous tumor perforation with intra-abdominal hemorrhage is even rarer, requiring emergency laparotomy. We had experienced one case of metastatic choriocarcinoma following term pregnancy that required emergency total abdominal hysterectomy due to uterine perforation and hemorrhage. So, we report this case with brief review of literatures.
Choriocarcinoma* ; Drug Therapy ; Emergencies ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Incidence ; Laparotomy ; Mortality ; Postpartum Hemorrhage ; Pregnancy ; Pregnancy* ; Prognosis ; Trophoblastic Neoplasms ; Uterine Perforation*

No abstract available.
Meningitis* ; Meningitis, Viral*

No abstract available.
Humans* ; Retroviridae*

No abstract available.
Humans ; Infant, Newborn*

Twenty five patients (twenty seven hips) who had Chiari osteotomy at Kang Nam St. Marys Hospital between 1980 and 1995 were reviewed to evaluate the factors in the operative technique that contribute to successful outcome and assess the clinical results in various conditions. The length of follow-up ranged from one to fourteen years and the age of at operation ranged from four to twentythree years. Eighteen patients had developmental dysplasia of the hip: four, septic hip: three had another disorders, Prior to the Chiari osteotomy, fourteen hips had an femoral osteotomy and four, trochanteric arthroplasty. We used to the standard osteotomy as described by Chiari with certain modification. A pneumatic saw and osteotome are used instead of Gigli saw. This technique is simple procedure to make the correct level and angle. Bone graft was not performed in all cases even the osteotomy was displaced more than 50 percent of the iliac width. The overall results were 12 excellent, eight good, five fair, and two poor. In eleven patients, the osteotomy had to be displaced more than 50 percent to provide good coverage of the femoral head. Their results were good or excellent. A good result will be obtained if enough attention is paid to displacing the osteotomy. The osteotomy using the pneumatic saw provides accurate level and direction of osteotomy and it is an simple procedure also.
Adolescent* ; Arthroplasty ; Child* ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Osteotomy* ; Transplants

We analyzed ninety one fractures of femoral neck treated with surgery and followed for more than 2 years at Seoul National University from January 1977 to June 1983. Of these, 45(49%) were treated with internal fixation(compression hip screw or Knowles' pinning), 26(29%) with primary endoprosthesis, 20(22%) with total hip replacement arthroplasty. The criteria for internal fixation were fresh fracture that could be reduced satisfactorily and the age of the patient were under 65 years. The criteria for endoprosthesis were displaced subcapital or transcervical type or severe osteoporosis with intact acetabular cartilage. The criteria for total hip replacement arthroplasty were neglected fractured patients with significant medical problems, including cardiovascular, pulmonary, and renal disease, that posed significant risks for a second operation, and patients who had previous hip disease such as degenerative arthritis or rheumatoid arthritis. Following results were obtained. 1. In our series, the most frequent occurrence of femoral neck fractures was in the 7th decade(34 %), and the most common cause was fall down(72.6%). 2. In fresh fractures less than 3 weeks after injury, transcervical type (73%) according to anatomical classification and Garden's type III(44%) according to displacement were the most common type, respectively. 3. After internal fixation, 11% of avascular necrosis and 9% of non-union occurred. After endoprosthesis, 4% of acetabular protrusion, 8% of loosening and 12% of loosening and 12% of painful hip occurred. After total hip replacement arthroplasty, 10% of dislocation and 10% of loosening occurred. 4. Functional end results of excellent 56%, good 22%, fair 6% and poor 16% in internal fixation group, excellent 31%, good 38%, fair 12% and poor 19% in endoperosthesis group, and excellent 45%, good 30%, fair 10% and poor 15% in total hip replacement arthroplasty group were obtained.
Acetabulum ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Cartilage ; Classification ; Clinical Study ; Dislocations ; Femoral Neck Fractures ; Femur Neck ; Hip ; Humans ; Necrosis ; Osteoarthritis ; Osteoporosis ; Seoul

