BACKGROUND: The purpose of this study was to evaluate the efficacy of suction drain use following arthroscopic rotator cuff repair by comparing early pain score and range of motion (ROM) between groups with and without suction drains. METHODS: The study included 153 patients with rotator cuff tears who underwent arthroscopic repairs at our clinic from April 2014 to March 2015. Following surgery, a suction drain was used in 85 patients (group D) and not used in 68 patients (group ND). There was no statistical difference between the groups in terms of age, gender, or total operation time. The clinical outcome with regard to pain (assessed by pain scores and analgesic requests) and passive ROM was assessed preoperatively and postoperatively. RESULTS: Immediate postoperative analgesic requirement was significantly higher in group D (p=0.001), although there was no difference in pain outcomes between the groups during the 3-month follow-up period. A statistically significant difference in passive ROM was observed at the postoperative 2- and 6-week follow-ups (p=0.036, 0.035, and 0.034 in forward elevation (FE), external rotation at the side (ER) and 90 ER at weeks 2, respectively; 0.045 and 0.009 in FE and ER at weeks 6, respectively); however no significant difference was observed at the end of 3 months. During the study period, no complication was reported in either group. CONCLUSIONS: Use of suction drains after arthroscopic rotator cuff repair provided little benefit in terms of ROM or pain in the early postoperative period (up to 3 months).
Arthroscopy ; Follow-Up Studies ; Humans ; Postoperative Period ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder ; Suction* ; Tears

PURPOSE: To analyze the clinical and radiological results of hip arthroplasty following the failed internal fixation of intertrochanteric fractures of the femur. MATERIALS AND METHODS: We analyzed the reasons for failure in 29 cases of hip arthroplasty from January 1997 through December 2008 in which the hip arthroplasty was necessary due to failed internal fixation of an intertrochanteric fracture of the femur. Furthermore, we tried to find pitfalls encountered when performing the operations. We assessed those patients and drew both clinical (Harris hip score, HHS) and radiological results. The follow-up period was 34.2 months(12-96 months), on average. RESULTS: The average operating time was 174 min.(115-205 min.) and the mean amount of perioperative bleeding was 1,335 ml(759-2,450 ml). The amount of packed RBC transfusion was 2.8 units(0-10 units) on average. We could see prolonged operation time and a large amount of blood loss as we performed both the removal of the previously fixed implant and reduction of the displaced bone fragment simultaneously. The mean Harris hip score of the patients was improved from the preoperative score of 43 to the postoperative score of 85.7. No cases showed any radiological signs of loosening of acetabular cups or femoral stems, although an articular dislocation and a postoperative joint infection occurred. CONCLUSION: Although hip arthroplasties performed because of a failure in internal fixation could provide relatively satisfactory outcomes, as they result in extended surgery time and greater blood loss, a requirement for higher-level surgical skills, and greater consideration required for the systemic conditions of patients before performing surgery.
Arthroplasty ; Dislocations ; Femur ; Follow-Up Studies ; Hemorrhage ; Hip ; Hip Fractures ; Humans ; Joints

PURPOSE: To obtain the findings of normal variant types of lower cervical body configuration for the purpose of differention from compression fracture. MATERIALS AND METHODS: We retrospectively analysed simple true lateral radiographs of cervical spine from C3 to C7 in 157 pediatric patients who did not have definitive clinical symptoms of cervical spinal injury. We classified the variations of normal cervical spine into 5 types by their configuration. In case of rounded upper corner or anteriorly wedged type, we measured the height and the width of vertebral body to classify these types, and undertook ANOVA test and multiple range test to determine the correlation between the gross configuration and the measured values. RESULTS: Type 1 was similarly observed at each of C3 to C7 in age of 1-4 group but the frequency was markedly decreased in age of 5-8 group. Type 2a was frequently observed at both age groups, and its incidence increased considerally at C3 and C4 with advancing age. Type 2b was more frequently observed at C3 body and Type 3 was observed only at C3 body in age group 1-4. Type 4 was markedly increased at 5-8 age group. Type 2b and 3 were seen mostly at C3, but sometimes at C4 body. Height of body was statistically more significant than width of body in classification of type 2a, 2b and 3. CONCLUSION: The configuration of lower cervical spine in infants and children changes from immature oval type(type 1) to mature rectagular type(type 4) with increasing age. Among the 4 types, the rounded upper corner type or anterior wedging type of lower cervical spine should be differentiated from compresson fracture. We concluded that the height of cervical body is more significant than the width of body in simple radiographic classification of types 2a, 2b and 3.
Child* ; Classification ; Fractures, Compression ; Humans ; Incidence ; Infant* ; Retrospective Studies ; Spinal Injuries ; Spine

