No abstract available.
Femur*

Contrast arteriography and phlebography remain the standard diagnostic techniques for evaluation of peripheral arterial and venous diseases. However, invasive angiographic techniques involve expense, time, discomfort, and potential risks to the patient which preclude their use as routine screening and followup procedures. In order to obtain accurate, objective information to complement the clinical diagnosis of peripheral vascular diseases, many noninvasive diagnostic techniques have recently become available to the clinican. Among these techniques, photoplethysmograph (PPG), strain gauge plethysmograph (SPG), and doppler ultrasound were adopted for our study. Fourty young volunteers were studied as a control group, and twenty peripheral vascular disease patients were studied as a patient group. We obtained average values of PPGa, blood flow, maximum PRT venous reflux folw (MVRF), maximum venous outflow (MVOF), pulse reappearance time (PRT), PRT/2 and pulsatility idex(PI) for control group. Results for patient group were analysed and compared with those of control group. 1. Normal PPGa wave has a steep upslope, a relatively narrow peak, and a dicrotic wave on the downslope which is concave toward the baseline. PPGa reflected skin blood flow sensitively than any other technique. 2. Average forearm blood flow by means of SPG was 5.7±2.0, and that of calf was 3.7±1.4ml/min/100cc tissue. MVOF of forearm was 32.9±10.4, and that of calf was 18.0±7.0ml/min/100cc tissue. Blood flow measurement was not useful for detection of arterial occlusive disease, but MV OF was useful for diagnosis of deep vein thrombosis. 3. PRT, PRT/2, over shooting reaction time by means of SPG have low diagnostic value and PI by means of doppler ultrasound was useful for localization of arterial narrowing or obstruction. 4. Noninvasive diagnostic techniques including PPG, SPG and doppler ultrasound are useful for screening and follow-up procedures in diagnosis of peripheral vascular disease. They are also valuable to supplement angiographic or physical findings.
Angiography ; Arterial Occlusive Diseases ; Complement System Proteins ; Diagnosis ; Follow-Up Studies ; Forearm ; Humans ; Mass Screening ; Peripheral Vascular Diseases ; Phlebography ; Reaction Time ; Skin ; Ultrasonography ; Vascular Diseases ; Venous Thrombosis ; Volunteers

The distal ulnar resection, Darrach operation, has been used for several conditions such as fracture about wrist joint, rheumatoid arthritis or ulno-carpal impingement syndrome. But, this operation could be led to have excessive unphysiologic increase radial loading on the radio-carpal joint and early osteoarthritis is thought to be inevitable in long-term follow-up. So, we performed various kind of reconstruction for 19 cases with dislocated distal radioulnar joint, and compared their radiologic and clinical results with that of the group for total 13 cases with distal ulnar resection. Through this study, we could find out that the preservation of normal relationship of dislocated distal radioulnar joint is considered as more desirable than that of removal of ulnar head.
Arthritis, Rheumatoid ; Dislocations ; Follow-Up Studies ; Head ; Joints ; Osteoarthritis ; Wrist Joint

No abstract available.
Carcinoma, Transitional Cell* ; Humans* ; P-Glycoprotein* ; Urinary Bladder*

Biliary strictures are one of the most common complications following liver transplantation, representing an important cause of morbidity and mortality in transplant recipients. The reported incidence of biliary stricture is 5% to 15% following deceased donor liver transplantations and 28% to 32% following living donor liver transplantations. Bile duct strictures following liver transplantation are easily and conveniently classified as anastomotic strictures (AS) or non-anastomotic strictures (NAS). NAS are characterized by a far less favorable response to endoscopic management, higher recurrence rates, graft loss and the need for retransplantation. Current endoscopic strategies to correct biliary strictures following liver transplantation include repeated balloon dilatations and the placement of multiple side-by-side plastic stents. Endoscopic balloon dilatation with stent placement is successful in the majority of AS patients. In patients for whom gaining biliary access is technically difficult, a combined endoscopic and percutaneous/surgical approach proves quite useful. Future directions, including novel endoscopic retrograde cholangiopancreatography techniques, advanced endoscopy, and improved stents could allow for a decreased number of interventions, increased intervals before retreatment, and decreased reliance on percutaneous and surgical modalities. The aim of this review is to detail the present status of endoscopy in the diagnosis, treatment, outcome, and future directions of biliary strictures related to orthotopic liver transplantation from the viewpoint of a clinical gastroenterologists.
Bile Duct Diseases ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Constriction, Pathologic ; Dilatation ; Endoscopy ; Humans ; Incidence ; Liver ; Liver Transplantation ; Living Donors ; Plant Extracts ; Plastics ; Recurrence ; Retreatment ; Stents ; Tissue Donors ; Transplants

The position of interventricular septum, which was measured by transitional zone of EKG, was compared with that measured by 2-D echocardiography in 51 patient. 1) The position of interventricular septum measured by 2-D echocardiography was very similar to that measured by transitional zone of EKG. 2) Extensive AMI (Anterior Myocardial Infarction) and LBBB showed moderate differences between two method. 3) RBBB and replaced mitral valve state showed severe differences between two methods. Transitional zone of EKG was helpful to define the position of interventricular septum except extensive AMI, bundle branch block and replaced mitral valve state.
Bundle-Branch Block ; Echocardiography ; Electrocardiography* ; Humans ; Mitral Valve

