PURPOSE: Objective measurements of knee of flexor and extensor strength using isokinetic equipment and function after total knee arthroplasty (TKA) were evaluated until postoperative 12 months. MATERIALS AND METHODS: The control group constituted of 15 persons who were of same age and weight without knee problems. Most of the patients (70%) were operated on both knees simultaneously. The patient group consisted of constituted with 20 patients (34 cases). Isokinetic testing (Cybex) of knee flexor and extensor strength of knee and functional evaluation by HSS score was performed preoperatively and at 3, 6, 12 months postoperatively. RESULTS: The peak torque of the knee extensor and flexor muscle in the patient group was decreased by 17-41% compared to the control group. Especially, the peak torque of extensor was more decreased than flexor muscles. At postoperative 12 months, the peak-torque values of hamstring and quadriceps were able to attain the same strength levels of the preoperative knee. According to the grade of the Hospital for Special Surgery knee rating scales by Insall, 28 cases (82 %) in the patient group could obtain good result at postoperative one year. CONCLUSIONS: Exercises to increase the strength of extensor should be emphasized in the rehabilitation programs after TKA
Arthroplasty* ; Exercise ; Humans ; Knee* ; Muscle Strength* ; Muscles ; Rehabilitation ; Torque ; Weights and Measures

Angioma serpiginosum is a rare acquired naevoid disorder, characterized by minute red or purple punta that are frequently arranged in serpiginous patterns in the lower extremities and buttocks. It usually begins in childhood and is more common in females. Histopathologically, thin-walled capillaries in the dermal papillae and the superficial reticular dermis are widely dilated without extravasation of red blood cells. We report a case of angioma serpiginosum on the lateral aspect of the right arm along the lines of Blaschko in a 36-year-old woman.
Adult ; Arm ; Buttocks ; Capillaries ; Dermis ; Erythrocytes ; Female ; Hemangioma* ; Humans ; Lower Extremity

Analyses were done on one hudred and twenty caaes of bleeding gastric ulcers diagnosed by emergency endoscopy for the past five years. The reaults are as the following: Much more cases were found in male than female and the most prevalent age group was 6th decade. The body of stomach along the lesser curvature was the most common bleeding site. No age related difference was noted in bleeding sites. Most common type of ulcer was in the round and shallow form. Five of six cases with exposed vessels showed atrophic changes in surrounding mucosa. Among the probable precipitating factors, analgesica, alcohols and certicosteroids were found in such order,
Alcohols ; Emergencies ; Endoscopy ; Female ; Hemorrhage* ; Humans ; Male ; Mucous Membrane ; Precipitating Factors ; Stomach ; Stomach Ulcer* ; Ulcer

The purpose of this study was to examine dietary attitudes of students and changes in their attitudes toward the school lunch service. The participants of the study were 483 students ranging from third grade elementary school students to middle school sophomores living in the Seoguipo area of Jeju Island. The subjects were asked to complete questionnaires under the supervision of their teachers or dietitians, and data were grouped into elementary school 3rd and 4th grades, elementary school 5th and 6th grades; and middle school 1st and 2nd grades for each gender. There were no significant differences among the groups with respect to their regularity of food intake, dietary considerations, or the frequency of imbalance in their diets. In the case of female participants, their frequency of snacking decreased as their grade level increased. In general, the overall changes in dietary attitudes became more negative as their grade level increased. Male students demanded increased serving sizes of both staple food and side dishes, while female students demanded increased serving sizes dishes, but not staple food as their grade levels increased. there was also an increase in the number of student sin higher grades who discarded or did not eat enough their entire meals. The major reasons for not eating the food were : no taste to the food and not proper saltiness of food. These results may suggest that school dietitians need to pay more attention to increased taste and proper seasoning of meals. Students suggested that the school lunch service should be continued, but that it needs improvement. Students in higher grades were more aware of the importance of the environment in which the meal was provided. Also, an early education in nutrition and healthy diets seemed important in preparing them for following a healthy lifestyle in later life.
Diet ; Eating ; Education ; Female ; Food Habits ; Humans ; Life Style ; Lunch* ; Male ; Meals ; Nutritionists ; Organization and Administration ; Seasons ; Serving Size ; Snacks ; Surveys and Questionnaires

