The high osteogenic potential in children can lead to the spontaneous regeneration of a significant bone loss, however, the site documented in the previous reports was limited to the diaphysis in long bones. We report an exceptional case of a spontaneous regeneration of the whole lateral malleolus, including epiphysis, physis, and metaphysic, after traumatic loss in a three-year-old boy. This case emphasizes the importance of attempts to save as much of the cartilaginous tissues and the periosteum as possible, which have a great osteogenic potential, in themanagement of open would in childrhood.
Child ; Diaphyses ; Epiphyses ; Follow-Up Studies ; Humans ; Male ; Metaphysics ; Periosteum ; Regeneration

BACKGROUND: Serologic markers are used to screen and diagnose the hepatitis B virus infection. In endemic area of hepatitis B, the coexistence of HBsAg and anti-HBs was frequently observed. This finding is unusual and difficult to interpret. In this study, we performed three molecular biologic assays-polymerase chain reaction (PCR), chemiluminescent molecular hybridization assay (CMHA), branched DNA (bDNA) nucleic acid hybridization assay- to detect HBV-DNA in the sera which showed both HBsAg and anti-HBs positivity. To define the patients` exact clinical conditions, we analysed the characteristics of the patients according to their diagnoses, other serologic markers and clinical findings. METHODS: HBsAg and anti-HBs were detected by EIA (Enzygnost, Behringwerke, Germany) from clinical specimens of Yonsei University College of Medicine Severance Hospital collected In the period between January 1996 and December 1996. Eighty three specimens from Severance Hospital and twenty two specimens from Health Care Center were randomly selected and were subjected to HBV PCR, HBV CMHA and HBV bDNA assay for the presence of HBV-DNA. RESULTS: The patients were arbitrarily divided into 4 groups on the basis of the optical density values of enzyme immunoassay results. Group I (high HBsAg and high antral-HBs) consisted of 6 cases; group II (high HBsAg and low anti-HBs) consisted of 70 cases, group III (low HBsAg and high anti-HBs) consisted of 1 case; group IV (low HBsAg and low antral-HBs) consisted of 6 cases. Among 83 cases, the positive rate was 51.8% (43 cases) using PCR method, 53.0% (44 cases) using CMHA, 60.2% (50 cases) using bDNA assay. HBeAg and anti-HBc IgM were helpful to predict the presence of HBV-DNA in the sera. CONCLUSIONS: More than half of the patients who showed both HBsAg and anti-HBs positivity were positive for HBV-DNA by molecular biologic methods. In contrast, no one whose serologic markers with only anti-HBc positivity with out HBsAg and anti-HBs positivity showed HBV-DNA positive in the sera from Health Care Center. Taken together, the management and follow-up of the patients of both HBsAg and anti-HBs positivity could be greatly aided by combined adoption of any one molecular biologic assay of HBY-DNA with other serologic markers such as HBeAg and anti-HBc IgM.
Biological Assay ; Branched DNA Signal Amplification Assay ; Delivery of Health Care ; Diagnosis ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoenzyme Techniques ; Immunoglobulin M ; Nucleic Acid Hybridization ; Polymerase Chain Reaction

Histiocytosis X patients present with a variety of clinical manifestations and outcomes. The principal difficulty in the establishment of a definite protocol for treatment is based on the poor understanding of the basic nature of this disease, the absence of reliable prognostic criteria, and the problems with nomenclature. The objectives of this study were to analysis the course of the disease and the results of treatment in patients who had Langerhans cell histiocytosis and to suggest prognostic factors and guidelines for management. We reviewed the thirty patient who had Langerhans cell histiocytosis for past ten years. These patients were followed for an average 4.8 years (range, excluding patients who died of the disease, two to eleven years). The patients were divided into tow group; eighteen patients who Langerhans cell histiocytosis localized in skeleton (group I) and twelve patients who had Langerhans cell histiocytosis disseminate in both skeleton and extra-skeleton (group II). Methods of treatment included curettage with or without bone graft, radiotherapy, or watchful observation alone in group I; chemotherapy, chemotherapy and radiotherapy, or curettage in group II. All eighteen patients in group I had a complete response to the therapy. Seventeen of these eighteen patients had not a recurrence by the time of the latest follow-up examination; one had a recurrence. Four of twelve patients in group II had a complete response to the therapy, four had a partial response, and four had no response. Eight of these twelve patients had a recurrence; four did not. Two patients in group II died of the disease. The significant prognostic factor was the extent of the disease, limited to the skeleton or not, and the age of onset was an indirect prognostic factor predictin multiple organ involvement.
Age of Onset ; Curettage ; Drug Therapy ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans ; Radiotherapy ; Recurrence ; Skeleton ; Transplants

