BACKGROUND: Management of massive rotator cuff tears can be challenging because of the less satisfactory results and a higher retear rate regardless of the use of open or arthroscopic repair technique. METHODS: We retrospectively analyzed 102 cases of massive rotator cuff tear treated with either open or arthroscopic repair. Open repair was performed in 38 patients; and arthroscopic repair, in 64 patients. The mean age at the time of surgery was 59.7 years in the open group and 57.6 years in the arthroscopic group. RESULTS: The Constant score increased from the preoperative mean of 55.9 to 73.2 at the last follow-up in the open repair group and from 53.8 to 67.6 in the arthroscopic repair group (p<0.001 and <0.001, respectively). The University of California at Los Angeles (UCLA) score increased from a preoperative mean of 17.7 to 30.8 at the last follow-up in the open group and from 17.5 to 28.7 in the arthroscopic group (p<0.001 and <0.001, respectively). No statistically significant difference in the Constant and UCLA scores was observed between the two groups at the last follow-up (p=0.128 and 0.087, respectively). Retear was found in 14 patients (36.8%) in the open group and 39 patients (60.9%) in the arthroscopic group (p=0.024). CONCLUSIONS: Open and arthroscopic repairs of massive rotator cuff tears may provide satisfactory clinical results with no significant difference. However, a significantly lower retear rate was observed for the open repair group compared with the arthroscopic repair group.
Arthroscopy ; California ; Follow-Up Studies ; Humans ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Tears* ; Tendon Injuries

With the increasing number of air bag-equipped vehicles, there has been a corresponding increase in the incidence of air bag-associated ocular trauma. We encountered a 38 years old man who sustained corneal damage, hyphema, angle recession, medial wall fracture, and visual damage by choroidal rupture of macula due to an inflated air bag in motor vehicle accident and brief review of related literature is presented.
Adult ; Air Bags* ; Choroid ; Humans ; Hyphema ; Incidence ; Motor Vehicles ; Rupture

STATEMENT OF PROBLEM: Temporary soft relining materials are used in a diverse clinical situations such as tissue conditioner, relining material, functional impression by varying its viscoelasticity. However, reproduction of consistent viscoelasticity has been not possible. MATERIALS AND METHODS: Considering setting mechanism of this material, this study has measured the effect of varying amount of void in dynamic viscoelasticity of soft relining material, with three different mixing methods. In each methods 10 specimens were made and subjected to dynamic viscoelastic test which were measured at specific times over period of 72 hours. RESULTS: The analysis of the result shown that there was no statistically significant differences between different mixing methods. CONCLUSION: Different mixing methods had no effect over control of viscoelasticity of soft lining material. Further research is recommended for under similar oral environmental condition.
Reproduction

BACKGROUND: Smoking prevention and anti-smoking education in schools must be designed and planned according to age and sex as well as the type of schools and their smoking status. But the current education programs do not consider these factors. This study, therefore, aims to evaluate the actual status of the smoking prevention and anti-smoking education in Korea and to find present recommendations for an effective and, systematic education. METHODS: We surveyed 15,310 teen-age students attending middle schools and high schools in such cities as Seoul, Incheon, Bucheon, Mokpo, and Pohang and smaller areas in the vicinity of these cities from June 1 to 15, 2005. Self-survey was done by the health education teacher of each school. It contained questions about the general disposition of respondents, their smoking habits, and awareness programs on prevention and cessation of smoking. We used SPSS 12.0 for chi-square-test to analyze the collected data. RESULTS: The most prevailing form of anti-smoking education was "video". Most of the students surveyed said that the fourth or fifth grade of elementary school will be a good starting point for anti-smoking education. Only 39.6% of students who were educated by the current smoking prevention and anti-smoking program answered that it was "helpful" and 29.6% was "satisfied". Higher percentage of middle school students said that they either tried to quit smoking ('pre-contemplation') or had no intention of doing it ('termination-fail') after having been involved in the anti-smoking education program, while high school students turned out to be more oriented towards 'contemplation' and 'termination-success'. CONCLUSION: Some students were found to begin smoking even at an early grade in elementary school. Most adolescents knew about the danger of smoking, but current smokers had a low educational satisfaction. The real target of such education programs, however, should be focused on higher grade students in elementary schools and middle school students, because data show that smoking rate increases explosively among these students.
Adolescent ; Surveys and Questionnaires ; Education* ; Gyeonggi-do ; Gyeongsangbuk-do ; Health Education ; Humans ; Incheon ; Intention ; Jeollanam-do ; Korea ; Seoul ; Smoke* ; Smoking Cessation ; Smoking*

