4.Radiologic findings of osteochondritis dissecans.
Jae seung KIM ; Choong Gon CHOI ; Heung Sik KANG ; Seon Kyu LEE ; Chu Wan KIM
Journal of the Korean Radiological Society 1993;29(3):528-534
To evaluate the radiographic characteristics of osteochondritis dissecans (OCD) and useful parameter for predicting mechanical stability, we retrospectively analysed 26 plain radiographic examinations and seven MR imagings in 28 cases of OCD in 24 patients. Typical radiologic findings were osteochondral defect with sclerotic rim of variable thickeness and osteochondral fragment. Sites of osteochondral defect were medial (35.9%) or lateral (32%) femoral chondyle and medial (7.1%) or lateral (25%) side of talar dome. Sclerotic rim was seen in 24 cases (85%) and osteochondral fragments including nine loose bodies were seen in 21 cases (75%). The size of osteochondral defect with unstable fragment (average 2.05cm) and loose body (2.04cm) in the knee joint were similar to, but statistically larger than that with stable fragment (1.35cm). All osteochondral defects were well visualized on MR images. Abnormalities of articular cartilage and effusion in the interface between the parent bone and fragment were seem in five cases of which there were confirmed three unstable cases arthroscopically. We conclude that size of defect may be a good parameter for predicting mechanical stability and MRI may be useful in the diagnosis of OCD and determining the methods of treatment.
Cartilage, Articular
;
Diagnosis
;
Humans
;
Knee Joint
;
Magnetic Resonance Imaging
;
Osteochondritis Dissecans*
;
Osteochondritis*
;
Parents
;
Retrospective Studies
5.A Case of Anti-Neutrophil Cytoplasmic Antibodies (ABCA) Positive Wegener's Granulomatosis.
Won Tae KIM ; Woo Jeong KIM ; Joon Sik KIM ; Chin Moo KANG ; Kwan Kyu PARK
Journal of the Korean Pediatric Society 1994;37(8):1175-1181
Wegener's granulomatosis is a disease of unknown etiology that is characterized by the clinicopathologic complex of necrotixing granulomatous vasculitis of the upper and lower respiratory tract, glomerulonephritis, and variable degrees of small vessel vasculitis. Recently Antineutrophil Cytoplasmic Antibody (ANCA) has been reported to be a highly specific test for the diagnosis of Wegener's granulomatosis. We have experienced a patient of Wegener's granulomatosis in a 11 year old girl who was admitted with complaints f arthralgia, hematuria, convulsion and associated with otitis media and sinusitis. Serologic test of C-ANCA was positive and histologic findings of the kidney showed crescentic glomerulonephritis with sclerosis and surrounding infiltration of multinucleated giant cells. Patient was treated with pulse methylprednisolone without improvement. The clinical course progressed rapidly and expired due to the renal failure, gastrointestinal bleeding and status epilepticus. A brief review of literatures was made.
Antibodies, Antineutrophil Cytoplasmic*
;
Arthralgia
;
Child
;
Diagnosis
;
Female
;
Giant Cells
;
Glomerulonephritis
;
Hematuria
;
Hemorrhage
;
Humans
;
Kidney
;
Methylprednisolone
;
Otitis Media
;
Renal Insufficiency
;
Respiratory System
;
Sclerosis
;
Seizures
;
Serologic Tests
;
Sinusitis
;
Status Epilepticus
;
Vasculitis
;
Wegener Granulomatosis*
6.MR Findings of Giant Cell Tumor: Signal Intensity and Morphological Characteristics.
Sang Hoon LEE ; Heung Sik KANG ; Chu Wan KIM ; Seon Kyu LEE ; Hah Koo LEE
Journal of the Korean Radiological Society 1994;31(1):139-144
PURPOSE: To describe the MR characteristics of giant cell tumor of bone. MATERIALS AND METHODS: MR iraagings of 15 cases of pathologically proved giant cell tumor were retrospectively analyzed. Signal intensity and homogeneity, involvement of articular surface, low signal intensity rim around the tumor, cortical disruption and soft tissue involvement were evaluated. RESULTS:Tumor showed low signal intensity on T1 weighted images(93%), inhomogenous high signal on T2 or T2* weighted images(93%) and inhomogeneous enhancing pattern(88%). In 11 cases of giant cell tumor of long bones, all cases showed involvement of articular margin and 10 cases(90%) showed rim of low signal intensity between tumor and normal marrow. Disruption of cortical bone(25%) and soft tissue involevement(7%) were also demonstrated. CONCLUSION: We concluded that giant cell tumor showed characteristic MR findings could be helpful in making correct diagnosis.
