The study was to evaluate the normal variations of abdominal aorta and its major branches in Koreans. Using atotal of 363 abdominal angiograms and selective organ angiograms, normal variation of aorta and its major branchesincluding level of aortic bifurcation and of origin of major branches, multiplicity of renal arteries andvariations of celiac trunk were observed and analyzed. The results are as follows; 1. The celiac trunk usuallyarises from aorta at the level between middle 1/3 of 12th thoracic vertebra and upper 1/3 of 1st lumbar vertebra,most frequently at the level of the lower 1/3 of 12th thoracic vertebra. 2. The superior mesenteric artery usuallyarises from aorta at the level between disc space of 12th thoracic vertebra and middle 1/3 of 1st of lumbarvertebra, most frequently at the level of uppe 1/3 of 1st lumbar vertebra. 3. The both renal arteries usuallyarise form aorta at the level between middle 1/3 of 1st lumber vertebra and disc space of 1st lumbar vertebra,most frequently at the level of lower 1/3 of 1st lumbar vertebra. The frequency of the multiple renal artery was19% and right renal artery was higher than left side in 56%. 4. The level of aortic bifurcation is usually at thelevel between middle 1/3 of 4th lumbar vertebra and and disc space of 4th lumbar vertebra, most frequently at thelevel of lower 1/3 of 4th lumbar vertebra. 5.The classical normal pattern of celiac and hepatic arteries was shownin 74.6%. Anomalous origin of common hepatic artery was seen in 1.9%, anomalous origin of right hepatic artery in5.8% and accessory right hepatic artery in 2.9%. Anomalous origin of splenic artery was in 1.3% and originatedfrom superior mesenteric artery.
Aorta ; Aorta, Abdominal ; Hepatic Artery ; Mesenteric Artery, Superior ; Renal Artery ; Spine ; Splenic Artery

Sjogren's syndrome has been considered to be an autoimmune disease affecting various organs including salivary and lacrimal glands. It occurs most commonly in middle-aged women, and less than 20 cases with primary Sjogren's syndrome have been reported in children. An 11-yim-old boy presented with recurrent annular erythema on the face that had been present for 2 years. A schirmers test showed a positive result. ANA was detected at a dilution of 1:640. Anti-Ro/SSA and anti-La/SSB antibodies were also detected. On histological examination, lymphocytes were infiltrated in the periappendegeal areas as well as the papillary and reticular dernis. The skin findimg is uncommon in children, but has become a characteristic feature of childhood Sjogrens syndrome with anti-Ro and/or anti-La antibodies.
Antibodies ; Autoimmune Diseases ; Child ; Erythema* ; Female ; Humans ; Lacrimal Apparatus ; Lymphocytes ; Male ; Sjogren's Syndrome* ; Skin

This study was planned by the necessities of basic information about the effects of Korean Ginseng upon fracture healing and biomechanical properties of bone. Three hundred white mice were used for this study, and we could have tested the biomechanical properties in one hundred and nintyfour. The bones of the white mice were evaluated by testing gross stability, radiological appearance, and biomechanical properties. It appears that Korean Ginseng has an excellent effect upon early phase of fracture healing of the bone. The summary of this study are as follows: 1. With near maximal dose, Korean Ginseng showed very excellent effect upon early phase of the fracture healing. 2. There was no apparent effect on remodeling phase of the fracture healing with Korean Ginseng of near maximal dose. 3. Korean Ginseng appeared to have no effect on fracture healing with minimal dose. 4. Upon biomechanical properties of the bone, Korean Ginseng was seemed to be effective with near maximal dose. But, there was no definite evidence for that.
Animals ; Fracture Healing ; Mice ; Panax

Paralytic hand is the ultimate result of permsnent damage of the central nervous system, failure of the functional repair of peripheral nerve injuries and extensive muscular or tendinous defect resulting in the impairment of hand function. There are a lot of controversies in the side of treatment methods in the paralytic hand, and it is very difficult to formulate the most adequate surgical reconstruction for a given pstient. At Depsrtment of Orthopedic Surgery, Seoul National University Hospital, 66 cases oi paralytic hands in 62 patients have been treated surgically with tendon transfers for 7 years from Jan, 1980 to Dec, 1986. 49 case in 46 patients were followed up for more than one year, and surgical method and its results were anslysed. They consist of CNS lesion (17), peripheral nerve lesion(23) and musulotenidinous defect(9). The methods of surgical reconstruction were opponenesplasty(12), standard set extensor reconstruction(9), Green and Bsnks FCU transfer(11), intrinsic reconstruction(7), pronator rerouting(7), adductorplasty (5) and so on. The mean follow-up was 2.2 years, and in 38 cases good or excellent results were obtained.
Central Nervous System ; Follow-Up Studies ; Hand ; Humans ; Methods ; Orthopedics ; Peripheral Nerve Injuries ; Peripheral Nerves ; Seoul ; Tendon Transfer