Carotid-cavernous fistulaes are traumatic in origin in over two thirds of all cases. Occlusion of these lesions by endovascular techniques or open surgical approaches is usually indicated. The current treatment of choice is occlusion by use of the intraarterial detachable balloon technique. Pseudoaneurysm, one of the complications after employment of the detachable balloon technique, develop at the balloon placement site after balloon deflation. Its incidence is approximately 44% in the literature. But peudoaneurysms are difficult to treat using endovascular techniques with detachable balloon or coils. The authors report that one case with a pseudoaneurysm who had abducens nerve palsy was treated successfully using Guglielmi detachable coils(GDC). His 6th cranial nerve palsy was improved within 6 weeks.
Abducens Nerve Diseases ; Aneurysm, False* ; Cranial Nerve Diseases ; Employment ; Endovascular Procedures ; Fistula ; Incidence

Acute necrotizing esophagitis (AEN), also called "black esophagus," is a rare disorder with an unknown pathogenesis. Endoscopic findings generally show black pigmentation throughout the esophagus. This case also offered rare views of the gross anatomy of this disorder. Histological examination revealed that the mucosal and submucosal layers of the esophagus were involved in the severe necrotizing inflammation. The chief manifestation of this disease is hematemesis from hemorrhage of the upper gastrointestinal tract with a typically multifactorial etiology. AEN is also characterized by a clear boundary at the gastroesophageal junction where the necrosis stops. In this study, we report an autopsy case of a 61-year-old man with necrotizing inflammation throughout the esophagus and esophageal necrosis from the laryngopharynx to the gastroesophageal junction. The patient was a disabled person with a history of alcohol abuse who was also diagnosed with mild coronary arteriosclerosis and fatty liver on the basis of the underlying diseases. In this case, the main etiology for poor perfusion from the distal esophageal area was likely underlying illness, history of alcoholism, and malnutrition.
Alcoholism ; Autopsy* ; Coronary Artery Disease ; Disabled Persons ; Esophagitis* ; Esophagogastric Junction ; Esophagus ; Fatty Liver ; Hematemesis ; Hemorrhage ; Humans ; Hypopharynx ; Inflammation ; Malnutrition ; Middle Aged ; Necrosis ; Perfusion ; Pigmentation ; Upper Gastrointestinal Tract

To evaluate outcomes of arthroscopic meniscal repair using fibrin clot for horizontal tears in young adults, we investigated clinical and morphological results after the meniscal repairs were performed. Between August 1995 and August 1997, we treated five patients with horizontal tears of the meniscus, of which the meniscal tears were not accompanied any concomitant intra-articular lesions or meniscal degeneration. We assessed outcomes using Lysholm score, magnetic resonance imaging(MRI) and second-look arthroscopy. In all 5 cases, MRI showed the following results 1 complete healing, 1 incomplete healing, and 3 with no healing. Two patients underwent second-look arthroscopy, one complained of persistent pain for two years after surgery, showing meniscal tears on the MRI and received partial meniscectomy, while the other showed complete healing using second-look arthroscopy after 3 months postoperative recuperation and MRI 68 months after surgery. According to Lysholm score, two cases were assessed with less than 70 points. For the horizontal meniscal tears in young adults, arthroscopic meniscal repair using fibrin clot produced satisfactory clinical results however, it exhibited morphologically poor results.
Arthroscopy ; Fibrin* ; Humans ; Magnetic Resonance Imaging ; Young Adult*

