To evaluate the diagnostic usefulness and significance of quantitative sacroiliac joint scintigraphy in the assessment of sacroiliitis, we measured Sacroiliac Joint/Sacrum Uptake Ratio(SIS Ratio) by region of interest(ROI) method using $^{99m}Tc-methylene$ diphosphonate. The observed results were as follows: 1. Using ROI method, the SIS ratios for the control group of 65 persons were $1.05{\pm}0.08$(left) and $1.06{\pm}0.07$(right) which were narrower in range than those of slice method $(mean{\pm}S.D.)$. 2. The effects of age, gender and laterality on SIS ratio were not significant. 3. In left side, one of 6 patients with rheumatoid arthritis had SIS ratio in excess of 2 standard deviation of normal control group, and remainder had SIS ratios within normal limit. In right side, 3 patients had SIS ratios in excess of 2 standard deviation of normal control group, and remainder, within normal limit. 4. In both sacroiliac joint, 2 of 3 patients having sacroiliitis clinically with Reiter's syndrome whose pelvis A-P X-ray findings showed normal had high SIS ratios (left/right; 1.31/1.69, 1.90/1.80), but SIS ratio of one patient who had no evidence of sacroiliitis clinically was within normal limit. 5. In 6 patients with ankylosing spondylitis in both sacroiliac joints, 4 whose pelvis A-P Xray findings showed severe sclerotic change of sacroiliac joints had SIS ratio within normal limit or below that of normal control group, and SIS ratios of 2 patients whose pelvis A-P X-ray findings showed were increased. 6. 4 of 5 patients with low back pain of which cause could not be evaluated clinically and radiologically had SIS ratios in excess of that of normal control group. It would be concluded that quantitative sacroiliac joint scintigraphy is useful and sensitive screening method in the diagnosis as well as in the assessment clinical activity of sacroiliitis.
Oh, Chung Hee;Oh, Joo Han;Jo, Ki Hyun;Kim, Sae Hoon;Bin, Seung Woo;Gong, Hyun Sik
The Journal of Korean Orthopaedic Ultrasound Society
/
v.1
no.1
/
pp.23-26
/
2008
Ultrasonography (USG) is widely accepted diagnostic method for the rotator cuff tear. The availability, low cost, easy to access is main factors that favor USG as a primary diagnostic modality for various cuff disorders. We experienced a case of discrepancy between USG, MR arthrography (MRA) and arthroscopic examination. Seventy four year old female patient complained of right shoulder pain. USG depicted rotator cuff tear with the size of 1cm, and MRA demonstrated about 3cm sized tear. Complex massive tear with delamination of degenerated rotator cuff was identified in the arthroscopic examination. When we encounter a patient who has loss of rotator cuff power or severe symptom than findings of USG, MRA or repeat USG is warranted. We report a case of discrepancy between examination modalities with brief review of the literature.
Purpose : This study was performed to analyze the endoscopic findings in Henoch-Schonlein purpura patients, and to compare the differences in endoscopic findings according to age and gastrointestinal symptoms. Methods : We examined children with Henoch-Schonlein purpura aged 3 to 15 years between September 1996 and October 2002. The total number studied was 65, consisting of 41 boys and 24 girls. Endoscopy was performed and the results were analysed. Results : Among 65 cases, 12 cases of duodenitis, nine cases of gastritis and duodenitis, six cases of duodenal erosion, five cases of gastritis, five cases of duodenal ulcer, two cases of gastric ulcer and one case of colonic erosion were noted. Endoscopic abnormality was found in 38 of 53 who had gastrointestinal symptoms, and in two of 12 who didn't have gastrointestinal symptoms. Conclusion : Most of the gastrointestinal symptoms in Henoch-Schonlein purpura patients were relieved without complication. But in some cases severe symptoms such as hematemesis, melena, and abdominal pain localized to epigastric area were developed when diagnosis was delayed. Prompt endoscopy will be helpful for diagnosis and therapy of Henoch-Schonlein purpura with gastrointestinal involvement.
A 47-year-old man presented with complaints of chest pain and dyspnea caused by deceleration injury due to an automobile accident. Systolic cardiac murmur was audible at the right sternal border. An electrocardiogram showed sinus tachycardia. Transthoracic echocardiography revealed a flailing anterior leaflet of the tricuspid valve, papillary muscle rupture, and severe valve insufficiency. Rupture of papillary muscle of the anterior leaflet and chordae tendineae of the posterior leaflet were confirmed by right atrial incision under routine cardiopulmonary bypass. Artificial chordae tendineaes were implanted between the anterior and posterior leaflet and papillary muscles in the right ventricles. De-Vega annuloplasty was also added. This is a very rare case in which a surgery was done for tricuspid valve regurgitation caused by post-traumatic papillary muscle rupture.
