Twenty-five consecutive patients who had contracture of the elbow were treated by arthroscopy. The techniques were removal of loose bodies, removal of osteohyte, anterior capsular release, abrasional arthroplasty and excision of the radial head. The type of arthroscopic procedure was determined by the cause of limiting motion which was intra-articular(intrinsic). The mean preoperative arc of total motion was 92°(21°-113°). Re-examination of the elbows after anaverage follow-up of 19 months showed tbat the mean arc of total motion was 116°(14°-130°). Twenty-three out of twenty-five patients (92%) who were followed up were satisfied with the results of the procedure and exhibited improved ability in carrying out daily activities. In conclusion, arthroscopy of the elbow is an effective diagnostic procedure and is also effective in treating certain intra-articular problems with minimal morbidity and rapid recovery to function.
Arthroplasty ; Arthroscopy ; Contracture ; Elbow ; Follow-Up Studies ; Head ; Humans ; Joint Capsule Release

Kawasaki disease (KD) is an immune-mediated disease which is a leading cause of acquired cardiovascular disease in developed country. Recently, tumor necrosis factor-alpha (TNF-alpha) blocker, infliximab has been considered a promising option for patients with refractory KD. Although chronic use of a TNF-alpha blocker could increase risk of opportunistic infections, a few studies have documented that use of infliximab was safe without serious adverse effects in patients with KD. We observed serious bacterial infection after infliximab treatment in an infant with refractory KD. Our patient was a 5-month-old male infant diagnosed with KD who did not respond to repeated doses of intravenous immunoglobulin. We effectively treated him with a single infusion of infliximab (5 mg/kg), but gram-negative (Acinetobacter lwoffii) septicemia developed after infliximab infusion. Therefore, we report a case of serious septicemia after treatment with infliximab, and suggest considering the risk of severe infection when deciding whether to prescribe infliximab to an infant with refractory KD.
Bacterial Infections ; Cardiovascular Diseases ; Developed Countries ; Humans ; Immunoglobulins ; Infant* ; Male ; Mucocutaneous Lymph Node Syndrome* ; Opportunistic Infections ; Sepsis* ; Tumor Necrosis Factor-alpha ; Infliximab

No abstract available.
Female ; Humans ; Osteoporosis* ; Uterine Prolapse*

BACKGROUND: The pathophysiology of non ulcer dyspepsia remains unknown. But Several related factors have been investigated and psychologic factor is one of the possible mechanism. Alexithymia was introduced to explain the psychopathology of psychosomatic disorder. Until now alexithymia has been variously shown to be associated with many psychosomatic disorder, psychiatric disorder, even medical patients. This study is designed to investigate whether non ulcer dyspepsia has more relationship with alexithymia than other illness. METHODS: To compare alexithymia tendency between non ulcer dyspepsia and general medical patients, we collected sample from January to September 1999. Each group of 72 patients were tested using Toronto Alexithymia Scale. RESULTS: A rate of 37.5% of alexithymia was found in the non ulcer dyspepsia group compared with significant lower rate of 19.4% in the general medical patients group. CONCLUSION: Non ulcer dyspepsia patients had more alexithymia compare to general medical patients. This finding shows the alexithymia could be part of the pathophysiology of non ulcer dyspepsia.
Affective Symptoms* ; Dyspepsia* ; Fibrinogen ; Humans ; Psychopathology ; Psychophysiologic Disorders ; Ulcer*

Two cases of gastric leiomyosarcoma diagnosed by ultrasound are presented. Upper abdominal sonogram discloseda large lobulated echogenic mass containing a few or multiple anechoic fluid-filled spaces in each cases. Theseanechoic spaces were confirmed to be necrotic or hemorrhagic cavities in the solid mass pathologically. Theauthors wish to emphasize thse echopatterns are characteristic of mesenchymal tumor, such as leiomyoma orleiomyo-sarcoma, in particular.
Leiomyoma ; Leiomyosarcoma ; Ultrasonography

Small hepatoma is defined as hepatocellular carcinoma less than 3cm in maximum diameter and fewer than 3 innumber. To assess the ability of ultrasound to detect small hepatomas, a prospectively study was done in a groupof patients with HBsAg-positive chronic hepatitis and liver cirrhosis. Herein, we present 4 hypoechoic smallhepatomas detected on ultrasound and emphasize the role of real-time ultrasonography as a practical test formonitoring hepatoma high-risk, subjects.
Carcinoma, Hepatocellular ; Hepatitis, Chronic ; Humans ; Liver Cirrhosis ; Mass Screening ; Prospective Studies ; Ultrasonography

