No abstract available.
Aged* ; Humans ; Hyperhomocysteinemia*

Various etiologies of hallux valgus and metatarsus primus varus have been reported, but still they are not conclusively established. Furthermore, between hallux valgus and metatarsus primus varus, the question is unanswered as to which is the cause and which is the result. To determine the primary cause and attribution of high heeled position to hallux valgus and metatarsus primus varus, we selected three different types of dancer. Traditional dancers wear cotton sox and strike the heels first to move, modern dancers walk or run and jump on naked feet, and ballerinas stand, walk or jump on their toes with hard wooden shoes, so the latter two types of dancers move with extremely high-heeled position. We analyzed the plain AP roentgenography of 84 feet for 16 ballerinas, 13 modern and 13 traditional dancers. The results were as follows : 1. First metatarsalgia was noted in 38% of modern dancers and 43% of ballerinas but none in traditional dancers. 2. The mean hallux valgus angle was 13.6°±2.7° in traditional dancers, 13.5°±3.8° in modern dancers, 18°±3.3° in ballerinas which are statistically significant between ballerinas and modern, traditional dancers(P < 0.01). 3. The mean intermetatarsal angle was 10.5°±1.4° in traditional dancers, 10.6°±1.1° in modern dancers, 10.8°±1.5° in ballerinas, and metatarsus primus varus angle was 17.6 °±5.1°, 18.3°±2.7°, 19.4°±3.6°, respectively, which were all statistically insignificant(P>0.01). Therefore, it is concluded that medio-lateral compression of shoes may be the principal contributor for the hallux valgus rather than high heel, and hallux valgus is the primary deformity.
Congenital Abnormalities ; Dancing ; Foot ; Hallux Valgus ; Hallux ; Heel ; Metatarsalgia ; Radiography ; Shoes ; Strikes, Employee ; Toes

No abstract available.
DNA* ; Kidney* ; Plasmids*

Fetus-in-fetu is a very rare condition in which a malformed monozygotic twin lies within the body of its fellow, usually in the retroperitoneal cavity. Today it is generally accepted that the distinction between fetus-in-fetu and teratoma is largely determined by whether an axial skeleton system is present. We experienced a 6 months female infant who was admitted to our unit because of incidental abdominal mass. a plain abdominal X-ray showed that the mass contained completely formed fetal skeletal system. It was removed by surgery. By pathologic and radiologic study of mass, We confirmed as a fetus-in-fetu. We report the case with brief review of related literatures.
Female ; Humans ; Infant ; Skeleton ; Teratoma ; Twins, Monozygotic

BACKGROUND: It is known that 20% of childhood epilepsy is refractory to anticonvulsants therapy, Recently, a few new anticonvulsants has been introduced. One of these, gabapentin is known to effective in such refractory cases. This study has been done to estimate the effectiveness of gabapentin in refractory childhood as well as adult epilepsies. SUBJECTS AND METHODS: 43 patients(male 25, female 18) has been selected among refractory epilepsies during the period of March, 1981 to Feb, 1996 diagnosed and treated at pediatric neurologic clinic School of Medicine, Yonsei University Those were already treated with various anticonvulsants and gabapentin was added to previous medication, and effectiveness of seizure frequency and the degree has been investigated over more than 3 month period as well as the side effect. RESULTS: 30 patients out of 43, showed seizure free or decreased frequency of seizure, those patients whose the seizure frequency was decreased over 50% was 11 cases, partial seizure 10 cases, generalized seizure 1 cases. 15 case out of 43 showed no changes or increased frequencies of seizure in 4 out of 27 in partial epilepsies, 1 out of 16 in generalized seizure, and 6 cases out of 43 manifested side effects such as behaviour change, abdominal pain and headache. CONCLUSION: Gabapentin was effective by add on therapy in refractory epilepsies and reducing the frequency of seizure over 50% was 25.6%. Most of these patients was partial seizure. We concluded that gabapentin as add on therapy is effective at least in 1/4 cases of refractory partial seizures.
Abdominal Pain ; Adult ; Anticonvulsants ; Epilepsies, Partial ; Epilepsy ; Female ; Headache ; Humans ; Seizures*

PURPOSE: This study was designed to compare fracture healing in normal and ovariectomized rat, and to evaluate the effect of intermittent administration of parathyroid hormone on fracture healing in osteopenic animal model, MATERIALS AND METHODS: Four-months-old mature female Sprague-Dawley rats were randomly elivided into 5 groups. Group I underwent a sham operation, and others (Group II-V) were ovariectomized. At three months after ovariectomy or sham operation, standardized bilateral transverse tibial fractures were created and intramedullary nailings with Kirschner wire were performed. The rats were then treated with daily subcutaneous injection of placebo in Groups I and II, 17beta-estradiol in Group III, low doses of recombinant human PTH (1-84) in Group IV, and high doses of recombinant human PTH (1-84) in Group V for 4 weeks. At day 30 of post-fracture the animals were sacrificed and fracture healing was assessed with histologic/histomorphometric analysis and three-point bending mechanical testing. RESULTS: On histologic/histomorphometric evaluation of sham operation group, the fracture callus mainly consisted of dense trabecular bone. On the other hand, Groups II and III seemed to have much looser cancellous network, abundant in fibrous marrow. In parathyroid hormone-treated g roups, external callus consisted of more dense trabecular, woven bone than that of Groups II or III, and especially the high doses of parathyroid hormone-treated group was comparable to the sham operation group in terms of per cent trabecular bone volume (Group I>V>IV>III=II, P<0.05). Mechanical testing indicated that ultimate load was reduced in Group II and III compared to sham operated or parathyroid hormone-treated groups (Group I=V>IV>III=II, P<0.05). Other significant differences were the increase in absorbed energy at ultimate load of Groups I and V (Group I=V>IV=III=II, P<0.05), and increase in ultimate stress of Groups I and V (Group I=V>IV=II=III, P<0.05). CONCLUSIONS: On the basis of this study, it may be concluded that fracture healing is delayed in the ovariectomy-induced osteopenic rat model. Our experiment also showed dose-related stimulation of parathyroid hormone in the strength of fracture, and that antiresorptive agents such as estrogen had no effect. Further study is needed in large animal model, and attention should be focused on systemic/long-term effect of parathyroid hormone and its relationship with local growth factors in fracture healing.
Animals ; Bone Density Conservation Agents ; Bone Marrow ; Bony Callus ; Estrogens ; Female ; Fracture Fixation, Intramedullary ; Fracture Healing* ; Hand ; Humans ; Injections, Subcutaneous ; Intercellular Signaling Peptides and Proteins ; Models, Animal ; Ovariectomy ; Parathyroid Hormone* ; Rats* ; Rats, Sprague-Dawley ; Tibial Fractures

