The slipped capital femoral epiphysis is characterized by a growth disturbance of the capital physi. resulting in weakening of this structure and a subsequent displacement of the femoral head on the fe moral neck. It is a rare entity in Korea and only six cases have been reported so far1-5). One of ou cases was a bilateral mild acute slips in 13 yearold boy which were treated by Hagie pinning. Th other case, a 17 year-old boy, who suffered from a moderate acute on chronic slip in his left hip an showed a typical Pistol grip deformity. He was treated by gentle closed rcduction and Knowles pi fixation with good result.
Congenital Abnormalities ; Epiphyses ; Hand Strength ; Head ; Hip ; Humans ; Korea ; Male ; Neck ; Slipped Capital Femoral Epiphyses

When the multiple myelographic defects at lumbosacral region are noted, the prudential effort for decision of appropriate area of surgical decompression would be needed. Fifty four patients who had been treated surgically for the deseases, such as HNP and spinal stenosis, from March in 1982 to Feb. In 1987 at Department of Orthopecdic Surgery, Soonchunhyang University Hospital, were analyzed in order to define the etiology, the level of the defect, indication for the operation and to assess the results of each level which had been operated. The results of the study were as follows. 1. The number of patients, which the multiple indentations were noted in the myelogrsphy, was 54 cases, 29 spinal stenosis, 15 HNP and 10 mixed types. 2. The most common defect levels in myelography were L3-4 snd L4-5, which were 19 cases (35.2%), the next levels were L4-5 and L5S1, which were 16 cases(29.6%), then L3-4, L4-5 and L5S1 were 7 cases(13%) and the other levels were 12 cases(22.2%). 3. The decision for the sppropriste operation area had not be done following to the size of the myelographic defect, but the clinical symptoms and physicsl exsminations. 4. The results were classified ss excellent or good in 79.7%, which was 80% at two levels snd 79.5% at one level. 5. The operation levels could be decressed for the reducing the spinal instability, operation time and possibility of the dangerous conditions and promotion of early restoration and, ambulation, if the severe differences between the results of one and two operation levels were not seen.
Decompression, Surgical ; Humans ; Lumbosacral Region ; Myelography ; Spinal Stenosis ; Walking

This study represents the radiologic, histologic features & clinical analysis of hyaline mambrane disease in 47 newborn infants who were delivered in Ewha Womans Univ. Hospital & expired caused by repiratory distress & confirmed by autopsy , during Jan. 1981 to June, 1984. The results were as follows; 1. Classification ofradiolgraphic stage (by Wolfson's criteria); Stage III(34.1%) was the most frequent. 2. Male to female ratio was 2.4:1. 3. Method of delivery; Cesarean section (44.7%) was the highest frequency, compared with percent ofcesarean section to total delivery(29.0%). 4. Distribution of birth weight; 1.0-2.0 Kg(48.9%) was the mostfrequent. 5. Distribution of gestational period; 32-36 weeks (29.8%) was the most frequent. 6. Complication; Pulmonary hemorrhage(31.9%) was the most frequent, in order, subarachnoid hemorrhage & pneumothorax were followed.7. Final diagnosis of hyaline membrane disease was based on histo-pathologic diagnosis.
Autopsy ; Birth Weight ; Cesarean Section ; Classification ; Diagnosis ; Female ; Humans ; Hyalin ; Hyaline Membrane Disease ; Infant, Newborn ; Infant, Newborn ; Male ; Methods ; Pneumothorax ; Pregnancy ; Subarachnoid Hemorrhage

PURPOSE: The purpose of this study was to evaluate the efficacy of focused ultrasound (US) to characterize small indeterminate hepatic lesions on contrast-enhanced CT in cancer patients. MATERIALS AND METHODS: Forty-three consecutive patients with proven cancers developed 70 indeterminate hepatic lesions that were less than 1.5 cm in size, as detected on contrast-enhanced CT. Two radiologists performed ultrasound focusing on the targeted area after referencing the location of the hepatic lesions on a previous CT image. When the hepatic lesions were visualized by focused US, the lesions were characterized as cysts, hemangiomas, or solid/metastases. Verification of the hepatic lesions was assessed by a histopathological examination or by follow-up imaging. RESULTS: Focused US detected 51 (73%) of 70 indeterminate hepatic nodules on CT and all of the nodules visualized on focused US could be characterized as cysts (n = 40), hemangiomas (n = 7), or solid/metastases (n = 4). All of the cysts and six hemangiomas were verified as benign lesions. One hemangioma was subsequently identified as a metastasis. Nineteen (27%) indeterminate hepatic nodules were not visible on focused US and 18 nodules were verified as benign lesions. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of focused US for differentiating metastases among indeterminate hepatic nodules less than 1.5 cm in size on CT were 66.7%, 100%, 97.1%, 100%, and 97%, respectively. CONCLUSION: Focused US may be the next appropriate examination to perform for cancer patients with indeterminate hepatic nodules detected on CT, Focused US may be a pivotal modality for defining prognosis and treatment.
Abdomen ; Follow-Up Studies ; Hemangioma ; Humans ; Liver ; Liver Neoplasms ; Neoplasm Metastasis ; Prognosis ; Sensitivity and Specificity

