In orthopedic trauma surgery, treatment of intraarticular distal humerus fractures is a challenge. With development of implants and biomechanical studies, surgical strategies with recommendations including preoperative computed tomography images, proper approaches and open reduction and internal fixation with dual plates have emerged. In addition, as an effort to provide stable fixation to permit early elbow motion, different methods of internal fixation, particularly plate configuration, have evolved. Using dual plates, either oriented parallel to each other or orthogonal, stable fixation has been achieved and satisfactory clinical outcomes have been reported. With rationales and advantages/disadvantages of each plate configuration, both techniques are selected according to surgeons' preference, and, in specific cases, one could be preferred over another. The key to successful fixation by either technique is obtaining anatomical reduction with restoration of two stable columns of the distal humerus.
Elbow ; Fracture Fixation ; Humeral Fractures* ; Humerus ; Orthopedics

Amidarone hydrochloride, benzofuran derivatives, particularly effective for the treatment of arrythmias by prolong the duration of the action potential in all cardiac-conducting tissues. We studied the 25 patients with typical amiodarone keratopathy, retrospectively. In 25 patients, ten patients developed grade 1, eleven patients developed grade 2, and four patients developed grade 3 keratopathy. They complained of decreased best corrected visual acuity(1 patient), halos(1 patient), hypothyroidism(3 patients), pulmonary toxicity(2 patients), thpatic dysfunction(5 patients) and sleep dusturbance(3 patients). Therefore ophthalmologists should be alert for the complications of amiodarone and regular careful slit-lamp examination will be helpful in minimizing amidarone toxicity.
Action Potentials ; Amiodarone* ; Arrhythmias, Cardiac ; Humans ; Retrospective Studies

We examined the factors which may serve as predictors of success or failure of amputation in lower extremity for vascular obstructive diseases in 52 consecutive patients who were treated at the Department of Orthopaedic Surgery and Yonsei Cardiovascular Center from January 1st, 1990 to December 31st, 1994. The minimum follow up period was 10 months. The population was divided into two groups, group of success of primary amputation and group of failure. The results were as follows, male and female ratio was 42:10 and the average age was 57.5 years old. Among total 52 cases, there were 22 cases of arteriosclerosis obliterans, 15 cases of Buerger's diseases, 12 cases of vasculitis, 3 cases of acute arterial embolism. Complications after primary amputation included 9 cases of superficial wound infections, 7 cases of marginal wound necroses. Sixteen cases belonged to the group in which reamputation were performed because of intractable poor wound healing. Preoperative value of hemoglobin, hematocrit, serum albumin and serum creatinine which had been generally known as prognostic factors in wound healing were not related to the necessity of reamputation (Multivariate Regression Test, P>0.05). And also age, blood pressure and smoking history and level of amputation didn't show any difference between two groups but existence of lower extremity infection and uncontrolled diabetes mellitus were related to the prognosis of reamputation (Multivariate Regression Test, P<0.05).
Amputation* ; Arteriosclerosis Obliterans ; Blood Pressure ; Creatinine ; Diabetes Mellitus ; Embolism ; Female ; Follow-Up Studies ; Hematocrit ; Humans ; Lower Extremity* ; Male ; Necrosis ; Prognosis ; Risk Factors* ; Serum Albumin ; Smoke ; Smoking ; Vasculitis ; Wound Healing ; Wound Infection ; Wounds and Injuries

No abstract available.
Acupuncture* ; Mycobacterium*

No abstract available.
Breast Neoplasms* ; Breast*

No abstract available.
Breast Neoplasms* ; Breast*

Acrodermatitis enteropathica, an autosomal recessive disease, usually presents with severe acral and circumorificial dermatitis, diarrhea, alopecia, intercurrent bacterial infection during early infancy, and is eventually fatal if left untreated. We report a case of acrodermatitis enteropathica in a 2-month-old male infant who presented with chronic diarrhea not responsive to conventional therapy and developed disseminated intravascular coagulation (DIC). He showed the characteristic eczematoid skin lesions, chronic diarrhea, failure to thrive, and low serum zinc concenturation. Zn2+ was administered with dramatic improvement of skin lesions, DIC and diarrhea. He rapidly catched up normal growth and development on continuing zinc supplementation.
Acrodermatitis* ; Alopecia ; Bacterial Infections ; Dacarbazine ; Dermatitis ; Diarrhea* ; Disseminated Intravascular Coagulation* ; Failure to Thrive ; Growth and Development ; Humans ; Infant ; Male ; Skin ; Zinc

