No abstract available.
Decompression* ; Head* ; Osteonecrosis*

No abstract available.
Aged* ; Child* ; Dislocations* ; Hip* ; Humans

The purpose of this study is to access and describe the status of patients with untreated anterior cruciate ligament ruptures to determine if prediction of functional deterioration in these knees were inevitable. 29 patients with rupture of the anterior cruciate ligament verified arthroscopically were evaluated at an average of 3 years and 8 month after injury. This group of patients was selected by the retrospective review in patients who were treated with traumatic ligament injury of the knee joint. The average age at the injury time was 25.9 years ranged from 16 to 44 years and most of injuries occured during sports activities including 12 cases (4196) occured while the patients were playing football. Meniscal lesions were found in 21 cases(72.4%) of all 29 cases of which were 15 cases in the medial, 4 in the lateral and 2 in both side. Follow up functional average score using the Hospital for Special Surgery Knee was 35.8 which would be fall in the Fair range defined as moderate functional disability and depending on the condition of thigh muscle, the functional score was 38.3 in case of less than 2cm atropy of the thigh on the involved side and 32.6 in case of more than 2cm atrophy. There was statistically significant difference (p < 0.05) of the functional score. Reinjuries of the same knee joint were experienced in 22 cases (76%). Rehabilitation of thigh muscles would play an important part in recovery from the injuries.
Anterior Cruciate Ligament ; Atrophy ; Follow-Up Studies ; Football ; Humans ; Knee Joint ; Knee ; Ligaments ; Muscles ; Rehabilitation ; Retrospective Studies ; Rupture ; Sports ; Thigh

No abstract available.
Cardioplegic Solutions* ; Ischemia*

Hypertensive encephalopathy and basal ganglia intracerebral hemorrhage (ICH) are a medical emergency caused by a sudden elevation of systemic blood pressure. Although the relationship between hypertensive encephalopathy and large ICH has not been clarified yet, Cushing reflex in acute elevations of ICP due to large ICH may induce or aggravate hypertensive encephalopathy. We report a rare case of isolated hypertensive brainstem encephalopathy combined with hypertensive ICH.
Basal Ganglia ; Blood Pressure ; Brain Stem* ; Cerebral Hemorrhage* ; Emergencies ; Hypertension ; Hypertensive Encephalopathy ; Magnetic Resonance Imaging ; Reflex

BACKGROUND: Although skin cancer incidence has recently increased, there has been little research into the incidence, clinical manifestations, and prognosis of skin cancers in Korea, especially in Daegu City and the Kyungpook Province. OBJECTIVE: To analyze changes over the recent two decades in incidence and clinical patterns, including recurrence of skin cancers diagnosed at a university hospital in Daegu City. METHODS: We reviewed 1,566 skin cancer cases from 1994 to 2013 at the Department of Dermatology in Kyungpook National University Hospital (KNUH). We also divided them into first (1994~2003) and second group (2004~2013) to examine changes over the years. RESULTS: The average incidence of skin cancers among the total number of outpatients was 1.39% through whole study period including 0.38% in the first and 2.10% in the second decade. Basal cell carcinoma (BCC) was the most commonly diagnosed skin cancer (total:1st:2nd=0.60%:0.16%:0.91%), followed by squamous cell carcinoma (SCC) (0.43%:0.12%:0.65%) and malignant melanoma (MM) (0.22%:0.05%:0.34%). The most common skin cancer site was the face in each decade. The recurrence of three major skin cancers (BCC, SCC and MM) was diagnosed in 49 of the 1,402 patients (3.50%). In each disease, the recurrence rate (1st:2nd) was 1.64% (BCC, 4.11%:1.34%), 3.51% (SCC, 11.11%:2.55%), and 8.57% (MM, 4.35%:9.01%). CONCLUSION: This epidemiological study provided useful information about the incidence and prognosis of skin tumors in Korea, especially in Daegu City and Kyungpook Province.
Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Daegu* ; Dermatology ; Epidemiologic Studies ; Gyeongsangbuk-do* ; Humans ; Incidence ; Korea ; Melanoma ; Outpatients ; Prognosis ; Recurrence ; Skin ; Skin Neoplasms

Strongyloides stercoralis, which has two different generations: the free living and parasitic generation, is primarily adapted to warm climates, but strongyloidiasis has been reported sporadically in temperate and cold regions. Strongyloidiasis may be asymptomatic in almost 50 percent of the cases, rarely, infestation presents with severe clinical pictures. The reason for this exacerbation of illness is probably a rapid increase in the number of infecting larvas through the development or acceleration of a cycle of autoinfection. A breakdown of the host-parasite equilibrium due to decreased host resistance may occur in malnutrition, debilitating diseases or therapy with immunosuppressive drugs. Corticosteroid treatment may have an important role in the sudden occurrence of severe stongyloidiasis. We experienced a case of strongyloidiasis with severe malnutrition, accompanied with bronchial asthma and diabetes mellitus. This patient has been treated with corticosteroid for several years. So, we report this rare case with the literature review.
Acceleration ; Asthma ; Climate ; Diabetes Mellitus ; Family Characteristics ; Humans ; Larva ; Malnutrition* ; Strongyloides stercoralis ; Strongyloidiasis*

