This is a long term follow-up study to clarify whether arthroscopic synovectomy would be able to prevent further destruction of the articular cartilage in rheumatoid joints. Three hundred and eighteen rheumatoid joints of 94 patients who had surgery in the multiple joints(average 3.4 joints per person) and was followed for an average 39.9 months (range, 24-126 months) were selected. Diagnosis of rheumatoid arthritis was made according to the 1987 revised criteria of the American College of Rheumatology. The preoperative roentgenographic narrowing of cartilage space (modified classification of ARA) and the arthroscopic findings (grading of Outerbridge) were recorded. The points of investigation were 1) further destruction of articular cartilage on X-ray, postoperatively, and 2) reaccumulation of effusion. The results were as follows; 1) Knee Joint: Among 103 knee joints there were 92 (89.3%) Stage I, G-0 knees, 8 Stage II (G-2: 1, G-3: 3, G-4: 4 joints), and 3 Stage IIIB, G-4, preoperatively. The 3 Stage IIIB, G-4 knees showed progression of narrowing of joint space and were replaced by artificial joints two years after the synovectomy. 2) Wrist joint: Fifteen joints (28.3%) out of 53 joints were Stage II, G-4, and 2 joints joints (3.8%) were Stage I, G-3, preoperatively. They were progressed to Stage IIIB at final follow-up. 3) Other Joints: There was no further narrowing of the joint space following surgery in 22 fingers, 2 toes, 34 elbows, 34 shoulders and 70 ankles. 4) Prognosis seemed to depend upon postoperative medication. From these results it would be suggested that the rate and severity of recurrence of synovitis and further destruction of articular cartilage can be decreased with early synovectomy so long as proper anti-rheumatic medication is followed, although the surgery can not halt the disease process.
Ankle ; Arthritis, Rheumatoid ; Cartilage ; Cartilage, Articular ; Classification ; Diagnosis ; Elbow ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Prognosis ; Recurrence ; Rheumatology ; Shoulder ; Synovitis ; Toes ; Wrist Joint

Eccrine nevus is an unusual entity with various clinical manifestations. Histologically the eccrine apparatus appears simply increased in number and/or size, but structurally normal. We present a case of eccrine nevus on the dorsum of the left 3rd and 4th fingers in a 20 year-old female. The lesions were 3 × 2cm sized, well demarcated, smooth surfaced, brownish plaques with mild hyperhidrosis. Histological examination revealed hyperkeratosis in the stratum corneum and hyperpigmentation of basal layer, and an increased number of eccrine sweat glands and many eccrine coils in the dermis was seen.
Dermis ; Female ; Fingers ; Humans ; Hyperhidrosis ; Hyperpigmentation ; Nevus* ; Sweat Glands

No abstract available.
Aneurysm* ; Carotid Artery, Internal*

Teratomas of the fallopian tube are extremely rare, and only about 50 cases have reported in the world literature. Most cases of mature cystic tubal teratoma are asymptomatic and are discovered as an incidental finding on physical or radiologic examination, or at the time of laparatomy. We report a case of mature cystic teratoma of the right fallopian tube which was discovered during pelvic ultrasonogram for antenatal care in a 28 year old woman. Right salpingectomy was performed during cesarean section for cephalo-pelvic distortion at IUP 39 weeks. Gross examination of the right fallopian tube reveals a distended fallopian tube, measuring 8cm in length and 2cm in diameter. On section, it is filled with several small pedunculated nodules and cysts containing sebaceous materials. Microscopically the tumor was seen in continuity with the lining epithelium of mucosal folds. The majority of the tumor was composed of well differentiated mature elements of three germ layers with skin and skin appendages, mature brain tissue, bone, breast tissue, intestinal mucosa and bronchial epithelium.
Female ; Humans ; Cysts

