A fatigue or stress fractures is one in which there is no initial overt break in bone continuity. Rather, there is a gradual alteration in bone architecture as a result of repeated stress. The stresses are submaxmum and usually are the result of unaccustomed activity. If continued, they may eventually result in a complete fracture. Fatigue fractures have been described in almost every bone in the body, but they are more common in the bones of the lower extremities. Fatigue fractures are commonly seen in military personnel, especially at basic training center, and have been noted in athletes, ballet dancers, laborers, and even pregnant women. The following clinical results were shown by analysis of 57 cases of stress fractures experienced in the Department of Orthopaedic Surgery, Capital Armed Forces General Hospital from Jan. 1978 to Sep. 1979. 1. In 57 fatigue tractures in military recruits, 48 were in the tibial shaft and 9 were in the fibula. 2. The main cause of the fatigue fractures was running on hard roads, and the other causes were marching on hard surfaces, playing football, and long jumping. 3. The site of predilection in the tibia was the proximal one third of the shaft, occurring in 35 (72.9%) of the cases. In the fibula the junction of the upper and middle thirds was most frequently affected, occurring in 4 (44.4%) of the cases. 4. Most of the tibial and fibular fatigue fractures were grade I (40 cases among 57), showing periosteal reaction only on one or two cortices. 5. All soldiers were treated by immediate stoppage of physical activity, with no plaster immobilization or non weight bearing.
Arm ; Athletes ; Dancing ; Fatigue ; Female ; Fibula ; Football ; Fractures, Stress ; Hospitals, General ; Humans ; Immobilization ; Lower Extremity ; Military Personnel ; Motor Activity ; Pregnant Women ; Running ; Tibia ; Weight-Bearing

No abstract available.
Adrenocortical Carcinoma*

BACKGROUND AND OBJECTIVE: The clinical manifestation of Henoch-Schonlein purpura and existance of renal involvement may influence on its course and prognosis. To verify prevention with early administration of steroid, we studied the efficacy of corticosteroid treatment. MATERIAL AND METHOD: We analysed 65 children under 15 years of age with Henoch-Scho nlein purpura according to their age, sex, and seasonal incidence. Forty children showed typical skin lesions, arthralgia and abdominal pain. We have divided them two groups. Group A consisted of 20 children who received 1 mg/kg of prednisolone/perday for 2 weeks and group B did not. We carried out their physical examination and urinalysis monthly for a year. RESULT: The main clinical manifestations were skin rash(100% ), abdominal symptoms(41.5 %), joint symptoms (49.2%), and renal involvement(34%). As for gastrointestinal symptoms, abdominal pain(66.7% ) was most commonly observed one and others were nausea or vomiting (44.7%) and melena(25.9%). The joint involvement was observed mostly in knee(56.3%) and ankle joint(31.3% ), Hematuria was observed in all cases with renal involvement and proteinuria, in 28% of them. The improvement of renal manifestations were noted in 84.2% of them within 4 months. Mild elevation of IgA was more frequently observed in renal involvement group than non-involved group (p< 0.01). There were no significant differences in immonologic parameters such as IgG, IgM, IgE, duration of the acute phase and severity of cutaneous symptoms between two growps. None of steroid treated growp showed progression of nephropathy. Of the 20 non-steroid treated growp, 2(10%) developed nephropathy. Conclusion We may suggest that existance of renal involvement in Henoch-Schonlein purpura influences its course and prognosis.
Abdominal Pain ; Ankle ; Arthralgia ; Child ; Hematuria ; Humans ; Immunoglobulin A ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Joints ; Nausea ; Physical Examination ; Prognosis ; Proteinuria ; Purpura* ; Purpura, Schoenlein-Henoch ; Seasons ; Skin ; Urinalysis ; Vomiting

