Neither the cause nor the correct treatment of Kienbocks disease has been clearly established, but its clinical and radiologic presentations have been distinctly defined. There are many controversies concerning therapeutic guidelines for the treatment of Kienbocks disease. The purpose of this study is to evaluate the clinical result of triscaphe fusion with radial styloidectomy of Kienbocks disease. Ten cases of stage III Kienbocks disease by Lichtmans classification were treated by triscaphe fusion with radial styloidectomy from September 1991 to March 1997. We followed up over 24 months and evaluated clinical results. In all cases, pain was relieved. The postoperative results according to Kuschners method revealed three excellent, six good and one fair. The triscaphe fusion and radial styloidectomy was considered as useful method of treatment which has clinical efficacy in Kienbocks disease.
Classification ; Osteonecrosis*

The present study was carried out to clarify the anatomical changes of lumbar intervertebral discs by aging. Anterior height, posterior height, anteroposterior diameter of intervertebral discs were measured on 512 normal plain lateral radiographs of lumbosacral spine. And the indices of disc wedging and relative disc height were calculated. There was a cephalocaudal gradient of increase in the indices of disc wedging in all age groups. The indices of relative disc height were constant at all lumbar levels. These suggest that the lower disc is more wedge shaped and the height of discs changes in the constant ratio with that of vertebral body.
Aging* ; Humans ; Intervertebral Disc* ; Spine

OBJECTIVE: The study was performed to evaluate whether thallium reinjection (RI) distinguishes viable from nonviable myocardium among myocardial segments which showed persistent perfusion defect (PD) in patients with acute myocardial infarction (AMI). MATERIALS AND METHODS: We studied 22 patients underwent PTCA after AMI. SPECT was performed in all patients using dipyridamole stress- 4 hour redistribution (RD) followed by 24 hour RI protocols. Dysfunctional segs were classified into 5 groups: 1) normal, 2) reversible, 3) mild to moderate PD, 4) severe PD and 5) reverse redistribution (RR). All patients underwent follow up echocardiography after 4 months to assess regional wall motion (WM) improvement such as a criteria of viable myocardium. RESULTS: A total of 127 segs with abnormal WM was analyzed. Of 74 segs with PD, 17 (23%) showed enhanced uptake after 24 hour RI. Five of 17 segs (29%) with PD that responded to RI with enhanced thallium uptake showed WM improvement. WM improvement were seen in the 24 of 57 segs (42%) not responding to RI. All four segs (100%) with RR that responded to RI showed improvement. WM improvement were not seen in the 5 of 8 segs (71%) with RR not responding to thallium RI. Eleven (73%) of 15 segs with mild-moderate PD after RI showed improvement, but 33% of segs with severe PD after RI did not showed improvement. Segs with mild-moderate PD after RI and fill in after RI showed improvement in comparison to segs with severe PD after RI(p<0.05). CONCLUSIONS: These data indicate that because only small proportion of PD showed further perfusion improvement after RI and predictive value by the uptake after RI was low, there was limited role of RI after myocardial infarction. Usefulness of RI could be found in segs showing RR responding to RI in AMI reflects viable myocardium.
Dipyridamole ; Echocardiography ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Myocardium ; Perfusion ; Thallium ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Humans

