No abstract available.
DNA Fingerprinting* ; DNA* ; Oligonucleotide Probes* ; Polymerase Chain Reaction*

Ankle arthrodesis has been regarded as a good operative treatment for post traumatic and rheumatoid arthritis of ankle, and ankle arthroplasty has been also developed with several types, from 1970, by Lord & Marotte. Ankle arthroplasty is more functional & less cosmetic troublesome than arthrodesis, and with more developed prosthesis design, more good result will come. The authors operated 6 cases of total ankle arthroplasty for posttraumatic and rheumatoid arthritis of ankle, which were also indications of arthrodesis, and introduce the results and operative problems of ankle arthroplasty.
Ankle ; Arthritis, Rheumatoid ; Arthrodesis ; Arthroplasty ; Prosthesis Design

No abstract available.
DNA* ; HLA-DR Antigens* ; Polymerase Chain Reaction*

PURPOSE:It is important to evaluate the healing process of avascular necrosis (AVN) involving femoral head after treatment. The purpose of this study was to assess the usefulness of pinhole bone scintigraphy in the AVN of femoral head after surgery. MATERIALS AND METHODS: We analyzed the changing pattern of pinhole bone scintigram in 21 femoral heads of 16 patients (14 lesions/11 male, 7 lesions/5 female, mean age: 39.4 yrs) before and after multiple drilling or vascularized bone grafting for AVN of the femoral head. In all patients, pre-operative scintigrams were obtained at 1 to 3 months before treatment and the first post-operative scintigrams were obtained at 1 to 3 months after treatment. All patients were followed for 2 to 4 years after operation. RESULTS: The findings of the pinhole scintigrams were divided into three patterns: 1) curvilinear, 2) scattered spotty and 3) undetermined. The 10 of 11 lesions with curvilinear pattern had good postoperative clinical and radiological follow-up findings. However, all 6 lesions with scattered spotty pattern showed poor postoperative findings, which necessitated total hip joint replacement. Of the 4 lesions with undetermined pattern, 2 required total hip joint replacement. There was significant difference in postoperative prognosis between the curvilinear and scattered spotty patterns (p<0.05). CONCLUSION: We conclude that the pattern of pinhole bone scintigram obtained within 1 to 3 months after multiple drilling or vascularized bone graft operation is a useful prognostic indicator in the AVN of femoral head.
Bone Transplantation ; Female ; Follow-Up Studies ; Head* ; Hip Joint ; Humans ; Male ; Necrosis* ; Prognosis* ; Radionuclide Imaging* ; Technetium Tc 99m Medronate ; Transplants*

Ocular disturbances related to cranial nerve lesion or increased intracranial pressure are well known in cryptococcal meningitis, but internuclear ophthaloplegia is very rare and only two cases have been reported to our knowledge. We report the third patient of internuclear ophthalmoplegia in cryptococal meningitis. The internuclear ophthalmoplegia in our case persisted for one year with a demonstrable lesion in brain MRI, in contrast to the other cases in which intranuclear ophthalmoplegia was transient and no responsible lesion was observed.
Brain ; Cranial Nerves ; Cryptococcosis* ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Meningitis ; Meningitis, Cryptococcal ; Ocular Motility Disorders ; Ophthalmoplegia

OBJECTIVE: This study aimed to comprehensively evaluate psychosocial risk factors associated with suicidality in patients with schizophrenia in Korea. METHODS: The study sample consisted of 84 hospitalized patients with schizophrenia. Suicidal thoughts and a clear desire to be dead within 2 weeks were defined as a current suicidal ideation. Socio-demographic and clinical variables, including family history of completed suicides and psychiatric illnesses, were collected, and the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Beck Depression Inventory (BDI), Simpson-Angus Scale (SAS), Scale to assess Unawareness of Mental Disorder (SUMD), and Alcohol Use Disorders Identification Test (AUDIT) were administered to identify factors associated with a current suicidal ideation. RESULTS: Forty-three subjects (51.2%) reported clear suicidal ideation. Multivariate analysis revealed that later age of illness onset, previous suicide attempt, family history of completed suicide, depression, or substance abuse, fewer than one family visitation to the hospital per month, and score on the CDSS were independently related to current suicidal ideation in these subjects. Age, education level, and scores on the SUMD were not significantly associated with current suicidal ideation in the multivariate analysis, but were associated with suicidal ideation in a univariate analysis on the level of p<0.1. CONCLUSION: The above clinical factors should be evaluated to predict and prevent suicidal risk in patients with schizophrenia. In particular, modifiable factors such as depression should be managed to reduce suicidality of hospitalized patients with schizophrenia.
Depression ; Humans ; Korea ; Mental Disorders ; Multivariate Analysis ; Risk Factors ; Schizophrenia ; Substance-Related Disorders ; Suicidal Ideation ; Suicide

