No abstract available.
Lip*

BACKGROUND: The purpose of this study is to evaluate the functional outcomes of reverse total shoulder arthroplasty (RTSA) and to assess factors affecting the patients' subjective satisfaction after RTSA. METHODS: Forty-three patients (mean age, 75.0 ± 5.2 years) who underwent RTSA for cuff tear arthropathy or irreparable cuff tears with preoperative magnetic resonance imaging and pre- and postoperative radiographs at 1 year, and whose various functional outcomes including pain visual analogue scale (VAS), simple shoulder test, Constant score, American Shoulder and Elbow Surgeons score, and active range of motion were evaluated preoperatively and at the last follow-up (>12 months) were enrolled. The outcome parameter was set as a satisfaction scale. Various clinical and radiographic factors were analyzed, and their correlations with postoperative satisfaction were evaluated. RESULTS: All functional scores, VAS pain score, and active forward flexion showed significant improvement after surgery (all p<0.001). Twenty-nine patients were satisfied with the results and 14 were dissatisfied. The presence of pseudoparalysis (p=0.028) and worse preoperative function (all p<0.05) were related with higher satisfaction. Any radiologic parameters did not affect patients' postoperative satisfaction. CONCLUSIONS: All patients showed a good functional outcome after RTSA, however the patients' subjective postoperative satisfaction was affected by preoperative functional status (higher satisfaction in poor preoperative function), not by radiological findings.
Arthroplasty* ; Elbow ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Range of Motion, Articular ; Shoulder* ; Surgeons ; Tears

PURPOSE: The purpose of this study was to make an assessment of distal radioulnar joint (DRUJ) instability after the treatment of intra-articular fractures of the distal radius using computed tomography (CT) including contralateral normal wrist. MATERIALS AND METHODS: Twenty-seven intra-articular fractures of the distal radius in twenty-seven patients who had had the surgical treatment were evaluated at follow-up of mean 17.9 months (range, 10-36 months). The DRUJ was assessed with clinical examination, plain radiography, and bilateral CT. CT scans were obtained in 70degrees pronation, neutral, and 70degrees supination. The radioulnar ratio and the subluxation ratio which was modified radioulnar line method were used to measure DRUJ instability. RESULTS: Eight patients were diagnosed as DRUJ instability based on CT assessment. Nine patients were considered to have DRUJ instability in clinical examination, but 4 patients of them were confirmed to have DRUJ instability based on CT measurements. Nonunions of ulnar styloid or malunions of the distal radius were not found to have statistical correlation with DRUJ instability (p>0.05). CONCLUSION: In patient with suspicious DRUJ instability following distal radius fractures, we recommend computed tomography scans of both the injured and uninjured wrists in pronation, neutral, and supination position for objective assessment.
Follow-Up Studies ; Humans ; Intra-Articular Fractures* ; Joint Instability* ; Joints* ; Pronation ; Radiography ; Radius Fractures ; Radius* ; Supination ; Tomography, X-Ray Computed ; Wrist

Aneurysm of the internal carotid artery is a rare disease and is known to be associated with congenital arterial anomalies such as neurofibromatosis type I (NF-I). NF-I is an autosomal dominant neurocutaneous disorder characterized by a variety of manifestations that involve the central and peripheral nervous systems, skin, vascular system, and skeleton. In particular, the involvement of vascular abnormalities in NF-I is well known. Any vessel may be affected by this condition, although the renal artery is most frequently involved. The vascular abnormality can be occlusive or an aneurysmal degenerative change. Therefore, symptomatic presentations might assume an indolent pathophysiologic course such as hypertension, or manifest as a catastrophic event such as arterial rupture that could result in sudden death. We report a rare autopsy case of an aneurysmal rupture of the internal carotid artery in a woman with suspected NF-I, who collapsed in her home.
Aneurysm ; Autopsy ; Carotid Artery, Internal ; Death, Sudden ; Female ; Glycosaminoglycans ; Humans ; Hypertension ; Neurocutaneous Syndromes ; Neurofibromatoses ; Neurofibromatosis 1 ; Peripheral Nervous System ; Rare Diseases ; Renal Artery ; Rupture ; Skeleton ; Skin

