Rheumatoid arthritis (RA) is a systemic disease with medication as the treatment of choice. However, surgical treatment is recommended when no improvement is noted despite aggressive conservative treatment. Synovectomy provides desirable outcomes for RA patients in the early stage with a glenohumeral joint of Larsen grade II or less; conversely, arthroplasty is recommended for patients with a glenohumeral joint of grade III or higher. RA patients often have attenuation and dysfunction of the rotator cuff, and reverse shoulder arthroplasty has been proven to provide favorable outcomes in some patients. RA is often complicated with osteoporosis and bony deformity; therefore, close attention is necessary to prevent fractures during shoulder arthroplasty.
Arthritis, Rheumatoid ; Arthroplasty ; Congenital Abnormalities ; Humans ; Osteoporosis ; Rotator Cuff ; Shoulder Joint* ; Shoulder*

No abstract available.
Curettage* ; Female ; Humans ; Pregnancy ; Pregnancy, Ectopic*

BACKGROUND: Calcipotrol, topical vitamin D analogue, has been demonstrated to have an effect for the treatment of psoriasis with good tolerability. It is required to have comparative studies with the other topical agents which are widely used for the treatment of psoriasis. OBJECTIVE: Our purpose is to compare calcipotriol with desoxymethasone ointemtn in their therapeutic efficacy and ability to affect dermal inflammatory cellular events. METHODS: This study was a randomized, double blind, right/left comparison over 8weeks in 10 patients. The ointments were applied twice daily to the lesions of psoriasis. Clinical efficacy, as measured by the Psoriasis Area and Severity Index(PASI) was assessed at 2, 4, 6 and 8weeks after starting treatments. The changes in the numbers of dermal immunocytes were assessed on frozen and paraffin-embedded sections by using immunohistochemical stain methods before and after the treatemtns. RESULTS: Reduction of PASI was statistically significant at all time points for both of the treatments (P<0.01) but there was no significant defference between the two treatment modalities. At the completion of 8 weeks of treatments, the mean PASI reduction was 65 percents and 67 percents for calcipotriol and desoxymethasone ointments, respectively. On immunohistochemical staining, the numbers of LCA and HLA-DR positive cells were decreased significantly(P<0.05), and IL-2R and CD4 positive cells were not significaltly reduced in each group after the treatment. CONCLUSION: Calcipotriol ointment was as effective as desoxymethasone ointment, judged by the PASI and the dermal inflammatory cellular events on immunohistochemical staining.
Dermatitis, Atopic ; Desoximetasone* ; HLA-DR Antigens ; Humans ; Ointments* ; Psoriasis* ; Vitamin D

We analyzed the mRNA expression patterns of major potassium channel genes to determine the mechanism of hypokalemia in familial hypokalemic periodic paralysis. We used quantitative RT-PCR to examine the mRNA levels of both inward (KCNJ2, KCNJ6, and KCNJ14) and delayed rectifi er (KCNQ1 and KCNA2) potassium channel genes in skeletal muscle cells from both normal and patient groups, prior to and after exposure to 4 mM and 50 mM potassium buffers. Quantitative RT-PCR analysis revealed no changes in the mRNA levels of these genes in normal and patient cells on exposure to 4 mM potassium buffer. However, after exposure to 50 mM potassium buffer, which was used to induce depolarization, normal cells showed a signifi cant decrease in KCNJ2, KCNJ6, and KCNJ14 expression, but no change in KCNQ1 and KCNA2 expression. In contrast, patient cells showed no change in KCNJ2 and KCNJ6 expression, but an increase in KCNJ14 expression. Furthermore, KCNQ1 and KCNA2 showed decreased expression. We found that the expression levels of both inward and delayed rectifi er potassium channel genes in patient cells differ from those in normal cells. Altered potassium channel gene expression in patient cells may suggest a possible mechanism for hypokalemia in familial hypokalemic periodic paralysis.

It is well established that the CT is an essential part not only in screening primary brain tumors, but alsoin staging known malignancy. This paper reports various CT findings demonstrated in 12 cases of choriocarciomawith brain metastasis. The CT findings such as the number, location and density of the metastatic lesions, thedegree of brain edema, mass effect and effect of contrast enhancement are reviewed as well as the episode ofstroke syndrome and survival duration after neurologic symptoms attacks. The results were as follows; 1. Ten ofthese cases showed solitary metastatic lesion and remaining 2 cases were multiple lesions. 2. One was isodensedensity and the others were hemorrhagic increased denstiy by CT. 3. All of these showed mass effect to thesurrounding structures along with moderate to marked brain edema. 4. The position of the metastatic lesion werelocated at the supratentorially in all cases. Most of them were at the unilateral frontal or parietal area of bothof them. One which noted multiple metastatic foci showed at the bilateral occipital regions. 5. Nine cases showedring enhancement after contrast infusion. One which noted isodense density on the noninfusion scan showed alsoring enhancement after contrast infusion. 6. Nine cases showed positive stroke syndrom. One of them was perforemdemergency craniotomy. The remainging 3 cases noted progressive neurologic symptoms. 7. Two cases were noted onlybrain metastasis but the others also had various degree of pulmonary metastasis and 2 of latter had hepaticmetastasis, too. 8. Most of the cases were treated with CHAMOCA regimen, and one of them was taken whole brainirradiation (3000 rads/2 weeks). Another one case revealed marked regression of not only metastatic brain lesionbut the pulmonary lesion after the 8th course of CHAMOCA regimen and still alive for over 460 days.
Brain Edema ; Brain Neoplasms ; Brain ; Choriocarcinoma ; Craniotomy ; Female ; Mass Screening ; Neoplasm Metastasis ; Neurologic Manifestations ; Occipital Lobe ; Pregnancy ; Rabeprazole ; Stroke

