VSD is the most common congenital carciac malformation and the natural history depends not only on the age ofpatients and the size of defect but the subtype of VSD as well, important factor in clinical management or thosepatients. In 110 patients, with surgically repaired VSD in Yonsei Medical Center in 1984, the subtype of VSDs evaluated by surgical observation were correlated with LV angiogram findings to verify the incidence of subtype inKorean and the diagnostic accuracy to predict the subtype by angiogram. 1. 110 patients included 64 boys and 46 girls, the age ranged from 3 months to 14 years(average 4.6 years old) 2. Angiographic findings were interpretedas follows; a. Perimembranous defects were profiled in LAO 60 degrees LV angiogram and located below the aorticvalve. In inlet excavation the shunted blood opacified the recess between septal leaflet of tricuspid valve and interventricular septum in early phase, in infundibular excavation opacified the recess between anterior leafletof TV and anterior free wall of RV and in travecular excavation the shunted blood traversed anterior portion of TVring, opacified trabecular portion of RV cavity. b. Subarterial type were profilled in RAO 30degrees LV angiogram,just below aortic valve as well as pulmonic valve. Total infundibular defects were profilled in RAO 30degrees andLAO 60 degrees LV angiogram subaortic in location in both views. c. In muscular VSD the profilled angle was variedaccording to the subtype but the defects were separated from the aortic valve as muscular septum interposedbetween the aortic valve and the defect. 3. The incedence of subtype of VSDs evaluated by surgical observationwere as follows. Subaterial type 32 cases(29.1%) Total infundibular defect 5 cases( 4.5%) Perimembranous type 73cases(66.3%) Infundibular excavation 32 cases(29.1%) Trabecular excavation 28 cases(25.5%) Inlet excavation 10cases(9.1%) Mixed 3 cases(2.7%) Muscular type 1 cases(0.9%) Total 63.6% of VSD, were the varieties of theinfundibular septum type. 4. The prediction of VSD subtype accoridng to the angiographic findings described above,were compared to the surgical observation. Diagnostic rate was 100% in perimembranous type, 75% in subarterialtype, 0% in total infundibular type, so 88% of cases were in accordance with the surgical findings.
Aortic Valve ; Bays ; Female ; Humans ; Incidence ; Natural History ; Tricuspid Valve

No abstract available.
Arthralgia*

No abstract available.
Amphotericin B* ; Hemoptysis*

For the reconstruction of various tissue defects, free tissue transfer has been a very popular method in recent years. A large thin flap is required for aesthetic and functional resurfacing of the extremity defects. As a result, anterolateral thigh free flap has been thought to be useful in reconstructing soft tissue defects requiring thin flap coverage of extremities. The anterolateral thigh flap is a septocutaneous flap based on the septocutaneous or musculocutaneous perforators of the lateral femoral circumflex system. It supplies a large area of skin on the anterolateral aspect of the thigh. The advantages of this flap are safe elevation, a long vascular pedicle, and large caliber vessel. The donor scar is inconspicuous and it could also be used in a sensated flap. From September 1996 to December 1997, 16 cases of soft tissue defect on extremities were resurfaced with anterolateral thigh free flap and the outcomes were satisfactory. This flap is considered useful in one-stage reconstruction of large soft tissue defects of extremities.
Cicatrix ; Equipment and Supplies ; Extremities* ; Free Tissue Flaps* ; Humans ; Skin ; Thigh* ; Tissue Donors

It awakens interest that the frequency of carcinoma of the uterine cervix is the highest among the carcinomas among the Korean women, althouth it is not so high among Westerns. It is admitted that the exfolicative cytologic technique is useful not only as a screening test for early detection of cervical cancer and its precursor lesions but also as a tool for follow-up, because it is accurate, economical, and easy to perform. But it remains to be solved that the false negativity of the cytologic diagnosis is relatively high. Five hundred and sevently two cases of cytology specimens, confirmed by either colposcopic biopsy or cone biopsy, were studied among 15,844 cases which were submitted to the Department of Pathology, Chonnam University Hospital between October of 1982 and August of 1986. The results obtained were as follows. 1) The accuracy of the cytologic diagnosis was 69.9%, the false nagativity, 19.4% and the false positivity, 6.6%. 2) Among the causes of discrepancies between cytologic diagnosis and histologic diagnosis, error in cytology reading was the most frequent (57%), error in cell collection was the second frequent (43.7%), and error in biopsy location was the least frequent (5.3%). 3) Among the 38 cases of false positive diagnosis, the percentage of error in cytology reading was 82.3%, and that of error in biopsy location was 20.7%. Among the 105 cases of false negative diagnosis, the percentage of error in cytology reading was 50.5%, and the percentage of error in cell collection was 56.6%.
Female ; Humans ; Biopsy

