No abstract available.
Membranes* ; Pregnancy* ; Rupture*

No abstract available.
Dizziness* ; Humans ; Hypotension, Orthostatic* ; Parkinson Disease* ; Stroke*

Erectile dysfunction (ED) has an adverse impact on men's quality of life. Penile erection, which is regulated by nerves that are innervated into the erectile tissue, can be affected by functional or anatomical trauma of the perineal region, including specific structures of the penis, causing ED. Penile erection is neurologically controlled by the autonomic nervous system. Therefore, it is of utmost importance to understand the neurogenic structure of the erectile tissue and the types of neurotransmitters involved in the penile erection process. Here, we highlight the basic clinical anatomy and erectile function of the penis. Understanding the clinical connotation of the relationship between penile erectile structure and function may provide fresh insights for identifying the main mechanisms involved in ED and help develop surgical techniques for the treatment of ED.
Autonomic Nervous System ; Erectile Dysfunction ; Male ; Neuroanatomy* ; Neurotransmitter Agents ; Parasympathetic Nervous System ; Penile Erection* ; Penis ; Quality of Life

PURPOSE: Obesity is a known risk factor for several cancers, including breast, colon, esophagus, kidney, uterus, and thyroid. Recent studies have reported that higher body mass index (BMI) is also associated with more advanced stage. The aim of this study was to investigate the clinicopathological relevance between BMI and papillary thyroid carcinoma (PTC). METHODS: A total of 798 patients surgically treated for PTC from January 2006 to June 2010 were included in this study. Medical records and pathologic reports were reviewed retrospectively. According to BMI, patients were divided into four groups: underweight (3.1%), normal (57.3%), overweight (31.6%), and obese (8.0%). Clinicopathological factors were analyzed and compared between normal and other groups. RESULTS: According to the results, 709 patients were women (89.0%) and mean age was 48.5 years; mean follow-up period was 1,721+/-464.2 days. In comparison between the normal and underweight groups, there was significantly more extra-thyroidal invasion [Odds ratio (OR) 3.923, P=0.006] in the underweight group. In the obese group, tumor size was significantly larger (OR 1.794, P=0.007). However, there was no significant difference between the normal and overweight group. CONCLUSION: In the obese group, tumor size was the only clinical significant factor between high BMI and PTC. Interestingly, more extra-thyroidal invasion was seen in the underweight group. To confirm this result, further studies with long-term follow-up and more patients are required.
Body Mass Index* ; Breast ; Colon ; Esophagus ; Female ; Follow-Up Studies ; Humans ; Kidney ; Medical Records ; Obesity ; Overweight ; Retrospective Studies ; Risk Factors ; Thinness ; Thyroid Gland ; Thyroid Neoplasms* ; Uterus

Vascular injury caused by a central venous catheter (CVC) has been reported to be a rare complication, especially delayed vascular injury due to CVC has a few cases and it can be fatal because of delayed recognition and more serious complications. A 59-year-old woman with no available medical history was admitted for treatment of ovarian cancer. For the surgery, a triple-lumen CVC was placed through the left subclavian vein. Parenteral nutrition through the CVC was used for postoperative nutritional management in the first postoperative day. On the sixth postoperative day (POD), the patient suddenly complained of dyspnea. The CT revealed bilateral pleural effusion and irregular soft tissue density and air bubble in anterior mediastinum suggesting migration of the distal portion of the CVC into the anterior mediastium. In the intensive care unit (ICU) bilateral thoracentesis and percutaneous drainage were performed. She was discharged from the ICU in 3 days later and transferred to the general ward. This case emphasizes the possibility of the delayed vascular injury related to CVC and some strategies for prevention of vascular injury.
Central Venous Catheters* ; Drainage ; Dyspnea ; Female ; Humans ; Intensive Care Units ; Mediastinitis* ; Mediastinum ; Middle Aged ; Ovarian Neoplasms ; Parenteral Nutrition ; Parenteral Nutrition, Total* ; Patients' Rooms ; Pleural Effusion ; Subclavian Vein ; Thoracentesis ; Vascular System Injuries*

