Intrinsic plus deformity, which results in severe functional impairment of the hand, is caused by contracture of intrinsic muscles. This deformity can be resulted from many causes such as ischemic damage, spasm of intrinsic muscles, thermal injury, and so on. The surgical release of tightened intrinsic muscles, may be the only solution to make usable hand, especially for severe cases. Sixty five digits in 22 patients who were operated on from 1982 to 1992, were evaluated retrospectively, to analyse the effects of surgery for intrinsic plus hand. Among 65 digits, 13 were thumbs and 52 fingers. The mean age of the patients was 26 years and 8 months and 17 cases were males and 6 females. The causes were ischemic damage by laceration or crushing injuries in 11 patients, compartment syndrome in 5, cerebral palsy in 5, and burn in one. Involved digits were thumb only in 4 patients, thumb and fingers in 9, and fingers in nine. All the digits were classified preoperatively by Zancolli's classification. In 13 thumbs retropulsion contracture was 4 and adduction-antepulsion contracture was nine. All of the thumbs were treated by intrinsic release and Z plasty(or rotational flap). Other procedures including arthrolysis, arthrodesis and tendon reconstruction were combined in 9 thumbs. In 52 fingers, in addition to distal release, arthrolysis was combined in 12 fingers, and arthrolysis plus volar plate release were combined in 4 fingers. For the assessment, our criteria, based on subjective satisfaction of the patient and range of motion, was used. The duration of follow up was from one year to 9 years with the average of 26 months. In 14 thumbs the results were excellent in 2, 6 good, 4 fair, and one poor. In 52 fingers excellent was 12, 24 good, 13 fair, and 3 poor. In summary we could improve the function of intrinsic plus deformity by appropriate sugery, and their results were good.
Arthrodesis ; Burns ; Cerebral Palsy ; Classification ; Compartment Syndromes ; Congenital Abnormalities ; Contracture ; Female ; Fingers ; Follow-Up Studies ; Hand ; Humans ; Lacerations ; Male ; Muscles ; Range of Motion, Articular ; Retrospective Studies ; Spasm ; Tendons ; Thumb

BACKGROUND: Insulin resistance syndrome shows extreme insulin resistance and is associated with acanthosis nigricans. We can differentiate it into type A insulin resistance that has insulin receptor defect, and type B insulin resistance due to insulin receptor autoantibody. Type B insulin resistance was firstly described by Kahn in 1976. It was often found in adult female and showed autoimmune characteristics. As clinical characteristics, there are hyperglycemia, hypoglycemia, hyperinsulinemia, extreme insulin resistance and acanthosis nigricans. METHODS: We investigated 17 insulin receptor autoantibody positive cases and 8 cases of normal control who had visited Wonju Christian Hospital from October 1994 to December 1995. Among insulin receptor autoantibody positive subject, male was 4 cases and female 13 cases. Their mean age was 42.2. We compared patients who had insulin receptor antibody positive acanthosis nigricans(IRA) with normal controls. IRA patients were 6 cases(35.3%) of nomal glucose tolerance, 11 cases(64.7%) of abnormal glucose tolerance including overt diabetes mellitus. RESULTS: The 11 cases(64.7%) among IRA patrents were obese and 13 cases(76.5%) had hyperininsulinemia. In IRA patients, mean serum insulin concentration during oral glucose tolerance test was 202.1mU/mL and it was greater than 46.3 of normal controls. Insulin sensitivity in 1.79mg/L * mM * xmU * min normal controls was higher than 0.74mg/L * mM * min of IRA patients. CONCLUSION: IRA patients showed abnormal glucose tolerance including overt diabetes millitus, severe insulin resistance, hyperinsulinemia and obesity.
Acanthosis Nigricans* ; Adult ; Diabetes Mellitus ; Female ; Gangwon-do ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Hyperinsulinism ; Hypoglycemia ; Insulin Resistance ; Insulin* ; Male ; Obesity ; Receptor, Insulin*

