Winging of the scapula is characterized clinically by a prominence of the vertebral border and inferior angle of the scapula. Trauma, neuritis, neural injury during surgical procedure and many other causes may develop winging of scapula. When pain and functional impairment persist, surgical intervention may become appropriate. We report two cases of winged scapula. One case was serratus anterior palsy due to blunt trauma, which was treated by transfer of teres major and pectoralis minor elongated with a tensor fascia strip. Another case was trapezius muscle palsy due to iatrogenic spinal accessary nerve injury, which was treated by transfer of the levator scapulae, rhomboid major and rhomboid minor muscle. In the former case, there was no weakness nor deformity of affected shoulder. In the later case, there was some residual pain and limitation of motion.
Congenital Abnormalities ; Fascia ; Neuritis ; Paralysis ; Scapula* ; Shoulder ; Superficial Back Muscles

BACKGROUNG AND OBJECTIVES: It was reported that low molecular weight heparin (LMWH) was more effective than unfractionated heparin in patients with acute coronary syndrome. Recent studies have shown that the pathophysiology of restenosis in stented lesions was different from those of nonstented lesions. Treatment strategies designed to limit cellular proliferation that were ineffective in nonstented lesions may be efficacious in reducing in-stent restenosis. This study was aimed to compare the clinical and angiographic results of LMWH (nadroparin) after coronary stenting with those of conventional ticlopidine regimen. MATERIALS AND METHODS: Patients were eligible for inclusion if they had angina and/or objective evidence of myocardial ischemia, and a significant (>50%) stenosis that was documented on a recent coronary angiogram. After stenting, prospective randomized comparison study was performed. Patients were randomly assigned to either nadroparin (200 IU/kg, sc, bid) or ticlopidine (250 mg bid) plus aspirin (200 mg qd) treatment groups. Repeat coronary angiography (KERN=*)was performed at 236+/-90days after stenting, and quantitative coronary angiographic analysis (QCA) was done. RESULTS: Intracoronary stent implantation was performed in eighty five lesions in eighty one patients (ticlopidine:40, nadroparin:41). There was no significant difference in any baseline clinical/angiographic variables between the two treatment groups. There were no subacute stent thrombosis, infarction and death in both groups. Six-month event-free survival was 36 (90%) in the ticlopidine group and 35 (85.4%) in the nadroparin group. Follow-up quantitative angiographic data such as late loss (1.35+/-0.70 vs 1.32+/-0.69), loss index (0.53+/-0.70 vs 0.56+/-0.23) and restenosis rate (36% vs 25.8%) were not different between ticlopidine and nadroparin groups. CONCLUSION: Effects of nadroparin were not different from those with ticlopidine therapy in the prevention of restenosis and subacute stent thorombosis after coronary stenting. Clinical outcomes between two strategies were similar. Low molecular weight heparin may be an alternative to ticlopidine in patients that ticlopidine cannot be administered because of severe adverse effects.
Acute Coronary Syndrome ; Aspirin ; Cell Proliferation ; Constriction, Pathologic ; Coronary Angiography ; Disease-Free Survival ; Follow-Up Studies ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Infarction ; Myocardial Ischemia ; Nadroparin* ; Prospective Studies ; Stents* ; Thrombosis ; Ticlopidine*

BACKGROUND: Fluid overload prior to continuous renal replacement therapy (CRRT) is an important prognostic factor. Thus, precise evaluation of fluid status is necessary to treat such patients. In this study, we investigated whether fluid assessment using bioelectrical impedance analysis (BIA) can predict outcomes in critically ill patients requiring CRRT. METHODS: A prospective observational study was performed in patients who were admitted to the intensive care unit and who required CRRT. BIA was conducted before CRRT; then, the ratio of extracellular water to total body water (ECW/TBW) was derived to estimate volume status. RESULTS: A total of 31 patients treated with CRRT were included. There were 18 men (58.1%), and the median age was 67 years (interquartile range, 51 to 78 years). Fourteen patients (45.2%) died within 28 days after CRRT initiation. Patients were divided into 16 with ECW/TBW ≥0.41 and 15 with ECW/TBW <0.41. Survival rate within 28 days was different between the two groups (P = 0.044). Cox regression analysis revealed a relationship between ECW/TBW ≥0.41 and 28-day mortality, but it was not statistically significant (hazard ratio, 3.0; 95% confidence interval, 0.9 to 9.8; P = 0.061). Lastly, the area under the curve of ECW/TBW for 28-day mortality was analyzed. The area under the curve of ECW/TBW was 0.73 (95% confidence interval, 0.54 to 0.92), and this was significant (P = 0.037). CONCLUSIONS: Fluid status can be assessed using BIA in critically ill patients requiring CRRT, and BIA can predict mortality. Further large trials are needed to confirm the usefulness of BIA in critically ill patients.
Body Water ; Critical Illness* ; Electric Impedance* ; Humans ; Intensive Care Units ; Male ; Mortality ; Observational Study* ; Prospective Studies* ; Renal Replacement Therapy* ; Survival Rate ; Water

