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*

No abstract available.
Histiocytosis*

OBJECTIVE: As an electronic health record system is implementing in Korean health care sectors, concerns about key functionalities of electronic health record systems are increasing. The purpose of this study was to identify core functions and set the priority in electronic health record systems under the Korean contexts in order to assure and improve the quality of the systems. METHODS: A survey was conducted using questionnaire developed by the study team based on literature review. The subjects were medical record administrators working at medical record department in general hospitals. RESULTS: The response rate was 59.8%(55/92). The functions which more than ninety percent of subjects responded as necessary right now and/or in near future related to 'drug alert', 'clinical guideline', 'chronic disease management', 'automated real-time surveillance', 'coded data', 'result reporting', 'de-identifying data', 'disease registry', and 'provider-provider communication and connectivity'. CONCLUSION: The results showed the high prioritized functions were decision support and health information/data management.
Electronic Health Records* ; Health Care Sector ; Hospitals, General* ; Humans ; Medical Record Administrators ; Medical Records ; Needs Assessment* ; Surveys and Questionnaires

No abstract available.

Crypt glandular infection theory is accepted as an explanation of anal fistula's major cause. However, the pathogenesis of an anal fistula in Crohn's disease is different from that of a conventional anal fistula because a Crohn's anal fistula is caused by ulceration which, in turn, is caused by transmural inflammation of the rectal wall due to Crohn's disease. The difficulty with operating on anal fistulas in Crohn's disease lies in the fact that healing of the wound is inhibited because of continuous inflammation of the anorectal tissue due to Crohn's disease. Hence, there is a high possibility of incontinence due to sphincter muscle injury. Especially, because almost all Crohn's disease patients have frequent defecation and diarrhea, the patients will suffer more if incontinence occurs. Nowadays, even with increased understanding of the etiology of Crohn's disease, new medications, and aggressive surgical approaches, the result of treatment is still not satisfactory. Recently, since Korean eating habits have changed to include more western-style food in the diet, inflammatory bowel disease, such as Crohn's disease, is expected to increase. Consequently, the number of cases of anal fistulas in Crohn's disease is also expected to increase. The authors reviewed 20 confirmed cases of anal fistulas in Crohn's disease, which were treated from January 1993 to December 1995 at Song-Do Colorectal Hospital. The results are as follows: 1) Anal fistulas in Crohn's disease were present in 20(0.6%) of the 3378 cases of anal fistulas treated during the time period considered. 2) The male to female ratio for these 20 cases was 2: 1, and the most Prevalent age group was the 3rd decade, followed by the 2nd decade, the 4th decade, and the 5th decade in that order. 3) Three cases of anal fistulas whose origins could be explained by crypt glandular infection theory and which did not involve the rectum healed, although the healing was delayed. 4) Seventeen cases of anal fistulas whose origins could not be explained by crypt glandular infection theory and which involved the rectum did not heal after the operation. he results of the study show that anal fistulas whose origins can be explanined by crypt glandular infection theory and which do not involve the rectum can be cured by conventional fistula surgery. However, perirectal fistulas whose origins can not be explained by crypt glandular infection theory and which involve the rectum do not heal. Because there is the possibility of incontinence after a conventional operation, it is suggested that, in the cases of perirectal fistulas in Crohn's disease, better results, although not completely satisfactory, can be obtained by long-term seton drainage and diversion colostomy.
Colostomy ; Crohn Disease* ; Defecation ; Diarrhea ; Diet ; Drainage ; Eating ; Female ; Fistula ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Male ; Rectal Fistula* ; Rectum ; Ulcer ; Wounds and Injuries

OBJECTIVES : The present study aimed to compare anxiety sensitivity among anxiety disorder groups, and to examine the relationships between lower-order factors of anxiety sensitivity and each anxiety disorder. METHODS : Three hundred and twenty four normal control subjects and 212 patients with anxiety disorders were enrolled in this study. All subjects completed a psychometric assessment package including the Korean Anxiety Sensitivity Index-Revised (ASI-R) test. Statistical analysis of the two groups was performed using the Mann-Whitney U test, and comparison of anxiety sensitivity amongthe anxiety-disorder groups (panic disorder-PD, general anxiety disorder-GAD, social phobia- SP, obsessive-compulsive disorder-OCD) was investigated using Kruskal-Wallis test. RESULTS : All anxiety disorder groups showed higher total scores of the ASI-R than did the normal control group (Z=-13.724, p<.001), and the mean total score of the ASI-R in the panic disorder group was the highest among the anxiety disorder groups. The mean score of each lower-order factor of the ASI-R in each anxiety disorder group was higher than that of the normal control group and there were statistically significant differences in fear of cardiovascular symptoms (PD,GAD>SP,OCD), fear of respiratory symptoms (PD>GAD, SP,OCD), and fear of publicly observable anxiety reactions (SP>PD,OCD) among the anxiety disorder groups. CONCLUSION : These results suggest that anxiety sensitivity reflects vulnerability to anxiety disorders, and that lower-order factors of the ASI-R may help in the differential diagnosis of anxiety disorders.
Anxiety ; Anxiety Disorders ; Diagnosis, Differential ; Humans ; Panic Disorder ; Psychometrics

