Six cases of lunate dislocation were treated in the departments of orthopaedic surgery, Hangang Sacred Heart Hospital and Kangnam Sacred Heart Hospital, Hallym College during the period from March 1, 1978 to August 31, 1982. The results were as follows; l. Among the total 6 cases, two cases had lunate dislocation only and the other four had associated injuries of the same wrist joints. 2. Marupulative reduction was successful in only one case. Five cases were treated by open reduction, and for four of them internal fixation was tried. 3. Postoperative roentgenograms showed acceptable reductions in all cases except one which redislocation occurred. This case showed lunate dorsiflexion instability and was treated with extensor carpi radialis longus tenodesis. 4. The cases with pure lunate dislocation yielded better functional recovery than those with associated carpal injuries.
Dislocations ; Heart ; Tenodesis ; Wrist Joint

The antinuclear antbody (ANA) test have been used to screen the patients with systemic lupus erythematosus (SLE) and other autoimmune diseases. We had retrospectively reviewed the 263 records of pediatric patients with doing ANA tests who admitted at Department of Pediatrics, Kyung Hee University Hospital, from January 1988 to May 1993. The following results were obtained. 1) The positive rate of ANA test in patients with connective tissue diseases is 16 out of 40(40%).In patients with SLE, the positive rate of ANA test is 9 out of 11 (82%). 2) The positive predictivity for SLE is 9 out 36 (25%). 3) The positive predictivity for connective tissue disease and possible immune disease is 28 out of 36 (78%). 4) The false positive rate is 8 0ut of 36 (22%), Thus, the pediatric patients with positive ANA test should be applicable for diagnosis with prudence. 5) The positive anti-dsDNA in patients with the positive ANA is shown in 4 cases and these patients are all SLE. In conclusion, the patients who had repeated positive ANA should be tested Anti-dsDNA antibody, and further clinical and diagnostic evaluation of other ANA associated diseases.
Autoimmune Diseases ; Connective Tissue Diseases ; Diagnosis ; Humans ; Immune System Diseases ; Lupus Erythematosus, Systemic ; Pediatrics ; Retrospective Studies

PURPOSE: The purpose of this study was to evaluate the utility of two-phase dynamic CT, early and equilibrium pahse, in the preoperative staging of rectal cancers. MATERIALS AND METHODS: We performed incremental dynamic CT after rectal infusion of water in 34 patients with pathologically proved rectal cancers. Two-phase dynamic CT findings were prospectively analyzed and correlated with surgical and histopathologic findings. A total of 150ml of nonionic contrast medium was intravenously administered with a power injector at a flow rate of 5ml/sec for 30 sec, and two-phase images were obtained at 30 sec(early phase) and 2 min (equilibrium phase) after bolus injection. Local tumor staging and regional lymph node were classified by TNM staging. RESULTS: All 34 rectal cancers showed a moderate to marked enhancement in the early phase and a homogeneous and prolonged enhancement of the entire lesion in the equilibrium phase. T-staging of primary tumors were 85.3%(29/34) in early phase and 70.6%(24/34) in equilibrium phase. The accuracy in determining the perirectal fat invasion of rectal cancer was 92%(23/25) in early phase, and 72%(18/25) in equilibrium phase. The sensitivity & specificity of the regional lymph node metastasis were 63.6% and 79.1% in early phase, and 54.5% and 65.2% in equilibrium phase, respectively. CONCLUSION: Early phase dynamic CT was more accurate for the preoperative staging of rectal cancer than that at equilibrium phase.
Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Prospective Studies ; Rectal Neoplasms* ; Sensitivity and Specificity ; Water

