It has been known that Korean adults have brachycephalus in their skull shape as compared with neighboring orientals. However, there is no difference between Korean newborn infants and other oriental newborn infants in skull shape. Acquired factors seem to be more important than hereditary factors as a possible cause of brachycephalus in Korean adults. In order to study the process of brachycephalization in the skull shape, I measured head girth, head length, head width and cephalic index. Those results were divided into three categories, namely, feeding, period of ingestion of undaria pinnatifida (sea weed) soup and sleep posture. 1) I studied 1,371 newborn infants who were born in th busan Maternity baby health center and 1,521 newborn infants in the Daegu maternity baby health center from June 1,1976 to may 31,1977. In Busan group, average weight of male newborn was 3.45kg, headgirth34.31cm, head length 11.68cm, head width 9.57cm. and cephalic index 82.02. Average weight of female newborn was 3.34kg, head girth 33.79cm, head length11.54cm, head width 9.44cm. and cephalic index 81.96. In Daegu group, average weight of male newborn was 3.28kg, head girth 34.65cm,head length 11.85cm, head width 9.50cm. and cephalic index 80.31. Average weight of female newborn was 3.18kg., head girth 34.08cm., headlength11.62cm., head width 9.38cm. and cephalic index 80.81. There was statistically significant difference in each item (p<0.01) 2) It was also studied in the order of delivery in the family. In Busan group, first baby was 43.5%, second baby 38.8% and sum of first and second baby was 82.3%. In Daegu group, first baby was 47.2%, second baby was 30.3% and sum of first and second baby was 77.5%. 3) I studied 1,686 male and 1,175 female from one to twelve month olds who visited my clinic for check up and vaccination from January 1,1976 to March 31,1978. Head girth, head length and head width were measured 3,660 times for male and 2,607 times for female. 4) Feeding was divided into breast feeding, Mixed feeding and artificial feeding. Period of maternal ingestion of sea weed soup were one, two, three and four weeks. Sleep postures were supine, lateral and prone position. Occipital protuberance that is not in the middline was divided into right or left occipital protuberance. 5) There were neither significant differences in head girth, head length, head width and cephalic index between breast, mixed and artificial feeding nor period of maternal ingestion of seaweed soup. 6) There was either significant difference in the cephalic index between supine and lateral position or supine and prone position. 7) Among 2,861 infants, breast feeding was 75.0%, mixed feeding 15.1% and artificial feeding 9.9%. Occipital protuberance that is not in the midline was 59.3%, left occipital protuberance 27.1% and right occipital protuberance 32.2%. 8) Occipital protuberance that is not in the midline was 70.5% in the supine position, 24.6% in the lateral position and 0.0% in the prone position. There were significant differences among them. 9) Period of maternal ingestion of seaweed soup were one week 10.4%, two weeks 28.0%, three weeks 33.0% and four weeks 28.6%.
Adult ; Breast ; Breast Feeding ; Busan ; Daegu ; Eating ; Female ; Head ; Humans ; Infant* ; Infant, Newborn ; Male ; Nutritional Support ; Posture ; Prone Position ; Seaweed ; Skull* ; Supine Position ; Undaria ; Vaccination

Traditionally, it has been emphasized that hemolytic disease was the primary cause of gallstones (cholelithiasis) in most young patients. In recent years, gallstones and common bile duct calculi have been increasingly diagnosed in infants and children, unrelated to hemolytic diseases. On the matter, the World Health Organization (WHO) classified intraepithelial neoplasia (dysplasia) of gall bladder as one of the precursor lesions of invasive cancer. The following article describes the case of a 2-year-old girl who had a laparoscopic cholecystectomy due to cholelithiasis and the pathologic diagnosis was chronic cholecystitis with diffuse, mild mucosal dysplasia.
Child ; Cholecystectomy, Laparoscopic ; Cholecystitis ; Cholelithiasis ; Gallbladder ; Gallstones ; Humans ; Infant ; Preschool Child ; Urinary Bladder ; World Health Organization

