No abstract available.
Cryptococcosis*

We performed erotic stimulation that in 63 patients with erectile dysfunction in order to investigate erectile responses to visual sexual stimulation in patients with psychogenic and organic impotence and to elucidate valuable parameters for differential diagnosis between psychogenic and organic impotence. After the test using polygraph system and erotic film, subjective sexual drive in each patient was evaluated as grade I (poor), grade II (moderate), grade III (good). Following parameters were statistically analyzed : degree of maximal rigidity, degree of maximal tumescence, T -up phase (time taking place from the beginning of the erection to maximal level). The T-max phase (time taking place for the plateau phase of maximal erection). The results obtained were summarized as follows. Regardless of sexual drive of each patient, psychogenic impotence group showed better maximal rigidity and shorter T-up phase of rigidity than organic impotence group (p<0.05}. Of patients with psychogenic impotence, good sexual drive group showed better maximal rigidity and maximal tumescence than poor sexual drive group (p<0.06). Psychogenic impotence group showing good sexual drive revealed much better maximal rigidity and shorter T-up phase of rigidity than organic impotence group with same degree of sexual drive (p<0.05). These results indicate erotic stimulation test is highly valuable method for differential diagnosis between psychogenic and organic impotence, especially when the patient shows sexual drive in moderate or good degree. And it is suggested that maximal rigidigity and T-up phase of erection parameters in erotic stimulation test provide high validity for the differention.
Diagnosis, Differential ; Erectile Dysfunction* ; Humans ; Male

PURPOSE: To analyse the risk factors for recurrence of hemangiomas in extremities after surgical treatment and to compare with those of trunk. MATERIALS AND METHODS: 120 cases of hemangioma with surgical treatments from June 1998 to September 2009 were analysed. 53 cases with surgical treatment on trunk in the same period were set to be the control group. We analyze several factors: age, location, site, size, histologic types and correlation between recurrence and each risk factor using logistic regression analysis. RESULTS: Recurrence rate was 11.7% in extremities and 9.4% in trunk. There were no correlation between recurrence and age, site, size, histologic type. But, there was stastically significant correlation between recurrence rate and location, especially hand, forearm, feet in extremities and head and neck in trunk. CONCLUSION: Recurrence after surgical treatment of hemangioma is highly prevalent in anatomical location such as, hand, foot and forearm those are difficult to achieve complete resection because of close to neurovascular structures. Careful observation should be needed owing to incomplete resection can occurs recurrence.
Extremities ; Foot ; Forearm ; Hand ; Head ; Hemangioma ; Logistic Models ; Neck ; Recurrence ; Risk Factors

Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.
Cardiomyopathies* ; Catecholamines ; Child, Preschool ; Extracorporeal Membrane Oxygenation* ; Female ; Humans ; Hypertension ; Myocarditis ; Neuroblastoma*

Posterior lumbar apophyseal fracture characterized by osteochondral fragments from posterior rim of a lumbar vertebral body, has often been misdiagnosed as herniated disc or spinal stenosis due to its similarity of symptoms. But recent use of CT scan facilitated the diagnosis of the lesion as a separate entity. This study was performed to verify the clinical characteristics, to find out the mechanism of injury and to determine the most effective method of diagnosis and treatment. Authors reviewed 17 patients(14 male, 3 female) who were subjected to surgical treatment at Department of Orthopaedic Surgery, Seoul National University Hospital for posterior lumbar spophyseal fracture during the period of 1990-1992, and followed up for average of 1 year and 6 months(range 1 to 3 years). Thirteen patients (76%) were related to a history of trauma or strenuous physical activity prior to the onset of symptoms. The mechanism of injury was the rapid flexion with axial compression in 7, hyperextension in 4, and pure axial compression in 2 patients. The mean age at the time of injury was 20 years(range 10 to 31 years). All patients presented low-back pain radiating to lower extremities and 11 patients showed neurogenic intermittent claudication. The mean age at the time of surgical intervention was 23 years and 10 months(range 15 to 31 years), and the mean duration of symptoms was 3 years(range 2 months to 13 years). Simple X-ray revealed the lesion in only 3 cases but CT scan demonstrated the characteristic osteochondral fragment displaced posteriorly into the spinal canal and the corresponding defect with degenerative changes in all patients. The fracture occured through the superior apophyseal rim of L5 in 9 superior rim of L4 in 3, inferior rim of L4 in 2, inferior rim of L5 in, superior rim of L2 in 1, and superior rim of L1 in 2 patients. Two patients had concomitant fractures at two levels. All patients except one were treated with posterior decompression including the removal of the displaced fragment and posterolateral fusion with pedicular screws was carried out to prevent further degenerative change and instablilty. One patient with the lesion at the superior rim of L1 was treated by anterior decompression and fusion. All patients showed relief of pain and claudication with satisfactory results. One patient had partial tear of L4 root with slight weakness of greater toe dorsiflexion, but it recovered in 4 months. In conclusion, posterior lumbar spophyseal fracture predominantly affected young males and the most common causative mechanism was rapid flexion with axial compression. The CT scan facilitated identification of the lesion. The most frequently affected site was the superior rim of L5. Satisfactory results could be achieved bvy adequate posteriior decompression with the removal of the fragment and posterolateral fusion with pedicular screws.
Decompression ; Diagnosis ; Humans ; Intermittent Claudication ; Intervertebral Disc Displacement ; Lower Extremity ; Male ; Methods ; Motor Activity ; Seoul ; Spinal Canal ; Spinal Stenosis ; Tears ; Toes ; Tomography, X-Ray Computed