No abstract available.
Leiomyoma*

Impotence is a common complication of diabetes. 4I diabetic impotent patients were evaluated by audiovisual stimulation penogram. pudendal somatosensory evoked potential (SEP), bulbocavernous reflex latency (BCRL), selective angiogram, erection penogram and nocturnal penile tumescence. This study suggests that neurogenic, vasculogenic and psychogenic abnormalities were prominent etiology in diabetic impotence. Penile prothesis is an adequate treatment for organic impotence and refractory psychogenic impotence.
Erectile Dysfunction* ; Evoked Potentials, Somatosensory ; Humans ; Male ; Penile Erection ; Reflex

No abstract available.
Digoxigenin* ; DNA* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis*

No abstract available.
Child* ; Gastritis* ; Humans

In a series of paleo-parasitological investigations, we have been able to obtain invaluable data on parasite infection patterns prevalent among the Joseon (1392-1910) people in Korea. Thus far we have established that the Joseon people were in fact heavily infected by various species of parasites, though precise patterns and exact statuses of infection in specific town and cities have proved elusive. In the present study, relevant historical documentation was obtained and examined, shedding light on some of the operative socio-cultural factors that might have played a role in inducing a high infection prevalence of Ascaris, a soil-transmitted roundworm, in Joseon society. On this evidentiary basis, we could confirm that the recycling of human feces as fertilizer and the habit of eating raw vegetables were both closely related to infection. These factors were sufficient to maintain the life cycle of Ascaris, there by perpetuating a cycle of infection and reinfection among the Joseon inhabitants. Overall, this study demonstrated the value of close medical-scientist / historian interdisciplinary collaboration infacilitating comprehensive and meaningful paleo-parasitological findings and interpretations.
Ascaris ; Cooperative Behavior ; Eating ; Feces ; Helminths ; Humans ; Korea ; Life Cycle Stages ; Light ; Parasites ; Prevalence ; Recycling ; Vegetables

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies

PURPOSE: Our objective was to evaluate mammographic findings of breast cancer in men. MATERIALS AND METHODS: This study includes 9 man with breast cancer diagnosed pathologically by radical mastectomy. Clinical and pathologic data were obtained by review of patients' medical record. Mammograms were analysed retrospectively. RESULTS: Of the 9 patients, eight had masses with spiculated margin or schirrous pattern with irregular margin. One patient had no specific evidence of breast cancer mammographically. Microcalcifications were seen in three patients, these calcifications were irregular in shape and were clustered. Of the 8 cases, four patients had the masses at the right breast, four at the left breast. Locations of breast cancer were subareolar(n=4) and were eccentric(n=4) from the nipple. The most common location was the upper outer quadrant. On histologic evaluation, 7 cases were infiltrating ductal carcinomas, one case was mucinous adenocarcinoma, and the remainder was proved as combined form of intraductal and infiltrating ductal carcinoma. Axillary lymph node metastasis were found in 4 cases. CONCLUSION: Mammographic findings of male breast carcinoma were that of subareolar or eccentrically located mass. Calcifications were same to the patterns of calcification as female breast cancer.
Adenocarcinoma, Mucinous ; Breast ; Breast Neoplasms ; Breast Neoplasms, Male* ; Carcinoma, Ductal ; Female ; Humans ; Lymph Nodes ; Male ; Male* ; Mastectomy, Radical ; Medical Records ; Neoplasm Metastasis ; Nipples ; Retrospective Studies