No abstract available.
Humans

PURPOSE: The crushing injury is one of the most severe type injuries in the finger. For the reconstruction of fingers with crushed and devitalized tissue, various surgical methods have been attempted to cover the soft tissue defects. We performed free flaps for finger reconstruction and investigated the results. MATERIALS AND METHODS: Between March 2010 and July 2011, we retrospectively reviewed 14 patients who had soft tissue defects of fingers after severe crushing injuries. There were 8 pulp losses, 4 dorsal skin losses with bony exposure, 1 nail complex loss, and 1 total loss of distal phalanx. In all cases, soft tissue defects in fingers were reconstructed with a free flap. RESULTS: All flaps survived successfully. We could reserve the functional length without additional necrosis and amputation. Reconstructed fingers were returned to normal activity in a short time and the atrophy or deformity was not observed. CONCLUSION: Free flap transfer for the reconstruction of the finger defect after crushing injury is useful for the functional recovery and cosmesis.
Amputation ; Atrophy ; Congenital Abnormalities ; Fingers ; Free Tissue Flaps ; Humans ; Nails ; Necrosis ; Retrospective Studies ; Skin

PURPOSE: The purpose of this study was to research whether measurement of cow's milk specific IgE on the newborn would be helpful in the diagnosis of cow's milk allergy. We tried to find out the relation between cow's milk specific IgE and other allergy diseases by following up cases. METHODS: We reviewed clinical features of 87 episodes in infants less than 4 weeks old who were positive in cow's milk specific IgE test. For the study group, history taking, physical examinations, elimination and cow's milk specific IgE tests were carried out. We investigated the connection among cow' milk specific IgE, allergic disease and family history in 40 of 87 patients we could follow up on. RESULTS: The mean age of the study group was 17.2+/-5.4 days. The subjects were classified in four groups according into allergens : 87 milk allergy positive patients, 24 casein positive, 38 alpha-lactoalbumin positive, and 75 beta-lactoglobulin positive. The number of patients who had follow-ups for more than 6 months to was 40(45.9 percent). The patients whose parents had allergic disease numberred 10(25 percent). Fiften patients had allergic diseases, 4 had asthma and 11 atopic dermatitis. According to the follow-up study, there is a significant relation between casein positive patients and allergic disease. But there is no statistical and significant relation between cow's milk specific IgE and a family history of allergic disease. CONCLUSION: For the newborn babies, elimination tests and cow's milk specific IgE tests can be useful in the diagnosis of IgE-mediated or mixed milk allergies.
Allergens ; Asthma ; Caseins ; Dermatitis, Atopic ; Diagnosis ; Follow-Up Studies ; Humans ; Hypersensitivity ; Immunoglobulin E* ; Infant ; Infant, Newborn* ; Lactoglobulins ; Milk Hypersensitivity ; Milk* ; Parents ; Physical Examination

PURPOSE: For the past two decades, there has been a significant increase in the prevalence of both asthma and obesity. Obesity may be associated with increasing childhood asthma and atopy. So, we performed this study to know the effects of body mass on bronchial hyperresponsiveness (BHR) and atopy in childhood asthma. METHODS: The subjects were, 340 children aged 6-15 years with asthma, visited the Pediatric Outpatient Clinic. There, their heights and, weights were measured and they underwent, pulmonary function tests (PFT), BHR to methacholine and skin prick tests. After determining body mass index (BMI), they were divided into four groups by BMI percentile curve based on gender and age (underweight < or =15th percentile, normal weight 15.1-85th percentile, overweight 85.1th-95th percentile, obesity > or =95.1th percentile). Atopy, allergen sensitization, BHR, respiratory symptoms, PFT were compared between each group. RESULTS: In all subjects, there were 70 (20.6%) and 73 (21.5%) cases in the overweight and obese groups, respectively. Increasing BMI was significantly associated with a higher prevalence of snoring,(P=0.004) wheezing in the perceding three months (P=0.002) and BHR- positive,(P=0.003) but not atopy.(P=0.075) Among the groups classified by BMI percentile, there were significant differences in FEV1 and FEV1/FVC.(P=0.027, P=0.033) Being overweight and/or, obese were significant risk factor for BHR, though only among females (OR 5.1; 95% CI 1.6-16.5, 4.9; 1.8-13.4) not male (OR 1.1; 95% CI 0.5-2.1, OR 1.7; 95% CI 0.7-2.0). CONCLUSION: Among girls, a higher BMI might be a risk factor for BHR. Higher BMI is not associated with atopy on either boys or girls.
Ambulatory Care Facilities ; Asthma* ; Body Mass Index ; Bronchial Hyperreactivity ; Child ; Female ; Humans ; Hypersensitivity ; Male ; Methacholine Chloride ; Obesity ; Overweight ; Prevalence ; Respiratory Function Tests ; Respiratory Sounds ; Risk Factors ; Skin ; Weights and Measures