A new method of urinary diversion via Skinner`s modification of Koch continent ileal reservoir was tried. With this method continence with storage of urine under low pressure is well maintained so that no external applicances are necessary. Ileorenal reflux is also prevented with this nipple forming technique. From May l986 to September l986, 4 patients underwent urinary diversion that included creation of a modified Koch pouch by Skinner. Previous urinary diversion was by ureterocutaneous diversion in 1 patient. A total of 3 patients underwent radical cystectomies for bladder cancer In 1 patient, simultaneous urethrectomy was done because of carcinoma in situ in the urethra. There were no operative mortalities. All patients are continent and without reflux to the upper urinary tract. The volume capacity of pouch is more than 400ml. The pouch is emptied by self-catheterization every 4 to 6 hours during the day and once at night. Postoperative follow-up presently is short and it is impossible to check late complications. Although preliminary, this clinical trial suggests that the quality of life for patients can be improved markedly by the modified Koch continent ileal reservoir.
Carcinoma in Situ ; Colonic Pouches* ; Cystectomy ; Follow-Up Studies ; Humans ; Mortality ; Nipples ; Quality of Life ; Urethra ; Urinary Bladder Neoplasms ; Urinary Diversion ; Urinary Tract

BACKGROUND/AIMS: The emergence of lamivudine-resistant mutant hepatitis B virus (HBV), with aminoacid substitution in the YMDD motif of DNA polymerase, has been reported in the long-term lamivudine use group. However there is no report about the emergence of mutant viruses during the short-term lamivudine therapy. The objective of this study was to investigate the emergence of YMDD mutant HBV during short-term lamivudine therapy. METHODS: We evaluated twenty-eight chronic hepatitis B patients who were HBeAg and HBV DNA positive and treated with lamivudine 100mg p.o. daily for 12 weeks. First, we investigated the emergence of YMDD mutants by nested polymerase chain reaction (PCR) method developed by Chayama et al in 19 patients who lost HBV DNA during lamivudine therapy but showed HBV DNA re-emergence 2 weeks after the end of therapy. Second, DNA subcloning and sequencing of HBV DNA polymerase including YMDD motif was undertaken in one patient's serial blood samples at 0, 8, 12 weeks to confirm the results of nested PCR. RESULTS: YMDD motif mutation was detected in 17(90%) out of 19 patients at the end of therapy and the type of mutations were YIDD only. At the end of therapy, mutant was predominant in 5 patients, both mutant and wild type were similar in proportion in 3 patients, and wild type was predominant in 9 patients. When we carried out nested PCR serially with samples of 0, 2, 4, 8, 12, 14 weeks after initiation of therapy in 5 patients who were mutant predominant at 12 weeks, YIDD mutant began to be detected from 2 weeks in 4 patients and from 4 weeks in one patient. However, rapid turnover from mutant to wild type happened after the end of therapy, so only wild type was detected in 3 patients and wild type became predominant in 2 patients at 2 weeks after the end of therapy. All the sequencing results of serial blood samples in one patient were consistent with nested PCR data. CONCLUSIONS: The presence of YMDD motif HBV polymerase mutant may be possible before administration of lamivudine in Korean chronic hepatitis B patients. Nested PCR assay would be an useful method to detect YMDD mutant.
DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Lamivudine* ; Polymerase Chain Reaction

Congenital melanocytic nevi are considered to be precursors of malignant melanoma. Although the risk of malignant melanoma with medium and small congenital melanocytic nevi is uncertain, it is important to notice the possibility of malignant transformation in those lesions. We describe a 62-year-old woman who had had a brown soft verrucous tumor on her right lower back since birth. She first noticed a black nodule in the center of the tumor 5 years before which had ulcerated 3 months prior to presentation without healing. A biopsy specimen revealed malignant melanoma arising from a congenital melanocytic nevus.
Biopsy ; Female ; Humans ; Melanoma* ; Middle Aged ; Nevus, Pigmented* ; Parturition ; Ulcer

