Dermatoglyphics has been studied in various diseases including mongolism, ruhella syndrome, congenital heart disease, selected neurologic diseases and other disorders. However, reports of derrnatoglyphic studies in patients with leprosy have not been evcountered a lot. Although Ieprasy is an infectious disease due to the hfycobacterium leprae, the hereditary susceptibility of the host to the organism is proposed as an additional predisposing factor. Thia concept has been proposed to reconcile the low incidence of lisease among large numbers of contacts. Most reports delving into the role of heredity in leprosy have been related ta epidemiological studies. Prasad and Mohamad suggest, on the basis of data related to rnultiple patient families, that the acquisition of leprosy may be determined genetically on the assumption of incomplete dominance of genes; on the other hand, Spickett suggested that if there is any genetic effect, it is but a component af the familial effect. This study of dennatoglyphics in 77 male leprosy patients was undcataken to determine if there might be significance in the analysis of dermal patterns af the hands as related to the hereditary susceptibility of individuals to the disease comparing with those of 234 healthy Korean soldiers. Results are as follows: 1. In the analysis of the total fingertip ridges, there is significant difference (P<0.01) between the leprosy (137.66+4.7) and the control group (152.93+9.50). 2. A aignificant statistical difference between the leprosy and the control group (14.73+2.79) does not exist with respect to the pattern intensity, however that af the borderline group of leprosy (12.00+5.09)is decreased (P<0.025). 3. In the incidence of simian lines, the leprosy group (5.20%) shows lower incidence rate than that of control group (8.98%). 4. As for the a-b ridge count, it is decreased significantly (P<0.05) in the left hand of leprosy group (34.71+0.87) than that of the eontrol group (37.11+0.52), Also there is significant difference(P<0. 05) in the right hands of tuberculoid type of leprosy (34.64+1.38). 5. With respect to the propoetional distance (mm.) between the distal flexion crease of the wrist to the base of the middle finger with the distance (mm.) of the same point of the wrist to the axial triradius, a significant statistical difference between the leprosy and the control group does not exist, but significantly longer distance (mm.) exists in the tuberculoid type of leprosy (P<0.05). 6. No significant fingertip pattern differences are noted between the leprosy and the control group.
Causality ; Communicable Diseases ; Dermatoglyphics* ; Down Syndrome ; Epidemiologic Studies ; Fingers ; Hand ; Heart Defects, Congenital ; Heredity ; Humans ; Incidence ; Korea* ; Leprosy* ; Male ; Military Personnel ; Wrist

Exposure with the tibial tubercle osteotomy was done for ten revisions and one primary total knee replacements out of 200 total knee arthroplasties performed from 1985 to 1996. The cases were analyzed with regard to complications and technical considerations. The preoperative diagnoses were infected total knee arthroplasty in seven, aseptic loosening in three and one ankylosed knee. Eixtensive exposure was achieved enough for debridement and reimplantation. The tubercle was fixed with two or three 3.5mm screws. The average duration of follow up was 30 months. Post operative knee flexion averaged 87 degrees. There were two complications, one avulsion of the fragment and one tibial fracture. The advantage of this procedure included wide exposure for difficult knee surgeries and more proximal fixation for improved flexion.
Arthroplasty* ; Arthroplasty, Replacement, Knee ; Debridement ; Diagnosis ; Follow-Up Studies ; Knee* ; Osteotomy* ; Replantation ; Tibial Fractures

STUDY DESIGN: This case report presents a 50-year-old patient with tabetic Charcoal spinal arthropathy combined with spinal stenosis, and its management. OBJECTIVES: To present the case report and follow-up results of Charcoal arthropathy with spinal stenosis of the lumbosacral spine, which was treated by circumferential fusion with instrumentation and decompressive laminectomy. LITERATURE REVIEW: Most reports of Charcot spine mention the etiology, clinical characteristics, pathology, and management of the condition. Surgical management of Chariot spines with spinal stenosis are rare. There is no report of the two-stage procedure of circumferential fusion and decom-pression for Charcot spine with spinal stenosis. MATERIALS AND METHODS: The patient complained of back pain, radiating pain to both lower legs, and 100m neurologic claudication. Serologic testing was positive in VDRL and FTA-ABS tests. Surgical treat-nent consisted of anterior resection of the L5 body with an autogenous iliad bone graft. It was followed by a posterior wide laminectomy of L5 for spinal stenosis, and CD instrumentation with transpedicular screws was applied to L3-S1 with lateral bone graft. RESULTS: At 27 months follow-up, clinical symptoms of back pain and radiating pain were disappeared. The patient walked without claudication, and satisfied with her condition. Firm bony fusions from L3 to S1 were obtained. There was no evidence of further destruction or neural compromise in the 27 months following surgery. CONCLUSION: A case of Charcoal arthropathy of the lumbosacral spine with spinal stenosis of L3-5 and L5-S1 has been reported, and the pathology, clinical features, and management of this condition were discussed. Circumferential fusion for Charcot spine and wide decompressive laminectomy for spinal stenosis are advisable.
Back Pain ; Charcoal ; Fluorescent Treponemal Antibody-Absorption Test ; Follow-Up Studies ; Humans ; Laminectomy ; Leg ; Middle Aged ; Pathology ; Pathology, Clinical ; Serologic Tests ; Spinal Stenosis* ; Spine* ; Transplants

