BACKGROUND: Recently, cardiopulmonary exercise testing (CPX) has become a popular diagnostic method for differentiating the main cause of exertional dyspnea or exercise limitation. We evaluated the difference in the CPX results according to interpretative algorithms and the methods of exercise in Korea. METHOD: Sixty-six patients with chronic lung disease and 48 adults with dyspneic symptoms, but with no abnormalities in a spirometry performed symptom limited CPX, were included in this study. The results were interpreted using both Wasserman's(WA) and Eschenbacher's algorithm (EA), and a comparison between both algorithms was made. Thirty-three healthy medical students performed the CPX with a cycle ergometer and treadmill. The results were interpreted with EA and the concurrenec in interpretations was evaluated according to the methods of exercise. RESULTS: 1. In patients with chronic lung disease, the overall concordance rate between the two algorithms was 63.6%. The concordance rates were 69.8% in patients with obstructive, 25.0% in those with restrictive, and 66.7% in those with mixed pulmonary insufficiency. In patients with dyspneic symptoms but normal findings in resting spirometry, the concordance rate was 60.4%. 2. In healthy medical students, in results interpreted with EA, the concordance rate between the cycle ergometer and treadmill exercise was 25.0%. CONCLUSION: Both interpretative algorithms and methods of exercise may affect the CPX results. In using CPX as a diagnostic test for the causes of dyspnea in the Korean population, the interpretative algorithms and method of exercise need to be standardized, and a predictive VO2max equation needs to be established.
Adult ; Diagnostic Tests, Routine ; Dyspnea ; Exercise Test* ; Humans ; Korea ; Lung Diseases ; Methods* ; Spirometry ; Students, Medical

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

No abstract available.
Adenocarcinoma*

No abstract available.
Knee*

Infantile hypertrophic pyloric stenosis (IHPS) is the most common condition requiring abdominal surgery in early infancy, and is caused by hypertrophied pyloric muscle. The development of successful surgical treatment in the early 1900s by Fredet and Ramstedt made it possible for infants worldwide to survive. Modern pediatric anesthetic techniques have virtually eliminated mortality from surgical management. Atropine sulfate is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated two cases of IHPS with incomplete pyloromyotomy in 3-month-old and 5-month-old male infants by administering atropine sulfate intravenously. They were free from vomiting after 5 days of intravenous atropine sulfate treatment. In these rare cases of persistent vomiting or refractory emesis following incomplete pyloromyotomy, there may be a role for atropine sulfate.
Atropine* ; Constriction, Pathologic* ; Humans ; Infant ; Male ; Mortality ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic ; Vomiting*

Twin reversed arterial perfusion (TRAP) sequence is a rare specific anomaly of twin gestation with fused placenta and umbilical anastomosis. This syndrome occurs once in about 34,600 births and reported first by Beneditti in 1533. We report on prenatal diagnosis of a case of TRAP sequence with color Doppler sonography, this case is presented with a brief review of the literature.
Humans ; Parturition ; Perfusion ; Placenta ; Pregnancy ; Prenatal Diagnosis*

Colloidal gold 198Au were injected into 40 knee joints of rabbits for the study of the change of synovial membrane. We verified even distribution of Colloidal gold 198Au about knee joints by use of scintigraphy. After then, histopathological examinations were performed by periodic intervals. The following results are obtained form this study. l. Intra-articular injection of Colloidal gold 198Au into rabbit's knee joints resulted in a mild resctive inflammation at synovium. In was charscterized by an infiltration of eosinophils and by sclerotic changes in the subsynovium and by fibrosis of synovial vessels. 2. From this study, intra-articular injection of Colloidal gold 198Au may by benefit to treat the chronic synovial effusion in human.
Colloids ; Eosinophils ; Fibrosis ; Gold Colloid ; Humans ; Inflammation ; Injections, Intra-Articular ; Knee Joint ; Rabbits ; Radionuclide Imaging ; Synovial Membrane

