The arthroscopic rotator cuff repair is now considered a mainstream technique with highly satisfactory clinical results. However, concerns remain regarding healing failures for large and massive tears and high revision rate. In recent decades, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. The focus of biomechanical test in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. Recent studies have shown that a transosseous tunnel technique provides improved contact area and pressure between rotator cuff tendon and insertion footprint, and the technique of using double rows of suture anchors to recreate the native footprint attachment has been recently described. The transosseous equivalent suture bridge technique has the highest contact pressure and fixation force. In this review, the biomechanical tests about repair techniques of rotator cuff tear will be reviewed and discussed.
Rehabilitation ; Rotator Cuff* ; Suture Anchors ; Sutures ; Tears* ; Tendons

Purpose: This study analyzed the changes in the number of surgeries and surgical patterns due to the adoption and diffusion of new medical technology while focusing on radical prostatectomy. Materials and Methods: Medical equipment status report data and the National Health Insurance claims data from 2007 to 2019 were used. A total of 62798 radical prostatectomies from 135 medical facilities were analyzed. Radical prostatectomy was classified into open radical prostatectomy (ORP), laparoscopic radical prostatectomy (LRP), and robot-assisted laparoscopic radical prostatectomy (RARP) using the fee schedule codes. A linear mixed model was used to determine whether the adoption of a robotic surgical system had an effect on the number of surgeries and surgical patterns after adjusting for medical characteristics. Results: The number of radical prostatectomies performed in Korea increased from 1756 in 2007 to 8475 in 2019. During this period, the proportion of RARP in total surgery increased from 17.5% to 74.3%. The mean number of surgeries at medical facilities adopting the robotic surgical system was 128.3, which was higher compared to 18.5 cases in medical facilities that did not adopt it. The adoption of a robotic surgical system increased the number of radical prostatectomy surgeries by 12.1 cases and the RARP share by 47.2% in a linear mixed model.  Conclusion The adoption and diffusion of robotic surgical systems in Korea increased the number of surgeries as well as the share of robotic surgery. It is necessary to manage a technology that is widely used in a state where its clinical effectiveness is uncertain.

No abstract available.
Aortic Rupture*

Authors experienced a 59-year-old male patient with the lymphoma of the small iritestine which involved the adjoining mesenteric lymph nodes, the parietaI pleura, and the skin. The skin lesions, simulating necrotizing angiitis, were deep purple colored, asymptomatic, tense, hemorrhagic bullae with soft consistency on the both thighs and left infraorbital area. He had extranodal type, and diffuse, poorly differentiated lymphocytic lymphoma by the Rappaport classification, and stage IV by the Ann Arbor staging classification. After about 50 days of clinical manifestations, he was died mainly due to massive intestinal bleeding.
Classification ; Hemorrhage ; Humans ; Intestine, Small* ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymph Nodes ; Lymphoma* ; Male ; Middle Aged ; Pleura ; Skin ; Thigh ; Transcutaneous Electric Nerve Stimulation ; Vasculitis

Toxic epidermal necrolysis(T.E.N.) is a toxic erythema of the skin that undergoes epidermal necrolysis and peding so that it appears to have been scalded. There seem to be two basic form of T.E.N. In children, the deavage of the epidermis that results from an acantholytic-dyskeratotic cytolytic process is in the malpighian or granular layer and is usually induced by a staphylococci toxin. In adult, it is characterized by a full-thicknees cytolytic cleavage of skin above the basal layer and is usually precipitated by a drug. The authors observed a 17 year-old male with T.E.N. He began to notify the erythematous skin lesion with burning sensation on the whole body surface at 12 hours after oral administration of some drugs for common cold and developed the characteristic flaccid bullous and denuded lesions with tenderness within next 20 hours.
Administration, Oral ; Adolescent ; Adult ; Burns ; Child ; Common Cold ; Epidermis ; Erythema ; Humans ; Male ; Sensation ; Skin

This study was conducted to set up a common mechanism for varying phases of focal segmental glomerulosclerosis(FSGS) by comparing the morphological differences between human FSGS and changes in 5/6 renal ablation animal model, which has been accepted as experimental prototype for hyperfiltration theory as pathogenesis of FSGS. Both the human and the experimental rats showed very similar changes such as segmental glomerulosclerosis, vacuole formations or inclusion of small granules of podocytes, appearance of foamy cells in the capillary lumina, eosinophilic deposits along the mesangial area, and focal atrophy of tubules with associated interstitial fibrosis. The halo, frequently seen in human FSGS, is due to detachment of visceral epithelium from basement membrane, however, did not appear in the experimental rat specimen. On the other hand, the foamy cells and hyalinization were more frequently noted in the rat series and even involved the arterioles. The mesangial proliferation never appeared in the rat series occasionally found in human FSGS. In conclusion, the pathogenesis of FSGS cannot depend solely on the hyperfiltration theory of hemodynamic derangement, but has complex impairment of visceral epithelium and cells forming the constituents of basement membrane.
Animals ; Arterioles ; Atrophy ; Basement Membrane ; Biopsy ; Capillaries ; Eosinophils ; Epithelium ; Fibrosis ; Hand ; Hemodynamics ; Humans* ; Hyalin ; Models, Animal* ; Nephrectomy* ; Podocytes ; Rats* ; Vacuoles

