The present report describes a case of VATER syndrome with situs inversus viscerum totalis in a newborn Korean male infant who died immediately after his birth. The disposition of all the organs in thoracic and abdominal cavities formed a complete mirror picture of normal disposition. In addition, the following abnormalities were also present : 1) Unsegmented bar of the 12th thoracic vertebra fused with 11th thoracic vertebra at left side and 1st lumbar vertebra at right side, 2) Imperforated anus (Type 3 of Ladd and Grorss classification), 3) Tracheoesophageal fistula with upper esophageal atresia, 4) Patent ductus arteriosus connected to the descending aorta, 5) Atrial septal defect, septum primum type, 6) Slightly enlarged ureter, 7) Translocation of cecum with appendix beneath the liver, 8) Coiled appendix, 9) Incomplete oblique fissure of the right lung.
Abdominal Cavity ; Anal Canal ; Aorta, Thoracic ; Appendix ; Cecum ; Ductus Arteriosus, Patent ; Esophageal Atresia ; Heart Septal Defects, Atrial ; Humans ; Infant* ; Infant, Newborn* ; Liver ; Lung ; Male* ; Parturition ; Situs Inversus* ; Spine ; Tracheoesophageal Fistula ; Ureter

No abstract available.
Drug Therapy* ; Neuroectodermal Tumors, Primitive*

Result of operative treatment for 120 cases in 168 casee of Herniated Disc in the Lumbar spine treated in the years, Jan. 1968 through Dec 1974. were reviewed and analyzed. 1) Of the 120 cases, 39 were found in the age of 20 to 30 years and the frequency was high in the male than female as 84 males and 36 females. 2) Sixty cases (50%) had unknown history, and 36 cases had sprain of the back and 24 cases had sliding down or trauma history. 3) Thirty eight cases (31.67%) had treated in Accupunture and 30 cases in Herb medicine. 4) Loves operation was performed in 112 cases and Loves operation with Hemi-laminectomy & H-graft in 8 cases. 5) Seventy three cases (60.83%) had hospitalization within 1 to 2 weeke, while 38 cases had 2 to 3 weeks hospitalization after operation. 6) Observation time after operation was within 1 to 3 years in 49 cases (40.83%) and 3 to 5 years in 36 cases, and 5 to 7 years in 24 cases. 7) Result of treatment was assessed according to Loves operation and 72 cases (60%) had excellent, 43 cases had good, 3 cases had fair snd 2 cases had poor result.
Female ; Hospitalization ; Humans ; Intervertebral Disc Displacement ; Love ; Male ; Spine ; Sprains and Strains

PURPOSE:There is a clear sexual dimorphism in circulating concentration of leptin in adulthood. However, we don' know when such dimorphism begins and how much pubertal development influences on it. So we examined body composition and circulating concentrations of leptin according to Tanner stage(TS). METHODS:We examined 112 children(M; 56, F; 56, Age; 8.5-17 yr) to evaluate the relationship of leptin and body composition. Body composition was determined by bioelectric impedence measurements(BIA) and by anthropometry. Leptin was measured by human specific RIA. Leptin level was analysed according to TS, body mass index(BMI), fat mass(FM), and lean body mass. RESULTS:BMI and free FM was correlated with TS in both sexes. FM was closely correlated with TS in girls but not in boys(M; r=0.08, P=0.54. F; r=0.73, P>0.001). Leptin levels increased in girls with advanced TS(r=0.355, P<0.01), but decreased in boys(r=-0.339, P<0.01). A strong exponential relationship was observed for leptin levels with BMI, FM, and percentage body fat as determined by BIA. There was significant sexual dimorphism of leptin level at TS VI/V. Because leptin level was significantly related FM, leptin level was normalized to FM(Leptin/FM). Leptin/FM of females(0.67+/-.27 ng/mL/kg) was also significantly higher then that of males(0.31+/-.15 ng/mL/kg)(P<0.001). CONCLUSION: These data suggest that plasma leptin levels increase in girls and decrease in boys after TS II as pubertal development proceeds; they show a significant gender difference, especially late puberty, even after adjustment for FM. Sexual dimorphism in leptin during puberty reflects not only differential changes in body composition but also different leptin resistance; reference ranges of leptin could be modified by TS and gender.
Adipose Tissue ; Adolescent* ; Anthropometry ; Body Composition* ; Child* ; Female ; Humans ; Leptin* ; Plasma ; Puberty ; Reference Values

