We studied the clinical features of 43 patients of trberculous peritonitis who had been admitted to Ewha Womans University Hospital from January, 1984 to December, 1994. The results are summarized as followings :

1) The male to female ratio was 1:2.3 and the peak incidence was between 21 and 30 years of age.

2) Chief complaints were abdominal distension(65.1%), and abdominal pain(51.2%). Besides these symptoms, indigestion, diarrhea, abdominal mass and general weakness were also noted.

3) Physical findings were abdominal tendemess(53.5%), abdominal mass(32.6%), jaundice(14.0%) and heparomegaly(2.3%)

4) The mean values of hemoglobin, WBC and ESR were 11.9g/dl. 8,300/mm³, and 65mm/hr respectively

5) The ascitic fluid analysis showed that the specific gravity was 1.031, protein concentration 5.0g/dl, mean lymppcyte percentage 98%, and the mean ADA activity was 61u/l.

6) On chest X-ray, the findings related to the pulmonary tuberculosis were noted in 26 patients(60.5%).

The development of hypomagnesemia was investigated retrospectively in 25 patients with malignancy treated with cisplatin containing combination at the first time. Serum magnesium levels were measured 1 day after completion of cisplatin infusion. The most common type of cancer was lung cancer(9 patients) followed ny gastric cancer(5 patients), pancreas cancer, unknown prinary cancer(2 patients, respectively) and so on. EP(etoposide, cisplatin)was the most frequently administered regimen. Five patients had previous history of chemotherapy. While 10 patients received cisplatin dose of 80 mg/m²(body surface area) or more, 15 patients received less than mg/m². The mean serum magnesium concentration after chemotherapy was 1.93±0.25mg/dl(1.5-2.6mg/dl), and 8 patients(32.0%) developed hypomagnesemia(<1.9mg/sl). The incidence of hypomagnesemia showed no correlation among age of patients, dose of cisplatin, history of previous chemotherapy and regimens of chemotherapy. The serum potassium concentration after chemotherapy was not statistically different compared with that of before chemotherapy. There was no episode of symptomatic hypomagnesemia. In conclusion, hypomagnesemia is relatively common side effect of cisplatin infusion, therefore, frequent measurement of serum magnesium concentration should be mandatory in patients redeiving cisplatin containing chemotherapy.

There has been a need for animal experimental models to study the peripheral nerves to evalute the peripheral neuropathy. However, electrophysiologic test methods to confirm peripheral neuropathy in small experimental animals has not been properly addressed due to technical difficulties and also the limitation of numbers of examinations due to the invasive natures of previous techniques of peripheral nerve conduction studies in experimental animals.

The purpose of this experiment is to find out easy, reliable and noninvasive repeatable technical of nerve conduction study of peripheral nerves of rat.

The electrophysiologic tests including motor and sensory nerve conduction studies were performed in both hind limbs of 64 rats. And the results were reported with detailed description of techniques. The mean value(±SD) of motor nerve conduction velocity was 41.8±3.0m/sec and that of the sendory nerve conduction velocity was 29.7±1.7m/sec and they showed stable results. In addition to its accuracy, this technique is a relatively simple and nonivasive repeatable methods of nerve conduction study of rat. But the amplitudes of compound muscle action potential(CMAP) and compound nerve action potential(CNAP) revealed wide ranges of variability.

Sclerotherapy has become a popular method for obliterating both varicose veins and telangiectases. Through the animal model of sclerotherapy, we would understand its mechanism as a basis of clinical application. Clinical and histologic changes were observed periodically after injecting the hypertonic saline into the dorsal marginal rabbit ear vein, and the results were as follows.

There was no color and diameter changes in the vein after the normal saline injection as a control. Clinical changes after injection of sclerosant were that the color of vein changed to blue or dark blue at the early period, and it eas faded out one month later. Histologic examination after injection of sclerocant showed the intravascular thrombosis, cutaneous necrosis, vascular proliferations, and fibrosis at the early period, and large vein was disappeared and replaced by several telangiectasis and matured fibrosis one month later.

