With a ordinary goniometer, we measured the range of active motion of the wrist flexion, extension, ulnar and radial deviation in 120 normal adult subjects ranging in age from 20 to 49 years old. Normal limits were determined for the male and female groups, for the age groups, and for the right and left sides, respectively. The data were compared with the axial angles in roentgenograms that described by T.E. Keats in 1966. And we have undertaken a study of the correlation between the range of motion and the axial angles. The results were as following: 1. Range of active motion (degrees±standard deviation) Rexion; 73.9 ±6.386. extension; 65.9 ±5.164 unlar deviation; 28.3 ±5.124 radial deviation; 18.6±2.556 2. Axial angles (degrees±standard deviation) P-A view;73.8±3.985 lateral view;79.7±4.777 3. Males had a smaller range of motion than female in wrist joint. 4. The right side showed a smaller range of motion than the left. 5. There were no correlations between the range of motion and the axial angles.
Adult ; Female ; Humans ; Male ; Range of Motion, Articular ; Wrist Joint ; Wrist

It has been emphasized that the treatment of choice for the trochantric fracture of the femur is open reduction and rigid internal fixation to reduce complications by early ambulation. The incidence of trochanteric fracture of the femur in the young age group has been considerably increased in recent years because of increased traffic and industrial accidents. The author treated 38 cases of trochanteric fracture of the femur in the year 1974 through 1979, at the Department of Orthopaedic Surgery, School of Medicine, Soon Chun Hyang College. The results were as follows: 1. In sex distribution, 24 out of 38 were males and 14 were females. 16 cases out of 24 male patients were in the age group 20-40 and 9 cases out of 14 female were over 60 years of age. Over all mortality was 7.9%. 2. The numbers of patients of type I and III were 11 cases in each type out of 38 trochanteric fracture. 3. 26 cases out of 38 cases were treated by open reduction and internal fixation and the others were by traction and cast. 4. The applied metal devices were 3 types: Smith-Peterson nail and Thornton or McLaughlin plate, compression hip screw, and multiple pinning. 5. Mean duration of bony union is shorter in the group of open reduction and internal fixation (13 weeks) than the group of traction and cast (15 weeks). The cause of difference is that the 6 out of 9 cases of type IV and V were included in conservative group. 6. The incidece of the complications such as coxa vara, slipping screw, long nail and traction palsy occurred higher in the group fixed with Smith-Peterson nail and plate than the group fixed with compression hip screw.
Accidents, Occupational ; Coxa Vara ; Early Ambulation ; Female ; Femur ; Hip ; Humans ; Incidence ; Male ; Mortality ; Paralysis ; Sex Distribution ; Traction

A case of histiocytosis X with the involvement of pituitary stalk in a 5 year old boy was described. He presented with diabetes insipidus and the endocrinological study showed growth hormone deficiency. On computerized tomography and magnetic resonance imaging, the pituitary stalk was abnormally thick. Overlooking of the skull lesion on plain X-ray film led to an erroneous diagnosis of germ cell tumor'. Gross total removal of the lesion and chemotherapy were performed. In the differential diagnosis of suprasellar masses, this disease entity should be included. The importance of histological diagnosis of the infundibular lesion in cases of central diabetes insipidus is also emphasized.
Child, Preschool ; Diabetes Insipidus ; Diabetes Insipidus, Neurogenic ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Germ Cells ; Growth Hormone ; Histiocytosis* ; Histiocytosis, Langerhans-Cell* ; Humans ; Magnetic Resonance Imaging ; Male ; Pituitary Gland* ; Skull ; X-Ray Film

A case of Nelson's syndrome in 23 year-old female, developing 6 years after bilateral adrenalectomy for Cushing's syndrome, is reported. Presenting symptoms were headache and hyperpigmentation of the skin and mucous membrane. Serum ACTH level was markedly elebated above 1000 pg/ml, but serum cortisol level diminished markedly. Transsphenoidal approach (TSA) with removal of gushing out hematoma and tumor underwent. Postoperatively, headache subsided and hyperpigmentation of the skin markedly improved.
Adrenalectomy ; Adrenocorticotropic Hormone ; Cushing Syndrome ; Female ; Headache ; Hematoma ; Humans ; Hydrocortisone ; Hyperpigmentation ; Mucous Membrane ; Skin ; Young Adult

The amniotic band syndrome is a collection of congenital deformities presurmably due to rupture of amniotic sac. It appears to cause fetal injury through three basic mechanisms including malformation, disruption, and deformation. The associated anomalies vary firom minor digital defect to major craniofacial and visceral defects. They can be categorized as neural tube-like defects, craniofacial anomalies, limb anomalies, abdominal and thoracic wall defects, visceral anomalies, and constriction bands. We had expericnced a case of severe congenital craniofacial anomaly due to amniotic bands diagnosed by ultrasonogram in the antenatal period is presented with a brief review of the literatures.
Amniotic Band Syndrome* ; Congenital Abnormalities ; Constriction ; Extremities ; Infant, Newborn ; Rupture ; Thoracic Wall ; Ultrasonography

A case of myxopapillary ependymoma of the lateral ventricle is reported. The patient was a 30 year old woman who had headache for 9 months' duration & visual disturbance of left eye for 2 months' duration. Brain CT and MRI scan revealed solid mass at trigonal area of left lateral ventricle with cystic component. And cerebral angiogram revealed faint punctate mottled staining. Total removal of the tumor was done via transcortical transventricular approach without further neurologic deficit. The tumor was diagnosed as myxopapillary ependymoma with H & E staining, immunohistochemical staining for gliofibrillary acidic protein and electron microscopic examination, Postoperative radiotherapy was performed on primary area & whole brain field with the dose of 5500 rads.
Adult ; Brain ; Ependymoma* ; Female ; Headache ; Humans ; Lateral Ventricles* ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Radiotherapy

