PURPOSE:To describe the features of displaced bucket-handle tears of the menisci on magnetic resonance (MR) images and to assess associated knee injuries. MATERIALS AND METHODS: We retrospectively reviewed coronal and sagittal MR images in 21 bucket-handle tears. The subjects were patients who had underwent preoperative MR evaluations of the knee and were identified from the arthroscopic surgical records as bucket-handle tear. We also described patterns of associated injuries. RESULTS:On coronal MR images, (a) in all cases, peripheral portion of the meniscus(bucket) had the appearance of a truncated or altered wedge;(b) central fragments(handle) were observed to be sitting in the intercondylar notch(16 cases) or located between the fernoral condyle and tibial plateau (5 cases). On sequential sagittal MR images, (c) the bow-tie appearance of the body of the meniscus was not seen (13 cases);(d) the bow-tie appearance of the displaced inner fragment was seen at the intercondylar notch level (9 cases);(e) "double posterior cruciate ligament" sign was presented (7 cases). Associated joint abnormalities included anterior cruciate ligament tears(l 1), contralateral meniscal tears(l 1), posterior cruciate ligament tears(3), medial collateral ligament tears(3), osteoarthritis(1), and Baker's cyst(l). CONCLUSION:Awareness of these characteristic MR findings(a-e) may increase the sensitivity of MR imaging in the diagnosis of displaced bucket-handle tears, and the MRI may be helpful to correctly characterize the displaced fragment and patterns of associated injury, providing arthroscopists a guide to appropriate surgical plans.
Anterior Cruciate Ligament ; Collateral Ligaments ; Diagnosis ; Humans ; Joints ; Knee ; Knee Injuries ; Magnetic Resonance Imaging* ; Posterior Cruciate Ligament ; Retrospective Studies

OBJECTIVE: 6-Gingerol, one component of ginger (Zingiber officinale) compound, has been known to possess anti-inflammatory, analgesic, anti-emetic, and anti-cancer effects. In this study, the apoptotic ability of 6-gingerol was investigated in human prostate cancer cells. METHODS: 3-(4,5-Dimethylthiazol-2-yl)- 2,5-diphenyl-tetrazolium bromide (MTT) assay, flow cytometry, and western blot analysis were done in LNCaP human prostate cancer cell lines treated with the various doses of 6-gingerol for the different durations of drug exposure. RESULTS: 6-Gingerol in doses ranging from 100 to 300 microM induced dose- and time-dependent inhibition of cell viability in prostate cancer cells by using MTT assay. Maximal inhibition of cell viability was observed at 300 microM of 6-gingerol for 48 hours treatment in LNCaP cells. 6-Gingerol at the dose of 100 microM did not produce any significant change in apoptotic cells in flow cytometry analysis. However, significant increase in sub-G0/G1 phase was observed in cells treated with 200 and 300 microM of 6-gingerol. Any significant cell cycle arrest was not induced by 6-gingerol. In western blotting analysis, expression of caspase-3 was not evident in cells treated with 6-gingerol for 24 hours. However, 48 hours treatment with 6-gingerol altered the expression of caspase-3 in LNCaP cells. Expression of cleaved poly showed the dose-dependent fashion in both 24 hours and 48 hours treatment of 6-gingerol. CONCLUSION: These observations suggest that 6-gingerol may induce apoptosis in LNCaP human prostate cancer cells.
Apoptosis ; Blotting, Western ; Caspase 3 ; Catechols ; Cell Cycle Checkpoints ; Cell Line ; Cell Survival ; Fatty Alcohols ; Flow Cytometry ; Ginger ; Humans ; Poly(ADP-ribose) Polymerases ; Prostate ; Prostatic Neoplasms

Atropine is the classic antimuscarinic anticholinergic drug that bas been used to block cholinergic neurotransmission in basic research and received recent interest clinically in the intracavernous pharmacotherapy of erectile dysfunction. It has been suggested that at low dose(0.00000001M), atropine blocks muscarinic receptors, thereby reducing both cholinergic of the adrenergic and cholinergic excitation of the NANC neuroeffector systems, on the other hand, at large pharmacological dose(0.001M),induces the release of EDRF which recently has been identified as nitric oxide(NO) or NO like substance. Therefore, we tried to confirm the action of atropine in the cavernosal tissue and define its mechanism. Strip of rabbit corpus cavernosum were isolated and mounted in 10 ml organ chambers to measure isometric tension. Muscle strips submaximally precontracted with phenylephrine(5x0.000001M) and treated with increasing concentrations of atropine(0.00000000001M to 0.00lM) showed tension increase upto 0.00000001M of atropine, and thereafter, relaxed concentration dependently(0.0000001M: 43.7%, 0. 000001M: 63.0%,0.00001M:86.2%,0.0001M:93.6%,0.001M:100%). Relaxations to atropine(5x0.000001M) were not inhibited even partially by endothelial disruption or by pretreatment with methylene blue or pyrogallol. Pretreatment of muscle strips with atropine(5x0.00000lM) caused concentration- related inhibition of a phenylephrine induced contraction, and in calcium-free high potassium depolarizing solution, decreased basal tension as well as inhibited contraction induced by CaC12. However, atropine did not produce reduction of responses to depolarizing medium(20, 40, 80mM KCl). With these results we can confirm the relaxation effect of atropine at a larger dose(>0.0000001M)on the cavernosal smooth muscle and suggest that its action is mediated by increasing intracellular calcium sequestration,not by hyperpolarization or EDRF.
Atropine* ; Calcium ; Drug Therapy ; Erectile Dysfunction ; Hand ; Male ; Methylene Blue ; Muscle, Smooth ; Phenylephrine ; Potassium ; Pyrogallol ; Receptors, Muscarinic ; Relaxation* ; Synaptic Transmission

