Various etiologies of hallux valgus and metatarsus primus varus have been reported, but still they are not conclusively established. Furthermore, between hallux valgus and metatarsus primus varus, the question is unanswered as to which is the cause and which is the result. To determine the primary cause and attribution of high heeled position to hallux valgus and metatarsus primus varus, we selected three different types of dancer. Traditional dancers wear cotton sox and strike the heels first to move, modern dancers walk or run and jump on naked feet, and ballerinas stand, walk or jump on their toes with hard wooden shoes, so the latter two types of dancers move with extremely high-heeled position. We analyzed the plain AP roentgenography of 84 feet for 16 ballerinas, 13 modern and 13 traditional dancers. The results were as follows : 1. First metatarsalgia was noted in 38% of modern dancers and 43% of ballerinas but none in traditional dancers. 2. The mean hallux valgus angle was 13.6°±2.7° in traditional dancers, 13.5°±3.8° in modern dancers, 18°±3.3° in ballerinas which are statistically significant between ballerinas and modern, traditional dancers(P < 0.01). 3. The mean intermetatarsal angle was 10.5°±1.4° in traditional dancers, 10.6°±1.1° in modern dancers, 10.8°±1.5° in ballerinas, and metatarsus primus varus angle was 17.6 °±5.1°, 18.3°±2.7°, 19.4°±3.6°, respectively, which were all statistically insignificant(P>0.01). Therefore, it is concluded that medio-lateral compression of shoes may be the principal contributor for the hallux valgus rather than high heel, and hallux valgus is the primary deformity.
Congenital Abnormalities ; Dancing ; Foot ; Hallux Valgus ; Hallux ; Heel ; Metatarsalgia ; Radiography ; Shoes ; Strikes, Employee ; Toes

BACKGROUND: We assessed the effectiveness of arthroscopic capsular release for the treatment of adhesive capsulitis. Further, we tried to ascertain the clinical benefits, if any, of pancapsular release over selective capsular release, where the two differ by performing or not performing a posterior capsular release, respectively. METHODS: Thirty-five consecutive patients with either primary or secondary adhesive capsulitis who failed conservative treatment for more than 6 months were enrolled in the study. A total of 16 patients allocated in group 1 received a pancapsular release that comprises the release of the rotator interval, anteroinferior capsular, and the posterior capsular release, whereas 19 patients in group 2 received a selective capsular release that comprises only the release of the rotator interval release and anteroinferior capsular release. The clinical outcomes, visual analogue scale (VAS) score, Constant score, and range of motion, were assessed preoperative and postoperatively. RESULTS: In both groups, the preoperative VAS score, Constant score, and ROM showed a significant improvement by the 6-month follow-up. We found that the immediate postoperative internal rotation was significantly higher in group 1 than group 2. Despite significant differences seen between the two groups at the initial postoperative period, there were no significant differences in Constant score, VAS score, and the ROM at all the subsequent follow-ups between the two groups. CONCLUSIONS: Arthroscopic capsular release for the treatment of adhesive capsulitis is very effective. However, pancapsular release did not show any advantage over selective capsular release in terms of overall clinical outcome.
Bursitis* ; Follow-Up Studies ; Humans ; Joint Capsule Release* ; Postoperative Period ; Range of Motion, Articular

Granulocytic sarcoma is an uncommon extramedullary localized tumor composed of granulocytic precursor cells. The majority of cases have been reported in association with acute myeloid leukemia(AML) especially in children, but infrequently may occur in patients with myeloproliferative disorders or myelodysplastic syndromes. Most common sites of involvement were bone, soft tissue, lymph nodes and skin, but gastrointestinal tract, testis, central nervous system are also involved rarely. We present an unusual case of granulocytic sarcoma of the intracranium and the retro-orbital soft tissue occurring in a patient with concurrent myelodysplastic syndrome, diagnosed by brain magnetic resonance images and ultrasound guided needle biopsy.
Biopsy, Needle ; Brain ; Central Nervous System ; Child ; Gastrointestinal Tract ; Granulocyte Precursor Cells ; Humans ; Lymph Nodes ; Myelodysplastic Syndromes* ; Myeloproliferative Disorders ; Sarcoma, Myeloid* ; Skin ; Testis ; Ultrasonography