PURPOSE: We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. MATERIALS AND METHODS: We have made an analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom,statistically. We also reviewed CT findings in 15 study groups. RESULTS: The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p <0.01) CONCLUSION: The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.
Congenital Abnormalities* ; Spondylolisthesis*

We report a rare case of a complete disassembly of the inner head from the bipolar cup without polyethylene wear and locking system failure. An 84-year-old man who had a femur neck fracture of the right hip underwent a replacement of the bipolar prosthesis 4 months ago. He fell down from a height of a chair and felt a sudden sharp pain in the right hip. Roentgenograms revealed that the inner head was dislocated from the outer cup; subsequently, a revision surgery was carried out. When the outer head was removed from the acetabulum, the bearing insert and locking ring were not deformed. Because there was no evidence of loosening of the femoral stem, identicallysized bipolar cup and metal head replacement was performed. At a 6 months follow-up, he had mild hip pain but had returned fully to daily living.
Acetabulum ; Aged, 80 and over ; Dislocations ; Femoral Neck Fractures ; Follow-Up Studies ; Head ; Hemiarthroplasty ; Hip ; Humans ; Polyethylene ; Prostheses and Implants ; Ursidae

Cystic lymphangiomas are uncommon benign tumor due to the lack of adequate drainage from the sequestrated lymphatic vessels to the venous system because of insufficiency or atresia of the efferent channels. They occur mostly in children and predilection sites are the neck and axilla. Treatment is complete surgical excision. Unless completely removed, recurrences are common. We report a case of cystic lymphangioma of adrenal gland in a 45-year-old woman with right flank pain. Adrenalectomy was performed and the mass consisted of three well demarcated cysts.
Adrenal Glands* ; Adrenalectomy ; Axilla ; Child ; Drainage ; Female ; Flank Pain ; Humans ; Lymphangioma ; Lymphangioma, Cystic* ; Lymphatic Vessels ; Middle Aged ; Neck ; Recurrence

STUDY DESIGN: Prospective study. OBJECTIVES: This study was conducted to investigate changes in perceptions of treatment using narcotic analgesics and quality of life in chronic back pain patients. SUMMARY OF LITERATURE REVIEW: Negative perceptions of narcotic analgesics as pain killers have been established as factors affecting compliance and adherence. MATERIALS AND METHODS: A total of 140 patients who had chronic back pain for over 3 months were examined using clinical scales such as the Korean version of the Oswestry Disability Index (KODI), the Short Form-12 (SF-12), and a visual analog scale (VAS). The survey regarding narcotic analgesics classified patients as having positive perceptions if they reported absolutely not wanting to use them or being unlikely to use them at the primary interview and after 4 weeks of treatment. RESULTS: Ninety-four patients (68%) reported negative perceptions of narcotic analgesics at the primary interview. Sixty-one of those patients (64%) changed their perceptions, reporting positive perceptions after 4 weeks of treatment, as indicated by the ODI (p=0.01), SF-12 (p=0.01), and VAS (p=0.01) scores. A change from positive to negative perceptions after 4 weeks of treatment was observed in 13 patients (28%) who experienced adverse effects of narcotics treatment (p=0.01). Among the 33 patients (23%) whose negative perceptions did not change, dissatisfaction with previous treatment was found to be a contributing factor in 22 (66%). CONCLUSIONS: Clinical improvements after treatment using narcotic analgesics in chronic back pain patients resulted in a significant positive impact on perceptions about narcotic analgesics. Narcotic analgesics could be an alternative treatment choice in chronic back pain patients because of improvements in their quality of life.
Back Pain* ; Chronic Pain ; Compliance ; Humans ; Narcotics ; Prospective Studies ; Quality of Life* ; Visual Analog Scale ; Weights and Measures