Soft-tissue sarcomas are derived from mesodermal tissues and with few exceptions are located in deeper planes of the musculoaponeurotic structures. Despite differences in histogenesis, the rate of locsl recurrence snd distant metastasis of these sarcomas reveals that their rstes are almost the same. These soft-fissue sarcomas do not respond well to chemotherpy or radiotheraphy. And soft-tissue sarcomas located on different anatomical sites, so the surgical approach to them located centrally is difficult than the approach to them located peripherally. The authors reviewed 75 cases of soft-tissue sarcoma, which were confirmed by pathological reports, and also analysed the results of some kinds of surgery on 60 cases of that tumor at the Department of Orthopedidic Surgery, Seoul National University Hospital during the period from January 1976 to Decomber 1985, and following results were obtained. 1. There were 54 males and 21 females, and the age incidence wss highest in 5th decade. There was no special age-peak. 2. Malignant fibrous histiocytomas accounted for 26.7% of the tumors in this study. Liposarcoma, rhabdomyosarcoma, and synovial sarcoma were the next common tumors. 3. The lower extremity was the most common anatomicsl site of malignant soft-tissue sarcomas, which acconted for 46.7% in this study. There showed low incidence below the wrist and ankle joints. 4. Enneking's stage II B was the most common tumor, which accounted for 41.7%. 5. When we decided the prognosis at 2 years postoperatively, in the inadequately treated group the local recurrence rate was 97.1%, distant metastasis rate was 80.0%, and 2 YSR was 28.6%. In the adequately treated group the local recurrence rate was 20.0%, distant metastasis rate was 24.0%, and 2 YSR was 84.0%. 6. The most common site of distant metastasis was the lungs, which accounted for 82.4%. So the significant factors affecting the prognosis of soft-tissued sarcomas were the location of sarcomas and the adequacy of sugical procedure.
Ankle Joint ; Female ; Histiocytoma, Malignant Fibrous ; Humans ; Incidence ; Liposarcoma ; Lower Extremity ; Lung ; Male ; Mesoderm ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Rhabdomyosarcoma ; Sarcoma ; Sarcoma, Synovial ; Seoul ; Wrist

Myasthenia gravis is a autoimmune neuromuscular disorder characterized by weakness and fatigability of skeletal muscles. The underlying defect is a decrease in the number of available acetylcholine receptors at neuromuscular junction due to an antibody-mediated autoimmune attacks. The course of myasthenia gravis during pregnancy is not predictable. We experienced a patient of myasthenia gravis associated with pregnancy who underwent cesarean section and transient neonatal myasthenia gravis of the newborn. We present this case with brief review of the concerned literatures.
Cesarean Section ; Female ; Humans ; Infant, Newborn ; Muscle, Skeletal ; Myasthenia Gravis* ; Myasthenia Gravis, Neonatal ; Neuromuscular Junction ; Pregnancy* ; Receptors, Cholinergic

