Purpose: The purpose of this study was to compare the spatiotemporal and kinematic gait parameters and muscle activity of the lower extremities between forward walking on sand (FWS) and backward walking on sand (BWS) in normal adults. Methods: This study was conducted on 13 healthy adults. Subjects performed FWS and BWS and the spatiotemporal and kinematic gait parameters of stride time, stride length, velocity, cadence, step length, stance, swing, double support, and hip range of motion (ROM), knee ROM were measured by a wearable inertial measurement unit system. In addition, the muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius (GA) was measured. Results: The stride length, stride velocity, cadence, and step length in the BWS were significantly lower than FWS (p < 0.05), and stride time was significantly greater (p < 0.05). However, there was no significant difference in the ratio of stance, swing, and double support between the two (p > 0.05). The kinematic gait parameters, including hip and knee joint range of motion in BWS, were significantly lower than FWS (p < 0.05). The muscle activity of the RF in BWS was significantly higher than FWS (p < 0.05), but the muscle activity of the BF, TA, GA did not show any significant differences between the two movements (p > 0.05). Conclusion A strategy to increase stability by changing the gait parameters is used in BWS, and this study confirmed that BWS was a safe and effective movement to increase RF muscle activity without straining the joints. Therefore, BWS can be recommended for effective activation of the RF.

A case of rare subcutaneous sparganosis in thigh treated by surgical excision is reported. In this 49year-old male with a palpable mass on the anteromedial aspect of mid-thigh (5x7x5cm sized) which was misdiagnosed with a soft tissue tumor initially, a sparganosis was suspected by a plain x-rays, bone scan and his past history which he frequently had raw snakes, frogs and raw fishes before but confirmed by MRI and surgical excision. This represents tor warning to some Koreans who have frequently comsumed raw fishes, snakes or frogs etc., and to some doctors because it is easily confused with a soft tissue tumor.
Fishes ; Humans ; Magnetic Resonance Imaging ; Male ; Snakes ; Sparganosis* ; Subcutaneous Tissue* ; Thigh*

It is well known that the murine T helper cell clones are divided by their lymphokine secretory activities. One is the Th-1 cell, producing IL-2 and IFN after stimulation and the other is the Th-2 cell, producing the IL-4 and IL-5. This study was undertaken to evaluate the immunomodulatory properties of the bacterial lipopolysaccharide(LPS) on the lymphokine production in vivo and in vitro. The results were as follows: There were no effects on the lymphokine secretion by the in vitro treatment of the LPS. The in vivo treatment of the LPS decreases the capability of the production of IL-2 and IFN , whereas it increases the capability of IL-4 production. The altered capacity of the lymphokine production was recovered about 2 weeks after the treatment of the LPS. There were no differences on the lymphokine production between E-coli LPS and salmonella LPS. The capacity of the lymphokine production was the same in the treatment of a non-heated LPS or heated-LPS. The lymphokine production of the mice which were desensitized by the long term treatment of the LPS was not different from the control mice. The in vitro treatment of RU486 can block the alterations of the lymphokine production after the treatment of the LPS. In summary, one can tell that the LPS increases the secretion of the IL-4 through the endogenous secretion of the glucocorticoids.
Animals ; Clone Cells ; Glucocorticoids ; Interleukin-2 ; Interleukin-4 ; Interleukin-5 ; Mice ; Mifepristone ; Salmonella ; T-Lymphocytes* ; T-Lymphocytes, Helper-Inducer

Myotonic dystrophy is a multisystemic disorder inherited as an autosomal dominant trait. The characteristic clinical features include the presence of myotonia, atrophy of the muscles of the face and the sternocleidomastoids and numerous nonmusclar manifestations such as cataracts, frontal baldness, gonadal dysfunctions and cardiac abnormalities. We experienced one case of myotonic dystrophy with prolonged atrial flutter in 30-year-old male who was admitted because of palpitation. We present this case with reviewing literatures.
Adult ; Alopecia ; Atrial Flutter* ; Atrophy ; Cataract ; Gonads ; Humans ; Male ; Muscles ; Myotonia ; Myotonic Dystrophy*

Traditionally, open choledochotomy with T-tube choledochostomy had been considered as the "gold standard" for choledocholithiasis. Recently, the frequency of performing the open choledochotomy with T-tube choledohostomy has decreased due to the progression of several less invasive procedures and laparoscopic technques, but until now open choledochotomy with T-tube choledochostomy is the most popular procedure in choledocholithiasis. Therefore we reviewed 126 cases who were treated with open choledochotomy with T-tube choledochostomy from January 1987 to June 1996 at our institution in order to inspect the several problematic points especially after T-tube removal. The results are summarized as follows, 1) The sex ratio of male to female was 1:1.29, and the average age was 59.6 years old. 2) 119 cases (94.4%) were biliary tract stone disease and 7 cases (5.6%) were non-calculous benign biliary tract disease. The most common etiologic disease was GB and CBD stone (37.3%). 3) Most of postoperative T-tube cholangiography was performed within 14 days (84.1%). 4) The number of patients containing some residual stone at postoperative T-tube cholangiography was 29 cases (23%). 14 of these patients were treated by Dormia-basket stone removal and its success rate was 85.7%. 5) The T-tube was removed within 2 months in 109 cases (86.5%). 6) The number of complications after T-tube removal were 8 cases (6.3%). All of them had bile peritonitis symptomes, and three of them were treated by reoperation. 7) The postoperative complications were noted in 27 cases (21.4%). and the most frequent complication is wound infection (25.8%). The postoperative mortality was noted in 1 case (0.8%).
Bile ; Biliary Tract ; Biliary Tract Diseases ; Cholangiography ; Choledocholithiasis ; Choledochostomy* ; Female ; Humans ; Male ; Mortality ; Peritonitis ; Postoperative Complications ; Reoperation ; Sex Ratio ; Wound Infection

