No abstract available.

BACKGROUND: The purpose of this study was to evaluate the angle between the long head of the biceps tendon (LHBT) and the glenoid during arthroscopic surgery and its correlation with biceps subluxation on magnetic resonance imaging (MRI). Furthermore, we evaluated the relationship of this angle with subscapularis tears and biceps pathologies. METHODS: MRI and arthroscopic images of 270 consecutive patients who had undergone arthroscopic surgery were retrospectively evaluated. On MRI, 60 shoulders with biceps subluxation and 210 shoulders without subluxation were identified. On the arthroscopic view from the posterior portal, the angle between the LHBT and the glenoid (biceps-glenoid angle) was measured. The biceps-glenoid angle, tears of the LHBT, degenerative superior labrum anterior to posterior (SLAP) lesions, and presence of a subscapularis tear were compared according to the presence of biceps subluxation on MRI. RESULTS: In the subluxation group, 51 (85%) had a subscapularis tendon tear and all shoulders showed biceps tendon pathologies. In the non-subluxation group, 116 (55.2%) had a subscapularis tendon tear, 125 (60%) had tears in the biceps tendon, and 191 (91%) had degenerative SLAP lesions. The incidences of subscapularis tears (p < 0.001) and biceps pathologies (p < 0.001) showed significant differences. The mean biceps-glenoid angle was 87.0° (standard deviation [SD], 11.4°) in the subluxation group and 90.0° (SD, 9.6°) in the non-subluxation group, showing a statistically significant difference (p = 0.037). CONCLUSIONS: Shoulders with subluxation of the biceps tendon on the preoperative MRI revealed more pathologies in the subscapularis tendon and biceps tendon during arthroscopy. However, the arthroscopically measured biceps-glenoid angle did not have clinical relevance to the determination of subluxation of the LHBT from the bicipital groove.
Arthroscopy ; Head* ; Humans ; Incidence ; Magnetic Resonance Imaging ; Pathology ; Retrospective Studies ; Shoulder ; Tears* ; Tendons*

Homogenization technique is employed to investigate the series of stress analyses of mandible for three different types of dental implants. This technique helps to make proper material model of bone and analyze such a non homogeneous structure at the level of individual microstructural unit. The stress analyses with homogenization technique show much higher stress level in the sponge bone, compared to those of conventional FEM. It also manifested that even a minor lateral force results in crucial stresses in the dental implant system and that the macroscale model should take the shape and size after real mandible to produce reasonable solution in the analyses of dental implant systems. The shapes of dental implants simulated in this study are rectangularcross-sectioned type, hemi-sphere rooted type, and wedge type implant. The stress states of mandible with hemisphere rooted type implant and wedge type implant show similar levels, while those with sectioned rectangular implant results in higher stresses. It is suggested that the distance between the implant tip and cortical bone be kept far enough to prevent stress concentrations in the mandible.
Dental Implants ; Mandible ; Porifera

Complications of mandibular angle contouring may include damage to the inferior alveolar nerve. This study was undertaken to quantify the path of the inferior alveolar nerve in the normal human mandible and in the mandibles of patients presenting for cosmetic reduction of the mandibular angles. The study was based upon the panorama radiography of 20 normal population (ten men, ten women) and 20 patients (ten men, ten women) complaining of square face. Using panorama radiographs and paper tracing, the distance from the "A" point (Fig. 1) to the inferior alveolar nerve was recorded within its mandibular osseous canal in the mandibular angle. The nerve was identifiable in each ramus. The average distance between A point and the other points along the osseous canal is 21.48mm. Therefore together with an additional margin of several millimeters, it is important to maintain a safe distance of at least an inch (25mm) between the saw and the anterior border of the ramus. From our clinical experiences, we are suggesting that this "1 inch maneuver" to be very helpful in avoiding injury to the inferior alveolar nerve, especially for the novice surgeon.
Humans ; Male ; Mandible ; Mandibular Nerve* ; Radiography ; Radiography, Panoramic

