No abstract available.
Intussusception*

Reconstruction of cruciate ligament has been controversial. Autogenous grafts has been used with inconsistent success rates due to their variable strength and limited length. If any autograft could cover such drawbacks it could surpass the advantage of artificial ligaments also. Recently, we used partial Achilles tendon autograft in reconstructive operation of anterior cruciate ligament with promising result. The main advantages of this Achilles tendon autograft are its sufficient length and strength. Preliminary study was done in 11 patients who received reconstruction of the anterior cruciate ligament using partial Achilles tendon autograft. The results were as followings :l. Anterior cruciate ligament reconstructions were done in 11 patients, with follow-ups ranging from 5 to 12 months, average being 8 months. 2. Average preoperative knee score was 49.1, and it was improved up to 87.4 after operation. 3. Among the 11 patients, 6 belonged to the Excellent, 4 to good, and 1 to fair. 4. Achilles tendon autograft turned out to be a good autograft substitute for the anterior crucate deficient knee. The results were promising. Long-term follow-up is needed to confirm the final status of the operated knee.
Achilles Tendon ; Anterior Cruciate Ligament ; Autografts ; Follow-Up Studies ; Humans ; Knee ; Ligaments ; Transplants

Splenic artery pseudoaneurysm is a relatively rare and potentially life-threatening complication of chronic pancreatitis. The authors present a case of splenic artery pseudoaneurysm complicating ,chronic pancreatitis. It was converting into a pseudoaneurysm by vessel rupturs. In this case report, color doppler US, CT, and MRI made the definite diagnosis.
Aneurysm, False* ; Diagnosis ; Magnetic Resonance Imaging ; Pancreatitis, Chronic* ; Splenic Artery*

PURPOSE: To evaluate the effectiveness and the most accurate element of the diagnostic criteria of the Japan Society of Uitrasonics in medicine(JSUM, Nov. 1989) for distinguishing between benign and malignant solid breast masses on the US. METHODS AND MATERIALS: We analyzed the ultrasonic findings of histopathologically proved 51 fibroadenomas, 12 fibrocystic disease, and 39 breast cancers in relation to the diagnostic criteria of the JSUM (shape, border, boundary echo, internal echo, posterior echo, lateral echo, and depth/width ratio). RESULTS: The number of cases of fibroadenoma, fibrocystic disease, and breast cancer corresponding to the diagnostic criteria was in the shape(26/51, 5/12, 33/39), border(41/51, 9/12, 29/39), boundary echo(48/51, 12/12, 27/39), internal echo(43/51, 9/12, 24/39), posterior echo(32/51, 3/12, 21/39), and lateral shadowing(15/51, 1/12, 35/39). All diagnostic criterias showed statistical significance for differentiation of benign/malignant breast mass on the US(Chi-square test: p<0.05). The order of accuracy was boundary echo, internal echo, and border. The mean of depth/width ratio was 0.54 +/- 0.15, 0.52 +/- 0.12, and 0.69 +/- 0.21 in fibroadenoma, fibrocystic disease, and breast cancer respectively and it had statistical significance for differentiation of benign/malignant breast mass on the US(ANOVA test: p=0.0002). CONCLUSION: The diagnostic criteria of JSUM is effective for differentiation of benign/malignant breast solid masses on the US and has accuracy in the order of boundary echo, internal echo, and border. Depth/width ratio also has statistical significance.
Breast Neoplasms ; Breast* ; Fibroadenoma ; Japan* ; Ultrasonics*

No abstract available.
Humans ; Nursing* ; Students, Nursing*

BACKGROUND: Total knee arthroplasty is a reliable and durable procedure in the treatment of knee arthritis. Patient selection is one scientific aspect of total knee replacement and the surgeon must develop knowledge about those patients who will benefit from total knee replacement. Authors tried to find any differences in preoperative status for Koreans and Americans undergoing total knee replacement arthroplasty(TKRA) for primary osteoarthritis(OA). Another goal of this study was to determine whether Koreans undergoing elective TKIRA for primary OA had more advanced disease preoperatively than Americans undergoing the same procedure. METHODS: Preoperative clinical and radiographic severity of knee OA was determined between Koreans who underwent TKRA at the National Medical Center in Seoul, Korea and Americans who underwent the same procedure at the Hospital of the University of Pennsylvania in Philadelphia, USA. RESULTS: There were 62 women and five men included in the group I(Koreans) compared to 60 women and thirty men in the group II(Americans). The mean age for the patients in the group I was 64.0 years and for the group II 69.5 years. The average weight for the group I was 63.8 Kg(range, 46-85 kg) with an average height of 152.4 cm(range, 133-168 cm). The corresponding data in the group II was 86.6 kg(range, 54-170 kg) and 167.4 cm(range, 147-196 cm). The mean preoperative knee score(developed by The Knee Society) for the group I was 32.7 points and the mean preoperative function score was 42.0 points. The mean preoperative knee and function scores for the group II were 38.1 and 46.2 points, respectively. The mean preoperative flexion contracture and further flexion were 11.7degrees(range, 0-40degrees) and 124.8degrees(range, 70-140degrees), respectively. The corresponding data in the group II were 4.0degrees(range, 0-15degrees) and 107.7degrees(range, 80-130degrees), respectively. The group I knees had a mean preoperative tibiofemoral angle of 4.8degrees(+/-6.0degrees) varus. For the group H knees, the preoperative tibiofemoral angle was 0.83degrees(+/-7.80degrees) valgus. Lateral FT(femorotibial) osteoarthritis was not found in any Korean patients but seen in 18 cases(17.8%) of American patients. CONCLUSION: The observed differences in the status prior to TKRA indicate that Koreans are operated on at a more advanced stage in the course of their disease than Americans. A number of important issues remain to be addressed in future research, such as the role of patient preference and different access to TKRA and the differences of their clinical presentation.
Arthritis ; Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Contracture ; Female ; Humans ; Knee ; Korea ; Male ; Osteoarthritis* ; Patient Preference ; Patient Selection ; Pennsylvania ; Seoul

