BACKGROUND: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a “knot-ache”. This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications. METHODS: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed. RESULTS: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3. CONCLUSIONS: The knots of suture anchor maybe a possible etiology of the pain, which we termed a “knot-ache”. Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, “knot-ache”. Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.

Background: Verruca vulgaris is a common cutaneous viral infectious disease caused by human papilloma virus (HPV). The main treatment modalities are cryotherapy, immunotherapy, laser therapy, intralesional injection of bleomycin, and salicylic acid therapy. However, there is no definitive tool for predicting clinical improvement or treatment response. Objective: This study was designed to evaluate clinical treatment response according to the hardness of verruca vulgaris skin lesions. We developed a new prediction tool called the “hardening sign” that divides the course of treatment into four categories based on inspection and palpation. Methods: We conducted a retrospective medical chart review of patients who visited Hanyang University Guri Hospital between January 2016 and January 2017 and were clinically diagnosed with verruca vulgaris. We divided the patients into four groups according to the grade of rigidity of their lesions. Results: Forty-seven patients (24 male and 23 female) were identified. The mean age at diagnosis was 17.2±8.5 years, and the mean duration of treatment was 28.8±27.7 weeks. The mean number of hospital visits was 16.5±12.4. Eleven patients underwent only cryotherapy, while 36 patients underwent combined cryotherapy and immunotherapy. We observed significantly shorter durations of treatment for patients with higher grades of hardening. There was no correlation between the hardening grade and the number of treatments required for patients to be completely cured. Conclusion This study suggests that the therapeutic response of verruca vulgaris warts to cryotherapy can be easily predicted by careful consideration of the “hardening sign”.

No abstract available.
Breast ; Carcinoma, Ductal ; Neoplasm Metastasis

No abstract available.
Embryonic Development* ; Female ; Humans* ; Pregnancy ; Serum Albumin*

Behcet's disease is a multisystem autoimmune disease with vasculitic features, and major vascular involvement occurs in 7.7-60% of patients. Venous lesions are more common than arterial lesions and arterial thrombotic events are relatively rare. We report a patient with Behcet's disease who developed a splenic infarct associated with splenic thrombotic arteritis. A 44-year-old man who had been diagnosed with Behcet's disease 5 years earlier presented with left flank pain lasting for 5 days. Laboratory tests revealed an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Computed tomography (CT) and three-dimensional CT showed a wedge-shaped splenic infarct and thrombus in the splenic artery. We treated him with low-molecular-weight heparin and prednisolone. The symptoms improved within 6 days of hospitalization, after which we stopped the heparin and added methotrexate and azathioprine. Splenic infarct should be ruled out if patients with Behcet's disease complain of new left-sided abdominal pain.
Abdominal Pain ; Adult ; Arteritis ; Autoimmune Diseases ; Azathioprine ; Blood Sedimentation ; C-Reactive Protein ; Flank Pain ; Heparin ; Heparin, Low-Molecular-Weight ; Hospitalization ; Humans ; Methotrexate ; Prednisolone ; Splenic Artery ; Splenic Infarction ; Thrombosis

Behcet's disease is a multisystem autoimmune disease with vasculitic features, and major vascular involvement occurs in 7.7-60% of patients. Venous lesions are more common than arterial lesions and arterial thrombotic events are relatively rare. We report a patient with Behcet's disease who developed a splenic infarct associated with splenic thrombotic arteritis. A 44-year-old man who had been diagnosed with Behcet's disease 5 years earlier presented with left flank pain lasting for 5 days. Laboratory tests revealed an elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Computed tomography (CT) and three-dimensional CT showed a wedge-shaped splenic infarct and thrombus in the splenic artery. We treated him with low-molecular-weight heparin and prednisolone. The symptoms improved within 6 days of hospitalization, after which we stopped the heparin and added methotrexate and azathioprine. Splenic infarct should be ruled out if patients with Behcet's disease complain of new left-sided abdominal pain.
Abdominal Pain ; Adult ; Arteritis ; Autoimmune Diseases ; Azathioprine ; Blood Sedimentation ; C-Reactive Protein ; Flank Pain ; Heparin ; Heparin, Low-Molecular-Weight ; Hospitalization ; Humans ; Methotrexate ; Prednisolone ; Splenic Artery ; Splenic Infarction ; Thrombosis

The purpose of this study was to standardize ingredients used by school foodservices. This study analyzed the current notation of ingredients in used by used in school foodservices through the NEIS system employed by school foodservices of elementary schools through high schools in South Korea. Specifically, this study suggests systemized standardization of ingredient classification and quality attributes of at school foodservices by applying a case study analysis. The findings from the case analysis of the Electronic Procurement System operator are as follows. Classifications for ingredients of the NEIS system used by school food services consisted of included food group, food name, detailed food name, and description. Classification was not clearly divided between the classification scheme and the attribute system. Therefore, food group, food name, and product information of each food should be categorized as the classification scheme, whereas the detailed food name (excluding product information) and description should be standardized as the attribute system, which is composed of required attributes, recommended attributes, and other attributes. This study suggests that system standardization should be carried out in the field of school foodservices, as advancements between distributors and school food service providers could affect food ingredient quality. Thus, standardization can influence purchase and distribution in many ways.
Classification* ; Food Services ; Humans ; Korea

