Ultrasongraphy is a safe, noninvasive examination which should be the first procedure in the workup of apatient with a definite or suspected pelvic masses. The diagnostic schemes were derived from correlating the sonographic features with histomorphology in 230 surgically proven pelvic masses. Besides separating pelvic masses into the conventional categories of cystic, complex and solid, grayscale sonographic features of a pelvic mass canbe used to subcategorized these masses into a more useful differential diagnosis. The results are as follows; 1.The most characteristic finding of uterine myoma was midly to mederately echogenic uterine enlargement (90.7%)with a lobulated uterine margin (62.8%), and often less echogenic than the normal uterine echoes. 2. The typical ultrasonographic finding of H-mole was uterine enlargement with multiple small vesicular patterns of intrauterincontents(93%). 3. The most frequent finding of cystic teratoma was cystic mass with echogenic foci(48%), but the echogenic appearance of the lesions was extremely variable. 4. The ultrasonographic findings of ectopic pregnancywere adnexal mass(comlex or cystic), decidual proliferation of the uterus, enlargement of uterine size, fluid incul-de-sac, deveiation of uterus by adnexal mass, and psuedointrauterine appearance. 5. Ultrasound provided information leading to the correct diagnosis in 57% of cases, contributory data in 21.3%, and non-specific information in 10.4%. Errors occured in 3.9% and false-negative in 7.4%.
Diagnosis ; Diagnosis, Differential ; Leiomyoma ; Teratoma ; Ultrasonography ; Uterus

It is notoriously difficult to obtain a sound bony union of large segmental bone defects secondary to trauma or following tumor resection, infected nonunion, congenital pseudarthrosis of the tibia, and avascular necrosis of the femoral head with conventional methods. Recent advances in microsurgery have made it possible to provide a continuing circulation of blood in bone grafts so as to ensure viability. With the nutrient blood supply preserved, healing of the graft to the recipient bone is facilitated without the usual replacement of the graft by creeping substitution. Thus, the grafted bone is achieved more rapid stabilization of bone fragments separated by a large defect without sacrificing viability. Thirty nine cases of the free vascularized fibular graft had been performed in the Department of Orthopedic Surgery, Kyung Hee University Hospital during the period of 3 years from October 1978 to December 1981. Of these, ll cases were congenital pseudarthrosis of the tibia, 4 cases were tuberculous spondylitis, 4 cases were infected nonunion, 7 cases were large segmental bone defects secondary to trauma, 9 cases were avascular necrosis of the femoral head and the other was one case. The results were obtained as follows: 1. The advantages of free vascularized living fibular graft are one stage procedure, resistance of torsion and angular stress, union with rapid hypertrophy of the graft, a shorter immobilization period and more rapid incorporation of the graft into the recipient area. 2. Free vascularized fibular graft can be widely used in the field of Orthopedic surgery. 3. The fibula is the bone best suited for reconstruction of a defect in a long bone. 4. In children, distal tibiofibular synostosis must be performed. 5. For prevention of clawing toe, the muscles around the bone is meticulously dissected, 6. Evaluation by selective arteriography and isotopic scanning both before and after operation may be used to assess the viability of the fibula graft.
Angiography ; Animals ; Child ; Fibula ; Head ; Hoof and Claw ; Humans ; Hypertrophy ; Immobilization ; Microsurgery ; Muscles ; Necrosis ; Orthopedics ; Pseudarthrosis ; Spondylitis ; Synostosis ; Tibia ; Toes ; Transplants

PURPOSE: To evaluate the clinical outcome of patients who underwent a lensectomy and IOL implantation at the time of the primary repair due to a penetrating ocular injury. METHODS: We analyzed the records of 25 eyes of 25 perforating injury patients[Group A (13 eyes)-who had undergone simultaneous corneal laceration repair, cataract extraction and IOL implantation, and Group B (12 eyes)-who had undergone corneal laceration repair, cataract extraction and had their refractive error corrected by contact lens or glasses later]. retrospectively from March, 1991 to June,1999. We examined the relationship between their final visual acuity and the influencing factors such as cause of injury, length and feature of the lacerated cornea, initial visual acuity and postoperative complications, etc. RESULTS: The average age of patients was 36.8 and 25.7 years in group A and B, respectively. The major cause of injury was a metallic foreign body. In group A, the wound is relatively short and has a linear shape. In group B, it is a nearly curved line. An anterior vitrectomy was done in 6 patients in both groups, respectively. Nine patients (69%) achieved a final visual acuity of 10/20 or better in group A and only four patients (33%) in group B. The postoperative complications were transient elevation of IOP (1 eye) and corneal ulcer (1 eye) in group A, and vitreous opacity (1 eye) and retinal detachment (1 eye) in group B. CONCLUSIONS: It is recommended for visual rehabilitation and attainment of binocular visual function to implant the IOL at the time of primary repair caused by a penetrating ocular injury.
Cataract Extraction ; Cornea ; Corneal Ulcer ; Eyeglasses ; Foreign Bodies ; Glass ; Humans ; Lacerations ; Lenses, Intraocular* ; Postoperative Complications ; Refractive Errors ; Rehabilitation ; Retinal Detachment ; Retrospective Studies ; Telescopes ; Visual Acuity ; Vitrectomy ; Wounds and Injuries

