In the real-time two-dimensional Doppler flow mapping(2DD) system, Doppler signals are processed using auto-correlation technique, so that the direction, velocity and turbulence of the intracardiac blood flow are displayed by coloration on the B mode image of the heart in real time. Aortic regurgitant flow is imaged as a mosaic jet spurting out from the aortic valve orifice to cardiac chamber. Dynamic features in the direction and extent of regurgitant flow and the site of regurgitation on the aortic valve orifice are readily obtained. Feasibility of the 2DD system in the assesment of aortic regurgitation was examined in 30 cases documented by angiography. In 30 cases, there were 20 cases with aortic regurgitation(AR) aged 16 to 57 years(mean 34) and 10 cases without AR aged 17 to 39 years(mean 30). The underlying disorders of AR were rheumatic in 15 cases, bicuspid aortic valve in 1, ventricular septal defect in 1, aortitis in 1, Marfan's syndrome in 1 and unknown in 1. The results are as follows : 1) In 19 out of 20 cases with AR the 2DD showed regurgitant jet spurting out from valve orifice(sensitivity=95%). One case missed by the 2DD had 1+AR. None of the 10 cases who had no AR manifested the evidence of AR on the 2DD(specificity=100%). 2) There was an excellent positive correlation between the maximal jet length of regurgitant flow on the 2DD and angiographic severity of regurgitation(r=0.998, p<0.001). The maximal jet length was less than 3cm for cases with 1+, 3-4.9cm for 2+, 5-5.9cm for 3+, and 6cm or more for 4+AR. 3) In 19 out of 20 cases with AR, the 2DD identifed the anatomic valvular site of regurgitation(sensitivity=95%, specificity=100%). 4) The regurgitant aortic valvular area was measured as 0.6cm2 or less in all of 12 cases with 2+ or less AR, while 0.9cm2 or more in 6 out of 7 cases with 3+or more AR. Thus, a less or greater than 0.8cm2 regurgitant aortic valvular area provides to discriminate between mild(< or = 2+) and severe(> or = 3+) AR. 5) In all 8 cases with fluttering of anterior mitral leaflet and 8 out of 9 cases with fluttering of interventricular septum, a regurgitant jet impinged on them. The results of this investigation indicate that the 2DD system is a very useful and unique noninvasive technique in the detection, estimation of severity and spatial orientation of AR.
Angiography ; Aortic Valve ; Aortic Valve Insufficiency* ; Aortitis ; Bicuspid ; Equidae ; Heart ; Heart Septal Defects, Ventricular ; Marfan Syndrome

Though many effort,s have been made to develop a safe and effective treatment to control osmidrosis, no such goal has been achieved yet. A subcutaneous shaving method, developed by Inaba, appeared to be a favorable choice because of minimal postoperative scar formation. The authors, with this method operated on 112 cases of osmidrosis and compared the results with those of conventianal surgical therapy performed earlier in our department. The results were as follows : 1. The. average age at the time of the operation was 22.0 years old, and the sex ratio between male and female was 37 to 75. 2. The age onset ranged from 11 to 36 years with average of 15.5 years. 3. Family history for osmidrosis was found in 84.8%. 4. General anesthesia were used in 13 cases, while 99 cases were operated under local anesthesia. 5. The mean duration for operation were 75 minutes. 6. Flematoma were observed in 4.5%, wound disruption in 1.3%, and skin necrosis in 3.1%. 7. The results of analysis in 72 follow up cases for more than 6 months showed: 1). Rate for successful reduction of the malodor was 91.7%. 2) The rate of suppression of sweating was 88.9%. 3) The rate of skin tensian with motion was 2.8%. 4 ) The, pstoperative scars were mild or invisible in 95.1%
Anesthesia, General ; Anesthesia, Local ; Cicatrix ; Female ; Follow-Up Studies ; Humans ; Male ; Necrosis ; Sex Ratio ; Skin ; Sweat ; Sweating ; Wounds and Injuries

63 of 348 patients patch tested with an European standard series, had positive reaction to either a fragrance mix or Balsam of Peru. Twelve showed positiv reaction to bot,h patches. The number of positive patch tests to the fragrance mix was 56, while those to Balsarn of Peru was 19 out, of the 63 patients, manifesting sensitivities of 83% and 30% repectively. The fragrance mix was considered a useful screening patch for fragrance allergies. Twenty-five of the patients showing fragrance allergy were further analysed with 8 individual fragrance ingredients at 2% petrolatum. Cinnamic aldehyde and cinnamic alcohol were considered as she most frequent and important. sensitizers.
Humans ; Hypersensitivity* ; Mass Screening ; Patch Tests* ; Peru ; Petrolatum

