Relationship between Hypogonadal Symptoms, Sexual Dysfunction and Chronic Prostatitis in Middle-Aged Men by Self-Reported Questionnaires, even without Biochemical Testosterone Deficiency

PURPOSE: To investigate the association of erectile dysfunction (ED), premature ejaculation (PE), and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men with late-onset hypogonadism (LOH).MATERIALS AND METHODS: We reviewed the data of 408 enrolled men between January 2014 and January 2019. All participants completed the Androgen Deficiency in the Aging Male (ADAM), international index of erectile function-5 (IIEF-5), National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), and premature ejaculation diagnostic tool (PEDT) questionnaires. Participants were divided by ADAM positive (ADAM+: Group 1) and ADAM negative (ADAM−: Group 2).RESULTS: Total of 289 subjects were in Group 1 and 119 were in Group 2. The mean age was 53.8±7.8 years. The mean total testosterone was 4.8±1.2 ng/dL and showed no differences between the groups (p=0.839). In Groups 1 and 2, ED (IIEF≤21) was identified in 233 (80.6%) versus 37 (31.1%), respectively (p<0.001). The prevalence of PE (PEDT≥9) was 112 (38.7%) versus 13 (10.9%) in Groups 1 and 2, respectively (p<0.001). However, PE (intravaginal ejaculation latency time<5 minutes) showed no differences between the groups (p=0.863). The incidence of chronic prostatitis (NIH-CPSI pain score≥4) showed significant differences with 49 (17.0%) versus 8 (6.7%) in Groups 1 and 2, respectively (p=0.007). IIEF-5 total score showed the significantly highest negative correlation (r=−0.313, p<0.001).CONCLUSIONS: Those who complained of LOH symptoms and positive results in the ADAM questionnaire need to be assessed concurrently with the above questionnaires. This could aid useful to detect of ED, PE, and chronic prostatitis co-occurrence.

Radiologic Analysis in Normal Glenohumeral Joint / 대한정형외과학회잡지

We measured several relationships of humeral and glenoid articular surfaces with radiologic analysis in the 60 shoulders of normal adults(the 30 males and 30 females) who were without pain and limitation of motion. The average age was 29.1 year-old in the males(from 26 to 39), 27.7 year-old in the females(from 20 to 34). The results of measurement were as follows. The average radius of curvature of humeral head was 28.8±1.9mm in the males, 25.3±2,3mm in the females. The average radius of curvature of glenoid was 34.5±3.5mm in the males, 29.3±2.8mm in the females and there was difference between the radius of curvature of humeral head and glenoid about 4-Smm. Average surface area ratio of humeral head versus glenoid was 1.8±0.2 in male, 2.0±0.2 in female. The average thickness of humeral head from anatomical neck was 23.1±1.5mm in the males, 20.5±2.lmm in the females and there was distance between the radius of curvature of humeral head and the thickness of humeral head about 5 me and it was suggested that humeral head was not hemisphere. The average neck shaft angle of humerus was 51.6±4.8 degree in the males, 52.7±3.8 degree in the females. The average flare index was 3.6±0.6 in the males, 3.9±0.7 in the females, so that metaphysis of female was broader than that of male. The lateral humeral offset was 68.5±3.8mm in the males, 63.6±4.3mm in the females. The average distance from the greater tuberosity of humerus to the lateral acromion process was 20.1±3.9mm in the males, 17.6±5.1mm in the females. The average distance of upper surface from the humeral head to the greater tuberosity of humerus was 6.5±1.4mm in males, 5.9±2.0mm in females. The distance from the humeral head to the undersurface of acromion was 9.5±3.1mm in the males, 7.7±3.5mm in females. Our measurement of normal glenohumeral relationship would be useful in the diagnosis of shoulder disorders and in the design of prosthestic reconstruction in Korean. Further study would be required for the analysis of the three dimensional relationship because of the limitation of our two dimensional analysis.

Finger Lengthening by Callotasis / 대한정형외과학회잡지

Indications for bone lengthening in the hand are less common than for the lower extremity. From 1991 to 1993 authors had performed nine hand bone lengthenings in the eight patients, based on callotasis and chondrodiastasis, Average age at the time of surgery was 18 years old(from 4 to 31 years old). Diagnoses included traumatic amputations in 7 cases and congenital syndactyly of both hand with hypoplastic digits in 2 cases. Sites of lengthening were metacarpal bone in 7 cases, phalangeal bone in 2 cases. Eight of 9 lengthening procedures resulted in complete consolidation of the bone gap after the single stage procedure. In one case secondary bone graft was required for the bone defect. Average consolidation period was 16 weeks(from 10 weeks to 22 weeks). Average gained length was 14.6mm (from 6 to 30mm) and average percent of gained digital bone length was 48%. There were minimal complications including marginal necrosis of skin, numbness and bone tip exposure and were responsed to conservative manage, but stump revision for bone tip exposure was performed in one case. In all cases followed to completion and for 1 to 3 years postoperatively, there was improvement of function with key pinch. The callotasis lengthening is one of the useful method of short hand bone lengthening to improve function of hand and cosmetic demand.

