For the recovery of broken bone or the free vascularized bone graft the vascular topography of the nutrient artery is very important. To estabilish the metric data of the nutrient foramen, its number, direction and site had been observed, and the size and position were measured. The results are as follows. 1. In 53% of the femurs, the number of the nutrient foramen was two, and in 57.1% of the paired materials. The number in both side was not different. The femoral nutrient foramen opened toward the superior direction in the most cases (97.3%). The foramens appeared most commonly (58.9%) on the medial lip of the linea aspera of the femur. The positional index was variable between 28.6 to 70.0 and it was 46.4±10.7 in average. Foramina appeared most commonly (41.9%) in the 30-40 index area of total length of the femur. 2. The number of the tibial nutrient foramen was one in 91.0% of the cases. All of the foramen opened toward the inferior direction. The foramen was most commonly observed on the lateral to vertical ridge of thie tibia (74.3%). Dividing the fibular into 10 parts, the positional index of the tibia was variable between 14.5 and 55.4, and it was 33.4±4.7 in an average. In 85.3% of the cases, the foramen observed in 4th segment. 3. The number of the fibular nutrient foramen was one in the most cases (81.0%). The direction of the foramen was inferior in 88.0% of the cases. The foramen positioned on the posterior surface of the fiular and its average positional index was 47.9±11.3, and its range was 20.3 to 72.4. The foramen was observed in 5th segment in the most cases (35.9%). 4. The size of the nutrient foramen was measured by the various sized stylet. The diameter of the femoral nutrient foramen was ranged from 0.5mm below 1.0mm in 46.6% of the cases. The that of the tibia was ranged from 1.0mm below 1.5mm in 53.2% of the cases. And that of the fibular was ranged from 0.5mm below 1.0mm in 54.0% of the cases.
Adult* ; Arteries ; Femur ; Fractures, Bone ; Humans ; Lip ; Tibia ; Transplants

We report a case of subcutaneous phaeohyphomycosis caused by Exophiala(E,) jeanselmei in a 66-year-old female, who showed a mild tender, 4.5x3.5cm sized, erythematous cystic mass with satellite lesions on the left forearm for 4 months. Histopathologically, suppurative granulomatous inflammation, brownish conidia in a chain and hyphae were observed. Fungal culture grew out the typical black-gray velvety colonies of E. jeanselmei after 2 weeks. The isolate grow well at 25 C, but very poorly at 37 C. No growth could be observed at 40 C. Sporulation adequate for evaluation was present on the malt extract agar. We confirmed E. jeanselmei by colony and microscopic morphology, temperature tolerance and sugar assimilation tests. The patient had been treated with itraconazole for 6 momths. Complete remission was observed.
Agar ; Aged ; Exophiala* ; Female ; Forearm ; Humans ; Hyphae ; Inflammation ; Itraconazole ; Phaeohyphomycosis* ; Spores, Fungal

No abstract available.
Renal Artery* ; Ureter* ; Veins*

PURPOSE: A consecutive series of 710 patients who underwent curative gastrectomy for carcinoma was studied with a special reference to the number or frequency of lymph node metastasis and the patient's prognosis. MATERIAL AND METHODS: Survival rates were calculated by the Kaplan-Meier method, and the difference between each group was evaluated statistically by the log-rank method. Follow-up was obtained for 709 patients (99.9%). RESULTS: According to the number of lymph nodal metastases, the five year survival rate for group 1 (1~3 positive nodes) was 50.9%; for group 2 (4~6 positive nodes), 56.7%; and for group 3 (more than 6 positive nodes), 12.0% (p<0.0001). According to the frequency of lymph node metastases, the five year survival rate for those with up to 25 per cent frequency of metastases was 47.5%; for those with up to 50 per cent frequency of metastases, 15.6%; and for those with greater than 50 per cent metastases, 6.3% (p<0.0001). According to the frequency of the regional lymph nodes (which include perigastric nodes along the lesser and greater curvatures, nodes located along the left gastric, common hepatic, splenic, and celiac arteries) metastasis, we categorized them as group 0 (N0: no metastasis), 1 (N1: metastasis in up to 25%), and 2 (N2: metastasis in greater than 25%). CONCLUSION: This subdivision could be successfully applied to the clinical evaluation of gastric carcinoma (five year survival rate for N0, 86.9%; for N1, 49.0%; and for N2, 10.7% (p<0.0001)) without difficulty in dividing certain lymph nodes into the correct location.
Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis ; Prognosis ; Stomach Neoplasms* ; Survival Rate

