No abstract available.
Anemia, Hypoplastic, Congenital*

Purpose: This study aims to verify the preoperative factor that can affect the footprint coverage during arthroscopic rotator cuff repair in full-thickness medium-size cuff tear and the change of footprint coverage on magnetic resonance imaging (MRI) at postoperative 6 months. Methods: A total of 30 medium-size full-thickness rotator cuff tears were analyzed. They were classified into complete footprint coverage group (CC, n=19) and incomplete footprint coverage group (IC, n=11) by arthroscopic findings and immediate postoperative MRI findings. MRI was performed before the operation, 1 day after the operation, and 6 months after the operation. Preoperative MRI evaluated the size of the anteroposterior tear width (cm), length of retraction (cm), fatty infiltration, and muscle atrophy. Postoperatively, footprint coverage, fatty degeneration, and muscle atrophy were evaluated. We compared healing and change of fatty degeneration between two groups. Results: The healing rate was significantly increased in the CC group (complete/partial healing, 10/9) compared to the IC group (complete/partial healing, 6/5) (p＜ 0.001). Six of 11 partial coverages (54.5%) were even improved to complete coverage at postoperative 6-month follow-up. However, the difference in footprint coverage did not affect the change of fatty degeneration at postoperative 6 months. Any change of fatty degeneration (FD) and initial FD of rotator cuff tendons were not correlated with healing (p＜ 0.05). Conclusion The footprint coverage can be changed in postoperative 6 months in MRI and anteroposterior tear size, retraction, fat degeneration, and muscle atrophy do not affect footprint coverage in medium-sized full-thickness rotator cuff tears.

PURPOSE: To investigate the various imaging factors associated with aggravation of lumbar disc herniation (LDH) and develop a scoring system for prediction of LDH aggravation. MATERIALS AND METHODS: From 2015 to 2017, we retrospectively reviewed the magnetic resonance imaging (MRI) findings of 60 patients (30 patients with aggravated LDH and 30 patients without any altered LDH). Imaging factors for MRI evaluation included the level of LDH, disc degeneration, back muscle atrophy, facet joint degeneration, ligamentum flavum thickness and interspinous ligament degeneration. Flexion-extension difference was measured with simple radiography. The scoring system was analyzed using receiver operating characteristic (ROC) analysis. RESULTS: The aggravated group manifested a higher grade of disc degeneration, back muscle atrophy and facet degeneration than the control group. The ligamentum flavum thickness in the aggravated group was thicker than in the group with unaltered LDH. The summation score was defined as the sum of the grade of disc degeneration, back muscle atrophy and facet joint degeneration. The area under the ROC curve showing the threshold value of the summation score for prediction of aggravation of LDH was 0.832 and the threshold value corresponded to 6.5. CONCLUSION: Disc degeneration, facet degeneration, back muscle atrophy and ligamentum flavum thickness are important factors in predicting aggravation of LDH and may facilitate the determination of treatment strategy in patients with LDH. The summation score is available as supplemental data.
Atrophy ; Back Muscles ; Humans ; Intervertebral Disc Degeneration ; Ligaments ; Ligamentum Flavum ; Magnetic Resonance Imaging ; Radiography ; Retrospective Studies ; ROC Curve ; Zygapophyseal Joint

BACKGROUND: Selective serotonin reuptake inhibitor (SSRI) is believed to accelerate wound healing, and thus expected to have a positive effect on rotator cuff repair. We hypothesized that SSRI has a positive effect on the healing of the bonetendon interface (BTI), and improved rotator cuff tear healing would be confirmed by mechanical strength measurements and histological assessment of the restored tendon. METHODS: The study used 40 adult male Sprague–Dawley wild-type rats. The animals were divided into two groups:group-SSRI, the supraspinatus repair with SSRI injection group, and group-C, conventional supraspinatus repair only without SSRI. Biomechanical and histological analyses were performed 8 weeks after index rotator cuff surgery. RESULTS: The ultimate load (N) was significantly higher in group-SSRI than in group-C (54.8 ± 56.9 Vs 25.1 ± 11.1, p = .031). In the histological evaluation, the Bonar score confirmed significant differences in collagen fiber density (groupC: 0.6 ± 0.5, group-SSRI: 1.1 ± 0.6, p = .024), vascularity (group-C: 0.1 ± 0.2, group-SSRI: 0.3 ± 0.4, p = .024) and cellularity (group-C: 1.7 ± 0.4, group-SSRI: 2.0 ± 0.0, p = .023) between the groups. Based on the total score, groupSSRI was significantly better compared with group-C (6.3 ± 2.7 Vs 4.3 ± 1.9, p = .019). CONCLUSION Our study demonstrated that SSRI could facilitate improved biomechanical and histological outcomes 8 weeks after rotator cuff repair in a rat model. Consequently, SSRI may improve healing after rotator cuff repair.

