This is a case report of a cystic hygroma with polycystic kidney in a fetus which was suspected by ultrasonography and was confirmed by autopsy. Recently, we have experienced this case in 25-year old woman repeatedly and we report that with a brief review of relevant literature.
Adult ; Autopsy ; Female ; Fetus ; Humans ; Lymphangioma, Cystic* ; Polycystic Kidney Diseases* ; Ultrasonography

No abstract available.
Umbilical Cord*

No Abstract available.
Ankle* ; Sarcoidosis* ; Tenosynovitis*

There are 3 basic methods for surgical treatment of axillary osmidrosis; 1) method that removes only subcutaneous cellular tissue without removing skin 2) method that removes skin and subcutaneous cellular tissue en bloc, and 3) method that partially removes skin and subcutaneous cellular en bloc as well as removing the subcutaneous cellular tissue of the adjacent region. We studied the results of partial removal of the skin and subcutaneous cellular tissue en bloc, as well as the removal of subcutaneous cellular tissue of the adjacent region to compare the results of the bipedicled flap with the graft conversion method. There was no difference between two methods in results and complication rates. There are 3 advantage to this procedure. First, about 70-80% of apocrine glands were centrally distributed among the axillary hairbearing region therefore, resection of the central portion of axillary hair distribution area is important for good result. Second, the preservation of the subdermal plexus with careful excision of adjacent underlying subcutaneous tissue under the aid of the magnifying surgical loupe, is important for good wound healing. Third, the central excision of the axillary hair distribution area provides good exploration for undermining and defatting of the undersurface of the adjacent area, therefore it tooks a shorter operation time.
Apocrine Glands ; Hair ; Skin ; Subcutaneous Tissue ; Transplants ; Wound Healing

PURPOSE: There have been many accidental ingestions of strong acid or alkali in early childhood. If the patient survives the acute effects of caustic ingestion, the reparative response can result in esophageal and gastric stenosis. However there have been few endoscopic studies on caustic esophagitis in children. The aim of this study was to review the contribution of the endoscopy to the diagnosis and management of eosphageal stricture and to search for the guidline of the proper management. METHODS: We carried out the retrospective study on 15 children who admitted to Seoul National University Children's Hospital after accidental ingestion of caustic agents from the March 1990 to July 1995. They all underwent flexible gastrofiberoscopy to predict the complication of the caustic esophagitis. RESULTS: The early gastrofiberoscopy showed that the 2nd degree esophageal injury was most common and the majority of patients had diffuse, not localized esophagitis. The incidence of the late occurance of the esophageal stenosis was higher in patients who showed more severe degree of the esophageal mucosal damage on the early endoscopic examination. After the detection of esophageal stenosis on follow up esophagographic examination, 7 children were initially managed with balloon dilatation : Only 2 of them were successfully treated and 5 of them showed poor response to dilatation and finally treated with surgical correction. One child was successfully treated with surgical correction without trial of esophageal balloon dilatation. One child with mild esophageal stenosis improved clinically with supportive care only including antibiotics, steroid therapy, hyperalimentation etc. CONCLUSIONS: The early gastrofiberoscopic examination immediately after the accident is essential for predicting the late occurance of the esophageal stenosis. Esophageal stenosis could be successfully treated with esophageal balloon dilatation and/or surgical correction with caustic esophagitis in childtren.
Alkalies ; Anti-Bacterial Agents ; Child* ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Eating ; Endoscopy ; Esophageal Stenosis ; Esophagitis* ; Follow-Up Studies ; Humans ; Incidence ; Retrospective Studies ; Seoul

No abstract available.
Bandages* ; Gentian Violet* ; Gentiana* ; Methicillin-Resistant Staphylococcus aureus* ; Wounds and Injuries*

The maxillary alveolar ridge separates the palate from the lip and clefts of the primary palate have a cleft of the alveolus as well. In the most common clefts of the primary palate, the alveolar portion of the cleft is located between the lateral incisor, if present, and the canine. The cleft may also pass between the central incisor and the lateral incisor, rarer forms of clefts may pass between the central incisor or more distally on the maxillary arch. There are still considerable differences of opinion as to the optimal time for closure of alveolar defects, with or without concomitant bone grafting. But the preferred time for the operation with bone graft is between age 9 and 11 before the canine teeth have fully erupted. As an alternative to primary bone grafting, Skoog developed the periosteoplasty, or "boneless bone graft" technique, in which periosteal continuity was established between maxillary segments by the transfer of local periosteal flaps from the anterior maxillary wall. this procedure, which takes advantage of the propensity of periosteum to form bone in young children, leads to the formation of new bone within the alveolar cleft in spite of the fact that no bone graft is used.This study attempts to defin the effectiveness of early alveolar cleft repair with gingivo-vestibular-mucoperiosteal flap.The results in 6 unilateral alveolar clefts and 1 bilateral alveolar cleft, which is corrected early by gingivo-vestibular-mucoperiosteal flap, have been satisfactory alveolar arch continuity and alveolar bone formation with tooth eruption.
Alveolar Process ; Bone Transplantation ; Child ; Cuspid ; Humans ; Incisor ; Lip ; Osteogenesis ; Palate ; Periosteum ; Tooth Eruption ; Transplants

