BACKGROUND: Isolated infraspinatus tear is very rare and clinical features are not as well known, therefore the purpose of this study was to evaluate clinical characteristics and outcomes of isolated infraspinatus tear that authors experienced. METHODS: Authors reviewed 288 cases of full-thickness rotator cuff tear involving infraspinatus between 2010 and 2015, and retrospectively analyzed six cases of isolated infraspinatus tear. Perioperative clinical characteristics, postoperative functional outcomes of 6 months were investigated. Functional evaluation included visual analogue scale (VAS), range of motions, American Shoulder and Elbow Surgeons (ASES) score, and Constant score. RESULTS: Calcific tendinitis was accompanied in 4 cases (66.7%). Three of them received steroid injection or aspiration or extracorporeal shockwave therapy. Mean preoperative pain VAS was 7.1 (range, 5–9), and mean postoperative pain VAS at 6 months later was 1.6 (range, 0–5). Preoperative muscle strength by isokinetic muscle performance test showed 52% deficit of abduction and 37.6% deficit of external rotation. All 6 patients had arthroscopic repair of the infraspinatus tendon. All the patients at the 6 months follow-up exhibited clinical improvement in the Constant score (67.8 [range, 45–77] to 89.3 [range, 81–100], p=0.029), and ASES score (52.3 [range, 30–77] to 90.0 [range, 80–100], p=0.002). There was no healing failure on imaging. CONCLUSIONS: Isolated infraspinatus tendon tear was frequently accompanied by calcific tendinitis, but pathophysiologic relationship should need more study. To rule out neurogenic etiology, magnetic resonance imaging and electromyography would be helpful. Arthroscopic infraspinatus tendon repair and supraspinatus debridement showed relatively good result in painful shoulder.
Debridement ; Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Muscle Strength ; Pain, Postoperative ; Retrospective Studies ; Rotator Cuff ; Rupture* ; Shoulder ; Surgeons ; Tears ; Tendinopathy ; Tendons

The authors investigated the radioallergosorbent test (RAST) for the specific IgE and the prick test with hose dust mite in 129 patients with atopic dermatitis(AD) wit4 four or more family numbers. RAST and prick test results were described according to family background of respiratory atopy(RA) and severity of AD. The results are summarized as follows : l. A comparison between the prick test results and RAST reactions gave a concordance of 88%. The prick test was more sensitive than the RAST. 2. The level of specific IgE in patients with personal history(PH) or family history(FH) of RA was significantly increased compared to those in patients with only AD. 3. In patients without PH and FH of RA, the level of specific IgE in patients with FH of AD was significantly increased compared to those in patients without FH of AD. 4. The level of specific IgE did not reflect the severity of AD. From the above results, it could be concluded that type I allergy to house dust mite is not directly related to AD and it occurs predominantly in those patients with AD wha have a predisposition to RA.
Dermatitis, Atopic* ; Dust* ; Humans ; Hydrogen-Ion Concentration ; Hypersensitivity* ; Immunoglobulin E ; Mites ; Pyroglyphidae* ; Radioallergosorbent Test

The corresponding author's name and E-mail address have been corrected. This article was corrected online. The authors would like to apologize for any inconvenience cause.

Limb salvage operation in primary malignant bone tumors is increasing recently, according to the improvement of diagnostic methods, surgical technique and adjuvant chemotherapy. The purpose of this study is to obtain the interim results of survival rate and the functional grade of the limb in primary malignant bone tumors treated by limb salvage operation. Between 1985 to 1993, 63 primary malignant bone tumors treated by limb salvage operations. Tumor prosthesis arthroplasty was performed in 49 patients, resection arthrodesis in 9 patients, and IM nailing with cement molding in 5 patients. Autoclave autograft was combined in 2 patients. Adjuvant chemotherapy and postoperative radiotherapy were performed in selected patients. The average follow-up period was 50 months(ranged 12 months to 116 months). In the cases of osteosarcoma, estimated survival rate was 61.9% based on Kaplan-Meier survival plot. In the parosteal sarcoma, the survival rate was 87.5% and 80% in chondrosarcoma patients. According to functional grading by Enneking, 66% was excellent, 20% was good, 11% was fair and one patients was poor. Complications occurred in 16 patients:wound infection was developed in 6 patients, local recurrence in 4, peroneal nerve palsy in 2 patients and femoral stem loosening in 2 patients. Fracture in resection arthrodesis and pulmonary metastasis were also occurred. Reoperation was performed in 10 patients at average 31 months after initial operation. Revision tumor persthesis arthroplasty was performed in one patient due to local recurrence and in 2 patients due to femoral stem loosening. Three amputations were done due to recurrence of tumor. IM nailing with cement molding was performed in one patient due to deep infection and repeated arthrodesis was done in a fracture patients. Scheduled custom-made tumor prosthesis arthroplasty was performed within a year in 2 patients treated with IM nailing with cement molding. In conclusion, with the careful preoperative assessment, adjuvant chemotherapy and skillful surgical technique, limb salvage operation would provide the primary malignant bone tumor patients for longer survival and better quality of life.
Amputation ; Arthrodesis ; Arthroplasty ; Autografts ; Chemotherapy, Adjuvant ; Chondrosarcoma ; Extremities ; Follow-Up Studies ; Fungi ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Osteosarcoma ; Paralysis ; Peroneal Nerve ; Prostheses and Implants ; Quality of Life ; Radiotherapy ; Recurrence ; Reoperation ; Sarcoma ; Survival Rate

