The authors investigated the radioallergosorbent test (RAST) for the specific IgE and the prick test with hose dust mite in 129 patients with atopic dermatitis(AD) wit4 four or more family numbers. RAST and prick test results were described according to family background of respiratory atopy(RA) and severity of AD. The results are summarized as follows : l. A comparison between the prick test results and RAST reactions gave a concordance of 88%. The prick test was more sensitive than the RAST. 2. The level of specific IgE in patients with personal history(PH) or family history(FH) of RA was significantly increased compared to those in patients with only AD. 3. In patients without PH and FH of RA, the level of specific IgE in patients with FH of AD was significantly increased compared to those in patients without FH of AD. 4. The level of specific IgE did not reflect the severity of AD. From the above results, it could be concluded that type I allergy to house dust mite is not directly related to AD and it occurs predominantly in those patients with AD wha have a predisposition to RA.
Dermatitis, Atopic* ; Dust* ; Humans ; Hydrogen-Ion Concentration ; Hypersensitivity* ; Immunoglobulin E ; Mites ; Pyroglyphidae* ; Radioallergosorbent Test

No abstract available.
Peritoneal Lavage*

Rectovagianl fistula(RVF) is a congenital or acquired communication between the two epithelial-lined surface of the rectum and the vagina. We present our experience with 62 patients with RVF. There were various etiologies and repair methods of rectovaginal fistula. The purpose of this study was to retospectively review the clinical course of the patients we treated and to evaluate the efficacy of various treatment options. The mean age was 40.5 yr, The type of RVF was classified to one of two(simple and complex), according to their location, size and etiology. RVF was developed most commonly after radiotherapy due to cervical cancer(n=17), then after pelvic surgery due to malignancy(n=16), obstetric trauma after episiotomy at delivery(n=7), congenital malformation(n=4), inflammatory bowel disease(n=1), Bechet's disease(n=1), infections such as perianal fistula or abscess(n=2), direct invasion of carcinoma(n=3), after chemotherapy(n=1), and idiopathic(n=6). Three cases of them associated with rectovesicovaginal fistula. Surgical therapeutic option was divided to local repair, abdominal approach and tissue transposition by the type of RVF. Most simple RVFs were repaired with local approach through the vagina or rectum. Most complex RVFs were repaired through abdominal approach or tissue transposition. With an average follow up of 20 months, the treatment results were as follows: completely healed(n=36, 58.1%), persistent symptom(n=6, 9.7%), recurrence after repair(n=5, 8.1%), loss of search or death(n=15, 24.1%). Therefore we assist that the management of RVF depends on size, location, and cause. anal sphincter function and overall health status of the patient. Careful preoperative assessment of the fistula, surrounding tissues, and anal sphincter and exclusion of associated disease are essential. With through evaluation, thoughtful consideration of treatment options, and meticulous operative technique, patient can be assured of an optimal outcome.
Anal Canal ; Episiotomy ; Female ; Fistula ; Follow-Up Studies ; Humans ; Radiotherapy ; Rectovaginal Fistula* ; Rectum ; Recurrence ; Vagina

PURPOSE: Because cryptorchid testes are known to undergo histopathologic changes affecting development, maturation, and tertility, early surgical correction is usually recommended. However there are differing opinions concerning whether retractile testes are affected by similar changes and also whether there is a need for surgical treatment. We aimed to assess the histopathologic changes in retractile testis by studying the changes in testes artificially placed back in the abdomen after they have descended to scrotum in experimental rat models. MATERIALS AND METHODS: Male Sprague-Dawley rats were divided into 3 groups; a control group(controls), prepubertal ascent group (P) in which testis were placed back intraabdominally by bilateral inguinal canal obstruction at 6 weeks, a neonatal group(N) in which intraabdminal testis was induced by bilateral inguinal canal obstruction at birth. The relative weight of the testis, morphology of the seminiferous tubules including Leydig cells, tubular degeneration phase(TDP), spermatogonia per tubules(S/T), and Sertoli cell index (SCI) of these three groups were analyzed and compared. RESULTS: The relative weight of testis was significantly decreased in the group of N(0.0016+/-0.001) and P(0.0015+/-0.0002) compared to controls(0.0037+/-0.0002) (p<0.05). The S/T value was also decreased in P(2.05+/-18.2) and N(73.2+/-32.4) when compared to controls (360.2+/-21.3). Similar changes were observed in SCI of both P(64.5+/-6.4) and N (91.2+/-14.2) when compared to controls (227.9+/-31.1). Only minority of N and P showed higher TDP values. However, although statistically insignificant, TDP was increased in both P and N when compared to controls. The Leydig cells in N and P showed cellular distortion and hypertrophy. CONCLUSIONS: This study demonstrate that prepubertal ascent, similar to that of innate cryptorchid testis, also can induce histopathologic changes such as changes in testicular seminiferous tubule, decrease in the S/T value and decrease in SCI value. Our findings supports that hypothesis that retractile testis may cause histological damage thus surgical correction may also be warranted similar to in case of genuine cryptorchism.
Abdomen* ; Animals ; Cryptorchidism ; Humans ; Hypertrophy ; Inguinal Canal ; Leydig Cells ; Male ; Models, Animal ; Models, Theoretical ; Parturition ; Rats* ; Rats, Sprague-Dawley ; Scrotum ; Seminiferous Tubules ; Spermatogonia ; Testis*

