BACKGROUND: To evaluate the usefulness of exercise echocardiography in diagnosis of coronary artery disease and to compare it with exercise ECG test. METHOD: We performed exercise test in 48 patients who suffered from angina-like chest pain, according to the modified Bruce protocol. During exercise, we observed the ECG changes and recored the images of left ventricular wall motion before and after exercise on the video tape. The echocardiogram were digitally stored and displayed in a format that allowed simultaneous analysis of rest and stress images. Newly developed left ventricular wall motion abnormalities were determined as positive findings. RESULTS: The feasibility of exercise echocardiography was 75%. The sensitivity and specificity fo exercise ECG test was 67% and 89%. The sensitivity and specificity of exercise echocardiography was 85% and 100%. The sensitivity of ECG and echocardiography was 50%(7 of 14) and 78.6%(11 of 14) in those with one-vessle disease and 84.6%(11 of 13) and 92.3%(12 fo 13) in those with multi-vessle disease. CONCLUSION: Exercise stress echocardiography was very usefull method for detecting the coronary artery disease especially in single vessle disease. And it had much higher accuracy than the stress ECG test.
Chest Pain ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis* ; Echocardiography ; Echocardiography, Stress* ; Electrocardiography ; Exercise Test ; Humans ; Sensitivity and Specificity

PURPOSE: To evaluate the functional outcome after surgical treatment for displaced fractures of proximal humerus and assess the final results according to surgical methods. MATERIALS AND METHODS: Thirty-three cases with follow-up over 12 months were divided into three groups: double tension band wiring (Group I, 14), plate fixation (Group II, 10) and closed reduction with internal/external fixation (Group III, 9). The pain index, the self-assessed functional score and the range of motion were obtained. RESULTS: Anatomical reduction was best obtained in group II and fractures united in 11-16 weeks. The pain index was worst in group III and the functional score of group I (80+/-12.2%) was higher than in the others (II: 69+/-15.7%, III: 55+/- 7.9%). The range of motion was worst in group III. Complications were noted in 9 cases, which occurred mostly in group II and III. CONCLUSIONS: Double tension band wiring in displaced proximal humerus fracture demonstrated that it provides a sufficient fixation for early rehabilitation and union, while minimizing complication
Follow-Up Studies ; Humerus* ; Range of Motion, Articular ; Rehabilitation

Since Pare's first report on Achilles tendon rupture in 1575, many authors have presented numerous operative and nonoperative methods for its treatment. Numerous controversies following its treatment have been concerned with the selection of its treatment method, which could minimizing the complications and enable early ambulation. We analysed 98 cases of Achilles tendon rupture in adults which were treated by direct repair, three-tissue bundle technique, or Plantaris/Peroneus augmentation repair for 3(1)/4 years from Oct. 1986 to Dec. 1989. We compared with types of cast after operation, periods for immobilization, and ankle motion of dorsiflexion at postoperative 6 weeks & long-term follow up. The results obtained from this study were as follows; l. After repair by three-tissue bundle technique, a short leg cast was applied, and then a weight bearing was started at postoperative 3 weeks. It can be demonstrated to shorten hospitalization and early ambulation when compared to other surgical techinques. 2. The patients who were repaired with the three-tissue bundle techinque averaged 12.5° dorsiflexion at the time of cast removal at postoperative 6 weeks, compared to 0°, 1° plantar flexion, and 4.4° plantar flexion with other techniques. The former group was significantly better than that of the latter group, and these differences were not present at long-term follow up. 3. On follow up period, discoverd complications were rerupture of Achilles tendon in 8 cases and mild wound infection in 3 cases, but the patients who were repaired by the three-tissne bundle technique showed no complications except mild wound infection in one case.
Achilles Tendon ; Adult ; Ankle ; Early Ambulation ; Follow-Up Studies ; Hospitalization ; Humans ; Immobilization ; Leg ; Methods ; Rupture ; Weight-Bearing ; Wound Infection

No abstract available.
Hepacivirus* ; Hepatitis C Antibodies* ; Hepatitis C* ; Hepatitis* ; Prevalence*

Five adult cases of post-laminectomy swan-neck deformity are reported. The factors causing the deformity, prophylactic measures, and treatment of the deformity are discussed. It is strongly adviced to the neurosurgeons and orthopedic surgeons that they should be aware of this unwanted complication of the multi-level cervical laminectomies, and that they should provide every preventive measures before post-laminectomy swan neck deformity develops. Anterior interbody fusion spanning the entire unstable segments is preferably recommended together with application of pre-fusion traction.
Adult ; Congenital Abnormalities ; Humans ; Laminectomy ; Neck ; Neurosurgeons ; Orthopedics ; Surgeons ; Traction