The congenital cystic adenomatoid malformation of the lung is an unusual pulmonary entity, and usuallysymptomatic in infancy with sign of resiratory distress. This abnormality consists of enlarged, multicystic lobewith smooth-walled cysts of variable sized, which can communicate with major bronchi through malformed air passagethat usually lacks in cartilage. Roentgenographic findings are three types. First type is multicystic patternshowing various sized of cysts and causing mediastinal shift with pulmonary herniation. Second type is dominantcystic pattern underlying multicystic lesion, Third type is solid homogenous mass. Prompt surgical resection ischoice of treatment. We recently experienced a case of congenital cystic adenomatoid malformation of the lung of27 day female in fant and report with reviwe of literatures.
Bronchi ; Cartilage ; Cystic Adenomatoid Malformation of Lung, Congenital ; Female ; Humans ; Lung

Grand multifetal pregnancies (4 or more), usually caused by ovulation induction agents and assisted reproductive technologies, challenge all members of a perinatal team and put mothers and infants increased risk. Important anesthetic considerations include greater incidence of complications that in the singleton pregnancy, risks related to the large pregnant uterus, impaired uterine contraction prior to delivery secondary to fetal oxygenation, and preparation of sufficient man-power and instruments. The importance of neonatal resuscitation cannot be overemphasized. We report a successful general anesthetic management for an emergent quadruplet cesarean section at 31 weeks 5 days weeks gestational age.
Anesthesia, General ; Cesarean Section ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Mothers ; Ovulation Induction ; Oxygen ; Pregnancy ; Quadruplets* ; Reproductive Techniques, Assisted ; Resuscitation ; Uterine Contraction ; Uterus

The development of glomerular injury in patients with malignancy is considered as paraneoplastic syndrome. The most frequently observed renal lesions associated with malignancies are the membraneous glomerulonephritis on carcinomas and minimal change nephrotic syndrome on Hodgkin's disease. However, glomerular diseases on non-Hodgkin's lymphoma were only occasionally reported. Here we report a case of IgA nephropathy associated with non-Hodgkin's lymphoma. A 53-year-old woman who had complained of gross hematuria and fever was admitted to Wonju Christian Hospital. A urinalysis revealed 2+ proteinuria and red blood cells >30/HPF. A 24-hour urinary protein excretion was 379mg. She was diagnosed as IgA nephropathy on renal biopsy. Subsequently, biopsy of her enlarged neck node was performed for evaluation of fever of unknown origin and it revealed non-Hodgkin's lymphoma (Ki-1 positive anaplastic lymphoma null cell type). Combination chemotherapy was instituted with cyclophosphamide, adriamycin, vincristine and prednisone. After 3 cycles of chemotherapy, she showed no evidence of proteinuria and hematuria with clinical and radiological improvement of malignant lymphoma. Therefore we suggest of certain association between IgA nephropathy and non-Hodgkin's lymphoma by the observation of corresponding disease activity.
Biopsy ; Cyclophosphamide ; Doxorubicin ; Drug Therapy ; Drug Therapy, Combination ; Erythrocytes ; Female ; Fever ; Fever of Unknown Origin ; Gangwon-do ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Hodgkin Disease ; Humans ; Immunoglobulin A* ; Lymphocytes, Null ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Middle Aged ; Neck ; Nephrosis, Lipoid ; Paraneoplastic Syndromes ; Prednisone ; Proteinuria ; Urinalysis ; Vincristine

