No abstract available.
Central Venous Catheters* ; Fibrin*

PURPOSE: Beginning in the eighth week of fetal life the neuroblasts migrate from the midline to the periphery to form the gray matter of the cerebral cortex. Abnormalities of cell migration are characterized by ectopic location of neurons in the cerebral cortex. This broad group of anomalies include lissencephaly, schizencephaly, cortical dysplasia, gray matter heterotopia, and unilateral hemimegalencephaly. The purpose of this study was to correlate clinical data with anatomic data, which was evaluated by brain magnetic resonance imaging characteristics that are most useful in predicting clinical METHODS: The clinical records, EEG, and MRI findings of 20 patients with neuronal migration disorders were retrospectively reviewed. RESULTS: The 20 patients with neuronal migration disorders consisted of 11 with lissencephaly, 7 with cortical dysplasia, 2 with heterotopia, and 2 with schizencephaly. Clinically, seizure was the most common symptom in 85%, next developmental delay in 50%, and then delayed speech in 25%, motor deficit 15% in order. The main associated brain anomalies included absence of septum pellucidum in 20%, periventricular leukomalacia in 15%, and corpus callosal agenesis in 15% of Patients. Bilateral involvement of lesion in MRI was 60%, comparing to unilateral lesion in 40% of the patients. The most common involved lobes was frontoparietal region. An abnormality of EEG examination was showed in 11 cases of patients(68.7%). Patients with diffuse, bilateral lesion in MRI findings of neuronal migration disorders had significantly developmental delay than those with unilateral lesion(p=0.0007). Patients with unilateral lesion had significantly motor deficit than those with bilateral lesion(p=0.04). CONCLUSION: Seizures were the most common symptoms among neurological manifestations of neuronal migration disorders. Statistically significant correlations of delayed developement with bilateral lesion and motor deficit with unilateral lesion were found.
Brain* ; Cell Movement ; Cerebral Cortex ; Electroencephalography ; Humans ; Infant, Newborn ; Leukomalacia, Periventricular ; Lissencephaly ; Magnetic Resonance Imaging* ; Malformations of Cortical Development ; Neurologic Manifestations ; Neuronal Migration Disorders* ; Neurons* ; Retrospective Studies ; Seizures ; Septum Pellucidum

Fractures in the subtrochanteric region of the femur present more formidable problems in treatment than do other trochanteric fractures, because such severe stresses exit at the fracture site. Therefore, as a rule we prefer to treat subtrochanteric fractures by operative means if possible. Many internal fixation devices have been recommanded for use in subtrochanteric fractures and each of these devices have advantages in certain types of subtrochanteric fractures, and their selection should be based on the individual fracture anatomy. A total of 20 patients with fracture of the subtrochanteric region of the femur, who were treated by internal fixation with Judet plate between January 1982 and December 1988 have been reviewed. Our conclusions were as follows; 1. Average age was 38 years old and most common cause of injury was traffic accident. 2. Cast immobilization was done after Judet plate fixation. Partial weight bearing ambulation was enabled from POD 10 weeks and full weight bearing ambulation was enabled from POD 16 weeks. 3. 18 in 20 cases, primary bony union was happened and the mean duration of radiological bony union was 24 weeks. 4. 3 cases of complications, metal failure with refracture (2 cases) and screw loosening (1 case), were occured due to early weight bearing in the post operative course. 5. Judet plate fixation was gave satisfactory result in uncomminuted subtrochanteric fracture, especially Seinsheimer's type I, II-A,B,C or Fieldings type I, II. 6. From a consideration of these series, Judet plate showed easy to use, perfect adaptation and rigid fixation. We thought Judet plate is one of a good implants for rigid fixation of subtrochanteric fracture without severe medial cortical disruption.
Accidents, Traffic ; Clinical Study ; Femur ; Hip Fractures ; Humans ; Immobilization ; Internal Fixators ; Walking ; Weight-Bearing

