The incidence of rhabdomyosarcoma of the bladder is extremely rare. Two cases of rhabdomyosarcoma of the bladder were reported here with a review of literature. Case I. Five year old boy complained urinary retention & hematuria for 5 months cystogram revealed filling defect of the bladder. Pathological specimen which was taken after cystectomy showed characteristic cross-striation of rhabdomyosarcoma. Case II. Two year old boy was admitted because of complete urinary retention & hematurie. Biopsy after exploratory laparatomy revealed cross-striation which is characteristic of rhabdomyosarcoma.
Biopsy ; Child* ; Cystectomy ; Hematuria ; Humans ; Incidence ; Male ; Rhabdomyosarcoma* ; Urinary Bladder* ; Urinary Retention

We experienced a case of childhood derrnatomyositis associated with calcinosis universalis in a 3-year-old boy. The skin lesion showed generalized, hard nodules and ulcers, 0, 3-1 cm in cliameter, or the trunk and buttock. The hitopathologic findings revealed patch fat necrosis and calcium deposits in the subcutis.
Buttocks ; Calcinosis* ; Calcium ; Child, Preschool ; Dermatomyositis* ; Fat Necrosis ; Humans ; Male ; Skin ; Ulcer

In addition to general charceteristics of tibial fracture, segmental tibial fracture is commonly combined with extensive soft tissue injury, comminution and displacement with poor blood supply in its middle segment. According to recent reports, intramedullary nailing was regarded as the excellent method in the management of this kind of fracture. Twenty-one cases were treated at the department of Orthopaedic Surgery, National Medical Center from January 1980 to December 1987 and following results were obtained; 1. Most common type of fracture was Type I (38.1%). Almost all the fractures were accompanied by open wounds(85.7%) and GIIIB open wounds were 12 cases(57.1%). 2. A verage union time was 31.8 weeks(union rate, 76.2%) and showed marked difference between closed fracture(20.2 weeks) and GIIIB open one(38.6 weeks). 3. Better results were seen in 8 cases of intramedullary nailing(average union time, 24.2 weeks), while all the plating method showed non-union in 3 cases of open wound.
Fracture Fixation, Intramedullary ; Methods ; Soft Tissue Injuries ; Tibia ; Tibial Fractures ; Wounds and Injuries

Angiographic findings were analysed in 22 cases of coronary occlusive disease which were selected from 50 cases of coronary arteriographies done in Department of Radiology, Seoul National Un iversity Hospital from September, 1981 to August, 1984. There were 16 cases of single vessel disease, in which 12 were LAD involvement and 4 were RCA involvement, 2 cases of two vessel and 4 cases of three vessel disease. Site, degree and extent of stenotic involvement in those occlusive coronary diseases were anal ysed with review of literature for selective coronaryarteriography. Since coronary arteriography is the final and accurate examination for the evaluation of occlusive coronary arterial disease, it is expected to be widely used for the diagnosis of occlusive coronary arterial disease which is rapidly increasing recently in this country.
Angiography ; Coronary Disease ; Diagnosis ; Seoul ; United Nations

With improvement of anterior fixation devices, anterior instrumentation-fusion in treatment of thoracolumbar fracture becomes as effective as posterior interbody fusion which has mainly been used up to now. Also, computerized tomography enables us to diagnose the spinal fracture accurately including retropulsive bony fragment and degree of narrowing of spinal canal. We analyzed 18 cases which were treated with anterior interbody fixation in thoracolumbar fracture from Mar. 1977 to Oct. 1986 in Orthopaedic dept. of National Medical Center. The results were as follows ; 1. The mechanism of injury involved falling down in 7 cases, traffic accident 5 cases, and miner injury in 4 cases. 2. The clsssification of fracture by Denis method was compression fracture in 4 cases, bursting fracture in 11 cases, Seat-belt injury in 1 case, Fx-dislocation in 2 cases. 3. The methods of internal fixation were iliac bone graft only in 8 cases, anterior Harrington rod in 2 cases, Webb implant in 6 cases, and Zielke rod in 2 cases. 4. The average preoperative kyphotic angulation was 19.5(range 10 to 22) and immediate postoperative angulation was 10.1(range 2–16). The correction rate was 48%, and the loss of correction was 2.8(range 2–13). The final correction rate was 38.1% with implants, 29.1% without implants. 5. Early operation can get better neurologic recovery. 6. Firm and stsble fixation device is needed.
Accidental Falls ; Accidents, Traffic ; Fractures, Compression ; Methods ; Miners ; Spinal Canal ; Spinal Fractures ; Transplants

