Survey for Musculoskeletal Pain of Korean Junior Tennis Players / 대한스포츠의학회지

The aim of this survey was to analyze the characteristics of musculoskeletal pain of Korean junior tennis players and its effect on games and psychology of players. Surveys were administered to 30 healthy male junior tennis players who took part in a 50th national junior tennis meet in 2015. We analyzed the incidence, location, cause and preferred prevention or treatment method of musculoskeletal pain, the correlation between training time and musculoskeletal pain as well as the effect of musculoskeletal pain on games and psychology of players. Overall, 22 out of 30 (73.3%) responded the experience of musculoskeletal pain. The incidence of lower extremity pain (16 out of 30, 53.3%) were higher than upper extremity pain (9 out of 30, 30%) and low back pain (8 out of 30, 26.7%). The long training hours per day (r=0.574, p=0.001) and old age (r=0.390, p=0.033) were correlated with intermittent back pain in univariate anlaysis. In multivariate ananlysis, the long training hours per day was a single risk factor of intermittent low back pain (p=0.038, odds ratio 10.01). 43.3% of players responded that the insufficent preventive conditioning program was thought to be the cause of musculoskeletal pain. The most preferred treatment or prevention method for musculoskeletal pain was rehabilitation (55.3%). Twelve players reported the negative affection of musculoskeletal pain to the performance in game. Six players experienced the frustration, 9 players experienced the loss of interest and 9 players experienced the emotional avoidance of games due to the musculoskeletal pain.

Evaluation of Setup Errors for Tomotherapy Using Differently Applied Vacuum Compression with the Bodyfix Immobilization System / 의학물리

The aim of this study is to evaluate the patient's setup errors in TomoTherapy (Hi-Art II, TomoTherapy, USA) Bodyfix system (Medical Intelligence, Ele-kta, Schwabmuchen, Germany) pressure in the vacuum compression, depending on and were evaluated. Bodyfix immobilization system and vacuum pressure was compression applied to the patients who received Tomotherapy thoracic and abdominal area, 21 patients were selected and TomoTehpay treatment total 477 of MVCT images were obtained. The translational (medial-lateral: ML, anterior-posterior: AP, superior-inferior: SI directions) and rolling were recorded and analyzed statistically. Using Pearson's product-moment coefficient and One-way ANOVA, the degree of correlation depending on the different vacuum pressure levels were statistically analyzed for setup errors from five groups (p<0.05). The largest average and standard deviation of systematic errors were 6.00, 5.95 mm in the AP and SI directions, respectively. The largest average of random errors were 4.72 mm in the SI directions. The correlation coefficients were 0.485, 0.244, and 0.637 for the ML-Roll, AP-Vector, and SI-Vector, respectively. SI-Vector direction showed the best relationship. In the results of the different degree of vacuum pressure in five groups (Pressure range: 30~70 mbar), the setup errors between the ML, SI in both directions and Roll p=0.00 (p<0.05) were shown significant differences. The average errors of SI direction in the vacuum pressure of 40 mbar and 70 mbar group were 4.78 mm and -0.74 mm, respectively. In this study, the correlation between the vacuum pressure and the setup-errors were statistically analyzed. The fact that setup-errors in SI direction is dependent in vacuum pressure considerly setup-errors and movement of interal organs was identified. Finally, setup-errors, and it, based on the movement of internal organs in Bodyfix system we should apply more than 50 mbar vacuum pressure. Based on the results of this study, it is suggested that accuracy of the vacuum pressure and the quantitative analysis of movement of internal organs and the tumor should be studied.

The Clinical Findings of Gastrointestinal Burkitt Lymphoma in Adults / 대한소화기내시경학회지

BACKGROUND/AIMS: The endoscopic and clinical findings of gastrointestinal (GI) Burkitt lymphoma in Koreans are not well known. METHODS: From January 1995 to July 2007, 80 patients (47 adults and 33 children) were diagnosed with Burkitt lymphoma at our institution. The clinical and endoscopic manifestations were analyzed in the adult patients (n=20, median age=52 yr) with GI Burkitt lymphoma. RESULTS: The most frequent symptom was abdominal pain (50%) followed by epigastic soreness (30%). Among the 20 patients with GI Burkitt lymphoma, 11 (55%) had gastric lesions, 4 (20%) had colonic lesions, 3 (15%) had both gastric and duodenal lesions, 1 (5%) had both gastric and colonic lesions, and 1 (5%) had gastric, duodenal and colonic lesions. For the 13 patients who had endoscopic pictures available, the most common type of disease was the ulcerative type (38.5%) followed by the ulcerofungating and ulceroinfiltrative types (23.1% and 23.1%, respectively). Most of the patients were diagnosed with advanced disease. The most common clinical stage was stage IVE (60%) by the Musshoff staging system. All 20 patients received combination chemotherapy, and the 5-year survival rate was 64%. CONCLUSIONS: For patients with GI Burkitt lymphoma, the most commonly involved site was the stomach. Most lesions were ulcerative with or without fungating morphology. Considering the advanced stage of most patients, the prognosis after systemic chemotherapy was favorable.

