No abstract available.
Child* ; Humans

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

Benign solitary osteochondroma are the most common benign bone tumor, and often arise in the long bone of the extremities about 80% of lesions, particulary about the knee and the upper extremity. In rare cases, the spine is involved. We describe a case in which a solitary sacral osteochondroma compressed the lumbosacral plexus, producing sensory disturbance. The tumor was removed through the anterior midline approach. The excised mass was round, lobulated, measuring 7. 5cm×6cm, pedunculated type and the cartilage cap is complete and is 4mm in thickness.
Cartilage ; Extremities ; Knee ; Lumbosacral Plexus ; Osteochondroma ; Sacrum ; Spine ; Upper Extremity

OBJECTIVE: To investigate the response of hyperplastic endometrium to Medroxyprogesterone acetate according to the histologic types such as simple typical, complex typical and atypical hyperplasia. METHODS: A total of 79 patients with histologically proved endometrial hyperplasia were enrolled into this prospective study between March 1996 and May 1998. Patients without atypia were placed on a regimen of cyclic therapy with 10mg MPA orally, each day for 14days per month for 3 months. In the cases in which hyperplasia did not regress , MPA was increased to 20mg. Patients with atypical hyperplasia received continuous MPA therapy, 20mg orally each day for 3 month. All patients were followed up for a minimum of 3 months and a maximum of 1 year(mean 7 months). RESULTS: In patients with simple typical hyperplasia, 45 patients(80.4%) had regression, 11 patients(19.6%) had persistence and none had progression. In patients with complex typical hyperplasia, 10 patients(83.3%) had regression, 2 patients(16.7%) had persistence and none had progression. But, in patients with atypical hyperplasia 5 patients(45.4%) had regression, 4 patients(36.4%) had persistence and 2(18.2%) patients had well differentiated endometrial adenocarcinoma. There was no recurrence during the follow up. CONCLUSION: This data suggest that most women with typical hyperplasia respond to progestin therapy, but there is high failure rate of response to progestin therapy and risk of endometrial cancer in patients with atypical hyperplasia. If the young patient desires to preserve her fertility, then progestin therapy may be considered as primary treatment in patients with atypical hyperplasia. But older patients in whom fertility is not an issue, hysterectomy should be selected as treatment of choice for atypical lesion.
Adenocarcinoma ; Endometrial Hyperplasia* ; Endometrial Neoplasms ; Endometrium ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hyperplasia ; Hysterectomy ; Medroxyprogesterone Acetate ; Medroxyprogesterone* ; Prospective Studies ; Recurrence

No abstract available.
Animals ; Brain* ; Carbon Monoxide* ; Carbon* ; Rats*

BACKGROUND: As an antihypertensive drug, Nifedipine, a calcium channel blocker was introduced recently, which also has antianginal effect. But due to the relatively short duration of action, another antihypertensive agents having longer duration of action and stronger hypertensive effect were under investigation. Nilvadipine, a new calcium channel blocker, was introduced to have more prologned duration of action and to act more specifically on vascular smooth muscle. So the efficacy and safety of oral Nilvadipine on essestial hypertension was investigated and represented by our institute. METHODS: In order to investigate the efficacy and safety of oral Nilvadipine, daily doses of 4mg twice a day were administered in 30 hypertensive patients whose states were compatible to the criteria : 1) severity of hypertension rated in Stage I and Stage II according to the classification by WHO, 2) ages ranging from 30 to 74 years regardless of sex, 3) blood pressure with 95mmHg or higher but less than 115mmHg in diastolic pressure which was the mean in a sitting position at the last two out of not less three consultations in the 2 week observation period, 4) outpatients with informed consent for 6 weeks. Blood pressure and heart rate were measured every 2 weeks. The complete with blood count with platelet, uronalysis and the electrocardiography were performed at the beginning period and the 6th weeks of therapy. And kinds of side effects were questioned by examining physicians. RESULTS: The following results were obtained : 1) Blood pressure fell significantly in 6 weeks of treatment with Nilvadipine(Mean pressure+/-S.D., 6.00mmHg vs 108.90+/-9.68mmHg p<0.05), 2) There was no significant change in EKG in 6 weeks of treatment with Nilvadipine, 3) Pulse rate was decreased in 6 weeks of treatment with Nilvadipine(80.14+/-11.90/min vs 75.39+/-6.47/min, p<0.05). 4) No significant chsange in body weight was observed(64.50+/-8.7kg vs 63.50+/-10.25kg, p<0.05). 5) There were no significant changes in blood chemistry including blood sugar, cholesterol, electrolytes, serum creatinine and alkaline phosphatase values, 6) Hematologic findings and urinalysis findings reamained unchanged, 7) Total 10 patients(33.30%) had various side effects;facial flushing 30.00%, palpitation 23.33%, headache 20.00%, nausea 10.00%, drowsiness 3.33%, heaviness 3.33% and indigestion 3.33%. But there was no serious side effect that requires to discontinue the medication of the test drug. And there was no need to reduce the dosage due to the side effect, 8) The antihypertensive effect was judged to decrease markedly in 76.70%, decrease 20.00%, unchange 3.30% and increase 0.00%, 9) The utility which was assessed with the data from the overall safety and antihypertensive effect, the drug was judged to be very useful in 60.00%, useful 33.30%, useless 6.67% and inhibited 0.00%. CONCLUSION: From the above results, Nilvadipine in doses of 4mg twice a day was effective and useful in most cases without severe side effects in essential hypertensive patients with diastolic blood pressure of 95 to 115mmHg.
Alkaline Phosphatase ; Antihypertensive Agents ; Blood Glucose ; Blood Platelets ; Blood Pressure ; Body Weight ; Calcium Channels ; Chemistry ; Cholesterol ; Classification ; Creatinine ; Dyspepsia ; Electrocardiography ; Electrolytes ; Flushing ; Headache ; Heart Rate ; Humans ; Hypertension* ; Informed Consent ; Muscle, Smooth, Vascular ; Nausea ; Nifedipine ; Outpatients ; Referral and Consultation ; Sleep Stages ; Urinalysis

