PURPOSE: Chronic dorsal wrist pain limits hand function and is related to several diseases. Especially, pain and tenderness over the fourth extensor compartment with repetitive wrist dorsiflexion was described as distal posterior interosseous nerve syndrome. This article details the history, symptoms, physical findings, and treatment of this syndrome. MATERIALS AND METHODS: This study includes six patients seen between 1996 and 1998. Five men and one woman (ages 17 to 57 years) presented with localized, nonradiating, dull dorsal wrist pain, ulnar and distal to Lister's tubercle. Presumptive diagnostic test was an injection of selective lido cane 2 cm proximal to the wrist joint. RESULTS: Six patients were diagnosed of having distal posterior interosseous nerve syndrome. The five patients who recurred symptoms after injection underwent surgical exploration. Histologic evaluations revealed abnormal perineural fibrosis and edema. Patients were reexamined at least 12 months after surgery and have returned to full asymptomatic activity. CONCLUSIONS: Initially, non-operative treatment seems to be effective. If conservative treatment fails, operative excision of distal posterior interosseous nerve may be required
Canes ; Diagnostic Tests, Routine ; Edema ; Female ; Fibrosis ; Hand ; Humans ; Male ; Wrist ; Wrist Joint

No abstract available.
Fingers*

No abstract available.
Child* ; Hand* ; Humans

The major cause of early dislocation after total hip arthroplasty is malposition of acetabular cup. Therefore, radiographic evaluation of acetabular cup placement is essential in determining the postsurgical prognosis. The purpose of this study was to establish principles which would aid in checking the radiography. We evaluated 33 patients who were treated with total hip arthroplasty between Jan. 1988 and Aug. 1993 and investigated the methods of measuring the position of the acetabular cup on radiography using pelvic skeleton and acetabular cup. The results were analyzed as followings. l. After the total hip arthroplasty, the inclination of the acetabular cup shows average 37.1 degress in pelvis AP, 36.4 degrees in hip AP and 43.4 degrees in femur AP. This result means that the more X-ray beam focus is far from the acetabular cup, the more inclination of acetabular cup on radiography is incerased. 2. After the total hip arthroplasty, the difference of acetabular cup angle between pelvis AP and hip AP is average 0.7 degree, 6.4 degrees between pelvis AP and femur AP and 7.1 degrees between hip AP and femur AP. This result means that the more X-ray beam focus is far from acetabular cup, the larger difference between acetabular cup angle on radiography is.3. In experimental study with pelvic rotation, acetabular cup angle on radiography is average 45.7 degrees in neutral position, 42.8 degrees in 10 degree rotation, and 39.6 degrees in 20 degree rotation. This result means that the more rotation of pelvic bone is increased, acetabular cup angle on radiography is reversely diminished. 4. In experimental study with pelvic flexion-extension, acetabular cup angle on radiography is average 45.7 degrees in neutral position, 56.4 degrees in 20 degree pelvic flexion, and 32.3 degrees in 20 degree pelvic extension. This result means that when the pelvis is flexed, acetabular cup angle on radiography is increased, and when the pelvis is extended, acetabular cup angle is decreased than normal acetabular cup angle. 5. In experimental study with X-ray beams, acetabular cup angle on radiography is average 45.7 degrees in pelvis AP, 45.5 degrees in femur AP and 50.4 degrees femur AP. This result means that the more X-ray beam focus is far from acetabular cup, the more inclination of acetabular cup on radiography is increased. As the result of the study, radiographs which focus centered on hip demonstrated a nearly true representation of acetabular cup angle.
Acetabulum ; Arthroplasty, Replacement, Hip ; Dislocations ; Femur ; Hip ; Humans ; Pelvic Bones ; Pelvis ; Prognosis ; Radiography ; Skeleton