No abstract available.
Leukemia*

A spinal synovial cyst is an uncommon lesion associated with degenerative spinal arthropathy. It can cause radicular symptoms and may masquerade clinically as other, more common entities. A 50-year-old female presented with an intraspinal synovial cyst at the L5-S1 level manifesting as lower back pain and right leg pain. The patient's clinical symptoms improved after surgical management. Intraspinal synovial cyst should be considered in the differential diagnosis of the patients presenting with acute radicular symptoms.
Diagnosis, Differential ; Female ; Humans ; Leg ; Low Back Pain ; Middle Aged ; Radiculopathy ; Synovial Cyst

Clear cell sarcoma (CCS), also called malignant melanoma of soft parts, is a rare malignant soft tissue tumor and is often associated with tendons or aponeuroses. Most of CCS involve extremities, especially lower extremities, but a tumor occurring in the trunk is rare. We report an extremely rare case of CCS originated in the upper thoracic back muscle. To our knowledge, this case is the second report of CCS of the back muscle.
Extremities ; Lower Extremity ; Melanoma ; Muscles ; Sarcoma, Clear Cell ; Tendons

Macrostomia is a relatively rare malformation. There have been many surgical methods for the correction of macrostomia. The old method, a simple straight line closure , did not include reconstruction of the orbicularis oris muscle. Postoperatively, a depressed scar and severe contraction on the cheek were found, especially with animation. As a result, many authors have known that reconstruction of the orbicularis oris muscle was very important to avoid a depressed scar for the correction of macrostomia. The tendency toward lateral displacement of the reconstructed commissure has been attributed to linear scar contraction, and Z-plasty is advocated to prevent this deformity. However, we found that the Z-plasty scar may be conspicuous when the patient smiles. So we performed reconstruction of the orbicularis oris muscle to avoid a depressed scar, and straight line closure to avoid a conspicuous scar. In order to prevent linear scar contracture due to straight line closure, we overcorrected the new commissure. We treated 6 cases of macrostomia form May 1, 1996 to April 30, 1999 using straight line closure and reconstruction of the orbicularis oris muscle. Periods of follow-up were from 12 months to 35 months, with an average of 20,2 months. Every patient was analyzed clinically by ordinary scale method and anthropometrically by the ratio of abnormal distances to normal distances between cheilion and crista philtri. In 3 clinical assessments : symmetry of the commissure was excellent: degree of the scar at rest was good: and degree of depression with animation was excellent. The anthropometrical ratio was 1:1.05. Despite the fact that the linear scars were perpendicular to the minimal skin tension lines, the scars were inconspicuous. The muscle repair provided reconstruction to the modiolus and gave a natural appearance to the commissure, however it did not seem to provide sufficient bulkiness around the commissure. The straight line skin closure and repair of the orbicularis oris muscle provide effective functional and aesthetic reconstruction.
Cheek ; Cicatrix ; Congenital Abnormalities ; Contracture ; Depression ; Follow-Up Studies ; Humans ; Macrostomia* ; Skin

Autogenous costal cartilage graft has been commonly used for reconstruction of auricular deformity. However, the risk of complication and discomfort at the donor site, as well as distortion of the graft due to morphological change in the cartilage have been serious drawbacks to this procedure. Previous studies examining the chondrogenic potential of perichondrium have suggested that perichondrium may be used as graft for cartilage reconstruction. When a perichondrial flap or a free perichondrium was used as graft, new cartilage formed appositional to the grafted perichondrium. However, the neocartilage was often irregular in shape and varied considerably in quantity. In this study, the feasibility of controlling the shape and the mass of neocartilage was investigated using coral, a porous biomaterial, as a template. A coral a template was wrapped with perichondrial flap from the ears of New Zealand white rabbits and placed into a subcutaneous pocket in the rabbits and placed into a subcutaneous pocket in the rabbit's back by incision. A total of 12 animals were used. Formation of new cartilage was later evaluated by gross and histological examination of the perichondrial flap and the coral template. New cartilage was formed in 11 animals. Immature chondrocytes were visible by 3 weeks after the surgery, and by 8 weeks the immature chondrocytes had formed a cartilage. New cartilage was formed only on the surface of the coral template. These results indicated that the shape and the mass of new cartilage may be controlled by using coral template. Therefore, the desired shape of cartilage may be achieved using a coral template of corresponding shape, and this may help in correcting subtle auricular contour defect and in correcting other structural defects that also require new cartilage formation.
Animals ; Anthozoa* ; Cartilage ; Chondrocytes ; Congenital Abnormalities ; Ear ; Humans ; Rabbits ; Tissue Donors ; Transplants