OBJECTIVE: To evaluate the efficacy of intravenous cyclophosphamide pulse therapy (IVC) in proliferative lupus nephritis (PLN) with normal serum creatinine. METHODS: We retrospectively reviewed 53 PLN patients treated with IVC more than 6 times from 1992 to 1997. The patients were classified into the alternative and the initial. In the former, IVC was started after failed remission with steroid or steroid and oral immunosuppressive drug; in the latter, IVC was started as initial treatment. Remmission was endpoint of study and defined as all of the followings should be maintained for more than 6 months, 1) 24-hour urine protein less than 1g, 2) normal serum creatinine, 3) less than 5 RBC in high power field microscopy and no granular and RBC cast in urine. We compared remission rate and frequency of complications associated with IVC between the initial and alternative by chi-square test and analyzed the variables of remission including methodological; initial or alternative, clinical; age, onset age of systemic lupus erythematous (SLE) and lupus nephritis (LN), duration of SLE and LN, laboratory; serum concentration of creatinine, C3, C4, albumin, anti ds-DNA Ab. titers and 24 hour urine proteins and pathological; activity and chronicity index, multivariatly. RESULTS: All 53 patients (22 initial, 31 alternative) had normal serum creatinine at start of IVC, treated with 9.7 +/-2.3 times of IVC and followed up during 37.2 +/-15.4 months. Thirty-four patients (64%) had remission (18 of the initial and 16 of the alternative). The remission rate of the initial was higher (82% vs 52%, p=0.04 by chi-square test) than the alternative, but frequency of complications was not different. In multivariate analysis, any other variables; including methodological, clinical, laboratory and pathological, did not influenced on remmission significantly. CONCLUSIONS: IVC is effective in PLN with normal serum creatinine as initial treatments and our results suggest that IVC may be chosen as an alternative therapy in PLN patients who failed remission with steroid or steroid and oral immunosuppressive drug.
Age of Onset ; Creatinine* ; Cyclophosphamide ; DNA ; Humans ; Lupus Nephritis* ; Microscopy ; Multivariate Analysis ; Retrospective Studies

Gastric carcinogenesis has been studied in various aspects. Helicobacter pylori (Hp) infection and mutation of the p53 tumor suppressor gene have recently been argued to be important factors of gastric carcinogenesis. There have been many studies to determine the precise mechanism of how Hp is related to gastric cancer, but it is so far still unknown. We studied the relationship of Hp infection and p53 overexpression and tried to discover some significance in clinicopathologic factors such as age, sex, stage, site, differentiation and gross morphology. Ninety-six patients who were diagnosed with gastric cancer at Severance Hospital, Yonsei University Medical College from November 1995 to March 1996, and 96 control patients of non-ulcer dyspepsia (NUD) were studied by endoscopic biopsy of normal gastric tissue and cancer tissue. They also underwent the CLO (Delta West, Melbourne, Western Australia) test for Hp positivity and p53 immunohistochemical stain for p53 positivity. These data were analyzed for comparison with the clinicopathologic characteristics of gastric cancers. In conclusion, the differentiated group cancer had a significantly high Hp positivity and p53 positivity. There is a possibility that Hp infection and p53 tumor suppressor gene mutation might be significantly related in the gastric carcinogenic process of well- and moderately-differentiated adenocarcinomas, but further study is necessary to determine more direct clues on the carcinogenic roles of these factors.
Adenocarcinoma/metabolism* ; Adult ; Aged ; Female ; Helicobacter Infections/metabolism* ; Helicobacter pylori* ; Human ; Male ; Middle Age ; Protein p53/analysis* ; Stomach Neoplasms/metabolism*

BACKGROUND: Argatroban, a direct thrombin inhibitor, has been suggested to be beneficial in acute ischemic stroke by preventing microthrombi formation. The aim of this multicenter, aspirin-controlled, randomized trial is to determine the safety and the efficacy of argatroban compared with aspirin in acute ischemic stroke. METHODS: The patients within 48 hours of noncardioembolic ischemic stroke were recruited from 8 centers. Argatroban was infused continuously at 2.5 mg/hr for the first 48 h, and then 10mg of argatroban was infused over 3 h twice a day on days 3-7. Control group received aspirin 300 mg/day for 7 days. The primary outcome was the NIHSS at 30 days and the secondary outcome was Barthel index (BI) and modified Rankin scale (mRS) at 90 days. The safety was evaluated by the incidence of bleeding complication. RESULTS: A total of 236 patients (123 for argatroban and 113 for aspirin) were included. NIHSS at 30 days, BI at 90 days and mRS at 90 days did not show significant difference between the argatroban and the aspirin group (3.1 +/- 3.1 vs 3.5 +/- 3.0, 88.9 +/- 22.5 vs 86.2 +/- 23.8, 1.4 +/- 1.1 vs 1.6 +/- 1.3, p>0.3, respectively). Post hoc analysis revealed that as for the patients who were treated within 24 hours after onset, numbers of patients with NIHSS=1 at 30 days were larger in the argatroban group (23 of 49) than in the aspirin group (10 of 40) (p=0.03). Bleeding complication was not different between the two groups (2 of 123 vs 0 of 113: p>0.4). CONCLUSIONS: Argatroban treatment is relatively safe in acute ischemic stroke. The efficacy of argatroban is not superior to aspirin. However, argatroban may be more beneficial in some subgroup of stroke patients than aspirin.
Aspirin ; Hemorrhage ; Humans ; Incidence ; Stroke* ; Thrombin