Case histories of isolated and complete volar dislocation of the carpal scaphoid have rarely been reported .We report here another such case. On examination, the wrist was moderately swollen and tender over its volar aspect. Radiographs showed isolated, complete volar dislocation of the scaphoid. We used open reduction with K-wire fixation as treatment. After four weeks of operative reduction the patient had undertaken neurolysis due to median nerve compression symptom (carpal tunnel syndrome). At six weeks, the K-wires were removed and the patient was allowed to do a range of motion exercise. Twenty months after injury, the wrist was asymptomatic and had a mid-range of active motion without instability. There was no roentgenographic evidences of scapholunate dissociation or avascular necrosis
Dislocations* ; Humans ; Median Nerve ; Necrosis ; Range of Motion, Articular ; Wrist

Cutaneous protothecosis sometimes poses diagnostic and therapeutic problems. Isolation of the causative organism may not be successful and spores may be mistaken for other skin diseases unless the characteristic sporangia are detected in tissue sections. Because there are few cases, the optimal therapy is still being debated. On Liebs crystal violet staining we found charateristic purplish dots in Prototheca spores; these correspond to the amyloplasts or dense bodies found under electron microscopy. The isolated organisms were inhibited in vitro by itraconazole, amphotericin B, ketoconazole, and amorolfine and we were able to successfully treat two patients with itraconazole.
Amphotericin B ; Gentian Violet* ; Humans ; In Vitro Techniques ; Itraconazole* ; Ketoconazole ; Microscopy, Electron ; Plastids ; Prototheca ; Skin Diseases ; Sporangia ; Spores

A study was made in the congenital anomalies in 137 babies born to 120 mothers with hydramnios, delivered at Ilsin Christian Hospital between Jan. 1st 1981 and Dec. 31th 1990. The results were as follows; 1) The incidence of hydramnios was 1.6/1000 deliveries, 120 cases in total 73, 129 deliveries. 137 infants was born and of these 71 (51.8%) had congenital anomalies. 2) Hydramnios was assiciated with a high incidence of prematurity and low birth weight infant. 3) The incience of multiple anomalies was 54.9% (39 out of 71 infants). The most common system involved with the congenital anomalies was the musculoskeletal system, 28.9% (39 cases out of 135) and the most frequent anomaly was anencephaly, 15 cases. 4) The perinatal mortality rate was 759/1000 total (104 cases) and of these 45 cases, 43.3% were associated with congenital anomalies. 53 of the live birth had congenital anomalies and of these 27 cases (50.9%) died in the neonatal period.
Anencephaly ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Live Birth ; Mothers ; Musculoskeletal System ; Parturition* ; Perinatal Mortality ; Polyhydramnios*

No abstract available.
Ciprofloxacin* ; Mycobacterium tuberculosis* ; Mycobacterium*

The foreign bodies in the upper GI tract are produced chiefly by accidental swallowing and rarely produce symptoms. But it is recommended to remove the foreign bodies if they produce symptoms or retained in GI tract for long duration, and if they have the possibilities of producing complications. Nowadays the development of therapeutic endoscopy enables the removal of the foreign bodies easily. We have reviewed 88 cases of foreign bodies diagnosed by endoscopy from January, 1980 to July 1990 and had the following results. 1) The most common foreign bodies were coins and bezoars, common with the ages under 10 years and over 50 years. 2) The foreign bodies were found in the upper gastrointestinal tract in the order of stomach, esophagus and duodenum. 3) The esophageal stricture especially by lye was the most common underlying cause of upper gastrointestinal foreign bodies. 4) The symptoms and complications were more common with esophageal foreign bodies. 5) By therapeutic endoscopy, the success rate for removal of foreign bodies was 98%.
Bezoars ; Deglutition ; Duodenum ; Endoscopy* ; Esophageal Stenosis ; Esophagus ; Foreign Bodies* ; Gastrointestinal Tract ; Lye ; Numismatics ; Stomach ; Upper Gastrointestinal Tract*

