Congenital pseudarthrosis of the tibia is a condition most often combined with cafe-au-lait spots and neurofibromatosis. It is notoriously difficult to attain a sound bony union. Compression plating and screw fixation with massive bone graft resulted in successful union in our case.
Cafe-au-Lait Spots ; Neurofibromatoses ; Pseudarthrosis ; Tibia ; Transplants

The paramount importance of breast feeding for the health of the infants has been recognized by untritionists and physicians. Although many advantages of the breast feedng, exclusive breast feeding without weaning diet or supplement food during prolonged perind in infants may produce iron deficiencyh anemia. This study was conducted to find out the hematologic state in exclusively prolonged breast-fed infants among these anemic patients and the way of thinking about their baby's feeding method in their mothers. Mothers of the anemic patients has been surveyed with questionare. The results and problems obtained from this study are summerized as follows. 1) Among 40 patients of this study, 27 were male (67.5%) and 13 were female (32.5%). Mean age was 12.6+/-2.7 month and 9 & 11 month of age were the most common, respectively (15.0%). 2) Mean age of mothers was 29.5 year. The 25 34 year-old group was most common. 3) Education levels of mothers were primary 10%, middle 10%, high 60%, and college graduate 20%. 4) In motivatins of breast feeding. Persuasion of husband or the parent of husband' 19(47.5%). 'Convenience for use' 12 (30.0%), and 'Through mass media or public information' 9 (22.5%). 5) In the causes of prolonged breast feeding, 'Think that satisfactory nutrition for baby is possible with breast milk alone' 4(10.0%), 'Due to persuasion of husband or the parents of husband' 11 (27.5%), 'Baby did no suck milk bottle or eat other diet except breast milk' 25 (62.5%). 6) In whether or not acknowledgment of the necessity of weaning diet, 'Know it but not consider so important 22 (55.0)%, 'Do not know at all) 15 (37.5%), and 'Breast milk, that will do' 3(7.5%). 7) Hb level in patient group, from 6 to 6.9g/dl was 2 (50.0%), from 7 to 7.9g/dl was 3 (7.5%), from 8 to 8.9%g/dl was 15 (37.5%), and from 9 to 10 g/dl was 20 (50.0%). From 9 to 10g/dl was the most common. Hematologic findings were Hb 8.8+/-0.9g/dl, Hct 28.8+/-3.0%, MCV 64.7+/-6.7 fl, MCH 20.0+/-2.5pg, MCHC 30.8+/-1.5g/dl. Platelet 452.5+/-142.9x103/mm3, Reticulocyte count 1.4+/-0.6%, Fe 28.6+/-14.1 g/dl, TIBC 446.7+/-66.2 g/dl, Ferritin 10.5+/-7.0ng/ml. Transferrin saturation 6.6+/-3.5%. 8) In association with duration of breast milk feeding and hematologic findings, as duration was prolonged, Hb, Hct, MCV & MCH were significantly decreased (p<0.01).
Adult ; Anemia* ; Blood Platelets ; Breast Feeding* ; Breast* ; Diet* ; Education ; Feeding Methods ; Female ; Ferritins ; Humans ; Infant ; Iron ; Male ; Mass Media ; Milk ; Milk, Human ; Mothers ; Parents ; Persuasive Communication ; Reticulocyte Count ; Spouses ; Thinking ; Transferrin ; Weaning*

No abstract available.
Diagnosis* ; Ectopia Cordis*

The Duodenal diverticulum is the rare cause of the common bile duct obstruction. We experienced a case of the diverticulum of the second portion of duodenum in a 59-year-old male, who complained recurrent attacks of right upper abdominal pain and fever since 16 months prior to admission. Duodenoscopic finding and UGI study revealed a typical duodenal diverticulum just side to the papilla of Vater. Diverticulectomy and cholecystectomy was performed and after than, he has been free front above mentioned symptoms. We reported a case of duodenal diverticulum which caused recurrent common bile duct obstruction.
Abdominal Pain ; Cholecystectomy ; Common Bile Duct* ; Diverticulum* ; Duodenum ; Fever ; Humans ; Male ; Middle Aged

