PURPOSE: Neurofibromas may present as multiple or solitary lesions. Although there is no predilection site for solitary lesions, they are rare on the hand. In addition, solitary intramuscular neurofibromas are a very rare pathological type. Here, we report a rare solitary intramuscular neurofibroma in the hand. This paper examines the clinical characteristics of intramuscular neurofibroma arising from the lumbricalis in order to enable a correct diagnosis and treatment. METHODS: A 32-year-old male presented with a painless mass on the palm. The physical examination revealed a 3 x 2cm protruding mass that was non-tender to palpation. The vascular and sensory examinations were unremarkable, while the motor examination showed mild difficulty with flexion and extension. Magnetic resonance imaging demonstrated an enhancing solid mass between the thenar eminence and second metacarpophalangeal joint. The diagnosis of an intramuscular neurofibroma was confirmed following surgical excision and histological evaluation. RESULTS: The pathological examination was consistent with a neurofibroma, with delicate fascicles and loose fusiform cells in a fibrous stroma, with oval or spindle-shaped nuclei and scant cytoplasm. The background matrix was pale staining and had focal myxoid stroma. There was no significant nuclear pleomorphism and no mitoses. Immunohistochemistry with S-100 was slightly positive. At the 6-month follow-up, motor and sensory function were intact and the range of motion was full. CONCLUSION: A neurofibroma is a rare tumor of the hand, especially the intramuscular type. Hand surgeons should consider the diagnosis of this tumor based on the examination and imaging.
Adult ; Cytoplasm ; Follow-Up Studies ; Hand ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging ; Male ; Metacarpophalangeal Joint ; Mitosis ; Neurofibroma ; Palpation ; Physical Examination ; Range of Motion, Articular ; Sensation

An endoscopic retrograde cholangiographic study of 25 consecutive cases of hepatic clonorchiasis was performed during the period from Aug. 1986 to Sep. 1991 Hepatic clonorchiasis was confirmed by stool of examination for Clonorchis sinensis. The findings consist of characteristic filling defects and changes in the intrahepatic and extrahepatic bile ducts. The filling defects due to adult worms are significant diagnostic criteria of clonorchiasis. Its appearance is elliptical and/or round. The change in the intrahepatic bile ducts consisits of dilatation, irregularity(tortousity and elongation) and blunting of termieal branches of bile tree, irregular stenosis, fuzziness and raggedness. The characteristic changes in the extrahepatic bile ducts in clonorchiasis are duct wall irregularities and mild dilatation of bile duct. ERCP is an excellent method to evaluate biliary tree in patient with clonorchiasis because it reveals not only its characteristic findings of clonorchiasis but also its severity and associated lesions.
Adult ; Bile ; Bile Ducts ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Clonorchiasis* ; Clonorchis sinensis ; Constriction, Pathologic ; Dilatation ; Humans

An endoscopic retrograde cholangiographic study of 25 consecutive cases of hepatic clonorchiasis was performed during the period from Aug. 1986 to Sep. 1991 Hepatic clonorchiasis was confirmed by stool of examination for Clonorchis sinensis. The findings consist of characteristic filling defects and changes in the intrahepatic and extrahepatic bile ducts. The filling defects due to adult worms are significant diagnostic criteria of clonorchiasis. Its appearance is elliptical and/or round. The change in the intrahepatic bile ducts consisits of dilatation, irregularity(tortousity and elongation) and blunting of termieal branches of bile tree, irregular stenosis, fuzziness and raggedness. The characteristic changes in the extrahepatic bile ducts in clonorchiasis are duct wall irregularities and mild dilatation of bile duct. ERCP is an excellent method to evaluate biliary tree in patient with clonorchiasis because it reveals not only its characteristic findings of clonorchiasis but also its severity and associated lesions.
Adult ; Bile ; Bile Ducts ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Clonorchiasis* ; Clonorchis sinensis ; Constriction, Pathologic ; Dilatation ; Humans

