No abstract available in English.

A 16-year old male patient visited the hospital complaining of inguinal pain and internal snapping of right hip joint. In physical examination, the patient was presumed to be diagnosed femoroacetabular impingement (FAI) and acetabular labral tear. In radiologic evaluation, FAI and acetabular labral tear were identified and bony tumor associated with internal snapping was found on the posteromedial portion of the femoral neck. Despite of conservative treatment, there was no symptomatic improvement. So arthroscopic labral repair, osteoplasty and resection of bony tumor were performed. The tumor was pathologically diagnosed as osteochondroma through biopsy and all symptoms improved after surgery. There was no recurrence, complication or abnormal finding during 1 year follow up. Osteochondroma located at posteromedial portion of femoral neck can be a cause of internal snapping hip and although technical demands are challenging, arthroscopic resection can be a good treatment option.
Acetabulum ; Arthroscopy ; Biopsy ; Femoracetabular Impingement ; Femur Neck ; Follow-Up Studies ; Hip ; Hip Joint* ; Humans ; Male ; Osteochondroma* ; Physical Examination ; Recurrence

BACKGROUND: The inhibitory effects of nitric oxide(NO) on platelet adhesion and vascular smooth muscle cell(VSMC) proliferation may have a possible role inhibiting development of neointima following balloon catheter induced injury. We tested the hypothesis that L-arginine, the precursor of NO, would attenuate neointima formation following balloon catheter induced injury via regulation of antagonistic balance between proliferation and apoptosis of VSMC. METHODS: Adult, male Sprague-Dawley rats(300 to 400g) were anesthetized with ketamine (100mg/kg intraperitoneally). The left common and external carotid artery were exposed. For endothelial denudation, 2mm angioplasty catheter was introduced through the left external carotid artery into the left common carotid artery. The catheter was inflated at I atm. and withdrawn three times. Animals were randomized to receive 2.25% L-arginine in their drinking water(n=14) or placebo(n=16) from 2 days prior to and 9 days following denudation. VSMC proliferation was quantified by immunohistochemical staining with an antibody to the proliferating cell nuclear antigen(PCNA). The cells undergoing apoptosis were identified by terminal nucleotidyl transferase-mediated nick end labeling(TUNEL) method and morphologic changes by computerized planimetry and transmission electron microscopy. RESULTS: 1) The neointimal area in injured arteries were significantly reduced in L-arginine supplemented animals compared with placebo group(p<0.05). 2) L-arginine administration significantly reduced the number of PCNA positive cells in neointima when compared with placebo at 9 days(p<0.05). 3) Positive TUNEL cells were not influenced by L-arginine supplementation. 4) On transmission electron microscopy, there were no cells showing characteristics of apoptosis in neointima. CONCLUSION: These results suggested that the inhibitory effect of L-arginine on neointima formation is due to reduced VSMC proliferation, but is not due to increased VSMC apoptosis at the early time period after initmal injur .
Adult ; Angioplasty ; Animals ; Apoptosis ; Arginine* ; Arteries ; Blood Platelets ; Carotid Artery, Common ; Carotid Artery, External ; Catheters ; Drinking ; Humans ; In Situ Nick-End Labeling ; Ketamine ; Male ; Microscopy, Electron, Transmission ; Muscle, Smooth, Vascular ; Neointima* ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley ; Vascular System Injuries*

Bilateral tubal pregnancy is the least common type of all extrauterine pregnancies, 1:725-1:1580 of pregnancies are bilateral. Simultaneous tubal pregnancies have been reported in natural cycles, recently, after ovulation induction, assisted reproductive techniques. The high incidence of ectopic pregnancy assisted with ovulation induction continues to be a problem. Bilateral tubal pregnancy associated with the ovulation induction has been reported few cases of 3.0% to 6.0% in frequency. This paper describes a case of simultaneous bilateral tubal pregnancy after ovulation induction and intrauterine insemination in a 27 year old patient. The diagnosis was confirmed by laparoscopy performed 30 days after intrauterine insemination, which revealed bilateral tubal pregnancy and mild hyperstimulated ovaries. Bilateral salpingectomy was performed. With a review of the literature on this topic, diagnostic aspect and incidence and treatment options are discussed.
Adult ; Diagnosis ; Female ; Humans ; Incidence ; Insemination* ; Laparoscopy ; Ovary ; Ovulation Induction* ; Ovulation* ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Tubal* ; Reproductive Techniques, Assisted ; Salpingectomy