The latissimus dorsi muscle or musculocutaneous flap is one of the most useful flaps in reconstructive surgery. This flap has many advantages, such as its reliable anatomy, long pedicle with large caliber vessels, minimal functional deficit of the donor site, and low incidence of donor site complications. However, the bulkiness of the flap has been considered a disadvantage, so various modifications of technique have been devised. The cutaneous portion of the flap can be safely elevated based on the cutaneous perforating branch of the thoracodorsal vessel. From March 1997 to February 1998, 10 patients underwent reconstructive procedures with thoracodorsal perforator-based free flaps. The composition of the flaps varied in accordance with the nature of the defect. The variances in the flaps were as follows; 3 were cutaneous, 6 musculocutaneous, and 1 osteomusculocutaneous including the rib. All flaps survived with good contour. We concluded that this thin and reliable flap was useful for reconstruction of various defects, and that the composition of the flap, such as subcutaneous, muscle and bone, gave it considerable flexibility as needed.
Free Tissue Flaps* ; Humans ; Incidence ; Myocutaneous Flap ; Pliability ; Ribs ; Superficial Back Muscles ; Tissue Donors

Horizontal tear of the meniscus occurs most commonly in older patients. The tear begins initially with a simple horizontal cleavage which divides the meniscus into superior and inferior leaves resembling a fish mouth and which may become a flap or more complex tear with time if subjected to repeated injury. Thirty-four patients(36knees/40menisci) with horizontal tear of the meniscus, treated with arthroscopic partial meniscectomy except in 3 extensive tears at Ulsan University Hospital from Jan. 1993 to Jun. 1996, were analyzed to investigate the factors that may be associated with this type of meniscal tear, and the results were as follows; 1. The tears commonly occurred in labor workers(61.7%) and without obvious trauma history(67.6%), and the average age at the time of surgery was 44 years. 2. The most common site of the tear was posterior horn of the medial meniscus (62.5%). 3. The 40 horizontal tears consisted of 12 horizontaVcleavage(30%), 3 horizontaVflap(7.5%), and 25 horizontaUdegenerative complex tears(62.5%). 4. Degenerative changes were frequently noted in both arthroscopy(69.5%) and roentgenography (72.2%).
Animals ; Horns ; Humans ; Menisci, Tibial ; Mouth ; Radiography ; Ulsan

We report a case of vulvar syringoma suggesting milia. A 20-year-old pregnant woman visited the obstetrical department of our hospital for labor pain. On physical examination, the skin lesions were revealed accidently and showed symmetrically distributed, numerous, 2-4mm sized, yellow to skin colored papules on the vulva. The lesions developed in the fifth gestational month and were aggravated thereafter. After delivery, we performed a skin biopsy of the lesion. Histopathologic findings of the biopsy specimen showed the typical findings of syringoma and milia.
Biopsy ; Female ; Humans ; Labor Pain ; Physical Examination ; Pregnancy ; Pregnant Women* ; Skin ; Skin Pigmentation ; Syringoma ; Vulva* ; Young Adult

