Crohn's disease is a chronic, nonspecific inflammatory process which most commonly involves the terminal ileum, but which can affect any region of the gastrointestinal tract from the mouth to the anus. When Crohn's disease does involve the upper gastrointestinal tract, there is nearly always concomitant disease in the small bowel or colon. However isolated gastric Crohn's disease is a rare entity, and gastroduodenal involvement in Crohn's disease has been considered unusual, having an incidence of 1.5 to 7.0%. Gastric Crohn's disease usually localizes to antrum of the stomach and or the pyloroduodenal junction. No single feature is pathognomonic of Crohn' disease, and the diagnosis is based on supportive clinical, radiographic, endoscopic, and pathologic findings. Crohn's disease is invariably a diagnosis of exclusion, so infectious, neoplastic, ischemic, infiltrative, and other inflammatory processes must be ruled out. Usually a patient with isolated Crohn's disease of the stomach will have the clinical symptoms of nausea, vomiting, and epigastric pain, and there will be radiographic evidence of a small contracted stomach (or occasionally, a huge dilated stomach). The treatment of stomach Crohn's disease is palliative and symptomatic. In this paper, we describe a patient with Crohn's disease who had diffuse involvement of the entire stomach without any evidence of involvement elsewhere in the gastrointestinal tract.
Anal Canal ; Colon ; Crohn Disease* ; Diagnosis ; Gastrointestinal Tract ; Humans ; Ileum ; Incidence ; Mouth ; Nausea ; Stomach* ; Upper Gastrointestinal Tract ; Vomiting

The purpose of this study was to evaluate the bone age and hand anomaly in Down syndrome patients. We reviewed radiographs in 52 children and youths with Down syndrome, aged from 2 to 23 years. The characteristic findings of hand anomaly were observed in the middle phalanx of the fifth finger, with the following incidence; brachymesophalangia (44%), clinodactyly (48%), and dysmesophalangia (15%). Pseudoepiphysis (21%) was found typically at the distal end of the first metacarpal bone and proximal end of the second metacarpal bone. Up to 8.5 years of age, bone maturation was retarded and thereafter bone age accelarated in advance of chronologic age. These findings may provide valuable information relative to the diagnosis and treatment of hand anomaly in Down syndrome.
Adolescent ; Child ; Diagnosis ; Down Syndrome* ; Fingers ; Hand* ; Humans ; Incidence

No abstract available.
Humans

PURPOSE: To assess the accuracy of magnetic resonance(MR) arthrography in the diagnosis of anterior labral tear of the shoulder. MATERIALS AND METHODS: Between Semptember 1996 and February 2000, MR arthrography of the shoulder was performed in 281 patients with a history of shoulder pain or instability. Among this total, only 157 shoulders in 154 patients who underwent arthroscopy or open surgery 0 to 230 (average, 20.9) days after MR arthrography were included in this study; the subjects comprised of 150 males and 4 females with an average age of 23.3 years. MR arthrographs of these 154 patients were analyzed for the presence of anterior labral tears, and the findings were correlated with the arthroscopic and surgical findings. Anterior labral tear was classified as A to D according to its location, as determined by arthroscopy and surgery. (A=4 to 6 o 'clock direction, anteroinferior; B=2 to 4 o 'clock direction, central; C=12 to 2 o 'clock direction, anterosuperior; D= SLAP lesions). The retrospective analysis of MR arthrographs showing false-positive and negative findings was also undertaken. RESULTS: In the diagnosis of anterior labral tear, MR arthrography showed a sensitivity of 94%, a specificity of 90% and an accuracy of 91%. Anterior labral tears were confirmed by arthroscopy or surgery in 62 of the 157 shoulders (39%). Among 62 lesions, two (3%) were observed in area A, 32(52%) in area A+B, nine (15%) in area A+B+C, one(2%) in area A+B+D, 13(21%) in area A+B+C+D, two (3%) in area B+C, one(2%) in area B+D, and two(3%) in area C. Among ten false-positive cases, seven were focal lesions (two, three and two lesions in area A, B and C, respectively), and in the remaining three cases, located in area A+B, MR arthrography revealed thickening and deformation. All four false negatives were focal lesions (two in area A and two in area C). CONCLUSION: Other than in focal lesions, in which accuracy was relatively low, MR arthrography showed high sensitivity, specificity and accuracy in the diagnosis of anterior labral tear of the shoulder.
Arthrography* ; Arthroscopy ; Diagnosis ; Female ; Humans ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder Pain ; Shoulder*

BACKGROUND: Esmolol is a short acting sympathetic beta receptor antagonist, and it was successfully applied to induced hypotension. Esmolol lowers blood pressure by decreasing cardiac output, and does not cause vasodilation. This property of esmolol may help to decrease bleeding during induced hypotension. In this study, we tried to elucidate the effect of esmolol on induced hypotension for total hip arthroplasty. METHOD: Twenty patients receiving total hip arthroplasty were randomly divided to two groups. Esmolol group (10 patients) received esmolol as a hypotensive agent, and sodium nitroprusside (SNP) group (10 patients) received SNP as a hypotensive agent. We measured arterial blood gas analysis, vital sign, amounts of bleeding, amounts of transfusion and administered fluid, and various laboratory findings. RESULTS: Induced hypotension was successfully performed in either esmolol and SNP group. Heart rate increased by SNP, and decreased by esmolol. There were no statistically significant differences between the two groups in amounts of bleeding, amounts of transfusion or administered fluid, and laboratory findings. Arterial oxygen tension was relatively constant in esmolol group, but decreased in SNP group. CONCLUSION: Esmolol can be used as a single hypotensive agent during induced hypotension without significant side effects during total hip arthroplasty.
Arthroplasty, Replacement, Hip* ; Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Nitroprusside* ; Oxygen ; Sodium* ; Vasodilation ; Vital Signs

No abstract available.