To study factors related to release of atrial natriuretic polypeptide(ANP) in human subjects, instracardiac pressure and plasma ANP concentration in peripheral and central circulation were measured in patients with various heart disease (18 valvular heart disease, 4 congenital heart disease, 2 cardiomyopathy). 1) The concentration in peripheral venous plasma were increased in 14 patients with New York Heart Associaion (NYHA) functional class III-IV (87+/-38 pg/ml) as compared with that in 10 patients with NYHA functional class I-II (39+/-21 pg/ml, P<0.005)and 15 normal subjects (51+/-21 pg/ml, P<0.01). 2)The concentration of plasma ANP in inferior vena cava, right ventricle, pulonary artery, left ventricle and aorta were markedly increased in patient with NYHA functional class III-IV, elevated mean right atrial pressure (MRAP> or =8 mmHg) elevated mean pulmonary capllary wedge pressure (MPCWP> or =15 mmHg) and/or elevated pulminary artery systolic pressure (PASP> or =35 mmHg), as compared with those in patients with NYHA functional class I-II and/or lower intracardiac pressure (MRAP<8 mmHg, MPCWP<15 mmHg, and/or PASP<35 mmHg). 3) A step up in ANP concentration between inferior vena cava and right atrium was seen in patients with elevated MRAP (81+/-28pg/ml, 137+/-60pg/ml, P<0.05), MPCWP (74+/-37pg/ml,112+/-62pg/ml, P<0.05) and/or PASP (75+/-29 pg/ml,119+/-64 pg/ml, P<0.05). But there were no differences among intracardiac ANP concentrations from right atrium though aorta. 4) Plasma concentrations in right atrium, pulmonary artery, left ventricle and aorta correlated with MRAP (r=0.82, 0.63, 0.56, p<0.005 and r=0.52, P<0.01, respectively), MPCWP (r=0.86, 0.75, 0.73 and 0.72 respectively, P<0.005 in all) and PASP (r=0.73, 0.57, 0.68 and 0.59 respectively P<0.005 in all). 5) Left atrial diameter correlated with plasma ANP concentration in peripheral plasma (r=0.55, P<0.01), inferior vena cava (r=0.51, P<0.025), right atrium (r=0.45, P<0.05), right ventricle (r=0.55, P<0.01), pulmonary artery (r=0.52, P<0.01), left ventricle (r=0.55, P<0.01) and aorta (r=0.56, P<0.005). These results suggest that the heart secrets atrial natriuretic polypeptide into right atrium in response to increased mean right atrial pressure, mean pulmonary capillary wedge pressure, pulmonary artery systolic pressure and/or left atrial distention.
Aorta ; Arteries ; Atrial Natriuretic Factor ; Atrial Pressure ; Blood Pressure ; Heart ; Heart Atria ; Heart Defects, Congenital ; Heart Diseases* ; Heart Valve Diseases ; Heart Ventricles ; Humans ; Plasma* ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Vena Cava, Inferior

No abstract available.
Administration, Intravenous* ; Cervix Uteri* ; Cisplatin* ; Female ; Fluorouracil*

A clinical study was retrospectively made on 33 patients with prostatic adenocarcinoma who were admitted to the Department of Urology, Eulji General Hospital, Seoul and DaeJeon between May 1985 and April 1992. The results were as follows: 1. The age distribution range was from 47 to 86 years (mean age 68.2 years). 2. The major presentations were prostatism (69%), acute urinary retention, gross hematuria and pain. On digital rectal examination, 14 patients (42.4%) had hard nodules on the prostate, and 7 patients had multiple nodules. 3. The clinical stages were stage A in 2 cases, stage B in 3, stage C in 8, and stage D in 20. The grades were: grade I in 7 cases, grade II in 14 and grade III in 12. Distant metastasis was round in 28 patients (84.8%). The sites involved were bone in 20 patients, lymph node in 5 patients, lune, liver and kidney in 1 patient each. Skeletal sites most frequently involved were spine (65%), pelvis (55%) and rib (50%). 4. For the treatment of 28 patients, orchiectomy only (9), DES only (7), DES +orchiectomy (3), endocrine therapy(orchiectomy or DES) + irradiation (8) and radical prostatectomy + irradiation (1) were performed. 5. In the response rate of treated 28 patients, partial or stable response 12 cases (42.9%) and progression 16 cases(57.l%). 7 patients expired, the causes of death were multiple metastasis with cachexia (4), sepsis (2) and congestive heart failure (1).
Adenocarcinoma* ; Age Distribution ; Cachexia ; Cause of Death ; Digital Rectal Examination ; Heart Failure ; Hematuria ; Hospitals, General ; Humans ; Kidney ; Liver ; Lymph Nodes ; Neoplasm Metastasis ; Orchiectomy ; Pelvis ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Prostatism ; Retrospective Studies ; Ribs ; Seoul ; Sepsis ; Spine ; Urinary Retention ; Urology

