PURPOSE: To determine the accuracy of automated computer aided volumetry for simulated small pulmonary nodules at computed tomography using various types of phantoms MATERIALS AND METHODS: Three sets of synthetic nodules (small, calcified and those adjacent to vessels) were studied. The volume of the nodules in each set was already known, and using multi-slice CT, volumetric data for each nodule was acquired from the three-dimensional reconstructed image. The volume was calculated by applying three different threshold values using Rapidia(R) software (3D-Med, Seoul, Korea). RESULTS: Relative errors in the measured volume of synthetic pulmonary nodules were 17.3, 2.9, and 11.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=0.96, p<0.001). For calcified nodules, relative errors in measured volume were 10.9, 5.3, and 16.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=1.03, p<0.001). In cases involving synthetic nodules adjacent to vessels, relative errors were 4.6, 16.3, and 31.2 % at -200, -400, and -600 HU, respectively. There was good correlation between true volume and measured volume at -200 HU (r=1.1, p<0.001). CONCLUSION: Using computer-aided volumetry, the measured volumes of synthetic nodules correlated closely with their true volume. Measured volumes were the same at each threshold level, regardless of window setting.
Cone-Beam Computed Tomography ; Seoul

Neurofibromas are common benign tumors and can originate from any nerve tissue in the body. A solitary neurofibroma in breast parenchyma has rarely been reported, however. We report a neurofibroma originating from breast parenchyma in a 61-year old woman. On mammography, the mass appeared as a well marginated and circumscribed mass, suggesting a benign tumor, and after excisional biopsy, was pathologically proven to be a neurofibroma.
Biopsy ; Breast* ; Female ; Humans ; Mammography ; Middle Aged ; Nerve Tissue ; Neurofibroma*

Solid pseudopapillary tumor of the pancreas is a rare tumor that affects young females with low malignant potential and good prognosis with more than 90% survival at 5 years. Metastasis is very rare. We report the case of a 74-year-old female who had pancreatic solid-pseudopapillary tumor and synchronous hepatic metastasis.
Aged ; Female ; Humans ; Neoplasm Metastasis ; Pancreas ; Pancreatic Neoplasms ; Prognosis

The hindfoot in the human body is known to play an important function for weight bearng, shock absorption and locomotion. The defect of hindfoot presents serious problems of the leg length discrepancy and weight bearing. Therefore, it is essential to reconstruct the defect of hindfoot. Up to date, many surgical modalities from a skin graft to the innervated osteocutaneous flap have been developed, but a completely satisfactory method of reconstruction has not been found. The ideal reconstructive method should provide sufficient padding tissue and sensibility. In the Department of Orthopaedic Surgery, capital Armed Forces General Hospital, two cases of hindfoot defect due to explosion were reconstructed by the midplantar fasciocutaneous flap with free iliac bone graft. The results of our procedure were very acceptable one year after the operations.
Absorption ; Arm ; Explosions ; Hospitals, General ; Human Body ; Leg ; Locomotion ; Methods ; Shock ; Skin ; Transplants ; Weight-Bearing ; Wounds and Injuries

The ankle is a complex structure supporting the entire musculoskeletal system during standing and walking. The injuries to the ankle joint result in a severe functional disturbance because of complex anatomical characteristics around the ankle joint. 284 patients of the ankle fracture that were treated in orthopedic Dept. Capital Armed Forced General Hospital from march 1985. to march 1988. were analized in clinical and radiological aspects. The following results were obtained: 1. The main cause of the injuries was falling from a height and the other were sports injury and slipping down in order. 2. The most common type by Lauge-Hansen classification was supination-external rotation type(122 case, 42.9%). 3. 211 case(74.3%) were treated with open reduction and internal fixation, and 73 case(25.7%) were treated with closed reduction. Poor outcome seemed closely related to the severity of the injury and degree of fracture displacement. 4. Accurate reduction and rigid internal fixation of the lateral malleolus with shortening was important factor. 5. Classification of Lauge-Hansen was useful in the diagnosis and treatment of the ankle fractures.
Accidental Falls ; Ankle Fractures ; Ankle Joint ; Ankle ; Arm ; Athletic Injuries ; Classification ; Clinical Study ; Diagnosis ; Hospitals, General ; Humans ; Musculoskeletal System ; Orthopedics ; Walking

