The incidence of testicular rupture by blunt trauma has been considered rare. But if testicular rupture has developed, the diagnosis of which is difficult. In the 50 cases of scrotal trauma patients, we investigated in the frequency of testicular rupture and early exploration in comparison with delayed exploration. Then the incidence of testicular rupture was in 46.1% of the cases of exploration, and early exploration of for scrotal trauma has resulted in higher testicular salvage rate than delayed exploration.
Diagnosis ; Humans ; Incidence ; Rupture*

The incidence of testicular rupture by blunt trauma has been considered rare. But if testicular rupture has developed, the diagnosis of which is difficult. In the 50 cases of scrotal trauma patients, we investigated in the frequency of testicular rupture and early exploration in comparison with delayed exploration. Then the incidence of testicular rupture was in 46.1% of the cases of exploration, and early exploration of for scrotal trauma has resulted in higher testicular salvage rate than delayed exploration.
Diagnosis ; Humans ; Incidence ; Rupture*

Usually the histologic response of muscle to the ischemia range from mild, reversible change to extensive necrosis and fibrosis in the case of anterior tibial compartment syndrome. But dystmphic calcification in the late stages is very rare condition.Only three cases were previously reported by Gallie and Broder et al in the literature. We are reporting six cases of dystrophic calcification following anterior tibial compartment syndrome in late stages. Onsets of dystrophic calcifications after original injuries ranged from twelve years to thirty-two years. Two out of six cases revealed painless maas in the anterior tibial compartment and remaining four cases revealed painful aases. At surgery, tooth-paste like, calcified material was evacuated in one of five operated cases and yellowish grey, brittle materials were evacuated in the remaining four cases.
Compartment Syndromes ; Fibrosis ; Ischemia ; Leg ; Necrosis

Global life expectancy has increased with the development of medicine, and better nutrition, hygiene, and health care. However, as the elderly population increases, the number of people who are immunocompromised and who have chronic diseases has also increased. New infectious diseases have also become a significant threat to public health. In particular, pathogens can have fatal consequences in the elderly and people with underlying diseases. Vaccination is an effective and safe means of preventing infectious diseases, and adult vaccination has gained increasing interest in recent years. The increased number of people with chronic diseases and underlying health conditions is a consequence of the aging population. Furthermore, the decline in immunity after immunization in childhood and adolescence, emergence of novel infectious diseases, change in epidemiology due to mutant microorganisms, and increased infectious diseases from overseas have all increased the need for adult vaccination.

BACKGROUND: To assess the effects of mDOT implementation on sputum smear conversion for AFB (Acid fast bacilli) positive pulmonary tuberculosis patients, modified Directly Observed Treatment (mDOT) was started on October 8th 2001 at a health center in Seoul. mDOT was defined through weekly interviewing and supervising of a patient by a supervisor (doctor, nurse, or lay health worker). The sputum smear conversion of a mDOT group was compared with that of a self-medication (self) group. METHODS: This study included 52 AFB positive pulmonary tuberculosis patients registered at a health center in Seoul between October 8th 2001 and April 23rd 2002. 24 and 28 patients were enrolled in the mDOT and self medication groups, respectively. Paired (1:1) individual matching, by gender, extent of disease, relapse and age-matching variables, was performed between the two groups, resulting in 20 paired matches. This prospective study was planned as an unblinded, non-randomized quasi- experimental pilot project. Outcomes were identified from results of sputum smear examinations for AFB in both groups at 2 weeks, and 1 and 2 months. The paired matching data were analyzed using the SAS program version 8.1 by McNemar test. RESULTS: At the end of 2 weeks of treatment, the sputum smear conversion of the mDOT group was somewhat higher than that of the self medication group (78.57 vs. 50%, p-value=0.289), and after 1 month of treatment no statistically significant difference was shown between the two groups (83.33 vs. 50, p-value=0.125). At the end of 2 months of treatment (initial intensive phase), the sputum smear conversions of the mDOT and self groups were 95 and 75%, respectively (p-value=0.219). CONCLUSIONS: The implementation of mDOT did not result in clinically significant increases in the sputum smear conversion at 2 weeks, and 1 and 2 months compared with that of the self medication group. However, the increases experienced might contribute to diminishing the infectious period of AFB positive patients, and this approach may act as a guide for a specific group of patients. In this study, mDOT was performed for one hundred percent of the intensive treatment phase. It can also be an effective treatment for pulmonary tuberculosis patients, and may be useful for some high risk tuberculosis patients.
Humans ; Pilot Projects ; Prospective Studies ; Recurrence ; Self Medication ; Seoul ; Sputum* ; Tuberculosis ; Tuberculosis, Pulmonary