Background: Thyroperoxidase(TPO) is one of the most important autoantigens in autoimmune thyroid disorders and autoantibody to TPO is found in almost every patients with various autoimmune thyroid diseases. Human TPO was already cloned and the completed nucleotide sequences are well known. In human thyroid tissues, several variants mRNA's of TPO are found in addition to the wild type. Especially the variants lacking exon 10(TPOΔexon10) and exon 16(TPOΔ exon16) are found in very large amount in both normal and Graves thyroid tissues. The significance of these variants TPO mRNAs are largely unknown. The authors tried to investigate the autoantigenic role of these variant TPO. Methods : To produce variant TPO cDNAs, oligonucleotide directed mutagenesis was performed using cDNA for wild type human TPO as template. The produced variants cDNAs were transfected into Cos-7 cells and variants TPO proteins were tested against patients sera showing high titers of anti-TPO antibody. Results: Seven of 12 Graves sera reacted with TPOΔexon 10 and 8 Graves sera with TPOΔ exonl6. Eight of 15 Hashimoto sera reacted TPOΔexon16 and 9 with TPOΔexon16. The reactivity with variants TPO was not related to clinical findings. Conclusion: These two variant TPOs, that is TPOexon10 and TPOΔexon16, could act as an autoantigen if they were translated in vivo, and could play a role in autoimmune thyroid disease. Their exact role in the pathogenesis of autoimmune thyroid disorders are to be clarified.
Animals ; Autoantigens ; Base Sequence ; Clone Cells ; COS Cells ; DNA, Complementary ; Exons ; Humans ; Mutagenesis, Site-Directed ; RNA, Messenger ; Thyroid Diseases ; Thyroid Gland

The distal tibial physeal plate is the second most frequently injured physis and the percentile incidence of its injury is reported to reach 11 percent of all physeal injuries. After physeal injuries, many complications may follow such as angulatory deformity, incongruity of the joint surface, and growth disturbance, which are well recognized. Therefore, for preventing these complications, we have to know mechanism of injury and position of foot in injury. There are several published articles about classification of these injuries. The first traumatological classification of ankle injuries in children is the one proposed by Bishop. Although there were many reports about classification since Bishop, those did not mention the position of foot in injury. Recently a modified classification by Dias and Tachdjian added the postiton of the foot during injury to the direction of the force as Lauge-Hansen did. There were only few reports about epiphyseal and physeal injuries of the ankle in Korea. Also, we could not find the reports which dealt with more than forty cases. The authors have made a clinical analysis on forty cases of childrens ankle fractures, and among them twenty-two could be followed over a year, who were treated at the Department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, from June 1981 to December 1986. Children were in age of 3 to 16 years. Forty cases were classified according to modified Dias and Tachdjians. 15 out of 40 cases (37.5%) had supination and external rotation injury, which is the most frequent mechanism of injury in this series. However, one case (2.5%) which was suspected to be axial compression type could not be accommodated to this classification. Twenty-seven cases were treated by gentle closed reduction and immobillization in a plaster cast, and thirteen by open reduction and internal fixation. Among the 22 cases who were followed over a year, five cases had complications, such as angulatory deformity, incongruity of the joint surface, and growth disturbance. Three cases out of these five cases had incongruity of the joint surface.
Ankle Fractures ; Ankle Injuries ; Ankle ; Casts, Surgical ; Child ; Classification ; Congenital Abnormalities ; Foot ; Humans ; Incidence ; Joints ; Korea ; Supination

