No abstract available.
Risk Factors*

BACKGROUND: The purpose of this study was to evaluate the efficacy of suction drain use following arthroscopic rotator cuff repair by comparing early pain score and range of motion (ROM) between groups with and without suction drains. METHODS: The study included 153 patients with rotator cuff tears who underwent arthroscopic repairs at our clinic from April 2014 to March 2015. Following surgery, a suction drain was used in 85 patients (group D) and not used in 68 patients (group ND). There was no statistical difference between the groups in terms of age, gender, or total operation time. The clinical outcome with regard to pain (assessed by pain scores and analgesic requests) and passive ROM was assessed preoperatively and postoperatively. RESULTS: Immediate postoperative analgesic requirement was significantly higher in group D (p=0.001), although there was no difference in pain outcomes between the groups during the 3-month follow-up period. A statistically significant difference in passive ROM was observed at the postoperative 2- and 6-week follow-ups (p=0.036, 0.035, and 0.034 in forward elevation (FE), external rotation at the side (ER) and 90 ER at weeks 2, respectively; 0.045 and 0.009 in FE and ER at weeks 6, respectively); however no significant difference was observed at the end of 3 months. During the study period, no complication was reported in either group. CONCLUSIONS: Use of suction drains after arthroscopic rotator cuff repair provided little benefit in terms of ROM or pain in the early postoperative period (up to 3 months).
Arthroscopy ; Follow-Up Studies ; Humans ; Postoperative Period ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder ; Suction* ; Tears

Total laminectomy for the removal of intradural-extramedullary spinal cord tumors has been used widely, but postoperative complications often develop, such as kyphosis, spinal instability, and persistent back pain. In this study, we evaluated seven patients with intradural-extramedullary spinal cord tumors with respect to the value of unilateral limited laminectomy. Our cases included six schwannomas, and one meningioma. The cervical region was involved in four cases, the thoracolumbar region in two cases, and the lumbar region in one case. The rationale for choosing a unilateral approach is to preserve musculoligamentous attachments and posterior bony elements as much as possible. The patients were mobilized on the third postoperative day and preoperative neurological symptoms were recovered within a few weeks. We did not observe any complication relating to unilateral limited laminectomy and at follow-up evaluation (at 3 and 12 months postoperatively), none of the patients showed spinal deformity or spinal instability. We think that the unilateral limited laminectomy is a safe and efficient technique for the treatment of intradural-extramedullary spinal cord tumors. We suggest that this technique is one of the best treatments for these tumors.
Back Pain ; Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Laminectomy ; Lumbosacral Region ; Meningioma ; Neurilemmoma ; Postoperative Complications ; Spinal Cord ; Spinal Cord Neoplasms

OBJECTIVE: The incidence of aneurysmal subarachnoid hemorrhage has been increasing. At the same time, surgical results for elderly patients are unsatisfactory and no guidelines of treatment are available. We carried out a study comparing variable factors and surgical results between young and old age groups to find ways to improve prognosis. METHODS: A retrospective study was carried out on 754 patients who were operated on between 1990 and 2004 by the same surgeon in our hospital. The patients were divided into seven groups according to age: 93 patients below 40 years of age (Group I), 419 patients aged 40~59 (Group II), 115 patients aged 60~64 (Group III), 82 patients aged 65~69 (Group IV), 28 patients aged 70~74 (Group V), 12 patients aged 75~79 (Group VI) and 5 patients over the age of 80 (Group VII). We then checked their medical history, Fisher's grade, Hunt-Hess grade, postoperative complications, and Glasgow Outcome Scale. RESULTS: Age was not a statistically significant factor among patients below 70 years of age (P value> or =0.05). But for those aged 70 and older, the age factor had a statistical value (P value< or =0.001). In addition, there was a close correlation between Hunt-Hess grade IV and V patients, and those with vasospasm, and hydrocephalus after surgery, with poor prognosis in elderly patients as well as young patients (P value< or =0.001). CONCLUSION: Advanced age (under the age of 70) dose not precluded adequate surgical treatment in patient with AN SAH, and we should be also alert to preventable causes of delayed neurological deterioration for improving the outcome in all elderly groups.
Age Factors ; Aged* ; Aneurysm* ; Glasgow Outcome Scale ; Humans ; Hydrocephalus ; Incidence ; Operative Time ; Postoperative Complications ; Prognosis* ; Retrospective Studies ; Subarachnoid Hemorrhage

