No abstract available.
Nephrosis, Lipoid*

Since Pare's first report on Achilles tendon rupture in 1575, many authors have presented numerous operative and nonoperative methods for its treatment. Numerous controversies following its treatment have been concerned with the selection of its treatment method, which could minimizing the complications and enable early ambulation. We analysed 98 cases of Achilles tendon rupture in adults which were treated by direct repair, three-tissue bundle technique, or Plantaris/Peroneus augmentation repair for 3(1)/4 years from Oct. 1986 to Dec. 1989. We compared with types of cast after operation, periods for immobilization, and ankle motion of dorsiflexion at postoperative 6 weeks & long-term follow up. The results obtained from this study were as follows; l. After repair by three-tissue bundle technique, a short leg cast was applied, and then a weight bearing was started at postoperative 3 weeks. It can be demonstrated to shorten hospitalization and early ambulation when compared to other surgical techinques. 2. The patients who were repaired with the three-tissue bundle techinque averaged 12.5° dorsiflexion at the time of cast removal at postoperative 6 weeks, compared to 0°, 1° plantar flexion, and 4.4° plantar flexion with other techniques. The former group was significantly better than that of the latter group, and these differences were not present at long-term follow up. 3. On follow up period, discoverd complications were rerupture of Achilles tendon in 8 cases and mild wound infection in 3 cases, but the patients who were repaired by the three-tissne bundle technique showed no complications except mild wound infection in one case.
Achilles Tendon ; Adult ; Ankle ; Early Ambulation ; Follow-Up Studies ; Hospitalization ; Humans ; Immobilization ; Leg ; Methods ; Rupture ; Weight-Bearing ; Wound Infection

The purpose of the study was to assess the role of two types screws(bicortical screws with 3.5mm diameter and monocortical screws with 4.5mm diameter) in anterior cervical spinal fusion. Seventy patients surgically treated on the same surgeon was retrospectively reviewed. All patients were managed as the same technique(modified Smith-Robinson technique) and the same non-locking plate system(Top plate system), but the bicortical screws were used in 40 patients(Group 1) and the monocorical screws in 30 patients(Group 2). The overall fusion rate during the 3 months follow up at least was to be satisfied on the both groups. The complication from the Group 2 was never seen but Group 1 was observed in 5 patients; one as slip of grafted bone, 2 as screw loosening, 1 as psychologic intolerance and 1 as CSF leakage. The monocortical screw was considered to be superior than bicortical screw and was related to the screw diameter.
Follow-Up Studies ; Humans ; Retrospective Studies ; Spinal Fusion ; Transplants

