No abstract available.
Dislocations* ; Elbow*

The gout is a hereditary condition of disturbed uric acid metabolism. There are medical and surgical management in tophaceous gout for prevention of recurrence of acute attack and creation of a negative uric acid balance. The surgical management is removal of tophaceous material in the soft tissue and osseous structure. Aditionally, the resection of bone and joint, arthrodesis and bone graft improve the functional capacity of the gouty patients. A 53 years old man was managed by removal of tophaceous materials in both prepatellar area, left olecranon area and both feet and arthrodesis of left first metatarsophalangeal joint with autogenous iliac bone graft and supportive medication with probenecid and indomethacine, and was followed up from March, 1986 to April, 1987. There was no significant difference in duration between the union of nonpathologic fracture and the union of arthrodesis area in this gouty patient. We found the progressive recovery of normal trabeculation in previous destructive bone lesions with drug therapy, but there was no specific change in the soft tissue lesions.
Arthrodesis ; Drug Therapy ; Foot ; Gout ; Humans ; Indomethacin ; Joints ; Metabolism ; Metatarsophalangeal Joint ; Olecranon Process ; Probenecid ; Recurrence ; Transplants ; Uric Acid

There are few reports in the literature on how to care and manage bi!ateral congenital dislocation of the hip. Six patients have been encountered at this hospital from June 1979, of them four children had operative treat ment and the other two conservative. As a result of our experience about the management of bilateral congenital dislocation of the hip. The authors obtained the following conceptions; 1. The patient with bilateral dislocation was rather delayed in diagnosis. Therefore, in comp the treatment of bilateral cases was poorer than that of unilateral case. 2. In the case of the dislocated hip that might be easily reduced and maintained in the stab servative care was usually recommeded even in the older child. Unstable, unreduced hip,; hip in old children, the more definitive operation and internal & external rigid immobilization mandatory to get good result. 3. It might be beneficial to operate the more deformed and resistive hip first, and then to p with the same procedure 2 weeks after the first operation.
Child ; Diagnosis ; Dislocations ; Fertilization ; Hip ; Humans ; Immobilization

No abstract available.
Endometriosis* ; Female ; Humans

Isolated tuberculosis of the coccyx is extremely rare. A 35-year-old man presented with a 3-month history of coccygeal and gluteal pain. Computed tomography and magnetic resonance imaging revealed osseous destruction and a large enhancing mass involving the coccyx with anterior and posterior extension. Pathologic examination of the surgical specimen revealed necrosis, chronic granulomatous inflammation, and multinucleated giant cells consistent with tuberculosis. This case highlights the importance of considering tuberculosis as a diagnosis even though unusual sites are involved.
Coccyx ; Giant Cells ; Inflammation ; Magnetic Resonance Imaging ; Necrosis ; Tuberculosis

OBJECTIVES: This study examined the influence of different sizes of spoons (normal spoon, 8.3 cc vs small spoon, 4 cc) on eating rate, energy intake and the satiety levels of female college students. METHODS: Twenty four healthy female college students participated in this study once a week for 2 weeks. Two hundred ten grams of cooked rice and 250 g of beef shank soup with a normal spoon and same amount of rice and soup with a small size spoon were served to the same participants over two consecutive weeks. After each lunch, the eating rate, energy intake, and the satiety levels were measured. RESULTS: Results showed that the subjects who were using a small spoon ate less beef shank soup (149.0 kcal) (p < 0.01) and had lower total energy intake (423.3 kcal) (p < 0.05) than using a normal spoon (178.7 and 461.1 kcal, respectively). Also, the meal time (15.7 min) (p < 0.01), a serving per one spoon (8.6 g) (p < 0.001), and eating rate (27.9 g/min) (p < 0.001) of those who used a small spoon were significantly different than that of those who used a normal spoon (13.6 min, 12.5 g and 35.7 g/min, respectively). However, despite consuming less energy at lunch, the level of satiety after eating from the small spoon was not significantly different from the normal spoon immediately after, 1 hour after and 2 hour after lunch. CONCLUSIONS: Our results revealed that students were able to control their eating rate by using a small spoon and they could feel full enough even though they eat less. In conclusion, eating rate decrease by using a small spoon may play an important role in food intake.
Eating* ; Energy Intake* ; Female* ; Humans ; Lunch ; Meals

