No abstract available.

No abstract available.
Anesthesia, Epidural* ; Radiculopathy*

No abstract available.
Chronic Pain* ; Electroacupuncture* ; Needles* ; Syringes*

Most proximal humeral fractures respond satisfactory to simple conservative treatment. But operative treatment is recornmended in the cases that poor results are anticipated by prolonged immobilization, or because of the severe displacement and comminution. After Neer. in 1970, emphasized the need for operative treatment in displaced proximal humeral fractures, many papers reported better results with the operative management. Twenty five cases of displaced fractures and fracture dislocations of the proximal humerus treated at the department of orthopaedic surgery, Keimyung University with open reduction and internal fixation were analyzed clinically and radiologically. The following results were obtained. 1. The prevalent age distribution was the second snd third decades(average 42.6 years) and ratio of male and female was 2.1: 1. 2. In 10 of the 25 cases, wire loop was used for internal fixation, and the result was satisfactory in 8 cases. However, the disadvantage was difficulty in wire removal after bony union because the loop was buried in the callus or cortex. 3. Over-all results were excellent or satisfactory in 64% of 25 cases. There were 4 excellent and 1 satisfsctory in 5 cases of type Il fracture, 7 excellent, 2 satisfactory and 3 unsatisfactory in 12 cases of type III fracture, 1 excellent and 4 unsatisfactory in 5 cases of type 1V fracture, and 1 excellent, 1 unsatisfactory and 1 failure in 3 cases of fracture dislocation. 4. In 6 patients with four part lesions treated with open reduction and internal fixation and followed up for an average of 23 months(from 18 months to 3 years and 2 months), only one case of fracture dislocation revealed avascular necrosis with resorption of the head.
Age Distribution ; Bony Callus ; Dislocations ; Female ; Head ; Humans ; Humerus ; Immobilization ; Male ; Necrosis ; Shoulder Fractures

BACKGROUND AND OBJECTIVE: Several recent studies have demonstrated that cognitive function is impaired in non-insulin dependent diabetes mellitus (NIDDM) patients compared with age-matched non-diabetic controls. However, the underlying pathophysiological mechanism of this diabetic central nervous involvement remains obscure. The present study was designed to explore further whether cognitive deficits are present in NIIDDM patients who do not show apparent symptoms and signs of central nervous system damage and to evaluate the influence of clinical parameters and diabetic complications on cognitive function. METHODS: Thirty patients over 50 years of age with NIDDM and 30 age-, sex- and education-matched normal controls were recruited for the study. P300 event-related potential test and neuropsychological tests (Mini-Mental State Examination, MMSE; Benton Visual Retention test; Digit Span Forward and Backward) were perfomed. P300 latencies were recorded according to the conventional technique using Counterpointer MK2. RESULTS: Compared with controls, NIDDM patients showed significant impairment in MMSE (P<0.05), Benton Visual Retention (P<0.05), and Digit Span Backward (P Blood Glucose ; Central Nervous System ; Diabetes Complications ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Event-Related Potentials, P300* ; Fasting ; Humans ; Neuropsychological Tests* ; Peripheral Nervous System Diseases ; Reference Values ; Triglycerides