No abstract available.
Constriction, Pathologic ; Stents

Gastrointestinal autonomic nerve tumors (GANT) are uncommon neoplasms of the gastrointestinal tract. The GANT is a specialized form of stromal neoplasm with the feature of myenteric plexus derivation. We report a patient with a GANT of the small intestine and liver metastasis. The patient was admitted for evaluation of hematochezia and a palpable abdominal mass. A CT of the abdomen showed an exophytic mass arising from the distal ileum and exhibiting deep ulceration and air-cavity formation, and a huge cystic mass in the right lobe of the liver. The gross appearance of a surgical specimen of the liver showed a huge cystic mass, containing liquified hemorrhagic fluid, with an irregular nodular peripheral portion. Its capsule was intact. An ileal mass, measuring 9x5 cm and arising from the submucosal layer, with deep ulceration was seen. Histological examination of the liver and the ileal mass revealed a malignant stromal tumor with neural differentiation on immunohistochemical staining.
Abdomen ; Autonomic Pathways* ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Humans ; Ileum ; Intestine, Small ; Liver* ; Myenteric Plexus ; Neoplasm Metastasis ; Ulcer

Peliosis hepatis is an uncommon liver condition involving abnormal dilation of hepatic sinusoids, eventually leading to blood-filled cavities within the hepatic parenchyma. Although the pathogenesis is not understood fully, peliosis hepatis has usually been associated with the use of anabolic steroid therapy, oral contraceptives, various malignancies or tuberculosis. We report a case of 59-year-old patient with cholangiocarcinoma with peliosis hepatis. The patient was admitted for evaluation of abdominal pain and fever. Abdomen CT showed a round cytic and solid mass with peripheral duct dilatation in liver. Grossly, the spongy-like solid mass and cyst was noted. Microscopically, the solid mass was composed of tubular and solid adenocarcinoma in fibrotic stroma and a blood-filled cavity with dilated sinusoids was noted.
Abdomen ; Abdominal Pain ; Adenocarcinoma ; Cholangiocarcinoma* ; Contraceptives, Oral ; Dilatation ; Fever ; Humans ; Liver ; Middle Aged ; Peliosis Hepatis* ; Tuberculosis

PURPOSE: To establish the CT findings and clinical characteristics of colorectal mucinous adenocarcinoma. MATERIALS AND METHODS: The CT features of 26 surgically proven cases of colorectal mucinous adenocarcinoma were reviewed. The subjects were selected from among 262 patients with colorectal cancer, of whom 40 with non-mucinous adenocarcinoma were included as a control group. Contrast-enhaneed CT images were analyzed for tumor location, the presence or absence of tumoral calcification, tumor shape (circumferential or eccentric, polypoid or infiltrative), tumor thickness-to-length ratio, and attenuation and homogeneity. In each group, the TNM stage of pathologic specimens was compared. During follow-up, the incidence of recurrence, and outcome, were also compared. RESULTS: CT images of mucinous adenocarcinoma revealed intratumoral calcification in three patients (12%, p < 0.01). Tumors were eccentric and polypoid-shaped, with a high tumoral thickness/length ratio (p < 0.01). On contrast-enhanced images, most were seen as a heterogenous hypoattenvuted mass. No differences in T-NM stage were found in surgical specimens. In patients with mucinous adenocarcinoma, recurrence during the early follow-up period is more common than in patients with non-mucinous cancer. CONCLUSION: Contrast-enhanced CT reveals mucinous adenocarcinoma as an eccentric polypoid mass with heterogeneous hypoattenuation. In patients with mucinous colorectal cancer, careful follow-up is required because tumors tend to recur early in the follow-up period.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Incidence ; Mucins* ; Recurrence ; Tomography, X-Ray Computed

PURPOSE: To establish the CT findings and clinical characteristics of colorectal mucinous adenocarcinoma. MATERIALS AND METHODS: The CT features of 26 surgically proven cases of colorectal mucinous adenocarcinoma were reviewed. The subjects were selected from among 262 patients with colorectal cancer, of whom 40 with non-mucinous adenocarcinoma were included as a control group. Contrast-enhaneed CT images were analyzed for tumor location, the presence or absence of tumoral calcification, tumor shape (circumferential or eccentric, polypoid or infiltrative), tumor thickness-to-length ratio, and attenuation and homogeneity. In each group, the TNM stage of pathologic specimens was compared. During follow-up, the incidence of recurrence, and outcome, were also compared. RESULTS: CT images of mucinous adenocarcinoma revealed intratumoral calcification in three patients (12%, p < 0.01). Tumors were eccentric and polypoid-shaped, with a high tumoral thickness/length ratio (p < 0.01). On contrast-enhanced images, most were seen as a heterogenous hypoattenvuted mass. No differences in T-NM stage were found in surgical specimens. In patients with mucinous adenocarcinoma, recurrence during the early follow-up period is more common than in patients with non-mucinous cancer. CONCLUSION: Contrast-enhanced CT reveals mucinous adenocarcinoma as an eccentric polypoid mass with heterogeneous hypoattenuation. In patients with mucinous colorectal cancer, careful follow-up is required because tumors tend to recur early in the follow-up period.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Incidence ; Mucins* ; Recurrence ; Tomography, X-Ray Computed