Iatrogenic damage of the rotator cuff followed by postoperative shoulder function loss is a potential complication after antegrade intramedullary nailing (AIN) for a humeral fracture. The authors present a case of arthroscopic rotator cuff repair and subacromial decompression of a non-healed rotator cuff tendon (mainly supraspinatus) and secondary impingement syndrome caused either by the tear or a proud nail after AIN for a mid-shaft humeral fracture. At presentation, the patient complained of right shoulder pain and 'snapping', especially during forward elevation and abduction of the shoulder, of 4 years duration. Right shoulder pain started sometime after pain due to the humeral shaft fracture, operation had subsided, and persisted after nail removal. Arthroscopic findings showed a longitudinal rotator cuff tear at the nail entry point that had not healed and severe fibrous hypertrophy on the acromion underspace, which is a unique finding since most longitudinal splits of tendon fibers are more likely to heal than conventional rotator cuff tears detached from bone. The torn rotator cuff was repaired after debridement and placing side-to-side sutures. At his 34-month follow-up after rotator cuff repair, the patient showed complete recovery and had excellent clinical scores.
Acromion ; Arthroscopy ; Debridement ; Decompression ; Follow-Up Studies ; Fracture Fixation, Intramedullary* ; Humans ; Humeral Fractures ; Hypertrophy ; Rotator Cuff ; Shoulder ; Shoulder Pain ; Sutures ; Tendons

Using the avidin-biotin-peroxidase complex(ABC) technique, 36 skin specimens from 30 patients with primary and secondary syphilis and a gastric mucosal specimen from a patient with secondary syphilis which were confirmed by clinical history, physical examination, the VDRL, FTA-ABS, TPHA, and 19s(IgM)-FTA test, were examined. The results were compared with that of the indirect mmunoperoxidase technique which was done by authors previously with same specimens. The following results were obtained. 1. Of the 37 specimens, 35(95%) were positive in ABC technique and 33 of the 37 specirnens(89%) were positive in the indirect immunoperoxidase technique. 2. The ratio of agreement of the results between the ABC and the indirect immunoperoxidase technique was 89%. 3. Most of the treponemes were located in the upper dermis, epidermis, and blood vessel walls in the arder named, and rarely in the lower dermis of the syphilitic skin lesions. There was no remarkable difference in histologic distribution of treponemes between the clinical stages and types of syphilitic skin lesions. :From the results, the ABC technique is considered to be an excellent method for detecting the treponemes in the suspected syphilitic lesions.
Avidin* ; Biotin* ; Blood Vessels ; Dermis ; Epidermis ; Humans ; Immunoenzyme Techniques ; Peroxidase* ; Physical Examination ; Skin ; Syphilis ; Treponema pallidum* ; Treponema*

Sclerosing lymphangitis of the penis is a peculiar disorder characterized by painless, firm, cord-like lesion in the coronary sulcus of the penis. Histologic findings include thickened lymphatic collecting vessels, fibrin thrombi and few inflammatory changes. The etiology is unknown, but the condition is benign and self-limited. We describe herein a 27-year-old man who had a typical painless, tender, firm, cord-like lesion in the coronary sulcus. Histologic findings disclosed a markedly thickened and fibrosed lymphatic vessel with a organizing thrombus. Whatever the cause of thrombi formation, it is prohable that the thrombi formation would be a main pathologic process, followed by the thickening of the vessel wall.
Adult ; Fibrin ; Humans ; Lymphangitis* ; Lymphatic Vessels ; Male ; Penis* ; Thrombosis

No abstract available.
Humans ; Infertility* ; Infertility, Male* ; Male ; Male*

No abstract available.
Peptic Ulcer*

Using the indirect immunoperoxidase and FTA ABS complement techniques, 36 skin specimen: from 30 patients with primary and secondary syphilis and a gastric mucosal specimen from a patient with secondary syphilis which were confirmed by elinical history, physical examination, VDRL, FTA ABS, TPHA, and 19s(IgM)-FTA test, were examined. The follwing results were obtained. l. Of the 37 specimens, 33(89%) were positive in the indirect immunoperoxidase techique and 26 of the 37 specimens(70g) were positive in the FTA ABS complement technique. Of the 17 specimens, 12(71%) were positive in the darkfield examination. 2. The ratio of agreement of the results between the indirect immunoperoxidase and FTA ABS complement techniques was 81%, The ratio of agreement of the results between the indirect immunoperoxidase technique and darkfield examination was 82%. 3. Most, of the treponemes were located in the upper dermis, epidermis, and blood vessel walls in the order named, and rarely in the lower dermis of the syphilitic skin lesion. There was no remarkable difference in histologic clistribution of treponemes between the clinical stages and types of syphilitic skin lesions. From the results, the indirect immunoperoxidase technique is considered a superior method than the FTA ABS complement technique and darkfield examination for detecting the treponemes in the suspected syphilitic lesions.
Blood Vessels ; Complement System Proteins* ; Dermis ; Epidermis ; Humans ; Immunoenzyme Techniques* ; Physical Examination ; Skin ; Syphilis ; Treponema pallidum* ; Treponema*