We studied retrospectively on clinical assessment of treatment in myasthenic patients who visited on our department regularly since 1985. They were divided as a group based on therapeutic modalities such as a thymectomy, steroid therapy. Combined therapy(steroid and thymectomy), plasma exchange. And whole body irradiation. We evluated clinical effectiveness of these therapeutic modalities and come up with following conclusions. Alltherapeutic modalities showed effectiveness. In steroid therapy, thymectomy and the combined therapy. W needed at least 6-24 months for clinical improvement. In thymectomy, rognosis was depend on the number of germinal centers. In whole body irradiation. Effectiveness was shown at 5h week and continued to 6th to 12th months. We also noted that symptomatic improvement was correlated with decreased lymphocyte counts. The effect of plasma exchange was rapid but only short duration.
Germinal Center ; Humans ; Lymphocyte Count ; Myasthenia Gravis* ; Plasma Exchange ; Retrospective Studies ; Thymectomy ; Whole-Body Irradiation

BACKGROUND: The purpose of this study was to evaluate the efficacy of suction drain use following arthroscopic rotator cuff repair by comparing early pain score and range of motion (ROM) between groups with and without suction drains. METHODS: The study included 153 patients with rotator cuff tears who underwent arthroscopic repairs at our clinic from April 2014 to March 2015. Following surgery, a suction drain was used in 85 patients (group D) and not used in 68 patients (group ND). There was no statistical difference between the groups in terms of age, gender, or total operation time. The clinical outcome with regard to pain (assessed by pain scores and analgesic requests) and passive ROM was assessed preoperatively and postoperatively. RESULTS: Immediate postoperative analgesic requirement was significantly higher in group D (p=0.001), although there was no difference in pain outcomes between the groups during the 3-month follow-up period. A statistically significant difference in passive ROM was observed at the postoperative 2- and 6-week follow-ups (p=0.036, 0.035, and 0.034 in forward elevation (FE), external rotation at the side (ER) and 90 ER at weeks 2, respectively; 0.045 and 0.009 in FE and ER at weeks 6, respectively); however no significant difference was observed at the end of 3 months. During the study period, no complication was reported in either group. CONCLUSIONS: Use of suction drains after arthroscopic rotator cuff repair provided little benefit in terms of ROM or pain in the early postoperative period (up to 3 months).
Arthroscopy ; Follow-Up Studies ; Humans ; Postoperative Period ; Range of Motion, Articular ; Rotator Cuff ; Shoulder ; Suction ; Tears

BACKGROUND AND OBJECTIVES: Tinnitus, a common complaint of workers who are exposed to noise, can cause substantial negative effects on the quality of life of these workers. The aim of this study was to analyze the characteristics of tinnitus in patients with noise-induced hearing loss and the relationship between tinnitus and the duration of noise exposure. SUBJECTS AND METHOD: Thirty-three patients with subjective tinnitus and noise-induced hearing loss were included in this study. Tinnitus questionnaire, Tinnitus Handicap Inventory (THI) and audiological examinations were investigated according to the duration of noise exposure. RESULTS: There was a significant correlation between the tinnitus loudness and the duration of noise exposure. Patients who had longer periods of noise exposure had a louder tinnitus and higher THI score. However, there is no significant correlation between the characteristics of tinnitus and aging process. CONCLUSION: The duration of noise exposure influences the loudness and distress of tinnitus. An awareness of tinnitus should be considered as part of hearing conservation program.
Aging ; Hearing ; Hearing Loss ; Hearing Loss, Noise-Induced* ; Humans ; Methods ; Noise* ; Quality of Life ; Tinnitus*