The percutaneous transhepatic biliary drainage (PTBD) is an effective intervention as a palliative therapy for relieving a jaundice and cholangitis. It may be used in place of Endoscopic retrograde cholangiopancreatography (ERCP) in the obstructive biliary disease. Recently, by developing invasive procedures, the incidence of the complications such as bleeding and perforation has been increasing in the diagnosis and treatment of hepatobiliary disease. We report here on a case of remained drawstring after PTBD in a 85-year-old man. The patient was conducted PTBD for relieving a jaundice and cholangitis. And then the patient had complained of abdominal pain constantly. A few days later, we removed PTBD and attempted ERCP for removal of CBD stone. The ERCP showed remained drawstring around ampulla of vater and we removed it by IT knife. The drawstring was successfully removed.
Abdominal Pain ; Aged, 80 and over ; Ampulla of Vater ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Diagnosis ; Drainage* ; Hemorrhage ; Humans ; Incidence ; Jaundice ; Palliative Care

OBJECTIVES: One object of this study is to provide a descriptive level of quality of lift(QOL)in a group of the first admitted schizophrenic patients through interviews being performed after two or five years of follow-up, and comparing them with patients in psychotic disorders other than schizophrenia. Another object is to identify clinical variables on the first admission which correlate to QOL factors, after two or five years of follow up. METHODS: A total of 73 subjects of the first admitted patients with schizophrenia(n=57) and psychotic disorders other than schizophrenia(other psychotic disorders group, n=16) were selected. A Quality of Life Scale(QLS) measuring 21 items of life variables was used. Demographic and psychiatric data were obtained through medical records and psychiatric RESULTS: Schizophrenia group(n=57) showed moderate decrease(mean 3.7 of 6) in all aspect of Quality of life. However, the schizophrenia group displayed a relatively high score in relations with household members(mean=5.2) only among 21 QOL items. Comparison to other psychotic disorders group(n=16), schizophrenia group showed a significant decrease in almost all aspects of QOL. We significant difference was obtained between the 2 year(n=27) and the 5 year(n=30) group. Duration of the first admission showed a significant correlation with current quality of life in the schizophrenic group. CONCLUSIONS: The significantly decreased score of quality of lit: suggests the need for careful observation and therapeutic concern for the early stage of schizophrenia. The schizophrenic group's relatively high score in relations with household members in this period may provide the importance of rehabilitation to improve their quality of life. Duration of the first admission may be a useful predictor of their subsequent quality of life.
Family Characteristics ; Follow-Up Studies* ; Humans ; Medical Records ; Psychotic Disorders ; Quality of Life* ; Rehabilitation ; Retrospective Studies* ; Schizophrenia