Primary lung cancer has recently increased progressively in its incidence in Korea. It is clearly evident that surgical resection offers the best offortunity for cure of non-small cell carcinoma. This study was designed to analyse the clinical data of 100 primary non-small cell carcinoma patients who underwent lung resection surgery from January 1992 to July 1995 at the department of Thoracic and Cardiovascular Sugery, Kyungpook National University Hospital. There were 86 males and 14 females(6:1). In the age distribution, the peak incidence was recorded in the seventh decade(43%). The methods of tissue diagnosis were bronchoscopic biopsy in 53 patients(50.5%), percutaneous needle aspiration in 17 patients(16.2%), transbronchial lung biopsy in 11 patients(10.5%), mediastinoscopic biopsy in 2 patients (1.9%), sputum cytology in 2 patients(1.9%), and thoracotomy in 20 patients(19.0%). Fifty-five lobectomies, 22 pneumonectomies, 15 bilobectomies, 2 segmentectomies, 4 sleeve lobectomies, a sleeve pneumonectomy, and a wedge pneumonectomy were performed. Operative mortality occured in 4 cases(sepsis in 2 cases, respiratory failure in 1 case, and acute myocardiac infarction in 1 case). The histologic types of tumor were 67 squamous cell carcinomas, 26 adenocarcinomas, 6 large cell carcinomas, and an adenosquamous cell carcinoma. Eighteen patients with N2 mediastinal lymph node metastases had 8 squamous cell carcinomas(11.9%), 9 adenocarcinomas(34.6%), and a large cell carcinoma(16.7%). The primary tumors in these patients were in the right upper lobe in 4 patients, the right middle and lower lobe in 9 patients, the left upper lobe in 3 patients, and the left lower lobe in 2 patients. With regard to pathologic stages, 45 patients had stage I disease; 13 patients, stage II; 36 patients, stage IIIa; 5 patients, stage IIIb; and 1 patient, stage IV. The overall actuarial survival rate was 77.5% at 12 months, 56.1% at 24 months and 43.7% at 43 months. The actuarial survival rates at 43 months were 81.3% in Stage I, 20.8% in Stage II, 27.9% in Stage IIIa, 25.0% in Stage IIIb and 33.3% in Stage IV. These facts suggest that early detection and surgical resection are recommended for favorable postoperative survival in non-small cell lung cancer.
Adenocarcinoma ; Age Distribution ; Biopsy ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Diagnosis ; Gyeongsangbuk-do ; Humans ; Incidence ; Infarction ; Korea ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Male ; Mastectomy, Segmental ; Mortality ; Needles ; Neoplasm Metastasis ; Pneumonectomy ; Respiratory Insufficiency ; Sputum ; Survival Rate ; Thoracotomy

URPOSE: To evaluate using spiral CT the effect of spleen size on blood flow in the portal venous system andto know the usefulness of this evaluation. MATERIALS AND METHODS: Fifty-one patients without evidence on spiralCT scan of abnormality thought to affect portal venous flow presented between December 1994 and June 1995. We measured spleen size and Hounsfield units of portal vein in dual-phase, and calculated the ratio of the unit inthe portal phase to that in the arterial phase. Spleen size was measured, using the length of X-axis by that of Z-axis on spiral CT scan. We then measured the correlation between the two values. CT was performed with a Somatom Plus-S scanner(Siemens, Erlangen, Germany). A total dose of 120ml of non-ionic contrast material(Ultravist) was administered at a rate of 3ml/sec. Arterial and portal phase were obtained after 30 seconds and 60 seconds fromthe beginning of the contrast agent injection. RESULTS: The correlation between spleen size and contrast enhancement of the portal vein was relatively significant(Pearson's correlation coefficient(r)=0.41801). CONCLUSIONS: Spleen size significantly affects portal venous flow on spiral CT scan. The evaluation of spleensize and contrast enhancement of the portal vein could be useful in the differential diagnosis of diseases which affect portal venous flow.
Diagnosis, Differential ; Humans ; Portal Vein* ; Spleen* ; Tomography, Spiral Computed*