The insulin-like growth factor(IGF)s are believed to play an important role in the maintenance of bone mass. The IGFs are found complexed with high affinity to a family of IGF-binding protein(IGFBP)s in the circulation. It is known that IGFBPs are involved in the transport of IGFs to tissues and modulate IGFs actions at local tissue The purposes of this study were to compare serum IGFBPs profiles in natural menopausal women with and without osteoporosis and in osteoporotic and nonosteoporotic women with premature menopause and to evaluate the relationship between serum IGFBPs profiles and bone mineral density(BMD) in women without ovarian function. Serum IGFBPs were measured by western ligand blot and immunoradiometric assay. The relative levels and proportions of serum IGFBP-2 measured by western ligand blot in natural menopausal women with osteoporosis(n=20) significantly increased compared to nonosteoporotic women(n= 20), whereas relative levels of serum IGFBP-3 in natural menopausal women with osteoporosis decreased. No significant differences in the relative levels of serum IGFBPs between osteoporotic(n=8) and nonosteoporotic women(n=10) with premature menopause were noted. The IGFBP-3 levels determined by immunoradiometric assay in women without ovarian function(n= 69) showed a similiar trend. The relative proportions of serum IGFBP-2 in osteoporotic women without ovarian function were signifcantly higher than those in nonosteoporotic women whereas relative levels of serum IGFBP-3 in osteoporotic women with natural menopause decreased. The relative levels and proportions of serum IGFBP-2 in women without ovarian function correlated negatively with BMD of lumbar spine, trochanter and Ward's triangle but there were significant positive correlations between levels and relative proportions of serum IGFBP-3 and BMD of above sites. No significant correlations between relative levels and proportions of serum IGFBP-1, IGFBP-2 and BMD were noted. Our data indicate that serum IGFBP profiles might be useful in identifying women without ovarian funcion at risk for osteoporosis,
Bone Density* ; Carrier Proteins* ; Female ; Femur ; Humans ; Immunoradiometric Assay ; Insulin* ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 2 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Menopause ; Menopause, Premature ; Osteoporosis ; Spine

Xanthogranulomatous epididymitis is extremely uncommon inflammatory disease of the epididymis that may result in massive destruction of the organ. It's clinical manifestation mimics epididymal tumor or abscess, which does not allow easy discrimination between theses diseases. We report here on a case of xanthogranulomatous epididymitis in a 69 years old man that, did not respond to antibiotic therapy.
Abscess ; Aged ; Discrimination (Psychology) ; Epididymis ; Epididymitis* ; Humans ; Male

No Abstract Available.
Carcinoma, Merkel Cell*

Pheniramine maleate(avil(R)) is a H1-antagonist that is derived from alkylamine. Skin reactions with parenteral administration of avil(R) are uncommon. A 29-year-old woman visited our department with a 3-year history of relapsing generalized multiple pruritic evanescent erythematous wheals after antihistamine and steroid injection. Intradermal skin test with Avil(R) was positive. We treated with 5 mg of mequitazine administration three times a day for 2 years.
Adult ; Female ; Humans ; Pheniramine* ; Skin ; Skin Tests ; Urticaria*

