BACKGROUND: This study investigated the efficacy and safety of combined subacromial and intravenous patient-controlled analgesia for control of postoperative pain after arthroscopic rotator cuff repair. METHODS: Between May 2012 and August 2014, 60 patients who underwent arthroscopic rotator cuff repair with acromioplasty and received patient-controlled analgesia were studied prospectively. Cases were divided into 2 groups: combined subacromial and intravenous infusion group (group A, 30 cases) and solitary intravenous infusion group (group B, 30 cases). The visual analogue scale was used to record the patient's level of pain every 12 hours during postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia. RESULTS: The mean preoperative visual analogue scale score was 7.8 in group A and 7.6 in group B, and the immediate postoperative visual analogue scale score was 7.9 and 8.1 for each group. At postoperative time (From 12 hours to 72 hours after operation), the scores of combined subacromial and intravenous infusion were significantly lower than those of solitary intravenous infusion. Significant difference in the frequency of supplemental analgesic injections was observed between group A and group B (p=0.008). However, no significant difference in complication rate was observed between the two groups (p=0.562). CONCLUSIONS: Combined subacromial and intravenous patient-controlled analgesia after arthroscopic rotator cuff repair is more effective than solitary intravenous infusion without significantly increasing complications. Therefore, combined subacromial and intravenous patient-controlled analgesia could be a effective pain control method.
Analgesia, Patient-Controlled* ; Humans ; Infusions, Intravenous ; Methods ; Pain, Postoperative ; Prospective Studies ; Rotator Cuff*

BACKGROUND: The aim of the present study was to determine the correlation between the amount of pain reduction after local anesthetic injection into the subacromial space preoperatively and clinical outcome after arthroscopic rotator cuff repair. METHODS: A total of 127 patients who underwent arthroscopic rotator cuff repair and followed up at least 1 year were analyzed retrospectively. Preoperatively, a visual analogue scale (VAS) for pain was measured in all patients before and after the ultrasound guided impingement test. The participants were divied into four groups according to pain reduntion ater impingement test (Group A: >75%, Group B: 50%–75%, Group C: 25%–50%, Group D: <25%). VAS for pain, shoulder range of motion, shoulder isometric strength, ASES score were evaluated preoperatively and at 3, 6, 9, and 12 months postoperatively. RESULTS: After surgery, the amount of pain reduction shows significantly at 3, 6 months in Groups A, B as compared to Groups C, D (p<0.05). Among the range of motion of shoulder joint, forward flexion was significantly improved in Group A at 3 months (p<0.05). The ASES score significantly improved at 3, 6 months in Groups A, B as compared to Group C, D (p<0.05). CONCLUSIONS: Preoperative degree of pain reduction after impingement test correlates with the improvement of pain after arthroscopic rotator cuff repair, especially in the early phase. Therefore, the impingement test could be effectively used.
Humans ; Range of Motion, Articular ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Shoulder Joint ; Shoulder Pain ; Ultrasonography

PURPOSE: Using magnetic resonance imaging (MRI) as the standard of reference, the purpose of this study was to evaluate the accuracy of sonoelastography (SE) for assessment of fatty degeneration of suprasupinatus (SSP). MATERIALS AND METHODS: A retrospective analysis was conducted in 131 shoulders of 126 consecutive patients who underwent shoulder MRI, and SE. Oblique sagittal images of SSP were obtained using SE; the SE images were evaluated by two orthopedic surgeons using a 256 degree color map image. RESULTS: When the supraspinatus fatty degenerations were based on MRI findings, the sensitivity of SE was 89.47%, specificity 92.85%, and accuracy 91.60%. The interobserver reliability of the SE findings was 'almost perfect agreement' with a weighted kappa coefficient of 0.81. By comparison of MRI with the SE findings, the grades of MRI and SE showed positive correlation (r=0.85, p< or =0.001). In addition, the occupation ratio and blue region area ratio also showed positive correlation (r=0.69, p< or =0.001). CONCLUSION: SE is valuable in quantitative assessment of the severity of fatty atrophy of the supraspinatus and has excellent accuracy, excellent correlation with MRI and conventional ultrasonography, and excellent interobserver reliability.
Atrophy ; Elasticity Imaging Techniques* ; Humans ; Magnetic Resonance Imaging ; Occupations ; Orthopedics ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder ; Ultrasonography

