Gorham's syndrome is a rare disorder involing a proliferation of vascular channels associated with extensive loss of bony matrix. It starts in bone, but it may secondarily involve soft tissue and adjacent bones. Although the osteolysis usuakky arrests spontaneously, its biologic behavior is difficult to predict. The mechanism of steolysis is unkown, and the role of osteoclasts is controverwial We have experienced one case of Gorham's syndrome affecting the scapula and clavicle, which is reported in this paper with brief review of literature.
Clavicle ; Osteoclasts ; Osteolysis ; Scapula

The aims of treatment of children with CDH untreated until walking age should be to reestablish the mechanics of the hip joint and avoid complications, especially avascular necosis, thus delaying the devlopment of osteoarthritis. In the child who is first seen between the ages of one and three years, considerable controversy still exists as to the merit of closed versus operative management. The average 29.3 months follow-up results in fifty congenitally dislocated hips in forty-five children with were between six and thirty-six months old when treatment was begun have been reviewed at the Department of Orthopaedic Surgery, In Je University, College of Medicine, Paik Hospital from June, 1979 to Aug, 1989. The results of this study were as follows: 1. Factors affecting method of treatment were age, degree of dislocation and acetabular index; A. Age 1) The children below ages of 18 months were treatment by closed reduction. 2) The children below ages of 18 months were treatment by open reduction with concomittant procedures. B. Degree of dislocation: Open reduction was more frequently reguired in higher degree of dislocation. C. Acetabular index: It was little influenced on method of treatment. 2. The complications were persisten subuxation (3 cases), temporary irregular ossification (16 cases) and avascular necrosis (1 cases).
Acetabulum ; Child ; Dislocations ; Follow-Up Studies ; Hip ; Hip Joint ; Humans ; Mechanics ; Methods ; Necrosis ; Osteoarthritis ; Walking

This study evaluated the pharmacokinetic profile and therapeutic efficacy of piroxicam (PX), a long acting non-steroidal anti-inflammatory drug for the treatment of arthritis, following intra-articular (IA) injection in comparison to the pharmacokinetic profile and therapeutic efficacy of PX after intramuscular (IM) injection. In the pharmacokinetic study in rats, systemic exposure and pharmacokinetic parameters of PX after a single IA dose were compared with systemic exposure and pharmacokinetic parameters of PX after administration of the same dose IM (0.6 mg/kg). The anti-inflammatory and analgesic effects of IA PX were evaluated simultaneously in a monoiodoacetate-induced osteoarthritis rat model. The plasma PX concentration rapidly rose following IA injection, and it was comparable to the plasma PX concentration following IM injection, suggesting the rapid efflux of the drug molecule from the joint cavity. However, in the efficacy study, the IA PX administration significantly reduced the knee swelling by reducing the level of prostaglandin E2 in the joint, compared to that following administration of IA vehicle and after administration of the IM PX dose. In addition, we found that the anti-inflammatory and anti-nociceptive efficacies of IA PX were synergistically increased upon co-treatment with hyaluronic acid (HA), a potent agent for the treatment of osteoarthritis, at the weight ratio of 1:1 or 1:2, and these effects were more pronounced than those following administration of HA or PX alone. In conclusion, this study demonstrated the efficacy of the IA use of PX alone and/or in combination with HA in osteoarthritis.
Animals ; Arthritis ; Dinoprostone ; Hyaluronic Acid ; Injections, Intra-Articular ; Joints ; Knee ; Models, Animal ; Osteoarthritis ; Pharmacokinetics* ; Piroxicam* ; Plasma ; Rats*

