Osteochondromadevelop most commonly at distal femur, proximal humerus and proximal tibia, but the rib osteochondroma was reported less commonly. In this report, scapular snapping syndrome complicated by adventitious bursa and soft tissue pseudotumor surrounding the osteochondroma of the 6th rib body was treated successfully by surgical excision of them. We report this rare case with reviewing the relevant literature.
Femur ; Humerus ; Osteochondroma* ; Ribs* ; Shoulder* ; Tibia

BACKGROUND: Do-Not-Resuscitate(DNR) order has been used without specific legislation commonly in hospitals of Korea. We designed this study to assess the current use of DNR order in the emergency department and to make a database for establishing a policy for DNR order, especially in ER. METHODS: We retrospectively reviewed medical records of 164 patients who expired in the emergency department of Severance hospital from Sep. 1996 to Aug. 1997. We evaluated age, sex, diagnosis, specific department involved, whether written orders were made and medical care after decision of DNR. The patients were divided into 2 groups : DNR vs CPR. To determine factors influencing DNR decision, we searched for presence of malignancy, irreversible shock, unconsciousness and chronic illness. The logistic regression analysis was used for statistical significance. RESULTS: We found that 102(62.2%) out of 164 expired patients had a DNR order. But only in 59% of cases, were written DNR order on the chart. Factors which had the most influence on decision of DNR were malignancy and age. The sex, chronic illness, irreversible shock, and unconsciousness were not significant factors. CONCLUSION: We found malignancy and old age as an important factor when DNR order had been made. But further evaluation of other factors may be necessary to establish definitely a policy for DNR order.
Cardiopulmonary Resuscitation ; Chronic Disease ; Diagnosis ; Emergency Service, Hospital ; Humans ; Korea ; Logistic Models ; Medical Records ; Retrospective Studies* ; Shock ; Unconsciousness

No abstract available.
Female ; Meigs Syndrome*

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

PURPOSE: Ethane 1,2-Dimethane sulfonate (EDS), an alkylating agent, has been widely used to create the testosterone withdrawal rat model. The present study was carried out to test the effect of EDS administration on the expression of steroidogenesis-related genes in the rat testis and on epididymal sperm counts. MATERIALS AND METHODS: Adult male Sprague-Dawley rats (300~350 g B.W.) were injected with a single dose of EDS (75 mg/kg, i.p.) and sacrificed on days 0, 7, 14, 21, 28, 35, 42, and 49. Tissue weights (testis, epididymis and seminal vesicle) were measured, and serum LH levels were determined by specific radioimmunoassay. The transcriptional activities of LH receptor (LH-R), 3beta-hydroxysteroid dehydrogenase (3beta-HSD), and steroidogenic acute regulatory protein (StAR) were evaluated by semi-quantitative RT-PCR. RESULTS: Weights of the reproductive and accessory organs declined progressively after the EDS treatment (weeks 1~3). After this, the decrease stopped, with a gradual return towards normal. Full recovery was observed in testis and seminal vesicle evaluations on weeks 5 and 6, respectively. Only 70% recovery was found in epididymis during weeks 5~7. A more dramatic drop was observed in caput epididymal sperm count, and the maximum recovery was 40% on week 7. Serum LH level increased significantly on week 2 after EDS treatment, then gradually decreased during weeks 3~5. The transcripts for the steroidogenesis-related genes in testis declined sharply during weeks 1~2, then returned to normal on week 4. CONCLUSIONS: Our results demonstrate that EDS might directly induce severe damage, such as tissue destruction and decreased sperm counts, in epididymis compared to those in testis and seminal vesicles. Changes in the activities of testicular steroidogenesis-related genes caused by abrupt death and repopulation of Leydig cells in EDS-treated rats were in good correlation with other parameters shown in this and previouslypublished data. Taken together, the EDS injection model might be useful to understand not only the mechanism of differentiation of testicular somatic and germ cells but also the function of the epididymis in the aging process.
Adult* ; Aging ; Animals ; Epididymis ; Ethane* ; Germ Cells ; Humans ; Leydig Cells ; Male ; Models, Animal ; Oxidoreductases ; Radioimmunoassay ; Rats* ; Rats, Sprague-Dawley ; Receptors, LH ; Seminal Vesicles ; Sperm Count* ; Spermatozoa* ; Testis ; Testosterone ; Weights and Measures

Synovial cysts occur typically in peripheral joints and tendon sheaths. They rarely occur intraspinally. Recently we have experienced a case of extradural synovial cyst in the cervical spine, causing a myelopathy which results in progressive motor weakness and sensory change. The case is therefore presented with review of literatures.
Joints ; Spinal Cord Diseases* ; Spine ; Synovial Cyst* ; Tendons