We could predict the outcome clinically and histologically, and the complication like cutanceous necrosis should be warned during the clinical application.

I reviewed the 20 pregnancies after In Vitro Fertilization and Embryo Transfer in EWHA Woman's University Hospital from 1990 September to 1994 December. And the Results were as follows.

1) The mean age of patients were 31.7±3.9 and the average duration of infertility was 4.3±2.3 years.

2) The major cause of infertility was tubal factor and especially bilateral tubal obstruction was most frequent.

3) Controlled Ovarian Hyoerstimulation methods were FSH/hMG and GnRH-agonist/GSH/hMG(long, shohrt, and ultrashort protocol). Long protocol using GnRH-agonist/GSH/hMG had the highest pregnancy rate(35.3%).

4) Regarding the response to controlled ovarian hyperstimulation, serum estradiol level in the day of hCG administration(DO) was 3169.4±3611.5pg/ml. Do endometrium thickness was 9.3±2.7mm, the number of aspirated oocytes was 9.8±7.1, the number of preovulatory oocytes was 9.3±14/7.4mm, the number of cleaved oocytes was 6.1±6.3 and so fertilization rate was 66.3%.

5) The outcomes of pregnancy comprised chemical pregnancy(2 cases), abortion(7 cases), ectopic pregnancy(1 case), term delivery(9 cases), and ongoing pregnancy(1 cases). As considered the number of fetus, singleton pregnancy was in 13 cases(76.5%) and twin pregnancy was in 4 cases(23.5%).

The foot has unique anatomic and functional characteristics, it endures constant weight loading or alternation stimulus of shoes while standing or walking. So the foot is the challening area for reconstructive.

I have reconstructed 23 cases of foor defects with various island or free flaps from March 1990 to Feb. 1995. The patients exhibited variable causes and sizes of foot defects, 15 cases of acute trauma, 3 cases of skin cancer, 2 cases of scar of scar contacture, 2 cases of pressure sore and a case of diabetic ulcer. Free flaps were chosen in 10 cases, such as lateral arm flap, scapular flap, latissimus dorsi muscle flap, forearm flap and superficial temporal fascia flap. Island flaps were also chosen in 13 cases such as medial plantar flap, dorsalis pedis flap, reverse peroneal flap, aosterior tibial flap. All flaps were survived without necrosis. 23 cases were divided into 4 groups according to foot defect area, 9 cases of heel and plantar weight-bearing area, 3 cases of Achilles tendon area, 6 cases of heel and plantar weight-bearing area alteral malleolar area and 5 cases of dorsal foot. I rfecommend that medial plantar island flap is suitable for heel reconstruction, reverse peroneal island flap for Archiles thedon area, dorsalis pedis island flap for malleolar area, superficial temporal fascia free flap for dersal foot.

The repair of striated muscle after injury by trauma or chemicals occurs simultaneously by the regeneration of disrupted muscle. Tlthough the efects of various external factors e.g. denervation, irradiation and steroid upon the repair of striated muscle injury has been previously studied, no attention has been focused on the effect of trauma and local anesthetics on the regenearted muscle fiber.

The author induced a constant contusion injury on the calf of rats using Drop-Weight method Lidocaine and/or epinephrine was intramuscularly injected at the site of injure.

The results of morphological and histochemical observation were as follows:

1) The striated muscle showed histological and histochemical evidences of the healing process for 90 days.

2) Formation of myotube appeared on 7th day and decreased on 15th day. Myotube persisted upto 30 days.

3) The cross sectional area of the muscle fibers was measured days 30 and 90. Local anestetic injection groups showed mire muscle fiber atrophy than trauma alone groups. Muscle fibers were significantly more atrophied on day 90 in all types of fiber after injection of mixture of lidocaine and epinephrine and on type B after injection of mixture of lidocaine and epinephrine and in type B after injection of epinephrine compared to control group.

