PURPOSE: This study was undertaken to investigate the serial alteration of collagen after resolution of the priapism in mechanically induced veno-occlusive priapism of rat model. METHODS: Sprague-Dawley male rats were used and divided into control and experimental groups (3, 6, 12, 24 and 48 hours according to the duration of ischemic time). The corpora were dissected out at 4 weeks after the relief of veno-occlusive condition, and then the collagen concentration was quantified. Type I, III and IV collagen were determined by immunohistochemical staining. RESULTS: The corporal collagen concentration showed significant increase in the groups of 12, 24, 48 hours of ischemic time. Types III collagen did not increased in intensity, but type I & IV collagen showed gradual increase in intensity according to the time interval of ischemic period. CONCLUSIONS: The irreversible collagen alteration in corpus cavernosum with veno-occlusive priapism occurred in case of 12 or more hours of ischemic time before resolution. Earlier non-surgical management is necessary for the patients to be safe from further cumulative damages either by recurrent episode or other kinds of disease.
Animals ; Collagen* ; Humans ; Male ; Models, Animal ; Priapism* ; Rats* ; Rats, Sprague-Dawley

Paragonimiasis is a chronic inflammatory process which frequently involve to the lung. The lung is the main site of infection with Paragonimus westermani, but any place of the body including brain, orbit, liver, intestinal wall, diaphragm, subcutaneous tissue, and etc. may be infected with the larva We report a case of ectopic Paragonimus westermani arising from the adrenal gland, in 70-year-old male.
Adrenal Glands* ; Aged ; Brain ; Diaphragm ; Humans ; Larva ; Liver ; Lung ; Male ; Orbit ; Paragonimiasis ; Paragonimus westermani* ; Paragonimus* ; Subcutaneous Tissue

Intussusception is a relatively common disease in children, but it is a rare clinical entity in adults. More than 80% of all patients with intussusception are less than two years of age, but adults account for only 5 to 10 percent of all intussusception cases. The significance of this disease in the aspect of statistics is mentioned as "rule of fives", which means 5% of all intussusceptions occur in adults, and it accounts for up to 5% of all cases of bowel obstruction in adults. In children, classic symptoms include episodic abdominal pain, "current-jelly" stool and a sausage-shaped abdominal mass on examination. However, in adults, it is likely to appear with non-specific gastrointestinal trouble without classic symptoms. Therefore, it is very important to use early diagnositic tool. In contrast to childhood intussusception, which is idiopathic in 90% of cases, adult intussusception has a definable lesion in more than 90% of cases 3). Tumors, both benign and malignant, are the most frequent cause of intussusecption in adults. We experienced seven cases of adult intussusception at Inha hospital from Jan. 1994 to Dec. 1997. The patients of adult intussusception are classified as three cases of ileoileal type and four ileocecal type. There were no specific signs or symptoms with patient experienced. It included abdominal pain, diarrhea and palpable mass. Their diagnosis was made in six patients using abdominal CT scan. It is difficult to define a diagnosis preoperatively, because the symptom of adult intussusception are variable and insignificant among individuals. We had been taken the final diagnostic tool with the abdominal CT scan in six of seven patients, which revealed "target lesions" in all cases. So, it is useful in the diagnosis of adult intussusception. Bowels were resected for the treatment of adult intussusception. The extent of the resection was contained the lesion and the defunctioned segments. The operations were performed as four segmental resections of small bowel and three ileocecal resections. The pathological findings were disclosed as three tumors, three lymphadenopathies and a adhesion of bowel. We concluded that the abdominal CT scanning is a usefull diagnostic tool in the diagnosis of adult intussusception.
Abdominal Pain ; Adult* ; Child ; Diagnosis ; Diarrhea ; Humans ; Intussusception* ; Tomography, X-Ray Computed*