PURPOSE:There is a clear sexual dimorphism in circulating concentration of leptin in adulthood. However, we don' know when such dimorphism begins and how much pubertal development influences on it. So we examined body composition and circulating concentrations of leptin according to Tanner stage(TS). METHODS:We examined 112 children(M; 56, F; 56, Age; 8.5-17 yr) to evaluate the relationship of leptin and body composition. Body composition was determined by bioelectric impedence measurements(BIA) and by anthropometry. Leptin was measured by human specific RIA. Leptin level was analysed according to TS, body mass index(BMI), fat mass(FM), and lean body mass. RESULTS:BMI and free FM was correlated with TS in both sexes. FM was closely correlated with TS in girls but not in boys(M; r=0.08, P=0.54. F; r=0.73, P>0.001). Leptin levels increased in girls with advanced TS(r=0.355, P<0.01), but decreased in boys(r=-0.339, P<0.01). A strong exponential relationship was observed for leptin levels with BMI, FM, and percentage body fat as determined by BIA. There was significant sexual dimorphism of leptin level at TS VI/V. Because leptin level was significantly related FM, leptin level was normalized to FM(Leptin/FM). Leptin/FM of females(0.67+/-.27 ng/mL/kg) was also significantly higher then that of males(0.31+/-.15 ng/mL/kg)(P<0.001). CONCLUSION: These data suggest that plasma leptin levels increase in girls and decrease in boys after TS II as pubertal development proceeds; they show a significant gender difference, especially late puberty, even after adjustment for FM. Sexual dimorphism in leptin during puberty reflects not only differential changes in body composition but also different leptin resistance; reference ranges of leptin could be modified by TS and gender.
Adipose Tissue ; Adolescent* ; Anthropometry ; Body Composition* ; Child* ; Female ; Humans ; Leptin* ; Plasma ; Puberty ; Reference Values

Porokeratosis are characterized by distinct clinical findings of a keratotic ridge that corresponds to the cornoid lamella on histology and has well defined potential for malignancy. We report a case of basal cell carcinoma(BCC) arising in linear porokeratosis in a 77-yearold man.
Carcinoma, Basal Cell* ; Porokeratosis*

The occurence of pseudarthroses associated with neurofibromatosis is a well documented phenomenon, with the majority of reported cases in the tibia but quite rare in forearm,Only ten cases in the English-literature and one case in Korean-literature of this lesion revealed appearing in the bones of the forearm till now. Of these, four in solitary pseudarthroses of the ulna(4.5.15), five in a solitary lesion of the radius(7.8.10.16.17), and only two cases was on the both bones of the forearm(9.14). We are presenting the case report of a Korean adult male with the clinical stigmata and a positive familial history of neurofibrormotosis who had congenital pseudarthroses of both the radius and ulna of the right forearm. Therefore, the present case is the third to be reported. We treated him with by production of an one-bone forearm using a dual a onlay bone graft positioned in neutral of supination and pronation. A stable, functional extremity with good union of pseudarthroses were encountered.
Adult ; Christianity ; Extremities ; Forearm ; Humans ; Inlays ; Male ; Neurofibromatoses ; Neurofibromatosis 1 ; Pronation ; Pseudarthrosis ; Radius ; Supination ; Tibia ; Transplants ; Ulna