Recently, the incidence of hematogenous osteomyelitis tends to increase dse to abuse of the antibiotics and resistent organisms to antibiotics. The three main causes of complication to be chronic stage in hematogenous osteomyelitis were failure of early diagnosis, inadequate choice of antibiotics with insufficient duration and insufficient surgical intervention. Furthermore, hematogenous osteomyelitis of fibula in children has low incidence, so the possibility of chronicity is able to be increased because of delayed diagnosis and inadequate treatment. During the period of 10 yesrs extending from 1977 to 1986, we have treated 12 cases of hematogenous fibular osteomyelitis in children and clinical analysis was made about comparison with prevalent hematogenous osteomyelitis of distal femur or proximal tibia. The following results were obtained; 1. The incidence in males was 1.4 times grester than females. 2. The incidence of involved sites was 2 times dominant in Rt, and all cases were observed in proximal and distal metaphyseal area of fibula. 3. Clinical symptomes and signs were pain, local heat, redness and local tenderness in all of acute cases and 70% of chronic cases with sinus formation and pathologic Fx. 4. ESR was elevated to average 42 mm/hr in all acute cases highestly, but highest leucocytosis was observed in subacute case. 5. Definite bone changes in radiologic findings was observed in only subacute and chronic cases, and uptake of radioisotope in bone scan was observed in 2 acute cases, which were all performed. 6. Causative organism was only staphylococcus aureus, and high sensitive antibiotics to taphylococcus aureus were Cephalosprin, Cloxacillin, Amikin and observed resistance to penicillin(82.5%) and tetracycline(82.5%). 7. Early diagnosis, adequate antibiotic choice with sufficient duration and early surgical decompression and drainage were considered to be essential part of management of hematogenous fibular osteomyelitis and preventing its chronicity.
Amikacin ; Anti-Bacterial Agents ; Child ; Cloxacillin ; Decompression, Surgical ; Delayed Diagnosis ; Drainage ; Early Diagnosis ; Female ; Femur ; Fibula ; Hot Temperature ; Humans ; Incidence ; Male ; Osteomyelitis ; Staphylococcus aureus ; Tibia

BACKGROUND: The concept of myocardial injury after coronary occlusion is changing in recent years. Brief episode of ischemial induces reversible myocardial injury and repeated brief ischemic insults might cause myocardial necrosis due to cummulative damages. Recent observations showed that brief episodes of ischemia have protective effects on the myocardium increasing the myocardial tolerance to a subsequent sustained ischemic insult. This phenomenon is termed ischemic preconditioning and can be noticed after a variety of protocols in multiple species of experimental animals. This study was planned to 1) measure the changes of hemodynamic parameters and the ischemic damage of insulted myocardium during ischemic preconditioning, and 2) compare the infarct sizes with or without preconditioning. METHODS: Using canine model of a single 90 minutes' occlusion of left anterior descending coronary artery and 240 minutes' reperfusion, 14 mongrel dogs were randomized to with(n=7) or without(n=7) ischemic preconditioning such as four 5 minutes' occlusion and 5 minutes' reperfusion, Changes of hemodynamic parameters and extents of the ischemic myocardial damages during preconditioning were observed. And using in vitro myocardial staining with monastral blue and triphenyl tetrazolium chloride, we compared the infarct sizes and risk areas in two groups of occlusion and reperfusion canine model with and without preconditioning. RESULTS: 1) Heart rate was significantly decreased after first 5 minutes' occlusion compared with those of basal control(151+/-27 VS 163+/-25 BPM, p<0.05) without further changes in subsequent ischemic insults. Left ventricular systolic pressure was significantly decreased after first 5 minutes' occlusion(109.0+/-19.9 VS 130.6+/-23.3mmHg, p<0.005), and after first 5 minutes' reperfusion and second 5 minutes' occlusion compared with those of basal control(111.3+/-29.8, 109.9+/-17.2 VS 130.6+/-23.3mmHg respectively, p<0.05), without further changes during remaining ischemia. Left ventricular end diastolic pressure and maximum +dp/dt were not changed. Peak -dp/dt was decreased significantly after first and second 5 min occlusion(943.7+/-294.4, and 962.1+/-281.5) from basal control level(1168.2+/-358.8mmHg, p<0.05). Thereafter no change was noted during remaining preconditioning. The changes in rate-pressure product were same as those of left ventricular systolic pressure(first 5 minutes occlusion ; 17.3+/-3.7 VS 21.2+/-3.5, p<0.005, second 5 minutes' occlusion ; 17.9+/-5.3, 18.1+/-3.4 VS 21.2+/-3.5, p<0.05). 2)Transmyocardial lactate extraction ratio was significantly decreased in early phase of ischemic preconditioning(17.5+/-11.3 VS 25.2+/-9.9%, p<0.05). 3) Hemodynamic parameters such as heart rate, left ventricular systolic pressure, left ventricular end-diastolic pressure, maximum +dp/dt, peak -dp/dt and rate-pressure product were changed similarly in both control and precontioned groups. 4) There was no significant difference of mean myocardial blood flows in infarct zones, which represent collateral blood flow, after 5 minutes' brief occlusion and 60 minutes of sustained occlusion in preconditioned group. 5) The infarct area/risk area ratio was significantly reduced in preconditioned group(27.0+/-9.6 VS 5.6+/-3.1%, p<0.005), but the risk area/left ventricular area ratio showed no difference in the two groups. CONCLUSIONS: These findings suggest that, in the early phase of brief repeated occlusion and reperfusion, myocardial ischemic damage accompaning systolic and diastolic myocardial dysfuctions develops and myocardial protective effect of ischemic preconditioning was obtained at the same time. Ischemic preconditioning group demonstrated reduced infarct sizes compared to those of control group after 90 minutes' sustained ischemia and reperfusion in canine acute myocardial infarction model.
Animals ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Heart Rate ; Hemodynamics ; Ischemia ; Ischemic Preconditioning* ; Lactic Acid ; Myocardial Infarction ; Myocardial Reperfusion ; Myocardium ; Necrosis ; Reperfusion

