Rotator cuff tears are a common cause of debilitating pain, reduced shoulder function, and weakness. Despite improvements in the understanding of the disease process and advances in surgical treatment, recent studies have reported that healing of massive rotator cuff tears is not as predictable as that of smaller rotator cuff tears. These high failure rates are a result of both mechanical and biologic factors that may affect the patients' intrinsic capacity to heal. Most research studies have concentrated on tissue engineering as a means for improvement of healing in rotator cuff repair, including the use of scaffolds, growth factors, and mesenchymal stem cells. There has been much interest in the development of various scaffolds that provide adequate strength as well as stimulate and enhance healing potential. The purpose of this paper is to review the current basic science and clinical application of extracellular matrix scaffolds, which are currently the most widely used scaffolds for repair of rotator cuff tears.
Biological Factors ; Extracellular Matrix ; Intercellular Signaling Peptides and Proteins ; Mesenchymal Stromal Cells ; Rotator Cuff ; Shoulder ; Tendons ; Tissue Engineering

PURPOSE: The authors intended to analyze the operative results of mild to moderate hallux valgus treated with distal chevron metatarsal osteotomy. MATERIALS AND METHODS: Twenty six feet of twenty three patients were followed for more than 1 year after the distal chevron metatarsal osteotomy. Biplanar osteotomy with wedge resection was done when the distal metatarsal articular angle (DMAA) was increased. The mean age was 39 years, and the mean follow up period was 27 months. Clinically preoperative and postoperative AOFAS hallux MP-IP scale and satisfaction after the surgery were analyzed. Radiologically hallux valgus angle, the 1st intermetatarsal angle, DMAA and sesamoid position before and after the operation were analyzed. RESULTS: Distal chevron osteotomy was done in 15 cases and biplanar osteotomy was done in 11 cases. Clinically AOFAS scale was increased from 65.3 points preoperatively to 92.2 points postoperatively. Two patients were not satisfied with the results. Radiologically hallux valgus angle was decreased from 21.9degrees preoperatively to 8.5degrees postoperatively. The first intermetatarsal angle was decreased from 11.8degrees preoperatively to 6.7degrees postoperatively. DMAA was decreased from 11.8degrees preoperatively to 5.5degrees postoperatively. There was one case of minor wound infection. CONCLUSION: Distal chevron metatarsal osteotomy appears to be safe and satisfactory procedure for mild to moderate hallux valgus.
Azasteroids ; Dihydrotestosterone ; Follow-Up Studies ; Foot ; Hallux ; Hallux Valgus ; Humans ; Metatarsal Bones ; Osteotomy

Bone marrow necrosis is infrequently diagnosed during life, and its presence often signifies a poor prognosis. It has been associated with a variety of disease, including acute and chronic leukemia, carcinoma, malignant lymph oma, infection and sickle cell disease. About 5-26% of acute myeloid leukemia has been reported to express lymphoid differentiation markers, of which CD7 is ex pressed very early during T-cell ontogeny. A 46-year-old male complaining severe bone pain had pancytopenia, leukoerythroblastosis and bone marrow necrosis. Peripheral blood immature cells expressed CD7 as well as myeloid markers such as CD13 and CD33 on immunophenotypic studies. We report a case of CD7 positive acute myeloid leu kemia associated with bone marrow necrosis, confirmed by bone marrow biopsy and immunophenotypic study.
Anemia, Sickle Cell ; Antigens, Differentiation ; Biopsy ; Bone Marrow* ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Male ; Middle Aged ; Necrosis* ; Pancytopenia ; Prognosis ; T-Lymphocytes

Infectious diseases, particularly pneumonia, remain a major cause of morbidity and mortality in patients with systemic lupus erythematous (SLE), accounting for 30~50% of all death. Because infection appears in various forms in lupus patients, early detection and appropriate treatment is very important. In the case of diffuse infiltration in the whole lung field, we should make a differential diagnosis with drug-induced pneumonitis, interstitial lung disease and pneumonia caused by atypical microorganism infection. In particular, in case of atypical microorganism pneumonia, we usually suspect cytomegalovirus, pneumocystis jiroveci and ebstein-barr virus, but influenza pneumonia is relatively neglected. Here, we report on the case of a 26-year-old female patient with lupus nephritis who presented with dyspnea and diffuse pulmonary infiltration immediately after intravenous cyclophosphamide. She was diagnosed with primary influenza B pneumonia and successfully treated with oseltamivir.
Accounting ; Adult ; Communicable Diseases ; Cyclophosphamide ; Cytomegalovirus ; Diagnosis, Differential ; Dyspnea ; Female ; Humans ; Influenza, Human ; Lung ; Lung Diseases ; Lung Diseases, Interstitial ; Lupus Nephritis ; Oseltamivir ; Pneumocystis jirovecii ; Pneumonia ; Viruses

