Congenital sinuses of the upper lip are extremely rare anomaly. Only 17 cases have been reported in English literature. They were described as a pit which was the opening of a blind sinus, sometimes penetrated the orbicularis oris muscle, but had no connection with the oral cavity. The pit was reportedly located in a lateral or midline area. There are a few theories regarding the etiology of this rare anomaly, but the exact cause still remains obscure. We report a 4-year-old boy with congenital midline sinus of the upper lip. The sinus had a pit-like opening in the midline philtral area with a duct extending into 14 mm posteroinferiorly. It was excised by extraoral elliptical excision. Histopathological examination showed that duct was covered with stratified squamous epithelium.
Child, Preschool ; Epithelium ; Humans ; Lip* ; Male ; Mouth

BACKGROUND: Osteoarthritis(OA) of the knee represents a common chronic disease, especially in the elderly, leading to functional impairment and disability. And OA patients have depressive symptoms frequently. Several factors contribute to the level of depressive symptoms. Authors tried to assess these factors and show effect of these factors to depressive symptoms. Through this study in the future physicians must consider psychiatric problems besides the pain itself in the treatment of OA patients. METHODS: Subjects included in this study were 64 knee joint OA patients. We obtained depressive symptoms from the CES-D(The Korean version of the Center for Epidemiological Studies-Depression Scale), level of pain, stiffness, functional disability from KWOMAC(WOMAC Korean Version 2, The Korean version of Western Ontario and Macmaster Osteoarthritis Index Score) and other factors able to contribute to depressive symptoms. RESULT: We divided the patients into two groups using CES-D cut-off score of 21. Each group consists of 46(CES-D<21) and 18(CES-D> or =21) patients. Frequency of sleep disturbance and pain consistency and level of pain, stiffness and functional disability were different significantly between two groups(p<0.0l). Through the correlation analysis level of pain, stiffness and functional disability were associated with CES-D score significantly(p<0.0l). And through the stepwise multiple regression analysis we demonstratred that the CES-D score influenced by level of functional disability, BMI, disease duration and, pain but only level of functional disability and BML were statistically significant(p<0.0l). Level of functional disability explained 46% of CES-D score(partial R2=0.46) so influenced on depressive symptoms most effectively. CONCLUSION: This study suggested that functional disability was most important factors to explain depressive symptoms of knee joint OA patients.
Aged ; Chronic Disease ; Depression ; Humans ; Knee Joint* ; Knee* ; Ontario ; Osteoarthritis*

Arthroscopy assisted anterior cruciate ligament(ACL) reconstruction with the autogenous bone-patellar tendon-bone(BPB) graft showed more favorable results in the hand of experienced surgeon, but it requires long leaming curve for skillful techniques. On the contrary, open method is very easy to learn, but it needs more soft tissue dissection affecting rehabilitation and morbidity. Arthrotomy through the patellar tendon harvest site provide good surgical approach without supplementary incision, and hence short operation time and good clinical result can be expected. The purpose of this study is to introduce this technique and compares the results with arthroscopic one. We performed 67 cases of ACL reconstruction with autogenous BPB graft through the patellar tendon harvest site. We recorded and analysed the physical findings, Lysholm score and Cybex test at preoperative and postoperative 3, 6, 12 months. Average Lysholm score was 58.0 preoperatively and 90.5 at postoperative one year. Cybex test at one year follow-up showed decreased muscle strength of quadriceps, which was nearly the same result with arthroscopic technique. In conclusion, this technique provided similar excellent clinical results comparing with the arthroscopy assisted ones. Furthermore, this technique had merits of short learning curve and short operation time.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Arthroscopy ; Follow-Up Studies ; Hand ; Learning Curve ; Muscle Strength ; Patellar Ligament* ; Rehabilitation ; Transplants

Deep cerebral venous thrombosis is a rare condition associated with edema, infarction or hemorrhage in basal ganglia, thalamus and periventricular white matter. It presents nonspecific clinical manifestations such as altered consciousness, headache, focal neurological deficit, nausea and vomiting. Extrapyramidal signs are very rare in deep cerebral venous thrombosis. We report a patient who presented micrographia, hypophonia and bradykinesia as an early manifestation of deep cerebral venous thrombosis.
Basal Ganglia ; Consciousness ; Edema ; Headache ; Hemorrhage ; Humans ; Hypokinesia* ; Infarction ; Nausea ; Parkinsonian Disorders* ; Thalamus ; Venous Thrombosis* ; Vomiting