Bone Marrow
;
Diagnosis
;
Giant Cell Tumor of Bone
;
Giant Cell Tumors*
;
Giant Cells*
;
Retrospective Studies
7.Indirect measurement of blood pressure in neonates using an automatic noninvasive oscillometric monitor.
Jung Hea PARK ; Hea Jin CHOEH ; Eun Sik KANG ; Chong Sung CHUNG ; Kyu Chul CHOEH
Journal of the Korean Pediatric Society 1993;36(9):1211-1218
The measurement of blood pressure in neonates is an important diagnostic procedure. But the measurement of blood pressure has not been performed routinely because of difficulty in measuring blood pressure and variable normal range according to measuring apparatus. Recently some accurate and convenient apparatus of measuring blood pressure have been introduced in neonatal care, so the reference values of neonatal blood pressure may be obtainable. The authors measured systolic and diastolic blood pressure using a noninvasive oscillometric monitor instrument on 1,3,6,12,24,48,72 hours of life in 200 neonates born at Eulji General Hospital, Taejon. And we analysed the results according to birth weight, gestational age, delivery type, sex, meconium stain, preeclampsia and hypocalcemia. The following results were obtained: 1) On the 1st day of life, systolic and diastolic blood pressure were 65.611.7 mmHg and 36.7+/-5.8 mmHg in the normal birth weight neonates, and 56.2+/-6.7 mmHg and 34.14.2 mmHg in the low birth weight neonates, respectively. So the blood pressure of normal birth weight neonates were higher than that of low birth weight neonates. 2) On the 1st day of life, systolic and diastolic blood pressure were 65.5+/-11.8 mmHg and 36.6+/-5.8 mmHg in the fullterm neonates, and 57.6+/-5.2 mmHg and 35.6+/-3.8 mmHg in the preterm neonates, respectively. So the blood pressure of full term neonates were higher than that of preterm neonates. 3) The difference of blood pressure in analysis according to birth weight were wider than that according to gestational age. 4) The blood pressure of neonates were lowest on the 3 hours of life and increased gradually during 72 hours of life. 5) The blood pressure of neonates did not show any significant difference in analysis according to sex. delivery type, Meconium stain, preeclampsia, and hypocalcemia.
Birth Weight
;
Blood Pressure*
;
Daejeon
;
Gestational Age
;
Hospitals, General
;
Humans
;
Hypocalcemia
;
Infant, Low Birth Weight
;
Infant, Newborn*
;
Meconium
;
Oscillometry
;
Pre-Eclampsia
;
Reference Values
8.A Study on Assessment of CAPs (Client Assessment Protocols) using MDS-HC 2.0 on City Elderly .
Chang Kyu KANG ; Mu Sik LEE ; Un Young KIM ; Jung Ho PARK ; Jae Sun YUN
Journal of the Korean Academy of Family Medicine 2008;29(12):915-924
BACKGROUND: This study used MDS-HC 2.0 (Minimum Data Set-Home Care) to analyze the health and the state of function of the traveling health objects. This study was intended to make use of it with the basic materials for providing them with traveling health service suited for the requirement on the health of the traveling health objects. METHODS: The subjects of this study were 1160 people (over 65 years) living under management control of local Health Center from September 7th to October 3th, 2006. This study was analyzed with inter RAI program & SPSS/WIN 10.0, chi-square -test, t-test, and ANOVA. RESULTS: The result showed that 8.97 CAPs per an elderly person was identified and the subjects over 60% had an injury problem from a fall, health prevention service, vision, IADL, pain, and cognition. The number of CAPs in general was high in higher age and the less educated, and those without a job. But, in subjects that had a life partner and a spouse, the number of CAPs was low. In CAPs by the distinction of sex, CAPs which was much more in man than women in statistics were the improvement of health, the abuse of alcohol and drinking wine, bedsore, and the weak supply system. CAPs which women had much more were the function of the heart and the lungs, pain, the performance of the doctor's advice, health prevention service, and incontinence of urine and insertion of catheter. According to the results comparing CAPs by the level of the ADL, the number of CAPs was shown that the group of ADL 2 was higher than group ADL 1. The matter in which the traveling health service had to be applied in all both ADL1 and ADL2 was injury from a fall, health prevention service, and vision. Conculsion: MDS-HC is applicable to decide the care needs for health and social service supplies. The results can be further applicable for careplan, and referral criteria in continuum of care service over long-term care spectrums.
