BACKGROUND: There is a long-standing controversy whether melanocytes in vitiligo of more than 1 year duration are actually lost or still present. Resolving this matter is essential in understanding the underlying pathology and for the development of the treatment. On previous immunohistochemical and ultrastructural studies of vitiligo lesions, damage of melanocyte and keratinocyte in early lesions were reported and complete absence of melanocyte in long standing lesions were known. OBJECTIVE: This study aimed to determine the existence of the differences in pathologic changes in melanocytes according to the duration of the lesion. METHODS: We investigated the vitiliginous skin samples from 31 patients with early(less than 1 year duration) vitiligo and 30 patients with long standing(l to 5 years duration) vitiligo under the electron microscopy. RESULTS: Multiple degenerative changes in melanocytes were observed in the early and long standing lesions. In long standing lesions, degeneration of melanocytes including pyknotic, in-dented nuclei, vacuolated cytoplasms and blunted dendrites were more pronounced than early lesions. Even in long standing lesions, definite or presumptive melanocytes were observed in 16(53.3%) of 30 cases. CONCLUSION: Our results suggest that the melanocytes of vitiligo lesions were damaged and that the percentage of degenerative changes increase in accordance with the duration of the lesion. However, in long standing lesions as well as in early lesions, some residual melanocytes can be observed ultrastructurally.
Cytoplasm ; Dendrites ; Humans ; Keratinocytes ; Melanocytes ; Microscopy, Electron ; Pathology ; Skin ; Vitiligo*

The slipped capital femoral epiphysis is characterized by a growth disturbance of the capital physi. resulting in weakening of this structure and a subsequent displacement of the femoral head on the fe moral neck. It is a rare entity in Korea and only six cases have been reported so far1-5). One of ou cases was a bilateral mild acute slips in 13 yearold boy which were treated by Hagie pinning. Th other case, a 17 year-old boy, who suffered from a moderate acute on chronic slip in his left hip an showed a typical Pistol grip deformity. He was treated by gentle closed rcduction and Knowles pi fixation with good result.
Congenital Abnormalities ; Epiphyses ; Hand Strength ; Head ; Hip ; Humans ; Korea ; Male ; Neck ; Slipped Capital Femoral Epiphyses

When the multiple myelographic defects at lumbosacral region are noted, the prudential effort for decision of appropriate area of surgical decompression would be needed. Fifty four patients who had been treated surgically for the deseases, such as HNP and spinal stenosis, from March in 1982 to Feb. In 1987 at Department of Orthopecdic Surgery, Soonchunhyang University Hospital, were analyzed in order to define the etiology, the level of the defect, indication for the operation and to assess the results of each level which had been operated. The results of the study were as follows. 1. The number of patients, which the multiple indentations were noted in the myelogrsphy, was 54 cases, 29 spinal stenosis, 15 HNP and 10 mixed types. 2. The most common defect levels in myelography were L3-4 snd L4-5, which were 19 cases (35.2%), the next levels were L4-5 and L5S1, which were 16 cases(29.6%), then L3-4, L4-5 and L5S1 were 7 cases(13%) and the other levels were 12 cases(22.2%). 3. The decision for the sppropriste operation area had not be done following to the size of the myelographic defect, but the clinical symptoms and physicsl exsminations. 4. The results were classified ss excellent or good in 79.7%, which was 80% at two levels snd 79.5% at one level. 5. The operation levels could be decressed for the reducing the spinal instability, operation time and possibility of the dangerous conditions and promotion of early restoration and, ambulation, if the severe differences between the results of one and two operation levels were not seen.
Decompression, Surgical ; Humans ; Lumbosacral Region ; Myelography ; Spinal Stenosis ; Walking

Gelastic Seizure(Ictal laughter) is frequently associated with hypothalamic hamartoma that is congenital tumor composed of heterotrophic and hyperplastic tissue located in the hypothalamus near the interpeduncular cistern, tuber cinereum, and mamillary body. The seizure usually begins in infancy or childhood and may be accompanied with precocious puberty and cognitive decline. A 14 year-old boy visited to our hospital because of paroxysmal frequent involuntary laughing regardless of emotional change. Brain MRI showed nonenhancing hypothalamic mass that had isointensity with gray matter on T1W1 and hyperintensity on T2Wl. So it was suspected that he had a gelastic seizure accompanied with hypothalamic hamartoma.
Adolescent ; Brain ; Hamartoma* ; Humans ; Hypothalamus ; Magnetic Resonance Imaging ; Male ; Mamillary Bodies ; Puberty, Precocious ; Seizures* ; Tuber Cinereum

No abstract available.
Glomerular Basement Membrane*

Renal abscess is rare in children and presents varying features which often lead to delay or error in diagnosis. Fever, lumbar pain, abdominal pain and occasional flank rnass are the usual presenting cornplaints but a high degree of suspicion is important for the early detection of renal abscess. Hematogenous seeding of the kidney or ascending infection from the urinary collecting system are two proposed mechanisms of renal abscess formation. Renal ultrasonography facilitates an earlier diagnosis and is also useful in establishing percutaneous drainage, which appears to be the treatment method of choice. We experienced a case of renal abscess which was treated by percutaneous aspiration and antibiotics without surgical intervention.
Abdominal Pain ; Abscess* ; Anti-Bacterial Agents ; Child* ; Diagnosis ; Drainage ; Fever ; Humans ; Kidney ; Ultrasonography

