BACKGROUND: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. METHODS: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. RESULTS: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. CONCLUSIONS: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.
Arthrography* ; Dislocations ; Follow-Up Studies ; Humans ; Incidence ; Joint Instability ; Recurrence ; Retrospective Studies ; Shoulder*

Data collection is a major problem in large scale clinical studies, especially muticenter and international trials. Data collection by mailing is too slow and expensive. Furthermore, difficulty in understanding handwritten notes from many investigators could result in potential errors in data entry. We developed web-based data collection system for patterns of care study of radiation oncology to collect data nation-widely and efficiently. We introduced drop-down box, check box, and radio button in data entry form for rapid, convenient and correct data entry. Our system also checks blank item, logical errors and other validity of data in real time. For security, we committed the server to the care of Korea Internet Data Center, implemented secure socket layer for communication between web server and clients, and established two remote backup systems. Participating investigators are satisfied with this system and we are collecting data efficiently. We think that web-based data collection system should be considered in any large scale clinical studies.
Data Collection* ; Humans ; Internet ; Korea ; Logic ; Postal Service ; Radiation Oncology* ; Research Personnel

The “delta phalanx”, first named by BlundeII Jones in 1964, is a triangular(“delta-shaped”) or trapezoidal phalanx with C-shaped epiphyseal plate causing progressive angular deformity of the digit with growth. Neither splinting nor physical therapy is effective in improving the condition. Surgical correction is indicated and several methods of correction have been reported. Authors have experienced a rare case of “delta phalanx” occuring in the proximal phalanx of the syndactylous digit.
Congenital Abnormalities ; Growth Plate ; Splints ; Syndactyly

Fourty one cases of open fractures of tibial shaft complicated with varying degrees of soft tissue injuries were trested by one-plane unilateral external fixation with AO fixator. In seventeen csses among them, interfragmental lag screw fixation was applied in addition, for more rigidity and stability of the fixation. All of thern were followed up at least for one year and we obtained the following results. 1. Rigid stable external fixation provided by additional minimum internal fixation may not increase the rate of infection but rather enhance prompt primary bone healing. 2. One-plane unilatersl external fixation may facilitate good access to the wound for subsepuent reconstructive procedures, and enhance pain-free early full range of joint motion, thus promote early bone union. 3. Comparing with bilsteral fixation, there wss almost no difference in the union time of the fracture even with one-plsne unilatersl fixation.
Clinical Study ; External Fixators ; Fractures, Open ; Joints ; Soft Tissue Injuries ; Tibia ; Wounds and Injuries

This study was designed to suggest community-based adolescent drug abuse program model to prevent, treat and rehabilitate the adolescent drug abusers, which works by cooperation between community hospitals and schools, by proving the effectiveness of community-based adolescent drug abuse problem for adolescent smoking students since smoking is one of the most common adolescent abuse problems in the community. To gain the basic data for proving the effect of community drug abuse program for adolescent smoking students, one male high school was selected as the studying school located in Seong Nam city. Among this high school students 146 students were selected randomly to investigate drug abuse status of this school. The experimental group was 33 students who participate in community-based drug abuse problem and the control group was 24 students who were selected randomly among the 60 smoking students who participated in investigating the drug abuse status in the studying school. The both experimental group and control group were reinvestigated of the drug abuse status eight months after completion of community-based drug abuse program, and change during this period was analysed with x2-test and t-test. The results and conclusions were as follows. 1) The smoking onset time was ranged mostly from senior in middle school to freshmen in high school and the most student smoked already habitually when they were freshmen in high school. 80% of smoking students had tried to quit smoking more th% one time and 20% had tried to quit smoking more than six times and failed. This data suggest that the smoking prevention program must be started as soon as possible far effectiveness of adolescent drug abuse program just before many students start smoking and the smoking cessation program for smoking students is needed desperately. 2) The the community-based drug abuse program for smoking students was effective. The smoking students who participate hi drug abuse program(experimental group) showed 19.2% decline of recent one month smoking rates eight months after completion of the program, but the smoking students who did not participate in drug abuse program(control group) showed 22.6% incline of recent one month smoking rates. In the experimental group, the Fagerstrom's nicotine dependance score and recent one month drinking rates showed no difference between initial and 8 month follow-up investigatement, but in the control group, the Fagerstrom's nicotine dependence scores were increased significantly from 1.80 to 3.43 and recent one month drinking rates showed 18.1% incline after 8 month 1311ow-up periods. 3) The smoking students who participate in drug abuse program has less school problems and increased family functioning and decreasing tendency of friends problems but less know ledge about cigarettes and more permissive in attitude to smoking after eight months follow-up period. These results suggest that students who participated in community-based drug abuse program experienced reduction of stress, which results in decline of smoking rates. Therefore, I think that the drug abuse program which deals with the psychological and emotional problems of adolescents is needed as much as direct education about the harmful effect of cigarettes in adolescent drug abuse program for smoking students.
Adolescent* ; Drinking ; Drug Users ; Education ; Follow-Up Studies ; Friends ; Gyeonggi-do ; Hospitals, Community ; Humans ; Male ; Nicotine ; Smoke* ; Smoking Cessation ; Smoking* ; Substance-Related Disorders* ; Tobacco Products ; Tobacco Use Disorder

