Neither the cause nor the correct treatment of Kienbocks disease has been clearly established, but its clinical and radiologic presentations have been distinctly defined. There are many controversies concerning therapeutic guidelines for the treatment of Kienbocks disease. The purpose of this study is to evaluate the clinical result of triscaphe fusion with radial styloidectomy of Kienbocks disease. Ten cases of stage III Kienbocks disease by Lichtmans classification were treated by triscaphe fusion with radial styloidectomy from September 1991 to March 1997. We followed up over 24 months and evaluated clinical results. In all cases, pain was relieved. The postoperative results according to Kuschners method revealed three excellent, six good and one fair. The triscaphe fusion and radial styloidectomy was considered as useful method of treatment which has clinical efficacy in Kienbocks disease.
Classification ; Osteonecrosis*

The present study was carried out to clarify the anatomical changes of lumbar intervertebral discs by aging. Anterior height, posterior height, anteroposterior diameter of intervertebral discs were measured on 512 normal plain lateral radiographs of lumbosacral spine. And the indices of disc wedging and relative disc height were calculated. There was a cephalocaudal gradient of increase in the indices of disc wedging in all age groups. The indices of relative disc height were constant at all lumbar levels. These suggest that the lower disc is more wedge shaped and the height of discs changes in the constant ratio with that of vertebral body.
Aging* ; Humans ; Intervertebral Disc* ; Spine

OBJECTIVE: The study was performed to evaluate whether thallium reinjection (RI) distinguishes viable from nonviable myocardium among myocardial segments which showed persistent perfusion defect (PD) in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: We studied 22 patients underwent PTCA after AMI. SPECT was performed in all patients using dipyridamole stress- 4 hour redistribution (RD) followed by 24 hour RI protocols. Dysfunctional segs were classified into 5 groups: 1) normal, 2) reversible, 3) mild to moderate PD, 4) severe PD and 5) reverse redistribution (RR). All patients underwent follow up echocardiography after 4 months to assess regional wall motion (WM) improvement such as a criteria of viable myocardium. RESULTS: A total of 127 segs with abnormal WM was analyzed. Of 74 segs with PD, 17 (23%) showed enhanced uptake after 24 hour RI. Five of 17 segs (29%) with PD that responded to RI with enhanced thallium uptake showed WM improvement. WM improvement were seen in the 24 of 57 segs (42%) not responding to RI. All four segs (100%) with RR that responded to RI showed improvement. WM improvement were not seen in the 5 of 8 segs (71%) with RR not responding to thallium RI. Eleven (73%) of 15 segs with mild-moderate PD after RI showed improvement, but 33% of segs with severe PD after RI did not showed improvement. Segs with mild-moderate PD after RI and fill in after RI showed improvement in comparison to segs with severe PD after RI(p<0.05). CONCLUSIONS: These data indicate that because only small proportion of PD showed further perfusion improvement after RI and predictive value by the uptake after RI was low, there was limited role of RI after myocardial infarction. Usefulness of RI could be found in segs showing RR responding to RI in AMI reflects viable myocardium.
Dipyridamole ; Echocardiography ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Myocardium ; Perfusion ; Thallium ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Humans

Hyperkeratosis of the nipple and areola is a rare condition. We report a case of hyperkeratosis of the nipple and areola occurrinp in man with no underlying endocrirop thy or synthetic estrogenic drug therapy. The patient was not associated with epidermal nevus orichthyosis and so fitted into the nevoid form of hyperkeratosis of the nipple and areola. The clinical appearance and histological findings of the lesion were the same as those reported before. He showed a slight improvement in the color and hyperkeratcsis of the nipple and areola with 6 months use of a topical keratolytic agent and corticosteroid crearn.
Drug Therapy ; Estrogens ; Humans ; Nevus ; Nipples*

No abstract available.
Masticatory Muscles* ; Spasm* ; Tetanus*

The incidence of thyroid cancer is rapidly increasing worldwide. Recently, attention to quality of life (QOL) issues has been increasingly addressed in the management of cancer. The goal of this review is provide a systematic overview for clinical factors associated with QOL in patients with thyroid cancer. Age is often cited as a QOL predictor with older patients more vulnerable than younger patients. High levels of fatigue and psychological distress such as anxiety and depression might be associated with decreased QOL. Although surgery for thyroid cancer leads to worse QOL shortly, there is a trend towards recovery with time. Levothyroxine treatment in thyroid cancer can result in similar or slightly impaired QOL. Thyroid hormone withdrawal causes significant reductions of QOL of thyroid cancer patients. The use of recombinant human thyrotropin (rhTSH) instead of thyroid hormone withdrawal can prevent QOL deterioration by thyroid hormone withdrawal. Generally, thyroid cancer survivors have a similar or slightly worse QOL compared with the normative population. In conclusion, thyroid cancer has a considerable impact on QOL of patients, and therefore multidisciplinary approach with special concern for QOL is recommended.
Anxiety ; Depression ; Fatigue ; Humans ; Incidence ; Quality of Life* ; Survivors ; Thyroid Gland ; Thyroid Neoplasms* ; Thyrotropin ; Thyroxine