In fusion of lumbar spine, every fused motion segments shows varisble limitation of motion in flexion, extension and lateral bending according to their types and level of fusion. The motion segment of lumbar spine is three joint complex which consists of posterior two articular facet joints and an anterior intervertebral disc. Nowadays, orthopedic surgeon prefer anterior fusion due to direct identification and removal of diseased tissue, reduction of fractured fragments, restoration of intrevertebral space, early rehabilitation and no damage of nerve root and cord, and is prefered short Segmental Spinal Instrumentation(e.g. Cotrel Dubousset Instrumentation, etc.) due to short and rigid fusion, no necessity of external support and low limitation of motion. We studied 58 cases of fused lumbar spine which had been operated since Sep.1983, by X-ray overlay method and 20 cases of healthy lumbar spine as eontrol group. In this study, we obtained following results ; 1. Harrington Rod Instrumentation reveals the most remarkable limitation of motion, whereas, C.D.I. and A.I.F. reveal the least limitation of motion. 2. Distinct differencies of motion are repersented by its range of fusion and range of motion in 2 segmental fusion reveals remarkable decreasement from range of motion in single segmental fusion. 3. In single segmental fusion, the most limitation of motion was represented in Harrington Rod Instrumentation and posterior fusion with bone graft. There is remarkable decreasement of flexion at lumbosacral junction by its site of fusion. 4.In double segmental fusion, the most limitation of motion was represented in Harrington Rod Instrumentation and there is no significant difference of motion by its site of fusion.
Intervertebral Disc ; Joints ; Methods ; Orthopedics ; Range of Motion, Articular ; Rehabilitation ; Spine ; Transplants ; Zygapophyseal Joint

Pelvic fistulas may result from obstetric complications, inflammatory bowel disease, pelvic malignancy, pelvic radiation therapy, pelvic surgery, or other traumatic causes, and their symptoms may be distressing. In our experience, various types of pelvic fistulas are identified after pelvic disease or pelvic surgery. Because of its close proximity, the majority of such fistulas occur in the pelvic cavity and include the vesicovaginal, vesicouterine, vesicoenteric, ureterovaginal, ureteroenteric and enterovaginal type. The purpose of this article is to illustrate the spectrum of imaging features of pelvic fistulas.
Bladder Fistula/diagnosis/etiology ; Female ; Fistula/*diagnosis/*etiology ; Human ; Intestinal Fistula/diagnosis/etiology ; *Pelvis ; Ureteral Diseases/diagnosis/etiology ; Urinary Fistula/diagnosis/etiology ; Uterine Diseases/diagnosis/etiology ; Vaginal Fistula/diagnosis/etiology

OBJECTIVE: Angiogenesis is a critical factor in the progression of solid tumors. The mechanisms responsible for angiogenesis in cervical neoplasia, however, are not well defined. Our study was aimed to determine the expression of VEGF(Vascular Endothelial Growth Factor), its receptor(KDR), and TGF-beta1(Transforming Growth Factor-beta1) in cervical neoplasia, to determine the role of these angiogenic factors in preinvasive(dysplastic) process and the progression of cervical cancer and to investigate the progression of angiogenesis in the transition from normal cervix to invasive squamous cell carcinoma of the uterine cervix. METHODS: The cervical lesions of 76 patients were punch biopsied and paraffin embedded. Among these, 5 were normal cervix, 36 were cervical intraepithelial lesion I-III, and the other 35 were invasive squamous cell carcinomas. The tissues were immunostained with antiVEGF, antiKDR, and antiTGF-beta1 polyclonal antibody. RESULTS: The expression of VEGF, KDR, and TGF-beta1 in CIN III was stronger than those of CIN I(p<0.01). Their expression were not significantly different among the each staged cervical cancers(p>0.01). CONCLUSIONS: These observations suggest that VEGF, KDR, and TGF-beta1 are important angiogenic factors in cervical neoplasia, especially in an early event to neoplastic transformation of cervical tissues, but these angiogenic factors are not associated with the progression of cervical cancer.
Angiogenesis Inducing Agents ; Carcinoma, Squamous Cell ; Cervix Uteri ; Female ; Humans ; Paraffin ; Phosphotransferases* ; Transforming Growth Factor beta1 ; Uterine Cervical Neoplasms ; Vascular Endothelial Growth Factor A*