No abstract available.

No abstract available.
Hirschsprung Disease*

Chilaiditis syndrome is very rare clinical condition that interposed of the hepatic flexure of large bowels between the liver and diaphragm. Clinically it is characterized by abdominal pain that becomes increasingly worse during the day and is often accentuated by deep breathing. On radiologic studies, it shows gas within the hepatic flexure interposed between the liver and diaphragm, which is simulating a pneumoperitoneum. A case was admitted at emergency care center of Yeungnam university hospital and we report it.
Abdominal Pain ; Chilaiditi Syndrome* ; Diaphragm ; Emergency Medical Services ; Liver ; Pneumoperitoneum* ; Respiration

The results of cementless total knee arthroplasty(TKA) have improved steadly during the past decade due to development of design, fixation and surgical technique. We analyzed the results of 45 total knee arthroplasties performed with Anatomic Modular Knee(AMK) prosthesis at the department of Orthopedic Surgery, Yonsei University College of Medicine between June 1989 and December 1991 and compared their results of rheumatoid arthritis(RA) and osteoarthritis(OA) patients. The follow up ranged from 2 years to 4 years and 2 months (average 2 years and 8 months). Using the Hospital for Special Surgery(H.S.S.) rating system and Knee Society(K.S.) clinical rating system, we found that the clinical results were similar for RA group(Average; H.S.S. 86.1, K.S. 81.2/74.4) and OA group(Average; H.S.S. 88, K.S. 87.8/77.1) even though the preoperative knee score was lower in RA group(Average;H.S.S.42.8) than OA group(Average;H.S.S. 57.7). The average age of RA patients was 14 years younger than that of OA patients. The improvement of range of motin and preoperative flexion contracture after TKA was remarkable in RA group. The radiologic evaluation based on Knee Society roentgenographic evaluation system revealed proper alignment of all component and no definite radiologic loosening except 1 case in which postoperative deep infection had occurred. On the basis of this prospective clinical and radiologic review, we concluded that uncemented implantation of AMK prosthsis both in RA and OA patients was encouraging.
Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Orthopedics ; Osteoarthritis ; Prospective Studies ; Prostheses and Implants

Repeated throwing of baseballs by juvenile pitchers is known to cause damages to bone and cartilage as well as soft tissue in the involved upper extremity. Authors present 4 cases of osteochondral lesion at capitellum of the humerus as a result of repeated insult by throwing baseballs in the juvenile pitchers. Pain and limitation of extension of the affected elbow were the commonest symptoms. Cystic change or osteochondral loose body was found on plain X-ray. Treatment consisted of rest and analgesic administration in the patient who has no loose body, while in case of having loose body it was removed surgically without further treatment to the crater. In spite of the rapid relief of the pain by these treatment, limitation of extension persisted for considerable period of time. It is strongly suggested not to overlook elbow pain in young adolescent whose bone is still growing and who can hardly withstand repeated insult to prevent the development of baseball elbow.
Adolescent ; Baseball ; Cartilage ; Elbow ; Humans ; Humerus ; Osteochondritis ; Upper Extremity

It was well known that atrial myocytes systhesize atrial natriuretic peptide[ANP], and secrete it into the atrial lumen through the atrial endocardium. But the mechanism for regulation of ANP secretion has not been clearly elucidated, because there was little information of the atrial morphology concerning basal lamina. Basal lamina is surmised as one of barriers that control the movement of ANP, a large molecule. This study was attempted to elucidate the morphological characteristics of basal lamina and connective tissue fibers of atrial endocardial layer by scanning electron microscopy. Basal lamina was exposed by removal of the overlying endothelium. This was achieved by using OsO4 maceration, immersion in aqueous boric acid or EDTA treatment. After removal of the endothelial cell, the specimens were exposed to ultrasonic vibration in case of need. The external surface of basal lamina showed a fairly smooth appearance on the whole, although a few irregular folds are often encountered. Fenestrations, 0.1-1 micrometer in diameter, were randomly observed on the basal lamina, and they were circular to oval in shape. Margin of fenestrations was somewhat distinct and some was divided into two parts by linear structures. The structural differences of fenestrations between right and left atria were not found. The fibroreticular lamina under the basal lamina was revealed by removal of the endothelial cells and their basal lamina. This layer was consisted of interwoven fine fibers. These fine fibers were repeatedly divided and fused, forming reticular network. Some fine fibers connected with basal lamina. Some connective tissue fibers below fibroreticular layer were collected into thick bundles running parallel to myocytes. Above results may serve as a basis for the physiological and morphological studies of atrium.
Animals ; Atrial Natriuretic Factor ; Basement Membrane* ; Connective Tissue ; Edetic Acid ; Endocardium* ; Endothelial Cells ; Endothelium ; Immersion ; Microscopy, Electron, Scanning ; Muscle Cells ; Rats* ; Running ; Ultrasonics ; Vibration