Sparganosis of the central nervous system is an uncommon parasitic zoonosis caused by the migrating larva of the genus Spirometra mansonoides. The patient, a 53-year-old woman, complained of focal involuntary movement involving the right face and headache. Three months after first admission, paraparesis developed. Serial MRI revealed cerebral and spinal lesions and micro-ELISA test disclosed positive reaction to sparganus antigen.
Central Nervous System ; Dyskinesias ; Female ; Headache ; Humans ; Larva ; Magnetic Resonance Imaging ; Middle Aged ; Paraparesis ; Sparganosis* ; Spinal Cord* ; Spirometra

Hereditary progressive dystonia develope in the first decade of ?life and is characterized by marked diurnal fluctuation of symptoms(dystonic postures and movements), i.e.symptoms aggrevated towards evening and alleviated after sleep. These symptoms and signs responded dramatically to levodopa. With the high incidence of familial cases this disorder is considers to be hereditary, but inheritance is not clear yet. Segawa regarded this disorder as a dystonia different from Parkinson's disease and other types of dystonic movement disorders, thereafter it has been reported under name of hereditary progressive dystonia with marked diurnal fluctuation.
Dystonia* ; Incidence ; Levodopa ; Movement Disorders ; Parkinson Disease ; Posture ; Wills

Paroxysmal choreoathetosis(dyskinesia) is classified into two subtypes: paroxysmal kinesigenic choreoathetosis(PKC) and paroxysmal dystonic choreoathetosis(PDC). PDC consist of attacks of dystonia and /or choreoathetosis during which the patients are dysarthric or anarthric, have irregular clonic movement and dystonic posturing of extremities, and these not precipitated by sudden movement but rather by alocohol, coffee and stress. Attacks are longer (2ninute-4hours), but less frequently(3-4times/day) than PKC, they are not responsive to anticonvulsants(eg, phenytoin, carbamazepine) but controlled by clonazepam.This disease is rare, in the reported families, the transmission was clearly autosomal dominant with high penetrance.
Coffee ; Dystonia ; Extremities ; Humans ; Penetrance ; Phenytoin

Repetitive nerve stimulation test(RNS) was performed on 32 patients with myasthenia gravis who showed positive response to the tensilon test. The result of the repetitive stimulation test before and after the tensilon injection was compared with the point of improvement of the CMAP and decremental response. The results were as follows: 1. All patients with myasthenis gravis showed decremental responses to the low rate of stimulation in RNS. 2. The results after tensilon injections showed significant improvements of the CMAP in ocularis oculi(OOC), flexor carpi ulnaris(FCU)(P <0.0005), deltoid and abductor digiti quinti muscles(ADQ)(P < 0.005). 3. There were improvements of decremental responses after tensilon injection. 1) At 2/sec, there were significant improvements in the muscles of ADQ(P <0.005), deltoidl OOC and FCU(P < 0.0005). 2) At 3/sec, there were significant improvements in the muscles of OOC(P <0.005), deltoid, FCU and ADQ(P < 0.0005). 3) At 5/sec, there were also significant improvements in all the muscles of OOC, deltoid, ADQ, FCU(P <0.0005). These results showed that tensilon improves the RNS abnorrnalities in myasthenic patients with positive tensilon test. We think these findings before and after the tensilon injection are helpful to diagnose and differentiate a patient with suspected myasthenia gravis who has a negative tensilon test or insignificant RNS findings.
Edrophonium* ; Humans ; Muscles ; Myasthenia Gravis*