Acetabular fractures are usually caused by violent external force such as car clash and commonly accompany injuries of the other parts of the body. And there has been long controversy between conservative and operative treatments. A clinical analysis was performed on the 29 patients with acetabular fractures, who had been treated at seoul National University Hospital from 1973 to 1982, mainly focussed on the result of treatment. Followings are the summary of the result. 1. Conservative treatment was done in 52% and operative treatment in 48%. 2. Mean follow-up period was 1 year and 8 months. 3. The result of treatment was good or fair in 53% of conservative treatment group comparedto 71 in operative treatment group. 4. Primary total hip replacement was done in one case of bursting fracture combined with fracture of femur neck and the result was good. 5. Superior and bursting fractures showed the worst result(poor in 83%). 6. Degenerative arthritis with or without avascular necrosis was the most common complication (45 %) and it was more common in conservative treatment group (60 vs. 29%). 7. From above results it could be said that operative treatment in acetabular fractures, if carefully done with reasonable indications, would improve the result and decrease the rate of degenerative arthritis.
Acetabulum ; Arthroplasty, Replacement, Hip ; Femur Neck ; Follow-Up Studies ; Humans ; Necrosis ; Osteoarthritis ; Seoul

The clinical studies were performen on 304 patients with heart disease who had been received corrective heart surgery at Kosin Medical Center from July, 1984 to December, 1991. The results were as follows: 1) Out of 304 patients, 162 cases (53.3%) were male and 142 cases (46.7%) were female and sex ratio was 1.15:1. 35 cases (11.5%) had clinical cyanosis and 269 cases (88.5%) had no evidence of cyanosis. 2) As age distribution of patients, under 2 years, 3~5 years, 6~10 years, 11~15 years, 16~18 years consist of 22.0%, 26.0%, 29.0%, 16.1% and 6.9%, respectively. 3) As disease distribution, out 304 patients, ventricular septal defect (57.9% of all) was the most common disease, and then atrial septal defect (13.2%), tetralogy of Fallot (11.2%), patent ductus arteriosus (9.9%) and pulmonic stenosis (5.3%), in their order. 4) As sex distribution of each disease, ventricular septal defect, atrial septal defect and tetralogy of Fallot were more common in male and patent ductus arteriosus and pulmonic stenosis were more common in female. 5) The most frequent cardiac anomaly associated with ventricular septal defect and atrial septal defect was pulmonic stenosis. In the case of subarterial ventricular septal defect, aortic insufficiency was associated in 13.3%. 6) Respiratory problems (11.3%), tricuspid regurgitation (9.5%), arrhythmia (6.2%) and congestive heart failure (5.8%) were the major complications after surgery. 7) Case fatality reat was 4.4%. Mortality rate in ventricular septal defect, tetralogy of Fallot and tricuspid atresia were 1.7%, 20.6% and 100%, respectively, Majority (75.0%) of expired patients were died within 24 hours after sugery and the cause of death was hypoxia due to low cardiac output syndrome.
Age Distribution ; Anoxia ; Arrhythmias, Cardiac ; Cardiac Output, Low ; Cause of Death ; Cyanosis ; Ductus Arteriosus, Patent ; Female ; Heart Diseases* ; Heart Failure ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Male ; Mortality ; Pulmonary Valve Stenosis ; Sex Distribution ; Sex Ratio ; Tetralogy of Fallot ; Thoracic Surgery ; Tricuspid Atresia ; Tricuspid Valve Insufficiency

Cutaneous larva migrans(CLM) is a ubiquitous self-limiting skin eruption which has intensely pruritic, serpiginous, raised, sharply demarcated, red lesions. It is most frequently caused by larvae of dog and cat hookworms. We report two typical cases of cutaneous larva migrans that appeared as pruritic exanthems in two people after they had travelled in Southeast Asia. It is suggested one should consider cutaneous larva migrans in the differential diagnoses of erythematous pruritic lesions.
Ancylostomatoidea ; Animals ; Asia, Southeastern ; Cats ; Diagnosis, Differential ; Dogs ; Exanthema ; Larva ; Larva Migrans* ; Skin

Freys syndrome is characterized by attacks of facial erythema and gustatory sweating occurring in the cutaneous distribution of the auriculotemporal nerve. After sugery, trauma, abscess, or other diseases of the parotid gland, the postganglionic sympathetic and parasympathetic nerve fibers are disrupted. Some misdirected auriculotemporal nerve fibrils join with the distal sympathetic nerves innervating the sweat glands and subcutaneous vessels. We report a case of Freys sindrome in a 6-year old boy without any definite injury to the parotid gland. After considering our case and review of literature of Freys syndrome in children, we conclude that there may be a congenital defect in the auriculotemporal nerve innervation responsible for cases occuring in children.
Abscess ; Child* ; Congenital Abnormalities ; Erythema ; Humans ; Male ; Nerve Fibers ; Parotid Gland ; Sweat Glands ; Sweating, Gustatory

