Isolated dorsal dislocation of the trapezoid is an unusual injury. In 1990 Ostroski found only 15 cases of dorsal dislocation of the trapezoid in the world literature. The trapezoid is a wedge-shaped bone with the larger dorsal and smaller volar surface area, and stabilized by strong palmar ligaments. Therefore the dislocation of the trapezoid is produced hy a violent force against the dorsum of the hand on a rigid object and often associated with other injuries of the hand. The diagnosis is often missed or delayed perhaps secondary to the difficulty in interpreting the X-ray if you have not kept in mind. Several therapeutic modalities are performed from the collected experience of the authors reporting this injury. A rare example of an isolated dorsal dislocation of the trapezoid bone is described.
Diagnosis ; Dislocations* ; Hand ; Ligaments ; Trapezoid Bone

The melanotic neuroectodermal tumor of infancy(MNTl) is a rare, usually benign, pigmented lesion which most frequently involves the maxilla. Skull, brain, and mandible are other craniofacial sites; this anatomic region accounts for 87% of all cases. The vast majority of MNTl, nearly 95%, present in infants of both sexes within the first year of life. Most cases of MNTl follow a benign course, with a 15% propensity for local recurrence. MNTl is regarded as a primitive neuroectodermal tumor with polyphenotypic differentiation. We report a classical MNTl which occurred in left lower maxilla in 6-month old female infant. She developed an ill defined, firm swelling on the left alveolar ridge and gum during 3 weeks. Mass excision reveals ill defined, grayish-tan hard mass, measuring 2.0x1.6 cm. Microscopically, the tumor reveals irregular alveolar pattern of melanin-containing cuboidal cells and nests of small round cells. The immunohistochemical staining for melanoma-associated antigen, neuron-specific enolase and cytokeratin show positive reactions. Ultrastructural examination showed intracytoplasmic melanosome, tonofilament and desmosome.
Infant ; Male ; Female ; Humans

A subperiosteal ganglion has been very rarely reported, since Ollier reported first one in 1864. A subperiosteal ganglion is produced by mucoid degeneration and cyst formation within the periosteum, which results in cortical erosion. The characteristic plain radiolographic appearance of irregular cortical erosion and scalloping, with reactive periosteal bone spicules, has been considered pathognomonic of subperiosteal ganglion. Magnetic resonance imaging is performed to further characterize the soft tissue component of the mass. As in our patient, the characteristic signal intensities of magnetic resonance imaging are especially useful in identifying the lesion as a ganglion and in defining the lobular nature and the anatomical extent. We report here the case of a 35-year-old female who had a sudperiosteal ganglion of the distal radius.
Adult ; Female ; Ganglion Cysts* ; Humans ; Magnetic Resonance Imaging ; Pectinidae ; Periosteum ; Radius*

Hemiplegic migraine is characterized by the occurrence of migraine attacks with unilateral weakness. The attack usually starts in childhood, adolescence, or early adulthood. The diagnosis may be delayed if there is no relevant family history. We experienced two cases of hemiplegic migraine of 8 and 14 years old girls whose neuroimaging studies including MRA showed no abnormal findings in the acute phases and the ictal EEG findings also revealed normal. The hemiplegic attacks associated with sensory disturbance were improved by calcium channel blocker(Flunarizine). Hemiplegic migraine should be considered in the differential diagnosis of a pediatric hemiparesis even if there is no familial migraine history.
Adolescent ; Calcium Channels ; Diagnosis ; Diagnosis, Differential ; Electroencephalography ; Female ; Flunarizine ; Humans ; Migraine Disorders* ; Neuroimaging ; Paresis

BACKGROUND AND OBJECTIVES: Otitis media with effusion (OME) is most commonly found during the first two years of life, and becomes somewhat less prevalent thereafter. There are many reports about the prevalence rate of OME in preschool children, but there has been no large scale survey of its prevalence rate in school-age children. The point prevalence of OME among children of the above age in Ansan city were investigated. MATERIAL AND METHODS: Tympanometry and pneumatic otoscopic examination were performed on 2713 children aged 6-12 years, during the spring season of 1998. RESULTS: A total of 4.5% of the subjects had unilateral or bilateral OME. The prevalence rate of OME in 6 year-old children was 10.8%. The prevalence rate in 12 year-old children was decreased to 2.1%. The incidence of OME in girls was higher than in boys. Bilateral involvement was noted in 38.3%, and the remainder had unilateral involvement. The majority of the cases (88.5%) were free of subjective symptoms. CONCLUSION: More attention should be required to OME in children aged 9 years and younger because of its high prevalence.
Acoustic Impedance Tests ; Child* ; Child, Preschool ; Epidemiology ; Female ; Gyeonggi-do* ; Humans ; Incidence ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Prevalence* ; Seasons

