We found that the packing of a rolled tensor fascia lata flap after the excision of avascular lunate was reasonably effective in relieving symptoms in 4 patients with advanced Kienbock's disease, even though there was still some residual postoperative loss of wrist motion and grip strength, and the slightly progressive tendencies of earpal collapse and translation as well as rotational deformities of scaphoid. Pre-operatively all patients had pain and limited motion of the wrist as well as weakness of grip. Roentgenographically all had sclerosis, fragmentation and collapse of the lunate. They were analysed each two cases in advanced stage II and III according to the classification by Lichtman. Most had symptoms for longer than two and half years. After removal of the avascular lunate through a dorsal incision, a rolled tensor fascia lata flap was packed to fit the defect. Patients were followed for an average of sixteen months. All were improved clinically but there were somewhat postoperative progress in carpal collapse, translation and rotational deformities of scaphoid roentgenographically.
Classification ; Congenital Abnormalities ; Fascia Lata ; Fascia ; Hand Strength ; Humans ; Osteonecrosis ; Sclerosis ; Wrist

No abstract available.
Hemolytic-Uremic Syndrome*

Sleeve type fracture of the patella in children is an extremely rare injury. Its avulsed fragment is so small that the diagnosis may be missed by radiogram and patella slta is complicated. A 14 year-old boy having the sleeve type fracture of the patella with patella alta was treated by open reduction with s screw fixation at St. Vincent Hospital in December 1985 and was followed up over two years. The final clinical result was good.
Child ; Diagnosis ; Humans ; Male ; Patella

The craniopharyngima has been known to be congenital origin and primary tumor of childhood. The craniopharyngioma may be found at all ages, though nearly one half in the first twenty years of life and equally in either sex. Important differences exist between younger and older patients. In children, signs of increased intracranial pressure, endocrine Abnormality and radiological calcification are common. In adults, mental disturbance becomes of increasing importance as well as remaining visual failure and endocrine disturbance. Because of slow growing rate of tumor in adult, subtotal excision is recommended. A 39-year-old male patient, suffering from agitation memory disturbance and almost total blindness, was diagnosed craniopharyngioma by neuroradiologic examinations. After surgical treatment, mental symptoms and visual acuity improved much more than before operation.
Adult* ; Blindness ; Child ; Craniopharyngioma* ; Dihydroergotamine ; Humans ; Intracranial Pressure ; Male ; Memory ; Visual Acuity

BACKGROUND: Intimal tear or dissection is a serious complication after coronary angioplasty,sometimes which may develop an acute ischemic event. We evaluate the factor that may predict the development of dissection after angioplasty. METHODS: To identify the factors that development of dissection after angioplasty, the data of 52 patients identified as having dissection with or without immediate vessel closure were examined. Follow-up coronary angiogram was obtained in 22 out of 58 lesions at mean 5.6 month after angioplasty. RESULTS: Intimal dissection developed 58 lesion(31%) out of 177 lesions in 122 patients after PTCA. Ischemic complications, defined as ischemic chest pain, myocardial infarction, the need for coronary bypass surgery occured in 5 patients(9.6%) out of 52 patients with dissections. Significant correlates of a development of dissection were the lesion morphology of type C(P<0.01), more tight diameter stenosis before PTCA(P<0.01), and right coronary artery(P<0.02), especially in the proximal portion (P<0.05). There were no significant correlations of clinical pictures, whether complex or simple angioplasty and PTCA in single vessel disease or in multivessel disease. Morphologic feature of dissection was type A(radiolucency) in 22(38%), B(filling defect)in 14(24%), C(extra-luminal "cap")in 8(14%), D(spiral dissection)in 5(9%), E(filling defect with delayded antegrade flow)in 7(12%) and F(total occlusion) in 2(3%). Twenty-two(38%) dissection out of 58 were obtained follow-up angiogram at mean 5.6 month. Angiographic restenosis occured in 9(41%) lesions, which included more type A dissections (7/9,78%) compared to lesions with dissection healing (3/13, 23%)(P<0.001) at follow-up. Thirteen lesions with dissection healing at follow-up included more B and C dissection(B;54%,C;15%)and E dissection in 1. Furthermoremore restenosis occurred more prevalent in the infarct-related artery(P<0.001) and left anterior decending coronary artery lesion(P<0.01). There was somewhat higher diameter residual stenosis after angioplasty (32+/-11% vs 26+/-10%) in the lesions with restenosis, but there was no statistical significance. CONCLUSION: Intimal dissection after angioplasty occurred in 58(31%) leisions out of 122(177leisions) consecutive patients underwent PTCA developments if intimal dissection after PTCA significantly correlated with the lesions if type C, more tight diameter stenois before PTCA and right coronary artery. At mean 5.6months follow-up,angiographic restenosis occured in 41% of dissections, which had more included type A(radiolucency)dissections, infarct-related artery and left anterior descending coronary artery leision.
Angioplasty* ; Arteries ; Chest Pain ; Constriction, Pathologic ; Coronary Vessels ; Follow-Up Studies* ; Humans ; Myocardial Infarction

