MR arthrography is a useful modality for evaluating the labrocapsular ligamentous complex (LCLC) of the shoulder. This study was performed to describe normal anatomic variations and pitfalls in image interpretation related to evaluation of the LCLC. MR arthrogram of 56 shoulders in 41 asymptomatic young, active, male volunteers were prospectively reviewed to evaluate the labral shapes, capsular insertions and images which may mimic the lesions of glenohumeral instability. The anterior and posterior parts of the labra, respectively, varied in shape: triangular (72%,36%), round (13%,35%), cleaved (8%,1%), notched (2%,0%), flat (5%,24%), and absent (0%,4%). The anterior and posterior capsular insertions, respectively, varied in site: Mosely and Oevergaard type I (82%,62%), type II (13%,36%), and type III (5%2%). A number of pitfalls in image interpretation were discovered. Articular cartilage undercutting the labrum (29%) and middle glenohumoral ligament in proximity to anterior labrum (5%) simulated a labral tear. Joint fluid interposed in the central, superior portion of the sublabral sulci (25%) simulated a SLAP lesion. Synovial fold (38%) in the axillary pouch resembled a loose body. Knowledge of normal variations and pitfalls in MR arthrogram image interpretation of labral-capsular-ligamentous complex will help the orthopedist to accurately detect debilitating derangements associated with the glenohumeral instability.
Arthrography* ; Cartilage, Articular ; Humans ; Joints ; Ligaments ; Male ; Prospective Studies ; Shoulder ; Volunteers

The purpose of this paper is to review the colonoscopic fingings of twenty two patients with colonic tuberculosis which were diagnosed by colonoscopic finding, histopathology, and follow-up observation after antituberculosis chemotherapy at Pusan National University Hospital from January 1992 to December 1994. The results were as follows: 1) The male to female ratio was 1: 1.2, and the average age of the patients was 39.4 years with a slight predominance in women. The age of peak incidence was the 4th decade 40.9%). 2) Abdominal pain(95%), diarrhea(63%), and weight loss(50%) were the most common clinical findings. Others were constipation, melena, and palpable abdominal mass. The location of the pain was right lower abdomen, epigastrium, central abdomen, and left lower abdomen in decreasing order. 3) Hematologic findings showed decrease in hemoglobin level, increase in ESR, and positive CRP(61.5%). The white blood cell counts were mostly normal. 4) The stool examination showed positive occult blood in 7 cases among 18 cases (38.9%). Acid-fast bacteria was observed in stool of one case. 5) On colonoscopy, the lesion sites were ileoeecal valve(75%), ascending colon(72.7 %), terminal ileum(52.6%), cecum(42.9%), transverse colon(31.8%), descending colon (27.3%), sigmoid colon(9%), and rectum(9%) in decreasing order of frequency. Most of them involved ileocecal area. 6) On colonoscopy, the shape of ulcer revealed circular(41%), fusion(36%), and irregular pattern(18%). It found skipped area in 9 cases, pseudopolyp in 8 cases, patency of ileocecal valve in 5 cases, and severe deformity of ileocecal valve in 6 cases. 7) Microscopic finding of biopsy specimens revealed noncaseating granulomatous inflammation in 12 cases, and nonspecific ulcerative inflammation in 10 cases. In conclusion the diagnostic yield may be greatly enhanced by obtaining multiple target biopsies frorn tbe deep portion of the ulcer bed and margins. Judged from the colonoscopic finding and clinical improvement after antituberculosis chemotherapy, more accurate diagnosis can be acquired.
Abdomen ; Bacteria ; Biopsy ; Busan ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Colonoscopy ; Congenital Abnormalities ; Constipation ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Ileocecal Valve ; Incidence ; Inflammation ; Leukocyte Count ; Male ; Melena ; Occult Blood ; Tuberculosis* ; Ulcer

