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

This review-article is aimed at shedding a light upon the nature of age-associated changes in the human skeletal system. When the anatomical, physiological and biochemical consequences of bone aging are considered together with the hardening, drying and the diminished repair capabilities of the elderly, it can be seen that fractures assume greater importance as a clinical problem in the geriatric population. Older people start out with a deficit of cortical bone, making them more fracture prone and once fractures occur, the necessary treatments (immobilization, use of casts, etc.) accelerate the rate of bone loss. In addition, aged individuals stand a higher risk for complications of the hospital and enforced bed rest that may ensue. The problems resulting from bone loss in the elderly may be partially alleviated by providing adequate health service support which should include consideration of the following points : 1. Age, sex and general health status ; 2. Habits and inclinations towards physical activities ; 3. Nutritional and endocrine background ; 4. Presence of any specific bone diseases, including osteoporosis, osteoarthritis, osteomalacia and ankylosis ; 5. Psychosocial adaptability and other behavioral elements.
Aged ; Aging ; Ankylosis ; Bed Rest ; Biology* ; Bone Diseases ; Health Services ; Humans* ; Motor Activity ; Osteoarthritis ; Osteomalacia ; Osteoporosis

PURPOSE: ATP (adenosine triphosphate) is a potent coronary vasodilator with a rapid onset of action and a very short half-life. Myocardial perfusion scintigraphy with intravenous ATP has not yet been sufficiently proven in the diagnosis, follow-up, and risk stratification of coronary artery disease. The purpose of this study was to evaluate the safety, feasibility and diagnostic accuracy of pharmacologic stress thallium-201 myocardial SPECT using an intravenous ATP infusion in patients with suspected coronary artery disease. MATERIALS AND METHODS: Thalliurn-201 myocardial SPECT in 319 patients with suspected coronary artery disease were performed after the infusion of ATP (0.08 mg/kg/min for 6 rnin). The adverse effects were carefully monitored. Coronary angiography was also performed within 3 weeks. RESULTS: Although 76.5% of the patients had sorne adverse effects, they were transient, mild, and well tolerated. In all patients, the ATP infusion protocol was completed and only 2 patients required aminophylline. The adverse effects were dyspnea in 63%, headache in 31%, flushing in 21%, chest pain in 14% and abdominal discomfort in 5% of the patients. The sensitivity and specificity were 80% and 90% respectively. CONCLUSION: Thallium-201 myocardial SPECT after 6 min-infusion of ATP at a rate of 0.08 mg/kg/min is safe and has a diagnostic value in detecting coronary artery disease.
Adenosine Triphosphate* ; Aminophylline ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Dyspnea ; Flushing ; Follow-Up Studies ; Half-Life ; Headache ; Humans ; Infusions, Intravenous* ; Perfusion Imaging ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

Several different methods of urinary diversion currently are available in conjunction with radical cystectomy. We reviewed our last 30 months of experience with diversion in 56 patients with bladder cancer undergoing surgery from May, 1990 through October. 1992 and focused on the decision- making process used to select the type of diversion. The results obtained were as follows. 1. Of the 56 patients. 27 patients had a diversion with an external appliance (26 via an ileal conduit and 1 via a cutaneous ureterostomy), 15 patients had a diversion with a continent urinary reservoir(Indiana pouch) and 14 patients had a diversion with an internal reservoir anastomosed to the urethra( 13 via an ileocolic neobladder and 1 via a Camey procedure). 2. The ileal conduit was evenly performed during the period. But the Indiana pouch was more performed between May 1990 and April 1991 and the ileocolic neobladder was mainly per formed since May 1991. 3. There were 50 men and 6 women. The majority of female patients (83%) underwent the Indiana pouch. The ileocolic neobladder was performed in patients who were relatively young and in good medical condition. 4. Urodynamic studies of the Indiana pouch and ileocolic neobladder performed at 6 months postoperatively showed low pressure, large capacity reservoir and high outlet (plicated ileum or urethra) resistance. All patients achieved satisfactory continence during the day. However.1 or 13 patients who underwent the ileocolic neobladder was incontinent at night. In conclusion. there are inherent advantages and disadvantages to each form of urinary diversion. Our general policy is the ileal conduit remains the most wise diversion in most patients but the alternative methods may be reasonable in certain circumstances and patients selection will be important to identify the most appropriate method of diversion for individual. Though the follow-up period is not long enough. Indiana pouch and ileocolic neobladder met the demands for ideal form of urinary diversion. With improvement in the technical aspects or the continent and internal functional reservoir, the number of patients having these reservoirs will increase.
Cystectomy* ; Female ; Follow-Up Studies ; Humans ; Ileum ; Indiana ; Male ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion* ; Urodynamics

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