BACKGROUND: The purpose of this study was to assess the results of arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. METHODS: From November 2009 to April 2011, 12 patients underwent arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. Patients were followed for an average of 33.9 months. Clinical outcome was evaluated preoperatively and postoperatively using the mean University of California, Los Angeles (UCLA) score and the Korean Shoulder Scoring System (KSS). Magnetic resonance imaging (MRI) was performed postoperatively at an average of 6.5 months. RESULTS: At a mean follow-up of 33.9 months (range, 25 to 42 months), 11 out of 12 patients were satisfied with their procedure. Patients showed significant improvement in their mean modified UCLA score from 15.9 preoperatively to 29.4 postoperatively (p=0.001). The mean KSS score improved from 45.6 preoperatively to 80.5 postoperatively (p=0.002). In MRI studies, 9 out of 12 patients had full incorporation of the graft into the native rotator cuff remnant. To date, there has been no intraoperative or postoperative complication from the graft procedure, such as infection or allograft rejection, in any patient. CONCLUSIONS: Arthroscopic bridging repair using a human dermis allograft can be considered as an option in treatment of select cases of massive irreparable rotator cuff tears, resulting in high patient satisfaction.
Allografts* ; California ; Dermis* ; Follow-Up Studies ; Humans* ; Magnetic Resonance Imaging ; Patient Satisfaction ; Postoperative Complications ; Rotator Cuff* ; Shoulder ; Tears* ; Transplants

Diaper dermatitis is an infant dermatosis associated with the wearing of diapers, Despite of its high frequency in clinical pediatrics the clinical characteristics are not well described in the korean literatvre. We investigated the clinical and mycological characteritics of diaper dermatitis in 50 serial patients. Clinically diaper dermatitis was classified. into five categories,irritant contact derniatitis(ID), candidiasis(CD). combined rash of ID and CD(CR.), intertrigo, and miliari. Of 50 patients with diaper dermatitis, 18 had ID; 16, CI3; 10, CR; 5, intertrigo, and 1, miliaria, The mean age of patients with ID (11.8 months) was higher than that of patients with CD (4.0 months). Candida albicans(C. albicans) w is isolated from 25 patients with diaper dermatitis. The rate of positive cultures by clinical diagnosis was 130% in CD, 11.1% in ID, 60, 0% in CR, and 20.0% in intertrigo. C. albicons was isolated from 23 patients(82.1%) of patients with clinically suspected Ci") and 2 of 22 patients without the characteristic erythematous papulesThe presence of eryhematous papules was the most characteristic clinical feature of infection, Other candida species isolated from cut,aneous lesions were C. tropicalsis, C.'. parapsiolosis, and C. stellatoidea.
Candida ; Candidiasis ; Dermatitis* ; Diagnosis ; Exanthema ; Humans ; Infant ; Intertrigo ; Miliaria ; Pediatrics ; Skin Diseases

BACKGROUND: As invasive streptococcal infections are increasing recently and the resistance rate to either erythromycin or clindamycin is elevating, epidemiologic surveillance and appropriate guideline for antibiotic use are required. Geographical epidemiologic characteristics with T typing and antibiotic resistance rate were investigated. METHODS: Distributions of T types according to geographical areas and sources of specimens were analyzed with 82 strains of Streptococcus pyogenes isolated from clinical samples in Seoul and Chinju. Antibiotic susceptibility test was performed for penicillin G, cephalothin, erythromycin, azithromycin, clarithromycin, clindamycin, chloramphenicol, and ofloxacin with agar dilution method. Antibiotic resistance rates were analyzed according to geographical areas, sources of specimens and T types. RESULTS: The most common T types were T12, T1 and T28 in decreasing order. The distribution of T types between Seoul and Chinju was different. While T1, T3, and T6 were frequent in throat or other respiratory specimens, T12, T28, and B3264 were common in blood or closed pus. The resistance rate to erythromycin, azithromycin, and clarithromycin was 20%, 13% to clindamycin, and 49% to tetracycline, respectively. None of the isolates were resistant to penicillin G, cephalothin, chloramphenicol, or ofloxacin. The isolates from Chinju showed higher resistance rate than the strains from Seoul. The isolates from blood or closed pus had higher resistance rate compared to those of throat or sputum. T28 and T6 strains presented higher resistance rate than other T types. CONCLUSIONS: As distributions of T types were variable according to geographical areas or sources of specimens, continuous microbiological and epidemiological surveillance for invasive streptococcal infections are needed. Minimizing unnecessary antibiotic use or acknowledging the severity of resistance are necessary, because the resistant proportions are increasing against macrolide, clindamycin and tetracycline.
Agar ; Azithromycin ; Cephalothin ; Chloramphenicol ; Clarithromycin ; Clindamycin ; Drug Resistance, Microbial ; Epidemiological Monitoring ; Erythromycin ; Gyeongsangnam-do ; Ofloxacin ; Penicillin G ; Pharynx ; Seoul ; Sputum ; Streptococcal Infections ; Streptococcus pyogenes* ; Streptococcus* ; Suppuration ; Tetracycline