Factors Associated with Malignancy in Gallbladder Polyps without Gallbladder Stone / 대한소화기학회지

BACKGROUND/AIMS: The purpose of this study was to find the factors predicting the neoplastic polyp of gallbladder and analyze the size criteria associated with malignancy. METHODS: A total of 354 subjects with gallbladder polyps confirmed by tissue pathology were included for the analysis. The clinical and radiological features of the polyps were compared between the two groups (neoplastic vs. non-neoplastic) and in the three groups (non-neoplastic vs. adenoma vs. adenocarcinoma). The independent factors associated with malignancy were studied. RESULTS: Of 354 patients, non-neoplastic polyps were observed in 229 (64.7%) patents, adenoma in 85 (24.0%) and adenocarcinoma in 40 (11.3%). The mean diameter of non-neoplastic polyp, adenoma, and adenocarcinoma were 11.3+/-2.8 mm, 16.0+/-7.2 mm, and 27.0+/-8.9 mm, respectively. The mean age of patients with non-neoplastic polyp, adenoma, and adenocarcinoma were 44.8+/-11.3, 49.9+/-12.5, and 60.8+/-9.6, respectively. Age, size of polyp, number of polyp, presence of diabetes, and presence of symptom showed statistically significant difference between the neoplastic polyp and non-neoplastic polyp groups. But only age, size of polyp, number of polyp were statistically independent factors associated with neoplastic polyp (p<0.05). To predict the neoplastic polyp, sensitivity was 94.4%, but specificity was 18.3% on the basis of 10 mm criteria. whereas sensitivity and specificity was 76.0% and 55.5% on the 12 mm-criteria. CONCLUSIONS: On the basis of our analysis, the size of polyp is the most important factor to predict the malignancy. In the 10 mm criteria, sensitivity is satisfactory but specificity is very low. Therefore 10 mm size should not be considered to be the absolute size-criterion for surgery.

Dilemma in Severity Classification of Incongruent Hallux Valgus Deformity Using Radiological Measurements / 대한정형외과학회잡지

PURPOSE: To study the availability of the radiological classification for incongruent hallux valgus deformities, which has been used as the key to the algorithm for selecting surgical options. MATERIALS AND METHODS: To determine radiological severity, 257 cases of incongruent hallux valgus deformities were studied. The hallux valgus angle (HVA) and the 1/2 intermetatarsal angle (IMA) were measured in each case. Following Mann's radiological classification system, the HVA and IMA were compared to determine any similarity in severity. The distal metatarsal articular angle (DMAA) was also measured to observe the extent of its effect on the incongruent deformity. RESULTS: The HVA was 36.1degrees on average (range, 16-60degrees) and the 1/2 IMA was 15.8degrees on average (range, 5-30degrees). In 126 cases (49.1%), the severity between the 1/2 IMA and HVA coincided with the index classification, whereas. 131 cases (50.9%) did not correspond. Overall, the severity of approximately half the cases, could not be graded. The DMAA was 15.6degrees on average (range, 0-40degrees) and 133 cases (51.8%) demonstrated a value above normal value (>15degrees). CONCLUSION: The radiological classification system used as a guide for surgical decision-making needs to be revised, due to the overt limits of correspondence between the severity of the 1/2 IMA and HVA. Because the HVA would be influenced by both the lateral subluxation and bony deformity around the first metatarsophalangeal joint, it is reasonable to consider these factors on the HVA as elements to be corrected individually, instead of the HVA alone.

Mesenchymal Hamartoma of the Liver in Adults / 대한간학회지

Mesenchymal hamartoma of the liver (MHL) is a rare benign tumor usually found in childhood, especially during the first two years. MHL is extremely rare in adults. Most reported cases present with a slow growing abdominal mass. It is thought to be a developmental anomaly and consists of bile ducts, hepatocytes and mesenchymal tissue. We report a case of mesenchymal hamartoma of the liver in an adult male with a brief review of the literature.