PURPOSE: We evaluated the lateral release rate and the clinical results according to the intraoperative assessment of patellar tracking in total knee arthroplasty (TKA). MATERIALS AND METHODS: We analyzed 365 primary total knee arthroplasties in 278 patients. The knees showing good patellar tracking without tourniquet deflation were classified into group 1, those showing improved patellar tracking after tourniquet deflation were classified into group 2, those showing improved patellar tracking after the single stitch method were classified into group 3 and those showing persistent patellar maltracking, that resulted in lateral retinacular release, were classified into group 4. The postoperative patellar tilting angle was measured and the clinical results were evaluated for all the groups. RESULTS: We classified 176, 127, 57 and 5 knees into groups 1, 2, 3 and 4 respectively. Only 5 knees (1.4%) showed poor patellar tracking with the single stitch method after tourniquet deflation and this resulted in lateral retinacular release. The postoperative mean patellar tilting angle was 4.1degrees, 3.4degrees, 5.1degrees and 4.3degrees in each group, respectively, and no statistical differences were shown between the groups (p>0.05). Nine knees complained of anterior knee pain and there was no difference between groups. CONCLUSION: Lateral retinacular release in TKA may not be necessary if the patellar tracking is improved with the single stitch method after tourniquet deflation.
Arthroplasty ; Humans ; Knee ; Tourniquets ; Track and Field

PURPOSE: Although RV infection is less common in neonate than older infants, because of high transmissibility and morbidity, it is devastating disease in nursery. With experience of RV infection outbreak in our nursery, we report its clinical and epidemiological characteristics. METHODS: From March 2002 to September 2003, 39 neonates were diagnosed with RV infection in nursery by immunochromatographic method. In addition to prevalence time, monthly distribution, and method of blocking outbreak of the disease, demographic, clinical and laboratory data for the neonates were evaluated. RESULTS: After occurring index patient in a nursery of Hanyang University Hospital in Seoul at March 22, 2002, the RV infection was increasing. Although the nursery was disinfected with 99% alcohol, 6 cases of new RV infections developed during July 2002. Eradication of RV infection was achieved after closing the nursery with cohort twice for 17 days and for 10 days. During period of this study, total 39 cases of RV infection were identified and the incidence of infection was 11.5%. Unlike to older infants, the majority of neonatal patient were asymptomatic (47.3%). CONCLUSION: We propose that instead of disinfection using 99% alcohol, long-term isolation with cohort is preferable to control RV transmission in nursery.
Acidosis ; Cohort Studies ; Disinfection ; Humans ; Incidence ; Infant ; Infant, Newborn ; Nurseries* ; Prevalence ; Rotavirus* ; Seoul

Henoch-Schonlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and C3 deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.
Abdominal Pain ; Acute Kidney Injury ; Adult ; Arthralgia ; Azotemia ; Biopsy ; Exanthema ; Fluorescent Antibody Technique ; Gastrointestinal Hemorrhage ; Glomerulonephritis ; Humans ; Immunoglobulin A ; Joints ; Kidney ; Lower Extremity ; Oliguria ; Purpura ; Purpura, Schoenlein-Henoch ; Renal Dialysis ; Skin ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous ; Wrist

BACKGROUND: Various methods have been employed for treatment of onychomycosis. These methods can be categorized as topical, oral, or device-related. Among them, oral therapies have been regarded as the gold standard for treatment. However, the efficacy of oral therapies on onychomycosis remains limited and safety may be an issue, leaving many patients in need of alternative treatments. As an alternative treatment for onychomycosis, topical therapies are under investigation with great interest. OBJECTIVE: We conducted an investigation on the efficacy of trichloroacetic acid (TCA) as a new therapeutic option in treatment of onychomycosis. METHODS: Fourteen patients with onychomycosis in both great toenails, which was confirmed by fungal examination, were enrolled. About 0.1 ml of 100% TCA solution was applied on one great toenail of the patients eight times at an interval of one week. The other great toenail of the patients was treated with vehicle. RESULTS: At the end of the treatment period, clinical improvement of TCA-treated great toenails with onychomycosis was observed in eleven out of 14 patients. By contrast, no clinical improvement was observed in vehicle-treated great toenails with onychomycosis. Irritant contact dermatitis of the periungual nail folds occurred in 29% as an adverse effect. CONCLUSIONS: Topical solution of TCA may become a new therapeutic option for treatment of patients with onychomycosis who desire alternatives to oral antifungal agents.
Antifungal Agents ; Dermatitis, Contact ; Humans ; Nails* ; Onychomycosis* ; Pilot Projects* ; Trichloroacetic Acid*