Tennis elbow is common, and offen disabling problem even in daily living;conservative treatments commonly make satisfactory results, but recurrence is frequent and discouraging. So, surgical treatments are considered in certain cases. The authors report the retrospective analysis of 15 patients treated by nirschl and pettrone procedure. Patients were evaluated with Nirschl and Pettrone assessment method at an average 10.3 months(range, 5 to 32 months0 after surgery. thirteen of 15(87%) patients had more than fair postoperative rating. Two patients had postoperative complications;one with infection and the other with transient mild limitation of elbow motion. No postoperative deterioration of the clinical state was seen. And biopsy specimens of all case showed degenerative changes. Resection of the degenerated site of tendon origin of the humeral epcondyle(The Nirschl and Pettrone procedure) yield satisfactory results in properly selected patients.
Biopsy ; Elbow ; Humans ; Methods ; Recurrence ; Retrospective Studies ; Tendons ; Tennis Elbow ; Tennis

We have experienced an unusual case of hemorrhagic renal cyst in the rt. kidney at 58 years old woman. The Rt. kidney was enlarged, and showed a few subcapsular ischemic areas The color of kidney was dark brown. As the cyst at lower pole of rt. kidney was dissected, hemorrhagic fluid visualized in the cystic cavity. The final pathologic finding was renal cyst associated with malignant change and renal cell carcinoma at another renal parenchyma. Herein, hemorrhagic renal cyst, a rare clinical entity, was reported with review of literatures.
Carcinoma, Renal Cell ; Female ; Humans ; Kidney ; Middle Aged

Voriconazole is a second-generation triazole that has an enhanced antifungal spectrum, compared with older triazoles. It will likely become the drug of choice for treatment of invasive aspergillosis and many Scedosporium/Pseudallescheria and Fusarium infections. Voriconazole should not replace fluconazole or other antifungal agents for treatment of most Candida infections. The drug has more side effects and drug interactions than fluconazole. The oral formulation, with its excellent bioavailability, is available it is especially beneficial in patients with renal failure, who should not be exposed to the cyclodextrin vehicle used for the intravenous formulation. Caspofungin, the first inhibitor of fungal beta -1, 3 glucan synthesis, is effective for the treatment of mucosal and invasive candidiasis and invasive aspergillosis. It is also active in vitro and in animal models against a number of other filamentous and dimorphic endemic fungi and in animal models of Pneumocystis carinii infection. Caspofungin has an excellent safety profile. Caspofungin may prove to be useful in empirical therapy for suspected invasive fungal infections. Additional clinical trial data that expand our knowledge of the usefulness of caspofungin for these and other mycoses is anticipated. The broad spectrum antifungal itraconazole is an effective and well tolerated agent for the prophylaxis and treatment of systemic fungal infections. The recent development of an itraconazole oral solution and an intravenous itraconazole solution has increased the options for the use of this drug. Intravenous itraconazole solution is at least as effective as intravenous amphotericin B in the empirical treatment of neutropenic patients with systemic fungal infections, and drug-related adverse events are more frequent in patients treated with amphotericin B. A large proportion of patients with confirmed aspergillosis also respond to the treatment with intravenous itraconazole followed by oral itraconazole. Liposomal nystatin is another promising antifungal agent that might be effective for treatment of invasive candidiasis and invasive aspergillosis. More clinical data, however, is needed for clinical application.
Amphotericin B ; Antifungal Agents* ; Aspergillosis ; Biological Availability ; Candida ; Candidiasis, Invasive ; Drug Interactions ; Fluconazole ; Fungi ; Fusariosis ; Humans ; Itraconazole ; Models, Animal ; Mycoses ; Nystatin ; Pneumocystis Infections ; Renal Insufficiency ; Triazoles