The term dilated(congestive) cardiomyopathy refers to a variety of cardiac disorders that have in common ventricular dilation and reduced myocardial contractility, and is derived from the common late clinical manifestation of congestive heart failure. Since echocardiography can evaluate several aspects of anatomical structures and cardiac function, it has provide a valuable contribution to the understanding of ventricular function and diagnosis of dilated cardiomyopathy. The purpose of this study is to perform the echocardiographic evaluation of left ventricular function in 44 patients with dilated cardiomyopathy and to compare the patients with normal individuals. The patients, 24 males and 20 females, had a mean age of 53.0 and body surface area of 1.61m2. Normal individuals as a control group, 10 males and 10 females, had a mean age of 47.2 and body surface area of 1.67m2. Among 44 patients with dilated cardiomyopathy, 22 cases had a history of heart failure and in 15 cases systolic murmur was heard at the apex. The cardiothoracic ratio was 0.7+/-0.1 on chest X-ray which showed significant difference when compared to normal control group, being 0.4+/-0.1(p<0.01) One case showed left ventricular thrombus and in 8 cases small mounts of pericardial effusion were noted. Among the 44 patients two had uremia, one had a history of myocarditis, one patient was young female whose illness began during the peripartum period and one had a diabetes mellitus. Results obtained were as follows; 1) Mitral valve echocardiogram (1) DE amplitude and EF slope of mitral valve(16.5+/-3.3mm and 83.5+/-3.65mm/sec respectively) showed significant decrease when compared to normal control group (20.1+/-3.0 mm and 102.4+/-28.9 mm/sec respectively) (p<0.01 and p<0.05). (2) EPSS (25.5+/-7.6mm) and the distance between posterior cusp of mitral valve and left ventricular posterior wall (9.1+/-2.1mm) showed significant increase (p<0.01) when compared to normal control group (7.1+/-2.1mm and 5.9+/-1.2mm). The ratio of the separation of two mitral leaflets to the left ventrticular diastolic dimension (0.4+/-0.1) showed significant showed significant decrease in patients when compared to normal control group (p<0.01) (3) Among 44 patients with dilated cardiomyopathy, 12 cases showed B-notch in mitral valve. 2) Echocardiographic findings of aortic valve. Left atrial size was markedly increased (37.7+/-7.5mm) when compared to nomal control group (29.1+/-4.9) (p<0.01). The ratio of left atrial size to aortic dimension was 1.3+/-0.3, showing significant increase when compared to normal control group (0.99+/-0.3) (<0.01). And 4 cases showed systolic notch in aortic valves. 3) Echocardiographic findings of left ventrcle and ventricular septum. (1) Left ventricular diastolic and systolic dimensions (41.8+/-7.8mm/m2 and 36.7+/-7.2mm/m2) were markedly increased in patient with dilated cardiomyopathy, when compared to normal control group (30.4+/-2.6mm/m2 and 11.4+/-3.2mm/m2) (p<0.1, both). Left ventricular diastolic and systolic volume (181.5+/-91.0ml/m2 and 136.6+/-69.7ml/m2) were also significantly higher in patients with dilated cardiomyopathy when compared to normal control group (79.1+/-23.8mm/m2 and 19.4+/-2.5ml/m2) (p<0.01, both). (2) Ejection fraction (0.32+/-0.10) percent fractional shortening (12.3+/-4.6) and mVcf (0.5+/-0.2 cric/sec) showed significant decrease in patients when compared to normal control group (0.74+/-0.05, 34.6+/-6.7 and 1.4+/-0.2) (p<0.01, all). Thus, We could find the reduced myocardial contractility in dilated cardiomyopathy. (3) Systolic amplitudes of venticular septum (LSa) and ventricular posterior wall (Ena) were markedly decreased (p<0.01). The sum of both values (LSa+ENa) also showed significant decrease (12.0+/-4.2mm) when compared to normal control group (p<0.01) (4) Thickness of ventricular septum and ventricular posterior wall showed slight increase in patients, but there was no significant changes when compared to normal group. 4) Systolic time interval Echocardiograms showed significant increase in ratio of preejection period to ejection time, when compared to normal group (p<0.01). Thus, the author observed that in dilated cardiomyopathy the contractility of left ventricle was significantly reduced and the left ventricular diameter and diastolic volume of left ventricle showed marked increase. And also the decreased motions of ventricular septum and posterior wall of left ventricle were noted.
Aortic Valve ; Body Surface Area ; Cardiomyopathies ; Cardiomyopathy, Dilated* ; Diabetes Mellitus ; Diagnosis ; Echocardiography* ; Female ; Heart Failure ; Heart Ventricles ; Humans ; Male ; Mitral Valve ; Myocarditis ; Pericardial Effusion ; Peripartum Period ; Systole ; Systolic Murmurs ; Thorax ; Thrombosis ; Uremia ; Ventricular Function ; Ventricular Function, Left* ; Ventricular Septum

No abstract available.
Eosinophilia*

PURPOSE: This study is to describe authors'experience on mammographic findings of breast cancer and to know if there is difference between 35 years of age or younger and older groups. MATERIALS AND METHODS: Mammograms of 72 patients with breast cancer detected from January, 1991 to December, 1993 were retrospectively analysed. Mammographic findings were classified into mass only, mass with microcalcifications, microcalcifications only and others. Marginal characteristics of mass were classified into spiculated, poorly marginated and well marginated. Shape of microcalcifications were classified into casting, granular and mixed types. These findings were compared between 35 years of age or younger and older groups. RESULTS: Mammogram showed mass only in 33 patients(46%), mass with microcalcifications in 26 patients (36%), microcalcifications only in seven(10%) and other findings in six(8%). Other findings were architectural distortion, asymmetric high density and incidental breart carcinoma from paraffinoma in one patient respectively, and dense breast in three patients. The margins of the breast mass were spiculated in ten(17%) poorly marginated in 30(51%), well-marginated in 19(32%). Shape of microcalcifications were casting type in 13(40%), granular in 14(42%) and mixed in six(18%) cases. 3 patients had dense breast with which mammography did not demonstrate the lesion. 3 patients without mammographically demonstrable lesions due to dense breasts were under 35 years in age. and there was statistically significant difference between the two groups(p-value<0.05). Microcalcifications only was more common findings in 35 years of age or younger. CONCLUSION: The most important mammographic findings of breast cancer were mass and microcalcifications. Architectural distortion and asymmetric high density were additional findings. In 35 years of age or younger, microcalcifications only was an important finding because mass lesions are frequently masked by dense breast. Thus other imaging modalities, such as ultrasonography, were required.
Breast Neoplasms* ; Breast* ; Humans ; Mammography ; Masks ; Retrospective Studies ; Ultrasonography