Carcinoid is a tumor that primarily affects the intestinal tract, which arises from entero-chromaffin cells. Rectal carcinoid tumor is a relatively rare neoplasm originated in Kul-chitszky cell and clinicians have the difficulties in predicting their malignant potential and in proper treatment. These cells are found to increase in the distal small intestine, are common in the appendix, and then decrease within the mucosa of the colon from cecum to rectum. In the cumulative world literature, the incidence of carcinoids of rectum is slightly higher than 10 percent. All of these tumors are within reach of the rigid procto-sigmoidoscope, most being located between 4 and 13 cm from the anal verge. Eighty five percent are found on the anterior and lateral walls. The tumors are usually submucosal and light yellowish or reddish color. The vast majority of rectal carcinoid tumors are be-nign, which can be treated by local excision safely. Lesions larger than 2 cm and invading the muscular wall of the rectum should be considered malignant, which are treated by more radical surgery such as abdominoperitoneal resection. We experienced a case of rectal carcinoid tumor, which was excised by endoscopic polypectomy, so we present this case with a review of relevant literatures.
Appendix ; Carcinoid Tumor* ; Cecum ; Colon ; Incidence ; Intestine, Small ; Mucous Membrane ; Rectum

In order to observe the effect on liver function after exposure to enlurane which has relatively minimal hepatotoxic effect, we evaluated the changes of the s-GOT & s-GPT levels caused by general anesthesia with enflurane. This study was undertaken to evaluate the effect of enflurane on liver function by comparing the preoperative and postoperative(1st day, 3rd day, 5th day, and 7th day) liver function(s-GOT & s-GPT) tests is il cases of the first general anesthesia with enflurane and 15 cases of a second general anesthesia with enflurane. The results were as folllows: 1) The 1st operative group. a. There are 5 cases (45%) of significant changes of s-GOT levels and no case of significant change in sGPT levels. b. In most of cases, the level of s-GOT & s-GPT have returned to normal values on the 7th postoperative day. 2) The 2nd operative group. a. The increase in the levels of s-GOT was found in 10 cases, and the s-GPT in 6 cases. b. Postoperatively, the simultaneous increase in the levels of s-GOT & s-GPT were found in 4 cases. c. On the 7th postoperative day, the levels of s-GOT & s-GPT was not normal in 3 cases, and not normal for s-GPT in 2 cases. The above results show that the higher of levels of s-GOT & s-GPT after the second general anesthesia with enflurane apparent compared to the levels after the first general anesthesia with enflurane. And it can be assumed that the extreme precaution is necessary in conduction the second general anesthesia with enflurane.
Alanine Transaminase ; Anesthesia, General ; Enflurane* ; Liver ; Reference Values

No abstract available.
Femur*

OBJECTIVES: To determine if unilateral pedicle screw fixation is comparable to bilateral fixation in one-or two-segment lumbar spinal fusion. METHODS: Eighty-eight patients with spinal stenosis or spondylolisthesis were assigned to either unilateral or bilateral pedicle screw instrumentation groups. Demographic variables, preoperative diagnosis, number of fusion segments, and kinds of instrumentation used were similar between the two treatment groups. RESULTS: There were no significant differences between the two groups in terms of blood loss, clinical results, time at which fusion was complete, fusion rate, and complication rate. There were significant differences between the two groups in terms of duration of operating time, duration of hospital stay, medical expenses. The number of fusion segments or kinds of instrumentation did not affect the fusion rate, time at which fusion was complete, or clinical outcomes. Metal failure rate of unilateral fixation was higher in patients with spondylolytic spondylolisthesis than in patients with spinal stenosis. CONCLUSIONS: Unilateral pedicle screw fixation was as effective as bilateral pedicle screw fixation in lumbar spinal fusion independent of the number of fusion segments (one or two segments) or pedicle screw systems. Unilateral pedicle screw fixation is not recommended for spondylolytic spondylolisthesis patients who were treated with Gill' s decompression.
Decompression ; Diagnosis ; Humans ; Length of Stay ; Spinal Fusion* ; Spinal Stenosis ; Spondylolisthesis