OBJECTIVES : The present study aimed to compare anxiety sensitivity among anxiety disorder groups, and to examine the relationships between lower-order factors of anxiety sensitivity and each anxiety disorder. METHODS : Three hundred and twenty four normal control subjects and 212 patients with anxiety disorders were enrolled in this study. All subjects completed a psychometric assessment package including the Korean Anxiety Sensitivity Index-Revised (ASI-R) test. Statistical analysis of the two groups was performed using the Mann-Whitney U test, and comparison of anxiety sensitivity amongthe anxiety-disorder groups (panic disorder-PD, general anxiety disorder-GAD, social phobia- SP, obsessive-compulsive disorder-OCD) was investigated using Kruskal-Wallis test. RESULTS : All anxiety disorder groups showed higher total scores of the ASI-R than did the normal control group (Z=-13.724, p<.001), and the mean total score of the ASI-R in the panic disorder group was the highest among the anxiety disorder groups. The mean score of each lower-order factor of the ASI-R in each anxiety disorder group was higher than that of the normal control group and there were statistically significant differences in fear of cardiovascular symptoms (PD,GAD>SP,OCD), fear of respiratory symptoms (PD>GAD, SP,OCD), and fear of publicly observable anxiety reactions (SP>PD,OCD) among the anxiety disorder groups. CONCLUSION : These results suggest that anxiety sensitivity reflects vulnerability to anxiety disorders, and that lower-order factors of the ASI-R may help in the differential diagnosis of anxiety disorders.
Anxiety ; Anxiety Disorders ; Diagnosis, Differential ; Humans ; Panic Disorder ; Psychometrics

PURPOSE: To determine whether dynamic or conventional MR imaging is most useful for the detection of pituitary microadenoma. MATERIALS AND METHODS: The study involved 20 patients (M:F=1:19, mean age=37 years) in whom a pituitary microadenoma had been identified. Routine unenhanced coronal T1-weighted MR imaging was followed by dynamic imaging (repetition time/echo time/excitation=200/10/1, 3-mm-thick sections, 256X128 or 256 ma-trix,14X14-cm field of view, scan time=30 or 60 seconds, spin-echo pulse sequence), and contrast-enhanced coronal T1-weighted imaging was then immediately performed. Temporal changes in signal intensity were quantified with manually placed ROIs (regions of interest, circular, 3 mm 2), and tissue contrast between the pituitary gland and microadenoma was calculated. Conspicuity of the tumor margin was graded by three radiologists working independently as either 4 (excellent clear margin), 3 (good clear margin), 2 (relatively clear mar-gin), or 1 (unclear margin). RESULTS: Average peak enhancement of the pituitary gland and microadenoma occurred at 58.5 and 91.5 seconds, respectively. Maximum enhancement of the pituitary gland occurred within 30 to 60 seconds of contrast infusion (signal intensity range: 426-442), but during dynamic MR imaging, the microadenoma showed rela-tively constant enhancement (signal intensity range: 230 -250). Maximal contrast between normal pituitary gland and the microadenoma was seen at 60 seconds or in the first three sequential images. Dynamic MR images were superior to conventional T1-weighted images, with or without contrast infusion, not only in terms of tissue contrast between the pituitary gland and the microadenoma (p=0.0048), but also as regards tumor margin conspicuity (p=0.0035). CONCLUSION: Dynamic MR imaging is a useful technique in the detection of pituitary microadenoma.
Humans ; Magnetic Resonance Imaging* ; Pituitary Gland

Primary papillary serous carcinoma of the peritoneum is a rare primary tumor involving the peritoneum. Histologically, it is indistinguishable from serous ovarian papillary carcinoma, although it either spares the o-varies or only microscopically involves their surface. The characteristic features of this tumor are extensive peritoneal and omental masses or implants with psammomatous calcification, and ascites. In addition, it can occur focally in the pelvic peritoneum. We report the CT findings, with histopathologic correlation of primary papillary serous carcinoma of the peritoneum occurring in the upper mesorectum.
Ascites ; Carcinoma, Papillary ; Peritoneum*

Polyarteritis nodosa is a systemic inflammatory disease resulting from necrotizing angitis of small to medium sized arteries. It involves various organs, including the gastrointestinal tract, which is involved in about 50% of all cases. Numerous complications-including abdominal pain, vomiting, and hematemesis-have been reported, but the CT findings have not been described. We report the CT findings in a case of gastric polyarteritis nodosa, and correlate these with the histopathologic findings.
Abdominal Pain ; Arteries ; Arteritis ; Gastrointestinal Tract ; Polyarteritis Nodosa* ; Stomach* ; Vomiting