BACKGROUND: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. METHODS: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. RESULTS: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was 1.29 ± 1.71 mm and AHD was 9.71 ± 2.65 mm. In cuff tear group, the mean SOC was 3.15 ± 3.41 mm and AHD was 8.28 ± 1.76 mm. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). CONCLUSIONS: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.
Humans ; Humeral Head* ; Magnetic Resonance Imaging ; Methods* ; Rotator Cuff ; Scapula ; Shoulder ; Tears

No abstract available.
Anemia, Hemolytic* ; Humans ; Infant, Newborn ; Infant, Premature* ; Vitamin E* ; Vitamins*

No abstract available.
De Lange Syndrome*

The case is presented a 49-year-old man had several year history with chronic renal failure with hyperlipidemia due to diabetes mellitus. Treatment of hyperlipidemia was started by oral bezafibrate intake 600 mg per day. Several days later, patient noticed muscle weakness and myalgia. The serum CK, LDH, AST levels were remarkably elevated, myoglobulinuria was also noticed The symptoms of the patient were resolved after the drug was discontinued, thus the diagnosis was established as having bezafibrate induced rhabdomyolysis. On the basis of the above description, bezafibrate may induce muscle damage if dose is excess over the renal capacity. Extreme caution is warranted when the patient is placed on bezafibrate and has renal dysfunction.Strict dose adjustment is necessary in taking account of renal function to avoid muscle damage including rhabdomyolysis.
Bezafibrate ; Diabetes Mellitus ; Diagnosis ; Humans ; Hyperlipidemias ; Kidney Failure, Chronic ; Middle Aged ; Muscle Weakness ; Myalgia ; Rhabdomyolysis

Purpose: This study examined the impact of a drinking reduction program on drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors in college students with problematic drinking habits. Methods: This study incorporated a non-equivalent control group prepost-test design. Study participants included 58 college students who scored 12 or more in the AUDIT-K test (Alcohol Use Disorders Identification Test-Korean version) (experimental group: 30; control group: 28). The intervention consisted of eight sessions and was conducted once a week.It was designed to promote autonomy, competence, and relatedness-the three elements of basic psychological needs in self-determination theory. The participants were assessed before the intervention, immediately after, and four weeks post intervention. Data were collected from October 12 to December 31, 2017. The analysis employed the chi-square test, Fisher’s exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 22.0. Results The mean age of participants was 21.8 years. There were 30 men (51.7%) and 28 women (48.3%). The differences in drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors were statistically significant for the group by time interaction (F = 42.56, p < .001; F = 54.96, p < .001; F = 39.90, p < .001, respectively). Conclusion: The findings indicate that the intervention effectively decreases drinking motivation, increases drinking refusal self-efficacy, and decreases problematic drinking behaviors. It can be an efficient strategy for college students with problematic drinking habits to enhance their self-determination ability.

Purpose: This study examined the impact of a drinking reduction program on drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors in college students with problematic drinking habits. Methods: This study incorporated a non-equivalent control group prepost-test design. Study participants included 58 college students who scored 12 or more in the AUDIT-K test (Alcohol Use Disorders Identification Test-Korean version) (experimental group: 30; control group: 28). The intervention consisted of eight sessions and was conducted once a week.It was designed to promote autonomy, competence, and relatedness-the three elements of basic psychological needs in self-determination theory. The participants were assessed before the intervention, immediately after, and four weeks post intervention. Data were collected from October 12 to December 31, 2017. The analysis employed the chi-square test, Fisher’s exact test, independent t-test, and repeated measures ANOVA using SPSS/WIN 22.0. Results The mean age of participants was 21.8 years. There were 30 men (51.7%) and 28 women (48.3%). The differences in drinking motivation, drinking refusal self-efficacy, and problematic drinking behaviors were statistically significant for the group by time interaction (F = 42.56, p < .001; F = 54.96, p < .001; F = 39.90, p < .001, respectively). Conclusion: The findings indicate that the intervention effectively decreases drinking motivation, increases drinking refusal self-efficacy, and decreases problematic drinking behaviors. It can be an efficient strategy for college students with problematic drinking habits to enhance their self-determination ability.

The higher the use of nonsteroidal anti-inflammatory drugs (NSAIDs), the more reports of adverse drug reactions, especially in children than in adults. As patients with fever take several NSAIDs alternatively, suspected symptoms allergic to drugs with different chemical structures are also experienced in the clinical field. This is because it appears not only through immunological mechanisms but also through cross-intolerant reactions. Therefore, when hypersensitivity to one or more NSAIDs is present, it is important to distinguish between the 2 mechanisms for future treatment planning. Although it is difficult to distinguish between the 2 mechanisms by clinical history, drug provocation test with aspirin is helpful in diagnosis. A 4-year-old patient who had urticaria/angioedema and shortness of breath after taking ibuprofen and acetaminophen visited Kangwon National University Hospital for a treatment plan using antipyretics and/or analgegics forward. We propose a diagnosis and treatment protocol for such patients with a brief literature review.

