Microparticle enzyme immunoassay (MEIA) for thyrotropin (TSH) was evaluated and results were compared with those of immunoradiometric assay (IRMA) procedure. Coefficient of variations of within day precision was 3.8-9.6% and those of between day precision was 3.6-17.2%. Correlation between the MEIA(Y) and two site IRMA(X) was excellent (Y=1.0445X-0.1538, r=0.9948). The sensitivity of the assay (mean±2 SD of the zero standard) was 0,0158 µIU/ml. The concentration measured in 497 healthy subjects were ranged from 0.2-3 µIU/ml (mean 1.37 µIU/ml, SD 0.59).

Conclusively, MEIA is more fully automated than IRMA, well correlated with IRMA, can be reliable method for screening test of thyroid function.

Eight hundred and eighty four autopsy brains from patients with clinically diagnosed Alzheimer's disease were examined pathologically. Six hundred ninety eitht(79.96%) of the 884 cases fullfilled histological criteria for Alzheimer's disease, with or withour additional fndings, such as substantia nigral degeneration, cerebellar degeneration, Parkinson's disease or cerebral infarcts. One hundred and eighty six cases(20.04%) were diagnosed as other neurodegenerative disease such as Parkinson's disease, non-specific cortical degeneration or Pick's disease. Degenerative changes in the substantia nigra were common in patients with Alzheimer's disease than has been reported for the general aged population. Brain atrophy was severer in presenile type of Alzheimer's disease than in senile type of Alzheimer's disease.

The present study was conducted to evaluate psychological traits of 69 forensic schizophrenia patients selected on the basis DSM-III-R criteria who were admitted to the Forensic Psychiatric Institution from March to June of 1992.84 Normal controls were matched for sex, age, education level to forensic schizophrenia patients. MMPI-R(Minnesota Multiphasic Personality Inventory), consisted of 556 items and revised to standard form, was administered to the subject and the normal control gruop. No significant differences were found between the two groups in sex ratio, age, and educational level.

Results of the present study were as follows :

1) Generally, the forensic schizophrenia patients presented statistically significant higher T score on L. F and 6(parania) scales than normal controls.

2) Two subgroups were formed as a result of multivariate cluster analysis of T scores of all MMPI scales from the forensic schizophrenia patient group. The first sub-group(N=51) gave statistically significant higher score on L, K scales and no clinical scales. The second sub-group(N=18) presented statistically significant higher score on L, F, K and 1(hypochondriasis), 3(hrsteria), 8(schizophrenia), 6(paranoia) scales.

3) High-K score group of forensic schizophrenia patients, selected on the basis high K scores at the level of 30%, gave statistically significant higher score on L, K scales than the other groups. Low-K score group of forensic schizophrenia patients, selected at the low level of 30%, had high score on, F, 6(paranoia), 8(schizophrenia) scales.

4) Forensic patients presented statistically but not clinically significant lower score on 9(hypomania) scale than normal controls.

5) The results were interpreted as suggested the overcontrolled personality trait and not completely treated psychotic symptoms of fornensic schizophrenia patients and their different personlity traits from general criminals.

The serum vitamin B₁₂(B₁₂) and folic acid estimations were performed on 206 psychiatric inpatients, consecutive admissions to a Ewha Womans University Hospital, Neuropsychiatric Department.

The mean serum B₁₂ value in the subjects(1004.24±479.76pg/ml) was somewhat higher than the normal serum B₁₂ value and none of the subjects has serum B₁₂ deficiency.

The mean serum B₁₂ value was the lowest in 21~30 age group and the highest in 31~40 age group(p<0.05).

The mean serum folic acid value(8.09±4.15ng/ml) was in the range of normal value. But the patients with low serum folic acid value(O~2.5ng/ml) were 6 cases(2.9%), consisting of 3 schizophrenia, 1 mood disorder and 1 epilepsy and the ratio of patients with low anti equivocal serum folic acid value(<5.Ong/ml) was 23.8%. The mean serum folic acid value was the lowest in 11~20 age group and the highest in 51~60 age group(p<0.05).

Patients with epilepsy, organic mental disorder and schizophrenia(in order) had significantly lower mean serum B₁₂ & folic acid values and alcoholism had significantly higher mean serum B₁₂ & folic acid values(p<0.05).