Glomus tumor is a kind of hemangioma that occurs at the glomerulus in the subcutaneous layer. It mainly occurs at the distal hand and subungual area, and rarely at the knee joint. Pain, tenderness, and cold intolerance are known symptoms; however, symptoms in practice are not so easily detectable, and the diagnosis can be delayed if it is presented at areas other than the hand. If the diagnosis is delayed, patients could suffer extreme pain. Therefore, early diagnosis and surgical treatment are important. Ultrasound and magnetic resonance imaging were used to diagnose glomus tumor in our cases, which were found in subcutaneous tissue and muscle fascia. We claim that, for patients with persistent pain, known symptoms—extreme pain, cold intolerance, and tenderness—should be examined carefully and rule out glomus tumor. We report 2 cases of glomus tumors around the knee joint, which is not a common location of occurrence.
Biopsy ; Diagnosis ; Early Diagnosis ; Fascia ; Glomus Tumor* ; Hand ; Hemangioma ; Humans ; Knee Joint ; Knee* ; Magnetic Resonance Imaging ; Subcutaneous Tissue ; Ultrasonography

BACKGROUND: Bisphosphonates are generally known to adversely affect fracture healing because they inhibit osteoclastic bone resorption. However, some authors argue that bisphosphonates have no adverse effect on the restoration of the mechanical integrity of long bones after fractures. It is unclear whether bisphosphonates can be initiated safely in patients with acute proximal humerus fractures. The aim of this study was to determine whether the early use of a bisphosphonate affects healing and outcomes of osteoporotic proximal humerus fractures treated with a locking compression plate. METHODS: Between August 2004 and June 2013, a total of 82 osteoporotic patients who underwent locking plate fixation of proximal humerus fractures were enrolled retrospectively. The patients were divided into two groups according to the timing of the commencement of treatment with alendronate after surgery: group A (n = 34, initiation of the bisphosphonate treatment within two weeks after surgery) and group B (n = 48, control group, initiation of the treatment three months after surgery). Patients were assessed for radiographic union at 2, 6, 10, and 16 weeks, 6 months, and 1 year after surgery. Clinical assessments were performed using the Constant score and American Shoulder and Elbow Surgeons (ASES) score at 1 year after surgery. RESULTS: No significant differences were observed between the two groups with respect to radiographic and clinical outcomes after locking plate fixation. All patients obtained fracture union, and the mean time to radiographic union was similar in group A and group B (6.3 and 6.6 weeks, respectively; p = 0.67). CONCLUSIONS: This study shows that the early initiation of bisphosphonate treatment does not affect bone union or clinical outcomes in patients with an osteoporotic proximal humerus fracture treated by locking compression plate fixation.
Alendronate ; Bone Resorption ; Diphosphonates ; Elbow ; Fracture Healing* ; Humans ; Humerus* ; Osteoclasts ; Osteoporosis ; Retrospective Studies ; Shoulder ; Shoulder Fractures ; Surgeons

Osseointegration is a result of bone formation and bone regeneration processes, which takes place at the interface between bone and implant, and it indicates a rigid fixation that can be stably maintained while functional loading is applied inside the oral cavity as well as after implant placement. Although many researches were carried out about osseointegration mechanism, but cellular and molecular events have not been clarified. With recent development of molecular biology, some researches have examined biological determinants, such as cytokine, growth factors, bone matrix proteins, during osseointegration between bone and implant surface, other researches attempted to study the ways to increase bone formation by adhering protein to implant surface or by inserting growth factors during implant placement. Cellular research on the reaction of osteoblast especially to surface morphology (e.g. increased roughness) has been carried out and found that the surface roughness of titanium implant affects the growth of osteoblast, cytokine formation and mineralization. While molecular biological research in dental implant is burgeoning. Yet, its results are insignificant . We have been studying the roles of growth factors during osseointegration, comparing different manifestations of growth factors by studying the effect of osseointegration that varied by implant surface. Of many growth factors, TGF-beta, IGF-I, BMP2, and BMP4, which plays a significant role in bone formation, were selected, and examined if these growth factors are manifested during osseointegration. The purpose of this article is to present result of our researches and encourage molecular researches in dental implant.
Bone Matrix ; Bone Regeneration ; Dental Implants ; Hypogonadism ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Mitochondrial Diseases ; Molecular Biology ; Mouth ; Ophthalmoplegia ; Osseointegration ; Osteoblasts ; Osteogenesis ; Proteins ; Titanium ; Transforming Growth Factor beta

PURPOSE: Although allogeneic blood transfusion is the most common method of transfusion in total knee arthroplasty (TKA), there are reports showing significant decrease in the amount of allogeneic transfusion and incidence of side effects after combined use of autologous transfusion. The purpose of this study is to investigate the efficacy of using an autologous transfusion device in TKA. MATERIALS AND METHODS: Patients who underwent TKA at our institution from January 2003 to January 2014 were divided into two groups: group A (n=127) who received allogeneic transfusion only in TKA and group B (n=118) who received autologous transfusion via an autologous transfusion device and allogeneic transfusion. In both groups, the patients were transfused when the hemoglobin level was below 9 g/dL. In group B, blood collected by the autologous transfusion device was transfused only once after surgery. The total blood loss volume, total transfusion volume, and the presence of side effects were assessed based on medical records. RESULTS: Group A received 294.6 mL more allogeneic transfusion than group B (p<0.001). There were no significant differences with regard to the development of side effects between groups. CONCLUSIONS: Application of an autologous transfusion device during TKA can be effective in reducing the allogeneic transfusion volume. Moreover, allogeneic transfusion was not necessary after autologous transfusion in some patients.
Arthroplasty ; Blood Transfusion ; Humans ; Incidence ; Knee ; Medical Records ; Osteoarthritis