No abstract available.
Durapatite* ; Radionuclide Imaging*

BACKGROUND: Hypertension is a major and growing public health problem and it calls for life-long management. The antihypertensive agents are still playing major roles in the management of hypertension. We studied the effect of the long-term therapy with a new calcium channel blocker, felodipine in patients with essential hypertension. METHODS: We recruited 31 patients with mild to moderate essential hypertention and gave them 5mg (1 tablet) of felodipine(Munobal(R)) once daily for 12 months. We measured the blood pressure and the heart rate every month and tried to detect any untoward symptoms and signs during the whole observation period. Baseline work-up for the hypertensive patients were done as usual before and after the study. RESULTS: The average systolic and diastolic blood pressures were 162.7+/-9.7/99.6+/-7.4mmHg respectively before the administration and they came down to the level of 139.7+/-15.0/87.3+/-8.6mmHg respectively at the end of the 1st month (p<0.05). This trend was maintained during the whole observation period, so they were 141.2+/-11.0/85.6+/-8.2mmHg respectively at the end of the study (p<0.05). Untoward drug reactions such as gastrointestinal troubles, facial edema, leg edema, chest pain and headache were present in 11 patients (35%) but they were not serious. There was no case in which the drug was withdrawn. There was one case in which the level of the serum triglyceride increased after the administration of the drug. CONCLUSION: Felodipine has good and persistent hypotensive effect and it is safe and easy to use.
Antihypertensive Agents ; Blood Pressure ; Calcium Channels ; Chest Pain ; Edema ; Felodipine ; Headache ; Heart Rate ; Humans ; Hypertension* ; Leg ; Public Health ; Triglycerides

The authors have reviewed 11 cases of prosthetic replacement for severe proximal humeral fractures which were treated from March 1989 to December 1993, paying particular attention to the range of motion attained after surgery and the factors which influence the limitation of shoulder motion. The results of this study were as follows: l. Among the 11 cases, 10 cases showed sttisfactory pain relief. 2. Active motion of the shoulder averaged 91° of forward flexion, 72.8° of abduction and 35° of external rotation. 3. The humeral offset averaged 30.9mm in normal shoulder and 18.9mm in affected shoulder. 4. In 6 cases which the humeral offset measured over 20mm, active motion averaged 104° of forward flexion and 83° of abduction and 5 cases showed satisfactory results. 5. In 5 cases which the humeral offset measured under 20mm, active motion averaged 104° of forward flexion and 83 of abduction and 5 cases showed unsatisfactory results. 6. Prosthetic replacements were performed within 1 week after injury in 7 cases and among these 5 cases showed satisfactory results. The range of motion after prosthetic replacement for severe proximal humeral fracture was disappointing. We concluded that limited range of motion is mainly due to reduced humeral offset and restoration of humeral offset by appropriate reattachment of greater tuberosity will allow better clinical result.
Range of Motion, Articular ; Shoulder ; Shoulder Fractures

Surgical oncologist plays a pivotal role in treating patients with cancer in the era of precision medicine. In this article, we summarized traditional roles of surgical oncologists and suggested further additional ones for the modern day in the multidisciplinary approach to gastric cancer treatment.

OBJECTIVES: We have previous reported that thawed testicular sperm and sperm extracted from seminiferous tubule could achieved optimal fertilization and pregnancy in azoospermic patients. However, thawed testicular sperm did not show motility in many cases. Therefore we studied viability of immotile sperm extracted from frozen-thawed seminiferous tubule using hypo-osmotic swelling (HOS) test and eosin-Y test. MATERIALS AND METHODS: After sperm extraction using for ICSI, the remained sections of seminiferous tubules were frozen with computerized freezer. For thawing and preparation of testicular sperm, the seminiferous tubules were thawed by removing from LN2 and letting them at room temperature for 10 min followed by 37degrees C water bath for 10 min. The prepared samples were washed for free of preservation medium and sperm preparation method described previous. Sperm was suspended in 0.1 ml hypoosmotic solution. After 30 minutes, the type of distally coiled sperm were assessed. RESULTS: In 44 cases of cryopreservation of seminiferous tubules in obstructive azoospermic patients, the fertilization rates with 2PN were 71.4% and pregnancy rates were 34.1%. The presence of motile spermatozoa on subsequent post-thaw testicular sperm remarked 15.1% and were increased to 77.3% just before ICSI. After sperm extracted from frozen-thawed seminiferous tubule, 3 hrs later in in vitro culture, the cases of presence of motile sperm, reaction of hypo-osmotic swelling test and viable sperm were 63.6% (28/44), 93.2% (41/44), and 77.3% (34/44), respectively. CONCLUSIONS: Just after post-thawed testicular sperm did not showed motility. Although motility was gained after in vitro culture, many cases showed non-motile sperm until optimal insemination time. However, HOS test showed positive reaction in non-motile sperm. Therefore, HOS test is an alternative method for the selection of viable sperm for ICSI.
Baths ; Cryopreservation ; Fertilization ; Humans ; Insemination ; Linear Energy Transfer ; Pregnancy ; Pregnancy Rate ; Seminiferous Tubules ; Sperm Injections, Intracytoplasmic ; Spermatozoa* ; Water