Pigmentary demarcation lines are borders of abrupt transition between more deeply pigmented skin and that of lighter pigmentation. We describe two patients with pigmentary demarcation lines associated with pregnancy symrnetrially involving the buttocks and flexor as jects of legs. Hormonal changes in pregnancy and compression by the enlarged uterus of Sl and S2 peripheral nerves may be responsible for these changes.
Buttocks ; Humans ; Leg ; Peripheral Nerves ; Pigmentation ; Pregnancy* ; Skin ; Uterus

There are many options for the management of osteoarthritis of the knee joint. Recently, arthroscopic surgery has been added to the armamentorium of the treatment modalities in osteoarthritis of the knee which does not respond to conservative treatment. Among 74 arthroscopic pocedures(including partial menisectomy, removal of loose bodies, synovectomy, cartilage drilling and simple lavage) done for osteoarthritis of the knee, 68 patients studied at average 3.1 years after procedure and the results were as follows 1. Seventy-one percent of patients had at least 2.5 years or more relief of pain and symptoms. 2. Fifty-six percent were still good at follow-up of 3.1 years. 3. The best result were obtained after removal of loose bodies and resection of unstable flap tear of a meniscus in association with mild osteoarthritis. 4. The poor result were obtained in patients with severe degenerative changes of both femoral condyle, 5. The results were much better in the normally aligned knee compared with valgus knee.
Arthroscopy ; Cartilage ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Osteoarthritis ; Tears

Phytases (myo-inositol hexakisphosphate phosphohydrolase; EC 3.1.3.8) are enzymes which catalyze the hydrolisys of phytate into myo-inositol and inorganic phosphates. Phytases are found in plants and a variety of microorganisms. Aspergillus species were treated with 254 nm of UV irradiation for the screening of phytase overproducing mutant strains. At 15 minute irradiation, the survivals of population were less than 5%, and UV irradiation time was decided at 20 minute for the isolation of mutant strains. Four UV mutant strains in A. oryzae (YUV-47, -169, -341, -511) and six in A. ficuum (FUV-17, -36, -69, -193, -317, -419) were isolated on PSM media containing ammonium phosphate. The specific enzyme activities of A. ficuum mutants are 110 to 140% higher than that of wild type.
6-Phytase* ; Ammonium Compounds ; Aspergillus oryzae ; Aspergillus* ; Mass Screening* ; Mutagenesis* ; Oryza ; Phosphates ; Phytic Acid

The clinical study was performed to 28 patients with the pericardiac effusion who were admitted in Busan university Hospital and Paik Hospital, In-Je Medical College, Busan, korea during March 1976 and July 1981. The results were as following; 1) 12 cases(42.9%) of total 28 pericardiac effusion occured in 3rd decade, 8(28.5%) in 2nd decade and 5 cases(17.9%) in 4th decade. Sex distribution showed male to female 2.5:1. 2) With etiological distribution there were 15 cases(53.6%) tuberculous, 5(17.9%) nonspecific, 3(10.7%) malignant, 2(7.1%) pyogenic, 2 traumatic and 1(3.6%) rheumatic. 3) On admission 28 cases(100%) complained of dyspnea, 24(85.7%) distant heart sound, 20(71.4%) each engorged jugular vein and edema, 18(64.3%) each cough and abdominal fullness, 17(60.7%) each sputum and chest discomfort and pain, 12(42.9%) fever, 11(39.1%) orthopnea, 10(35.7%) chilling, 7(25%) oliguria, 4(14.6%) palpitation and 3(17.2%) headache. Increased cardiac dullness was observed in 26 cases(71.4%), hepatomegaly 18(64.3%), pulmonary rales 17(60.7%), ascites 13(46.1%), fever 12(42.9%), pericardiac friction rub 10(35.7%), splenomegaly 7(25%), paradoxical pulse 6(21.4%) and jaundice 2(7.1%). 4) On amission SGOT and SGPT level was increased each in 15(53.6%) and 13(46.7%), TTT and CCF abnormal in 10(35.7%), and 8(28.5%), serum NPN, BUN, creatinine increased in each 10(35.7%), 11(39.1%), 8(28.5%), WBC increased in 6(21.4%), RBC decreased in 8(28.5%) and ESR increased in 16(57.1%). 5) Characteristics of pericardiac effusion showed hemorrhagic 17(60.7%), serosangeous 6(21.4%), sangeous 3(17.2%) and pyogenic 2 cases(7.1%). 6) The ECG on admission revealed low voltage in 25(89.1%), depressed ST segment in 13(46.1%) and inverted T wave in 12(42.9%). 7) Chest X-ray showing cardiomegaly 28(100%), pleural effusion in 20(71.4%), and pulmonary congestion in 16(57.1%). 8) The m mode and 2-D Echocardiogram showed echo free space in 28 cases and after pericardiocentesis the space was reduced or disappeared. 9) 19 cases of 28(67.5%) were improved clinically, while 5 cases(17.9%) were not improved and 4 cases(14.6%) died.
Alanine Transaminase ; Ascites ; Aspartate Aminotransferases ; Busan ; Cardiomegaly ; Cough ; Creatinine ; Dyspnea ; Edema ; Electrocardiography ; Estrogens, Conjugated (USP) ; Female ; Fever ; Friction ; Headache ; Heart Sounds ; Hepatomegaly ; Humans ; Jaundice ; Jugular Veins ; Korea ; Male ; Oliguria ; Pericardiocentesis ; Pleural Effusion ; Respiratory Sounds ; Sex Distribution ; Splenomegaly ; Sputum ; Thorax

