We studied 193 Diabetics without any symptoms of coronary artery disease and 39 Normal healthy subjects as Control group, using treadmill exercise test and obtained following results. 1) The positive rate was significantly higher in Diabetics(19.4% in Normal ECG groups and 25.4% in total Diabetics)than Control groups(5.1%)(0.010.05). 5) There was no difference in HbAIC, Total cholesterol and Triglyceride between positive and negative groups(P>0.05). In summary, with exercise test, the positive rate was higher in Diabetics than in Normal control groups and it seemed to be treadmill exercise test is a useful screening method for evaluation of coronary artery disease as well as for assesment of treatment and follow up care.
Blood Pressure ; Cholesterol ; Coronary Artery Disease ; Diabetes Mellitus* ; Electrocardiography ; Equidae ; Exercise Test* ; Heart Rate ; Mass Screening ; Triglycerides

Twenty four cases of acromioclavicular seperation were admitted and treated at Severance Hospital, Yonsei University from October 1964 to September 1975. Of these, six cases were subluxations and eighteen cases were dislocations. Acromioclavicular joint injury is relatively rare and there are many methods of treatment. In our cases, all the six subluxations and seven of the eighteen dislocations were treated by conservative method, while eleven of the eighteen dislocations were treated by operative method. The results of all the subluxated cases were satisfactory. In cases of dislocation, the results were considerably better in operated cases with Weavers method.
Acromioclavicular Joint ; Dislocations ; Methods

There has been increased attention given to the radial tunnel syndrome since Roles and Maudsley first described it in 1972. The occurance of radial tunnel syndrome is due to the following four anatomical causes: the fibrous bands in front of the "radial head, the radial recurrent fan" of vessels, and the tendinous margins of extensor carpi radialis brevis and of the arcade of Frohse. In these cases, the progressive paralysis of the posterior interosseous nerve was caused by the arcade of Frohse and the radial recurrent artery. The results of splitting the arcade of Frohse and dividing the radial recurrent artery have been sufficiently good in all 3 cases.
Arteries ; Head ; Paralysis

IgA nephropathy can occur rarely as a complication of D-penicillamine treatment, but it is exact pathogenesis remains unclear. If a patients has gross or microscopic hematuria during D-penicillamine treatment, D-penicillamine induced IgA nephropathy should be suspected as a cause of hematuria. In those cases, renal biopsy should be taken for diagnosis and proper management. We experienced a case of IgA nephropathy confirmed by renal biopsy in a 39-years-old female patient with scleroderma during D-penicillamine therapy and report this case with a review of literature.
Biopsy ; Diagnosis ; Female ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Penicillamine*

Herein we report a rare case of primary esophageal malignant melanoma in a 56-year-old gentleman who presented with a 2-month dysphagea. Esophagoscopy reveals a polypoid tumor and a total thoracic esophagectomy was performed through a right thoracotomy and esophageal replacement with stomach. The tumor was proven to be a primary esophageal malignant melanoma by histological and immunohistochemical studies. The pathologic stage was IIa. He received no postoperative adjuvant therapy. He died of liver metastasis at 8 months postoperatively.
Esophageal Neoplasms ; Esophagectomy ; Esophagoscopy ; Humans ; Liver ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Stomach ; Thoracotomy

OBJECTIVE: We determined the radiographic outcome of distal radius fractures with Acu-loc volar plate. METHODS: Forty-one patients were recruited between August 2009 and September 2010. There were 10 males and 31 females, with a mean age 61.2. Fractures were radiologically classification the Frykman. Fifteen fractures were group 8, eight were group 7, ten were group 6, four were group 5 and four were group 3. Distal part of the fractures was dorsally inclined in 37 wrists and inclined to volar side in four wrists. Lateral and anteroposterior radiographs taken after operated day, the fracture were compared with radiographs of the injured wrist and the differences in palmar tilt, ulnar variance; radial height; radial shift and radial inclination were measured. RESULTS: There was significant improvement in the measurements of radial height, radial inclination, volar tilt, ulnar variance and radial shift postoperatively. The radial height improved from an average of 8.5 mm (range, 3 to 15 mm) to 11.0 mm (range, 8 to 15 mm), the radial inclination improved from an average of 21.5 degree (range, 10 to 40 degree) to 28.1 degree (range, 19 to 44 degree), the palma tilt improved from an average of 12.9 degree (range, 6 to 22 degree) to 17.2 degree (range, 7 to 27 degree), the ulnar variance improved from an average of -2.3 mm (range, -6 to 4 mm) to 1 mm (range, -3 to 7 mm) and the radial shift improved from an average of 18.7 mm (range, 15 to 26 mm) to 17.3 mm (range, 12 to 21 mm). CONCLUSION: Acu-loc volar plate is a safe and effective device.
Female ; Humans ; Male ; Radius ; Radius Fractures ; Palmar Plate ; Wrist