There have been reports in Korea of imported malaria cases of four Plasmodium species, but there has been no report of imported Plasmodium ovale malaria confirmed by molecular biological methods. We report an imported case of that was confirmed by Wright-Giemsa-stained peripheral blood smear and nested polymerase chain reaction targeting the small subunit ribosomal RNA gene. The amplified DNA was sequenced and compared with other registered P. ovale isolates. The isolate in this study was a member of the classic type group. The patient was a 44-yr-old male who had worked as a woodcutter in Cote d'Ivoire in tropical West Africa. He was treated with hydroxychloroquine and primaquine and discharged following improvement. In conclusion, P. ovale should be considered as an etiology in the imported malaria in Korea, because the number of travelers to P. ovale endemic regions has recently increased.
Sequence Analysis, DNA ; Polymerase Chain Reaction ; Plasmodium ovale/*genetics ; Male ; Malaria/*diagnosis/etiology ; Humans ; Genes, rRNA ; Adult

A questionnaire on a variety of ophthalmic topics was made up and sent to 150 members of the Korean Society of Cataract and Refractive Surgery-[KSCRS] in May, 1996. Forty percent [60/150] responded within the deadline in June, 1996. As the contents of the questionnaire were almost identical to the ones prepared in the USA [1994, 1995] and in Japan [1994], the answer to the questionnaire could be compared with those gathered from the USA and Japan. Over half of the respondents [57%] were in their forties. The average number of operations done per month was 26. Cataract operation accounted for over 60% of the total operations in 34% of KSCRS members. And more than 76% of the cataract operation were done using phacoemulsification technique in 31% of the respondents. There were no difference in the preferred method of local anesthesia for the cataract surgery in Korea compare to the USA or Japan. And there was less likelihood of using peribulbar anesthesia and no suture technique in Korea compared to the USA. Sixty-one percent of the Korean ophthalmic surgeon implanted the intraocular lenses even before the patients were younger than 20 years old whereas, 82% of ophthalmic surgeon in Japan did only when the patients were older than 20 years of age. For radial keratotomy as a means of correcting myopia, 91% of the Korean respondents were not performing the procedure any more, while 45% of the American respondents abandoned it. Fifty four percent of the Korean respondents and 46% of the American respondents have been doing excimer laser photorefractive keratectomy. There was no statistical difference between the two. From the answers to the qustionnaire, we found that our results did not differ significantly from those of the USA or Japan and we believe that these results reflect the present trends of cataract and refractive surgeries in Korea.
Anesthesia ; Anesthesia, Local ; Cataract* ; Surveys and Questionnaires ; Humans ; Japan ; Keratotomy, Radial ; Korea ; Lasers, Excimer ; Lenses, Intraocular ; Myopia ; Phacoemulsification ; Photorefractive Keratectomy ; Refractive Surgical Procedures* ; Suture Techniques ; Young Adult

ERCP may provide more definite diagnosis, preoperative guidance, and endoscopic therapy in many children with known and suspected disorders of the pancreas or biliary tract. To our knowledge, there has been rare case of ERCP in children and no reported case of ERCP performed in inf~int less than 2 years old in Korea. We report a case of KRCP performed in 26 month old girl who was admitted to evaluate jaundice. We diagnosed CBD stones and choledochal cyst, Todani type III containiaig stones by ERCP. After endoscopic sphincterotomy(EST), removal of stones, and endoscopic nasobiliary drainage(END) her bilirubin level normalized about 2 months later.
Biliary Tract ; Bilirubin ; Child ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde* ; Choledochal Cyst* ; Diagnosis ; Female ; Humans ; Infant* ; Jaundice ; Korea ; Pancreas ; Sphincterotomy, Endoscopic*