PURPOSE: Retinoic acid (RA) is well known as a potent teratogenic agent in both deficiency and excess. Cellular retinoic acid binding proteins (CRABPs) are involved in RA. We carried this study in order to determine the possible relations of CRABPs with RA-induced teratogenesis through observation of the expression patterns of CRABP l and ll in developing rats. METHODS: 35S-labeled RNA probes were synthesized using SP6-RNA polymerase in CRABP l and T7-polymerase in CRABP ll. The distribution of CRABP l and ll transcripts analyzed by in situ hybridization of rat embryosections from day 12 to 19, and postnatal brains from day 1 to 14. RESULTS: The CRABP ll transcripts were more widely distributed than CRABPl distribution, however, the relative level of CRABPl transcripts were higher than CRABP ll. The CRABP l mRNA transcripts showed its highest expression on the 16th day of gestation and these distribution correlated well with structures known to be targets of RA-induced teratogenesis. CRABP ll transcripts were expressed in brain vesicle, spinal cord, head, face, tongue and genital tubercle and also found in the structures which are not involved in RA-induced teratogenesis. CONCLUSION: These results suggest the possible involvement of both CRABPs in the RA-induced teratogenesis. However, CRABP l may have more specific roles than CRABP ll which may play a role through a different mechanism.
Animals ; Brain ; Carrier Proteins* ; Head ; In Situ Hybridization ; Pregnancy ; Rats* ; Receptors, Retinoic Acid ; RNA Probes ; RNA, Messenger* ; Spinal Cord ; Teratogenesis ; Tongue ; Tretinoin*

BACKGROUND: During coronary angiography, some electrocardiographic changes occured due to contrast media, which do life threatening influences. METHODS: We compared the electrocardiographic changes which were induced by injection of three radiopaque contrast media during selective coronary angiography in 49 patients with chest pain. One of the contrast media was high osmolar ionic(Urografin_76) and the another was low osmolar ionic(Hexabrix) and the last was non-ionic(Ioversol). Electrocardiograms were obtained before, during and after selective coronary angiography. RESULTS: The changes of S-T segment or T were decreased in non-ionic group rather than high osmolar or ionic group. And there was significant Q-Tc interval prolongation among all three groups except comparision of low osmolar ionic contrast dye and non-ionic contrast dye in left coronary angiography. CONCLUSION: Non-ionic low osmolar contrast media was safer than high osmolar or ionic contrast medial because of lesser change of Q-Tc interval during selective coronary angiography.
Chest Pain ; Contrast Media* ; Coronary Angiography* ; Diatrizoate Meglumine ; Electrocardiography* ; Humans ; Ioxaglic Acid ; Osmolar Concentration

A paraurethral cyst is a rare congenital or acquired abnormality in females that is characterized by a round, yellow or orange-colored cystic mass on either side of the urethral meatus. We report a patient who presented with frequent, postvoiding dribbling. The important differential diagnostic considerations in infants and adults are an ectopic ureterocele, urethral diverticulum, cystocele and paraurethral tumors. Intravenous pyelography, voiding cystourethrogram, cystourethroscopy are essential for differentiating these lesions. This case of a paraurethral cyst was treated with complete excision.
Adult ; Cystocele ; Diverticulum ; Female ; Humans ; Infant ; Ureterocele ; Urethra ; Urography

PURPOSE: Imaging studies for the diagnosis of breast cancer such as ultrasonography or mammography, play an essential role; however, it is well known that they have some limitations; the low specificity of ultrasonography and the low sensitivity of mammography, especially in the dense breasts of Korean women. Recently, 99mTc-MIBI scintimammography was introduced for the detection of breast cancer, and showed acceptable results in its diagnostic accuracy. In this study, the clinical usefulness of 99mTc-MIBI scintimammography was evaluated for the determination of a better imaging study for the diagnosis of breast cancer. METHODS: This study included 75 patients with breast masses, and 3 imaging studies were performed; mammography, ultrasonography and 99mTc-MIBI scintimammography and the results compared on the basis of the pathological reports from core needle or excisional biopsies of the patients. RESULTS: From the pathological reports of 75 patients, 45 cases were confirmed as malignant and 30 as benign diseases. Based on the pathological reports, the sensitivities of mammography, ultrasonography and 99mTc-MIBI scintimammiography were 62.2, 88.9, and 86.7%, and the specificites of 3 imaging studies were 90.0, 76.7, and 90.3% respectively. The positive predictive values were 90.3, 85.1, and 92.9% and the negative predictive values were 61.4, 82.1, and 81.8%, respectively. 99mTc-MIBI mammoscintigraphy showed a comparable sensitivity to ultra-sonography, and a similar specificity to mammography, in the diagnosis of breast cancer. CONCLUSION: Clinically, as a primary imaging tool, 99mTc-MIBI mammoscintigraphy showed acceptable results in the diagnosis of breast cancer. Considering the weak points of ultrasonography and mammography, 99mTc-MIBI mammoscintigraphy would be a very useful tool in the diagnosis of breast cancer.
Biopsy ; Breast Neoplasms* ; Breast* ; Diagnosis* ; Female ; Humans ; Mammography ; Needles ; Sensitivity and Specificity ; Ultrasonography

