No abstract available.
Gastrectomy* ; Stomach Neoplasms*

PURPOSE: Osteoporosis is generally regarded as disease of women and there are extensive data about post-menopausal osteopotosis, but there is relatively little information concerning the osteoporosis in aging male. We aimed to determine the relationships between age ,androgen and bone mineral density (BMD) in elderly korean men. MATERIALS AND METHODS: We evaluated the sex hormones and BMD of 82 elderly men between May 1999 and April 2000. Serum free testosterone (FT), total testosterone (TT), DHT, LH, FSH and Prolactin were measured by RIA. BMD at anteroposterior L2-4, femoral neck, ward's triangle, femoral trochanter and femoral shaft were determined by dual-energy X-ray absorptiometry. We defined group I as free testosterone <10ng/dl and group II as 10ng/dl. RESULTS: Serum LH and FSH increased with age. There was a significant decrease in serum FT with age, but T concentrations remained unchanged. There were significant declines with age in BMD at femoral neck, Ward's triangle, femoral trochanter, femoral shaft. Serum FT were significantly correlated to BMD at anteroposterior L2-4, femoral neck, Ward's triangle, femoral trochanter, femoral shaft. After controlling for age, serum FT were significantly correlated to BMD at femoral trochanter, femoral shaft. Mean BMD was significantly lower in group I than group II at anteroposterior L2-4, femoral shaft. CONCLUSIONS: We suggest that FT is a male osteoporotic marker in man older than 50 years and bone mineral density should be considered for diagnosis of male osteoporosis associated with PADAM, especially when FT is lower than 10ng/dl.
Absorptiometry, Photon ; Aged ; Aging* ; Bone Density* ; Diagnosis ; Female ; Femur ; Femur Neck ; Gonadal Steroid Hormones ; Humans ; Male* ; Osteoporosis ; Prolactin ; Testosterone

Concepts regarding the evaluation and management of the infertile male have evolved during the past decade primarily because of the development of new methodology. Nevertheless, the causes of male infertility is often obscure, and the clearly defined causes are infrequent or rare. Testicular biopsy findings are basic and very important in evaluating the causes of infertility. The testis biopsy findings of 30 azoospermic patients were evaluated and it was observed in aspect of testicular size and past history. Following results were obtained. 1. Among the 91 patients who underwent semenalysis, 30 cases (33%)were azospermia. 2. In testicular biopsy findings hypospermatogenesis was the most frequent finding and the more severe hypospermatogenesis was the more atrophic the seminiferous tubule is and showed frequent Leydig cell hyperplasia. 3. Testicular biopsy findings revealed no specific correlation between small testis and normal testis patients. 4. In aspect of past history 2 epididymal tubercu1osis patients showed normal biopsy findings which suggest obstruction of sperm route and one cryptorchism and one varicocele patients showed hypospermatogenesis. 5. By testicular biopsy most of the cause of infertility was testicular and 3 cases were posttesticular.
Azoospermia ; Biopsy* ; Cryptorchidism ; Humans ; Hyperplasia ; Infertility ; Infertility, Male ; Male ; Oligospermia ; Seminiferous Tubules ; Spermatozoa ; Testis* ; Varicocele

OBJECTIVES: Sleep disorders cause changes of autonomic nervous system (ANS) which affect cardiovascular system. Primary insomnia (PI) makes acceleration of sympathetic nervous system (SNS) tone by sleep deficiency and arousal. Obstructive sleep apnea syndrome (OSAS) sets off SNS by frequent arousals and hypoxemias during sleep. We aimed to compare the changes of heart rate variability (HRV) indices induced by insomnia or sleep apnea to analyze for ANS how much to be affected by PI or OSAS. METHODS: Total 315 subjects carried out nocturnal polysomnography (NPSG) were categorized into 4 groups - PI, mild, moderate and severe OSAS. Severity of OSAS was determined by apnea-hypopnea index (AHI). Then we selected 110 subjects considering age, sex and valance of each group's size [Group 1 : PI (mean age=41.50+/-13.16 yrs, AHI <5, n=20), Group 2 : mild OSAS (mean age=43.67+/-12.11 yrs, AHI 5-15, n=30), Group 3 : moderate OSAS (mean age 44.93+/-12.38 yrs, AHI 16-30, n=30), Group 4 : severe OSAS (mean age=45.87+/-12.44 yrs, AHI >30, n=30)]. Comparison of HRV indices among the four groups was performed with ANCOVA (adjusted for age and body mass index) and Sidak post-hoc test. RESULTS: We found statistically significant differences in HRV indices between severe OSAS group and the other groups (PI, mild OSAS and moderate OSAS). And there were no significant differences in HRV indices among PI, mild and moderate OSAS group. In HRV indices of PI and severe OSAS group showing the most prominent difference in the group comparisons, average RR interval were 991.1+/-27.1 and 875.8+/-22.0 ms (p=0.016), standard deviation of NN interval (SDNN) was 85.4+/-6.6 and 112.8+/-5.4 ms (p=0.022), SDNN index was 57.5+/-5.2 and 87.6+/-4.2 (p<0.001), total power was 11,893.5+/-1,359.9 and 18,097.0+/-1,107.2 ms2 (p=0.008), very low frequency (VLF) was 7,534.8+/-1,120.1 and 11,883.8+/-912.0 ms2 (p=0.035), low frequency (LF) was 2,724.2+/-327.8 and 4,351.6+/-266.9 ms2 (p=0.003). CONCLUSIONS: VLF and LF which were correlated with SNS tone showed more increased differences between severe OSAS group and PI group than other group comparisons. We could suggest that severe OSAS group was more influential to increased SNS activity than PI group.
Acceleration ; Anoxia ; Arousal ; Autonomic Nervous System ; Cardiovascular System ; Heart ; Heart Rate ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Sympathetic Nervous System

