The antiphospholipid syndrome is characterized by arterial thrombosis, venous thrombosis, pregnancy wastage, and thrombocytopenia associated with a persis tently positive lupus anticoagulant and/or moderate to high positive anticardiolipin antibodies(IgG or IgM). The antiphospholipid antibodies have been detected in many medical conditions, but the antiphospholipid syndrome (APS) has mainly been restricted to the primary antiphospholipid syndrome and APS associated with systemic lupus erythematosus. Rarely, the APS has been reported in other autoimmune disorders in the literature. We describe a woman with a limited form of scleroderma and the APS manifested by complete occlusion of left axillary artery with probable thrombotic occlusive nature, thrombocytope nia, prolonged aPTT, and persistently positive lupus anticoagulant.
Antibodies, Antiphospholipid ; Antiphospholipid Syndrome* ; Axillary Artery ; Female ; Humans ; Lupus Coagulation Inhibitor ; Lupus Erythematosus, Systemic ; Pregnancy ; Scleroderma, Limited* ; Thrombocytopenia ; Thrombosis ; Venous Thrombosis

The thoracolumbar fracture and fracture-dislocations are ever increasing today as the traffic accidents and industrial accidents frequently occur. But the controversy as to the relative values of early surgical instrumentation and conservative means has continued for well over a decade. The duration of this dispute without final resolution suggests an absence of significant differences in the results of surgical and non-surgical method. The purpose of this study is to review the results of conservative treament for 132 patients with thoracolumbar fracture and fracture-dislocations, who were admitted and treated at Yonsei University Severance Hospital from January, 1980 to December, 1984. And we obtained following results. l. In cases of stable fracture without neurologic deficit, especially when the wedging deformity of vertebral body is below 50%, it seems to be better to treat conservatively; that is, immediate postural reduction and after 2 or 3 weeks of bed rest, to start ambulation with back brace or cast. 2. In cases of stable fracture with neurologic deficit, operative treament is necessary when the frac-fragment is protruded into the spinal canal and neural compression sign is evident. But if not so, attempt to treat by conservative means may be done. 3. In cases of unstable fracture without neurologic deficit, it is more retional to treat conservatively by bed rest for a suffient time and then wearing back brace or cast. If the spinal deformity is so severe that it needs spinal fusion, the operation can be performed later on. 4. In cases of unstable fracture with neurologic deficit, spinal instrumentation and fusion do nothing to enhance neural recovery but are done to provide anatomic spinal alignment and stability to allow early the patient mobilization and rehabilitation.
Accidents, Occupational ; Accidents, Traffic ; Bed Rest ; Braces ; Congenital Abnormalities ; Dissent and Disputes ; Humans ; Methods ; Neurologic Manifestations ; Rehabilitation ; Spinal Canal ; Spinal Fusion ; Spine ; Surgical Instruments ; Walking

Coronary spasm may be induced by a variety of physiologic and pharmacologic stimuli but specific receptor blockade has not been consistently shown to prevent the attacks. Most patients with variant angina respond well to treatment with calcium antagonists and nitrates. A small proportion of patients are refractory to this therapy. We report a case of the patient with a 9-year-history of variant angina who has been refractory to high doses of calcium antagonists and nitrates. The repeated addition of clonidine was consistently effective in abolishing both symptoms and objective evidence of myocardial ischemia in this particular patient.
Calcium ; Clonidine* ; Humans ; Myocardial Ischemia ; Nitrates ; Spasm

These are 2 cases report of the Characot-Marie-Tooth disease. One patient is a 21 year-old female with gait ataxia, foot drop, muscular atrophy in the both feet, pes cavus and equinovarus. On family history, her older and younger brothers and younger sister showed same symptoms and signs which is rather milder. On neurologic examination, there were atrophy, high arched feet, and steppage gait. There were decreased pain, temperature and touch sensation, and absence of position and vibration, and absence of DTR in lower extremities. On sensory nerve conduction velocity study, the amplitude of evoked action potential is very low. On motor NCV, there are markedly prolonged distal latency and markedly decreased conduction velocity. On EMG study, there are dencervated potentials at rest and reduced interference pattern at maximal contraction. The other patient is 62 year-old female with gait disturbance, foot drop, muscular atrophy in the both feet, pes cavus and equinovarus. On family history, her father, 2 younger brothers and her 3 nephews showed same degree or rather mild degree of symptoms and signs. The findings on physical, neurologic examination and EMG with NCV study are compatible with Charcot-Marie-Tooth disease.
Action Potentials ; Atrophy ; Charcot-Marie-Tooth Disease* ; Clubfoot ; Fathers ; Female ; Foot ; Foot Deformities ; Gait ; Gait Ataxia ; Humans ; Lower Extremity ; Middle Aged ; Muscular Atrophy ; Neural Conduction ; Neurologic Examination ; Sensation ; Siblings ; Vibration ; Young Adult

No abstract available.
Aneurysm, False* ; Blood Pressure Monitors* ; Blood Pressure* ; Compression Bandages* ; Humans ; Radial Artery*

