Methods: Thirty-six patients with calcific tendinitis of the shoulder treated by US-guided barbotage with a spinal needle and subacromial steroid injection were included in the study. We evaluated clinical outcomes based on American Shoulder and Elbow Surgeons (ASES) score, Constant score, and visual analog scale (VAS) for pain score. Radiological outcomes were assessed by X-ray imaging at each visit. Results: Our results showed that US-guided barbotage and subacromial steroid injection produced good clinical and radiological outcomes in patients with calcific tendinitis of the shoulder. Of the 36 patients, only one required surgical treatment, while the others showed improvement without any complications. Compared to values before the procedure, calcific deposit size and VAS, ASES, and Constant scores showed significant improvement 6 weeks after the procedure. No significant correlation was found between the initial calcific deposit size and clinical outcomes at each time point. Conclusions In patients with calcific tendinitis of the shoulder, US-guided barbotage using a spinal needle and subacromial steroid injection can yield satisfactory clinical and radiological results.

Background: Many researchers have questioned whether shoulder kinematics such as the glenohumeral position and scapular kinematics would be different in different age groups. However, studies comparing shoulder kinematics between different age groups have been rare. The aim of this study was to analyze and compare the three-dimensional (3D) glenohumeral position, scapular kinematics, and scapulohumeral rhythm (SHR) during scapular plane arm abduction between a normal young male group and a normal older male group. Methods: Twenty normal men (10 young and 10 older) were enrolled in this controlled laboratory study. Fluoroscopic images were obtained using a single plane X-ray system. Bilateral computed tomography scans were taken to create a 3D model. A 3D-2D registration technique was used to determine the 3D position and orientation of the bones of the shoulder. Results: During scapular plane arm abduction, there were significant differences in scapular kinematics between the groups. The older male group showed more upward rotation, posterior tilt, and external rotation than the young male group. On the other hand, the glenohumeral position such as superior inferior translation, anterior posterior translation, and external rotation of the humeral head did not show significant difference between the groups. The mean value of SHR for the overall arm elevation range from start to maximum elevation angle for the older group and young group was 2.298 ± 0.964 and 2.622 ± 0.931, respectively, showing a significant difference between the two groups (p = 0.035). Conclusions Scapular kinematics and SHR were significantly different between the older male group and the young male group. Our study could provide reference values of shoulder kinematics for older men aged 55–65 years.

Background: Many researchers have questioned whether shoulder kinematics such as the glenohumeral position and scapular kinematics would be different in different age groups. However, studies comparing shoulder kinematics between different age groups have been rare. The aim of this study was to analyze and compare the three-dimensional (3D) glenohumeral position, scapular kinematics, and scapulohumeral rhythm (SHR) during scapular plane arm abduction between a normal young male group and a normal older male group. Methods: Twenty normal men (10 young and 10 older) were enrolled in this controlled laboratory study. Fluoroscopic images were obtained using a single plane X-ray system. Bilateral computed tomography scans were taken to create a 3D model. A 3D-2D registration technique was used to determine the 3D position and orientation of the bones of the shoulder. Results: During scapular plane arm abduction, there were significant differences in scapular kinematics between the groups. The older male group showed more upward rotation, posterior tilt, and external rotation than the young male group. On the other hand, the glenohumeral position such as superior inferior translation, anterior posterior translation, and external rotation of the humeral head did not show significant difference between the groups. The mean value of SHR for the overall arm elevation range from start to maximum elevation angle for the older group and young group was 2.298 ± 0.964 and 2.622 ± 0.931, respectively, showing a significant difference between the two groups (p = 0.035). Conclusions Scapular kinematics and SHR were significantly different between the older male group and the young male group. Our study could provide reference values of shoulder kinematics for older men aged 55–65 years.

Metachromatic leukodystrophy (MLD) is an autosomal recessive disease caused by a deficiency in arylsulfatase A (ARSA). However, decreased ARSA activity is also observed in pseudodeficiency (PD). To distinguish between MLD and PD, we performed gene mutation and sulfatide analyses by using dried blood spots (DBSs) from seven Korean individuals who underwent an analysis of ARSA activity. DNA was extracted from DBSs, and PCR-direct sequencing of ARSA was performed. The cDNA obtained was analyzed to confirm a novel mutation. Of the seven subjects, three were confirmed as having MLD, one was confirmed as having MLD-PD, one was confirmed as having PD, and the remaining two were obligate heterozygotes. We verified the novel pathogenic variant c.1107+1delG by performing familial and cDNA analyses. Sulfatide concentrations in DBSs were analyzed and were quantified by using ultra-performance liquid chromatography and tandem mass spectrometry, respectively. Total sulfatide concentration was inversely correlated with ARSA activity (Spearman's coefficient of rank correlation, P=0.929, P=0.0025). The results of this mutational and biochemical study on MLD will increase our understanding of the genetic characteristics of MLD in Koreans.
Cerebroside-Sulfatase ; Chromatography, Liquid ; DNA ; DNA, Complementary ; Heterozygote ; Leukodystrophy, Metachromatic* ; Tandem Mass Spectrometry