The most common complication of total ankle arthroplasty is skin problem including delayed wound healing, skin necrosis, and superficial wound infection. In the present study, we aimed to reduce the wound complications associated with total ankle arthroplasty using a curvilinear incision. We examined 5 patients with ankle osteoarthritis who underwent total ankle arthroplasty using a curvilinear incision from September 2012 to January 2013. Wound dehiscence was noted in 1 case, which was treated with a re-repair procedure at 13 days after the initial surgery. The use of a curvilinear incision in total ankle arthroplasty may reduce the associated wound complications.
Ankle* ; Arthroplasty* ; Humans ; Necrosis ; Osteoarthritis ; Skin ; Wound Healing ; Wound Infection ; Wounds and Injuries

In orthognathic surgery to obtain proper functional and esthetic form after skeletal discrepancy treatment, precise diagnosis and treatment plan are essential. Especially in two jaw surgeries that have serious upper and lower jaw problems, maxilla and mandible are arranged in three dimensions. Based on the maxillary rearrangement, mandibular sagittal and transverse position are determined, and thus new occlusal plane is established. The object of this study is to evaluate the stability of the individual ideal occlusal plane based on the architectural and structural craniofacial analysis of Delaires. The subjects of this study were 48 patients who underwent two jaw surgeries, and they were equally divided into two groups. A and B. A group was operated with ideal occlusal plane and B group was not. Two groups were compared at the preoperative, immediate postoperative (average 4.3days). and long-term postoperative (average 1.3years) lateral cephalometric radiographs. The following results were obtained : 1. ANS was lower than that of PNS for both A and B after the surgery. That is, maxilla and mandible are rotated in posterior and superior direction. 2. Significances were found between T2 and T3 for both a and B are HRP-Me at vertical measurements, articular angle(p<0.01), gonial angle(p< 0.01), and Mn. plane angle(p<0.05) at angular measurement. Mn. plane angle is increased at HRP-Me is decreased for both A and B 3. There is no significance in skeletal stability after the surgery between group A and B. 4. Horizontal movements of B and Pog by surgery have statistically significant inverse correlations with horizontal relapse of B and Pog, and vertical relapse of PNS, as well as Mn. plane angle, and gonial angle after the surgery.
Dental Occlusion* ; Diagnosis ; Humans ; Jaw ; Mandible ; Maxilla ; Orthognathic Surgery* ; Recurrence

STUDY DESIGN: Case report OBJECTIVES: We report a case of surgically proven tophaceous gout of the lumbar spine at the L5-S1 level in a 43-year-old man that mimicked infectious spondylodiscitis and epidural abscess on magnetic resonance (MR) images. SUMMARY OF LITERATURE REVIEW: Some patients have chronic back pain with an epidural mass. Among the many causes of epidural masses, tophaceous gout of the lumbar spine is very rare. MATERIALS AND METHODS: A 43-year-old man presented with fever and chronic back pain with radiating pain. In an MR image of L4-5, an abnormal subcutaneous mass was found in the posterior epidural space. The subcutaneous mass was isointense on T1-weighted images compared with the intervertebral disc, and focally and strongly hyperintense and heterogeneous on T2-weighted images. After the intravenous administration of gadolinium contrast, the mass was fairly homogenous, with a low signal intensity and without enhancement. With the diagnosis of infective spondylitis with epidural abscess, we performed a decompressive mass resection. RESULTS: The pathologic examination revealed multinuclear giant cells and amorphous crystalline fibrous tissue. The lesion was diagnosed as tophaceous gout. CONCLUSIONS: This case underscores the importance of considering tophaceous gout in the differential diagnosis of an epidural mass in a patient with chronic back pain.
Administration, Intravenous ; Adult ; Back Pain ; Crystallins ; Diagnosis ; Diagnosis, Differential ; Discitis ; Epidural Abscess ; Epidural Space ; Fever ; Gadolinium ; Giant Cells ; Gout ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Spine ; Spondylitis

OBJECTIVES: We report a case of surgically proven tophaceous gout of the lumbar spine at the L5-S1 level in a 43-year-old man that mimicked infectious spondylodiscitis and epidural abscess on magnetic resonance (MR) images.SUMMARY OF LITERATURE REVIEW: Some patients have chronic back pain with an epidural mass. Among the many causes of epidural masses, tophaceous gout of the lumbar spine is very rare. MATERIALS AND METHODS: A 43-year-old man presented with fever and chronic back pain with radiating pain. In an MR image of L4-5, an abnormal subcutaneous mass was found in the posterior epidural space. The subcutaneous mass was isointense on T1-weighted images compared with the intervertebral disc, and focally and strongly hyperintense and heterogeneous on T2-weighted images. After the intravenous administration of gadolinium contrast, the mass was fairly homogenous, with a low signal intensity and without enhancement. With the diagnosis of infective spondylitis with epidural abscess, we performed a decompressive mass resection. RESULTS: The pathologic examination revealed multinuclear giant cells and amorphous crystalline fibrous tissue. The lesion was diagnosed as tophaceous gout. CONCLUSIONS This case underscores the importance of considering tophaceous gout in the differential diagnosis of an epidural mass in a patient with chronic back pain.