This study was conducted to set up a common mechanism for varying phases of focal segmental glomerulosclerosis(FSGS) by comparing the morphological differences between human FSGS and changes in 5/6 renal ablation animal model, which has been accepted as experimental prototype for hyperfiltration theory as pathogenesis of FSGS. Both the human and the experimental rats showed very similar changes such as segmental glomerulosclerosis, vacuole formations or inclusion of small granules of podocytes, appearance of foamy cells in the capillary lumina, eosinophilic deposits along the mesangial area, and focal atrophy of tubules with associated interstitial fibrosis. The halo, frequently seen in human FSGS, is due to detachment of visceral epithelium from basement membrane, however, did not appear in the experimental rat specimen. On the other hand, the foamy cells and hyalinization were more frequently noted in the rat series and even involved the arterioles. The mesangial proliferation never appeared in the rat series occasionally found in human FSGS. In conclusion, the pathogenesis of FSGS cannot depend solely on the hyperfiltration theory of hemodynamic derangement, but has complex impairment of visceral epithelium and cells forming the constituents of basement membrane.
Animals ; Arterioles ; Atrophy ; Basement Membrane ; Biopsy ; Capillaries ; Eosinophils ; Epithelium ; Fibrosis ; Hand ; Hemodynamics ; Humans* ; Hyalin ; Models, Animal* ; Nephrectomy* ; Podocytes ; Rats* ; Vacuoles

The p53 gene is believed to play an important role through the mutation and overexpression in the progression of various human malignant tumors. The type IV collagenase (matrix metalloproteinase: MMP-2) initiates the degradation of the extracellular matrix, and consequently may play a role in the tumor invasion and metastasis. To investigate the correlation between clinicopathologic features of the colorectal adenocarcinomas and benign tumors and expression of p53 and MMP-2 proteins, we performed an immunohistochemical study on 40 colorectal adenocarcinomas, 20 adenomas and 20 hyperplastic polyps by using the antibodies to p53 and MMP-2 proteins. The positive expression rate of the p53 protein in adenocarcinomas was 62.5% and significantly higher than in benign tumors. The positive expression rate of the MMP-2 protein was 47.5% in adenocarcinomas, but there was no expression of MMP-2 protein in benign tumors. The difference in p53 and MMP-2 expression rates between malignant and non-malignant tumors was statistically significant. The positive expression rate of p53 protein in the non-metastatic and metastatic adenocarcinomas was 59.1 and 66.7%, respectively. The positive expression rate of MMP-2 protein in the non-metastatic and metastatic adencarcinomas was 45.5 and 50.0%, respectively. The correlation between several clinicopathologic features and expression of p53 and MMP-2 protein was not statistically significant, but the rate of positive MMP-2 immunoreactivity showed a statistically significant difference between Astler-Coller stage B1 C1 group and B2 C2 group of adenocarcinoma (p=0.0431). We concluded that the expression of p53 and MMP-2 protein contributes to the cancer development and MMP-2 may play a certain role in the invasiveness of the colorectal tumor. p53 and MMP-2 protein expression is not correlated with lymph node metastasis.
Adenocarcinoma* ; Adenoma ; Antibodies ; Collagenases ; Colorectal Neoplasms ; Extracellular Matrix ; Genes, p53 ; Humans ; Lymph Nodes ; Matrix Metalloproteinase 2* ; Neoplasm Metastasis ; Polyps

The clinical study on recurrent dislocation of the shoulder was performed on fourteen cases who were treated by Putti-Platt operation from July 1967 to November 1968. The cases studied were treated at the 17th Army Hospital in Kwang-ju and U.S. 121st Evacuation Hospital in Bu-pyung. Ages in initial dislocation were varied from 11 to 25 with an average of 18 years. Five cases of them were recurred over ten times prior to operation. On radiological findings, Hill-Sachs lesion has been revelaed in 57.1%. On pathological finding, Bankart lesion was seen in 78.5% and detachment of the glenoid labrum with capsular separation in 28.6%. No recurrence has been encountered in this s ries, and average rarige of abduction was gained upto 165 and external rotation 30°.
Clinical Study ; Dislocations ; Gwangju ; Hospitals, Military ; Recurrence ; Shoulder

Hypokalemic familial periodic paralysis is one of the rare familial disease characterized by recurrent and transient attacks of weakness or paralysis of the somatic musculature. Also, this disease is usually inherited as an autosomal dominant trait in most cases. During an attack, the plasma potassium falls as a rasults of shift of potassium from the extracellular to the intracelluar compartment, but there is no loss of total potassium from the body. We have experienced hypokalemic familial periodic paralysis recently which affected 4 members in a family,and report this disorder.
Accidental Falls ; Humans ; Paralyses, Familial Periodic ; Paralysis ; Plasma ; Potassium