No abstract available.
Ambulatory Care* ; Osteoarthritis*

Subtrochsnteric varization osteotomy with open wedge technic was performed for the Legg-Calve-Perthes disease patients of 6 years to 9 years of age. Open wedge technic is less complicated with unwilling effect of postoperative leg shortening than closed wedge technic, but has seldom performed for the patients over 5 years of age because of possible delayed or nonunion of osteotomy site. Authors trial of this technic in a older patient(6 to 9 years of age) showed excellent post-operative result with noneventual post-operative course including delayed or nonunion.
Humans ; Leg ; Legg-Calve-Perthes Disease ; Osteotomy

BACKGROUND: Pulmonary tuberculosis with a remaining cavitary lesion is considered to be a problem with the course of treatment. In particular, re-treatment cases tend to respond poorly to current anti-tuberculosis agents. Therefore the factors that are related with the poor closure of a cavitary lesion in pulmonary tuberculosis during treatment were evaluated. METHODS: A retrospective review of the medical records and chest X-ray films of 68 patients who had chemotherapy for the pulmonary tuberculosis with cavitary lesions was made. All the patients had been followed up for more than 12 months at National Masan Tuberculosis Hospital as of Aug. 2000. RESULTS: The male to female ratio was 3.9:1. 72.4% of the patients were between 20 to 50 years of age. 66.2% of the cavitary lesions on the chest X-ray films were confined to the upper lung fields : 36.8% in the right upper lung field and 29.4% in the left upper lung field. 82.4% of the cavities were less than 40mm in their size, and 83.8% were less than 6mm thick. The cavitary lesions were closed in 48 cases and remained in 20 cases during a follow-up period of more than 12 months. The factors that are though to affect ot the outcomes of the cavities were age, past medication history, the number of unused drugs, and the number of sensitive drugs. CONCLUSION: In the treatment courses of pulmonary tuberculosis with cavitary lesions, the following factors are associated with less desirable outcome:an age over 45, a past medication history of more than 2 courses of treatment, The number of unused drugs not exceeding average 6 and the number of sensitive drugs not exceeding average 7.
Drug Therapy ; Female ; Follow-Up Studies ; Hospitals, Chronic Disease ; Humans ; Lung ; Male ; Medical Records ; Retrospective Studies ; Thorax ; Tuberculosis, Pulmonary* ; X-Ray Film

A Listeria monocytogenes infection is relatively rare in healthy adults. However, the chance of an infection increases almost 17 times in pregnancy due to changes in the immune function. A Listeria monocytogenes infection results in characteristic gross and microscopic features in the placenta, including multiple yellowish nodules showing microscopic intervillous abscess and intervillositis. We describe the placental findings of a Listeria monocytogenes infection that was complicated by maternal sepsis, myocarditis and congestive heart failure. The infection was discovered in the 34th week of a twin gestation in a 28 year-old woman. This case should emphasize the importance of this condition to pathologists. Antibiotic treatment was started based on the placental histologic findings before a maternal blood culture confirmed growth of Listeria monocytogenes. Both the mother and twin babies were healthy at the time of this report.
Abscess ; Adult ; Female ; Heart Failure ; Humans ; Listeria monocytogenes* ; Listeria* ; Mothers ; Myocarditis ; Placenta ; Pregnancy ; Pregnancy, Twin* ; Sepsis

PURPOSE: To evaluate clinical and radiological results and to analyse the parapatellar complications after endoscopic anterior cruciate ligament reconstruction using central one-third bone-patellar tendon-bone autografts. MATERIALS AND METHODS: 66 cases among 158 consecutive cases from Feb 1990 to May 1996 were reviewed and evaluated with regard to patellofemoral pain, crepitus, quadriceps atrophy, graft donor site complication, Lysholm knee scoring system and radiological assessment. The average period of follow up was 23 months (range, 12-57 months) and the average age at operation was 31 years old (range, 18-58 years). RESULTS: The average Lysholmn knee score improved from 57.5 points preoperatively to 91.3 points at follow up. The instrumented anterior laxity test showed that excellent anterior stability was regained in most patients. There were many cases of parapatellar complications, 7 cases (10.6%) of anterior knee pain, 21 cases (32.8%) of crepitus, 43 cases (65.1%) of quadriceps weakness, 29 cases (45.3%) of graft donor site paresthesia and 15 cases (23.4%) of pain on kneeling. CONCLUSIONS: Although endoscopic ACL reconstruction using central one-third bone-patellar tendon-bone autografts had good clinical results, many parapatellar complications were noted. In order to prevent these complications, different reconstruction techniques and graft materials should be considered
Adult ; Anterior Cruciate Ligament Reconstruction ; Atrophy ; Autografts* ; Follow-Up Studies ; Humans ; Knee ; Paresthesia ; Tissue Donors ; Transplants

