BACKGROUND: The purpose is to determine the efficacy of additional intravenous patient-controlled analgesia (IV-PCA) by comparing the analgesic effects between interscalene block (ISB) combined with IV-PCA and single ISB after arthroscopic shoulder surgery. METHODS: A total of 213 patients who underwent arthroscopic shoulder surgery were divided into two groups based on the type of perioperative anesthesia. The single ISB group included 100 patients, while the IV-PCA group included 113 patients. The visual analogue scale for pain (VAS pain) scores were assessed at 12, 24, and 48 hours postoperatively in accordance with shoulder pathology. Postoperative narcotics-related complications and consumption of additional non-steroidal anti-inflammatory drugs between the two groups were compared. RESULTS: VAS pain showed no significant difference between the two groups at most points of the postoperative timeline, regardless of shoulder pathology, except in patients with rotator cuff repair at postoperative 24 hours. Although the IV-PCA group showed a statistically lower VAS pain score than the ISB group at postoperative 24 hours (p=0.04), the difference in the VAS pain score was only 9.0 mm in patients with rotator cuff repair. Narcotics-related complications were observed more frequently in the IV-PCA group than in the ISB group for patients with rotator cuff repair. CONCLUSIONS: Additional IV-PCA demonstrated no booster effect for immediate pain control in patients undergoing arthroscopic shoulder surgery with preoperative single ISB. Furthermore, patients with IV-PCA experienced greater narcotics-related complications.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia ; Arthroscopy ; Humans ; Pathology ; Prospective Studies* ; Rotator Cuff ; Shoulder*

PURPOSE: To evaluate the role of CT in the diagnosis of bowel and mesenteric injury we studied the CT findings and its usefulness in patients of abdominal trauma. MATERIALS AND METHODS: CT scans of 27 patients who were confirmed to have bowel and/or mesenteric injury due to abdominal trauma were analyzed retrospectively. Of these 27 patients 15 had bowel injury only and 12 had both bowel and mesenteric injury. CT findings analysed were bowel wall thickening, presence or absence of highly attenuated bowel wall, sentinel clot, mesenteric infiltration, peritoneal fluid collection and free intraabdominal air in cases with bowel injury only and with both bowel and mesenteric injury respectively. Ten patients had other accompanying abdominal injuries, such as liver, spleen, pancreas, kidney, bladder injuries, intraperitoneal abscess or retroperitoneal hemorrhage. RESULTS: Findings observed were bowel wall thickening in 23 cases(85%), peritoneal fluid collection in 21 (78%), highly attenuated bowel wall in 19(70%), mesenteric infiltration in 17(63%), free intraperitoneal air in 10 (37%) and sentinel clot in 7(26%). Pneumoperioneum were observed in 10 of 24 patients(41.7%) having bowel perforation. Two cases did not show any CT findings suggesting bowel and/or mesenteric injury. There was no significant difference in the prevalence of the CT findings between the patient group with bowel injury only and the patient group with both bowel and meseneric injury. CONCLUSION: CT scan is a useful tool in evaluating the degree and extent of bowel and/or mesenteric injury as well as in planning the patient's management.
Abdominal Injuries ; Abscess ; Ascitic Fluid ; Diagnosis ; Hemorrhage ; Humans ; Kidney ; Liver ; Pancreas ; Prevalence ; Retrospective Studies ; Spleen ; Tomography, X-Ray Computed ; Urinary Bladder

