BACKGROUND: Few studies have reported the results of arthroscopic coracoplasty concomitantly conducted with subscapularis tear. Therefore, this study was conducted to examine and compare the outcomes of arthroscopic subscapularis repair after arthroscopic coracoplasty using either the subacromial approach or rotator interval approach. METHODS: We retrospectively reviewed 51 patients who underwent coracoplasty with subscapularis repair. The patients were grouped according to whether the subacromial approach group (24 patients) or rotator interval approach group (27 patients) was used during coracoplasty. Preoperative and postoperative visual analogue scale scores, American shoulder and elbow surgeons scores, Korean shoulder scores, and range of motion (ROM) were assessed. Assessment of repaired rotator cuff tendon integrity was performed at 1 year after surgery using either magnetic resonance imaging or ultrasonography. RESULTS: At final follow-up, overall functional scores and ROM improved significantly in both groups when compared with preoperative values (p>0.05). The re-tear rates were not significantly different between groups; however, the rotator interval approach group showed a significant increase in ROM compared with that in the subacromial approach group (p<0.05). CONCLUSIONS: Arthroscopic coracoplasty conducted concomitantly with subscapularis repair can provide a satisfactory outcome. There were no significant differences between the two approach groups regarding final functional scores and re-tear rates. However, the rotator interval approach group showed a greater increase in ROM at final follow-up, especially in external rotation.
Arthroscopy ; Elbow ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Retrospective Studies ; Rotator Cuff ; Shoulder ; Surgeons ; Tears* ; Tendons ; Ultrasonography

It has been widely accepted that complete surgical resection of hepatoblastoma is essential for long-term survival. But unfortunately less that 50% of hepatic tumors in children can be totally removed at the time of diagnosis. This report is to present the experience of successful resection of hepatoblastoma after concurrent radiotherapy with transarterial chemoinfusion in a child. We believe this modality of treatment enables complete resection of unresectable hepatoblastoma, which is resistant to the systemic chemotherapy.
Child ; Diagnosis ; Drug Therapy ; Hepatoblastoma* ; Humans ; Radiotherapy*

The concept of bipolar disorder is an ongoing process, still in evolution, although its roots can be found from ancient Greek. Until recently, it was believed that no more than 1% of the general population has bipolar disorder. But literature on the lifetime prevalence of the bipolar spectrum disorder suggests rates of 4-5%. Bipolar spectrum disorder is a longitudinal diagnosis characterized by abnormal mood swings comprising some of the following cross-sectional clinical states: mania, hypomania, mixed states, hyperthymic temperament, major depressive episode, and depressive mixed state. Failure to recognize subthreshold expressions of mania, such as hypomania, cyclothymia, and hyperthymia, contributes to the frequent under-diagnosis of bipolar disorder. There are several reasons for the lower rate of recognition of subthreshold manic symptoms, when compared to the analogous pure depressive one. These include the lack of subjective suffering, enhanced productivity, egosyntonicity, diurnal and seasonal rhythmicity associated with many of the manic and hypomanic symptoms, and the psychiatrists' difficulty in differentiating with personality disorders. In addition, most patients with bipolar spectrum disorder seek treatment for depression, rather than mania or hypomania. Therefore clinicians often miss the diagnosis of bipolar spectrum disorder. The recent 10 years of researches have suggested that 30-55% of patients with major depressive disorder are actually identified with broader spectrum of bipolar disorders. However, 48% of patients of bipolar disorder consulted 3 or more professionals before receiving a correct diagnosis, and 10% consulted 7 or more for their first diagnosis of bipolar disorder. Several studies have documented that patients often wait as long as 10 years for the correct diagnosis of bipolar spectrum disorder. This delay in diagnosis often has substantial adverse results. Patients do not get the appropriate treatment to alleviate their symptoms. They may even get treatments that exacerbate their symptoms, such as prescription of antidepressants precipitating mania and producing rapid cycling. The concepts of hypomania, cyclothymia, mixed state, depressive mixed states, hyperthymic temperament are the new areas of studying mood disorders in recent 20 years. The authors will review the studies on various subtypes of bipolar spectrum disorder with their historic aspects, and introduce the suggested screening tests for bipolar spectrum disorder in clinical practice.
Antidepressive Agents ; Bipolar Disorder ; Classification ; Depression ; Depressive Disorder, Major ; Diagnosis ; Efficiency ; Humans ; Mass Screening ; Mood Disorders ; Periodicity ; Personality Disorders ; Prescriptions ; Prevalence ; Seasons ; Temperament