BACKGROUND: There were several reports that thyroid autoimrnune disease commonly found in myasthenia gravis patients. We performed this study to determine the prevalence of thyroid autoimmune disease as well as analyze correlation between acetylcholine receptor antibody and various thyroid autoantibadies among the myasthenia gravis patients in Korea. METHOD: The patient group, 48 patients, diagnosed as myasthenia gravis from January 1985 to December 1995 at the department of Neurology, Internal medicine at Dongsan Medical Center was compaired to the control group, 40 patients, with no age and sex difference from the patient group. The samples were collected from both group for the measure of the values of acetylcholine receptor antibody, thyroid autoantibody and thyroid hormones. RESULT: 1) The values of acetylcholine receptor antibody in myasthenia gravis group and control group were 5.78+-0.7nM and 0.05+-0.06nM respectively. Of 48 patients with myasthenia gravis, 38 patients have been measured acetylcholine receptor antibody value > 0.5nM, Their mean average value was 7.24+-0.66nM. 2) The severe myasthenia gravis group with value of acetylcholine receptor antibody 0.5nM and severe myasthenia gravis group with value of acetylcholine receptor antibody 0.5nM showed thyroglobulin antibody value of 159.6+-79.91IU/mL versus 56.86+-32.99IU/mL. also thyroid microsomal antibody value showed 159.0+-79.9IU/mL and 23.633+-0.19IU/mL respectively. 3) Of 48 myasthenia gravis patients, 12 patients (24%) had high value of antithyroglobulin antibody or anti-microsomal antibody and 5 patients (10%) had both antibodies at the same times. In contrast, only 3 patients (8%) were observed with high value of either one of antibodies. Patient with both antibodies was not observed in normal control group. CONCLUSION: According to the datas we have obtained, appearence of the thyroid autoantibody is significantly greater in severe myasthenia gravis group than normal control group. Therefore it is suggested that the prevalence of thyroid autoimmune disease is higher in severe myasthenia gravis group than mild myasthenia gravis group or normal control group.
Acetylcholine* ; Antibodies ; Autoimmune Diseases ; Humans ; Internal Medicine ; Korea ; Myasthenia Gravis* ; Neurology ; Prevalence* ; Sex Characteristics ; Thyroglobulin ; Thyroid Diseases* ; Thyroid Gland* ; Thyroid Hormones

The authors analyzed 24 cases of intraspinal tumors in children who had been operated upon at the Seoul National University Hospital from 1973 to 1986. The ratio of male of female was 2:1. The pathologic diagnosis revealed neurogenic tumor in 8 cases(33%), metastasis in 3 cases(13%), glioma in 3 cases(13%), lymphoma in 3 cases(33%), metastasis in 3 cases(13%), sarcoma in 3 cases(13%), and tumor of dysembryogenesis in 2 cases(8%). The tumors were located most frequently in the thoracolumbar area(7 cases, 29%) and in the epidural space(12 cases, 50%). Two thirds of the epidural tumors were malignant. The most common initial presentation was motor weakness(9 cases, 38%). Three cases(13%) presented with mass and one case(4%) with flexion deformity. On admission 9 cases(38%) were in the paraparetic stage, 6 cases(25%) in the radiculopathic stage, and 6 cases in the Brown-Sequard syndrome stage. The mean value of the CSF protein was 1, 108 mg%. Plain spine X-rays were abnormal in 17 cases(74%) and the increased interpedicular distance(11 cases, 48%) was the most common radiological abnormality. Myelographic studies were performed in 21 cases and all of them revealed abnormal findings. Total and gross total removal was possible in 13 cases(54%). Radiation therapy was done in 8 cases(33%) and chemotherapy in 5 cases(21%). The surgical result on discharge or at the postoperative one month was recovery in 7 cases(29%), improvement in 10 cases(42%), stationary state in 4 cases(17%), and progression in 3 cases(13%). After 20.8 months of mean follow-up duration in 20 cases(84%), the result was recovery in 13 cases(65%), improvement in 2 cases(10%), stationary state in one case(5%), and progression in 4 cases(20%). As a major complication, there was a spinal deformity in 6 cases(29%) among 21 cases who did not have spinal deformity preoperatively. Three cases(13%) were followed up to their deaths. And the authors discussed the clinical features of the pediatric intraspinal tumors reported in the literature and the results of the present study.
Brown-Sequard Syndrome ; Child* ; Congenital Abnormalities ; Diagnosis ; Drug Therapy ; Epidural Neoplasms ; Female ; Follow-Up Studies ; Glioma ; Humans ; Lymphoma ; Male ; Neoplasm Metastasis ; Sarcoma ; Seoul ; Spine