BACKGROUND: Kirschner's wire (K-wire) transfixation and locking hook plate fixation techniques are widely used in the treatment of acute acromioclavicular joint (ACJ) dislocation. The purpose of this study was to compare the clinical and radiologic outcomes between K-wires transfixation and a locking hook plate fixation technique. METHODS: Seventy-seven patients with acute ACJ dislocation managed with K-wire (56 shoulders) and locking hook plate (21 shoulders) were enrolled for this study. The mean follow-up period was 61 months. RESULTS: At the last follow-up, the shoulder rating scale of the University of California at Los Angeles (UCLA) was higher in patients treated with locking hook plate than with K-wires (33.2 +/- 2.7 vs. 31.3 +/- 3.4, p=0.009). In radiologic assessments, coracoclavicular distance (CCD) (7.9 mm vs. 7.7 mm, p=0.269) and acromioclavicular distance (ACD) (3.0 mm vs. 1.9 mm, p=0.082) were not statistically different from contralateral unaffected shoulder in locking hook plate fixation group, but acromioclavicular interval (ACI) was significant difference. However, there were significant differences in ACI, CCD, and ACD in K-wire fixation group (p<0.001). Eleven complications (20%) occurred in K-wire transfixation group and 2 subacromial erosions on computed tomography scan occurred in locking hook plate fixation group. CONCLUSIONS: ACJ stabilization was achieved in acute ACJ dislocations treated with K-wires or locking hook plates. Locking hook plate can provide higher UCLA shoulder score than K-wire and maintain CCD, and ACD without ligament reconstruction. K-wire transfixation technique resulted in a higher complication rate than locking hook plate.
Acromioclavicular Joint* ; Bone Wires ; California ; Dislocations* ; Follow-Up Studies ; Humans ; Ligaments ; Shoulder

A case of cryptococal hepatitis in a 4-year-old girl was presented with a brief review of the literature. She was admitted with the chief complaints of jaundice, abdominal pain, and semicomatose mental state. Treatment was started including dexamethasone under impression of fulminant hepatitis. During treatment massive G-I bleeding appeared which required eleven pints of blood and 20 days for control. Upper G-I series revealed duodenal ucer. And explolparotomy was performed because of free air in the peritoneum. Operative liver biopsy done at that time revealed many cryptococci in the biopsy tissue. Therefore we treated her with-5-fluorocytosine and the result was good. Follow-up of her for a year and half revealed that she was in here good general condition. Therefore we consider that secondary change in liver such as cirrhosis has not yet occurred in her.
Abdominal Pain ; Biopsy ; Child, Preschool ; Dexamethasone ; Female ; Fibrosis ; Follow-Up Studies ; Hemorrhage ; Hepatitis* ; Humans ; Jaundice ; Liver ; Peritoneum

This is a clinical study of 30 cases of congenital malformation of ileum at Severance hospital from 1966 to 1975. They were confirmed after operation and the results were summarized as follows; 1. Total number of patients was 30 cases including 25 males 5 females. Among them 20 cases were included at pediatric agr from birth to 15 years of age. The most frequent occurrence was within 1 month of age with 11 cases. 2. Confirmed diagnesis after operation were 3 cases of ileal duplication,3 cases of ileal stenosis, 2 cases of ileal atresia, 1 cases of ileal hypoplasia, and 21 cases of Meckel's diverticulum. 3. Except for Meckel's diverticuium all the patients were studied which simple abdominal X-ray, which revealed complete and partial intestinal obstruction. Among them 4 cases were found microeolon and narrowing of distal 1 cases of ileum at 1 cases of ileal atresia and 2 cases. 4. After operation, 26 of 30 cases were recovered but 3 cases (atsesia 1, stenosis 1, and hypoplasia 1) were discharged with complications. And 1 case of multiple ileal stencelsdied of sepsis and wound infection.
Constriction, Pathologic ; Female ; Humans ; Ileum* ; Intestinal Obstruction ; Male ; Meckel Diverticulum ; Parturition ; Sepsis ; Wound Infection

