No abstract available.
Kidney* ; Perfusion* ; Radionuclide Imaging*

The recent introduction of chemotherapy in the treatment of the gynecologic malignancies has gained wide acceptance along with preoperative and postoperative adjuvant therapy and with preradiation and concurrent chemoradiaton therapy. But, the side effects of chemotherapy including bleeding and infection due to bone marrow suppression have resulted in increased morbidity and mortality of the patients and delayed treatment and a reduction in the chemotherapeutic agents used. In spite of the development of antibiotics and the supportive care of infection, sustained leukopenia in the patients during chemotherapy accounts for the high mortality rate due to sepsis. The early detection of the leukopenia during chemotherapy may enable clinicians to overcome infection problems by timely use of prophylactic broad spectrum antibiotics and G-CSF or GM-CSF. The author investigated the grade, duration, time of onset and other clinical features of the leukopenia and the effects of the age (> or =60 years vs <60 years), the number of the cycle of chemotherapy (> or =3 cycles vs < 3 cycles), fever and performance scale on the leukopenia. 79 cases (32 patients) of the leukopenia during chemotherapy of various gynecologic malignancies at the Department of Obstetrics and Gynecology at Hanyang University between January, 1996 and December, 1998 entered to this study. The results were as follows; 1. Leukopenia occurred at 14.2+/-6.1 day from the first day of chemotherapy, 2. The duration of leukopenia was 2.5+/-1.6 days 3. No significant difference was found between eldely patients ( > or =60 years, n=13) and younger patients ( <60 years, n=66) about the severity, duration and time of onset of leukopenia. 4. No significant difference was found between the patients with more than 3 cycles of chemotherapy (n=40) and less than 3 cycles (n=39) about the severity, duration and time of onset of leukopenia. 5. Febrile leukopenic cases (n=6) had significantly lower granulocyte count, longer leukopenic period and earlier onset of leukopenia than afebrile (n=73). 6. It is thought that performance status scale does not affect the grade of leukopenia, onset of leukopenia and the leukopenic period.
Anti-Bacterial Agents ; Bone Marrow ; Drug Therapy* ; Fever ; Granulocyte Colony-Stimulating Factor ; Granulocyte-Macrophage Colony-Stimulating Factor ; Granulocytes ; Gynecology ; Hemorrhage ; Humans ; Leukopenia* ; Mortality ; Obstetrics ; Sepsis

No abstract available.
Captopril* ; Diagnosis* ; Hypertension, Renovascular* ; Radionuclide Imaging*

No abstract available.

No abstract available.
Gallium* ; Lymphoma*

PURPOSE: Pilon fracture has several serious complications such as joint stiffness, arthrosis and delayed angular deformity. We report short-term results of new treatment modality using distracted dynamic external fixators and early controlled ankle motion. MATERIALS AND METHODS: Eight cases of severe pilon fractures for which we tried small plate fixation and additional distracted dynamic external fixators from July 2007 to June 2009 were included. Half passive continuous ankle joint motion was allowed under free hinged ring fixators after the operation. The external fixators were removed after two or three months from the surgery. We investigated joint space by radiograph, joint pain, range of motion, patient's satisfaction of treatment protocol. RESULTS: Joints were distracted when external fixators were applied and mean 28% of space loss developed after removal of external fixators. In most of cases, satisfactory alignments were maintained. Regarding range of joint motion, mean dorsiflexion angle was 15 degrees and mean plantarflexion angle was 32 degree in the condition of wearing external fixators. There was mean 8% reduction of range of motion but no further progression of ankle stiffness after removal of external fixators. Dorsiflexion was not improved after that, but plantarflexion angle was improved 10% even after removal of external fixators. Patients were generally in compliance with the treatment protocols with high level of satisfaction. CONCLUSION: We got good results with distracted dynamic external fixators and early continuous half-passive joint motion for pilon fractures in terms of joint pain and range of motion. Therefore we suggest this new protocol as an alternative modality for severe pilon fractures.
Animals ; Ankle ; Ankle Joint ; Arthralgia ; Clinical Protocols ; Compliance ; Congenital Abnormalities ; External Fixators ; Humans ; Joints ; Range of Motion, Articular

Rigid fixation with metallic plates & screws have been widely used in craniofacial surgery. But the metallic plating system had some problems including intracranial migration, growth restriction, foreign body reaction, infection and artifacts in radiologic evaluation. To overcome these drawbacks, there had been a continuous research on the development of a bioabsorbable skeletal fixation system using polymers of polylactic and polyglycolic acid. There is an increasing acceptance of its application as an alternative fixation device in craniofacial surgery. The resorbable fixation devices have been used in our department between January 2001 and June 2004 in craniofacial surgery. The aim of this retrospective study is to review the complications experienced during this period. We have used the SR-PLDLA(Self reinforecd poly- L/DL-lactide polymer, BioSorbFX(R)) in 131 patients of craniofacial bone fractures. Age varied from 3 to 72 and follow up period varied from 4 months to 40 months. We encountered 4 cases of foreign body reaction, 3 cases of infection and 1 cases of device exposure. In patient showing foreign body reaction, we treated with antibiotics. In case of uncontrolled infection, we removed implants. We think that the resorbable plating system on the rise as alternative method in craniofacial surgery. But more research is needed about its complications.
Anti-Bacterial Agents ; Artifacts ; Follow-Up Studies ; Foreign-Body Reaction ; Fracture Fixation ; Fractures, Bone* ; Humans ; Polyglycolic Acid ; Polymers ; Retrospective Studies

