No abstract available.
Antibodies, Antinuclear* ; Scleroderma, Systemic*

No abstract available.
Cervix Uteri* ; Female ; Hysterectomy*

The anatomical characteristics of the tibia, which is covered by subcutaneous tissue anteriorly, emphasize the vulnerability of the tibia to trauma and frequently result in open comminuted fracture. Open fractures add to the risk of infection and nonunion and require treatment that prevent infection, provide skin coverage, and maintaine reasonable fixation during the early healing phase. 50 cases of tibia shaft fractures were reviewed from May 1978 to December 1983, managed with the modified Vidal-Adrey frame of Hoffmann extemal fixator, at the Orthopaedic Department of Kyung Hee University Hospital. The results obtained were as follows; 1. In 50 cases of tibia fractures, 46 cases are open injuries and 43 cases (86.0%) among them were Grade II and IU open fractures. 2. 31 operative procedures were performed for the coverage of soft tissue injury; 13 cases of rotation and cross-leg pedicle flaps were effective aids, but futher good results could be expected with the micmvascular free flap. 3. 17 operative procedures for acceleration of bony union and reconstruction of bone defect were performed. In cases of massive bone defect, vascularized fibular transplantation and free vascularized fibular graft should be employed, and additional bone shortening and electric stimulation would contribute to the enhancement of the bony union process. 4. The mean period of extemal immobilization with the frame was 15.4 weeks and that of bone union was 31.7 weeks. The periods of bone union were markedly delayed in cases of Grade II andIII open fracture than those of closed and Grade I open fractures. 5. Nonunion developed in 17 cases (34.0%); 4 cases in Grade II and 13 cases in Grade III injury. 6. 12 cases of wound infection developed. 7. 12 cases of pin tract infection happened. More careful pin tract management could diminish this troublesome complication.
Acceleration ; Electric Stimulation ; Fractures, Comminuted ; Fractures, Open ; Free Tissue Flaps ; Immobilization ; Skin ; Soft Tissue Injuries ; Subcutaneous Tissue ; Surgical Procedures, Operative ; Tibia ; Transplants ; Wound Infection

Intracranial hypoglossal neurinomas are rare and only about fifty cases have been reported worldwidely. They usually present with hypoglossal nerve palsy preoperatively. The authors experienced, however, two cases of intracranial hypoglossal neurinomas without preoperative hypoglossal nerve palsy. One patient was operated using transcondylar retrosigmoid approach with C1 laminectomy and the other using midline suboccipital craniectomy with C1 laminectomy. Postoperatively hypoglossal nerve palsy was developed in both cases. Absence of preoperative hypoglossal palsy seemed to be related to somewhat different growth pattern in these two cases. When the tumor shows typical radiological findings of hypoglossal neurinoma, it must be included in differential diagnosis despite absence of preoperative hypoglossal nerve palsy.
Diagnosis, Differential ; Humans ; Hypoglossal Nerve Diseases* ; Hypoglossal Nerve* ; Laminectomy ; Neurilemmoma* ; Paralysis

PURPOSE: The authors report a case of optic nerve evulsion with literature review. METHOD: 15-year-old boy, who had optic nerve evulsion by tear of inferior rectus and medial rectus muscles, and hypotony by retinal and choroidal detachment RESULTS: we could preserve the eyeball with normal pressure by pars plana vitrectomy, endolaser photocoagulation and silicone oil injection
Adolescent ; Choroid ; Humans ; Light Coagulation ; Male ; Muscles ; Optic Nerve Injuries ; Optic Nerve* ; Retinaldehyde ; Silicone Oils ; Vitrectomy

OBJECTIVE: This study was undertaken to review the disease course, clinical and laboratory manifestations, prognosis and treatment of adult onset Still s disease (AOSD) in Korea. METHODS: Thirty-two patients with AOSD were enrolled from 1986 to 1997 in Hanyang University Hospital. Diagnosis of AOSD was based on the criteria proposed by Yamaguchi. We classified the disease course into self-limited, inter mittent, or chronic disease course. RESULTS: Twenty-four (75%) patients were female. Skin rash occurred in 28 (88%) patients, lymphadenopathy in 8 (25%), hepatomegaly in 4 (13%), and pericarditis in 2 (6%) out of 32 patients. The most commonly affected joints were knee joints (88%). Elevated LDH was seen in 18 (60%) patients and decreased CK in 17 (61%) patients. Rheumatoid factor was detected in 4 (13%) patients and ANA in 12 (38%) patients. Anemia (Hb < 10 g/dL) was seen in 13 (41%) patients and hypoalbuminemia (<3. 5 g/dL) in 14 (52%) patients. Elevated ferritin (300 ng/mL) level was seen in 23 (79%) patients. Twenty-five (78%) patients had elevated serum transaminase. Bone marrow studies were performed in 16 patients. Nine out of 16 patients showed hyperplasia of the myeloid series and 2 patients displayed the features of a hemophagocytic syndrome. The mean duration of follow up of 32 patients was 32 months (range 3- 108). Eight (27%) patients had a self-limited, 9 (30%) an intermittent, and 13 (43%) a chronic disease course. The hypoalbuminemia was significantly associated with an "intermittent or chronic disease group" (p<0. 05). Thirty-two patients received systemic corticosteroids and 21 patients received single or combination of disease modifying antirheumatic drugs. CONCLUSION: We found that hypoalbuminemia at presentation was significantly associated with an unfavorable outcome, intermittent or chronic disease group. The clinical manifestations and disease course of AOSD in Korea were similar to those previously reported in other countries except significantly lower incidence of lymphadenopathy, hepatomegaly, and pericarditis.
Adrenal Cortex Hormones ; Adult* ; Anemia ; Antirheumatic Agents ; Bone Marrow ; Chronic Disease ; Diagnosis ; Exanthema ; Female ; Ferritins ; Follow-Up Studies ; Hepatomegaly ; Humans ; Hyperplasia ; Hypoalbuminemia ; Incidence ; Joints ; Knee Joint ; Korea* ; Lymphatic Diseases ; Lymphohistiocytosis, Hemophagocytic ; Pericarditis ; Prognosis ; Rheumatoid Factor ; Still's Disease, Adult-Onset*