OBJECTIVES: The purpose of this study was to determine whether or not the shed endometrial tissues in menstrual fluid (MF) have adhesive potentials, using human amniotic membrane (AM). METHODS: The MF from 20 patients with regular menstruation was collected with Wallace catheter by aspiration from the uterine cavity on the second or third day of the menstrual period. The AM was obtained from the placenta of term delivery without any complication. The MF was washed and diluted fivefold with Hams F-10 medium supplemented with 10% fetal bovine serum. The cell suspension was placed on either epithelial layer (EP) or extracellular matrix layer (ECM) of the AM. After 5 days of culture, the adhesion sites were observed under a stereomicroscope. For histological observation, each cultured AM was prepared for the serial paraffin section. RESULTS: The adhesion sites of endometrial tissues in MF were found both ECM (20/20) and EP (11/20) of the AM. The size of adhesion sites in each AM were highly variable from microscopic to macroscopic size. CONCLUSION: We found that the shed endometrial tissues in MF have adhesive potential to epithelial layer in addition to extracellular matrix layer of amniotic membrane. This adhesive potential may be related to pathogenesis of endometriosis. We suggest that this culture system can be useful as an in-vitro model for endometriosis.
Adhesives* ; Amnion* ; Catheters ; Endometriosis* ; Extracellular Matrix ; Female ; Humans ; Menstruation ; Paraffin ; Placenta

Purpose: This retrospective study investigated the feasibility, diagnostic, and therapeutic advantages of the gastrografin challenge on patients with adhesive small bowel obstruction (ASBO). Methods: There were 125 patients reviewed who were admitted to the Department of General Surgery at a single institution (September 2018 to August 2019) with a diagnosis related to ASBO. The study population included 100 patients (114 cases) who had received initial conservative management. Patient characteristics and operation rates were compared between the gastrografin challenge success group and failure group, and operation rates and length of hospital stay were compared between the gastrografin challenge group and “non-challenge” group. Results: During the study period, 21 patients with ASBO underwent the gastrografin challenge. The challenge was successful in 17 patients where the bowel obstruction was resolved without the need for surgery. Among patients who failed the challenge, 2 patients underwent adhesiolysis and 2 patients were able to progress their diet avoiding surgery. In patients who underwent surgery (n = 2), the length of hospital stay was significantly shorter in the gastrografin challenge group compared with the “non-challenge” group sub analysis (n = 13 cases; 10.5 vs. 20 days, p = 0.038), indicating that the gastrografin challenge assisted rapid decision-making for surgery. No adverse events were reported for the 21 gastrografin challenges. Conclusion In patients with ASBO, the gastrografin challenge is an accurate, safe method to determine the need for surgery. In addition, the gastrografin challenge may reduce the length of stay in patients who required surgery for ASBO resolution.

Purpose: This retrospective study investigated the feasibility, diagnostic, and therapeutic advantages of the gastrografin challenge on patients with adhesive small bowel obstruction (ASBO). Methods: There were 125 patients reviewed who were admitted to the Department of General Surgery at a single institution (September 2018 to August 2019) with a diagnosis related to ASBO. The study population included 100 patients (114 cases) who had received initial conservative management. Patient characteristics and operation rates were compared between the gastrografin challenge success group and failure group, and operation rates and length of hospital stay were compared between the gastrografin challenge group and “non-challenge” group. Results: During the study period, 21 patients with ASBO underwent the gastrografin challenge. The challenge was successful in 17 patients where the bowel obstruction was resolved without the need for surgery. Among patients who failed the challenge, 2 patients underwent adhesiolysis and 2 patients were able to progress their diet avoiding surgery. In patients who underwent surgery (n = 2), the length of hospital stay was significantly shorter in the gastrografin challenge group compared with the “non-challenge” group sub analysis (n = 13 cases; 10.5 vs. 20 days, p = 0.038), indicating that the gastrografin challenge assisted rapid decision-making for surgery. No adverse events were reported for the 21 gastrografin challenges. Conclusion In patients with ASBO, the gastrografin challenge is an accurate, safe method to determine the need for surgery. In addition, the gastrografin challenge may reduce the length of stay in patients who required surgery for ASBO resolution.