PURPOSE: The admission rates for pediatric asthma are increasing annually and are partially responsible for the increased rates of readmission. Selections of children with a high-risk of readmission and aggressive treatments of them may improve treatment outcome and cost- effectiveness. The purpose of this study is to evaluate the risk factors affecting readmission in cases of bronchial asthma in children. METHODS: We reviewed the medical records of 95 cases under 14 years of age who were admitted to the Department of Pediatrics, Kyung-Hee University, from March 1996 to February 1997 and divided them into readmission and first admission group. RESULTS: Readmission cases were 52 (55%). Age, sex, duration of admission, duration of oxygen therapy, serum IgE concentration, duration of symptoms prior to admission and severity of asthma were not statistically significant compared with those of the control group (t-test) (P>0.05). Use of prophylactic agents, family history of allergic diseases and past history of bronchiolitis were significant (P<0.05), but age under 4 years and sex were not significant (X2-test). Age under 4 years, history of bronchiolitis, and history of previous hospital admission for asthma were significant (P<0.05), but sex, severity of asthma, history of frequent upper respiratory tract infection, family history, and the use of prophylactic agents were not statistically significant (P>0.05) as independent risk factors. CONCLUSION: Age under 4 years, past history of bronchiolitis, and history of previous hospital admission for asthma were significant risk factors for hospital readmission. Further study needs to be done to decrease the readmission rates.
Asthma* ; Bronchiolitis ; Child ; Humans ; Immunoglobulin E ; Medical Records ; Oxygen ; Patient Readmission ; Pediatrics ; Respiratory Tract Infections ; Risk Factors* ; Treatment Outcome

PURPOSE: Hormone-refractory prostate cancer(HRPC) is the terminal step in the natural history of prostate cancer, for which no chemotherapeutic agents have been shown to impact on the clinical outcomes. However, taxane-based therapies have recently appeared to have a significant efficacy on HRPC. The therapeutic effect of paclitaxel was evaluated against metastatic human prostate cancer PC-3 xenografted into athymic nude mice. MATERIALS AND METHODS: A total of 24 male nude mice subcutaneously transplanted with the PC3 cell line were divided in 2 groups. An experimental group was given paclitaxel intraperitoneally at a dose of 12.5mg/kg per injection per day for 4 consecutive days, from the 6th and 20th day following tumor injection. All mice were observed for 31 days, and sacrificed by CO2 gas asphyxiation at the end of the experiment. The mean tumor volume and body weight of both groups were compared using student's t-tests. A tumor volume of more than 200mm3 was regarded as dead. The survival rate was indirectly analyzed using the Kaplan-Meier method. RESULTS: The mean tumor volume of the paclitaxel treatment group was significantly reduced from the 20th day after tumor injection until the end of the experiment compared with the control group. The mean body weight of both groups was different significantly from the 17th day after tumor injection until the end of the experiment, but after removal of the tumor mass, at the 31st day after tumor injection, no significant difference was observed between the two groups. The survival rate of the paclitaxel treatment group was significantly higher than that of the control group. CONCLUSIONS: Our data has shown that paclitaxel is effective in suppressing the growth rate of a HRPC cell line in vivo and improved the survival rate. It is believe that further clinical assessment of the optimal dose and schedule of this drug are warranted.
Animals ; Appointments and Schedules ; Body Weight ; Cell Line* ; Heterografts* ; Humans ; Male ; Mice ; Mice, Nude* ; Natural History ; Paclitaxel* ; Prostate ; Prostatic Neoplasms ; Survival Rate ; Tumor Burden ; Xenograft Model Antitumor Assays

BACKGROUND: Prostaglandin system is known to participate in manifestation of the renin-angiotensin system. However, role of prostaglandins on the renin-angiotensin system in development of hypertension is not well established. This study was to examine whether the role of prostaglandins is altered in experimental hypertension. METHODS: Two-kidney, one-clip(2KIC) renal hypertension was made by clipping the left renal artery with a silver clip(internal gap of 0.2mm) and deoxycorticosterone acetate (DOCA)-salt hypertension by subcutaneous implantation of DOCA(200mg/kg) strip plus saline(1%) drinking. They were used 3 weeks later. Age-matched normal rats served as a control. Femoral artery was cannulated and arterial blood pressure and heart rate were monitored continuously. RESULTS: 1) In normotensive rats, saralasin infusion(20 microg/kg/min, IV) caused a decrease in mean arterial pressure without significant alterations in heart rate. Indomethacin-pretreatment(10mg/kg, IP) abolished the depressor response to saralasin. 2) The depressor response to saralasin was more marked in renal hypertensive rats than in normotensive rats. The magnitude of maximum decrease in blood pressure, however, was comparable between the hypertensive and normotensive rats. Indomethacin-pretreatment did not affect the depressor response to saralasin in renal hypertensive rats. 3) In DOCA-salt hypertensive rats, saralasin infusion rather caused an increase in mean arterial pressure without significant alterations in heart rate. The pressor response to saralasin was not affected by indomethacin-pretreatment. CONCLUSION: These results indicate that prostaglandin system may modify renin-angiotensin system in normotensive rats. It is suggested that mechanisms other than prostaglandin system participate in the full-blown manifestation of renin-angiotensin system in 2KIC renal hypertensive rats.
Animals ; Arterial Pressure ; Blood Pressure ; Desoxycorticosterone ; Drinking ; Femoral Artery ; Heart Rate ; Hypertension ; Hypertension, Renal ; Prostaglandins I ; Prostaglandins* ; Rats* ; Renal Artery ; Renin-Angiotensin System* ; Saralasin ; Silver