The characteristic features of the Forestier's disease, ankylosing hyperostosis of the spine, consist essentially in marginal proliferation at the vertebral edges which are apt to unit their homologues to form bridges and to extend as a bony layer which thickens the vertebral cortex with an overgrowth of bone spreading like a flow. The disease had been long looked upon as vertebral spondylosis or other spinal diseases such as ankylosing spondylitis before Forestier first defined it as a new disease entity. The bony changes could be occurred everywhere on the spinal column, but are mainly confined to the anterior part of the thoracic spine, especially in the right side. It clinically may be of little significance because of little symptoms. Forestier reported 88% of the patients was over 50 years old and 65% was male of 45 cases. Although the pathogenesis is uncertain, a spinal expression of more diffuse ossifying diathesis may be considered. We are reporting a case of the Forestier's disease which was incidentally found on a 55 years old paraplegic patient who had suffered from back trauma.
Disease Susceptibility ; Humans ; Hyperostosis* ; Hyperostosis, Diffuse Idiopathic Skeletal ; Male ; Middle Aged ; Spinal Diseases ; Spine ; Spondylitis, Ankylosing ; Spondylosis

No abstract available.
Gangwon-do* ; Humans ; Norovirus* ; Sequence Analysis*

The juvenile pilocytic astrocytoma has histologically the same features as the adult type one. Contrary to the adult type, the parallel arrangement of fibrils in long thin tapering cells of the tumor is peculiarly independent of the environment in which the tumor is growing and it gives rise to the main tumor mass that is usually well circumscribed. The overall incidence is relatively rare of all the brain tumor, it occurs in children mainly from three to five of age. Its predilection sites are the hypothalamus and the optic chiasm. We are reporting an experience of a juvenile pilocytic astrocytoma in a three years old female patient, involving the hypothalamus, basal ganglia and deep white matter of the temporoparietal lobe of the left side.
Adult ; Astrocytoma* ; Basal Ganglia ; Brain Neoplasms ; Child ; Female ; Humans ; Hypothalamus ; Incidence ; Optic Chiasm