Reactive human mesothelial cells were examined by immunocytochemical stain with intermediate fiiaments (cytokeratin [CK1, CK7, CK8, CK18, CD19], vimentin, desmin, actin), epithelial membrane antigen, carcinoembryonic antigen (CEA), MHC class II antigen (HLA-DR), LeuM-1 (CD15), alpha1-antitrypsin(ACT), alpha1-antichymotrypsin(ACMT), CD68(KP-1) and FcyRIII(CD16). The mesothelial cells were isolated from patients with liver cirrhosis and pleural effusion, and short-term cultured in RPMI 1640 media containing 10% heat inactivated fetal calf serum and 1% identical supernatant fluid of the patients transudates. The results obtained are as follows. 1. The cultured-reactive mesothelial cells were positive for the protein of cytoskeleton such as cytokeratin and vimentin, but negative for desmin and actin. The resting mesothelial cells showed positive reactions for cytokeratin, but negative for vimentin, desmin and actin. 2. The primary antibodies to the cytokeratin were strongly reactive for CK1, CK8 and CK18 but negative r CK7 and CK19 in both reactive and resting mesothelial cells. 3. Resting mesothelial cells showed negative reactions for CEA, but strong positive reactions in cultured-reactive mesothelial cells. 4. The markers for the monocytes/histiocytes(CD11b, CD14, CD16, CD68, lysozyme and alpha1-antitrypsin and alpha1-antichymotrypsin) were nonreactive in resting mesothelial cells, but lysozyme and alpha1-antitrypsin were weakly reactive in reactive and proliferative mesothelial cells. 5. MHC Class II molecule(HLA-DR antigen) was negative in both resting and reactive mesothelial cells. These results suggest that the short-term cultured, reactive mesothellal cells show a newly aberrant expression of the vimentin and carcino-embryonic antigen. The reason of the aberrant expression of the intermediate filament and oncofetal antigen in reactive and proliferative mesothellal cells should be further evaluated.
Actins ; Antibodies ; Carcinoembryonic Antigen ; Cytoskeleton ; Desmin ; Exudates and Transudates ; Follow-Up Studies* ; Histocompatibility Antigens Class II ; Hot Temperature ; Humans ; Hydronephrosis* ; Intermediate Filaments ; Keratins ; Liver Cirrhosis ; Mucin-1 ; Muramidase ; Pleural Effusion ; Salivary Glands ; Vimentin

Pelvic actinomycosis is a rare disease, and has variable clinical manifestations and courses, which make it difficult to diagnose the disease initially. We experienced a pelvic actinomycosis in a woman who complained vaginal discharge and lower abdominal pain, and had not been carring a intrauterine contraceptive device. This infection results in tissue destruction, fibrosis, and the formation of draining sinuses. We describe the case with brief review of clinical diagnosis and management.
Abdominal Pain ; Actinomycosis* ; Diagnosis ; Female ; Fibrosis ; Humans ; Intrauterine Devices ; Rare Diseases ; Vaginal Discharge

BACKGROUND: As many as several weeks of incubation may be necessary for the recovery of mycobacteria when conventional culture media are used. Previous studies evaluating Mycobacteria Growth Indicator Tube (MGIT) as a rapid for the growth and detection of mycobacteria from clinical specimens have been reported. We compared MGIT with Ogawa media for the recovery of mycobacteria from clinical specimens. METHODS: Ninety nine clinical specimens received in the laboratory of Wonju Christian Hospital from June to September 199 were used for this study. The specimens from nonsterile body sites were digested, decontaminated, and concentrated, for culture and Ziehl-Neelsen stain, and specimen were inoculated onto MGIT tube and 3% Ogawa egg medium, and cultured for 8 weeks. RESULTS: Of the 38 specimens culture-positive for mycobacteria, 3 grew isolates in MGIT medium only, 8 grew isolates in Ogawa media only, and 27 grew isolates in both media. Mean (median, range) times to detection of mycobacteria were 13.7 (5.5, 2-48) days with MGIT and 19.6 (18, 13-37) days with Ogawa (P>0.05). The number recovered with MGIT plus Ogawa media was 24 (63.2%) within 14 days of receipt of specimen, and 31 (81.6%) within 21 days. The contamination rates were 31 % for MGIT and 1 % for Ogawa media. CONCLUSIONS: MGIT appears useful to quickly detect and identify mycobacteria from clinical specimens. However, because the number of culture-positive specimen in MGIT was not greater than those recovered with Ogawa media, MGIT should be used in combination with solid media to reduce turnaround times and increase the isolation rate.
Culture Media ; Gangwon-do ; Mycobacterium ; Ovum