Anaphylactic deaths are frequently observed at autopsies. Since death associated with medical practice has become social concern, the identification of anaphylactic shock is an important part of forensic medicine. However, autopsy findings of anaphylactic shock are usually non-specific; therefore, the diagnosis of anaphylactic shock must be inferred from collecting data on the past history of the deceased, circumstances of death, and negative autopsy findings. The analysis of serum mast cell tryptase level is a well-known, useful ancillary test for the diagnosis of anaphylactic shock, but is not widely used in daily practice in Korea. We recently encountered 2 autopsy cases of anaphylactic shock and confirmed that analysis of serum mast cell tryptase level was useful for the diagnosis of anaphylactic shock. In this report, we present these 2 autopsy cases of anaphylactic shock, with literature review of the usefulness and limitations of serum mast cell tryptase analysis.
Anaphylaxis ; Autopsy ; Forensic Medicine ; Korea ; Mast Cells ; Tryptases

PURPOSE: The purpose of this study was to investigate the prevalence of depression and suicidal ideation in elders with dementia and to identify factors influencing their suicidal ideation. METHODS: A descriptive and cross-sectional study was conducted from February to March, 2011. The participants were 298 older adults whose MMSE-KC score was 15 to 23. Collected Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression. RESULTS: According to the Geriatric Depression Scale (GDS) classification criteria, 86.2% of the elders in this study exhibited depression (GDS=5), and 31.5% manifested severe depression. The mean score of suicidal ideation was 5.70 (range 0-20). The risk factors for suicidal ideation were depression, suicidal attempt experience, present location for care, and activities of daily living. CONCLUSION: The results of this study can be utilized in the development of suicide prevention programs for older adults with dementia. In particular, depression should be screened and managed to reduce suicidal ideation of older adults with dementia.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Analysis of Variance ; Cross-Sectional Studies ; Dementia/*psychology ; Depression/*epidemiology ; Female ; Humans ; Male ; Questionnaires ; Risk Factors ; *Suicidal Ideation ; Suicide, Attempted

OBJECTIVE: The aim of this study is to evaluate the efficacy of anterior cervical plating systems, such as ORION? plate(locked plate), PCB plate-cage, TOP plate(unlocked plate). METHODS: This study was performed in 97 degenerative cervical spondylotic patients who adimitted to the hospital from January 1996 to March 1999. The average follow-up period was 13 months. RESULTS: One-level anterior plating appeared to have better surgical results(p<0.05) and a lower complication rate(p<0.001) than multi-level plating. And a group of patients with radiculopathy appeared to have better surgical results than that of patients with myelopathy(p<0.001). Unlocked TOP? plate system appeared to have higher metallic failure rate(p<0.001) and worse results(p<0.05) than the other plating systems. The outcome based on Odom's criterion was excellent or good in 95.8% of the patients. CONCLUSION: The one-level anterior plating of cervical anterior fusion in degenerative cervical spondylotic patients appears to have better result and no complication than multi-level plating. Also, locked plating system appears to have better result and no metallic failure than unlocked plating system.
Follow-Up Studies ; Humans ; Radiculopathy ; Spondylosis*

Wrist arthroscopy has been used as an important adjunct procedure to distal radius fracture management. This procedure allows minimal surgical intervention and provides excellent visualization of the joint for anatomical restoration of articular fracture of the distal radius and early management of associated injuries. To many, it is still technically challenging to adequately perform arthroscopy in the distal radius fractures. With this review, we aimed to provide an updated arthroscopic technique in the management of distal radius fractures and potential pitfalls of this technique.
Arthroscopy ; Joints ; Radius ; Radius Fractures* ; Wrist

No abstract available.

Hand fractures are the second most common fracture in the upper extremities after the distal radius, and patients with these injuries may be experienced in hand surgery clinics. On the other hand, during the treatment of hand fractures, complications can occur due to complex functions of the hand and small-sized injuries to the bone and soft tissues. This review focused on the principles of management of these fractures, including injury mechanism, evaluations and recent treatment options. Minimally invasive surgery in various types of hand fractures, including the phalanx and metacarpal bone, is preferred because early mobilization after surgery has been emphasized to reduce complications, such as stiffness.
Early Ambulation ; Finger Phalanges ; Hand ; Humans ; Metacarpal Bones ; Minimally Invasive Surgical Procedures ; Radius ; Upper Extremity