An Armored tube is known to be the most effective in maintaining of airway patency during anesthesia in any position. Unfortunately, the tube itself may become the cause of airway obstruction. One of the known complications of the armored tube is a separation of the individual latex layers. This can be caused by herniation into the lumen. Diffusion of nitrous oxide into the inner hernia considerably intensifies the obstruction. The bubbles in the tube wall arise during manufacturing as well as during resterilization. A 62-year-old man with herniation of lumbar disc herniation was intubated with a 8.0 mm armored tube for general anesthesia. 30 minutes later, we experienced signs of partial endotracheal tube obstruction including high arterial PCO2 and inspiratory pressure in prone position. Then, tube suction with catheter was done and signs was slightly improved. But, 90 minutes later, passage of suction catheter was impossible. When operation was finished, patient was turned to supine position. We exchanged the tube with another tube and found inner wall herniation into the armored tube lumen caused by layer separation.
Airway Obstruction* ; Anesthesia ; Anesthesia, General ; Catheters ; Diffusion ; Hernia ; Humans ; Latex ; Middle Aged ; Nitrous Oxide ; Prone Position ; Suction ; Supine Position

PURPOSE: Articular chondrocytes have been known to have heterogeneity in articular cartilage. The different responses of chondrocytes to various cytokines and growth factors have been reported. These variations are likely a result of metabolic differences among the cell populations. We used the Percoll density gradient method to separate chondrocytes from articular cartilage into distinct subpopulations. Several growth factors are known to enhance the synthesis of cartilage matrix. In particular, IGF has specific anabolic effects. Addition of IGF to chondrocytes increased the synthesis of proteoglycans and collagen type-II while inhibiting the degradation and release of proteoglycans. MATERIALS AND METHODS: Chondrocytes were isolated from rabbit knee articular cartilage by collagenase digestion. In brief, male rabbits weighing 250g were euthanized by injecting an overdose of Nembutal, and nonfibrillated articular cartilage of the knee was removed by sterile dissection. Isotonic Percoll was mixed with 10x PBS to give a 60% stock solution. This was further diluted with PBS to give Percoll concentrations of 10, 20, 30, 40, 50, and 60%. RT-PCR, western blot analysis, immunocytochemistry, and immunohistochemistry were done for examination of collagen type II and aggrecan as the specific marker of extracellular matrix and proteoglycan synthesis on cultured chondrocytes. RESULTS: The sub-populated cells were proliferated variously. On the other hand, the addition of IGF to the sub-populated cells increased the proliferation in all fractions. Also the expression of collagen type-II and TIMP-2 was increased by IGF treatment. After alginate culture, collagen type-II expression was not significantly different between the IGF treated and the control groups in high density fractions. However, the addition of IGF to chondrocytes increased the expression of collagen type-II in low density fractions. The expression of collagen type-II after IGF addition was decreased in monolayer culture while it was increased in alginate culture. CONCLUSION: The effects of IGF are various among the subpopulated chondrocytes. These results will provide useful information for the separation of articular chondrocytes with an active metabolic activity and extracellular matrix for the investigation of the pathogenesis of articular cartilage.
Aggrecans ; Anabolic Agents ; Blotting, Western ; Cartilage ; Cartilage, Articular ; Chondrocytes* ; Collagen ; Collagen Type II ; Collagenases ; Cytokines ; Digestion ; Extracellular Matrix ; Hand ; Humans ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Knee ; Male ; Pentobarbital ; Population Characteristics ; Proteoglycans ; Rabbits ; Tissue Inhibitor of Metalloproteinase-2