This study was performed to establish an experimental model of ischemia for the investigation of new treatment modality of limb-threatening ischemia. We produced ischemia in the hindlimbs of 8 New Zealand white rabbits. Under general anesthesia, the left femoral artery was exposed, freed, and excised from distal external iliac artery to proximal popliteal and saphenous arteries. And then both hindlimbs were serially examined to assess the ischemia according to the time table until postoperative 6 weeks. We assessed clinical observation, blood pressure, radioisotopic perfusion scan, and angiography. Clinical ischemic changes of the operated feet were observed in 63%. The blood pressure of left calves was measurable on postoperative day 3 (p<0.05, vs preoperative day 2) and then gradually increased to reach a plateau in postoperative week 6. Radioisotopic arterial perfusion showed similar profiles as in blood pressure. Angiography of ischemic hindlimbs demonstrated a few collateral vessels arising from the internal iliac artery with the reconstitution of the posterior tibial artery in postoperative week 2. In postoperative week 6, collaterals remained the same in number. However, these became dilated and tortuous and showed reconstitution in distal hindleg. In conclusion, this is a reproducible, measurable, and economical animal model of hind limb ischemia.
Angiography ; Animal ; Blood Pressure ; *Disease Models, Animal ; Hindlimb/*blood supply ; Ischemia/*physiopathology/radiography ; Male ; Rabbits

Radiation-induced lower cranial neuropathy shows a clinical presentation similar to tumor recurrence or amyotrophic lateral sclerosis. We experienced two patients with bulbar palsies several years after radiotherapy for nasopharyngeal cancer. Brain magnetic resonance imaging showed no evidence of tumor recurrence. Electrophysiologic studies demonstrated mild denervation changes and myokymic discharges in muscles innervated by cranial nerves. Bulbar palsies progressed for 1 year then became stable. We emphasize the importance of myokymic discharges in the differential diagnosis of radiation-induced cranial neuropathy as radiation plexopathies.
Amyotrophic Lateral Sclerosis ; Brain ; Bulbar Palsy, Progressive ; Cranial Nerve Diseases ; Cranial Nerves ; Denervation ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; Muscles ; Myokymia ; Nasopharyngeal Neoplasms ; Recurrence

BACKGROUND: Source material used to fill calvarial defects includes autologous bones and synthetic alternatives. While autologous bone is preferable to synthetic material, autologous reconstruction is not always feasible due to defect size, unacceptable donor-site morbidity, and other issues. Today, advanced three-dimensional (3D) printing techniques allow for fabrication of titanium implants customized to the exact need of individual patients with calvarial defects. In this report, we present three cases of calvarial reconstructions using 3D-printed porous titanium implants. METHODS: From 2013 through 2014, three calvarial defects were repaired using custommade 3D porous titanium implants. The defects were due either to traumatic subdural hematoma or to meningioma and were located in parieto-occipital, fronto-temporo-parietal, and parieto-temporal areas. The implants were prepared using individual 3D computed tomography (CT) data, Mimics software, and an electron beam melting machine. For each patient, several designs of the implant were evaluated against 3D-printed skull models. All three cases had a custom-made 3D porous titanium implant laid on the defect and rigid fixation was done with 8 mm screws. RESULTS: The custom-made 3D implants fit each patient's skull defect precisely without any dead space. The operative site healed without any specific complications. Postoperative CTs revealed the implants to be in correct position. CONCLUSION: An autologous graft is not a feasible option in the reconstruction of large calvarial defects. Ideally, synthetic materials for calvarial reconstruction should be easily applicable, durable, and strong. In these aspects, a 3D titanium implant can be an optimal source material in calvarial reconstruction.
Freezing ; Hematoma, Subdural ; Humans ; Meningioma ; Skull* ; Titanium* ; Transplants