Posterior lumbar apophyseal fracture characterized by osteochondral fragments from posterior rim of a lumbar vertebral body, has often been misdiagnosed as herniated disc or spinal stenosis due to its similarity of symptoms. But recent use of CT scan facilitated the diagnosis of the lesion as a separate entity. This study was performed to verify the clinical characteristics, to find out the mechanism of injury and to determine the most effective method of diagnosis and treatment. Authors reviewed 17 patients(14 male, 3 female) who were subjected to surgical treatment at Department of Orthopaedic Surgery, Seoul National University Hospital for posterior lumbar spophyseal fracture during the period of 1990-1992, and followed up for average of 1 year and 6 months(range 1 to 3 years). Thirteen patients (76%) were related to a history of trauma or strenuous physical activity prior to the onset of symptoms. The mechanism of injury was the rapid flexion with axial compression in 7, hyperextension in 4, and pure axial compression in 2 patients. The mean age at the time of injury was 20 years(range 10 to 31 years). All patients presented low-back pain radiating to lower extremities and 11 patients showed neurogenic intermittent claudication. The mean age at the time of surgical intervention was 23 years and 10 months(range 15 to 31 years), and the mean duration of symptoms was 3 years(range 2 months to 13 years). Simple X-ray revealed the lesion in only 3 cases but CT scan demonstrated the characteristic osteochondral fragment displaced posteriorly into the spinal canal and the corresponding defect with degenerative changes in all patients. The fracture occured through the superior apophyseal rim of L5 in 9 superior rim of L4 in 3, inferior rim of L4 in 2, inferior rim of L5 in, superior rim of L2 in 1, and superior rim of L1 in 2 patients. Two patients had concomitant fractures at two levels. All patients except one were treated with posterior decompression including the removal of the displaced fragment and posterolateral fusion with pedicular screws was carried out to prevent further degenerative change and instablilty. One patient with the lesion at the superior rim of L1 was treated by anterior decompression and fusion. All patients showed relief of pain and claudication with satisfactory results. One patient had partial tear of L4 root with slight weakness of greater toe dorsiflexion, but it recovered in 4 months. In conclusion, posterior lumbar spophyseal fracture predominantly affected young males and the most common causative mechanism was rapid flexion with axial compression. The CT scan facilitated identification of the lesion. The most frequently affected site was the superior rim of L5. Satisfactory results could be achieved bvy adequate posteriior decompression with the removal of the fragment and posterolateral fusion with pedicular screws.
Decompression ; Diagnosis ; Humans ; Intermittent Claudication ; Intervertebral Disc Displacement ; Lower Extremity ; Male ; Methods ; Motor Activity ; Seoul ; Spinal Canal ; Spinal Stenosis ; Tears ; Toes ; Tomography, X-Ray Computed

The authors attempted to examine the allelic association between the A1 allele of Dopamine D2 receptor and schizophrenia, alcoholism, drug addiction in Koreans. Schizophrenic patients(n=31), alcoholism(n=65), drug addiction(n=18) and controls(n=52) were examined by case-control study for distribution of the Taql polymorphism of the dopamine D2 receptor gene in Korean population to minimize the effect of racial differencies in gene frequencies. In schizophrenics, the numbers of schizophrenics with A1A1, A1A2, A2A2 were 9(29%), 15(48%) and 7(22%) respectively and in alcoholics with A1A1, A1A2, A2A2 were 14(21.5%), 36(55.4%) and 15(23.1%) respectively and in drug addiction with A1A1, A1A2, A2A2 were 4(7.6%), 24(46.2%) and 24(46.2%) respectively. The prevalence of the A1 allele in schizophrenics, alcoholics, drug addiction and controls were 77%, 76.9%, 67% and 53.8% respectively. And the frequency of the A1 allele in schizophrenics, alcoholics, drug addiction, and controls were 0.53 0.49, 0.39 and 0.31 respectively. There was significant difference in the frequency of the A1 allele between schizophrenics, alcoholics and controls. We also classified our alcoholic population. For classification by severity, we used the median MAST score 30 in our samples. There was also significant difference in the frequency of the A1 allele between less severe group(0.42) and more severe group(0.57). This data suggest that the A1 allele is associated with schizophrenia and alcoholism in Korean. Furthermore the prevalence of the A1 allele increased in more severely affected alcoholics. The authors conclude that our data support an allelic association between the A1 allele at dopamine D2 receptor and schizophrenia, alcoholism. These results suggest the A1 allele of the DRD2 gene is associated with a number of behavior disorders in which it may act as a modifying gene rather than as the primary etiological agent.
Alcoholics ; Alcoholism* ; Alleles ; Case-Control Studies ; Classification ; Dopamine* ; Gene Frequency ; Humans ; Mental Disorders ; Prevalence ; Receptors, Dopamine D2* ; Schizophrenia* ; Substance-Related Disorders*