Potentially, some donor site complications are associated with the harvesting of autogenous tricortical iliac bone grafts for anterior spinal fusion. The purpose of this study was to evaluate the reliability of the anterior iliac crest reconstruction after harvesting autogenous iliac grafts for anterior spinal fusion. We devided into two groups : the study group were the anterior iliac crest reconstruction in 57 patients with minimal twelve months follow up period, the control group were not the anterior iliac crest reconstruction in 21 patients who could not obtain the rib from retroperitoneal approach. The average follow up was obtained at 43.3 months(12 to 72 months) in study group, at 41.6 months(12 to 60 months) in control group. The study group had a tendency to improve the donor site pain after incorporation of the rib graft and the control group tend to remain the donor site pain till late especially in the thinner group and combined disease group. In residual deformity of the donor site, the study group was superior to the control group. Residual deformity of the study group was associated with the complications such as displacement and resorption of the grafts. Cosmetic residual deformity tends to be higher in the thinner group. Radiographically all rib gragts incorporated in situ in 51 patients despite of some cases of migration(Average 11 weeks and 4 days) and clinical results did not affect by biological behavior of rib grafts on the follow up radiogram. The authors attempted anterior iliac crest reconstruction using the implants (Mennen plate in 3 patients, threaded pin in 3 patients) after large harvesting of autogenous tricortical graft in 6 patients who could not obtain the rib from retroperitoneal approach or could not fit the rib too the defect. In those cases the results were satisfactory clinically. These results suggest anterior iliac crest reconstruction can minimize painful deformity after the harvesting of autogenous tricortical iliac grafts for anterior spinal fusion.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Ribs ; Spinal Fusion ; Tissue Donors ; Transplants

This study was conducted to evaluate the effect of PTSD on memory funtion and hippocampal volume, and to identify major variables correlated to hippocampal volume and memory function. Thirty four Vietnam veterans were collected for this study, among whom eighteen were PTSD patients and sixteen were combat control subjects. The author used Impact of Event Scale(IES), Combat Exposure Scale(CES), Hamilton Depression Rating Scale(HDRS) and Beck Depression Inventory(BDI). Korea Memory Assessment Scale(K-MAS) was assessed for memory function. Magnetic resonance imaging(MRI) was used to measure hippocampal volume. There were significant differences between PTSD and Non-PTSD veterans in IES, HDRS and BDI. Significant difference was found in verbal memory and total memory of K-MAS between PTSD and Non-PTSD veterans. There was significant difference in hippocampal volume between PTSD and Non-PTSD veterans. Short term memory, verbal memory and total memory were positively correlated to hippocampal volume. Hippocampal volume was negatively correlated to IES, HDRS, and BDI. These results suggest that PTSD severity be associated with hippocampal atrophy and memory dysfunction. Reduced or smaller hippocampal volume may be preexisting risk factor for stress exposure or the development of PTSD on combat exposure.
Atrophy ; Depression ; Hippocampus ; Humans ; Korea ; Memory* ; Risk Factors ; Stress Disorders, Post-Traumatic* ; Veterans ; Vietnam

Granulosa cell tumors are uncommon neoplasm of ovary that are characterized by their long natural history and for their tendency to recur years after an aparrent clinical cure. Endometrial cancer occurs in association with these tumor in at least 5% of cases and 25%-50% are associated with endometrial hyperplasia. In this study, we present a case of granulosa cell tumor of right ovary with endometrial cancer after left oophrectomy.
Endometrial Hyperplasia ; Endometrial Neoplasms* ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Natural History ; Ovary*

BACKGROUND: This study investigated the efficacy and safety of combined subacromial and intravenous patient-controlled analgesia for control of postoperative pain after arthroscopic rotator cuff repair. METHODS: Between May 2012 and August 2014, 60 patients who underwent arthroscopic rotator cuff repair with acromioplasty and received patient-controlled analgesia were studied prospectively. Cases were divided into 2 groups: combined subacromial and intravenous infusion group (group A, 30 cases) and solitary intravenous infusion group (group B, 30 cases). The visual analogue scale was used to record the patient's level of pain every 12 hours during postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia. RESULTS: The mean preoperative visual analogue scale score was 7.8 in group A and 7.6 in group B, and the immediate postoperative visual analogue scale score was 7.9 and 8.1 for each group. At postoperative time (From 12 hours to 72 hours after operation), the scores of combined subacromial and intravenous infusion were significantly lower than those of solitary intravenous infusion. Significant difference in the frequency of supplemental analgesic injections was observed between group A and group B (p=0.008). However, no significant difference in complication rate was observed between the two groups (p=0.562). CONCLUSIONS: Combined subacromial and intravenous patient-controlled analgesia after arthroscopic rotator cuff repair is more effective than solitary intravenous infusion without significantly increasing complications. Therefore, combined subacromial and intravenous patient-controlled analgesia could be a effective pain control method.
Analgesia, Patient-Controlled* ; Humans ; Infusions, Intravenous ; Methods ; Pain, Postoperative ; Prospective Studies ; Rotator Cuff*