PURPOSE: To evaluate the safety of transgression of the bowel during intraperitoneal percutaneous catheter placement in an animal model. MATERIALS AND METHODS: Eight 8-F straight catheters were percutaneously insertedinto the small and large bowel of eight rabbits. In four animals, the catheters were left in place until autopsy, whereas in the remaining four, the catheters were withdrawn five days after insertion. Autopsy was performed inall animals ten days after catheter placement, and gross and microscopic examination was carried out. RESULTS: Transgressing the bowel during intraperitoneal percutaneous catheter placement did not contribute to any clinically significant complications. At autopsy, there was no bowel leakage, peritonitis, or abscess, although peritoneal adhesions were found around the catheter tract. CONCLUSION: Although further study is warranted, ourstudy with an animal model indicated that transgression of the intestine during percutaneous placement of an intraabdominal catheter did not produce significant complications.
Abscess ; Animals ; Autopsy ; Catheters* ; Drainage* ; Intestinal Perforation* ; Intestines ; Models, Animal ; Peritonitis ; Rabbits

The gene for tyrosinase has been mapped to the long arm of chromosome 11 at 11q14-21. The gene is at least 50Kb in length and its coding region is divided into five exons. Until now several mutations of the tyrosinase gene have been identifed in patient with typical oculocutaneous albinism (OCA) who are responsible for tyrosinase negative OCA. It may be possible to determine the types of OCA by measuring the hairbulb tyrosinase activity. Hairbulb tyrosinase activity was examined in a Korean albino to determine the type of OCA. And also tyrosinase assay was carried out in normally pigmented individuals and all members of a Korean albino's family to examine the tyrosinase activities. Five exons of tyrosinase gene from a Korean albino were amplified by polymerase chain reaction. Each amplified exon segments were independently subcloned and DNA sequences of clones were determined. The results obtained were as follows : 1. A Korean albino had no measurable hairbulb tyrosinase activity and was identified as type IA (tyrosinase negative) oculocutaneous albinism. 2. Normally pigmented individuals had different ranges of hairbulb tyrosinase activity. 3. A Korean albino had two single base insertions within exon V (between 337bp and 338bp, 353bp and 354bp) of tyrosinase gene. These insertional mutations might disrupt tyrosinase function and were associated with a total lack of melanin biosynthesis.
Albinism* ; Albinism, Oculocutaneous ; Arm ; Base Sequence ; Chromosomes, Human, Pair 11 ; Clinical Coding ; Clone Cells ; Exons ; Humans ; Melanins ; Monophenol Monooxygenase* ; Polymerase Chain Reaction

Multiple gastric caner, now considered to be a sort of multiple primary cancer by Moertel's classification, is a special type of cancer in which two or more tumor lesions arise independently from the stomach. Although its incidence is rare and it has never been reported in Korea yet, the report of multiple gastric cancer is increasing with lengthened life survival and improved diagnostic method. We recently experienced two cases of triple gastric cancer, the one in 53-years-old male who had well differentiated adenocarcinoma(EGC IIb+c) on antrum, poorly differentiated adenocarcinoma on cardia and moderately differentiated adenocarcinoma on mid-body, and the other in 65-years-old female who had two poorly differentiated adenocarcinoma on cardia and anterior wall of low body and moderately differentiated adenocarcinoma (EGCIIc) on posterior wall of low body. Triple gastric cancer is rare, so we reported 2 cases of triple gastric cancer.
Adenocarcinoma ; Cardia ; Classification ; Female ; Humans ; Incidence ; Korea ; Male ; Stomach ; Stomach Neoplasms*

OBJECTIVES: The EPDS (Edinburgh Postnatal Depression Scale) is a 10-items self-report scale designed as a specific instrument to detect postnatal depression by Cox et al. (1987). This study was to determine the optimal cut-off point of the KEPDS for postpartum depression in Korea. METHODS: The 239 pregnant women assessed their own psychiatric features with the Korean version of the Edinburgh Postnatal Depression Scale (K-EPDS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Rosenberg Self-Esteem Scale (RSES) and Marital Satisfaction Scale (MSS) at 6 months of pregnancy, 1 week after delivery, and 6 weeks after delivery. Subjects above 9 points of K-EPDS at 6 week after delivery were interviewed with Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) to confirm postpartum depression. RESULTS: The prevalence of postpartum depression was 12.6% (30/239 pregnant women) in our study. The total scores of K-EPDS at 6 weeks after delivery were higher significantly than those of normal group. The score gap of K-EPDS between the depressed pregnant group and the normal pregnant group was increased after the delivery. However, there were no differences in the epidemiological characteristics and the BDI scores at 6 weeks after delivery between groups. Using the AUC (area under the curve), the optimal point to assess the postpartum depression was revealed as 6 weeks after delivery (AUC=85.8%) or 24 weeks of pregnancy (83.7%). The cut-off point of K-EPDS to detect postpartum depression among pregnant women was 9/10 score of K-EPDS (AUC= 81.8%). CONCLUSION: In the K-EPDS, cut-off score of 9/10 was optimal to assess the postpartum depression, and K-EPDS at 6 weeks of delivery was more useful than any other point of time. K-EPDS administrated during pregnancy may be a useful tool to find the vulnerability on the postpartum depression.
Anxiety ; Area Under Curve ; Axis, Cervical Vertebra ; Depression ; Depression, Postpartum ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Glycolates ; Humans ; Postpartum Period ; Pregnancy ; Pregnant Women ; Prevalence

