Seventeen patients with classical rheumatoid arthritis have been treated with gold sodium thiomalate(G.S.T) injection and followed up for 1.7 years on average. The results obtained are as follows: 1. Clinical improvement was obtained in 12(70.3%) out of 17 cases, but only in 5 cases(29.3%) marked and persisting improvement was obtained. Such improvement was first noticed when the total dose of the gold sodium thiomalate reached 500mg or more, and also noticed about 10 weeks after initiation of G.S.T therapy. 2. Changes in laboratory parameters such as hemoglobin, hematocrit, eosinophilia, titers of rheumatoid factor and C-reactive protein, and proteinuria began to appear at the time of the clinical improvement. 3. Adverse reaction consisted mostly of mucocutaneous lesions. The main causes of drop-out during therapy also are severe skin rashes and pruritus. Most of the adverse reactions appeared when the total dose of G.S.T. administered reached over 500mg. In two severe cases skin rashes terminated the gold therapy. Our findings suggest, because of high incidence of adverse reaction during G.S.T therapy, repeated careful clinical and laboratory examination of the patient are mandatory especially when the total dose of G.S.T is reached 500mg. In spite of the well documented reports of the maintenance gold therapy for rheumatoid arthritis it is felt that the maintenance gold therapy should be studied further before it can be safely used as a routine in daily rheumatology practice because of its toxicity.
Arthritis ; Arthritis, Rheumatoid ; C-Reactive Protein ; Eosinophilia ; Exanthema ; Gold Sodium Thiomalate ; Hematocrit ; Humans ; Incidence ; Proteinuria ; Pruritus ; Rheumatoid Factor ; Rheumatology ; Sodium

Repeated throwing of baseballs by juvenile pitchers is known to cause damages to bone and cartilage as well as soft tissue in the involved upper extremity. Authors present 4 cases of osteochondral lesion at capitellum of the humerus as a result of repeated insult by throwing baseballs in the juvenile pitchers. Pain and limitation of extension of the affected elbow were the commonest symptoms. Cystic change or osteochondral loose body was found on plain X-ray. Treatment consisted of rest and analgesic administration in the patient who has no loose body, while in case of having loose body it was removed surgically without further treatment to the crater. In spite of the rapid relief of the pain by these treatment, limitation of extension persisted for considerable period of time. It is strongly suggested not to overlook elbow pain in young adolescent whose bone is still growing and who can hardly withstand repeated insult to prevent the development of baseball elbow.
Adolescent ; Baseball ; Cartilage ; Elbow ; Humans ; Humerus ; Osteochondritis ; Upper Extremity

Reduction of displaced diaphyseal fractures of the radius and ulna in adult must be nearly anatomical for restoration of mormal function. Most of the fractures require operative management, and various methods of open reduction and internal fixation have been recommended. Because we believe that anatomical reduction followed by rigid internal fixation provides the most satisfactory results for these injuries, dynamic compression plating method is frequently used in our hos pi tal. We studied 52 diaphyseal fractures of the forearm bone in 33 patients treated at the S.R.C.H. from May 1980 to December 1985. Of the 33 patients, 20 had fractures of the radius and ulna; 6, fractures of the radius only; and 7, fractures of the ulna only. The fractures of both bones were treated with plate and screws in 19 patients. In another one, the ulna was treated with plate and screws and the radius was treated by screw fixation only. The results were as follows: l. Of the 52 fractures, 51(98.1%) were united after the initial operation within 23 weeks. 2. The average time for radiological union of the fracture, excluding those complicated by infection or non-union, was 11.1 weeks for 24 radii and 10.9 weeks for 25 ulnae. 3. Only one patient(3.0%) was complicated by infection and only one(1.9%) non-union of radius occurred. 4. The functional results were excellent or satisfactory in 25 patients(83.3%). 5. We have found that in adults the auto compression plating is a successful method for the diaphyseal fractures of the forearm.
Adult ; Diaphyses ; Forearm ; Humans ; Methods ; Radius ; Retrospective Studies ; Ulna

The scleral fixation of a posterior chamber intraocular lens is known to be a technique for managing cataract, aphakia, lens dislocation, pseudophakic bullous keratopathy with incomplete zonular or capsular support. We performed a retrospective review of longterm results and complications of 86 patients(103 eyes) who had a minimum of 12 months follow-up after scleral fixation of a posterior chamber intraocular lenses. At the last examination, mean postoperative corrected visual acuity is 0.7 +/- 0.28 and 62 eyes(57.4%) had a vision of 0.8 or better. Especially in aphakia, postoperative corrected visual acuity was significantly improved. The complications related to scleral fixation were exposed scleral fixation suture, glaucoma, cystoid macular edema, subluxation of intraocular lenses, retinal detachment, herpetic keratitis, vitreous hemorrhage and vitreous opacity. The other factors influenced on visual acuity were age-related macular degeneration, optic atrophy, diabetic retinopathy and clinical significant macular edema, and corneal opacity. Though these longterm results suggest that overall prognosis for visual acuity is quite good, careful assessment preoperatively and proper management are important.
Aphakia ; Cataract ; Corneal Opacity ; Diabetic Retinopathy ; Follow-Up Studies ; Glaucoma ; Keratitis, Herpetic ; Lens Subluxation ; Lenses, Intraocular* ; Macular Degeneration ; Macular Edema ; Optic Atrophy ; Prognosis ; Retinal Detachment ; Retrospective Studies ; Sutures ; Visual Acuity ; Vitreous Hemorrhage