MRI has proved to be very reliable in evaluating the menisci and cruciate ligaments. On MRI, several diagnostic criteria of ruptured ACL were reported. Boeree and Ackyroyd reported that when the ACL is ruptured the PCL may appear to be curled up or sigmoid. But these morphologic changes may be shown in the normal ACL, so the quantitative analysis of these morphologic changes in considered as a way to increase the diagnostic sensitivity. We have used 1.0 tesla MRI scanner(SIMENS W. Germany) with a surface coil. We compared two groups of patients; a ruptured ACL group(16 patients) in which had indicated and arthroscopy confirmed rupture of the ACL and control group(46 patients), in which had shown the ACL to be entirely normal. At first, we made a line(basal line) between the femoral attachment and tibial attachment of the PCL and decided the point(apex) which was located far distant from the line. And we made a line(A line) between the femoral attachment and apex of the PCL, another line(B line) between the tibial attachment and apex of the PCL. We divided the basal line into the four areas. We measured the each angle between basal line and A line(angle a), between basal line and B line(angle b). And we measured the entire length of basal line, each height of the PCL previously divided point of the basal line(H1, H2, H3) and the apex of the PCL on the basal line. We compared the control group and ruptured ACL group by t-test from the measured factors angle a, angle b, H1, H2, H3, H4, and length of basal line. We studied factors which were able to decide whether the ACL was ruptured or not in MRI finding by logistic regression. 1. H1, the distance from the basal line to the PCL at 1/4 point on the basal line, were 5.7±1.6 mm in ruptured ACL group, 4.7±1.3 mm in control group, so there was statistically significant increase in ruptured ACL group. 2. The angle a were 56.0±14.4° in ruptured ACL group, 39.7±10.1° in control group, so there was statistically significant increase in ruptured ACL group. 3. From the measured factors angle a was able to decide whether the ACL was ruptured or not in MRI and the slope of angle a in logistic regression was 0.1. In conclusion, when the apex of the PCL is located at proximal 1/4 of the PCL and PCL and greater curve, above signs will be considered to be a sign of ruptured ACL in MRI.
Arthroscopy ; Colon, Sigmoid ; Humans ; Ligaments ; Logistic Models ; Magnetic Resonance Imaging ; Rupture ; Tears

We studied the distribution patterns of perforating branch of superficial circumflex iliac artery for flap surgery in Korean. Fifty one thighs from 34 Korean cadavers (17 males/ 17 females) were dissected and standard points were determined as follows: point of anterior superior iliac spine (A), point of pubic tubercle (B), cross point of the line AB and femoral artery (FA), cross point of the femoral artery and the sartorius muscle (FAS), beginning point of superficial circumflex iliac artery (O), and perforating point of superficial circumflex iliac artery (P). We measured the distance and the angles between the standard points. Each frequency of superficial circumflex iliac artery from femoral artery and superficial epigastric artery is 69.6% and 30.4% respectively. The mean distance between the beginning point of superficial circumflex iliac artery (O) and the point A was 7.3+/-1.3 cm and the mean distance between the point O and the point B was 5.7+/-0.6 cm. The angle from line OA to line AB was 17.9+/-8.0 degrees and The angle from line OB to the line AB was 24.9+/-5.1 degrees. The mean distance between the perforating point for superficial circumflex iliac artery (P) and the point A was 6.3+/-2.4 cm and the mean distance between the point P and the point B was 8.3+/-2.7 cm. The angle from line PA to line AB was 33.4+/-18.3 degrees and the angle from line PB to the line AB was 24.5+/-14.3 degrees. Consequently, the pattern of distribution of superficial circumflex iliac arteries, obtained in this study, will provide useful anatomical backgrounds for the superficial circumflex iliac artery flap surgery in Korean.
Cadaver ; Epigastric Arteries ; Femoral Artery ; Iliac Artery* ; Spine ; Thigh

