This report is a clinical review of 58 patients suffering from frostbite, who were treated at the department orthopedic surgery, Seoul City Dong Bu Hospital from November 1982 to March 1985. The results are as follows: 1. The male to female sex ratio was 13.5:l. 2. The majority of the patients (72%) were decades between 30 and 50. 3. Frostbite began on November and registered the highest incidence in January, the lowest temperature of the year. 4. The most commonly affected region was the lower extremities, bilaterally. 5. The average duration of exposure in cold weather was 23 days, 6. The average hospitalization period was 84 days. 7. Among the 58 patients, 14 patients were treated by conservative treatment, 14 patients by closed amputation and 25 patients by open amputation.
Amputation ; Clinical Study ; Female ; Frostbite ; Hospitalization ; Humans ; Incidence ; Lower Extremity ; Male ; Orthopedics ; Seoul ; Sex Ratio ; Weather

The influences of adrenal corticosteroid on the development and regression of neurons of dentate and hippocampus were studied by adrenalectomy and steroid overload in neonatal rats. The results obtained were as follows. 1. The cell death occurred naturally in numerous dentate granule cells and hippocampal pyramidal cells. 2. The number of dentate granule cells undergoing cell death decreased by injection of adrenal corticosteroid, but increased in adrenalectomized rat brains. The changes occurred prominently at postnatal day 6. 3. The number of hippocampal pyramidal cells undergoing cell death decreased in CA3 region by injection of adrenal corticosteroid, but was not changed in adrenalectomized rat brains. However, other regions exhibited no change by adrenal corticosteroid and adrenalectomy. 4. The cell death of pyramidal cells of CA3 region occurred in close relationship with the cell death of dentate granule cells, which was different from other CA regions. In summary, the cell death of dentate and hippocampal neurons occurred naturally but seemed to be influenced by other factors as well as adrenal corticosteroid.
Adrenalectomy ; Animals ; Brain ; Cell Death ; Hippocampus* ; Neurons* ; Pyramidal Cells ; Rats*

Primary hepatic carcinoid tumors are extremely rare although the liver is a frequent site of metastases from intestinal carcinoids. Recently we investigated a case of primary hepatic atypical carcinoid in a 47-year-old man who had infested with Clonorchis sinensis for 20 years. The resected right lobe of the liver was almost completely occupied by a huge tumor, measuring 20 x 19 x 12 cm. The cut surfaces of the mass were solid, soft and pale yellow, accompanied by several small satellite nodules, measuring up to 1.5 cm in diameter. Microscopically, the tumor consisted of polygonal to columnar cells with eosinophilic granular cytoplasm forming Lym-numerous small acini and large trabeculae. Their nuclei were round to polygonal with coarse stone chromatin, had obscure to small nucleoli and frequent mitoses. There were multiple necrotic foci of varing sizes. The surrounding dilated bile ducts contained several degenerating worms on in of Clonorchis sinensis. The tumor cells were argyrophil-positive but argentaffin-negative. Immunohistochemically, the tumor cells were positive for cytokeratin, chromogranin and somatostatin but were negative for CEA, AFP, insulin, glucagon, ACTH, growth hormone and volve-prolactin. Ultrastructually, the tumor cells contained variable-sized numerous electron dense of neurosecretory granules.
Male ; Humans ; Neoplasm Metastasis

No abstract available.
Lissencephaly* ; Walker-Warburg Syndrome

BACKGROUND: Alexithymia refers to a specific disturbance in psychic functioning characterized by difficulties in capacity to verbalize affect and to elaborate fantasies. Although initially described in the context of psychosomatic illness, alexithymic characteristics may be observed in patients with a wide range of medical and psychiatric disorders. OBJECTIVE: The present study was to evaluate the relationship between the alexithymia and bronchial asthma, and to compare the results with finding from a group of acute infectious illness subjects. MATERIAL AND METHOD: Alexithymia was measured with on Korean translation of the TAS-20 (Toronto Alexithymic Scale-20 Korea version) and the Scored Archetypal 9 Test(SAT9). Thirty patients with bronchial asthma and thirty patients with acute infectious illness completed these tests. The SAT9 and the TAS-20K scores were compared in the both group, considering the age, gender, education level, and duration of illness. RESULT: Bronchial asthma patients had significantly higher score of on the TAS-20K and SAT9 compared with those with infectious illness(p<0.05). The two scales correlated in expected direction. Alexithymia was significantly related to education level(SAT9: r=0.335, TAS-20K: r=-0.376, p<0.01) and duration of illness(asthma group, SAT9: r=-0.383, TAS-20K: r=0.288, p<0.05). CONCLUSION: Bronchial asthma patients had significantly higher alexithymic scores. This finding suggests that psycliathic consultation may be considered for the management of asthmatic patients with alexithyria.
Affective Symptoms* ; Asthma* ; Education ; Fantasy ; Humans ; Korea ; Weights and Measures