The purpose of this study is to compare the difference of the tendency for depression and leisure functioning between two elderly groups in differnt socio-cultural environment. Also, this study investigated whether the difference of lesiure functioning affected the tendency for depression. The participants are 55 elderly residing in the nursing home in Seoul and 35 Sahalin returning Koreans in KangWon-Do. Leisure Diagnostic Battery (LDB) developed by Witt and Eliss (1987) was used to measure leisure functioning of the elderly and Yesavage (1983)'s Geriatric Depression Scale (GDS measured the tendency of depression. The LDB and GDS were gathered through interviewing. The result of this study reports that the tendency of depreesion in Sahalin returning Koreans was higher than the elderly in Seoul. And the result supports the hypothesis that the elderly in Seoul who have maintained higher leisure functioning showed lower depression level than the Sahalin elderly who had poor leisure functioning. In other words, there were significance between these two groups. This study suggests that education and the leisure program shoud developed and applied for the higher leisure functioning and satisfaction of the elderly (especially elderly in nursing home).
Aged* ; Depression* ; Education ; Gangwon-do ; Humans ; Leisure Activities* ; Nursing ; Nursing Homes ; Seoul

PURPOSE: To evaluate the effect on surface dose due to Aquaplast used for immobilizing the patients with head and neck cancers in photon beam radiotherapy. MATERIALS AND METHODS: To assess surface and buildup region dose for 6MV X-ray from linear accelerator(Siemens Mevatron 6740), we measured percent ionization value with the Markus chamber model 30-329 manufactured by PTW Frieburg and Capintec electrometer, model WK92. For measurement of surface ionization value, the chamber was embedded in 25 X 25 X 3 cm3 acrylic phantom and set on 25 X 25 X 5 cm3, polystyrene phantom to allow adequate scattering. The measurements of percent depth ionization were made by placing the polystyrene layers of appropriate thickness over the chamber. The measurements were taken at 10 cm SSD for 5 X 5 cm2 , 10 X 10 cm2 , and 15 X 15 cm2 field sizes, respectively. Placing the layer of Aquaplast over the chamber, the same procedures were repeated. We evaluated two types o Aquaplast: 1.6mm layer of original Aquaplast(manufactured by WFR Aquaplast Corp.) and transformed Aquaplast similar to moulded one for immobilizing the patients practically. We also measured surface ionization values with blocking tray in presence or absence of transformed Aquaplast. In calculating percent depth dose, we used the formula suggested by Gerbi and khan to correct overresponse of the Markus chamber. RESULTS: he surface doses for open fields of 5 X 5 cm2 , 10 X 10 cm2 , 15 X 15 cm2 were 7.9%, 13.6%, and 18.7% respectively. He original Aquaplast increased the surface doses upto 38.4%, 43.6% and 47.4% respectively. There were little differences in percent depth dose values beyond the depth of Dmax. Increasing field size, the blocking tray caused increase of the surface dose by 0.2%, 1.7%, 3.0% without Aquaplast, 0.2%, 1.9%, 3.7% with transformed Aquaplast, respectively. CONCLUSION: The original and transformed Aquaplast increased the surface dose moderately. The percent depth doses beyond Dmax, however, were not affected by Aquaplast. In conclusion, although the use of Aquaplast in practice may cause some increase of skin an dbuildup region dose, reduction of skin-sparing effect will not be so significant clinically.
Carboxymethylcellulose Sodium* ; Head ; Humans ; Neck ; Polystyrenes ; Radiotherapy ; Silver Sulfadiazine ; Skin