OBJECTIVES: To reveal differences in drug-drug interaction (DDI) alerts and the reasons for alert overrides between admitting departments. METHODS: A retrospective observational study was performed using longitudinal Electronic Health Record (EHR) data and information from an alert and logging system. Adult patients hospitalized in the emergency department (ED) and general ward (GW) during a 46-month period were included. For qualitative analyses, we manually reviewed all reasons for alert overrides, which were recorded as free text in the EHRs. RESULTS: Among 14,780,519 prescriptions, 51,864 had alerts for DDIs (0.35%; 1.32% in the ED and 0.23% in the GW). The alert override rate was higher in the ED (94.0%) than in the GW (57.0%) (p < 0.001). In an analysis of the study population, including ED and GW patients, 'clinically irrelevant alert' (52.0%) was the most common reason for override, followed by 'benefit assessed to be greater than the risk' (31.1%) and 'others' (17.3%). The frequency of alert overrides was highest for anti-inflammatory and anti-rheumatic drugs (89%). In a sub-analysis of the population, 'clinically irrelevant alert' was the most common reason for alert overrides in the ED (69.3%), and 'benefit assessed to be greater than the risk' was the most common reason in the GW (61.4%). CONCLUSIONS: We confirmed that the DDI alerts and the reasons for alert overrides differed by admitting department. Different strategies may be efficient for each admitting department.
Admitting Department, Hospital* ; Adult ; Antirheumatic Agents ; Decision Support Systems, Clinical ; Drug Interactions ; Electronic Health Records ; Emergency Service, Hospital ; Humans ; Observational Study ; Patients' Rooms ; Prescriptions ; Retrospective Studies

PURPOSE: To evaluate the clinical and radiologic results of the fracture fixation using the Proximal Femoral Nail (PFN) or Gamma nail in patient with the intertrochanteric fractures. MATERIALS AND METHODS: From January 1999 to February 2002, we reviewed 63 patients of intertrochanteric fractures including 31 patients managed with Gamma nail and 32 patients with PFN. In variate analysis of age, the pattern and stability of fracture, bone density (Singh index), preoperative patient activity, there was no difference between two groups. We evaluated the operation time, blood loss, stable reduction rate and varus reduction rate as operation-related factors, and radiologically investigated union time, the frequency of delayed union and nonunion, failure of fixation, status of the fracture line and complications. Functional results were evaluated by the possibility of early ambulation, ambulation ability at last follow up, and the pre and postoperative difference of ambulatory ability. RESULTS: Mean operation time was 103+/-40 minutes in Gamma nail group and 101+/-28 minutes in PFN group. It was not statistically significant (p=0.801). Even though intraoperative blood loss was less in PFN group, it was not significant (p=0.601). Postoperative stable reduction rate was 31% in Gamma nail group and 30% in PFN group (p=0.934), suggesting not significant. Postoperative varus reduction and impacted amount of the fracture line was not significant. Delayed union developed in one case of Gamma nail group and 2 cases of PFN group. Mean loss of ambulation ability was 1.28 grade in Gamma nail group and 0.86 grade in PFN group (p=0.383). Statistical analysis was performed with the use of Student T test and Chi-square test. Analyses resulting in a p value of <0.05 were considered to show significance. CONCLUSION: Generally, the radiologic and clinical results of intertrochanteric fractures were comparable for the PFN group and Gamma nail group. Even though it was not statistically significant, PFN group had superior results in operation time and blood loss than Gamma nail group for the fixation of the patients with intertrochanteric fracture.
Early Ambulation ; Femur* ; Follow-Up Studies ; Fracture Fixation ; Fractures, Bone ; Hip Fractures* ; Humans ; Walking

OBJECTIVES: This study was conducted to determine whether or not newly proposed high-resolution activity features could provide a superior analytic foundation compared to those commonly used to assess transitions in children's activities, under circumstances in which the types of courses attended exert different situational effects on activity levels. METHODS: From 153 children at a local elementary school, 10 subjects with attention deficit hyperactivity disorder (ADHD) and 7 controls were recruited. Their activity data was collected using an actigraph while they attended school. Ratios of partitioned activity ranges (0.5-2.8 G) during the entire activity were extracted during three classes: art, mathematics, and native language (Korean). Extracted activity features for each participant were compared between the two groups of children (ADHD and control) using graphs and statistical analysis. RESULTS: Activity distributions between ADHD and control groups for each class showed statistically significant differences spread through the entire range in art class compared to native language and mathematics classes. The ADHD group, but not the control group, experienced many significantly different intervals (> 50%) having low to very high activity acceleration regions during the art and languages courses. CONCLUSIONS: Class content appears to influence the activity patterns of ADHD children. Monitoring the actual magnitude and activity counts in a wide range of subjects could facilitate the examination of distributions or patterns of activities. Objective activity measurements made with an actigraph may be useful for monitoring changes in activities in children with ADHD in a timely manner.
Acceleration ; Actigraphy ; Activities of Daily Living ; Attention Deficit Disorder with Hyperactivity ; Child ; Humans ; Mathematics ; Motor Activity ; Pilot Projects