BACKGROUND: The role and future of family physician are not yet clearly determined even when 20 years lapsed since its introduction to Korea. This study was conducted to establish identity of family physician, to develop pragmatic curriculum of training, and to sort out frame of certification exam by analysing the job of family physicians who were practicing in community. METHODS: We analysed the job of practicing family physician by using DACUM(Development of Curriculum) method from March 11, 2000 through March 12. Job analysis team was composed of five practitioners, four professors, one facilitator, and one scriber. Six sessions of 2 hours were mainly devoted to brain storming of the idea related to family physician. RESULTS: Job analysis results are as follows. Family physician was defined as "primary care physician who provides primary medical service continuously and comprehensively by offering individual patient and/or family health promotion, disease prevention, and treatment of common illness". Family physician had seven duties and 129 tasks. The duty of physical exam had 18 tasks, duty of test, 21 tasks, duty of treatment, 40 tasks, duty of health promotion and disease prevention, 15 tasks, duty of patient/client management, 12 tasks, duty of clinic management, 15 tasks, and self development, 8 tasks respectively. Number of tasks whose impotance was classified as `A'(very important) were 43 as total, 3 in physical exam, 7 in test, 9 in treatment, 11 in health promotion and disease prevention, 2 in patient/client management, 9 in clinic management, and 2 in self development respectively. Number of tasks whose difficulty was classified as `A'(very difficult) were 19 as total, 2 in physical exam, 7 in test, 7 in treatment, 1 in clinic management, and 2 in self development respectively. Number of tasks whose frequency was classified as `A'(very frequent) were 22 as total, 6 in physical exam, 1 in test, 8 in treatment, 3 in health promotion and disease prevention, 3 in patient/client management, and 1 in clinic management respectively. Number of tasks which were required for entry level were 74 as total, 18 in physical exam, 14 in test, 29 in treatment, 9 in health promotion and disease prevention, 3 in patient/client management, and 1 in clinic management respectively. CONCLUSION: Family physicians in Korea perform 7 duties and 129 tasks. Seventy four tasks are required to enter into the job.
Brain ; Certification ; Curriculum ; Family Health ; Health Promotion ; Humans ; Job Description ; Korea* ; Physicians, Family*

No abstract available.
Aged ; Cysticercosis/*diagnosis/radiography ; Humans ; Immunocompetence ; Incidental Findings ; Male ; Neurocysticercosis/diagnosis/radiography

PURPOSE: The present study investigates the seasonal variations of acute angle-closure glaucoma in patients visiting the hospital. METHODS: Eighty-seven patients (94 eyes) who underwent laser iridotomy were retrospectively analyzed over 5 years. Monthly and seasonal variations were investigated and the difference in seasonal variations according to sex, age, and inhabited area were inspected. RESULTS: When evaluating monthly variations, acute angle-closure glaucoma occurred mostly in January (13.8%). Incidence of glaucoma was the highest in winter (29.9%), decreased in spring and summer (26.4%) and was lowest in autumn (17.2%). In big cities, the incidence trend was highest in spring (31.8%), lowest in autumn (19.7%) and slightly elevated in winter (27.3%). However, in small cities and rural areas, the incidence was highest in summer (42.9%) and winter (38.1%). There were significant differences between inhabited areas. CONCLUSIONS: Among the patients, seasonal incidence of acute angle-closure glaucoma was the highest in winter and decreased as autumn approached. There were differences of incidence between inhabited areas.
Glaucoma ; Glaucoma, Angle-Closure ; Humans ; Incidence ; Retrospective Studies ; Seasons

PURPOSE: Penile fracture is a relatively rare condition that is defined as a traumatic rupture of the tunica albuginea followed by subsequent subcutaneous hematoma of various degrees. The aim of this study was to evaluate the clinical presentations and outcomes of the treatment according to causes of penile fractures. MATERIALS AND METHODS: Between March 1998 and December 2002, ten patients aged 19 to 65 years underwent immediate surgical repair on the first or second day after fracture of the penis at our hospital. All patients came to the hospital 20 minutes to 34 hours after the injury. A complete history of the patient was taken and a thorough examination was performed including physical examination and cavernosography. RESULTS: All patients had taken cavernosography. Three of the patients showed hematuria(microscopic or gross) and were taken retrograde urethrography. All patients were surgically treated. Nine patients showed unilateral corporal ruptures. Two patients had urethral injuries; one had a total urethral rupture and the other had a corporal spongiosal partial tearing. Regardless of the causes of penile fractures, the lesions on the penile mid-shaft were the most common. Of the direction of lesions the transverse tearings of tunica albuginea at 6 to 8 o'clock position were the most common. At follow-up, all patients who were available reported erections adequate for intercourse without erectile or voiding dysfunction. CONCLUSIONS: All patients were treated successfully by immediate surgical repair regardless of the causes of the penile fractures, which is recommended for penile fracture.
Follow-Up Studies ; Hematoma ; Humans ; Male ; Penis ; Physical Examination ; Rupture