Distal radioulnar is a part which has a rotational movement through the function of distal radioulnar joint and extensor carpi ulnaris. The injury mechanism in this area is usually a trauma largely due to traffic accidents. In general these injuries to the distal radioulnar joint are treated by a closed reduction. However, the isolated distal ulnar fracture without radial fracture, which is often called the night stick fracture, is difficult to treat by a closed reduction and a cast immobilization alone, especially if there is a displacement or fracture segment impinging soft tissue or severe comminution. Nonunion has been the frequent outcome with this method of treatment and limitation of rotation of forearm and distal radioulnar joint have occurred due to long period of immobilization or malunion. Thus, a different treatment modality such as open reduction and internal fixation and early active joint motion has arisen as a better treatment modality. In this study, 8 cases of isolated distal ulnar fracture without radial fracture have recieved the operation and the early active joint movement, if a displacement was present either at the time of injury or after the initial closed reduction. As a result, this method has enabled the patients to reduce the rate of complication of nonunion and to recover limitation of joint motion in a shorter time period.
Accidents, Traffic ; Forearm ; Humans ; Immobilization ; Joints

Malignant esophago-bronchial fistula is an incurable and distressing condition. The passage of swallowed saliva and solid or liquid food into the bronchial tree causes coqghing and frequent pulmonary infection and collapse. Most patients are unfit for major surgery, but intubation offers a quick, simple and effective treatment with improved length and quality of life. However, intubation with simple esophageal tubes are liable to result in failure to occlude the fistela, migration of the tube, erosion, and in the case of latex tubes, disintegration. To overcome these problems, the fistula is intubated perorally with a prosthesis surrounded by a foam rubber cuff contained ia silicone sheath, in which vacuum can be created. This cuffed prosthesis is the most satisfactory design for the treatment of malignant esophago-bronchial fistula with effiective and gentle occlusion of the fistula without risk of pressure necrosis. We experienced a case of the endoscopic treatment with a cuffed prosthesis for malignant esophago-bronchial fistula. So we report this case with brief review of the previous literatures.
Bronchial Fistula* ; Esophageal Neoplasms ; Fistula ; Humans ; Intubation ; Latex ; Necrosis ; Prostheses and Implants* ; Quality of Life ; Rubber ; Saliva ; Silicones ; Vacuum

PURPOSE: More effective diagnosis and treatment through a survey on clinical aspect for the last 5 years and interrelation between cold agglutinin titer and mycoplasma antibody titer of Mycoplasma pneumoniae pneumonia. METHODS: 369 patients hospitalized in the department of pediatrics of Chung Goo Sung Shim Hospital for the 5 years from January 1990 to December 1994 have been surveyed, which diagnosed to be Mycoplasma pneumoniae pneumoniaby physical findings or chest x-ray findings with the titer of 1:64 in cold agglutinin test or the titer of 1:80 in Mycoplasma antibody test or forefold increase of any one or both of 2 titers in follow-up tes RESULTS: 1) More cases were found in 1990(76 cases, 20.6%) and 1994(181 cases, 49%) and the monthly distribution showed irregular fluctuations. Male to female ratio was 1:1.2 and high incidence was in the age of 3 to 5 years(27.9%), but 46 cases(12.5%) affected the infants below 1 year old. 2) Cough, fever, sputum were the most chief complaints. More moist rales, pharyngial injection, wheezing were found in physical examination. 86.7% of pneumonic infiltration were found in x-ray findings, 35.8% of which were both lung infiltration. The most common affected site was Rt. lower lobe and then Lt lower lobe and then followed by Rt. upper lobe. 71.8% of the whole cases were hospitalized for 5-8 days. 3) EM administration started 10-12 days after the onset in 29.3%. Mean duration of hospitalization of the cases administrated within 6 days from onset was 7.5+/-2 days, which was shorter than 8.4+/-3.5-that of the cases administrated after 6days from onset. The observation on those duration meant little atatistically(p>0.1) 4) The measure of Mycoplasma antibody titer in 142 cases among 245 positive cold agglutinin test case showed 61.3% of positive ratio. Positive ratio of cold agglutinin test peaked from 13th to 15th day after onset(89%) and went down(33%) after 19th day. Positive ratio of Mycoplasma antibody titer was at its summit(91%) from 7th to 9th day and went down(63%) after 16th day. decreased to 63% after 16 days. 264 cases tested simultaneously for cold agglutinin titer and Mycoplasma antibody titer. Titers of each simultaneous test for cold agglutinin and Mycoplasma antibody were in proportion each other(p<0.005, N=264, r=0.51). CONCLUSIONS: Mycoplasma pneumoniae pneumonia prevailed every 4 years(1990, 1994) and monthly distribution had been irregular. The most cases were found at age of 4 and 5. Mycoplasma antibody titer seems more effective for early diagnosis for Mycoplasma antibody titer showed high positive rate earlier and the rate went down earlier than cold agglutinin titer. The earlier diagnosis and treatment are required because of tendency of later erythromycin administration.
Child* ; Cough ; Diagnosis ; Early Diagnosis ; Erythromycin ; Female ; Fever ; Follow-Up Studies ; Hospitalization ; Humans ; Incidence ; Infant ; Lung ; Male ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pediatrics ; Physical Examination ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory Sounds ; Sputum ; Thorax