PURPOSE: To assess the utility of shoulder MRI by using ROC (receiver operating characteristic) curve in theevaluation of rotator cuff tear, anterior labral tear, superior labral tear and Hill-Sachs Lesion. MATERIALS AND METHODS: We evaluated 38 arthroscopically confirmed patients who had undergone shoulder MRI. According to thesignal intensity of the rotator cuff, as seen on T2 and proton density imaging, a five-stage grading system wasdevised. Labral tears were graded according to the separation of the labium; this was based on gleaned,morphologic and signal intensity changes of the labrum : six grades of anterior labral tear and three grades ofsuperior labral tear. Hill-sachs lesion was also classified into four grades according to morphologic and signalchanges of the humeral head. These findings were reviewed by two musculoskeletal radiologists and ROC curves andareas under the curve (Az) was abtained. RESULTS: The ratio of area under the curve of rotator cuff tear,anterior labral tear, superior labral tear and Hill-Sachs lesion were 82.4%, 88.%%, 62.4% and 91.3%, respectively. CONCLUSION: The Accuracy of shoulder MRI using ROC curve was relatively high in rotator cuff tear, anteriorlabral tear and Hill-Sachs lesion, but low in superior labral tear.
Humans ; Humeral Head ; Magnetic Resonance Imaging* ; Protons ; ROC Curve* ; Rotator Cuff ; Shoulder*

The antihypertensive effect and side reactions of perdipine was studied in 22 cases of essential hypertension using 20mg 3 times daily regimen for average period of 5 weeks. 1) Average reduction of 20mmHg in systolic and 17mmhg in diastolic pressure was observed and percentile reduction was 11.90% and 14.92%, respectively. The overall effect rate was 81.82%. The blood pressure lowered significantly after 2 weeks of treatment both in systolic and diastolic pressure. 2) There was no significant change in heart rates before and after treatment. 3) No specific side reaction was observed except 1 case in which discontinued the medication because of severe headache and fatigability on the 1st day of medication.
Blood Pressure ; Headache ; Heart Rate ; Hypertension ; Nicardipine*

PURPOSE: To document the radiologic characteristics of Korean Gaucher disease. MATERIALS AND METHODS: Fifteen bone marrow biopsy and laboratory data confirmed Gaucher disease patients (age 1 -21, mean 10.9 yr) wereundertaken plain X ray and MRI. Number of type I were 10, type II, 2, type III, 3. Seven were splenectomized oninitial evaluation or during follow up. Five enzyme treated patient were undertaken follow-up MR examinationduring 6 -40 month with 6 month interval. Conventional T1 and T2WI of spine and femur was performed and FMPSPGR inand out of phase image was also done. Volume of liver and spleen were measured, and bone marrow infiltration andpresence of infarction were scored according to 6 scale scoring system. Clinical data were also reviewed andcorrelated with the MR findings. RESULTS: Marrow infiltration was noted in 71.4% of all patients in MRI, while itwas in 45.7% with plain radiography. Type I group showed marrow infiltration in all but one cases, which wasparallel with ages, SGPT, and presence of osteopenia, reversely correlated with spleen size. Severe bonecomplications (infarction or fracture) were noted in 7 of 10 type I group, and 6 patients showed severe growthretardation (below 3rd percentile). Follow up MR examination of 5 patient showed decrease in liver and spleen sizefirst without bone change until 6 months. There showed bone regeneration in 2 patient 1 year after, and increasedfat signal in one patient 3.5 years after. In and out of phase images couldn't help in quantifying fatcomposition in bone marrow. CONCLUSION: Korean Gaucher patients revealed as more severe skeletal complicationsthan others reported from Western groups. MR examination is a effective modality to evaluate and monitor ofGaucher patients.
Alanine Transaminase ; Biopsy ; Bone Diseases, Metabolic ; Bone Marrow ; Bone Regeneration ; Femur ; Follow-Up Studies ; Gaucher Disease* ; Humans ; Infarction ; Liver ; Magnetic Resonance Imaging ; Metabolism ; Radiography ; Spine ; Spleen

