We report one case of aseptic necrosis of both talus which has developed without any evidence of previous trauma. Aseptic necrosis of the talus is known to occur after any trauma which result in iterruption the blood supply to talus. Atraumatic aseptic necrosis of talus is extremely rarre condition. Some cases of atraumatic aseptic necrosis of talus were repoted by some authers, in whom Garcia described the first case in 1928. Most of the reported atraumatic aseptic necrosis were due to long term steroid therapy for unrelated medical problems and others were related to Alcoholism, Sepsis and Tuber culosis. ln this case we think for it may be caused or contributed by steroid therapy.
Alcoholism ; Necrosis ; Sepsis ; Talus

The study was designed to observe the correlation between the eating habits and growth development in 1,574 children(3 - 6 years old) in Kyunggi-do and Seoul, Korea. The eating habits and nutrient intake were determined by mini dietary assessment and food frequency questionnaire (FFQ). 35.6% children had been practicing an unbalanced diets. Children with unbalanced diet consumed less amount of protein source foods (meat, fish, egg, soy products), vegetables and fruits and had irregular meal time, but more of them preferred sweet foods (ice creme, cookies) and carbonated drinks as snack compared with children in balanced diet. 24 - 35% children consumed energy, iron (Fe), calcium (Ca), Niacin, Zinc (Zn) less than 75% RDA. Energy intake of children with unbalanced diet was not significantly different from those with balanced diet, but they consumed less amount of niacin, Fe, Ca and Zn than those with balanced diet. By using the relative percentage of standard weight-length-index (WLI), 65.7% children was normal weight, 12.9% was underweight, 13.4% was overweight and 7.9% was obese. However, 11.9% of underweight and normal weight children was so called thin obese since their body fat content was greater than 20%. There were 16.8% underweight in children with unbalanced diet and 12.6% underweight in those with balanced diet. Compared to normal weight, the underweight children significantly consumed less amount of milk and its product, high protein foods, fried foods and fruits, but obese children consumed more high protein source foods (meat, fish, egg, etc) and sweet foods. In conclusion, the eating habits of unbalanced meal was prevalent problem in preschool children which resulting in their health risks. Therefore, it would be needed that new approach for nutrition education to improve eating habits in preschoolers.
Adipose Tissue ; Calcium ; Carbonated Beverages ; Child ; Child, Preschool* ; Diet ; Eating* ; Education ; Energy Intake ; Fruit ; Gyeonggi-do ; Humans ; Iron ; Korea ; Meals ; Milk ; Niacin ; Overweight ; Ovum ; Seoul ; Snacks ; Surveys and Questionnaires ; Thinness ; Vegetables ; Zinc

Granular cell tumor is an uncommon neoplasm with uncertain histogenesis that rarely occurs in the orbit. Although it is regarded as a benign lesion, one case of malignancy has been recorded. The authors present a case of recurred, infiltrating orbital granular cell tumor in a 39-year-old woman. On light microscopic examination, the tumor cells showed the characteristic findings of granular cell tumor, but there were hyperchromatic and pleomorphic nuclei with unusual mitotic figures, suggesting a malignant nature.
Adult ; Female ; Granular Cell Tumor* ; Humans ; Orbit*

The effects of topical sodium-hyaluronan on the stromal and endothelial healing were examined in the repair process of experimental corneal alkali wounds. Corneal alkali wounds were produced in one eye of each rabbit by applying a 5.5 mm round filter paper soaked in 1N NaOH onto the central cornea for 60 seconds. Then the eyes were treated topically with either 1% Na-HA(the treatment group)or a phosphate buffered saline(PBS)(the con-trol group)4 times per day for 3 weeks. Endothelial wound morphometry was performed after alizarin red and trypan blue staining. The stromal healing was assessed by counting polymorphonuclear leukocytes(PMNs)and keratocytes in the central and marginal wounds areas. The stroma treated with Na-HA had less PMNs than that of the control group during the early healing period. The defect area of the endothelium was significantly smaller in the Na-HA treated group than in the control corneas. The present findings indicate that topically applied 1%Na-HA affects stromal and endothelial healing during the early repair process after corneal alkali wounds.
Alkalies* ; Cornea ; Endothelium ; Trypan Blue ; Wounds and Injuries*