OBJECTIVE: To investigate dose-related effects of repeated intraarticular steroid injection on the experimental arthritis. METHOD: Twenty-four adult male rabbits received Zymosan A into their right knee joint for experimental arthritis. After a week, they were injected with 2 mg (group I; n=9), 10 mg (group II; n=7) or 20 mg (group III; n=8) triamcinolone acetonide into their right knee weekly interval for 4 weeks. We measured weekly changes of the weight and the mediolateral diameter of both knees for the calculation of edema index. 99mTechnetium pertechnate (99mTc) uptake measurement were performed before the first steroid injection and a week after the final steroid injection. All rabbits were sacrificed and histologic examinations of their proximal tibia were performed. RESULTS: A progressive weight loss and changes of edema index were evident for all rabbits (p<0.05) and difference among the groups was not found (p<0.05). 99mTc uptake significantly decreased after the steroid injection in group I (p<0.05) but it was not profound in others (p>0.05). In the histological findings, fibrillation-frayings and fissures of the surface were similar in all rabbits, but loss of nuclear stains and cyst formations were increased prominently in group III than group I (p<0.05). CONCLUSION: Low-dose repeated steroid intraarticular injections are safe and effective treatment in arthritis though no definite evidence of chondroprotection, and high-dose steroid injections accelerate degeneration of the arthritic cartilage.
Adult ; Arthritis* ; Cartilage ; Coloring Agents ; Edema ; Humans ; Injections, Intra-Articular ; Knee ; Knee Joint ; Male ; Rabbits* ; Tibia ; Triamcinolone Acetonide ; Weight Loss ; Zymosan

BACKGROUND: Systemic hypertension produces varying degree of LVH which is associated with increased cardiovascular morbidiity. Previous studies have documented regression of LVH with various antihypertensives including calcium channel blockers, except diuretics and vasodilators. Recently echocadiographic assessment of the change of left ventricular mass(LVM) after antihyertensive therapy have been reported to offer prognostic cardiovascular information. The aim of this echocardiographic study is determining the influence of nicardipine, a calcium channel blocker, on the change of LVM in patients with essential hypertenison. METHODS: Left ventricular mass(LVM) and left ventricular mass index(LVMI) were measured by M-mode echocardiography in 15 patients with essential hypertension. Nicardipine, a calcium channel blocker, was administered for 6 months and two echocardiographies were done before and after administering, respectively. RESULTS: In the 15 patients treated for 6 months, systolic and diastolic pressure remained very significantly decreased compared with pressure before before therapy(135+/-15mmHg vs 168+/-26mmHg, and 86+/-7mmHg vs 105+/-16mmHg, both p<0.01). Concomitantly both LVM and LVMI decreased significantly(209+/-49g vs 235+/-71g, and 116+/-6g/m2 vs 131+/-38g/m2,both p<0.05). And no change was noted in left ventricular cavity size, demonstration that LVM reduction was due to regression of hypertrophy. CONCLUSION: This study showed that nicardipine produced a significant decrease in blood pressure, LVM, and LVMI over the 6 months period. And large and longterm controlled studies are needed for the clarification of the association between nicardipine and regression of LVH in hypertensive patients.
Antihypertensive Agents ; Blood Pressure ; Calcium Channel Blockers ; Calcium Channels ; Diuretics ; Echocardiography ; Humans ; Hypertension ; Hypertrophy ; Nicardipine* ; Vasodilator Agents

BACKGROUND: In vitro measurement of allergen-specific IgE has become an important part of allergy diagnoses. HYTEC 288 system (Hycor Biomedical Inc., USA), which was recently introduced in Korea, is a fully automated immunoassay for quantitative measurements of allergen-specific IgE. In this study, we compared the clinical utility of this in vitro allergy test with that of ImmunoCAP assay (ImmunoDiagnostics, Sweden). METHODS: To evaluate the reproducibility of HYTEC 288 system, 50 serum samples were tested in duplicate each for Dermatophagoides pteronyssinus (d1) and D. farinae (d2) specific IgE. To assess the agreement between ImmunoCAP and HYTEC 288 assays, 56 serum samples were tested for the other 21 allergen-specific IgE. RESULTS: No significant differences within the range of quantitative analysis were observed between HYTEC 288 and ImmunoCAP assays for d1 and d2 (P=0.65 and 0.55, respectively). The agreements of HYTEC allergen-specific IgE assay with ImmunoCAP within +/-1 class grade were 80% and 100% for d1 and d2, respectively. The correlation coefficients between HYTEC 288 and ImmunoCAP results within the range of quantitative analysis were overally 0.90, regardless of allergen, for d1 and d2 specific IgE, 0.91 and 0.98, respectively. Running times for the HYTEC 288 and Phardia 100 were 5.5 and 4.6 min per test, respectively. CONCLUSIONS: Hycor HYTEC 288 showed a favorable agreement with ImmunoCAP and can be used for fully automated quantitative measurements of allergen-specific IgE in the clinical laboratory.
Automation ; Dermatophagoides pteronyssinus ; Diagnosis ; Hypersensitivity ; Immunoassay ; Immunoglobulin E* ; Korea ; Running

