BACKGROUND: Osteoarthritis(OA) has become one of the most important medical problem among the old age because it causes severe functional disability, but, up to date, the therapeutic methods for OA have not been so satisfactory to the patients with OA. Authors have investigated the effectiveness of intramuscular stimulation(IMS) therapy as an substitutive therapy for the relief of pain and dysfunction in patients with OA of the knee. METHODS: Eighteen patients who had visited the department of family medicine, Korea university anam hospital, with symptomatic OA of the knee during the period from March 1 to May 31. 2001 were included in this study and treated with IMS therapy on the quadriceps and hamstring muscles four times during two weeks. Patients self-scored Korean Western Ontario and McMaster universities Osteoarthritis Index (KWOMAC) at baseline and after the last therapy. The result was analysed by paired t-test and ANOVA. RESULT: Patients improved on KWOMAC scales for pain, stiffness, function and total scores after IMS therapy(p<0.05). The demographic characteristics such as body mass index (BML), duration of disease, affected site, radiologic finding did not have influence on the result of this study. No adverse effects of IMS therapy were reported. CONCLUSION: In this study, the improvement of pain, stiffness, and function of knee joint after treatment was reported. This study suggest that IMS is an effective and safe substitutive therapy for patients with OA of Knee.
Body Mass Index ; Humans ; Knee Joint* ; Knee* ; Korea ; Muscles ; Ontario ; Osteoarthritis* ; Weights and Measures

PURPOSE: This study was designed to evaluate the efficacy of intracameral lidocaine injection on patient' s pain relief during phacoemulsification in vitrectomized eyes and the influence on the corneal endothelial cells. METHODS: A prospective, double blind clinical trial was performed on 60 eyes of 60 patients who had undergone phacoemulsification from October 2000 to February 2001 at Busan PAIK Hospital. Thirty eyes had prior vitrectomy. Before surgery specular microscopic examination was performed. The patients were divided into vitrectomized and nonvitrectomized groups, and the lidocaine or placebo (BSS) was injected into the anterior chamber of 15 eyes each in two subgroups within each group. Pain was assessed using a visual analogue scale before, during and after operation. Endothelial cells were examinined at one week, one month, and three months after operation with a specular microscope. RESULTS: In vitrectomized patients, intracameral lidocaine injection resulted in significantly lower intraoperative pain score. There were no significant differences in morphological changes of endothelium between lidocaine and placebo groups. CONCLUSIONS: Intracameral lidocaine injection with topical anesthesia had significant effect in intraoperative pain relief during phacoemulsification in vitrectomized eyes. There was no significant effects on corneal endothelium. We conclude that intracameral anesthesia is safe and reduces intraoperative pain in vitrectomized eyes.
Anesthesia ; Anterior Chamber ; Busan ; Cataract ; Endothelial Cells ; Endothelium ; Endothelium, Corneal ; Humans ; Lidocaine* ; Phacoemulsification* ; Prospective Studies ; Vitrectomy

No Abstract Available.
Posterior Cruciate Ligament*

OBJECTIVES: In healthcare, mobile computing made possible by smartphones is becoming an important tool among healthcare professionals. However, currently there is very little research into the effectiveness of such applications of technology. This study aims to present a framework for a smartphone application to give doctors mobile access to patient information, then review the consequences of its use and discuss its future direction. METHODS: Since 2003 when Samsung Medical Center introduced its first mobile application, a need to develop a new application targeting the latest smartphone technology was identified. To that end, an application named Dr. SMART S was officially launched on December 22nd, 2010. RESULTS: We analyzed the usage data of the application for a month until April 25th, 2011. On average, 170 doctors (13% of the entire body of doctors) logged on 2.4 times per day and that number keeps growing. The number was uniformly distributed across all working hours, with exceptions of heavy accesses around 6-8 AM and 4-6 PM when doctors do their regular rounds to see the patients. The most commonly accessed content was inpatient information, this constituted 78.6% of all accesses, within this 50% was to accesses lab results. CONCLUSIONS: Looking at the usage data, we can see the use of Dr. SMART S by doctors is growing in sync with the popularity of smartphones. Since u-Health seem an inevitable future trend, a more rigorous study needs to be conducted on how such mobile applications as Dr. SMART S affect the quality of care and patient safety to derive directions for further improvements.
Computers, Handheld ; Delivery of Health Care ; Hospital Information Systems ; Humans ; Inpatients ; Medical Informatics Applications ; Patient Safety ; Pyridines ; Thiazoles

Osteogenesis imperfecta is a rare congenital disease. It is a heterogeneous group of inherited disorders characterized by multiple bone fracture, blue sclera, hearing loss, abnormalities of dentition and widespread connective tissue ahnormality. We experienced a case of osteogenesis imperfecta diagnosed in utero by ultrasonogram and confirmed hy postnatal radiograph after delivery. We present the case with a hrief review of the literature.
Connective Tissue ; Dentition ; Fractures, Bone ; Hearing Loss ; Osteogenesis Imperfecta ; Sclera ; Ultrasonography