BACKGROUND: To access the accuracy and clinical usefulness of microplate identification (ID) system for the identification of Enterobacteriaceae, we compared microplate ID system with API 20E(bioMerieux, Etoile, France). METHODS: Ninety-two cultures of Enterobacteriaceae and one isolate of Aeromonas species were simultaneously identified by microplate ID system and the API 20E. Twenty biochemical tests used in microplate ID system were lactose, sucrose, and H2S in Kligler's iron agar media; indole, sucrose, raffinose, arabinose, trehalose, adonitol, dulcitol, sorbitol, cellibiose, methy-red, phenylalanine deaminase, ornithine decarboxylase, lysine decarboxylase, arginine dihydrolase, urease, and citrate in microplate; and oxidase test. The identification was obtained by considering percent likelihood(% ID), modal frequency and ID score method. RESULTS: Among the 92 cultures of Enterobacteriaceae and one isolate of Aeromonas species, agreement rate of identification according to the % ID between microplate ID system and API 20E were 90.3% to the species level and 97.8% to the genus level. CONCLUSIONS: For the identification of clinical Enterobacteriaceae isolates, the microplate ID system compares favorably with API 20E in identification accuracy and have the advantage of costsaving and easy to use.
Aeromonas ; Agar ; Arabinose ; Arginine ; Citric Acid ; Enterobacteriaceae* ; Galactitol ; Iron ; Lactose ; Lysine ; Ornithine Decarboxylase ; Oxidoreductases ; Phenylalanine ; Raffinose ; Ribitol ; Sorbitol ; Sucrose ; Trehalose ; Urease

No abstract available.
Retroperitoneal Fibrosis*

The incidence of thyroid cancer is rapidly increasing worldwide. Recently, attention to quality of life (QOL) issues has been increasingly addressed in the management of cancer. The goal of this review is provide a systematic overview for clinical factors associated with QOL in patients with thyroid cancer. Age is often cited as a QOL predictor with older patients more vulnerable than younger patients. High levels of fatigue and psychological distress such as anxiety and depression might be associated with decreased QOL. Although surgery for thyroid cancer leads to worse QOL shortly, there is a trend towards recovery with time. Levothyroxine treatment in thyroid cancer can result in similar or slightly impaired QOL. Thyroid hormone withdrawal causes significant reductions of QOL of thyroid cancer patients. The use of recombinant human thyrotropin (rhTSH) instead of thyroid hormone withdrawal can prevent QOL deterioration by thyroid hormone withdrawal. Generally, thyroid cancer survivors have a similar or slightly worse QOL compared with the normative population. In conclusion, thyroid cancer has a considerable impact on QOL of patients, and therefore multidisciplinary approach with special concern for QOL is recommended.
Anxiety ; Depression ; Fatigue ; Humans ; Incidence ; Quality of Life* ; Survivors ; Thyroid Gland ; Thyroid Neoplasms* ; Thyrotropin ; Thyroxine