OBJECTIVE: To know the clinical features of overuse injury in performing musicians and to evaluate related factors that may affect the overuse injury and playing related pain. METHODS: Eighty professional musicians and music college students were examined during 1 year. All were examined by a history taking, physical examination, radiologic exam and if needed electromyography. Nonparametric Sperman's correlation were used for the statistic analysis and 5 interval grading system, visual analog scale for pain, and stress, criteria of joint hypermobility were used for various measurements. RESULTS: Fifty four men were studied in 3 music colleges and a professional orchestra. Frequency of symptom was 46.3%. The string players were most frequently affected (65%), whereas the wind instrument players were least frequently affected (11.5%). The most commonly affected site was the hand and wrist (54.2%) followed by the spine. Patients were divided by the severity into 5 groups and among them the grade 1 was most common (29.6%). No significant correlation was seen between the practice hours per week but a significant correlation was noted between the stress and playing related pain. Joint hypermobility plays an important role in music playing which is dependent on the kind of instruments. CONCLUSION: Incidence of the overuse injury in musicians is high in Korea and the prevention and early treatment are essential for the good outcome of overuse syndrome.
Cumulative Trauma Disorders* ; Electromyography ; Hand ; Humans ; Incidence ; Joint Instability ; Korea ; Male ; Music ; Physical Examination ; Spine ; Visual Analog Scale ; Wind ; Wrist

BACKGROUND: The efficacy of tumescent liposuction in the treatment of axillary osmidrosis has been widely established. But there have been few studies that have conducted a comparative analysis according to the level of dermal curettage with respect to the efficacy and safety. OBJECTIVE: The aim of this study was to evaluate the clinical efficacy and complications of tumescent liposuction according to the degree of dermal curettage. METHODS: From September 2004 through August 2009, a total of 33 patients with axillary osmidrosis (66 axillae) were included in this study. Twelve patients (24 axillae) were treated by tumescent liposuction with dermal curettage at the level of the mid-dermis (the classical technique group), and the other 21 patients (42 axillae) were treated by tumescent liposuction with dermal curettage at the level of the dermo-subcutis junction (the modified technique group). The preoperative and postoperative disease severity was measured as 0, 1, 2 and 3. The improvement of symptoms was graded by the patient as excellent, good, fair and poor. We also evaluated the postoperative complications, including skin necrosis, scar, hematoma, sensory disturbance and infection. Biopsies of the axillary skin were performed in 7 patients to confirm the level of dermal curettage and the reduction of apocrine glands after treatment. RESULTS: The follow-up ranged from 6 to 60 months. Six months after treatment, 95.8% (23/24) of the axillae in the classical technique group and 95.2% (40/42) of the axillae in the modified technique group had reduced disease severity below 1. Among the 12 patients treated with the classical technique, 11 (91.7%) had excellent to good results, while 95.2% (20/21) of the patients treated with the modified technique had excellent to good results by the patients' own grading. The complications included skin necrosis, scar and hematoma. In the classical technique group and the modified technique group, the incidence of skin necrosis was 12.5% (3/24) and 2.4% (1/42), respectively, the incidence of scar formation was 4.2% (1/24) and 0%, respectively, and the incidence of hematoma was 8.3% (2/24) and 0%, respectively. The postoperative histologic examinations confirmed that the dermal curettage level was at the mid-dermis in the classical technique and at the dermo-subcutis junction in the modified technique. Interestingly, the histologic examination from the classical technique group revealed vacuolar alteration of keratinocytes and partial separation of the dermo-epidermal junction. CONCLUSION: The efficacy of the modified technique is compatible with that of the classical technique, but the modified technique offers fewer complications. So, the modified technique may improve the cosmetic outcome without reducing the treatment efficacy for the patient with axillary osmidrosis.
Apocrine Glands ; Axilla ; Biopsy ; Cicatrix ; Cosmetics ; Curettage ; Follow-Up Studies ; Hematoma ; Humans ; Incidence ; Keratinocytes ; Lipectomy ; Necrosis ; Postoperative Complications ; Skin ; Treatment Outcome

OBJECTIVE: To assess the jumper's knee for the symptoms and diagnostics by MRI and ultrasonography in basket ball players. METHOD: Twenty knees of 10 basketball players with chronic knee pain were assessed by the history taking, physical examination and diagnosis by magnetic resonance imaging and ultrasonography. Their average age was 17.4 years. Stanish classification is used for grading the symptoms of jumper's knee. RESULTS: Nine proximal patellar tendons were diagnosed as jumper's knees (45%) and 11 distal tendons were diagnosed as jumper's knees (55%). In ultrasonographic findings, average proximal patellar tendon thickness was 4.5 mm+/-1.2 mm, and distal patella tendon thickness was 7.1+/-1.1 mm. Sensitivity was 63% (12/19) and specificity was rated as 100% (21/21). By the MRI findings, sensitivity was rated as 32% (6/19) and specificity was rated as 90% (16/21). Study between the patient's clinical severity level by Stanish classification and thickness of patellar tendon showed no significant correlation (<0.5). CONCLUSION: The ultrasonography to be more convenient and easier as a diagnostic method for the jumper's knee than MRI.
Basketball ; Classification ; Diagnosis ; Knee* ; Magnetic Resonance Imaging* ; Patellar Ligament ; Physical Examination ; Sensitivity and Specificity ; Tendons ; Ultrasonography*

