The Seoul Journal of Medicine- Brief historical review on the occasion of its discontinuation as a periodical -

The Seoul Journal of Medicine was launched in 1960 as an official Journal of the Seoul National University College of Medicine. The start was an epoch in the viewpoint of establishing a long cherished dream of faculty of our medical school. It was actually the third medical Journal that was published by this Institute in its history of hundred years

A Case of Vogt-Koyanagi-Harada Disease in a Patient With Graves Disease

A case of Vogt-Koyanagi-Harada disease (VKH) that developed in a 36-year-old woman with Graves' disease was described. The patient was treated with Lugol's solution and presented with bilateral serous retinal detachment. She had also suffered from methimazole-induced hypersensitivity and steroid-induced myopathy. Fluorescein angiography showed multiple leakage points and a lumbar puncture revealed pleocytosis, which was compatible with VKH. High dose steroid pulse therapy was successful. Altered immune regulation associated with drug-induced hypersensitivity may contribute to the development of VKH in patients with Graves' disease

Retinopathy of Prematurity in Anencephaly:Pathological and Immunohistochemical Studies of Six Eyes from Three Female Stillborn Holoanencephalic Infants

Retinopathy of prematurity (ROP), a disease of developing blood vessels, is seen predominantly in premature infants requiring oxygen administration. We have noted various degrees of ROP in 6 eyes from 3 female stillborn holoanencephalic babies. Their gestational ages ranged from 30 to 35 weeks. All 6 eyes showed marked hypoplasia of the ganglion cell layer, the nerve fiber layer, and the optic nerve head. At the junction of vascularized and avascular anterior retina, proliferation of vanguard spindle cells (in 4 eyes from 2 cases) and of rear guard angioblastic cells (in all 6 eyes) were noted. Intravitreal vascular proliferation (in 3 eyes from 2 cases) and partial retinal detachment with vitreous hemorrhage (in 1 eye) were also seen. Immunohistochemical studies revealed positive staining for 5-100 protein and negative staining for laminin & Ulex aeropaeus in spindle cells (2/2 cases); the reversed pattern in angioblastic cells (3/3 cases). The reduced mass of retina generally lacking intact ganglion cells and their axons in our cases may induce local vasoconstriction in response to tissue hyperoxia, which result in the retinal hypoxia and consequently, provide the impetus for the establishment of neovascularization. The immunohistochemical findings lend support to the neuroglial origin of the vanguard spindle cells

Congenital Esophageal Stenosis- Case SNUCH-32 -

This 3-year-old girl was admitted to the Seoul National University Children's Hospital (SNUCH) for the fifth time on July 16, 1990, for a surgical intervention. She was born on September 19, 1987 via normal full term spontaneous delivery with the birth weight of 3.4 kg. The vaccination was done as scheduled The family history was unremarkable except for her maternal grandmother who had diabetes mellitus and grandfather died of stomach cancer. She had been healthy until June, 1988 (9 months of age) when her meal was changed from breast milk and weaning food to solid food. She experienced episodes of regurgitation and vomiting. The vomiting was intermittent and cyclic, and was not projectile or bilious. However, since her general condition was good the parents did not pay much attention for these symptoms On August 21, 1988 (11 months of age) she started to run fever with cough, for which she was brought to a local pediatric Clinic. With the 22impression of pneumonia she was managed With antibiotics. She developed diarrhea at that clinic, and was transferred to SNUCH

Atheromatous Embolization during Angiography(A Case Report)

Cholesterol embolization is one of the serious complications of ulcerative atheromatous plaque. Ischemic changes in the lower extremity, brain and other organs including the kidney, pancreas and gastrointestinal tract due to atherosclerotic microemboli have been well documented in autopsy cases in the western world. However, it has been seldom reported in the Korean literature. We report a case of cholesterol embolization of a foot that happened during coronary angiography with resultant gangrene necessitating amputation. A 60-year-old man visited hospital for the evaluation of angina pectoris. He felt a sudden severe abdominal pain during the coronary angiography followed by loss of pulsation of the dorsalis pedis arteries. Acute renal failure, glucose intolerance and gangrene in both feet developed almost simultaneously, and Syme operation was done. Dissection of the dorsalis pedis artery demonstrated segmental occlusion by cholesterol emboli with various stages of organization

Klebsiella Sepsis in a Premature Baby(SNUCH CPC-45)