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography, Stress* ; Humans ; Myocardium* ; Tomography, Emission-Computed, Single-Photon*

we report a case of elastosis perforans serpiginosa associated with pseudoxanthoma e1asticurn on t:he neck of 27-year-old male patient. The lesions showecl erythematous scaly hyperkeratotic papules forming serpiginous pattern on yellowish elevated plaques. A skin biopsy specimen from the neck lesion revealed dense accurmulations of coarse elastic fibers partly cngulfed by epithelium in the papillary dcrrnis and increase cif short, irregulary clumped and degenerated clastic fibers in the middermis. On funduscopic exarnination, angioid streak is noted around the optic disk.
Adult ; Angioid Streaks ; Biopsy ; Elastic Tissue ; Epithelium ; Humans ; Male ; Neck ; Optic Disk ; Pseudoxanthoma Elasticum* ; Skin

We messured delayed cutaneous hypersensitivity reactions by Multitest CMI Kit. Total 209 normal adults ranging in age from 17 to 55 year(male 106, female 103) were tested. The results were obtained as follows ; 1. Sum of average diameter of positive antigens wss 20.7mm in male and 15.6mm in female. 2. Number of positive antigens was 3.9 in male and 3.4 in female. 3. Rate of anergy was 1.4%(0.9% in male, 1.9% in female). 4. The rate of subjects below warning score(below 10mm in male, below 5mm in female) was 2.8% in male and 5.8% in female. 5. Antigen with the highest response was tuberculin in both sex(male 95.3%, female 89.3%) and antigen with the lowest response was trichophyton(22.5%). 6. Aversge score of positive response of every antigens was highest in tuberculin at both sex(male 2.8mm, female 2,6mm) 7. Average score of total antigens with positive response was 5.5mm in male and 4.6mm in female. 8. The rate of false positive reaction to 70% W/V glycerine was 1.4% totally.
Adult* ; False Positive Reactions ; Female ; Glycerol ; Humans ; Hypersensitivity* ; Korea* ; Male ; Tuberculin

Systemic lupus erythematosus is an autoimmune disease characterized by multisystem involvement and various laboratory findings. A retrospective study was made of the medical records of 59 patients with SLE at Severance hospital, Yonsei University College of Medicine, for the analysis of clinical and laboratory findings during the years 1970 through 198I. The results were compared with those of previous serial studies in Korea and western countries. The results obtained are as follows: l. In 59 patients with SLE, 7 patients were men and 52 patients were women (M: F=l: 7.4). Their age at onset of the dsiease ranged mainly in the 3rd and 4th decades. 2. The major clinical manifestations were skin eruptions (81%), fever(73%), renal involvements(66%), pulrnonary(66%) and cardiac(61%) abnomalities. 3. The variety of skin and mucus membrane manifestations seen included butterfly rash of face(53%), maculopapular eruption (34%), purpura(22%), and mucosal ulcer (19%) in that order. 4. Mucosal ulcers and alopecia were correlated closely with exacerbations of disease activity. Patients with Raynauds phenomenon were not likely to have severe organ involvement. 5. Compared with Western series, renal manifestation, anemia and thrombocytopenia were more frequent, and lymphadenopathy, Raynauds phenomenon and alopecia were less frequent. 6. The ANA test showed a, high sensitivity(96%) and a high titer. Compared with the patients showing a speckled pattern(30%), those showing a homogenous pattern(60%) had more severe organ involvement and poorer prognosis. 7. The anti-nDNA antibody test had a high sensitivity(81%), and indicated. severe renal involvement and poorer prognosis. Also, the titer correlated well with disease activity. 8. The disease was associated with autoimmune hemolytic anemia, Buergers disease, thyroid diseases, myelofibrcsis and chilblain. 9. A bimodal rnortality pattern was seen with infection being the major cause of early death, and renal failure and cardiopulmonary abnormalities in late death.
Alopecia ; Anemia ; Anemia, Hemolytic, Autoimmune ; Autoimmune Diseases ; Butterflies ; Chilblains ; Exanthema ; Female ; Humans ; Korea ; Lupus Erythematosus, Systemic* ; Lymphatic Diseases ; Male ; Medical Records ; Membranes ; Mucus ; Prognosis ; Renal Insufficiency ; Retrospective Studies ; Skin ; Thromboangiitis Obliterans ; Thrombocytopenia ; Thyroid Diseases ; Ulcer