PURPOSE: To evaluate the health status of institutionalized handicapped children, a general health assessment was done in an asylum in Taegu in May 1998. METHODS: Body measurements, including height, weight, head circumference, skin fold thickness and mid-arm circumference, were done with physical examination on 53 children. Blood tests and chest radiography were done, and fat impedance was measured. RESULTS: Of the 53 children, height, weight and head circumference were below the third percentile in 37(69.8%), 35(66%) and 28(52.8%) children, respectively. Body mass index, skin fold thickness and mid-arm circumference were below the third percentiles in 77.3, 50.9% and 56.6% of the children, respectively. Although serum protein levels were within normal range, anemia was detected in 31 children(58.5%). Two children showed interstitial pneumonia on chest radiograms. And HBsAg was detected in three but their liver enzymes were within normal limits. CONCLUSION: Due to the poor nutritional status of handicapped children in the asylum, the prevalence of anemia was high. Evaluation of the nutritional status and hemoglobin measurernent must be included in the routine health assessment of these children.
Anemia ; Body Mass Index ; Child ; Daegu ; Disabled Children ; Disabled Persons* ; Electric Impedance ; Head ; Hematologic Tests ; Hepatitis B Surface Antigens ; Humans ; Liver ; Lung Diseases, Interstitial ; Nutritional Status ; Physical Examination ; Prevalence ; Radiography ; Reference Values ; Skin ; Thorax

Primary small cell carcinoma of the salivary gland is a rare neoplasm that accounts for approximately 1.8% of all primary major salivary gland malignancies. Because of its rarity, it is difficult to diagnose small cell carcinoma of the parotid gland by fine needle aspiration cytology(FNAC). We experienced a case of primary small cell carcinoma of the parotid gland in a 72-year-old woman who presented with two palpable masses of the left infraauricular and ocular regions of two to three month's duration, respectively. Aspirate smears from the left infraauricular area were highly cellular on necrotic and lymphocytic background and showed individually dispersed cells or three-dimensional clusters of small cells. The tumor cells were round to oval with a very high nucleocytoplasmic ratio. Nuclei were about two times the size of lymphocytes and had uniformly dispersed but hyperchromatic to pyknotic chromatin. Nucleoli were occasionally visible but were generally inconspicuous. Numerous mitotic figures were detected. The clusters of these small tumor cells exhibited angular nuclear molding, irregular nuclear outlines, and occasionally rosette like arrangement. The tumor was confirmed by histology and immunohistochemistry.
Aged ; Animals ; Benzodiazepines* ; Biopsy, Fine-Needle ; Carcinoma, Small Cell ; Chromatin ; Female ; Fungi ; Humans ; Immobilization* ; Immunohistochemistry ; Lymphocytes ; Parotid Gland ; Rats* ; Receptors, GABA-A* ; Salivary Glands ; Thyroid Gland

No abstract available.
Vitamin K Deficiency* ; Vitamin K* ; Vitamins*

Black adenoma is known to be a rare variant of adrenal cortical adenoma containing characteristic abundant lipofuscin pigments in the cytoplasm. Almost all of them are nonfunctioning and only occasionally they are associated with Cushing's syndrome or primary hyperaldosteronism. We present two cases of black cortical adenoma of the adrenal gland associated with Cushing's syndrome in a 24-year-old woman and a 64-year-old man. This report dealt with clinical and pathologic presentation including ultrastructural identification of lipofuscin pigment.
Female ; Male ; Humans ; Adenoma

No abstract available.
Muir-Torre Syndrome*

Xanthogranulomatous cholecystitis is a rare form of inflammatory disease of the gall bladder and was first described in 1970 by Christensen and Ishak as fibroxanthogranulomatous inflammation of the gall bladder. Recently authors experienced three cases of xanthogranulomatous cholecystitis, two of which were erroneously diagnosed as malignant tumor in preoperative clinical and radiological examinations. Grossly, the gallbladders were enlarged and the walls were thickened with yellowish granular necrotic areas ranging from a few millimeters to 1.0 cm in diameter. Microscopically, all of three cases showed diffuse infiltration of the foamy histiocytes containing bile pigments and mononuclear leukocytes associated with fibroblastic proliferation and foreign body reactions. The pathogenesis of the xanthogranulomatous cholecystitis is uncertain, but opinion favours an inflammatory response to extravasated bile probably, from ruptured Rokitanky-Aschoff sinuses. Three cases of xanthogranulomatous cholecystitis with brief review of literature are presented.