Epidermolytic keratosis palmaris is a rare disease which shows clinical findings of Unna Thost keratoderma and histopathologic of epidermolytic hyperkeratosis. We report herein a case of epidermolytic keratosis palmaris et plantaris in a 16-month-old female baby. Light microscopy shows marked hyperkeratosis, large irregular keratohyalin granules, and large clear spaces in the granular and upper spinous layers. Eletron microscopic findings shows that the clear spaces are areas of cytoplasm filled with a fibrillar material and cellular organelles. Abnormal clumping of tonofilament and keratohyalin is also present.
Cytoplasm ; Female ; Humans ; Hyperkeratosis, Epidermolytic ; Infant ; Intermediate Filaments ; Keratoderma, Palmoplantar* ; Keratosis* ; Microscopy ; Organelles ; Rare Diseases

No abstract available.
Female ; Fibronectins* ; Hypertension, Pregnancy-Induced* ; Plasma* ; Pregnancy ; Pregnancy*

Benign symmetric lipomatosis is characterised by diffuse symmetric deposits of adipose tissue, predominantly on the neck, shoulder, back and upper extremities. We report a case of benign symmetric lipomatosis in a 61-year-old-man, which was first noted one year previously. It began growing rapidly about 3 months ago and was associated with alcoholic liver disease. Histopathological findings showed that the reticular dermis had been replaced by normal uncapsulated mature fat cells that were slightly increased in number in the fibrous connective tissue. He was treated with theophylline 300mg/day for two months.
Adipocytes ; Adipose Tissue ; Connective Tissue ; Dermis ; Lipomatosis* ; Liver Diseases, Alcoholic ; Neck ; Shoulder ; Theophylline ; Upper Extremity

Fracture of the carpal scaphoid bone is the most common fracture of the carpus. Unfortunately, nonunion are common since the symptoms do not alert patents to seek early medical treatment and the diagnosis is easily missed. Fracture of the scaphoid is a common condition whose management remains controversial. The conservative treatment has many complications, these include inability to word while in plaster, stiffness of the wrist afterwards, muscle wasting, weakness and malunion. So various operative treatments of scaphoid fracture have been developed. Open reduction by use of screws suggested by Maclaughlin first in 1954. In 1984 a new and simple operative technique has been developed to provide rigid internal fixation for all types of fractures of the scaphoid by T.J. Herbert. This involves the use of a double-treaded bone screw which provides good fixation that, after operation, a plaster cast in rarely required and most patients are able to return to work within a few weeks. Authors have experienced 10 cases of scaphoid fracture and accomplished good result in all cases by internal fixation using Herbert screw. The results are as follows Of these 10 fractures, 2 were fresh fractures and 8 were nonunions of scaphoid fracture. In nonunion cases, the time interval between fracture and operation was from 5 months to 5 years. The postoperative immobilization period was average of 4 weeks. Short period of immobilization achieved early functional recovery of the wrist. The bony unions in roentgenogram were seen from 3 months to 9 months after operation. In 2 cases the fracture gap was seen after 9 months. But in these cases the symptoms such as pain and range of motion of wrist were improved.
Bone Screws ; Casts, Surgical ; Diagnosis ; Humans ; Immobilization ; Range of Motion, Articular ; Return to Work ; Scaphoid Bone ; Wrist

PURPOSE: To evaluate effectiveness of oblique approach under biplane fluoroscopic guidance in transthoracic fine needle aspiration biopsy. MATERIALS AND METHODS: Fourteen consecutive patients underwent transthoracic fine needle aspiration biopsy for subcarinal lesions. Subcarina was the only accessible biopsy site in 13 patients. Subcarinal biopsy was performed to determine the presence of metastasis in an enlarged subcarinal lymph node in the remaining one patient. Before biopsy, we evaluated the size and location of the lesion on preliminary plain chest X-ray film and CT scan. Under dual projection fluoroscopic guidence, biopsy was performed through right posterior intercostal space with the patient prone by using oblique approach. On 15 degree LAO projection the needle was directed to the area anterior to the spine and advanced to the line extending through the posterior wall of the main bronchus. RESULTS: Cytologic diagnosis was made in 12 out of 14 patients(accuracy 85.7%). The final diagnosis consisted of 5 squamous cell carcinoma, 5 small cell carcinoma, 1 adenocarcinoma and 1 adenosquamous carcinoma. Pneumothorax developed in 2 patients(14%) and was managed by chest tube drainage. Mild hemoptysis was observed in 2. CONCLUSION: Transthoracic fine needle aspiration biopsy using oblique approach under biplane fluoroscopic guidance is a relatively safe and sensitive method for the histologic diagnosis of subcarinal lesion.
Adenocarcinoma ; Biopsy* ; Biopsy, Fine-Needle* ; Bronchi ; Carcinoma, Adenosquamous ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Chest Tubes ; Diagnosis ; Drainage ; Hemoptysis ; Humans ; Lymph Nodes ; Needles ; Neoplasm Metastasis ; Pneumothorax ; Spine ; Thorax ; Tomography, X-Ray Computed ; X-Ray Film

Aortic root diameter by two dimensional and M-mode echocardiography in predicting prosthetic aortic valve size preoperatively was measured in 10 adult patients undergoing aortic valve replacement. Correlation of aortic root diameter measured by two dimensional echocardiography and actual prosthetic valve size implanted by aortic valve replacement was excellent. Correlation coefficient was statistically significant (r=0.91, P<0.001). Correlation of aortic root diameter measured by M-mode echocardiography and actual prosthetic valve size was also excellent. Correlation coefficient was statistically significant (r=0.86, P<0.001). This study demonstrates that aortic root diameter by two dimensional and M-mode echocardiography can accurately predict prosthetic aortic valve size in patient undergoing aortic valve replacement.
Adult ; Aortic Valve* ; Echocardiography* ; Humans

No abstract available.
Pregnancy*