Lamotrgine is an antiepileptic drug that is effective for multiple types of seizure and has side-effects such as headache, nausea, dizziness, diplopia, ataxia, cutaneous lesions, and anticonvulsant hypersensitivity syndrome. Anticonvulsant hypersensitivity syndrome consists of the hallmark features of fever, rash, lymphadenopathy and internal organ involvement, induced by aromatic anticonvulsants, for example phenytoin, phenobarbital, carbamazepine, and lamotrigine. We report a case of 13-year-old girl who had a fever, generalized erythematous skin eruption, facial edema, eosinophilia, and elevated liver enzyme induced by lamotrigine and resolved with discontinuation of medication and intravenous steroid and immunoglobulin.
Adolescent ; Anticonvulsants ; Ataxia ; Carbamazepine ; Diplopia ; Dizziness ; Edema ; Eosinophilia ; Exanthema ; Female ; Fever ; Headache ; Humans ; Hypersensitivity* ; Immunoglobulins* ; Liver ; Lymphatic Diseases ; Nausea ; Phenobarbital ; Phenytoin ; Seizures ; Skin

To find out the predictors of nocturnal arterial oxygen desaturation in patients with respiratory diseases, transcutaneous oxygen saturation(StcO2) monitoring studies using a pulse oximeter were performed during sleep in 20 patients. StcO2 was decreased more than 4% from the baseline value in 18 patients(90%) and more than 10%('Desaturator') in 8(40%). Five of the seven patients(71.4%) with awake PaO2<60mmHg and three of the thirteen patients(23.1%) with awake PaO2≥60mmHg were 'desaturators'. The awake PaO2/FIO2 and PaO2/PAO2 could distinguish 'desaturator' from 'nondesaturator, and PaO2, SaO2 or StcO2 could not. These results suggest that the nocturnal oxygen desaturation depends on the severity of the underlying disease rather than the baseline PaO2. Anthropomorphic and lung function factors could not separate between 'desaturator' and 'non-desaturator', and about a quarter of patients with a wake PaO2≥60mmHg developed significant desaturation. Therefore, it is necessary to monitor the nocturnal arterial oxygen saturation in patients with respiratory diseases regardless of their severity of airflow obstruction or awake PaO2.
Humans ; Lung ; Oxygen*

High altitude exposure may produce multiple symptoms of mountain sickness. A 27-year-old man presented with metamorphopsia in his left eye which occurred following climbing the Himalaya Mountains. His best corrected visual acuity was right eye, 0.9 and left eye, 0.3. Ophthalmoscopy disclosed retinal hemorrhages in both eyes and a subfoveal hemorrhage in left eye. Fluorescein angiography showed blockage of fluorescence caused by retinal hemorrhages. Indocyanin green angiography showed no hot spot. One month later, best corrected visual acuity of his left eye was 0.4 and the degree of metamorphopsia decreased. Thus we report the case of mountain sickness who showed retinal hemorrhage and subfoveal hemorrhage with a review of available literatures.
Adult ; Altitude ; Altitude Sickness ; Angiography ; Fluorescein Angiography ; Fluorescence ; Hemorrhage ; Humans ; Ophthalmoscopy ; Retinal Hemorrhage* ; Retinaldehyde* ; Vision Disorders ; Visual Acuity