Reactive human mesothelial cells were examined by immunocytochemical stain with intermediate fiiaments (cytokeratin [CK1, CK7, CK8, CK18, CD19], vimentin, desmin, actin), epithelial membrane antigen, carcinoembryonic antigen (CEA), MHC class II antigen (HLA-DR), LeuM-1 (CD15), alpha1-antitrypsin(ACT), alpha1-antichymotrypsin(ACMT), CD68(KP-1) and FcyRIII(CD16). The mesothelial cells were isolated from patients with liver cirrhosis and pleural effusion, and short-term cultured in RPMI 1640 media containing 10% heat inactivated fetal calf serum and 1% identical supernatant fluid of the patients transudates. The results obtained are as follows. 1. The cultured-reactive mesothelial cells were positive for the protein of cytoskeleton such as cytokeratin and vimentin, but negative for desmin and actin. The resting mesothelial cells showed positive reactions for cytokeratin, but negative for vimentin, desmin and actin. 2. The primary antibodies to the cytokeratin were strongly reactive for CK1, CK8 and CK18 but negative r CK7 and CK19 in both reactive and resting mesothelial cells. 3. Resting mesothelial cells showed negative reactions for CEA, but strong positive reactions in cultured-reactive mesothelial cells. 4. The markers for the monocytes/histiocytes(CD11b, CD14, CD16, CD68, lysozyme and alpha1-antitrypsin and alpha1-antichymotrypsin) were nonreactive in resting mesothelial cells, but lysozyme and alpha1-antitrypsin were weakly reactive in reactive and proliferative mesothelial cells. 5. MHC Class II molecule(HLA-DR antigen) was negative in both resting and reactive mesothelial cells. These results suggest that the short-term cultured, reactive mesothellal cells show a newly aberrant expression of the vimentin and carcino-embryonic antigen. The reason of the aberrant expression of the intermediate filament and oncofetal antigen in reactive and proliferative mesothellal cells should be further evaluated.
Actins ; Antibodies ; Carcinoembryonic Antigen ; Cytoskeleton ; Desmin ; Exudates and Transudates ; Follow-Up Studies* ; Histocompatibility Antigens Class II ; Hot Temperature ; Humans ; Hydronephrosis* ; Intermediate Filaments ; Keratins ; Liver Cirrhosis ; Mucin-1 ; Muramidase ; Pleural Effusion ; Salivary Glands ; Vimentin

Myocardial scintigraphy is a widely used noninvasive procedure with high sensitivity for the detection of patients with suspected coronary artery disease. The purpose of this study was to determine the prognostic value of a normal myocardial scintigraphy in 292 patients (150 males, 142 females, mean age 53+/-12 years) with chest pain who were followed from 7 to 58 (mean 25) months. Myocardial SPECT was performed with Tc-99m MIBI in 173 patients, with Tc-99m tetrofosmin in 74 patients and with T1-201 in 45 patients. During the follow-up period, there were 2 cardiac deaths and 2 nonfatal myocardial infarctions resulting in cardiac event rate of 1.37% (0.66% per year). The cardiac event rate was not different in patients with angiographically normal coronary arteries (1/30, 3.3%) and in those who had significant coronary a disease (2/27, 7.4%) (p=0.60). In conclusion, patients with chest pain and normal myocardial scintigraphy have a low cardiac event rate, and there was no significant difference of cardiac event rates between patients with normal and abnormal coronary angiograms.
Chest Pain* ; Coronary Artery Disease ; Coronary Vessels ; Death ; Female ; Follow-Up Studies ; Humans ; Male ; Myocardial Infarction ; Myocardial Perfusion Imaging ; Perfusion Imaging* ; Perfusion* ; Prognosis ; Thorax* ; Tomography, Emission-Computed, Single-Photon

It has been shown that both rest and stress myocardial perfusion imagings with technetium agents can be performed on the same day using two different doses injected within few hours. The purpose of this study was to compare the two protocols (stress-rest and rest-stress) in detecting coronary artery diseases. One hundred and sixty patients (101 males, 59 females, mean age 57+/-9 years) and 120 patients (79 males, 41 females, mean age 59+/-10 years) underwent stress-rest myocardial perfusion SPECT and rest-stress myocardial perfusion SPECT, respectively All of them underwent both myocardial perfusion SPECT and coronary angiography within 1 month. A coronary stenosis was considered significant when it compromised the luminal diameter by> or =50%. The chi square test was used to compare differences in sensitivity, specificity and accuracy between the two groups. The overall sensitivity, specificity and accuracy of stress-rest protocol were 99%, 35%and 68%, respectively. Those of rest-stress protocol were 96%, 47%, and 78%, respectively. There was no difference between the two protocols in identifying individual diseased coronary artery branches. Therefore, one day stress-rest and rest-stress myocardial SPECT using Tc-99m agents were comparable and were very sensitive tests in detecting coronary artery diseases.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Female ; Humans ; Male ; Perfusion Imaging ; Perfusion* ; Phenobarbital ; Sensitivity and Specificity ; Technetium ; Tomography, Emission-Computed, Single-Photon