PURPOSE: To assess the results and usefulness of interventional procedures for hepatic arterial stenosis or thrombosis following liver transplantation. MATERIALS AND METHODS: During the past five years, eight patients aged 1-59 (mean, 39) years among 187 liver transplant recipients showed elevated of liver enzyme levels (AST/ALT) and decreased arterial flow at Doppler ultrasound. Hepatic arteriography revealed luminal stenosis or occlusion at the proper hepatic artery, and six patients, one of whom required thrombolysis before the procedure, underwent percutaneous transluminal angioplasty (PTA) using a balloon. In two with thronbosis, thrombolysis without PTA was performed. In order to increase hepatic arterial flow, four patients underwent additional coil embolization of the gastroduodenal or splenic artery. RESULTS: Hepatic arterial flow recovered in all six patients after PTA. Three required repeat PTA for restenosis and one of these needed stent placement after repeated PTA. At follow-up, 6-17 months later, the three had good hepatic function. Within four days, the other three expired due to graft failure, hepatorenal syndrome and sepsis. One of the patients who underwent thrombolysis without PTA expired and the other required retransplantation. In this case there were no procedure - related complications. CONCLUSION: Radiologic interventions are useful for treatment of hepatic arterial stensis or thrombosis in patients with liver transplantations.
Angiography ; Angioplasty ; Constriction, Pathologic* ; Embolization, Therapeutic ; Follow-Up Studies ; Hepatic Artery ; Hepatorenal Syndrome ; Humans ; Liver Transplantation* ; Liver* ; Phenobarbital ; Sepsis ; Splenic Artery ; Stents ; Thrombosis* ; Transplantation ; Transplants ; Ultrasonography

A 54-year-old woman presented with an exophthalmos and a mass on her right eye, which proved to be recurred adenoid cystic carcinoma of the lacrimal gland. Orbital CT and MRI showed that tumor was located in the right orbit, but skin over right eye brow was also involved. There was no visualization of tumor extension into the intracranial compartment. The authors have performed an en bloc orbitectomy. Although en bloc orbitectomy is known to be useful in reducing recurrence, this case showed the tumor recurrence and even distant metastasis that occurred after total tumor removal via en bloc orbitectomy. As adenoid cystic carcinoma of lacrimal gland is known to have high rate of recurrence and metastasis, en bloc orbitectomy should be performed to reduce local advancement and distant metastasis. In case of distant metastasis, radiotherapy could be useful strategy in selected case.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Exophthalmos ; Female ; Humans ; Lacrimal Apparatus* ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis ; Orbit ; Radiotherapy ; Recurrence ; Skin

OBJECTIVES: This study is to investigate clinicopathologic characteristics, survival and prognostic factors in patients with Krukenberg tumor of the ovary. MATERIAL & METHODS: From Jan. 1991 to Dec. 2000, 42 patients with Krukenberg tumor of the ovary were investigated with clinical profiles, such as age, stage, primary sites, clinical symptoms, and survival, retrospectively. RESULTS: A mean age of 42 patients was 44.8 years (range 27-77). Stomach was the most frequent primary site (30/42, 71.4%), followed by colon (7/42, 16.7%) and gallbladder (1/42, 2.4%). In 38 patients, primary sites diagnosed before or after 1 month of diagnosis of Krukenberg tumor of ovary (36/38 cases, 94.7%). The most common feature of patients with Krukenberg tumor of ovary was bilateral abdominal mass. 5-year survival rate of patients with Krukenberg tumor of ovary was 8.94% (95% CI=3.33-14.55) and median survival time was 11 months. Age, bilaterality of tumor, time of diagnosis, presence of ascites and the primary site did not affect the survival. The patients who received post-operative adjuvant chemotherapy had better 3-year survival than those who did not (17.28% vs 10% p=0.03). CONCLUSION: Krukenberg tumor of the ovary is an aggressive tumor with poor prognosis. Post-operative adjuvant chemotherapy may increase the survival of patients with Krukenberg tumor of the ovary. Further prospective studies for the role of surgery and chemotherapy are needed.
Ascites ; Chemotherapy, Adjuvant ; Colon ; Diagnosis ; Drug Therapy ; Female ; Gallbladder ; Humans ; Krukenberg Tumor* ; Ovary* ; Prognosis ; Retrospective Studies ; Stomach ; Survival Rate