The syndrome of protracted diarrhea (PD) includes several diseases with diverse etiologies. This study was conducted to characterize the spectrum of causes, clinical manifestations, and the outcomes of PD. A retrospective analysis of the clinical and pathological findings was performed on 25 patients with diarrhea starting within the first 2 yr of life and a requirement of parenteral nutrition (PN). According to the intestinal histopathology, patients were classified into four groups: immune enteropathy (12 cases), lymphangiectasia (6 cases), epithelial dysplasia (5 cases), and unclassified (2 cases). All patients with epithelial dysplasia had earlier onset of diarrhea and longer duration of PN than those in the other groups. Three patients (12%) had an evidence of a familial condition. Five patients (three with microvillous inclusion disease and two with immune enteropathy) died. Sixteen patients recovered, and three (two with primary lymphangiectasia and one with microvillous inclusion disease) still had diarrhea. One patient underwent intestinal transplantation for tufting enteropathy. In conclusion, infants with PD should be referred to specialized centers where advanced diagnostic and therapeutic facilities are available, because histological analysis is critical for the diagnosis of PD, and PN or intestinal transplantation is the only therapeutic option in a subset of cases.
Academic Medical Centers ; Age of Onset ; Autoimmune Diseases/pathology ; Child, Hospitalized ; Child, Preschool ; Data Collection ; Diarrhea/*pathology ; Enteritis/immunology/*pathology ; Female ; Human ; Infant ; Infant, Newborn ; Intestinal Mucosa/pathology ; Intestine, Small/immunology/pathology ; Korea ; Lymphangiectasis, Intestinal/pathology ; Male ; Microvilli/pathology ; Retrospective Studies

PURPOSE: In the Spring 1995, there was an outbreak of adenoviral infection, which caused four death out of ten patients with adenoviral pneumonia in our hospital. Clinical courses of ten patients with severe pneumonia were similar each other, and two were confirmed as adenoviral pneumonia by postmortem autopsy. Although not proven, we believe eight patients had adenoviral pneumonia. Therefore, we report clinical features in ten cases of severe adenoviral pneumonia. METHODS: Two cases with adenoviral pneumonia and eight cases with presumed adenoviral pneumonia were admitted in this hospital from March to June, 1995. Age and sex distribution, clinical manifestations, laboratory data, chest X-ray findings were reviewed. RESULTS: They were young children between 4 to 25 months of age(mean 12.7+/-6.1 months), and male to female ratio was 9:1. They presented with abrupt fever, cough, tachypnea, and dyspnea. Mean duration of fever were 12.7+/-6.1 days. Crackles on auscultation were heard in all patients. Studies for Mycoplasma and Tuberculosis were all negative. Cultures of bacteria and fungi were negative, and they did not respond to the antibiotics. The chest X-ray revealed the diffuse lobar consolidation with varying amount of pleural effusions. The findings of pleural fluid showed characteristics of transudate with predominant monocyte. Eight of our severe adenoviral pneumonia patients were enjoying normal health previously. Only two patients had previous medical problems, one with chronic cytomegalovirus pneumonia and the other with neutropenia induced by phenobarbital. The course of illness suggests that the infection was hospital acquired and the final outcome was fatal. Three of them developed seizure with fever, five change of consciousness, four conjunctivitis, three otitis media, and two gastro-intestinal symptoms. Autopsy was done in two of four patients. Grossly, the lungs were heavy and dark- red in color. There were bilateral pneumonic consolidation with patchy areas of hemorrhage. Microscopically, severe necrotizing bronchitis and bronchiolitis with numerous intranuclear inclusion of Cowdry type A and B were found. Alveoli were edematous and filled with fibrinous exudate, and covered with hyaline membrane. Ultrastructurally, typical adenoviral particles showing hexagonal shape in paracrystalline array symmetry were found in the nucleus of aleveolar lining cells. CONCLUSIONS: Yet, occasionally, adenoviral infection becomes most aggressive form of pneumonia. We should consider adenoviral pneumonia when clinical findings of pneumonia are very similar with baterial pneumonia except poor response to broad spectrum antibiotics. There is no specific treatment for adenoviral infection. So, for prevention of adenoviral pneumonia, we recommend isolation in suspicious adenoviral infection.
Adenoviridae ; Anti-Bacterial Agents ; Auscultation ; Autopsy ; Bacteria ; Bronchiolitis ; Bronchitis ; Child ; Conjunctivitis ; Consciousness ; Cough ; Cytomegalovirus ; Dyspnea ; Exudates and Transudates ; Female ; Fever ; Fibrin ; Fungi ; Hemorrhage ; Humans ; Hyalin ; Intranuclear Inclusion Bodies ; Lung ; Male ; Membranes ; Monocytes ; Mycoplasma ; Neutropenia ; Otitis Media ; Phenobarbital ; Pleural Effusion ; Pneumonia* ; Respiratory Sounds ; Seizures ; Sex Distribution ; Tachypnea ; Thorax ; Tuberculosis