BACKGROUND: Reperfusion of ischemic myocardium has been postulated to result in a specific oxygen radical mediated tissue injury. Iron may liberate during ischemia and we hypothesized that administration of the iron chelator, deferoxamine during ischemia would result in improved recovery after postischemic reperfusion. PURPOSE: To test whether iron-catalyzed processes contribute to myocardial necrosis during ischemia and reperfusion, deferoxamine was administered to block iron catalyzed hydroxyl radical formation in rabbits. METHODS: Eleven rabbits were divided into two groups: control group (n=5) and deferoxamine pretreatment group (n=6). the left circumflex coronay artery was ligated for 30 minutes and reperfused for 180 minutes. Area at risk (AR) was measured by non-stained area with ethylene blue injection into left atrium after left circumflex coronary artery ligation. Infarct size was measured by weighing after tripheyltetrazolium chloride staining. Heart rate was measured using electrocardiographic recording and systemic blood pressure was monitored by pressure transducer connected to the catheter in the left ventricle. RESULTS: 1. There was no significant difference of heart rate and blood pressure in deferoxamine pretreatment group compared with control group. 2. There was significant decrease of serum iron concentration after continuous infusion of deferoxamine compared with serum iron concentration before ligation of coronary artery (P<0.05). 3. There was no significant difference of area at risk between control and deferoxamine pretreatment group. 4. Area at necrosis to area at risk was significantly reduced in deferoxamine pretreatment group compared with control group (P<0.05) The results suggest that deferoxamine infusion prior to coronary artery occlusion has a significant benefit in reducing infarct size in this model.
Arteries ; Blood Pressure ; Catheters ; Coronary Vessels ; Deferoxamine* ; Electrocardiography ; Heart Atria ; Heart Rate ; Heart Ventricles ; Hydroxyl Radical ; Iron ; Ischemia ; Ligation ; Myocardial Infarction* ; Myocardium ; Necrosis ; Oxygen ; Rabbits ; Reperfusion ; Transducers, Pressure

OBJECTIVES: There is now some evidence that, in humans, psychological stress may affect immune and neuroendocrine system. In stress response, cytokines are known to orchestrate the cellular interaction of immune system and act as a major messenger in a communication with CNS. Specifically, IL1beta has been reported to be colsely related with stress induced behavior change, such as depression. Accordingly, we assessed cytokine production by peripheral blood mononuclear cells (PBMC) before and after an academic examination in 45 healthy medical students. Furthermore the possibility that IL1beta TaqI polymorphism may be associated with stress response of IL1beta production was investigated. METHODS: Blood samples were collected on the day of examination and at the second week after examination. For cytokine assay seperated PBMC were incubated for 3 days at 37 degrees C, 5% CO2. DNA was prepared by Ficoll-paque method and polymorphic region was amplified by PCR. After TaqI restriction, products were seperated by 15% polyacrylamide gel electrophoresis. RESULTS: IL1beta production and stress score were significantly higher on the examination day. The change of stress score was significantly correlated with the change of IL1beta production. However, the frequency of allele A2 was too low that the significance of genetic association could not be properly estimated. CONCLUSION: This study reports that psychological stress is accompanied by an increased production of IL1 beta with significant correlation.
Alleles ; Cytokines ; Depression ; DNA ; Electrophoresis, Polyacrylamide Gel ; Humans ; Immune System ; Monocytes* ; Neurosecretory Systems ; Polymerase Chain Reaction ; Stress, Psychological ; Students, Medical

