To identify whether acromial shape, osteophyte, and acromio-humeral interval have effects on impingement syndrome or rotator cuff tear, we reviewed 40 cases of normal group (F:M=22:18), and 30 cases of impingement syndrome(F:M=16:14). Forty cases of normal group aged from 40 to 69 who had no pain, no abrasion sign, no limitation of motion, and normal function of shoulder joint were selected. Thirty cases of impingement syndrome were managed by acromioplasty of direct repair from October, 1993 to May, 1994. Twenty-five cases of 30 were identified rotator cuff tear(RCT), and the others were turned out subacromial abrasion. We reviewed the acromial thickness, the acromial shape, the anterior protuberance, the presence of osteophyte, and the acromio-humeral interval to compare the difference between two groups. Forty-seven point five per cent of normal group had a flat, type I acromion, 47.5% had a curved, type II acromion and 5% were identified by a hooked, type III acromion. However, in subjects with impingement syndrome and RCT, 37% had type I, 20% had type II, and 43% displayed type III. Type III was considerably noticed in the massive tear. In regarding to acromial thickness, normal group had type A(less than 8mm)-37.5%, type B(8-12mm)-62.5%, and the impingement syndrome or RCT group had type A-53%, type B-47%. We couldn’t find any significant difference with each group in type III(more than 8mm)-15% in normal, and type I-17%, type II-33%, type III-50% in the impingement syndrome or RCT. It was suggested that the anterior protuberance was related with the evidence of RCT. A-H interval was 10.25mm±1.46mm in normal, and 9.44mm±1.70mm in the impingement syndrome or RCT. There was on significance in A-H interval except rotator cuff arthropathy. Thirty three percent of normal group had osteophytes and 40% of impingement syndrome or RCT had osteophytes on the undersurface of acromion.
Acromion ; Osteophyte ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Tears

A SLAP lesion is a tear in the superior aspect of the glenoid labrum, in which the injury begins posteriorly and extends anteriorly, stopping at or above the mid glenoid notch. We reviewed retrospectively the clinical history, the positive physical findings, the associated diseases, and the final results of twenty four patients with SLAP lesion which were diagnosed and treated arthroscopically between October 1993 and February 1996. There were twenty three males and or.e female with an average age of 28 years. Follow-up time was averaged 18 months (range; 12 to 20) In according to Snyder's classification, seven cases were Type I, six cases were Type II, seven cases were Type III and four cases were Type IV. The common mechanisms of injury were compression force to the shoulder (ll cases),traction injury (7 cases) and the remainders were unknown. Among these, solitary SLAP lesion was eight cases. A high incidence of associated pathology was noted in these patients; multidirectional instability (1), unidirectional anterior instability (7), full thickness rotator cuff tear (3), partial thickness rotator cuff tear (5) and the frozen shoulder (1). Patients were treated for associated pathology and additional treatment of SLAP lesion was done by arthroscopic excision (9), repair (5), biceps tenodesis (1) and arthroscopic debridement (9). On evaluation, seventy nine percentages of patients obtained either good or excellent results post-operatively, and especially in the solitary SLAP lesions, eighty eight percentages achieved significant improvements, even though it was difficult to say whether the arthroscopic surgery itself contributed to resolve some of shoulder pain and instability when SLAP lesion was associated with other shoulder diseases.
Arthroscopy ; Bursitis ; Classification ; Debridement ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Pathology ; Retrospective Studies ; Rotator Cuff ; Shoulder Joint* ; Shoulder Pain ; Shoulder* ; Tenodesis