BACKGROUND: An increase in oxidative stress has been suggested to play major roles in the complications of diabetes. The bulk of the experimental data favors enhanced free radicals in diabetes and antioxidant defense mechanisms may be reduced in diabetes. Melatonin, the major secretory product of the pineal gland has been shown to be a potent and specific hydroxyl radical scavenger. The purpose of our study was to determine the antioxidative effeet of melatonin in streptozotocin-induced diabetic rats. METHODS: Sprague-Dawley rats weighing 200-240 g were divided into 3 groups: normal controls(n-7), diabetic contmls(n-9), melatonin-treated diabetic animals(n-9). Diabetes was induced by intraperitoneal injection of streptozotoein(55 mg/kg body weight) and melatonin(6 mg/kg body weight) was orally administered for 20 days. At day 20 after streptozotocin administration, blood was collected for the assay of glucose, albumin and cholesterol. Erythrocyte membrane lipid peroxidation was determined by malonyldialdehyde(MDA) reactivity. RESULTS: 1) The MDA resctivity of erytbrocyte membrane in melatonin-treated diabetic animals (meanstandard deviation: 5.52+-1.52nmol/ml packed cells) were lower(p<0.05) than that in diabetic controls(7.68+-1.16nmol/mL packed cells). But, there was no significant difference between melatonin-treated diabetic animals and normal contls(4.93+-1.19 nmol/mL packed cells). 2) There were no significant differences of blood glucose and body weight between diabetic controls and melatonin-treated diabetic animals. CONCLUSION: These results show the antioxidative effect of melatonin in streptozotocin-induced diabetic rats. Further clinical and long-term experimental studies are needed to assess the effect of melatonin on development and progression of diabetic complications.
Animals ; Blood Glucose ; Body Weight ; Cholesterol ; Defense Mechanisms ; Diabetes Complications ; Erythrocyte Membrane ; Free Radicals ; Glucose ; Hydroxyl Radical ; Injections, Intraperitoneal ; Lipid Peroxidation ; Melatonin* ; Membranes ; Oxidative Stress ; Pineal Gland ; Rats* ; Rats, Sprague-Dawley ; Streptozocin

Acute renal failure is a rare complication of acute pyelonephritis. Therefore, acute pyelonephritis is not usually considered in the differential diagnosis of acute renal failure. However, it is important to consider this entity because of potential for recovery of renal function if appropriate early antibiotics are instituted. We report a case of biopsy proven acute pyelonephritis which was manifested as acute renal failure. A 38 year old women was admitted to this hospital owing to abdominal distension and generalized edema. On admission she was started on hemodialysis because of severe hyperkalemia and marked uremic sypmtoms. She had pyuria and hematuria, but no organism was isolated at urine. We initially don't know the cause of renal failure. She was improved with antimicrobial therapy and hemodialysis. A kidney biopsy was performed on the 26th hospital day because of persistent proteinuria. Microscopic examination revealed focal tubular atrophy, necrosis or loss with heavy infilteration of leukocytes and histocytes in interstitium. Atrophic tubules contain pus casts. The patient was treated with ciprofloxacin for 4 weeks. At about 2 month follow up, proteinuria completely disappeared and serum creatinine level decreased to 1.0 mg/dL.
Acute Kidney Injury* ; Adult ; Anti-Bacterial Agents ; Atrophy ; Biopsy ; Ciprofloxacin ; Creatinine ; Diagnosis, Differential ; Edema ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Hyperkalemia ; Kidney ; Leukocytes ; Necrosis ; Proteinuria ; Pyelonephritis* ; Pyuria ; Renal Dialysis ; Renal Insufficiency ; Suppuration

This study was initiated to investigate the effect of ultrasound(US) stimulation on therapeutic effects on human osteoarthritic cartilage repair. Cartilage explants from human osteoarthritic knee were sonicated for 10 minutes every day using continuous wave at frequency 1 MHz US signals with spatial and temporal average intensities of 0, 40, 200, 500 and 700mW/cm2. One group of explants was exposed to sham ultrasound as a control. After 1 week of culture, the intensity-dependent effects of US on DNA, proteoglycan (PG) and collagen synthesis were measured by 3H-thymidine, 35S-sulfate, 3H-proline incorporation, respectively. The expression of PG and type II collagen released into medium were measured by DMB (dimethylmethylene blue) method and western blot analysis. Safranin O/fast green and immunohistochemical staining with anti-collagen type II antibody were performed using the serial sections of cartilage explants. The histochemical examination showed that the expression of PG at the pericellular area in the deep layer increased continuously up to 700mW/cm2. In contrast, the depth of the superficial layer significantly decreased after treatment of sonication at 500 and 700mW/cm2. The expression of PG and type II collagen assessed by the isotope incorporation was significantly enhanced to the level up to 140%, 120% respectively, although US had no stimulatory effect on cell proliferation. These results suggest that optimum intensity of US for the effective expression of extracellular matrix in osteoarthritic cartilage may be around 200mW/cm2. In conclusion, our study suggests the possibilities that sonication may be therapeutically utilized for the repair of human osteoarthritic cartilage.
Blotting, Western ; Cartilage* ; Cell Proliferation ; Collagen ; Collagen Type II ; DNA ; Extracellular Matrix ; Humans* ; Knee ; Osteoarthritis* ; Proteoglycans ; Sonication* ; Ultrasonography