BACKGROUND: In patients with myocardial infarction, one needs to know the location, extent and severity of wall motion abnormalities to assess prognosis and guide therapy. Thus more precise quantatative estimates of regional ventricular function are required. Regional wall motion has generally been assessed by displaying the multiple cardiac images of RVG as endless-loop movie, but the cinematic display was not objective. We used the usefulness of the phase analysis in evaluating the global left ventricular function and regional wall motion abnormalities of patients with myocardial infarction. The accuracy of the RVG cinematic display in detecting regional wall motion abnormalities in patients with myocardial infarction was also evaluated. METHODS: Studied cases were 97 patients with myocardial infarction and 20 normals with low likelihood of coronary artery disease. Coronary angiography and contrast left ventriculography were performed in all patients with myocardial infarction. The regional wall myocardial infarction(presence) is defined when the EKG presented the evidence of myocardial infarction, left ventriculogram showed RWMA(regional wall motion abnormality) along with stenosis of 50% or greater of the regional supplying coronary artery. Each patient was imaged in 45 left anterior oblique(LAO) view, anterior(Ant) view and left lateral(Lt Lat) view. We evaluated Left ventricular ejection fraction(LVEF) from time-activity curve. We constructed the histogram for the left ventricle and both ventricle separately to obtain the global and total phase angle(GPA, TPA), standard deviation of phase angle(GSDPh, TSDPh), full width half maximum(GFWHM, TFWHM). The left ventricle was divided into 7 segments. LAO projection ; septal, apical, basal lateral, apical lateral, Ant projection ; anterolateral, Lt Lat projection ; inferior, posterior, Phase angle(RPA) and full width half maximum(RFWHM) from the histogram (regional 7 segments) were examined. On the RVG cinematic display, the standard 4 grading system was used, normal, hypokinesia, akinesia, dyskinesia. The observer evaluated regional wall motion abnormality of the 7 segments for all cases. The sensitivity of the above parameters and RVG cinematic display was evaluated. We analyzed the regional parameters among the patents with regional wall myocardial infarction(presence), those without regional wall myocardial infarction(absence) and control group using the t-test. The statistical analysis was done by one way ANOVA between regional phase analysis and RVG cinematic display. RESULTS: The sensitivity of LVEF was lowest(70.1%) and the GFWHM was highest among the global parameters(89.1%). But RFWHM showed even higher sensitivity(96.9%), thus regional phase analysis was also required. The RVG cinematic display was also sensitive(92.7%), but less sensitive than the RFWHM. On regional phase analysis the RPA of septal, apical, inferior, posterior walls of the left ventricle was able to separate presence group from absence group and also presence group from control group and the RPA of the apical lateral wall could separate presence group from absence group. The RPA of basal lateral and anterolateral wall was inaccurate in diagnosing the regional wall myocardial infarction, because basal lateral wall was overlapped by adjacent vascular structures, and the area of anterolateral wall dose not correlate completely beteen the RVG & the left ventriculogram, also the anterolateral wall can be supplied by the obtuse marginal branch of left circumflex artery. The RFWHM of all regional walls of left ventricle could separate presence group from absence group and presence group from control group. We found good correlation between regional phase analysis & left ventriculogram for detection of regional wall myocardial infartion. On RVG cinematic display, the RPA of the normal group was different from that of dyskinesia, akinesia and hypokinesia groups. The RPA of the dyskinesia group was also different from that of skinesia and hypokinesia groups by oneway ANOVA(p<0.05). The RFWHM of the dskinesia group was different from that of the normal group and hypokinesia group. RVG cinematic display correlated well with regional phase analysis and also quantitation of wall motion. CONCLUSIONS: Thus RVG cinematic display was useful and can not be replaced by phase analysis. But the regional phase analysis was sensitive and objective in diagnosing the wall motion abnormality in myocardial infarction.
Ants ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Dyskinesias ; Electrocardiography ; Heart Ventricles ; Humans ; Hypokinesia ; Myocardial Infarction* ; Prognosis ; Radionuclide Ventriculography ; Ventricular Function ; Ventricular Function, Left

PURPOSE: After delivery, eating brown seaweed soup is a typical Korean tranditional habit. But, excessive intake of iodine transiently inhibits biosynthesis and secretion of thyroid hormones if a certain threshold of iodine is reached in the serum. The aim of our study was to demonstrate whether the observed the elevations of TSH level in the breast fed neonatal infants was caused by mother's eating brown seaweed soup or not. METHODS: We performed neonatal TSH test by enzyme linked immunosorbent assay(FRELISA Screenig TSH) and cheked TSH level for 178 newborns with a appropriate gestational age. We divided the study subject into 3 groups, the group used breast feeding, mother had taken brown seaweed soup and blood sampled at 6th day after birth was categorized Group A, formular feeding, blood sampled at the 4th days after birth was categorized Group B, breast feeding and had taken brown seaweed soup and blood sampled at the 19th day after birth was categorized Group C. RESULTS: 1) The mean TSH level was 1.5+/-1.3 uU/ml in Group A, 3.3+/-2.5uU/ml in Group B, 1.7+/-l.3uU/ml in Group C(Group A vs Group B: p<0.05, Group A vs Group C: p<0.05). 2) There was no statistical significances between the TSH levels and the amount of brown seaweed soup which mother had one day, the duration which mother had brown seaweed soup and duration of breast feeding. CONCLUSIONS: Mother had taken brown seaweed soup about 3 times a day in korea at present days, There was no significant changes of TSH levels in the beast fed newborn infants after the korean mother had taken brown seaweed soup.
Breast Feeding* ; Breast* ; Eating* ; Gestational Age ; Humans ; Infant ; Infant, Newborn* ; Iodine ; Korea ; Mothers ; Parturition ; Seaweed* ; Thyroid Hormones

