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*

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

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

No abstract available.
Urticaria*

Sunlight is one of the well-established factors which play key roles in the induction and exacerbation of lupus erythematosus. In two patients of discoid lupus erythematosus, we have experimentally reproduced skin lesions by provocative phototesting. Both UVA (100 joules/cm²) and UVB (80 millijoules/cm²) radiation induced the skin lesions. The reproduced skin lesions were clinically and histopathologically consistent with lupus erythematosus.
Humans ; Lupus Erythematosus, Discoid ; Reproduction* ; Skin ; Sunlight

BACKGROUND: Patients with sinus rhythm, the left atrial appendage(LAA) appeared as a vigorously contracting structure and the blood flow patterns of LAA showed biphasic configuration. However, patients with AF rhythm the blood flow showed irregular or no configuration in doppler echocardiographic study. The purpose of this study is to evaluate relationship between the blood flow patterns of LAA with the presence of spontaneous contrast(SC) and thrombi in LAA. METHODS: We performed TEE and TTE simultaneously to 58 consecutive patients who had native mitral valve disease or mitral prosthesis. Spontaneous contrast(SC) and the presence and location of LAA thrombi were evaluated during TEE and left atrial dimension(LAD) & ejection fraction(EF) were evaluated during TTE. We divided the whole subjects into three groups according to the blood flow patterns ; regular pattern(Group 1), irregular pattern(Group 2), no flow pattern(Group 3). RESULTS: 1) Blood flow within the left atrial appendage is divided with three groups among of them, atrial fibrillation have two blood flow patterns. 2) Peak prositive & negative flow velocity within LAA in AF rhythm groups were slower than normal sinus rhythm group.(p<0.01) 3) Left atrial dimension in group 3 is significantly larger than others groups.(p<0.01) 4) Spontaneous contrast(SC) with LAA could be detected in 2(6.8%) of the 29 patients of group 1, 6(31.5%) of the 19 patients of group 2, 10(100%) of the 10 patients of group 3. Incidence of SC within LAA in group 3 is significantly higher than others groups. 5) LAA thrombi could be detected in 1(3.4%) of the 29 patients of group 1, 1(5.2%) of the 19 patients of group 2, 3(30%) of the 10 patients of group 3. Incidence of LAA thrombi is significangly higher than other groups. CONCLUSIONS: We can suggest that blood flow within LAA is divided into three groups according to the blood flow patterns, and spontaneous contrast and thrombi in LAA were closely related with the blood flow pattern.
Atrial Appendage ; Atrial Fibrillation ; Echocardiography ; Humans ; Incidence ; Mitral Valve ; Prostheses and Implants

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