The hypotensive effect and side reactions of Buterazine were evaluated in 21 patients with essential hypertension. The results were as follows; 1) Before medication and after 2 and 4 weeks of medication, the over all average systolic and diastolic pressure were 188+/-23/112+/-7, 168+/-13/101+/-17, and 158+/-12/95+/-8mmHg, respectively. After 2 and 4 weeks of medication, the over all average systolic pressure decreased by 20 and 30mmHg(P<0.005, P<0.001), and the over all average diastolic pressure decreased by 11 and 17mmHg(P<0.025, P<0.001), respectively. In 69% of all cases, marked or moderate degree of hypotensive effect was observed. 2) There was no significant changes in heart rates before and after treatment. 3) In 84% of all cases, improvement of symptoms were observed. 4) There was no side effects which required discontinuing the treatment, except 2 cases which discontinued the medication.
Blood Pressure ; Heart Rate ; Humans ; Hypertension

PURPOSE: To compare results of the modified Brostrom procedure and the Chrisman-Snook procedure for chronic lateral ankle instability. MATERIALS AND METHODS: Twenty-eight patients (30 ankles) who underwent 20 modified Brostrom procedures or 10 Chrisman-Snook procedures were available. Follow-up averaged 3.2 years (1.3-5.4 years). Clinical results were graded according to the AOFAS clinical rating system. The talar tilting angle was also measured. RESULTS: Clinical results were rated as excellent in 15, good in 4, and fair in 1 ankle after the modified Brostrom procedure, and excellent in 7, and good in 3 ankles after the Chrisman-Snook procedure. Three complications occurred after the Chrisman-Snook procedure; delayed wound healing in 1 ankle, and transient neuralgia in 2. Mean talar tilting angle was improved from 17.4+/-6.6degrees to 6.6+/-1.2degrees by the modified Brostrom procedure, and from 15.6+/-5.9degrees to 3.0+/-1.1degrees by the Chrisman-Snook procedure. CONCLUSION: Significant differences were found in the clinical results obtained using the two procedures, and good function was obtained in a high percentage of patients. The procedure of choice should be decided upon based on the patient's condition and the doctor's preference.
Ankle* ; Follow-Up Studies ; Humans ; Neuralgia ; Wound Healing

Generally, esophageal cancer metaetasizes to lymph node, lung, liver but metastasis to another digestive organ is very rare. A 51 year old man who had experienced dysphagia for 1 month was diagnosed as an esophageal cancer. After combined radiation therapy and chematherapy(5-FU, cisplatinum), he still had dysphagia. After implanta tion of self-expandable metallic esophageal stent, he could swallow solid food. Recently, he experienced pharyngeal pain for 1 month. Endoscopy showed multiple nodules in right pyriform sinus. Biopsy specimen revealed squamous cell carcinoma. Because the distance between esophageal cancer and pharyngeal nodule is more than 10 cm and computed tomography of the neck shows normal esophageal wall no cervical lymphadenopathy, we concluded that this case was an esophageal cancer with metastasis to the pharynx. Hence, we reported a case of esophageal cancer with pharyngeal metastasis with a review of literatures.
Biopsy ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Endoscopy ; Esophageal Neoplasms* ; Humans ; Liver ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Middle Aged ; Neck ; Neoplasm Metastasis* ; Pharynx* ; Pyriform Sinus ; Stents

Generally, esophageal cancer metaetasizes to lymph node, lung, liver but metastasis to another digestive organ is very rare. A 51 year old man who had experienced dysphagia for 1 month was diagnosed as an esophageal cancer. After combined radiation therapy and chematherapy(5-FU, cisplatinum), he still had dysphagia. After implanta tion of self-expandable metallic esophageal stent, he could swallow solid food. Recently, he experienced pharyngeal pain for 1 month. Endoscopy showed multiple nodules in right pyriform sinus. Biopsy specimen revealed squamous cell carcinoma. Because the distance between esophageal cancer and pharyngeal nodule is more than 10 cm and computed tomography of the neck shows normal esophageal wall no cervical lymphadenopathy, we concluded that this case was an esophageal cancer with metastasis to the pharynx. Hence, we reported a case of esophageal cancer with pharyngeal metastasis with a review of literatures.
Biopsy ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Endoscopy ; Esophageal Neoplasms* ; Humans ; Liver ; Lung ; Lymph Nodes ; Lymphatic Diseases ; Middle Aged ; Neck ; Neoplasm Metastasis* ; Pharynx* ; Pyriform Sinus ; Stents