It has been widely accepted that complete surgical resection of hepatoblastoma is essential for long-term survival. But unfortunately less that 50% of hepatic tumors in children can be totally removed at the time of diagnosis. This report is to present the experience of successful resection of hepatoblastoma after concurrent radiotherapy with transarterial chemoinfusion in a child. We believe this modality of treatment enables complete resection of unresectable hepatoblastoma, which is resistant to the systemic chemotherapy.
Child ; Diagnosis ; Drug Therapy ; Hepatoblastoma* ; Humans ; Radiotherapy*

Advances in multimodal treatment using radiation and chemotherapy, more sophicated diagnostic, radiologic methods, and newer reconstructive surgical techniques have led to aggressive surgical treatment of chondrosarcoma of the pelvis. Recently, good results have been reported in even high grade chondrosarcoma of the pelvis with surgery with/without adjuvant therapy. From January 1984 to June 1992, ten patients with chondrosarcoma of the pelvis were treated. Their average age was 40(18 to 55). Location of the lesion were ilium(5), periacetabular lesion(1), ischiopubic region(1) and sacrum(3). Nine cases were conventional type and one was dedifferentiated type. Surgical resection was done for nine patients, with which radical margin in one, wide margin in four, marginal margin in one and intralesional margin in three. Postoperative radiotherapy(6000-7000cGy during 6-7week) was done for five patients of having wide(1), marginal(1) or intralesional(3) surgical margin. One patient took radiotherapy only after biopsy. The average follow-up period was 2 years and 9 months(1 year to 6 years 1 month). Six patients wer continuously disease free(CDF) or disease free(DF). One patient is alive with disease(AWD). Three patients died of disease(DOD). With Kaplan-Meier's method, 5-year actuarial survival rate for total 10 cases was 60%, for operated group(9 cases) 66.7% and for operated conventional group(8 cases) 80%. With wider resection margin, better survival could be achieved.
Biopsy ; Chondrosarcoma ; Combined Modality Therapy ; Drug Therapy ; Follow-Up Studies ; Humans ; Methods ; Pelvis ; Radiotherapy ; Survival Rate

STUDY DESIGN: A retrospective analysis of 166 patients was undertaken to observe radiologically the changes of adjacent segments at follow-up more than three years after lumbar fusion. OBJECTIVES: The purpose of this study is to analyse the changes of adjacent segments and to correlate these changes to the length of using level and to the degree of deviation from physiologic lumbar lordosis. The authors also correlate these radiologic changes to the clinical symptoms. MATERIALS AND METHODS: In simple x-ray, authors observed traction spur, disc space narrowing, endplate sclerosis and vacuum phenomenon of adjacent segments. Authors used Gelb's criteria in segmental lordosis angle(SLA) and Katz's classification in clinical results. RESULTS: The average age was 49.6 years old and the average follow-up period was 57.2 months(4 years and 9.2 months). We observed radiologically the traction spurs in 35 cases(21.1%), end-plate sclerosis in 32 cases(19.3%), disc space narrowing in 33 cases(19.9%) and the vacuum phenomenon in 10 cases(6.0%). The numbers of fusion segments and the degree of unphysiologic segmental lordosis angle in fusion segments were related with the frequency and degree of changes of adjacent segments(P<0.05). The clinical results showed satisfaction in 142 cases(85.5%), unsatisfaction in 24 cases(14.5%) and low back pain in 24 cases(14.5%), leg pain in 11 cases(6.6%) and extension of fusion level in 4 cases(2.4%). In low back pain patients more than two kinds of radiological changes were frequently observed than the patients without low back pain(P<0.05). CONCLUSIONS: The radiological changes of adjacent segments were more frequently observed in long fusion and in fusion with unphysiologic lumbar lordosis angle. And these changes are frequently associated with low back pain. Thus long fusion and fusion with unphysiologic lumbar lordosis angle should be avoided if possible.
Animals ; Classification ; Follow-Up Studies* ; Humans ; Leg ; Lordosis ; Low Back Pain ; Retrospective Studies ; Sclerosis ; Spinal Fusion* ; Traction ; Vacuum