BACKGROUND: Vitiligo is an acquired disorder with destruction of melanocytes and is clinically characterized by depigmented patches of skin. The pathogenesis of vitiligo is still unclear, but melanocyte self destruction, neurohumoral factors, autoimmunity and inherent cellular defects have all been proposed as possible etiological factors. OBJECTIVE: The purpose of this study was to find out the differences in expression of HLA antigens among subtypes of vitiligo according to classification, onset and family history and then to disclose the pathogenesis of vitiligo in view of genetic and autoimmunological aspects. METHODS: We investigated HLA-A, B, C, DR in subgroups of 87 vitiligo patients according to type, onset, and family history. Results : 1. There were no HLA antigens with significantly increased frequency in vitiligo patients compared to the control group. 2. There was a significant increase in frequency of HLA-DRl2 in patients of non-segmental vitiligo with a family history ; an increase in frequency of HLA Cw2 in patients without a family history ; and a significant increase in frequency of HLA-DRl2 in all patients of non-segmental vitiligo compared to the control group.(p(c)<0.05). 3. The frequency of HLA-B63 was significantly increased in all patients of segmental vitiligo compared to the control group(p(c)<0.05), but there were no HLA antigens with significantly increased frequency in patients of subgroups of segmental vitiligo divided by the presence or absence of a family history of vitiligo. 4. The frequency of HLA-B54 was significantly increased in all vitiligo patients with a family history(p(c)0.05) but there were no HLA antigens with significantly increased frequency in all vitiligo patients without a family history. 5. There were no HLA antigens with significantly increased frequency in vitiligo patients subgrouped by age of onset (less or over 16 years) of disease. Conclusion : From the above results, we can assume that non-segmental vitiligo may have autoimmune mechanisms in the pathogenesis, as there was a significant increase in HLA-DRl2 in patients with non-segmental vitiligo.
Age of Onset ; Autoimmunity ; Classification ; HLA Antigens* ; HLA-A Antigens ; Humans ; Melanocytes ; Skin ; Vitiligo*

Granulosa cell tumor of the testis is extremly rare in adult males and granulosa cell tumor occurring in the paratesticular area has not been reported. We report a paratesticular granulosa cell tumor in a 34-year-old man who presented with a 5.5 cm sized scrotal mass. The tumor was present in the paratesticular area near the head of epididymis. It was located in the tunica and completely separated from the testis by thick fibrous tissue. Microscopically, the tumor exhibited solid, microfollicular, and trabecular patterns. The tumor cells had ovoid to elongated nuclei with longitudinal intranuclear grooves and one or two nucleoli and scanty cytoplasm. Mitoses were relatively frequent with an average number of 9/10 HPFs. The tumor extended into the visceral tunica vaginalis and showed multiple lymphatic tumor emboli. Immunohisto chemical stains revealed diffuse strong positivity for inhibin, vimentin, and keratin and diffuse weak positivity for estrogen and progesteron receptor. Placental alkaline phosphatase (PLAP) and epithelial membrane antigen (EMA) were negative. On electron microscopic examination, tumor cells were polygonal and had large indented nuclei. The cytoplasm contained a moderate number of small round mitochondria, abundant rough and smooth endoplasmic reticula, and a few lipid droplets. Small aggregates of intermediate filaments and intercellular junctions were observed. The patient was alive and well 5 months after orchiectomy. This is the first case of adult granulosa cell tumor arising in the paratesticular area.
Adult ; Alkaline Phosphatase ; Coloring Agents ; Cytoplasm ; Epididymis ; Estrogens ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Head ; Humans ; Inhibins ; Intercellular Junctions ; Intermediate Filaments ; Male ; Mitochondria ; Mitosis ; Mucin-1 ; Orchiectomy ; Testis ; Vimentin