The primary goal in the treatment of the nail bed avulsion injury is complete regrowing of the nail plate without any deformity. There are many procedures for treatment of the nail bed avulsion injury as a split-thickness skin graft, full-thickness nail bed graft, reverse dermal graft or split-thickness nail bed graft. From February, 1984 to June, 1985 at In-Chon Gill Hospital, 13 cases of nail bed avulsion injury were treated with split-thickness nail bed grafts. The intact residual part of the injured nail bed or the toe nail bed was served as a donor site. The results were as followings; 1. The incidence of nail bed avulsion injury of all hand injuries was 9.7%. 2. The main cause of injury was the industrial accident and more prevalent in the left hand. 3. The good result was obtained in the split-thickness nail bed graft for the nail bed avulsion injury, but in nail root portion, the poor result was noticed. 4. The average time for normal nail appearance is six months.
Accidents, Occupational ; Animals ; Congenital Abnormalities ; Gills ; Hand ; Hand Injuries ; Humans ; Incheon ; Incidence ; Skin ; Tissue Donors ; Toes ; Transplants

BACKGROUND/PURPOSE: Phospholipase A (PLAq) is an rate-limiting enzyme hydrolyzing arachidonic acid from the sn-2 position of membrane phospholipids. In vitro studies demonstrated that the enzyme could be secreted into extracellular mileu by pro-inflammatory cytokines and endotoxin which were reported to have important roles in chronic liver diseases. This study was performed to know whether the enzyme is involved in the pathophysiology of the diseases. METHODS: The subjects were composed of 24 patients with chronic hepatitis B, 26 patients with liver cirrhosis and 14 healthy individuals. The PLAp activities wem measured in the sera of the subjects by detecting radioactivity of "C-fatty acid hydrolyzed from "C-labeled phosphotadylethanolamine by the enzyme. RESULTS: The activities of PLA were increased in the patients with chronic liver diseases, especially in the chronic hepatitis B patients with acute exacerbation and in the decompensated cirrhosis patients. Furthermore, their activities were closely related with the levels of transaminase in hepatitis group and with the levels of serum albumin in cirrhosis group, respectively. CONCLUSIONS: These results suggest that extracellular PLA might be involved in the exacerbution and progression of the chronic liver diseases.
Arachidonic Acid ; Cytokines ; Fibrosis ; Hepatitis ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; Liver Diseases* ; Liver* ; Membranes ; Phospholipases A2* ; Phospholipases* ; Phospholipids ; Radioactivity ; Serum Albumin

No abstract available in English.
Fracture Fixation, Intramedullary

No abstract available.
Acute Kidney Injury* ; Rhabdomyolysis*

To evaluate the detection of HPV DNA according to subtype of lesions of uterine cervix and its clinical applicability, in situ hybridization (ISH) and immunohistochemistry for HPV were performed in 189 cases of uterine cervical lesion, including 23 cases of low grade squamous intraepithelial lesion (SIL), 115 cases of high grade SIL and 51 cases of invasive carcinoma. Positive immunostaining, brown precipitate, was mainly noted in the nucleus of koilocytes in the superficial and intermediate layer. Positivity of immunostaining was 21.7% in low grade SIL, 13.0% in high grade SIL and 9.8% in invasive carcinoma. Positive reaction in ISH, red precipitate, was noted in the nucleus of not only koilocytes but also non-koilocytes in the superficial and intermediate layer, and dot precipitate was rarely identified in the nest of squamous cell carcinoma. Based on HPV subtype, 6/11 was 21.7% in low grade SIL, 16/18 was 32.2% and 39.2% in high grade SIL and invasive carcinoma, respectively. With regard to their associated HPV types, low grade SILs were heterogeneous and high grade SILs and invasive carcinomas were related with the high oncogenic risk group only. The correlation of HPV subtypes with panHPV was 91.3% in low grade SIL, 91.3% in high grade SIL and 98.0% in invasive carcinoma. These results suggest that detection of HPV infection by ISH may be a more useful method than immunohistochemistry and application of the HPV subtype probe with the panHPV probe could improve the sensitivity of ISH.
Carcinoma, Squamous Cell ; Cervix Uteri* ; DNA ; Female ; Humans* ; Immunohistochemistry* ; In Situ Hybridization*