BACKGROUND: There is a wide spread increase in the use of CAM by patients with rheumatic disease. This study was performed to identify the prevalence of CAM use and determining factors affecting CAM use by patients with rheumatic disease. METHODS: From October 23 to November 31 in 2003, face-to-face structured interviews were conducted in a rheumatology hospital in Seoul. A total of 182 patients with rheumatic disease, who visited the hospital, participated. RESULTS: CAM was used by 59.3% (95% CI=52.1~66.2%) of the patients with rheumatic disease. The most common use of CAM was traditional Chinese medicine such as acupuncture and herbs. Demographic variables were not predictive for the use of CAM. As the duration of disease was longer, probability on CAM use was lower (odd ratio: 0.922, 95% CI=0.855~0.994). CAM use on disabled people who registered were 4.623 (95% CI=1.105~19.348) times higher than non-disabled. CONCLUSION: CAM use is common in patients with rheumatic disease. The duration of disease and physical disability were the influencing factors for using CAM. These findings support a need for outcome studies on the effectiveness of CAM in rheumatic disease, as well as the improvement of providing patients with information on CAM usage.
Acupuncture ; Complementary Therapies* ; Humans ; Korea* ; Medicine, Chinese Traditional ; Outcome Assessment (Health Care) ; Prevalence ; Rheumatic Diseases ; Rheumatology ; Seoul

BACKGROUND: There is a wide spread increase in the use of CAM by patients with rheumatic disease. This study was performed to identify the prevalence of CAM use and determining factors affecting CAM use by patients with rheumatic disease. METHODS: From October 23 to November 31 in 2003, face-to-face structured interviews were conducted in a rheumatology hospital in Seoul. A total of 182 patients with rheumatic disease, who visited the hospital, participated. RESULTS: CAM was used by 59.3% (95% CI=52.1~66.2%) of the patients with rheumatic disease. The most common use of CAM was traditional Chinese medicine such as acupuncture and herbs. Demographic variables were not predictive for the use of CAM. As the duration of disease was longer, probability on CAM use was lower (odd ratio: 0.922, 95% CI=0.855~0.994). CAM use on disabled people who registered were 4.623 (95% CI=1.105~19.348) times higher than non-disabled. CONCLUSION: CAM use is common in patients with rheumatic disease. The duration of disease and physical disability were the influencing factors for using CAM. These findings support a need for outcome studies on the effectiveness of CAM in rheumatic disease, as well as the improvement of providing patients with information on CAM usage.
Acupuncture ; Complementary Therapies* ; Humans ; Korea* ; Medicine, Chinese Traditional ; Outcome Assessment (Health Care) ; Prevalence ; Rheumatic Diseases ; Rheumatology ; Seoul

OBJECTIVES: The early detection of ectopic tubal pregnancy in unruptured state is increased as the transvaginal sonography and sensitive serum hCG test are available. For this unruptured tubal pregnancy, the medical treatment using methotrexate via various routes and dosage is being tried. Our study was to evaluate the efficacy of single systemic injection of methotrexate in the treatment of unruptured tubal pregnancies. Material and METHODS: From the January 1997 to July 1999, of 152 ectopic pregnancy patients, 22 patients who were diagnosed as unruptured tubal pregnancies were treated with single-dose systemic methotrexate injection (50 mg/m2/IM). Exclusion criteria were unstable vital signs with hemoperitoneum, adnexal mass > 5-6 cm. Serum hCG titers were checked before injection and 4, 7 day after injection. If serum hCG titer declined more than 15% on 7 day after injection compared with titer on 4 day, the weekly hCG titer was followed until it was <10 mIU/ml .If the hCG titer did not decline more than 15 %, a second dose was given. If hCG titer was not decreased or vital signs became unstable after 1-2 injections, the treatment was considered failure and surgery was done. RESULTS: 18 cases (82%) of 22 were successfully treated with single-dose methotrexate. The mean size of ectopic mass and initial serum hCG titers were 2.7+/-1.3 cm (range, 1.5-5.4 cm) and 3,298+/-1,007 mIU/ml (range, 132-12,239), respectively. Of 22, 6 cases (28%) needed second dose of methotrexate. The mean time to resolution of serum beta-hCG titer was 27.5+/-13.6 days (range, 8-53 days). Elevation of liver enzyme did not occurred in all cases during treatment. Initial hCG titer was more important prognostic factor than ectopic mass size for successful medical treatment. CONCLUSION: Single-dose methotrexate appears to be an effective medical treatment for the unruptured tubal pregnancy. However, patients selection using strict criteria is needed to increase its success rate.
Female ; Hemoperitoneum ; Humans ; Liver ; Methotrexate* ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Vital Signs