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*

Mirtazapine-a newly developed drug with reduce adverse effects and toxicity of original antidepre-ssants-has been known to have antidepressant effect by enhancing the transmission of norepinephrine and serotonin via blockade of alpha2-noradrenergic autoreceptor and heteroreceptor and to have common side effects such as sedation, weight gain, and dizziness. We report a case of 50 years old female depressive patient who developed mirtazapine-associated hyperglycemia during treatment with mirtazapine and returned to normal glucose level after stopping the usage of mirtazapine. In patients who receive drugs with the risk of hyperglycemia and diabetes mellitus, we should consider the evaluation for diabetes mellitus and follow it up carefully in the future.
Autoreceptors ; Diabetes Mellitus ; Dizziness ; Female ; Glucose ; Humans ; Hyperglycemia* ; Middle Aged ; Norepinephrine ; Serotonin ; Weight Gain

Sertoli-Leydig cell tumor or Brenner tumor is a relatively rare ovarian tumor. Other associated elements in the form of epithelial, mesenchymal, and tumor components of each tumor have been reported. The Sertoli-Leydig cell tumor with a Brenner tumor element has not been documented in the literature, so we are reporting on a case of Sertoli-Leydig cell tumor coexisting with a Brenner tumor. This 62-year-old woman presented with a 4 year history of lower abdominal mass and vaginal bleeding. Exploratory laparotomy was done. The left ovary showed a multiseptated, cystic, yellow-white solid mass, measuring 17.0x13.0x5.0 cm and weighing 985.0 gm. Microscopic examination revealed a tubular or trabecular arrangement of the Sertoli cells and variable numbers of Leydig cells. There were several tumor nests with cystic spaces composed of ovoid cells showing longitudinal nuclear grooving. Sarcomatoid or heterologous elements were not found.
Female ; Humans

Vibrio cholerae strain other than O1 and O139 (Vibrio cholerae non-O1/O139) are associated with sporadic diarrhea and have often been reported in association with extraintestinal infections. We report a case of peritonitis by V. cholerae non-O1/O139 in 43-year-old male who was diagnosed cirrhosis. He, was complained of abdominal distension and fever without history of consumption of raw sea food and exposure to sea water. Gram negative bacilli were cultured from his peritoneal fluid and identified as V. cholerae sero group O14.
Adult ; Ascitic Fluid ; Cholera ; Diarrhea ; Fever ; Fibrosis ; Humans ; Male ; Peritonitis* ; Seafood ; Seawater ; Vibrio cholerae* ; Vibrio*

Vibrio cholerae strain other than O1 and O139 (Vibrio cholerae non-O1/O139) are associated with sporadic diarrhea and have often been reported in association with extraintestinal infections. We report a case of peritonitis by V. cholerae non-O1/O139 in 43-year-old male who was diagnosed cirrhosis. He, was complained of abdominal distension and fever without history of consumption of raw sea food and exposure to sea water. Gram negative bacilli were cultured from his peritoneal fluid and identified as V. cholerae sero group O14.
Adult ; Ascitic Fluid ; Cholera ; Diarrhea ; Fever ; Fibrosis ; Humans ; Male ; Peritonitis* ; Seafood ; Seawater ; Vibrio cholerae* ; Vibrio*

Background: : In the case of simulation practice, if the visual information obtained through observation is described in text along with video observation learning, students will be able to reinforce their memory of the acquired content, promote the learning process, and further enhance nursing performance skills. The purpose of this study was to confirm the effectiveness of communication training through observational learning and recording of simulation practice videos and to provide basic data for developing strategies to improve learning effects. Methods: : We conducted a simulation of chronic obstructive pulmonary disease patient nursing with fourth-year students in the department of nursing at University B in A City. The described communication contents while watching a video of a colleague’s team’s implementation in real time, were analyzed by content analysis method. Results: : In this study, nursing students have an opportunity to think critically by recording their judgments on effective or ineffective situations in therapeutic communication with patients, information transfer, and cooperative communication between professionals and used it for reflection and application. Conclusion : Creating a structured observation sheet while observing the simulation situation of a peer team in real time is a way to reinforce the memory of the learned content by allowing more focus on observational learning and elaborate processing of visual information through recording.

Objectives: ：This study aimed to compare autonomic nervous system (ANS) dysregulation and differential relationships with clinical severities between anxiety disorder, depressive disorder, and trauma·stressor related disorder using heart rate variability (HRV) parameters. Methods: ：We conducted a retrospective chart review of outpatients from 2017 to 2018 in Stress Clinic of National Center for Mental Health. Total 473 patients were included; 166 anxiety disorder; 184 depressive disorder ; 123 trauma·stressor related disorder. Parameters of 5-min analysis of HRV were compared in three groups. Additionally, we investigated the differential association of each parameters with Clinical Global Impression-Severity Scale (CGI-S) across each group. Results: ：No significant differences were found in all HRV parameters between the three groups. However, significant group interactions by CGI-S were found in standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD) (SDNN, p=0.017 ; RMSSD, p=0.034). A negative relationship between CGI-S and SDNN, RMSSD has been found in anxiety disorder and depressive disorder. However, a positive relationship between CGI-S and SDNN, RMSSD has been found in trauma·stressor related disorder. Conclusions ：Despite of no significant differences of each HRV parameter, our findings suggested the differential associations of HRV parameters with clinical severity among anxiety disorder, depressive disorder and trauma·stressor related disorder. In trauma·stressor related disorder, the clinical severity and degree of ANS dysregulation may differ, so more aggressive treatment is suggested.

Uterine inversion is a rare but a potentially fatal complication of labor, and may occur in the third stage of labor. Because it can lead to shock and hemorrhage, immediate management should be attempted to replace the inverted uterus. We report a case in which uterine inversion was not replaced by manual manipulation, but which was successfully replaced by the induction of general anesthesia.
Anesthesia, General* ; Hemorrhage ; Shock ; Uterine Inversion* ; Uterus

Sinus histiocytosis with massive lymphadenopathy known as Rosai-Dorfman disease is characterized by painless bilateral cervical lymphadenopathy. Extranodal manifestations are uncommon and spinal involvement is rare. A 15-year-old man presented with intermittent midthoracic back pain only. He had no specific findings on neurologic examinations, hematologic and biochemical laboratory tests. Radiological examination of thoracic spine revealed collapse of T6 vertebrae with thoracic kyphosis and osteolytic lesion of T12 vertebra body. He underwent a removal of bone tumor, anterior reconstruction with mesh and pedicle screw fixation via posterior approach for pathologic confirmation and stabilization. Histopathologic study of the lesion revealed focal infiltration of large histiocytes showing emperipolesis. Immunochemistry stain of histiocytes was positive for CD68 and S-100 but negative for CD1a. This report presents a rare case and literature review of extranodal Rosai-dorfman disease in thoracic spine.
Adolescent ; Back Pain ; Emperipolesis ; Fractures, Compression* ; Histiocytes ; Histiocytosis, Sinus* ; Humans ; Immunochemistry ; Kyphosis ; Lymphatic Diseases ; Neurologic Examination ; Spine*