No abstract available.
Child* ; Heart Diseases* ; Heart* ; Humans ; Physical Examination

To evaluate the risk and factors associated with seizure recurrence in children with epilepsy while receiving the adequate anticonvulsant treament, we studied 58 patients with newly diagnosed epilepsy who were followed prospectively for a median of 26 months (range 7 to 54). The results were as follows: 1) Forty-four of the 58 patients (75.9%) had recurrence of seizure. 2) The rate of recurrence according to type of seizure was observed to be 22 patients (68.8%) in generalized tonic-clonic seizure, 6 patients (85.7%) in simple partial seizure, 5 patients (83.3%) in complex partial seizure, 3 patients (100%) in mixed seizure, 2 patients (100%) in absence, 3 patients (100%) in infantile spasm, 1 patient (100%) in atonic seizure, 2 patients (50%) in secondary generalized seizure. There was no significant difference in the risk of recurrence observed among these seizure types. 3) The risk of recurrence varied according to the history of seizure, seizure recurrence was observed in 100% of the cases with history of neonatal seizure, 72.7% of the cases with febrile convulsion, and 73.3% of the cases with non-specific history. No significant difference was observed among these past history of seizure. 4) The rate of seizure recurrence according to electroencephalographic abnormalities did not differ significantly. Seizure recurrence was noted in 13 of the 18 patients with mildly disordered tracings (72.2%), 15 of the 20 patients with moderate abnormality (75.0%), and 12 of the 16 patients with severe abnormality (75.0%). 5) Recurrence rate according to cause of seizure was more significantly frequent in those with symptomatic epilepsy than in those with idiopathic type (100% vs 70.2%, p<0.05). 6) The frequency percentage of seizure recurrence by age groups of below 1 year, 1 to 3 years, 4 to 6 years, and above 6 years at onset of seizure were 100, 66.7, 57.1, and 72.7, respectively. The rate of seizure recurrence was significantly highest in patients aged below 1 year at onset of seizure. 7) There was significant difference in seizure recurrence between those with and without abnormalities as shown by neurologic examination (100% vs 70.8%, p<0.05). 8) There was no consistent difference in valproic acid serum levels between those who had a recurrence and those who did not. The patients receiving phenobarbital had significantly high serum levels of the phenobarbital in recurrent groups than those who had no recurrence. In conclusion, factors associated with an increased risk of seizure recurrence were early age at onset of epilepsy, symptomatic epilepsy, and neurologic abnormalities. We found no associations between risks of recurrence and types of epilepsy, or electroencephalographic abnormalities.
Anticonvulsants* ; Child ; Epilepsy ; Humans ; Infant ; Infant, Newborn ; Neurologic Examination ; Phenobarbital ; Prospective Studies ; Recurrence* ; Risk Factors ; Seizures* ; Seizures, Febrile ; Spasms, Infantile ; Valproic Acid

BACKGOUND: Arterial blood gas analysis is essential on diagnosis and treatment of hypoxia and acid-base imbalance. It is important to decide the timing of arterial blood sampling as well as sampling method, sample transport, and analysis of the results. So we investigated to the adequate timing of sampling when inspired oxygen fraction is changed from 0.5 to 1.0. METHODS: 20 patients were anesthetized with enflurane-N2O-O2 (FiO2=0.5), and paralyzed with pancuronium 0.07~0.08 mg/kg. Ventilation was controlled with Ohmeda 7000 ventilator (BOC Health Care Inc., Madison, USA), using a constant tidal volume of 10 ml/kg and respiration rate of 12/min. After 1 hour of anesthesia, the nitrous oxide inhalation was stopped and 100% oxygen was inhaled, and then arterial blood gas values were measured at 2 min intervals for 20 min, 5 min intervals for next 30 min, and 10 min later. Blood samlpes were drawn from the radial artery and measured immediately on a blood gas analyzer (Civa-Corning 288 Blood Gas System, Civa-Corning Diagnostic Corp., Medifield, USA). Determining the optimal time of sampling was performed with the rate of variation of PaO2 according to time progression, then the point at which the slope decreased abruptly was regarded as statistically significant timing. RESULTS: After 12 minute, arterial oxygen partial pressure was not any more changed significantly. There were no change of pH, arterial carbon dioxide partial pressure, oxygen saturation, base excess, and bicarbonate. CONCLUSION: The timing of arterial blood gas sampling in change with inspired oxygen fraction from 0.5 to 1.0 is about 12 minute later.
Acid-Base Imbalance ; Anesthesia ; Anoxia ; Blood Gas Analysis ; Carbon Dioxide ; Delivery of Health Care ; Diagnosis ; Humans ; Hydrogen-Ion Concentration ; Inhalation ; Nitrous Oxide* ; Oxygen* ; Pancuronium ; Partial Pressure ; Radial Artery ; Respiratory Rate ; Tidal Volume ; Ventilation ; Ventilators, Mechanical

