No abstract available.
Automatic Data Processing*

No abstract available.
Somatoform Disorders*

The spine fracture of osteoporotic patients is considered as meaningful since it occurs prior to other life-threatening fractures (for example; fracture of proximal of femur). The purpose of this study were to analyze the relationship between BMD and spine fracture in patients who complained of back pain without any obvious trauma history. We studied the cases of one hundred thirty patients above an age of sixty years, whose visited the Department of Orthopaedic Surgery at Kosin University Medical Center, from March 1995 to April 1996. Both simple X-ray and Dual Energy X-ray Absorptiometry (DEXA) were checked in old patients. The following results were obtained. 1. The BMD of spine fracture group with the osteoporosis (mean; -3.66 standard deviation (SD)) was significantly lower than the nonfracture group (mean; -2.38 standard deviation (SD)) (P = 0.0000). 2. According that the BMD Z-score is decreased, the proportion of spine fracture is increased significantly (above-1.0SD; 16.67%, -1.0SD~ -2.0SD; 16.67%, -2.0SD~ -3.0SD; 37.83%, - 3.0SD~ 4.0SD; 51.61%, below -4.0SD; 61.54% (P = 0.000)). 3. The probability of developing the spine fracture based on above -2.0 standard deviation (SD) was 2.8 times in -2.0SD~ -3.0SD (P = 0.044), 5.3 times in -3.0SD~ -4.0SD (P = 0.004), and 7.9 times below -4.0SD (P = 0.001). We recommended more intensive treatment to the osteoporotic patients below -2.0 SD in BMD Z- score.
Absorptiometry, Photon ; Academic Medical Centers ; Back Pain ; Humans ; Middle Aged* ; Osteoporosis ; Spine*

We evaluated the effectiveness of photoastigmatic refractive Keratectomy(PARK) by excimer laser on patients with compound myopic astigmatism. Spherocylindrical PARK was performed on 181 myopic eyes with astigmatism(mean spherical equivalent : -6.61 D, range : -1.88~-14.5 D) using the visx excimer laser. The eyes were divided into three groups according to the amount of desired astigmatic correction : Group 1(-0.5~-1.0 D), Group 2(-1.25~3.0 D), and Group 3(-3.25~-5.5 D). Patients were followed up for 6 months. Uncorrected visual acuity at postoperative 6 month, was 0.80+/-0.27 in Group 1, 0.79+/-0.19 and 0.71+/-0.21bin Group 2 and 3 respectively. The mean spherical equivalent refraction was -0.24 D 6 months after PARK. Mean astigmatism was reduced from preoperative -0.85+/-0.51 D to postoperative -0.34+/-0.38 D in Group 1, from -2.08+/-0.65 D to -0.43+/-0.64 D and from -4.42+/-0.63 D to -1.23+/-1.25 D in Group 2 and 3 respectively. We also analyzed the angle of error, magnitude of error, index of success, and coefficient of afjustment by vector analysis. No significant complications were observed during the follow-up period. These results show that PARK by excimer laser was effective in correction of astigmatism. The effect of astigmatic correction in Group 2 and 3 were better than that of Group 1. Group 1 showed overcorrected tendency and Group 2 and 3 showed undercorrected tendency.
Astigmatism ; Follow-Up Studies ; Humans ; Lasers, Excimer* ; Visual Acuity

We evaluated the effectiveness of photoastigmatic refractive Keratectomy(PARK) by excimer laser on patients with compound myopic astigmatism. Spherocylindrical PARK was performed on 181 myopic eyes with astigmatism(mean spherical equivalent : -6.61 D, range : -1.88~-14.5 D) using the visx excimer laser. The eyes were divided into three groups according to the amount of desired astigmatic correction : Group 1(-0.5~-1.0 D), Group 2(-1.25~3.0 D), and Group 3(-3.25~-5.5 D). Patients were followed up for 6 months. Uncorrected visual acuity at postoperative 6 month, was 0.80+/-0.27 in Group 1, 0.79+/-0.19 and 0.71+/-0.21bin Group 2 and 3 respectively. The mean spherical equivalent refraction was -0.24 D 6 months after PARK. Mean astigmatism was reduced from preoperative -0.85+/-0.51 D to postoperative -0.34+/-0.38 D in Group 1, from -2.08+/-0.65 D to -0.43+/-0.64 D and from -4.42+/-0.63 D to -1.23+/-1.25 D in Group 2 and 3 respectively. We also analyzed the angle of error, magnitude of error, index of success, and coefficient of afjustment by vector analysis. No significant complications were observed during the follow-up period. These results show that PARK by excimer laser was effective in correction of astigmatism. The effect of astigmatic correction in Group 2 and 3 were better than that of Group 1. Group 1 showed overcorrected tendency and Group 2 and 3 showed undercorrected tendency.
Astigmatism ; Follow-Up Studies ; Humans ; Lasers, Excimer* ; Visual Acuity