For the measurement of the bone quantity, various methods have been used. Recently, the methods such as a microdensiometry, single photon absorptiometry, quantitative computed tomography were introduced. However, these methods are expensive modalities to be used in daily clinical practice. For the evaluation of the osteoporosis, author's observed Saville's grades, spine contral score and spine fracture on the simple spine roentgenograms of 346 patients over 40 years of age who were exsmined due to their backache at the Department of Orthopedadic Surgery, Kang Nam St. Mary's Hospital, Seoul, and following results were obtained: 1. The percentile incidence of osteoporosis with regard to age and sex : (1) The percentile incidence of osteoporosis over Saville's Grade I was 59.2%(205 of 346 persons); in males 47.4%(55 of 116 persons) and in females 65.2%(150 of 230 persons). (2) The percentile incidence of osteoporosis over Grade 1 in 5th decade was 27.2%(17.1% in males and 33.9% in females), 55.8% in 6th decade(46.6% in males, and 60.4% in females), 78.1% in 7th decade(64.7% in males, and 82.9% in females), 93.7% in 8th decade(87.5% in males and 97% in females), and 100% in both sexes of 9th decade. (3) The percentile incidence of Grade 1 osteoporosis in 5th decade was 23.9%, and in 6th decade it was 46.7%. Thus, Grade I osteoporosis was most common in these age groups. In 7th and 8th decades, Grade I osteoporosis was more common in males, while in the females ot these age groups Grade II was more common. There was no sex difference in the incidence of osteoporosis after the age of 80. Grade IV osteoporosis was found only in a woman who had hysterectomy 7 years ago, and has suffered from Parkinsonism for 3 years. (4) The overall incidence of Grade I osteoporosis was 34.6%, and Grade II was 21.3 %. The incidence of osteoporosis over Grade III was 1.7% in males, and 6.5% in females. 2. Incidence of osteoporosis assessed by Barnett's central score and its correlation with Saville's assessment: (1) The central score obtained at the 3rd lumbar spine ranged from 71.4 to 106.4. The number of cases were 16 in the score range of 70 to 80, 93 in the score range of 101 to 110, and 5 in the score range of 111 to 120. In consequence the most high incidence was in the score range of 91 to 100. (2) Grade O Oxteoporosis corresponded with the central score of 96.4 on an average (range : 86.8 to 106.4), Grade I corresponded with 91.6 (range : 85.7–103.1), Grade II corrosponded with 86.4 (range : 78.3–96.9), Grade III corresponded with 79.4 (range : 71.4–91), and Grade IV corresponeded with 75.8. (3) Barnett defined the spine is osteoporotic, when the central score is below 80. However, in this study only 16 patients(4.6%) had the score below 80. No bodies having Grade 0 and I osteoporosis had the score below 80; of those 16 patients having the score below 81, 5 were Grade II, 10 Grade III, and one Grade IV. Through this study, it is clesr that there is no correlation in these two assessing methods. The central score below 80 was found in severely porotic patients such as Grade III and IV, but was not found in most cases of Grade I and II osteoporotic patients. (4) The vertebral defromity was found only in 38 cases (10.9%), and it was found only in 18.9% of osteoporosis patients. The percentile incidence of deformity was 5.3% of Grade I, 31% of Grade II and 52.9% of Grade Ill. (5) Of these deformities, wedge-shaped one was found in 6 cases of Grade I porosis, 20 of Grade II, and 3 of Grade III. Cod-fish vertebrae (biconcave) were found in 2 of Grade II and 4 of Grade III. The flattened body was found in 1 of Grade II and 2 of Grade III. Thus, biconcave and flattened vertebrae were found only in the porotics over Grade II severity. (6) In 24 cases, one body was deformed, and in 14 cases multilevel vertebral deformities were found. In these 20 cases had deformity in the Ll, 10 cases each in T12 and L2, 7 cases in L3, 6 cases in L4, and 4 cases in Tll. In summary, the most deformities were in the dorsolumbar region. (7) Fracture was induced by trauma in the 11 cases(29%), among which 10 were wedgeshaped, and the rest was flattened. The biconcave vertebra was found not to be related with injury.
Absorptiometry, Photon ; Back Pain ; Congenital Abnormalities ; Female ; Humans ; Hysterectomy ; Incidence ; Male ; Osteoporosis ; Parkinsonian Disorders ; Seoul ; Sex Characteristics ; Spine

A full term nomal baby girl who born by C.S. due to C.P.D. had been done well until the age of 5 days when she suddenly developed vomiting & abdominal distension & became not doing well? Immediate abdominal X-ray revealed free air under the both diaphragm without gastric air bubble & air fluid level. Emergency operation was performed under the tentative diagnosis of stomach perforation & found a laceration, 6cm in length in the great curvature. She died 6 hrs after operation. We reported this case with a brief review of literature.
Diagnosis ; Diaphragm ; Emergencies ; Female ; Humans ; Infant, Newborn* ; Lacerations ; Stomach ; Vomiting

No abstract available.
Child* ; Humans ; Methemoglobinemia*