PURPOSE: Many neurologic and psychiatric behaviors can mimic epileptic seizures. Making a diagnosis of these nonepileptic paroxysmal disorders is very important to prevent inappropriate use of antiepileptic drugs. We studied the clinical characteristics of nonepileptic paroxysmal events in order to help differentiate them from true epileptic seizures. METHODS: We retrospectively reviewed 77 patients aged 2 months-15 years who visited the Pediatric Neurology clinic from January, 1990 to January, 1999 for evaluation of seizure disorders who were diagnosed as having nonepileptic paroxysmal disorders. RESULTS: Nonepileptic paroxysmal disorders were classified into 6 major groups as follows : movement disorders 19 cases (23.5%), respiratory disorders 16 (19.8%), loss of consciousness or tone 15 (18.5%), drug-induced dystonia 14 (17.3%), behavioral disorders 12 (14.8%), and perceptual disturbances 5 (6.1%). The final diagnoses of the 6 major groups were as follows : breath holding spell 16 cases (19.8%), syncope 14 (17.3%), drug-induced dystonia 14 (17.3%), pseudoseizure 6 (7.4%), sleep disorders 5 (6.1%), tics 4 (4.9%), headache 4 (4.9%), temper tantrum 4 (4.9%), sleep myoclonus 3 (3.7%), paroxysmal choreoathetosis 2 (2.5%), and masturbation 2 (2.5%). Five of the 77 patients also had idiopathic epilepsy. Breath holding spell is common in 2 months-6 years of age, syncope in 2-15 years, and pseudoseizure in 6-15 years. Monitoring in patients with pseudoseizure and abnormal eye movement with video EEG is helpful for diagnosis. CONCLUSION: Nonepileptic neurologic disorders are common and show a different incidence according to age group. The exact diagnosis of nonepileptic paroxysmal disorders using video EEG, is very important for preventing misdiagnosis and inappropriate use of antiepileptic drugs.
Anticonvulsants ; Breath Holding ; Diagnosis ; Diagnosis, Differential* ; Diagnostic Errors ; Dystonia ; Electroencephalography ; Epilepsy ; Eye Movements ; Headache ; Humans ; Incidence ; Masturbation ; Movement Disorders ; Myoclonus ; Nervous System Diseases ; Neurology ; Retrospective Studies ; Sleep Wake Disorders ; Syncope ; Tics ; Unconsciousness

Phylloides tumor is very similar to giant fibroadenoma in that they have benign appearance in breast radiologic image. Fibroadenoma has no malignant potential, but phylloides tumor is locally recurrent, invasive and may occasionally metastasize. It thus appears that evaluation of the differential point of the two tumor groups by radiologic study is very important. We retrospectively compared sonographic find;.ngs of 6 cases of phylloides tumor with those of 4 cases of fibroadenoma, which proved pathologically in Ye mgnam University Hospital from 1984 to 1986. The mean age of the patients were 31.8 years old(from 14 to 41 years old) in phylloides tumor and 28.8 years old (from 17 to 40 years old) in giant fibroadenoma, respectively. The viewpoints of this analysis were size, shape and contour of the masses, internal echo pattern, posterior enhancement, and especially the existence of peripheral cyst or septal band echo. We found that diffenentiation of these two tumors by sonography was difficult. But peripheral cyst was found only in phylloides tumor and septal band echo was found largely in giant fibroadenoma. Although the existence of peripheral cyst or septal band echo in the breast mass was not pathognomonic findings, we suggest that the existence of septal band echo is preferential finding to fibroadenoma, and peripheral cyst is preferential finding to phylloides tumor.
Breast ; Diagnosis, Differential* ; Fibroadenoma* ; Humans ; Retrospective Studies ; Ultrasonography