Isolated acute monoarticular septic arthritis of the sternoclavicular joint is a extremely rare disorder, and is usually associated with predisposing factors such as contiguous foci of infection, heroin addiction, rheumatoid arthritis, diabetes mellitus and maintenance hemodialysis. This case occurred in healthy adult. The etiological agent was staphylococcus aureus. Good result wads achieved by applying appropriate antibiotic therapy combined with an adequate drainage.
Adult ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Causality ; Diabetes Mellitus ; Drainage ; Heroin Dependence ; Humans ; Renal Dialysis ; Staphylococcal Infections ; Staphylococcus aureus ; Sternoclavicular Joint

There have been reports of a reductioin in the intraocular pressure(IOP) measured with the Goldmann applanation tonometer(GAT) in eyes that have undergone excimer laser photorefractive keratectomy(PRK). The authors determined whether laser in-situ keratomileusis(LASIK) for myopia also affected GAT readings. The IOP was measured with the GAT before LASIK and 1 and 3 months postoperatively on 45 eyes of 30 patients. Measurements were performed at the central and temporal parts of the cornea; the paired Student`s t test was used for statistical analysis. The mean preoperative IOPs at the central and peripheral cornea were 13.2+/-2.5mmHg and 13.2+/-2.5mmHg, respectively. Three month after LASIK, IOPs at the central and peripheral cornea decreased to 8.9+/-1.8mmHg and 12.3+/-2.3mmHg, respectively. Similar to PRK, the GAT readings from the central cornea after LASIK for myopia were significantly lower than the preoperative IOPs(P<0.001) and the postoperative GAT readings from the peripheral cornea(p<0.001).
Cornea ; Humans ; Intraocular Pressure* ; Keratomileusis, Laser In Situ* ; Lasers, Excimer ; Myopia ; Reading

Granular cell tumor(GCT) has been identified in all organ systems, most often in the oral cavity and subcutaneous tissue. GCT of the esophagus has been considered rare. However, this neoplasm is being recognized with increased frequency since the use of fiberoptic endoscopy has become widespread. We report 5 cases of granular cell tumors involving the esophagus, all of which were incidentally found. Four additional cases of GCT which appeared in the Korean literature were reviewed.
Endoscopy ; Esophagus* ; Granular Cell Tumor* ; Mouth ; Subcutaneous Tissue

BACKGROUND: Although a number of indices of diastolic function based on transmitral flow have been proposed, no single factor seems to be adequate for seperating patients with normal from with abnormal diastolic functions. Pulsed Doppler echocardiography of pulmonary venous flow(PVF) is another non-invasive method to evaluate left ventricular diastolic performance. The purpose of this study is to evaluate the normal PVF pattern by TEE. METHOD: We performed pulsed-wave Doppler studies of the PVF and of the mitral flow by transesophageal-(TEE) and transthoracic echocardiography(TTE) in a healthy young adults. RESULTS: In TEE, all sublects showed four phases of the PVE pattern ; two antewgrade systolic phase(early and late : SE and SL), one antewgrade diastolic phase(D) and one retrograde diastolic phase(A). In TTE, there were three phases of the PVF pattern ; two antewgrade phase(systolic, diastolic) and one retrograde diastolic phase but we couldn't find out early systolic phase flow. Peak velocity of each phase of PVF was as follows:SE was 48.9+/-14.1cm/sec, SL was 56.3+/-16.1cm/sec, D was 52.6+/-14.9cm/sec. The timing of SL flow was correlated significantly with that of peak aortic flow(r=0.42, p=<0.01), while the timing of D flow and that of A flow were correlated significntly with timing of mitral E peak and A peak, respectively(r=0.84, p<0.01 ; r=0.80, p<0.01). CONCLUSIONS: In the young normal subject, PVF showed four phase of flow pattern and could be easily obtained by TEE. Furthermore it may be used for evaluation of left ventricular function.
Echocardiography, Doppler, Pulsed ; Echocardiography, Transesophageal* ; Humans ; Ventricular Function, Left ; Young Adult*

The hypotony with cyclodialysis after blunt trauma to the eye rarely happens and the cyclodialysis is diagnosed by finding the cleft in the anterior chamber anglel It is treated with cycloplegics conservatively or with surgery. In this study, the authors reviewed the hyphema, the onset of hypotony, the size of cyclodialysis cleft and transient scleral buckling that is one of the surgery in 7 eyes of 7 patients . The hyphema was seen in all cases after blunt trauma to the eyes and the duration between the trauma and the onset of hypotony was average 7.2 days. The traumatic cyclodialyses clefts were half an clock hour in 3 patients and 1 to 4 clock hours in 4 patients . Six patients had an initial conservative treatment, 3 patients required surgical treatment, scleral buckling, for 3 weeks for the full recovery of intraocular pressure.
Anterior Chamber ; Humans ; Hyphema ; Intraocular Pressure ; Mydriatics ; Scleral Buckling