The various biomechanical responses such as stress distribution, facet contact force and nucleus pressure change in the lumbar spine under vertical static and dynamic loading conditions were. Investigated with a nonlinear three dimensional finite element model. Finite element model of one motion segment, consisted of two vertebral bodies(L3-4) with one disc, was developed from 1 mm thick transverse CT cross-sections. Geometrical nonlinearity was also considered for the large deformation on the disc. ABACUS package was used for calculation and its results were verified comparing with the existing in-vitro experimental data. Clinically useful results could be obtained with this analysis. Stress was concentrated on the endplate under static and dynamic loading condition, especially posterior and anterior aspect and central portion along midsagittal plane. The facet contact force showed some discontinuity when Δt/2=0.03 sec. This discontinuity was considered to de due to the vibration of upper vertebra. Relatively smooth contact force profile was detected when t/2=0.1342 sec. Intradiscal pressure and stress pattern changes on the vertebra were also analyzed.
Spine ; Vibration

Malignant transformation of fibrous dysplasia to osteosarcoma is rare. We report a case in which monostotic fibrous dysplasia of the proximal femur treated with curettage, Ender nailing and bone grafting was differentiated into the osteosarcoma in a 58-year-old female.
Bone Transplantation ; Curettage ; Female ; Femur ; Fibrous Dysplasia, Monostotic ; Humans ; Middle Aged ; Osteosarcoma

BACKGROUND AND OBJECTIVES: Acute sinusitis is a mild, self-limiting disease. In children, however, sinusitis may lead to other severe, even life-threatening, conditions. Therefore, appropriate diagnosis and management are needed. Orbital complications from sinusitis are caused by expansion through natural suture lines, foramen, dehiscence of lamina bone and bony erosion due to acute infection and necrosis. The purpose of this study was to analyze the common types of orbital complications and to compare the symptoms, prognoses and treatments of children and of adults, respectively. Materials and Method: Twenty-one children under15 years of age and thirteen adults over 15 were enrolled in the study. Symptoms, durations of treatment, treatment modalities, prognoses, and CT findings were analyzed. RESULTS: Preseptal cellulitis was found in 6 children (28.6%) and 8 adults (61.5%) ; subperiosteal abscess in 9 children (42.9%) and 3 adults (23.1%) ; and orbital cellulitis in 6 children (28.6%) and 2 adults (15.4%). Eye lid swelling was found in all subjects, while diplopia and limitation of eye movement was found in 4 children (19%) and 2 adults (15.4%). Medical treatment was the first line of therapy for both children (76.2%) and adults (61.5%), with the remaining children (23.8%) and adults (38.5%) receiving surgical treatment. CONCLUSION: While generally more severe, orbital complications in children can be treated more conservatively than those arising in adults.
Abscess ; Adult ; Cellulitis ; Child ; Diagnosis ; Diplopia ; Eye Movements ; Humans ; Necrosis ; Orbit* ; Orbital Cellulitis ; Prognosis ; Sinusitis* ; Sutures

BACKGROUND: The aim of this study was to evaluate the contribution of the proximal nerve stump, in end-to-side nerve repair, to functional recovery, by modifying the classic end-to-side neurorrhaphy and suturing the proximal nerve stump to a donor nerve in a rat model of a severed median nerve. METHODS: Three experimental groups were studied: a modified end-to-side neurorrhaphy with suturing of the proximal nerve stump (double end-to-side neurorrhaphy, Group I), a classic end-to-side neurorrhaphy (Group II) and a control group without neurorrhaphy (Group III). Twenty weeks after surgery, grasping testing, muscle contractility testing, and histological studies were performed. RESULTS: The grasping strength, muscle contraction force and nerve fiber count were significantly higher in group I than in group II, and there was no evidence of nerve recovery in group III. CONCLUSIONS: The contribution from the proximal nerve stump in double end-to-side nerve repair might improve axonal sprouting from the donor nerve and help achieve a better functional recovery in an end-to-side coaptation model.
Anastomosis, Surgical/methods ; Animals ; Axons/pathology ; Forelimb ; Hand Strength ; Male ; Median Nerve/pathology/*surgery ; Muscle Contraction ; Muscle, Skeletal/physiopathology ; Nerve Regeneration ; Nerve Transfer/*methods ; Rats ; Rats, Sprague-Dawley ; Recovery of Function ; Ulnar Nerve/pathology/*surgery

No abstract available.
Thyroid Gland* ; Thyroid Nodule*