PURPOSE: To verify the usefulness of left portal vein angle (LPVA) on CT scan in the diagnosis of liver cirrhosis and to compare its diagnostic value with that of caudate to right lobe ratio (C/RL ratio). MATERIALS AND METHODS: LPVA, an angle formed by a vertical line and a line connecting the center of the vertebral body to the umbilical point of the left portal vein, and C/RL ratio were measured on CT scans of 100 cirrhotic and 100 normal livers. Diagnostic values of LPVA and C/RL ratio were compared statistically. RESULTS: The mean of LPVA was 18.9 degrees(SD; 7.6) for normal livers and 25.8 degreesSD; 8.4) for cirrhotic livers (P<0.001). The mean of C/RL ratio was 0.47(SD; 1.10) for normal livers and 0.58(SD;0.14) for cirrhotic livers (P<0.001). When LPVA was greater than 30 degreesliver cirrhosis was diagnosed with 36% sensitivity and 92% specificity. When C/RL ratio was greater than 0.60, the diagnose of liver cirrhosis was with 41% sensitivity and 90% specificity. There was no significant difference of the diagnostic accuracy between LPVA and C/R L ratio in ROC analysis. CONCLUSION: Both LPVA and C/RL ratio are useful diagnostic indices of liver cirrhosis on CTscan. LPVA is more convenient to measure than C/RL ratio.
Diagnosis* ; Fibrosis ; Liver Cirrhosis* ; Liver* ; Portal Vein* ; ROC Curve ; Sensitivity and Specificity ; Tomography, X-Ray Computed

No abstract available.
Anemia, Aplastic* ; Bone Marrow Transplantation* ; Bone Marrow* ; Immunomodulation*

PURPOSE: To evaluate MR characteristics of acute disseminated encephalomyelitis (ADEM) in children, which was confirmed by clinical findings. MATERIALS AND METHODS: The subjects were six patients, who were diagnosed by clinical findings. One subject had recurrence one year after clinical improvement leading to one additional care with the total of seven. The modes of viral infections were as follows;four cases of non-specific upper respiratory tract infection, one of E-B virus, one of Japanese-B-encephalitis vaccination, and one of upper respiratory infection in Bruton's disease. The Gd-DTPA enhanced scan was performed in all cases. MR findings were evaluated in anatomic location of the lesions, presence or absence of contrast enhancement, and the temporal changes were also evaluated on follow-up MRI. RESULT: There were multifocal high signal intensity lesions on T2WI in all cases. The location of lesions were basal ganglia in five, thalamus and brain stem in four, and cerebral gray and white matter and cerebellar white matter in three. Bilaterality was 77%. There were contrast enhancement in two of three cerebral cortical lesions and one of three white matter lesions. The size of lesions decreased on the first follow-up MRI which were done after 1 month in 4 cases, but new lesions were developed in two cases. On the second follow-up MRI which were done 2 months after, all lesions were decreased in size and there was no newly developed lesion. However, in one case who had recurrent similar symptom after 1 year, several new lesions developed on follow-up MRI, and it was comidened as a recurrence. CONCLUSION: The characteristic MR findings of ADEM were multifocal bilateral white and gray matter lesions which were high signal intensities on T2WI. The majority of lesions improved on follow-up MRI, but occasionally showed multiphasic pattern.
Basal Ganglia ; Brain Stem ; Child* ; Encephalomyelitis, Acute Disseminated ; Follow-Up Studies ; Gadolinium DTPA ; Herpesvirus 4, Human ; Humans ; Magnetic Resonance Imaging ; Recurrence ; Respiratory Tract Infections ; Thalamus ; Vaccination