PURPOSE: The purpose of this study was to identify the relationship of job stress, state of sleep, and depression and to identify factors influencing depression of emergency medical technicians. METHODS: The research was a cross-sectional, descriptive study. Data collection were done using self-report questionnaires with 162 emergency medical technicians working in hospitals who agreed to participate in the study. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple regression with the SPSS/WIN 18.0 Program. RESULTS: Depression had significant negative correlations with state of sleep, (r=-482, p<.001) and positive correlations with job stress (r=.196,p=.013). State of sleep had significant negative correlations with job stress (r=-.168, p=.033). The variance for life satisfaction was 23.7% (F=25.964, p<.001). Variable of state of sleep significantly predicted depression of emergency medical technicians. CONCLUSION: Considering these results, for emergency medical technicians' job stress, state of sleep, and depression, further studies are needed. Furthermore, there is a need to develop and implement new strategies to improve depression among emergency medical technicians.
Data Collection ; Depression ; Emergencies ; Emergency Medical Technicians ; Humans ; Surveys and Questionnaires

PURPOSE: We evaluated the effects of amitriptyline in patients with urinary frequency or pelvic pain syndrome and compared with propiverine hydrochloride (BUP-4(R)) and diazepam (Valium(R)). MATERIALS AND METHODS: One-hundred and sixty-eight patients with urinary frequency or pain were included and 38 out of 168 patients were lost to follow up. The patients with interstitial cystitis, UTI and neurogenic bladder were excluded. Amitriptyline group were instructed to take 25mg to 75mg of amitriptyline before bed. Propiverine hy drochloride and diazepam group were instructed to take 20mg, 4-6mg before bed, respectively. The clinical effects and side effects were evaluated after 4 weeks of medication. RESULTS: In the amitriptyline group, 73.1% in 78 patients with frequency, 68.3% in 60 pain, 65.6% in 32 nocturia, 53.8% in 26 weak urinary stream, 53.8% in 13 dysuria, 72.7% in 11 urgency showed symptom improvement. Urinary frequency and pain score were significantly decreased in the amitriptyline group. In the propiverine hydrochloride group, 66.7% in 21 patients with frequency, 38.8% in 18 pain showed symptom improvement. In the diazepam group, 37.5% in 24 patients with frequency, 31.3% in 16 pain showed symptom improvement. Side effects of amitriptyline had appeared in 24 (27.6%) out of 87 patients; 17 cases of dry mouth, 10 drowsiness, 2 agitation, 2 nausea, 1 constipation and 1 skin rash. CONCLUSIONS: Amitriptyline is useful in vague voiding symptoms especially in urinary frequency and chronic pelvic pain syndrome. It is equally effective in both men and women. Side effects are minimal and tolerable. A double-blind placebo-controlled trial is necessary for general acceptance in the future.
Amitriptyline* ; Constipation ; Cystitis, Interstitial ; Diazepam ; Dihydroergotamine ; Dysuria ; Exanthema ; Female ; Humans ; Lost to Follow-Up ; Male ; Mouth ; Nausea ; Nocturia ; Pelvic Pain* ; Rivers ; Sleep Stages ; Urinary Bladder, Neurogenic

Idiopathic small bowel ulceration occurring beyond the duodenum is rare, and less than 5% of all the reported cases have occurred in children. In most of the cases, single ulcer of unknown cause is observed in jejunum or ileum. The diagnosis is difficult and usually made at the time of surgical exploration for the complications, such as perforation, hemorrhage or obstruction. We experienced a case of perforation of idiopathic ileal ulceration due to blunt abdominal trauma in a 11-year-old boy. The ileal segment including the lesion was resected and the pathologic findings were compatible with idiopathic small bowel ulceration. The clinical and pathological aspects are discussed, and the literatures were reviewed.
Child* ; Diagnosis ; Duodenum ; Hemorrhage ; Humans ; Ileum ; Jejunum ; Male ; Ulcer*

No abstract available.
Hazardous Substances* ; Occupations* ; Skin*