A case of a clinical syndrome of selective hereditary complete IgA deficiency with partial T-lymphocyte inactivation is reported. A 14 year old boy was admitted with chjef complaint of persistent wide shallow ulcerated non-vesicular patches on the skin folds of whole body, chronic upper respiatory infections and gastointestinal upsets. General appearance showed us as if the undemourished or malabsorption status had been accompanied. The duration of illness was about 10 years under the incorrect or mistaken diagnosis and skin lesions have incompletely responded to the treatment. Peripheral T-lymphocyte determination was carried out by the method of Wybran to be tumed out active T-cell 14%, total T-cell 48%. Tuberculin test showed negative with 5 TU. Immunoglobulin values were respectively as follows: IgG 325 mg%, IgM 60 mg%, and IgA trace. And we diagnosed this case as selective IgA defiency with partial T-lymphocyte inactivation. We started the immunochemotherapy with tuberculo-protein complex, Tubercin-3 and antibictics for 2 months. After 2 months with above regimen. the skin lesions were markedly improved. T-cell count also retumed to the normal limit(active 35%, total 59%) and levels of TgG and IgM raised(IgG 617.5 mg%, IgM 75mg%), but IgA still showed trace amount, Tuberculin test tumed out positive.
Adolescent ; Dermatitis* ; Diagnosis ; Humans ; IgA Deficiency* ; Immunoglobulin A* ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Lymphocytes* ; Male ; Skin ; T-Lymphocytes ; Tuberculin Test ; Ulcer

No Abstract Available.
Alopecia* ; Telemedicine*

Tuberculosis remains high incidental disease in Korea with an estimated incidence of 2.5% in generalpopulation. Among the tuberculosis of bone, spinal tuberculosis is high incidence and curable disease, but earlytreatment demands early diagnosis. Authors reviewed clinical aspects of 376 cases, and reviewed conventional filmsof 74 cases and CT of 8 cases, confirmed histopathologically as spinal tuberculosis from Jan. 1976 to May 1985 atYonsei medical center, Yonsei University. The results were as follows: 1. The frequent site of involvement werelower thoracic and lumbar vertebra, 4th lumbar vertebra was the most common lesion site among them. 2. Theseperated lesions were 10.2% among spinal lesion. 3. The most common type and pattern of bone density wasintervertebral type and mixed pattern each other. 4. Paravertebral abscess, kyphosis and narrowing ofintervertebral disc space were discovered more than 80% in reviewed conventional films. 5. In children, there isno predilection site. 6. Spinal CT was more accurate diagnostic method than conventional study in the evaluationof following aspects: 1) extent of lesion 2) degree of spinal canal involvement 3) changes of surrounding organ.
Abscess ; Bone Density ; Child ; Early Diagnosis ; Humans ; Incidence ; Korea ; Kyphosis ; Methods ; Spinal Canal ; Spine ; Tuberculosis ; Tuberculosis, Spinal

The clinical observation was made on 174 patients with congestive heart failure among the admitted patients in Chung Ang university hospital between 1971 and July, 1978. The results were summarized as follows: 1. There were 89 females and 85 males and the incidence was the highest in the 6th decade. 2. The common causes of congestive heart failure were hypertensive heart disease 44.8%, valvular heart disease 21.3% and ischemic heart disease 9.2%. 3. The precipitating factors of congesive heart failure were found in 73.6% of cases and the major factors were arrhythmia 25.3% and infection 15.5%. 4. The important symptoms and signs were dyspnea 86.8%, hepatomegaly 53.4%, pulmonary rales 49.4%, cardiac murmur 46%, tachycardia 35.1% cough 35.1% and orthopnea 34.5%. 5. The ECG findings were abnormal in 92.1% of cases and the frequent abnormal findings were inverted or flat T wave 47.3%, atrial fibrillation 40.6% and left ventricular hypertrophy 33.3%. 6. The chest PA on admission revealed abnormalities in 159 cases, including cardiomegaly 74.6%, pulmonary congestion 66.9% and pleural effusion 26.6%. 7. The major abnormalities of laboratory data were proteinuria and the increase of globuline, BUN, TTT, alkaline phosphatase and SGOT.
Alkaline Phosphatase ; Arrhythmias, Cardiac ; Aspartate Aminotransferases ; Atrial Fibrillation ; Cardiomegaly ; Cough ; Dyspnea ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Female ; Heart Diseases ; Heart Failure* ; Heart Murmurs ; Heart Valve Diseases ; Hepatomegaly ; Humans ; Hypertrophy, Left Ventricular ; Incidence ; Male ; Myocardial Ischemia ; Pleural Effusion ; Precipitating Factors ; Proteinuria ; Respiratory Sounds ; Tachycardia ; Thorax