PURPOSE: To evaluate the incidence of intraocular pressure (IOP) elevation and the associated factors following intravitreal triamcinolone acetonide injection. METHODS: A retrospective observational case study was performed in 143 eyes of 143 patients who received intravitreal injection of 4 mg triamcinlone acetonide and who had a minimum follow-up of 6 months. The eyes were examined before and periodically after the intravitreal injection of triamcinolone acetonide. A significant IOP elevation was defined as IOP>21 mmHg or a rise of more than 5 mmHg in patient with IOP over 21 mmHg at their first examination. RESULTS: Mean IOP increased from 16.1+/-3.2 mmHg preoperatively to 23.3+/-7.7 mmHg postoperatively. A significant IOP elevation was observed in 68 eyes (47.6%). IOP elevation was observed the day after injection and decreased to the baseline value after 6 months following injection. The time to reach maximum IOP was 3 months in 24.5%, 2 months in 20.3% and 1 week in 12.6%. Factors associated with IOP elevation were younger age, high IOP before injection, myopia, and unaccompanying anterior chamber paracentesis. Most cases of IOP elevation following intravitreal triamcinolone acetonide injection were controlled by antiglaucoma medication. However, in 4 eyes, filtering surgery or valve implantation was required. CONCLUSIONS: IOP elevation after intravitreal triamcinolone injection is common and may take an extended period of time to manifest. Cautious monitoring of IOP is recommended after intravitreal triamcinolone injection especially in younger patients and those with high IOP before injection, myopia, and unaccompanying anterior chamber paracentesis.
Anterior Chamber ; Filtering Surgery ; Follow-Up Studies ; Glaucoma ; Humans ; Incidence ; Intraocular Pressure* ; Intravitreal Injections* ; Macular Edema ; Myopia ; Paracentesis ; Retrospective Studies ; Triamcinolone Acetonide* ; Triamcinolone*

The pathogenesis, incidence, complication rates, response to acid suppression and Helicobacter pylori (H. pylori) eradication therapy in peptic ulcer associated with chronic disease such as liver cirrhosis, chronic renal failure, diabetes mellitus, and critically ill conditions are different from those with general population, so that the management strategies also should be differentiated. The eradication of H. pylori are not so effective for preventing recurrence of peptic ulcer in liver cirrhosis patients as shown in general population, and conservative managements such as preventing deterioration of hepatic function and decrease in portal pressure are mandatory to reduce the risk of ulcer recurrence. The standard triple therapy for H. pylori eradication are as effective in chronic renal failure patients as in normal population, but the frequency of side effects of amoxicillin is higher in the patients not receiving dialysis therapy. Delay in eradication therapy until beginning of dialysis therapy or modification of eradication regimen should be considered in such cases. High prevalence of asymptomatic peptic ulcers and increased mortality in complicated peptic ulcer disease warrant regular endoscopic surveillance in diabetic patients, especially with angiopathy. The prolongation of duration of eradication therapy also should be considered in diabetic patients with angiopathic complication because of lower eradication rate with standard triple regimens as compared to normal population. Prophylactic acid suppressive therapy is highly recommended in critically ill patients with multiple risk factors. Herein, we propose evidence-based treatment guidelines for the management of peptic ulcer disease in special conditions based on literature review and experts opinion.
Amoxicillin/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Critical Illness ; Diabetes Mellitus/diagnosis/drug therapy ; Helicobacter Infections/diagnosis/drug therapy ; Helicobacter pylori ; Humans ; Kidney Failure, Chronic/diagnosis/therapy ; Liver Cirrhosis/diagnosis/therapy ; Peptic Ulcer/*therapy ; Risk Factors