BACKGROUND: There has been controversy about predicting difficult LMA insertion and suboptimal position. Our aim was to evaluate bedside predictors for difficult LMA ProSeal(TM) (PLMA) insertion and suboptimal position. METHODS: As the potential predictive factors for difficult PLMA insertion and suboptimal position, we considered male gender, increased body mass index (BMI), seven individual items suggesting difficult airway [modified Mallampati classification > or = III, inter-incisor distance < or = 5 cm, thyromental distance < or = 6.5 cm, head/neck movement < or = 90degrees, history of difficult intubation, buck of teeth > or = moderate, upper lip bite test (ULBT) > or = II] and > or = 3 of total airway score which is the sum of scores assessed by a score of 0, 1, 2 in seven individual items. The PLMA position was assessed by fiberoptic bronchoscopy to determine whether these predictors predict suboptimal position of PLMA (fiberoptic score < 3, as graded on a standard fiberopitc scale). We also investigated the effect of predictive factors on the failure of the first insertion of PLMA and time required for successful Proseal LMA insertion on the first attempt. RESULTS: 154 patients were enrolled in the study. The total airway score did have a significant relationship with the fiberoptic findings. The male gender and ULBT I of investigated predictors did significantly correlate with failure on the first insertion of PLMA. We did not find any significant relationship between the predictive factors and PLMA insertion time on the first attempt. CONCLUSIONS: The male gender and ULBT I indicate difficult PLMA insertion, and the total airway score > or = 3 indicates suboptimal position of PLMA.
Body Mass Index ; Bronchoscopy ; Classification ; Humans ; Intubation ; Laryngeal Masks* ; Lip ; Male ; Tooth

PURPOSE: To determine the relationship between change in the expression of the p75 neurotrophin receptor (NTR) and transient receptor potential vanilloid 1 (TRPV1) after a spinal nerve injury with time. MATERIALS AND METHODS: The L5 and L6 spinal nerve of the rats were cut unilaterally. The spinal cord and dorsal root ganglion (DRG) were subjected to immunohistochemistry for p75 NTR and TRPV1. RESULTS: The immunoreaction (IR) for p75 NTR in the neuronal cytoplasm was persistently lower on the ipsilateral L5 and L6 DRG but higher in the satellite cells and fibers. The colocalization between p75 NTR and TRPV1 was increased temporarily in the L4 DRG in both sides. In the spinal cord, p75 NTR-IR decreased temporalily in the ipsilateral dorsal horn of the L4-L6 level and had recovered at 28 days after injury. CONCLUSION: These results show that a differential change in the expression of p75 NTR and TRPV1 is related to the different functional recovery of the sensory and motor system, and that increased colocalizations between p75 NTR and TRPV1 in a non-injured DRG might be related to the development of neuropathic pain after a peripheral nerve injury.
Animals ; Cytoplasm ; Diagnosis-Related Groups ; Ganglia, Spinal* ; Horns ; Immunohistochemistry ; Neuralgia ; Neurons ; Peripheral Nerve Injuries ; Rats* ; Receptor, Nerve Growth Factor* ; Spinal Cord* ; Spinal Nerve Roots* ; Spinal Nerves*

PURPOSE: The authors studied the effect of the 3-AB, an inhibitor of poly(ADP-ribose)polymerase (PARP), on the changes of primary afferents and spinal cord after spinal nerve injury. METHOD: The L5 and L6 spinal nerve of the rats were cut, and 3-AB (10 mg/Kg) was injected intraperitoneally once per day. The animals were sacrificed 3 days, 7 days, 14 days and 28 days after nerve injury. Binding of isolectin B4 (IB4) and immunohistochemistry (IHC) of CGRP for the changes in primary afferents, IHC of NK1 for sensory neurons, and of cleaved caspase 3 and NeuN for the apoptotic changes in spinal neurons were performed. RESULT: Decreased binding of IB4 and immunoreactivity (IR) for CGRP, increase of IR for NK1, and cleaved caspase 3 in both neurons and glia in ipsilateral dorsal horn were observed after spinal nerve injury. These changes were attenuated, especially at between 3 days and 14 days, by administration of 3-AB. CONCLUSION: It is suggested that inhibition of PARP by 3-AB may attenuate alterations of primary afferents and spinal neurons, at least in early stage, after spinal nerve injury.
Animals ; Apoptosis ; Caspase 3 ; Horns ; Immunohistochemistry ; Lectins ; Neuroglia ; Neurons* ; Rats* ; Sensory Receptor Cells ; Spinal Cord ; Spinal Nerves*