IgA nephropathy(IgAN) is the most frequent primary glomerular disease in many countries, including Korea. The typical clinical manifestation of IgAN is synpharygitic gross hematuria, which is usually innocuous for the renal function. Some patients who developed acute renal failure coinciding with episodes of gross hematuria are rarely observed in IgAN. We have observed a 29-year-old male patient with IgAN in whom the duration of gross hematuria(total 28 days) was clearly longer than usual, inducing anemia. We report a case of IgAN associated with anemia due to persistent gross hematuria and a brief review of the literature.
Acute Kidney Injury ; Adult ; Anemia* ; Glomerulonephritis, IGA* ; Hematuria* ; Humans ; Immunoglobulin A* ; Korea ; Male

The aim of this study was to measure the immediate pull-out strengths by increasing the number of suture loops and to compare the immediate pull-out strengths of three different suturing techniques. In one group, the number of suture loops increased from 2 to 9 and the suturing technique of multiple loops through the proximal ligament stumps was used. The other group, the three different techniques were transverse, vertical, and criss-cross suture. The ultimate strength for the 2 loops was 16.62 (+/-6.7)N, for the 3 loops was 34.45 (+/-12.5)N, for the 4 loops was 54.80 (+/-17.7)N, for the 5 loops was 74.30 (+/-21.4)N, for the 6 loops was 102.49 (+/-13.5)N, for the 7 loops was 105.05 (+/-24.8)N, for the 8 loops was 129.50 (+/-76.1)N, for the 9 loops was 229.50 (+/-48.7)N. The transverse suture had a mean ultimate strength of 47.38 (+/-14.8)N, where-as the vertical suture failed at 76.94 (+/-26.4)N and the criss-cross suture at 101.82 (+/-25.7)N. Consequently, their strength can be improved by increasing the number of loops and we suggest that the criss-cross suture technique is reliable method for clinical use, because of high failure strength and wider apposition area of bone to ligament.
Ligaments* ; Suture Techniques ; Sutures

BACKGROUND: With different injection levels, the dose-requirements of epidural opioids association with lipid solubility are controversial. The purpose of this study was to compare the effect of patient controlled lumbar(L group) and thoracic(T group) epidural morphine on dose-requirements, analgesia and side effects after thoracotomy. METHODS: Twenty patients were randomly assigned into one of two groups. Before the induction of general anesthesia, the epidural taps with 17G with Tuohy needle were done on the 6th or 7th thoracic and 2nd or 3rd lumbar intervertebral levels, respectively. The epidural catheter tips were placed 3~4 cm above the needle tips in either groups . Morphine 3 mg in 3 ml normal saline was administered via the epidural catheter in all the patients immediately at the end of surgical manipulation. PCA/basal infusion dose and lockout interval was 0.02 mg/once, 0.08 mg/hr and 5min respectively. After the initial dose dose-requirements were checked at 4, 8, 24 and 48hour and pain was assessed on visual analogue scale at 1, 4, 8, 24 and 48hour. Side effects were observed. RESULTS: There were no significant difference between groups in the dose-requirements of morphine, their analgesia and side effects. CONCLUSIONS: Lumbar epidural morphine provides postoperative analgesia after thoracotomy that is clinically indistinguishable from that provided by thoracic epidural morphine with respect to dosage, quality of analgesia and side effect.
Analgesia ; Analgesia, Epidural* ; Analgesia, Patient-Controlled ; Analgesics ; Analgesics, Opioid ; Anesthesia, General ; Catheters ; Humans ; Morphine* ; Needles ; Solubility ; Thoracotomy

STUDY DESIGN: Retrospective study. OBJECTIVES: The purpose of this study was to compare factors that influence degenerative changes in patients undergoing total laminectomy and patients undergoing partial laminectomy. SUMMARY OF LITERATURE REVIEW: Lumbar or lumbosacral fusion with total or partial laminectomy may result in adjacent segment problems of the upper segment. However, the differences between the two procedures that may influence adjacent segment instability are still controversial. MATERIALS AND METHODS: We evaluated 95 patients, followed up for at least 2 years, who had been treated with short level (at most 2 levels) posterior lumbar interbody fusion with pedicle fixation, secondary to spinal stenosis. Treatment procedures included total laminectomy (42 cases) and partial laminectomy (53 cases). We analyzed the preoperative status of the intervertebral discs (Thompson grade), difference of disc height, and difference between preoperative segmental sagittal angle and last follow-up sagittal angle. We excluded cases that required revision secondary to infection, nonunion, or hematoma formation. However, we included cases that required revision due to adjacent segmental problems during the follow-up period. RESULTS: The mean age of the patients treated with total laminectomy was 59.0+/-10.9 years, and of the patients treated with partial laminectomy was 58.8+/-10.2 years. The preoperative Thompson grade showed no statistical difference. The difference in disc height and segmental sagittal angle between the preoperative and last follow-up examinations showed no statistical difference between the two groups. CONCLUSIONS: There was no significant difference in the radiographic or clinical outcomes based on removal or preservation of posterior structures. Nevertheless, we need further follow-up to evaluate adjacent segment degeneration.
Follow-Up Studies ; Hematoma ; Humans ; Intervertebral Disc ; Laminectomy ; Retrospective Studies ; Spinal Fusion ; Spinal Stenosis