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

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

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

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*

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

It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes and girls. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probability of remaining at the same group was more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in he future to investigate the long-term change of lipids from adolescents to adults.
Adolescent* ; Adult ; Blood Pressure ; Cholesterol, HDL ; Cholesterol, LDL ; Fasting ; Female ; Follow-Up Studies ; Humans ; Korea ; Male ; Triglycerides

BACKGROUND: Insulin resistance is an integral feature of metabolic syndromes, including obesity, hyperglycemia, and hyperlipidemia. In this study, we evaluated whether the aloe component could reduce obesity-induced inflammation and the occurrence of metabolic disorders such as blood glucose and insulin resistance. METHODS: Male C57BL/6 obese mice fed a high-fat diet for 54 days received a supplement of aloe formula (PAG, ALS, Aloe QDM, and Aloe QDM complex) or pioglitazone (PGZ) and were compared with unsupplemented controls (high-fat diet; HFD) or mice fed a regular diet (RD). RT-PCR and western blot analysis were used to quantify the expression of obesity-induced inflammation. RESULTS: Aloe QDM lowered fasting blood glucose and plasma insulin compared with HFD. Obesity-induced inflammatory cytokine (IL-1beta, -6, -12, TNF-alpha) and chemokine (CX3CL1, CCL5) mRNA and protein were decreased markedly, as was macrophage infiltration and hepatic triglycerides by Aloe QDM. At the same time, Aloe QDM decreased the mRNA and protein of PPARgamma/LXRalpha and 11beta-HSD1 both in the liver and WAT. CONCLUSION: Dietary aloe formula reduces obesity-induced glucose tolerance not only by suppressing inflammatory responses but also by inducing anti-inflammatory cytokines in the WAT and liver, both of which are important peripheral tissues affecting insulin resistance. The effect of Aloe QDM complex in the WAT and liver are related to its dual action on PPARgamma and 11beta-HSD1 expression and its use as a nutritional intervention against T2D and obesity-related inflammation is suggested.
11-beta-Hydroxysteroid Dehydrogenase Type 1 ; Aloe ; Animals ; Blood Glucose ; Blotting, Western ; Cytokines ; Diabetes Mellitus, Type 2 ; Diet ; Diet, High-Fat ; Fasting ; Glucose ; Humans ; Hyperglycemia ; Hyperlipidemias ; Inflammation ; Insulin ; Insulin Resistance ; Liver ; Macrophages ; Male ; Mice ; Mice, Obese ; Obesity ; Plasma ; PPAR gamma ; RNA, Messenger ; Thiazolidinediones ; Triglycerides