Activities of Daily Living
;
Aged
;
Catheters
;
Cognition
;
Continuity of Patient Care
;
Drinking
;
Equipment and Supplies
;
Female
;
Health Services
;
Heart
;
Humans
;
Long-Term Care
;
Lung
;
Pressure Ulcer
;
Referral and Consultation
;
Social Work
;
Spouses
;
Vision, Ocular
;
Wine
9.Acute Neuropathic Joint in Diabetic Foot: Plain Radiographic Findings.
Heung Sik KANG ; Yong Kyu YOON ; Dae Young YOON ; Jung Suk SIM ; Chu Wan KIRN
Journal of the Korean Radiological Society 1994;30(5):929-933
PURPOSE: To determine the plain film findings of acute neuropathic joint in diabetic foot. MATERIALS AND METHODS: Acute neuropathic joint in diabetic foot was considered when fragmentation of the articular ends of bone and subluxation of the affected joint developed within eight weeks after clinical onset of diabetic gangrene. Eight toes of six diabetics were satisfactory to our criteria. We analyzed plain radiographic findings of the affected joint and soft tissue, interval changes in follow-up radiographs, and deformities after healing. RESULTS: The time interval between clinical onset of gangrene and bone destruction ranged from 2 weeks to 4 weeks(mean 2.6 weeks). Plain radiographs showed fragmentation of the articular ends, subluxation, and soft tissue swelling of the metatarsophalangeal joint or interphalangeal joint. The significant feature of these patients was rapid progression of the lesions. Clinically, all patients had diabetic gangrene in affected toes, however, there was no evidence of osteomyelitis in our series. Amputation was done in 2 cases, and lesions in 3 of the remaining 4 cases were repaired spontaneously with regression of gangrene, leaving radiological residua such as pointed-end, tapered-end, and ball and socket deformity. CONCLUSION: Rapid disorganization of the joint with associated evidence of soft tissue gangrene in plain radiograph is believed to be valuable for the diagnosis of diabetic osteoarthropathy.
Amputation
;
Congenital Abnormalities
;
Diabetic Foot*
;
Diagnosis
;
Follow-Up Studies
;
Gangrene
;
Humans
;
Joints*
;
Metatarsophalangeal Joint
;
Osteomyelitis
;
Toes
10.Clinical Analysis of 62 patients with Rectovaginal Fistula.
Seung Hyun KANG ; Nam Kyu KIM ; Dae Jin LIM ; Seung Kook SOHN ; Jin Sik MIN
Journal of the Korean Society of Coloproctology 1998;14(1):109-114
Rectovagianl fistula(RVF) is a congenital or acquired communication between the two epithelial-lined surface of the rectum and the vagina. We present our experience with 62 patients with RVF. There were various etiologies and repair methods of rectovaginal fistula. The purpose of this study was to retospectively review the clinical course of the patients we treated and to evaluate the efficacy of various treatment options. The mean age was 40.5 yr, The type of RVF was classified to one of two(simple and complex), according to their location, size and etiology. RVF was developed most commonly after radiotherapy due to cervical cancer(n=17), then after pelvic surgery due to malignancy(n=16), obstetric trauma after episiotomy at delivery(n=7), congenital malformation(n=4), inflammatory bowel disease(n=1), Bechet's disease(n=1), infections such as perianal fistula or abscess(n=2), direct invasion of carcinoma(n=3), after chemotherapy(n=1), and idiopathic(n=6). Three cases of them associated with rectovesicovaginal fistula. Surgical therapeutic option was divided to local repair, abdominal approach and tissue transposition by the type of RVF. Most simple RVFs were repaired with local approach through the vagina or rectum. Most complex RVFs were repaired through abdominal approach or tissue transposition. With an average follow up of 20 months, the treatment results were as follows: completely healed(n=36, 58.1%), persistent symptom(n=6, 9.7%), recurrence after repair(n=5, 8.1%), loss of search or death(n=15, 24.1%). Therefore we assist that the management of RVF depends on size, location, and cause. anal sphincter function and overall health status of the patient. Careful preoperative assessment of the fistula, surrounding tissues, and anal sphincter and exclusion of associated disease are essential. With through evaluation, thoughtful consideration of treatment options, and meticulous operative technique, patient can be assured of an optimal outcome.
Anal Canal
;
Episiotomy
;
Female
;
Fistula
;
Follow-Up Studies
;
Humans
;
Radiotherapy
;
Rectovaginal Fistula*
;
Rectum
;
Recurrence
;
Vagina