Rigid posterior fixation of the atlas to the third and fourth cervical spine was achieved in a patient in whom axis pedicle fracture and dislocation of axis on the third cervical spine. Althouth there was no evidence of neurologic disorder, marked instability of axis on the third cervical spine should inevitably be fused in any procedures. An anatomically contoured loop was secured to the posterior arch of the atlas and the laminae of the third and the fourth cervical spine by sublaminar wirings. The technique has the advantage over bone graft, either alone or with cement, in that it affords rigid stabilization, allows early mobilization and some flexion movement of atlanto-occipital joint.
Atlanto-Occipital Joint ; Dislocations ; Early Ambulation ; Humans ; Nervous System Diseases ; Spine ; Spondylolisthesis ; Transplants

Duplex ultrasonography (USG) is an accepted method to assess noninvasively arterial inflow to the penis. Optimal pharmacological agents as well as timing of the scan and stimulation during the scan continue to be debated. Between August 1994 and May 1996, 24 normal males (control group) and 45 impotent patients (impotence group) underwent penile doppler sonography, and their records were reviewed. Scans were performed at 1, 3, 5, 10, 15, 20 and 30 minutes after intracavernous injection of PGE1 (10 pg) in all subjects. Any subject not having a full erection at 15 minutes performed private self-stimulation for at least 5 minutes before the 30 minute scan. If we define normal arterial inflow as a peak systolic velocity (PSV) of 30 cm. per second or greater in the best artery, 46% of control group and 55% of impotence group achieved this velocity until 5 minutes. One (4%) of control group and three (6%) of impotence group achieved maximum velocity at 1 or 3 minutes but continually PSV of 30 cm. per second or greater after 5 minutes, so any subject may not have had an incorrect diagnosis. When we calculated maximum velocity in the best artery in relation to percentage tumescence, maximum velocity were recorded most often at 10% tumescence (46% of control group and 51% of impotence group). If we define normal arterial inflow as PSV of 30 cm. per second or greater in best artery, the cumulative percentage of patients who achieved this velocity at 1, 3, 5, 10, 15, 20 and 30 minutes were 4, 34, 46, 88, 96, 96 and 100% in control group and 6, 28, 55, 90, 92, 94 and 96% in impotence group. In conclusion, we support delaying the initial scan until 5 minutes, performing the additional scans until 30 minutes and self-stimulation when necessary. We believe all efforts should be made to have studies performed in the setting of least anxiety to the patient.
Alprostadil* ; Anxiety ; Arteries ; Diagnosis ; Erectile Dysfunction ; Humans ; Male ; Penis ; Ultrasonography*

PURPOSE: The Purpose of this study is to investigate th relations among ego identity, stress, and internet addiction in high school students. METHODS: In order to get the data by self-questionnaire, 750 subject were selected from Aug. 20 to Aug. 31, 2008. The data was analyzed by percentage, mean, standard deviation, t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple regression using SPSS/WIN 12.0 program. RESULTS: Ego identity scores were 39.54, stress scores were 64.68, internet addiction scores were 65.34. There were significantly negative correlations between ego identity and stress, between ego identity and internet addiction. But there was significantly positive correlation between stress and internet addiction. Multiple regression analysis revealed that the most powerful predictor of internet addiction was stress related to individual. CONCLUSION: The findings of study suggest that broad internet addiction and stress program should be provided to prevent problems of internet addiction.
Ego ; Humans ; Internet*