The hook-nail deformity after finger tip amputation is very common problem. This usually occurs after loss of part of the distal pulp, phalanx, and nail bed. This deformity for some patients is a trivial lesion and may be ignored, but it may be of great cosmetic significance or disabling with regard to certain occupations to the others. To correct the deformity, it is necessary to release volarly displaced nailbed, return it to its normal position, and provide adequate support to maintain correction by a carefully planned "antenna" procedure. Deformed nail is removed, tethered pulp is freed from distal phalanx, and then full thickness of the nail bed is elevated and splinted with multiple small Kirschner wires in a straight position like antennae. The coverage of defect created is done by cross finger flap. The knowledge of anatomy and physiology of nail and sorrunding structures is important to obtain good results and reduce secondary deformities. Two cases of antenna procedures for the hook nail deformily is reported with good results.
Amputation ; Bone Wires ; Congenital Abnormalities ; Fingers ; Humans ; Occupations ; Physiology ; Splints

Familial juvenile polyposis is a rare intestinal polyposis characterized by the occurrence of multiple juvenile polyps in the gastrointestinal tract. We report a case of familial juvenile polyposis in a 17-year-old man with a review of the literature. This patient underwent total colectomy due to a 6 years history of rectal bleeding. Grossly, the colon showed 36 variable sized pedunculated polyps, measuring 2.5cm x 2cm from the largest size and 0.2cm x 0.2cm to the smallest size. Histologically, the polyps consisted of cystically dilated glands, lined by normal colonic epithelial cells, scattered in loose, edematous stroma containing inflammatory cell infiltration. There were no areas of tubular adenoma or malignancy in any of the polyp.
Adenoma ; Adolescent ; Colectomy ; Colon ; Epithelial Cells ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intestinal Polyposis ; Polyps

BACKGROUND: Chronic stress is associated with physical illness such as coronary artery disease and hypertension. Daily life habits being able to affect physical health and are associated with mental stress. We studied the relationship between physical illness and stress amount so far. However, the investigation about the stress and the health habits to affect disease directly was not studied enough. Eventually we tested this investigation to know the relationship between stress amount and health habits. METHODS: We measured stress amount and health habits for a month(from May 1 to May 31, 1997) through the people who had already received health screening and were working as researchers. We used 147 results out of 212. Health habits were investigated about 6 articles out of "Breslow's 7 Health habits" and stress amount was measured by evaluation scale made by Lee, Pyoung-sook. RESULTS: There were no differences in amounts of stress of subjects according to age, years in work, hours of sleeping, having breakfast or not, the frequency of exercise and body mass index(BMI). But there were significant differences in amounts of stress of subjects according to drinking amount, smoking or not, and health habit index(P<0.01). CONCLUSIONS: Drinking and smoking appeared to be health habits related to the amounts of stress. Prospective studies are needed ? find a causal relationship between health habits and stress amount.
Breakfast ; Coronary Artery Disease ; Drinking ; Hypertension ; Mass Screening ; Smoke ; Smoking

No abstract available.
Carpal Tunnel Syndrome*

This study is concerned with a comparison of lower tibial and fibular epiphyseal growth and deformities of the ankles in normal and paralysed children. The data were based on 87 children with residual paralysis due to poliomyelitis an 20 non-paralysed children who were admitted to Severance Hospital and Sam Yook Children's Rehabilitation Center. The difference in level between the lower tibial and fibular ends and between the lower epiphysial lines of the tibia and fibula in X-rays of the ankles were measured in order to investigate the growth pattern of the lower tibio-fibular epiphysis. The difference between the level of the lower ends of the fibula was an avergage of 15.3mm in the normal and 6.2mm in paraysed children. Thus the fibular ends in paralysed limbs was an average of 9.1mm less than that of the normal. The difference between the level of the lower epiphyseal lines of the tibia and the fibula was an average of 13.7mm in normal and 5.5mm in paralysed children. Therefore, the level of the fibular epiphyseal lines in paralysed limbs was sn average of 8.2mm less than that of normal. In paralysed limbs, the lower tibial epiphyses showed lateral epical wedge shaped deformities. The tilting angle of the ankles and the wedging angle of the of the lower tibial epiphyses were measured in erder to investigate the degree of deformities of the ankles and the lower tibial epiphyses in paralysed limbs. The tilting angle of the ankles averaged 1.3° in normal and 7.6° in paralysed limbs. The wedging angle of the lower tibial epiphyses averaged 3.7° in normal and 11.5° in paralysed limbs. In paralysed children, muscle strength examination was performed to clarify the relationship between the degree of growth disturbance and the severity of the muscular paraysis. This lead us to conclude that: 1. In paralysed children, the growth disturbance of the lower fibular epiphyses was greater than that of the lower tibial epiphyses. 2. The difference of the growth disturbance between the tibial and fibular epiphyses was not due to muscle imbalance of the foot invertors and evertors but to muscle weakness. 3. In paraysed children, the shape of the lower tibial epiphyses changed to a wedge shape, a deformity which might be considered secondary to growth disturbance of the fibula. 4. In paralysed children, the lower tibial ends were tilted upward and laterally. This was thought to be the cause of valgus deformities of the ankles. 5. The relationship between the degree of muscle paralysis and the deformities of the ankles was not proved in this study.
Ankle ; Child ; Congenital Abnormalities ; Epiphyses ; Extremities ; Fibula ; Foot ; Humans ; Muscle Strength ; Muscle Weakness ; Paralysis ; Poliomyelitis ; Rehabilitation Centers ; Tibia

