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With the advancement of shoulder arthroscopy, use of biodegradable suture anchors in the surgical repair of rotator cuff tears has increased. Because of the radiolucency of these anchors, radiography is not appropriate for early detection of anchor failure. Ultrasonography is an advantageous modality in visualizing biodegradable, radiolucent anchors on a real-time basis without risk of radiation exposure. We report on two cases of displacement of a biodegradable suture anchor diagnosed on ultrasonography during the postoperative follow- up, which has not been previously reported. Because this displacement could be missed in the postoperative follow up ultrasonography, we describe the ultrasonographic features of the displaced biodegradable anchors. Surgeons and radiologists should pay special attention to the possibility of displacement of the suture anchor in patients who underwent rotator cuff repairs using suture anchors.
Arthroscopy ; Follow-Up Studies ; Humans ; Radiography ; Rotator Cuff* ; Shoulder ; Suture Anchors* ; Sutures* ; Tears ; Ultrasonography*

BACKGROUND: Isolated infraspinatus tear is very rare and clinical features are not as well known, therefore the purpose of this study was to evaluate clinical characteristics and outcomes of isolated infraspinatus tear that authors experienced. METHODS: Authors reviewed 288 cases of full-thickness rotator cuff tear involving infraspinatus between 2010 and 2015, and retrospectively analyzed six cases of isolated infraspinatus tear. Perioperative clinical characteristics, postoperative functional outcomes of 6 months were investigated. Functional evaluation included visual analogue scale (VAS), range of motions, American Shoulder and Elbow Surgeons (ASES) score, and Constant score. RESULTS: Calcific tendinitis was accompanied in 4 cases (66.7%). Three of them received steroid injection or aspiration or extracorporeal shockwave therapy. Mean preoperative pain VAS was 7.1 (range, 5–9), and mean postoperative pain VAS at 6 months later was 1.6 (range, 0–5). Preoperative muscle strength by isokinetic muscle performance test showed 52% deficit of abduction and 37.6% deficit of external rotation. All 6 patients had arthroscopic repair of the infraspinatus tendon. All the patients at the 6 months follow-up exhibited clinical improvement in the Constant score (67.8 [range, 45–77] to 89.3 [range, 81–100], p=0.029), and ASES score (52.3 [range, 30–77] to 90.0 [range, 80–100], p=0.002). There was no healing failure on imaging. CONCLUSIONS: Isolated infraspinatus tendon tear was frequently accompanied by calcific tendinitis, but pathophysiologic relationship should need more study. To rule out neurogenic etiology, magnetic resonance imaging and electromyography would be helpful. Arthroscopic infraspinatus tendon repair and supraspinatus debridement showed relatively good result in painful shoulder.
Debridement ; Elbow ; Electromyography ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Muscle Strength ; Pain, Postoperative ; Retrospective Studies ; Rotator Cuff ; Rupture* ; Shoulder ; Surgeons ; Tears ; Tendinopathy ; Tendons

No abstract available.
Gastrectomy*

Limb salvage operation in primary malignant bone tumors is increasing recently, according to the improvement of diagnostic methods, surgical technique and adjuvant chemotherapy. The purpose of this study is to obtain the interim results of survival rate and the functional grade of the limb in primary malignant bone tumors treated by limb salvage operation. Between 1985 to 1993, 63 primary malignant bone tumors treated by limb salvage operations. Tumor prosthesis arthroplasty was performed in 49 patients, resection arthrodesis in 9 patients, and IM nailing with cement molding in 5 patients. Autoclave autograft was combined in 2 patients. Adjuvant chemotherapy and postoperative radiotherapy were performed in selected patients. The average follow-up period was 50 months(ranged 12 months to 116 months). In the cases of osteosarcoma, estimated survival rate was 61.9% based on Kaplan-Meier survival plot. In the parosteal sarcoma, the survival rate was 87.5% and 80% in chondrosarcoma patients. According to functional grading by Enneking, 66% was excellent, 20% was good, 11% was fair and one patients was poor. Complications occurred in 16 patients:wound infection was developed in 6 patients, local recurrence in 4, peroneal nerve palsy in 2 patients and femoral stem loosening in 2 patients. Fracture in resection arthrodesis and pulmonary metastasis were also occurred. Reoperation was performed in 10 patients at average 31 months after initial operation. Revision tumor persthesis arthroplasty was performed in one patient due to local recurrence and in 2 patients due to femoral stem loosening. Three amputations were done due to recurrence of tumor. IM nailing with cement molding was performed in one patient due to deep infection and repeated arthrodesis was done in a fracture patients. Scheduled custom-made tumor prosthesis arthroplasty was performed within a year in 2 patients treated with IM nailing with cement molding. In conclusion, with the careful preoperative assessment, adjuvant chemotherapy and skillful surgical technique, limb salvage operation would provide the primary malignant bone tumor patients for longer survival and better quality of life.
Amputation ; Arthrodesis ; Arthroplasty ; Autografts ; Chemotherapy, Adjuvant ; Chondrosarcoma ; Extremities ; Follow-Up Studies ; Fungi ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Osteosarcoma ; Paralysis ; Peroneal Nerve ; Prostheses and Implants ; Quality of Life ; Radiotherapy ; Recurrence ; Reoperation ; Sarcoma ; Survival Rate