It was concluded that serum B₁₂ deficiency was not related to the psychiatric disorders and the serum folic acid deficiency, but folic acid deficiency appeared to be in certain psychiatric disorders and related to the chronicity of mental illness.

The study was performed to get the basic knowledge about the changes of the cyclic AMP concentration and protein contents in cultured human melanocyte during 7 weeks of cultivation.

The results are as follows :

1) The concentrations of cyclic AMP were linearly increased from the 1st week to the 3rd week up to 8.l0×10^-5 pmoles/cell and 0.85 pmoles/mg of protein, which were found to be 2.88-fold and 1.73-fold larger than the those of the 1st week's cultivation. The concentrations of cyclic AMP then gradually decreased from the 3rd week to the 7th week of the cultured-lifespan.

2) The biosynthetic amount of protein was found to be 1.74×10^-5mg/cell on the 1st weekand 9.51×10^-5mg/cell on the 3rd week of cultivation. Values were gradually declined from the 3rd week to the 7th week of cultivation.

In the present investigation, it is clear that the amount of protein content and the concentration of cyclic AMP in the cultured human melanocytes derived form the epidermis of human skin were vividly increased up to the 3rd week of cultivation.

Thus, it might be suspected that the suitable time for the successful transplantation of cultured human melanocytes is around the 3rd week of cultivation.

The patient of herniated intervatebral disc of lumbar spine was treated as conservatively and did respond well in majority. But in patient who had not responded to conservative therapy, opeative method was performed such as open discectomy, chemonucleolysis, or automated percutaneous lumbar discectomy.

Open discectomy is useful for most patients but still carries the risk of general anesthesia and risk to sofi tissues. joints. nerves, and the invariable production of epidural fibrosis. Chemonucleolysis was introduced by Smith in 1964 as an alternative method but, it carries many complications such as anaphylaxis, subarachnoid hemorrhage, transverse myelitis, and severe back pain. Because of reducing this complications automated percutaneous lumbar discectomy has been advocated as an alternative treatment of herniated intervertebral disc in selected patients.

Twenty patients with symptomatic lumbar disc herniation were treated with automated percutaneous lumbar discectomy from August 1989 to October 1991 in Ewha Women University Hospital. They were followed up for more than 12 months. Changes in the objective and subjective signs and aymptoms of patients were examined preoperatively and postoperatively.

The results were as follows :

1) Age was ranged from 14 to 54 years with average 30 years, and 12 males and 8 females.

2) LA-5 was the most commonly involved level(80%).

3) In MRI classification subannular herniation was 11 cases and subligamentous herniationwas 4 cases.

4) Average duration of procedure was 31 minutes. and average amount of tissue aspirated was 3.9cc and average hospitalization period was 5 days.

5) Clinical results were satisfactory in 85% and unsatifactory in 15% of patients.

6) Unsatisfactory results were combined stenosis, insufficient removal of disc material, or recurred herniation of interverebral disc.

7) There was no significant complications postoperatively.

From this results, automated percutaneous lumbar discectomy is a good treatment method for selected cases of lumbar dsic herniation.

The largest character of the modern society, so called the era of the information. is 'C&C'(Computer and communication). As the up-to-date science and new knowledges develope,so far there is increasement of the real necessity of the computer to use huge medical informationmore rapidly and effectively.

As the electronic industry is developed, it is possible to do a business with the personalcomputer(PC), which was possible only by a large-computer at past.

After the recognition of the rational inevitability of the business computerization, and ifsomeone looks for the sujects to computerize. they must choose the supervision of the clinicaldata about the in-patient first of all.

The patient supervising system should retain the databases which serve the reference functionto user's requirements. Under these purposes, it is very important to classify the cases dependingon the names of the diagnoses and operations, and easy and rapid recollect of the appropriatedata. And of course this system also be able to contribute to the research and education aswell as the preservation of the patient data.

So, we report the results of 2-year practice in urologic patient supervising program, whichwe enlighted for presenting the guidelines for Program making of the in-patinent data- supervi-sion and the standard for the mandatory clause and database files so that in order to gaugethe ability of the computerization of the patient supervision with PC from now on.

We retrospectively reviewed chest radiographs of 101 patients with primary pneumonia treatedat department of pediatrics between January 1990 and June 1992 to understand pnelimoniaradiologic patterns in ages of children and to attain helpful information in diagnosing pediaoicpneumonia hereafter.