No abstract available.
Encephalitis, Arbovirus* ; Korea*

Chronic postirradiation changes of skin reflect the injury of dermal structures particularly the vasculature and connective tissue. The clinical signs include atrophy, partial or complete destruc tion of cutaneous appendatges, telangiectasis, sclerosis of underlying tissue, pigrnentary changes, and in rare instances, ulceration with or without var ious premalignant and malignant neoplasms. The patient, was a 65-year-old man, who had been exposed to a large amount. of X-ray irradi- ation on his hands incidentally or accidentally for a long time. The skin changes of his hand were thickening and hardening of all digits loss or focal consttict,ion of digits, and keratotic papules. Epidermal hyperplasia and fibrous thickening of collagen bundles were found on skin biopsy. Gradual narrowingal of the bony caliber with eventual resorption was noticed on radiologic examination. It has been rarely reported in the literature that chronic radiation dermatitis develops severe and unusal manifestions such as acrosclerosis and loss of digit due to osteoradionecrosis.
Aged ; Atrophy ; Biopsy ; Collagen ; Connective Tissue ; Dermatitis* ; Hand ; Humans ; Hyperplasia ; Osteoradionecrosis* ; Sclerosis ; Skin ; Telangiectasis ; Ulcer

No abstract available.
Asian Continental Ancestry Group* ; Hepatitis B Surface Antigens* ; Hepatitis B* ; Hepatitis* ; Humans ; Korea*

The neurovascular cross-compression (NVCC) of the eighth cranial nerve (CN) is a clinical entity with symptoms of recurrent vertigo or tinnitus. Although the diagnostic criteria have been defined, the precise clinical presentation and pathomechanism have not been clarified. The treatment response to the carbamazepine; drug of choice for first line medical treatment, has been considered as one of the diagnostic criteria. Herein, we present a case of chronic uncompensated unilateral vestibular hypofunction who responded dramatically to carbamazepine medication. A 55 year-old male admitted to the hospital with symptoms of recurrent oscillopsia and headache for more than 7 years. His symptoms were aggravated by positional changes. Vestibular function tests showed spontaneous nystagmus, canal paresis on caloric test and vestibular dysfunction on dynamic posturography, which represented unilateral uncompensated vestibular hypofunction. Although his symptom was not relived by vestibular rehabilitation, he was treated with carbamazepine. A long standing uncompensated unilateral vestibular hypofunction without any auditory symptoms could be one of the clinical presentations in NVCC of the eighth CN.
Caloric Tests ; Carbamazepine ; Headache ; Humans ; Male ; Nerve Compression Syndromes ; Paresis ; Tinnitus ; Vertigo ; Vestibular Function Tests ; Vestibular Neuronitis ; Vestibulocochlear Nerve

BACKGROUND: Endoscopic Ultrasonography(EUS), a combination of endoscopy and ultrasonography is one of the most useful tools for diagnosis of digestive system diseases. EUS is useful in staging the primary tumor invasion and regional lymph node metastasis because of its ability to image the gut wall and adjacent structures in unique detail. We performed a study preoperatively for assessing the accuracy and limitation of EUS in gastric carcinoma. METHODS: In 75 patients(Male 54, Female 21, Mean age 62.3 years) with a gastric carcinoma confirmed by endoscopic biopsy, we performed EUS preoperatively. The results were compared with the postoperative histopathologic staging. RESULTS: 1) In assessing the depth of tumor invasion, EUS accuracy on depth of invasion was 76.0% and overstaging and understaging were 14.7% and 9.3%, respectively. 2) In assessing the lymph node metastasis, the accuracy rate of EUS was 65.3%. A rate of false-positive diagnosis was 27.3%, and a rate of false-negative diagnosis was 24.5%.3) In assessing the incidence of lymph node metastasis for each T stage, the involve rate was 10.5% in pT1, 36.4% in pT2, 95.7% in pT3, 100% in pT4. CONCLUSIONS: EUS is the most accurate diagnostic methods presently available to determine tumor infiltration depth and lymph node metastasis.
Biopsy ; Diagnosis ; Digestive System Diseases ; Endoscopy ; Endosonography* ; Esophagus* ; Female ; Humans ; Incidence ; Intestines* ; Lymph Nodes ; Neoplasm Metastasis ; Stomach* ; Ultrasonography