No abstract available.
Acupuncture* ; Mycobacterium*

No abstract available.
Breast Neoplasms* ; Breast*

No abstract available.
Breast Neoplasms* ; Breast*

Owing to the paucity of information on the clinical outcomes in female patients with acute myocardial infarction (AMI) in relation to the comorbid disease burden, we explored the differences in their clinical outcomes and identified predictive indicators.A total of 3,419 female AMI patients were stratified into two groups: Group A (those with zero or one comorbid diseases) (n=1,983) and Group B (those with two to five comorbid diseases) (n=1,436). Five comorbid conditions were considered: hypertension, diabetes mellitus, dyslipidemia, prior coronary artery disease, and prior cerebrovascular accidents. The primary outcome was major adverse cardiac and cerebrovascular events (MACCEs). The incidence of MACCEs was higher in Group B than in Group A in both the unadjusted and propensity score-matched data. Among the comorbid conditions, hypertension, diabetes mellitus, and prior coronary artery disease were found to be independently associated with an increased incidence of MACCEs. Higher comorbid disease burden was positively associated with adverse outcomes in the female population with AMI. Since both hypertension and diabetes mellitus are modifiable and independent predictors of adverse outcomes after AMI, it may be necessary to focus on the optimal management of blood pressure and glucose levels to improve cardiovascular outcomes.

The authors report eight cases of thoracic stenosis due to ossification of ligamentum flavum. Motor and sensory deficits were found in all cases and urinary incontinence was found in one case. Diagnosis was made from simple x-rays, myelography, computerized tomography, myelography-CT, and magnetic resonance imaging. Treatment consisted of sufficient posterior decompressive laminectomy and medial facetectomy which resulted in satisfactory improvement in 6 cases, fair course in 1 case and poor course in 1 case.
Constriction, Pathologic* ; Diagnosis ; Laminectomy ; Ligamentum Flavum* ; Magnetic Resonance Imaging ; Myelography ; Urinary Incontinence

Spinal stenosis has several types of etiology such as degenerative, spondylolisthetic and postoperative, etc. Operative management for spinal stenosis is adequate decompression and stabilization of the unstable lumbar spine created by the decompressive procedure. We analysed 52 operative cases of spinal stenosis delete from January 1994 to October 1996. The following results were obtained 1) The male and female ratio was 1:1.9 and mean age was 52.1 years old 2) Mean follow-up period was 20.3 months 3) The involved site was one level in(28)(53.9%), two level in(19)(36.5%), and three levels in(5)(9.6%) 4) For decompression method, total laminectomy combined with foraminotomy and facetectomy was employed procedure. 5) For stabilization, bilateral posterolateral fusion was performed in major damaged facet joint and transverse process. Instrumentation was combined in 61.5% delete of all cases 6) According to the criteria of Kirkaldy-willis, excellent and good results were shown in 90.6% of fused group with instrumentation and 85% of fused group without instrumentation.
Decompression ; Female ; Follow-Up Studies ; Foraminotomy ; Humans ; Laminectomy ; Male ; Spinal Stenosis* ; Spine ; Zygapophyseal Joint

The occurence of multiple primary malignant tumor is cansidered infrequent and the primary adenocarcinoma of the duodenal bulb is a rare conditian. The autopsy incidence of duodenal adenocarcinoma is between 0.019 and 0.5%. The first documented case of duodenal carcinoma was described by Hamburger in 1746. Increased awareness of the condition, improvement in diagnostic technics and a more aggressive surgical approach have changed this disease from a postmortem curiosity to a condition that can be treated with satisfactory results. There are several reports on the high incidence of second additinoal cancer in patients with small intestinal cancer. Recently, we have experienced a case of primary duodenal bulb adenocarcinoma with early gastric cancer in a 68 year old male patient with complaints of epigastric pain, diarrhea and body weight loss. So we report the case of primary duodenal bulb adenocarcinoma combined with early gastric cancer with a brief review of literature.
Adenocarcinoma ; Aged ; Autopsy ; Body Weight ; Diarrhea ; Exploratory Behavior ; Humans ; Incidence ; Intestinal Neoplasms ; Male ; Stomach Neoplasms*