Primary hypothyroidism can result in reactive enlargement of the pituitary gland which is indistinguishable from primary pituitary lesions in clinical presentation and on magnetic resonance imaging. A 17-year-old girl came to the hospital due to short stature, general weakness and galac-torrhea. The magnetic resonance imaging (MRI) study showed pitutary enlargement. The hormone study showed hyperprolactinemia, decreased basal growth hormone level and primary hypothyroi-dism. By thyroid replacement therapy only, mass was successfully regressed on follow up MRI after 4 months, and growth acceleration could be achieved.
Acceleration ; Adolescent ; Female ; Follow-Up Studies ; Growth Hormone ; Humans ; Hyperplasia* ; Hyperprolactinemia ; Hypothyroidism* ; Magnetic Resonance Imaging ; Pituitary Gland ; Thyroid Gland

Letterer-Siwe disease occurred in a 3 year 7 month old male child showing severe emaciation, hepatosplenomegaly, otitis media, hemorrhagic and impetiginous crusted patches on the body, and seborrheic dermatitis like skin rashes in the scalp. Also showed are severe anemia, thrombocytopenia, bronchopneumonia and multiple bony defects in skull. The child expired in a month after admission.
Anemia ; Bronchopneumonia ; Child ; Dermatitis, Seborrheic ; Emaciation ; Exanthema ; Histiocytosis, Langerhans-Cell* ; Humans ; Infant ; Male ; Otitis Media ; Scalp ; Skull ; Thrombocytopenia

No abstract available.
Appendicitis*

As novel antipsychotic agents are introduced, the needs for practical guidelines on switching medications is becoming increasingly important. Cross-tapering is generally the most acceptable methods of switching, although abrupt change may be used in some cases. The important goal of antipsychotic agents witching guidelines is to reduce adverse effect of antipsychotic agents and to minimize the aggravation of the psychiatric symptoms during the switching periods. Recently, drug switching to novel antipsychotics is increased. In this article authors reviewed previous clinical studies on the antipsychotic medications switching.
Antipsychotic Agents* ; Drug Substitution

No abstract available.
Asian Continental Ancestry Group* ; Humans ; Humans* ; Sarcoma, Kaposi*

Toward the beginning of the twenty-first century, the world experiences the dramatic changes in politics, economics and culture, and it is evident that the Korean medical field will not be able to survive provided it doesn't prepare ourselves to adapt to those changes. The Korean Medical Society held a forum for the active operation of the medical society, inviting several leading affiliated societies, to meet the needs of the times. This review describes the summary of the presentation that the authors made on behalf of the Korean Radiological Society in the forum, including the organization, current status of academic activity, current status of international communication, and problems encountered in the internationalization of the Korean Radiological Society.
Politics ; Societies, Medical

Personal and Social Performance scale (PSP) is the new measurement scale of patient functioning. PSP is simple and useful questionnaire for psychiatrist and medical personnel, especially for rehabilitation center workers. Compared with GAF (Global Assessment of functioning Scale), PSP has relatively good covariance with social and occupational and psychological symptoms. In clinical practice, PSP can be adopted for treatment planning and the evaluation of treatment effect, especially for the patients with schizophrenia.
Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Outcome Assessment (Health Care) ; Psychiatry ; Surveys and Questionnaires ; Rehabilitation Centers ; Schizophrenia*

Various measurements of cerebral ventricles in 50 normal newborn infants were performed, using ultrasonography. In transverse scan using linear array real-time scanner with 3 MHz transducer, the ratio of the distance between the falx and lateral wall of lateral ventricle to the hemispheric width was measured, In coronal scan through the anterior fontanelle using gray scale B-mode scanner with 5 MHz trand ucer, the ratios of the bifrontal diameter of the lateral ventricles to externally measured biparietal diameter and to head circumference were measured. Width of frontal horn at 5mm distance from the lateral end of frontal horn was also measured. In addition, the presence of cavum septi pellucidi was investigated in coronal scan. The result are as follows; 1. The lateral ventricle/hemispheric width ratio in transverse scan was 0.31±0.03. 2. Bifrontal diameter of lateralventricle/biparietal diameter ratio was 0.20±0.02 and bifrontal diameter of lateral ventricle/head circumference ration was 0.054±0.006. 3. Width of frontal horn was about 1mm and maximum width was 2 mm. 4. There was no significant difference in ventricular size between male and female, and among different gestation ages. 5. Cavumsepti pellucidi was found in 44 neonates (88%) among 50 normal neonates in coronal scan.
Animals ; Cerebral Ventricles ; Cranial Fontanelles ; Female ; Head ; Horns ; Humans ; Infant, Newborn ; Lateral Ventricles ; Male ; Pregnancy ; Transducers ; Ultrasonography