OBJECTIVES: To examine the effect of extracts of Korean native Cimicifuge species on cell proliferation in vascular smooth muscle cells (VSMC). METHODS: VSMC were isolated from rat aorta. Cell proliferation was assessed by measure of bromodeoxyuridine incorporation into the cells. Differences in Reactive oxygen species (ROS) levels were examined after exposure to the extracts of Korean native Cimicifuge species using the detection reagents dichlorofluorecin diacetate. The rhizomes/roots were air-dried and milled with a commercial food mixer. Milled rhizomes/roots of each Cimicifuga species were separately extracted by 80% ethanol, absolute methanol, and 40% 2-propanol using homogenizer and evaporated under reduced pressure at low temperatures. Effects of extracts dissolved in phosphate-buffered saline (0.3 mg/mL) were examined. RESULTS: Ethanolic, methanolic or propanolic extracts of 4 Korean native Cimicifuge species (Cimicifuga [C] davurica, C. japonica, C. heracleifolia var. bifida Nakai, C. simplex) were screened. The addition of extracts of each Korean native Cimicifuge species to cells in the presence of 10% fetal bovine serum (FBS) potently inhibited cell proliferation. Significant decrease of 23%-30% was observed. Vitamin E, a potent antioxidant, inhibited 10% FBS-stimulated cell proliferation of VSMC. We also demonstrated that extracts of each Korean native Cimicifuge species decreased intracellular ROS generation induced with 10% FBS. The effect of Korean native Cimicifuge species was not species-specific and solvent-specific. CONCLUSION: TExtracts of Korean native Cimicifuge species inhibit VSMC proliferation via inhibition of intracellular ROS. These findings suggest that Cimicifuge species used for reducing menopause symptoms might be cardioprotective in women.
1-Propanol ; 2-Propanol ; Animals ; Aorta ; Bromodeoxyuridine ; Cardiovascular Diseases ; Cell Proliferation ; Cimicifuga ; Estrogens ; Ethanol ; Female ; Humans ; Indicators and Reagents ; Menopause ; Methanol ; Muscle, Smooth, Vascular ; Rats ; Reactive Oxygen Species ; Vitamin E ; Vitamins

BACKGROUND: The purpose of this study was to evaluate the clinical feasibility of bedside intravenous ergonovine test with echocardiography as a noninvasive diagnostic method for coronary vasospasm. METHODS: Bedside ergonovine test was performed in 50 patients with chest pain one day after coronary angiography with spasm provocation test ; 30 patients showed positive results of provocation test while in 20 patients there was no evidence of coronary vasospasm. A bolus of ergonovine maleate(0.025 or 0.05mg) was injected at 5 min intervals up to total cumulative dosage of 0.35mg, and 12-leads ECG and 2D-echo were recorded every 3 min after each injection. Left ventricular wall motion was analyzed with a commercially available 'QUAD' system. The positive criteria of bedside ergonovine test included reversible ST segment elevation or depression, T wave changes in ECG(ECG criteria) and reversible regional wall motion abnormalities(RWMA) in Echo(Echo criteria). RESULTS: The overall sensitivity and specificity of ECG criteria were 73%(22/30) and 100% respectively ; The sensitivity of Echo criteria increased up to 90%(27/30) without the change of the specificity. Among 22 patients with reversible ECG changes only 73%(16/22) showed typical ST segment elevation while ST depression was recorded in 2 patients(9%) and minor T wave peaking or flattening without ST segment displacement in 4 patients(18%). Concomitant fixed coronary lesion does increase the sensitivity of the test compared to pure coronary vasospasm with ECG criteria(100% vs 60%, p<0.05). Mean dose of ergonovine with positive result was 173+/-95 microgram(mcg) and the amount of ergonovine for positive result was significantly larger in patients with low disease activity(Chest pain <5 times/week) than those with high disease activity(213+/-83 vs 123+/-86mcg, p<0.01). There was no procedure related mortality or fatal arrhythmias. CONCLUSIONS: Ergonovine echocardiography is a highly sensitive and specific test for coronary vasospasm and is safe in selected patients in whom the exercise test is negative and severe fixed coronary artery disease has been excluded. Presence of concomitant fixed coronary artery disease and the degree of clinical activity of coronary vasospasm may influence the results of this test.
Arrhythmias, Cardiac ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vasospasm* ; Depression ; Echocardiography* ; Electrocardiography ; Ergonovine* ; Exercise Test ; Humans ; Mortality ; Sensitivity and Specificity ; Spasm