Adenoids ; Carcinoma, Squamous Cell ; Diagnosis ; Female ; Hemorrhage ; Humans ; Male ; Mouth ; Mouth Neoplasms ; Neck Dissection ; Paralysis ; Paresthesia ; Pigmentation ; Suppuration ; Surgery, Oral ; Survival Rate ; Trismus ; Ulcer

PURPOSE: Moyamoya disease is a primary vascular disease characterized by stenosis that is followed by occlusion of the intracranial portion of the internal carotid artery and other vessels of the circle of Willis. Since there has not been any specific reports about clinical manifestation in children, we plan to study on clinical manifestation through these patients who have moyamoya disease. METHODS: We have reviewed our case of moyamoya disease in patients admitted to Yonsei University College of Medicine and analyzed their age & sex distribution as well as clinical manifestations, together with brain CT and angiographic findings. RESULTS: The results were as follows: 1) Fifty cases of moyamoya disease were encounted during a 10-year period. 2) The male to female ratio was 1:2.3 and mean age was 6.3 years old. 3) The most common chief complaint on admission was hemiparesis followed by convulsion. 4) 42 patients(84%) showed infarction on brain CT and only 5 patients(10%) showed hemorrhage. Most common lesion was frontal lobe. 5) Bilateral occlusion of the internal carotid arteries was most common site of lesions on cerebral angiography.
Brain ; Carotid Artery, Internal ; Cerebral Angiography ; Child ; Circle of Willis ; Constriction, Pathologic ; Female ; Frontal Lobe ; Hemorrhage ; Humans ; Infarction ; Male ; Moyamoya Disease* ; Paresis ; Seizures ; Sex Distribution ; Vascular Diseases

We experienced a cose of occupational asthma induced by the tobacco leaf in 49-year old man. He has worked at the Korean Tobacco and Ginseng company for 23 years but suffered from the intermittent mild wheezing and dyspnea since 6 years ago. He has not involved in the process making the tobacco directly, but just managed it at the storage barn. He showed a whole negative reaction to 55 inhalant allergens(Bencard, UK) and the allergen extracted from the yellow Korean tobacco leaf, but showed the dual asthmatic respose to the allergen bronchial provocation test with it. His basal PC is 6.35 mg/ml with methacholine inhalation challenge. Now he changed the workplace far away from the barn at the same company and is treated with bronchodilator and anti-asthmatic inhaler.
Asthma, Occupational* ; Bronchial Provocation Tests ; Dyspnea ; Humans ; Inhalation ; Methacholine Chloride ; Middle Aged ; Nebulizers and Vaporizers ; Panax ; Respiratory Sounds ; Tobacco*

Sphenoid sinus aspergillosis is notorious for its serious complications, such as permanent cranial nerve deficits and possible death. The most common associated symptoms are headache, followed by visual changes, and cranial nerve palsies. Because of an insidious onset, frequently resulting in missed and delayed diagnosis, sphenoid sinus aspergillosis is a potentially lethal medical condition. We report a case of visual loss secondary to isolated sphenoid sinus aspergillosis. A 69-year-old man presented to our hospital with the complaint of headache. The headache started one year previously and was described as severe dull pain localized bilaterally to the temporo-orbital region. The patient took daily NSAIDs for the pain. The neurological examination was normal. The MRI of the brain showed a left sphenoid sinusitis. A transnasal endoscopic superior meatal sphenoidotomy was performed. Aspergillosis was confirmed after a surgical biopsy was obtained. The patient was discharged from hospital without antifungal therapy. One month later, the patient complained of headache and loss of vision bilaterally. The orbital MRI showed a left cavernous sinus and bilateral optic nerve invasion. The loss of visions was permanent. In our case, the diagnosis was delayed; antifungal agents were not administered after surgery and the patient lost his vision as a result. Therefore, early diagnosis and proper treatment are important. Although the treatment of an invasive type of aspergillus has not been established, surgical removal of a nidus and aggressive antifungal therapy are recommended.
Aged ; Anti-Inflammatory Agents, Non-Steroidal ; Antifungal Agents ; Aspergillosis* ; Aspergillus ; Biopsy ; Blindness* ; Brain ; Cavernous Sinus ; Cranial Nerve Diseases ; Cranial Nerves ; Delayed Diagnosis ; Diagnosis ; Early Diagnosis ; Headache* ; Humans ; Magnetic Resonance Imaging ; Neurologic Examination ; Optic Nerve ; Orbit ; Sphenoid Sinus* ; Sphenoid Sinusitis