BACKGROUND: The elderly ex-smokers are not free from the effect of previously exposed smoking, and have a tendency to participate in health promoting behavior eagerly. This study was designed to evaluate factors that affect pulmonary function in the elderly ex-smokers. METHODS: The ex-smokers with normal chest radiological findings who visited Seoul National University Hospital Health Promotion Center were analyzed. The effect of various factors including age, height, smoking amount, and duration of smoking cessation on pulmonary function indices were analyzed with bivariate correlation analysis. Multiple regression analysis was performed using factors indentified significant in bivariate correlation tests. RESULTS: Multiple regression analyses were done for the all age group and the elderly group. Factors significantly affecting Forced vital capacity(FVC) were height,age and duration of smoking cessation for both grroups. Smoking amount was not significant. Forced expiratory volume in 1 second(FEV1) was significantly influenced by height, age, duration of smoking cessation, and smoking amount for both group. In the all age group, peak expiratory flow(PEF) was siginificantly influenced by age, regular exercise, and duration of smoking cessation. In the elderly group, PEF was significantly affected by height, age, regular exercise, and duration of smoking cessation. The factors significantly affectiong FEV1/FVC were age, smoking amount in the all age group, and regular exercise, smoking amount in the elderly group. CONCLUSION: Smoking amount was a significant factor decreasing FEV1 in the elderly ex-smoker. Duration of smoking cessation was significant in normalization of pulmonary function indices in both the all age group and the elderly group. It is inferred that smoking cessation is beneficial in reversing the adver sely affected pulmonary function indices even in the elderly.
Aged* ; Forced Expiratory Volume ; Health Promotion ; Humans ; Seoul ; Smoke ; Smoking ; Smoking Cessation ; Thorax

PURPOSE: The purpose of this study was to determine the differences in the level of disease related knowledge, compliance of health behavior, and educational needs in relation to time (at discharge and 6 months after discharge) among patients underwent percutaneous coronary intervention (PCI). METHODS: Data were collected from January 1, 2006 to September 30, 2006 and a total of 60 patients participated in the study. The survey was conducted in patients underwent PCI at the time of discharge right after discharge education was provided and at a follow up visit which was 6 months after discharge. RESULTS: The level of disease related knowledge (p<.001), the compliance of health behavior (p<.001), educational need (p=.496), the sub-item of sexual life (p<.001), follow up (p<.001), diet (p=.021), stress (p<.001) in compliance of health behavior, and the sub-item of specific character of disease in educational needs (p=.015) were significantly different between discharge and 6 months after discharge. CONCLUSION: The results of this study suggested that further education should be provided to the patients underwent PCI regarding medication, smoking cessation, daily life and exercise at a time of 6 months after discharge in order to increase patient compliance of health behavior.
Compliance ; Coronary Artery Disease ; Diet ; Follow-Up Studies ; Health Behavior ; Humans ; Patient Compliance ; Percutaneous Coronary Intervention ; Smoking Cessation

A total of 68 primary melanorna cases diagnosed at Seoul National University Hospital for the past 10 years from 1978 to 1987 were included for this clinico pathological study. Among the 31 primary cutaneous melanomss, 19 cases (61.3%) occurred on hands or feet, especially on the plantar surfaces. The average age of patients with acral melanomas was 49.3 years at the tirne of diagnosis and the male to female ratio of 19 cases was 3.8 to 1. The clinical and histopathologic findings showed that most ecral melanomas, if not all, were the acral lentiginous type. A high incidence of metastasis (73.7%) was recognized in acral melanomas.
Diagnosis ; Female ; Foot ; Hand ; Humans ; Incidence ; Male ; Melanoma* ; Neoplasm Metastasis ; Seoul