PURPOSE: This study was designed to investigate that men with prostatodynia have petechiae in the bladder and improvement of symptoms after hydrodistension. MATERIALS AND METHODS: A total of 14 men with the diagnosis of prostatodynia underwent cystoscopy and hydrodistension under a general or regional anesthetic. Their charts were retrospectively reviewed. RESULTS: Of the 14 men 5(36%) had moderate to severe petechiae similar in appearance to women with interstitial cystitis after hydrodistension. Men with moderate to severe bladder petechiae had fewer leukocytes in expressed prostatic secretions and smaller bladder capacities than men with more normal appearing bladders after hydrodistension. Symptomatic improvement 2 to 6 weeks after hydrodistension was more common in men with moderate to severe petechiae than in those with fewer petechiae. CONCLUSIONS: We suggest that bladder petechiae after hydrodistension may be a diagnostic finding in men with prostatodynia as well as women with interstitial cystitis. Therefore, the diagnosis of interstitial cystitis should be considered in patients with prostatodynia.
Cystitis, Interstitial ; Cystoscopy ; Diagnosis ; Female ; Humans ; Leukocytes ; Male ; Purpura ; Retrospective Studies ; Urinary Bladder

Agnogenic myeloid metaplasia (AMM) is a myeloproliferative disorder characterized by leukoerythroblastosis, tear-drop erythrocytes, extramedullary hematopoiesis with hepatosplenomegaly, and varying degrees of myelofibrosis. The mean age at presentation is about 60 years, and pediatric cases are rare. We experienced a case of AMM in a 9 months old female who was presented with pallor, huge splenomegaly and intermittent fever. Peripheral blood showed leukoerythroblastosis poikilocytosis, and tear drop cells. Bone marrow was difficult to aspirate, and biopsy specimen showed increased reticulin with decreased cellularity, which was compatible with myelofibrosis. We presented a case of AMM with brief review of the literatures.
Biopsy ; Bone Marrow ; Erythrocytes ; Female ; Fever ; Hematopoiesis, Extramedullary ; Humans ; Infant ; Myeloproliferative Disorders ; Pallor ; Primary Myelofibrosis* ; Reticulin ; Splenomegaly

It has been thought the histological features of rheumatoid arthritis do not reliably indicate the degree of activity or prognosis of the disease and that they are not specific for that condition (Hemerman, 1963). Recently, however, Muirden and Mills (1971) found in rheumatoid joints submitted for synovectomy a direct correlation between the degree of lymphocytic infiltration and joind damage. Lymphocytes might play a helpful role in protection of the rheumatoid joint. Muirden (1970) has also reported a significant relationship between histological estimates of the extent of the iron deposits nd the grades of roentgenographic changes in biopsied joints. The present study directed to confirm and analyze the changes in the clinical and pathological aspects, with the cases synovectomized at Korea and Severance Hospital, Seoul, Korea. Resuits: Clinical and histological studies were made on 21 cases of “classical” and “definite” rheumatoid arthritis submitted to the Department of Orthopaedic, Korea General Horsital and the Department of Pathology, Yonsei University College of Medicine, during the period from 1966 to 1975, and results were as follows. 1 In age distribution, 16 cases (76.2%) were in the interval between 21 and 51 years old: the mean age was 33.5 years old. The sex distribution showed approximately a three fold female predominance with 16 females (76.2%) to 5 male cases (23.8%). 2. The most common chief complaint recorded were morning stiffness and multiple joint pain. Other symptoms, in descending order of occurrence were tenderness, synovial swelling, flexion deformity, joint swelling and subcutaneous nodules. The interval from initial complaint to admission varied from 7 months to 15 years, with a mean interval of 5.9 years. 3. Serological studies for rheumatoid factor were done on 15 cases and eight (53.3%) were found to be positive while seven cases (46.7%) were negative. The positive cases had longer histories and were in older age groups than the negatives. 4. Histologic findings were characterized by proliferation of suface lining cells of synovium, infiltration of lymphocytes, proliferation and thickeness of the vessels, and synovial villi, deposition of fibrins and hemosiderins and infiltration of acute inflammtory celIs. Each of the characteristics studied was ratect on a scaled score ranging from 0 to 3 from 1 to 3. For each patient the scaled scores were totaled and the totals ranged between 6 and 18 with a mean score of 10.5 5. Roentgenographic findings were characterized by swelling of the soft tissues swelling of the joints,. narrowed space of the joint cavity, and destruction of bone. Each of the characteristics studied was rated. on a scaled score ranging from 0 to 3 or from 1 to 3. For each patient the scaled scores were totaled and the totals ranged between 3 and 11 with a mean score of 7.1. 6. There was no significant correlation between histologic findings such as synovial hyperplasia or infiltration of lymphocytes, and clinical findings such as age, duration of histories, presence of rheumatoid factor, roentgenographic findings or surgicaI findings.
Age Distribution ; Arthralgia ; Arthritis, Rheumatoid ; Congenital Abnormalities ; Female ; Fibrin ; Hemosiderin ; Humans ; Hyperplasia ; Iron ; Joints ; Korea ; Lymphocytes ; Male ; Pathology ; Prognosis ; Rheumatoid Factor ; Seoul ; Sex Distribution ; Synovial Membrane