Vasoactive intestinal polypeptide (VIP) has a vasodilatory effect as a non-adrenergic, non-cholinergic neurotransmitter. The role of VIP on penile erection has been controversial. This study was undertaken to elucidate the effect of VIP on penile erection in-vivo and to predict whether this drug can be clinically applied to the diagnosis and/or treatment of impotence. The results are as follows. Intracavernosal injection of VIP alone (0.000000001to 0.00001M, n=10) did not show any increase in basal ICP Pretreatment of VIP (0.000005M, 0.00001M, n=7) enhanced partial erection induced by electric intensity with suboptimal level(frequency; 1 Hz, intensity; 1.2-2.0 volt, pulse duration, 1 msec.) (p<0.05)Intracavernosal injection of VIP-antagonist (0.000000001 to 0.00001M,n=7) was found to suppress the full erection induced by the optimal electric stimulation(frequency; 1 Hz, intensity; 3-4 volt, pulse duration; 1 msec.) in dose dependent manner (p<0.05). These results suggest that VIP may induce penile erection in rat through its receptor on corpus cavernosum, although it requires the cooperative action of other neurotransmitter(s).
Animals ; Diagnosis ; Erectile Dysfunction ; Male ; Neurotransmitter Agents ; Penile Erection* ; Rats* ; Vasoactive Intestinal Peptide*

BACKGROUND: We studied the incidence of trauma caused by alcohol related accidents, and the effects that has on the occurrence, the extent, and the outcome to the patient. METHODS: In our study we studied trauma patients excluding pediatric patients(15 years old and under) who came to the Emergency department of Korea University Medical School Anam Hospital from the 1st of january 1996 to 30th of June 1996, looked into their medical records, and studied the records in a retrospective manner. The trauma patients were divided into two groups, a) alcohol-related and b) alcohol-non-related. The two groups were then subdivided according to their sex, age, the time they came in, the anatomical part of the trauma, the mechanism of their injury, the extent of the injury, the length of their hospital stay, the length of their ED stay and were seperately compared and analysed. Statistically, ANOVA and logistic regression analysis using SAS were used in the study and then was assessed in Chi-square analysis methods. RESULTS: The total of the trauma patients, added up to 832 people, 577: male and 255: female. Among this sum, 16 trauma patients were alcohol related(male:127 & female 36). 115 people were in the age group of 21-40. Compared to the non-alcohol related trauma group, the alcohol-related group had more facial & scalp injuries and tended to come in the hours between 0-6 AM. The cause of the injuries were mossy by fast-fighting and suicide, compared to mostly accidental-slipping injuries in the non alcohol-related group. There were no difference in the degree of the injury(ISS) and the length of hospital stay between the two groups, whereas the length of the stay at the ED was longer alcohol-related trauma patients. CONCLUSION: Alcohol related trauma patients were mostly in their 20s and 30s, came to the hospital at a late time it the reason for their visit were mossy because of fist fighting. In the Emergency department, because prompt and correct diagnosis is quite difficult to make in this group, their ED stay tended to be longer. We can conclude that measuring the blood alcohol level of these patients, continuing the psychological therapy and educating people is needed.
Diagnosis ; Emergency Service, Hospital ; Female ; Humans ; Incidence ; Korea ; Length of Stay ; Logistic Models ; Male ; Medical Records ; Retrospective Studies ; Scalp ; Schools, Medical ; Suicide

Carpal tunnel syndrome is most commonly applied to compression neuropathy of the median nerve at the wrist, and is the most cause of buring pain, numbness and tingling in the thumb, index and long fingers, and in the lateral half of the palm, with or without progressive atrophy of the thenar muscles. Fifteen symptomatic hands of 13 patients of the carpal tunnel syndrome managed and operated at the Department of Orthopedic Surgery Severance Hospital from Jan. 1972 to Mar. 1982 were analized in clinical aspect. l. Among 13 patients, 3 were male and 10 were female. 2. Nine patients (69.2%) were affected on dominant hand. 3. Average duration of the symptoms was 17 months. 4. In electromyographic study, conduction delay of the motor fiber of the median nerve was found in 11 cases(73.3%) and sensory fiber in 13 cases(86.6%). Fibrillation of the thenar muscles was found in 11 cases(73.3%). 5. Ten patients, 11 cases were followed up from 11 months to 9 years and 11 months and 72.8% was improved.
Atrophy ; Carpal Tunnel Syndrome ; Clinical Study ; Female ; Fingers ; Hand ; Humans ; Hypesthesia ; Male ; Median Nerve ; Muscles ; Orthopedics ; Thumb ; Wrist

No abstract available in English.
Clinical Study

Buerger's disease was first identified in 1908 by Leo Buerger as a distinct clinicopathological entity, which causes severe pain and necrosis on distal parts of the extremities and occurs especially in young male adults. In spite of many treatment modalities, it is not completely cured but results in amputation in the long run. So, we studied a total of 120 cases of Buerger's disease, who were admitted at Yonsei University, Severance Hospital from Jan., 1975 to June, 1985 and we obtained the following results. 1. All the patients were male and majority of them were under 40 years of age (69.2%). 2. 118 cases were smokers and 2 cases were non-smokers. 3. The initial symptoms were resting pain, necrosis, and color change in descending order of frequency. 4. Diagnoses were made mainly by angiogram(75.8%) and most common site of obstruction was popliteal artery (49.4%). 5. After sympathectomy and angioplasty, there was temporary relief of symptoms, but none showed good results after long term follow up. As a result, amputations were performed after sympathectomy in 47 cases(39.2%), of which 36 cases(76.6%) received that surgery within 2 yeas after sympathectomy. 6. The pressure index not only helps diagnose the disease but also is a very useful method to objectively assess the severity of the initial symptoms and postoperative results.
Adult ; Amputation ; Angioplasty ; Clinical Study ; Diagnosis ; Extremities ; Follow-Up Studies ; Humans ; Male ; Methods ; Necrosis ; Popliteal Artery ; Sympathectomy ; Thromboangiitis Obliterans