4) Regenerative capacity of the injured muscle piber was correlated with the formation of myotubes.

There are variable radiological method for breast disease including mammography, breast ultrasound, thermography, CT-mammography and MRI. Among these, mammography is the oldest and the gold standard for diagnosis of breast disease. In mammography, the primary consideration is the demonstration of the absence or presence of the breast lesion and if present, the benignity of malignancy of the lesion.

The authors analyzed the mammographic findings in 145 cases pathologically proven cases of various breast disease.

The results were as follows:

1) The most prevalent age group of benign lesion was 3rd-4th decade with frequency of 65.3% and that of malignant lesion was 4th-5th decade with frequency of 66.6%.

2) The most frequent site of breast lesion was upper outer quadrant in benignity and malignancy.

3) Pathologic type of breast malignancy was all of ductal carinoma with various type, and the most common benignity is breast tumor(57.8%) and followed fibrocystic disease(27.3%).

4) The detection of abnormal findings of malignant lesion was 87.5% including mass lesion(75%) and benign lesion was 80.1% including mass lesion(54.5%).

Conclusively, the authours suggest that mammography is very useful method for the detection & diagnosis of breast disease.

The concepts of hydrocephalus can be applied at all conditions in which the intracranial volume of the cerebrospinal fluid is abnormally largd in relation to the volume of the brain. Most patients suffering from hydrocephalus has increased significantly with the advent of more sophisticated diagmostic tools sucy as CT, MRI and with rapid technical advances in shunt equipment. Since intracranial pressure is variable parameter depending on the factors as that some shunt complication are related to too much or to little cerebrospinal fluid drainage. In this report, the author analyzes post shunt complications of 46 patients from Jan, 1990 to Dec, 1994.

The rate of post shunt complications was 30% and the most common things were underdrtainage(16%), infction(10%), and shunt malfunction(6%).

In order to investigate the clinical application of media and fetal cord serum in human In Vetro Ferulization program, its preparation and quality control was performed and the results were as follows.

1) When the in vitro growth and developmental to hatching blastocyst of 2-cell stage mouse embyos was observed three times, the average developmental rate was 84.5% in m-KRB media with an addition of 0.3% bovine serum albumin. And m-KRB media was accepted as adequate to experiment.

When the in vitro growth and development to hatching blastocyst of 2-cell stage mouse embyos was observed three times in m-KRB media with an addition of 10% fetal cord blood serum, if the developmental rate was no significance between test media with control, we approved the serum as safe and used it in human in vitro fertilization program.

2) When the in vitro growth and development to hatching blastocyst of 2-cell stage mouse embyos was observed three times in the contol and Ham's F-10 media was accepted as adequate to experiment.

3) When the safe fetal cord serum was used in the human in vitro fertilization program, the average pregnancy rate was 33.3%.

Judging from above results, the strict quality control of media and fetal cord serum should be necessary for obtaining the high pregnancy rate in human in vitro fertilization program However, this kind of quality control system is very complex and time-consuming, so, therefore, the more effective and simple quality control system should be developed in the near future.

Hypothyroidism may accompany pericardial may accompany pericardial effusion occasionally, in the patient who complains of any symptom of hypothyroidism and dose not receive treatment. We have experienced two cases of hypothyroidism presenting with the symptoms of dyspnea and chest tightness. The cuase of dyspnea and chest tightness was pericardial effusion and congestive heart failure. So we report two cases of primary hypothyroidism presenting with pericardial effusion and review the literature.

Cutaneous periarteritis nodosa is a chronic and benign vascular disease in which cutaneous lesions are perdominent without visceral involvement.

We report a case of cutaneous periarteritis nodoas in a 8-year-old boy who presinted tender plaque with hemorrhagic ulceration and telangiectatic patches on the inner side of the right thigh with no visceral involvement. Histologic examination showed panarteritis of small and medium-sized arteries at the dermal-subcutaneous junction.

The patient was treated with prednisolone and dapsone with a good clinical response.