BACKGROUND: Vitiligo is an acquired disorder with destruction of melanocytes and is clinically characterized by depigmented patches of skin. The pathogenesis of vitiligo is still unclear, but melanocyte self destruction, neurohumoral factors, autoimmunity and inherent cellular defects have all been proposed as possible etiological factors. OBJECTIVE: The purpose of this study was to find out the differences in expression of HLA antigens among subtypes of vitiligo according to classification, onset and family history and then to disclose the pathogenesis of vitiligo in view of genetic and autoimmunological aspects. METHODS: We investigated HLA-A, B, C, DR in subgroups of 87 vitiligo patients according to type, onset, and family history. Results : 1. There were no HLA antigens with significantly increased frequency in vitiligo patients compared to the control group. 2. There was a significant increase in frequency of HLA-DRl2 in patients of non-segmental vitiligo with a family history ; an increase in frequency of HLA Cw2 in patients without a family history ; and a significant increase in frequency of HLA-DRl2 in all patients of non-segmental vitiligo compared to the control group.(p(c)<0.05). 3. The frequency of HLA-B63 was significantly increased in all patients of segmental vitiligo compared to the control group(p(c)<0.05), but there were no HLA antigens with significantly increased frequency in patients of subgroups of segmental vitiligo divided by the presence or absence of a family history of vitiligo. 4. The frequency of HLA-B54 was significantly increased in all vitiligo patients with a family history(p(c)0.05) but there were no HLA antigens with significantly increased frequency in all vitiligo patients without a family history. 5. There were no HLA antigens with significantly increased frequency in vitiligo patients subgrouped by age of onset (less or over 16 years) of disease. Conclusion : From the above results, we can assume that non-segmental vitiligo may have autoimmune mechanisms in the pathogenesis, as there was a significant increase in HLA-DRl2 in patients with non-segmental vitiligo.
Age of Onset ; Autoimmunity ; Classification ; HLA Antigens* ; HLA-A Antigens ; Humans ; Melanocytes ; Skin ; Vitiligo*

Balloon pulnounary valvuloplasty is an established method in the treatment of congenital valvular pulmonary stenosis. Balloon valvuloplasty was performed by using one or two balloons in a total of 19 mongrel dogs. Cross sectional area ratio ranging 145-406% was used to compare the relative sizes of the pulmonary annulus the balloon Hemodynamic changes and cardiac damages in single and double balloon groups were analyzed. Survival time of double balloon group was longer than that of single balloon group(P<0.05). Increment of the right ven?dular systolic pressure in single balloon group (mean 38 mmHg) was greater than that in double balloon group (mean 18 mmHg) (p<0.05). Decrement of the femoral arterial pressure in single balloon group (mean 87 mmHg) was greater than in double balloon group (mean 41 mmHg) (p<0.05). The locations of trauma were mainly the right ventricular free wall, the main pulmonary artery, the anterior leaflet of the pulmonary valve and in a less degree, anterior wall of the right atrium, the right ventricular outflow tract and the left pulmonary artery in the order of frequency. There were no significant differences in cardiac damages between single and double balloon groups (P>0.05). Major microscopic findings were sloughing of the endotheliu, fibrin deposition, hemorrhage, localized myocardial infarction and so on. In conclusion, double balloon pulmonary valvuloplasty is superior to single balloon technique in survival time and hemodynamics. Therefore, double, balloon technique is recommended for the pulmonary valvuloplasty.
Animals ; Arterial Pressure ; Balloon Valvuloplasty ; Blood Pressure ; Catheters* ; Dogs ; Fibrin ; Heart Atria ; Hemodynamics ; Hemorrhage ; Methods ; Myocardial Infarction ; Pulmonary Artery ; Pulmonary Valve ; Pulmonary Valve Stenosis

Balloon pulnounary valvuloplasty is an established method in the treatment of congenital valvular pulmonary stenosis. Balloon valvuloplasty was performed by using one or two balloons in a total of 19 mongrel dogs. Cross sectional area ratio ranging 145-406% was used to compare the relative sizes of the pulmonary annulus the balloon Hemodynamic changes and cardiac damages in single and double balloon groups were analyzed. Survival time of double balloon group was longer than that of single balloon group(P<0.05). Increment of the right ven?dular systolic pressure in single balloon group (mean 38 mmHg) was greater than that in double balloon group (mean 18 mmHg) (p<0.05). Decrement of the femoral arterial pressure in single balloon group (mean 87 mmHg) was greater than in double balloon group (mean 41 mmHg) (p<0.05). The locations of trauma were mainly the right ventricular free wall, the main pulmonary artery, the anterior leaflet of the pulmonary valve and in a less degree, anterior wall of the right atrium, the right ventricular outflow tract and the left pulmonary artery in the order of frequency. There were no significant differences in cardiac damages between single and double balloon groups (P>0.05). Major microscopic findings were sloughing of the endotheliu, fibrin deposition, hemorrhage, localized myocardial infarction and so on. In conclusion, double balloon pulmonary valvuloplasty is superior to single balloon technique in survival time and hemodynamics. Therefore, double, balloon technique is recommended for the pulmonary valvuloplasty.
Animals ; Arterial Pressure ; Balloon Valvuloplasty ; Blood Pressure ; Catheters* ; Dogs ; Fibrin ; Heart Atria ; Hemodynamics ; Hemorrhage ; Methods ; Myocardial Infarction ; Pulmonary Artery ; Pulmonary Valve ; Pulmonary Valve Stenosis