The purpose of this study is to evaluate the prognostic significance of argyrophilic nucleoalr organizer regions (AgNORs) and proliferating cell nuclear antigen (PCNA) by using DMBA hamster buccal pouch carcinogenesis which provides a good experimental model in reproducing steps from precancerous lesions to invasive squamous cell carcinomas. The buccal pouches of 50 Syrian hamsters were applied with 0.5% DMBA in mineral oil three times a week to reproduce various lesions from precancerous ones such as hyperkeratosis or epithelial dysplasia to invasive squamous cell carcinomas. Their sections were stained with H & E, and silver colloid, and processed immunohistochemically by being applied with monoclonal antibody to PCNA. The histopathologic examainations were done and the counts of AgNORs were evaluated. The PCNA labelling indices on each lesions were evaluated. The correlation between histopathological grades and counts of AgNORs or PCNA labelling indices were evaluated. The number of AgNORs was 2.22+/-0.22 in control group, 3.46+/-0.72 in carcinoma in situ (CIS), 3.78+/-0.63 in squamous cell carcinoma (SCC), respectively. AgNORs significantly increased in severe epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The PCNA Labeling Index (LI) was 39.47+/-6.68% in control group, 79.61+/-4.14% in CIS, and 85.43+/-6.25% in SCC, respectively. PCNA LI also significantly increased in epithelial dysplasia, CIS, and SCC compared with normal tissue (P<0.05). The number of AgNORs, AgNOR area, and PCNA LI slightly increased in the advancing front than in the center of SCC, but, it was not statistically significant. It appeared that there were a good correlation between the number of AgNORs and PCNA LI (Pierson correlation coefficient : 0.649, P<0.001). These results suggested that the number of AgNORs and the PCNA LI could be useful markers for evaluating the risk of malignant transformation and prognosis of SCC. It was thought that the clinical usefulness of these markers should be verified by using human tissue specimens.
9,10-Dimethyl-1,2-benzanthracene ; Animals ; Carcinogenesis* ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Colloids ; Cricetinae* ; Humans ; Mesocricetus ; Mineral Oil ; Models, Theoretical ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Silver

The ideal sites of vascular access are on the forearm, however, where superficial vein are usually poor due to the chronicity of the disease. Limitation of microsurgical technique forces to use upper arm or synthetic grafts in spite of the presence of small vessels. In this prospective study, we evaluated the success-rate of microsurgical arteriovenous shunt (AVS) using a microscope (M group) and compared the results with those using a loupe ( 3.5, L group) on the 95 patients from October, 1996 to April, 1998. The magnifiers were selected according to the external diameter of the vein, microscope below 1.5 mm. The results of operation were evaluated immediately after operation and were classified by the strength of thrill : strong thrill (ST); week thrill (WT); pulsation (P); none (F). The mean external diameters(mm) of the radial arteries and cephalic veins in both groups were 2.5; 2.3 (L) and 2.0; 1.3 (M), respectively (p<0.05). The immediate results of operation was ST,38; WT,11; P,2; N,0 in L group and ST,34; WT,10; P,1; N,0 in M group, which revealed no significant differences between both groups. After two months of operation, the rates of failure for vascular access were 5.9% (3/51) in L group 6.7% (3/45) in M group. In conclusion, small superficial veins on the wrist below 1.5 mm in diameter can be used successfully for vascular access with microsurgical technique using a surgical microscope.
Arm ; Forearm ; Humans ; Kidney Failure, Chronic* ; Microsurgery ; Prospective Studies ; Radial Artery ; Transplants ; Veins ; Wrist*

No abstract available.
Ductus Arteriosus* ; Indomethacin*

Transeurethral Radiofrequency (TURF) Thermotherapy is a new acceptable treatment modality for benign prostatic hyperplasia. We treated 70 cases of BPH patients by TURF Thermotherapy (THERMEX-II). Among them, we got a follow-up observation on 37 patients (urinary retention: 16 cases, non-urinary retention:21 cases) each at 1 month and 3 months after treatment. Mean age of patients was 69.1 years and their mean prostatic weight was 40.5gr by transrectal prostatic ultrasonogram. All patients were treated single session for 2 hours without any sedation, and well tolerated with the temperature of 47-48degree. We evaluate patients with Boyarsky symptom score, urine flow rate, volume of residual urine and patient`s subjective symptoms before and after treat- The results were as follows ; 1. The mean Boyarsky symptom score was 15.4 before treatment, it became 9.9 at 1 month and 8.8 at 3 months after treatment. 2. In the retention patients : Mean maximal flow rate was 6.53ml/sec at 1 month. 8.47ml/sec at 3 months, and residual urine was 70ml at 1 month, 57ml at 3 months after treatment. 3. In the non-retention patients : Mean maximal flow rate increased from 4.74ml/sec to 10.29ml/ sec at 1 month. 10.76ml/sec at 3 months, and residual urine decreased from 60.7ml/ to 20ml at 1 month. 17.2ml at 3 months after treatment. 4. Complications were acute urinary retention (14.3% ) and gross hematuria (8.1%), but it was resolved by conservative treatment. There were no urinary tract infection, bladder spasm or other complications after treatment. We conclude TURF thermotherapy is one of the good and safe treatment in benign prostatic hyperplasia.
Follow-Up Studies ; Hematuria ; Humans ; Hyperthermia, Induced* ; Prostatic Hyperplasia* ; Spasm ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Urinary Tract Infections