PURPOSE: Postoperative strength of knee flexor and extensor, and functional evaluation after arthroscopic menisectomy of the knee was evaluated objectively at the time of returning to daily life. MATERIALS AND METHODS: The 31 knees (29 patients) had meniscal injuries without associated ligament injury. The muscle strength was tested with Cybex 340 isokinetic dynamometer preoperatively and at 2, 4, 6, 10 weeks postoperatively. Clinical evaluation by Lysholm scoring system was also done simultaneously. The statistical analysis was evaluated by repeated measures of ANOVA. RESULTS: Muscle strength of extensor (quadriceps) was abruptly decreased to about 45% torque of the preoperative level at postop 2 weeks, but slowly increased to about 90% torque at 10 weeks in 90 degree/sec and 180 degree/sec exercise. The flexor strength was also a little bit decreased at post-op 2 weeks, slowly increased to about 120%-150% torque of preoperative level in 90 degree/sec and 180 degree/sec exercise at post-op 10 weeks. The clinical evaluation by Lysholm scale showed 45 points at postop 2 weeks and slowly improved to 80 points at post-op 10 weeks. CONCLUSIONS: Muscle weakness of knee extensor and flexor remained in isokinetic test at post-op 4-6 weeks. The recovery rate for weakness of hamstrings was faster than quadriceps. The rehabilitation of quadriceps should be accentuated in the prevention of knee injury due to muscle weakness.
Arthroscopy ; Knee Injuries ; Knee* ; Ligaments ; Muscle Strength* ; Muscle Weakness ; Rehabilitation ; Torque

OBJECTIVE: The authors report the operative methods and postoperative outcomes of 14 cases with intractable supplementary sensorimotor area(SSMA) seizures. METHODS: From September 1996 to July 2001, 14 intractable cases treated by operation were reviewed and analysed with the help of each clinical characteristics, magnetic resonance images, histopathologic findings, noninvasive and invasive electroencephalographies(EEG), subdural grid and strip insertion and intracranial electrocorticographies and brain mapping results, retrospectively. The follow-up duration was from 2 months to 70 months(average, 26 months). RESULTS: There were eight males and six females and the age ranged from 2 to 47 years(average, 26.2). In the MRI findings, six lesional and eight nonlesional cases, and there were six localized and eight lateralized cases in the semiology and noninvasive EEG studies. In the histopathologic findings, cortical dysplasia was eight cases, gliosis three cases, leukomalacia one case and normal finding was two cases. In the seizure outcome, Engel's class I was 71.4%, class II was 21.4% and class III was 7.2%. The postoperative neurologic deficits were 12 in 14 cases and nine in 12 cases were dramatically improved within two or three weeks postoperatively and the remained three cases, the lesion was involved in the eloquent area but, all of them were improved via the rehabilitation programs. CONCLUSION: In the intractable SSMA seizure, the surgical treatment is an excellent method of treatment and early transient postoperative neurologic deficits were dramatically improved within several weeks.
Brain Mapping ; Electroencephalography ; Female ; Follow-Up Studies ; Gliosis ; Humans ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development ; Neurologic Manifestations ; Rehabilitation ; Retrospective Studies ; Seizures*

BACKGROUND: Most patients with malignant esophageal stricture are surgically incurable at the time of presentation. The aim of this study was to determine the safety and efficacy of endoscopic expandable metal stent for palliation of dysphagia caused by malignant stricture. METHODS: From January 2000 to December 2001, thirty-two expandable metal stents (Nitis(R) Taewoong Med. Co. Korea, 6 uncovered, 12 covered, 14 double stents for antimigration, 18 mm diameter) were placed in 28 consecutive patients with dysphagia caused by malignancy. Dysphagia score, complications, reintervention, survival length after stent placement were evaluated. RESULTS: This study consisted of 23 men and 5 women. The patients were composed of 13 esophageal carcinomas, 11 gastro-esophageal junction cancers or cardiac cancers, 3 lung cancers, 1 breast cancer. Immediate improvement of dysphagia symptom was seen after initial stent placement in 27 patients (96%). Dysphagia score decreased from 3.0 (+/-0.51) to 1.06 (+/-0.77) after stent placement. There was one death due to hemorrhage after the procedure. There was no stent migration. Restenting was required in 4 cases due to tumor ingrowth (1/4) and overgrowth (3/4) and average interval to restenting was 95 days. Mean survival length was 109 days. CONCLUSION: Expandable metal stents offer excellent rapid palliation of malignant dysphagia. In a small subset of patients who received chemoradiation before stent placement, major complications such as bleeding, perforation, were observed.
Breast Neoplasms ; Constriction, Pathologic ; Deglutition Disorders ; Esophageal Stenosis ; Female ; Heart Neoplasms ; Hemorrhage ; Humans ; Korea ; Lung Neoplasms ; Male ; Stents*

