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.

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

PURPOSE: To compare the thickness of the lamina cribrosa (LC) and vascular factors of early normal-tension glaucoma (NTG) patients with high and low intraocular pressure (IOP) that are expected to be associated with the development of glaucoma. METHODS: Seventy-one Korean NTG patients with low IOP (the highest IOP <15 mmHg, 40 patients) and high IOP (the lowest IOP >15 mmHg, 31 patients) were included in this study. The thickness of LC and vascular factors were compared. The thickness of the LC was measured using the enhanced depth imaging method with spectral domain optical coherence tomography (Heidelberg Spectralis). RESULTS: The mean thickness of the central LC was 190.0 +/- 19.2 microm in the low IOP group and 197.8 +/- 23.6 microm in the high IOP group, but there was no statistical significant difference between the two groups (p > 0.05). The prevalence of self-reported Raynaud phenomenon was significantly higher in the low IOP group (33.0%) than the high IOP group (10.3%, p = 0.04). CONCLUSIONS: The laminar thickness did not significantly differ between the high and low IOP groups. However, the prevalence of Raynaud phenomenon was higher in the low IOP groups. These results suggest that the development of glaucoma with low IOP patients may be more influenced by peripheral vasospasm, such as Raynaud phenomenon, rather than laminar thickness in NTG.
Aged ; Cross-Sectional Studies ; Female ; Humans ; *Intraocular Pressure ; Low Tension Glaucoma/*diagnosis ; Male ; Middle Aged ; Nerve Fibers/pathology ; Optic Disk/*pathology ; Optic Nerve Diseases/*diagnosis ; Raynaud Disease/*diagnosis ; Retinal Ganglion Cells/pathology ; Tomography, Optical Coherence ; Tonometry, Ocular ; Vision Disorders/diagnosis ; Visual Fields

Solid pseudopapillary tumor (SPT) of the pancreas is a rare tumor that typically affects young women without causing significant clinical symptoms. No case of SPT in an old man has been reported in South Korea, and such cases are very rare worldwide. We report a 70-year-old man with SPT of the pancreas with multiple organ metastasis. Although surgical resection is the treatment of choice for SPT, we decided not to treat, considering his age and the disease severity.
Aged ; Diagnosis ; Female ; Humans ; Korea* ; Neoplasm Metastasis ; Pancreas*

BACKGOUND: It has been suggested that humoral immune mechanisms might play a role in the pathogenesis of a subset of patients with Stevens-Johnson syndrome (SJS). Circulating antibodies (Abs) against desmoplakin I and II (dp I/II) were detected in a subset of patients with SJS, which could impair the function of desmosome-keratinfilament complexes resulting in suprabasal acantholysis as a humoral autoimmune phenomenon. OBJECTIVE: The purpose of this study was to detect the presence of circulating autoantibodies against dp I/II in the sera of patients with toxic epidermal necrolysis (TEN), as well as SJS. METHOD: In this study, the sera of ten patients with TEN and SJS were investigated. Immunoblot analyses of extracts of EDTA-separated normal human epidermis were performed. We also performed an indirect immunofluorescence (IIF) test using normal human skin, mouse tongue, esophagus, and rat bladder. In addition, we performed direct IF studies using three perilesional tissues obtained from one patient of SJS and two patients of TEN. RESULTS: By immunoblotting using human epidermal extract, 215-kD and 250-kD proteins were detected in the sera of six out of ten patients with TEN and SJS. IIF using normal human foreskin demonstrated dense IgG deposits in the intercellular spaces and cytoplasmic membrane of epidermal cells in all sera of patients with SJS and TEN. In the direct IF test, IgG and IgA deposits appeared in an intercellular staining of epidermis of perilesional skin from two out of three patients with TEN and SJS. CONCLUSION: These findings suggest that circulating Abs against dp I/II and constitutive desmosomal plaque proteins might play a role in the pathogenesis of SJS and TEN.
Acantholysis ; Animals ; Antibodies ; Autoantibodies* ; Cell Membrane ; Desmoplakins* ; Epidermis ; Esophagus ; Extracellular Space ; Fluorescent Antibody Technique, Indirect ; Foreskin ; Humans ; Immunoblotting ; Immunoglobulin A ; Immunoglobulin G ; Mice ; Rats ; Skin ; Stevens-Johnson Syndrome* ; Tongue ; Urinary Bladder

OBJECTIVE: The purpose of this study is to investigate the incidence of new compression and to analyze factors that influence the fractures in adjacent levels after percutaneous vertebroplasty (PVP). METHODS: This retrospective study examined 206 patients who had undergone PVP for single level osteoporotic or osteopenic compression fractures during the last seven years in our department. After PVP, the patients were observed for at least over one year, and 29 patients showed new additional compression fractures in adjacent levels. One hundred seventy seven patients who did not show additional compression fractures were analyzed as the control group. Statistical comparisons were performed between the groups, in terms of age, gender, bone mineral density, whether bisphosphonate (BPP) was treated, preoperative kyphosis, preoperative wedge angle, change in wedge angle, amount of bone cement, existence of intradiscal bone cement leakage, and initial fracture levels. RESULTS: The statistically significant factors that influence new compression fractures in adjacent levels after PVP were as follows: being female, initial thoracolumbar junction fracture, preoperative large kyphotic, preoperative large wedge angle, change in wedge angle, administration of BPP in osteopenia group, and intradiscal cement leakage. CONCLUSION: This study identified many factors that influence newly developed compression fractures in adjacent levels after PVP. Interestingly, the administration of BPP in osteopenia group had positive influence on new fractures in this study. Therefore, we recommend early administration of BPP to patients with osteopenia.
Aged* ; Bone Density ; Bone Diseases, Metabolic ; Diphosphonates ; Female ; Fractures, Compression* ; Humans ; Incidence ; Kyphosis ; Retrospective Studies ; Risk Factors* ; Spinal Fractures ; Vertebroplasty*