Cerebral cysticercosis presents a quite variable clinical picture in its manifestation and course. This clinical polymorphism produces principal difficulties in its diagnosis and in planning therapeutic strategies as well as in evaluating therapeutic results. The author reviewed his experience with 52 cases of cerebral cysticercosis, surgically treated from 1977 to 1987 in Department of Neurosurgery, Seoul National University Hospital. The age of patients at time of diagnosis varied between 7 and 66 years(mean 43.4 years), with 75% from the fourth to the seventh decade. There was a 1.6:1 male to female ratio. The two most common residency of the patients, next to the Seoul area, were Cheju Provience(21%) and Chollanam Province(15%). The chief symptoms and signs were those of increased ICP(94%), focal neurological deficits(69%), seizure(40%), mental change(33%) and meningismus(21%). We classified 52 cases into the following groups based on the location of lesion in the brain CT scans:a) Parenchymatous(34%), b) Intraventricular(25%), c) Meningocisternal(18%), and d) Mixed type(33%). ELISA was highly reliable in making the diagnosis, this test, however, should not be regarded as a quantitative clue to evaluate the degree of curability. In cases no improvenent was achived clinically after praziquantel therapy and/or surgical treatment disappeared cysts in follow-up brain CT, a further diagnostic work-up to search for a intraventricular or mixed type is recommended. In 2 cases with a single, superficially located parenchymatous cyst, one burr hole trephination followed by aspiration using a brain needle was proved to be very effective. Surgical treatment in combination with a praziquantel therapy produced a marked improvement in 47 cases(90.4%) out of 52 cases. In the mixed type, the surgical outcome was unfavorable compared with other types.
Brain ; Cysticercosis* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Female ; Follow-Up Studies ; Humans ; Internship and Residency ; Jeju-do ; Male ; Needles ; Neurosurgery ; Praziquantel ; Seoul ; Trephining

No abstract available.
Female ; Fibromatosis, Aggressive ; Mammaplasty ; Silicones

Keratoacanthoma is a rapidly growing cutaneous tumor with a histopathologic pattern often suggestive of a squamous cell carcinoma (SCC). It may be viewed as an aborted malignancy which only rarely progresses into an aggressive SCC. It is most likely arising from hair follicle that has the tendency of spontaneous resolution. The diagnosis of keratoacanthoma is based on clinical, histopathologic features and biologic behavior. A 75-year-old woman presented with a 1-month history of a rapidly enlarging exophytic tumor on the lower lip. A biopsy was performed leading to a diagnosis of keratoacanthoma. We report a case of keratoacanthoma on the lower lip, because the mucosal area is an unexpected location.
Aged ; Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Female ; Hair Follicle ; Humans ; Keratoacanthoma* ; Lip*

BACKGROUND: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. METHODS: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. RESULTS: The risk of acute kidney injury was about ×3 higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. CONCLUSION: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.
Acute Kidney Injury ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump* ; Creatinine ; Emergencies ; Glomerular Filtration Rate ; Hemodynamics ; Humans ; Kidney ; Perioperative Care ; Renal Insufficiency ; Renal Insufficiency, Chronic* ; Renal Replacement Therapy ; Transplants*

Hypertrophic lupus erythematosus is a clinical variant of chronic cutaneous lupus erythematosus (CCLE). It is critical to differentiate hypertrophic lupus erythematosus from CCLE because of treatment and prognosis. We report a case of hypertrophic lupus erythematosus with CCLE occured on arms. Combination therapy with acitretin and intralesional corticosteroid injection resulted in control of previously refractory skin lesion.
Acitretin ; Arm ; Lupus Erythematosus, Cutaneous ; Prognosis ; Skin

Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder that is characterized by aggressive arterial and aortic disease, often involving the formation of aortic aneurysms. We describe the cases of two children with LDS who were diagnosed with aortic root aneurysms and successfully treated by valve-sparing aortic root replacement (VSRR) with a Valsalva graft. VSRR is a safe and suitable operation for children that avoids prosthetic valve replacement.
Aneurysm ; Aorta ; Aortic Aneurysm ; Aortic Diseases ; Child* ; Connective Tissue ; Humans ; Loeys-Dietz Syndrome* ; Transplants