Localized cystic degeneration of peripheral arteries represents and unusual cause of arterial insufficiency. It frequently occurs in patient without generalized arteriosclerosis. It has been reported in patients from age 11 to 62 years. Cystic adventitial disease is most common in the popliteal artery. At least 115 cases have been reported worldwide, but none in Korea. We report a case of cystic adventitial disease involving the left popliteal artery. This 64-year-old man presented with an 18-month history of cramping pain of sudden onset in the left calf and claudication. Angiographic findings showed a 6 cm length of luminal obliteration of the popliteal artery. Segmentally resected popliteal artery showed two longitudinally directed cystic masses measuring 3.5x1.5 cm and 2.5x1.5 cm in the adventitia. Microscopic examination revealed cystic space in the arterial adventitia compressing arterial lumen. There were a number of foamy histiocytes collected along the cystic lumen.
Male ; Humans

Injuries and pains of musculoskeletal joint in human body is common onset in industrialized world. However, muscle fatigue plays a very significant role in contributing causes of many pains associated with musculoskeletal joints. Based on this hypothesis, degree of muscle fatigue was investigated using electromyography measurement technique during isometric and concentric/eccentric muscle contractions. Different response of the muscle fatigue between two different muscle contractions (isometric and concentric/eccentric contractions) was examined by comparison of parameters which were median frequency, median power and RMS value. Healthy 16 young persons without previous musculoskeletal diesease history were tested with Noraxon Myosystem 2000 EMG measurement system. In this study, two different exercises were performed. First exercise was concentric/eccentric exercise. Second exercise was isometric muscle contraction. In the case of the isometric exercise, median frequency was decreased, but median power and RMS were increased. However, during the concentric/eccentric exercse, median frequency was increased, but median power and RMS were decreased. Both of those revealed that the pattern of the median frequency was W type, but median power and RMS were M type as time passed. In this study, the patterns of the muscle fatigue during concentric/eccentric exercise as well as isometric exercise were identified. It will be helpful to prevent musculoskeletal injury from over-working andexercising.
Electromyography* ; Exercise ; Human Body ; Humans ; Joints ; Muscle Contraction ; Muscle Fatigue*

The dysfunction of either or both noradrenaline and serotonin system are important in the pathophysiology of depression. Previous reports have suggested that there may be an important interaction between these two systems. Recently, some investigators have suggested that the combination of tricyclic antidepressants(TCAs and selective serotonin reuptake inhibitors(SSRIs would produce a rapid synergistic effect on down-regulation of either or both of these two systems and that this combination may produce a more rapid and absolute antidepressant effect. We compared the treatment efficacy, treatment associated side effects, treatment satisfaction, and the quality of life between the combination therapy of dothiepin-sertraline as well as the therapy of dothiepin alone in the treatment of major depressive disorder and dysthymic disorder. In our study, the combination therapy of dothiepin and sertraline produced a more rapid and absolute antidepressant effect than dothiepin alone. And the patients with combination therapy experienced relatively high treatment satisfaction than the patients with dothiepin therapy. The patients quality of life improved more rapidly in the combination therapy, especially, in the health perception, social behavior, and life satisfaction, that dothiepin alone. These results support the hypothesis that the combination of TCA an SSRI may produce a rapid synergistic effect on either or both norepinephrine and serotonin system, and more rapid antidepressant effect and high treatment satisfaction.
Depression ; Depressive Disorder* ; Depressive Disorder, Major ; Dothiepin* ; Down-Regulation ; Dysthymic Disorder ; Humans ; Norepinephrine ; Quality of Life ; Research Personnel ; Serotonin ; Sertraline ; Social Perception ; Treatment Outcome

No abstract available.
Spinal Fractures*