Herpes simplex esophagitis has been recognized with increased frequency as an opportunistic infection in immunosuppressed or debilitated patients. However, it is also documented as self-limited esophagitis in apparently healthy patients. We report two cases of herpetic esophagitis diagnosed by biopsies. One case was noted in an immunocompetent patient having gastric peptic ulcer who had clinical improvement with symptomatic treatment. And the other was noted in an immunosuppressed patient having chemotherapy for gastric carcinoma who had resolution of symptoms with acyclovir therapy. Histologically, esophageal mucosa exhibited erosion and inflammatory cellular exudate with intranuclear eosinophilic inclusions in the epithelial cells. These were confirmed by the PCR and immunohistochemical stain for herpes simplex virus using a biopsy material.
Acyclovir ; Biopsy ; Drug Therapy ; Eosinophils ; Epithelial Cells ; Esophagitis* ; Exudates and Transudates ; Herpes Simplex* ; Humans ; Mucous Membrane ; Opportunistic Infections ; Peptic Ulcer ; Polymerase Chain Reaction ; Simplexvirus

We assessed the accuracy of clinical evaluation, arthrography, and arthroscopy in the diagnosis of meniscal lesions in twenty-nine knees in which arthrotomy and menisectomy were performed after evaluation by these three methods, At surgery, thirty menisci of twenty-nine knees were removed, of which twenty-eight were abnormal and two were normal. In these thirty menisci, a correct diagnosis was made clinically eighteen times, arthrographically twenty times, and arthroscopically twenty-seven times. Posterior horn tears of medial meniscus and discoid lateral meniscus were well visualized but lateral meniscal tears were poorly visualized on arthrogram. The errors of arthroscopy occurred in two tears confined to outer one half of medial menscal posterior horn, and in a normal meniscus as false positive. Based on this study, it was concluded that both the arthrography and arthroscopy are valuable techniques for the diagnosis of meniscal lesions, and that we can expect correct diagnosis of all the meniscal lesions by the use of complementary roles of the two and by the experiences.
Animals ; Arthrography ; Arthroscopy ; Diagnosis ; Horns ; Knee ; Menisci, Tibial ; Tears

Ligamentous injury of the knee which could be easily occur in sports or traffic accidents resulted in more and severe disability than that of other joints. Rupture of the anterior cruciate ligament which restrain hyperextension, excessive rotation and anterior motion of tibia on femur is the most frequent and significant injury of the knee. Its treatment and clinical significance is one of the most controversial issue and its incidence tends to increase. From 1983 to 1985, modified Scott operation were performed on 10 patients at the department of orthopedic surgery, Chung Ang university hospital. Following results are obtained. 1. No limitation of range of motion of the knee was developed. 2. Intra-articular fixation by use of pull-out wire was done and special consideration was done for the site of fixation on tibia plateau and method of dilatation of posterior capsule. 3. Of the ten patients, nine had negative anterior drawer test, postoperatively.
Accidents, Traffic ; Anterior Cruciate Ligament ; Dilatation ; Femur ; Humans ; Incidence ; Joints ; Knee ; Ligaments ; Methods ; Orthopedics ; Range of Motion, Articular ; Rupture ; Sports ; Tibia

The relative rarity and anatomical position of presacral tumors may lead to difficulty in diagnosis and surgical treatment. The clinical features and surgical approach of 4such tumors(teratocarcinoma 1, endodermal sinus tumor 1, chordoma 1, neurilemmoma 1) have therefore reviewed. Low back pain or sacral pain was present in 3patients although all tumors were palpable on rectal examination. Surgical resection was carried out using the posterior transverse approach in Kraske's prone position. Complete surgical excision was performed in 3cases(chordoma, teratocarcinoma, neurilemmoma) and incomplete excision in 1 case(endodermal sinus tumor). A review of literature concerning these tumors and the surgical approach are presented.
Chordoma ; Diagnosis ; Endodermal Sinus Tumor ; Low Back Pain ; Neurilemmoma ; Prone Position ; Teratocarcinoma

