Reflex sympathetic dystrophy(RSD) defines as a chronic pain syndrome with sympathetic manifestations that afflicts individuals who haute suffered a trauma to the hand. Persistent pain and dysfunctions of the hand are frequently overlooked by the surgeons. The exact pathophysiology of RSD is not known but severity of injury and prolonged immobilization of the joints are considered as resonable causes on the retrospective studies. The diagnosis of reflex sympathetic dystrophy is based on clinical manifestations, simple X-ray and three-phase bone scan. Confirmative diagnosis absolutely depends on the presence of a diffusely abnormal pattern of uptake in phase III in a patient haying pain with underlying cause and strong clinical signs of sympathetic overactivities. As with most disease processes, early diagnosis and treatment is a goal of management of RSD. Surgical restoration of anatomical structures such as tendon, nerve and joint goes ahead of any kind of procedures and it made the VAS pain score decrease from 7.8 to 3.4 in 16 patients. Also, decrease of pain could be achievable with sympathetic or stellate ganglion block with steroid medication. Active physical therapy after surgery is also verb helpful to functional recovery of the hands. Once the appropriate diagnosis is made, combined therapy composed of surgical restoration of anatomical structure, physiotherapy and steroid medication with sympathetic block will be free from pain and produce early functional recovery.
Chronic Pain ; Diagnosis ; Early Diagnosis ; Hand Injuries* ; Hand* ; Humans ; Immobilization ; Joints ; Reflex Sympathetic Dystrophy* ; Reflex* ; Retrospective Studies ; Stellate Ganglion ; Tendons

No abstract available.
Wilms Tumor*

Balloon-tipped, flow-directed (Swan-Ganz) catheters are used commonly for monitoring of cardiac function in patients undergoing cardiac surgical procedures. We report a case of pulmonary hypertension with hypoxemia which may be caused by incorrect positioning of pulmonary artery catheter (PAC) during CABG. Pulmonary arterial pressure (PAP) of 70/40 mmHg which was nearly high as systemic pressure was measured when we tried to wean patient from cardiopulmonary bypass. But, TEE (transesophageal echocardiography) showed nonspecific finding. PAP decreased soon and maintained about 33/16 mmHg for a few minutes. But, the PAP elevated high to 70/40 mmHg again and the arteral oxygen tension (PaO2) decreased to 61.2 mmHg. When we withdrew the PAC to the depth of 35 cm, the PAP and systolic pressure returned to normal range and PaO2 elevaed to 320 mmHg. End tidal CO2 was elevated from 30 mmHg to 35 mmHg.
Anoxia* ; Arterial Pressure ; Blood Pressure ; Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Catheters* ; Coronary Artery Bypass* ; Coronary Vessels* ; Humans ; Hypertension, Pulmonary* ; Oxygen ; Pulmonary Artery ; Reference Values

To investigate the nature of artifacts caused by air and chemical shift by fat, a test tube phantom study was performed in 2.0T and 0.5T superconducting magnetic resonance imaging systems in various imaging sequences. Spatial mismapping and signal change made image distortion in spin echo images of the air-column and severe signal voids in gradient echo images. Chemical shift artifacts appeared in the planes of frequency-encoding axis as crescent-shaped signal voids and summated bright signals, Both artifacts were more prominent in high field strength, Images at 0.5T showed more severe artifacts in the T2-weighted images than those in the other sequences. As the acquisition matrix increased, truncation artifacts decreased and susceptibility artifacts in gradient echo images diminished. Familiarity with causes, appearances and mechanisms of various artifacts will help radiologists for interpretation of MRI.
Artifacts* ; Magnetic Resonance Imaging* ; Recognition (Psychology)

We experienced a case of primary aldosteronism due to adrenal adenoma. The patient was 45-year old female, whose main complaints were weakness, headache, and fatigue. By use of abdominal CT scan, ultrasonogram, adrenal angiogram and by result of clinical laboratory findings, we conculuded the diagnosis of adrenal adenoma, and confirmed it by surgical and pathologucal findigs. The clinical sympyoms disappeared after left adrenalectomy, and laboratory findings of renin, aldosterone, electrolutes were normalized but hypertension persisted, so she has been managed by antihypertensives.
Adenoma ; Adrenalectomy* ; Aldosterone ; Antihypertensive Agents ; Diagnosis ; Fatigue ; Female ; Headache ; Humans ; Hyperaldosteronism* ; Hypertension* ; Middle Aged ; Renin ; Tomography, X-Ray Computed ; Ultrasonography