BACKGROUND: Preventive measures need to be implemented to lower the incidence of osteoporotic fractures. Osteoporotic fractures increase morbidity and mortality as well as impose a socioeconomic burden; however, current research is limited to the administration rates of osteoporosis drugs for Korean postmenopausal females. METHODS: This study represents a nationwide, observational, and cross-sectional survey that investigates the administration rates of osteoporosis drugs based upon a bone mineral density (BMD) test performed on Korean postmenopausal patients who visited outpatient orthopedic clinics. BMD test results were examined in postmenopausal female patients (50 to 80 years of age); subsequently, the patients were classified into an osteoporosis group, osteopenia group, and normal group. The administration rates of osteoporosis drugs and bisphosphonates were then analyzed. The osteoporosis group was subdivided into a T-score less than -3.0 group and a T-score between -3.0 and -2.5 group that were separately analyzed. RESULTS: Based on the lumbar spine BMD, the rate of administration of osteoporosis drugs in the osteoporosis group was 42.1%, which was significantly higher compared to the osteopenia group or normal group. A significantly low bone mineral density was observed in patients who were administered bisphosphonates. Based on the lumbar spine BMD, the administration rate of osteoporosis drugs in the group with a T-score between -3.0 and -2.5 (34.2%) was significantly lower than the group with a T-score less that -3.0 (46.2%). The bisphosphonate administration rate was also significantly low; however, the administration rate for osteoporosis drugs was significantly lower than that of the osteopenia group. CONCLUSIONS: Only about 40% of Korean postmenopausal female patients with osteoporosis were administered osteoporosis drugs. The administration rate in patients with a T-score between -3.0 and -2.5 was particularly low and active treatment to prevent osteoporotic fractures is required in this group.
Aged ; Aged, 80 and over ; Bone Density Conservation Agents/*therapeutic use ; Cross-Sectional Studies ; Drug Prescriptions/*statistics & numerical data ; Female ; Humans ; Insurance Benefits/*methods ; Middle Aged ; Osteoporosis/*drug therapy/epidemiology ; Republic of Korea

The aim of this study was to compare periodontal conditions around mesially tipped molars by a tipping degree. Patients who had been consecutively treated at the Department of Periodontology, Chonbuk National University Hospital from October 1999 to August 2001 were assessed with radiographs taken at their molar regions. Of all molars investigated, 142 molars of 116 patients tipped mesially more than 10 degrees to the line perpendicular to an occlusal plane were selected for the study. The tipped molars were divided into 2 groups with a reference to a tipping degree, i.e., 66 slightly tipped(group 1 : <30degrees) and 76 severely tipped molars (group 2 : > or =30degrees). Probing depth(PD), plaque retention index(PRI) at mesial surfaces of tipped molars and tooth mobility(TM) were recorded at the clinical examination. Tipping degree(TD) and alveolar bony defect(ABD) at the mesial surface of the molars were measured in a radiograph. The results showed that no statistical differences were found between groups in all measured variables. In Pearson correlation analysis performed in the same group, a positive relationship was shown between PRI and PD in the group 1 and, in the group 2, between PRI and PD as well as PRI and ABD(p < 0.01). However, no statistically significant relationship was found between TD and all other variables in both groups. Within limitations of this study, it may be concluded that tipping degree did not seem to influence periodontal conditions, i.e., PD, ABD and TM of mesially tipped molars per se, but plaque presence/absence seemed to mainly affect the periodontal conditions of the tipped molars.
Dental Occlusion ; Humans ; Jeollabuk-do ; Molar* ; Prevalence ; Tooth