The accepted radiographic method to determine cervical spinal stenosis is the direct measurement of the sagittal diameter of the spinal canal on the routine lateral view of the cervical spine. The reported normal and abnormal values for this measurement are inconsistent because of various methods of obtaining the roentgenograms and different body types which affect the size of the X-ray image. According to Pavlow, the ratio method of determining crevical spinal stenosis, in which the sagittal diameter of the spinal canal is divided by the sagittal diameter of the corresponding vertebral body, is independent of technical factor variables and is a reliable method for determining cervical spinal stenosis. In order to determine the Pavlov's ratio of normal Koreans, and compare it with that of radiculopathic group, we measured the diameter of cervicl canal in 47 normal persons(28 male, 19 female), and 32 patients( 9 male, 23 female) who had transient tingling sensation and radiculopathic symtom from the second to fifth decades. The results were as follows :1) The average Pavlov's ratio from C3 to C7 in normal Korean men are 0.906(0.70–1.13), 0.899 (0.070–1.13),0.948(0.70–1.67) and 0.948(0.67–1.17), respectively, and those of normal Korean women are 0.977(0.83–1.15), 1.021(0.83–1.13), 1.014(0.84–1.33) and 1.055(0.88–1.18), respectively. 2) The average Pavlov's ratio from C3 to C7 in radiculopathic Korean men are 0.88(0.65–1.12), 0.90(0.68–1.12), 0.95(0.79–1.12) and 0.95(0.78–1.06), respectively, and those of radiculopathic Korean women are 0.902(0.70–1.27), 0.905(0.69–1.27), 0.939(0.70–1.33) and 0.931(0.70–1. 18), respectively. 3) There are not statistically differences of the Pavlov's ratio between the control group and the radiculopathic group. 4) We believe that the Pavlov's ratio is an effective method in detection of cervical stenosis and is able to eliminate technical factor such as body position, target and object-to-film distanc.
Asian Continental Ancestry Group ; Constriction, Pathologic ; Female ; Humans ; Male ; Methods ; Sensation ; Somatotypes ; Spinal Canal ; Spinal Stenosis ; Spine

No abstract available.

Voluntary habitual dislocation of the hip is very rarely reported in children, and only 13 cases have been reported in the literature. We add a new case in a 5 year old boy. The boy did not have previous history of trauma, skeletal and/or soft tissue anomalies, nor known connective disease. He was treated by intertrochanteric varusinward rotation osteotomy of the affected hip on February 25, 1985 and was followed until January 11, 1993. Postoperative convalescence was uneventfully successful, and the hip developed well without any obvious dysplasia at the latest follow-up.
Child ; Convalescence ; Dislocations ; Follow-Up Studies ; Hip Dislocation ; Hip ; Humans ; Male ; Osteotomy

No abstract available.
Arthroplasty, Replacement, Knee* ; Humans

In general, soft tissue and bone tumors are diagnosed clinically by physical findings, laboratory data, and X-ray findings with only limited reliability, and a definite diagnosis must be supported by histopathological evidence. For this purpose, open biopsy routinely has been carried out, but there have been many disadvantages and sometimes followed by surgical complications. The present study was undertaken to compare the cytologic findings of soft tissue and bone lesions with the histological findings. The specimen were obtained by fine needle aspiration and Franklin-Silverman needle. For cytodiagnosis Stormby's cell block of aspirates were utilized. For histological diagnosis small tissue fragments obtained by the Franklin-Silvermans cutting needle were used. Then, the diagnostic accuracy of 3 different methods were compared, and the clinical applicability of those methods as adjunctive diagnostic procedures in the diagnosis of the soft tissue and bone tumors were assessed. The results obtained were as follows: l. In 15 out of the 20 cases (75%) in which clinically and roentgenologically the soft tissue and bone tumors were suspected, sufficient material was aspirated to enable detailed cytological diagnosis possible by fine needle aspiration. ln 13 out of the 15 cases, diagnosis could be made by cytologic findings, which was similar to histologic findings of tissue obtained by Franklin-Silverman needle. 2. In 6 out of the 20 cases, sufficient tissue fluid for cell block preparation were obtained from the tumor tissues. In 5 cases, cytologic findings of cell blocks were consistent with that ot the tissue obtained by Silverman needle. But in one case malignancy was susupected by cytodiagnostic method, and definite diagnosis could not be made. Finally the lesion was found to be malignant schwannoma through the histological study of tissue specimen obtained by Franklin-Silverman needle biopsy. 3. In 19 out of the 20 cases, diagnosis could be made by Franklin-Silverman needle biopsy. 4. Diagnostic accuracy of the lesions by clinical and roentgenological method was 75%, which overall diagnostic accuracy of 3 methods were 86.7% in aspiration cytology, 83.3% in cytodiagosis of cell block and 95% of histodiagnosis of tissue specimen obtained by Franklin-Silverman needle. Through this study it is found that cytodiagnostic method of aspirates and histodiagnosis of the small tissue specimen by Franklin-Silverman needle are very useful adjunctive methods in enhancing the diagnostic accuracy of the soft tissue and bone lesion prior to open biopsy trial.
Biopsy ; Biopsy, Fine-Needle ; Biopsy, Needle ; Cytodiagnosis ; Diagnosis ; Methods ; Needles ; Neurilemmoma