PURPOSE: The authors studied the effect of the 3-AB, an inhibitor of poly(ADP-ribose)polymerase (PARP), on the changes of primary afferents and spinal cord after spinal nerve injury. METHOD: The L5 and L6 spinal nerve of the rats were cut, and 3-AB (10 mg/Kg) was injected intraperitoneally once per day. The animals were sacrificed 3 days, 7 days, 14 days and 28 days after nerve injury. Binding of isolectin B4 (IB4) and immunohistochemistry (IHC) of CGRP for the changes in primary afferents, IHC of NK1 for sensory neurons, and of cleaved caspase 3 and NeuN for the apoptotic changes in spinal neurons were performed. RESULT: Decreased binding of IB4 and immunoreactivity (IR) for CGRP, increase of IR for NK1, and cleaved caspase 3 in both neurons and glia in ipsilateral dorsal horn were observed after spinal nerve injury. These changes were attenuated, especially at between 3 days and 14 days, by administration of 3-AB. CONCLUSION: It is suggested that inhibition of PARP by 3-AB may attenuate alterations of primary afferents and spinal neurons, at least in early stage, after spinal nerve injury.
Animals ; Apoptosis ; Caspase 3 ; Horns ; Immunohistochemistry ; Lectins ; Neuroglia ; Neurons* ; Rats* ; Sensory Receptor Cells ; Spinal Cord ; Spinal Nerves*

OBJECTIVE: The purpose of this study is to develop telesurgical conference system by establishing a gigabit broad-banded network between hospitals in Korea and Japan using Digital Video Transport System(DVTS) on internet protocol, and to audit performance of this system through questionnaire study. METHODS: The Korea Advanced Research Network(Korean side), the Fukuoka Gigabit Highway(Japanese side), and the Korea-Japan Cable Network(international line)were used for assuring a high speed network connectivity. DVTS streaming was propagated with 30 M bps bandwidth for two channels on IPv4 network. Network security was built with virtual private network solution to guarantee protecting patient's privacy. Technological performance and satisfaction of users were evaluated following the events. RESULTS: The teleconference sessions and live surgery transmission with DVTS on internet protocol using advanced research network were performed successfully. Bandwidth of 60 Mbps for two-line transmission was maintained throughout the conference. The quality of the transmitted pictures had no frame loss with the rate of 30 frames per second. The sound was also clear and the time delay was less than 0.3 sec. Effectiveness of telesurgical conference using advanced network was felt beneficial for 94% of the attendants in questionnaire study. CONCLUSION: Establishing an international telesurgical conference system with high quality digital video transmission over internet protocol using international gigabit network was performed successfully. With the improvement of network engineering, this system is expected to contribute penetration of medical skills and knowledge through network infrastructure.
Internet ; Japan ; Korea ; Privacy ; Surveys and Questionnaires ; Rivers ; Telecommunications*

Primary afferents sensitive to capsaicin and noxious heat express vanilloid receptor 1(VR1) in both their peripheral and central fibers and terminals. We used multiple immunofluorescence and confocal microscopy to characterize their pattern of termination in rat spinal cord, colocalization of neurochemical markers of primary afferents and other presynaptic receptors. VR1-positive unmyelinated fibers mainly terminate in lamina I, where they co-stain for CGRP, and to a limited extent for SP, and in lamina II, especially its medial half, where they co-stain for IB4. VR1 positive thin myelinated fibers terminate in lamina I and co-stain for the neurochemical tracer CTB, injected in the sciatic nerve. As revealed by simultaneous staining for the synaptic marker synaptophysin, VR1-positive terminals are abundant in lamina I and sparse in lamina II. In L6-S1 spinal cord, VR1-positive fibers and terminals were abundant in Lissauer's tract, lamina I-V, medial collateral path to lamina X, and lateral collateral path to sacral parasympathetic nucleus. Most of VR1 positive fibers in Lissuer's tract and LCP are colocalized with SP. In conclusion, it is suggested that VR1 positive fibers in spinal cord are both peptidergic and non-peptidergic, IB4 positive fibers, mediating both somatic and visceral sensations, and that peptidergic VR1 positive fibers are mainly related with visceral sense.
Animals ; Capsaicin ; Fluorescent Antibody Technique ; Ganglia, Spinal ; Hot Temperature ; Microscopy, Confocal ; Myelin Sheath ; Negotiating ; Rats* ; Receptors, Presynaptic ; Sciatic Nerve ; Sensation ; Spinal Cord ; Synaptophysin