OBJECTIVES: To determine differences of common personality profiles and coping mechanisms of medical students who prefer specific specialties (medicine and surgery), the authors evaluated the defense mechanisms of the medical students by using Ewha Defense Mechanisms Test. METHODS: The authors compared the defense mechanisms between two groups (medicine selection group and surgery selection group) who are in the senior year of the Soonchunhyang University School of Medicine. RESULTS: There were no significant differences in mean scores of the each defense mechanism and 4 groups of defense mechanisms divided by maturity level between the groups of students who selected medicine and surgery. But, frequency of major defense mechanisms were as follows; For the surgery selection group, the passive-aggression in the Immature defense mechanism and show-off in the Neurotic defense mechanism were significantly higher than in the medicine selection group. Contrarily, in the medicine selection group, humor in the mature defense mechanism as the major defense mechanism was significantly higher than in the surgery selection group. CONCLUSION: After analysis of the differences of frequency of major defense mechanisms between the two groups, there were no significant differences between the two groups in personality. However, the students of the medicine selection group used humor of the mature defense mechanism as a major defense mechanism in higher frequency than the surgery selection group. In situations of complications, anxiety and suffering, the use of the humor defense mechanism gave the students strength to endure these situations. Among these students, there is a high probability that many of them possess strong ego strength. Contrarily, the students of the surgery selection group did not express aggression directly, rather, they expressed these feelings indirectly through passive opposition. There was a high frequency of passive-aggression defense mechanism in dealing with feelings of aggression. Also, in the neurotic defense mechanism, compared to ability, excessive goals were set as was the resulting behavior. Especially, behavior was extremely sensitive to how others would evaluate those actions resulting in using show-off mechanism as a major defense mechanism in higher frequency by the surgery selection group. The results seem to be useful in understanding the student's optimal character for specific specialities that were selected by evaluating the differences of the common characteristics and coping mechanisms of each specialty group.
Aggression ; Anxiety ; Defense Mechanisms* ; Ego ; Humans ; Students, Medical*

Transhiatal gastric transpositions were performed in two case of long gap esophageal atresia without tracheoesophageal fistula. The patients were a 12 months old female and an 18 months old male. Stamm type gastrostomies were performed at other hospitals in both cases. The stomach was mobilized preserving the right gastric artery, the right gastroepiploic artery and spleen. The proximal and distal esophageal pouches were excised by transcervical and transhiatal route, respectively. The mobilized stomach was pulled up to the neck through esophageal hiatus and posterior mediastinal route. The esophagogastrostomy, the only one anastomosis of this procedure, was performed in the neck. There was no clinical evidence of anastomotic leakage, stricture, regurgitation, difficulty of gastric emptying, hoarseness or respiratory problem. Transhiatal gastric transposition seems to be a safe and easy alternative surgical procedure for esophageal replacement in long gap esophageal atresia.
Anastomotic Leak ; Arteries ; Constriction, Pathologic ; Esophageal Atresia* ; Female ; Gastric Emptying ; Gastroepiploic Artery ; Gastrostomy ; Hoarseness ; Humans ; Infant ; Male ; Neck ; Spleen ; Stomach ; Tracheoesophageal Fistula