BACKGROUND: There have been few outcomes studies with follow-up after performing ulnar shortening osteotomy for ulnar impaction syndrome. We investigated the long-term clinical and radiological outcomes of ulnar shortening osteotomy for the treatment of idiopathic ulnar impaction syndrome. METHODS: We retrospectively reviewed 36 patients who had undergone ulnar shortening osteotomy for idiopathic ulnar impaction syndrome for a mean follow-up of 79.1 months (range, 62 to 132 months). The modified Gartland and Werley scores were measured pre- and postoperatively. The radiographic parameters for the assessment of the distal radioulnar joint (DRUJ) as well as the relationship between these radiographic parameters and the clinical and radiological outcomes were determined. RESULTS: The average modified Gartland and Werley wrist score improved from 65.5 +/- 8.1 preoperatively to 93.4 +/- 5.8 at the last follow-up visit. The average preoperative ulnar variance of 4.7 +/- 2.0 mm was reduced to an average of -0.6 +/- 1.4 mm postoperatively. Osteoarthritic changes of the DRUJ were first seen at 34.8 +/- 11.1 months follow-up in 6 of 36 wrists (16.7%). Those who had osteoarthritic changes in the DRUJ had significantly wider preoperative ulnar variance, a longer distal radioulnar distance and a greater length of ulnar shortening, but the wrist scores of the patients who had osteoarthritic changes in the DRUJ were comparable to those who did not have osteoarthritic changes in the DRUJ. CONCLUSIONS: The clinical outcomes are satisfactory for even more than 5 years after ulnar shortening osteotomy for treating idiopathic ulnar impaction syndrome despite the osteoarthritic changes of the DRUJ. The patients who need a larger degree of ulnar shortening may develop DRUJ arthritis.
Bone Diseases/*surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; *Osteotomy ; Retrospective Studies ; Syndrome ; Time Factors ; Treatment Outcome ; Ulna/*surgery

BACKGROUND: An inverse relationship between cholesterol level and the degree of depressive symptoms was found in several studies targeted to Westerners. But, other studies failed to replicate this finding, giving diverse opinion on this matter. The objective of this study was to investigate the association between the degree of depressive symptomps and lipid level, total calorie intake and fat intake respectively in adults screened in a health promotion center in Korea. METHOD: The study group consisted of 352 men and women who visited the Health Promotion Center of Seoul National University Hospital from June to August in 1998. Their depressive symptoms were measured by Korean version of the Center for Epidemiologic Studies Depression Scale(CES-D). Lipid level was measured by enzymatic methods with fasting blood specimen. Total calorie and fat intake were calculated from a self-reported questionnaire on the types and amount of food. RESULTS: Depressive symptoms were not significantly related to lipid levels, total calorie intake, fat intake, age, exercise, BMI, smoking or alcohol consumption(p>0.05). But sex(P<0.05), marital status(P<0.05), educational level(P<0.05) and average income(P<0.05) were significantly related to depressive symptoms in the whole study group(n=352). Educational level(P<0.05), menopausal status(P<0.05) and LDL cholesterol(P<0.05) were significantly related to depressive symptoms only in women(n=185). However in multivariate models which adjusted for confounding factors these associations were not found(p>0.05). CONCLUSION: In contrast to the results of previous studies, no significant association between the degree of depressive symptoms and lipid levels, total calorie intake and fat intake respectively were found in Korean adults after adjusting for several factors related to health.
Adult* ; Cholesterol ; Depression* ; Epidemiologic Studies ; Fasting ; Female ; Health Promotion ; Humans ; Korea ; Male ; Seoul ; Smoke ; Smoking ; Surveys and Questionnaires

Pheochromocytoma is usually associated with a combination of various clinical manifestations caused by the overproduction of catecholamines. It is frequently accompanied by impaired glucose tolerance operating through 2-and-adrenergic mechanisms. A 41-year-old-woman was admitted to the hospital because of poorly-controlled diabetes mellitus and hypertension. She had suffered intermittent paroxysmal attacks of headache and chest discomfort and had been treated intermittently over a 2 year period for diabetes mellitus and hypertension. At admission, the levels of serum epinephrine, norepinephrine urinary excretion of total metanephrine, and VMA were all abnormally elevated. Adrenal CT showed a well-defined, homogenous mass in the right adrenal region and the tumor was diagnosed as pheochromocytoma. After tumor resection, the increased blood level of catecholamines, the urinary excretion of total metanephrine, and VMA were normalized, as was the hyperglycemia state. Diabetes mellitus of the patient was considered permanently resolved after tumor removal by the result of glucose tolerance in 75g oral glucose tolerance test.
Catecholamines ; Diabetes Mellitus* ; Epinephrine ; Glucose ; Glucose Intolerance ; Glucose Tolerance Test ; Headache ; Humans ; Hyperglycemia ; Hypertension ; Metanephrine ; Norepinephrine ; Pheochromocytoma* ; Thorax