Cytomegalovirus (CMV) infection is an uncommon association with idiopathic inflammatory bowel disease (IBD) often leading to a variety of serious complications. A total of 41 resected cases of IBD were examined to elucidate the pathologic features of intestinal CMV infection which was assessed by histologic examination and confirmed by immunohistochemistry with CMV antibody. Six cases were positve for CMV antibody; five cases in 19 ulcerative colitis (UC, 26.3%) and one case in 22 Crohn's disease (CD, 4.5%). Of 7 cases of the steroid-treated UC group, five cases were superinfected with CMV (71.4%) but none in 12 cases of the steroid-untreated UC group. All of the five CMV-positive cases in UC showed deep ulceration and transmural inflammation, while none of 10 UC cases without above features were CMV positive. Fibrinoid necrosis and thrombi were found in 83.3% of the CMV infected group, while none in the CMV-negative group of UC cases (p=0.01). We conclude that IBD, particularly UC, is susceptible to the CMV infection when steroid hormone is administered, and that deep colonic ulceration, transmural inflammation and fibrinoid necrosis of vasculature may suggest superinfection of CMV in UC patients. It seems that deep colonic ulceration may be the consequence of an ischemic change following vascular luminal occlusion or vasculitis by CMV infection.
Colitis, Ulcerative ; Colon ; Crohn Disease ; Cytomegalovirus Infections* ; Cytomegalovirus* ; Humans ; Immunohistochemistry ; Inflammation ; Inflammatory Bowel Diseases* ; Necrosis ; Phenobarbital ; Superinfection ; Ulcer ; Vasculitis

Histopathologic studies for Helicobacter pylori (H. pylori)-associated chronic gastritis have been mostly undertaken with endoscopic biopsy specimens, often leading to an inappropriate evaluation of the gastric mucosal alterations. The purpose of this paper was designed to investigate the actual prevalence of lymphoid follicle formation by H. pylori infection using the resected stomachs. A total of 16 fresh gastrectomy specimens bearing gastric carcinoma were examined under the quick and gentle procedure, with which H. pylori was detected in 12 cases (75%) and lymphoid follicles in 14 cases (87.5%), while the detection rate of H. pylori remained 56.3% in the control group which comprised the same 16 resected stomachs and were examined by routine tissue preparation procedure without any special care. There was a significant correlation between the presence of H. pylori and lymphoid follicle formation (p=0.05), but no correlation was found between the grades of H. pylori and lymphoid follicles. The topographical distribution of H. pylori or lymphoid follicles in antrum and body gave no statistical difference. Similarly, there was no correlation between H. pylori infection and intestinal metaplasia, activity of chronic gastritis or histologic types of accompanying adenocarcinoma. We conclude that studies of the gastric mucosal change by H. pylori infection using the gastrectomy specimens provide a useful information for analysis of lymphoid follicle formation which is a consistent morphological characteristic of H. pylori infection.
Adenocarcinoma ; Biopsy ; Gastrectomy* ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Metaplasia ; Prevalence ; Stomach