(Clinicopathologic conference) This male baby was born to a 39 year old mother via Caesarian section because of breech presentation and premature rupture of the membrane. The gestation period was 30weeks and the birth weight was 1200gm. The mother had had 3 spontaneous abortions and 4 therapeutic abortions. During this pregnancy she suffered from a severe toxemia of pregnancy for which she received magnesium sulfate and hydralazine. The immediate postnatal activity of the baby was fair although Moro and sucking reflexes were poor. Apgar scores at 1 minute and 5 minutes were 3 and 7,respectively. The muscle tone was very poor and he was slightly cyanotic. Because of respiratory difficulty the baby was intubated and intermittent positive pressure breathing was applied

Hepatic Ultrastructural Findings of Familial Hyperbilirubinemia Syndrome

Seven liver biopsies of congenital/familial hyperbilirubinemia were studied ultrastructurally including 3 cases of Dubin-Johnson syndrome, 2 cases of Rotor syndrome, one case of Gilbert syndrome and one case of type 2 Crigler-Najjar syndrome. All five cases of Dubin-Johnson syndrome and Rotor's syndrome had conjugated hyperbilirubinemia and both cases of Gilbert's syndrome and a CriglerNajjar syndrome had unconjugated hyperbilirubinemia. In Gilbert's syndrome, the microvilli of the sinusoidal membrane of hepatocytes showed decreased height and number with collagen lay down in the sinusoidal spaces, Megamitochondria, mild proliferation of smooth endoplasmic reticulum, and dilated rough endoplasmic reticulum were also noted. Lipofuscin bodies were seen, but they were less numerous than characteristic Dubin-Johnson bodies. In Crigler-Najjar syndrome, bile canalicular and ductular cholestasis were noted both light microscopically and ultrastructurally. Most bile canaliculi are filled with ovoid homogeneous electron dense material (bile pigments). Widening of the intercellular spaces with increased number of microvilli on the lateral surface of hepatocytes were present. All three cases of Dubin-Johnson syndrome revealed characteristic abundant lysosomal bodies and dilatation of bile canaliculi. These bodies were numerous and membrane bound in round, oval or pleomorphic shapes with variable degrees of electron densities. Dilated bile canaliculi showed expanded lumen with decreased number of microvilli. In Gilbert and Rotor syndromes, the hepatocytes contained lipofuscin-like lysosomal bodies. In both cases of Rotor's syndrome, we found reduced number of microvilli along the sinusoidal side of hepatocyte, like Gilbert syndrome, immature bile canaliculi and pleomorphic megamitochondria and lipofuscin-like lysosomal bodies. We concluded that hepatocytic hyperbilirubinemia syndromes could be differentiated by ultrastructural study along with clinicopathologic correlation

Reduced Expression of nm23 Protein is Related to Nodal Metastasis of Human Gastric Carcinoma

Reduced expression of nm23 gene or protein has been known to be related with nodal metastasis in a variety of malignant tumors of the breast. lung. liver, prostate. ovary and stomach. To elucidate a possible prognostic factor. we studied 42 cases of gastric adenocarcinomas for the expression of nm23 protein using immunohistochemical methods and compared with the known prognostic parameters. The nm23 protein was intensely stained in the cytoplasm and/or the nucleus of carcinoma cells in 9 cases(21.4%). The nm23 protein expression of the non-metastatic group(46.7%) was higher than that of the nodal metastasis group(7. 4%). Perigastric lymph node rnetastasesipttl.Otrl) were more frequently found in the nrn23 protein neqative group(75.8%) than in the nm23 positive group(22.2%). There was no significant correlation between nrn23 protein expression and other parameters such as patient age. sex. WHO grade. Lauren classification. depth of invasion. location of tumor and size. The results suggest that nm23 protein expression plays a role in suppression of nodal metastasis in the gastric adenocarcinoma

Failure to Thrive and Multiple Anomalies in a Newborn: Edwards Syndrome (CPC 95-1)

A 3 hour-old male baby was admitted to the Neonatal Intensive Care Unit of Sowha Children's Hospital due to low birth weight He was delivered to a 32 year-old mother by normal vaginal delivery at a local obstetric clinic at 39 weeks' gestational age with: birth 'I/eight of 1,850gm. There was no history of premature rupture of membrane or maternal fever before delivery On admission, his vital signs were as follows: BP 60/40 mmHg, respiration rate 40/min, heart rate 120/min, body temperature 36°C He was pale In appearance and weak In movement The fontanelles were normotensive The face was symmetrical But micrognathia and low set ears were noted. HIs respiration was weak with a grade IIIVI murmur audible at the left sternal border There were 2 arteries and a vein In the umbilical cord. The baby had abnormally clenched fists and rockerbottom feet, Moro reflex was weak