Descriptions of symptomatic focal dystonia caused by focal lesions of the central nervous system (CNS) are rare in the literature. We report a 9-year-old child who experienced sudden-onset left-hand dystonia for 6 months. Brain magnetic resonance imaging showed a mass lesion involving the putamen, globus pallidus, head of caudate, and the anterior limb of the internal capsule. Histopathological and immunocytochemical examinations of the mass revealed features characteristic of malignant germinoma. CNS germinoma in the basal ganglia is very rare. Combining previous reports in the literature with the anatomical and clinical presentation of our case suggests that this phenomenon results from disruption of the pathways within and adjacent to the basal ganglia.
Basal Ganglia* ; Brain ; Central Nervous System ; Child ; Dystonia* ; Dystonic Disorders ; Extremities ; Germinoma* ; Globus Pallidus ; Hand* ; Head ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Putamen

Descriptions of symptomatic focal dystonia caused by focal lesions of the central nervous system (CNS) are rare in the literature. We report a 9-year-old child who experienced sudden-onset left-hand dystonia for 6 months. Brain magnetic resonance imaging showed a mass lesion involving the putamen, globus pallidus, head of caudate, and the anterior limb of the internal capsule. Histopathological and immunocytochemical examinations of the mass revealed features characteristic of malignant germinoma. CNS germinoma in the basal ganglia is very rare. Combining previous reports in the literature with the anatomical and clinical presentation of our case suggests that this phenomenon results from disruption of the pathways within and adjacent to the basal ganglia.
Basal Ganglia* ; Brain ; Central Nervous System ; Child ; Dystonia* ; Dystonic Disorders ; Extremities ; Germinoma* ; Globus Pallidus ; Hand* ; Head ; Humans ; Internal Capsule ; Magnetic Resonance Imaging ; Putamen

47,XYY males are found in approximately 1 per 1,000 men. There is no significant difference in intelligence compared with a normal karyotype group. 47,XYY males are fertile and are considered to be relatively tall in stature owing to the increased growth velocity during the earliest childhood. It has been known that 47,XYY males are usually quite normally developed at birth with normal birth weight and length without any physical abnormalities. We have experienced a case of 47,XYY male with increased nuchal fold thickness, choroid plexus cyst and limb anomaly and we report the case with brief review of the literature. A 31-year-old woman, who had terminated her first pregnancy due to limb anomaly at 24 weeks gestation, received ultrasonography at about 16 weeks gestation and was found having a fetus with increased nuchal fold, choroid plexus cyst and limb anomaly. Through the genetic counselling, her pregnancy was terminated and the chromosome karyotyping was performed with the fetal tissue and parent's peripheral blood. The results revealed that the parents had normal karyotypes, but the karyotype of the fetus showed 47,XYY.
Adult ; Birth Weight ; Choroid Plexus* ; Choroid* ; Extremities* ; Female ; Fetus ; Humans ; Intelligence ; Karyotype ; Karyotyping ; Male* ; Nuchal Translucency Measurement* ; Parents ; Parturition ; Pregnancy ; Ultrasonography

BACKGROUND AND OBJECTIVES: It had been well known that Lipoprotein(a) had proatherogenic and thrombogenic action because of structural similarity with plasminogen. However the role of Lipoprotein (a) (Lp(a)) in the development of ischemic cerebrovascular disease had not sufficiently clarified. The aim of this study was to evaluate the effect of diabetes mellitus (DM) and hypertension (HBP) to the role of Lp(a) as a risk factor of ischemic cerebrovascular disease. METHOD: For comparing Lp(a) and the lipid profile of ischemic stroke group (5, N=232) with those of control group (C, N=158), we divided each group into four subgroups according to the existance of DM and HBP: stroke patients and control subjects with DM only(DMS, N=27; DMC, N=44), those with HBP only(HBPS, N=94; HBPC, N=44), those with both of DM and HBP (DMHBPS, N=46; DMHBPC, N=29), and those with none of DM and HBP(NS, N=65; NC, N=41). We evaluated Lp(a) and the lipid profile measured less than 72 hour after onset of stroke and 3 month later in 33 ischemic stroke patients. Also we divided the stroke group into two subgroups according to the type (large artery thrombotic vs small artery perforating) and the age of onset (below 50 year-old vs above 50 year-old), and compared Lp(a) and the lipld profile in each subgroups. RESULT: 1. In control group, the Lp(a) in DMC was significantly higher t that in NC. 2. The Lp(a) compared between HBPC & HBPS and between & NS were statistically significant. 3. The Lp(a) in DMS revealed no significant difference compared with that in DMC. 4, The type of ischemic stroke did not give specific Lp(a) level. 5. The Lp(a) in the young age onset revealed no significant difference compared with that in the old age onset. CONCLUSION: The Lp(a) is likely to contribute to the ischemic stroke at independent risk factor, However it is seemed that the role of Lp(a) as a risk factor of the ischemic stroke is evaluated after being subdivided according existence of DM.
Age of Onset ; Arteries ; Diabetes Mellitus ; Humans ; Hypertension* ; Lipoprotein(a) ; Middle Aged ; Plasminogen ; Risk Factors* ; Stroke