BACKGROUND/AIMS: Auscultation of bowel sounds is a traditional technique for evaluating patients with abdominal symptoms. It is, however, subjective and qualitative method in general. Recently, analysis of bowel sounds becomes possible. We analyzed bowel sounds in healthy volunteers and measured platelet depleted plasma 5-hydroxytryptamine (5-HT) that may be associated with postprandial symptoms in irritable bowel syndrome. METHODS: We recorded both fasting and postprandial bowel sounds for 30 minutes in 16 healthy volunteers with a sensitive electronic stethoscope attached to a digital recorder. The files were saved in computer as wav files and analyzed with a specialized program. Blood samples were also taken before and 1 hour after meal for 5-HT analysis. RESULTS: Meal challenge made no statistically significant changes in the 5-HT concentrations and all the sound parameters including sound to sound interval, sounds/minute, average of sound amplitudes, sound length, percentage of bowel sounds representing sound clustering and dominant frequency of sounds. CONCLUSIONS: Postprandial changes in bowel sounds and plasma 5-HT were insignificant in healthy Korean volunteers.
Adolescent ; Adult ; *Auscultation ; English Abstract ; *Fasting ; Female ; Humans ; *Intestines ; Male ; *Postprandial Period ; Reference Values ; Serotonin/*blood

OBJECTIVE: To investigate whether polymorphism of Catechol-O-methyltransferase (COMT) gene is associated with the risk of polycystic ovary syndrome (PCOS) in Korean women. METHODS: One hundred and thirty-six PCOS patients and eighty four controls were enrolled. Blood samples were collected from the patients diagnosed according to the 2003 revised criteria of the Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Age matched women with regular menstruation from same geographic region were recruited as control subject. Polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) of PCR products were done to determine all individuals' genotype. RESULTS: In women with COMT(LL) genotype, there was decreased PCOS risk and this difference was statistically significant (OR 0.24, 95% CI 0.11~0.51). CONCLUSION: The results suggest that the COMT(LL) genetic polymorphism might be associated with PCOS risk in Korean women.
Catechol O-Methyltransferase ; Consensus Development Conferences as Topic ; Female ; Genotype ; Humans ; Menstruation ; Polycystic Ovary Syndrome ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Restriction Fragment Length

OBJECTIVES: Developments in endoscopic technique and equipments have improved duct clearance rate in patients with extrahepatic bile duct(EHBD) stone. In this study, we reviewed our experience in extracting EHBD stones with standard and more advanced technique and equipments such as mechanical lithotripsy and extra corporeal shock wave lithotripsy. Aims of this study were to determine the overall success rate of endoscopic ex tracting for EHBD stone, to identify risk factors for failed duct clearance at initial and final therapeutic ERCP. METHODS: We retrospectively reviewed 214 consec utive patients who underwent Endoscopic Retrograde Cholangiopancreatography(ERCP) for EHBD stone over 45 months period. Factors evaluated for failed duct clearance included stone size, stone number, stone shape, concomitant stone of gallbladder and intrahepatic duct, presence of distal bile duct stricture, periampullary diverticula(PAD), Billroth-II gastrojejunostomy, and sepsis at admission. RESULTS: The overall success rate of endoscopic treatment for EHBD stone was 93.5% (200/214). The causes of failed duct clearance were failed endoscopic sphincterotomy in 5/214 (2.3%), technical failure of extracting stone in 5/214(2.3%), and aggravation of acute cholecystitis between therapeutic endoscopic sessions in 4/214(1.9%). Risk factors for failed duct clearance with endoscopic extraction of EHBD stone were size and shape of the stone, concomitant stone of gallbladder and intra hepatic duct, and stricture of distal common bile duct. The duct clearance rate with initial therapeutic ERCP was 56.5%(121/200). Risk factors for failed duct clearance with initial therapeutic ERCP were size, shape and number of stone, and sepsis at admission. The com plications of endoscopic treatment for EHBD stone were major bleeding in 5/200 (2.5%), pancreatitis in 18/200 (9.0%), but there was no perforation. CONCLUSION: Eventhough risk for failure of endo scopic treatment for EHBD stone were giant or piston shaped stone, concomitant stone of gallbladder and intra hepatic duct, and stricture of distal common bile duct, we conclude that endoscopic treatment for EHBD stone is safe and effective treatment modality, and choice of treatment.
Bile ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystitis, Acute ; Common Bile Duct ; Constriction, Pathologic ; Gallbladder ; Gastric Bypass ; Hemorrhage ; Hepatic Duct, Common ; Humans ; Lithotripsy ; Pancreatitis ; Retrospective Studies ; Risk Factors ; Sepsis ; Shock ; Sphincterotomy, Endoscopic