This research is to examine the detoxication effect of methionine on cadmium intoxication. For this purpose, this paper provides an analysis of the data on the groups of mice (ICR), one group of mice treated with 40 ppm of cadmium only, and other groups of mice combined-treated with cadmium and 0.1%, 0.25%, 0.5% and 1% methionine. After breeding for 40 days, the data on the growth of mice, changes in activation of alkaline phosphatase in blood, and the cadmium content in the liver and kidney, are analysed. The results were as follow: 1) The growth-rate of mice, in the cadmium only injected group, was declined by 9% in comparison with the control group after 40 days. But the two groups of cadmium with 0.5% and 1% methionine showed the rise of 9% and 14% respectively above the growth-rate of the control group. The results from the groups of cadmium with 0.1% and 0.25% methionine were similar to that from the cadmium only injected group. 2) Changes in activation of alkaline phosphatase in blood decreased to 86.45% in the cadmium only injected group behind the 100% activation of the control group. The groups of cadmium with 0.1% and 0.25% methionine showed no difference with the former group. But the groups of cadmium with 0.5% and 1% methionine recovered to the 93.14% and 96.08% of activation respectively. 3) The mean content of cadmium in the liver was 0.028+/-0.001 microgram/g in the control group. The cadmium only injected group showed the mean cadmium content of 2.80+/-0.62 microgram/g in the liver, which was similar to 2.82+/-1.03 microgram/g in the group of cadmium with 0.1% methionine, and 2.56+/-0.77 microgram/g in the group of cadmium with 0.25% methionine. But the groups of cadmium with 0.5% and 1% methionine showed the reduction of cadmium contents in the liver to 1.84+/-0.56 microgram/g and 1.74+/-0.35 microgram/g respectively. In the kidney, the groups of cadmium with 0.1%, 0.25% and 0.5% methionine showed the similar cadmium content to the group treated with cadmium only. But the group of cadmium with 1% methionine showed a small increase to 4.13+/-1.00 microgram/g in comparison with the group treated with cadmium only. This analysis proves that the mobility and diffusion of cadmium in the tissues advance faster in the group treated with cadmium and methionine than in the group treated with cadmium only.
Alkaline Phosphatase* ; Animals ; Breeding ; Cadmium* ; Diffusion ; Kidney* ; Liver* ; Methionine* ; Mice*

PURPOSE: Oncogen or growth factor receptor such as phospholipase C isoenzyme gamma-1 (PLC gamma-1), epidermal growth factor receptor (EGFR), and Her-2/neu which related with tyrosin kinasemay and then regulating vell proliferation may have a role as prognostic factors for breast cancer. MATERIAL AND METHODS: With assumption that expression of PLC gamma-1, EGFR and Her-2/neu oncogene has close relationship with prognosis of breast cancer, 59 breast cancer patients who were operated upon at Korea University Hospital during a period of 6 years starting June 1988 to May 1994 were selected for this study. This study was carried out by comparing between expression of PLC gamma-1, EGFR and Her-2/neu oncogene and patient's survival rate. These expression were also compared with TNM system, estrogen and progesterone receptor and at same time these expressions were compared with each other to see whether there are any relationship among these expression. RESULTS: Expression of PLC gamma-1, EGFR and Her-2/neu were present in 42% (25/59), 46% (27/59) and 20% (12/59). The expression of PLC gamma-1 was closely related with the expression of EGFR (p<0.05) and Her-2/neu (p<0.05), but there were no relationship between the expression of PLC gamma-1 and hormonal receptors and TNM stage (p>0.05). The expression of EGFR was closely related with the expression of Her-2/neu (p<0.05) and hormone receptors (p<0.05), but there were no relationship between the expression of EGFR and pathologic TNM stage (p>0.05). The expression of Her-2/neu was not closely related with hormone receptors and TNM stage except axillary lymph node metastasis. There were close relationship between overall and disease free survival and PLC gamma-1 and Her-2/neu. But EGFR had only related with disease free survival rate. CONCLUSION: In conclusion, the expression of PLC gamma-1, EGFR and Her-2/neu oncogene in human breast cancer may be useful prognostic factors independently and it may potentiated its individual value as a prognostic factors if use them together.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Epidermal Growth Factor* ; Estrogens ; Humans* ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes ; Phospholipases* ; Prognosis ; Receptor, Epidermal Growth Factor* ; Receptors, Progesterone ; Survival Rate ; Type C Phospholipases*