Although the association between obesity and asthma has been well documented, the nature of this association has yet to be clarified. The aim of this study was to examine the association of body mass index (BMI), lipid profiles, and atopy, wheezing, and lung function in older adults living in a rural area in Korea. BMI (kg/m2), lipid profiles, skin prick test, spirometry, and questionnaire including airway symptoms were obtained in a cross-sectional survey in 707 (259 males and 448 females) older adults (aged 50 to 93; mean, 65.7 yr) living in a high-altitude rural area in Korea. The prevalence of self-reported wheezing was 17.1% (121/707). The prevalence of atopy was 13.8%. The mean of BMI was 23.3+/-0.13 (14.6-32.8). The BMI was higher in females than in males (23.8+/-0.16 vs 22.4+/-0.17; p<0.01). The prevalence of wheezing was higher in group with BMI> or = 25 than in group with BMI<25 [57/201 (28.3%) vs 64/505 (12.6%), p<0.01]. The BMI was higher in group with wheezing than in group without wheezing (24.3+/-0.34 vs 23.1+/-0.13, p<0.01). No association between BMI and atopy was found. These findings suggest that BMI associated with wheezing in older adults.
Aged ; Aged, 80 and over ; *Altitude ; Asthma/*epidemiology/metabolism ; *Body Mass Index ; Bronchial Hyperreactivity/immunology ; Comorbidity ; Female ; Humans ; Hypersensitivity/epidemiology/immunology ; Korea/epidemiology ; Lipids/blood ; Male ; Middle Aged ; Questionnaires ; Respiratory Function Tests ; *Respiratory Sounds/immunology ; Skin Tests

Purpose: The purpose of this study is to identify changes in knowledge, self-efficacy and anxiety achieved through the provision of video education on chemotherapy with a portable infusion pump to colorectal cancer patients. Methods: This study is a nonequivalent control group and non-synchronized design as a quasi-experimental study. Participants in this study were colorectal cancer patients who received chemotherapy with a portable infusion pump through an ambulatory care unit. For 48 subjects, the education was divided into printed materials and videos, and knowledge, self-efficacy, and anxiety were measured. Data were analyzed using independent t test, paired t-test, and Wilcoxon’s signed rank test. Results: In the video education group, knowledge (Z=-4.09, p<.001) and self-efficacy (Z=-2.72, p=.012) significantly increased after education, and anxiety significantly decreased after education (Z=2.24, p=.035). However, there was no difference in knowledge (t=0.09, p=.931), self-efficacy (t=1.22, p=.229), and anxiety (t=-1.16, p=.250) between the groups after education. Conclusion To improve the quality of life of cancer patients, it is necessary to promote self-efficacy and reduce anxiety. The results of this study suggest that more diverse educational methods should be attempted to improve knowledge and self-efficacy and reduce anxiety in colorectal cancer patients.

Lymphocytic hypophysitis, an inflammatory disease of the pituitary gland that is often associated with pregnancy, is caused by autoimmune destruction of the pituitary gland evidenced by diffuse inflammatory cell infiltration of the pituitary gland and some kinds of detectable autoantibodies. We report a case of lymphocytic hypophysitis in a 31-year-old woman presenting with severe hypoglycemia and hyponatremia after delivery. Hormonal study revealed panhypopituitarism and magnetic resonance imaging with enhancement showed the bulging contour of the right side pituitary gland with an ill-defined mass-like lesion and nodular thickening of the stalk. The patient's symptoms and biochemical data improved greatly with replacement of L-thyroxine and glucocorticoid. Partial recovery of panhypopituitarism was also seen. The follow-up tests revealed dramatic resolution of the pituitary lesion.
Adult ; Autoantibodies ; Female ; Follow-Up Studies ; Humans ; Hypoglycemia* ; Hyponatremia ; Hypopituitarism ; Magnetic Resonance Imaging ; Pituitary Gland ; Pregnancy ; Thyroxine

