A 72-year-old woman developed pruritic erythematous patches on sun-exposed areas for 2 months following treatment with hydrochlorothiazide (Dichlozid) for hypertension. A phototest revealed a decreased minimal erythemal dose to UVA (MED(UVA)=2 J/cm²). A photopatch test with 0.5%, 1%, and 5% hydrochlorothiazide ointment revealed no response. Two weeks after discontinuation of hydrochlorothiazide, the skin lesions improved with complete loss of photosensitivity without any therapy. At that time, an oral provocation phototest with hydrochlorothiazide was performed and it showed a decreased MED to UVA (MED(UVA)=2 J/cm²).
Aged ; Dermatitis, Phototoxic* ; Female ; Humans ; Hydrochlorothiazide* ; Hypertension ; Skin

PURPOSE: To determine the significance of anomalous position of the gallbladder. MATERIALS AND METHODS: Sixteen patients with anomalous position of the gallbladder were evaluated for analysis. The diagnosis was confirmed by ultrasonography(15 patients) and oral cholecystography(1patient). Among those, six patients underwent CT scan and a patient had 99mTc-DISIDA scan. The images were analysed with respect to the location of the GB and configuration and associated abnormality of the liver and hepatobiliary systems. Medical records of each patient were also reviewed. RESULTS: Among 16 patients having an anomalous position of the gallbladder, nine had retrodisplaced gallbladder, four had left-sided gallbaldder, two had suprahepatic gallbladder, and one had floating gallbladder. Except for one patient, fifteen had abnormality in the liver such as focal atrophic or hypoplastic change and liver cirrhosis. Intrahepatic stones were demonstrated in 6 patients. CONCLUSION: Our results showed that anomalous position of the gallbladder was commonly associated with atrophy or hypoplasia of the liver rather than congenital in origin. The possiblity of an anomalous location of gallbladder should be kept in mind when GB is not in its normal location.
Atrophy ; Diagnosis ; Gallbladder* ; Humans ; Liver ; Liver Cirrhosis ; Medical Records ; Technetium Tc 99m Disofenin ; Tomography, X-Ray Computed

Multidirectional shoulder instability is often difficult to diagnose and treat and can be cause of significant disability. Nonoperative rehabilitations and life tyle modifications are the primary treatments. Hiwever, the inferior capsular shift procedure, performed either from an anterior or posterior approach, as described by Neer and Foster, is recommended for symptomatic multidirectional instability that is unresponsive to nonoperative therapy. Twenty-seven shoulders in twenty-seven patients with inferior and multidirectional instability were managed with Neer s inferior capsular shift, through anterior or posterior approach depending on the direction in which the shoulder is most unstable. All of the patients were followed up for an average of 3 years (range one to seven years). The postoperative range of motion of the shoulders was well maintained except 1 patient. Three patients had recurrence of symptomatic and disabling multidirectional instability, but twenty-four (89%) of the shoulders continued to function well with no instability, no pain, no recurrence and no remarkable limitation of motion.
Humans ; Range of Motion, Articular ; Recurrence ; Shoulder*

No abstract available.
Malaria*

Detection of tears of the posterior cruciate ligament (PCL) with MRI is usually based on the appearance of the ligament. However, other MRI findings may be useful in establishing the diagnosis. We assessed these associated injuries in the cases of complete tears of the PCL, reviewing MRls. We evaluated 26 patients who received PCL reconstruction with complete tear of posterior cruciate ligament from Feb 1995 to May 1997 retrospectively. We studied associated findings with PCL injuries. Anterior tibial plateau lesions were found in 15 of 26 cases (57.7%). Meniscal injuries were found in 8 of 26 cases (30.8%). Popliteus muscular injuries was found in 7 of 26 cases (26.9%). Capsular injuries were found in 2 of 26 cases (7.7%). Retinacular injury which has never been described in PCL injuries, was found in 7 cases (26.9%, P>0.05), Other ligamentous injuries were associated in 22 of 26 cases (84.6%). Medial collateral ligament injuries were found in 16 of 22 (61.5%, P<0.05) cases. The frequency of associated ligamentous injury and meniscal tear correlated well with results reported by other authors. The presence and location of bone contusions and fractures correlated with the mechanisms of injury; the anterior tibial plateau was the most commonly affected site. We concluded that the associated injuries were very helpful in diagnosing PCL injuries with MRI.
Collateral Ligaments ; Contusions ; Diagnosis* ; Humans ; Knee* ; Ligaments ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament* ; Retrospective Studies

