In thirteen adult male patient with scaphoid nonunion associated with DISI(Dorsal intercalated Segment Instability) defined as scapholunate angle is greater than 70 degrees of the radiolunate angle is greater than 10 degrees, anterior interpostitional bone grafting has been performed. Surgical procedure: 1) Closed reduction of lunate(reduction of DISI) by volar flexing of the wrist and holding the position by Kirschner wire inserted obliquely through the radial styloid to lunate. 2) Radical curettage of nonunion site and intraoperative measurement of the gap in the scaphoid through volar approach. 3) A bicortical wedge shaped graft from the iliac crest was then impacted between the fragments. 4) Temporary K-wire fixation of the grafted scaphoid from the scaphoid tubercle to prevent distortion of nonunion site and loss of fixation. 5) A Herbert screw was then inserted. Results: Mean patient age was 24.5 years, and mean duration of nonunion before surgery was 19.4 months. Mean follow-up time was 22.6 months. The nonunion involved the middle one-third of scaphoid in 11 patients and distal one-third in 2 patients. The mean postoperative grip strength was 39.4kg by Dynamometer(PC-5303J). The mean postoperative range of motion was volar flexion 50.5 degrees; dorsiflexion 47.3 degrees. The scaphlunate angle decreased from a mean of 78.8 preoperatively to 52.9 degrees postoperatively. The radiolunate angle was decresed from a mean of 16.8 degrees prope- ratively to a mean of 1.8 degrees postoperatively. Union was obtained in all 13 cases, According to Herbert and Fisher's formulation, 2 excellent, 10 good and 1 fair results were obtained from our study. The results of the series suggest that treatment of scaphoid nonunion associated with DISI by this method is an effective method that reconstitutes scaphoid anatomy and promotes excellent wrist function.
Adult ; Bone Transplantation ; Curettage ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Methods ; Range of Motion, Articular ; Transplants ; Wrist

BACKGROUND: Organophosphate and carbamate insecticides have been used extensively in agriculture resulting in serious increases in poisoning. Levels of poisoning by carbamates and organic phosphorus compounds and the severity of associated symptoms are dependent not only on the degree of reduction of acetylcholinesterase activity in the nervous system but also on the rate of inhibition and the type of inhibitive action. The most striking differences between the clinical effects of the two groups of compounds are the much more rapid and spontaneous recovery from poisoning by carbamates and the relatively large difference between the smallest dosage of any carbamate that will cause mild illness and the lethal dosage of the same compound. The purpose of this study is to compare the clinical characteristics of acute intoxication by organophosphate and carbamate insecticides. METHOD: We retrospectively analyzed the clinical characteristics of 41 patients poisoned with organophsphates and 12 patients poisoned with carbamates, who were admitted to the department of internal medicine, Soonchunhyang Chunan hospital from January 1995 to December 1996. RESULTS: 1) The most common organophosphate was EPN (9 cases) followed by Dichlorvos (7 cases). In the carbamates group, Carbofuran (5 cases) was the most common followed by Methomyl (3 cases).2) The main cause of poisoning was ingestion for the purpose of suicide in both groups.3) The severity of poisoning was more acute in the organophosphate group than in the carbamate group.4) Altered consciousness and respiratory depression occurred more frequently in the organophosphate group than in the carbamate group. Six cases out of the organophosphate group suffered from respiratory depression 24 hours to 96 hours after poisoning.5) The activity of serum cholinesterase showed no significant difference between poisoning with organophosphates and with carbamates.6) The mortality rate was 22% in organophosphate intoxication and 16.7% in carbamate intoxication. The most common complication of organophosphate and carbamate intoxication was aspiration pneumonia. CONCLUSION: Carbamate insecticides exhibited less toxicity than organophosphates.
Acetylcholinesterase ; Agriculture ; Carbamates ; Carbofuran ; Cholinesterases ; Chungcheongnam-do ; Consciousness ; Dichlorvos ; Eating ; Humans ; Insecticides* ; Internal Medicine ; Methomyl ; Mortality ; Nervous System ; Organophosphates ; Phosphorus Compounds ; Pneumonia, Aspiration ; Poisoning* ; Respiratory Insufficiency ; Retrospective Studies ; Strikes, Employee ; Suicide

No abstract available.
Gestational Sac* ; Ultrasonography*

Syphilitic involvement of the stomach often takes the appearance of neoplastic conditions. We describe the radiological findings of syphilitic gastritis. A 36-year-old man was diagnosed with gastric cancer by upper GI and CT, but syphilitic gastritis was confirmed by endoscopy and upper GI series performed after penicillin therapy, We report a case of syphilitic gastritis presented as advanced stomach cancer by clinical, endoscopic and radiological study.
Adult ; Endoscopy ; Gastritis* ; Humans ; Penicillins ; Stomach ; Stomach Neoplasms

No abstract available.