A recent application of anal endosonography has been popularized in adult patients to access staging of the rectal cancer and other lesions of the anorectum; however, this study has not been familiar to pediatric surgeons. We performed anal endosonography in 30 children without anorectal disease in order to obtain standard morphology of the anorectum. Internal anal sphincter (IAS) was clearly identified as a homogeneous hypoechoic circular band, extending caudally to a level just proximal to anal verge. The external anal sphincter (EAS) showed mixed echogenicity and different architecture along anal canal ; the EAS had U-shape in the upper canal and it showed circular pattern in the lower canal. In the upper canal of girls, the perineal body and the vagina were shown just anterior of the anal canal, which made the U shape of the EAS, whereas in male the sphincter tapered anteriorly into two arcs that met in the midline. The perineal body was prominent in female. Posteriorly, the anococcygeal ligament showed triangular shadow in both sex. The thickness of the IAS was measured in 3 directions, left, right and posterior, at 3 levels, upper, middle and lower of the anal canal. The average thiskness was 0.86-2.40mm between 6 and 18 months of age (Group 1), 0.88-3.20mm between 19 and 36 (Group 2), 1.07-2.20mm between 37 and 54 (Group 3) and 1.18-2.42mm more than 54-month-old (Group 4). The thickness was correlated wtih the age of the children only in the right upper(p=0.008) and the left middle portion (p=0.015). We could obtain standard morphologic features of normal anal canal in children with anal endosonography and we also believe that this technique is a safe and an effective procedure to evaluate anorectal lesions in children.
Adult ; Anal Canal* ; Child* ; Endosonography ; Female ; Humans ; Ligaments ; Male ; Rectal Neoplasms ; Vagina

PURPOSE: Adrenal tumor is relatively rare disease. But according to the development of diagnostic tools, their incidence is rising. Therefore, new concept of surgical treatment for adrenal tumor should be established. METHODS: We analysed medical records for 41 cases of adrenal tumor patients who was performed adrenalectomy at Samsung Medical Center from Sep. 1994 to Apr. 1997. RESULTS: 39 cases were adenoma and 2 were adenocarcinoma. 24 cases were functioning tumors. Of these, 4 were Cushing's syndrome, 12 were pheochromocytoma and 8 were primary aldosteronism. Mean age for the patients was 45.6 years old. Among various diagnostic tools, abdominal CT scan was particularly helpful for diagnosis and localization. 2 cases of pheochromocytoma were MEN II. So, when we treat pheochromocytoma, a possibility of MEN II should be considered. CONCLUSION: 2 cases of 12 pheochromocytoma were proven to MEN II. So, when we treat pheochromocytoma, a possibility of MEN II should be considered. Considering improvement of surgical technique, such as laparoscopic adrenalectomy, we could consider more aggressive treatment for adrenal tumors.
Adenocarcinoma ; Adenoma ; Adrenalectomy ; Cushing Syndrome ; Diagnosis ; Humans ; Hyperaldosteronism ; Incidence ; Medical Records ; Multiple Endocrine Neoplasia Type 2a ; Pheochromocytoma ; Rare Diseases ; Tomography, X-Ray Computed

Extraction and fractionation of Pulsatilla koreana flowers followed by, repeated open column chromatography for EtOAc and n-BuOH fractions yielded four flavonoid glycosides, namely, astragalin (1), tiliroside (2), buddlenoide A (3), and apigenin-7-O-(3"-E-p-coumaroyl)-glucopyranoside (4). The chemical structures of these flavonoid glycosides were elucidated on the basis of various spectroscopic methods including electronic ionization mass spectrometry (EI-MS), 1D NMR (1H, 13C, DEPT), 2D NMR (gCOSY, gHSQC, gHMBC), and infrared (IR) spectrometry. This study represents the first report of the isolation of the flavonoid glycosides from the flowers of P. koreana.
Chromatography ; Flowers* ; Glycosides* ; Magnetic Resonance Spectroscopy ; Mass Spectrometry ; Pulsatilla* ; Spectrum Analysis