The purpose of this study is to determine whether magnetic resonance imaging(MRI) can assist in deci- sion-making in the treatment of acute posterolateral complex injuries. We reviewed retrospectively seven patients with acute posterolateral complex injury, among the 79 cases that had taken cruciate ligament recon- struction. MRI findings were then correlated with the results of examination under anesthesia or operi lateral reconstruction. Based on surgical and clinical findings, there were six complete and four partial posterolateral complex injuries. MRI was able to accurately describe the extent of injury in each case. All ten patients had concomitant anterior cruciate ligament tears, and seven were three posterior cruciate ligament injuries. The iliotibial band was avulsed from Gerdys tubercle in seven patients. In knees with complete tears, separation of the coronary ligament of the lateral meniscus was noted on MRI. A characteristic bone contusion on the anteromedial femoral condyle was present in nine patients. Popliteal tendon tearing was observed in eight cases, and biceps femoris was torn in six patients. In knee with complete tears, tears of the lateral collateral ligament complex was noted both on MRI and intraoperatively. A high-quality MRI in patients sustaining these injuries will assist the surgeon in directly applying surgical techniques in a timely fashion.
Anesthesia ; Anterior Cruciate Ligament ; Contusions ; Humans ; Knee* ; Lateral Ligament, Ankle ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Posterior Cruciate Ligament ; Retrospective Studies ; Tendons

The purpose of this study is to evaluate the stress distribution in the bone around dental implants supporting mandibular overdenture according to the number of implant and the type of attachment. Two or four implants were placed in an edentulous mandibular model and three dimensional photoelastic stress analysis was carried out to measure the fringe order around the implant supporting structure and also to calculate principle stress components at cervical area of each implant. The attachments tested were rigid and resilient type of Dolder bar, Round bar, Hader bar and Dal-Ro attachment. The results were as follows; 1. In 2-implant supported overdenture using Round bar, Hader bar, and Dal-Ro attachment, compressive stress pattern was observed on the supporting structure of implant on loaded side, while tensile stress pattern in unloaded side. 2. In 2-implant supported overdenture using Dolder bar, the rigid Dolder bar shared the occlusal loads between 2 implants in a more favorable manner than was exhibited by the resilient type, while the resilient type placed a more stress on the distocervical area of the implant on the loaded side. But compressive stress pattern was observed in both the loaded and unloaded sides in either case. 3. In 2-implant supported overdenture, rigid and resilient type of Dolder bar exhibited more cross arch involvement than the Round bar, Hader bar, or Dal-Ro attachment. 4. In 4-implant supported overdenture using resilient Dolder bar and Hader bar, stress turned out to be distributed evenly among the implants between loaded and unloaded side, but ther was no reduction in the magnitude of the stress in the surrounding structure of implant contratry to 2-implant supported overdenture.. 5. The stress pattern at cervical area of implant was different with the number of implant or the type of attachment but the overload, harmful to surrounding structure of implant, was not observed.
Dental Implants ; Denture, Overlay*

No abstract available.
Child* ; Gastroenteritis* ; Humans* ; Infant*

Three cases of giant pituitray adenoma are reported. Two cases were operated by transsphenoidal approach and a case by transcranial approach. Transsphenoidal approach showed satisfactory results despite of marked suprasellar extension of tumors. We report rare giant pituitary adenomas with review of relevant literatures.
Adenoma ; Pituitary Neoplasms*

No abstract available.
Cyclosporine* ; Scleredema Adultorum*