BACKGROUND: To compare the diagnostic usefulness of dobutamine stress echocardiography(DSE) and 99mTc-methoxyisobutyl isonitrile SPECT (MIBI SPECT), two studies were performed simultaneously. METHOD: Fifty-six consecutive patients undergoing coronary angiogram and MIBI SPECT for clinical indications without clincal evidence of myocardial infarction were studied prospectively. During the DSE, MIBI was injected at peak stress, and post-stress images of MIBI SPECT were required on hour later. Both echocardiographic and MIBI SPECT images were visually analysed in a blind fashion. RESULTS: On the basis of coronary angiographic findings, the sensitivites of the DSE and MIBI SPECT (n=36) were 89% and 86%, respectively. The specificities of those (n=20) were 90% and 85%, respectively. Among 33 patients without resting perfusion defect on MIBI SPECT, resting regional wall motion abnormalities on DSE were found in only one patient, whereas, resting perfusion defect on MIBI SPECT were found in 9 patients among 41 patients without resting regional wall motion abnormalities on DSE. Among 17 patients who had resting perfusion defects with partial reversibility on MIBI SPECT, resting wall motion abnormalities were present in 11 patients and five of them showed improvement in the regional wall motion during low dose dobutamine infusion. CONCLUSION: Both dobutamine stress echocardiography and MIBI SPECT are useful methods in the detection of the coronary artery disease, however, MIBI SPECT seems to overestimate the regional ischemic myocardium with contractile reserve that can hardly be evaluated with MIBI SPECT.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Humans ; Myocardial Infarction ; Myocardium* ; Perfusion ; Prospective Studies ; Tomography, Emission-Computed, Single-Photon*

The popularity of baseball has resulted in an increase in medical attention directed toward participating players. This study focuses on injuries of the throwing arm in adolescents which occur during participation in organized youth baseball matches. History taking, physical examination and roentgenographic study of both elbows were made on 67 adolescent baseball players who visited the Department of Orthopaedic Surgery of Hanyang Vniversity Hospital from December, 1981 to January, 1982. The results obtained were as follows: 1. The average age was 12.4 years and average career playing baseball was 1 year 11 months. 2. There were 18(85.7%) overhand type pitchers. This was the most common pitching style. 3. 7(10.4%) complained of elbow pain. In all cases the pain was located on the medial aspect of the elbow. 4, On physical examination, hypertrophy of the forearm was seen in 19(28.4%), hypertrophy of the arm in 27(40.3%), limb length discrepancy in 28(41.8%), cubitus valgus deformity in 2(3.0%), and flexion contracture of the elbow in 6(9.0%) cases. 5. On roentgenographic study, cortico-trabecular hypertrophy of the humerus, and separation and fragmentation of the medial humeral epicondyle were the common findings. 6. The pain and flexion contracture of the elbow were more marked in pitchers. 7. To prevent these injuries of the elbow, the following recommandations were made by authors. Use a pitching machine in batting exercise. Restrict the number of innings pitched per game, Abolish curve ball throwing in this age group. Ensue an adequate warmup period before exercise or games. Inform parents and coaches of the possible harmful nature of excessive throwing.
Adolescent ; Arm ; Baseball ; Clinical Study ; Congenital Abnormalities ; Contracture ; Elbow ; Extremities ; Forearm ; Humans ; Humerus ; Hypertrophy ; Parents ; Physical Examination

Sensation is the key element that allows the fingertip to participate effectively in virtually all hand functions. Therefore, it is very important to restore sensation as well as well padded, durable skin coverage following severe fingertip injuries. Many ingenious operations have been described to provide the fingertip with sensate coverage. Among them, the innervated cross-finger flap, reported by Cohen et al. in 1983, is very effective and successful in reconstruction of severe fingertip injuries, We report five cases of severe fingertip injuries treated with innervated cross-finger flap. The results are as follows : 1. The level of sensory return and the functional result is excellent in those fingertips reconstructed with the innervated cross-finger flap. 2. Mean time for flap detachment is 16 days post operative and local anesthesis at outpatient department is sufficient. 3. Four of five treated patients achieved excellent sensibility with measurable two-point discrimination(mean 5.0 mm) and ability to recongnize textures and objects.
Fingers ; Hand ; Humans ; Outpatients ; Sensation ; Skin