Purpose : The purpose of this study was to evaluate clinical efficacy of the arthroscopic anterior acromioplasty for the treatment of chronic impingement syndrome of the shoulder. Materials and Methods : Between July 1995 and December 1997, twenty seven consecutive shoulders of 26 patients with chronic impingement syndrome of the shoulder were treated by arthroscopic anterior acromioplasty. The patients who had severe osteoarthritis of the shoulder full thickness tear of the rotator cuff, and nonoutlet impingement were excluded. The clinical results were evaluated by using UCLA shoulder rating scale. The average follow-up was 2years 3months(range, 1year 7months to 3years 1 11months). Results : Twenty three patients$(85.2\%)$ were rated as excellent or good results, while four patients$(14.8\%)$ were fair. Twenty six cases$(96.3\%)$ were satisfied with the results of the operations, while one case$(3.7\%)$, who had Parkinsonian syndrome, ossification of posterior longitudinal ligament(OPLL) of the cervical spine, and spinal stenosis of the 5th and 6th cervical spine was not satisfied. Conclusion : Arthroscopic anterior acromioplasty was an effective treatment method, especially for relief of pain, for the treatment of chronic impingement syndrome of the shoulder. If the patient has the combined lesions in the cervical spine and the shoulder, and systemic lesions, these lesions may influence the results of treatment after operation, and cause the unpredictable results.
The purpose of this study was to discuss the nature of pregnancy experience among unwed Korean mothers and to figure out what it meant for them, by asking some of them to reflect on themselves in a written form from interpretative and phenomenological perspective, based on van Manen's research method of the same approach. The subjects in this study were seven unmarried mothers in Korea. The data were collected from July through December 2000 through in- depth interview and observation. The statements of the participants were taped, recorded, analyzed and select essential themes. To have a phenomenological understanding of the pregnancy unmarried mothers, literary works, including essays and novels, were reviewed. The findings of this study were as below: The selected substantial themes about the pregnancy and birth experiences of the single mothers included 'hatred for boy friend,' 'hatred for the fetus,' and 'hatred for myself.' The unmarried mothers met their boy friends through the introduction of friends. At first, they were good friends, but they soon went on a date and had sexual relation with no common knowledge about sex. Most of them were aware of their pregnancy after they felt fetal movement, but they put off taking the test because they didn't want to accept the fact and feared it. Such an attitude was rare among married pregnant women, and being pregnant with no prior preparation or sexual knowledge is not common in Western countries. They felt guilty and informed their boy friends of the fact, but the boy friends didn't admit their responsibility and rejected the babies. This made the poor girls hate them, and it turned into severe abhorrence. They thought their lives were ruined by the babies, and wished they would disappear. They reproached the babies, hitting their own bellies or making a kick. They considered themselves to be abandoned and didn't want to live any more. Giving themselves up to despair, some attempted to commit a suicide. They hoped to die, thinking their death would solve the problem. When they lost a chance of abortion and were about to have the babies adopted, they felt sorry for them. The unwanted pregnancy gave them a pain, but they keenly felt they were loved by their mothers, and learned the value of family. It's attempted in this study to clearly show how much unmarried Korean mothers suffered from pregnancy, and this effort paved the way for seeing unwed mothers in a new light and having a better understanding of them, instead of sticking to general perception.
Park, Chan Sung;Lee, Soon Jung;Do, Gi Won;Oh, Ssang Yong;Cho, Hyun;Kim, Min Su;Hong, Il Ki;Bang, Sung Jo;Jegal, Yang Jin;Ahn, Jong-Joon;Seo, Kwang Won
Tuberculosis and Respiratory Diseases
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v.65
no.2
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pp.131-136
/
2008
Cholethorax (bilious pleural effusion) is an extravasation of bile into the thoracic cavity via a pleurobiliary fistula (and also a bronchobiliary fistula). It is an extremely rare complication of thoraco-abdominal injuries. It can be caused by congenital anomaly and also by hepatobiliary trauma, severe infection or iatrogenic procedures. The definitive diagnosis is made with aspiration of bilious fluid from the pleural space during thoracentesis, by finding a fistulous tract during endoscopic retrograde cholangiopancreatography (ERCP) or cholagioscopy, or with finding an abnormal pleural accumulation of radioisotope during hepatobiliary nuclear imaging. Its symptoms include coughing, fever, dyspnea and pleuritc chest pain. Herein we report on a case of cholethorax following performance of percutaneous transhepatic cholangioscopy (PTCS) to remove incidentally discovered common bile duct (CBD) stones.
