No abstract available.
Patella*

The morbidity of spondylolisthesis tends to increase in accordance with the popularization of sports and increase of mean life span by the development of medicine. We had applied surgical treatment for 39 cases of spondylolisthesis during the period of 8 yrs. from Jan. 1976 to Dec. 1983 at Department of Orthopaedic Surgery, National Police Hospital, among them 35 cases were followed up for mean 27 months. Twenty eight cases with posterolateral spinal fusion were isthmic spondylolisthesis and seven cases with posterior spinal fusion and facetectomy were degenerative type. We analysed them with clinical aspects and surgical treatment for 35 cases. The results were as follows: 1. The most common clinical symptoms were low back pain (96.7%) and tenderness (93.5%). 2. The degree of slipping was Grade I by Meyerding's classification in all cases and mean 12.5% by Taillard method. 3. In the 7 cases of isthmic spondylolisthesis, the degree of slipping increased on standing lateral view. And in these cases the clinical symptoms were aggrevated at welking. 4. In the degenerative spondylolisthesis with posterior spinal fusion and facetectomy, we found mean 70% spontaneous correction of slipping commpared with preoperative. 5. In postoperative evaluation we gained 94.3% above good according to Gill's criteria and no pseudarthrosis.
Classification ; Humans ; Low Back Pain ; Methods ; Police ; Pseudarthrosis ; Spinal Fusion ; Spondylolisthesis ; Sports

PURPOSE: To evaluate the outcome of ductal carcinoma in situ (DCIS) patients who underwent surgery followed by radiation therapy (RT). MATERIALS AND METHODS: We retrospectively reviewed 106 DCIS patients who underwent surgery followed by postoperative RT between 1994 and 2006. Ninety-four patients underwent breast-conserving surgery, and mastectomy was performed in 12 patients due to extensive DCIS. Postoperative RT was delivered to whole breast with 50.4 Gy/28 fx. Tumor bed boost was offered to 7 patients (6.6%). Patients with hormonal receptor-positive tumors were treated with hormonal therapy. RESULTS: The median follow-up duration was 83.4 months (range, 33.4 to 191.5 months) and the median age was 47.8 years. Ten patients (9.4%) had resection margin <1 mm and high-grade and estrogen receptor-negative tumors were observed in 39 (36.8%) and 20 (18.9%) patients, respectively. The 7-year ipsilateral breast tumor recurrence (IBTR)-free survival rate was 95.3%. Resection margin (<1 or > or =1 mm) was the significant prognostic factor for IBTR in univariate and multivariate analyses (p < 0.001 and p = 0.016, respectively). CONCLUSION: Postoperative RT for DCIS can achieve favorable treatment outcome. Resection margin was the important prognostic factor for IBTR in the DCIS patients who underwent postoperative RT.
Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Estrogens ; Follow-Up Studies ; Humans ; Mastectomy ; Mastectomy, Segmental ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome*

No abstract available.
Cyclophosphamide* ; Hypersensitivity*

Lyme disease caused by Borrelia species is transmitted via infected tick bites. Erythema migrans, a typical skin lesion on the tick-bitten site, is a hallmark of Lyme disease. A 63-year-old female presented an erythematous, semi-circular patch in the left inguinal area. It disappeared spontaneously without treatment. However, after 3 months, an erythematous patch with a diameter of 1 cm recurred on the left thigh. B. burgdorferi antibody testing revealed positive results. At the second visit, doxycycline was prescribed, and the skin lesion was resolved. However, the patient exhibited persistent systemic symptoms, including arthralgia and fatigue, and was diagnosed with post-treatment Lyme disease syndrome (PTLDS). The PTLDS prognosis is associated with delayed diagnosis. Thus, antibiotic treatment should be promptly initiated after suspecting Lyme disease to minimize the associated systemic symptoms. PTLDS diagnosis should be followed by proper medical care to alleviate the symptoms.

There is no sport in which the knee does not play an integral role. Blazina described the clinical aspects and treatment of the “jumper's knee”. A jumper's knee is a tendinitis of the patella or less frequently quadriceps tendon at the inferior or superior pole of the patella, respectively. It is typically encountered in athletes who are involved in some type of repetitive activity such as jumping, climbing, kicking, or running. the pathology is still ill understood and further date on the etiology and treatment are scarce. Fourty seven cases of patella tendinitis were analyzed in clinical aspects. Results of the study are as follows: l. Of the 47 cases, male were 9 or 19.1%, female were 38 or 80.9%. 2. Complained pain on proximal pole of patella were 11 or 23.4%, both pole were 9 or 19.1%, distal pole were 27 or 57.4%. 3.0f 47 cases, 22 cases or 46.8% were Grade I, 20 cases or 42.5% were Grade II, 4 cases or 8.5% were Grade III, 1 case or 2.1% was Grade IV. 4. 1 case, Grade IV, was confirmed fracture on distal pole of patella by radiologic examination. 5. The Grade I & II patients had subsided an improved by a few days rest, Quadriceps and Hamstrings setting exercise, Ice massage and medication.
Athletes ; Female ; Humans ; Ice ; Knee ; Male ; Massage ; Patella ; Pathology ; Running ; Sports ; Tendinopathy ; Tendons

