All authors would like to withdraw the article because they have found a mistake in selecting subjects for this study.

Thirty-eight patients with a musculoskeletal chest wall syndrome were evaluated for the musculoskeletal findings of chest wall. All patients had the chest wall tenderness and the typical chest pain could be reproduced by the palpation. There was no significant difference in the diagnostic features of the pain for the onset, location, characteristics, duration, radiation, and area of references for chest pain among the different groups of the patients. However, a reproduction of pain by palpation and the pressure threshold difference between the lesion and control points by using pressure algometry was a reliable and specific diagnostic tool. Pressure threshold difference was correlated with numerical rating scale by the correlation coefficient 0.96. The common causes of the chest wall syndrome were the myofascial pain syndrome, chostochondritis, sternalis syndrome, rib-tip syndrome, xiphodynia in order. Six patients had chest wall disorders in conjunction with other associated intrathoracic condition. Thirty-two patients had an isolated chest wall syndrome. Chest wall syndrome should be considered in all patients with the chest pain, as its recognition could help the patient management.
Chest Pain ; Humans ; Myofascial Pain Syndromes ; Palpation ; Reproduction ; Thoracic Wall* ; Thorax*

A retrospective study on 78 cases of surgically treated acute(within 24 hours) subdural hematoma(ASDH) with special reference to the size is presented. The thin ASDH is defined as the hematoma of which thickness is less than 3 mm in the printed CT film(true thickness about 10 mm). 27 cases are the thin ASDH and 51 cases are the not-thin ASDH. Pre-operative Glasgow coma score(GCS1), Postoperative Glasgow coma score(GCS2) and difference between GCS2 and GCS1(GCS2-GCS1) are compared in two groups by student t-tests. The mean GCS2 is worse than the mean GCS1 in the thin ASDH. In the not-thin ASDH, the mean GCS2 is better than the mean GCS1. Futhermore, in the thin ASDH, the mean difference between GCS2 and GCS1 is -1.04("-" means deteriorated after operation). In the not-thin ASDH, it was 0.77. In the thin ASDH, 44.4% is deteriorated(GCS2-GCS1 < or = -2), and 14.8% is improved(GCS2-GCS1 > or = 2). In the not-thin ASDH, 31.4% is improved and 17.6% is deteriorated. Comparisons between the improved cases and the deteriorated cases with various factors are made by chi square tests. Four statistically significant differences are found. The size of hematoma and midline shift are rather smaller in the deteriorated cases, but brain swelling or contused underlying cortex is more commonly observed during operation in the deteriorated cases and craniectomy with or without excision of the contused cortex is more frequently performed. One possible explanation of these results is that surgical decompression on the thin ASDH may cause or exercerbate brain swelling, hemorrhagic contusion or intracerebral hematoma-justlike "popping", thus replacement of the bone flap is difficult. Therefore, the thin ASDH should not be operated immediately, but closely observed in the ICU. If deteriorated, seek for the causing lesion by such as repeated CT scanning, then, treat the causing lesion, often it is not the ASDH itself.
Brain Edema ; Coma ; Contusions ; Decompression, Surgical ; Hematoma ; Hematoma, Subdural, Acute* ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed

A retrospective study on 107 cases of acute(within 24 hours) subdural hematoma(ASDH) with special reference to the size is presented. The thin ASDH is defined as the hematoma of which thickness is less than 3 mm in the printed CT film(true thickness about 10 mm). 45 cases are the thin ASDH and 62 cases are the not-thin ASDH. Age, Glasgow coma score, pupil, CT finding, operation finding, operation method, interval from injury to CT and operation, and outcome at 1 month are compared and analysed with chi square tests. The most significant difference is the high surgical mortality (92.6%) in the thin ASDH despite of the fact that there are no significant bad prognostic factors. This difference might be due to the fact that diffuse brain injury is more commonly associated with the thin ASDH and suggested that the thin ASDH should be managed differently from the not-thin ASDH.
Brain Injuries ; Coma ; Hematoma ; Hematoma, Subdural, Acute* ; Mortality ; Pupil ; Retrospective Studies

No abstract available.
Breast ; Breast Neoplasms ; Neoplastic Stem Cells

No abstract available.
Aged, 80 and over ; Cholecystitis/*complications/diagnosis ; Hemobilia/diagnosis/*etiology ; Humans ; Jaundice, Obstructive/etiology ; Male