A Clinical observation was made on five patients with ruptured aortic sinus of Valsalva who visited Seoul National university hospital during the period of May, 1975~Jan., 1980. 1. Age distribution was from 19 to 32 years and four patients were male and the rest one case was female. 2. Chief complaints on admission were dyspnea in 3 cases and chest pain in 2 cases. Onset of symptoms was abrupt in 4 cases. 3. Continuous murmur was heard at third and fourth intercostal space along left sternal border with thrill in all cases. 4. Cardiac catheterization and aortography showed regurgitant flow from aorta to right ventricle in all cases. 5. Operation was done successfully in 3 cases, of which aortic insufficiency was persistent in one case.
Age Distribution ; Aorta ; Aortography ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Dyspnea ; Female ; Heart Ventricles ; Humans ; Male ; Seoul ; Sinus of Valsalva*

PURPOSE: To evaluate the usefulness of real-time ultrasound-guided biopsy as an aid in diagnosing pleural attached lung lesions. MATERIALS AND METHODS: Over a 2-year period (March 1992 through February 1994), 52 US-guided diagnostic biopsies were performed in 50 patients with peripheral lung lesions in contact with chest wall. 15 cases were performed with gun biospy and 37 cases with fine needles. Final diagnosis was confirmed by surgery and clinical follow-up. RESULTS: In 44 of 52 cases(84.6%), we obtained histologic or cytologic material by US-guided biopsy. Diagnostic accuracy and tissue type specific accuracy for malignancy were 83.9%(26/31) and 67.7% (21/31), respectively. Eighteen case% were reported to be benign and one of them was proven to be metastatic lesion. We could not find any complications such as hemoptysis or pneumothorax. CONCLUSION: Ultrasound-guided biopsy is a simple, safe and accurate diagnostic procedure for evaluation of peripheral lung lesion attached to the pleura.
Biopsy* ; Diagnosis ; Follow-Up Studies ; Hemoptysis ; Humans ; Lung* ; Needles ; Pleura ; Pneumothorax ; Thoracic Wall

BACKGROUND: Follicular dendritic cells (FDCs) play key roles during T cell-dependent humoral immune responses by allowing antigen-specific B cells to survive, proliferate, and differentiate within the FDC networks of secondary follicles, i.e., germinal centers (GC). METHODS: A novel monoclonal antibody, 3C8, was generated by immunizing with an FDC line HK, in order to understand the molecular signals involved in the FDC-B cell interactions in the microenvironment of the GC. RESULTS: The 3C8 antibody did not bind to mononuclear cells, including T cells, B cells, and monocytes. Murine L929 and human skin fibroblasts exhibited no or little reactivity to 3C8. However, 3C8 specifically recognized HK cells by flowcytometry. Furthermore, the antigen recognized by 3C8 was restricted to the GC of the human tonsil. Dendritic networks of the GC were intensely stained by 3C8, but cells out side the GC were not. CONCLUSION: Our result s suggest that the antigen 3C8 may play some unique role on FDCs during the GC reactions.
B-Lymphocytes ; Cell Communication ; Dendritic Cells, Follicular* ; Fibroblasts ; Germinal Center ; Humans ; Immunity, Humoral ; Monocytes ; Palatine Tonsil ; Skin ; T-Lymphocytes