Congenital lobar emphysema has the clinical features of an air block' syndrome with- out the evidence of pulmonary infection or intrabronchial foreign body. The hyperinflated lung causes a compression of uninvolved lobes creating respiratory distress, cyanosis within the first weeks of life. We experienced a case of congenital lobar emphysema diagnosed incidentally by chest reontgenogram in an infant with frequent upper respiratory infection within a few weeks of life. Chest X-ray revealed extensive emphysematous changes in the left upper lobe, shifting of heart and medistinum to the right and compression of the right lung. Respiratory distress, cyanosis and chest wall retraction ensued and left upper lobe Lobectomy was performed successfully.
Cyanosis ; Emphysema* ; Foreign Bodies ; Heart ; Humans ; Infant ; Lung ; Thoracic Wall ; Thorax

STUDY DESIGN: Clinical and radiographic results of spine fracutre treated with pedicle screws and hooks were reviewed. OBJECTIVES: Evaluate the efficacy of tile pedicle screw and hook for thoracolumar bursting fracture. SUMMARY OF LITERATURE REVIEW: Despite of the mechanical advantage of the pedicle screw, the metal failure in short segment fusion has been reported. A biomechanical study showed additional laminar hook increased rotational strength. MATERIALS AND METHODS: Between 1994 and 1996, seventeen patients who had a Denis type B bursting fracture of the thoracolumbar spine were treated by posterior instrumentation with pedicle screws and laminar hooks and auterior interbody fusion after partial corpectomy. They have been followed for an average of 13.4 months. RESULTS: At last follow-up, radiographs showed successful fusion of the injured spinal segment in all patient. The subsidence of grafts which were used In anterior interbody fusion was an average of 0.76mm. There was a loss of 2.6 degrees on average in the correction of the kyphosis. No patients had screw breakage or loosening. CONCLUSIONS: We concluded that posterior fixation with screws and hooks, anterior decompression by partial corpectomy, and strut-grafting in patient who had a Denis type B bursting frafture of the thoracolumbar spine yielded good radiographic and functional results.
Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Spine* ; Transplants

PURPOSE: To setup procedures of quality assurance (QA) for implementing intensity modulated radiation therapy (IMRT) clinically, report QA procedures performed for one patient with prostate cancer. MATERIALS AND METHODS: P3IMRT (ADAC) and linear accelerator (Siemens) with multileaf collimator are used to implement IMRT. At first, the pos itional accuracy, reproducibility of MLC, and leaf transmission factor were evaluated. RTP commissioning was performed again to considers mall field effect. After RTP recommissioning, a test plan of a C-s haped PTV was made using 9 intensity modulated beams, and the calculated isocenter dose was compared with the measured one insolid water phantom. As a patient-specific IMRT QA, one patient with prostate cancer was planned us ing 6 beams of total 74 segmented fields. The same beams were used to recalculate dose in a solid water phantom. Dose of these beams were meas ured with a 0.015cc microionization chamber, a diode detector, films, and a narray detector and compared with calculated one. RESULTS: The pos itioning accuracy of MLC was about 1 mm, and the reproducibility was around 0.5 mm. For leaf transmission factor for 10 MV photon beams, interleaf leakage was measured 1.9% and midleaf leakage 0.9% relative to 10x10 cm2 open filed. Penumbra meas ured with film, diode detector, microionization chamber, and conventional 0.125 cc chambers howed that 80~20% penumbra width meas ured with a 0.125cc chamber was 2 mm larger than that of film, which means a 0.125 ccionization chamber was unacceptable for meas urings mall fields uch like 0.5 cm beamlet. After RTP recommissioning, the discrepancy between the meas ured and calculated dose profile for a small field of 1x1 cm2 size was less than 2%. The isocenter dose of the test plan of C-s haped PTV was meas ured two times with microionization chamber in solid phantom showed that the errors upto 12% for individual beam, but total dose delivered were agreed with the calculated within 2%. The transverse dose distribution meas ured with EC-L film was agreed with the calculated one ingeneral. The isocenter dose for the patient meas ured in solid phantom was agreed within 1.5%. Off-axis dose profiles of each individual beam at the position of the central leaf measured with film and array detector were found that at out-of-the-field region, the calculated dose underestimates about 2%, at inside-the-field the meas ured one was agreed within 3%, except some position. CONCLUSION: It is necessary more tight quality control of MLC for IMRT relative to conventional large field treatment and to develop QA procedures to check intensity pattern more efficiently. At the conclusion, we did setup an appropriate QA procedures for IMRT by a series of verifications including the measurement of absolute dose at the isocenter with a microionization chamber, film dosimetry for verifying intensity pattern, and another meas urement with an array detector for comparing off-axis dose profile.
Film Dosimetry ; Humans ; Particle Accelerators ; Prostatic Neoplasms ; Quality Control ; Water