A case of hepatic fascioliasis misdiagnosed as metastatic carcinoma was reported. The patient was a 22-year-old woman who had had rectal adenocarcinoma (Duke stage C2), and had been treated by Mile'operation 8 months ago. A computed tomogram(CT) demonstrated multiple low density nodules in the liver suggesting a metastatic tumor. A partial liver lobectomy was performed. The resected liver showed multiple necrotic nodules, which appeared to be abscesses containing eggs of the Fasciola species. Parasitic infection should be considered as one of the possible etiologies of hepatic nodules which mimic metastatic carcinoma either clinically or radiologically.
Female ; Humans ; Adenocarcinoma ; Neoplasm Metastasis

PURPOSE: We critically evaluated the most appropriate management of renal and perirenal abscess and identified the set of patients who had benefited from conservative management. MATERIALS AND METHODS: Between May 1995 and June 1999, fifteen patients with renal (10 cases) and perirenal abscess (5 cases) were treated in our hospital. Among the fifteen patients, six patients were managed by antibiotics alone, the other nine patients were managed by percutaneous aspiration and antibiotics. Percutaneous abscess aspiration and drainage was done under ultrasound guidance and local anesthesia. RESULTS: On the urine culture, 4 cases had positive urine culture (27%); E. coli was in 3 cases, Klebsiella in 1 case respectively. On the blood culture, E. coli was in 2 cases. On the abscess culture (9 cases were performed), the organisms were identified in 8 cases (89%); E. coli was in 6 cases, S. aureus was in 1 case, S. epidermidis in 1 case respectively. CONCLUSIONS: We suggest that proper antibiotic therapy alone or combined with ultrasound guided percutaneous drainage of renal and perirenal abscesses is a choice of reasonable, safe and effective management in selected patients.
Abscess* ; Anesthesia, Local ; Anti-Bacterial Agents ; Drainage ; Humans ; Klebsiella ; Ultrasonography

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

Clinical observation was performed on the 84 hips of 72 patients which were replaced by total hip, who were treated at Department of Orthopedic Surgery, College of Medicine, Busan National University, from March 1978 to March 1981. The follow-up period of each case varied from 1 to 4 years. The results obtained were as follows: 1. The peak age incidence ranged from 51 to 60 years, which comprised 37.1% (23 patients) of total cases. 2. The causes of the hip diseases were; 25 cases of post-traumatic avscular necrosis of the head, which comprised highest incidence, 19 osteoarthritis, 14 primary avscular necrosis of the head, 4 ankylosing spondylitis, and 3 rheumatoirl arthritis. 3. The most commonly used prosthesis was Muller type in 64 cases (88.9%); Trapezoidal-28 in 3 cases; Ceramic-metal type in 4 cases; and modified Muller type by Japanese in 1 case. 4. Anterolateral approach was used in all cases except for the 3 cases in whom anterior approach was made. In most cases, greater trochanter osteotomy was not performed except for the 9 cases in whom operative field were poorly exposed without osteotomy. 5. Several complications developed; perforation of femur shaft and acetabulum during the operation in 1 case each, Post-operative deep seated infection in 2 cases, thrombophlebitis in 1 case, wire breakage in 2 cases, stem failure in 1 case, and femoral shaft fracture in 1 case. 6. Postoperative functional evaluation by the Merle d'Aubigne and Postel method was done; pain relief in 92.4%, mobility recovery in 71.6% and functional inprovement in 70.1% belonged to grade 5 and 6. Relief of pain is the most prominent effect of the total hip rep1acement surgery in this series.
Acetabulum ; Arthritis ; Arthroplasty, Replacement, Hip ; Asian Continental Ancestry Group ; Busan ; Femur ; Follow-Up Studies ; Head ; Hip ; Humans ; Incidence ; Methods ; Necrosis ; Orthopedics ; Osteoarthritis ; Osteotomy ; Prostheses and Implants ; Spondylitis, Ankylosing ; Thrombophlebitis

