A 44-year-old man had Sweet's syndrome (acute febrile neutrophilic dermatosis), accompanied by erythematous tender subcutaneous nodules resembling erythema nodosum(EN). The EN-like lesions histologically showed a septal panniculitis with predominantly neutrophilic in-filtrates. The association of Sweet's syndrome with EN seems to be uncommon and only a few cases have been reported until the present. We describe a patient with Sweet's syndrome associated with acute EN.
Adult ; Erythema Nodosum* ; Erythema* ; Humans ; Neutrophils ; Panniculitis ; Sweet Syndrome*

We reviewed 40 consecutive patients having a primary total hip replacement(THR) and 60 patients having a primary total knee replacement(TKR) for osteoarthritis to compare the qu;dity of hfe(QoL) before and after operation. Bilateral arthroplasties were perfomed 10 cases of THR and 25 cemes of TKR. We used a modified Harris hip score and a knee score of American knee society, the Rosser Lndex Matrix and authors eval- uation system to generate these scores. Quality of life was highly improved by Rossers and authors evalua- tion system after THR and TKR. The median values of QoL scores before and after operation were signifi- cantly different(p<0.05). The median preoperative QoL score in THR was t>etter than in TKR. Postoperative QoL scores for both groups were similar. Quality of life evaluated by Rossers score and authors evaluation system in bilateral THR was better than bilateral TKR. We think better quality of life in bilateral THR over bilateral TKR by authors evaluation system is because the hip joint is mcire stable and has better range of motion than knee joint. We conclude that change of life style including the use of bed, toilet seat elevation, and the use of dinning table will be neccesary after bilateral TKR.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Climacteric ; Hip ; Hip Joint ; Humans ; Knee Joint ; Knee* ; Osteoarthritis ; Quality of Life* ; Range of Motion, Articular

Since CT scanning was introduced in the diagnosis of calcaneal fracture, we became to understand more clearly the pathoanatomy of the injury. However we have to determine if we would or would not take CT scanning by simple radiography in the acute setting and most of the surgeons still use simple radiography in evaluating postoperative result. And also we have to determine the accuracy of reduction and position of screws by simple radiography intraoperatively. The purpose of this report is to determine the accuracy of simple radiography in assessing the pathological anatomy of the intraarticular calcaneal fracture by experimental and clinical studies. This is a combined experimental and clinical studies using four below knee amputation specimens and 15 patients with 19 displaced intraarticular calcaneal fractures treated at Hanil General Hospital between Jan. 1996 and May 1997. The lateral view of the foot was the best radiographic view for visualizing the degree of depression of the posterior facet. With regard to the location of a fracture line, findings of Broden views correlated well with findings on CT in 17 of 19 fractures. With regard to gapping between fragments, the axial view was not satisfactory in the majority of cases(15 of 19 cases). There was no case which showed more than 2 mm of discrepancy between the findings on Broden view and CT. We conclude that we may obtain most of the important informations about the pathological anatomy of the intraarticular calcaneal fracture by simple radiography.
Amputation ; Depression ; Diagnosis ; Foot ; Hospitals, General ; Humans ; Knee ; Radiography* ; Tomography, X-Ray Computed

The remarkable potential of embryonic stem (ES) cells is their ability to develop into many different cell types. ES cells make it possible to treat patients by transplanting specialized healthy cells derived from them to repair damaged and diseased cells or tissues, known as "stem cell therapy". However, the issue of immunocompatibility is one of considerable significance in ES cell transplantation. One approach to overcome transplant rejection of human ES (hES) cells is to derive hES cells from nuclear transfer of the patient's own cells. This concept is known as "therapeutic cloning". In this review, we describe the derivations of ES cells and cloned ES cells by somatic cell nuclear transfer, and their potential applications in transplantation medicine.
Animals ; Cell Culture Techniques/*methods ; Cloning, Organism/*methods ; Embryo/cytology ; Embryo Culture Techniques ; Humans ; Pluripotent Stem Cells/*cytology/immunology ; Stem Cell Transplantation/*methods