Popliteal artery entrapment syndrome (PAES) is rare, but increasingly reported in the literature as a cause of lower limb arterial impairment. Management of a patient with PAES depends on the clinical pictures. Currently, myotomy of the medial head of gastrocnemius muscle with interposition grafting or bypass of diseased popliteal artery has been widely used in cases with a demaged or occluded artery. But, other less extensive therapeutic approaches were also performed instead of it. We present a case of type II popliteal entrapment syndrome in an 36-year-old male. Presenting symptom was exercise- induced pain in his right calf since one month ago. Arteriography showed occlusion in short segment of right popliteal artery and intact distal run-off arteries. After overnight urokinase thrombolysis, residual focal stenosis and medial deviation of popliteal artery were observed. CT scan showed abnormal structure between right popliteal artery and popliteal vein, so, diagnosis was established. After myotomy of the medial head of gastrocnemius muscle, the symptom resolved completely. Post-operative duplex scan showed normal blood flow, even in active plantar flexion of the foot. In our case, early diagnosis and combined approach of endovascular thrombolytic therapy followed by surgical release of popliteal artery enabled to avoid direct vascular surgery such as bypass or interposition grafting with resolution of ischemic symptoms. This thrombolytic therapy does not obviate surgery but may permit a less extensive procedure to be performed in PAES.
Adult ; Angiography ; Arteries ; Constriction, Pathologic ; Diagnosis ; Early Diagnosis ; Foot ; Head ; Humans ; Lower Extremity ; Male ; Muscle, Skeletal* ; Popliteal Artery* ; Popliteal Vein ; Thrombolytic Therapy* ; Tomography, X-Ray Computed ; Transplants ; Urokinase-Type Plasminogen Activator

BACKGROUND: The prevalence of hypercholesterolemia in Korea is growing. In spite of the wide use of HMG-CoA reductase inhibitors (statins), some patients don't reach optimal cholesterol reduction and suffer hepatotoxicity or myopathy. Combination therapy of lipid lowering agents, which inhibits hepatic synthesis of cholesterol (i.e. simvastatin) and intestinal cholesterol absorption (i.e. ezetimibe), may achieve further reduction of serum cholesterol levels and less drug side effects. This study assessed the safety and efficacy of the combination therapy with ezetimibe and simvastatin in Korean patients with primary hypercholesterolemia. METHODS: This study was a randomized, double-blind, simvastatin controlled, multi-center trial. After 4 weeks of life style modification for cholesterol reduction, patients with a baseline low-density lipoprotein cholesterol (LDL-C) 145~250 mg/dL and triglyceride (TG) Absorption ; Apolipoprotein A-I ; Apolipoproteins ; Cholesterol ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia* ; Korea ; Life Style ; Lipoprotein(a) ; Lipoproteins ; Muscular Diseases ; Prevalence ; Simvastatin* ; Triglycerides ; Ezetimibe

Peritoneal dialysis (PD) has been utilized for the children with end stage renal disease. Nevertheless, it is thought to promote inguinal hernia by increasing intraabdominal pressure. To investigate the clinical characteristics of inguinal hernia in children on PD, 155 cases of PD in children between January 1996 and June 2007 at Seoul National University Children's Hospital were reviewed retrospectively. Inguinal hernia developed in 16 cases (10.3%, M:F=8:8). Hernia occurrence was not correlated to age. Eleven cases (69%) of inguinal hernia developed in first 6 months after initiation of PD. All inguinal hernias were surgically repaired. No complications occurred related to inguinal hernia or surgery. Recurrent hernia developed in 1 patient (6.3%) of 2 cases who had PD postoperatively on the day of surgery. In conclusion, inguinal hernia developed more frequently with children on PD than general population (3.5~5%). The rate of hernia development was highest within the first 6 months following initiation of PD. After repair of hernia, we recommend to discontinue PD immediate postoperatively to prevent recurrence.
Child ; Hernia ; Hernia, Inguinal ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Retrospective Studies