For cervical cancer, the combination chemotherapy could increase the trial of radical hysterectomy due to reduction in tumor volume even in advanced stage and help to decrease corrected dose of radiotherapy. It also reduces postoperative radiotherapy to avoid the side effect and therefore make the quality of life better. Cisplatin chemotherapy alone was known to result in objective response rates of 20%. Todays animal experiment studies stated that Ifosfamide could accelerate the efficacy of Cisplatin. Thus in this study, neoadjuvant chemotherapy was applied to those cervical cancer patients in the use of the combination chemotherapy including Ifosfamide, PI(Cisplatin+ Ifosfamide) and PAIB(Cisplatin+ Ifosfamide+ Adriamycin+ Bleomycin). A total of 43 patients were entered in this trial, 23(53%) achieved at least a 50% reduction in tumor volume, 20(47%) showed no change. After completion of combination chemotherapy, 30(70%) of the 43 were done radical hysterectomy, 13(30%) given to radiotherapy. 9(30%) of the 30 patients were applied postoperative radiation therapy. Nausea and vomiting occurred in 35 of the 43 patients(81%) and alopecia 15(34%) for toxicity. Severe CNS toxicity(Grade 4) was detected in one patient. This study suggest that Ifosfamide combination chemotherapy is effective in tumor reduction and minimal toxity and can performed radical operation in cases of large tumor volume.
Alopecia ; Animal Experimentation ; Cisplatin ; Doxorubicin* ; Drug Therapy ; Drug Therapy, Combination ; Humans ; Hysterectomy ; Ifosfamide* ; Nausea ; Quality of Life ; Radiotherapy ; Tumor Burden ; Uterine Cervical Neoplasms* ; Vomiting

Diagnosis of a thymic carcinoid was made on transthoracic fine needle aspiration in a 36-year old woman who had an anterior mediastinal mass on chest X-ray and CT scan. The aspiration smears showed numerous anastomosing ribbons and cords of small round tumor cells. The tumor cells had slightly eccentric nuclei and some granular cytoplasm. The small and uniform nuclei of the tumor cells had finely granular chromatin and thin nuclear membrane. The cytologic diagnosis of a carcinoid was confirmed on histopathologic, immunohistochemical, and electromicroscopic examination of surgical specimen.
Adult ; Alleles* ; Biopsy, Fine-Needle ; Carcinoid Tumor ; Carotid Body ; Child* ; Chromatin ; Cytoplasm ; Diagnosis ; Female ; Humans ; Immunoglobulin A* ; Nuclear Envelope ; Paraganglioma ; Thorax ; Tomography, X-Ray Computed

The purpose of this in vitro study was to compare the effects of root canal debridement following rotary Ni-Ti instruments with positive versus negative rake angle. Seventy sound, extracted human anterior teeth & premolars were randomly divided into four groups. The used rotary instruments were Ni-Ti HERO 642(Micro-Mega in France, 20 specimen), Ni-Ti ProFile(Maillefer, Ballaigues, Switzerland, 20 specimen), stainless steel engine reamer(Mani, Matsutani Seisakusho Co.,Japan, 20 specimen) and negative control group(10 specimen) was only extirpated with barbed broach(Mani, Matsutani Seisakusho Co.,Japan) Group 1 & 2 teeth were prepared to a #40 at the apex followed by 1 mm using crown-down technique. Group 3 teeth were instrumented from a #15 to a #40 in sequential order. After preparation and final irrigation, the roots split longitudinally into a bucco-lingual direction. Root halves were cross-sectioned in apical third portion again. all root specimens were prepared for SEM investigation & photographed. Separate evaluations were undertaken for smear layer on prepared walls with a five score-index for each using reference photograph in root halves. the penetration depth of smear layer into dentinal tubules was also estimated in the other halves. the following results were obtained : 1. Smear layer was observed on all the prepared walls with three experimental groups except negative control group 2. Smear layer characteristics 1) HERO 642 groups showed snowy & dusty appearance & were observed only few some dentinal tubuli open on the prepared walls, and the penetration depth of it into dentinal tubules may be 1-2 microm thick. 2) ProFile groups showed shiny & burnished appearance & complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli and penetration depth of it into dentinal tubules may be 1-2 microm thick. 3) Engine reamer groups showed obviously file's passed tracks on the prepared walls & were observed complete root canal wall covered by a homogenous smear layer with no open dentinal tubuli. The results revealed that a completely clean root canal could not be achieved regardless of positive & negative rake angle, which is in accordance with the majority of studies on root canal cleanliness. In conclusion, throughout irrigation with antibacterial solutions or chelating agents is recommended to remove the smear layer on prepared canal walls.
Bicuspid ; Chelating Agents ; Debridement ; Dental Pulp Cavity ; Dentin ; Electrons ; France ; Humans ; Nickel ; Smear Layer ; Stainless Steel ; Switzerland ; Titanium ; Tooth ; Track and Field

Primary carcinoma of the female urethra is relatively rare neoplasm. Urethral cancers account for less than 0.02 per cent of all neoplasms occurring In women and 0.01 per cent of all urologic malignancies. The rarity of the disease as well as the changes and improvements in the various treatment modalities have prevented unanimity of opinion with regard to its proper treatment. We report one case of transitional cell carcinoma in female urethra with brief review of the literature.
Carcinoma, Transitional Cell* ; Female* ; Humans ; Urethra* ; Urethral Neoplasms