A carefull inspection of an AP X-ray of a normal hip reveals in the weight-bearing surface of the ilium a curved area of dense bone, called SOURCIL by Pauwels (1963). The configuration of this dense area is semilunar and represents subchnodral bony eburnation due to a respose by the articular portion of the ilium to the stress provoked by the compressive force acting on it. However, in many cases of idiopathic avascular necrosis of the femoral head, changes in SOURCIL may be seen. So we reviewed our 49 patients (unilateral 16, bilateral 33) since 1983 with comparison to normal hips (100 persons). The results are as follows; 1. SOURCIL is not visible at birth and by walking, it is developed with age and has the adult configuration at the age of 18. It is thought the configuration and sloping angle of SOURCIL is not changed with age after skeletal growth is completed. 2. Although the position of the X-ray tube may be changed, the shape and angle of SOURCIL is not changed significantly. 3. The average SOURCIL angle is 2.1° in normal hip group and 3.5° for the avascular necrosis group but, there is no meaningful statistical differences. It seems to be meaningful that the mean SOURCIL angle is 10.3° for patients under the age of 35 in avascular necrosis groups (9 persons). 4. If a high SOURCIL angle (about 10° or more) is present, the hemiarthroplasty such as bipolar endoprosthesis should be avoided because there is biomechanically far more wearing of the acetabular roof after that kind of operation. If inevitable, deepening the acetabulum by reaming is recommended for prevention of superolateral migration of prosthesis after operation. 5. With close observation of SOURCIL before and after operation, one can easily point out what is able to predict the prognosis on the biomechanical basis.
Acetabulum ; Adult ; Head ; Hemiarthroplasty ; Hip ; Humans ; Ilium ; Necrosis ; Parturition ; Prognosis ; Prostheses and Implants ; Walking ; Weight-Bearing

OBJECTIVE: Rebamipide is a propionic acid derivative that has an action of the inhibition of superoxide production and removal of hydroxyl radical with the sperm incubation and cryopreservation. In the present study, to investigate whether rebamipide is useful to treat male infertility and sterility, the author observed the antioxidative effects in patient with male infertility and also examined its absorption and distribution in rat genital organ. METHODS: To measure the distribution of rebamipide in reproductive organ in the rat, carbon indicated rebamipide, 14C-OPC-12759, was orally administered to 10 Spraque-Dawley rats and its organ concentration in serum, liver, kidney, stomach, duodenum, colon, urinary bladder, seminal vesicle, epididymis and testicle were measured each time after 0.5, 1, 2, 4, 8 and 24 hours by using HPLC fluorescent method. The concentrations in semen were measured by HPLC fluorescent method in a sample of 50 infertile males who took 900 mg of rebamipide daily for 3 months. To measure the antioxidative effect and fertility rate for 3 months, each month before and after the treatment, sperm motility, vitality, the oxygen free radical formation, level of peroxidation, fetilizing capacity of semen sample which were obtained from infertile male patients by masturbation after at least 48 hours abstinence were analyzed by computer assisted semen analyzer, eosin-nigrosin stain, chemiluminescence, thiobarbituric acid method and hypo-osmotic swelling test. Simultaneously in a sample that wanted baby, both pregnancy and delivery were researched. RESULTS: The 14C-OPC-12759 concentration in the body of white rats was highest in gastrointestinal organ like stomach, smal intestine and duodenum and followed by genital organ like seminal vesicle, testis and epididymis. The rebamipide concentration in semen of infertile males was 220.77+/-327.84 ng/mL (SD) which showed a large deviation but it was higher than serum which was 126+/-76 ng/mL (SD). In the infertile males, after the treatment with rebamipide, the level of seminal reactive oxygen species (ROS) and lipid peroxidation have significantly decreased in duration of the treatment (p<0.05) and sperm vitality and fertilizing capacity except sperm motility significantly improved on post treatment of 2~3 months (p<0.05). Out of the 41 cases who hoped for pregnancy, 15 cases (36.6%) became pregnant and 12 cases had childbrith, 2 cases had miscarriage and one case is ongoing. The side effect was observed in 1 case (2%) which experienced diarrhea but it was lost spontaneously. CONCLUSIONS: We conclude from this study that rebamipide showed relatively high tendancy of absorption and excretion in the genital organ. In infertile males who had elevated ROS in semen, by specifically inhibiting the cell damage from the antioxidation, a way to preserve sperm motility, vitality and fertilizing capacity was confirmed.
Abortion, Spontaneous ; Absorption* ; Animals ; Birth Rate ; Carbon ; Chromatography, High Pressure Liquid ; Colon ; Cryopreservation ; Diarrhea ; Diethylpropion ; Duodenum ; Epididymis ; Female ; Genitalia ; Hope ; Humans ; Hydroxyl Radical ; Infertility ; Infertility, Male ; Intestines ; Kidney ; Lipid Peroxidation ; Liver ; Luminescence ; Male ; Masturbation ; Oxygen ; Pregnancy ; Rats ; Reactive Oxygen Species ; Semen ; Seminal Vesicles ; Sperm Motility ; Spermatozoa ; Stomach ; Superoxides ; Testis ; Urinary Bladder

