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

Dermatofibrosarcoma protuberans is a slow-growing, but locally aggressive fibrous tumor that has a high rate of local recurrence after surgical resection. This tumor most commonly occurs in the trunk and proximal extremities. In this report we present a case of a 47-year-old woman with dermatofirbosarcoma protuberans in her breast, which is a very unusual site. Complete and careful resection is recommended for this type of tumor to prevent its recurrence.
Breast* ; Dermatofibrosarcoma* ; Extremities ; Female ; Humans ; Middle Aged ; Recurrence

BACKGROUND AND PURPOSE: Sleep need differs between individuals, and so the same duration of sleep will lead to sleep insufficiency in some individuals but not others. The aim of this study was to determine the separate and combined associations of both sleep duration and unmet sleep need with excessive daytime sleepiness (EDS) in Korean adults. METHODS: The participants comprised 2,769 Korean adults aged 19 years or older. They completed questionnaires about their sleep habits over the previous month. The question regarding sleep need was "How much sleep do you need to be at your best during the day?" Unmet sleep need was calculated as sleep need minus habitual sleep duration. Participants with a score of >10 on the Epworth Sleepiness Scale were considered to have EDS. RESULTS: The overall prevalence of EDS was 11.9%. Approximately one-third of the participants (31.9%) reported not getting at least 7 hours of sleep. An unmet sleep need of >0 hours was present in 30.2% of the participants. An adjusted multivariate logistic regression analysis revealed a significant excess risk of EDS in the groups with unmet sleep needs of ≥2 hours [odds ratio (OR), 1.80; 95% confidence interval (CI), 1.27-2.54] and 0.01-2 hours (OR, 1.42; 95% CI, 1.02-1.98). However, habitual sleep duration was not significantly related to EDS. CONCLUSIONS: EDS was found to be associated with unmet sleep need but not with habitual sleep duration when both factors were examined together. We suggest that individual unmet sleep need is more important than habitual sleep duration in terms of the relation to EDS.
Adult* ; Disorders of Excessive Somnolence ; Humans ; Korea ; Logistic Models ; Prevalence

PURPOSE: Guardix-sol(TM) is solution type of anti-adhesion barrier, and it is composed of a mixture of hyaluronate (HA) and carboxymethylcellulose (CMC). The anti-adhesive effect was proved through several clinical trials with using this material, but the most efficient viscosity for this solution has not been shown by the previous research. The objective of this study was to evaluate the efficacy and safety of HA/CMC mixture solutions, with varying viscosities, in a rat model. METHODS: Three different viscosities (low=LV, mid=MV and high=HV) of the HA/CMC mixture solutions were prepared to evaluate their potential as a tissue adhesion barrier. The viscosity was measured by a Brookfield viscometer. To evaluate the anti-adhesion effect, a cecal-abdominal wall abrasion model was adopted. The denuded cecum was coated by a HA/CMC mixture of different viscosity or it was left uncoated (the negative control group) and then the denuded cecum was apposed to the abdominal wall (each group: n=10). All the rats underwent a second celiotomy after 14 days to evaluate the extent of their abdominal adhesions and tissue reactions (inflammatory response, granulation tissue formation and toxicity in organs). RESULTS: The viscosities of the HA/CMC mixture solutions were 248.+/-24.4 cps in the LV, 1,353.8+/-4.4 cps in the MV and 3,556.7+/-38.8 cps in the HV. The grade of adhesion and the adhesion area were significantly lower in the all HA/CMC mixture solution groups compared to the control regardless of their viscosity. The inflammatory responses were not remarkable at the application site and the major solid organs did not show histological change in the experimental groups. CONCLUSION: The difference of viscosity of HA/CMC mixture solutions did not affect the efficacy of the adhesion barrier. All the HA/CMC mixture solutions with varying viscosities showed a low inflammatory response and non-toxicity.
Abdominal Wall ; Animals ; Carboxymethylcellulose Sodium ; Cecum ; Granulation Tissue ; Rats ; Tissue Adhesions ; Viscosity

PURPOSE: Guardix-sol(TM) is solution type of anti-adhesion barrier, and it is composed of a mixture of hyaluronate (HA) and carboxymethylcellulose (CMC). The anti-adhesive effect was proved through several clinical trials with using this material, but the most efficient viscosity for this solution has not been shown by the previous research. The objective of this study was to evaluate the efficacy and safety of HA/CMC mixture solutions, with varying viscosities, in a rat model. METHODS: Three different viscosities (low=LV, mid=MV and high=HV) of the HA/CMC mixture solutions were prepared to evaluate their potential as a tissue adhesion barrier. The viscosity was measured by a Brookfield viscometer. To evaluate the anti-adhesion effect, a cecal-abdominal wall abrasion model was adopted. The denuded cecum was coated by a HA/CMC mixture of different viscosity or it was left uncoated (the negative control group) and then the denuded cecum was apposed to the abdominal wall (each group: n=10). All the rats underwent a second celiotomy after 14 days to evaluate the extent of their abdominal adhesions and tissue reactions (inflammatory response, granulation tissue formation and toxicity in organs). RESULTS: The viscosities of the HA/CMC mixture solutions were 248.+/-24.4 cps in the LV, 1,353.8+/-4.4 cps in the MV and 3,556.7+/-38.8 cps in the HV. The grade of adhesion and the adhesion area were significantly lower in the all HA/CMC mixture solution groups compared to the control regardless of their viscosity. The inflammatory responses were not remarkable at the application site and the major solid organs did not show histological change in the experimental groups. CONCLUSION: The difference of viscosity of HA/CMC mixture solutions did not affect the efficacy of the adhesion barrier. All the HA/CMC mixture solutions with varying viscosities showed a low inflammatory response and non-toxicity.
Abdominal Wall ; Animals ; Carboxymethylcellulose Sodium ; Cecum ; Granulation Tissue ; Rats ; Tissue Adhesions ; Viscosity