BACKGROUNDS/AIMS: This study was performed prospectively to evaluate the short - term effect of cisapride tartrate on the frequency and the degree of symptoms in patients with functional dyspepsia and functional constipation. METHODS: One-hundred thirty-two patients with a mean age of 44.7 years in men and 43.1 years in women, who presented with symptoms of both functional dyspepsia and functional constipation were recruited, and the frequency and the degree of symptoms corresponding to functional dyspepsia and functional constipation were assessed by an interview in 10 hospitals respectively. In an open, multicenter trial, 132 patients received 10 mg of cisapride tartrate three times a day (TID) for 8 weeks. Patients wrote a defecation diary for 8 weeks and checked symptom scores, which represented the degree of symptoms of dyspepsia and constipation, at the 4th and 8th week. RESULTS: The frequently reported symptoms of functional dyspepsia were epigastric fullness (2.34+/-0.80), bloating (2.05+/-0.82), early satiety (1.67+/-0.99), anorexia (1.04+/-0.95) and nausea (0.94+/-0.93). The mean defecation frequency per week was 3.07+/-2.35 and patients showed subjective symptom scores as follows; 97.0+/-25.26 % in the rate of sense of incomplete evacuation, 1.85+/-0.73 in the hardness of stool and 1.62+/-0.57 in difficulty to pass stool. After adminstration of cisapride tartrate in the case of functional dyspepsia, 66.1% of patients at the 4th week and 81.5 % of patients at the 8th week showed good or excellent improvements. In the case of functional constipation, 82.7% of patients also showed good or excellent improvements. Overall improvements of symptoms in both functional dyspepsia and functional constipation were 78.2% at the 8th week. CONCLUSION: Cisapride tartrate reduced the frequency and the degree of symptoms in functional dyspepsia and functional constipation without significant adverse effects. Functional dyspepsia and functional constipation without significant adverse effects.
Anorexia ; Cisapride* ; Constipation* ; Defecation ; Dyspepsia* ; Female ; Hardness ; Humans ; Male ; Nausea ; Prospective Studies

The objective of the study was to document practice pattern of gastroenterologists for the management of gastroesophageal reflux disease (GERD) under the minimal influence of the insurance reimbursement guideline. Data on management for 1,197 consecutive patients with typical GERD symptoms were prospectively collected during 16 weeks. In order to minimize the influence of reimbursement guideline on the use of proton pump inhibitors (PPIs), rabeprazole was used for the PPI treatment. A total of 861 patients (72%) underwent endoscopy before the start of treatment. PPIs were most commonly prescribed (87%). At the start of treatment, rabeprazole 20 mg daily was prescribed to 94% of the patients who received PPI treatment and 10 mg daily to the remaining 6%. At the third visits, rabeprazole 20 mg daily was prescribed to 70% of those who were followed and 10 mg daily for the remaining 30%. Continuous PPI treatment during the 16-week period was performed in 63% of the study patients. In conclusion, a full-dose PPI is preferred for the initial and maintenance treatment of GERD under the minimal influence of the insurance reimbursement guideline, which may reflect a high proportion of GERD patients requiring a long-term treatment of a full-dose PPI.
2-Pyridinylmethylsulfinylbenzimidazoles/therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Enzyme Inhibitors ; Female ; Gastroenterology ; Gastroesophageal Reflux/*diagnosis/*drug therapy ; *Guideline Adherence ; Humans ; Insurance, Health, Reimbursement ; Male ; Middle Aged ; *Physician's Practice Patterns ; Proton Pump Inhibitors/therapeutic use ; Republic of Korea ; Treatment Outcome