The particle size of suspended particulates was measured by a Andersen air sampler from Mar. 1982 to Feb. 1984 in a part of Seoul. It was concluded as follows: 1) The arithmetic concentration of suspended particulates was 147.8 microgram/m3 in Spring, 136.9 in Summer, 131.9 in Autumn and 158.1 in Winter respectively. 2) The cumulative distribution of suspended particulates size in logarithmic diagram showed similar to normal log distribution. 3) The atmospheric particulate matters showed a bimodal size distribution on the base of unit particle concentrations, which divided at approximately 2 micrometer in the diameter. 4) While the fine particulates less than 2.1 micrometer was 35.4-45.0%, the coarse particulates was 55.0-64.5%. 5) The higher the concentration of suspended particulates, the more increased the ratio of fine particulates. The higher the concentration of suspended particulates, the lower median size of suspended particulate as well. 6) The respirable dust particulates less than 4.7 micrometer was 52.2-62.9% in seasonal average through the 2 year samples. With the above result, air pollution concerned with public health could be evaluated and the control measures also are suggested.
Air Pollution ; Atmosphere* ; Dust ; Particle Size* ; Public Health ; Seasons ; Seoul*

No abstract available.
Female ; Pregnancy ; Pregnancy, Tubal*

Pseudoaneurysm of splenic artery may arise from a vascular erosion by the inflammatory processes around the splenic artery, particularly in acute pancreatitis and chronic pancreatitis, which may cause rupture of pseudoaneurysm and life threatening hemorrhage. Collective experience with this massive hemorrhage is attended by a high mortality rate even with prompt therapy, and conservative management is associated with an almost 100 per cent of mortality rate. Identification of the bleeding site at laparotomy may be exceedingly difficult, which makes the preoperative detection of bleeding source desirable. Peripancreatic vascular lesions can be identified by angiography, and in selected cases the risk of urgent operation to control massive hemorrhage may be obviated by embolization. The authors have recently experienced a case of ruptured splenic artery pseudoaneurysm combined with a pancreatic pseudocyst in a 6 years old boy. A bolus enhanced CT scan and angiography were essential to confirm these complications of pancreatic pseudocyst. We managed this child successfully with an urgent procedure of transcatheter arterial embolization and another elective surgery of pancreatic pseudocyst.
Aneurysm, False* ; Angiography ; Child* ; Hemorrhage ; Humans ; Laparotomy ; Male ; Mortality ; Pancreatic Pseudocyst ; Pancreatitis ; Pancreatitis, Chronic ; Rupture ; Splenic Artery* ; Tomography, X-Ray Computed

We underwent 3 cases of laparoscopic splenectomy in pediatric patients of hereditary spherocytosis and had excellent outcome. Average operation time was 100 minutes and it was longer than average operation time of traditional open splenectomy in pediatric patients of hereditary spherocytosis (83 minute), but average hospitalization day was 3 days and it was shorter than compared group (6.2 days). Advantages of laparoscopic surgery were appeared in this study. Excellent outcome of these cases will help further performance of laparoscopic splenectomy in children.
Child* ; Hospitalization ; Humans ; Laparoscopy ; Splenectomy*

Toxicogenomics combines transcriptome, proteome and metabolome profiling with conventional toxicology to investigate the interaction between biological molecules and toxicant or environmental stress in disease caution. Toxicogenomics faces the problems of comparison and integration across different sources of data. Cause of unusual characteristics of toxicogenomic data, researcher should be assisted by data analysis and annotation for getting meaningful information. There are already existing repositories which claim to stand for toxicogenomics database. However, those just contain limited abilities for toxicogenomic research. For supporting toxicologist who comes up against toxicogenomic data flood, now we propose novel toxicogenomics knowledgebase system, XPERANTO-TOX. XPERANTO-TOX is an integrated system for toxicogenomic data management and analysis. It is composed of three distinct but closely connected parts. Firstly, Data Storage System is for reposit many kinds of '-omics' data and conventional toxicology data. Secondly, Data Analysis System consists of analytical modules for integrated toxicogenomics data. At last, Data Annotation System is for giving extensive insight of data to researcher.
Information Storage and Retrieval ; Knowledge Bases* ; Metabolome ; Proteome ; Statistics as Topic ; Toxicogenetics* ; Toxicology ; Transcriptome