BACKGROUND: The aim of this study was to investigate the correlation between the type of subscapularis tendon tears diagnosed during arthroscopy and the outcomes of physical tests and of isokinetic muscle strength tests. METHODS: We preoperatively evaluated physical outcomes and isokinetic muscle strength of 60 consecutive patients who underwent an arthroscopic rotator cuff repair and/or subacromial decompression. We divided the patients into five groups according to the type of subscapularis tear, which we classified using Lafosse classification system during diagnostic arthroscopic surgery. RESULTS: When we performed a trend analysis between the outcomes of the physical tests and the severity of subscapularis tendon tear, we found that both the incidence of positive sign of the collective physical tests and that of individual physical tests increased significantly as the severity of the subscapularis tear increased (p<0.001). Similarly, the deficit in isokinetic muscle strength showed a tendency to increase as the severity of subscapularis tear increased, but this positive correlation was statistically significant in only the deficit between those with Lafosse type II tears and those with Lafosse type III tears. CONCLUSIONS: Although no single diagnostic test surpasses above others in predicting the severity of a subscapularis tear, our study implies that, as a collective unit of tests, the total incidence of the positive rate of the physical tests and the extent of isokinetic strength deficit may correlate with severity of subscapularis tears.
Arthroscopy ; Classification ; Decompression ; Diagnostic Tests, Routine ; Humans ; Incidence ; Muscle Strength* ; Physical Examination ; Rotator Cuff ; Shoulder ; Tears* ; Tendons

No abstract available.
Appendicitis* ; Humans

No abstract available.
Humans

Microvascular tissue transfers have facilitated primary closure of various complex defects after radical ablation of head and neck cancers. From Oct 1991 to Feb 1992, we used forearm free flap in two patients and delto-pectoral flap in one patient who had preoperative irradiation for pharyngoesophageal reconstruction. The stricture and fistula formation were most troublesome complication in forearm free flap, so we designed as lazy S shape in distal flap margin to prevent circular contraction and longitudinal margin was deepithelialized (5 mm) and sutured double layer to withstand fistular formation and this can be considered useful in place of a free jejuna transfer.
Constriction, Pathologic ; Fistula ; Forearm ; Free Tissue Flaps ; Head ; Humans ; Neck

The infected nonunion of clavicle with bone defect is an uncommon complication following clavicle shaft fracture. There were a few reports regarding treatment of the infected nonunion after clavicle fracture. We report on a case of infected clavicle nonunion successfully treated with autologous bone graft and dual plate fixation.
Clavicle* ; Transplants

Cisternography is isotopic demonstration of CSF dynamics, CSF rate & pathways, by scintillation scanning of the head after intrathecal administration of RISA. We have investigated the cisternographic findings in the hydrocephalus patients in view of the diagnosis and prognostic criteria. Cisternography provides the etiology & classification of hydrocephalus and reliable indication of CSF shunt operation. We found correlation between prolonged ventricular retention, delayed migration, inadequate clearance of the isotope and favorable response to shunting.
Classification ; Diagnosis* ; Head ; Humans ; Hydrocephalus*

BACKGROUND AND OBJECTIVES: Conventional two dimensinnal computed tomography (2DCT) may provide precise details of soft tissues and bony structures of the temporal bone, but does not make an impression of direct visulaization of the lesions. The present study is to investigate the usefulness of three dimensional CT (3DCT) studies in the evaluation of bony defects caused by cholesteatoma. MATERIALS AND METHODS: Fifteen cholesteatoma patients who showed bony destruction or suspicious destruction in the 2DCT were examined using 3DCT, The examination was carried out in axial or coronal planes with the technical factors of 125 kV, 200 mA, 1 mm thickness, and scanning time of 1 second. The CT data was transferred to a workstation with a real-time image processor. We used a software (solaris Adw 1.2, Sun co. USA) enabling image processing. The threshold-based imaging was used for 3D reconstruction. RESULTS: In all patients, 3DCT clearly delineated the destruction of bony structures by cholesteatoma, The 3DCT generated images did provide spatial relationships which were not easily appreciated on 2DCT. Intraoperative bony destniction findings were correlated with 3DCT. CONCLUSION: The 3DCT could be useful to evaluate the invasiveness of cholesteatoma to the cranial base. It would be also helpful in planning to reconstruct during surgery.
Cholesteatoma* ; Humans ; Skull Base ; Solar System ; Temporal Bone*