Background: The purpose of this study was to investigate the effects of commercially available calamansi soju and other alcoholic beverages on the microhardness and erosion of resin restorations. Methods: In this study, we evaluated the effects of Calamansi soju, Chamisul fresh, Cass fresh, and Gancia Moscato D’asti on resin restorations. Jeju Samdasoo and Coca-Cola were used as negative and positive controls, respectively. Specimens to be immersed in the beverages were manufactured using composite resin according to the product instructions. In each group, the surface microhardness was measured using a surface microhardness instrument before and after immersion for 5, 15, 30, and 60 minutes. The pattern of change in the surface of the composite resin was observed under a scanning electron microscope (SEM). Paired t-tests, one-way ANOVA, and repeated measures ANOVA were performed to compare the surface microhardness of the specimens, and the Tukey test was used as a post hoc test. Results: The pH of all beverages except Jeju Samdasoo was ＜5.5, which is the critical pH that can induce erosion. The difference in surface microhardness of the composite resin before and after immersion for 60 minutes was significant in all groups. In particular, the largest change in surface microhardness was observed in the calamansi soju group. In the SEM analysis, loss of composite resin was observed in all groups except the Jeju Samdasoo group, and rough surfaces with pores of various sizes were observed. Conclusion In this study, all beverages except Jeju Samdasoo decreased the microhardness of the composite resin surface, and it was confirmed that calamansi soju had the greatest change.

BACKGROUND: Chlamydia pneumoniae is an obligate intracellular organism, which can cause respiratory tract infections, exacerbation of asthma, and possibly atherosclerosis. Detection of C. pneumoniae in the atherosclerotic tissue was made using electron microscopy to elucidate the correlation between C. pneumoniae and atherosclerosis. METHODS: Ten cases of paraffin-embedded atherectomy tissue, which were positive in the immunohistochemistry (IHC) were prepared to demonstrate C. pneumoniae on the electron microscope. Two cases of atherosclerotic tissue, which were negative in IHC were processed identically at the same time as negative controls. The tissues were embedded in resin, ultrathin-sectioned, and stained with uranyl acetate and lead citrate, and then observed on electron microscopy. RESULTS: Nine of 10 (90%) atherosclerotic tissue samples were positive for C. pneumoniae on electron microscopy. Negative controls did not show elementary bodies. Elementary bodies of C. pneumoniae were rarely observed in a scattered pattern in the positive specimens. CONCLUSION: Elementary bodies of C. pneumoniae could be demonstrated on electron microscopy in 9 out of 10 atherosclerotic tissue samples with positive IHC for C. pneumoniae. This finding suggests that C. pneumoniae may play an important role in atherogenesis.
Asthma ; Atherectomy ; Atherosclerosis ; Chlamydia* ; Chlamydophila pneumoniae* ; Citric Acid ; Immunohistochemistry ; Microscopy, Electron* ; Pneumonia ; Respiratory Tract Infections

BACKGROUND: Because Chlamydia trachomatis infection is the most frequent etiological agent in sexually transmitted diseases, accurate diagnostic methods are essential. The enzyme-linked fluorescence assay and Papanicolaou smear were evaluated for detection of C. trachomatis in patients with vaginitis. METHODS: Endocervical swabs from 78 women with symptoms of vaginal discharge, itching or lower abdominal pain in the obstetrics/gynecology department of Gyeongsang National University Hospital were tested by Vidas Chlamydia assay. Slides were stained with Papanicolaou and Giemsa stain to demonstrate inclusion body. RESULTS: Five (6.4%) of 78 endocervical specimens were positive by Vidas Chlamydia assay. Only one case was positve for C. trachomatis with Papanicolaou stain. We could not detect any C. trachomatis by Giemsa stain. CONCLUSION: The Vidas Chlamydia test allows sensitive and high-volume testing for chlamydiae and could be useful for the diagnosis of infection with C. trachomatis in patients with vaginitis and pelvic inflammatory disease.
Abdominal Pain ; Azure Stains ; Chlamydia trachomatis* ; Chlamydia* ; Diagnosis ; Female ; Fluorescence ; Humans ; Inclusion Bodies ; Papanicolaou Test ; Pelvic Inflammatory Disease ; Pruritus ; Sexually Transmitted Diseases ; Vaginal Discharge ; Vaginitis