BACKGROUND/AIMS: Therapies of functional dyspepsia (FD) are limited. DA-9701 is a novel prokinetic agent formulated with Pharbitis semen and Corydalis Tuber. We aimed to assess the efficacy of DA-9701 compared with itopride in FD patients. METHODS: Patients with FD randomly received either itopride 50 mg or DA-9701 30 mg t.i.d after a 2-week baseline period. After 4 weeks of treatment, 2 primary efficacy endpoints were analyzed: the change from baseline in composite score of the 8 dyspeptic symptoms and the overall treatment effect. Impact on patients' quality of life was assessed using the Nepean Dyspepsia Index (NDI) questionnaire. RESULTS: We randomly assigned 464 patients with 455 having outcome data. The difference of the composite score change of the 8 symptoms between the 2 groups was 0.62, indicating that DA-9701 was not inferior to itopride. The overall treatment effect response rate was not different between the groups. When responder was defined as > or = 5 of the 7 Likert scale, responder rates were 37% of DA-9701 and 36% of itopride group. Patients receiving DA-9701 experienced similar mean percentage of days with adequate relief during the 4-week treatment period compared with those receiving itopride (56.8% vs 59.1%). Both drugs increased the NDI score of 5 domains without any difference in change of the NDI score between the groups. The safety profile of both drugs was comparable. CONCLUSIONS: DA-9701 significantly improves symptoms in patients with FD. DA-9701 showed non-inferior efficacy to itopride with comparable safety.
Corydalis ; Dyspepsia* ; Humans ; Quality of Life ; Surveys and Questionnaires ; Semen

This study compared the efficacy of DA-9601 (Dong-A ST Co., Seoul, Korea) and its new formulation, DA-5204 (Dong-A ST Co.), for treating erosive gastritis. This phase III, randomized, multicenter, double-blind, non-inferiority trial randomly assigned 434 patients with endoscopically proven gastric mucosal erosions into two groups: DA-9601 3 times daily or DA-5,204 twice daily for 2 weeks. The final analysis included 421 patients (DA-5204, 209; DA-9601, 212). The primary endpoint (rate of effective gastric erosion healing) and secondary endpoints (cure rate of endoscopic erosion and gastrointestinal [GI] symptom relief) were assessed using endoscopy after the treatment. Drug-related adverse events (AEs), including GI symptoms, were also compared. At week 2, gastric healing rates with DA-5204 and DA-9601 were 42.1% (88/209) and 42.5% (90/212), respectively. The difference between the groups was −0.4% (95% confidence interval, −9.8% to 9.1%), which was above the non-inferiority margin of −14%. The cure rate of gastric erosion in both groups was 37.3%. The improvement rates of GI symptoms with DA-5204 and DA-9601 were 40.4% and 40.8%, respectively. There were no statistically significant differences between the two groups in both secondary endpoints. AEs were reported in 18 (8.4%) patients in the DA-5204 group and 19 (8.8%) in the DA-9601 group. Rates of AE were not different between the two groups. No serious AE or adverse drug reaction (ADR) occurred. These results demonstrate the non-inferiority of DA-5204 compared to DA-9601. DA-5204 is as effective as DA-9601 in the treatment of erosive gastritis. Registered randomized clinical trial at ClinicalTrials.gov (NCT02282670)
Artemisia ; Double-Blind Method ; Drug-Related Side Effects and Adverse Reactions ; Endoscopy ; Gastritis* ; Humans ; Seoul

BACKGROUND: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. METHODS: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. RESULTS: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more common in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. CONCLUSIONS: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.
Cefotaxime ; Humans ; Immunization Programs ; Korea ; Levofloxacin ; Multiplex Polymerase Chain Reaction ; Penicillins ; Pneumococcal Vaccines ; Pneumonia ; Serogroup ; Streptococcus pneumoniae ; Streptococcus ; Vaccines