The double pylorus is a rare condition consisting of a double communication between gastric antrum and duodenal bulb. Some investigators postulate that the doubling of the pyloric channel is a congenital phenornenon, but others believe that it is an acquired lesion. A 72 year-old-man was admitted to this hospital because of epigastric pain for 1 month. Upper G-I series revealed thickened rnucosal folds of pylorus and duodenal bulb and dilated, deformed duodenal bulb filled with barium materials. Endoscopic findings also showed two ovoid large openings of the pyloric channel divided by smooth thickened septum and multiple gastroduodenal ulcers. We thought that this case was an acquired lesion. The relevant literatures on the subject were reviewed.
Barium ; Duodenal Ulcer ; Humans ; Peptic Ulcer ; Pyloric Antrum ; Pylorus* ; Research Personnel ; Stomach Ulcer

BACKGROUND: Persistent auras after temporal lobectomy may be bothersome to the patients even though they are seizure free. But most authors specifically are concerned about the seizure outcome itself. The aim of the present study was to investigate which factors are related to persistent auras in patients with temporal lobe epilepsy(TLE) after temporal lobectomy. METHODS: We have retrospectively analysed many factors in 38 TLE patients with aura. All patients underwent anterior temporal lobectomy with amygdalo-hippocampectomy. Twenty three patients were seizure and aura free (completely seizure-free) and 15 patients had persistent auras(persistent auras) in spite of seizure-free. Characteristics of auras, past medical history, presence of secondary GTC, seizure frequency, age of surgery, age of onset, duration of habitual seizure, ictal EEG pattern, and pre- and postoperative MRI findings were compared between group with completely seizure-free and group with persistent aura. RESULTS: Characteristics of aura, past medical history, presence of secondary GTC, seizure frequency, ictal EEG pattern, age of onset, and age of surgery had no statistical differences between both groups. Seizure duration of group with persistent aura seemed to be longer than that of group with completely seizure-free(13.6 years vs 17.0 years, median test, p=0.10) and remained hippocampus in postsurgical MRI seemed to be related to persistent auras(Fisher's exact test, p=0.06). CONCLUSIONS: We found that there were suggestive differences in seizure duration and remained hippocampus between the two groups.
Age of Onset ; Anterior Temporal Lobectomy ; Electroencephalography ; Epilepsy* ; Epilepsy, Temporal Lobe ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Retrospective Studies ; Seizures ; Temporal Lobe

PURPOSE: To describe the CT findings of automastoidectomy caused by cholesteatoma, and to evaluate the natural course of cholesteatoma by comparing it with the postmastoidectomy defect of the temporal bone. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 15 cases of automastoidectomy in 13 patients with cholesteatoma and of 14 cases of postmastoidectomy in 13 patients. RESULTS: In automastoidectomy, the posterior walls of bony defects of the temporal bone were thinner (mean thickness in automastoidec/postmastoidec tomy :2mm/3.5 mm) and smoother(n=10) than those of bony defects in postmastoidectomy(n=6). Defects of the posterosuperior wall of the bony external auditory canal were present in all cases of automastoidectomy(100%) andmost of postmastoidectomy(79%). there were gross defects of the lateral bony cortex of the mastoid(71%), Henle'sspine(100%), and the postero superior extension of the exit of bony defect(100%) in cases of postmastoidectomy(n=10), but there were rare findings in cases of automastoidectomy(20%, 21%, 23%, respectively).There were soft tissue densities within the bony defect and sinus tympani in all cases of automastoidectomy(100%)and in some cases of postmastoidectomy(64% and 36% respectively). CONCLUSION: When comparing automastoidectomyand postmastoidectomy, CT findings concerning bony defects were different with regard to the remaining posteriorwall, the extent of bony defect, and the presence of findings which suggested an active disease process. These differences are helpful in differentiating automastoidectomy and postmastoidectomy and in understanding thenatural course of cholesteatoma.
Cholesteatoma ; Ear Canal ; Humans ; Retrospective Studies ; Temporal Bone*

Ovarian hyperstimulation syndrome is a serious complication of ovulation induction and has a diverse clinical spectrum from edema to thromboembolism. Antiphospholipid antibody syndrome, one of the well known hypercoagulable states, can be also manifested as an arterial or venous thrombosis and recurrent spontaneous abortion. Sometimes a patient with antiphospholipid antibodies might not notice a miscarriage and seek for assisted reproduction treatment, which harbors a chance of developing ovarian hyperstimulation syndrome. If this happens, the ovarian hyperstimulation syndrome can exacerbate the thrombotic complication of underlying antiphospholipid antibody syndrome, resulting in a catastrophic vascular event. The authors experienced a case of middle cerebral artery infarct, which developed during ovarian hyperstimulation syndrome in a 33-yr-old woman with a previous history of fetal loss. An elevated titer of anticardiolipin antibodies was noticed and persisted thereafter. The authors suggest screening tests for the presence of antiphospholipid antibodies before controlled ovarian hyperstimulation.
Adult ; Antibodies, Anticardiolipin/blood ; Antiphospholipid Syndrome/*complications/pathology ; Female ; Humans ; Iatrogenic Disease ; Infarction, Middle Cerebral Artery/*etiology/pathology ; Magnetic Resonance Angiography ; Ovarian Hyperstimulation Syndrome/*complications/pathology ; Ovulation Induction ; Pregnancy ; *Pregnancy Complications/pathology