It has been widely accepted that complete surgical resection of hepatoblastoma is essential for long-term survival. But unfortunately less that 50% of hepatic tumors in children can be totally removed at the time of diagnosis. This report is to present the experience of successful resection of hepatoblastoma after concurrent radiotherapy with transarterial chemoinfusion in a child. We believe this modality of treatment enables complete resection of unresectable hepatoblastoma, which is resistant to the systemic chemotherapy.
Child ; Diagnosis ; Drug Therapy ; Hepatoblastoma* ; Humans ; Radiotherapy*

Advances in multimodal treatment using radiation and chemotherapy, more sophicated diagnostic, radiologic methods, and newer reconstructive surgical techniques have led to aggressive surgical treatment of chondrosarcoma of the pelvis. Recently, good results have been reported in even high grade chondrosarcoma of the pelvis with surgery with/without adjuvant therapy. From January 1984 to June 1992, ten patients with chondrosarcoma of the pelvis were treated. Their average age was 40(18 to 55). Location of the lesion were ilium(5), periacetabular lesion(1), ischiopubic region(1) and sacrum(3). Nine cases were conventional type and one was dedifferentiated type. Surgical resection was done for nine patients, with which radical margin in one, wide margin in four, marginal margin in one and intralesional margin in three. Postoperative radiotherapy(6000-7000cGy during 6-7week) was done for five patients of having wide(1), marginal(1) or intralesional(3) surgical margin. One patient took radiotherapy only after biopsy. The average follow-up period was 2 years and 9 months(1 year to 6 years 1 month). Six patients wer continuously disease free(CDF) or disease free(DF). One patient is alive with disease(AWD). Three patients died of disease(DOD). With Kaplan-Meier's method, 5-year actuarial survival rate for total 10 cases was 60%, for operated group(9 cases) 66.7% and for operated conventional group(8 cases) 80%. With wider resection margin, better survival could be achieved.
Biopsy ; Chondrosarcoma ; Combined Modality Therapy ; Drug Therapy ; Follow-Up Studies ; Humans ; Methods ; Pelvis ; Radiotherapy ; Survival Rate

Leiomyoma is rare. Most of patients present with urinary tract infection, hematuria, dyspareunia, or complaint of mass. A case of leiomyoma on urethrovaginal septum in a 36 years old female was presented. The presenting symptom was a protruding mass at the anterior vaginal wall The mass was removed surgically and confirmed as a leiomyoma pathologically.
Adult ; Dyspareunia ; Female ; Hematuria ; Humans ; Leiomyoma* ; Urinary Tract Infections

PURPOSE: The purpose was to evaluate the procedure-related complications of the TIPS and its clinical significance. MATERIALS AND METHODS: The materials consisted of 52 patients who had 57 TIPS procedures for the management of variceal bleeding due to portal hypertension. To detect the occurrence of complications during transhepatic needle puncture(from hepatic vein to the portal vein), contrast material was injected with the withdrawl of the puncture needle. RESULTS: Procedure-related complications occurred in 28 patients (54%) among 52 patients. The corn lications were biliary tree puncture(15 cases), transperitoneal puncture(14 cases), stent malposition(3 cases) stent migration(1 case), hepatic arteries puncture(1 case), splenic vein perforation(1 case), and paroxysmal tricular tachycardia(1 case). Three patients had acute stent thrombosis with rebleeding immediately after procedure. The procedure was repeated in two patients. One patient was expired due to rebleeding. CONCLUSION: The procedure related complications were clinically insignificant in most instances, when stent thrombosis or proxysmal ventricular tachycardia was developed.
Biliary Tract ; Esophageal and Gastric Varices ; Hepatic Artery ; Hepatic Veins ; Humans ; Hypertension, Portal ; Needles ; Portasystemic Shunt, Surgical* ; Punctures ; Splenic Vein ; Stents ; Tachycardia, Ventricular ; Thrombosis ; Zea mays

A new technical method using bone plugs with oblique posterior interbody fusion(OPIF) was designed to increase the fusion rate. One hundred-seventy-five patients were operated for lumbar instability between November 1990 and December 2000. The L5/S1 segment was affected in 129 cases(74%) of the patients. Oblique posteior interbody fusion with bone plugs by unilateral approach was performed in all patients. Eight-nine percent of these patients showed good surgical results. This stable transplant interbody fusion has the several advantages. Foreign substance is not used and this method increases fusion rate and cost-effective. OPIF using bone plugs along with Oh's screw could provide sufficient stability for segmental instability of the lumbar spine including spondylolisthesis of the lumbar spine, with or without concurrent herniated intervertebral disc or spondylotic narrowing.
Humans ; Intervertebral Disc ; Spine ; Spondylolisthesis