A 55-year-old female experienced acute left shoulder pain without specific trauma. Radiography showed calcific deposits in the inferior part of the glenoid fossa. Magnetic resonance arthrography showed calcific deposits in the origin of the long head of triceps brachii muscle. Conservative treatment failed to resolve the symptoms; therefore, arthroscopic surgery was performed. The patient experienced immediate and dramatic pain relief, and normal shoulder motion was demonstrated 1 year after surgery. In conclusion, although rare, calcific tendinitis of the triceps brachii muscle, which causes shoulder pain, should be included in the differential diagnosis of acute shoulder pain. Arthroscopic surgery is a treatment option for chronic cases and those resistant to conservative treatment.
Arthrography ; Arthroscopy ; Diagnosis, Differential ; Female ; Head* ; Humans ; Middle Aged ; Radiography ; Shoulder ; Shoulder Joint ; Shoulder Pain ; Tendinopathy*

With the advancement of shoulder arthroscopy, use of biodegradable suture anchors in the surgical repair of rotator cuff tears has increased. Because of the radiolucency of these anchors, radiography is not appropriate for early detection of anchor failure. Ultrasonography is an advantageous modality in visualizing biodegradable, radiolucent anchors on a real-time basis without risk of radiation exposure. We report on two cases of displacement of a biodegradable suture anchor diagnosed on ultrasonography during the postoperative follow- up, which has not been previously reported. Because this displacement could be missed in the postoperative follow up ultrasonography, we describe the ultrasonographic features of the displaced biodegradable anchors. Surgeons and radiologists should pay special attention to the possibility of displacement of the suture anchor in patients who underwent rotator cuff repairs using suture anchors.
Arthroscopy ; Follow-Up Studies ; Humans ; Radiography ; Rotator Cuff* ; Shoulder ; Suture Anchors* ; Sutures* ; Tears ; Ultrasonography*

Adrenal cortical carcinoma is a rare disease both in adults and in children. Most of these tumors are functional, especially in children, producing endocrine syndromes such as virilization, Cushing syndrome, hyperaldosteronism or feminization. We experienced a case of adrenal cortical carcinoma in a 7yr old boy who showed features of virilization such as rapid growth rate, penile enlargement, and pubic hair. This case was diagnosed with typical hormonal findings and abdominal MRI and confirmed by pathologic findings. He was successfully treated by total left adrenalectomy and has been followed up without problem over eight months.
Adrenalectomy ; Adrenocortical Carcinoma* ; Adult ; Child ; Cushing Syndrome ; Feminization ; Hair ; Humans ; Hyperaldosteronism ; Magnetic Resonance Imaging ; Male ; Rare Diseases ; Virilism

BACKGROUND: Infantile Hypertrophic Pyloric Stenosis (IHPS) is one of the most common surgical problems of early infancy and one for which an eminently successful surgical treatment has been available since the work of Ramstedt in 1912. A clinical study was begun to access further the accuracy of ultrasonography in identifying hypertrophic pylorus. METHODS: This study is a retrospective clinical analysis of 31 cases of IHPS treated at the Department of Surgery of Pohang St. Mary's Hospital from Jan. 1990 to Dec. 1997. RESULTS: (1) The most prevalent age group was between 3 weeks and 8 weeks in 24 cases (77.4%), and the ratio of males to females was 5.2:1. (2) Among the 31 cases, new born babies were 21 cases (67.7%). (3) In 30 cases (96.8%), the gestational age was between 37 weeks and 42 weeks, and the birth weight was more than 3.5 kg in 21 cases (67.7%). The body weight percentile at admission was lower than the 50 percentile in 31 cases. (4) Among the 31 cases, breast-fed infants were 15 cases (48.4%), milk-fed 13 cases (41.9%), and mixed-fed 3 cases (9.7%). B type blood group was 23 cases (74.2%), and O type was 4 cases (12.9%). (5) In 4 cases (12.9%), an inguinal hernia was noted as an associated anomaly. (6) The onset of symptoms was neonatal (1 week-12 weeks) in all 31 cases, and the duration of the symptoms was between 1 week and 2 weeks in 18 cases (58.1%). (7) Non-bile stained, projectile vomiting was noted in all 31 cases (100.0%), an olive-shaped mass in right upper quadrant of the abdomen was felt in 27 cases (87.1%), and visible peristalsis on the epigastrium was noted in 25 cases (80.6%). (8) On laboratory tests, 17 patients had leukocytosis, and anemia was observed in 2 cases. Hypokalemia was observed in 9 cases (29.0%), hypochloremia in 4 cases (12.9%), and moderate to severe alkalosis (CO2 content > 25 mEq) in 7 cases. (9) Among the 25 cases, for which an the ultrasonographic evaluation was performed, the length of the stenotic canal was from 16 mm to 20 mm in 23 cases (92.0%), and the thickness of the stenotic portion was from 5 mm to 6 mm in 21 cases (84.0%). (10) All 31 cases were surgically treated by using a Fredet-Ramstedt pyloromyotomy, and the mortality was nil. The average hospitalization was 9.4 days. (11) There was 1 case of duodenal perforation and 1 case of intermittent non-projectile vomiting after the operation. CONCLUSIONS: We conclude that early accurate diagnosis, adequate preoperative preparation of the fluid & electrolyte imbalance, immediate surgical correction, and scheduled careful oral feeding are important in treatment of IHPS. Ultrasonographic determination of pyloric muscle length and thickness is the most accurate of the currently available techniques. A Fredet-Ramstedt pyloromyotomy is a safe and successful surgical procedure.
Abdomen ; Alkalosis ; Anemia ; Birth Weight ; Body Weight ; Diagnosis ; Female ; Gestational Age ; Gyeongsangbuk-do ; Hernia, Inguinal ; Hospitalization ; Humans ; Hypokalemia ; Infant ; Leukocytosis ; Male ; Mortality ; Peristalsis ; Pyloric Stenosis, Hypertrophic* ; Pylorus ; Retrospective Studies ; Ultrasonography ; Vomiting