Purpose: We aimed to evaluate the impact of non-pharmaceutical interventions (NPIs) on the transmission of respiratory viruses other than severe acute respiratory syndrome coronavirus 2 among children during the coronavirus disease 2019 pandemic. Methods: We analyzed the clinical and polymerase chain reaction (PCR) findings using electronic medical records of children (< 18 years) with fever or respiratory symptoms who were hospitalized via the emergency department of Wonkwang University Hospital (Iksan, Korea), from March 2018 through December 2021. The children were divided into before and after groups based on the hospitalization date relative to February 2020, starting point of the implementation of NPIs. PCR was performed using nasopharyngeal swab samples. Between the 2 groups, we compared age, sex, length of hospital stay, and PCR findings. Results: The before and after groups consisted of 3,160 and 989, respectively, showing a 68.7% decrease in the number of children undergoing PCRs after the implantation of NPIs. The after group showed higher median values of the age and length of hospital stay than the before group (Ps < 0.001). A 76.9% decrease was noted in the number of children having PCR positivities (from 1,101 [34.8%] to 254 [25.7%]; P < 0.001). Among detected viruses, an increase in the proportion was noted only in human bocavirus (from 81 [2.6%] to 54 [5.5%]; P < 0.001). In contrast, significant decreases in the proportions were found in adenovirus, enterovirus, influenza A and B, respiratory syncytial viruses A and B, human coronaviruses (229E, NL63, and OC43) and human metapneumovirus. Conclusion NPIs may be effective in reducing the transmission of respiratory viruses other than severe acute respiratory syndrome coronavirus 2 among children during the pandemic.

We found a mistake in our recently published article.

Special idiopathic female pseudohermaphroditism with urinary tract, m llerian duct, and lower gastrointestinal tract anomalies, in addition to masculinization of the external genitalia, is rare phenomenon. Masculinization of external genitalia and other anomalies occur in the absence of a recognized exposure to androgen or other teratogenic factors. We report a case of a female pseudohermaphroditism with m llerian agenesis, bilateral multicystic dysplastic kidney, urethral agenesis, left double ureter, rectovesical fistula, imperforate anus, single umbilical artery, detected after therapeutic abortion at 23+5 weeks of gestational age. The final diagnosis is based on autopsy.
46, XX Disorders of Sex Development* ; Abortion, Therapeutic ; Anus, Imperforate* ; Autopsy ; Diagnosis ; Female* ; Fistula ; Genitalia ; Gestational Age ; Humans ; Lower Gastrointestinal Tract ; Multicystic Dysplastic Kidney ; Pregnancy ; Single Umbilical Artery ; Ureter ; Urinary Tract*

Endometriosis is defined as the presence of endometrial tissue(gland and stroma) outside the uterus. The incidence of scar endometriosis is quite rare, and must differentiate with cellulitis and abscess. We have experienced one case of perineal endometriosis and one case of abdominal wall endometriosis at the site of postoperative wound scar. The possible pathogenesis of endometriosis and treatment were discussed.
Abdominal Wall ; Abscess ; Cellulitis ; Cicatrix* ; Endometriosis* ; Female ; Incidence ; Uterus ; Wounds and Injuries

PURPOSE: The purpose of this research was to address the working conditions of home health nurses through a nationwide home health agency survey conducted at hospitals. METHOD: The mail surveys were sent to 303 home health nurses nation wide and returned with a response rate of 71.8%. RESULT: (a) Seventy-five percent of home health agencies were established within the past5 years and half of home health nurses are over 40 years old. (b) Working conditions were considered as follows: Seventy-one percent of respondents were full-time employees, sixty-sixpercent of home health nurses had unscheduled visits on a regular day of duty and forty-eight percent were on vacation. Fifty-one percent of home health nurses have experienced traffic accidents and paid penalties (65.9%). Self-reported monthly income level per year was an average of 28,364,000 won. (c) Rates were significantly higher for shoulder pain (61.5%), lower back pain (54.1%), knee pain (39.4%), and gastrointestinal problems (33.0%). CONCLUSION: These baseline results show the importance of improving home health nursing working conditions, a comprehensive prevention system and safeguards from physical discomfort.
Middle Aged ; Korea ; Humans ; Home Care Services, Hospital-Based ; *Home Care Services ; Home Care Agencies ; Female ; Data Collection ; *Community Health Nursing ; Adult