PURPOSE: The purpose of this study was to examine the significance of increased bone density according to whether bone grafts were applied using demographic data with Cone Beam Computed Tomography (CBCT) and to compare the bone densities between before and after implant prosthesis using the Hounsfield index. MATERIALS AND METHODS: Thirty-six randomly selected computed tomography (CT) scans were used for the analysis. The same sites were evaluated digitally using the Hounsfield scale with V-Implant 2.0(TM), and the results were compared with maxillary posterior bone graft. Statistical data analysis was carried out to determine the correlation between the recorded Hounsfield unit (HU) of the bone graft and implant prosthesis using a Mann-Whitney U test and Wilcoxon Matched-pairs test. RESULTS: The bone grafted maxillary posterior teeth showed an increase in the mean values from-157 HU to 387 HU, whereas non-grafted maxillary posterior teeth showed an increase from 62 HU to 342 HU. After implantation, the grafted and non-grafted groups showed significantly higher bone density than before implantation. However, the grafted group showed significantly more changes than the non-grafted group. CONCLUSION: Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density (Hounsfield scale) and bone grafts in the maxillary molar area.
Bone Density ; Cone-Beam Computed Tomography ; Data Interpretation, Statistical ; Dental Implants ; Molar ; Prostheses and Implants ; Tooth ; Transplants

OBJECTIVE: To overcome the limitations of the single gene transfer, the authors present the results of wild-type p16 and p53 combined genes transfer in vitro to the U251MG and U373MG cell lines using cationic liposome as a vector. METHODS: To compare the therapeutic effect of the combined p16 and p53 genes transfer with the single p16 and p53 gene transfer, full length of wild-type human p16 and p53 gene, and combined p16-p53 genes were transferred in vitro to the U251MG and U373MG cell lines using cationic liposome as a vector. As the U251MG and U373MG cell lines are devoid of p16 and p53 genes, the therapeutic effect of the three groups of gene transfer could be evaluated by the growth suppression or percentage of the viable cells. Reverse transcription polymerase chain reaction(RT-PCR), flow cytometry, and electron microscopy(EM) were used for evaluation of the growth suppression or apoptosis of the tumor cells. RESULTS: p16 gene, p53 gene and the combined p16-p53 genes were effectively transferred to the cell lines using cationic liposome as a vector resulting in dramatic decrease of the viable tumor cells in comparison to the control group(p=0.004). The cytotoxic effect of the gene transfer in the U251MG cell line was the most significant in the combined p16-p53 group. However, in the U373MG cell line p53 single gene transfer group showed more significant effect than the combined gene transfer group. Apoptosis was confirmed by EM in the combined p16-p53 genes group. The G1 phase arrest effect, confirmed by the flow cytometry was more prevalent in the p16 gene transfer group than the other groups. CONCLUSION: Cationic liposome-mediated transfer of combined p16-p53 genes to the human glioblastoma cell lines is proven effective. However, the therapeutic effect of the combined p16-p53 genes transfer was not consistently superior to the single p16 or p53 gene transfer.
Apoptosis ; Cell Line* ; Flow Cytometry ; G1 Phase ; Genes, p16 ; Genes, p53* ; Glioblastoma* ; Humans* ; Liposomes ; Reverse Transcription