OBJECTIVE: The objective of this study was to determine whether complications and nursing interventions during hemodialysis could be reduced by using gradient ultrafiltration(GUF) and high sodium dialysate(HSD). METHODS: Thirty outpatients who had been on hemodialysis for more than 3 months were enrolled. Patients received Conventional HD(Na+ 137 mEqX4 hrs, constant UF), GUF(UF 62.5%X2 hrs, UF 37.5 %X2 hrs), HSD(Na+ 145 mEqX2 hrs, Na+ 140 mEqX2 hrs) and HSUF(GUF and HSD). Each methods were prescribed for 2 weeks. The clinical features such as thirst, interdialytic weight gain, postdialytic weight loss and MAP(mean arterial pressure) and the frequency of intradialytic complications and nursing interventions were evaluated. RESULTS: The results were as followings. Interdialytic thirst, weight gain, postdialytic weight loss and MAP(pre/post HD) were not significantly different in each method. On the other hand, there was significant difference between 4 methods in serum sodium, osmolality and Hct. There were significantly fewer episodes of hypotention, muscle cramp and headache when using GUF, HSD and HSUF than CHD. The number of nursing interventions was significantly reduced in GUF, HSD and HSUF than CHD. CONCLUSION: Hemodialysis with gradient ultrafiltration and high sodium dialysate leads fewer complications and nursing interventions, more patient's well being.
Hand ; Headache ; Humans ; Muscle Cramp ; Nursing ; Osmolar Concentration ; Outpatients ; Renal Dialysis* ; Sodium* ; Thirst ; Ultrafiltration* ; Weight Gain ; Weight Loss

No abstract available.
Eosinophilia* ; Fever* ; Glomerulonephritis*

PURPOSE: There was marked decline of measles outbreak in the world since the first measles vaccine had been introduced. Recently, however, measles outbreak in the vaccinated children have been reported worldwide, which was ascribed to the possibilities of primary or secondary vaccine failure. We investigated the incidence in the school-aged children in the Kyong-gi Do area, the larger district which covers the urban and rural area, by the questionnaire. METHODS: The questionnaires which were asked to the students' parents of 14 elementary schools in and nearest Sungnam city, Kyong-Gi Do for their present age, experience of measles attack and vaccination, and the age of measles attack. The answers of this questionnaire were analysed by SAS computer program. RESULTS: 1) Measles vaccination rate at 9 months was 70.5% and MMR vaccination rate at 15 months was 91.3%. 2) Measles attack rate among unvaccinated group was 53.8%, and 16.1% in vaccinated group. There was significant low risk of measles attack among vaccinated group than unvaccinated group(relative risk=3.35, p<0.001). 3) Vaccine efficacy of measles in this age group was 69%. 4) Age distribution of measles outbreak reveals bimodal pattern, the graph shows two peak incidence of 1 year-old and 6 years-old. 5) There were no significant differences of measles incidence in the different medical care service center that measles vaccination had been done. CONCLUSIONS: Despite high rate of measles vaccine coverage in Sungnam, the attack rate of measles in the vaccinated population was relatively high. There may be due to primary, secondary vaccine failure or the other factors. The policy of measles vaccination in Korea should be reestablished as soon as possible.
Age Distribution ; Child* ; Epidemiologic Studies* ; Gyeonggi-do* ; Humans ; Incidence ; Korea ; Measles Vaccine ; Measles* ; Measles-Mumps-Rubella Vaccine ; Parents ; Surveys and Questionnaires ; Vaccination

BACKGROUND: Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. METHOD: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. RESULTS: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. 2) Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82% of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1% and large opacity is 17.9%. Small opacity has t/t type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest X-ray density, the more decreasing FEV1 (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. 6) Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. CONCLUSION: These findings indicate that tuberculosis infection has a decisive influence on the progress and prognosis of pneumoconiosis.
Chest Pain ; Coal ; Cough ; Disease Progression ; Dust ; Dyspnea ; Electrocardiography ; Hemoptysis ; Humans ; Inhalation ; Korea ; Lung Diseases ; Medical Records ; Pneumoconiosis* ; Prevalence ; Prognosis ; Pulmonary Heart Disease ; Respiratory Function Tests ; Respiratory Insufficiency ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary