We have experienced a case of neurofibromatosis with unusual giant pigmentation, which presents itself as a 28 cm x 40 cm sized, serrated bordered light brownish patch speckled with small dark hyperpigmented macules on his back. Histopathologic examinations of light brown patch and speckles showed only an increase in basal melanin pigmentation.
Melanins ; Neurofibromatoses* ; Pigmentation*

Zielke introduced new anterior instrumentation by modifying Dwyer system and called it the ventral derotation spondylodesis(VDS) system in 1976. This system is a powerful device and when the excised disc spaces are compressed with it, stable fixation can be obtained. But proper patient selection, meticulous operative technique and good post-operative care are essential to minimize serious complications. No results of this technique had been published in English-language literature until Moe reported the results of 66 cases of Zielke instrumentation in 1983. Zielke instrumentation was carried out in 12 cases of scoliosis;8 in idiopathic scoliosis and 4 in congenital scoliosis, at the Department of Orthopedic Surgery, Seoul National University Hospital, for 16 months from November 1984 to March 1986. Seven cases had been followed for more then 9 months and'following results were obtained. 1. Numbers of vertebrae involved in major curve and numbers of fused vertebrae were 6·3 respectively. 2. Average preoperative curve was 72.7 degrees and immediate postoperative curve was 17.6 degrees with 75.8% correction. There was only 1.0 degree loss of correction with an average follow-up of 14 months (9-16 months). 3. Zielke instrumentation has the advantage of shorter fusion and better correction in thoracolumbar and lumbar scoliosis.
Follow-Up Studies ; Orthopedics ; Patient Selection ; Scoliosis ; Seoul ; Spine

A pathologic fracture is a fracture of a bone with preexisting structural weakness. When considering the local treatment of pathologic fractures, those resulting from disorders which cause a generalized weakness of the whole or part of the skeleton can be largely treated conservatively. And those because of localized bone destruction or weakness often require operative treatment. For ten years from 1973 to 1983, we observed and analysed 26 cases of pathologic fractures, excluding those due to osteoporosis. The results were as follows: 1. The age distribution showed an even pattern, and the male to female ratio was 58% (15 Males): 42% (11 Females). 2. The underlying etiologies were infection in 6 cases (23%), disturbance in skeletal development in 7 cases (27%), benign tumorous lesion in 10 cases (38%) and malignant tumorous lesion in 3 cases (12%). 3. The most common site was femur, 54% (14 cases). 4. Previous treatment was carried on 38% (10 cases). 5. Of the 26 cases, conservative treatment was done in 4 cases (15%) and surgical treatment was done in 22 cases (85%).
Age Distribution ; Clinical Study ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Male ; Osteoporosis ; Skeleton

No abstract available.
Cholesterol* ; Granuloma*

This study was carried out to investigate the development rates of human embryos co-cultured with cumulus cells to each blastocyst stage. Human zygotes were co-cultured on cumulus cell monolayer in YS medium supplemented with 20% hFF. On day 2, if patient had four or more 'good' embryos(regular blastomeres without fragmentation), embryos were further cultured for 72hrs. Blastocysts on day 5 were classified into early blastocyst (ErB), early expanding blastocyst (EEB), middle expanding Blastocyst (MEB), and expanded blastocyst (EdB) on the basis of their morphological aspects of trophectoderm cells and blastocoele. Subsequently, maximum 3 of best blastocysts were transferred in 486 cycles. The results in this study were as follows: Patients who had four or more 'good' embryos on day 2 were 498 persons, but patients whose embryos could not be transferred due to failure in development to the blastocyst stage on day 5 were 12 persons (2.4%). The development rate of embryos to the blastocyst stage was 58.2% (2,885/4,957) on day 5, and the rates that developed to the ErB, EEB, MEB, and EdB stage were 15.0% (743/4,957), 14.9% (739/4,957), 14.4% (714/4,957), and 13.9% (689/4,957), respectively. Total 1366 blastocysts were transferred in 486 cycles (mean number=2.81). The implantation rate and the ongoing implantation rate obtained by observing the number of G-sac and FHB were 29.9% (409/1,366) and 22.5% (308/1,366), respectively. The clinical pregnancy rate was 51.2% (249/486), and the ongoing pregnancy rate was 39.1% (190/486). Among women showing ongoing pregnancy, women with singleton were 50% (95/190), women with twin were 37.9% (72/190), and women with triplet were 12.1% (23/190). Although triplet pregnancy rate in this study was high such as 12.1%, because many blastocysts with high viability were produced in our co-culture system using cumulus cells on day 5, we really believe that a multiple pregnancy except twin should not occur by selecting good embryos for maximum two blastocyst transfer. These results demonstrate that autologous cumulus cells may be used for the production of blastocysts with high developmental competence, and the use of autologous cumulus cells to be collected easily, and to be treated conveniently at OPU must be an effective means for obtaining high implantation and pregnancy rate.
Blastocyst* ; Blastomeres ; Coculture Techniques* ; Cumulus Cells* ; Embryo Transfer ; Embryonic Structures* ; Female ; Humans* ; Mental Competency ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Pregnancy, Triplet ; Triplets ; Zygote