BACKGROUND: Reperfusion of ischemic myocardium is clinically encountered during thrombolytic therapy of acute myocardial infarction, percutaneous transluminal coronary angioplasty(PTCA), and coronary artery bypass graft(CABG). Reperfusion results in endothelial dysfunction characterized by a reduced release of endothelium-derived relaxing factor(EDRF) in animal studies. Studies with experimental animals have emphasized the role of oxygen free radicals and lipid peroxidation in pathophysiology of reperfusion injury and myocardial stunning. The object of this study is to determine whether endothelial dysfunction was developed after open heart surgery and to evaluated the role of oxygen free radical and lipid peroxidation in reperfusion injury. METHODS: The study group was comprised 13 patients who underwent open heart surgery(male/female : 2/11, mean age : 43+/-4 year, Atrial septal defect in 4, Ventricular septal defect in 1, Mitral regurgitation in 2, Tetralogy of Fallot in 1, and Aortic stenosis and Regurgitation with Mitral stenosis in 5 patients). The endothelial function was evaluated with the vasomotor response to acetylcholine and nitroglycerin by change of arterial diameter during the continous infusion of acetylcholin, from 10(-9) to 10(-6) molar concentration to the coronary artery and intracoronary injection of 200microg nitroglycerin after acetylcholine infusion. The infusion study was performed before and 10 days after surgery. For analysis of the role of oxygen free radical and lipid peroxidation in reperfusion injury, blood samples for malondialdehyde and neutrophil respiratory burst test(hydrogen peroxide amount of neutrophils) were obtained in pre-declamping of aorta and 5 min, 10 min, and 20 min after declamping of aorta from coronary sinus. RESULTS: 1) The vasoconstrictor response to acetylcholine, 10(-9) to 10(-6)M concentration, at proximal and distal left anterior descending coronary artery, were increased significantly in post-operation infusion study but there was no singnificant difference in vasodilator response to nitroglycerin. 2) The mean absorbance value of malondialdehyde(MDA) in pre-declamping and 5min, 10min, and 20min after reperfusion were 96+/-12, 73+/-12, 89+/-11 and 77+/-12, respectively. There was no significant difference in plasma MDA level and hydrogen peroxide amount of neutrophils after reperfusion(aortic declamping). CONCLUSION: These data suggest that endothelium dependent vascular relaxation is impaired in patients with open heart surgery and post-ischemic reperfusion injury may be responsible for the abnormal response. But we did not determine the role of lipid peroxidation and oxygen free radical in reperfusion injury.
Acetylcholine ; Animals ; Aorta ; Aortic Valve Stenosis ; Coronary Artery Bypass ; Coronary Sinus ; Coronary Vessels ; Endothelium ; Free Radicals ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Heart* ; Humans ; Hydrogen Peroxide ; Lipid Peroxidation* ; Malondialdehyde ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Molar ; Myocardial Infarction ; Myocardial Stunning ; Myocardium ; Neutrophils ; Nitroglycerin ; Oxygen* ; Plasma ; Relaxation ; Reperfusion Injury* ; Reperfusion* ; Respiratory Burst ; Tetralogy of Fallot ; Thoracic Surgery* ; Thrombolytic Therapy