Tuberculosis can involve any part of the body and there are case reports of tuberculosis coexisting with malignancy in most body organs. However, cases of intestinal tuberculosis associated with colon cancer have rarely reported. Inflammatory bowel diseases can progress to malignant diseases due to mucosal dysplastic change. Similarly, intestinal tuberculosis can cause chronic inflammation, but the exact relationship between intestinal tuberculosis and colon cancer is currently obscure. A 71-year-old woman visited our hospital because of abrupt right lower abdominal pain that progressed to rebound tenderness and abdominal rigidity. Abdominal computed tomography showed a polypoid mass in the cecum and a distended terminal ileum. Right hemicolectomy was performed and the surgical specimen revealed extremely well differentiated adenocarcinoma combined with intestinal tuberculosis and bowel perforation in the cecum. We report here on a rare case of colon cancer coexisting with colonic tuberculosis and this presented as bowel perforation. We also include a review of the relevant literature.
Abdominal Pain ; Adenocarcinoma ; Aged ; Cecum ; Colon ; Colonic Neoplasms ; Female ; Humans ; Ileum ; Inflammation ; Inflammatory Bowel Diseases ; Tuberculosis

Purpose: Ankle dorsiflexion is an essential element of normal functions, including walking, activities of daily living and sport activities.The tibialis anterior (TA) muscle functioned as a dorsiflexor and as a dynamic stabilizer of the ankle joint during walking and jumping.This study aimed to compare TA muscle thickness using ultrasonography according to the four different toe and ankle postures for the selective TA strengthening exercise. Methods: This study were recruited 26 (males: 15, females: 11) aged 20-30 years, with no injury ankle and calf in the medical history, had normal dorsiflexion and inversion range of motion (ROM). The thickness of the TA muscle was measured by ultrasonography in the four different toe and ankle postures: 1. Ankle dorsiflexion with all toe extension and ankle inversion (ITEDF); 2. Ankle dorsiflexion with all toe flexion and ankle inversion (ITFDF); 3. Ankle dorsiflexion with all toe extension and neutral position (NTEDF); 4. Ankle dorsiflexion with all toe flexion and neutral position (NTFDF). One-way repeated analysis of variance (ANOVA) and Bonferroni correction were used to confirm the significant difference among conditions. The level of statistical significance was set at α = 0.01. Results: TA muscle thickness with ITFDF was significantly greater than in any other ankle positions, including ITEDF, NTFDF, and NTEDF (p < 0.01). Conclusion Among the four toe and ankle postures, isometric contraction in ITFDF postures showed the greatest increase in thickness of TA rather than ITEDF, NTEDF, and NTFDF postures. Based on these results, ITFDF can be recommended in an efficient way to selectively strengthen TA muscle.

Purpose: This study investigated the muscle activity of the lower trapezius (LT) during three different shoulder flexion exercises. Methods: Twenty-three subjects between 20 and 25 years of age were enrolled. The subjects were asked to perform three different shoulder flexion exercises: 1) shoulder flexion in prone (SFP), 2) shoulder flexion in push-up with a swiss ball (SFPUS) and 3) shoulder flexion in a quadruped position with a swiss ball (SFQPS) in random order. The muscle activity of LT during each shoulder flexion exercise was measured by using surface electromyography. The muscle activity of LT was compared using one-way analysis of variance (ANOVA) and Bonferroni post hoc test among three different shoulder flexion exercises. The statistical significance level was set at α = 0.01. Results: The muscle activity of LT was significantly different among three different shoulder flexion exercises (SFP, SFPUS, and SFQPS).The LT muscle activity with SFQPS exercise was greater than SFP and SFPUS exercises (p < 0.01). There was no significant difference in LT muscle activity between SFP and SFPUS exercises (p > 0.01). Conclusion The LT muscle activity was greater during SFQPS than SFP and SFPUS. Therefore, SFQPS exercise can be recommended for selectively activation of LT muscle.

