We reviewed the knee radiographs of 68 cases of arthroscopically-proven discoid lateral meniscus to evaluate usefulness of plain radiographs in diagnosing discoid lateral meniscus. The subject included 42 cases of complete type and 26 cases of incomplete type discoid lateral meniscus. Knee radiographs of 70 cases which had no pathology of the meniscus in knee arthroscopy were used as controls. We excluded patients who had a significant history of trauma and who were under 16 years of age or over 60 to avoid measuring radiographs of skeletally immature or degenerative knees. The absolute values and relative normalized values of specific knee dimensions such as a squared-off appearance of the lateral femoral condyle, widened femorotibial joint space, cupping of the lateral tibial plateau, obliquity of the lateral tibial plateau articular surface, high fibular head and hypoplasia of the Iateral intercondylar spine in discoid lateral meniscus and normal controls were compared. Among these dimensions, high fibular head and widened lateral tibiofemoral joint space showed statistically significant difference between the discoid lateral meniscus group and normal control group. We suggest that these findings could be useful in screening lateral discoid meniscus in plain radiographs.
Arthroscopy ; Head ; Humans ; Joints ; Knee* ; Mass Screening ; Menisci, Tibial* ; Pathology ; Spine

This study was conducted to examine the effect of mefenamic acid for treatment of PDA in premature newborns. Ductus arteriosus is reopened by locally produced prostaglandin E2 in a premature newborn during hypoxia. Mefenamic acid is one of non-steroidal antiinflammatory drugs acting by inhibition of cyclo-oxygenase in the prostaglandin synthesis pathway. For three premature newborns with PDA, we administered mefenamic acid and evaluated them with echocardiography to study the effect of mefenmic acid for closure of PDA. In all three babies, ductus arteriosus was closed successfully. We feel that mefenamic acid is safe and effective medication for treatment of PDA in premature newborns, but further-study need to be conducted with larger numbers of cases to confirm this effect.
Anoxia ; Dinoprostone ; Ductus Arteriosus ; Echocardiography ; Humans ; Infant, Newborn* ; Mefenamic Acid* ; Prostaglandin-Endoperoxide Synthases

No abstract available.
Tibia*

Eczema herpeticum is a herpes simplex virus infection with disseminated skin involvement superimposed on a pre-existing dermatosis. Dariers disease has been reported to be among the dermatoses susceptible to the sudden onset of a widespread vesicular eruption accompanied by high fever known as Kaposis varicelliform eruption. We report a case of eczema herpeticum in a 46-year-old woman associated with Dariers disease.
Darier Disease* ; Eczema* ; Female ; Fever ; Humans ; Kaposi Varicelliform Eruption* ; Middle Aged ; Simplexvirus ; Skin ; Skin Diseases

No abstract available.
Drainage*

Patients with lumbar spinal stenosis may exhibit symptoms such as back pain, radiating pain, and neurogenic claudication. Although long-term outcome of treatments manifests similar results for both nonsurgical and surgical treatments, positive effects such as short-term improvement in symptoms and decreased fall risk may be expected with surgery. Surgical treatment is basically decompression, and a combination of treatments can be added depending on the degree of decompression and the accompanying instability. Recently, minimally invasive surgery has been found to result in excellent outcomes in the treatment of lumbar spinal stenosis. Therefore, better treatment effects can be anticipated with an approach aimed at understanding the overall pathophysiology and treatment methods of lumbar spinal stenosis.

No abstract available.
Hypertension, Pulmonary*

BACKGROUND : Treatment of a severe burn injury with total parenteral nutrition can produce bacterial translocation to mesenteric lymph nodes through the intestinal mucosa due to permeability changes. Early enteral feeding will help to restore the mucosal barrier function. Certain nutrients may have a beneficial effect on bacterial translocation and gut immunity. METHODS : We choose the glutamine and korean cabbage as dietary factors to study the beneficial effect on gut immunity of feeding different dietary formulations of low amino acid concentrated total parenteral nutritional fluids in burned rats. Forty-eight (48) male pathogen-free Sprague-Dowley rats were allocated in 4 groups(group A, control chow diet and water ad libitum; group B, oral TPN diet; group C, oral TPN diet supplemented with 2% glutamine; and group D, oral TPN diet supplemented with korean cabbage). All groups, except control group A, recieved 40% total body surface area, full-thickness burn injury. Group A received sham burn injury. Bacterial translocation to mesenteric lymph nodes, the cecal bacterial population level, the intestinal mucosal protein content, and the total IgA of the intestinal luminal washing fluid were measured and light-microscope changes of the small intestine were observed in the rats on the 4th and the 7th days after corresponding diet intake. RESULTS : The incidence of bacterial translocation in the oral TPN diet group B was reduced signifi cantly compared with control group A and glutamine supplemented group C on 4th day postburn (p< 0.05) The cecal bacterial population level of control group A showed significant lower values, compared with the other groups, in total aerobic (on 4th day p<0.01, on 7th day p<0.01) and gram-negative enterics species (on 4th day p<0.01, on 7th day p<0.05). The mucosal protein amount per cm of length of intestine was decreased slightly in groups B, C, and D, compared with the control group A, but without statistical significance, on the 7th day postburn. The total (serum and secretary) IgA per cm of length of intestine was increased significantly in the glutamine-supplemented group C and the cabbage- sup plemented group D on the 7th day postburn, compared with the oral TPN group B (p<0.05). However,there was no corresponding decrease in the bacterial translocation ratio or the cecal bacterial population level. Histologic observations on the 4th and the 7th days of glutamine-supplemented group C & cabbage- supplemented group D revealed increases in the villous height, and the numbers of villous cells and goblet cells, compared with the oral TPN group B. A slight desquamation of the villous cells was observed in the cabbage-supplemented group on the 7th day. CONCLUSION : In summary, early enteral feeding is not sufficient to avoid bacterial translocation. Certain nutritional factors such as glutamine are helpful in overcoming the bacterial translocation in burned rats. Korean cabbage was beneficial became promoted an IgA increase in the intestine without a direct effect on the bacterial translocation.
Animals ; Bacterial Translocation* ; Body Surface Area ; Brassica ; Burns ; Diet ; Enteral Nutrition ; Food, Formulated ; Glutamine* ; Goblet Cells ; Humans ; Immunoglobulin A ; Incidence ; Intestinal Mucosa ; Intestine, Small ; Intestines ; Lymph Nodes* ; Male ; Parenteral Nutrition, Total ; Permeability ; Phenobarbital ; Rats* ; Water

