An 18-year-old man had suffered from intense burning with redness and an increased temperature of both the lower legs, forearms and hands since the age of 5. Symptoms were exacerbated by exposure to heat or walking. The patient obtained temporary relief by immersing his feet and hands in cold water. We observed the increase of skin temperature in relation to pain by thermography. No specific abnormalities were noted in laboratory studies. Treatment with aspirin was ineffective. We report a rare case of primary erythermalgia with typical features.
Adolescent ; Aspirin ; Burns ; Erythromelalgia* ; Foot ; Forearm ; Hand ; Hot Temperature ; Humans ; Leg ; Skin Temperature ; Thermography ; Walking ; Water

No abstract available.
Thumb*

Hemorrhagic fever with renal syndrome (HIFRS), scrub typhus, murine typhus and leptospirosis have been the principal acute febrile diseases in Korea. To evaluate the seroepidemiologic patterns of acute febrile illness, sera collected from 2,423 patients in 1996 were examined for antibodies against Hantaan virus, Orientia tsutsugamushi, Rickettsia typhi, and Borrelia burgdorferi by indirect immunofluorescent antibody technique (IFA) and macroscopic agglutination test for Leptospira interogans. Seropositive cases against O. tsutsugamushi, Rickettsia typhi, Leptispira interogans and Hantaan virus were 192 (7.9%), 193 (8.0%), 12 (0.5%) and 324 (13.4%), respectively. Male was more affected in HFRS and murine typhus contrasting to scrub typhus and leptospirosis in female. Most positive cases occurred during October and November for scrub typhus, and during November and December for HFRS. These results showed similar patterns with previous epidemical data for recent couple of years, and possibly implied no significant changes occurred in ecologic situations for acute febrile diseases in Korea.
Agglutination Tests ; Antibodies ; Borrelia burgdorferi ; Female ; Hantaan virus ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea* ; Leptospira ; Leptospirosis ; Male ; Orientia tsutsugamushi ; Rickettsia typhi ; Scrub Typhus ; Typhus, Endemic Flea-Borne

Since Pare's first report on Achilles tendon rupture in 1575, many authors have presented numerous operative and nonoperative methods for its treatment. Numerous controversies following its treatment have been concerned with the selection of its treatment method, which could minimizing the complications and enable early ambulation. We analysed 98 cases of Achilles tendon rupture in adults which were treated by direct repair, three-tissue bundle technique, or Plantaris/Peroneus augmentation repair for 3(1)/4 years from Oct. 1986 to Dec. 1989. We compared with types of cast after operation, periods for immobilization, and ankle motion of dorsiflexion at postoperative 6 weeks & long-term follow up. The results obtained from this study were as follows; l. After repair by three-tissue bundle technique, a short leg cast was applied, and then a weight bearing was started at postoperative 3 weeks. It can be demonstrated to shorten hospitalization and early ambulation when compared to other surgical techinques. 2. The patients who were repaired with the three-tissue bundle techinque averaged 12.5° dorsiflexion at the time of cast removal at postoperative 6 weeks, compared to 0°, 1° plantar flexion, and 4.4° plantar flexion with other techniques. The former group was significantly better than that of the latter group, and these differences were not present at long-term follow up. 3. On follow up period, discoverd complications were rerupture of Achilles tendon in 8 cases and mild wound infection in 3 cases, but the patients who were repaired by the three-tissne bundle technique showed no complications except mild wound infection in one case.
Achilles Tendon ; Adult ; Ankle ; Early Ambulation ; Follow-Up Studies ; Hospitalization ; Humans ; Immobilization ; Leg ; Methods ; Rupture ; Weight-Bearing ; Wound Infection

OBJECTIVES: Obstructive sleep apnea (OSA) syndrome is diagnosed through history, physical examination, imaging studies and polysomnography. Clinical examination of this condition may point to hypertrophic tonsils and crowded oropharynx. The objective of this study is to investigate the usefulness of modified Mallampati grade (MMG) and tonsil grade (TG) in predicting the severity of obstructive sleep apnea. METHODS: MMG and TG were divided into 4 and 5 groups, respectively, according to their severity. Medical records were collected from 94 patients who had received polysomnography and otorhinolaryngologic examination for snoring and sleep apnea at Keimyung University Dongsan Medical Center from March 2002 through April 2004. Patients were divided into two groups according to the apnea-hypopnea index (AHI) : control (n=24), and patients with sleep apnea (n=70). RESULTS: Patients with higher MMG and TG had higher AHI, and MMG and TG proved to have a statistically significant correlation with AHI (p< 0.05) CONCLUSION: MMG and TG were reliable predictors of OSA and helpful parameters in deciding treatment method.
Humans ; Medical Records ; Oropharynx ; Palatine Tonsil ; Physical Examination ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Snoring

About half of all burst fractures at the thoracolumbar junction lead to neurological impairment and several clinical series have demonstrated a statistically significant correlation between canal encroachment and neurologic impairment, but not directly related. Spontaneous canal remodelling over time due to bone resorption has been observed in conservatively treated burst fractures. The aim of this study was to measure spinal canal remodelling after stabilization of burst fractures. So, we evaluated 22 cases of surgically stabilized burst fractures of thoracolumbar junction about pre and postoperative spinal canal stenotic ratio and canal remodelling by bone resorption over time. The results were as follows; l. Pedicle splaying increases the spinal canal area and necessitates correction. 2. Patients with neurological deficits had average 53% encroachment and the neurological normal patient had a canal compromise of 33.9%. 3. Postoperatively canal encroachment had decreased to a mean of 17.4% and further reduced by resorption of bony fragment to a mean of 8.3% within 14 months. In conclusions, remodelling of the spinal canal by resorption of encroaching bone fragments is a consistent feature in surgically stabilized thoracolumbar burst fractures and most patients regain their prefracture canal demensions within 14 months.
Bone Resorption ; Humans ; Spinal Canal*

