The purpose of this study is to evaluate the morphologic findings of the labrum and capsuloligamentous structures in the normal and unstable shoulders and to compare the effectiveness of double contrast arthrographic findings which were taken with supine and prone position. We reviewed the computerized tomographic arthrogram in 9 cases of normal shoulder and l3 cases of shoulder instability. We evaluated the shape of the labrum, the attachment of anterior capsule and the amount of capsular laxity. Capsular laxity was compared each others in normal, the unidirectional instability and the multidirectional instability. Among these materials, we simultaneously performed CT arthrogram with supine and prone position and evaluated which is more reliable and accurate. Scapular inclination was ahout 25 degrees in the supine position and ahout 60 degrees in the prone position. Normal glenoid labrum varied in size and shape, so its lack of a classic appearance might not indicate a labral tear. Variations existed in the anterior capsular attachment onto the glenoid. The anterior capsule was used to attach far away from the glenoid rim. but it might not indicate an anterior instability. With the prone position, the labral lesion took more excellent visualization due to the contrast coating on the glenoid labrum in both anterior and posterior. Anterior capsular expansion was seen well with prone position in anterior instability. In summary, for proper interpretation of the instability, awareness of the morphologic variations of the labrum and capsuloligamentous structure is important. CT double contrast arthrography with prone position has made a significant contribution to improving and easing the documentation of variety of anatomic abnormalities. Now we recommend the prone position in CT arthrogram for imaging glenoid labrum pathology in shoulder instability.
Arthrography ; Pathology ; Prone Position ; Shoulder* ; Supine Position

PURPOSE: Peyronie's disease is characterized by the presence of one or more fibrous plaques in the tunica albuginea or intercavernous septum, that is a slowly evolving disease which may cause a bending of the penis as well as pain during erection. Despite its self-limiting nature in many patients, a few patients will eventually require therapies if deformity or impotence is severe and conservative cares have failed. Currently numerous surgical and non-surgical therapies have been used for Peyronie`s disease. In this study we evaluated the effectiveness of oral medication in the treatment of Peyronie`s disease. MATERIALS AND METHODS: We analyzed retrospectively 123 patients with Peyronie`s disease treated with oral medication in the period of 1991-1997. 20 patients were observed without medication. 23 patients were treated with oral prednisolone, 22 patients with oral vitamin E, 40 patients with oral prednisolone and vitamin E, and 18 patients with potassium p-aminobenzoate(Potaba). RESULTS: Age distribution of patients was 23-84 years(mean: 51.4 years). Chief complaints were curvature of the penis during erection for 82% of the patients, painful erection for 66%, and problems with sexual intercourse for 34%. Average size of the plaques was 6.25cm2. The average duration of symptoms was 12.5 months. With prednisolone, curvature of penis during erection, plaques and painful erection were improved 55.6%, 57.1% and 86.7% respectively. With vitamin E, clinical results were reported 65.0%, 66.7% and 73.3% and with prednisolone and vitamin E 70.9%, 79.5% and 78.6% and with Potaba 81.3%, 82.4% and 90.9%. No patients with sexual dysfunction experienced improved sexual function. No serious side effects were observed in any of our patients. CONCLUSIONS: With these results, it can be concluded that the distressing symptoms of Peyronie`s disease can be treated with oral agents. Oral medication therapy may be a safe, noninvasive therapeutic alternative treatment method in patients with Peyronie`s disease but further studies were need to evaluate the effectiveness compared with intralesional injection therapy or surgery for Peyronie`s disease.
4-Aminobenzoic Acid ; Age Distribution ; Coitus ; Congenital Abnormalities ; Erectile Dysfunction ; Humans ; Injections, Intralesional ; Male ; Penile Induration* ; Penis ; Potassium ; Prednisolone ; Retrospective Studies ; Vitamin E ; Vitamins

Background: Femoral neck stress fractures (FNSFs) are rare but potentially disabling injuries if the diagnosis is missed or delayed and proper treatment is not provided. The aim of this study was to investigate and describe the characteristics and clinical course of FNSFs in South Korean male military recruits. Methods: Between May 2015 and October 2019, 16 fractures in 12 young male military recruits were reviewed. The characteristics of the fractures were ascertained by detailed analysis of the history and clinical course, as well as radiographs, bone scintigrams, and magnetic resonance images. Results: The median duration between endurance training and the development of hip pain was 5 weeks, while the median duration of pain before the patient sought medical attention was 3 weeks. Four patients (33.3%) exhibited bilateral fractures, and concomitant lesions involving the proximal tibia were found in 3 patients (25%). Fourteen of the 16 fractures (87.5%) were compression-type fractures, and surgery was performed for 7 hips. Complete union without malunion or osteonecrosis was achieved in all cases, and all cadets returned to their full activity levels in an average of 10 weeks. Conclusions We observed excellent prognosis of FNSFs. Our report highlights the importance of early reporting, detection, and treatment regarding the challenging management of FNSFs. When a military recruit reports hip pain, a FNSF should be considered; furthermore, the bilaterality of the fracture and the presence of concomitant lesions should also be investigated.