PURPOSE: The purpose of this study was to analyse the characteristics of acalculous cholecystitis (AC) compared with those of calculous cholecystitis (CC), and also to find the relationship of preoperative radiologic findings to the classification of pathological degree of inflammation of the gallbladder in AC. METHODS: Between March 1996 and June 2000 a total of 163 patients undergoing cholecystectomy for cholecystitis were divided into group AC (21 patients) and group CC (142 patients) and retrospectively studied by analyzing clinical data. RESULTS: The incidence of AC among cholecystitis cases was 12.9%. there was male preponderance in group AC whereas female preponderance in group CC (P<0.036). The pulse rate (P<0.02) and white blood cell count (P<0.003) were significantly elevated in group AC. Possible etiological factors were found in 6 cases (28%) in group AC. The rates of preoperatively observed pericholecystic fluid collection in US (P<0.033) and dilatation of the gallbladder in CT (0.012) were significantly higher in group AC than in group CC. Additionally, the rate of tube drainage during surgery was significantly higher in group AC than group CC (P<0.02). Finally, wall thickness (P<0.05), dilatation (P<0.05) of the gallbladder in CT and the total sum of findings in CT (P<0.01) and US (P<0.05) were strongly related to the degree of inflammation of the gallbladder. CONCLUSION: The majority of AC patients exhibit nonspecific clinical findings, often delaying diagnosis; however, if it develops, AC tends to display more acute and inflammatory characteristics than calculous cholecystitis. laparoscopic surgery cannot be sucessful in cases of delayed diagnosis. US, CT and scintigram are useful diagnostic tools if we interpretate each finding in relation to the severity of inflammation.
Acalculous Cholecystitis* ; Cholecystectomy ; Cholecystitis* ; Classification ; Delayed Diagnosis ; Diagnosis ; Dilatation ; Drainage ; Female ; Gallbladder ; Heart Rate ; Humans ; Incidence ; Inflammation ; Laparoscopy ; Leukocyte Count ; Male ; Retrospective Studies

PURPOSE: During the night time decision making on patients suspicious of appendicitis is often difficult because diagnosis and timing for operation are frequently delayed. Therefore, we analyzed above cases and solution is suggested. METHODS: This retrospective study included 360 patients who underwent laparotomies for suspected appendicitis at Hanil Hospital during one year, from March 1998 to Feb. 1999. They were divided into two groups according to presenting time to physician (Day time: 6 a.m. to 6 p.m., Night time: 6 p.m. to 6 a.m.). Sex & age distribution, time of presentation to physician, duration of symptoms, symptoms & physical findings, white blood cell counts, interval from presentation to operation, hospital stay, and pathologic diagnosis were compared. RESULTS: There were no significant differences in sex & age distribution, duration of symptoms, symptoms & physical findings, white blood cell counts, pathologic diagnosis between the two groups. However, during the night time, the interval from presentation to operation was longer than that of the day time (9.15 hours versus 4.83 hours, p<0.001), the rate of delayed appendectomy during the night was 58.0%, the rate of negative laparotomy increased when appendectomy was delayed for more than 12 hours compared with less than 12 hours (28.1% vs 11.7%, p<0.01), and in the cases with perforated appendicitis, delayed appendectomy for more than 12 hours had longer hospital stay compared with less than 12 hours (12 days vs 9.44 days, p<0.01). Factors causing delayed appendectomy were related to the physician (42.5%), lack of anesthetic & nursing supports (19.5%), failure to structure the operation team (20.7%), and patient itself (17.3%). When white blood cell counts were rechecked in the next morning, levels above 10,000 cells/mm3 were highly associated with appendicitis in contrast to that below 10,000 cells/mm3 (91.7% vs 43.5%, p<0.002).
Age Distribution ; Appendectomy ; Appendicitis* ; Decision Making ; Diagnosis ; Humans ; Laparotomy ; Length of Stay ; Leukocyte Count ; Nursing ; Retrospective Studies