No abstract available.
Cytomegalovirus* ; DNA* ; Humans* ; Polymerase Chain Reaction*

No abstract available.
Durapatite* ; Forehead*

No abstract available.
Histiocytoma, Malignant Fibrous*

No abstract available.
Hypopharyngeal Neoplasms*

No abstract available.
Kidney Transplantation*

PURPOSE: Biliary dyskinesia was considered as a wastebasket of quasi-biliary disease which could not be clearly explained under the basis of morphologic pathology. This entity was a source of confusion because of misconception and poor understanding. Recent introduction of biliary manometric technique enlightened some of these disorders. We evaluated the cholangiographic morphology of these disorders to clarify and to characterize the some characteristic findings, subsequently in order to help the diagnosis. MATERIALS AND METHODS: Five cases were confirmed by this technique as sphincter of Oddi dysfunction for last 13 months. All patients were female and age range was 53 to 75 years old. All patients were suffered from intermittent and recurrent biliary type pain. RESULTS: ERCP showed five common findings. The common bile duct was dilated over 12ram in all patients. Different from recurrent pyogenic cholangiohepatitis, intrahepatic ducts were proportionally dilated as extrahepatic ducts, in four patients and they branched normally and ductal wall was smooth. Transient or persistent meniscus sign was observed in four patients. All patients showed delayed emptying of contrast media from the common bile duct into the duodenum. Following IV injection of cholecystokinin, persistent meniscus disappeared and contrast media inflowed into the duodenum. CONCLUSION: Identification of all or some characteristic cholangiographic findings may eliminate a cumbersome and painful biliary manometric test for the diagnosis of sphincter of Oddi dysfunction.
Aged ; Biliary Dyskinesia ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystokinin ; Common Bile Duct ; Contrast Media ; Diagnosis ; Duodenum ; Female ; Humans ; Manometry* ; Pathology ; Sphincter of Oddi Dysfunction* ; Sphincter of Oddi*

A 44-year-old woman who comlpained of dizziness and generalized weakness was admitted. The hemoglobin was 6.6g/dL, hematocrit 25.5%, and serum ferritin 2.14 ng/mL Stool occult blood was positive and microcytic hypochromic anemia was found on periyheral blood smear. Gastroscopic examination showed about 2 x 1 cm sized hemispherical sebmucosal tumor on antrum. The patient underwent operatioh for confirmatory diagnosis and treatment. The final pathologic diagnosis of the resected lesion was hemangioma of stomach. Cavernous hemangioma of stomach is a rare disease.Mostly, it has a benign course clinically, but early diagnosis is important because massive hemorrhage and anemia by chronic blood loss can occur. We report a case of hemangioma of stomach with review of literature.
Adult ; Anemia ; Anemia, Hypochromic ; Diagnosis ; Dizziness ; Early Diagnosis ; Female ; Ferritins ; Hemangioma ; Hemangioma, Cavernous* ; Hematocrit ; Hemorrhage ; Humans ; Occult Blood ; Stomach*

PURPOSE: The reconstruction of femur and tibia defects following tumor resection remains a surgical challenge. The clinical outcome of free vascularized fibula graft (VFG) reconstruction with locking plate for massive femur and tibia defects of more than 10 cm that were secondary to skeletal tumor resection is reported. MATERIALS AND METHODS: Thirteen patients with a mean follow-up of 3.3 years were reviewed. Seven patients received vascularized fibula grafts in the femur and six in the tibia. The mean bony defect of the femur and tibia was more than 10 cm and the length of the grafted fibula was more than 15 cm. All defects were stabilized with long locking plates. RESULTS: All patients were free of disease at final follow-up; All VFGs were transferred successfully. All patients had a successful outcome with bony union. Stress fractures of the grafted fibula had occurred but the locking plate stabilized the fracture and healed until the last follow-up. All patients were able to walk without a brace after a mean of 9 months postoperatively. CONCLUSIONS: VFG with locking plate is a reliable reconstructive procedure for massive femur and tibia defects.
Braces ; Femur* ; Fibula* ; Follow-Up Studies ; Fractures, Stress ; Humans ; Tibia* ; Transplants*

