Human Adjuvant Disease(HAD) is a connective tissue disease occuring after cosmetic surgery with a foreign substance. It was first reported by Miyoshi in 1964. There have been specific connective disorders such as systemic lupus erythematosus, rheumatoid arthritis, progressive systemic sclerosis and mixed connective tissue disease. Scleroderma is the single most commonly reported disease. A 55-year-old woman was seen for evaluation of dypnea. Four years previously, she underwent cosmetic surgery with silicone injected directly into eyelid, forehead, both hand and monspubis. The patient presented the classic feature of systemic sclerosis and pericardial effusion. Following pericardiocentesis, she felt somewhat better and became less dyspneic. Seventeen days later, however, she progressively deteriorated and died in spite of intensive medical therapy and supportive care.
Arthritis, Rheumatoid ; Connective Tissue Diseases ; Eyelids ; Female ; Forehead ; Hand ; Humans ; Lupus Erythematosus, Systemic ; Middle Aged ; Mixed Connective Tissue Disease ; Pericardial Effusion ; Pericardiocentesis ; Scleroderma, Diffuse ; Scleroderma, Systemic ; Sclerosis* ; Silicone Gels* ; Surgery, Plastic*

BACKGROUND: The effects of a newly synthesized potassium channel opener, KR-30816((-)(nitro-2-hydroxymethyl-2-methy-2H-1-benzopyran-4-y1)pyridine oxide) on the action potential of papillary muscles of guinea pigs and the ATP-sensitive potassium channel current(IKATP) of single ventricular muscle cells of rats were examined to make clear its action mechanism of the KATPchannel. METHODS: We used the conventional microelectrode and the excised inside-out patch configuration. RESULTS: KR-30816 caused a shortening of the action potential duration in dose-dependent manner, which was inhibited by glibenclamide(3microM). Before run-down of the K+channel, KR-30816 activated the cardiac ATP-sensitive K+ channel only in the presence of ATP and shifted the dose-response relation curve between [ATP]i and the channel activity to the right in parallel. After run-down of the KATP channel, KR-30816 did not after the channel opening either in the absence or in the presence of UDP. CONCLUSION: These results suggest that KR-30816 antagonizes the inhibitory effect of ATP on the KATPchannel in a competitive manner, thereby enhancing the channel openings.
Action Potentials ; Adenosine Triphosphate ; Animals ; Guinea Pigs ; Heart ; Microelectrodes ; Muscle Cells ; Papillary Muscles ; Potassium Channels* ; Potassium* ; Rats ; Uridine Diphosphate

PURPOSE: Recently, there are many good reports on the arthroscopic management of tibial condylar fractures. But, it may be appropriate for selected tibial condylar fractures and also needs a skilled technique. So we report the results of the tibial condylar fractures treated by the arthroscopy and limited percutaneous fixation or the arthroscopic-assisted management with conventional internal fixation without arthrotomy. MATERIALS AND METHODS: From June 1996 to December 1997, we treated 22 cases of the tibial condy- lar fractures including relatively comminuted one and analysed the results of patients who have been observed at least 1 year with Porters knee evaluation criteria. RESULTS: In 18 out of 22 cases, the results were Acceptable on symptoms(excellent 3, good 15, fair 4), in 18, on function(excellent 10, good 8, fair 3), in 21, on appearance(excellent 12, good 9, fair 1) and in 20, on radiographic appearance(excellent 11, good 9, fair 2). Overall results were Acceptable in 18 cases(82%) and Unacceptable in 4 cases(18%). CONCLUSION: The arthroscopic-assisted management with conventional internal fixation without arthrotomy can be the recommendable treatment for the tibial condylar fractures, including relatively comminuted one, without complications.
Arthroscopy ; Humans ; Knee

NAG activity has been measured in the urine of hypertension, diabetes mellitus and renal disease subjects. Results have shown significantly higher levels of Urinary NAG in hypertension, diaetes and renal disease subjects compared to normal control Subjects group(P<0.001). Urinary NAG measurement is simple and accurate and it provides a valuable information in the early detection of renal dysfunction in hypertension and diabetes subjects and also in the follow up of these patients.
Acetylglucosaminidase* ; Diabetes Mellitus* ; Follow-Up Studies ; Humans ; Hypertension*

PURPOSE: To review the results of resections of heterotopic ossification around the hip in patients with central nervous system injuries. MATERIALS AND METHODS: Heterotopic ossification was resected in ten hips of eight patients and followed for at least one year. Average age was 38.1 years (range, 21-56 years). We reviewed the charts and the radiographs for overall patient function, location of the lesion, radiographic evidence of maturation and any recurrence. Heterotopic ossification was resected regardless of the result of bone scan. RESULTS: All patients showed improved function. Three minimal recurrences and one moderate recurrence were identified at the last follow-up radiography, but the range of motion had not decreased due to recurrence. CONCLUSION: Severe heterotopic ossification around the hip in patients with spastic paralysis was resected, and it was found that the range of motion was improved in all patients and that the chance of recurrence was minimal, even though the bone scan showed hot uptake on the bone scan.
Adult* ; Central Nervous System ; Follow-Up Studies ; Hip Joint ; Hip* ; Humans ; Muscle Spasticity* ; Ossification, Heterotopic* ; Paralysis ; Radiography ; Range of Motion, Articular ; Recurrence