Cytomegalovirus (CMV) pneumonia is an important cause of treatment related mortality after allogeneic stem cell transplantation (SCT) and autologous SCT, particularly in a CD34 selected setting. There is little known about the immune reconstitution pertaining to the CMV after CD34 selected SCT. However, several studies have suggested there is more profound immunodeficiency early in the CD34 selected population compared with the unselected population. We encountered two fatal cases of CMV pneumonia at the CD34 selected SCT for T-cell lymphoblastic lymphoma and high-risk breast cancer that was confirmed through a lung biopsy and bronchoalveolar lavage. In conclusion, autologous CD34 selected CMV seropositive recipients need to be monitored in a similar manner to allogeneic recipients.
Biopsy ; Breast Neoplasms ; Bronchoalveolar Lavage ; Cytomegalovirus* ; Lung ; Mortality ; Pneumonia* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Stem Cell Transplantation* ; Stem Cells* ; T-Lymphocytes

PURPOSE: Although muscle hernia has been well described in the lower-extremity, muscle hernias in the upper extremity are extremely rare. As with lower extremity muscle hernias, the forearm muscle hernia may result from forced exertion of strenuous activity or following blunt trauma. The objective of this paper is to report an extraordinary case of forearm muscle hernia after radial forearm sensory tendocutaneous free flap with references. METHODS: A 58-year-old male patient received wide excision and radical neck dissection and lower lip reconstruction with radial forearm sensory tendocutaneous free flap for squamous cell cancer on the lower lip. 16 weeks after the operation, he complained of protruding mass on the forearm and the size was increasing. In postoperative 18 weeks, MRI showed herniation of flexor digitorum superficialis. For unaesthetic cause and preventing progress, the authors performed direct fascial closure and Mesh graft. RESULTS: In 12 months after the surgery there was no recurrence and the patient remained symptom-free. CONCLUSION: Pain on extremity exertion and unaesthetic buldge of forearm due to forearm muscle hernia were the primary indications for surgery which consist of direct closure, fasciotomy, fascia lata onlay graft, fascia lata inlay graft, etc. The authors experienced uncommon forearm muscle hernia after radial forearm free flap and satisfying result of treatment.
Extremities ; Fascia Lata ; Forearm ; Free Tissue Flaps ; Hernia ; Humans ; Inlays ; Lip ; Lower Extremity ; Male ; Middle Aged ; Muscles ; Neck Dissection ; Neoplasms, Squamous Cell ; Recurrence ; Transplants ; Upper Extremity

No abstract available.
Breast Neoplasms* ; Breast*

PURPOSE: Finger injury by green onion cutting machine is one of the common hand injuries in the kitchen. It has a unique feature: there are multiple parellel laceration 3 -5mm wide. There are two directions of injuries(vertical, oblique). It may involve bone, tendon, nerve, and vessel injuries. We discuss its management and the long -term progress. METHODS: We have treated six patients from 2003 to 2007. We carried out low tension approximation with thin suture materials to avoid ischemia and performed the additional operation as nail bed repair, tenorrhaphy, open reduction, vessel anastomosis, and composite graft. We reviewed the record of initial injury and collected the follow-up record. RESULTS: They were all middle aged - women who had worked in the kitchen. Right hand was dominent over left hand. The ratio of the directions was 3:3 (vertical:oblique). They were all competely healed although there were three atrophy, four hyperesthesia, and one nail deformity. CONCLUSION: Finger injury by green onion cutting machine is a unique pattern of laceration with various accompanied injuries. It may look like a severe form of injury, but in most cases have relatively favorable progress. We have to perform careful examination of accompanied injuries and carry out the proper management. First and foremost, the user especially in the middle aged women should be warned to be careful in handling this risky machine.
Atrophy ; Female ; Finger Injuries ; Fingers ; Follow-Up Studies ; Glycosaminoglycans ; Hand ; Hand Injuries ; Handling (Psychology) ; Humans ; Hyperesthesia ; Ischemia ; Lacerations ; Middle Aged ; Nails ; Onions ; Sutures ; Tendons ; Transplants