PURPOSE: Deep vein thrombosis (DVT) after joint arthroplasty in the lower extremity has been a major cause of death postoperatively. However, there is few reports on incidence and risk factors of DVT in Korea. We evaluated the incidence of DVT, correlation between the DVT, and risk factors and effectiveness of color doppler ultrasonography for diagnosis of DVT after joint arthroplasty in the lower extremity. MATERIALS AND METHODS: One hundred and six cases (99 patients) of total hip or knee arthroplasties from March 1996 to August 1997 were included in this study. There were forty-four total hip arthroplasties and sixty-two total knee arthroplasties. No patients received prophylactic agents for DVT. Venogram and color doppler ultrasonogram were obtained within 7 days preoperatively and in 7 to 14 days postoperatively. Only venography was performed in 45 cases and both venography and color doppler ultrasonography were performed in 61 cases. RESULT: On venogram, there were no evidence of thrombi in all cases preoperatively but thrombi were observed in 9 cases (8.5%) postoperatively. Among these positive cases, eight cases showed thrombi in the calf vein and one case in the femoral vein. Color doppler ultrasonography could not detect any thrombi among 3 cases which had positive findings with venogram. In contrast to other reports, we did not identify a correlation between DVT and so-called risk factors such as age, tourniquet time, BMI (body mass index), diastolic blood pressure, operation time and coagulation assay (platelet, PT, aPTl, Anti-thrombin III, fibrinogen) CONCLUSIONS: We concluded that color doppler ultrasonography may not be an effective method in the diagnose is of DVT of calf vein in asymptomatic patients and that so-called risk factors had no relation to DVT.
Arthroplasty* ; Blood Pressure ; Cause of Death ; Diagnosis ; Femoral Vein ; Hip ; Humans ; Incidence ; Joints* ; Knee ; Korea ; Lower Extremity* ; Phlebography* ; Risk Factors ; Tourniquets ; Ultrasonography ; Ultrasonography, Doppler, Color* ; Veins ; Venous Thrombosis*

This study was performed to investigate whethere there is cross-reactivity between Dirofilaria immitis and three intestinal nematodes of dogs. In ELISA, D. immitis-infected dog sera obtained at the 4th molting stage (9-11 weeks) and microfilaremic stage (25-30 weeks) were shown to be highly reactive with crude extract of T. canis. In immunoblotting, some antigenic fractions, 44, 57, 88, 100 kDa of crude extract of T. canis, were found to be positive reaction with sera of dogs infected with D. immitis. However, little or no cross-reaction were observed between sera of D. immitis-infected dogs and crude extract antigen of T. vulpis or A. caninum. These result suggest that there are partial cross reaction between sera of D. immitis-infected dogs and the antigen of T. canis.
Animals ; Antibodies, Helminth/*immunology ; Antigens, Helminth/*immunology ; Cross Reactions ; Dirofilaria immitis/*immunology ; Dirofilariasis/*immunology ; Dogs ; Enzyme-Linked Immunosorbent Assay ; Immunoblotting ; Toxocara canis/*immunology

Sinus histiocytosis with massive lymphadenopathy(SHML) is a benign, generally selflimited pseudolymphomatous disease that typically appears with cervical massive lymphaclenopathy. Extranodal involvement including skin occurs in the 28% of the cases. We report a case af SHML in 51 year-old male who had several, prominent firm masses ranging from 1-10cm in the cervical, axillary, inguinal areas and multiple, plum colored nodules and plaques in the face, trunk for about 10 years. The histopathological findings of cervical lymph node, facial nodule showed dense heavy infiltration of large histiocytes with abundant pale eosinophilic cytoplasm in the subcapsular and medullary sinuses of lymph node and dermis of skin. No atypical cells suggesting malignancy is seen in the infiltrates. The patient had been treated with combination of prednisolone and vinblasstine, but he expired 1 month later.
Cytoplasm ; Dermis ; Drug Therapy ; Eosinophils ; Histiocytes ; Histiocytosis, Sinus* ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Prednisolone ; Prunus domestica ; Skin