A 41-yr-old man was admitted with acute headache, neck stiffness, and febrile sensation. Cerebrospinal fluid examination showed pleocytosis, an increased protein level and, a decreased glucose concentration. No organisms were observed on a culture study. An imaging study revealed pituitary macroadenoma with hemorrhage. On the 7th day of the attack, confusion, dysarthria, and right-sided facial paralysis and hemiparesis were noted. Cerebral infarction on the left basal ganglia was confirmed. Neurologic deficits gradually improved after removal of the tumor by endoscopic transnasal transsphenoidal approach. It is likely that the pituitary apoplexy, aseptic chemical meningitis, and cerebral infarction are associated with each other. This rare case can serve as a prime example to clarify the chemical characteristics of pituitary apoplexy.
Adenoma/*complications ; Adult ; Cerebral Infarction/*etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis/*etiology ; Pituitary Apoplexy/*complications/etiology ; Pituitary Neoplasms/*complications ; Tomography, X-Ray Computed

To evaluate the clinical results of implantation of Acrysof foldable intraocular lens[IOL], we retrospectively analyzed 814 patients who had been implanted with Acrysof IOLs in their eyes and followed-up over 6months postoperatively. Postoperative conditions such as best corrected visual acuity[BCVA], postoperative complications and capsular fibrosis were evaluated. Postoperative BCVA, with measurement above 0.7 was 83%and above 0.5 was 92%.If there was no ocular pathology, BCVA with measurement above 0.7 was 96.5%.Postoperative complications included 9.8%[80 cases]of posterior capsular opacity, 3.2%[28 cases]of microvacuole, and also anterior capsule contracture, haptic damage.7 cases of posterior capsular opacity[totally 80 cases]required Nd;Yag laser posterior capsulotomy.Capsular fibrosis[61.8%]was divided to 4 grades.Most of them were grade I or IIand above grade was 9.8%. In conclusion, the Acrysof IOL implantation showed good visual outcome and few postoperative complications, especially in PCO, it had excellent results.So, it will show excellent longterm visual prognosis including visual quality.
Contracture ; Fibrosis ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Pathology ; Postoperative Complications ; Prognosis ; Retrospective Studies

Orbital infarction syndrome is defined as ischemia of all intraorbital and intraocular structures and is a rare disorder due to rich anastomotic vascularization of the orbit. It results in orbital and ocular pain, total ophthalmoplegia, anterior and posterior segment ischemia, and acute bindness. It can occur secondary to different mechanisms such as acute perfusion failure, systemic vasculitis, orbital cellulitis and vasculitis. We experienced a case of orbital infarction syndrome in a 61-year-old nonketotic diabetic woman who had developed paranasal sinusitis by mucormycosis and presented orbital cellulitis, multiple nerve paralysis, chorioretinal ischemia, facial necrosis around orbit and acute blindness. Prompt recognition of clinical pictures and rapid diagnosis is essential for early treatment of orbital infarction due to rhino-orbitocerebral mucormycosis because its progression is very rapid and fatal.
Blindness ; Diagnosis ; Female ; Humans ; Infarction* ; Ischemia ; Middle Aged ; Mucormycosis* ; Necrosis ; Ophthalmoplegia ; Orbit* ; Orbital Cellulitis ; Paralysis ; Perfusion ; Sinusitis ; Systemic Vasculitis ; Vasculitis

Orbital infarction syndrome is defined as ischemia of all intraorbital and intraocular structures and is a rare disorder due to rich anastomotic vascularization of the orbit. It results in orbital and ocular pain, total ophthalmoplegia, anterior and posterior segment ischemia, and acute bindness. It can occur secondary to different mechanisms such as acute perfusion failure, systemic vasculitis, orbital cellulitis and vasculitis. We experienced a case of orbital infarction syndrome in a 61-year-old nonketotic diabetic woman who had developed paranasal sinusitis by mucormycosis and presented orbital cellulitis, multiple nerve paralysis, chorioretinal ischemia, facial necrosis around orbit and acute blindness. Prompt recognition of clinical pictures and rapid diagnosis is essential for early treatment of orbital infarction due to rhino-orbitocerebral mucormycosis because its progression is very rapid and fatal.
Blindness ; Diagnosis ; Female ; Humans ; Infarction* ; Ischemia ; Middle Aged ; Mucormycosis* ; Necrosis ; Ophthalmoplegia ; Orbit* ; Orbital Cellulitis ; Paralysis ; Perfusion ; Sinusitis ; Systemic Vasculitis ; Vasculitis