Purpose: The purpose of this study was to compare the influence of external scapular stabilization on the isometric strength of shoulder flexor muscle in subjects with and without scapular winging and conditions with and without external scapular stabilization. Methods: A total of 30 subjects with and without scapular winging were enrolled. Two groups were classified using clinical and diagnostic tests to divide the groups with and without scapular winging (15 with scapular winging 15 without scapular winging). The isometric strength of the shoulder flexor was measured using a tensiometer. The isometric strength was evaluated in the sitting position with and without an external scapular stabilization. The external scapular stabilization was provided with the examiner’s hand to fix scapular winging during shoulder flexion. The changing value was calculated to determine the isometric strength difference between shoulder flexion with and without the external scapular stabilization in each group. The changing value between isometric strength of shoulder flexor with and without scapular winging was compared using the independent t-test. Statistical significance was set at 0.05. Results: In the group with scapular winging, the shoulder flexor isometric strength in the sitting position was greater with an external scapular stabilization than without an external scapular stabilization (p < 0.05). There was no significant difference in the shoulder flexor isometric strength in the subjects without scapular winging between conditions with or without an external scapular stabilization (p > 0.05). Conclusion The external scapular stabilization in the individuals with scapular winging may increase shoulder flexor isometric strength in the sitting position.

Purpose: The purpose of the current study was to determine the intra- and inter-rater reliability of muscle thickness measurement of the TA using ultrasonography (US) conducted at different inward pressures of approximately 0.5 kg, 1.0 kg, and no pressure control. Methods: Twenty healthy subjects were recruited for this study. Two different examiners measured the thicknesses of the dominant TA of each subject randomly to assess the intra- and inter-rater reliability. The measurement values were analyzed using the intra-class correlation coefficient (ICC) with a 95% confidence interval, standard error of measurement, minimal detectable change, and coefficient of variance. Results: All intra-rater reliability ICC values showed high reliability above 0.9. Inter-rater reliability ICC values showed high reliability above 0.9 with 0.5 and 1.0 kg of inward pressure. In contrast, Inter-rater reliability ICC values showed poor reliability (0.23) with no pressure control of inward pressure. Conclusion The findings showed that maintaining consistent inward pressure is essential for reliable results when the muscle thickness of the TA is measured by different examiners in a clinical setting.

Purpose: The purpose of the current study was to determine the intra- and inter-rater reliability of muscle thickness measurement of the TA using ultrasonography (US) conducted at different inward pressures of approximately 0.5 kg, 1.0 kg, and no pressure control. Methods: Twenty healthy subjects were recruited for this study. Two different examiners measured the thicknesses of the dominant TA of each subject randomly to assess the intra- and inter-rater reliability. The measurement values were analyzed using the intra-class correlation coefficient (ICC) with a 95% confidence interval, standard error of measurement, minimal detectable change, and coefficient of variance. Results: All intra-rater reliability ICC values showed high reliability above 0.9. Inter-rater reliability ICC values showed high reliability above 0.9 with 0.5 and 1.0 kg of inward pressure. In contrast, Inter-rater reliability ICC values showed poor reliability (0.23) with no pressure control of inward pressure. Conclusion The findings showed that maintaining consistent inward pressure is essential for reliable results when the muscle thickness of the TA is measured by different examiners in a clinical setting.

Purpose: The purpose of this study was to investigate the effects of posterior oblique sling activation on the muscle activities of the gluteus maximus (GM), multifidus (MF), and biceps femoris (BF) during three different prone hip extension exercises in healthy male individuals. Methods: Twenty healthy subjects participated in this study. An electromyography device was used to measure the muscle activities of the GM, MF, and BF. Each subject was asked to perform three different prone hip extensions as follows: [1) Prone hip extension with knee flexion + hip abduction 30°; PHE1, 2) Prone hip extension with knee flexion + hip abduction 30° and shoulder abduction 125°; PHE2, 3) Prone hip extension with knee flexion + hip abduction 30° and shoulder abduction 125° with 1kg loading; PHE3, in random order. A oneway repeated measures analysis of the variance and a Bonferroni post hoc test were used to analyze the results. The statistical signifi-cance was set at α= 0.01. Results: The muscle activity of the GM was significantly different between the three positions (Padj < 0.01). The muscle activity of the GM was significantly greater during PHE3 compared with PHE1 and PHE2 (Padj < 0.01). The BF muscle activity was significantly lower during PHE3 compared with PHE1 and PHE2 (Padj < 0.01). There was no significant difference in the muscle activity of the MF (Padj < 0.01). The ratio of the muscle activity (ratio= GM/BF) during PHE3 was significantly greater compared to PHE1 and PHE2 (Padj < 0.01). Conclusion The GM activity and GM/BF ratio during the PHE3 exercise were significantly greater compared to that during PHE1 and PHE2. Therefore, the PHE3 exercise could be recommended as a selectively effective GM activation exercise while decreasing the muscle activity of the BF.