BACKGROUND/AIMS: The efficacy of standard triple therapy (STT) in treating Helicobacter pylori infection has decreased. Many investigators have attempted to increase the eradication rate. We investigated the outcomes of concomitant therapy (CT) and STT combined with probiotics (STP) as a first-line treatment for H. pylori infection. METHODS: We reviewed the medical records of 361 patients who received either STP (n=286) or CT (n=75). The STP group received STT combined with a probiotic preparation for 1 week. The CT group received STT and metronidazole for 1 week. RESULTS: The intention-to-treat and per-protocol eradication rates were 83.6% (95% confidence interval [CI], 79.0 to 87.7) and 87.1% (95% CI, 81.2 to 89.7) in the STP group and 86.7% (95% CI, 78.7 to 93.3) and 91.4% (95% CI, 83.6 to 97.1) in the CT group (p=0.512 and p=0.324), respectively. The frequency of adverse effects was higher in the CT group (28.2%) than in the STP group (12.8%) (p=0.002). CONCLUSIONS: STP and CT are encouragingly efficacious as first-line treatments for H. pylori infection. Therefore, adding probiotics to STT may be a feasible option to avoid side effects.
Helicobacter pylori* ; Helicobacter* ; Humans ; Medical Records ; Metronidazole ; Probiotics* ; Research Personnel

Collagenous colitis is an uncommon condition charaeterized clinically by diarrhea and weight loss and histologically by thickening of the subepithelial collagen band with chromic inflammation. Laboratory tests of blood, urine and stool, and colonscopic findings are usually normal. The etiology of collagenous colitis is unknown. We report a case of collagenous colitis improved after treatment with sulfasalazine with review of literatures.
Colitis, Collagenous* ; Collagen* ; Diarrhea ; Inflammation ; Sulfasalazine ; Weight Loss

Nocardiosis is a rare opportunistic infection and only sporadic cases were reported in systemic lupus erythematosus (SLE). We report a case of a nocardial infection in a patient with SLE. A 37-year-old woman was admitted to our hospital because of general weakness and edema. She had been diagnosed as SLE in 1995 and was diagnosed as lupus nephritis (class IV, diffuse proliferative glomerulonephritis) in 1999, but had refused the treatment for SLE. After admission, she was diagnosed as active SLE with lupus nephritis based on clinical and laboratory findings. She was treated with methylprednisolone pulse (1 gx3 days) and cyclophosphamide pulse (750 mg) therapy followed by daily high dose oral prednisone (60 mg) and plasmapheresis (7 times). On 32 days after admission, chest radiograph revealed a massive pleural effusion. The pleural fluid was exudate and cultures for bacteria, fungi and tubercle bacilli were negative and pleural biopsy showed mesothelial thickening. The thoracentesis was done (1 L), but the effusion recurred within 3 days. Further four thoracentesis and thoracostomy were performed due to recurrent massive pleural effusion. On 60 days after admission, thoracostomy tube was removed, but 4 days later, fever occurred and Nocardia asteroides was cultured in pleural fluid. Treatment with oral trimethoprim/sulfamethoxazole (TMP-SMX, 160~800 mg) was started. After treatment with TMP-SMX, the pleural effusion decreased. On 76 days after admision, she was discharged and maintained on TMP-SMX (80~400 mg) for another 12 months. At present, her SLE activity is on control and has no pleural effusion.
Adult ; Bacteria ; Biopsy ; Cyclophosphamide ; Edema ; Exudates and Transudates ; Female ; Fever ; Fungi ; Humans ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Methylprednisolone ; Nocardia asteroides ; Nocardia Infections ; Opportunistic Infections ; Plasmapheresis ; Pleural Effusion ; Prednisone ; Radiography, Thoracic ; Thoracostomy ; Trimethoprim, Sulfamethoxazole Drug Combination