PFAPA (periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis) syndrome is one of the causes of periodic fever in pediatrics with unknown etiology. It is characterized by abrupt onset of fever, malaise, aphthous stomatitis, pharyngitis and cervical adenitis without long-term sequelae. Laboratory findings of this sporadic and nonhereditary syndrome are so non-specific that the diagnosis is based on clinical findings. Oral prednisolone is quite effective in controlling the symptoms. We report a case of a 6-year-old girl who was diagnosed as having PFAPA syndrome after 2 years of episodes, by excluding other disease entities with similar clinical features. The patient was treated with oral prednisolone and her symptoms improved dramatically.
Child ; Diagnosis ; Female ; Fever* ; Humans ; Lymphadenitis ; Pediatrics ; Pharyngitis* ; Prednisolone ; Stomatitis, Aphthous* ; Yemen

BACKGROUND: Thoracic outlet syndrome(TOS) is caused by the compression of neurovascular structures that supply to the upper extremities. Only a few reports have been published in Korea, and this study attempts to investigate the clinical aspects and results of the patients who underwent surgical treatment. MATERIAL AND METHOD: This study consist of 16 patients who underwent operations for thoracic outlet syndrome from May, 2002 to October, 2004. The surgical indications were confined to patients with: 1) symptoms too severe to perform ordinary daily life because of pain, paresthesia, edema of upper extremities, 2) no improvement after proper physical therapy, 3) definite findings of compression confined by radiologic examinations (MRI, angiography, etc), and 4) no other diseases such as cervical intervertebral herniation, myositis, neurologic diseases below the brachial plexus. The surgical approaches were by transaxillary approaches in 12 cases, supraclavicular approaches in 2 cases, and infraclavicular approaches in 2 cases. RESULT: There were 15 males and one female with an average age of 23.9 years (range: 19~39). Rib anomalies were observed in four cases (25.0%), but the others had no abnormal ribs. Right lesions were found in eight cases (50.0%), left lesions in five cases (31.3%), and bilateral lesions in three cases (18.7%). The follow-up period was 9~26 months and recurrence rate was 12.5% (2/16). Complications were one case of ulnar nerve palsy, one case of persistent pain despite radiologic improvement and three cases of wound dehiscence due to fat necrosis and hematoma. CONCLUSION: Although the choice of treatment in patients with TOS has been disputed, patients who have no response with proper physical therapies can benefit from the surgical treatment which may help patients to return to normal daily activity in shorter period of time.
Angiography ; Brachial Plexus ; Edema ; Fat Necrosis ; Female ; Follow-Up Studies ; Hematoma ; Humans ; Korea ; Male ; Myositis ; Paresthesia ; Recurrence ; Ribs ; Thoracic Outlet Syndrome* ; Ulnar Neuropathies ; Upper Extremity ; Wounds and Injuries

BACKGROUND: The expression and secretion of ABH antigens in epithelial cells of glands are controlled by secretor type alpha (1,2)fucosyltrasnferase activity and the human secretor alpha (1,2)fucosyltransferase gene (Sec2) determines the ABH secretor status and influences the Lewis phenotype of an individual. Homozygosity of the mutation for this allele is responsible for the nonsecretor phenotype in nonsecretor individual. The aim of this study was to investigate the status and the distribution of the Sec2 genotype in the Korean population. METHODS: In order to explore the secretory genotypes of the Korean population, the 158 specimens were analyzed by the PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) method designed for the detection of the A385T, the C357T and the G428A mutations of Se alleles. RESULTS: The frequencies of Se1, Se2 and sej among 316 alleles examined in a random sample of 158 Korean individuals were 11.1%, 40.5% and 48.4%. The frequencies of Se1/Se1, Se1/Se2, Se2/Se2, Se1/sej, Se2/sej and sej/sej among 158 genotypes were 3.2%, 3.2%, 20.3%, 12.7%, 37.3% and 23.4%. The G428A nonsense mutation discovered in the Sec2 gene of nonsecretors in Caucasian was not found in any of 158 Korean population. CONCLUSIONS: The distribution of the genotypes of the Sec2 gene in the Korean population showed a rather wide distribution of the sej allele than the Caucasian population and was similar to the Japanese population. PCR-RFLP method can be effectively used for the genotyping of the Sec2 gene.
Alleles ; Asian Continental Ancestry Group ; Codon, Nonsense ; Epithelial Cells ; Genotype ; Humans ; Phenotype