Postpartum ovarian vein thrombosis has been thought to be a rare disease of which clinical finding is not accurate. Most of postpartum ovarian vein thrombosis presents as symptoms consisting of fever, lower abdominal pain, abdominal mass. If the symptom does not response even with intravenous antibiotics therapy or diagnosis is inaccurate, a ultrasound or a CT scan should be obtained for diagnosis. We report a case of postpartum ovarian vein thrombosis after cesarean section diagnosed and treated, with a brief review of literatures.
Abdominal Pain ; Anti-Bacterial Agents ; Cesarean Section* ; Diagnosis ; Female ; Fever ; Postpartum Period* ; Pregnancy ; Rare Diseases ; Thrombosis* ; Tomography, X-Ray Computed ; Ultrasonography ; Veins*

STUDY DESIGN: A retrospective study OBJECTIVES: In the operative treatment of lumbar spinal stenosis, the wide decompression and fusion method has many problems, such as a long operation time, large blood loss and the long time required to achieve solid fusion. As a solution to these problems, a minimal decompression method was been performed, which minimizes the resection of laminae and facet joints. SUMMARY OF LITERATURE REVIEW: In the operative therapy for lumbar spinal stenosis, favorable results can be obtained by simple decompression. MATERIALS AND METHODS: 42 cases of degenerative lumbar stenosis, with neither segmental instability nor spondylolisthesis, underwent a minimal decompressive surgery, without instrumentation. The mean operation time and amount of blood loss were analyzed, and the clinical results evaluated according to Kim's criteria and the postoperative segmental instability by the Dupuis method. The average follow-up period was 70 months. RESULTS: Transfusions were not required in all cases. The mean operative times were 1hour 5minutes and 1hour 46minutes in the one and two segment decompressions, respectively. The clinical results, according to Kim's criteria, were excellent in 24 cases and good in 12. There was no dynamic instability in the radiographs at the last follow-up. CONCLUSIONS: With the degenerative lumbar stenosis, without segmental instability or spondylolisthesis, minimal decompression was an effective surgical method.
Constriction, Pathologic* ; Decompression* ; Follow-Up Studies ; Operative Time ; Retrospective Studies ; Spinal Stenosis ; Spondylolisthesis ; Zygapophyseal Joint

The imidazopyridine, zolpidem, a non-benzodiazepine hypnotic drug, is widely-prescribed for insomnia. It is regarded as a good alternative to benzodiazepine because of the reduced possibility for abuse and development of dependence. However, more recently, due to the reduced possibility for abuse and development of dependence, it is regarded as a good alternative to benzodiazepine. adverse effects of zolpidem have been recognized. The objective of this report is to provide information on the potential for occurrence of benzodiazepine-like withdrawal seizure in patients who chronically take zolpidem continually. We present and discuss a case of seizure after sudden interruption of the protracted use of an abusively high dose of zolpidem. Zolpidem may not be the ideal drug for long-term pharmacotherapeutic management of insomnia. Clinicians should administer zolpidem at a low-dose for a short period of time for prevention of drug abuse and dependence and the potential for occurrence of benzodiazepine-like withdrawal seizure.
Benzodiazepines ; Humans ; Seizures* ; Sleep Initiation and Maintenance Disorders ; Substance-Related Disorders

Leiomyomas of the vagina are rare benign solid tumors. A leiomyoma arises frommuscle in the round ligament and appears as a firm movable tumor deep in the substanceof the labium majus, but minority of these tumors occur in vaginal wall. A case of a 39year old woman with leiomyoma of the vaginal orifice was reported with a brief review ofliterature.
Female ; Humans ; Leiomyoma* ; Round Ligament of Uterus ; Vagina