Psoriasis is characterized by disregulation of keratinocyte growth with profound epidermal hyperplasia. Keratinocyte hyperplasia in psoriasis may be expained in part by overproduction of growth factor, and by altered metabolism of the epidemal growth factor receptors (EGFR) in affected skin. The expression of epidermal growth f ictor receptor was investigated by Northern blot and slot-blot analysis of total RNA extrated from biopsies of normal skin and psoriatic lesions. In Northern blot analysis, EGFR-specific mRNA transcripts from psoriatic tissues demonstrated the specificity of hybridizarion with a EGFR mDNA probe. The size of EGFR mRNA transcript was 6.7kb in psoriasis lesions which showed no change of quality. In slot-blot analysis, the levels of EGFR mRNA in poriasis revealed a 1.2 fold to 4.1 fold elevation when compared to normal skin. EGFR were present in all epidermal layers by immunoperoxidase staining, whereas in normal skin they were primarily present in the stratum basalis. These results indicate that the increased expresion of the EGFR gene may be, in part, responsible for the hyperproliferation of the epider nis and that retained EGFR may reflect incomplet; abnormal differentiation in active porasis. This altered process of EGFR metabolism may be involved in the pathogenesis of psoriasis.
Biopsy ; Blotting, Northern ; Epidermal Growth Factor* ; Genes, erbB-1 ; Hyperplasia ; Keratinocytes ; Metabolism ; Psoriasis* ; Receptor, Epidermal Growth Factor* ; Receptors, Growth Factor ; RNA ; RNA, Messenger ; Sensitivity and Specificity ; Skin

BACKGROUND: Recently technetium-99m sestamibi (99mTc MIBI), which dose not require withdrawal of thyroid hormone, has been used for imaging of thyroid carcinoma. The aim of this study was to determine the clinical usefulness of Tc MIBI scintigraphy after total thyroidectomy for thyroid carcinoma. The results were compared with those of standard 131I scintigraphy. METHODS: One hundred twelve patients with a median age of 44 years (range, 14-76 years) were included in the study. After optimal endogenous thyroid stimulating hormone stimulation (>50 mIU/mL), whole body scintigraphy using 4 mCi of 'I and 20 mCi of Tc sestamibi were done simultaneously. Concomitantly serum thyroglobulin and anti-thyroglobulin antibody levels were checked. If abnormal findings on any of the scintigraphic methods or high levels of thyroglobulin (> 10ng/mL) were detected, diagnostic imaging studies were done to confirm the existence of the disease. And high dose (150-200 mCi) 'I was administered as therapy and then whole body scans were performed again after the therapy. The presence or absence of thyroid cancer was established by pathologic, radiologic, and/or high dose I scan findings. RESULTS: In 11 patients, Tc MIBI scan revealed positive accumulations which were not found on 131I scan, of whom 6 had elevated thyroglobulin levels. In these cases, 5 cases were interpreted to have normal thyroid remnant and 6 cases showed pathologic findings (2 lung, 1 lymph node, 1 lung and lymph node, 1 local recurrent cancer, and 1 false positive accumulation of 99mTc MIBI). Metastasis or residual cancer were confirmed histologically in 1 and radiologically in 4 cases. Negative 99mTc MIBI scans, despite of positive I scans, occurred in 9 patients, of whom 2 had abnormal thyroglobulin levels. Seven cases were interpreted to have thyroid remnant, 2 cases were confirmed to have lung metastasis, and another one was misinterpreted due to breast shadow. CONCLUSION: In conclusion, these results suggest that 99mTc MIBI scan may have similar sensitivity and specificity for the detection of residual or metastatic differentiated thyroid carcinoma. The 99mTc MIBI scan, especially in cases of negative 131I scan despite of abnormal thyroglobulin levels, can be used as a very useful complementary diagnostic tool.
Breast ; Diagnostic Imaging ; Follow-Up Studies* ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Radionuclide Imaging* ; Sensitivity and Specificity ; Technetium Tc 99m Sestamibi ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyrotropin ; Whole Body Imaging