The use of lower extremity tourniquets for procedures of the lower leg is considered routine in orthopedic surgery, but, lower extremity tourniquets do harm occasionally. While the tourniquet is inflated, metabolic changes such as increased PaCO2 , lactic acid, and serum potassium and decreased level of PaO2 and pH occur in the ischemic limb. Deflation of tourniquet results in release of anaerobic metabolic products during ischemia into systemic circulation. In this ischemia/reperfusion situation, oxygen free radicals could potentially be produced during the reperfusion period by several mechanisms. One of these mechanisms is release of intracellular superoxide or hydrogen peroxide by activated neutrophils in the area. These reactive oxygen species(ROS) could be a causative factor for the postreperfusion no-flow, lung injury, induction of tourniquet shock, etc. The purpose of this clinical study was to investigate the effect of tourniquet deflation on the hemodynamic changes, changes of blood gas analysis, and hydrogen peroxide production using flow cytometric analysis of fluorescent DCF(Dichlorofluorescein). Quantitative analysis of fluorescent DCF was performed in resting and fMLP(N-formyl-methyonyl-leucyl-phenylalanine) or PMA(phorbol myristate acetate) stimulated neutrophils. Also differences of these factors between two groups of tourniquet time, one is less than one hour and the other more than one to two hours, were analysed. The hemodynamics(blood pressure, pulse rate), arterial PO2, bicarbonate, base excess, and hydrogen peroxide production showed no significant change before and after tourniquet release(p>0.05). Arterial pH and PaCO2 decreased significantly until 10 and 5 minutes after tourniquet release, respectively(p>0.05). Tourniquet time didn’t reveal any significances differences. These results indicate that tourniquet application with400mmHg pressure and less than 2 hours does not release significant hydrogen peroxide into systemic circulation during reperfusion period after tourniquet release.
Blood Gas Analysis ; Blood Pressure ; Clinical Study ; Extremities ; Flow Cytometry ; Free Radicals ; Hemodynamics ; Hydrogen Peroxide ; Hydrogen ; Hydrogen-Ion Concentration ; Ischemia ; Lactic Acid ; Leg ; Lower Extremity ; Lung Injury ; Myristic Acid ; Neutrophils ; Orthopedics ; Oxygen ; Potassium ; Reperfusion ; Shock ; Superoxides ; Tourniquets

No abstract available.
Breast Neoplasms* ; Breast* ; Survival Rate*

Recently, the incidence of fracture and dislocation of the proximal humerus has been increased with increment of traffic accident and industrial accident. Although most proximal humeral fractures can be treated satisfactorily by simple conservative treatment, the displaced fracture or fracture-dislocatiion of the proximal humerus demands special treatment and judgement. It has been reported that the results of the surgical treatment of the unstable fracture of the proximal humerus was better than that of conservative treatment. The authors analysed 32 cases displaced fracture or fracture-dislocation of the proximal humerus treated operatively which were followed up more than 1 year at the Dae Han Hospital from June, 1990 to May, 1993. The obtained results were as follows; l. According to Neer's classification, there were 2-part fracture in 3 cases(9%), 3-part in 17 cases(54%), 4-part in 2 cases(6%), fracture-dislocation in 8 cases(25%) and head splitting in 2 cases(6%). 2. The clinical results by Neer's criteria were excellent in 9 cases(28%), good in 14 cases(44%), fair in 7 cases(22%), and poor in 2 cases(6%) among the 32 cases. 3. The complication were limitation of motion in 4 cases, avscular necrosis of humeral head in 2 cases, nonunion in 1 case, delayed union in 1 case, ectopic ossification in 1 case and malunion in 1 case. 4. In the unstable fracture of the proximal humerus treated by accurate reduction and rigid fixation with intensive rehabilitation can be obtained, relatively satisfactory results because of the inability to maintain an acceptable closed reduction.
Accidents, Occupational ; Accidents, Traffic ; Classification ; Dislocations ; Head ; Humeral Head ; Humerus ; Incidence ; Necrosis ; Ossification, Heterotopic ; Rehabilitation ; Shoulder Fractures

Hantaviruses are distributed in rodent population world-widely even in geographical areas where hemorrhagic fever with renal syndrome (HFRS) has not been reported. Va.ictus species of Family Muridae and Arvicolidae serve as the natural reservoirs of hantaviruses. Hantaan virus, Seoul virus, Puumala virus, Prospect Hll virus, Sin Hombre virus and New York virus are members of genus Hantavirus and isolated from lungs of A. agrarius, C glareolus, M. pennsylvanicus, P. maniculatus and P. leucopus respectively. This experiment was intended to find the distribution of hantavirus infection among wild rodents and isolate the hantavirus from lung tissue of seropositve Apodemus peninsulae, and compared the nucleotide and amino acid sequences with prototype of hantaan virus 76-118 strain. Hantaviral sequences were amplified from lung tissues of A. peninsulae by reverse-transcriptase polymerase chain reaction. Alignment and comparison of the 324 nucleotide of G2 region of M-genomic segment diverged 4.6% and 0% at the nucleotide and amino acid levels, and complete N protein-coding region of S-genomic segment diverged 3.7% and 1.4% nucleotide and amino acid levels, respectively. This is the report to spill-over on the hantaan virus from A. peninsulae to A. peninsulae in Korea.
Amino Acid Sequence ; Animals ; Gyeonggi-do* ; Hantaan virus ; Hantavirus Infections ; Hantavirus* ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea ; Lung ; Muridae ; Murinae* ; Polymerase Chain Reaction ; Puumala virus ; Rodentia ; Seoul virus