STATEMENT OF PROBLEM: The long-term success of implants is the development of a stable direct connection between bone and implant surface, which must be structural and functional. To improve a direct implant fixation to the bone, various strategies have been developed focusing on the surface of materials. Among them, altering the surface properties can modify cellular responses such as cell adhesion, cell motility and bone deposition. PURPOSE: This study was to evaluate the cellular behaviors on the surface-modified titanium by morphological observation, cellular proliferation and differentiation. MATERIAL AND METHODS: Specimens were divided into five groups, depending on their surface treatment: electropolishing(EP) anodizing(AN), machining(MA), blasting with hydroxyapatite particle(RBM) and electrical discharge machining(EDM). Physicochemical properties and microstructures of the specimens were examined and the responses of osteoblast-like cells were investigated. The microtopography of specimens was observed by scanning electron microscopy(SEM). Surface roughness was measured by a three-dimensional roughness measuring system. The microstructure was analyzed by X-ray diffractometer(XRD) and scanning auger electron microscopy(AES). To evaluate cellular responses to modified titanium surfaces, osteoblasts isolated from neonatal rat were cultured. The cellular morphology and total protein amounts of osteoblast-like cell were taken as the marker for cellular proliferation, while the expression of alkaline phosphatase was used as the early differentiation marker for osteoblast. In addition, the type I collagen production was determined to be a reliable indicator of bone matrix synthesis. RESULTS: 1. Each prepared specimen showed specific microtopography at SEM examination. The RBM group had a rough and irregular pattern with reticulated appearance. The EDM-treated surface had evident cracks and was heterogeneous consisting of broad sheet or plate with smooth edges and clusters of small grains, deep pores or craters. 2. Surface roughness values were, from the lowest to the highest, electropolished group, anodized group, machined group, RBM group and EDM group. 3. All groups showed amorphous structures. Especially anodized group was found to have increased surface oxide thickness and EDM group had titaniumcarbide(TiC) structure. 4. Cells on electropolished, anodized and machined surfaces developed flattened cell shape and cells on RBM appeared spherical and EDM showed both. After 14 days, the cells cultured from all groups were formed to be confluent and exhibited multilayer proliferation, often overlapped or stratified. 5. Total protein amounts were formed to be quite similar among all the group at 48 hours. At 14 days, the electropolished group and the anodized group induced more total protein amount than the RBM group(P<.05). 6. There was no significant difference among five groups for alkaline phosphatase(ALP) activity at 48 hours. The AN group showed significantly higher ALP activity than any other groups at 14 days(P<.05). 7. All the groups showed similar collagen synthesis except the EDM group. The amount of collagen on the electropolished and anodized surfaces were higher than that on the EDM surface(P<.05).
Alkaline Phosphatase ; Animals ; Bone Matrix ; Cell Adhesion ; Cell Movement ; Cell Proliferation ; Cell Shape ; Edible Grain ; Collagen ; Collagen Type I ; Durapatite ; Osteoblasts* ; Rats ; Surface Properties ; Titanium*

OBJECTIVE: To investigate the changes of gait patterns in hemiplegic patients with ankle foot orthosis (AFO) and with functional electrical stimulation (FES). METHOD: Fifteen hemiplegic patients who can walk independently with cane participated in this study. Kinematic gait analysis was performed for all subjects using three-dimensional gait analysis system in barefoot, wearing AFO, and applying FES. The mean values of each gait trials were taken and statistically analysed by repeated measures of ANOVA. RESULTS: Genu recurvatum at stance phase and excessive ankle plantar flexion at stance and swing phase were decreased after wearing AFO. Excessive ankle plantar flexion at swing phase were decreased after applying FES. CONCLUSION: The results showed that the FES is useful for the correction of hemiplegic gait as mush as of wearing AFO.
Ankle* ; Canes ; Electric Stimulation* ; Foot Orthoses* ; Foot* ; Gait ; Gait Disorders, Neurologic* ; Humans ; Plastics*

OBJECTIVE: Day hospital program for the brain injured patients has been developed and conducted as a model project in the National Rehabilitation Hospital of Korea since August 1998. This article is to present our 1-year experience and evaluate the efficacy and effectiveness of the program. METHOD: All patients treated in day hospital from August 1998 to July 1999 were included. Functional Independence Measure (FIM), ESCROW (Environment, Social support, Cluster of family members, Resources, Outlook, Work or School status), Medical Outcome Study 36-item Short Form Survey (SF-36) were assessed at admission and discharge. Patient satisfaction was surveyed at discharge. Program cost was compared with that of inpatient control group. RESULTS: 1) Among 51 subjects (32 males, 19 females, mean age 57), 48 suffered stroke and 2 had traumatic brain injury. Average length of stay was 10 weeks and 45 patients (88.2%) were discharged to home. 2) FIM total score, motor subtotal score and cognitive subtotal score were all incresed significantly (p<0.01). 3) ESCROW score was also improved significantly (p<0.01). 4) SF-36 showed significant improvement in physical functioning, role limitation-emotional, mental health and general health (p<0.05). 5) 95.1% answered satisfaction with the program and 73.2% reported health enhancement. 6) Program costs were significantly lower than the inpatient group (p<0.01). CONCLUSION: Day hospital seems to be a useful program for comprehensive rehabilitation for the brain injured, and needs to be pervaded throughout the country with proper payment.
Brain ; Brain Injuries ; Female ; Humans ; Inpatients ; Korea ; Length of Stay ; Male ; Mental Health ; Outcome Assessment (Health Care) ; Patient Satisfaction ; Rehabilitation* ; Stroke