The purpose of this study is to investigate whether paraspinal muscle wasting occurs in association with chronic low back pain(LBP) and to know whether low back muscle exercise is effective for abating chronic low back pain. Cross sectional areas(CSA) of lumbar vertebral bodies and paraspinal muscles were measured using CT at the level of the fouth lumbar vertebral body in 37 patients(23 males 14 females) with acute low back pain and in 44 patients(20 males, 24 females) with chronic low back pin. The results were as follows; 1) The mean age of the patients with chronic LBP were higher than those with acute LBP. 2) The CSAs of L4 vertebral bodies were correlated significantly with body weight and the CSAs of L4 vertebral bodies, erector spinae and psoas muscles were larger in males than in females. 3) The volumes of the paraspinal muscles were significantly reduced in patients with chronic LBP compared to a cute LBP. These changes can cause erector spinae and psoas muscle weakness and disuse atrophy and thereby predispose to spinal instability and progressive dysfuction.
Back Muscles ; Body Weight ; Female ; Humans ; Low Back Pain* ; Male ; Muscular Atrophy ; Muscular Disorders, Atrophic ; Paraspinal Muscles* ; Psoas Muscles

OBJECTIVE: Cerebral vasospasm is a common and potentially devastating complication of aneurysmal subarachnoid hemorrhage (aSAH). Inflammatory processes seem to play a major role in the pathogenesis of vasospasm. C-reactive protein (CRP) constitutes a highly sensitive inflammatory marker. Elevation of serum CRP levels has been demonstrated in patients with aSAH. The purpose of the current study was to evaluate the possible relationship between CRP levels in the serum and transcranial Doppler (TCD) and the development of vasospasm in patients with aSAH. METHODS: A total of 61 adult patients in whom aSAH was diagnosed were included in the study from November 2008 to May 2011. The patients' demographics, Hunt and Hess grade, Fisher grade, CT scans, digital subtraction angiography studies, and daily neurological examinations were recorded. Serial serum CRP measurements were obtained on days 1, 3, 5, 7, 9, 11 and 13 and TCD was measured on days 3, 5, 7, 9, 11 and 13. All patients underwent either surgical or endovascular treatment within 24 hours of their hemorrhagic attacks. RESULTS: Serum CRP levels peaked on the 3rd postoperative day. There were significant differences between the vasospasm group and the non-vasospasm group on the 1st, 3rd and 5th day. There were significant differences between the vasospasm group and the non-vasospasm group on the 3rd day in the mean middle cerebral artery velocities on TCD. CONCLUSION: Patients with high levels of CRP on the 1st postoperative day and high velocity of mean TCD on the 3rd postoperative day may require closer observation to monitor for the development of vasospasm.
Adult ; Aneurysm* ; Angiography, Digital Subtraction ; C-Reactive Protein* ; Demography ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Neurologic Examination ; Organothiophosphorus Compounds ; Subarachnoid Hemorrhage* ; Vasospasm, Intracranial*

OBJECTIVE: Detection of focal non-hemorrhagic lesion (NHL) has become more efficient in diffuse axonal injury (DAI) patients using an MRI. The aims of this study are to find out the radiological distribution, progress of NHL and its clinical significance. METHODS: Between September 2005 and October 2011, 32 individuals with NHLs on brain MRI were enrolled. NHLs were classified by brain location into 4 major districts and 13 detailed locations including cortical and subcortical, corpus callosum, deep nuclei and adjacent area, and brainstem. The severity of NHL was scored from grades 1 to 4, according to the number of districts involved. Fourteen patients with NHL were available for MRI follow-up and an investigation of the changes was conducted. RESULTS: Thirty-two patients had 59 NHLs. The most common district of NHL was cortical and subcortical area; 15 patients had 20 NHSs. However the most common specific location was the splenium of the corpus callosum; 14 patients had 14 lesions. The more lesions patients had, the lower the GCS, however, this was not a statistically meaningful difference. On follow-up MRI in 14 patients, out of 24 lesions, 13 NHLs resolved, 5 showed cystic change, and 6 showed atrophic changes. CONCLUSION: NHLs were located most commonly in the splenium and occur frequently in the thalamus and the mesial temporal lobe. Because most NHS occur concomitantly with hemorrhagic lesions, it was difficult to determine their effects on prognosis. Since most NHLs resolve completely, they are probably less significant to prognosis than hemorrhagic lesions.
Brain ; Brain Injuries ; Brain Stem ; Corpus Callosum ; Diffuse Axonal Injury ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Temporal Lobe ; Thalamus