The intra-articular tibial plateau fracture can induce many complications of the knee joint after conservative treatment or operative treatment. Recent experience could decrease the complications with accurate anatomical reduction, stable internal fixation and early knee ROM exercise, but still unsatisfactory results were reported from 20% to 40%. The authors analyzed the 30 cases that could be follow-up from 1 year to 6 years and were treated with operative methods, and the following results were obtained. 1. The most common cause of injury was traffic accident (14 cases-46.4%). 2. The most common fracture type by Hohls classification was type VI (13 cases-43.1%). 3. According to Blokker's criteria, 26 cases (86.7%) among 30 cases had satisfactory results. 4. The one of the most important factor influencing end results was thught to be the anatomical reduction of the articular margin.
Accidents, Traffic ; Classification ; Follow-Up Studies ; Knee ; Knee Joint

OBJECTIVES: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. METHODS: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. RESULTS: In serum lipid profile test, MDD group showed higher cholesterol (197.68+/-42.94 mg/dL vs. 176.85+/-34.68 mg/dL, p=0.044), TG (139.45+/-92.54 mg/dL vs. 91.4+/-65.68 mg/dL, p=0.018), LDL (130.03+/-33.18 vs. 106.62+/-27.08, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant (32.82+/-14.33 ms vs. 40.36+/-21.40ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group (1.13+/-0.11 vs. 0.91+/-0.18, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). CONCLUSION: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.
Anxiety ; Autonomic Pathways ; Cholesterol ; Depression ; Depressive Disorder, Major ; Heart ; Heart Rate ; Humans

Rapid crestal bone resorption following maxillary tooth loss is further accentuated in the posterior regions because of pneumatization and enlargement of the maxillary sinuses. A treatment rationale that allows preservation and augmentation of vertical available bone at the time of posterior maxillary tooth extraction may offer numerous therapeutic benefits which are more short courses of therapy and no needs of additional surgical augmentation. The present study comprised 3 patients who had 4 posterior maxillary teeth with no evident bone between the tooth apex and sinus floor, as estimated through preoperative radiographic analysis. Sinus floor augmentation at the time of tooth extraction was chosen for the ltreatment of these patients. After the tooth was carefully extracted, the empty alveolus was thoroughly debrided and a trephine approach was performed. Particulated autogenous bone was gently pushed beyond the empty alveolus to elevate the sinus membrane using an osteotome. The distance between bone crest and sinus floor was radiographically estimated 4 months after the first procedure. Another procedure was then carried out to place the implants of 11 mm length without another augmentation procedure. All implant were clinically stable, with no sign of infection. The presented surgical procedure performed at the time of extraction of posterior maxillary teeth in close proximity to the sinus floor allowed placement of implants of proper length.
Bone Resorption ; Humans ; Maxillary Sinus ; Membranes ; Sinus Floor Augmentation* ; Tooth Apex ; Tooth Extraction ; Tooth Loss ; Tooth*

No abstract available.
Head* ; Neck*

Gastrointestinal submucosal tumors originate from submucosal histologic structures such as muscles, lymph nodes, nerves, fibers and vessels. Most patients are asymptomatic. Lesions that are large or ulcerated may cause abdominal pain or upper gastrointestinal bleeding, and those that grow intraluminally sometimes become pedunculated and occasionally prolapse to cause intussusception. Adenocarcinoma is the most common primary gastrointestinal tumor, accounting for approximately 90-9 5 % of such lesions, while submucosal tumors account for approximately 2 -6% of all gastrointestinal tumors. Because their overlying mucosa appears normal, submucosal tumors age after difficult to visualize endo-scopically, and for this reason, barium studies or CT scans are helpful for diagnosis. In this paper, variable CT and barium study findings of the different types of gastrointestinal submucosal tumor are demonstrated, and a brief discussion of the respective disease entities is included.
Abdominal Pain ; Adenocarcinoma ; Barium ; Diagnosis ; Gastrointestinal Tract* ; Hemorrhage ; Humans ; Intussusception ; Lymph Nodes ; Mucous Membrane ; Muscles ; Prolapse ; Tomography, X-Ray Computed ; Ulcer

No abstract available.
Colorectal Neoplasms*