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

No abstract available.
Central Venous Catheters* ; Fibrin*

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

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

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

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*

Squamous cell carcinoma from the draining sinus of chronic osteomylitis has been recognized as a rare complication. The incidence of this complication is between 0.23% and 1.6% in cases of osteomyelitis. The cause of development of carcinoma at the site of chronic osteomyelitis is not well understood. This is a disease of middle aged men, and tibia is the most common site. Biopsy of squamous cell carcinoma which arises in the proliferating edge of the cutaneous ulcer and invades the bone, should include tissues from all sites of ulcer and bone marrow spaces. Histological diagnosis may be difficult because of preexisting metaplasia and pseudoepitheliomatous hyperplasia. Amputation at the adequate level is the treatment of choice. Four cases of squamous cell carcinoma involving tibia, metatarsal bone or calcaneus are reported with review of literatures.
Amputation ; Biopsy ; Bone Marrow ; Calcaneus ; Carcinoma, Squamous Cell ; Diagnosis ; Epithelial Cells ; Humans ; Hyperplasia ; Incidence ; Male ; Metaplasia ; Metatarsal Bones ; Middle Aged ; Osteomyelitis ; Tibia ; Ulcer

The parathyroid cyst is a relatively uncommon disease and usually identified during the operation for a presumed thyroid mass. Thirteen cases of parathyroid cyst (2 males, 11 females) treated from 1981 to 1993 were reviewed. Ages ranged from 17 to 59 years(mean, 41 years). Gross measurement of the tumor size varied from 1.0 to 10.0 cm in diameter with a mean of 4.8cm. All of the 13 patients presented with a chief complaint of painless anterior cervical mass. Only one complained of mild symptom of dyspnea and voice change due to huge cyst in paratracheal space. No functional cyst was identified. Diagnostic studies included ^99mTc thyroid scan (n=11), ultrasonography (n=10), computerized tomography (n=4) and fine needle aspiration(FNA) (preoperative, n=4; intraoperative, n=3). All diagnostic precedures but needle aspiration were nonspecific. Cysts were found in right inferior parathyroid(n=4), left inferior parathyroid (n=7), or anterior superior mediastinum (n=2). The FNA of the cyst contents revealed watery clear fluid with elevated parathyroid hormone level and was diagnostic in each cases. Four patients were treated initially with needle aspiration, of which only one patient was successful, and 3 patients who were unsuccessful to needle aspiration and the remaining 9 were effectively treated with surgical extirpation. Our experience suggested that needle aspiration may be of significant help in diagnosis and treatment of parathyroid cyst, but most of the patient could be treated successfully by surgical extirpation with an excellent chance for curability.
Biopsy, Fine-Needle ; Diagnosis ; Dyspnea ; Humans ; Male ; Mediastinum ; Needles ; Parathyroid Hormone ; Thyroid Gland ; Ultrasonography ; Voice