Eosinophilic granuloma of bone is the most common variant of histiocytosis X. Most of the lesions occur in the skull, ribs, spine or long bone and may be single or multiple. The occurrence in a growing epiphysis is extremely rare and only seven cases have been reported in the literature. A 13 year old boy with eosinophilic granuloma occurring in proximal humeral epiphysis was seen at Seoul National University Hospital in Nov. 1984 and was treated with curettage and autogenous bone graft followed by radiotherapy. The patient was followed for 13 months and complete healing was obtained.
Curettage ; Eosinophilic Granuloma ; Eosinophils ; Epiphyses ; Histiocytosis, Langerhans-Cell ; Humans ; Male ; Radiotherapy ; Ribs ; Seoul ; Skull ; Spine ; Transplants

This study examined the relation between anger-coping types and hypertension in employed men aged 40-60 who consented to participate during the biannual physical checkup in the department of health management in 1988. The subjects analyzed were five hundred thirteen excluding those having hypertension history and/or current antihypertensive medications. Anger-coping types were constructed from the Harburg's model with two hypothetical anger-provoking situations involving wife and boss. Hypertensives were defined more than 140mmHg systolic blood pressure and/or 90mmHg diastolic blood pressure. Hypertensives were one hundred fifty two(29.6%) and those who suppressed their anger were 61.6%0 and 62.8% in wife and boss situations respectively. Items of anger, guilt, protest, and suppressed anger in wife situation showed odds ratios of 0.78-0.94 without statistical significance. But four items in boss situation showed odds ratios more than 1, especially anger-in types of anger item had 1.58 times the prevalence of hypertension of anger-out types(95% confidence intervals(CI) 1.06~2.35) and subjects who indicated that suppressed their anger had 1.55 times the prevalence of hypertension of those who expressed their anger(95% CI l.03~2.32). For anger suppressed vs. expressed types of total suppressed anger index, prevalence of hypertension was 1.31(95% CI 0.83~2.08). After adjusting for age, body mass index, smoking and drinking, the odds ratios were slightly increased in both situations except guilt items compared with univariate analysis. These results suggest that the relation between Harburg's anger-coping model and hypertension is replicated partially in this subjects.
Anger ; Blood Pressure ; Body Mass Index ; Drinking ; Guilt ; Humans ; Hypertension* ; Male ; Odds Ratio ; Prevalence ; Smoke ; Smoking ; Spouses

BACKGROUND: Doxylamine succinate(DS) is an antihistamine commonly used as an over-the-counter medication to relieve insomnia and frequently involved in overdoses. Its overdoses are dominated by anticholinergic effect. Recently it was revealed that DS had a direct effect on muscle, while its exact mechanism is not clear yet. We evaluated the patients with rhabdomyolysis induced by DS overdose for patients disposition based upon clinical decision, especially by creatinine phosphokinase(CPK). METHODS: We reviewed retrospectively the medical records of patients admitted by DS overdose from Jan. 1998 to Oct. 1999. Seventy and nine cases of DS overdose were evaluated with respect to age and sex distribution, amount ingested, clinical symptomatology, time from ingestion to visit, pattern of CPK, amount of bicarbonate used as therapy, complication and prognosis, especially in patients complicated rhabdomyolysis. RESULTS: Rhabdomyolysis, diagnosed as more than 1,000I. U/L of CPK, has been noted in 25(31.6%) of 79 cases of DS overdose visited to our emergency department(ED). In patients diagnosed rhabdomyolysis, the number of man was 10 cases(40%) and the number aged between 20 and 40 years was 22 cases(88%). The average time from DS ingestion to ED visit was 459 minutes. The amount of DS ingested was 500-5,000mg(mean, 1,980mg). 13(52%) cases ingested less than 2,250mg of DS. The initial levels of CPK(range, 48-14900I. U/L; normal range, 26-200I. U/L) after admitting to our emergency department were normal in 15 cases(60%) of rhabdomyolysis patients. The range of peak CPK levels after ingestion was 607 to 412,500I. U/L(mean, 33,550I. U/L). Its peak time was 6 to 96 hours(mean, 28.96 hours). In 14 cases(67%) of 21 visiting within 24 hours after ingestion, peak time of CPK ranged 12 to 24 hours after ingestion. The amount of bicarbonate used as therapy of rhabdomyolysis ranged 100 to 2,740mEq(mean, 656mEq) and all patients was discharged after improvement without other complication including acute renal failure. CONCLUSIONS : Although patients ingested less than 2,250mg of DS, emergency physicians should observe them more than 24 hours after DS ingestion with CPK follow-up after gastric irrigation and charcoal administration.
Acute Kidney Injury ; Charcoal ; Creatinine ; Doxylamine* ; Eating ; Emergencies ; Emergency Service, Hospital ; Follow-Up Studies ; Gastric Lavage ; Humans ; Medical Records ; Prognosis ; Reference Values ; Retrospective Studies ; Rhabdomyolysis* ; Sex Distribution ; Sleep Initiation and Maintenance Disorders ; Succinic Acid*

