Surgical repair has been widely accepted for full thickness tear of the rotator cuff. In traditional method, hony trough on the greater tuberosity of the humerus has heen used for tendon to hone suture. Recently, there have been some suggestions that hony trough would not he essential for repairing the rotator cuff. Purpose of this study was to investigate the clinical result of rotator cuff repair without bony trough. We evaIuated the clinical results of 23 operative repairs of the full-thickness tear of the rotator cuff, using modified ASES scoring system, at an average of l4 months postoperatively. For these cases, all the tendon to hone sutures were done without makin bony trough. There were 3 cases of small tear. 14 case of medium tear, 1 case of large tear and 5 cases of massive tear. Mini-open repairs with arthroscopic acromioplaslies were used for 9 cases with small or medium sized tear. Open acromioplasties and repairs were done for 14 cases. Nine cases were rated excellent (39%), and twelve cases showed good results (52%). Two cases showed fair results (9%). Averagc increase of score was 40 (ranee, 18 to 78). There were no complications or deteriorations of function. No patient needed additional surgery. Repair without hony trough is more simple and easier than the traditional method making bony trough. There would he possibility of less tension to the tendons and preserving more natural course of tendons. The authors believe that this method provides larger contact surface between the tendon and hone. The repairing method without hony trough is considered to he a safe and efficient method for the full thickness tear of the rotator cuff. This technique can he useful not only for ordinary open repair, but also for mini-open repair.
Humans ; Humerus ; Rotator Cuff* ; Shoulder ; Sutures ; Tendons

The functional knee hrace has been used to provide or to assist knee stahility in the anterior cruciate ligament (ACL) deficient knee, Nowadays, it is more indicated in the postoperative care of ACL injury to protect the reconstructed or repaired ligament, but eontroversies still exist regarding the effectiveness and the selection of an appropriate model. For successful application, it must restrict the knee motion within the range of certain arc, especially hyperextension, during weight bearing together with convenience and comfort.. The six commercial functional knee braces, which were introduced in Korea, were ehecked to detect the angle discrepancy between angle of brace and knee joint motion. The purpose of this study was to guide correct application of the functional knee brace in preventing hyperextension of the knee joint. Each brace was grouped into small, medium and large by size, and fixed with the arc of motion 30 to 90. The brace was applied to 3 healthy volunteers whose size was just fit mth the brace size small, rnedium and large, respectively. True lateral X-ray of the knee joint was taken in active flexion and extension state under the fluoroscopic control and measured the lateral intershaft angle of femur and tibia. Average angle discrepancy between the brace and the intershaft ang]e of femur and tibia in active extension was 22 and 3 in acTive flexion. In active extension at 30, angle discrepancy of Denzo brace was the large:st recording 26, that of Sentry hrace was the smallest recording 17. In active flexion at 90', angle discrcyancy of Sentry hrace was the largest recording 13, that of ACL brace (custom made modified Sentry brace) was the smallest recording 2. There was no statistically significant difference of the angle discrepancy among each size of brace. This study suggests that, at least 20 of angle discrepancy must be considered in appling the knee brace for prevention of hyperextension of the knee joint and careful selection of the brace, which may be affected by the design of hrace and the soft tissue compliance, is mandatory.
Anterior Cruciate Ligament ; Braces* ; Compliance ; Femur ; Healthy Volunteers ; Knee Joint ; Knee* ; Korea ; Ligaments ; Postoperative Care ; Tibia ; Weight-Bearing

Anti-Müllerian hormone (AMH), a peptide growth factor of the transforming growth factor-β family, is a reliable marker of ovarian reserve. Regarding assisted reproductive technology, AMH has been efficiently used as a marker to predict ovarian response to stimulation. The clinical use of AMH has recently been extended and emphasized. The uses of AMH as a predictive marker of menopause onset, diagnostic tool for polycystic ovary syndrome, and assessment of ovarian function before and after gynecologic surgeries or gonadotoxic agents such as chemotherapy have been investigated. Serum AMH levels can also be affected by environmental and genetic factors; thus, the effects of factors that may alter AMH test results should be considered. This review summarizes the findings of recent studies focusing on the clinical application of AMH and factors that influence the AMH level and opinions on the use of the AMH level to assess the probability of conception before reproductive life planning as a “fertility test.”
Drug Therapy ; Female ; Fertility ; Fertilization ; Gynecologic Surgical Procedures ; Humans ; Menopause ; Ovarian Reserve ; Polycystic Ovary Syndrome ; Reproductive Techniques, Assisted