Arterial cannulation for constant monitoring of arterial pressure and blood gase analyses has become commonplace in the care of the critically ill patients. The radial artery is often regarded as causing a negligible complication risk because of extensive collateral arterial flow in the hand. One of other alternative sites for arterial cannulation is femoral artery. Femoral artery cannulation has a high degree of success in very small, critically ill children. It should be considered an acceptable alternative to small-vessel cannulation when the latter is not technically achievable, or in the unstable patient where rapid establishment of reliable artery access is necessary. Arterial cannulation may cause many complications: arterial catheters can directly injure the vessels, resulting in thrombosis, occlusion, distal embolization or ischemia. Local insertion site complications, such as hematoma, hemorrhage, and infection may occur. Arterial catheter may also be a source of systemic sepsis. We report an unusual case of unintentional release of a catheter fragment into the external iliac artery in a 7-month (7.8 kg) male patient with tetralogy of Fallot, which was inadvertently inserted during right femoral artery cannulation. The catheter fragment was successfully retrieved with the Amplatz Goose Neck microsnare under fluoroscopy without any problems.
Arterial Pressure ; Arteries ; Catheterization* ; Catheters* ; Child ; Critical Illness ; Femoral Artery* ; Fluoroscopy ; Hand ; Hematoma ; Hemorrhage ; Humans ; Iliac Artery* ; Ischemia ; Male ; Neck ; Radial Artery ; Sepsis ; Tetralogy of Fallot ; Thrombosis

The common bile duct and the duct of Wirsung cojoin at the level of the duodenum, forming the major. papilla of Vater. Existence of a double major papilla, i.e., two neighboring independent papillary structure:, is infrequent. In our endoscopy unit we have experienced one case of double papilla of Vater wherein canulation of the common bile duct and pancreatic duct could be accom plished through either orifice independently.
Common Bile Duct ; Duodenum ; Endoscopy ; Pancreatic Ducts

OBJECTIVES: To investigate the frequency and clinical characteristics of premenstrual syndrome(PMS)/premenstrual dysphoric disorder(PMDD) in high school students, and determine the correlates of PMS/PMDD in association with comorbid depression and anxiety. METHODS: A total of 1688 students were recruited from 5 high schools in Seoul, Korea. Subjects completed the questionnaire composed of scales to measure premenstrual symptoms, depression, and anxiety, as well as sociodemographic and reproductive variables. Subjects were categorized into 3 groups by using the Premenstrual Symptom Screening Tool(PSST) to determine the frequency and clinical characteristics of PMS/PMDD. Multivariate logistic regression was used to identify the correlates of PMS/PMDD. RESULTS: The frequency of moderate to severe PMS and PMDD was 20.1% and 6.4%, respectively. Irritability (78.8%), fatigue(76.4%), and emotional sensitivity(69.8%) were common premenstrual symptoms, and functional impairment in academic performance(67.1%) was dominant. Dysmenorrhea[odd ratio(OR)=3.68, 95% confidence interval(CI) 2.45-5.55], family history of PMS(OR=1.91, 95% CI 1.35-2.71), and use of oral contraceptive (OR=1.85, 95% CI 1.16-2.94) were associated with the increased risk of PMS/PMDD after adjustment for depression and anxiety. Negative attitude to menses(OR=15.60, 95% CI 3.61-67.42) was associated with the increased risk of PMS/PMDD, particularly in subjects without depression and anxiety. CONCLUSIONS: PMS was common, as the frequency of PMS more than moderate severity including PMDD exceeded 25%, and disrupted daily functioning in adolescents. PMS is associated with various sociodemographic and menstrual characteristics, and these associations are affected by comorbid depression and anxiety.
Adolescent ; Anxiety ; Depression ; Humans ; Korea ; Logistic Models ; Mass Screening ; Premenstrual Syndrome ; Questionnaires ; Weights and Measures