PURPOSE: Recently, a key role of tumor necrosis factor (TNF) in the development of inflammatory bowel disease (IBD), especially Crohn's disease (CD), has emerged. In Japan, 3 single base pair polymorphisms in the 5'-flanking region of the TNF-alpha gene at position 1031, 863, and 857, which are related to high transcriptional promoter activity, have been identified in the Japanese CD patients. And the polymorphisms of the TNF-alpha gene at position 308, 238 have been reported in western CD patients. So, in order to find the same polymorphisms in Korean population and CD patients, the author evaluate the patients diagnosed with CD, ulcerative colitis (UC) and healthy controls (HCs). METHODS: Blood samples were obtained from 70 patients with CD, 72 patients with UC and 52 healthy controls. Polymorphisms in the TNF-alpha gene at their respective positions were analyzed by single strand conformational polymorphism (SSCP), and allele frequencies in CD and UC patients were compared with those in healthy controls. RESULTS: Allele frequencies of 1031C, 863A, and 857T in health controls were 18.3%, 8.7%, and 19.2%, respectively. Polymorphic allele frequencies of 1031C, 863A, 857T were 22.9%, 27.1%, and 24.3% in CD patients respectively. The frequencies at all 3 positions were higher in CD patients than in HCs. However, the frequency at 863A was statistically significant (P=0.000). The allele frequencies of 308A and 238A alleles were 0.7% and 3.6% in CD, 0.7% and 2.1% in UC, and 1.9% and 4.8% in HCs, respectively. The allele frequency of 1031C was significantly higher in B3 than in B2 (P=0.033). CONCLUSION: Polymorphisms of 5'-flanking region of the TNF-alpha at positions 1031 (T/C), 863 (C/A) and 857 (C/T) may be associated with susceptibility of CD.
Alleles ; Asian Continental Ancestry Group ; Base Pairing ; Colitis, Ulcerative ; Crohn Disease* ; Gene Frequency ; Humans* ; Inflammatory Bowel Diseases ; Japan ; Korea ; Tumor Necrosis Factor-alpha*

Craniopharyngiomas exhibit benign histologic features. However, such tumors have a relatively high incidence of recurrence after surgical removal, In order to device reliable and efficient methods in identifying craniopharyngiomas with increased risk for recurrence after surgical removal, proliferating cell nuclear antigen(PCNA) expressions as well as histological characteristics of the tumor were analyzed. There were 43 patients who had been surgically confirmed and had paraffin-embedded tissue from June, 1984 to May, 1993 available for analysis from our department. Of the 43 patients, eighteen cases were in children(age of 15 years of less) and 25 cases were in adults. The mean follow-up period was 42.7 months. The histologic types were adamantinomatous in 30 cases, squamous papillary in 9 cases and mixed in 4 cases. There was no case of tumor recurrence in the squamous papillary group, while the recurrence rate was about 55% in the adamantinous group after surgical removal alone. The mean age of the admantinous group was younger than that of the squamous papillary group(17.5 vs. 37.9 years old. p=0.0012), and the squamous papillary type was found only in adults(age over 20). In the group of 30 patients treated by surgical removal without radiation, the PCNA labelling index, calculated by counting the basal cell layer only, was significantly higher in the group with recurrence than without recurrence(9.51 vs. 6.58. p=0.001). However, the PCNA labelling index obtained by counting all cells in the four high-power(x400) fields failed to demonstrate any correlation with tumor recurrence. With a reference value of 8, PCNA index of the basal cell layer demonstrated the predictive sensitivity of 81.8% and specificity of 84.2% for tumor recurrence. There was no significant difference in PCNA labelling indices between adamantinous and squamous papillary types. As PCNA labelling index of the basal cell layer, as well as the histologic type, are sensitive indicators for prediction of tumor recurrence after surgical removal of craniopharyngiomas, therefore they should be considered as an index for biologic behavior of the tumor.
Adult ; Craniopharyngioma* ; Follow-Up Studies ; Humans ; Incidence ; Proliferating Cell Nuclear Antigen* ; Recurrence ; Reference Values ; Sensitivity and Specificity ; Treatment Outcome*

The clinical and pathologic features, including prognostic factors and survival data, were analyzed for 23 patients with intracranial ependymoma treated surgically at the Seoul National University Hospital during the years 1979 to 1990. The age at diagnosis ranged from 2 months to 55 years(mean : 14.9 years). The male to female ratio was 10:13. Fifteen patients(65%) were under the age of 15. The tumors of twenty one patients(91%) were located infratentorially. The adjusted overall 5-year-survival rate of infratentorial ependymomas was 77% excluding 4 cases of surgical mortaltiy(Kaplan-Meier method). The period of follow-up ranged from 2 to 70 months. No correlation was possible between 5-year-survival rate and extent of tumor, age group(below and above 6 years), extent of removal, or pathologic grading. Clinical or pathological evidence of spinal metastasis was not found.
Diagnosis ; Ependymoma* ; Female ; Follow-Up Studies ; Humans ; Male ; Neoplasm Metastasis ; Seoul

A case of huge aneurysmal bone cyst involving left temporal bone is reported. Radiologic, operative, and histopathologic findings are described in details.
Aneurysm* ; Bone Cysts ; Temporal Bone*