OBJECTIVE: To evaluate the safety and efficacy of the laparoscopic incidental appendectomy during gynecologic laparoscopic operation. Methods: This study was evaluated for the clinical analysis of 118 patients who underwent laparoscopic assisted vaginal hysterectomy(LAVH group, 65 cases) and LAVH with laparoscopic incidental appendectomy(LAVH + IA group, 53 cases) at the Wallace Memorial Baptist Hospital from Oct. 1996 to Nov. 1998. RESULTS: The following results were obtained: 1) There was no significant difference between two groups in regard to age. The mean age was 45.7 years in LAVH group and 43.8 years in LAVH + IA group. 2) There was no significant difference between two groups in mean operative time. The mean operative time was 90.4 minutes in LAVH group and 97.5 minutes in LAVH + IA group. 3) The mean appendectomy time was 7.1 minutes. 4) The mean time recovering normal bowel activity was 46.2 hours in LAVH group and 45.8 hours in LAVH + IA group. There was no significant difference between two groups. 5) The mean hospital stay was 6.4 days in LAVH group and 5.7 days in LAVH + IA group. There was no significant difference between two groups. 6) The postoperative complications occurred in 11 cases(9.3 %). The serious complications of appendectomy was not found. 7) Of the 53 appendices removed, 5(9.4 %) were abnormal pathologic findings. CONCLUSION: Laparoscopic incidental appendectomy during laparoscopic operation was not found to influence the operation time, hospital stay, gas passing time, but there is one case of wound infection due to incidental appendectomy. Therefore, a large number of study should be performed to evaluate the safety and efficacy of laparoscopic incidental appendectomy during laparoscopic operation.
Appendectomy* ; Humans ; Length of Stay ; Operative Time ; Postoperative Complications ; Protestantism ; Wound Infection

PURPOSE: To evaluate the utility of quantification of coronary artery calcification using spiral CT. MATERIALS AND METHODS: Spiral CT scans of the heart were obtained in 25 patients with coronary artery disease diagnosed by coronary angiography and in six controls without coronary artery disease. Spiral CT was performedwith 3 mm collimation at 3 mm/sec table speed and the obtained volume data of the heart was reconstructed at 2 mm intervals. Total calcium scores of the 30 contiguous slices of the proximal coronary artery were calculated basedon the areas and peak density. Two groups were compared for total scores and sensitivity, and specificity and positive predictive values were calculated. RESULTS: The number of subjects with coronary calcification(totalcalcium score>0) detected by spiral CT were 20(80%) of 25 with coronary artery disease and 2(33%) of 6 without coronary artery disease. The sensitivity, specificity, and positive predictive values were 80%, 67% and 91% respectively. Sensitivity was 64%, specificity was 80% in patients aged < or =60. Sensitivity was 76% and specificity was 83%(total calcium score 10). CONCLUSION: Quantification of coronary artery calcification using spiral CT haslow specificity in the older group and low sensitivity in the younger group ; the procedure is therefore may notbe useful as a non invase screening test to predict the prescence of coronary artery disease. In the younger group, however, a cardiac workup is strongly indicated if calcification is present.
Arteries ; Calcium ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels* ; Heart ; Humans ; Mass Screening ; Sensitivity and Specificity ; Tomography, Spiral Computed*