PURPOSE: Serum squamous cell (SCC) antigen levels were examined in uterine cervix cancer undergoing radiation therapy, and authors analyzed the relationship between SCC antigen levels and treatment results. MATERIALS AND METHODS: This is a retrospective study of 181 cervical carcinoma patients who received radiotherapy and examined serial serum SCC antigen from 1991 to 1997 at Soonchunhyang University Hospital. One hundred and eighteen patients underwent SCC antigen evaluation at diagnosis The relationship between the serum tumor marker level and disease free survival, recurrence pattern, and other prognostic factors were analyzed according to various statistical methods. RESULTS: The positivity rate (initial serum value above 2.5 ng/ml) was increased with FIGO stage (IB-IIA 57% to IV 91%) and more discriminative than cutoff value of 1.5 ng/ml. Five year disease free survival rates for the stage IB-IIA, IIB, III and IV were 79.2%, 68.7%, 33.4% and 0%, respectively. The 5-year disease free survival rate for patients with serum SCC antigen levels above 5.0 ng/ml was 34% versus 55~62% for patients with normal range (<1.5 ng/ml) or mildly elevated levels (1.5~5.0 ng/ml). Rising SCC antigen levels preceded the clinical detection of disease by a mean of 4.8 months (range 1~13 months). Negative linear corelation was observed between initial SCC antigen levels and relapse free survival (r=-0.226), and by multivariate analysis, initial SCC antigen level had a large impact on the relapse free survival. CONCLUSIONS: SCC antigen assay is a useful aid to predict the prognosis of squamous cell carcinoma of the uterine cervix and to detect recurrence.
Carcinoma, Squamous Cell ; Cervix Uteri* ; Diagnosis ; Disease-Free Survival ; Female ; Humans ; Multivariate Analysis ; Prognosis ; Radiotherapy ; Recurrence* ; Reference Values ; Retrospective Studies ; Uterine Cervical Neoplasms

PURPOSE: Non-cement total hip arthroplasty for unstable intertrochanteric fracture in elderly patients is regarded as another surgical technique preventing complications such as non-union, long term limitation of weight bearing, pressure sore, pulmonary thromboembolism after open reduction or closed reduction with intramedullary nailing, or plate fixation. We would like to announce the short-term results of primary non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring for unstable intertrochanteric fracture in elderly patients. MATERIALS AND METHODS: All of the 20 patients admitted to the hospital between April 2010 and February 2012 who underwent non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring for unstable intertrochanteric fractures were evaluated. The mean age was 71.1(57-86), there were nine males, and 11 females, with an average follow up period of six months. The post-operative state was evaluated by Harris hip score. RESULTS: The mean operation time was 95 min, and the average blood loss was 800 cc. Mean Harris hip score at the last available follow-up was 92.7, and, among the patients, 15 had all functions of daily life without limitation of walking distance, one had hip dislocation, one had breakage of strands. Pressure sore, deep vein thrombosis, and pulmonary thromboembolism were absent. Radiography at the last available follow-up showed no loosening of the femoral stem in any of the patients, and 13 patients had osteogenesis around the fracture site, and there was no osteolysis. CONCLUSION: Primary non-cement total hip arthroplasty with double strands and double loops figure of 8 wiring in elderly patients with unstable intertrochanteric fractures showed satisfactory results. These results are expected to be useful for further studies with a long-term follow-up and in development of a reduction method.
Aged ; Arthroplasty ; Female ; Femur ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; Hip ; Hip Dislocation ; Hip Fractures ; Humans ; Male ; Osteogenesis ; Pressure Ulcer ; Pulmonary Embolism ; Venous Thrombosis ; Walking ; Weight-Bearing