Kim, Ji-Hee;Choi, Byung-Jai;Kim, Seong-Oh;Choi, Hyung-Jun;Son, Heung-Kyu;Lee, Jae-Ho
Journal of the korean academy of Pediatric Dentistry
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v.35
no.3
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pp.532-538
/
2008
Lesch-Nyhan syndrome is a rare X-linked recessively inherited disorder, caused by complete absence or decrease in activity of hypoxanthine guanine phosphoribosyl transferase(HPRT), an enzyme involved in purine metabolism. This enzyme deficiency gives rise to nephropathy symptoms, such as hyperuricosuria and hyperuricemia by excessive uric acid production and neuropathy symptoms, such as mental retardation, choreoathetosis and self mutilation behavior. Patients with Lesch-Nyhan syndrome have tendency to bite their lip, tongue and finger. In severe cases, partial or even total amputation of tongue or finger occur. Self-inflicted bites are often complicated by secondary infection to the injured site as well as pain. Furthermore tissue loss by biting results in esthetic problems. The dental management of self mutilation includes treatment with appliances such as soft mouth guard or lip bumper, extraction of all the teeth, and orthognathic surgery. We report a case of a 13 year-old boy with Lesch-Nyhan syndrome, who severely injured himself on his tongue. At first, conservative treatment using soft mouth guard was considered, but it could not prevent trauma on his tongue. Therefore, extraction of the lower anterior and posterior teeth was carried out.
Radiologists who experience extravasation of the contrast medium even once suffer mentally during testing due to the fear of its reoccurrence. Establishing a plan for preventing it beforehand is necessary above all because patients experience severe physical and mental pain and become distrusting of medical staff and treatment. Therefore, the present study attempts to prevent extravasation, which is the result of damage from pressure applied to the patient's blood vessels, by lowering PSI, and conducted a comparative analysis of PSI changes during contrast medium injection depending on the diameter of the Y-shape connecting tube which connects the automatic injector and the intravenous injection of the patient. In the case of product A in which the diameter of the Y-shape connecting tube is about 2mm, the average PSI for all ages was 98.5 and standard deviation was 9.72. In the case of product B in which the diameter of the Y-shape connecting tube is about 3mm, the average PSI for all ages was 62.0 and standard deviation was 8.59. Product B with its wider diameter decreased in average pressure by 37.05% when compared to product A, and when product B is used with the p-value at 0.00, pressure decreased even more, achieving statistically significant results.
An outbreak of dermatosis occurred at a machine manufacture factory in Kyongju on Aug 1995. Authors conducted a questionnaire ,survey among 92 workers in the factory and a dermatologist examined their skin lesions. Authors also collected moths and identified them. The results are as follows; 1. Forty-two cases of dermatosis were identified with attack rate of 45.7%. Attack rate was not different by company, age, sex, educational level and duration of employment. Attack rate was 47.8% among productive workers, 25.0% among clerical workers and 100.0 % among patrolmen. 2. Two cases among 42 dermatosis cases and three subjects among 50 non-cases had a history of same dermatosis last year. Four of dermatosis cases had a history of dermatosis among their family members. 3. Skin lesions of the cases were scattered or grouped rice-sized erythematous papules or vesicles. Duration of dermatosis from the onset to the time of survey was from one day to more than 30 days. The most frequent site of skin lesion was the arms(81.0 %), and it was also observed at the neck(47.6 %), abdomen(45.2 %), chest(42.9 %), legs(38.1 %) and back(35.7 %). Skin lesion was aggravated with sweating(31.0 %), after shower(16.7 %) and with scratching(11.9 %). 4. Moths were collected and identified as Euproctis subflava (Bremer). Many poisonous stings were observed on their wngs which is harmful to human. 5. Contact with moths' wing droppings to two authors on thier forearms for provocation resulted in severe immediate pain followed by prolonged pruritus. Erythematous macules quickly appeared and succeeded by firm wheal-like red papules. Authors thought that the outbreak of dermatosis was brought about by Euproctis subflava (Bremer). Further studies on the factors contributing to the prosperity of the moths in this area are needed.
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