BACKGROUND AND OBJECTIVES: The peak resonance corresponds to the fundamental frequency whose wavelength is approxi-mately four times the canal length and is between 2 and 3 kHz in a normal ear canal. The possibility that creation of an open cavity mastoid alters the acoustical characteristics of the external ear has been suggested. The aim of this study was to ascertain the acoustical changes in the external auditory canal occasioned by the open cavity mastoidectomy, and compare it with the mastoid obliteration. MATERIALS AND METHODS: We measured the external ear resonance (EER) characteristics in 40 normal ears, 20 ears with open cavity mastoid and 40 ears with obliterated mastoids. The EER characteristics were measured using 6500 hearing aid test system. RESULTS: The means of the peak resonant frequency and the peak amplitude at open cavity mastoids (2350 Hz, 18.5 dB) showed significant differences (p<0.1) when compared with those at normal mastoids. However, the means at obliterated mastoids (2850 Hz, 20.5 dB) recovered to the near normal state. CONCLUSION: While the open cavity mastoidectomy can affect the resonance frequency, the mastoid obliteration may help anatomical reconstruction as well as acoustical recovery.
Acoustics* ; Ear ; Ear Canal ; Ear, External* ; Hearing Aids ; Mastoid

BACKGROUND: From a pharmacokinetic standpoint, middle ear effusion (MEE) acts as a sequestered compartment since diffusion of antibiotics from serum and to this compartment is limited. The effectiveness of an antibiotic to eradicate infection within an anatomic compartment is related to both its ability to penetrate and the susceptibility of the causative pathogen. OBJECTIVE: The goal of this study was to determine the steady state plasma and MEE concentrations of cefprozil in pediatric chronic otitis media with effusion (COME). MATERIALS AND METHODS: Twenty-five children with COME were enrolled, and MEE was collected using a ventilation tube insertion after 0.5, 2, 3, 5, and 6 hours of single oral administration of 15 mg Cefprozil/kg body weight. Blood samples were also collected as soon as the MEE was collected, and analyzed in order to measure the concentration of Cefprozil using the validated high performance liquid chromatography (HPLC) method. RESULTS: The mean concentrations of cefprozil in MEE ranged from 0.4 to 4.4 ug/ml. The penetration of cefprozil into the MEE was rapid and effectively. Cefprozil in the MEE was maintained at a greater level than MIC90 in Streptococcus pneumoniae for at least 6 hours after administration of 15mg/kg. CONCLUSION: Cefprozil penetrates well into MEE in patients with pediatric COME.
Administration, Oral ; Anti-Bacterial Agents ; Body Weight ; Child ; Chromatography, Liquid ; Diffusion ; Ear, Middle* ; Humans ; Otitis Media with Effusion* ; Otitis* ; Plasma ; Streptococcus pneumoniae ; Ventilation

BACKGROUND: The aim of this study was to determine the prognostic value and optimal sampling time of serum S-100B protein for the prediction of poor neurological outcomes in post-cardiac arrest (CA) patients treated with therapeutic hypothermia (TH). METHODS: We prospectively measured serum S100 calcium binding protein beta subunit (S-100B protein) levels 12 times (0-96 hours) after the return of spontaneous circulation (ROSC). The patients were classified into two groups based on cerebral performance category (CPC): the good neurological outcome group (CPC 1-2 at 6 months) and the poor neurological outcome group (CPC 3-5). We compared serial changes and serum S-100B protein levels at each time point between the two groups and performed receiver operating characteristic curve analysis for the prediction of poor neurological outcomes. RESULTS: A total of 40 patients were enrolled in the study. S-100B protein levels peaked at ROSC (0 hour), decreased rapidly to 6 hours and maintained a similar level thereafter. Serum S-100B protein levels in the poor CPC group (n = 22) were significantly higher than in the good CPC group (n = 18) at all time points after ROSC except at 4 hours. The time points with highest area under curve were 24 (0.829) and 36 (0.837) hours. The cut-off value, the sensitivity (24/36 hours) and specificity (24/36 hours) for the prediction of poor CPC at 24 and 48 hours were 0.221/0.249 ug/L, 75/65% and 82.4/94.1%, respectively. CONCLUSIONS: Serum S-100B protein was an early and useful marker for the prediction of poor neurological outcomes in post-CA patients treated with TH and the optimal sampling times were 24 and 36 hours after ROSC.
Area Under Curve ; Heart Arrest* ; Humans ; Hypothermia* ; Prospective Studies ; ROC Curve ; S100 Calcium Binding Protein beta Subunit* ; Sensitivity and Specificity