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

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

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

PURPOSE: Testicular seminomas are radiosensitive and adjuvant radiation therapy after orchiectomy results in long term survival in early stage diseases. Ten year results of radiation therapy after orchiectomy and results of definitive treatment of recurrent seminoma are presented. MATERIALS AND METHODS: Between August 1980 and February 1990, 32 patients with testicular seminomas were treated at the Department of Therapeutic Radiology, Seoul National University Hospital. Twenty-seven patients received radiation therapy after orchiectomy and 5 patients for treatment of recurrent tumors. Two of postoperatively treated patients and 2 of recurrent patients were excluded from the study because of incomplete treatment. Of the patients treated postoperatively. 18 were stage I, 5 were stage IIA, one was stage IIB, and one was stage IIC. There were 4 ipsilateral and 2 contralateral cryptorchids. Preoperatively, b-HCG levels were elevated in 5 patients. Median dose to pelvic and paraaortic lymph node area was 2900 cGy (1550-4550 cGy). One patient with stage I, 4 with stage IIA, and 1 with stage IIB received prophylactic mediastinal irradiation. Two patients were treated with chemotherapy before radiation therapy. Median follow-up period was 104(3-144) months. RESULT: Local control rates were 100% at 5 years after orchiectomy. Five year survival rates were 94.4% in Stage I and 100% in Stage II patients. One patient with stageII disease died 3 months after surgery due to mediastinal metastasis. All the 3 patients treated for recurrent disease are alive without disease. CONCLUSION: Postorchiectomy radiation to the pelvis and para-aortic area remains the treatment of choice for patient with early stage testicular seminoma. Radiation therapy is also an excellent treatment modality for recurrent seminoma.
Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Orchiectomy ; Pelvis ; Radiation Oncology ; Seminoma* ; Seoul ; Survival Rate

PURPOSE: To develop a method for verifying a treatment setup in stereotactic radiotherapy by matching portal images to DRRs. MATERIALS AND METHODS: Four pairs of orthogonal portal images of one patient immobilized by a thermoplastic mask frame for fractionated stereotactic radiotherapy were compared with DRRs. Portal images are obtained in AP (anterior/posterior) and lateral directions with a target localizer box containing fiducial markers attached to a stereotactic frame. DRRs superimposed over a planned isocenter and fiducial markers are printed out on transparent films. And then, they were overlaid over orthogonal portal images by matching anatomical structures. From three different kind of objects (isocenter, fiducial markers, anatomical structure) on DRRs and portal images, the displacement error between anatomical structure and isocenters (overall setup error), the displacement error between anatomical structure and fiducial markers (immobilization error), and the displacement error between fiducial markers and isocenters (localization error) were measured. RESULTS: Localization errors were 1.5+/-0.3 mm (AP), 0.9+/-0.3 mm (lateral), and immobilization errors were 1.9+/-0.5 mm (AP), 1.9+/-0.4 mm (lateral). In addition, overall setup errors were 1.6+/-0.9 mm (AP), 1.3+/-0.4 mm (lateral). From these orthogonal displacement errors, maximum 3D displacement errors(sqrt{(Delta AP)^2 +(Delta Lat)^2}) were found to be 1.7+/-0.4 mm for localization, 2.6+/-0.6 mm for immobilization, and 2.3+/-0.7 mm for overall treatment setup. CONCLUSION: By comparing orthogonal portal images with DRRs, we find out that it is possible to verify treatment setup directly in stereotactic radiotherapy.
Fiducial Markers ; Humans ; Immobilization ; Masks ; Radiotherapy*

Intrameduallary spinal hemangioblastoma is frequently associated with syringomyelia. It grows slowly and can be removed totally. Syringomyelia can be subcided by total removal of tumor and opening of syringomyelia. Two cases of intramedullary spinal hemangioblastomas associated with syringomyelia are reported. Intramedullary tumor and syrinx was easily diagnosed by magnetic resonance imaging(MRI). They are successfully managed by total removal of tumor and opening of syrinx. Patients showed improved neurological status after operations.
Hemangioblastoma* ; Humans ; Syringomyelia*