PURPOSE: To evaluate clinical features and the effect of parathyroid hormone (PTH) on treatment outcomes of patients with pelvic insufficiency fractures. MATERIALS AND METHODS: Fifteen patients diagnosed with pelvic insufficiency fractures were evaluated retrospectively. All patients had osteoporosis with mean lumbar T score of −3.9 (range, −3.1 to −6.4) and the mean age was 76.5 years. In all cases, simple radiography and computed tomography was used for final diagnosis; additional magnetic resonance imaging and technetium bone scans were used to confirm the diagnosis in 2 and 6 patients, respectively. Initial conservative treatment was used in all cases; treatment with PTH was applied in 5 cases. Radiological follow-up was done every 4 weeks up to 6 months and every 3 months thereafter. Symptom improvement was measured using visual analogue scale (VAS) score. RESULTS: Fractures were located: i) sacrum and pubis (9 cases), ii) isolated sacrum (4 cases) and iii) isolated pubis (2 cases). One case showed fracture displacement and pain aggravation at 4 week follow-up which was treated with percutaneous sacro-iliac fixation using cannulated screws. Duration of bone union was significantly shorter in the patients who used PTH (P<0.05). VAS scores were also lower in the group treated with PTH; however, statistical significance was not reached. CONCLUSION: In patients with osteoporosis, a pelvic insufficiency fracture should be considered if pain is experienced in the pelvic area in the absence of major trauma. While nonoperatic has been shown to be sufficient for treatment, our study shows that PTH therapy shortens treatment period and could be a favorable treatment option.
Diagnosis ; Follow-Up Studies ; Fractures, Stress* ; Humans ; Magnetic Resonance Imaging ; Osteoporosis* ; Parathyroid Hormone ; Pubic Bone ; Radiography ; Retrospective Studies ; Sacrum ; Technetium

The purpose of this study was to investigate the operational characteristics of the contract-managed highschool foodservice and to analyze the factors to effect the menu price. The data was collected from 249 highschools in Seoul. The results are as follows; Those surveyed highschools were established as 1 national, 74 public, and 174 private institution. Highschools were classified as 176 academic, 66 vocational, and 7 specific purposed institution. Students were organized as 70 boys', 23 girls', and 41 coeducational highschools. Most highschool started contract-managed highschool foodservice from 1999 and the period of foodservice contract was most 3 years and the operation styles in food distribution were 96 classrooms, 105 dining halls and 17 classrooms combined dining halls. The scale of contract foodservice management companies was 63.1% small and medium and 36.9% large enterprises. The surveyed highschools had the average meal price 2,141 won per meal and they had 1,518 pupils on the register. The participating rate to the foodservice was 68.5%. The facilities investment cost of the contract foodservice management company was 179,204,230 won for private institutions and was 138,119,010 won for national&public institutions. The period of the contract was 3.22 years in private institutions, which was significantly higher than national&public institutions which showed 2.85 years. The commissary foodservice schools had higher facilities investment cost than conventional foodservice schools. Classrooms foodservice had higher participating foodservice rate than Dining halls. The investment cost for facilities showed high in order of girls', boys', and coeducational high schools, and the number on the register and the number participating in the foodservice showed high in order of boys', girls', and coeducational high schools. The number on the register showed the highest in academic and vocational schools, specific purposed institutions in sequence, and the number participating in the foodservice showed high in order of academic schools, specific purposed institutions and vocational. However, the participating foodservice rate showed high in specific purposed institution, academic and vocational schools in order, and the meal price, the investment cost for facilities showed high in specific purposed institution, academic and vocational schools in sequence. Regionally, the district south of Han river had the average meal price 2,266.13 won, which showed higher in the eastern part which had 2,033.33 won. The western part had the average investment cost for facilities of 233,331,060 won, and the central district 126,137,140 won. The number on the register showed 1845.68 in the eastern part and 1308.00 in Dong-Jak area, that had clear differences among areas. When the period of the contract went longer, the investment cost for facilities had a tendency to increase. The significant differences were existed among meal price, the investment cost for facilities, the number on the register, the number participating in the foodservice, and the participating foodservice rate. The investment cost for facilities had increased according to the number participating in the foodservice and the participating foodservice rate. And the large enterprises showed higher participating foodservice rate than the small and medium enterprises.
Costs and Cost Analysis ; Humans ; Investments ; Meals ; Pupil ; Rivers ; Seoul*