Facial depression is not rare conditions caused by soft tissue loss or bone distortion. In such conditions, autogenous bone, cartilage and bioacceptible materials are used for soft tissue augmentation. De Nicola used silicone rubber implant first in 1950. That after, silicone implants are used for bone defect and soft tissue augmentation. We experienced 31-year-old male patient who injured open depressed fracture of right temporal bone. He was operated with autogenous bone graft for bone defect area and silicone implants for soft tissue augmentation. After about 6 years later, mass palpated in right temporal area. There was no inflammatory sign in physical examination and CT finding. So we removed hyperfibrotic tissue totally with previous inserted silicone implants and augmented soft tissue with pored Medpor(R) block. In light microscopic findings, only tissue hyperfibrosis were proved without inflammatory cell, such as giant cell or ephithelioid cell.
Adult ; Cartilage ; Depression ; Giant Cells ; Humans ; Male ; Physical Examination ; Silicone Elastomers ; Temporal Bone ; Transplants

Phenylpropanolamine is a sympathomimetic amine used widely as a decongestant or appetite suppressant. Reports of the myocardial injury from the use of phenylpropanolamine are rare and the mechanism of the myocardial injury is not known clearly. We experienced a case of myocardial injury after ingestion of phenyl-propanolamine. A 46-year-old woman was admitted because of chest pain and dyspnea after ingestion of 5 tablets of anorectic pill containing phenylpropanolamine 75 mg per tablet. The serum creatine kinase MB isoenzyme levels were elevated and electrocardiographic abnormalities suggesting myocardial infarction were seen in the precordial lead. In echocardiograpy, left ventricular anteroseptal wall motion was nearly akinetic but coronary angiography showed normal coronary arteries except sluggish blood flow in left anterior descending artery.
Appetite ; Arteries ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Creatine Kinase ; Dyspnea ; Eating* ; Electrocardiography ; Female ; Humans ; Middle Aged ; Myocardial Infarction ; Phenylpropanolamine* ; Tablets

OBJECTIVE: The objective of this study was to evaluate clinical significance of endometrial and corporal extensions of Carcinoma of the uterine cervix. METHODS: The 273 patients with locally advanced cervical cancer who underwent radical hysterectomy after neoadjuvant chemotherapy between Jan 1983 to May 1998 were included in this study and endometrial and corporal extension was examined by pathologic report. Then, clinical characteristics such as age, stage, tumor size, geographic contour, the lymph node and parametrial invasions, recurrence rate, and 5 year-survival rate were compared between extension(n=30) and non-extension(n=243) group. Pearson chi-square test, Fisher's exact test, and Kaplan-mayer survival analysis were used for calculation of statistical significance between two group. p-value less than 0.05 was considered to be clinically significant. RESULTS: The incidence of endometrial and corporal extension in this locally advanced cervical cancer group was 11% (30/273). The endometrial and corporal extension were closely related with advanced stage, larger cervical tumor mass, endophytic type, and pelvic lymph node metastasis. However, 5-year disease free survival rates or 5-year actuarial survival rates did not show statistically significant differences between extension and non-extension group (7S% vs 83% and 81% vs 84%, respectively) CONCLUSION: The endometrial and corporal extension were closely associated to high risk factors of advanced cervical cancer. Though its clinical significance for poor outcome were not proved in this study, prospective study with more patients is needed to clarify its clinical significance.
Cervix Uteri* ; Disease-Free Survival ; Drug Therapy ; Female ; Humans ; Hysterectomy ; Incidence ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence ; Risk Factors ; Survival Rate ; Uterine Cervical Neoplasms

Placntal site trophoblastic tumor (PSTT) has been demonstrated to be a rare form of gestational trophoblastic tumor (GTT). Kurman (1976) et al recognized this disease as Trophoblastic pseudotumor and they thought it to be a benign exaggerated placental site reaction, but Twiggs et al (1981) reported a patient who died of widespread metastasis. Death has been reported in 2 of 14 cases due to metastatic disease, and therefore it is thought to have a malignant course and metastatic potential. It may occur at any age during the reproductive age but usually occurs in relation to second or subsequent pregnancies (a normal pregnancy, an abortion, or a molar pregnancy) rather than primipara. PSTT can metastasis to the brain, lung, liver, vagina and bladder. Larsen et al (1991) report metastasis rate about 10%. It produces little hCG and larger quantities of hPL. We experienced a case of PSTT after normal delivery, which was diagnosed and operated on in our hospital, and report this case with a brief review of literatures.
Brain ; Humans ; Liver ; Lung ; Molar ; Neoplasm Metastasis ; Pregnancy ; Trophoblastic Neoplasms ; Trophoblastic Tumor, Placental Site* ; Trophoblasts ; Urinary Bladder ; Vagina

