PURPOSE: This study was performed to design a safe air-pressure reduction system which can absorb rapidlyrising intraluminal pressure during intussusception, and comparison with other reduction systems to test itsclinical availability. MATERIALS AND METHODS: The air-pressure reduction system consisted of a pressure gauge,air insufflators, a pressure controller, buffers, and rapid exhaustion devices, and to determine itsabsorbability, it was connected with a bowel model. By using it in 20 infants with intussusception, we comparedthe absorbability of our air-pressure reduction system with preexisting systems. RESULTS: While extraluminalpressure was applied to the bowel model in which baseline intraluminal pressure was set to 120mmHg, this rose to176mmHg (56mmHg high to standard, 100%) in the direct infusion system, but to only 130 mmHg (10mmHg high tostandard, 17.9%) in a system connected to a large buffer of 10,500 mL capacity. Immediately after the applicationof extraluminal pressure for less than 1 sec, this air-pressure reduction system showed better absorbability thanthe hydrostatic reduction system. Applying this system to 20 infants with intussusception, this was successfullyreduced in 19 cases(95%), without complications. CONCLUSION: In this experiment, it was proved that the systemabsorbed rapid intraluminal pressure elevation. Its use would help prevent bowel perforation during air reductionoccurring during intussusception.
Buffers ; Humans ; Infant ; Intussusception*

Purpose: To evaluate the relationship between the clinical outcome and the cuff integrity following open repair in large and massive rotator cuff tears using ultrasonography as an imaging modality. Material and Methods: From November 2001 to April 2005, 17 cases(16 patients) who had open repair of tear measuring more than 3cm were assessed with minimal follow-up of 12 months in this study. 6 cases had a large tear and 11 cases a massive tear. There were 6 men and 11 women with a mean age of 52 years at surgery (range, 33 to 72 years). The evaluation consisted of the preoperative and postoperative shoulder scores according to UCLA shoulder scoring system and Visual analogue scale (VAS). Ultrasonography was performed by a experienced musculoskeletal physician at a minimum of 12 months postoperatively to evaluate the postoperative cuff integrity. Results: Retear were detected in four of seventeen cases. Regardless of the presence of recurrent tear, 14 cases had UCLA score of more than 29 points (good grade). All 17 had an improvement in the functional score, which increased from an average of 15.1 to 31.2 points. All cases showed pain relief and five cases had no pain. Sixteen cases except one had the range of motion of forward elevation above 90degrees. Conclusion: Open rotator cuff repair in large and massive tears showed low retear rate. At a minimum of twelve months follow-up, all cases had improvement on UCLA score, pain relief, increased range of motion of the shoulder regardless of retear. And the correlation between recurrent tear and function score was not statistically significant.
Female ; Follow-Up Studies ; Humans ; Male ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder ; Ultrasonography

PURPOSE: To evaluate the results of fracture fixation between using Proximal Femoral Nail and using Proximal Femoral Nail A and to analyze the effectiveness of proximal femoral nail A. MATERIALS AND METHODS: We reviewed 32 patients who suffered from intertrochanteric fracture in our hospital, which were 19 cases of PFN and 13 cases of PFNA. Retrospectively we evaluated mean operation time, amount of bleeding, beginning of ambulation, average union period, changes of neck shaft angle and complication on set of telephone interview and OPD. We also evaluated postoperative capability of function and mobility using 'Social function score' and 'Mobility score'. RESULTS: PFNA showed shorter mean operation time, less bleeding, shorter average union period, earlier ambulation and less change of neck shaft angle than PFN. Although they didn't show statistical difference, postoperative capability of function and mobility showed statistical and mathematical difference on each group. CONCLUSION: PFNA showed better results of postoperative function and mobility and less complications than PFN. So treatment using PFNA is better method than that of PFN.
Fracture Fixation ; Hemorrhage ; Humans ; Interviews as Topic ; Nails ; Neck ; Retrospective Studies ; Walking

BACKGROUND: A large amount of attention in anorectal physiologic studies has been devoted to the diagnosis of fecal incontinence. The current study was designed firstly to assess the physiologic characteristics of fecal incontinence and secondly to analyze how the physiologic findings correlate with each other. METHODS: The physiologic findings of 47 patients (24 men and 23 women) were analyzed, retrospectively. Studies included anal manometry (n=38), anal electromyography/pudendal nerve terminal motor latency (PNTML) (n=30), and endoanal ultrasound (n=37). The degrees of continence were estimated by using continence grading scores (CGS) that ranged from 0 to 20 points based on the type and the frequency of incontinence. Control data were obtained from volunteers (n=23). RESULTS: The patients were categorized as having neurogenic (group I, n=25) or myogenic (group II, n=17) incontinence. Despite intensive investigations, unknown etiology was noted in 5 patients (10.4%). The CGS was not different between groups I and II. Pudendal neuropathy was found in 96% of group I and 37.5% of group II patients. Group I showed a higher value of PNTML than that of group II (2.96 1.0 msec vs. 2.07 0.48 msec, p=0.003). The CGS was proportional to the value of the PNTML in group I (r=0.476, p=0.01). However, no correlation was found between the mean PNTML and the CGS in group II. In the manometric parameters, there were no statistical differences between the values of the mean resting pressure (RP), the maximum RP, and the maximum voluntary contraction (MVC) between groups I and II. The MVC was inversely proportional to the CGS in group I (r= 0.616, p=0.02) and in group II (r= 0.664, p=0.02). No correlation was found between the PNTML and the manometric parameters. When we consider the presence of a defect or a scar as an abnormal anal ultrasound finding, such findings were more frequent in group II than in group I (group I, 20% vs. group II, 88%, p<0.001, Fisher's exact test). CONCLUSIONS: The value of the PNTML had relevance to the degree of symptoms in the patients with neurogenic incontinence. Specifically, the squeeze profiles of the manometric parameters were inversely related to the grade of incontinence. No correlation between the PNTML and the manometric parameters could be independently specified based on the etiology. Complementary examination by using the PNTML and anal ultrasound provided the only useful information to discriminate the etiology of incontinence.
Cicatrix ; Diagnosis ; Fecal Incontinence* ; Humans ; Male ; Manometry ; Physiology* ; Pudendal Neuralgia ; Retrospective Studies ; Ultrasonography ; Volunteers