OBJECTIVE: It was reported that nocturnal polyuria in cervical cord injured patients may be due to attenuation of diurnal variation of antidiuretic hormone (ADH) level. However, it has been unclear whether the attenuation of diurnal variation of ADH level caused nocturnal polyuria and bladder overdistension. To improve the management of neurogenic bladder with overdistension during the night, we investigated whether the attenuation of diurnal variation of ADH level is the cause of nocturnal polyuria or bladder overdistens-ion in patients with cervical cord injury. METHOD: The subjects consisted of 17 patients with cervical cord injury. The age distribution ranged from 31 to 63 years with an average of 41.5 years. The duration of illness ranged from 5 months to 4 years. Oral intake was restricted below 2,000 ml per day. We measured urine volume and urine osmolarity during the day (8 AM~8 PM) and night period (8 PM~8 AM) and the level of plasma ADH and serum osmolarity at 2 PM and 2 AM. RESULTS: Plasma ADH level was 0.81+/-0.51 pg/ml during the day and 1.04+/-0.65 pg/ml during the night (p=0.17). Urine volume was 1050+/-410 ml during the day and 970+/-550 ml during the night (p=0.92). The average of urine osmolarity was 450.4+/-182.8 mosm during the day and 558.4+/-359 mosm during the night (p=0.25). The average of serum osmolarity was 292.4+/-14.5 mosm during the day and 290.4+/-9.3 mosm during the night (p=0.53). CONCLUSION: This study showed that there was no significant difference in each parameter for two periods and urine volume was not increased in spite of attenuation of diurnal variation of ADH level. Therefore this indicated that attenuation of diurnal varia-tion of ADH was less likely responsible for nocturnal polyuria in patients with cervical cord injury.
Age Distribution ; Humans ; Osmolar Concentration ; Plasma ; Polyuria* ; Urinary Bladder ; Urinary Bladder, Neurogenic

BACKGROUND: During coronary angiography, some electrocardiographic changes occured due to contrast media, which do life threatening influences. METHODS: We compared the electrocardiographic changes which were induced by injection of three radiopaque contrast media during selective coronary angiography in 49 patients with chest pain. One of the contrast media was high osmolar ionic(Urografin_76) and the another was low osmolar ionic(Hexabrix) and the last was non-ionic(Ioversol). Electrocardiograms were obtained before, during and after selective coronary angiography. RESULTS: The changes of S-T segment or T were decreased in non-ionic group rather than high osmolar or ionic group. And there was significant Q-Tc interval prolongation among all three groups except comparision of low osmolar ionic contrast dye and non-ionic contrast dye in left coronary angiography. CONCLUSION: Non-ionic low osmolar contrast media was safer than high osmolar or ionic contrast medial because of lesser change of Q-Tc interval during selective coronary angiography.
Chest Pain ; Contrast Media* ; Coronary Angiography* ; Diatrizoate Meglumine ; Electrocardiography* ; Humans ; Ioxaglic Acid ; Osmolar Concentration

BACKGRUND & OBJECTIVE: Prognosis of alopecia areata have been attributed to various factors; age of onset, duration before treatment, extent of hair loss, clinical type of alopecia areata, sex, nail changes or accompaniment of atopy. The study on prognostic factors has only been conducted from statistical data of patients and individualized medical conditions. The histopathologic findings of alopecia areata have been investigated by the minute pathologic changes associated with the hair growth cycle in the transverse section. Moreover, these findings were used mainly for diagnostic purpose, but clinical significance of histopathologic severity in prognosis has not been established to date. METHODS: A clinical study, including histopathological and clinical evaluation was conducted on 108 alopecia areata patients between July 1997 and August 2005 at the Department of Dermatology, Dong-A University Hospital. The evaluation criteria INCLUDED: sex, age, age at onset, duration before treatment, clinical types, extent of hair loss, nail changes, accompaniment of atopy, and scalp biopsy finding. The clinical types of alopecia areata were classified as follows; patchy, subtotalis, totalis, and universalis. The extent of hair loss before treatment was classified into 5 grades (S1~S5), according to the method designed by Olsen and Canfield. Clinical improvements after treatment were classified into 5 grades according to degree of regrowth and reduction of the alopecia areata area. Biopsy findings were classified into 4 grades (type I, II, III, and IV) according to classification by Uno and Orecchia. RESULTS: The mean age was 28.6 years, without any sex predominance. The severe histopathologic gradings were significantly associated with early age of onset (p=0.008), a long disease duration before treatment (p=0.003), a greater extent of hair loss (p=0.009), and poor response to treatment (p=0.036). The histopathologic gradings were not significantly associated with sex (p=0.657), clinical types of alopecia areata (p=0.529), nail changes (p=0.746), or accompaniment of atopy (p=0.924). CONCLUSION: Histopathologic gradings in alopecia areata, using vertical sections are significantly associated with prognostic factors such as age of onset, extent of hair loss, disease duration before treatment, as well as the response to treatment. Therefore we consider that the histopathologic grading system is recommendable as an independent prognostic factor in alopecia areata, in addition to the well-known clinical prognostic factors. They may also be used to predict the response to treatment.
Age of Onset ; Alopecia Areata* ; Alopecia* ; Biopsy ; Classification ; Dermatology ; Hair ; Humans ; Prognosis ; Scalp

Nicolau syndrome or embolia cutis medicamentosa is an acute necrotic condition of skin that follows intramuscular injection of drugs. A 36-year-old man developed a painful, purpuric and erythematous patch on his left buttock following an intramuscular injection of diclofenac sodium. Histologically, the patch lesion displayed epidermal necrosis, dermal degeneration, and vascular thrombosis. We report a rare case of Nicolau syndrome following intramuscular injection of diclofenac sodium. In our case, the patient was successfully treated by surgical excision with primary closure.
Adult ; Buttocks ; Diclofenac ; Humans ; Injections, Intramuscular ; Necrosis ; Skin ; Thrombosis