Background: The purpose of this study was to investigate the characteristics of osteoporotic vertebral compression fractures (OVCFs) in Korean postmenopausal women and the association between OVCFs and clinical factors such as age, bone mineral density (BMD), and quality of life. Methods: According to the population distribution in four regions in Korea, 1,281 postmenopausal female patients were recruited from nationwide orthopedic outpatient clinics. Radiologic, asymptomatic, and within 3 months of OVCF groups were analyzed based on age, fracture location, and prevalence according to BMD. In addition, BMD, T-score, body mass index, and European Quality of Life-5 Dimensions (EQ-5D) were investigated in the three groups, and the differences between groups were compared and analyzed. Results: The prevalence of radiologic OVCFs at the T11–L1 was 3.7 times higher in the 70s group (44.0%) than in the 50s group (11.9%). Femur and total hip BMD were significantly lower in patients with thoracolumbar junction fractures than in patients with L2–5 fractures, whereas no difference was observed in lumbar spine BMD. Of the three OVCF groups, the within 3 months of OVCF group had the lowest lumbar spine T-score of –2.445. The asymptomatic OVCF group also showed significantly lower lumbar spine T-score than did the group without radiologic OVCFs (p < 0.001). The EQ-5D showed a significant decrease in the radiologic OVCF group (p < 0.001) and within 3 months of OVCF group (p < 0.001). Conclusions The prevalence of OVCFs in the thoracolumbar junction rapidly increases with old age and low BMD in Korean postmenopausal women. Femur and total hip BMD are more predictive of thoracolumbar junction fractures than lumbar spine BMD.Patients with radiologic OVCFs had a significantly lower quality of life than no OVCF group. Therefore, this study shows it is important to treat and prevent osteoporosis before an OVCF occurs.

Background: The purpose of this study was to investigate the characteristics of osteoporotic vertebral compression fractures (OVCFs) in Korean postmenopausal women and the association between OVCFs and clinical factors such as age, bone mineral density (BMD), and quality of life. Methods: According to the population distribution in four regions in Korea, 1,281 postmenopausal female patients were recruited from nationwide orthopedic outpatient clinics. Radiologic, asymptomatic, and within 3 months of OVCF groups were analyzed based on age, fracture location, and prevalence according to BMD. In addition, BMD, T-score, body mass index, and European Quality of Life-5 Dimensions (EQ-5D) were investigated in the three groups, and the differences between groups were compared and analyzed. Results: The prevalence of radiologic OVCFs at the T11–L1 was 3.7 times higher in the 70s group (44.0%) than in the 50s group (11.9%). Femur and total hip BMD were significantly lower in patients with thoracolumbar junction fractures than in patients with L2–5 fractures, whereas no difference was observed in lumbar spine BMD. Of the three OVCF groups, the within 3 months of OVCF group had the lowest lumbar spine T-score of –2.445. The asymptomatic OVCF group also showed significantly lower lumbar spine T-score than did the group without radiologic OVCFs (p < 0.001). The EQ-5D showed a significant decrease in the radiologic OVCF group (p < 0.001) and within 3 months of OVCF group (p < 0.001). Conclusions The prevalence of OVCFs in the thoracolumbar junction rapidly increases with old age and low BMD in Korean postmenopausal women. Femur and total hip BMD are more predictive of thoracolumbar junction fractures than lumbar spine BMD.Patients with radiologic OVCFs had a significantly lower quality of life than no OVCF group. Therefore, this study shows it is important to treat and prevent osteoporosis before an OVCF occurs.

STUDY DESIGN: A nationwide, observational, and cross-sectional study targeting postmenopausal patients from 62 orthopedic outpatient clinics in Korea between October 2010 and February 2011. PURPOSE: This study was carried out to investigate comorbidity, trauma history, and the status of osteoporotic fracture treatment in Korean postmenopausal women. OVERVIEW OF LITERATURE: There has been little reports on the comorbidity, family history, trauma history, and treatment status of osteoporotic fractures in patients visiting the orthopedic outpatient clinics in Korea. METHODS: A total of 1,255 postmenopausal women between the ages of 50 and 80 years were enrolled in the study and the population distribution was reflected by region. Comorbidity, familial history of osteoporosis, familial history of osteoporotic fracture, history of falls, and status of osteoporotic fracture management were evaluated using an interview and questionnaire. The relationship between family history of osteoporosis and bone mineral density was analyzed. RESULTS: A number of patients (23%) had a family history of osteoporosis and 16.5% had a family history of fractures. Most (64.7%) of the patients had one or more comorbidities, including 58.8% exhibiting a chronic disease and 16.4% suffering from diseases that restrict exercise or walking. The results of the questionnaire indicated that 21.8% of these fracture patients had experienced a fracture previously and that the most common type of fracture was that of the spine. Lumbar spine bone mineral density was found to be lower in the presence of family history of osteoporosis. CONCLUSIONS: Postmenopausal women are liable to have osteoporotic fractures due to the high prevalence of osteoporosis, a history of falling, and the comorbidity with diseases that restrict ambulation. A better understanding of postmenopausal women in the orthopedic outpatient settings is important to the management of osteoporotic fractures.