PURPOSE: Mechanical bowel preparation aims to eliminate solid stool in the colon prior to colonoscopy and colorectal surgery. During colorectal surgery, a clean bowel has advantages such as a lower bacterial load, reduced chance of spillage of fecal content, and easiery handling of the bowel. The aim of this prospective trial was to compare polyethylene glycol (PEG) and sodium phosphate solutions for colorectal surgery according to patient's tolerance, side effects, cleansing quality, and postoperative complication. METHODS: Eighty patients prospectively received either a standard 4 liter PEG solution or a 90 ml oral sodium phosphate solution. Patient's tolerance for solution was assessed with a detailed questionnaire. Before and after bowel preparation, we checked the patient's body weight, blood pressure, pulse, and biochemical parameters such as hematocrit, serum electrolyte, blood urea nitrogen, and creatinine levels. The cleansing quality was checked by the surgeon during the operation. Statistical analysis was performed using the chi-square test for patient's tolerance, body weight, blood pressure, pulse, and postoperative complication and using the paired t-test for biochemical parameters with SPSS 11.0 version. RESULTS: The PEG and sodium phosphate solutions were each administered to 40 patients, separately. Thirty-seven patients (92.5%) had colorectal cancer in each group. The other underlying diseases were benign tumor, multiple polyps, diverticulitis, and familiar adenomatous polyposis. In comparing tolerance, there was no significant difference in the rate of patients who complained of difficulty on the questionnaire for discomfort (P=0.954), nor in the rate of patients who complained of severe subjective symptoms such as nausea, vomiting, abdominal pain, dizziness and sleep loss. The cleansing quality, body weight, blood pressure, pulse change and postoperative complication rates were not significantly different. In the PEG group, hematocrit (P=0.008), serum magnesium (P=0.03), phosphorus (P= 0.004), and blood urea nitrogen (P=0.001) were decreased and serum chloride (P=0.001) was increased. In the sodium phosphate group, serum sodium (P=0.001) was increased and serum potassium (P=0.018) was decreased. There was no significant changes in serum calcium (P=0.086) and phosphate (P=0.191) in the sodium phosphate group. CONCLUSION: In both groups, there was no significant difference in patient's tolerance, cleansing quality and postoperative complication rate. Though there were some biochemical changes between the two groups, they were not significant clinically. Therefore, the sodium phosphate solution can be substituted for the PEG solution in preoperative bowel preparation.
Abdominal Pain ; Bacterial Load ; Blood Pressure ; Blood Urea Nitrogen ; Body Weight ; Calcium ; Colon ; Colonoscopy ; Colorectal Neoplasms ; Colorectal Surgery ; Creatinine ; Diverticulitis ; Dizziness ; Hematocrit ; Humans ; Magnesium ; Nausea ; Phosphorus ; Polyethylene Glycols* ; Polyethylene* ; Polyps ; Postoperative Complications ; Potassium ; Prospective Studies* ; Surveys and Questionnaires ; Sodium* ; Vomiting

OBJECTIVE: To evaluate the effects of piroxicam patch(Trast) in rheumatoid arthritis patients with knee joint pain and swelling and to determine the concentration of plasma and synovial fluid following patch application. METHODS: Twenty-two patients with rheumatoid arthritis participated in a double-blind, placebo-controlled study. The patients were instructed to apply piroxicam or placebo patch at one knee and re-apply it every other day for 2 weeks. They had washout period for 2 weeks and then applied the other patch for 2 weeks at the same joint. The patients recorded knee joint pain using visual analog scale. Knee joint swelling and tenderness were assessed before and after application of piroxicam and placebo patch. Complete blood count, AST, ALT, BUN, creatinine, joint fluid analysis were also done. Piroxicam concentration in plasma and synovial fluid were measured by high performance liquid chromatography(HPLC) after 2 weeks of piroxicam patch application. RESULTS: Knee joint pain improved significantly after the application of piroxicam patch for 2 weeks(visual analog scale, 56. 2+5. 9m vs 48. 2+5. 7mm, p=0. 03 by Wilcoxon signed rank test). There was no significant change in white cell count of synovial fluid, peripheral blood cell count, chemistry, C-reactive protein and erythrocyte sedimentation rate. In terms of adverse effects, mild gastrointesti nal disturbance(8/21 cases, 38%) and local side effects such as pruritus and ery thema(3/21 cases, 14%) were developed, which were insignificant compared with control groups(30%, 15% respectively). Piroxicam concentrations in plasma and synovial fluid after the application of piroxicam patch were 0. 129+0. 04ug/ ml (mean+SE) and 0. 644+0. 202ug/ml respectively. CONCLUSIONS: Piroxicam patch is a safe and effective therapeutic modality for knee joint pain in patients with rheumatoid arthritis. Mild adverse effects such as gastrointestinal disturbance and local side effects were noted. Piroxicam concentration was higher in synovial fluid than in plasma following the application of piroxicam patch.
Arthritis, Rheumatoid* ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Cell Count ; Chemistry ; Creatinine ; Humans ; Joints ; Knee ; Knee Joint ; Piroxicam ; Plasma ; Pruritus ; Synovial Fluid ; Visual Analog Scale