OBJECTIVES: To determine if unilateral pedicle screw fixation is comparable to bilateral fixation in one-or two-segment lumbar spinal fusion. METHODS: Eighty-eight patients with spinal stenosis or spondylolisthesis were assigned to either unilateral or bilateral pedicle screw instrumentation groups. Demographic variables, preoperative diagnosis, number of fusion segments, and kinds of instrumentation used were similar between the two treatment groups. RESULTS: There were no significant differences between the two groups in terms of blood loss, clinical results, time at which fusion was complete, fusion rate, and complication rate. There were significant differences between the two groups in terms of duration of operating time, duration of hospital stay, medical expenses. The number of fusion segments or kinds of instrumentation did not affect the fusion rate, time at which fusion was complete, or clinical outcomes. Metal failure rate of unilateral fixation was higher in patients with spondylolytic spondylolisthesis than in patients with spinal stenosis. CONCLUSIONS: Unilateral pedicle screw fixation was as effective as bilateral pedicle screw fixation in lumbar spinal fusion independent of the number of fusion segments (one or two segments) or pedicle screw systems. Unilateral pedicle screw fixation is not recommended for spondylolytic spondylolisthesis patients who were treated with Gill' s decompression.
Decompression ; Diagnosis ; Humans ; Length of Stay ; Spinal Fusion* ; Spinal Stenosis ; Spondylolisthesis

BACKGROUND: Postmenopausal osteoporosis is the main problem in women, but senile osteoporosis is believed to occur after 65 years and affects men and women equally. Measurement of biochemical markers in conjunction with bone mineral density (BMD) determination can detect individual patients at the greatest risk of developing osteoporosis. METHODS: We measured serum osteocalcin levels as a bone formation marker, and urinary deoxypyridinoline (DPD) levels as a bone resorption marker, in 2190 men (from 22 to 83 year-old), and 1209 women (from 25 to 80 year-old). The age and sex related variations of serum osteocalcin and urinary DPD levels were analysed. The serum osteocalcin and urinary DPD levels were compared with BMD. These biochemical bone turnover markers were compared with each other. RESULTS: In women, serum osteocalcin and urinary DPD levels were increased with age from forties to sixties, after then showed decrease from seventies. In men, serum osteocalcin levels were slightly decreased with age, but DPD levels were slightly increased with age in men. These biochemical bone markers and BMD showed negative correlations. Osteocalcin and DPD levels showed positive correlations, especially in women. Osteocalcin levels were higher in men than women, age before fifth decades but lower in men than women after fifties. DPD levels was higher in women than men through all the age. CONCLUSION: Osteocalcin and DPD levels showed age and sex related variations in healthy Koreans. In management of patients with a risk of osteoporosis, consideration of variations according to the age and sex should be given.
Biomarkers ; Bone Density ; Bone Resorption ; Female ; Humans ; Male ; Middle Aged* ; Osteocalcin* ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal

PURPOSE: Stress, depending on its intensity and duration, results in either adaptive or maladaptive physiological and psychological changes in humans. Also, it was found that stressful experiences increase the signs of behavioral despair in rodents. On the other hand, exercise and melatonin treatment is believed to have many beneficial effects on health. Thus, this study was designed to evaluate the anti-depressant effects of physical activity and melatonin against chronic stress-induced depression in rats. METHODS: Adult male Sprague-Dawley(SD) rats(200-250g, 7 weeks of age) were subjected to depression induced by chronic stress. Chronic depression was induced with forced-swim stress (FSS) and repeated change of light-dark cycle for 4 weeks. In the last 2 weeks, some rats were confined in a cage enriched with a running wheel, seesaw and chewed a ball from 19:00 to 07:00 every day. Melatonin was injected intra-peritoneally (I.P), and the rats received intraperitoneal injections of melatonin (15 mg/kg). The Forced Swim Test (FST) was performed to evaluate the immobility behaviors of rats for a 5 min test. RESULTS: It was found that, the immobility time in FST was significantly (p<.05) lower in physical exercise (M=58.83+/-22.73) and melatonin (M=67.33+/-37.73) than in depressive rats (M=145.93+/-63.16) without physical activity. Also, TPH positive cell in dorsal raphe was significantly (p<.05) higher in exercise (M=457.38+/-103.21) and melatonin (M=425.38+/-111.56) than in depressive rats (M=258.25+/-89.13). CONCLUSION: This study suggests that physical activity and melatonin produces antidepressant-like effect on stress-induced depression in rats. So, physical exercise and melatonin may be a good intervention in depression patients.
Adult ; Animals ; Depression* ; Exercise ; Hand ; Humans ; Injections, Intraperitoneal ; Male ; Melatonin* ; Models, Animal* ; Motor Activity* ; Photoperiod ; Rats* ; Rodentia ; Running