BACKGROUND: Arterial stiffness is a strong indicator of cardiovascular risk. Increased visceral fat confers greater risks of metabolic syndrome and cardiovascular events. The aim of this study was to elucidate the relationships between arterial stiffness and regional distribution of abdominal adiposity (i.e. subcutaneous and visceral adipose tissue). METHODS: Thirty obese participants (M:F=17:13, mean age=53.6+/-12.0 years) underwent anthropometric measurements, laboratory procedures such as serum lipid levels and abdominal computed tomography scan. The aortofemoral pulse wave velocity was measured by foot to foot method using two continuous Doppler waves. RESULTS: Pulse wave velocity was positively associated with age, hip circumference (P<0.01), visceral to subcutaneous abdominal fat ratio and body weight (P<0.05), but independent of the total abdominal, visceral, and subcutanous fat. Although not positively associated, the mean pulse wave velocity tended to be higher in patients with history of hypertension or diabetes. CONCLUSIONS: The site of abdominal fat distribution contribute to the prediction of arterial stiffness and visceral adiposity is associated with increased risk of cardiovascular events.
Abdominal Fat ; Adiposity* ; Body Weight ; Foot ; Hip ; Humans ; Hypertension ; Intra-Abdominal Fat ; Methods ; Pulse Wave Analysis ; Vascular Stiffness*

BACKGROUND: There has been a general feeling among surgeons that recurrence or metastasis following a curative gastric resection is a hopeless surgical proposition. This study was conducted to evaluate the clinical features and significance of relaparotomy following a gastrectomy for gastric cancer. METHODS: Fifty-six cases of relaparotomies following resection for 53 gastric cancer patients, which were performed over a nine-year period, were investigated retrospectively. On preoperative diagnosis, there were 17 cases of remnant and anastomotic recurrence, 15 cases of intestinal obstruction, 7 cases of cholecystitis, 7 cases of rectosigmoid obstruction, 5 cases of E-loop obstruction and 5 cases of other diseases. RESULTS: Of all the laparotomies eleven cases (19%) were non-recurrence, benign diseases and forty-six (81%) were recurrence. In the 17 cases of remnant and anastomotic recurrence, re-resection was possible in 13 (76%) and major postoperative complications developed in 4 cases with 2 cases of death within one month. Also 6 of 7 re-resected cases which was stage I at first operation were still alive well. In 15 cases of mechanical obstruction, 5 cases were non-recurrence and 10 cases involved recurrence, of which 6 had a bypass or enterostomy and 4 an exploration only. All cholecystitis cases had a cholecystectomy; metastasis was found in 2 cases. Rectal obstruction and E-loop obstruction all involved recurrence and a palliative resection was possible in only one case of each type of obstruction. CONCLUSIONS: In a relaparotomy of remnant and anastomotic recurrence, most of the survival-improving re-resection cases were in stage I at the first operation. In late-onset cholecystitis tumor recurrence should be suspected and a relaparotomy of the malignant obstruction, with bypass and ostomy procedure, can be justified for symptomatic relief.
Cholecystectomy ; Cholecystitis ; Diagnosis ; Enterostomy ; Gastrectomy ; Humans ; Intestinal Obstruction ; Laparotomy ; Neoplasm Metastasis ; Ostomy ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Stomach Neoplasms*