No abstract available in English.
Antigen-Antibody Complex ; Arthritis ; Rabbits ; Synovial Membrane

Three hundred and fourty two patients with a fracture of tibial shaft were treated and managed in the Department of Orthopaedic Surgery, Soon Chun Hyang University Hospital from January 1981 to December 1985. In 147 cases, 62 cases had only tibial shaft fracture and 85 tibial and fibular shaft fracture. All of these were treated conservatively by manipulation and cast immibilization. We analyzed the initial fracture characteristics, the treatment employed, and the subsequent complications in fracture healing in a series of patients who had sustained a tibial shaft fracture with and without a fibular fracture. The results were as follows; 1. Duration of average bone healing was more slowly in the patients more than twenty years old who were treated for a tibial shaft fracture with and without a concomitant fibular fracture than in the patients less than twenty years old. 2. Duration of average bone healing was more slowly by one or two weeks in the the group of tibial shaft fracture without fibular fracture than in than in those with fibular fracture. 3. The frequency of delayed union, nonunion, varus malunion and pain in the ipsilateral ankle joint were more increased in the group of the tibial shaft fractures without fibular fracture in than those with fibular fracture. 4. The frequency of valgus malunion was more increased in the group of the tibial shaft fractures with fibular fracture than in those without fibular fracture.
Ankle Joint ; Fracture Healing ; Humans ; Tibia

Granular cell tumor is one of the rare tumorous condition. At present there are estimated 600 reported examples of the tumor in the medical literature. Malignant granular cell tumor is a well established but extremely rare entity that is found in appr- oximately 2 % of all granular cell tumor. Diagnosis should be restricted to neoplasms that are similar in their histological appearance to benign granular cell tumors but can be seperated on the basis of cellular pleomorphism, mitotic activity, and, most importantly, their capacity to produce metastases. The authors had experienced that a 55 years old male patient had two large malignant granular cell tumors at the left thigh and left inguinal area with metastatic lesion.
Diagnosis ; Granular Cell Tumor ; Humans ; Male ; Neoplasm Metastasis ; Thigh

Skin and soft tissue infection (SSTI) is common and important infectious disease. This work represents an update to 2012 Korean guideline for SSTI. The present guideline was developed by the adaptation method. This clinical guideline provides recommendations for the diagnosis and management of SSTI, including impetigo/ecthyma, purulent skin and soft tissue infection, erysipelas and cellulitis, necrotizing fasciitis, pyomyositis, clostridial myonecrosis, and human/animal bite. This guideline targets community-acquired skin and soft tissue infection occurring among adult patients aged 16 years and older. Diabetic foot infection, surgery-related infection, and infections in immunocompromised patients were not included in this guideline.
Adult ; Cellulitis ; Communicable Diseases ; Diabetic Foot ; Diagnosis ; Erysipelas ; Fasciitis ; Fasciitis, Necrotizing ; Humans ; Immunocompromised Host ; Impetigo ; Methods ; Pyomyositis ; Skin* ; Soft Tissue Infections*