OBJECTIVE: The purpose of this study was to investigate the methods for analysis of restriction fragment length polymorphisms of hemophilia B (coagulation factorIX) gene in Korean population. METHODS: Genomic DNAs were extracted from 40 Korean females. In order to amplify genomic DNAs at the region of the polymorphic sites, two sets of primers (Hha I and Dde I) were synthesized. The primers were named as FIX1, FIX2 for Hha I, and Dde I 59, Dde I 39 for Dde I, respectively. Hha I primers annealed 3'-flanking region of the FactorIX gene and amplified 230 bp long fragment. The PCR fragment (230 bp) treated with Hha I endonuclease produced two fragments (150 bp and 80 bp), when the polymorphic site existed. Dde I primers annealed the region of the first intron of Factor IX gene and amplified 319 bp long fragments. People cases with Dde I polymorphic site are supposed to produce 369 bp long fragment. Results: It has been found that seven (14 X chromosomes) out of forty individuals showed Hha I polymorphism. However, none of the experimental People cases showed the Dde I polymorphism. CONCLUSIONS: By the analysis of 80 chromosomes, the PICs calculated from allele frequency of Hha I-RFLP (0.175/0.825) and that of Dde I-RFLP (0.0/1.0) were 0.289=[1-(0.1752+0.8252)] and 0=[1-(02+12)], respectively. From these results, it can be postulated that Hha I and Dde I polymorphisms of the Factor IX gene in Korean exhibited different patterns from those of Caucasian.
Blood Coagulation Factors* ; Blood Coagulation* ; Dichlorodiphenyl Dichloroethylene ; DNA ; Factor IX* ; Female ; Gene Frequency ; Genes, vif* ; Hemophilia B ; Humans ; Introns ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length*

OBJECTIVE: This study was performed to evaluate the expression of MAGE gene and human papillomavirus (HPV) 16, 18 type in patients with cervical neoplasia using in exfoliated cervical cells. METHODS: The expression of common MAGE gene (MAGE 1 to 6) in cervical scraps was studied by reverse-transcription polymerase chain reaction (RT-PCR) in 12 normal control patient and 48 patients with abnormal cytologic results. In all 60 patients, colposcopic directed biopsy and HPV test by polymerase chain reaction (PCR) was done. RESULTS: The pathologic results of 60 patients was 12 cervicitis, 37 cervical intraepithelial neoplasia (14 LSIL, 23 HSIL), and 11 invasive squamous cell carcinomas. No expression of common MAGE gene was detected in 12 cervical scraps of cervicitis. The common MAGE gene of LSIL, HSIL and invasive squamous cell carcinomas was expressed in two (14.3%), seventeen (73.9%), ten (90.9%) respectively. HPV type 16 or 18 was detected in 1 cervicitis, 5 LSIL, 20 HSIL and 10 invasive squamous cell carcinoma. In 51 patients (85%), the HPV test result and the common MAGE gene expression showed coincident results. CONCLUSION: This result suggests common MAGE gene might be potential tumor marker in cervical neoplasia and adjuvant test of the Papanicolaou smear.
Biopsy ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Gene Expression ; Human papillomavirus 16* ; Humans* ; Papanicolaou Test ; Polymerase Chain Reaction ; Uterine Cervicitis

Ectopia cordis is a rare congenital anomaly in which the heart is situated outside the chest cavity and has been known for many years, being reported first in 1671 by Neil Stenson. Ectopia cordis appears closely related with defective embryonic development, arising as the result of defective formation and differentiation of the ventral mesoderm at 14 to 18 days of embryonic life. Ectopia cordis is usually classified into many types according to the site at which the heart protrudes: thoracic type, abdominal type, thoraco-abdominal type, cervical type. We have experinced one case of ectopia cordis which was diagnosed by ultrasonography at 16th gestational weeks in 30 year old multiparity. We report this case with brief review of literatures.
Adult ; Ectopia Cordis* ; Embryonic Development ; Female ; Heart ; Humans ; Mesoderm ; Parity ; Pregnancy ; Thorax ; Ultrasonography ; Ultrasonography, Prenatal*