BACKGROUND: Phadiatop test which was developed for screening of atopy in eastern asia area, has not been sufficiently evaluated in Korea. In our previous study, the clinical usefulness of Phadiatop test for screening of atopy was evaluated on atopics and non-atopics defined by the results of skin prick tests with 10 inhalant allergens in Korea. In this study, we evaluated the usefulness of Phadiatop test for screening of atopy based on the level of CAP specific IgE in Korean asthmatics. METHODS: On 136 Korean asthmatics, the level of CAP specific IgE to 10 important inhalant allergens and the level of Phadiatop specific IgE to mixture of 8 important inhalant allergens in Korea were measured. Atopics and non-atopics were defined by the results of CAP specific IgE and the sensitivity, specificity, predictive value of a positive and negative result, and concordance rate of Phadiatop test were estimated. RESULTS: The sensitivity, specificity, predictive values of a positive and negative result, and concordance rate of Phadiatop test were 90.5%, 95.0%, 99.1%, 63.3%, and 91.2%, respectively. CONCLUSIONS: Phadiatop test was very sensitive, rapid and convenient, and corresponded well to the results of CAP specific IgE. We concluded that Phadiatop test is very useful as a screening tool of atopy in Korea.
Allergens ; Asthma ; Far East ; Immunoglobulin E* ; Korea ; Mass Screening* ; Sensitivity and Specificity ; Skin

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

A case of congenital absence of right atriovntricular (A-V) connection of heart is reported. Patient was 81 day old male infant with chief complaints of dyspnea and irritability. Clinical evaluation revealed increased pulmonary vascularity on chest x-ray, absence of right A-V connection, regurgitation of left A-V valve, right-sided ventricular hypoplasia and L-TGA. Clinical assessment of the case was tricupsid atresia with LTGA and mitral regurgitation. Pulmonary artery banlding and artial septectomy was performed. Parenteral alimentation through the femoral veins resulted in obstruction of IVC and subsequent multiorgan failure. The autopsy findings of the heart were corrected transposition of great arteries with associated anomallies of right-sided mitral atresia, Ebstein's malformation of left-sided tricuspid valve, ventricular septal defect, muscular hypertrophy of right-sided left ventricle with luminal obliteration. Long segment of IVC was completely occluded due to occlusive thrombi with fungal infection. Bilateral kidneys were infarcted and azygos vein was markedly engorged. Microscopic examination revealed candidal colonization in the inferior vena cava and septic embolzation in brain.
Infant ; Male ; Female ; Humans

Since Ender introduced the concepts of multiple flexible intramedullary nailing in 1970, Ender nailing has been mostly used in intertrochanteric fractures of the elderly patients, but it has been rarely used in younger patients because of serious complications such as shortening and external rotation deformity. Authors already contended that the incidence of such complications had intimate connection with the quality of bone, and accordingly with the age. To substantiate the contention, we analyzed thirty-four cases with more than one year follow-up among forty cases of intertrochanteric fractures treated with Ender nails during the period from 1982 to 1989. And the results are summarized as follows;1. The average age was 39 yrs., and the most common cause of fractures was fall from a height. 2. According to the Kyle et al. clsssification, stable fractures(type I & II ) were 13 cases(38%), and unstable fractures (type III & IV) were 21 cases(62%). 3. According to the Singh's index, the good in bone quality(Grade 4, 5, & 6) were 31 cases(91 %), and the poor(Grade 1, 2, & 3) were only 3 cases(9%). 4. Postoperative complications occurred in 6 cases(17%), which included ROM limitation of knee joint in three cases(9%), proximal migrations of nails in two(5%), and distal migrations of nails in one(3%). Among them, 4 cases required revisional operations. There was no case with apparent external rotation deformity over 20 and shortening over 2cm. 5. It is thought that, contradictory to common beliefs, Ender nailingis a safe method for intertrochanteric fractures of femur in younger patients with good bone quality, but requires some experiences and cautions to prevent such complications as external rotation deformity and shorterning.
Aged ; Congenital Abnormalities ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip Fractures ; Humans ; Incidence ; Knee Joint ; Methods ; Postoperative Complications

Neovascular glaucoma is considered to be one of the most difficult forms of glaucoma to control. In neovascular glaucoma fibrovascular tissue grows over the surface of the iris and trabecular meshwork. Many modified filtering surgery with artificial drainage devices have been tried in attempts to maintain openings for aqueous humor to leave the eye. Modified trabeculectomy was performed with inexpensive easily available simple silicone tube in 8 eyes with neovascular glaucma. Of the 8 eyes, 6 had postopeoative intraocular pressures lower rhan 25mmHg through a mean follow-up period of 6 months.
Aqueous Humor ; Drainage ; Filtering Surgery ; Follow-Up Studies ; Glaucoma ; Glaucoma, Neovascular* ; Intraocular Pressure ; Iris ; Silicones ; Trabecular Meshwork ; Trabeculectomy*