Thirty patient with essential hypertension were administered Manidipine, a new calcium antagonist, 10~20mg once daily to evaluate the hypotensive efficacy and safety for 8 weeks. And the followings were the result. 1) Patients were consists of 14 male, 16 female, aged 53 in average and classified as mild in 21 and moderate in 9 patients. 2) Optimum intial dose was 10mg and 10 to 20mg were the doses recommended. 3) Blood pressure dropped after 8 weeks 24/13mmHg in average, rewarding 80% effectiveness and normalized in 87%. 4) Most frequent side reaction was facial flushing in 5 patiens followed by palpitation and dizziness, all of which did not disturb the continuation of medication. 5) Most of routine laboratory parameter were normal and unchanged between before and after the trial. 6) Overall rating of usefulness was 77%. In conclusion, Manidipine 10 to 20mg once daily regimen is well tolerated and effective in the treatment of mild to moderate essential hypertension.
Blood Pressure ; Calcium ; Dizziness ; Female ; Flushing ; Humans ; Hypertension* ; Male ; Reward

To investigate the effect of tumor removal and administration of OK432 on the splenic natural killer (NK) cell activity in the subcutaneous tumor bearing rats, NK cell activity assay using a 4-hour 51Cr release assay and flow cytometric analysis for NK cell population were performed. The results were as follows: 1. Splenic NK cell activity and population in the subcutaneous tumor bearing rats decreased along with the growth of the tumor. 2. The rats with subcutaneous tumor removal showed decrease of splenic NK cell activity, but splenic NK cell population was not decreased. 3. In the rats with subcutaneous tumor removal and OK432 administration, splenic NK cell activity was significantly increased 1 week after administration of OK432 and then gradually returned to normal, whereas increase of NK cell population was not significant. In the present study, splenic NK cell activity was significantly decreased despite removal of subcutaneous tumor. But with the administration of OK432, splenic NK cell activity returned to normal. Considering the role of NK cells on the first line of defense against the metastatic implantation of circulating tumor emboli, we suggest that perioperative administration of immunopotentiator such as OK432 may improve the patient's outcome after surgery of human neoplasm.
Animals ; Humans ; Killer Cells, Natural* ; Picibanil* ; Rats* ; Spleen

Msny clinical and experimental studies trying to elucidate the cause of idiopathic scoliosis have been carried out. There, however, is no established theory to explain it. This paper is aimed at approaching one of various causes of idiopathic scoliosis by producing thoracic scoliosis in growing rabbits with unilateral resection of thoracic spinal nerves. All 43 rabbits were divided into four different groups. The first group(11 rabbits) consisted of rsbbits whose primary anterior and posterior divisions of the unilateral thoracic spinal nerves were resected. The second(11 rabbits) and the third(11 rabbits) were groups of rabbits whose primary anterior and posterior devisions were resected respectively. The fourth(10 rabbits) was the control group. The first group of rsbbits showed the most prominent curvature of the spine. The group of resection of primary posterior division showed less severe scoliosis than the first group but more marked scoliosis than the group of resection of primary anterior division. The biopsy of the denervated muscles included in the scoliosis revealed atrophy. It is concluded from the animal experiments with 43 growing rabbits that unilateral paralysis of the thoracic spinal nerves could be one csuse of iniopathic scoliosis and the primary posterior division of the thoracic spinal nerve contributed to the production of scoliosis more than the primary anterior division.
Animal Experimentation ; Atrophy ; Biopsy ; Muscles ; Paralysis ; Rabbits ; Scoliosis ; Spinal Nerves ; Spine

No abstract available.
Genetic Therapy*

To assess the prognostic value of the 14 ECG variables obtained from the pre-discharge ECG, 35 patients were followed up for at least one year among the 80 patients of the acute myocardial infarction admitted at Seoul Paik Hospital from Sep. 1983 to Aug. 1986. The following results were obtained. 1) The overall in-hospital mortality rate was 20% and the mortality rate tended to decline year by year. 2) The one-year mortality and morbidity rate of the followed patients was 31.4%. 3) Among the 14 variables obtained from the pre-discharge ECG, T-negativity was the only statistically significant (p<0.05) one to predict the one-year prognosis in the patients after the first myocardial infarction, and we could not derive any meaningful datd from the analysis of the combined effects of the three ECG variables (PTF, ST depression and ST elevation).
Depression ; Electrocardiography* ; Hospital Mortality ; Humans ; Mortality ; Myocardial Infarction* ; Prognosis ; Seoul