Degloving injuries of the fingers receive digital sensory nerve damage as well as digital artery damage together with degloving of the finger skin at the time of injury. Although the finger is well covered with skin and the joint motion has completely recovered after the injury, if there is no sensation in the finger tip problems remain. From October, 1982 to December, 1985 Dong San Medical Center, Keimyung University did free digital sensory nerve grafts on 11 cases using the sural nerve. Follow up studies which lasted from 10 to 39 months showed good results. Therefore this free digital nerve graft operation is considered to be a favourable mothod in obtaining sensation for digital degloving injuries.
Arteries ; Fingers ; Follow-Up Studies ; Joints ; Sensation ; Skin ; Sural Nerve ; Transplants

There had been total 20 patients with early onset(4 months~2 years) primary nephrotic syndrome in the Department of Pediatrics, Seoul National University Children's Hospital, during the period from March 1987 to February 1993. We analysed clinical courses, response to treatment, pathological findings and prognosis of the patients And the results were as follows; 1) The initial responders to steroid treatment were 10(50%), of whom 3 became late nonresponders. Of the 10 initial nonresponders, 8 revealed continuing nonresponsiveness. 2) Incidence of hypertension was significantly higher in the intial nonresponders than in the initial responders. 3) Renal biopsies were performed in 9 initial nonresponders and 2 late nonresponders. And the results were 6 with minimal change lesion, 4 with focal segmental glomerulosclerosis and 1 with mesangiocapillary glomerulonephritis. 4) Six continuing or late nonresponders received methylprednisolone pulse therapy or cyclophosphamide. And partial remission was induced in 4 of them. 5) The overall 3 year maintenance rate of normal renal function was 81%(100% in the initial responders and 64% in the initial nonresponders). In conclusion, the initial steroid responsiveness and prognosis were poorer in patients with early onset nephrotic syndrome than in patients with usual childhood nephrotic syndrome.
Biopsy ; Cyclophosphamide ; Glomerulonephritis, Membranoproliferative ; Glomerulosclerosis, Focal Segmental ; Humans ; Hypertension ; Incidence ; Methylprednisolone ; Nephrotic Syndrome* ; Pediatrics ; Prognosis ; Seoul

OBJECTIVE: The purpose of this study was to develop a health information web site evaluation categories with items for diabetes mellitus in order to offer verified health information, and to propose directions for development of web sites. METHODS: A preliminary evaluation categories with items was developed using domestic and foreign web site evaluation standards for health information and through a review of the literature. The evaluation categories with items was composed of 'evaluation for web site attributes' and 'evaluation for content information on diabetes mellitus'. Through expert validity tests and a feasibility test of the preliminary tool, the health information Web site evaluation tool for diabetes mellitus was finalized. RESULTS: This evaluation categories with items included 'evaluation for web site attributes' and 'evaluation for content information on diabetes mellitus'. 'Evaluation for web site attributes' included 8 categories with 28 items. The 'evaluation for content information on diabetes mellitus' included 7 categories with 40 items. 'Evaluation component for content' and 'evaluation of category content' included 4 items on 'accuracy', 6 on 'harmfulness' and 3 on 'comprehensibility'. CONCLUSION: From this study guidelines are propose for providing health information for diabetes mellitus, so that health information providers will be able to offer consumers verified good quality health information themselves.
Diabetes Mellitus*