Atrial fibrillation (AF) is the most common arrhythmia which needs management for stroke prevention. Therefore, it has emphasized the importance of screening for general population to detect AF earlier. We conducted screening for AF in the Chonbuk region in South Korea. Participants who were older than 50 years were enrolled. The screening test used a single lead electrocardiography (ECG) (KardiaBand, AliveCor, CA, USA). Diagnosis of AF was confirmed by electrophysiologists, if the single lead ECG demonstrated AF of more than 30 seconds. We analyzed the prevalence of AF and the characteristics of newly detected AF patients. A total of 2728 participants, 145 (5.3%) participants had already been diagnosed with AF before. The number of screening positive was 55. Among them, 40 participants were confirmed for AF. Male gender and age older than 70 years were the independent risk factors for AF among the screening positive participants. Most of newly detected AF patients were at high risk for stroke which had more than 2 points on the CHA2DS2-VASc score. We followed up with those patients and encouraged them to visit the hospital. As a result, 31 (77.5%) patients started to manage AF. The additional 1.2% of AF was detected by a screening test with a single lead ECG monitor device. Considering most participants of newly detected AF by screening were at high risk for stroke, it was thought that AF was still undertreated. Therefore, screening tests with simple mobile device might be useful for early detection of AF.

Atrial fibrillation (AF) is the most common arrhythmia which needs management for stroke prevention. Therefore, it has emphasized the importance of screening for general population to detect AF earlier. We conducted screening for AF in the Chonbuk region in South Korea. Participants who were older than 50 years were enrolled. The screening test used a single lead electrocardiography (ECG) (KardiaBand, AliveCor, CA, USA). Diagnosis of AF was confirmed by electrophysiologists, if the single lead ECG demonstrated AF of more than 30 seconds. We analyzed the prevalence of AF and the characteristics of newly detected AF patients. A total of 2728 participants, 145 (5.3%) participants had already been diagnosed with AF before. The number of screening positive was 55. Among them, 40 participants were confirmed for AF. Male gender and age older than 70 years were the independent risk factors for AF among the screening positive participants. Most of newly detected AF patients were at high risk for stroke which had more than 2 points on the CHA2DS2-VASc score. We followed up with those patients and encouraged them to visit the hospital. As a result, 31 (77.5%) patients started to manage AF. The additional 1.2% of AF was detected by a screening test with a single lead ECG monitor device. Considering most participants of newly detected AF by screening were at high risk for stroke, it was thought that AF was still undertreated. Therefore, screening tests with simple mobile device might be useful for early detection of AF.

No abstract available.
Muscle, Skeletal* ; Tibial Nerve*

PURPOSE: This retrospective study reports the intermediate-term clinical outcomes including the practical function in daily and sports activities after total ankle arthroplasty for end-stage rheumatoid arthritis, as well as the effects of modification of perioperative anti-rheumatic medications. MATERIALS AND METHODS: Twelve patients were followed for a minimum of 2 years after total ankle replacement for end-stage rheumatoid arthritis. Perioperative anti-rheumatic medications in all patients were modified based on a specific guideline. Clinical evaluations consisted of American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM) scores. Periodic radiographic evaluation was conducted to detect changes in ankle alignment and postoperative complications. RESULTS: Mean AOFAS, FAOS, and FAAM scores improved significantly from 37.5 to 81.2, 39.1 to 72.4, and 33.8 to 64.0 points at final follow-up, respectively (p<0.001). Functional outcomes in daily and sports activities at final follow-up were found to be 76.5 and 55.8 points for the FAOS and 70.5 and 57.5 points for the FAAM, respectively. As early postoperative complications, there was one case of local wound necrosis, one case of medial malleolar fracture, and one case of deep peroneal nerve injury. Radiological evaluation revealed two cases of asymptomatic heterotopic ossification and one case of progressive arthritis in the talonavicular joint. Reoperation was performed in only one patient (8.3%) with a medial soft tissue impingement at a mean of 35.6 months follow-up. CONCLUSION: Total ankle arthroplasty appears to be an effective surgical option for end-stage rheumatoid arthritis. Practical functions in daily and sports activities were significantly improved at intermediate-term follow-up. Modification of perioperative anti-rheumatic medications can be one of the solutions to reduce the postoperative complication rate.
Ankle ; Arthritis ; Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Ankle ; Follow-Up Studies ; Foot ; Humans ; Joints ; Necrosis ; Ossification, Heterotopic ; Peroneal Nerve ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Sports ; Wounds and Injuries