No abstract available.
Cesarean Section* ; Female ; Pregnancy ; Pulmonary Embolism*

Transrectal Ultrasonography (TRUS) easily provides an accurate assessment of the seminal tract. In Magnetic Resonance Imaging(MRI) of the seminal tract, the anatomic relationships are more clearly seen and the multiplanar imaging is available, so a more definitive diagnosis can be achieved. Although TRUS and MRI have been studied extensively, the findings of TRUS have not been compared with those of MRI. We studied 29 patients who were assessed with TRUS and MRI simultaneously due to disease of the seminal tract. The findings of cystic disease were coincident between TRUS and MRI. But the small size Mullerian duct cysts were not found in TRUS but were found in MRI. Hemorrhage of the ejaculatory duct and seminal vesicle, thickened ampulla portion of vas deferens were found only in MRI. Ejaculatory duct and seminal vesicle calcification were not easily found in TRUS due to their small size. The findings of seminal vesicle atrophy, dilatation and prostatic calcification between TRUS and MRI were discrepant. In conclusion, MRI is more helpful than TRUS in the diagnosis of small Mullerian duct cyst, small ejaculatory duct calculi, small seminal vesicle calculi, hemorrhage of ejaculatory duct and seminal vesicle and thickened ampulla portion of vas eferens.
Atrophy ; Calculi ; Diagnosis* ; Dilatation ; Ejaculatory Ducts ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Male ; Seminal Vesicles ; Ultrasonography* ; Vas Deferens

No abstract available.

Ossifying fibroma is a slow-growing benign neoplasm that occurs most often in the jaws, especially the mandible. The tumor is composed of bone that develops within fibrous connective tissue. Some ossifying fibromas consist of cementum-like calcifications, while others contain only bony material; however, a mixture of these calcification types is commonly seen in a single lesion. Of the craniofacial bones, the mandible is the most commonly involved site, with the lesion typically inferior to the premolars and molars. Ossifying fibroma of the jaw shows a female predominance. Some reports of ossifying fibroma have been published in the literature; however, this report continues the research on this topic by detailing 3 types of ossifying fibroma findings on panoramic radiographs and cone-beam computed tomographic images of 4 patients. The radiographs of the presented cases could help clinicians understand the variations in the radiographic appearance of this lesion.

Split hand split foot(SHSF) is a rare human developmental defect characterized by mi-ssing digits, fusion of remaining digits, and a deep median cleft in the hands and feet. Cy-togenetic studies of deletions and translocations associated with this disorder have indicated that an autosomal dominant split hand/split foot locus maps to 7q21-q22. We have experienced a case of ectrodactyly in a 25-year-old primigravida woman and her baby and reported out our experience with a review of related literature.
Adult ; Female ; Fetus* ; Foot ; Hand ; Human Development ; Humans

OBJECTIVES: Despite remarkable development of pharmacotherapy for schizophrenia, some patients continuously have had violence problems. The violence of psychotic patients is recently becoming the focus of the attention. The aim of this study is to investigate the influence of Cognitive Behavioral Therapy (CBT) on patients with schizophrenia having violence related history. METHODS: 15 Patients with schizophrenia spectrum disorder of crime history were treated with individual CBT for 12 sessions, and assessed with 4 scales (Korean version of Aggression Questionnaire, Korean version of the Barratt Impulsiveness Scale-11-Revised, Beck Cognitive Insight Scale and Positive and Negative Syndrome Scale) to evaluate anger, impulse, insight and clinical symptoms respectively at baseline and post treatment. The comparison group consisted of 15 patients with schizophrenia spectrum disorder of crime history. They were also assessed with the same scales during the same period. RESULTS: Although impulsivity is not changed significantly after treatment, but there was significant improvement in clinical symptom, insight and aggression, especially self-reflectiveness and anger respectively. CONCLUSION: CBT can be one of the good therapeutic tools for patients with schizophrenia having violence problems in that it reduces aggression and enhances insight of patients with schizophrenia spectrum disorder.
Aggression ; Anger ; Case-Control Studies* ; Cognitive Therapy* ; Crime* ; Drug Therapy ; Humans ; Impulsive Behavior ; Surveys and Questionnaires ; Schizophrenia* ; Violence ; Weights and Measures