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*

Intramedullary schwannomas without evidence of Von Recklinghausen's disease are extremely rare. We report a case of solitary intramedullary schwannoma of the dorsal spinal cord and review the literature on these rare neoplasms. The possible etiology of the tumor as well as wome difficulties encountered in the diagnostic procedure and treatment are discussed.
Neurilemmoma* ; Neurofibromatosis 1 ; Spinal Cord ; Spinal Cord Neoplasms ; Spine*

Myocarditis is defined as the myocardial inflammation caused by various infectious agents (such as virus, rickettsia , bacteria, protozoa, fungus and parasites). The clinical manifestations of myocarditis ranges from the asymptomatic state due to focal inflammation to fulminant fatal congestive heart failure secondary to diffuse myocardial involvement. Clinically, in some cases, it may simulate an acute myocardial infarction. We experienced a case of acute fulminant myocarditis that presented as acute myocardial infarction initially, and then progressed into and recovered from congestive heart failure and multiorgan failure.
Asymptomatic Diseases ; Bacteria ; Estrogens, Conjugated (USP)* ; Fungi ; Heart Failure* ; Inflammation ; Myocardial Infarction ; Myocarditis* ; Rickettsia

This study aimed to plan nutrition support programs for the elderly living alone whose nutrition status were seriously concerned, conducted seven stages nutrition intervention program on a trial basis, and evaluated the effectiveness of the program of the Elderly Nutrition Support Project. Subjects were selected for personalized nutrition management based on nutritional risk score and nutrition intervention were tailored to the problems occurred. The elderly nutrition support program targets were 44 senior citizens who lived alone with low income. The 33 (as Type 1) of the subjects with whom milk, tofu, seaweed, eggs, black beans have been supported, and also provide nutrition education, and the rest 11 persons (as Type 2) to whom food was not supported but provide nutrition education programs. As a result, all subjects showed that compared with pre and post program implementation, their daily exercise time and milk and protein consumption level were increased and some improvement was observed regular meals consumption and low-salt diets. Their nutrient intake level such as calories, protein, calcium, iron improved after implementation. In addition, NSL DETERMINE scores significantly improved from 13.21 to 7.24 in Type 1 and 11.27 to 9.91 in Type 2. As positive dietary behavioral changes were observed as in that they purchased more protein and calcium rich foods.
Aged ; Calcium ; Diet, Sodium-Restricted ; Eggs ; Fabaceae ; Humans ; Iron ; Meals ; Milk ; Nutritional Status ; Ovum ; Seaweed ; Soy Foods

Acquired port-wine stain is rare. It mimics a congenital port-wine stain morphologically but the pattern of onset is acquired after birth. It represents a progressive ectasia of vessels located in the superficial vascular plexus. The exact mechanism is unknown but some reported cases have occurred after trauma. We herein report five cases of acquired port-wine stains and they were idiopathic in nature.
Dilatation, Pathologic ; Parturition ; Port-Wine Stain*

No abstract available.
Cerebrospinal Fluid Rhinorrhea* ; Cerebrospinal Fluid*

Purpose: This study was performed to evaluate the incidence of vasovagal reactions (VVRs) and the efficacy of lidocaine injection for prevention. Methods: One hundred seventeen patients diagnosed with hemorrhoids and scheduled to undergo a stapled hemorrhoidopexy (SH) were randomly divided according to submucosal injection to the rectum: lidocaine group (n = 53, lidocaine injected just before full closure of the stapler) and control group (n = 58). Outcomes included baseline patient characteristics (American Society of Anesthesiologists physical status classification, body mass index, diabetes mellitus, hypertension, and previous VVR history), vital signs during the operation, incidence of VVRs (hypotension, bradycardia, dizziness, diaphoresis, and nausea/vomiting), and postoperative complications (pain, bleeding, and urinary retention). Results: Baseline characteristics were similar between groups. The number of patients with lower abdominal pain after firing the stapler and incidence of dizziness were lower for the lidocaine group than for the control group (9.4% vs. 25.9%, P = 0.017; 0% vs. 8.6%, P = 0.035, respectively). However, there were no significant between-group differences in incidence of nausea and diaphoresis (0% vs. 3.4%, P = 0.172) and syncope (1.9% vs. 3.4%, P = 0.612). Fewer patients in the lidocaine group complained of postoperative pain (41.5% vs. 58.6%, P = 0.072), and these patients used analgesics less frequently than those in the control group (28.3% vs. 36.2%, P = 0.374). Conclusion Patients who received a submucosal lidocaine injection prior to SH experienced less lower abdominal pain and dizziness compared with those who received standard treatment. A larger, more detailed prospective study is needed for further analysis.