A Case of Superimposed Viral Myocarditis in a Patient with Systemic Lupus Erythematosus

Lupus myocarditis is usually treated using immunosuppressive agents, such as high-dose corticosteroids, azathioprine and cyclophosphamide. Viral myocarditis and enteroviruses have been identified as the most common causative agents of myocarditis in lupus patients. Although immunosuppressive therapy has an important role in the treatment of lupus myocarditis, it is not recommended in patients with infectious or post-infectious viral myocarditis, and supportive care is very important in these patients. A 25-year old female patient, with systemic lupus erythematosus, was admitted due to severe dyspnea, and diagnosed as having heart failure. She recovered 7 days after supportive care for heart failure, without Immuno-suppression. Her sera neutralized coxsackievirus B3 (CVB3) in neutralization test, with the horse anti-CVB3 antibody (Ab, ATCC V030-501-560) used as a positive control. The titers for the neutralizing Ab in her sera were 4 times higher than that of the standard control ATCC Ab.

A Case of Granular Cell Tumor in the Rectum / 대한소화기내시경학회지

Granular cell tumor (GCT), first described by Abrikossoff in 1926, is relatively uncommon, usually benign and solitary neoplasm. The most frequently involved organs include the tongue, skin, breast, and digestive tract. Until now, less than 200 cases of GCTs of the digestive tract have been reported in the esophagus, and less than 50 cases in the large intestine, stomach, biliary tract in the world. Only less than 20 cases of GCT of the rectum have been reported in the world. It is believed that there have been no reported cases of GCT of the rectum in Korea. Recently, the incidence of granular cell tumor has been slowly rising since endoscopy has been used more commonly as a diagnostic tool. We report a case of granular cell tumor in the rectum in a 49-year-old male patient, which was confirmed by microscopic examination after colonoscopic polypectomy.

A Case of Primary Small Cell Neuroendocrine Carcinoma of the Rectum / 대한소화기내시경학회지

Neuroendocrine carcinoma of the colon is a very rare entity. However, this type of tumor is known to have aggressive progression and poor prognosis. A case of a 72-year-old male is presented in this report. A 3 cm sized tumor was found on the rectum with multiple liver metastases. The pathological findings including a positive immunohistochemical staining for synaptophysin and cytokeratin done with colonoscopic biopsy and liver biopsy confirmed the tumor as a neuroendocrine carcinoma. The nomenclature and definition of this disease still remains somewhat unclear, and not a small population of this disease may thus have been misdiagnosed and treated as other less aggressive entities, such as carcinoid tumor. The necessity to make an accurate differential diagnosis in such cases is thus emphasized because of different treatments and clinical courses. For its rarity and clinical significance, we report this case with a review of the literatures.

A Case of Primary Small Cell Neuroendocrine Carcinoma of the Rectum / 대한소화기내시경학회지

Neuroendocrine carcinoma of the colon is a very rare entity. However, this type of tumor is known to have aggressive progression and poor prognosis. A case of a 72-year-old male is presented in this report. A 3 cm sized tumor was found on the rectum with multiple liver metastases. The pathological findings including a positive immunohistochemical staining for synaptophysin and cytokeratin done with colonoscopic biopsy and liver biopsy confirmed the tumor as a neuroendocrine carcinoma. The nomenclature and definition of this disease still remains somewhat unclear, and not a small population of this disease may thus have been misdiagnosed and treated as other less aggressive entities, such as carcinoid tumor. The necessity to make an accurate differential diagnosis in such cases is thus emphasized because of different treatments and clinical courses. For its rarity and clinical significance, we report this case with a review of the literatures.

A Case of Serous Cystadenoma of the Pancreas Communicating with the Pancreatic Duct / 대한소화기학회지

Serous cystadenoma of the pancreas is a rare disease and is usually benign. Mucinous cystadenoma, another cystic neoplasm of the pancreas, has a malignant potential. Serous cystadenoma is usually composed of many small cysts lined by small, cuboidal or flattened cells containing abundant glycogen. With the finding of endoscopic retrograde pancreatography, a communication between the cyst and pancreatic duct is observed occasionally in the mucinous cystadenoma, but rarely in the case of serous cystadenoma of the pancreas. We experienced a case of serous cystadenoma of the pancreas that had a communication between a cyst and the pancreatic duct.