OBJECTIVE: Choroidal metastases (CMs) are the most common intraocular tumor. Management is mainly radiation therapy with goals of pain control and visual improvement. However, many radiation-related complications are reported. Since gamma knife radiosurgery (GKS) for CM was first reported in 1995, few cases have been reported. We report 7 cases of CMs treated with GKS.METHODS: From April 2011 to November 2014, 7 patients with CM underwent GKS. Their median age at treatment was 64 years (range, 51–71 years). Four males and three females were treated. Lung cancer was the most common primary pathology, followed by renal cell carcinoma and stomach cancer. Four patients had multiple cerebral lesions and were treated simultaneously for choroidal lesions. The median marginal dose of 20 Gy (range, 15–25 Gy) was administered at the 50% isodose line.RESULTS: Median follow-up period after GKS was 8 months (range, 2–38.3 months). Four patients expired due to underlying malignancy progression. Except for two patients who were not followed with magnetic resonance image after GKS, all patients showed size reduction in the treated lesions, but a new choroidal lesion appeared in one patient and one recurred. Six of seven patients reported subjectively improved visual symptoms. Visual acuity improved in 2 patients, and 2 were stable upon objective examination. One patient showed no improvement in visual acuity, but ocular pain was relieved; another patient showed improved vision and tumor remission, but visual deterioration recurred.CONCLUSION: GKS was shown to be safe and effective and should be considered for CM treatment.
Carcinoma, Renal Cell ; Choroid ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Male ; Neoplasm Metastasis ; Orbit ; Pathology ; Radiosurgery ; Stomach Neoplasms ; Visual Acuity

Infertility due to ejaculatory failure and poor semen quality is a main problem for sexual dysfunction of spinal cord injured (SCI) men. A 27-year-old paraplegic man who wished to father children was induced to repeated ejaculations for eight times with a rectal probe electrical stimulation at one or two weekly interval. For the 4th to 8th stimulations, the subject took pseudoephedrine 20 mg, three times a day orally to improve the semen quality. We report a triplet childbirth between the SCI man and his healthy wife through the ejaculatory stimulations in conjuction with advanced reproductive techniques such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).
Adult ; Child ; Ejaculation ; Electric Stimulation ; Fathers ; Fertilization in Vitro ; Fertilization* ; Humans ; Infertility ; Male ; Parturition* ; Pseudoephedrine ; Reproductive Techniques ; Semen Analysis ; Sperm Injections, Intracytoplasmic ; Spinal Cord* ; Spouses ; Triplets

PURPOSE: The aim of this study was to evaluate the effect of cyclic loading and screw retightening on reverse torque value (RTV) in external and internal type implants. MATERIALS AND METHODS: Cement-retained abutments were connected with 30 Ncm torque to external and internal type implants. Experimental groups were classified according to implant connection type and retightening/loading protocol. In groups with no retightening, RTV was evaluated after cyclic loading for 100,000 cycles. In groups with retightening, RTV was measured after 3, 10, 100 cycles as well as every 20,000 cycles until 100,000 cycles of loading. RESULTS: Every group showed decreased RTV after cyclic loading. Before and after cyclic loading, external type implants had significantly higher RTVs than internal type implants. In external type implants, retightening did not affect the decrease in RTV. In contrast, retightening 5 times and retightening after 10 cycles of dynamic loading was effective for maintaining RTV in internal type implants. CONCLUSION: Retightening of screws is more effective in internal type implants than external type implants. Retightening of screws is recommended in the early stage of functional loading.
Torque*

Teeth wear and extrusion of antagonist are commonly observed in deep bite patient having severe vertical and horizontal overlap. These problems cause collapse of occlusal plane and abnormal anterior guidance. Without restoring harmonious occlusion, loss of multiple teeth and decreased masticatory function could not be prevented. To resolve problems associated with deep bite, multidisciplinary treatment including oral surgical, orthodontic and prosthetic treatment should be performed. This clinical report describes the results of increasing occlusal vertical dimension with a full-mouth restoration procedure. The treatment procedures include extraoral and intraoral examination, diagnosis, treatment planning, diagnostic wax-up, segmental osteotomy, orthodontic intrusion and prosthodontic rehabilitation. Full mouth rehabilitation with increasing occlusal vertical dimension can solve esthetic and functional problems.
Dental Occlusion ; Diagnosis ; Humans ; Methods ; Mouth Rehabilitation* ; Osteotomy* ; Overbite* ; Prosthodontics ; Rehabilitation ; Tooth ; Vertical Dimension