BACKGROUND: Drug reactions are common problems in hospital inpatients and outpatients. Reliable diagnosis is essential but often difficult. OBJECTIVE: This study attempts to define the clinical features and causative drugs in the patients with drug eruptions, and to evaluate the diagnostic value of skin tests. METHODS: Sixty one patients with drug eruptions were reviewed clinically. In 18 patients, patch and prick tests were performed using suspected drugs. RESULTS: 1. The highest incidence of drug eruptions was observed in the third and forth decades(44.2%) and there was no sexual prodominence. 2. The most frequent latent peroid was 4 hours to 1 week(49.2%). 3. The common morphological features were exanthematous eruptions(57.3%), urticaria(14.8%) and fixed drug eruptoins(11.5%). 4. The major causative drugs were antibiotics(cephalosporin, ampicillin), antipyretics/anti-inflammatory analgesics(aspirin, piroxicam) and CNS depressants(diphenylhydantoin). 5. Clinical manifestations according to possible causative drugs were as follows; exanthematous eruptions by antibiotics, antipyretics/analgesics, herbs, CNS depressants, propylthiouracil and captopril; urticaria by antibiotics and herbs; fixed drug eruption by sulfonamide, antipyretics/analgesics and phenobarbital; acneiform eruptions by diphenylhydantoin and isoniazid; Stevens-Johnson syndrome by ampicillin, sulfonamide, aspirin and piroxicam, erythema nodosum by sulfonamide, and lichenoid drug eruptions by propylthiouracil. 6. Positivity to patch and prick tests was shown in 2 of the 18 patients and in 1 of 18 patients, respectively. CONCLUSIONS: The most frequent clinical feature of the drug eruptions were exanthematous in nature and the most common causative drugs were antibiotics, as suspected. To search for the causative drug of the drug eruption, the only usual methods of patch and prick tests were not sufficient in our study.
Acneiform Eruptions ; Ampicillin ; Anti-Bacterial Agents ; Aspirin ; Captopril ; Central Nervous System Depressants ; Diagnosis ; Drug Eruptions* ; Erythema Nodosum ; Humans ; Incidence ; Inpatients ; Isoniazid ; Outpatients ; Patch Tests ; Phenobarbital ; Phenytoin ; Piroxicam ; Propylthiouracil ; Skin Tests* ; Skin* ; Stevens-Johnson Syndrome ; Urticaria

The empty sella syndrome is characterized by obesity, frequent pregnancy, headache and high blood pressure, but its exact cause remains unknown. Usually the incomplete diaphragmatic sella has been considered as the cause of the empty sella syndrome, but some authors recently have suggested that the antipituitary antibody way be related to development of pituitary atrophy and the pituitary empty sella syndrome, and thus it may be clinically useful as screening test for the empty sella syndrome. We experienced two empty sella syndromes associated Graves disease and applied the antipituitary antibody as the diagnostic tool of the empty sella syndrome. But none of this two patients had antipituitary antibody and we report these cases with reviews of literatures.
Atrophy ; Empty Sella Syndrome ; Graves Disease ; Headache ; Humans ; Hypertension ; Mass Screening ; Obesity ; Pregnancy

PURPOSE: We report a case of sphenoid and ethmoid mucocele causing orbital apex syndrome, which was successfully treated with drainage under nasal endoscopy. METHODS: A 82-year-old female visited the hospital complaining of decreased visual acuity in her left eye for 15days. Visual acuity of the left eye was hand motion . She also complained of left ocular pain and headache. In ophthalmologic examination, exophthalmos, mild ptosis, extraocular muscle movement limitation and RAPD (relative afferent pupillary defect) of the left eye were found. Orbital CT showed a 3.3 X 2.9 X 4.1 cm sized well-demarcated cystic lesion involving the left sphenoid sinus, left ethmoid sinus, and posterior portion of the right ethmoid sinus. The ethmoid air cell was remodeled by this cystic mass. The medial wall of the left orbit was protruded outward. So, the medial rectus muscle and optic nerve in the left orbit were compressed. We found a bulging yellowish cystic mass supero-posterior to the middle turbinate under nasal endoscopy. We performed incision and drainage under nasal endoscopy. RESULTS: At post-operative 2days, orbit CT showed the removed large mucocele in the sphenoid and ethmoid sinuses. At post-operative 2weeks, corrected visual acuity of the left eye was 0.6. There was no exophthalmos, ptosis, or extraocular muscle movement limitation. CONCLUSIONS: Endoscopic surgery in the treatment of paranasal mucocele can be performed during a short time under local anesthesia and anatomical change of the paranasal sinus can be minimized. We therefore suggest that drainage through nasal endoscopy is effective method in the treatment of paranasal sinus mucocele.
Aged, 80 and over ; Anesthesia, Local ; Drainage ; Endoscopy ; Ethmoid Sinus ; Exophthalmos ; Female ; Hand ; Headache ; Humans ; Mucocele* ; Optic Nerve ; Orbit ; Sphenoid Sinus ; Turbinates ; Visual Acuity