Silicone gel breast implants may induce local(fibrous capsular contracture) or systemic(rheumatoid arthritis, systemic sclerosis, etc) complications. The exact mechanism of fibrous capsular contracture has not been fully understood. In the present study, we tried to find out the effect of silicone gel on the fibroblast proliferation which has been known as a major contributing factor in fibrous capsular contracture formation. In vitro, activated macrophages are known to secrete monokines which affect fibroblast proliferation and collagen synthesis. And tumour necrosis factor-alpha(TNF-alpha) and interleukin-6(IL-6), which were released by macrophages, were reported as potent stimulator of fibroblast proliferation. The goal of this study is to investigate the role of macrophages and tumour necrosis factor-alphaor interleukin-6 in the interaction of fibroblasts and silicone gel. We designed four groups, two experimental and two control, using Institute for Cancer Research(ICR) mouse peritioneal macrophage and silicone gel. For the preparation of the conditioned medium of macrophages, peritoneal macrophages were prepared and cultured for 24 hours on the silicone gel-coated and naked (not coated) surface [silicone gel-macrophage conditioned medium(SCM; experimental group) and normal polystyrene-macrophage conditioned medium(NCM; control group) respectively]. To correct the effect of 10% fetal bovine serum which was included in Rapid Prototyping and Manufacturing Institute (RPMI) 1640 medium and draw the effect only by macrophages, the RPMI 1640 medium with 10% fetal bovine serum was cultured by the same method on the silicone gel-coated and naked surface (silicone gel-macrophage free conditioned medium; SFM and normal polystyrene-macrophage free conditioned medium; NFM respectively). Each conditioned medium was added onto NIH 3T3 fibroblasts culture at a final 25% concentration of total culture medium and followed by the cultivation for 24 hours. For antibody neutralizing experiments, each conditioned medium was preincubated with polyclonal rabbit anti-mouse TNF-alpha antibody or polyclonal rat anti-mouse IL-6 antibody for 1 hour and then, conditioned medium with antibody was added to the culture medium of NIH 3T3 fibroblasts by the same method. After 24 hours cultivation, total number of viable fibroblast(cell growth), DNA synthesis and collagen synthesis of fibroblasts with each medium were measured by sulforhodamine B(SRB) assay, 3H-thymidine and 3H-proline incorporation respectively. The results were as follows: 1. In the experiment about the effect of the conditioned medium on the fibroblast activity, the experimental group(SCM), compared with the control group(NCM), showed a significant increase of the cell growth (p<0.01), a significant decrease of DNA synthesis(p<0.001), but no significant difference in the collagen synthesis. 2. In the experiment about the effect of polyclonal rabbit anti-mouse TNF-alpha antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.01), but no significant difference in the collagen syn thesis. 3. In the experiment about the effect of polyclonal rat anti-mouse IL-6 antibody on the fibroblast activity, after the addition of antibody the experimental group, compared with the control group, showed a significant decrease of the cell growth(p<0.001), a significant increase of DNA synthesis(p<0.0001), but no significant difference in the collagen synthesis. In conclusion, culture supernatants (conditioned medium) of peritoneal macrophages, activated by silicone gel, stimulate the NIH 3T3 fibroblast proliferation. TNF-alpha and IL-6, products of macrophage, are involved in the stimulation of NIH 3T3 fibroblast proliferation in an in vitro condition.
Animals ; Arthritis ; Breast Implants ; Collagen ; Contracture ; Culture Media, Conditioned ; DNA ; Fibroblasts* ; Interleukin-6* ; Macrophages ; Macrophages, Peritoneal* ; Mice ; Monokines ; Necrosis ; Rats ; Scleroderma, Systemic ; Silicone Gels* ; Tumor Necrosis Factor-alpha*

Acellular pertussis vaccine has been used widely in Korea since 1984. However, because many of the former generations were not inoculated with pertussis vaccine, they may infect infants with pertussis. With this background, we investigated the prevalence of pertussis antibodies in all age groups. Enzyme-linked immunosorbent assay (ELISA) to assess IgG antibodies to pertussis toxin (PT) and filamentous hemagglutinin (FHA) and bacterial agglutination (BA) to assess antibodies to agglutinogen were compared on 842 serum samples which were donated from 11 hospitals in Seoul area. In comparison with age groups under 20 years, antibodies of adults against PT and FHA were maintained. But antibodies against agglutinogen showed no pattem in all age groups. Antibodies to PT were correlated with antibodies to FHA. There was no significant difference in antibody levels between male and female (p<0.05).
Adult ; Agglutination ; Antibodies ; Bordetella pertussis ; Enzyme-Linked Immunosorbent Assay ; Family Characteristics ; Female ; Hemagglutinins ; Humans ; Immunoglobulin G ; Infant ; Korea* ; Male ; Pertussis Toxin ; Pertussis Vaccine ; Prevalence ; Seoul ; Whooping Cough*