PURPOSE: Little is known about outcomes in the use of third-line chemotherapy in cases of advanced gastric cancer (AGC). The primary aim of this retrospective study was to evaluate outcomes of docetaxel-based chemotherapy in patients with AGC that progressed after both oxaliplatin-based and irinotecan-based regimens. MATERIALS AND METHODS: Eligible patients were those with AGC who had previous chemotherapy including fluoropyrimidine and oxaliplatin as well as fluoropyrimidine and irinotecan and who received subsequent docetaxel-based chemotherapy. Thirty-five patients were retrospectively recruited from 5 medical centers in Korea. Patients received either weekly or 3 weekly with docetaxel +/- cisplatin. RESULTS: Thirty-one out of 35 patients were evaluated for treatment response. A total of 94 cycles of chemotherapy (median, 2; range, 1 to 7) were administered. The overall response rate was 14.3%, and the disease control rate was 45.7%. The median progression-free survival (PFS) was 1.9 months (95% confidence interval [CI], 1.1 to 2.7 months). The median overall survival (OS) was 3.6 months (95% CI, 2.8 to 4.4 months). PFS and OS were significantly prolonged in patients of the Eastern Cooperative Oncology Group, with performance status of 0 or 1 in multivariate analysis (PFS: hazard ratio[HR], 0.411; 95% CI, 0.195 to 0.868; p=0.020 and OS: HR, 0.390; 95% CI, 0.184 to 0.826; p=0.014, respectively). Four of the 35 patients enrolled in the study died due to infection associated with neutropenia. CONCLUSION: Our findings suggest that salvage docetaxel-based chemotherapy is a feasible treatment option for AGC patients with good performance status (PS), whereas chemotherapy for patients with poor PS (PS< or =2) should be undertaken with caution for those who previously failed oxaliplatin- and irinotecan-based regimens.
Camptothecin ; Disease-Free Survival ; Humans ; Korea ; Multivariate Analysis ; Organoplatinum Compounds ; Retrospective Studies ; Stomach Neoplasms ; Taxoids

OBJECTIVES: Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. METHODS: We performed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we performed rectal swabs on the cattle raised by the household of the index patient. RESULTS: We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. CONCLUSIONS: We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.
Animals ; Cattle ; Diarrhea ; Enterohemorrhagic Escherichia coli* ; Family Characteristics ; Grandparents ; Hemolytic-Uremic Syndrome ; Humans ; Korea* ; Mothers ; Shiga Toxin 2 ; Zoonoses

PURPOSE: The purpose of this study is to determine the relationship between the repetitive flexion or extension posture on the cervical spine on labor and degenerative change of the cervical spine, and the factors affecting degenerative change of the cervical spine. MATERIALS AND METHODS: To determine the factors affecting degenerative change of the cervical spine, age, sex, height, weight, body mass index, smoking, diabetes mellitus (DM), time engaging in labor, and cervical spine posture (flexion or extension) required repetitively on labor were investigated in the subjects. In addition, to evaluate the level of degenerative change of the cervical spine on 83 people in the flexion group (flexion strain) and 83 people in the extension group (extension strain), cervical degenerative index (CDI) in the simple cervical spine lateral radiograph was used to score (0-60 points) the degenerative severity. RESULTS: A total of 166 subjects (flexion group: 83 people, extension group: 83 people) participated in this study, and for the CDI, the cervical spine flexion group scored 7.8±6.2 points, and the cervical spine extension group scored 12.2±6.0 points to show that the cervical spine extension group had significant degenerative change in the cervical spine. In the multiple linear regression test performed to verify the risk factors affecting the degenerative change of the cervical spine, age (p=0.004), contraction of DM (p=0.029), and extension posture of cervical spine (p<0.001) influenced the degenerative change of the cervical spine. CONCLUSION: Repetitive extension posture on the cervical spine on labor and contraction of diabetes affected degenerative change of the cervical spine, therefore, training in medical care and posture on labor are required to prevent the progression of degenerative change in the cervical spine.
Agriculture* ; Body Weight ; Cervical Vertebrae ; Diabetes Mellitus ; Female ; Linear Models ; Neck* ; Posture ; Risk Factors* ; Smoke ; Smoking ; Spine ; Spondylosis*