It is known that humidity in the laser room might affect the outcomes of excimer laser refractive surgery. This study evaluated the outcomes of laser in situ keratomileusis (LASIK)according to humidity changes in laser room. Hinged flap was made by SCMD turbokeratome and photoablation was performed by utilizing VISX 20/20 excimer laser system. The differences between targeted refraction and actual refractive error, namely, refractive correction errors (defined by authors)were calculated. We have divided LASIK patients into two groups. Group A consisting of 61 eyes of 31 patients underwent LASIK when laser room humidity was over 70% (average 73%) and Group B includes 49 eyes of 28 patients when laser room humidity was under 40% (average 35%). Each group was broken into two subgroups, that is high myopia (> or= -6 D)and mild to moderate myopia (< -6 D). The mean refractive correction errors in the high myopia (> or= -6 D)was 1.28+/-1.42 D in the group A (n=46 eyes)and 1.99 +/-1.38 D in the group B (n= 26 eyes). In both groups, the difference between two subgroups was statistically significant and high myopes group B was overcorrected compared with ones in group A (t-test, p<0.05). The mean refractive correction errors in the low to moderate myopia (< -6 D)was 0.38 +/-0.49 D in the group A (n=15 eyes)and 0.4 +/-0.38 D in the group B (n=23 eyes). In both subgroups, there was no statistically significant difference in mean refractive correction errors (t-test, p>0.05). The proper room humidity is critical for LASIK results, particularly in the high myopia (> or= -6 D)because humidity can affect outcomes of LASIK. Therefore, the humidity should be maintained properly for enhancement of surgical outcome predictability in the high myopia.
Humans ; Humidity* ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Myopia ; Refractive Errors ; Refractive Surgical Procedures

PURPOSE: Air bubbles developed during phcoemulsification procedure are known to be harmful to corneal endothelial cells and balanced salt solution(BSS) contained within plastic bag(Bag BSS) has been thought to be more prone to the air bubble formation than the one encased within bottle(Bottle BSS). For the above reason, we tried to see whether there is any difference in corneal endothelial cell changes between two groups of patients who underwent phacoemulsification using Bag BSS and Bottle BSS respectively. METHODS: 85 cataract eyes of 60 patients were randomly assigned to two groups of Bag BSS(43 eyes) and Bottle BSS(42 eyes), on which phacoemulsification was performed through scleral tunnel incision followed by silicone PCL placement. Corneal endothelial cells were examined using specular microscopy postoperatively at 1 month and compared with preoperative specular microscopic data. RESULTS: The percent loss of corneal endothelial cell density at postoperative 1 month for the Bag BSS group(13.02+/-0.7%) was not significantly different from the Bottle BSS group(12.8+/-8.1%)(p>0.05). Coeffcient of variation in cell size(p>0.05) and mean endothelial cell size(p>0.05) also showed no significant difference between the two groups. CONCLUSION: In conclusion, Bag BSS and Bottle BSS have similiar protective effect on the corneal endothelial cell damage during phocoemulsification.
Cataract ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Humans ; Microscopy ; Phacoemulsification ; Plastics* ; Silicones

PURPOSE: To evaluate the effect of preoperative keratometric value on corneal flap dimensions, records of 81 eyes of 45 patients who had LASIK were analyzed retrospectively. METHOD: Corneal thickness and diameter , and keratometric value were measured preoperatively. RESULTS: In this study, SCMD Turbokeratome was set for making a corneal flap with 150 micron thickness and 8.25 mm diameter. In reality, however, the mean corneal flap thickness was 110.7+/-15.7 micron and the mean corneal flap diameter was 7.89+/-0.33 mm. The lower mean preoperative keratometric value, the thicker(r=-0.325, p=0.003) and the smaller(r=0.460, p=0.009) diameter flap was made. When we divided eyes into three groups according to their keratometric values, eyes with keratometric values lower than 42.5 D resulted in corneal flap with 116.70+/-12.6 micron thickness and 7.65(0.28mm diameter as opposed to 102.16+/-13.41 micron thickness and 8.05+/-0.37 mm diameter flap in corneas having keratometric values above 44.5 D(p<0.05). CONCLUSION: When a LASIK flap was made using SCMD manual keratome, steeper corneas tend to have larger and thinner corneal flaps. In conclusion, for making the corneal flap according to the intended thickness and diameter in LASIK, preoperative keratometric value should be considered carefully.
Cornea ; Humans ; Keratomileusis, Laser In Situ* ; Retrospective Studies