BACKGROUND: This study investigated the efficacy and safety of combined subacromial and intravenous patient-controlled analgesia for control of postoperative pain after arthroscopic rotator cuff repair. METHODS: Between May 2012 and August 2014, 60 patients who underwent arthroscopic rotator cuff repair with acromioplasty and received patient-controlled analgesia were studied prospectively. Cases were divided into 2 groups: combined subacromial and intravenous infusion group (group A, 30 cases) and solitary intravenous infusion group (group B, 30 cases). The visual analogue scale was used to record the patient's level of pain every 12 hours during postoperative 72 hours and the following 48 hours after the suspension of patient-controlled analgesia. RESULTS: The mean preoperative visual analogue scale score was 7.8 in group A and 7.6 in group B, and the immediate postoperative visual analogue scale score was 7.9 and 8.1 for each group. At postoperative time (From 12 hours to 72 hours after operation), the scores of combined subacromial and intravenous infusion were significantly lower than those of solitary intravenous infusion. Significant difference in the frequency of supplemental analgesic injections was observed between group A and group B (p=0.008). However, no significant difference in complication rate was observed between the two groups (p=0.562). CONCLUSIONS: Combined subacromial and intravenous patient-controlled analgesia after arthroscopic rotator cuff repair is more effective than solitary intravenous infusion without significantly increasing complications. Therefore, combined subacromial and intravenous patient-controlled analgesia could be a effective pain control method.
Analgesia, Patient-Controlled ; Humans ; Infusions, Intravenous ; Methods ; Pain, Postoperative ; Prospective Studies ; Rotator Cuff

BACKGROUND: The aim of the present study was to determine the correlation between the amount of pain reduction after local anesthetic injection into the subacromial space preoperatively and clinical outcome after arthroscopic rotator cuff repair. METHODS: A total of 127 patients who underwent arthroscopic rotator cuff repair and followed up at least 1 year were analyzed retrospectively. Preoperatively, a visual analogue scale (VAS) for pain was measured in all patients before and after the ultrasound guided impingement test. The participants were divied into four groups according to pain reduntion ater impingement test (Group A: >75%, Group B: 50%–75%, Group C: 25%–50%, Group D: <25%). VAS for pain, shoulder range of motion, shoulder isometric strength, ASES score were evaluated preoperatively and at 3, 6, 9, and 12 months postoperatively. RESULTS: After surgery, the amount of pain reduction shows significantly at 3, 6 months in Groups A, B as compared to Groups C, D (p<0.05). Among the range of motion of shoulder joint, forward flexion was significantly improved in Group A at 3 months (p<0.05). The ASES score significantly improved at 3, 6 months in Groups A, B as compared to Group C, D (p<0.05). CONCLUSIONS: Preoperative degree of pain reduction after impingement test correlates with the improvement of pain after arthroscopic rotator cuff repair, especially in the early phase. Therefore, the impingement test could be effectively used.
Humans ; Range of Motion, Articular ; Retrospective Studies ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Shoulder Pain ; Ultrasonography

OBJECTIVE: A defense mechanism is an automatic psychological process necessary for successful adaptation. It reflects adaptive capacity. The purpose of this study is to explore the relationship between the adaptation ability of individuals who face mandatory military service and the pattern of defense mechanisms. METHODS: The subjects were 69 men (21.4±2.2 years) who expressed psychological difficulties in three military service situations. Control group was 36 men (24.0±1.4 years) who had successfully completed military service. We examined psychiatric history, the pattern of defense mechanisms, and depression and anxiety levels. Defense mechanisms were compared between two groups. RESULTS: The maladjusted group used immature defenses more frequently than the control group did. There were no differences in the defense patterns according to diagnosis. The control group used more identification and rationalization, classified as immature defenses. The temporarily maladjusted group used more somatization, regression, and avoidance. CONCLUSION: Using mature defense mechanisms helped young adults to adapt to a particular situation. The maturity of the defense is more valuable than the psychiatric diagnosis. Some immature defenses are also helpful to adapt. We cautiously assume that some defenses can be protective or risk factors in adapting to stressful situations by young adults.
Anxiety ; Defense Mechanisms ; Depression ; Diagnosis ; Humans ; Korea ; Male ; Mental Disorders ; Military Personnel ; Rationalization ; Risk Factors ; Social Adjustment ; Young Adult