BACKGROUND: This study compared the clinical and radiological outcomes of the single calcar screw plate and Polarus nail techniques for the treatment of the proximal humerus fractures. METHODS: Seventy-two patients diagnosed with displaced proximal humerus fracture were enrolled for the study. Of these, 50 patients underwent the locking plate surgery with a single calcar screw (plate group), whereas 22 patients underwent the Polarus nail surgery (nail group). The plate group was further divided into plate 1 group (with medial support), and plate 2 group (without medial support). The radiological and functional results of both groups were compared to the nail group. RESULTS: The α angle 1 year after surgery was significantly different between plate 1 and plate 2, and plate 2 and nail groups (p=0.041, p=0.043, respectively). The ratio that does not satisfy the reference value of γ angle was 2.8% in plate 1, 7.1% in plate 2 and 22.7% in nail group (p=0.007); there was a significant difference between plate 1 and nail group, and plate 2 and nail group (p=0.014, p=0.033, respectively). CONCLUSIONS: No significant differences were observed in the clinical results between locking plate and Polarus nail. However, in the plate 2 group and nail group, the rate of failure to maintain reduction during the 1-year period after surgery was statistically and significantly higher than the plate 1 group (level of evidence: level IV, case series, treatment study).
Humans ; Humeral Fractures ; Humerus* ; Reference Values

In general, the long head of the biceps brachii originates from the superior glenoid labrum and the supraglenoid tubercle, crosses the rotator cuff interval, and extends into the bicipital groove. However, rare anatomic variations of the origins of the long head have been reported in the past. In this report, we review the clinical history, radiologic findings, and arthroscopic identifications of 3 anatomic variants of the biceps tendon long head. As the detection of long head of biceps tendon pathology during preoperative radiologic assessment can be difficult without prior knowledge, surgeons should be aware of such possible anatomic variations.
Anatomic Variation ; Head* ; Pathology ; Rotator Cuff ; Shoulder ; Tendons

PURPOSE: The penis has been attracted to everyone associated with various diseases and sexual activity. Lots of materials and instruments has been applied to the penis for sexual arousal. Furthermore, those ar e usually made and applied in inappropriate ways by non-medical personnel. This resulted in lots of complications in various degrees. So, we investigated the real problems concerning various procedures performed on the genitalia by non-medical personnel. MATERIALS AND METHODS: We reviewed retrospectively medical records of 32 male and one female patients having complications which had been developed following some procedures on the genitalia by non-medical personnel from January 1995 to December 1999. These patients were analyzed according to characteristics of the patients, the methods, purposes, complications and treatments. RESULTS: Their age at first visit was various from 12 years to 70 years (mean, 35.8 years). At that time when procedures had been performed, their age were 12 years to 56 yeats (mean, 30.8 years) in 26 cases whose ages were identified. Among them 22cases (66.7%) were the married and 11 (33.3%) were the unmarried. Occupations were various and out-of-work were 10 (30.4%), commerce 8 (24.2%), firm worker 6(18.2%), student 5 (15.2%), and private job manager and the not-identified 2 (6.1%). according to the school career, the high school graduates were 18 (54.6%), the college graduates 7 (21.2%), middle school graduates 4 (12.1%), and 4 were under middle school. These procedures were performed for sexual satisfaction in 29 cases (87.9%) and for cheap and easy circumcision in 4 cases (12.1%), of which 26 cases (78.8%) had been performed by other person and 7 cases (21.2%) by himself. According to the materials used, 22 (66.7%) cases had been injected vaseline or paraffin in to the penis and one (3.0%) into the vulva, and one (3.0%) plicated his penile skin with rubber band using sewing needle, which 24 cases (72.7%) were for enlargement of the genitalia. 2 (6.0%) cases inserted plastic balls into the penile skin for sexual arousal of partner. 3 (9.1%) cases put a metallic ring, a ceramic ring, and a vacuum device over their penis for improving erection quality, respectively. 4(12.1%) cases had applied the commercially-maid self-circumcision devices over their prepuce, Complications were foreign body sensation, pain at erection, inflammation, skin necrosis, and septic condition, which were variable case by case. Treatments were removal of foreign materials and devices, necrotic tissue, and primary repair of defected skin, for that, in 2 (6.0%) cases, skin flap and graft were needed. CONCLUSIONS: Lots of complications, severe in some cases, had been developed on external genitalia following various procedures performed by medically unauthorized person. So, we have to strongly for their purpose and it would be rather harmful. At the same time, we have to strongly recommend the government to control strictly such materials and instruments not to be sold and used inappropriately.
Arousal ; Ceramics ; Circumcision, Male ; Commerce ; Female ; Foreign Bodies ; Genitalia ; Humans ; Inflammation ; Male ; Medical Records ; Necrosis ; Needles ; Occupations ; Paraffin ; Penis ; Petrolatum ; Plastics ; Retrospective Studies ; Rubber ; Sensation ; Sexual Behavior ; Single Person ; Skin ; Transplants ; Vacuum ; Vulva