BACKGROUND: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs). METHODS: Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups. RESULTS: Mean pain VAS improved, from 6.6+/-1.2 to 2.7+/-0.9 (p=0.001), and the mean functional VAS from 35.7+/-4.2 to 73.3+/-5.4 (p=0.006). The mean ASES score improved from 37.2+/-2.8 to 75.0+/-3.8 (p=0.012). The mean KSS improved from 36.5+/-7.2 to 75.6+/-5.4 (p=0.009), the mean forward elevation from 66.3+/-4.7 to 135.6+/-8.4 (p=0.0001), and the mean abduction from 45.2+/-4.2 to 119.0+/-6.5o (p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture. CONCLUSIONS: RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in short-term follow-up.
Arthroplasty* ; Clavicle ; Dislocations ; Elbow ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder* ; Visual Analog Scale

No Abstract Available.
Allografts* ; Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Tendons*

OBJECTIVES: The objectives of this study is to compare the differences of fetal heart rate (FHR) variables between preterm and term pregnancies after acoustic stimulation using computerized analysis of fetal heart rate. METHODS: Eighty-two normal pre-term and term pregnancies entered to this study after conventional 20-minutes nonstress test(NST) and 10-minutes acoustic stimulation test (AST). Acoustic stimulations were performed using Fetal Acoustic Stimulator (Model 146, Corometrics, US). We analyzed the FHR response after acoustic stimulation using our on-line computerized FHR analysis system, HYFM-I & II software. The changes of loss of signal, baseline FHR, variability, number of fetal movements, and number of FHR accelerations were analyzed numerically. RESULT: The mean baseline FHR was increased in term pregnancies from 141+/-7.0bpm to 152.7+/-9.7bpm, and in preterm pregnancies from 144.6+/-6.8bpm to 156.8+/-10.2bpm, respectively. The mean baseline FHR was significantly increased in both term and preterm pregnancies (p<0.01. paired t-test). The variability of FHR was increased in term pregnancies from 18.2+/-6.4bpm to 22.6+/-5.0bpm and in preterm pregnancies from 17.8+/-5.5bpm to 22.7+/-5.9bpm, respectively. The variability of FHR was also significantly increased in both term and preterm pregnancies. (p<0.01. paired t-test) CONCLUSION: The mean baseline FHR and the variability of FHR was significantly increased both preterm and term pregnancies. But the difference of each FHR variables between preterm pregnancies and term pregnancies was not statistically significant in this study.
Acceleration ; Acoustic Stimulation* ; Acoustics* ; Female ; Fetal Heart* ; Fetal Movement ; Heart Rate, Fetal* ; Pregnancy

No abstract available.
Female ; Pregnancy ; Pregnancy, Multiple*