PURPOSE: A hypoechoic lesion is the most common finding of prostate cancer, but its diagnostic value is still an area of debate. The diagnostic significance of a hypoechoic lesion and the increased blood flow observed on transrectal ultrasonography (TRUS) were evaluated for the detection of prostate cancer. MATERIALS AND METHODS: The records of 266 patient's, between January 2003 and December 2005, were retrospectively reviewed. The cancer detection rates were compared according to the presence of a hypoechoic lesion in TRUS, and estimated with respect to stratification of the prostate- specific antigen (PSA) value and digital rectal examination (DRE) findings. RESULTS: The overall cancer detection rate was higher in the hypoechoic (40 of 101 cases, 39.6%) than in the isoechoic group (30 of 157 cases, 19.1%) (p<0.05). When the cases were divided into three groups, according to their PSA level (<4, 4-10 and >10), the cancer detection rate apparently increased in those with a hypoechoic lesion in TRUS (10.3 vs. 0%, 25 vs. 13.6% and 68.2 vs. 31% respectively) (p<0.001). Furthermore, the cancer detection rate was further increased in patients with a hypoechoic lesion than in those with an isoechoic lesion after division into two groups according to the presence of a hard nodule on DRE (with hard nodule, 56.9 vs. 46.7%; without hard nodule, 20 vs. 8.1%, respectively) (p<0.05). However, hypoechoic lesions with an increased blood flow did not improve the detection rate compared to those without (p>0.05). CONCLISIONS: The hypoechoic finding on TRUS not only supports the detection of prostate cancer, but also has independent diagnostic value. However, the findings of color Doppler are not helpful in the detection of prostate cancer.
Biopsy ; Digital Rectal Examination ; Humans ; Prostate* ; Prostatic Neoplasms* ; Retrospective Studies ; Ultrasonography*

OBJECTIVE: To determine the dincal significance of placenta previa totalis. METHODS: Maternal and neonatal medical rerords were reviewed retrospectively. Between March 1990 and June 1997, sixty-nine pregnant women with placenta previa totalis delivered at Asan Medical Center. Diagnosis of placenta previa totalis was confirmed during cesarean section. RESULTS: Mean maternal age at diagnosis was 31.7+ 3.9 years and 3 patients(4.3%) were nullipara. Fifty two patients(75%) had the history of vaginal bleeding during their index pregnancy and seventeen of 52 patients were admitted more than once. Median gestational age at the time of initial bleeding episode was 33.2 weeks(range 23.5-41. 1) and median interval from the first admission to delivery was 11 days(range 1-63), Major placental implantation site was posterior uterine wall(64%, 44/69). Six cases(8%) were complicated with placenta accreta or increta and no case was combined with abruptio placentae. Estimated blood loss at the time of cesarean section was 1,510+/-952ml(mean+/-SD) and 43 patients(62%) were transfused. No case was complicated with disseminated intravascular coagulation. Eight patients(11.6%, 8/69) underwent cesarean hysterectomy because of uncontrollable bleeding. Thirty four patients(49.3%) delivered their babies before 37 weeks of gestation. The mean gestational age at delivery was 36.4+/-3.0 weeks(mean+/-SD). Major neonatal morbidity was respiratory distress syndrome(20.3%, 14/69). Perinatal death rate was 4.3%(3/70). CONCLUSION: Because pregnant women complicated with placenta previa totalis have high probability for transfusion and cesarean hysterectomy, these patients should be managed cautiously and thoroughly. The most frequent neonatal morbidity was respiratory distress syndrome due to preterm delivery.
Abruptio Placentae ; Cesarean Section ; Chungcheongnam-do ; Diagnosis ; Disseminated Intravascular Coagulation ; Female ; Gestational Age ; Hemorrhage ; Humans ; Hysterectomy ; Maternal Age ; Mortality ; Placenta Accreta ; Placenta Previa* ; Placenta* ; Pregnancy* ; Pregnant Women ; Retrospective Studies ; Uterine Hemorrhage