OBJECTIVE: Adult onset Still s disease is an acute systemic inflammatory disorder. There are no pathognomonic symptoms or specific laboratory abnormalities. In recent reports, serum ferritin concentration is increased in active disease phase and decreased after defervescence. Our purpose was to determine the clinical significance of serum ferritin as an indicator for disease activity. METHODS: Seven patients who were diagnosed as adult onset Still s disease at Samsung Medical Center between October 1994 and March 1997, were reviewed. In these patients we checked leukocyte count, ESR, CRP and serum ferritin concentrations at the time of diagnosis and during follow-up periods and recorded febrile events during follow-up periods. RESULTS: At the time of diagnosis and during febrile periods, the concentrations of ferritin were extremely high(927ng/ml to 96,650ng/ml normal 10-290.8 ng/ml). The values were unrelated to other manifestations of the disease or laboratory findings. The ferritin concentrations decreased rapidly after adequate treatment. Eleven febrile reattacks happened in 7 patients. Serum ferritin concentrations were increased in 8 febrile attacks, while leukocyte count, ESR, and CRP were increased in 5, 5, 6 febrile attacks respectively, There were 10 events of increased serum ferritin concentrations in 7 patients during follow-up periods and 8 events were related with fever. The increases of other laboratory tests were similar. CONCLUSIONS: In all patients, serum ferritin concentrations were increased at the time of diagnosis and closely related to fever. During follow-up periods, serum ferritin concentrations are helpful in monitoring disease activity and guiding decisions about treatment.
Adult* ; Diagnosis ; Ferritins* ; Fever ; Follow-Up Studies ; Humans ; Leukocyte Count ; Still's Disease, Adult-Onset*

BACKGROUND AND OBJECTIVES: The incidence and prevalence of hyperthyroidism has been reported to be 0.2-0.9/1000 population/year and 5-10/1000 population in foreign countries, respectively. However, there has been no nationwide survey to evaluate them in Korea. Therefore, this study was conducted to investigate the incidence and prevalence of hyperthyroidism in Korea using medicare claims data provided by the Health Insurance Review and Assessment Service. Preference for its therapeutic modalities and its change were also analyzed. MATERIALS AND METHODS: This study was performed in 308,584 (men 86,460, women 222,124) Korean patients with hyperthyroidism treated from January 2006 to June 2012. Patients with past history of hyperthyroidism were not included. RESULTS: The incidence of hyperthyroidism was 0.72/1000 population/year (men 0.40, women 1.03), and its prevalence was 3.40/1000 population (men 2.09, women 4.70) in Korea. Its peak prevalence was detected between 45 and 49 years of age. Among 177,487 patients with hyperthyroidism treated from 2007 to 2011, anti-thyroid drugs were prescribed in 97.9%, and radioiodine therapy and surgery were finally performed in 8.2% and 0.9%, respectively. The prescription of propylthiouracil (PTU) has been reduced from 63.3% in 2007 to 42.9% in 2011, but the use of methimazole (MMI) increased from 33.9% in 2007 to 54.8% in 2011. Primary physicians preferred PTU to MMI, but physicians in general hospitals preferred MMI to PTU. CONCLUSION: This is the first nationwide report to investigate the incidence and prevalence of hyperthyroidism in Korea.
Female ; Hospitals, General ; Humans ; Hyperthyroidism ; Incidence ; Insurance, Health ; Korea ; Medicare ; Methimazole ; Prescriptions ; Prevalence ; Propylthiouracil

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is hardly controllable organism among the pathogen of nosocomial infection, because it is resistant to most antibiotics except vancomycin and local treatment with most antiseptics are not effective to eradicate MRSA from the infected wounds. There is increasing fear that MRSA infection can be spread widely in the hospitals. The effectiveness of Gentian Violet against MRSA was reported by Saji et al in 1992 for the first time. We tried Gentian Violet dressing on MRSA infected wounds to evaluate whether at not the Gentian Violet is effective to eradicate 11RSA which existed in the open wound. METHODS: 24 patients were treated by wet dressing with 0.1%Gentian Violet soaked gauze twice daily. They included 10 cases of sacral and trochanteric pressure sore, 6 cases of postoperative wound infectious, 3 cases of posttraumatic skin defects, 2 cases of DM foot, 1 case of post infectious skin defect and 2 cases of electrical burn, The wound culture was evaluated for elimination of MRSA infection twice weekly. RESULTS: The clinical results revealed that MRSA was not detected in all cases within 34days (average 13.5 days) after topical administration 0.1% Gentian Violet. CONCLUSION: There is no evidence of tissue irritation with Gentian Violet dressing on open wound or wound margin. After negative conversion of MRSA with Gentian Violet dressing, gram (-) organism was isolated in a half of the cases. 0.1% Gentian Violet topical administration is a useful treatment method of wound infection with MRSA.
Administration, Topical ; Anti-Bacterial Agents ; Anti-Infective Agents, Local ; Bandages* ; Burns ; Cross Infection ; Femur ; Foot ; Gentian Violet* ; Gentiana* ; Humans ; Methicillin-Resistant Staphylococcus aureus* ; Pressure Ulcer ; Skin ; Vancomycin ; Viola ; Wound Infection* ; Wounds and Injuries*