Methods: In this study, 30 patients with DS with checked standing dynamic radiographs of the lumbar spine in Gwangmyeong Sungae Orthopedic Clinic were recruited. Standing lateral radiographs were evaluated in extension, 45° of flexion (mid-range) and 90° of flexion (terminal-range) of the lumbar spine. Instability was defined as sagittal translation greater than 3 mm from the extension position. Patients were divided into three groups: a control group, an MI group, and a terminal-range instability (TI) group. Radiographic outcome (stenosis grade) and clinical outcome were compared between the three groups. Results: The average sagittal translation of the lumbar spine was 5.2 mm in extension, 6.6 mm in mid-range, and 7.2 mm in endrange. MI was observed in eight patients (26.2%) and TI was seen in 12 patients (40%). Of eight patients with MI, three patients did not have instability at terminal-range (occult patients) and five patients had instability at terminal-range (typical patients). Body weight and body mass index (BMI) was significantly higher in the MI group as compared to the control group. BMI was positively correlated with slippage to mid-range. There was no significant difference in stenosis grade, Visual Analog Scale, and Oswestry Disability Index. In the TI group, there was no significant difference in radiographic clinical parameters as compared to the control group. Conclusions MI was demonstrated in 25% of DS patients. Mid-range motion was increased with BMI. Mid-range lateral radiography can reveal occult instability in patients with DS, particularly in obese patients.

PURPOSE: T1-201 SPECT has been used in differentiating benign and malignant pulmonary lesions. While its sensitivity may be high, the specificity and predictive values are reported to be variable depending on the type of benign lung lesion. The purpose of this study was to prospectively assess the efficacy of T1-201 SPECT for differentiating benign and malignant single pulmonary lesions in a population with a high prevalence of begin pulmonary lesions, especially, tuberculosis. MATERIALS AND METHODS: One-hundred thirty-three patients, having 89 malignant and 44 benign lesions(23 active tuberculosis, 5 inactive tuberculosis, 3 aspergilloma, 3 focal pneumonia, 2 thymoma, and 8 others), were imaged using a dual-headed system at 15 minute(early) and 3 hour (delayed) following administration of 111MBq T1-201. The images were read visually and lesion-to-background ratios(L/B) were obtained from transverse tomographic slices. Retention index was expressed as [(delayed L/B-early L/B) / early L/B]. RESULTS: 82/89(92%) and 83/89(93%) of the malignant lesions were visually positive on the early and delayed images, and 27/44(61%) and 26/44(59%) of the benign lesions wefe also between the mean L/B's of the malignant and benign lesions, L/B was not useful for differentiating the two due to a large overlap. There was no difference in retention indices. CONCLUSION: Despite of its high sensitivity, the specificity of T1-201 SPECT was unacceptably low in patients with active benign lesions. The positive and negative predictive values for lung cancer in a population with a high prevalence of the benign single pulmonary lesion was only marginal.
Diagnosis, Differential* ; Humans ; Lung ; Lung Neoplasms ; Pathology* ; Pneumonia ; Prevalence ; Prospective Studies ; Sensitivity and Specificity ; Thymoma ; Tomography, Emission-Computed, Single-Photon* ; Tuberculosis

Thymoma is the most common tumor in the compartment of anterior mediastinum. The malignant thymoma is classified into invasive thymoma( category I ) and thymic carcinoma( category II ). Recently, well-differentiated thymic carcinoma is a proposed category 1.5 used to describe a subset of thymic epithelial tumors, allowing for the existence of intermediate form based on the clinical features and the histological characteristics. Thymic cyst is a congenital or a acquired disorder. Congenital thymic cyst may develop due to failure of the thymopharyngeal duct to obliterate and acquired thymic cyst develops from inflammation( multilocular thymic cyst ), or neoplasm( cystic thymoma ). Cystic degeneration in thymoma is a relatively frequent but focal event. In rare cases, the process proceeds to the extent that most or all of the lesion becomes cystic. Until now, well-differentiated thymic carcinoma with extensive cystic degeneration has not been reported in our country. We experienced a case of 14 year-old female patient showing extensive cystic degeneration in well-differentiated thymic carcinoma. and so we report it with review of the articles related.
Adolescent ; Female ; Humans ; Mediastinal Cyst ; Mediastinum ; Thymoma*

PURPOSE: Critically ill patients frequently require rapid measurements of serum potassium. Analyses of serum samples take some time, but the results of blood gas analyses are often available more promptly. This study aims to determine the correlation between potassium concentrations measured by blood gas analyzer and automated chemical analyzer with a view to identifying whether the plasma potassium level can be used as an alternative to the serum values in the clinical management of selected patients in the Emergency Department (ED). METHODS: This prospective study of patients who were deemed by their treating doctor to require a blood gas analysis and chemistry analysis compared the potassium concentrations obtained from plasma and serum taken simultaneously. Data were analyzed using a Pearson correlation and a linear regression. RESULTS: Four hundred ninety-six patients were entered into the study. The potassium concentrations measured using two blood gas analyzers and two automated chemical analyzers were relatively highly correlated (coefficient=0.871), with an average difference between two methods of 0.449 mmol/L. There was also a high level of agreement between the methods with the 95% limits of agreement being -0.2 to 1.2 mmol/L. CONCLUSION: Compared with data from other previous test, our data were unsatisfactory. However our trial makes it possible in our ED to obtain serum potassium level from the plasma level. In addition, hypokalemia obtained by blood gas analyzer should be made an exception in treating it.
Blood Gas Analysis ; Chemistry ; Critical Illness ; Emergency Service, Hospital ; Humans ; Hypokalemia ; Linear Models ; Plasma ; Potassium* ; Prospective Studies