BACKGROUND: Bupivacaine is a potent, and commonly used, long acting local anesthetic. If accidentally injected into the systemic circulation, bupivacaine can cause lethal dysrhythmias and circulatory collapse. Attempts to treat bupivacaine induced cardiac toxicity have been varied and controversial, and they have not been very successful. The aim of this study was to investigate the electrophysiologic effects of bupivacaine in Purkinje fibers. METHODS: Effects of bupivacaine on the membrane potential were studied in 12 isolated canine Purkinje fibers. Purkinje fibers from ventricle were dissected and mounted in a tissue chamber perfused with Tyrode's solution. Transmembrane potentials recorded through glass microelectrodes filled with 3M KCI in the beating or quiescent Purkinje fibers during infusions of bupivacaine at concentratons of 3*10/-7M,10/-6M, 3*10/-6M,10/-5M, and 3*10/-5M. RESULTS: Bupivacaine reduced action potential druation in a dose-dependent manner. Bupivacaine produced a decrease in intracelullar sodium ion activity in driven(1Hz) and quiescent canine Purkinje fibers. Bupivacaine-induced hyperpolarizaton of diastolic membrane potential in quiescent Purkinje fibers was dose dependent, and the hyperpolarization by bupivacaine was attenuated by depolarization induced by high potassium extracellular concentration in part. CONCLUSIONS: These results suggest that bupivacaine decreases the fast inward sodium current, and inhibits pacemaker current in canine Purkinje fibers.
Action Potentials ; Bupivacaine* ; Glass ; Membrane Potentials* ; Membranes* ; Microelectrodes ; Potassium ; Purkinje Fibers ; Shock ; Sodium ; Sodium Channels

We report two cases of extramammary Paget's disease associated with ad enocarcinoma with metascases. Histologically, Iaget cells in the epidermis and the hair follicles and adenocarcinoma in the der mis was observed in both cases. Of special interest was the demonstration of Eaget cells extending from the involved epidermis to the underlying dermis in case 2, There were metastatic lesioris of 3rd lumbar vertebra in case 1 and of the liver and lymph nodes in rase 2.
Adenocarcinoma* ; Dermis ; Epidermis ; Hair Follicle ; Liver ; Lymph Nodes ; Neoplasm Metastasis* ; Paget Disease, Extramammary* ; Spine

From January to December 1984, 191 patients with associated ventricular septal defect(VSD) were studied in the cardiac cathetherization laboratory. Among theses 191 cases, 58 cases(30.4%) of subpulmonic VSD were identified by angiocardiography. Among the 59 cases of subpulmonic VSD, 12 cases(20.6%) were complicated with aortic infficiency(AI). The relative frequency of subpulmonic VSD increased with the increase of age and the frequency of complication of AI with the subpulmonic VSD also increased with the increase of age. The amount of left to right shunt in the patients with subpulmonic VSD and AI was small and Qp/Qs ratio was less than 2.0 in all of the 12 cases. Among the 12 patients 4 cases had a pressure gradient greater than 20 mmHg across the infundibular region of the right ventricle.
Angiocardiography ; Heart Septal Defects, Ventricular* ; Heart Ventricles ; Humans

Objective : The aim of this study was to evaluate cross - reactivity between pollens in patients with strong skin reactivity to multiple pollens. METHODS: A pool of sera from 20 patients who showed strong skin responses( > or = 3+ ) to all three kinds of pollens ( tree, grass, and weed ) was used. Oak, ryegrass, mugwort, ragweed and hop Japanese pollens were chosen for the subject of study. The level and pattern of bound IgE to each pollen and cross - reactivity between pollens were investigated by ELISA and immunoblot experiments. RESULTS: In ELISA, the IgE of a pool of sera reacted to ryegrass and ragweed in 100%, to mugwort in 95%, to oak in 75%, and to hop Japanese in 65%, respectively. In inhibitory ELI - SA, more than 50% of bound IgE was mutually inhibited in oak vs ryegrass, oak vs mugwort, mugwort vs ryegrass and mugwort vs hop Japanese. In immunoblot, the IgE binding rate to major allergens of each pollen was 95% for hop Japanese, 75% for ragweed, 50% for ryegrass, 35% for mugwort, and 30% for oak, respectively. In inhibitory immunoblot, the mutually inhibited bound IgE could not be observed between major allergens of each pollen, but some minor allergens of oak pollen were mutually inhibited by ryegrass. CONCLUSION: Cross - reactivity between major allergens of oak, ryegrass, mugwort, ragweed and hop Japanese pollens was not observed at all, but some minor allergens of oak pollen cross-reacted with ryegrass and mugwort, and so did those of mugwort pollen with ryegrass and hop Japanese.
Allergens ; Ambrosia ; Artemisia ; Asian Continental Ancestry Group ; Enzyme-Linked Immunosorbent Assay ; Humans ; Humulus ; Immunoglobulin E ; Lolium ; Poaceae ; Pollen* ; Skin