Solitary fibrous tumors (SFTs) most often involve the pleura and also may encompass the peritoneum and nonserosal sites. They occur as solitary encapsulated tumors and pursue a relatively benign clinical course. The usual criteria for malignancy are high cellularity, mitotic activity (more than 4 per 10 high-power fields), cellular pleomorphism, hemorrhage and necrosis as well as infiltrative growth. We report a case of malignant SFT of pleura who presented with an anterior mediastinal mass. Grossly, it was a 10x8x6.5 cm sized, encapsulated and well-demarcated, solid neoplasm with areas of extensive necrosis. Microscopically, parallel or haphazard arrangement of spindle cells with variable degrees of collagenous background were noted. Storiform fascicle formation, hemangiopericytoma-like pattern, and epithelioid cell clusters were often intermingled. Nodular areas with high cellularity and mitotic activity (> or =10/10 HPFs) were scattered throughout the neoplasm, however no definite cellular pleomorphism was encountered. Tumor cells were immunoreactive for vimentin and CD-34, which distinguished them from the mesothelial cells. Electron microscopically, they revealed fibroblastic and myofibroblastic differentiation.
Collagen ; Epithelioid Cells ; Fibroblasts ; Hemorrhage ; Mediastinum ; Myofibroblasts ; Necrosis ; Peritoneum ; Pleura ; Solitary Fibrous Tumor, Pleural* ; Solitary Fibrous Tumors* ; Vimentin

A histopathological study of erythema nodosum-like lesions in Behcet's disease was performed on 55 patients with incomplete and suspect types of Behcet's disease. Relatively common characteristics in histopathology of erythema nodosum-like lesions could be found in the patients with incomplete type of Behcet's disease. The histopathologic findings of erythema nodosum-like lesions in 21 patients with incomplete type of Behcet's disease were as follows : l. A moderate lymphocytic infiltration was found around the blood vessels and the sweat glands in the dermis. In the subcutaneous tissue, besides lymphohistiocytic infiltration, neutrophils were present in significant number in 9 cases (42.9%) 2. Vasculitis of small vessels was found within the periphery of fat lobules in 7 cases (81.0%), Five cases (23.8%) also showed thrombophlebitis. Seven cases (33.3%) showed histiocytic granuloma formation within the fat lobules. Microabscess formation in the subcutaneous tissue was seen in 5 cases (23.8 %), but it was not certain whether this was the charateristic feature.
Blood Vessels ; Dermis ; Erythema Nodosum* ; Erythema* ; Granuloma ; Humans ; Neutrophil Infiltration ; Subcutaneous Tissue ; Sweat Glands ; Thrombophlebitis ; Vasculitis

BACKGROUND: To describe the fast experience of case-leased advanced cardiac life support(ACLC) course in Korea. METHODS: We have given case-based ACLC course to 13 nurses(6 emergency nurses, 4 coronary care unit muses, 3 professors) and 17 physicians(4 emergency physicians, 12 emergency residents, 1 intem). We performed the case-based ACLS course according to 1992 American Heart Association guidelines and recommendations for advanced cardiac life support by american ACLS instructors(1 pulmonologist, 4 critical care nurses). We performed final theoretical written test and 2 times written survey (immediate and 100th day after the course) about the course. RESULTS: On final written test, all practitioners answered at leasts 70% of the questions correctly. There was no significant difference between nurses and physicians(86.2+/-3.6 of physicians and 82.5+/-6.8 of nurses, p=0.06). 90%of participants considered that case-based advanced cardiac life support was acceptable. 100th day after the course, 93%of participants answered that ACLS course have been helpful on his/her job and also want retraining of ACLS course. 70%of participants considered that ideal ACLS training committee in Korea is the Korean Society of Emergency Medicine. CONCLUSION: Case-based ACLS course is a useful educational method far physicians and nurses in Korea. In the future, we should organize Korean resuscitation committee and then make guidelines for ACLS, and then continuously educate physicians and nurses.
Adult* ; Advanced Cardiac Life Support ; Alprostadil ; American Heart Association ; Coronary Care Units ; Critical Care ; Emergencies ; Emergency Medicine ; Humans ; Korea* ; Resuscitation