BACKGROUND: Polyvinyl (PVC) plastic container plasticized with di-(2-ethylhexyl) phthalate (DEHP) has been used for the storage of platelet concentrates for five days in Korea. Authors evaluated a second generation platelet storage container plasticized with tri (2-ethylhexyl) phthalate (TOTM) which was recently produced by Green Cross Medical Corp.(Korea). METHODS: 30 units of platelet concentrates were stored in TOTM-PVC container at 22'C in a flatbed agitator. Samples were taken at day 1,3,5, and 7 from the containers and tested for platelet count, MPV, PDW, pH, HCO3-,LDH, lactate, hypotonic shock response and beta-thromboglobulin (beta-TG). Electron microscopic examination was also performed. RESULTS: The number and functions of platelets were well preserved during storage. pH was maintained above 6.8 and any evidence for platelet activation was minimal. CONCLUSION: The TOTM-PVC second generation platelet storage container recently produced by the Green Cross Medical Corp.(Korea) was able to preserve platelets for at least five days without significant storage lesions.
beta-Thromboglobulin ; Blood Platelets* ; Dihydroergotamine ; Hydrogen-Ion Concentration ; Korea ; Lactic Acid ; Osmotic Pressure ; Plastics ; Platelet Activation ; Platelet Count ; Polyvinyls

Well differentiated fetal adenocarcinoma of the lung is a subtype of pulmonary blastoma. In this report, CT-guided fine needle aspiration smears were performed at the right upper lobe of the lung in a 45 year-old male patient who had the smoking history of one pack per day for 25 years. The smears disclosed round, papillary, and tubular patterns of cell clusters. The individual cells had relatively uniform, small to medium sized nuclei without nucleoli, and showed vesicular or eosinophilic cytoplasm with indistinct cell border. The morules were seen in the central area of papillary clusters. They were composed of two cell types, outer single layered cuboidal cellular lining and central three-dimensional cluster of cells simulating fetal lung. These cytologic features need to be differentiated from usual pulmonary adenocarcinoma, carcinoid, and pulmonary blastoma. On histologic findings, the tumor arised in the bronchial epithelium. And the tumor cells had abundant intracytoplasmic glycogen with neuroendocrine feature on histochemical study. In addition, the multiplicity of this tumor is the unique point comparable to the previous reports.
Adenocarcinoma* ; Biopsy, Fine-Needle ; Carcinoid Tumor ; Cytoplasm ; Eosinophils ; Epithelium ; Glycogen ; Humans ; Lung* ; Male ; Middle Aged ; Pulmonary Blastoma ; Smoke ; Smoking

BACKGROUND: The knowledge about the nucleotides sequence of 9th chromosome that regulates the phenotype of ABO blood group has made the ABO genotyping possible. Since the genotyping can be done with only a small amount of DNA sample, it was primarily applied to the field of forensic medicine. When applied to the blood bank, it is useful in the resolution for ABO discrepancies between the cell and serum typing and determination of A and B subgroups. Rapid ABO genotyping using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method and its value in determination of ABO subgroups is presented. METHODS: ABO genotyping was performed in seven patients and three families, seven were the cases of ABO discrepancies in routine ABO grouping and three families were for the confirmation of the ABO group. To identify the 261th nucleotide, a 252 bp PCR amplifed fragment was amplified by PCR and digested with Kpn I. For 703th nucleotide, a 128 bp PCR amplified fragment was designed and digested with Alu I. To determine the ABO genotype, the patterns of digestion in DNA fragment were examined. RESULTS: Among the seven cases of ABO discrepancies, B3 and Ael were two cases each. Weakened B due to leukemia was the one, and the other two cases were cis-AB and Am. The three families for confirmation of the ABO group were acquired B due to infection one family, cis-AB two families. CONCLUSIONS: ABO genotyping is a rapid and reliable method that can be used in the case of ABO discrepancies and determination of ABO subgroups.
Blood Banks ; Digestion ; DNA ; Forensic Medicine ; Genotype ; Humans ; Leukemia ; Nucleotides ; Phenotype ; Polymerase Chain Reaction