PURPOSE: The number of patients with HIV disease has been increasing rapidly, with anorectal discomfort being the most common complaint of these patients. However, there are no data on HIV disease relating to the benign anorectal area in Koreans. METHODS: A retrospective chart review was performed on patients diagnosed with benign anal diseases, combined with HIV disease, between 1996 and 2001. Their clinical aspects were compared with HIV patients registered with the National Institute of Health in Korea between 1985 and 2001. RESULTS: A total of 1,613 patients were registered, with the National Institute of Health in Korea, as having HIV disease. The ratio of sex was 7.2:1, with a male predominance. The disease was most common in the 3rd & 4th decades, with 64.2%, of the patients in this age range. As for the routes of transmission, sexual contact was the most common (96.9%), followed by blood transfusion (including blood products) (2.8%), vertical transmission (0.1%) and drug injection (0.1%). With regard to the sexual contact routes, homosexuality accounted for 28.0%. Of the cases of HIV disease presenting with a benign anal disease, 32 patients, with a sex ratio of 31:1, with an overwhelming male predominance, were selected. Twenty-six cases had been newly diagnosed at our hospital. As for the routes of the transmission, the disease had been transmitted by sexual contact in all cases. In 43.8% of these cases, the disease had been transmitted by homosexual contact, which showed a marked difference to that of the National database (P<0.05). For those associated with an anal diseases, there were 10 cases of anal fistula, 9 of perianal abscess, 7 of condyloma acuminata, 7 of anal fissure, 5 of hemorrhoids and 2 of ulceration on the lower rectum, noted. CONCLUSIONS: Nowadays, the numbers of anorectal-disease patients with HIV are increasing in Korea. Since HIV is common in the area of benign proctology, all proctologists must consider the possibility of HIV when managing patients.
Abscess ; Blood Transfusion ; Colorectal Surgery ; Fissure in Ano ; Hemorrhoids ; HIV Infections ; HIV* ; Homosexuality ; Humans ; Korea ; Male ; Rectal Fistula ; Rectum ; Retrospective Studies ; Sex Ratio ; Ulcer

No abstract available.
Humans

It has been held that excessive mechanical forces to the osseous and soft tissues of the TMJ result in joint dysfunction. Understanding the stress pattern on TMJ is very important in TMJ research. But, it is very difficult to measure directly the biomechanical stress distribution in the TMJ during functional movement was studied through animal experiment or mathematical model . It was observed and compared the stress distribution occuring in the working and balancing condyle when lower right canine, lower right first molar and lower right second molar were clenched by the three dimensional finite element analysis. Also, stress distribution in the working and balancing condyles were observed and compared when 20 forward and buccal bite forces were applied to the first molar The results were as follows : 1. Stress distribution in the condyles during unilateral clenching of the first molar, second molar, canine showed no difference. In the working condyle, tensile force was concentrated on the lateral aspect of the condylar articular surface and condylar neck. And compressive force was concentrated on the anteromedial and lateral aspect of condyle. In the balancing condyle, tensile and compressive force was concentrated on the lateral aspect of the condylar articular surface and stress transmission to the temporal bone was not observed. 2. When lateral force were applied to the first molar, tensile force were concentrated on the medial aspect of the condylar neck and condylar posterior surface in working and balancing condyle. Compressive force was concentrated on the anteromedial and lateral surface of condyle and stress transmission to the temporal bone was not observed. 3. During unilateral clenching, stress in the working condyle decreased as the occlusal load moved posteriorly while the stress in the balancing condyle increased when lateral forces were applied to the first molar, the incremental amount of stress was greater than vertical load. 4. During unilateral clenching, the average balancing/ working stress ratio was 2.52. There was a greater concentration of stress in the balancing condyle. The ratio increased at the occlusal load moved posteriorly and decreased considerably when lateral forces were applied to the first molar
Animal Experimentation ; Bite Force ; Finite Element Analysis ; Joints ; Mandibular Condyle* ; Models, Theoretical ; Molar ; Neck ; Temporal Bone ; Temporomandibular Joint