No abstract available.
Humans

We studied retrospectively twenty-nine operations for removal of loose bodies from the knee under arthroscopic control from August, 1982 to Mach, 1985. We succed to remove loose bodies arthroscopically in 24 knees, but failed in 5 knees. The loose bodies were not visible radiologically in 12knees, and more than one loose body was present in 10 knees. The loose bodies, above Smm in diameter among the removed, were forty three; their mean diameter was 7.5mm and the most large one was 35 mm in diameter. The loose bodies were found most commonly from intercondylar notch area and the most common associated internal derangements was meniscal injury. The mean time for return to work was 2.5weeks(range 1 to 4.5weeks). The operation required considerable arthroscopic expertise and could be technically more exacting than other artroscopic procedures. After average two years and four months follow-up(range one year and five months to three years and eleven months), pain on knee joint was remained in five patients who had taken other associated derangement in same knee, but the patients who had loose bodies in knee joint as only problems were cured completely to normal knee joint function.
Arthroscopy ; Humans ; Knee Joint ; Knee ; Retrospective Studies ; Return to Work

The author reviewed eighteen congenitally dislocated hips in Kyung Hee University Hospital during the three and a half year period (rom September, 1973 to March, 1977. The following observations were made. 1. The average age of the patients at the first visit was 17.9 months. 2. All 16 patients were female. 3. There were 2 bilateral dislocations and 14 unilateral dislocations. 4. Left side was dislocated in 12 hips snd right side in 6 hips. 5. Limping was the chief complaint in 12(75%) of the patients. 6. Arthrogram gave valuable information as to make correct diagnosis and treatment. 7. Twelve hips were successfully treated by closed methods and 6 hips required operative treatment. 8. Following reduction, cast immobilization was continued for an average of 5 months in the conservative series. 9. In the conservative series, the acetabular index decreased from 33.4 degree before treatment to 28.1 degree immediately after removal of cast. 10. The results were good or excellent in all except for 2 cases of avascular necrosis and 1 case of redislocation.
Acetabulum ; Diagnosis ; Dislocations ; Female ; Hip ; Humans ; Immobilization ; Necrosis

Segmental Spinal Instrumentation(S.S.I.) is more effective means of managing unstable thoraco-lumbar spine fractures than traditional Harrington Rod Instrumentation as an operative procedure which afforded rigid internal fixation with stability and needed minimal external immobilization. Early return to normal activity and successful rehabilitation are facilitated by efficient stabilization with S.S.I. Fifty-nine patients with fractures and fracture-dislocations of thoraco-lumbar spine were treated by Harrington Rod Instrumentation (29 patients) and S.S.I. (30 patients) at this hospital from June 1979 to July 1984. We have analysed the results of these treatment and obtained following conclusions: 1. S.S.I. is more rigid internal fixation than Harrington Rod Instrumentation. a) no or minimal external immobilization b) early ambulation and rehabilitation c) lowered complications 2. There was no significant difference in correction rate, loss of correction, and neurologic recovery between Harrington Rod Instrumentation and S.S.I.
Early Ambulation ; Humans ; Immobilization ; Rehabilitation ; Spine ; Surgical Procedures, Operative

Intracranial teratomas which were first described by Maier in 1861 are uncommon. Those presenting at birth are very rare and in our knowledge no case has been reported in Korea. In November, 1988, we experience a case of congenital intracrainal teratoma which replaced almost all cerebral tissue, filled out the oral cavity, and was protruded from the mouth. A female fetus was artificially delivered by a 25-year-old primigravida at 22 weeks of gestation, because of marked hydramnios and fetal hydrocephalus which were detected by prenatal ultrasonography. Microscopically, tissues from all three germ layers, including a lot of neuroepithelim and primitive mesenchymal tissue, were shown. A brief review of the literature was done.
Female ; Humans

BACKGROUND: The present study was carried out in association with neutrophilic respiratory burst in the lung in order to clarify the pathogenesis of acute respiratory distress syndrome(ARDS) following acute severe hemorrhage. Because oxidative stress has been suggested as one of the principal factors causing tissue injury, the role of free radicals from neutrophils was assessed in acute hemorrhage-induced lung injury. METHOD: In Sprague-Dawley rats, hemorrhagic shock was induced by withdrawing blood(20 ml/kg of B.W) for 5 min and the hypotensive state was sustained for 60 min. To determine the mechanism and role of oxidative stress associated with phospholipase A2(PLA2) by neutrophils, the level of lung leakage, pulmonary myeloperoxidase(MPO), and the pulmonary PLA2 were measured. In addition, the production of free radicals was assessed in isolated neutrophils by cytochemical electron microscopy in the lung. RESULTS: In hypotensive shock-induced acute lung injury, the pulmonary MPO, the level of lung leakage and the production of free radicals were higher. The inhibition of PLA2 with mepacrine decreased the pulmonary MPO, level of lung leakage and the production of free radicals from neutrophils. CONCLUSION: A. neutrophilic respiratory burst is responsible for the oxidative stress causing acute lung injury followed by acute, severe hemorrhage. PLA2 activation is the principal cause of this oxidative stress.
Acute Lung Injury* ; Free Radicals ; Hemorrhage ; Lung ; Lung Injury ; Microscopy, Electron ; Neutrophils* ; Oxidative Stress ; Phospholipases A2* ; Phospholipases* ; Quinacrine ; Rats, Sprague-Dawley ; Respiratory Burst* ; Shock, Hemorrhagic