The purpose of this study was to identify the relationship between the clinical response to neoadjuvant chemotherapy and PCNA and VEGF protein expression, apoptosis and its related gene expression such as Bcl-2 and Bax in cervical cancer. We retrospectively reviewed 30 patients with locally advanced or bulky cervical cancer treated with three courses of neoadjuvant chemotherapy followed by radical hysterectomy or radiation therapy at Seoul National University Hospital from June 1995 to June 1998. The specimen were obtained before chemotherapy by colposcopy directed biopsy. The protein expressions of Bcl-2, Bax, VEGF and PCNA were examined by immunohisto- chemical staining and the apoptosis was examined by TUNEL staining. These results were compared with chemotherapeutical response which was evaluated by colposcopy or CT/MRI. There were 2 CR(complete response), 19 PR(partial response) and 9 NC(no change) and there was no progressive disease. There was no significant difference between responder and nonresponder according to the age, tumor size and FIGO stage. The 3 year survival rates of responder and nonresponder were 90.0% and 66.7% respectively and there was significant difference between two groups(p=0,015). The expression of Bcl-2 and Bax was positive in 23.3%(7/30) and 46.7%(14/30). The expression of VEGF was positive in 83.3%(25/30). PCNA PI(positive index), defined as PCNA positive cells in percentage was more than 25.0% in 20 cases. Apoptotic index, defined as the number of the cells undergoing apoptosis per 1,000 tumor cells, ranged from 3 to 53(mean 22.3). Although there was no significant relationship between the clinical response to neoadjuvant chemotherapy and the expre- ssion of Bcl-2, Bax, VEGF and PCNA PI, apoptotic index was significantly higher in responder than nonresponder when the cutoff value of positive was defined as apoptotic index more than 5(p=0.032). In conclusion, the evaluation of the pattern of apoptosis before neoadjuvant chemothera- py is potentially useful for the prediction ofz tumor response to neoadjuvant chemotherapy for cervical cancer.
Apoptosis* ; Biopsy ; Colposcopy ; Drug Therapy* ; Gene Expression ; Humans ; Hysterectomy ; In Situ Nick-End Labeling ; Proliferating Cell Nuclear Antigen* ; Retrospective Studies ; Seoul ; Survival Rate ; Uterine Cervical Neoplasms* ; Vascular Endothelial Growth Factor A*

BACKGROUND: Epidermolysis bullosa is a group of inherited disorcier characterized by blistering of the skin as a result of minor trauma. OBJECTIVE: There exist very little epidemiologic data for most of the major and minor subsets of inherited epidermolysis bullosa in Korea. We look forward to obtaining basic data for the pathogenesis and treatment of epidermolysis bullosa. METHOD: We performed 1st and 2nd trial of survey with the help of 28 dermatologic Departments snd 28 pediatric departments of medical colleges and 14 dermatologic dipartments of general hospitals. RESULTS: 68 cases were collected and classified by disease type, sex distribution, age distribution, and regional distribution. In disease type, 42 cases of EB simplex(62%), 8 cases of junctional type(12%), 10 cases of dominant dystrophic type(15%), 8 cases of recessive dytrcphic type(12%) were reported. In most cases males predominnted, but in dominant dystrophic type both sexes were equivalent. EB simplex, junctional type, RDEB were mostly developed in the 1st decade of life, dominant dystrophic type in the 2nd decade of life. In regional distribution, the number of pi tients was outstanding in large cities such as Seoul, Pusan, Taegu, Kwanju. CONCLUSION: Due to many limitations and shortage of techniques, this epidemiologic study may be notgood enough for the total estimated number of epidermolysis bullos. patients, prevalence rate, and therapeutic modalities. Furthe evaluation should be necessary next time.
Age Distribution ; Blister ; Busan ; Daegu ; Epidemiologic Studies* ; Epidermolysis Bullosa* ; Gwangju ; Hospitals, General ; Humans ; Korea* ; Male ; Prevalence ; Seoul ; Sex Distribution ; Skin

The household survey was performed in a urban slum and a rural Chonnam areas to measure the level of illness and medical care utilization and to find the determinants of physician utilization. The data revealed that age-adjusted prevalence rates of acute and chronic diseases were much the same in both areas ranged between 10.0 to 11.3%. But medical care utilization was more frequent in urban slum than in rural area. The facility of the first medical contact was also different. Some personal and disease related variables including disease severity and activity restricted day were significantly, but somewhat differently by area, associated with physician utilization pattern. When applying Anderson model, the medical need factors explained 42.2 and 40.4% of physician utilization in urban slum and in rural areas respectively, while the enabling factors explained 18.0 and 12.2% and the predisposing factors explained 17.1 and 8.9% correspondingly.
Causality ; Chronic Disease ; Family Characteristics ; Humans ; Jeollanam-do ; Poverty Areas ; Prevalence