PURPOSE: The outcome after operations for intermittent exotropia were frequently unsatisfactory because of high incidence of postoperative undercorrection, overcorrection or recurrence. The author studied surgical outcome of each operation method in intermittent exotropia. METHODS: The results of surgical treatment in 90 patients with intermittent exotropia were reviewed. The operative procedure were devided into 3 groups-bilateral rectus muscle recessions, unilateral lateral rectus muscle recession and medial rectus muscle resection and medial rectus muscle resection of dominant eye and lateral rectus muscle recession of non-dominant eye. The success of operation was defined as a final alignment of orthotropia, esotropia less than 5 prism diopter or exotropia less than 10 prism diopter in primary position at postoperative 6 months. RESULTS: The method of of operation in medial rectus muscle resection of dominant eye and lateral rectus muscle recession of non-dominant eye lead to higher success rate than other surgical method (96.7%) and the difference with statistically significant (p=0.03). The success rate of bilateral rectus muscle recessions group was 76.6%, and that of unilateral lateral rectus muscle recession and medial rectus muscle resection group was 80.0%. CONCLUSIONS: This result suggested that medial rectus muscle resection of dominant eye and lateral rectus muscle recession of non-dominant eye might be a most effective surgical method for intermittent exotropia.
Esotropia ; Exotropia* ; Humans ; Incidence ; Recurrence ; Surgical Procedures, Operative

PURPOSE: This study aimed to analyze the clinical characteristics, results of operational method and causes of operational failure in rhegmatogenous retinal detachment except macula hole induced retinal detachment, and to analyze several factors of vision. METHOD: We reviewed the records of 720 patients, 743 eyes with regmatogenous retinal detachment who had undergone operation from January 1990 to December 1999, and followed up for at least 3 months or longer. RESULT: Scleral buckling (728 eyes, 98.0%), gas injection (9 eyes, 1.2%) and vitrctomy (6 eyes, 0.8%) were done as a primary operation. Anatomical success rate was 684 eyes(34.9%). A good visual acuity ( V A >or=0.5) was achieved in 239 eyes (34.9%), reasonable vision (VA 0.4~0.15) in 192 eyes(28.1%), ambulatory vision (VA 0.1~0.02) in 95 eyes (13.8%), whereas 158 eyes (23.2%) became blind (VA Animals ; Beak ; Humans ; Reoperation ; Retinal Detachment* ; Retinaldehyde* ; Scleral Buckling ; Visual Acuity

BACKGROUND: Chronic shoulder pain draws the attention of doctors since it is a very common and serious disease at primary care level. The patients with this pain usually have a tendency to see many doctors, to take an abundance of medication, and sometimes to even suffer from depression. The pain and the symp- toms thereof often disable the patients in their every day lives. This study aims to seek the most efficient way of treatment between two therapies, namely, the existing drug therapy based on NSAID and the intramuscular stimulation(herein after IMS) therapy, which has re- cently been introduced, by comparing them in accordance with the following method. METHODS: The two therapies were applied for 3 weeks to female patients aged between 50 and 70 who had visited a hospital over a period of more than 3 months due to this type of pain. The patients were randomly given each therapy although the treatment and monitoring was done by the same physiotherapist. The monitoring was performed four times, the day before the start of treatment, 1 week, 2 weeks and 3 weeks after respectively. It measured the following elements: (1) pain scale by VAS(Visual Analogue Scale), (2) Sleep hygiene scale by VAS, (3) ROM(Range of Motion), Repeated measure ANOVA was used for analysis. RESULTS: While both therapies reduced the pain significantly during the 3 weeks, the study showed that IMS was more effective than the drug therapy in every element monitored(p<0.05). IMS turned out to be more effective the 1st week in every measured element, however, the drug therapy was more effective the 3rd week if compared to the 2nd week in terms of Sleep VAS score. CONCLUSION: IMS is more effective in easing chro nic shoulder pain since it has better results than NSAID in pain VAS score, sleep VAS score and ROM.
Chronic Pain ; Depression ; Drug Therapy ; Female* ; Humans ; Hygiene ; Physical Therapists ; Primary Health Care ; Shoulder Pain* ; Shoulder*

The funding acknowledgment in this article was partially omitted as published.

PURPOSE: This study evaluated the efficacy of a water-soluble contrast enema (WCE) in predicting anastomotic healing after a low anterior resection (LAR). METHODS: Between January 2000 and March 2012, 682 consecutive patients underwent a LAR or an ultra-low anterior resection (uLAR) and were followed up for leakage. Clinical leakage was established by using physical and laboratory findings. Radiologic leakage was identified by using retrograde WCE imaging. Abnormal radiologic features on WCE were categorized into four types based on morphology: namely, dendritic, horny, saccular, and serpentine. RESULTS: Of the 126 patients who received a concurrent diverting stoma, only two (1.6%) suffered clinical leakage due to pelvic abscess. However, 37 patients (6.7%) in the other group suffered clinical leakage following fecal diversion (P = 0.027). Among the 163 patients who received a fecal diversion, 20 showed radiologic leakage on the first WCE (eight with and 12 without a concurrent diversion); 16 had abnormal features continuously until the final WCE while four patients healed spontaneously. Eleven of the 16 patients (69%), by their surgeon's decision, underwent a stoma restoration based on clinical findings (2/3 dendritic, 3/4 horny, 5/7 saccular, 1/2 serpentine). After stoma reversal, only 2 of the 11 (19%) complained of complications related to the rectal anastomosis. CONCLUSION: WCE is helpful for detecting radiologic leakage before stoma restoration, especially in patients suffering clinical leakage after an uLAR. However, surgeons appear to opt for stoma restoration despite the persistent existence of radiologic leakage in cases with particular features on the WCE.
Abscess ; Anastomotic Leak ; Colorectal Surgery ; Enema* ; Humans ; Rectal Neoplasms*