The Persistent auditory hallucinations may provoke the uncomfortable feeling and can be dangerous according to its contents in treatment-resistant schizophrenic patients. Previous functional brain imaging studies on auditory hallucinations reported that the abnormal activations of the normal auditory pathway and the activations of the left upper temporal lobe were found while patients were hallucinating voices. Base on the these findings, we treated a female schizophrenic patient with persistent auditory hallucinations that were treatment-refractory with rTMS and the ECT continuously while she was on the drug treatment. The total amount of pulses applied in each trial ranged from 240 to 1000pulses. Fourteen trials were done and resulted in decrease by 30% in the subject severity of auditory hallucinations and the improvement of the affect. Two weeks after the completion of rTMS trials, nine trials of ECT were administered which leaded to complete disappearance of auditory hallucinations. This result suggest that ECT is more effective than rTMS in treating persistent auditory hallucinations in treatment-resistant schizophrenic patients.
Auditory Pathways ; Female ; Functional Neuroimaging ; Hallucinations* ; Humans ; Schizophrenia ; Temporal Lobe ; Transcranial Magnetic Stimulation ; Voice

No abstract available.
Neck Dissection* ; Neck*

No abstract available.
Ganoderma* ; Pancytopenia*

Malignant germ cell tumore occur in children and young women in reproductive age, of all the germ cell maligaanci orily pure dysgerminiomas had a high cure rate prior to 1970. This was due to the exquisite wdioseneitivity of these tumors. Multiple agent chemotherapy has dramatieally improved the pr nosis af patients with malignant ovarian germ cell tumors. The purpose of this study is to report the experience at Aaan Medical Center, department of Obstetrics and Gynecology, in 16 patients withmalignant ovarian germ cell tumors treated between July, l989 and June, l994. We analyzed the effect of age, histolagic subtype, FIGO stage, surgical pmcedurse and regimens of chemotherapy, on the prognosis of thwe tumors. The results obtained were as follows: 1. In histologic subtypes, dysgenninoma(38.0%), endodermal sinus tumor(25.0%), squamous cell carcinoma arising in mature cystic teratoma(19.0%), mixed cell tumor(6.0%), immature teratoma(6.0%), malignant ectodermal tumor in mature cystic teratoma(6.0%), were counted in order. 2. No site predilection was identifed. 3. Main initial symptoms were abdominal distension(31.0%), abdominal pain(31.0%), abdominal mass palpation(25.0%), amenorrhea(6.0%) in order. 4. Multiple tumor markers were considered to be useful in diagnosis and follow up of malignant germ cell tumors of ovary. 5. The mean age of malignant ovarian germ cell tumors was 29.5 years, and 11 cases(69.3%) of tumors under the age of 30.0 years. 6. The survival rate seemed to be decreased with advancing FIGO stage.
Carcinoma, Squamous Cell ; Child ; Diagnosis ; Drug Therapy ; Ectoderm ; Endoderm ; Female ; Follow-Up Studies ; Germ Cells* ; Gynecology ; Humans ; Neoplasms, Germ Cell and Embryonal* ; Obstetrics ; Ovary* ; Prognosis ; Survival Rate ; Biomarkers, Tumor