Benign Joint Hypermobility Syndrome (BJHS) is characterized by generalized ligamentous laxity, with associated tendency to recurrent sprain and dislocation. Whereas ankylosing spondylitis (AS) is characterized by ankylosis and loss of mobility of the affected joints by fibrosis and ossification of cartilage and enthesis. The association of these two pathologies is rare. We report on a 18-year old man with a joint hypermobility and laxity as well as accompanying 18-month history of back pain at the lumbar spine, both knee and left buttock pain. At physical examination the patient presented 5 points of Nine-Point Beighton hypermobility score and limitation of movement in the lumbar spine due to back pain. Magnetic resonance imaging of the pelvis showed bilateral sacroiliitis and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated and HLA B27 was positive. Transthoracic echocardiography and opthalmologic examination excluded other cause of joint hypermobility. We diagnosed co-existent BJHS and AS.
Adolescent ; Ankylosis ; Back Pain ; Blood Sedimentation ; Buttocks ; C-Reactive Protein ; Cartilage ; Dislocations ; Echocardiography ; Fibrosis ; Humans ; Joint Instability* ; Joints* ; Knee ; Ligaments ; Magnetic Resonance Imaging ; Pathology ; Pelvis ; Physical Examination ; Sacroiliitis ; Spine ; Spondylitis, Ankylosing* ; Sprains and Strains

We report a non-obese patient suffering from spastic gait and right leg paresis caused by thoracic spinal cord compression secondary to spinal epidural lipomatosis. Although spinal epidural lipomatosis is most often associated with the administration of exogenous steroid or endogenous Cushing syndrome, obesity also has been reported as a possible cause. However, idiopathic(non-glucocorticoid induced) spinal epidural lipomatosis in non-obese healthy man is an extremely rare disease and dose not have any good explanation for the abnormal fat deposition in spinal epidural space. We recently experienced a patient with idiopathic thoracic epidural lipomatosis in whom MRI and histopathology established the specific diagnosis. With a case report, brief review of the disease including clinical feature, diagnostic procedure and therapeutic considerations is described.
Cushing Syndrome ; Diagnosis ; Epidural Space ; Gait Disorders, Neurologic ; Humans ; Leg ; Lipomatosis* ; Magnetic Resonance Imaging ; Obesity ; Paresis ; Rare Diseases ; Spinal Cord Compression

Objective The aim of this study was to evaluate the clinicopathologic findings of eight patients with primary cancer of fallopian tube diagnosed and treated in the department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center for nine years. Methods Demographic characteristics, symptoms, signs, stage, tumor grade, mode of therapy and survival of patients were reviewed retrospectively. Results The patients with primary cancer of fallopian tube constituted 0.4% of all gynecologic malignancies encountered during this period. The age of patients ranged 42 to 70 years(mean+/- S.D.; 53.9+/-9.9) and half of patients were postmenopausal and two patients were nulliparous. Patients were treated by simple or radical hysterectomy and bilateral salpingoophorectomy with or without omentectomy and five patients received postoperative chemotherapy. The FIGO surgical stages of the patients were I(4 cases), II(2 cases), III(1 case) and IV(1 case). There were 3 cases of adenocarcinoma, 3 cases of malignant mixed Mullerian tumor, 1 case of undifferentiated carcinoma and 1 case of serous cystic tumor of low malignancy potential. Serum CA 125 values were followed during treatment and decreased during clinical remission and increased at the time of tumor progression. The mean follow-up duration was 24.3(+28.3) months and 7 patients were alive free of disease and one patients with stage Ic died of the disease. Conclusion Primary fallopian tube cancer is an extremely rare malignancy of the female genitalia and preoperative diagnosis of this disease is difficult. Cytoreductive surgery and postoperative combination chemotherapy seem to be effective treatment and CA 125 value could reflect the disease status during the treatment and follow-up of patients.
Adenocarcinoma ; Carcinoma ; Chungcheongnam-do ; Diagnosis ; Drug Therapy ; Drug Therapy, Combination ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Follow-Up Studies ; Genitalia, Female ; Gynecology ; Humans ; Hysterectomy ; Obstetrics ; Retrospective Studies ; Ulsan