BACKGROUND: Mutations of the tumor suppressor gene p53 cause subsequent cellular accumulation of p53 gene product and a specific immunologic response. Detection of circulating antibodies against p53 protein has been evaluated for a tumor marker or prognostic factor for several cancers including those of the breast, stomach, ovary and lung. METHODS: Serum samples from 74 colorectal cancer patients were obtained preoperatively and anti-p53 antibody was measured by enzyme immunoassay (Anti-P53 ELISA II: PharmaCell, France). Carcinoembryonic antigen (CEA) and Carbohydrate antigen (CA) 19-9 were measured in parallel. Tissue p53 protein expression was examined by immunohistochemical staining. RESULTS: Anti-p53 antibodies were positive in the serum from 34% (25/74) of patients, but normal controls were all negative. Anti-p53 antibodies were significantly associated with p53 protein overexpression. CEA and CA19-9 were detected in 38% and 11%, respectively. There was no correlation among anti-p53 antibody, CEA and CA19-9. No differences were found between the anti-p53 antibody positive and negative groups in the following parameters: tumor site, histologic grades, Dukes stages, margin invasion, vessel invasion, lymph node and distant metastasis, and survival duration. CONCLUSIONS: The measurement of serum anti-p53 antibody is not suitable for preoperative markers of prognostic significance, but can be used as a simple serological marker for detection of p53 alteration. There should be more studies of the serum p53 antibody as a possible marker for postoperative monitoring in colorectal cancer.
Antibodies* ; Breast ; Carcinoembryonic Antigen ; Colorectal Neoplasms* ; Enzyme-Linked Immunosorbent Assay ; Female ; Genes, p53 ; Genes, Tumor Suppressor ; Humans ; Immunoenzyme Techniques ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Ovary ; Stomach

The most common endogenous cause of Cushing's syndrome is Cushing's disease. The evaluation of patients with suspected Cushing's disease and syndrome requires an understanding of the proper use and limitations of the tests commonly included in the diagnostic work-up. The best screening test for Cushing's syndrome is a 24-hour urine collection with analysis for urinary free cortisol excretion. Low-dose and high-dose dexamethasone suppression tests, corticotropin assays, a corticotropin-release hormone stimulation test and inferior petrosal sinus cathaterization may be required for a definitive diagnosis. MRI is useful in localizing the lesion but some limitations. Surgical removal of the lesion by a trans-sphenoidal appraoch is usually successful, but long-term follow-up is required. We report a case of Cushing disease which shows such typical clinical characteristics of Cushing syndrome as weight gain, skin lesions, truncal obesity, striae, hypertension.
Adrenocorticotropic Hormone ; Cushing Syndrome ; Dexamethasone ; Diagnosis ; Follow-Up Studies ; Humans ; Hydrocortisone ; Hypertension ; Magnetic Resonance Imaging ; Mass Screening ; Obesity ; Petrosal Sinus Sampling* ; Pituitary ACTH Hypersecretion* ; Skin ; Urine Specimen Collection ; Weight Gain

BACKGROUND: To avoid the risks associated with transfusion of homologous blood products, artificial colloid solutions represent an alternative for intra-operative blood loss replacement. However, synthetic colloids have been implicated as a cause of coagulopathy when administered in large quantities. We investigated the effect of Hydroxyethyl starch (HES) on blood coagulation in vitro under thromboelastography (TEG). METHODS: Whole blood was withdrawn from fifteen volunteers undergoing peripheral surgery who had no history of coagulation defect. Whole blood was diluted with HES to 25, 50 and 75 vol% concentrations, and the changes in coagulation status were analysed using TEG and were compared with those of an undiluted control specimen obtained concurrently from the same patients. RESULTS: Hemodilution with HES solution at 50 vol% concentration decreased the MA and alpha angle values (P < 0.05), but the R and K values remained unchanged. In case of profound hemodilution at a 75 vol% concentration, the values of MA and alpha angle were severely decreased (P < 0.05) and the values of R and K were severely increased (P < 0.05). CONCLUSIONS:There were many reports that moderate hemodilution with crystalloids increased coagulability, but hemodilutions up to 50 vol% concentration with HES solution did not significantly change blood coagulability. Significant hypocoagulability occurred at a 75 vol% hemodilution with HES.
Blood Coagulation ; Colloids ; Hemodilution ; Humans ; Starch* ; Thrombelastography* ; Volunteers