There have long been a lot of controversies on the treatment of unstable thoracolumbar spine fracture, and the role of decompression is also controversial. Compression of the neural elements by retropulsed bone fragments can be relieved indirectly by the reduction with posterior instrumentation or directly by the exploration of the spinal canal through a posterolateral or anterior approach. There is no universal agreement about the indications for each of these method. Authors analyzed the result of 24 cases of thoracolumbar spine fracture which had been operated by anterior decompression and Kaneda instrumentation from the February 1990 to May 1993 at Inha general hospital. The results were as follows: 1. The most common cause of injury was falling from a height, 20 cases (83.3%). And the 12 cases were in the 4th decade, with an average age of 37.7 years. 2. According to McAfee classification, there were 7 stable(29.2%) and 15 unstable bursting fractures(62.5%). And the most common level of injury was L1(11 cases, 45.8%). 3. Neurologic status was improved one or more grade(Frankel grade) in 21 cases except one case of complete paraplegia. 4. The average correctional angle of kyphotic deformity was 13.1° immediate postoperatively, and the loss of correction(average, 6.7°) was observed during the follow-up period. 5. The segmental instability was found at the level below the fusion in three cases during the follow-up period. 6. There was neither failure of instrument, dislodgement of graft bone nor lateral wedging during the follow-up period.
Accidental Falls ; Classification ; Congenital Abnormalities ; Decompression ; Follow-Up Studies ; Hospitals, General ; Methods ; Paraplegia ; Spinal Canal ; Spine ; Transplants

The spinal fusion is used for correcting malformations, stabilizing unstable segments, and suppressing the progression of disease, but it causes more load on the adjacent segment and as a result, the degenerative changes accelerate. Furthermore, the accelerated changes case spinal stenosis, degradation of nucleus pulposus, degenerative spondylolisthesis, acquired isthmus defect, and arthritis of articular facet, it rarely needs surgical treatment. The purpose of this study is to know the effect of the fusion level and range on the adjacent segment, to be a standard for determining the fusion range prior to operation, and to help to find the complication like degenerative changes by measuring the range of motion on the adjacent segment after the spinal fusion. Authors analyzed the result of 29 cases of posterolateral lumbar spinal fusion which were operated from February 1989 and January 1994. The intervertebral angle was measured on the flexion and extension lateral radiographs, and the calculated angular motion and sagittal plane rotation at follow-up periods were compared with those of preoperative values. The results were as follows; 1. Among the adjacent segm0ent, the increment of angular motion of superior adjacent segment was 2.6°(-5°~15°) which was higher than that of inferior one with 1.5°(-3°~7°) 2. The increment of angular motion of superior adjacent segment for 1 segment rather than 2 or 3 segments was more than two times with 3.9°(-2°~15°) 3. Regardless of level and range of fusion, the increment of angular motion was 3.0°(-2°~8°) on 4.5th lumbar segment which was increased mostly and 1.5°(-3°~7°) on 5th lumbar and 1st sacral segment which was increased leastly. 4. There were 3 cases showed instability at the superior adjacent segment and no cases showed instability at the inferior adjacent segment among all the cases showing stability prior to operations. In conclusion, the sagittal plane rotation was increased in adjacent segment after posterolateral spine fusion. So, we would recommend that the adjacent segment is very important to the decision of fusion extent and level.
Arthritis ; Follow-Up Studies ; Range of Motion, Articular ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

Allografts or autografts of bone-tendon unit have been used for ligament injuries or deficiencies after limb salvage operation for malignant bone tumors around joints. While the remodeling process of the ligament or tendon of the allograftor autograft and the microscopic and biomechanical changes of tendon-bone graft interface have been widely investigated, little is known about the ultrastructural and biochemical changes of the transitionall zone in tendon-bone junction. This study was performed to analyzed the ultrastructural and biochemical changes of the transitional zone after tendon-bone auto-and allo-grafting. A total of twenty four rabbits were divided into two group. In 12 animals(allograft group), two Achilles ten-don-bone unit per each animal were taken and transplanted to another rabbit after preservation below -70degrees C for 2 weeks. In the other 12 animals(autograft group), the Achilles tendon-bone unit was harvested from one side and transplanted to the other side of the rabbit. After operation, their legs were immobilized with short leg cast for 4 weeks, and then mobilized freely. Four animals in each group were sacrificed at four, eight and sixteen-weeks after the transplantation, and their grafted Achilles tendon-bone interfaces were used for analysis of the ultrasturctural and biochemical changes. The following results were obtained. 1. Histologically new cartilage cells were observed at postoperative 16 weeks with local presence of faint tidemark in the autograft group but not in the allograft group. Complete remodeling of the transitional zone had not observed histologically in both groups. 2. Ultrasturctural analysis revealed no definite differences between both groups. However, the slightly rapid appearance of parallelism and cross-striation of microfibrils in the autograft group and time-related restoration of fibers and fibroblasts were observed. 3. From biochemical analysis, type I collagen concentratin was increased, and an early rapid increase of type III collagen and glycosaminoglycan were also observed. In conclusion, these data suggested that type III collagen and glycosaminoglycan are important in stabilization of grafted tendon-bone unit, especially in the transitional zone. The histological and biochemical changes in allograft group were relatively similar to that of autograft group although the allograft group showed the delayed pattern of remodeling. Therefore, the tendon- allograft could be used as a good substitute for the autograft for tendon or ligament reconstruction when no suitable autograft is available.
Allografts ; Animals ; Autografts ; Cartilage ; Collagen Type I ; Collagen Type III ; Fibroblasts ; Joints ; Leg ; Ligaments ; Limb Salvage ; Microfibrils ; Rabbits* ; Tendons ; Transplants*

No abstract available.

The Mayer-Rokitansky-K ster-Hauser syndrome represents a spectrum of m llerian anomalies, including vaginal agenesis with or without renal anomalies, in genotypically and phenotypically normal female subjects with normal endocrine status. We experienced a case of this anomaly which combined with unilateral renal agenesis and pelvic cystic mass in child.
Child* ; Female ; Humans

No abstract available.
Sensation* ; Zygote Intrafallopian Transfer*