Catheter related and perianal problems are common surgical complications encountered during the treatment of pediatric malignancies. However acute surgical abdominal emergencies are rare. The aim of this study is to review acute surgical abdominal complications that occur during the treatment of childhood malignancies. Out of a total of 1,222 patients who were newly diagnosed with malignant disease, between January 2003 and May 2008, there were 10 patients who required surgery because of acute abdominal emergencies. Their medical records were reviewed retrospectively. Hematologic malignancies were present in 7 patients (4 leukemia, 2 lymphoma, 1 Langerhans cell histiocytosis) and solid tumors in 3 patients (1 adrenocortical carcinoma, 1 desmoplastic small round cell tumor, 1 rhabdomyosarcoma). Seven patients had intestinal obstruction, two had gastrointestinal perforation and one, typhlitis. Intestinal obstructions were treated with resection of the involved segment with (N=2) or without (N=3) enterostomy. Two patients had enterostomy alone when resection could not be performed. Intestinal perforation was treated with primary repair. Typhlitis of the ascending colon was treated with ileostomy. Right hemicolectomy was necessary the next day because of the rapidly progressing sepsis. Three patients are now alive on chemotherapy and one patient was lost to followed-up. Among six patients who died, five died of their original disease progression and one of uncontrolled sepsis after intestinal perforation. Although rare, acute surgical abdominal complications can occur in childhood malignancies. Rapid and accurate diagnosis and appropriate operation are required for effective treatment of the complications.
Abdomen ; Adrenocortical Carcinoma ; Catheters ; Child ; Colon, Ascending ; Desmoplastic Small Round Cell Tumor ; Disease Progression ; Emergencies ; Enterostomy ; Hematologic Neoplasms ; Humans ; Ileostomy ; Intestinal Obstruction ; Intestinal Perforation ; Leukemia ; Lymphoma ; Medical Records ; Retrospective Studies ; Sepsis ; Typhlitis

The usefulness of totally implantable central venous port for long-term intravenous infusion is widely accepted in children. Usually the catheters are placed through the internal or external jugular vein. In case of jugular vein cut-down, two separate incisions are needed for catheter and port respectively. Patients also feel uncomfortable as the catheter run through the neck. However these disadvantages can be overcome by using the cephalic vein (CV). We reviewed our experiences on CV cut-down for totally implantable central venous port in children. From January 2002 to December 2006, 201 patients (M:F=127:74) underwent 218 central venous port insertions. Mean age at operation was 5.9 years (2 months - 19 years). Indications included chemotherapy (N=167), long-term intravenous antibiotics infusion (N=36), and total parenteral nutrition (N=15). CV was selected preferentially. The incision includes the deltopectoral triangle laterally, and both the CV cut-down and port insertion were achieved with a single incision. The number of insertion through external, internal jugular vein, and CV was 77, 66 and 75, respectively. The median age, height and body weight were higher in CV cut-down group. The youngest age for CV cut-down was 8 months, the shortest height was 69 cm and the smallest body weight was 5.9 kg. Of 118 trials of CV cut-down, cut-down was successful in 75 cases (63.6 %). CV was absent in 10 cases(8.4 %) and CV was sacrificed after catheter tip malposition in 10 cases (8.4 %). There was only one complication, in which the catheter was inserted into the minute branch of subclavian artery. The CV cut-down method for totally implantable central venous port was safe and feasible in selected groups of patients in children. In addition, preservation of jugular vein and a more favorable cosmetic effect are other benefits of CV cut-down.
Anti-Bacterial Agents ; Body Weight ; Catheterization, Central Venous ; Catheters ; Child ; Cosmetics ; Humans ; Infusions, Intravenous ; Jugular Veins ; Neck ; Parenteral Nutrition, Total ; Subclavian Artery ; Veins ; Venous Cutdown

The diagnosis of breast disease relies primarily on histopathological diagnosis of hematoxylin-eosin stained specimens. Recently, the histopathological diagnosis has been complemented to an extent by analyses of a growing array of immunohistochemical and molecular markers. Prohibitin is an evolutionarily conserved gene with homologues found in organisms ranging from yeast to man. Prohibitin has anti-proliferous activity and available data suggest a role in such diverse processes as normal cell cycle regulation, replicate senescence, cellular immortalization, and the development of sporadic breast tumors. In this study, the prohibitin protein was immunohistochemically stained in representative samples from 10 patients with fibrocystic diseases, 10 with fibroadenomas, 10 with ductal carcinomas in situ, and 33 with infiltrating ductal carcinomas of the breast. There were weaker expressions throughout the tissue in benign breast diseases, but there was stronger staining in the glandular epithelium of breast cancers than with the stromal components. The epithelial and the stromal prohibitin expressions were elevated in carcinomas in situ and in infiltrating ductal carcinomas. However, the expression was most notable in infiltrating ductal carcinomas. There was no correlation between the prohibitin protein and the histologic grade or the TNM stage in breast cancer(p<0.05). These results show that imunohistochemical staining of prohibitin can be used as a diagnostic biomarker in breast cancer.
Breast Diseases ; Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Cell Aging ; Cell Cycle ; Complement System Proteins ; Diagnosis ; Epithelium ; Fibroadenoma ; Humans ; Yeasts