BACKGROUND: Few studies have reported the results of arthroscopic coracoplasty concomitantly conducted with subscapularis tear. Therefore, this study was conducted to examine and compare the outcomes of arthroscopic subscapularis repair after arthroscopic coracoplasty using either the subacromial approach or rotator interval approach. METHODS: We retrospectively reviewed 51 patients who underwent coracoplasty with subscapularis repair. The patients were grouped according to whether the subacromial approach group (24 patients) or rotator interval approach group (27 patients) was used during coracoplasty. Preoperative and postoperative visual analogue scale scores, American shoulder and elbow surgeons scores, Korean shoulder scores, and range of motion (ROM) were assessed. Assessment of repaired rotator cuff tendon integrity was performed at 1 year after surgery using either magnetic resonance imaging or ultrasonography. RESULTS: At final follow-up, overall functional scores and ROM improved significantly in both groups when compared with preoperative values (p>0.05). The re-tear rates were not significantly different between groups; however, the rotator interval approach group showed a significant increase in ROM compared with that in the subacromial approach group (p<0.05). CONCLUSIONS: Arthroscopic coracoplasty conducted concomitantly with subscapularis repair can provide a satisfactory outcome. There were no significant differences between the two approach groups regarding final functional scores and re-tear rates. However, the rotator interval approach group showed a greater increase in ROM at final follow-up, especially in external rotation.
Arthroscopy ; Elbow ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Retrospective Studies ; Rotator Cuff ; Shoulder ; Surgeons ; Tears* ; Tendons ; Ultrasonography

No abstract available.
Adult* ; Femoral Neck Fractures* ; Femur Neck* ; Humans

The ankle joint is a modified complex hinge joint which plays an important role in weight bearing, walking and standing. Injuries about the ankle joint cause destruction of not only bony architecture but often also the ligamentous and soft tissue component. So the goal of the treatment of ankle fracture is restoring normal relations of ankle mortise and regaining a smooth articular surface. The author have reviewed 84 cases of ankle fractures which were treated through the admission in the Orthopedic Department, In Je Medical College Pusan Paik Hospital from June 1979 to August 1986. The average duration of the follow-up was one year. The results obtained from this study were as follows : 1. The most common type was Danis-Weber type C. Nexts were B and A in order. According to the classification of Lauge-Hansen, the most common type was Pronation-external rotstion(39.2%). 2. In Danis-Weber type B and C, satisfactory result was obtained by operative treatment. 3. Danis-Weber's classification was very practical criteria for treatment of the ankle fracture.
Ankle Fractures ; Ankle Joint ; Ankle ; Busan ; Classification ; Clinical Study ; Follow-Up Studies ; Joints ; Ligaments ; Orthopedics ; Walking ; Weight-Bearing

OBJECTIVE: Despite advances in both operative techniques (endovascular coiling or surgical neck clipping), management of basilar artery aneurysms has not been completed. The goal of this retrospective study is to evaluate endovascular coiling compared with surgical neck clipping of upper basilar artery aneurysms. METHODS: From january of 1990 to December of 2001, the authors treated 31 cases of upper basilar artery aneuryms. Among of those upper basilar artery aneurysms, 22 patients received surgical neck clipping and 9 patients recevied non-surgical endovascular coiling. Results from outpatient follow-ups for 12 months after operation were classified with Glasgow outcome scale (GOS) analyzed respectively. RESULTS: Overall, 11(50%) of the surgical neck clipping patients and 6(66.7%) in endovascular coiling patients were showed good outcomes(GOS 4~5). Morbidity of the surgical clipping is about 22.7%(5/22) and the endovascular coiling is about 22.2%(2/9) There were two death in the surgical clipping group due to vasospasm and brain stem infarction, but none in the endovascular coiling group. The major causes of surgical morbidity were direct brain damage, perforator occlusions, vasospasm and meningitis. Endovascular coiling group was shorter hospital stay and lesser hospital expenses than surgical neck clipping group. CONCLUSION: Non-surgical endovascular coiling of upper basilar artery aneurysms is considered to be useful alternative treatment in improving short-term prognosis(12 months follow-ups) and reducing medical expenses compared to surgical neck clipping although long-term follow-up is needed.
Basilar Artery* ; Brain ; Brain Stem Infarctions ; Follow-Up Studies ; Glasgow Outcome Scale ; Humans ; Intracranial Aneurysm* ; Length of Stay ; Meningitis ; Neck ; Outpatients ; Retrospective Studies ; Surgical Instruments*