In general, the long head of the biceps brachii originates from the superior glenoid labrum and the supraglenoid tubercle, crosses the rotator cuff interval, and extends into the bicipital groove. However, rare anatomic variations of the origins of the long head have been reported in the past. In this report, we review the clinical history, radiologic findings, and arthroscopic identifications of 3 anatomic variants of the biceps tendon long head. As the detection of long head of biceps tendon pathology during preoperative radiologic assessment can be difficult without prior knowledge, surgeons should be aware of such possible anatomic variations.
Anatomic Variation ; Head* ; Pathology ; Rotator Cuff ; Shoulder ; Tendons

No abstract available.
Acanthoma*

No abstract available.
Fallopian Tubes* ; Female ; Mucous Membrane* ; Sterilization*

OBJECTIVES: Advance directives (AD) are designed to protect patients’ autonomy and self-determination, which mean the end of life care planning should precede before loss of their decision ability. We aimed to analyze our experience of AD at field of oncology, focusing on preference of end-of-life care and outcome in advanced cancer patients. METHODS: A retrospective review was conducted on advanced cancer patients who underwent AD at the department of Oncology of Hanil General Hospital, between April 2013 and January 2014. AD are composed of decision about end of life care (resuscitation, ventilator, artificial tube feeding) and determination of proxy. RESULTS: Among 23 patients who were recommended AD during study period, 19 patients (83%) successfully underwent AD. The median age was 67 years (range, 50 to 95 years) and male was predominance (84%) was observed. Most of them (90%) have not heard of AD in the past. With regard to decision of end-of-life care, decision for resuscitation and ventilator were selected only by 1 patient (5%), respectively, while 10 patients (52%) decided to receive tube feeding. Among 5 patients who underwent AD during chemotherapy, there was neither transfer to other hospital for anti-cancer treatment nor follow up loss. CONCLUSION: AD might be applicable in advanced cancer patients at field of oncology, including also patients treated with palliative chemotherapy.
Advance Directives* ; Drug Therapy ; Enteral Nutrition ; Follow-Up Studies ; Hospitals, General ; Humans ; Male ; Proxy ; Resuscitation ; Retrospective Studies ; Terminal Care ; Ventilators, Mechanical

BACKGROUND/AIMS: We aimed to evaluate recognition of the 2013 revised guidelines for diagnosis and treatment of Helicobacter pylori infection in Korea by members of the society through a web survey. MATERIALS AND METHODS: We analyzed the respondents' agreement with the 19 guidelines in terms of awareness and adherence. Among 718 physicians, 149 (20.8%) answered the questionnaire by e-mail between October and November 2013. RESULTS: The mean age of the respondents was 40+/-7 years, and the ratio of men to women were 74.5:25.5. The respondents were as follows: professors (36.2%), fellows (31.5%), salaried doctors (17.4%), private practitioners (11.4%), and screening center clinicians (3.4%). Among the 141 respondents, 69.1% had read, 17.3% agreed completely, and 77.3% agreed generally with the guidelines. The respondents indications for eradication were peptic ulcer disease (77.2%), MALT lymphoma (89.3%), and following endoscopic therapy for early gastric cancer (71.1%). However, 42.3% and 48.3% of the physicians administered H. pylori eradication treatment for patients with atrophic gastritis and a family history of gastric cancer, respectively. Triple therapy as first line regimens was administered by 81.2% of the respondents. The duration was one-week for 77.7% and two-weeks for 13.4%. A total of 55.7% prescribed a bismuth-based secondary treatment. When bismuth-based initial therapy failed, a combination of 2 antibiotics that were not used as first-line therapy were used (37.6%). CONCLUSIONS: This web survey was very helpful for analyzing society members' recognition of 2013 revised guidelines. Generally, all the society members followed the guidelines.
Anti-Bacterial Agents ; Surveys and Questionnaires ; Diagnosis* ; Electronic Mail ; Female ; Gastritis, Atrophic ; Helicobacter pylori* ; Humans ; Internet ; Korea ; Lymphoma, B-Cell, Marginal Zone ; Male ; Mass Screening ; Peptic Ulcer ; Stomach Neoplasms

The aim of the present study was to evaluate the degree of restoration of acromiohumeral distance of immediate postoperative period in patients who have rotator cuff repair surgery with large-to-massive rotator cuff tears and to find clinical and radiologic factors influencing this. Fifty four patients who had arthroscopic rotator cuff repair with available postoperative magnetic resonance images done within postoperative one week were included. Retrospective review of the medical data and radiologic images was done. It was revealed that acromiohumeral distance of immediate postoperative period was smaller in patients with larger sized rotator cuff tears, more retraction of the torn end and narrower preoperative acromiohumeral distance. The degree of inferior migration of the humeral head which could be obtained through the surgery alone was more in patients who have more difference between acromiohumeral distance measured on preoperative standing simple radiography and acromiohumeral distance measured on preoperative magnetic resonance image.
Acromion ; Humans ; Humeral Head ; Humerus ; Postoperative Period* ; Radiography ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Tears*