Results were as follows :

1) The cases of infantile pneumonia (under 1 year of age) were 42. The most frequent Hadingwas peribronchial infiltration with overaeration(24 cases, 57.1% ), followed by multiple patchyatelectasis associated with peribronchial infiltration and overaeration(8 cases, 19.0%). parahilarperibronchial infiltration (5 cases. 11.9%), peribronchial infiltration and air space consolidation(2 cases,4.8%), air space consolidation(2 cases,4.8%) and bronchopneumonia pattern(1 case,2.4%).

2) The cases of 1~6 years of age were 52. The most common finding was parahilar peribron-chial infiltration(29 cases, 55.8%), followed by air space consolidation(13 cases. 25.0%), andbronchopneumonia pattern(10 cases, 19,2%).

3) The rases of 7~13 years of age were 7. All cases showed air space consolidation.Under 6 years of age, the radiographic findings of pneumonia differed from that of adult.

Over 7 years of age, the pattern of pneumonia was similar to that of adult.

Cis-DDP has been used as a radiosensitizer in combination treatment modality far malignanttumors, of which mechanism is uncertain. The efects of combined Cis-DDP and irradiationon number of tumors have been studied in vitro and in vivo. The effects of combined Cis-DDP and irradiation on the liver are important because the liver is a radiosensitive organand frequently exposed to irradiation during treatment for intra-abdominal malignancies. Butthe studies of combined Cis-DDP and irradiation on the liver have not been reported.

So, this study was peformed to see the effect of Cis-DDP in combination with radiationon the liver. Total 66 Sprague-Dawley rats were divided into 5 groups; control, Cis-DDP(2.5mg/kg) administration, radiation(6, 8, lOGy, respectively), and combined Cis-DDP and radia-tion. which consisted of pre- and post-administration of Cis-DDP. Light and electron microscopic examination was performed 30 days after each experiments.

Cis-DDP administration induced mild congestion and focal hemorrhage in hepatic lobuleswith focal necrosis and degeneration of hepatocytes. Electron microscopic examination showedirregular cytoplasmic organelles and chromatin clumping in hepatocytes. In radiation treatmentgroup. hemorrhage of hepatic lobules, necrosis and degeneration of hepatocytes, edema andinflammation in portal tracts were aggravated with increased dosage of radiation. Hepatic lobulardisarray and inflammatory cell infiltration in portal tracts were noted from 8 Gy radiation.Vacuoles and electron dense bodies as well as swollen mitochondria in hepatocytes were frequently noted on electron microscopic examination. With combined treatment all He light andelectron microscopic changes were more severe than radiation alone regardless of sequenceof Cis-DDP administration and lobular disarray and inflammation in portal tracts were startedto note with 6 Gy radiation. When the hepatic lobular disarray and inflammation in portaltracts were used as end-points. the enhancement ratio of Cis-DDP was 1.3 in normal rat livers.

Conftroversy has existed concerning the choice of anesthetic technique for Cesarean section.

The aim of this study was to compare the effects of epidural anesthesia using bupivacaine-fen-tanyl-epinephrine-sodium bicarbonate mixture on mother and neonate with general anesthesia.

The induction-to-delivery time(IDT), uterine incision-to-delivery time(UDT), Apgar scoresat 1 and 5 minute. maternal arterial, umbilical arterial and venous blood gas analysis, degreeof uterine contraction. and preoperative, postoperative hemoglobin and hematocrit level weremeasured in 28 pregnant women underwent Cesarean section(15 under epidural anesthesia,13 under general anesthesia).

The results were as follows :

1) The mean IDT was much longer(p<0.001) with epidural anesthesia group comparedwith general anesthesia group, but the average UDT were similar. The Apgar scores at 1 and5 minute were generally satisfactory with no significant differences between groups.

2) Mean maternal arterial PH, PCO₂ and BE were simitar between two groups. but meanmaternal PO₂ and O₂ saturation were less in the epidural anesthesia group. reflecting thesmaller FI₀₂ inhaled by the mother in the epidural anesthesia group.

3) The PH. BE and O₂ saturation in both umbilical vein and artery was significantly lowerin the epidural anesthesia group than in the general anesthesia group respectively, but remainedwithin normal ranges.