OBJECTIVE: Strong genetic evidence has shown an association between cytotoxic T lymphocyte associated antigen-4 (CTLA-4) and autoimmune diseases. This study was set out to determine whether the polymorphisms of the CTLA-4 exon 1 and promoter are associated with susceptibility to systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and their clinical features. METHODS: Polymerase chain reaction of genomic DNA-restriction fragment length polymorphism using Bst E II and Tru9 I was used to determine genotypes of the CTLA-4 exon 1 and promoter in 80 SLE, 86 RA patients and 86 healthy control subjects. Clinical manifestations were analyzed in each patient and correlated with the genotypes. RESULTS: The genotype frequency of the CTLA-4 exon 1 differed between SLE patients and controls (chi-squared=.74, 2 degrees of freedom (df), p=.03). The CTLA-4 AG genotype occurred more frequently in patients with SLE (46.3% vs. 33.7% controls). On the other hand, the CTLA-4 AA genotype as well as the CTLA-4 GG genotype was less frequent among SLE patients than among control subjects (1.3% vs. 9.3% and 52.5% vs. 57.0% respectively). The genotype distribution of the CTLA-4 promoter differed between SLE patients and control subjects (CT, TT, CC genotypes 27.5%, 0%, 72.5% vs. 16.3%, 4.7%, 79.1% controls respectively, chi-squared=.36, 2 df, p=0.04). When the association was analyzed with respect to sex, the distribution of the CTLA-4 exon 1- promotor genotypes was significantly different between female SLE patients and females in the control group (chi-squared=8.16, 3 df, p=0.04). The frequencies of the CTLA-4 exon 1 and promoter genotypes, allele and phenotypes and exon 1-promotor genotypes were not significantly different between RA patients and control subjects. Clinically, there were no significant differences in patients with SLE and RA according to the CTLA-4 polymorphisms. CONCLUSION: The polymorphisms within the CTLA-4 exon 1 and promoter appear to play a role in susceptibility to SLE, but not to be associated with clinical features of SLE, susceptibility to RA and its clinical features.
Alleles ; Arthritis, Rheumatoid* ; Autoimmune Diseases ; Exons* ; Female ; Freedom ; Genotype ; Hand ; Humans ; Lupus Erythematosus, Systemic* ; Lymphocytes ; Phenotype ; Polymerase Chain Reaction

OBJECTIVE: To investigate the efficacy of combined intravenous cyclophophamide pulse and low dose oral prednisolone treatment in patients with systemic sclerosis with -interstitial lung disease. METHOD: Six patients with systemic sclerosis with interstitial lung disease were treated with intravenous infusion of cyclophosphamide(0. 75g/m2 body surface area) and low dose oral prednisolone (10mg/day). RESULTS: 1) Respiratory symptoms, cough and dyspnea, were improved in all patients in both frequency and severity. 2) The mean value of FVC, FEV1, and DLC test showed tendency of increase during the follow up period (upto 24 months) compared to decrease in the past studies. 3)There was no serious side effect during the trreatment. Herpes zoster was developede in I patient during treament. CONCLUSIONS: Combined intravenous cyclophosphamide pulse and low dose oral prednisolone treatment is effective for the patients with systemic sclerosis with interstitial lung disease. A controlled prospective trial is warranted in patients with systemic sclerosis with interstitial lung disease.
Cough ; Cyclophosphamide ; Dyspnea ; Follow-Up Studies ; Herpes Zoster ; Humans ; Infusions, Intravenous ; Lung Diseases ; Lung Diseases, Interstitial ; Prednisolone ; Pulmonary Fibrosis* ; Scleroderma, Systemic ; Sclerosis*

BACKGROUND: To determine the prevalence of chronic fatigue syndrome and idiopathic chronic fatigue in Korea and to describe demographic, clinical, and psychological differences among those with chronic fatigue syndrome (CFS), those with idiopathic chronic fatigue, and healthy controls. METHODS: 1,526 persons aged 18-76 years who visited Korea university hospital health management center for general check-up between December 1998 and August 1999 were participated in the study. The questionnaire made according to the Centers for Disease Control and Prevention criteria was administered to the recruited persons and patients with chronic fatigue syndrome were diagnosed by questionnaire, physical examination and laboratory tests. The Korean version of the Center for Epidemiological Studies-Depression Scale (CES-D) was used to assess depression. RESULTS: Of the 1,526 persons studied, 433 (29.4 %) reported severe fatigue lasting at least 6 months. Of the 202 persons with unexplained chronic fatigue, 31 persons (2.0% of the study population) were classified as CFS cases. The prevalence of CFS was 2.81% in women, 1.49% in men respectively (p<0.05). When CES-D cut-off score of 25 was used, 30.43% of persons with CFS and 5.93% of persons without chronic fatigue had scores suggestive of depression. CFS patients had higher mean scores on CES-D than persons without chronic fatigue (p<0.05). CONCLUSION: Persons who met the criteria for chronic fatigue syndrome were found in 2.0%. The prevalence of chronic fatigue syndrome in our study were high, compared with previous studies in other countries. CFS patients had higher mean scores on CES-D than persons without chronic fatigue.
Centers for Disease Control and Prevention (U.S.) ; Depression ; Fatigue ; Fatigue Syndrome, Chronic* ; Female ; Humans ; Korea ; Male ; Physical Examination ; Prevalence* ; Surveys and Questionnaires

No abstract available.
Colchicine* ; Dupuytren Contracture*