Pronator Quadratus Pedicled Bone Graft for the Kienbock's disease: Three cases report / 대한정형외과학회잡지

Pedicled bone flap raised from the volar aspect of lower end of the radius, pedicled by the pronator quadratus has been used for the treatment of scaphoid nonunion and Kienbock's disease. From July 1991 to Jan. 1992, authors performed this procedures for 3 cases of Kienbock's disease. Patients were 2 cases in the left hand, l case in the right hand. There was no critial trauma history. Age at operation were 25, 37 and 57 years. All patients were in Stage I in 2 cases and stage II-A in 1 case of Lichtman's radiologic classification. Preoperative grip powers were 11%, 38%, 63% and pinch powers were 20%, 41%, 61% of that of normal opposite hand. Follow up periods were 28, 31 and 33 months. At last follow up roentgenographic finding shows no progression of necrosis of lunate, new bone formation, decreased sclerosis, and joint space were preserved in all cases. The fuctional results at the last follow up were as follows. Pain during motion was markedly diminished in all patients. Grip power were 57%, 89% and 96% and pinch powers were 68%, 83% and 100% of that of normal opposite hand with use of calibrated Jamar dynamometer which showes significant increase than preoperative state. The ranges of motion of wrist were as follows. Volar flexion were 40, 45 and 80 degree. Dorsiflexion were 10, 20 and 45 degree. Ulnar deviation were 10, 20 and 30 degree. Radial deviation were 10, 25 and 30 degree. This viable bone graft with blood supply gives very satisfactory clinical results.

The Bankart Procedure in the Traumatic Recurrent Dilocation of the Shoulder / 대한정형외과학회잡지

Fifteen shoulders in 15 patients with traumatic recurrent anterior dislocation were performed from Sept. 1993 to April 1994. The position in which the dislocation occurred were abduction and external rotation in 10 cases, but most likely direct injuries in the 13 cases. The average interval between the initial and second dislocation was 5.4 months, and the average frequency of dislocation was 15 times per year. Physically, crank test in 13, fulcrum test in 12, sulcus test in 4, and jerk test in 3 cases were positive. The classic Bankart lesions were 4 cases, the bony Bankart lesions in 11 cases, so all of them had an abnormal tension on the inferior glenohumeral ligament. The Hill-Sachs lesions were associated in 14 cases, the Superior Labrum Anterior Posterior lesion in 1 case. Traditional Bankart procedure in 12 cases, traditional method and shift surgery simultaneously for inferior laxity in 3 cases were performed. In 4 cases of bony Bankart lesion with large bone fragment, anterior capsule and subscapularis muslce was splitted during exposure. Velpeau sling was applied in a daytime for postoperative immobilization, exercise with 90° of flexion but no external rotation was permitted during 3 weeks after operation. After than 140° of flexion and 40° of flexion and averag 57° of external rotation. There was no recurrence in our series. The result at follow up were exellent in 9 cases, good in 6 cases.

Glomus Tumors in the Hand / 대한정형외과학회잡지

A tumor of the neuromyoarterial apparatus, the glomus, was described by Masson : the epitheloid cell of glomus was derived from the pericyte of Ziemmermann and these cells were widely distributed in the body. From Jan. 1987 to Oct. 1993, six patients (male 1, female 5), who were diagnosed as a glomus tumor in the hand were operated. The lesions were distributed in the distal phalanges of thumb (3 cases), index (1 case), ring finger (1 case) and little finger (1 case). The average duration of clinical manifestation was 6.3 year. Nail extraction was performed because of pain in 2 cases, but symptom was not improved. The clinial symptoms were severe lancinating pain, tenderness and cold induced pain in all 6 cases, palpable mass in 2 cases, bluish purple discoloration of skin in 4 cases, subcutaneous hemorrhage in 1 case, swelling in 2 case. On the reontgenography, bone changes were detected in 2 cases, soft tissue change was detected in 1 case and 3 cases showed unremarkable findings. The treatments were simple excision in 5 cases,curettage and bone graft in 1 case and symptoms were improved in the 6 case with the remnant mild pain and there was no recurrence. The aim of this study was to report the rare cases of glomus tumor in the hand.

Cleidocranial dysostosis occurred in the mother and her son: Case Report / 대한정형외과학회잡지

Cleidocranial dysostosis is a rare congenital developmental disorder in which membranous bones fail to ossify sufficiently, particularily in the calvarium and the clavicles where fibrous tissue replaces the bone. Authors report two cases of cleidocranial dysostosis occurred in a 44-year-old woman and her 19-year-old son.

Accuracy of diagnoses from magnetic resonance imaging of the knee

No abstract available.

The osteonecrosie of knee associated with avascular necrosis of femoral head: case report

No abstract available.

The clinical value megnetic resonance imaging of discoid lateral meniscal disorders / 대한정형외과학회잡지

No abstract available.