PURPOSE: To evaluate the radiologic results between compressive hip screw and compressive hip screw with additional trochanteric stabilizing plate in patients with femoral unstable intertrochanteric fractures in patients with more 65 years old. MATERIALS AND METHODS: From 2006 to May 2009, 121 cases were included. Group I (compressive hip screw only) was 54 cases and group II (compressive hip screw with trochanteric stabilizing plate) was 67 cases. We checked the lag screw sliding, lateral translation of greater trochanter, changes of neck-shaft angle and complications through periodic follow up of radiographs. RESULTS: Mean lag screw sliding was 7.6 mm in group I and 3.9 mm in group II (p=0.001). Mean lateral translation of greater trochanter was 3.86 mm in group I and 0.59 mm in group II (p=0.01). Mean changes of neck-shaft angle was nearly the same, 3.57degrees in group I and 3.66degrees in group II. Complications were 15 cases in group I and 10 cases in group II. CONCLUSION: Compressive hip screw with additional trochanteric stabilizing plate was effective surgical option in patients with femoral unstable intertrochanteric fractures in patients with more than 65 years old. It decreased lag screw sliding, lateral translation of greater trochanter and complication rates.
Aged ; Femur ; Follow-Up Studies ; Hip ; Hip Fractures ; Humans

BACKGROUND: We retrospectively assessed the clinical outcomes and investigated risk factors influencing retear after arthroscopic suture bridge repair technique for rotator cuff tear through clinical assessment and magnetic resonance arthrography (MRA). METHODS: Between January 2008 and April 2011, sixty-two cases of full-thickness rotator cuff tear were treated with arthroscopic suture bridge repair technique and follow-up MRA were performed. The mean age was 56.1 years, and mean follow-up period was 27.4 months. Clinical and functional outcomes were assessed using range of motion, Korean shoulder score, Constant score, and UCLA score. Radiological outcome was evaluated with preoperative and follow-up MRA. Potential predictive factors that influenced cuff retear, such as age, gender, geometric patterns of tear, size of cuff tear, acromioplasty, fatty degeneration, atrophy of cuff muscle, retraction of supraspinatus, involved muscles of cuff and osteolysis around the suture anchor were evaluated. RESULTS: Thirty cases (48.4%) revealed retear on MRA. In univariable analysis, retear was significantly more frequent in over 60 years age group (62.5%) than under 60 years age group (39.5%; p = 0.043), and also in medium to large-sized tear than small-sized tear (p = 0.003). There was significant difference in geometric pattern of tear (p = 0.015). In multivariable analysis, only age (p = 0.036) and size of tear (p = 0.030) revealed a significant difference. The mean active range of motion for forward flexion, abduction, external rotation at the side and internal rotation at the side were significantly improved at follow-up (p < 0.05). The mean Korean shoulder score, Constant score, and UCLA score increased significantly at follow-up (p < 0.01). The range of motion, Korean shoulder score, Constant score, and UCLA score did not differ significantly between the groups with retear and intact repairs (p > 0.05). The locations of retear were insertion site in 10 cases (33.3%) and musculotendinous junction in 20 cases (66.7%; p = 0.006). CONCLUSIONS: Suture bridge repair technique for rotator cuff tear showed improved clinical results. Cuff integrity after repair did not affect clinical results. Age of over 60 years and size of cuff tear larger than 1 cm were factors influencing rotator cuff retear after arthroscopic suture bridge repair technique.
Adult ; Aged ; Analysis of Variance ; Arthroscopy/*methods ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Orthopedic Procedures/*methods ; Range of Motion, Articular ; Retrospective Studies ; Rotator Cuff/*injuries/radiography/*surgery ; *Suture Techniques ; Treatment Outcome

We analysed retrospectively pharmacokinetic parameters of gentamicin and amikacin in 44 and 58 Korean pediatric patients, respectively, with normal renal function. Pharmacokinetic parameters were calculated from two concentrations in serum by method of Sawchuck. There was wide individual variation in peak serum concentrations of gentamicin and amikacin, Administration of the usually recommended doses yielded subtherapeutic concentrations in 47% and 82%, respectevely, of patients in the peak concentrations of gentamicin and amikacin. The volumes of distribution of gentamicin and amikacin in children of over 1 year of age were 0.37+/-0.13L/kg and 0.41+/-0.13L/kg which are greater than those reported from the western countries. We conclude that the wide individual variation and high frequency of subtherapeutic levels in the peak concentrations of gentamicin and amikacin obtained by usually recommended dosage as well as the narrow safety margin of these drugs necessitate monitoring of serum concentration and adjustment of individual dosage regimen early in the course of treatment with aminoglycosides.
Amikacin* ; Aminoglycosides ; Child* ; Gentamicins* ; Humans ; Pharmacokinetics* ; Retrospective Studies