A clinical analysis of infective endocarditis was done in 34 patients who were admitted to National Medical Center from march. 1972 to June. 1984, and the results were as follows. 1) There was no difference in ratio between sexes. The prevalence was highest in the 3rd decade. 2) The important preexisting heart diseases were rheumatic heart disease(32.4%), congenital heart disease(17.6%) and undefined cardiac condition(20.6%) in order of frequency. 3) The common symptoms and signs on admission were fever(88.3%), cardiac murmur(79.4%), malaise(70.6%), dyspnea (64.7%), palpitation(55.9%) and hepatosplenomegaly(55.9%). 4) The positive blood culture was obtained in 15(47%) of the cases. Those who had not received antibiotics before admission showed higher rate of positive culture(72.7%) than in those who had received(33.3%). 5) The laboratary findings revealed anemia(73.5%), leukocytosis(35.3%), increased ESR(73.5%), microscopic hematuria(61.8%) and positive CRP(100.0%). 6) The EKG findings showed normal(11.8%), sinus tachycardia(32.4%), LV hypertrophy(29.4%), non-specific ST-T change(20.6%) and AV block(14.7%). 7) Vegetation was detected by echocardiography in 43% of cases and the most frequently involved valve was aortic(66.7%). 8) The combination of penicillin and aminoglycoside was effective in 86.4% of patients so treated.
Anti-Bacterial Agents ; Dyspnea ; Echocardiography ; Electrocardiography ; Endocarditis* ; Heart ; Heart Diseases ; Humans ; Penicillins ; Prevalence

Here, we report the case of a 43-year-old female who was diagnosed with a cotyledonoid dissecting leiomyoma (CDL) of the uterus. CDL is a recently described and extremely rare variant of a benign leiomyoma that can grossly masquerade as a malignancy. The 13-cm sized tumor was located primarily on the extrauterine surface as an intrauterine continuity, which showed dark red, congested, bulbous protuberances. It was multinodular appearance, encasing the bilateral adnexae and the left iliac vein. Microscopically, the nodules were separated by extensive hydropic degeneration. The nodules were composed of cigar-shaped spindle cells with no mitosis, cellular pleomorphism or coagulation necrosis. They also showed an intravascular luminal growth pattern. CDL with intravascular growth was diagnosed after excluding intravascular leiomyomatosis, disseminated peritoneal leiomyomatosis, and benign metastasizing leiomyoma. The present case is the second reported case of CDL in Korea. Recognition of this rare and bizarre, malignancy-mimicking leiomyoma is crucial to prevent inappropriate treatment.
Adult ; Estrogens, Conjugated (USP) ; Female ; Humans ; Iliac Vein ; Korea ; Leiomyoma* ; Leiomyomatosis ; Mitosis ; Necrosis ; Phenobarbital* ; Uterus*

HIV-1 p24 was cloned into multiple cloning site of pMV261, extrachromosomal expression vectors carrying BCG replication origin and BCG-specific heat-shock promoter, and then introduced into BCG and E. coli. Western blot experiments showed that the p24 efficiently expressed in recombinant BCG (rBCG), but not in E. coli. Recombinant p24 expression induced by a single heat-shock of rBCG was maintained longer than 3 weeks. Immunoblot experiments with intact rBCG did not show any distinctive positive signal, suggesting that the recombinant protein was not secreted or exposed at the surface of BCG. The guinea pigs immunized with live rBCG showed delayed type hypersensitivity (DTH) by the systemic area as well as an effective humoral immunity, suggesting that tbis rBCG is believed to elicit eKcient immune responses against p24, even though the expression is restricted only in the cytoplasm as reported previously with other antigen. These results demonstrate that BCG can be developed as a live recombinant vaccine vector against a broad spectrum of infectious disease.
Animals* ; Blotting, Western ; Clone Cells ; Cloning, Organism ; Communicable Diseases ; Cytoplasm ; Guinea Pigs ; HIV* ; HIV-1 ; Hypersensitivity ; Immunity, Humoral ; Mycobacterium bovis* ; Replication Origin

OBJECT: This study was aimed to find the contributing factors that influence the length of stay in mental health related facilities and to present future direction for the mental health policy. METHODS: The 1,875 patients who are aged between eighteen and sixty-five are chosen by the stratified random sampling from ten psychiatric hospitals, six psychiatric nursing facilities and five homeless asylums. We investigate about length of stay of all subjects by sociodemographic characteristics, socioeconomic status, functional status, disease related characteristics and analyse contributing factors. RESULTS: From total subjects, average length of stay was 1,906 days, and facilities, where subjects are institutionalized, explains 40% of length of stay. Other related factors are female, old age, single, lack of supportive system before admission and after discharge, medical assistance type I, unavailable of public transportation and utility, long duration of illness, and psychotic disorder. CONCLUSION: For lowering the rate of long-term hospitalization, evaluation of appropriateness is needed for admission to nursing facility and homeless asylum and make up for the medical payment system and the supportive system from family and community.
Female ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Length of Stay* ; Medical Assistance ; Mental Health ; Nursing ; Psychiatric Nursing ; Psychotic Disorders ; Social Class ; Transportation