No abstract available.
Forehead* ; Methylmethacrylate*

BACKGROUND: For Neer type IIB fracture of distal clavicle with coracoclavicular ligament injury, various surgical treatments have been used in literatures. However, there was no consensus on the optimal treatment. The aim of this study is to report the clinical and radiological results of open reduction and internal fixation of unstable distal clavicle fracture and suture augmentation of disrupted coracoclavicular ligament. METHODS: A prospective study was performed in 23 patients with Neer type IIB distal clavicle fracture in Seoul Medical Center, Eulji Hospital, and National Medical Center. Firstly, suture anchors are inserted in the base of coracoid process and preliminary reduction was achieved by tie-off of three suture limbs around the clavicle. Then, the final fixation was completed with anatomical locking plate. Bony union and the distance between coracoclavicular ligaments were evaluated. Clinical results and complications including stiffness and secondary procedures were evaluated. RESULTS: Bony union was achieved in all cases except one (22 of 23). At mean 14.9 months, no significant difference in the mean coracoclavicular distance was observed compared to uninjured shoulder (8.2 +/- 7.9 mm versus 7.3 +/- 3.4 mm, p=0.14). Pain visual analogue scale, American Shoulder and Elbow Surgeons score, Constant score, and Disabilities of the Arm, Shoulder and Hand score were 0.5, 83.4, 78.5, and 6.2, respectively. Revision surgery was performed in one case of nonunion. Four patients who complained of skin irritation underwent implant removal. CONCLUSIONS: In cases of an unstable distal clavicle fracture with coracoclavicular ligament disruption, satisfactory clinical results were obtained by locking plate fixation and coracoclavicular ligament suture augmentation concurrently.
Arm ; Clavicle* ; Consensus ; Elbow ; Extremities ; Hand ; Humans ; Ligaments* ; Prospective Studies ; Seoul ; Shoulder ; Shoulder Fractures ; Skin ; Suture Anchors ; Sutures*

The use of a tissue expander and implant is the simplest option for breast reconstruction after mastectomy. Use of a round dome-shaped prosthesis and the commonly used one-stage technique with a Becker type prosthesis, however, often produces an undesirable upper pole fullness. To overcome this and to achieve improved aesthetic results, we started using an anatomically-shaped expander and implant, as described by Maxwell, as a two-stage breast reconstruction. We reviewed the results of our 21 reconstructed breasts in 22 patients who were deemed suitable for reconstruction using this technique since January 1995. The most commonly used expander was 350cc (range 350-550cc) and an average of 4.2 inflations were required before replacing the expander with a permanent implant. All the expanders were placed in submuscular pockets and implant volume. The longest follow-up was 36 months. Few complications developed and most patients were satisfied with the results. We found that the anatomically-shaped expander and implant produced better aesthetic results compared to a done-shaped prosthesis.
Breast* ; Female ; Follow-Up Studies ; Humans ; Mammaplasty* ; Mastectomy ; Prostheses and Implants ; Tissue Expansion Devices

OBJECTIVES: To determine if hysterectomy with or without ovarian preservation is asso-ciated with obesity in premenopausal women. METHODS: 581 women for routine check up from Jan. 1985 to Dec. 1995 in the depart-m ent of Gynecology at Korea Veterans Hospital were included. The obesity was evaluated by BMI(body mass index) scores. 80% of hysterectomy were confirmed from the hospital records. The age, weight, height, blood pressure, menstr- ual history, history of DM and hypertension, social history of alcohol and smoking and other cardiovascular risk factors such as cholesterol, HDL-cholesterol, triglycerides were checked. The 248 women with natural postmenopausal status before hysterectomy, taking hormonal replacement therapy after hysterectomy and having performed hysterectomy due to malign- ancy were excluded. RESULTS: All women performed hysterectomy were in premenopausal status in this study. Therefore, the final numbers of subjects included in the analysis was 333. Hysterectomy wit- hout ovarian preservation were performed in 58 cases and hysterectomy with ovarian pres- ervation were in 57 cases. The 218 premenopausal cases which did not performed hystere- ctomy were considered control group. BMI scores were higher in cases without ovarian pres- ervation than with ovarian preservation. And BMI score was associated with the postoper- ative duration in hysterectomy with ovarian preservation. CONCLUSIONS: We suggest that hysterectomy without ovarian preservation in premeno- paussal women were associated with increased obesity, especially BMI scores.
Blood Pressure ; Cholesterol ; Female ; Gynecology ; Hospital Records ; Hospitals, Veterans ; Humans ; Hypertension ; Hysterectomy* ; Korea ; Obesity* ; Risk Factors ; Smoke ; Smoking ; Triglycerides