PURPOSES: To compare the radiologic results in the minimally invasive quadriceps sparing total knee arthroplasty(MIS-QS TKA) with those in conventional total knee arthroplasty(TKA). MATERIALS AND METHODS: Between June 2004 and December 2004, we underwent 20 MIS-QS TKAs (group I) and 20 conventional TKAs(group II). All cases were female with osteoarthritis. The average age was 68.0 years in group I and 65.0 years in group II. The mechanical axis and the implant position were measured by 2 observers according to the reontgenographic evaluation system of the American Knee Society. RESULTS: The mean length of skin incision was 9.2 cm in group I and 16.1 cm in group II. The mean operative time was 127 minutes in group I and 85 minutes in group II. The mean postoperative mechanical axis was varus 1.35 degrees in group I and varus 0.37 degrees in group II. And the mean alpha, beta, gamma and delta angle were 94.9, 90.6, 4.5 and 85.5 degrees in group I, and 94.3, 91.4, 4.7 and 84.6 degrees in group II, respectively. There was no significant difference in the radiologic results between both groups. CONCLUSIONS: There was no significant difference in the implant position and mechanical axis between MIS-QS TKA group and conventional TKA group. Average skin incision was shorter in MIS-QS TKA, but longer operation time taken compared to that of conventional TKA.
Arthroplasty* ; Axis, Cervical Vertebra ; Female ; Humans ; Knee* ; Operative Time ; Osteoarthritis ; Skin ; Surgical Procedures, Minimally Invasive

STUDY DESIGN: A retrospective study about spinal intradural tumor. OBJECTIVES: We analyzed clinical symptom, findings of MRI, and surgical outcome of spinal intradural tumor. SUMMARY OF LITERATURE REVIEW: Intradural tumors are not commonly reported and they show non-specific clinical features. MATERIALS AND METHODS: In this study, 18 patients who underwent surgical treatment and radiologically and pathologically diagnosed as spinal intradural tumor from 1997 to 2009 were reviewed. We evaluated pain, neurological symptoms, location of tumor as well as degrees of signal intensity and its enhancement of MRI(T1 and T2). And clinical outcomes were analyzed according to Klekamp-Samii scoring system and Visual Analogue Scale(VAS). RESULTS: All patients were clinically suffered from back pain and radiating pain of lower extremity including 3 patients with neurological symptoms. We radiologically found single tumor in 16 cases and masses more than two lesion in 2 cases. 1 case was located on cord level(T7), 14 cases cauda equine level, and 3 cases sacral level. We performed laminectomy in 18 cases and posterior instrumentation was applied to 8 cases. In clinical features, mean Klekamp-Samii score was improved from 21.6 to 23.5(p<0.05) and VAS was recovered from 5.2 to 3.0 (p<0.05). CONCLUSIONS: Spinal intradural tumor has non-specific clinical symptoms. Therefore we should perform MRI to find intradural tumor and active management including surgical treatment should be performed due to clinically good results.
Back Pain ; Humans ; Laminectomy ; Lower Extremity ; Retrospective Studies

Non-Hodgkin's lymphoma frequently involves the kidneys, with previous reports demonstrating approximately a 48 Yo incidence at autopsy. In contrast, lymphoma originating within the kidneys is a rare event, because the renal parenchyma does not have lymphatics. Most common type of primary renal lyrnphoma that calssified by Working formulation and irnmunohistochemistry was diffuse large B-cell, intermediate grade. A 43-year-old woman presented with epigastric discomfort, anorexia, fever, and weight loss. The past rnedical history was unremarkable. On physical examination, she was febrile, and conjunctiva was pale. Lymph node was enlarged and palpated at right inguinal area. But no other lymphadenopathy or hepatosplenomegaly was found. Laboratory study showed WBC 6,900/mm, hemoglobin 6.7g/dL, serum LDH 783IU/L, GFR 31.45 ml/min. The chest X-ray was within normal limit; no mediastinal lympha- denopathy was present. The abdominal X-ray revealed enlargement of right kidney. The abdominal CT scan showed markedly enlarged both kidneys containing inhomogeneous solid masses with poor excretion of intravenous contrast, a few small paraaortic lymphadenopathies, and contour bulging on the pancreas body. A percutaneous renal biopsy was obtained from this patient at the right kidney. Microscopic exarnination showed a diffuse infiltrate of predominantly large lymphoid cells having round to oval vescicular nuclei. Immunohistochemical studies revealed a B-cell-type lymphoma. The tumor was judged to be an intermediate-grade, large-cell, diffused, B-cell-type non-Hodgkin's lymphoma. We report a case of primary bilateral B-cell renal lymphoma in a 43-year-old female patient with review of the literature.
Adult ; Anorexia ; Autopsy ; B-Lymphocytes* ; Biopsy ; Conjunctiva ; Female ; Fever ; Humans ; Incidence ; Kidney ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Pancreas ; Physical Examination ; Thorax ; Tomography, X-Ray Computed ; Weight Loss