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

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

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

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

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

BACKGROUND: The purpose of this study is to evaluate the immediate survival, complication and follow-up results of aortic dissection and to analyze the risk factors that determine the prognosis after aortic dissection. METHODS: 29 patients(M : 12, Age : 59.0+/-11 yrs) with aortic dissection were reviewed retrospectively. Any dissection involving the ascending aorta was classified as proximal dissection and the dissection was considered to be acute if time from clinical onset of the dissection to admission was less than 2 weeks. The immediate survival rate and follow-up results of aortic dissection was compared by type, onset and mode of treatment. RESULTS: 1) The studied patient were 29(Acute onset : 24, Proximal type : 14) and 17 patients(Proximal type : 14) were surgically treated. 2) Five of 10 patients with proximal dissection and 4 of 12 patients with distal dissection, who were managed by medical treatment, died, and 1 of 4 patients with proximal dissection and none of 3 patients with distal dissection, who were managed by surgical treatment, died at hospital. There was no significant statistical difference in mortality according to type, onset and mode of treatment. 3) Nine of 14 patients with proximal dissection and 8 of 15 patients with distal dissection had one or more complications. 4) The cause of death could be established in 10 patients. The most frequent cause of death was aortic rupture including cardiac tamponade(4 of 6 patients for proximal dissection, 2 of 3 patients for distal dissection). 5) The most of death, 8 of 10 deaths occurred within 2 weeks of onset of disease. there was a good life expectancy for the discharged patient regardless of type, onset and mode of treatment. CONCLUSION: These data showed that there was equivalent outcomes in patients with aortic dissection regardless of type, onset and mode of treatment. But these data would not be applied to general population with aortic dissection because of limited number of the study.
Aorta ; Aortic Rupture ; Cause of Death ; Follow-Up Studies* ; Humans ; Life Expectancy ; Mortality ; Prognosis ; Retrospective Studies ; Risk Factors ; Survival Rate