PURPOSE: Paraquat is widely used non-selective contact herbicide. In spite of efforts to improve the outcome in paraquat poisoning, the mortality rate still remains high. The purpose of this study is to assess the predictive factors of prognosis by investigating initial laboratory data on paraquat poisoning. METHODS: The author retrospectively analyzed the clinical features, laboratory data, and outcomes for 130 paraquatpoisoning patients treated from June 1997 to September 2003 at the emergency medical center of Chonnam National University Hospital. RESULTS: The results were as follows: 1) The mortalities were significantly older than the survivors (49.3 years vs 37.6 years, p<0.05). Among the total 130 cases, the survivors numbered 50, and the deceased numbered 80. The mean age of all 130 cases was 44.8+/-16.9 years. 2) The white blood cell count and the levels of serum AST and ALT in the deceased were significantly higher than they were in the survivors. The levels of arterial pH, PaCO 2, base excess, HCO3 -, and serum potassium in the survivors were significantly higher than they were in the deceased. 3) A multivariate Cox-Regression analysis revealed that sex, serum potassium, and arterial HCO3 - were associated with the mortality rate. CONCILUSION: The above data reveal that the ingested amount, the result of the urine sodium dithionite test, and the initial state of laboratory parameters, including the white blood cell count, ABGA (pH, PaCO2, HCO3 -, base excess), serum potassium, AST, and ALT, can be used to predict the outcome of paraquat poisoning.
Dithionite ; Emergencies ; Humans ; Hydrogen-Ion Concentration ; Jeollanam-do ; Leukocyte Count ; Mortality ; Paraquat* ; Poisoning* ; Potassium ; Prognosis* ; Retrospective Studies ; Survivors

PURPOSE: Serum aspartate aminotransferase (AST) is an enzyme widly used in the diagnosis of acute liver disease. It is also highly sensitive in cases of myocardial infarction and muscular injury. This study is designed to ascertain the utility of AST for diagnosis in emergency room. METHODS: From July 2001 to September 2002, 98 patients with AST greater than ten times (400 U/L) the normal range were identified by the biochemistry laboratory in the Emergency Medical Center of Chonnam National University Hospital. The patients 'clinical records were studied to determine the diagnosis, the clinical course, the physical finding on arrival, the past history, other serological and imaging studies, etc. RESULTS: The most common cause of elevated AST level was hepatic in origin (74 cases, 75.5%). Other causes were soft tissue injury (13 cases, 13.3%) and myocardial infarction (11 cases, 11.2%). In group with hepatic causes for raised AST, 21 (28.3%) patients had pancreaticobiliary desease, 20 (27.0%) patients were in conditions producing hepatic ischemia, 18 (24.3%) patients had hepatocellular desease, 6 (8.1%) patients had traumatic liver injury, and 4 (5.4%) patients had malignancy. The hepatic ischemia was caused by sepsis (6 cases, 30.0%), heart failure (6 cases, 30.0%), hypoxia (5 cases, 25.0%), and prolonged hypotension (3 cases, 15.0%). CONCLUSION: The main cause of a notably increased serum AST level is known to be hepatocellular disease, but this study for emergency patients revealed that other causes, such as hepatic ischemia, traumatic liver injury, and muscular disease, were also remarkable. When the level of serum AST is abnormally high, the clinician must consider not only hepatocellular disease but also prolonged hypotension, circulatory collapse, hypoxia, traumatic liver injury, etc.
Anoxia ; Aspartate Aminotransferases ; Biochemistry ; Diagnosis ; Emergencies* ; Emergency Service, Hospital ; Heart Failure ; Humans ; Hypotension ; Ischemia ; Jeollanam-do ; Liver ; Liver Diseases ; Muscular Diseases ; Myocardial Infarction ; Reference Values ; Sepsis ; Shock ; Soft Tissue Injuries