No abstract available.
Humans ; Infant, Newborn* ; Rhabdomyoma*

Mucin-hypersecreting biliary neoplasm excretes excessive mucin that fills the biliary tree and results in marked dilatation of the bile ducts and obstructive jaundice. In these neoplasm, the mucin produced by the tumor rather than the tumor itself plays an important role in clinical course and radiologic patterns. The purpose of this paper is to report characteristic radiologic patterns of mucin-hypersecreting biliary neoplasms in two cases. These neoplasms were characterized by not only multilocular cystic hepatic mass or extra-hepatic bile duct mass resulting in marked biliary dilatation distal to the mass on US or CT, but also change of shape and extent of amorphous filling defects in the markedly dilated bile duct on serial cholangiograms.
Bile Ducts ; Biliary Tract ; Dilatation ; Jaundice, Obstructive ; Mucins

OBJECTIVE: Recently, there are many reports that glutamate receptors have close relationships with a pathophysiology of schizophrenia. The purpose of this study was to assess the effects of D-cycloserine, which is glycine site partial agonist in NMDA receptor on psychopathologic symptoms and cognitive functions. METHODS: This study was done for chronic schizophrenic inpatients taking typical antipsychotics for more than 4 months. Exclusion criteria were patients with over 8 points according to Simpson-Angus scale for EPS or those with over 17 points of Hamilton Depression Scale. Patients were randomized to classify into two groups; D-cycloserine group (n=13) and placebo group (n=13). Each group received D-cycloserine 100 mg or placebo separately for 8 weeks. Psychopathology was evaluated with PANSS at baseline, 2nd week, fourth week and eighth week. Cognitive function was evaluated with KWIS at baseline and eighth week. RESULTS: Total 26 patients completed this trial. The average period of morbidity was 10.39+/-3.87 years and the average doses of antipsychotic was 1228.35+/-720.30 mg based on chlorpromazine equivalent. In positive subscale, negative subscale, general psychopathology subscale, total PANSS scale and KWIS, there were no significant differences between D-cycloserine and placebo groups. However, negative subscale scores had decreased from 24.92+/-3.64 (Baseline) to 23.46+/-3.41 (week 8) (p=0.077). CONCLUSION: There were no clear changes in positive symptom, negative symptom, memory, language function, and performance intelligence when D-cycloserine 100 mg was given with antipsychotic medication. However, some patients showed clear improvement in negative symptom, especially blunted affect. Therefore, D-cycloserine combination therapy could be effective for negative symptom. In future, study that can show effectiveness in psychopathology and cognitive function according to drug dosage is needed.
Antipsychotic Agents ; Chlorpromazine ; Cognition* ; Depression ; Glycine ; Humans ; Inpatients ; Intelligence ; Memory ; N-Methylaspartate ; Psychopathology ; Receptors, Glutamate ; Schizophrenia*

A case of the comminuted fracture of the femoral shaft with osteoporosis is presented. The patient lacked sufficient bony stability and cortical bone-contact which allows union by conventional reconstruction method. Therefore, the authors performed a technique utilizing an intramedullary plate in combination with the standard lateral plate in order to obtain bony stabilization, early range of motion of the knee, and partial weight bearing ambulation and the technique is introduced.
Femur ; Fractures, Comminuted* ; Humans ; Knee ; Methods ; Osteoporosis ; Range of Motion, Articular ; Walking ; Weight-Bearing