BACKGROUND: As the elderly population increases, elderly patients visiting emergency departments (ED) with acute abdominal pain will also likely increase. The underlying causative diseases in these older patients are different from younger patients, usually more serious. Thus, correct diagnosis is very important, but difficult. There needs to be a better understanding of the characteristics of the elderly patient with acute abdominal pain seen in the ED. METHODS: We retrospectively reviewed the medical records of 98 elderly patients (>or=65 years) and 109 adult controls (<65 years) visiting an ED at one general hospital looking at the final diagnoses, characteristics of abdominal pain, admissions, and surgeries. RESULTS: Hepatobiliary tract diseases and bowel obstruction were more common in the elderly patients. The elderly had more admissions and surgeries than younger patients. In addition, they were more likely to have a fatal disease such as myocardial infarction. CONCLUSION: There is a difference in the underlying diseases causing acute abdominal pain in the elderly patients versus younger patients. In terms of frequency of admission and surgery, the elderly present with more serious and fatal diseases. We must consider these features when seeing an elderly patient with acute abdominal pain in an ED.
Abdominal Pain ; Adult ; Aged ; Emergencies ; Hospitals, General ; Humans ; Medical Records ; Myocardial Infarction ; Retrospective Studies

Kaposi's varricelliform eruption is a characteristic syndrome of disseminated vesiculopustules superimposed on variable pre-existing dermatoses. Among these, atopic dermatitis is most common disease. We report two cases of Kaposi's varicelliform eruption associated with atopic dermatitis in a pair of identical twins. Diagnosis was made by the history, clinical feature, histologic examination and serologic test. These patients' condition was much improved by the treatment with antiviral agent and antibiotics.
Anti-Bacterial Agents ; Dermatitis, Atopic ; Diagnosis ; Humans ; Kaposi Varicelliform Eruption* ; Serologic Tests ; Skin Diseases ; Twins, Monozygotic*

PURPOSE: To analyse the angiographic findings of recurrent pyogenic cholangitis. MATERIALS AND METHODS: Hepatic arteriography and portography were performed preoperatively in 34 patients with intrahepatic stones and recurrent cholangitis. Twenty five of these underwent partial resection of the liver and in nine, the biliary tract was drained. Hepatic arteriogram and portogram findings correlated with liver atrophy and were analysed retrospectively by two radiologists; angiographic and pathologic findings also correlated. RESULTS: In the arterial phase, abnormal stained areas, were seen in 17 of 34 cases, periarterial staining in 14, mass-like staining in two and a mixed pattern in one. The hepatic artery showed spastic change in 11 of 34 cases and tortuous change in 17. Arteriovenous shunting was not seen. In the portal phase, abnormal findings of the portal veins were noted in 16 cases; decreased size and nonvisualization were seen in eleven patients, and decreased size only, in five. Fifteen cases showed liver atrophy; in 13 of these, portal vein abnormalities were also present. CONCLUSION: In recurrent pyogenic cholangitis, angiographic findings may be normal or findings of abnormal periarterial staining, mass-like staining, spastic and tortuous change of the hepatic artery, and abnormal portal vein can be present. The differential diagnosis of hepatitis, hepatic mass and cirrhosis should be considered.
Angiography ; Atrophy ; Biliary Tract ; Cholangitis* ; Diagnosis, Differential ; Fibrosis ; Hepatic Artery ; Hepatitis ; Humans ; Liver ; Muscle Spasticity ; Portal Vein ; Portography ; Retrospective Studies