Leukemic infiltration of the testes has been relatively rare disease. But increased survival due to advance in the treatment of childhood leukemia has been associated with an increase in incidence of leukemic infiltration of the tests. Six of 66 male children with acute lymphocytic leukemia and 2 of 2 male children with leukemic transformation on non-Hodgkin's lymphoma, who have been admitted to our pediatric department during past 7.5 years period, from January, 1974 to June, 1981 developed testicular leukemia. This represents an incidence of 11.8% and the median age was 6.6 years(9 mo. to 14 yrs). All patients were symptom free despite testicular enlargement. Testicular enlargement was initial presenting manifestation in two patients. The enlargement was unilateral in 5 and bilateral in 3. Initial white blood cell count was greater than 100,000/mm3 in five patients and was less than 10,000/3 in other three. Microscopic findings on specimens were leukemic infiltration mainly in the interstitial spaces and atrophy of spermatogenic cells. Four patients developed testicular relapse during bone marrow remission. Hepatosplenomegaly and lymphadenopathy were present in 5 and 6, and these appeared to imply an increased risk of testicular relapse. The median duration from diagnosis to testicular relapse was 33.5 months(2 mo. to 93 mo.). Three patients developed subsequent relapses(CNS; 2, BM; 1) 1.5 to 26 months after the testicular relapse, the median interval being 14.5 months. Radiotherapy with chemotherapy has resulted clinical improvement, but only one patient showed long survival without relapse.
Atrophy ; Bone Marrow ; Child ; Diagnosis ; Drug Therapy ; Humans ; Incidence ; Leukemia* ; Leukemic Infiltration ; Leukocyte Count ; Lymphatic Diseases ; Lymphoma, Non-Hodgkin ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Radiotherapy ; Rare Diseases ; Recurrence ; Testis

PURPOSE: To present a surgical result of Yokoyama procedure in myopic strabismus fixus. CASE SUMMARY: A 51-year-old female patient presented with progressive esotropia and diplopia. According to the Krimsky test, the patient showed 70 prism diopter esotropia and 30 prism diopter hypotropia in her left eye. The axial length was 34.97 mm in the right eye and 33.71 mm in the left eye. The patient was diagnosed with myopic strabismus fixus. The authors performed the Yokoyama procedure on her left eye. Surgical examination revealed each medial rectus muscle was recessed. Half of the muscle bellies of the superior and lateral rectus muscles were sutured together without muscle splitting 15 mm posterior from their insertion. At 1 year postoperatively, the patient showed 30 prism diopter esotropia and 20 prism diopter hypotropia in her right eye by alternative prism cover test. The authors performed the same procedure on her right eye. At 2 months after the second surgery, the patient showed orthotropia in the primary position and gaze limitation was improved. CONCLUSIONS: The Yokoyama procedure can be an effective method for improving deviation and ocular motility in esotropia caused by high myopia.
Diplopia ; Esotropia ; Eye ; Female ; Humans ; Muscles ; Myopia ; Strabismus

We experienced a case of thanatophoric dwarfism with a relatively large head and shortened limbs. The diagnosis was confirmed by clinical features, radiologic examinations and autopsy. A review of literature was made briefly.
Autopsy ; Diagnosis ; Extremities ; Head ; Thanatophoric Dysplasia