No abstract available.
Arthroplasty* ; Arthroplasty, Replacement, Hip*

OBJECTIVES: This study was conducted to compare the characteristics of psychiatric inpatients in mental health related facilities and community mental health services-utilizing patients by diverse factors in Korea. METHODS: Questionnaires were sent via mail to 140 standard mental health centers from October to December of 2008. 64 facilities responded and data of 461 mentally disabled who are registered at and utilize the services of these mental health centers were analyzed. T-test and cross-analysis were performed to determine the differences in the averages of the variables and the discrepancy in ratios, respectively. RESULTS: Differences between long-term psychiatric inpatients and community mental health services-utilizing patients were seen in characteristics such as gender, age, type of medical coverage, family support systems, diagnosis, age of onset, duration of hospitalization, community-dwelling period, and clinical symptoms and functions. It was significantly short in length of stay in facilities in users of community mental health services with comparison to institutionalized patients. CONCLUSION: The results of this study suggest that invigoration of community mental health services is an alternative that can help deter long-term hospitalization.
Age of Onset ; Community Mental Health Services* ; Diagnosis ; Hospitalization ; Humans ; Inpatients ; Korea* ; Length of Stay ; Mental Health* ; Mentally Disabled Persons ; Postal Service ; Surveys and Questionnaires

OBJECTIVE: The authors present the results of management outcomes for upper basilar artery aneurysms via transclinoidal approach. METHODS: Clinical and angiographic evaluations were performed in twenty two consecutive patients with upper basilar artery aneurysms(three of them had superior cerebellar artery aneurysms) treated by surgery via transclinoidal approach between January, 1990 and April, 2000. RESULTS: Of the 22 patients, fifteen patients had multiple aneurysms including basilar bifurcation aneurysms and basilar-superior cerebellar aneurysms. Seventy seven percent were in good preoperative neurological status(H-H grade I-III), 23% were in poor grade(H-H grade IV). The management outcome was:Glasgow outcome scale(GOS) I 54.5%, GOS II 18%, GOS III 13.6%, GOS IV 4.5% and GOS V(death) 9%. The major causes of morbidity were direct brain damage, perforator occlusion, vasospasm and meningitis. CONCLUSION: The management outcome of upper basilar artery aneurysms treated via clinoidectomy was good(72.5%). Transclinoidal approach is an acceptable alternative for upper basilar artery aneurysms.
Aneurysm ; Arteries ; Basilar Artery* ; Brain ; Humans ; Intracranial Aneurysm* ; Meningitis

No abstract available.
Cesarean Section, Repeat* ; Female ; Fistula*

A case of a ruptured aneurysm originating at the proximal portion of the left posterior inferior cerebellar artery and an arteriovenous malformation in the left cerebellar hemisphere fed by the same artery is reported. The coincidental occurrence of these two vascular anomalies within the posterior fossa is uncommon. Aneurysms of the posterior inferior cerebellar artery require special consideration during surgical planning and operation because of the proximity of the posterior inferior cerebellar artery to the brain stem and to the origin of the lower cranial nerves. In our reported case, the aeurysm was located 2.7mm from the midline and 4.7mm from the clivus when measured radiometrically. The operation was carried out with the patient in a three quarter prone position through a left lateral suboccipital approach. Clipping of the neck of the aneurysm and total removal of the arteriovenous malformation were performed successfully in a one-stage operation.
Aneurysm* ; Aneurysm, Ruptured ; Arteries* ; Arteriovenous Malformations* ; Brain Stem ; Cranial Fossa, Posterior ; Cranial Nerves ; Humans ; Intracranial Aneurysm ; Neck ; Prone Position

The authors report on an endovascular experience using electrically detachable coils and direct clipping for the treatment of ruptured irregularly shaped aneurysms associated with pseudo-sac formation in a thrombotic cavity at the rupture site. These aneurysms might be fragile and associated with a high possibility of repeated rupture, especially, during an endovascular and direct clipping procedures. Between March 1998 and August 2001, 298 aneurysm patients underwent operations at our hospital. Among these patients, 4 patients showed pseudo-sac formation in a thrombotic cavity at the aneurysm rupture site, and were treated using an early endovascular occlusion technique or direct clipping after diagnostic angiography. These aneurysms showed delayed opacification and delayed washout of contrast medium from the irregularly shaped portion of the aneurysm on digital subtraction angiography. Moreover these aneurysms tend to rerupture during GDC embolization because of the fragile pseudoaneurysmal thrombotic cavity at the rupture point. Ruptured aneurysm with pseudo-sac formation in thrombotic cavity display delayed and irregularly shaped filling and retention of contrast medium at the rupture point. Early treatment of these aneurysms prevents rebleeding from the pseudo-sac in the thrombotic cavity at the ruptured site.
Aneurysm* ; Aneurysm, False ; Aneurysm, Ruptured ; Angiography ; Angiography, Digital Subtraction ; Humans ; Rupture*