PURPOSE: Preamplifier and amplifier are very important parts for developing a portable counting or imaging gamma probe. They can be used for analyzing pulses containing energy and position information for the emitted radiations. The commercial Nuclear Instrument Modules (NIMs) can be used for processing these pulses. However, it may be improper to use NIMs in developing a portable gamma probe, because of its size and high price. The purpose of this study was to develop both preamplifier and amplifier and measure their performance characteristics. MATERIALS and Methodes: The preamplifier and amplifier were designed as a charge sensitive device and a capacitor resistor-rsistor capacitor (CR-RC) electronic circuit, respectively, and they were mounted on a print circuit board (PCB). We acquired and analyzed energy spectra for Tc-99m and Cs-137 using both PCB and NIMs. Multichannel analyzer (Accuspec/A, Caberra Industries Inc., Meriden Connecticut, U.S.A) and scintillation detectors (EP-047 (Bicron Saint-Gobain/Norton Industrial EP-047 (Ceramics Co., Ohio, U.S.A) with 2"x2" NaI (T1) crystal and R1535 (Hamamatsu Photonics K.K., Electron Tube Center, Shizuoka-ken, Japan) with 1"x1"NaI (T1) crystal) were used for acquiring the energy spectra. RESULTS: Using PCB, energy resolutions or EP-047 detectors for Tc-99m and Cs-137 were 12.92% and 5.01%, respectively, whereas R1535 showed 13.75% and 5.19% of energy resolution. Using the NIM devices, energy resolutions of EP-047 detector for Tc-99m and Cs-137 were measured as 14.6% and 7.58%, respectively. However, reliable energy spectrum of R1535 detector could not be acquired, since its photomultiplier tube (PMT) requires a specific type of preamplifier. CONCLUSION: We developed a special preamplifier and amplifier suitable for a small sized gamma probe that showed good energy resolutions independent of PMT types. The RESULTS indicate that the PCB can be used in developing both counting and imaging gamma probe.
Connecticut ; Ohio ; Optics and Photonics

To evaluate the effect of Perindopril in patients with essential hypertension, we administered Perindopril 4 to 8mg/day once daily to 30 patients(18 males, 12 females) for 12 weeks. Baseline blood pressure after 4 weeks with placebo was 150.4+/-7.5/102.0+/-4.3mmHg. The blood pressures of the patients were declined significantly at 4th(140.6+/-14.9/95.4+/-6.5), 8th(136.7+/-11.4/91.7+/-7.6), and 12th(132.3+/-11.1/87.5+/-6.9) week(p<0.01) without change of heart rate. The blood pressure of the patients was normalized below 140/30mmHg in 24 patients(80%) and declined diastolic blood pressure more than 10mmHg in one patients. Therefore the response rate of perindopril was 83.3%. There were reported 3 patients who revealed mild adverse reactions as follows; cough, indigestion, dizziness in one each. In conclusion, these results indicate that antihypertensive therapy with perindopril single daily dose was effective in patients with mild to moderate essential hypertension and well tolerated.
Blood Pressure ; Cough ; Dizziness ; Dyspepsia ; Heart Rate ; Humans ; Hypertension* ; Male ; Perindopril*

PURPOSE: The purpose of this study was to investigate the experience and perception of sexual harassment during the clinical practice among nursing students and to identify the relationship between these variables and self-esteem. METHODS: Participants included 191 senior nursing students who voluntarily participated. Sexual harassment experiences and perceptions were measured using the tools developed by the researcher. Self-esteem was measured using self-esteem inventory developed by Rogenberg. RESULTS: 50.8% of the participants experienced sexual harassment. Physical harassment was the most common, followed by verbal, visual and gender-role related sexual harassment. ‘Blocking the way’ and ‘Brushing one's body on purpose’ were the most common behaviors. The perception of sexual harassment severity was 3.35 out of 5 points. There were negative correlation between sexual harassment experience and self-esteem (r=-.17, p=.013). The subjects who experienced sexual harassment showed lower self-esteem score than those who did not (t=-2.10, p=.037). The main offender was a male patient in 40s, and the psychiatric ward was the most vulnerable to sexual harassment. CONCLUSION: Results showed that sexual harassment in clinical practice among nursing students were serious. It is necessary to develop an educational program to prepare them for sexual harassment in clinical practice.
Criminals ; Education ; Humans ; Male ; Nursing* ; Sexual Harassment* ; Students, Nursing*