Among the erythrocyte membrane defects, hereditary spherocytosis is the most common. The erythrocyte membrane defect results from a deficiency of spectrin, the most important structural protein in red cell. Hereditary spherocytosis often presents with hemolytic anemia, jaundice, moderate splenomegaly. Diagnosis is established by the presence of spherocytes in the peripheral blood, reticulocytosis, an increased osmotic fragility, and a negative Coombs test. In children, splenectomy is usually performed after age 6 years but can be done at a younger age if warranted by the severity of the anemia and the need for frequent transfusions. In the period December 1987 to Agust 1993, 9 patients with hereditrary spherocytosis underwent splenectomy and the following results were obtained. 1. Nine patients were comprised of five males and four females. 2. Five patients(55.6%) had been admitted to our hospital during age 6-10 years. 3. Four of the nine patients had autosomal dominant inheritance with variable expression. The other five patients had no known inheritance. 4. The diagnosis of the spherocytosis was based on the increased osmotic fragility and increased autohemolysis of the erythrocytes, as well as on the appearance of spherocytes in the peripheral blood smear. 5. In all cases splenectomy was performed. Two patients had concomitant gall stones and choledocholithiasis, respectively. One patient with concomitant gall stones underwent simultaneous cholecystectomy and splenectomy. The other patients associated with choledocholithiasis underwent splenectomy, cholecystectomy, choledocholithotomy, and T-tube drainage. 6. Complete hematologic recovery was obtained by the splenectomy in all cases. 7. Postoperative complication was not occurred.
Anemia ; Anemia, Hemolytic ; Child ; Cholecystectomy ; Choledocholithiasis ; Coombs Test ; Diagnosis ; Drainage ; Erythrocyte Membrane ; Erythrocytes ; Female ; Gallstones ; Humans ; Jaundice ; Male ; Osmotic Fragility ; Postoperative Complications ; Reticulocytosis ; Spectrin ; Spherocytes ; Splenectomy* ; Splenomegaly ; Wills

No abstract available.
Emergencies* ; Emergency Medicine* ; Internship and Residency*

Osteopetrosis is a very rare bone dysplasia characterized by failure of resorption and persistence of calcified chondroid and primitive bone. In 1904 Albers-Schonberg first described the radiological appearance of marble bone. This is named osteopetrosis by Karshner in 1926. A fulminating form is manifested from birth in which fractures and deformity, hydrocephalus and cranial nerve palsies lead to early death from intractable anemia and intercurrent infection. In other cases the stigmata are delayed until later childhood, when retardation of growth and of mental and sexual development occurs, and not infrequently accompanied by rickets, dental caries and osteomyelitis. We have experienced a familial osteopetrosis, father and three siblings, which was thought to be a autosomal dominant inheritance. One of those family, 20 years old man, has been complained of anemia and low back pain without radiating pain to the lower extremities. The other 3 patients has not been complained of any other clinical symptoms. But X-Ray examination of the entire skeletal survey of those members of the family have revealed the uniform opacity of long bones and flat bones.
Anemia ; Bone Diseases, Developmental ; Calcium Carbonate ; Christianity ; Clothing ; Congenital Abnormalities ; Cranial Nerve Diseases ; Dental Caries ; Fathers ; Humans ; Hydrocephalus ; Low Back Pain ; Lower Extremity ; Osteomyelitis ; Osteopetrosis ; Parturition ; Rickets ; Sexual Development ; Siblings ; Wills

Synovial sarcoma is an uncommon, highly malignant soft tissue tumor usually arising from the synovial lining of a joint, bursa and tendon sheath. Occurence in muscle fascia is extremely rare. We present a case of synovial sarcoma of the left calf muscle fascia, which was confirmed by microscopically sarcomatous growth of spindle cells and irregular small multiloculation. Above knee amputation was done.
Amputation ; Fascia ; Joints ; Knee ; Sarcoma, Synovial ; Tendons

Isolated radial head dislocation, without an associated fracture of the ulna in adult, is rare. Two cases which can be thought as old unreduced isolated radial head dislocation were experienced in this hospital. Dislocated radial heads have not been reduced, however the cases revealed normal elbow motion including pronation and supination. We report these cases with a review of the literature.
Adult ; Dislocations ; Elbow ; Head ; Humans ; Pronation ; Supination ; Ulna