BACKGROUND: Currently the most common treatment modality of refractory ascites in patients with liver cirrhosis was large volume paracentesis, but this procedure usually needed albumin infusion and occasionally developed unwanted complications. By reason of albumin shortage in Korea and occasional unfavorable complications, we studied the usefulness of dialytic ultrafiltration as an another treatment modality of refractory ascites. METHODS: Dialytic ultrafiltration was done in 10 patients (total 48 times) with liver cirrhosis or hepatocellular carcinoma. Two drainage conduit (via 16 gauge angio-catheter) of input and output were made by puncture of patient's right and left lower quadrant abdomen. The initial ultrafiltration rate of dialyser was 250mL/min. Ascitic fluid was removed continuously until the filtration rate down at 50mL/min. After ultrafiltration, ascitic fluid contained concentrated albumin and large molecules was reinfused via input conduit. Pre-treatment and post-treatment level of blood chemistry, plasma renin concentration, aldosterone, and electrolytes in serum; total protein and albumin in ascites were measured. During the ultrafiltration, we closely observed the change of blood pressure, heart rates and mental status. RESULTS: The mean ultrafiltration time was 231+/-28min, ultrafiltrated volume was 5.15+/-1.41 L. During dialytic ultrafiltration, patient's blood pressure and heart rate were stable and there was no change of mental status. After dialytic ultrafiltration, blood urea nitrogen level significantly decreased from 30.5+/-23.7mg/dL to 25.7+/-20.2mg/dL; serum aldosterone level decreased from 807.3+/-301.1pg/ml to 431.1+/-187.2pg/ml in serum (P<0.01). The albumin level in the ascitic fluid significantly increased from 0.67+/-0.28g/dL to 1.90+/-1.16g/dL (P<0.01). Plasma renin concentration level tend to decreased (P=0.06). The patient's serum total protein, albumin, electrolytes, and creatinine were not changed. Complications of dialytic ultrafiltration were peritonitis (one case) and hypotension (one case). But these unwanted complications were readily managed by adequate antibiotics and intravenous fluid therapy. CONCLUSION: The dialytic ultrafiltration can be used effectively without albumin infusion in the treatment of refrartory ascites in patients with advanced liver cirrhosis.
Abdomen ; Aldosterone ; Anti-Bacterial Agents ; Ascites* ; Ascitic Fluid ; Blood Pressure ; Blood Urea Nitrogen ; Carcinoma, Hepatocellular ; Chemistry ; Creatinine ; Drainage ; Electrolytes ; Filtration ; Fluid Therapy ; Heart Rate ; Humans ; Hypotension ; Korea ; Liver Cirrhosis* ; Liver* ; Paracentesis ; Patient Rights ; Peritonitis ; Plasma ; Punctures ; Renin ; Ultrafiltration*

Endobronchial involvement in non-Hodgkin's lymphoma is rare. We experienced 36-year-old woman with endobronchial non-Hodgkin's lymphoma whose first presentation was breathless ness due to the total atelectasis of the left lung. The patient underwent fiberoptic bronchoscopy and the histologic finding with immunohistochemical staining confirmed CD30(+), EMA(+) anaplastic large cell lymphoma. Although the patient showed dramatic response to radiation therapy and combination chemotherapy, subsequently she died of disease progression.
Adult ; Bronchoscopy ; Disease Progression ; Drug Therapy, Combination ; Female ; Humans ; Lung ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, Non-Hodgkin* ; Pulmonary Atelectasis

Stress-induced cardiomyopathy is characterized by transient wall-motion abnormalities involving the left ventricular apex. Emotional or physical stress might play a key role in this reversible form of cardiomyopathy, but the etiology remains unclear. Clinical features of stress-induced cardiomyopathyare similar to those of acute coronary syndrome, but there is no significant stenosis in the coronary arteries. Recently, transient mid-ventricular ballooning syndrome, a variant form of stress-induced cardiomyopathy in which only the mid-ventricle is affected, has been reported. Here, we report a case of a 42-year-old female patient who developed transient mid-ventricular ballooning syndrome after cardiac arrest during autologous fat transplantation.
Acute Coronary Syndrome ; Adult ; Cardiomyopathies ; Constriction, Pathologic ; Coronary Vessels ; Female ; Heart Arrest ; Humans ; Takotsubo Cardiomyopathy ; Transplants

No abstract available.
Aneurysm* ; Atrial Appendage*

BACKGROUNDS: Katz index of ADL and Barthel index of ADL have been used to evaluate the function of disabled elderly in Korea. But no ADL scale reflecting Korean's own language expression and culture has been developed and verified yet. METHODS: Descriptions of basic activities which needed others' help were collected from 190 Korean disabled elderly. The collected results were categorized into basic activities of daily living and instrumental activities of daily living, and then in each domain such as bathing, shopping, etc. Preliminary instrument items were selected by the judgement of the expert committee, considering the frequency of the responses and the importance of each item. A preliminary questionnaire was developed based on the selected items. The preliminary questionnaire was pretested twice, and corrected by the results. Finally a scholar on Korean literature verified the questionnaire on the grammar and context. RESULTS: A total of 408 basic activities of daily living and 242 instrumental activities of daily living were collected. The activities were categorized into 7 domains of ADL(dressing, washing face and hand, bathing, eating, transfer, toileting, continence) and 10 domains of IADL(decorating, housework, preparing meals, laundry, outgoing for a short distance, using transportation, shopping, handling money, using telephone, taking medicine) CONCLUSIONS: We developed a Korean Activities of Daily Living(K-ADL) scale and Korean Instrumental Activities of Daily Living(K-IADL) scale reflecting Korean elderly's own language expression and culture.
Activities of Daily Living ; Aged ; Baths ; Eating ; Hand ; Housekeeping ; Humans ; Korea ; Meals ; Surveys and Questionnaires ; Telephone ; Transportation