PURPOSE: There is yet no ideal single staging system for hepatocellular carcinoma (HCC). The aim of this study was to analyze HCC survival times according to the TNM, Okuda, CLIP, JIS, and BCLC staging systems and their prognostic discrimination ability. METHODS: A retrospective analysis of medical records and statistical data from the Korean statistical information service was done for HCC patients diagnosed at Bundang CHA hospital between June, 1992 and February, 2009. RESULTS: During follow-up, 121 (72%) of 168 people died and 1, 3 and 5 year overall survival rates were, respectively, 58%, 35% and 25%. In the analysis of discriminative ability of each staging system, the CLIP staging system showed the highest LR chi-square value, and the lowest AIC value (p<0.05). Therefore, the CLIP staging system appears to be superior to the other systems. CONCLUSION: Of the 5 staging systems in this study, the CLIP staging system was superior to the other systems, but the results of many other studies from different countries have varied. It is necessary to establish the staging system suitable for each country's actual circumstances.
Carcinoma, Hepatocellular ; Discrimination (Psychology) ; Follow-Up Studies ; Humans ; Information Services ; Medical Records ; Prognosis ; Retrospective Studies ; Survival Analysis ; Survival Rate

Breast reconstruction with free TRAM flap is a common procedure. However patients with abdominal scars can be confronted with a challenging problem in performing flap reconstruction. The inadequate blood supply around the scar can result in various skin complications in flap or donor site, but there are no reported guidelines in our country. From May 1999 to March 2003, a total of 38 breast reconstructions using free TRAM flaps were performed for 37 patients, of whom 12 had abdominal scars from previous operations; 7 had midline vertical scars and 4 had low transverse scars from Cesarean section or total hysterectomy, 3 had right lower quadrant oblique scars from appendectomy (2 also had transverse scars from Cesarean section). We attempted to minimize flap and donor site complications by modifying classic free TRAM flap designs and procedures according to the characteristics of the abdominal scars and performed periodic follow-up observations of flaps and donor sites for presence of complications and also gave surveys for patient satisfaction on the reconstructed breast. All 38 patients underwent successful breast reconstructions with neither skin complications around the scar nor flap loss and 96.4% patients reported being very satisfied or satisfied with the results.
Appendectomy ; Breast* ; Cesarean Section ; Cicatrix* ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Mammaplasty* ; Patient Satisfaction ; Pregnancy ; Skin ; Tissue Donors

PURPOSE: Premature ejaculation is the most common problem in patients with ejaculatory dysfunction and frequently occurs with erectile dysfunction. Although sildenafil (Viagra(R)) has dramatically improved the treatment of patients with erectile dysfunction, many still complain of premature ejaculation. We investigated the combined clinical efficacy of sildenafil and SS-cream in patients with erectile dysfunction and premature ejaculation. MATERIALS AND METHODS: Of men aged over 20 years who visited our Andrology clinic with erectile dysfunction, a total of 52 patients with concomitant premature ejaculation were enrolled. Each patient was administered with sildenafil for 4 weeks and then sildenafil plus SS-cream for 4 weeks. Sexual function was measured before and after therapy using an abbreviated version of the International Index of Erectile Function-5 (IIEF-5), which includes 5 categories regarding sexual function. RESULTS: Mean score of IIEF-5 was 10.2+/-4.1 at baseline, 18.8+/-5.2 after treatment with sildenafil and 22.2+/-4.2 after treatment with sildenafil and SS-cream, respectively. Mean score of four domains of sexual function, that is, overall satisfaction, orgasmic function, erectile function, intercourse satisfaction was 1.8+/-0.4, 2.1+/-0.5, 3.8+/-0.9, 1.8+/-0.4 at baseline, 4.0+/-0.6, 3.6+/-0.6, 8.0+/-1.2, 3.4+/-0.6 after treatment with sildenafil, and 4.4+/-0.8, 4.2+/-0.6, 9.2+/-1.4, 4.4+/-0.8 after treatment with sildenafil and SS-cream, respectively. Patient satisfaction was significantly higher after sildenafil and SS-cream administration (90.4%) compared to sildenafil alone 80.8%. CONCLUSIONS: The combination of sildenafil and SS-cream is more effective in patients with erectile dysfunction and premature ejaculation compared to sildenafil alone.
Andrology ; Erectile Dysfunction* ; Humans ; Male ; Orgasm ; Patient Satisfaction ; Premature Ejaculation*