PURPOSE: The tension-free vaginal tape SECUR(R) (TVT-S) is a new, minimally invasive sling procedure for treating female stress urinary incontinence (SUI). However, results of comparisons of the TVT-S with the transobturator tape (TOT) sling are lacking. Therefore, we investigated outcome and satisfaction of the TVT-S procedure compared with the TOT procedure. MATERIALS AND METHODS: We included 64 patients with SUI who underwent the TVT-S (n=31) or TOT (MONARC(R), n=33) procedure and were followed up for more than 1 year. The preoperative evaluation included history taking, pelvic examination, consecutive 3-day voiding diary, and urodynamic study including Valsalva leak point pressure. Postoperatively, continence status and subjective patient satisfaction were evaluated. Cure was defined as the absence of any episodes of involuntary urine leakage during stressful activities and a stress cough test. RESULTS: The TVT-S group (71.0%) showed a slightly lower cure rate than did the MONARC group (84.8%); however, there was no significant difference between the 2 groups (p=0.179). Nine of the patients who underwent the TVT-S showed incontinence postoperatively. Among them, the H approach was used in 7 patients and the U approach was done in 2 patients. Following TVT-S and MONARC, the patients' reported satisfaction was 80.6% and 78.8%, respectively. Patient satisfaction did not differ significantly between the two groups (p=0.854). CONCLUSIONS: Our results showed that the TVT-S and MONARC procedures may be comparable in terms of cure rate and patient satisfaction after more than 1 year of follow-up.
Cough ; Female ; Follow-Up Studies ; Gynecological Examination ; Humans ; Patient Satisfaction ; Suburethral Slings ; Surgical Procedures, Minimally Invasive ; Treatment Outcome ; Urinary Incontinence ; Urinary Incontinence, Stress ; Urodynamics

Pneumocystis carinii pneumonia(PCP) remains the leading cause of death in patients with AIDS. Although the most common radiographic presentation of PCP is the developme-nt of diffuse, bilateral interstitial or alveolar infiltrates in 48 to 86 per cent of AIDS patients, PCP may also present with either a completely normal or only minimally abnormal chest radiograph in 6 to 23 per cent of patients. We experienced two patients with AIDS presenting high fever and chest pain but normal chest radiograph, who had been proved to have PCP by bronchoalveolar lavage and trans-bronchial lung biopsy.
Biopsy ; Bronchoalveolar Lavage ; Bronchoscopy ; Cause of Death ; Chest Pain ; Fever ; Humans ; Lung ; Pneumocystis carinii ; Pneumonia* ; Radiography, Thoracic ; Thorax*

Cryptococcosis is a systemic mycosis that most often involves the lungs and central nervous system and, less frequently, the skin, skeletal system, and prostate gland. Cryptococcus neoformans, the causative organism, is a yeastlike round or oval fungus, 4 to 6microm in diameter, which is surrounded by a polysaccharide capsule and reproduces by budding and found in soil and other enviromental areas, especially those contaminated by pigeon droppings. Humans and aninmals acquire infection after inhalation of aerosolized spores. Condition or factors that predispose to cryptococcosis include corticosteroid therapy, lymphoreticular malignancies, HIV infection, and sarcoidosis etc. We discribed a case of cryptococcosis involving lung and CNS coincidently without specific underlying disease and the literature on subject were reviewed. A fifty-six year-old previously healthy female presented with headache of 3 months of duration. She had no history suggesting immunologic suppression and we could not find any abnormal laboratory findings including blood sugar, serum immunoglobulin and complement level, HIV antibody, and T cell subsets. Chest roentgenogram and CT scan showed a solitary soft tissue mass in LUL with distal pneumonitis. Brain MRI showed granulomatous lesion in cerebellum and parasagittal cortex of right frontal lobe. The diagnosis was made by bronchoscopic brushing cytology, transthoracic fine needle aspiration, and sputum OH mount and culture. She was treated 6 weeks course of Amphotericin B and switched to oral fluconazole therapy for 3 months. Her symptoms and X-ray findings were improved gradually and she is now under regular clinical follow up.
Amphotericin B ; Biopsy, Fine-Needle ; Blood Glucose ; Brain ; Central Nervous System ; Cerebellum ; Columbidae ; Complement System Proteins ; Cryptococcosis* ; Cryptococcus neoformans ; Diagnosis ; Female ; Fluconazole ; Follow-Up Studies ; Frontal Lobe ; Fungi ; Headache ; HIV ; HIV Infections ; Humans ; Immunoglobulins ; Inhalation ; Lung* ; Magnetic Resonance Imaging ; Pneumonia ; Prostate ; Sarcoidosis ; Skin ; Soil ; Spores ; Sputum ; T-Lymphocyte Subsets ; Thorax ; Tomography, X-Ray Computed