BACKGROUND: IL - 5 has been recognized as a potent proeosinophilic cytokine and IL-10 has been reported as an important anti - inflammatory cytokine in allergic inflammation. But the clinical roles of these cytokines in allergic asthma are still unclear. Objectives : We studied the clinical implications of IL - 5 and IL - 10 secretions from stimulated peripheral blood mononuclear cells ( PBMC ) in Dermatophagoides farinae ( DF ) atopic asthmatics ( BA ). METHODS: Thirty - six DF sensitized BA and 9 non - atopic BA were enrolled for this study. Twenty - seven out of 36 subjects were challenged by inhalation of DF crude allergen. The isolated PBMCs were cultured for 6 days with DF antigen and the stimulatory index ( SI ) and secretions of IL - 5, IFN - y and IL - 10 from PBMC were measured. We analyzed these parameters with clinical parameters. RESULTS: SI (4.2 +/- 1.0 vs. 1.3 +/- 0.3, p<0.05) and secretions of IL - 5 ( 19.9 vs. 1.7 g/L, p< 0.001 ) and IL-10 ( 185.5 vs. 34.3 g/L, p(0.05 ) from the atopic BA were significantly higher than those of non-atopic BA, but the secretion of IFN - r was not different between the two groups ( 56.6 vs. 47.3 ug/L ). No significant difference in secretions of IL - 5, IL - 10, IFN - r and SI of PBMC was found between responder and non - responder of DF inhalation challenge test. Among responders to antigen challenge test ( n = 17 ), the production of IL - 5 correlated with the productions of IL - 10 (r = 0.773, p< 0.01 ) and methacholine PC20 ( r = 0.503, p< 0.05 ). Production of IL - 5 from the PBMC of atopic mild intermittent BA ( n = 10 ) was higher than that of atopic per'sistent BA ( n = 27 ) ( p< 0.01 ), but no difference in IL - 10, IFN - r and SI was found between the two groups. Conclusions : Allergen specific productions of IL - 5 and IL - 10 from the PBMC may be specific for atopic subjects and secretion of IL - 5 from the stimulated PBMC may contribute to the pathogenesis of atopic BA. The severity of BA may be more influenced by other factors.
Asthma ; Cytokines ; Dermatophagoides farinae ; Inflammation ; Inhalation ; Interleukin-10 ; Methacholine Chloride

No abstract available.
Carcinoma, Squamous Cell*

A series of 84 cases operated upon for herniated intervertebral disc of lumbar region was studied with respect to the diagnostic value of myelographic examination. Various clinical signs including level of tenderness, sensory impairment, motor weakness, door-bell sign and Lasegue test, were reviewed. The clinical diagnosis derived from these signs was correct in 54.8%. The plain X-ray film showed narrowing of disc space in 44 cases. As to the myelographic findings, mode and level of indentation, positive and negative findings were analyzed and comparisons were made with operative findings. Among 84 cases, 47 cases showed lateral indentation, 32 cases central and 5 cases complete block. As to the level, L4~5 disc space was dominant. As a whole, the myelographic findings accurately corresponded with the operative findings in 77.4%, 65 cases. However, diagnostic accuracy was varied according to level, i.e., in case of L4~5 disc herniation, 45 cases among 53 cases showed correct myelographic diagnosis, while only 10 cases among 17 cases showed correct myelographic diagnosis in L5~S1 disc herniation. In addition, if electomyography and discography are added as diagnostic aid, the preoperative diagnostic accuracy will be higher but those are not available in our circumstance.
Diagnosis ; Intervertebral Disc ; Lumbosacral Region ; Myelography ; X-Ray Film