Objectives: The purposes of this study were to (1) examine the multi-year prevalence of highly caffeinated beverage (HCB) consumption, (2) identify sex differences in the prevalence, and (3) investigate relationships between HCB consumption and behavioral characteristics in a nationally representative sample of Korean adolescents. Methods: Data from the Korea Youth Risk Behavior Web-based Survey (2014–2017) were analyzed. Results: HCB consumption was higher in 2017 than 2014 (23.9% vs. 12.0%), and higher among boys than girls (17.2% vs. 13.1%). HCB drinkers were more likely to (1) be boys, (2) be overweight or obese, (3) use alcohol and tobacco, (4) consume soda at least once per week, (5) consume sweetened beverages at least once per week, (6) have seriously considered suicide during the past 12 months, and (7) have attempted suicide during the past 12 months (p<0.05 for all). Conclusion Effective programs to curb HCB consumption among Korean adolescents need to be established.

Mycoplasma pneumoniae is responsible for approximately 20% to 30% of community-acquired pneumonia, and is well known for its diverse extrapulmonary manifestations. However, acute necrotizing pancreatits is an extremely rare extrapulmonary manifestation of M. pneumoniae infection. A 6-year-old girl was admitted due to abdominal pain, vomiting, fever, and confused mentality. Acute necrotizing pancreatitis was diagnosed according to symptoms, laboratory test results, and abdominal computed tomography scans. M. pneumoniae infection was diagnosed by a 4-fold increase in antibodies to M. pneumoniae between acute and convalescent sera by particle agglutination antibody assay. No other etiologic factors or pathogens were detected. Despite the occurrence of a large infected pseudocyst during the course, the patient was able to discharge without morbidity by early aggressive supportive care. This is the first case in Korea of a child with acute necrotizing pancreatitis associated with M. pneumoniae infection.
Abdominal Pain ; Agglutination ; Antibodies ; Child* ; Female ; Fever ; Humans ; Korea ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pancreatitis ; Pancreatitis, Acute Necrotizing* ; Pneumonia ; Pneumonia, Mycoplasma* ; Vomiting

Herein, two cases of penile Mondor's disease are described. The first was a 45-year-old man who complained of a small subcutaneous induration, with localized discomfort at the distal rim of the coronal sulcus of the penis. The other was a 46-year-old man who complained of similar symptoms of penile induration. The lesions were surgically removed under local anesthesia, and found to be thromboses of the penile superficial dorsal vein. As a result, the diagnoses of Mondor's disease of the penis were confirmed.
Anesthesia, Local ; Diagnosis ; Humans ; Male ; Middle Aged ; Penile Diseases ; Penile Induration ; Penis* ; Thrombophlebitis* ; Thrombosis ; Veins*

The musculoskeletal system can be involved as an extra-intestinal manifestation of inflammatory bowel disease. Among these, myositis in ulcerative colitis (UC) is very rare. A 14-year-old girl was admitted due to severe shoulder tenderness. She had complained of left jaw pain and swelling for the past 10 days. Inflammatory markers were elevated with no evidence of infectious etiology. Myositis was suspected by shoulder magnetic resonance imaging. Three days after admission, she developed hematochezia. Muscle biopsy and colonoscopy was performed due to worsening left mandibular area pain and persistent hematochezia. Colonoscopy showed consistent findings with UC. She was finally diagnosed with UC with myositis as an extra-intestinal manifestation. She showed a dramatic response to UC treatment. Gastrointestinal symptoms were well-controlled. After 14 months, UC symptoms and muscle pain were aggravated, which were relieved after steroid and cyclosporin treatment. We report a unique case of UC initially presented with myositis, preceding gastrointestinal symptoms.

Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disorder presenting with sterile osteomyelitis, most often presenting in childhood. Although the etiology is understood incompletely, its association with other auto-inflammatory diseases including inflammatory bowel disease (IBD); psoriasis; Wegener’s disease; arthritis; and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome suggests that dysregulated innate immunity may play an important role in the pathogenesis. We report a case of a 13-year-old boy with CRMO associated with Crohn’s disease (CD) successfully treated with infliximab after failure of non-steroidal anti-inflammatory drug (NSAID) treatment. He initially was diagnosed with CRMO based on symmetric and aseptic bone lesions with no fever, lack of response to antibiotic treatment, vertebral involvement, and normal blood cell counts. Despite five months of NSAID treatment, his musculoskeletal symptoms were aggravated, and he developed gastrointestinal symptoms. Finally, he was diagnosed with CRMO associated with CD. Due to the severity of symptoms, infliximab was initiated and produced symptom improvement. This case supports infliximab as another choice for treatment of bowel symptoms in addition to the bone and joint symptoms of CRMO when other first-line treatments are ineffective.

PURPOSE: Norovirus infection, a common cause of community-acquired gastroenteritis, can also lead to severe illness in immunocompromised patients. We investigated clinical manifestations of norovirus infection in pediatric cancer patients. METHODS: Stool specimens were collected from pediatric patients with gastrointestinal symptoms between November 2008 and September 2009 at Samsung Medical Center, Seoul, Korea. Norovirus infection was identified by reverse-transcription polymerase chain reaction (RT-PCR). A retrospective chart review was performed in pediatric cancer patients who were diagnosed with norovirus infection. RESULTS: Ten patients were diagnosed with norovirus infection by RT-PCR in stool samples. The median age was 0.83 years (range 0.25-5.5 years) and the male to female ratio was 1.5:1 (6 males and 4 females). Underlying diseases were hematologic malignancies (4/10, 40%), neuroblastoma (4/10, 40%), and brain tumors (2/10, 20%). Three patients were infected before hematopoietic cell transplantation (HCT) and four patients after HCT. All patients had diarrhea (10/10, 100%), with a median frequency of diarrhea of 8.5 times/day (range 4-22 times/day). Median virus shedding duration was 72.5 days (range 19-299 days). Four patients with pneumatosis intestinalis were conservatively treated with bowel rest and total parenteral nutrition. One patient with severe diarrhea and bloody stool had concomitant chronic gut graft-versus-host disease (GVHD). Norovirus infection-related mortality was not observed. CONCLUSION: Norovirus infection can cause significant clinical manifestations with prolonged viral shedding in immunocom-promised patients. Norovirus should be considered in pediatric cancer patients with severe gastrointestinal symptoms.
Brain Neoplasms ; Cell Transplantation ; Child ; Diarrhea ; Female ; Gastroenteritis ; Graft vs Host Disease ; Hematologic Neoplasms ; Humans ; Immunocompromised Host ; Korea ; Male ; Neuroblastoma ; Norovirus ; Parenteral Nutrition, Total ; Polymerase Chain Reaction ; Retrospective Studies ; Transplants ; Virus Shedding

PURPOSE: Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals. METHODS: A 4-year-old child without Bacille Calmette-Guérin vaccination was diagnosed as having culture-proven disseminated TB. The child initially presented with symptoms of inflammatory bowel disease, and nosocomial and kindergarten exposures were reported. The exposed individuals to the index case were divided into 3 groups, namely household, nosocomial, or kindergarten contacts. Evaluation was performed following the Korean guidelines for TB. Kindergarten contacts were further divided into close or casual contacts. Chest radiography and tuberculin skin test or interferon-gamma-releasing assay were performed for the contacts. RESULTS: We examined 327 individuals (3 household, 10 nosocomial, and 314 kindergarten contacts), of whom 18 (5.5%), the brother of the index patient, and 17 kindergarten children were diagnosed as having latent TB infection (LTBI). LTBI diagnosis was more frequent in the children who had close kindergarten contact with the index case (17.1% vs. 4.4%, P=0.007). None of the cases had active TB. CONCLUSION: This is the first reported case of TB transmission among young children from a pediatric patient with disseminated TB in Korea. TB should be emphasized as a possible cause of chronic diarrhea and failure to thrive in children. A national TB control policy has been actively applied to identify Korean children with LTBI.
Child* ; Child, Preschool ; Diagnosis ; Diarrhea ; Failure to Thrive ; Family Characteristics ; Humans ; Inflammatory Bowel Diseases* ; Korea ; Mortality ; Radiography ; Siblings ; Skin Tests ; Thorax ; Tuberculin ; Tuberculosis* ; Vaccination