4) No significant differences in the degree of uterine contraction was noted between twogroups.

5) A decrease in the homoglobin level 72 hour after Cesarean section is significantly less in epidural anesthesia group than in general anesthesia group.

These data suggest that epidural anesthesia using bupivacaine-fentanyl-ephinephrine-sodiumbicarbonate mixture in patients undergoing Cesarean section may be safe without significantmaternal or neonatal side effect.

Preoperative consultation interwines anesthesiology, surgery and internal medicine. Its goalis the efficient transfer of information in each consultant's speciality to other members ofthe team caring for the patient thus increasing the liklihood of satisfactory outcome and decresaing the morbidity and the mortality.

Form January 1988 to December 1992 at the anesthetic department of Ewha Womans University Hospital, 775 patients who were consulted to department of anesthesiology preoperativelywere analized annually, according to age, ASA classification, depaartments, causative diseases.recommendations and anesthetic methods.

The results were as follows :

1) The ratio of anesthetic consultation to operation was 3.8% Annually consultation ratiowas increased about twice from 2.0% in 1988 to 4.1% in 1992.

2) The number of 61~70 years of age was the greatest number of cases as 156 cases(20.1%).each 132 cases(17.0%) were in 51~60 and 71~80 years of age, 45 cases(5.9%) over 81 yearsof age and 26 cases(3.4%) under 1 year of age. Over 61 years of age were 333 cases(43.0%).

3) According to ASA clssification. 406 cases(52.4%) in class 2 was the greatest and theorder was 332 cases(42.9%) in class 3, 22 cases(2.8%) in class 4. The almost cases were inclass 2 and 3.

4) Comparing between departments, the order of the greatest number of cases was 239 cases(30.9%) of orthopedic forgery. 151 cases(19.5%) of general surgery. 131 cases(16.9%) of urologyand 114 cases(14.7%) of chest surgery.

5) Comparing between causative diseases. the order of the greatest number of cases was389 cases of repiratory diseases. 326 cases of cardivoascular diseases. 124 cases of endocrinedisease and 89 cases of hepatic diseases.

6) About preoperative recommendations. the number of the checklists for the respiratorydiseases was 249 cases 173 cases for the cardiovasclar disease and 153 cases for the hematologicdiseases. 177 cases was anesthetic permission that was taken by anesthesiologist with sufficient explanations to patients and relatives about the risk of anesthesia and surgery. The numberof consultation to other department was 96 cases and 272 cases was no more necessaries ofmanagements.

7) According to anesthetic managements, the number of general anesthesia was 484 cases(62.5%) and that of regional anesthesia was 159 cases(20.5%). Among the regional anesthesiathe incidence of epidural anesthesia was increased annually and up to 96 cases(12.4%) andthat of spinal anesthesia was decreased to 57 cases(7.3%).

Periorbital hemanogiomas are commonly associated with ocular complications such as amblyopia or strabismus. So early treatment and regular ophthalmologic study are recommended.

We report a case of upper eyelid strawberry hemangioma in a 5-month-old infant. Thehemangioma was treated with intralesional corticosteroid injection, and so a marked involutionof the tumor resulted. There were no local or gystemic complications. So this therapeutic methodis considered to be sueful in the management of strawberry haemangioma.

We experienced a case of trisomy 16 discovered with missed abortion in pregnancy achievedby IVF-ET. Spontaneous abortion rate after IVF-ET was higher than normal pregnancy. Chro-mosome anomalies had been reported in spontaneous abortions after IVF-ET. We had attempted to karyotype which miscarriged gestational 8 weeks, and the result was found trisomy 16.So we reported the case with a brief review of literatures.

Primary signet ring cell adenocarcinoma of the bladder accounts for less than 1 per centof all primary bladder neoplasm. 19 cases have been reported in the literature.

This tumor is insidious because of its subepithelial infiltrative nature, which makes diagnosis possible only late in the course of the disease.

Survival is poor ; greater 50 per cent of the patients are dead within a year after diagnosis.Radical surgery offers the only hope of palliation ; irradiation and chemotherapy have notbeen effective.

We are reporting two cases of primary signet ring cell adenocarcinoma of the bladder treatedwith radical cystectomy with pathological findings and review of the literature.