The tongue is located inside the oral cavity at rest, and the structural interrelations between the tongue and the oral cavity is essentially important for normal tongue function. Macroglossia is clinically diagnosed whenever the tongue does not fit the oral cavity, thus patients complain of noisy breathing, drooling, speech and swallowing dysfunction, malocclusion, and social ridicule. Partial glossectomy for macroglossia volume has been assumed to be difficult. In this study, we attempted to measure the tongue volume with the plaster tongue model in a 7-year-old macroglossia patient. This method is reliable and simple for measuring the tongue volume in macroglossia.
Child ; Deglutition ; Glossectomy* ; Humans ; Macroglossia* ; Malocclusion ; Mouth ; Respiration ; Sialorrhea ; Tongue*

Zielke introduced new anterior instrumentation by modifying Dwyer system and called it the ventral derotation spondylodesis(VDS) system in 1976. This system is a powerful device and when the excised disc spaces are compressed with it, stable fixation can be obtained. But proper patient selection, meticulous operative technique and good post-operative care are essential to minimize serious complications. No results of this technique had been published in English-language literature until Moe reported the results of 66 cases of Zielke instrumentation in 1983. Zielke instrumentation was carried out in 12 cases of scoliosis;8 in idiopathic scoliosis and 4 in congenital scoliosis, at the Department of Orthopedic Surgery, Seoul National University Hospital, for 16 months from November 1984 to March 1986. Seven cases had been followed for more then 9 months and'following results were obtained. 1. Numbers of vertebrae involved in major curve and numbers of fused vertebrae were 6·3 respectively. 2. Average preoperative curve was 72.7 degrees and immediate postoperative curve was 17.6 degrees with 75.8% correction. There was only 1.0 degree loss of correction with an average follow-up of 14 months (9-16 months). 3. Zielke instrumentation has the advantage of shorter fusion and better correction in thoracolumbar and lumbar scoliosis.
Follow-Up Studies ; Orthopedics ; Patient Selection ; Scoliosis ; Seoul ; Spine

Since Luque introduced new posterior instrumentation by segmental sublaminar wiring for neuromuscular scoliosis in 1976, preliminary reports have been published regarding its use with Harrington rod or Luque rod for other types of scoliosis, traumatic lesions of the spine, and spondylolisthesis as well as for degenerative disorders and tumors. Its advantage includes rigid internal fixation which often obviates the requirement for postoperative immobilization and the significant correction of deformity. Disadvantages are longer operation time, increased blood loss and the risk of neurologic damage. Segmental spinal instrumentation was carried out using either Harrington rod or Luque rod in 30 cases of scoliosis; 16 in idiopathic scoliosis, 12 in paralytic scoliosis and 1 each in congenital scoliosis and neurofibromatosis, at the Department of Orthopedic Surgery, Seoul National University Hospital, for 3 years from January 1984 to December 1986, Twenty six cases had been followed for more than 1 year and following results were obtained. 1. In idiopathic scoliosis, average preoperative curve was 65.0 degrees and immediate postoperative curve was 27.9 degrees with 57.4% correction. There was 1.2 degrees loss of correction with an average follow-up of 19.5 months (14–28 months). 2. In papalytic scoliosis, average preoperative curve was 108.5 degrees and immediate postoperative curve was 55.5 degrees with 49.5% correction. There was little loss of correction with anaverage follow-up 24.5 months (13–38 months). 3. No neurological complication occurred as a result of sublaminar wiring. 4. Segmental spinal instrumentation is an effective method with an advantage of better correction, greater contouring of the spine to avoid flat back, and less external immobilization in the treatment of idiopathic or paralytic scoliosis without increased complication.
Congenital Abnormalities ; Follow-Up Studies ; Immobilization ; Methods ; Neurofibromatoses ; Orthopedics ; Scoliosis ; Seoul ; Spine ; Spondylolisthesis

No abstract available.
Diagnosis* ; Magnetic Resonance Imaging* ; Spinal Stenosis*

The Acknowledgements was published incorrectly.

A case of extrapulmonary silicosis involving abdominal lymph nodes in a 62-year-old man is presented. The patient underwent subtotal gastrectomy and regional lymph nodes dissection for gastric adenocarcinoma of clinical stage III. On gross examination, two separate gastric adenocarcinomas and multiple enlarged lymph nodes mimicking metastatic lesion were noted. Microscopic examination of the enlaged lymph nodes revealed characteristic sclerohyaline silicotic nodules without metastatic adenocarcinoma. Chest roentgenogram showed diffusely scattered multiple tiny nodular lesions in the entire lung fields, particularly the posterior side of both upper lung fields. He had worked in a mine for 18 years and had been exposed to silica for 5 of those years. We report incidentally found, unusual case of extrapulmonary silicosis.
Adenocarcinoma ; Gastrectomy ; Humans ; Lung ; Lymph Nodes ; Middle Aged ; Silicon Dioxide ; Silicosis* ; Thorax

No abstract available.
Pemphigus