PURPOSE: Hysterectomy without lymph node dissection was considered an inadequate treatment method for invasive uterine cervix cancer. Usually the procedure was performed inadvertently on patients who were thought to have benign or premalignant conditions preoperatively. We analysed radiotherapy results of such patients to evaluate survival rates, failure patterns and prognostic factors according to various conditions. METHODS AND MATERIALS: Sixty one patients undergoing hysterectomy in the presence of invasive cervical carcinoma were reviewed retrospectively. Preoperative diagnosis were carcioma in situ (38 cases), severe dysplasia(2), myoma(6), uterine bleeding (4), uterine prolapse (2), and early invasive cervix cancer (10) (One patient had myoma and carcinoma in situ coincidently). Patients received postoperative megavoltage radiotherapy form August 1985 to December 1993, and minimum follow-up period was 24 months. Eight patients reveived ICR only, 6 patients ICR and external radiation, and 47 patients received external radiation therapy only. RESULTS: Overall 5-year survival rate and relapse-free survival rate were 83.8%, 86.9% respectively. For patients with retrospective stage IA, IB, IIB (gross residual after surgery), and vaginal cuff recurrence were 90.9%, 88.8%, 38.4%, and 100% respectively. There were 8 cases of treatment failure, most of them (5/8) were in patients with gross residual disease, other patients were full thickness involvement of cervix wall (2/8) except one. Patients with early vaginal cuff recurrence and microinvasive cervical cncer (stage IA) had no treatment related failure. Prognostic factors affecting survival by univariate analysis were status of residual disease, tumor histology and retrospective stage. CONCLUSION: Adjuvant radiotherapy appeared to be effective treatment method for patients with presumed stage IA, IB and early local recurrent disease after inadvertent hysterectomy. Survivals for patients with gross disease remained after inappropriate hysterectomy was poor. So, early cancer detection and proper management with precise pretreatment staging is necessary to avoid inadherent hysterectomy especially in the cases of gross residual disease.
Carcinoma in Situ ; Cervix Uteri ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Lymph Node Excision ; Myoma ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Uterine Cervical Neoplasms ; Uterine Hemorrhage ; Uterine Prolapse

Peritoneal lavage cytology was performed at the time of gastrectomy for 295 patients with gastric cancer from September 1991 to January 1996 in the Department of Medical Sciences,Chonbuk National University Graduate School. The results were as follows;1) Positive intraperitoneal free cancer cells were observed in 9.8% of all case. And,the higher the S-category, the higher the increase in positive intraperitoneal free cancer cells, but the lower the rate of survival. 2) The higher the spatial extent of the invasion of the gastric serosa,the higher the increase in the positive intraperitoneal free cancer cells. However, There was no statiscal relation between the areas of gastric serosa invasion and the 3-year survival rate. But, especially when the areas of serosa invasion are 5-10cm2, the 3-year survival rate was statiscally higher in the negative intraperitoneal free cancer cell group than in the positive free cancer cell group.(P<0.012). 3) The rate of positive intraperitoneal free cancer cells become higher progressively with increasing the peritoneal invasion, but, there were no 3-year survival patients who have positive peritoneal invasion . In patients with no evidence of peritoneal spread, negative intraperitoneal free cancer cell group had a statistically signigficant higher 3-year survival rate than the positive group.(P<0.0004). 4) For histopathological types of tumors, the incidence of positive intraperitoneal free cancer cells was higher in undifferentiated adenocarcinomas than in differentiated types, though the difference was statistically insignificant. For signet-ring cell carcinomas, the 3-year survival rate of the negative intraperitoneal free cancer cell group was statistically higher than that of the positive group.(P<0.0005). 5) The incidence of positive intraperitoneal free cancer cells increased as the stage of gastric cancer increased, but the survival rate was decreased. 6) In the noncurative resection group, the incidence of positive intraperitoneal free cancer cells was higher, but the survival rate was lower, than in the curative resection group. The 3-year survival rates were higher for the patients with curative resection and negative intraperitoneal free cancer cells than for the patients with curative resection and positive intraperitoneal free cancer cells (P<0.0009). The difference in the 3-year survival rate between the noncurative resection with positive intraperitoneal free cancer cell group and the noncurative resection with negative intraperitoneal free cancer cell group was stastistically significant. (P<0.0000). 7) For the types of recurrence, hematogenous metastasis was the most common type of recurrence in the negative intraperitoneal free cancer cell group; peritoneal metastasis was the most common type of recurrence in the positive intraperitoneal free cancer cell group. In conclusion; at the time of gastrectomy, peritoneal lavage cystology is very impotant and basic examination which can help early detection of intraperitoneal free cancer cells. Therefore, when intraperitoneal free cancer cells are negative,radical curative gastrectoy make the high survival rate of patients.
Adenocarcinoma ; Gastrectomy ; Humans ; Incidence ; Neoplasm Metastasis ; Peritoneal Lavage ; Prognosis* ; Recurrence ; Serous Membrane ; Stomach Neoplasms ; Survival Rate