Purpose: Long-term culture- initiating cells(LTC-IC) are stem cells that have the capacities of long-term engraftment and helping to establish hematopoietic microenvironment. For evaluation of the LTC-IC, we measured the counts and function with multidimentional flowcytometry in long-term culture media. METHODS: Samples were obtained from umbilical cord blood, leukapheresis products and bone marrow(BM). LTC-IC were counted with flowcytometric analysis using anti- CD34, anti-CD38, and anti-HLA-DR antibodies at 0, 5, and 8 weeks. Cell adhesion molecule related with stem cell were evaluated with flowcytometric analysis also using anti-VCAM-1(CD106) and anti-VLA-4(CD49d) at 0 and 8 weeks. RESULTS: The proportion of CD34+/CD38- cell from fractionated mononuclear cells at 0 week were 0.46%, 0.044%, and 0.038% for BM, leukapheresis products, and umbilical cord blood respectively and then rapidly decreased at 5 weeks, but still persisted at 8 weeks in all three groups. The proportion of CD34+/HLA-DR- cells was the same tendency to CD34+/CD38-. VCAM+ expression rate from fractionated CD34+ cells at 0 and 8 weeks were 67.3% and 40.2% for BM and 64.1% 44.2% for umbilical cord blood but it was very low 31.2% and 5.1% for leukapheresis products. VLA-4+ expression rate for fractionated CD34+ cells at 0 and 8 weeks were similar tendency to VCAM+ cells. CONCLUSION: This study suggest that the count of LTC-IC decreased with time but still persisted until 8 weeks. Umbilical cord blood including BM help to establish the hematopoietic microenvironments.
Antibodies ; Cell Adhesion ; Culture Media ; Fetal Blood ; Leukapheresis ; Stem Cells

The purpose of this study was to investigate the perception of foodservice managers in childcare centers and kindergartens for identifying the vulnerable areas of safety management. The foodservice managers in 1,144 of nationwide childcare centers and kindergartens were surveyed from May to October 2007 to answer a total 72 questions in areas of general characteristics, actual practice of foodservice management and safety management perception. Meals were served in 97.7% of surveyed facilities and 91.0% among them were self-operated. The hiring rate (27.8%) of dietitians in childcare centers was significantly lower than the rate (82.0%) of kindergartens. The needs of dietitian employment between childcare centers and kindergartens differed as 44.9% and 87.5%, respectively. In knowledge on food-borne illnesses, they have the wrong information in the field of season for frequent outbreak, major pathogens and foods causing food-borne illnesses. The food-borne illnesses (36.2%) were indicated as the major problem in foodservice facilities and the degree of risk exposure was considered as safe (70.1%). More than 70% of both facilities answered as sanitary in the status of personal hygiene. Only 38.0% recognized the Facility and Equipment Standard in the Childcare Law and Early Childhood Education Law. In preparation of meals and management of cooking processes, kindergarten scored significantly high compared to childcare centers (p < 0.05 or p < 0.01) while the necessity of standards was not different in both facilities. Among managers surveyed, 28.8% had taken food safety education from professional institutions and more than 80% in both facilities indicated the need of professional educations. These results suggest that it is necessary for the systematic sanitary education of foodservice managers by developing the sanitary management standard as well as the amendment of laws related foodservice in childcare centers and kindergartens.
Cooking ; Employment ; Food Safety ; Foodborne Diseases ; Humans ; Hygiene ; Jurisprudence ; Meals ; Safety Management ; Seasons

OBJECTIVES: The purposes of this study were to assess the smoking status, knowledge and attitude related to smoking and smoking cessation activity of the physicians in a community, and to identify their predictors of smoking cessation activity. METHOD: All physicians employed by various health facilities in a community were surveyed using a structured questionnaire. Of the physicians surveyed, 523 (69.6%) returned completed questionnaires. RESULTS: The smoking rate of physicians was 29.3% (34.2% in males, 3.6% in females) and the knowledge and attitude scores to smoking were 22.5+/-2.4 and 65.4+/-6.9, respectively. The self-efficacy score was 3.4+/-1.0 and the smoking cessation activity score was 65.4+/-6.9. The smoking cessation activity was statistically significant with working place, specialty, knowledge and attitude to smoking and self-efficacy. In stepwise multiple regression, smoking cessation activity was predicted by doctors' working place, specialty, attitudes related to smoking issues, and self-efficacy of counseling knowledge and skills. CONCLUSION: Physicians need to participate routinely and actively in smoking cessation activity. For doctors to effectively counsel and intervene in patients regarding smoking cessation, it is essential to integrate education on smoking cessation intervention into curricula in formal education and to offer continuing education including smoking cessation intervention.
Counseling ; Curriculum ; Education ; Education, Continuing ; Health Facilities ; Humans ; Male ; Methods ; Smoke* ; Smoking Cessation* ; Smoking*