The aim of this study was to investigate viral etiology in dilated cardiomyopathy (DCM) by polymerase chain reaction (PCR) or nested reverse tanscription PCR (RT-PCR), and characterize the enteroviral RNA presented in the clinical specimens. Twenty-eight paraffin-embedded heart tissue samples were assayed to detect cytomegalovirus, herpes simplex virus type 1, type 2, parvovirus, adenovirus, and enterovirus (EV) with each specific primer. Of these 28 patients (mean age: 27, M: 24, F: 4), 26 were histologically diagnosed as DCM and 2 as myocardial infarction (MI). Nested RT-PCR detected enteroviral RNA in 7 (26.9%) of 26 patients with DCM, and none of patients with MI. And none of DNA viruses tested were detected from the samples. Amplified products were also genotyped by single-variation of EV is present in the explanted heart tissues from patients with DCM. Although most of the sequences among the wild isolates have the greatest similarity to those of coxsackievirus B3, there are specific regions of variable sequences (no 490 - no 510). The data suggest that enterovirus may be a major viral pathogen for the DCM in Korea and nucleotide sequence data indicate that coxsackievirus B3 may be a leading etiologic agent of DCM.
Adenoviridae ; Base Sequence ; Cardiomyopathy, Dilated* ; Cytomegalovirus ; DNA Viruses ; Enterovirus ; Heart* ; Herpesvirus 1, Human ; Humans ; Korea ; Myocardial Infarction ; Parvovirus ; Polymerase Chain Reaction ; RNA*

PURPOSE: Most recently developed anti-adhesive membranes are not suitable for laparoscopic surgery due to weak mechanical properties or adhesive characteristics. To overcome these problems, we prepared electrospun bioabsorbable nanofibrous poly (lactic-co-glycolic acid)-based membranes as an adhesion barrier. We evaluated the efficacy and safety of this material for laparoscopic surgery in a rabbit model. METHODS: A standardized laparoscopic surgical trauma was made on the rabbit's uterine horn and adjacent abdominal wall to induce adhesion formation. The injured uterus was covered by a nanofibrous barrier or it was left untreated (the negative control group) (each group: n=14). To evaluate acute toxicity of this material, blood sampling was made 3 and 7 days after laparoscopic surgery to check liver and renal function. Three weeks after laparoscopy, a second look laparoscopy was performed and the adhesions were scored according to Blauer's scoring system. Tissue between abdominal wall and uterus was obtained to examine microscopically. Liver, kidney and uterus were harvested to examine chronic toxicity. RESULTS: 36.4% of the nanofiber treatment group and 70% of the untreated control group showed severe adhesions (grade>3) after laparoscopic surgery but failed to get a statistical significance (P=0.198). Acute and chronic toxicity induced by this material were not noted in the blood and tissue exam. CONCLUSION: This study showed that nanofiber barrier seems to be a novel resorbable biomaterial for the reduction of postoperative adhesions. Easy placement and handling of this material make these membranes potentially successful candidates for laparoscopic surgery. But further study is needed to get a statistical significance.
Abdominal Wall ; Adhesives ; Animals ; Handling (Psychology) ; Horns ; Kidney ; Laparoscopy ; Liver ; Membranes ; Nanofibers ; Uterus

Superior vents lava(SVC) syndrome is mostly related to a malignant process, but many different benign causes haute also been described. We report a case of SVC syndrome caused by Klebsiella pneumonia diagnosed by sputum culture and serial chest X-ray changes. A 27-year-old man had been in stable health until three days before admission, when he complained of pleuritic chest pain, facial flushing, and shortness of breath. Examination of the head and neck disclosed edema of face and both arms, and jugular venous distention to the angle of the jaw. The chest auscultation resealed decreased breath sound without crackle on right upper lung field. The chest roentgenogram showed homogenous air space consolidation on right upper lobe, asociated with downward displacement of minor fissure and contralateral displacement of trachea, but air bronchogram was not seen. We began antibiotic therapy under impression of pneumonia after assailable culture was taken from blood and sputum. SVC scintigraphy showed stasis of drain of right brachiocephalic vein at the proximal portion with reflux into the right internal jugular vein and faintly visible SVC via the collaterals. Sputum culture resealed Klebsiella pneumoniae. Antibiotic therapy resulted in a cure of infection and disappearance of facial swelling. Follow-up SVC scintigraphy after 20 days showed normal finding. We first report a case of SVC syndrome caused by klebsiella pneumonia
Adult ; Arm ; Auscultation ; Brachiocephalic Veins ; Chest Pain ; Dyspnea ; Edema ; Flushing ; Follow-Up Studies ; Head ; Humans ; Jaw ; Jugular Veins ; Klebsiella pneumoniae ; Klebsiella* ; Lung ; Neck ; Pneumonia* ; Radionuclide Imaging ; Respiratory Sounds ; Sputum ; Superior Vena Cava Syndrome* ; Thorax ; Trachea ; Vena Cava, Superior*