PURPOSE: To verify the value of CT in the diagnosis of cirrhosis, CRL ratio was measured in 225 Koreans who had and evidence of cirrhosis both clinically and radiologically. MATERIALS AND METHODS: The mean value of CRL ratio was 0.68+/-0.21 which was significant difterent from the published value of normal person(0.45+/-0.07). The difference of CRL ratio between men and women and that among different age groups were found to be not statistically signficant. RESULTS: CRL ratio of virus- related group(N:149) was 0.64+/-0.18, whereas that of virus-nonrelated group (N=76) was 0.76+/-0.23. There was a statistically significant difference of CRL ratio between virus-related group and virus-nonrelated group. CRL ratio of hepatoma-related group(N:113) was 0.71+/-0.22 whereas that of heparoma-nonrelated group(N:112) was 0.66+/-0.19. There was no statistically significant difference of CRL ratio between hepatoma-related group and hepatoma-nonrelated group. CONCLUSION: Measurement of CRL ratio by CT is a useful method in assessing cirrhosis of the liver.
Diagnosis ; Female ; Fibrosis ; Humans ; Liver Cirrhosis* ; Liver* ; Male

No abstract available.
Hypoglycemia*

Bulimia nervosa is a disorder that is defined as binge eating combined with inappropriate ways of stopping weight gain. It is significantly more common in females than in males. Males in bulimia account for 10-15% of all bulimic patients. There are many methods of treatment, including drug therapy, or psychotherapy. Among them cognitive behavior therapy is reported to be the most effective method of improving the binge eating behavior and the cognitive distortion about body weight and body image. In this case, a male bulimic patient, who was hospitalized in the closed ward involuntarily, was treated with modified Fairburn's cognitive behavior therapy model. After 6 weeks of treatment, binge eating and self-induced vomiting behaviors were controlled and weight gain was nearly successful.
Body Image ; Body Weight ; Bulimia Nervosa* ; Bulimia* ; Cognitive Therapy* ; Drug Therapy ; Female ; Humans ; Male* ; Psychotherapy ; Vomiting ; Weight Gain

PURPOSE: To assess the effectiveness and clinical usefulness of prostate biopsy by automated gun biopsy device under the transrectal ultrasonographic guidance, authors analysed the result of biopsy and the patients status after biopsy procedure. METHODS AND MATERIALS: The subjects consisted of 24 patients with prostatic disease. Biopsy instrument was an automated gun biopsy device loaded with an 18 gauze biopsy needle. All the patients were admitted to the hospital. No analgesics was given. All the procedure was performed with the patient in left lateral decubitus. Biopsy was performed at 2-4 different points of the prostate in 22 cases, but recently, six different points were targeted in two patients. RESULTS: Biopsy specimens were sufficient in 21 cases but insufficient in three cases. Histologic examination of biopsy specimens showed that 13 cases were nodular hyperplasia, eight cases were cancerous and three cases were inflammation. There was no clinically significant complication. There was mild to moderate degree of pain in all patients. CONCLUSION: Tansrectal biopsy of the prostate with an automated gun biopsy device under ultrasonographic guidance is considered relatively easy, handy and useful procedure in patients with prostatic disease. The procedure may be performed on the outpatient basis.
Analgesics ; Biopsy* ; Humans ; Hyperplasia ; Inflammation ; Needles ; Outpatients ; Prostate* ; Prostatic Diseases ; Ultrasonography*

Until recently, the cervical pregnancy have been treated with surgery, usually hy- sterectomy, because of uncontrollable heavy vaginal bleeding. The development of sophisticated ultrasound which allows early diagnosis of cervical pregnancy and methotrexate chemotherapy opened up new therapeutic options in the management of this unusual but potentially life threatening complication of pregnancy which have been always a nightrnare for the gynecologist. We are reporting a case of cervical pregnancy diagnosed in 12 weeks of gestation. The patient was successfully treated with alternative administration of methotrexate (1 mg/kg, intramuscularly) and leucovorin (0.1 mg/kg, intramuscularly) without surgical intervention, in order to preserve both the uterus and fertility. Follow up was done with serum beta hCG and pelvic ultrasonography. Complete resolution of the cervical pregnancy was obtained at 50 days after starting methotrexate treatment. This case gave us the opportunity to review the recent literature on cervical pregnancy.
Drug Therapy ; Early Diagnosis ; Fertility ; Follow-Up Studies ; Humans ; Leucovorin* ; Methotrexate* ; Pregnancy* ; Ultrasonography ; Uterine Hemorrhage ; Uterus