Between March 1995 and March 1996, we used a newly-designed neurosurgical procedure, based on 'keyhole surgery', to operate on 20 patients diagnosed as suffering from lumbar spinal stenosis without instability. The unique surgical steps involved in this procedure are: 1) three-quarter prone position of the patient; 2) small paramedian skin incision; 3) half-way incision of the spinous process; 4) small turnover funnel shaped unilateral laminectomy and wide forminotomy using high speed drills; 5) extensive ligament flavectomy; 6) microsurgical decompression without using nerve root retractor; 7) cosmetic wound closure. In some cases, if bilateral radicular symptom was present, the contralateral nerve root was explored through the unilateral laminectomy opening; this was achieved by changing the inclination of the base of the spinous process and extensively removing of the ligamentum flavum. Compared with conventional procedures, these technical innovations offer both procedural adventages and a better clinical outcome. Because of the small patient populations and short follow-up period, this technique requires further investigation, but we hope it will provide another option for future lumbar stenosis surgery. Further technical refinements and long-term follow-up results will be reported elsewhere.
Constriction, Pathologic* ; Decompression* ; Follow-Up Studies ; Hope ; Humans ; Laminectomy ; Ligaments ; Ligamentum Flavum ; Neurosurgical Procedures ; Prone Position ; Skin ; Spinal Stenosis ; Wounds and Injuries

BACKGROUND: Cicletanine bydrochloride is a newly developed anti-hypertensive agent. The presence of a furopyridine group characterizes its uncommon chemical structure as an antihypertensive molecule. This clinical trial was performed to confirm the efficacy and safety of cicletanine for the treatment of hypertension as a monotherapy. METHODS: In order to investigate the efficacy and safety of oral cicletanine, a now class of antihypertensive durgs, the furopyridines, on essential hypertension, a single daily dose of 50mg to 100mg cicletanine was administered in 46 hypertensive patients with diastolic blood pressure in the range of 95mmHg-115mmHg. The patients were asked to cut off other anti hypertensive agents for 10 weeks prior to this clinical trial. Blood pressure and heart rate were measured every 4 weeks. The complete blood count, blood chemistry done by SMA-12, serum electrolytes and urinalysis were performed at the 12th week of therapy. RESULTS: 1) Baseline blood pressures after 2 weeks of placebo at sitting and standing positions were 158.7+/-16.1/102.9+/-6.2 and 148.7+/-14.5/102.7+/-6.7mmHg, respectively. The overall slope which represents the tendency of blood pressure decline over the treatment period with cicletanine for all the patients in each position are as follows ; -0.726(SE : 0.150) for sitting systolic blood pressure(BP), -0.390(SE : 0.080) for sitting diastolic BP, -0.214(SE : 0.183) for standing systolic BP and -0.341(SE : 0.139) for standing diastolic BP. 2) The slope of sitting systolic BP line in cicletanine 100mg treated group was significantly stiffer than that of cicletanine 50mg treated group(-0.445 vs -1.021, p=0.0336). 3) There were no significant interval changes in heart rate over the treatment period. 4) There were no significant interval changes in blood chemistry, electrolytes, hematologic findings and urinalysis over the treatment period. 5) Several side effects were observed in six patients(epigastric discomfort in 4, easy fatigue and insomnia in one patient, respectively). CONCLUSION: Treatment with cicletanine was well-tolerated and the incidence of side effects was relatively low. Because of its unique anti-hypertensive mechanism and moderated antihypertensive effects, cicletanine may be well suited in the treatment of hypertension combined with other classes of antihypertensive agents.
Antihypertensive Agents ; Blood Cell Count ; Blood Pressure ; Chemistry ; Electrolytes ; Fatigue ; Heart Rate ; Humans ; Hypertension ; Incidence ; Sleep Initiation and Maintenance Disorders ; Urinalysis

BACKGROUND: Clonidine, alpha2-adrenoreceptor agonist, has nonopiate antinociceptive properties, which might be an alternative for postoperative analgesia free of opioid induced side effects. The aim of this study was to evaluate the fentanyl sparing effect of clonidine and reducing side effects with intravenous administration. METHODS: Fourty seven patients undergoing a cesarean section were randomly allocated to two groups to be given the following agents by intravenous administration. Group I, fentanyl 0.2ng/kg/h with clonidine 0.2ng/kg/h for 72 h adding normal saline for a total of 150 cc. Group II, fentanyl 0.4ng/kg/h for 72 h adding normal saline for a total of 150 cc and analgesia was provided intravenously via patient -controlled analgesia (PCA; basal rate = 2 ml, rescure dose = 1 ml, lock-out time = 10 min). Postoperative analgesia was assessed by VAS at 2, 4, 8, and 24 h after extubation. In addition, we also checked the vital sign sedation score. RESULTS: There were no differences of VAS scores, hemodynamic values except systolic pressure (P < 0.05), or side effects between group I and group II. The frequency of nausea was 8.7% in group I and 29% in group II, and dizziness was 4.3% in group I and 8.3% in group II. CONCLUSIONS: Intravenous clonidine with narcotics is a possible approach to postoperative pain management in patients recovering from major surgery, especially spine surgery, and clonidine spares and reduces side effects in narcotics.
Administration, Intravenous ; Analgesia ; Blood Pressure ; Cesarean Section* ; Clonidine* ; Dizziness ; Female ; Fentanyl* ; Hemodynamics ; Humans ; Infusions, Intravenous* ; Narcotics ; Nausea ; Pain, Postoperative ; Pregnancy ; Spine ; Vital Signs

No abstract available.
Malignant Atrophic Papulosis*