BACKGROUND: Management of massive rotator cuff tears can be challenging because of the less satisfactory results and a higher retear rate regardless of the use of open or arthroscopic repair technique. METHODS: We retrospectively analyzed 102 cases of massive rotator cuff tear treated with either open or arthroscopic repair. Open repair was performed in 38 patients; and arthroscopic repair, in 64 patients. The mean age at the time of surgery was 59.7 years in the open group and 57.6 years in the arthroscopic group. RESULTS: The Constant score increased from the preoperative mean of 55.9 to 73.2 at the last follow-up in the open repair group and from 53.8 to 67.6 in the arthroscopic repair group (p<0.001 and <0.001, respectively). The University of California at Los Angeles (UCLA) score increased from a preoperative mean of 17.7 to 30.8 at the last follow-up in the open group and from 17.5 to 28.7 in the arthroscopic group (p<0.001 and <0.001, respectively). No statistically significant difference in the Constant and UCLA scores was observed between the two groups at the last follow-up (p=0.128 and 0.087, respectively). Retear was found in 14 patients (36.8%) in the open group and 39 patients (60.9%) in the arthroscopic group (p=0.024). CONCLUSIONS: Open and arthroscopic repairs of massive rotator cuff tears may provide satisfactory clinical results with no significant difference. However, a significantly lower retear rate was observed for the open repair group compared with the arthroscopic repair group.
Arthroscopy ; California ; Follow-Up Studies ; Humans ; Retrospective Studies ; Rotator Cuff* ; Shoulder ; Tears* ; Tendon Injuries

BACKGROUND: The purpose of our study was to evaluate the functional and radiologic outcomes of additive augmentation sutures through rotator cuff for proximal humeral fractures stabilized locking plate in elderly patients. METHODS: We enrolled 74 patients over the age of 60 years who received internal fixation using locking plates for proximal humeral fractures. Of these, 50 patients had additive augmentation sutures through rotator cuff. The mean age at the time of surgery was 72.1 years (range, 60-89 years), and the mean follow-up period was 17.5 months (range, 12-62 months). The humeral neck-shaft angle and humeral head height were used as radiological markers to assess the effect of additive augmentation sutures through rotator cuff. We allocated the patients who received additive augmentation sutures into group A and those who did not into group B. RESULTS: At the final follow-up, the mean Korean Showlder Society score and Constant scores were 88.96 +/- 12.1 and 86.6 +/- 11.9, respectively, in group A and 86.21 +/- 11.8 and 85.3 +/- 11.7, respectively, in group B (p=0.368, 0.271). At the final follow-up, the mean loss in humeral neck-shaft angle from the time of immediate postoperative measurement was 1.6degrees in group A and 4.8degrees in group B, whereas the mean loss in humeral head height was 0.82 mm in group A and 0.52 mm in group B (p=0.029, 0.178). CONCLUSIONS: The surgical outcomes of internal fixation using locking plates for proximal humeral fractures were clinically and radiologically good in elderly patients over the age of 60 years without any observable complications. Further, the loss of humeral head shaft angle at the final follow-up from its initial postoperative measurement was significantly smaller in patients who received an additive augmentation suture than in those who did not. Thus, we conclude that augmentation sutures are a beneficial option for elderly patients that clinicians can consider at the time of surgical decision making.
Aged* ; Decision Making ; Follow-Up Studies ; Humans ; Humeral Head ; Rotator Cuff ; Shoulder Fractures* ; Sutures*

BACKGROUND: A novel technique for the repair of tears of the upper subscapularis tendon—intraarticular knotless fixation—has been introduced recently. The purpose of this study was to evaluate the clinical and structural outcomes of arthroscopic intraarticular knotless fixation for the treatment of upper subscapularis tendon tears. METHODS: We retrospectively analyzed the clinical and radiological outcomes of 27 patients who underwent arthroscopic intraarticular knotless fixation for upper subscapularis tendon tears. Finally, a total of 10 patients who could participate in at least a 6 month follow-up of magnetic resonance imaging evaluation and in a least 1-year follow-up on an outpatient basis were enrolled in our study. The mean age at the time of operation was 60.7 years, and the mean duration of follow-up was 14.7 months. Two patients had concomitant tears of the supraspinatus tendon and 8 patients had concomitant tears of the supraspinatus and the infraspinatus tendons. RESULTS: The clinical and radiological outcomes improved after the patients had undertaken arthroscopic intraarticular knotless fixation. The mean visual analogue scale score for pain during motion improved from 6.7 preoperatively to 1.4 at the final follow-up (p<0.001). The mean Constant score improved from 59.3 preoperatively to 79.6 at the final follow-up, and the mean the University of California at Los Angeles score, from 21.7 to 30.2, respectively (p<0.001 and p<0.001). The upper subscapularis tendon tear was healed in every patient except one (90%), for the patient had suffered from a postoperative trauma that resulted in a retear. CONCLUSIONS: We found that arthroscopic intraarticular knotless fixation gives good clinical and structural outcomes for the repair of upper subscapularis tendon tears. Arthroscopic intraarticular knotless fixation provided such a reliable and efficient restoration of the subscapularis tendon footprint that we anticipate it will become a widely-used procedure for upper subscapularis tendon tears.
Arthroscopy ; California ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Outpatients ; Retrospective Studies ; Shoulder ; Tears* ; Tendons* ; Treatment Outcome

PURPOSE: We studied 278 men who are over 40 years of age to educate BPH and to evaluate the prevalence of BPH in Busan city of Korea. MATERIALS AND METHODS: Between December 1997 and February 1998, 278 men in Busan city were investigated. The screening tests included urinary symptom questionnaire (IPSS), digital rectal examination (DRE), prostate specific antigen (PSA) and uroflometry. RESULTS: Based on the IPSS, 36.3%, 49.7% and 14.0% of the men were mild (1-7), moderately (8-19) and severely (20-35) symptomatic. The mean maximal flow rate and PSA for men 40 to 49, 50 to 59, 50 to 69 and over 70 years old were 18.4 ml/sec, 14.2 ml/sec, 12.9 ml/sec, 10.6 ml/sec and 1.081 ng/ml, 1.195 ng/ml, 1.527 ng/ml, 2.352 ng/ml respectively. CONCLUSIONS: The prevalence rate of clinical BPH(IPSS>7 and peak urinary flow rate<10 ml/sec) in community-based study of 278 men was 25.5%.
Aged ; Busan* ; Digital Rectal Examination ; Humans ; Korea ; Male ; Mass Screening ; Prevalence* ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Surveys and Questionnaires

No abstract available.
Biopsy*

This erratum is being published to correct the printing error on page 286 of the article entitled 'Panton-Valentine leukocidin positive Staphylococcus aureus isolated from blood in Korea' by Kim JS, Park JS, Song W, Kim HS, Cho HC, Lee KM, Kim EC in Korean J Lab Med 2007;27:286-91. DOI 10.3343/kjlm. 2007.27.4.286 as follows. The heading of the right column of the Table 1 was misprinted as methicillin-resistant, so it should be corrected to methicillin-susceptible.
Adult ; Amino Acid Substitution ; Brain Neoplasms/radiotherapy/surgery ; Breast Neoplasms/diagnosis/radiotherapy/surgery ; Female ; *Genetic Counseling ; Genetic Predisposition to Disease ; *Germ-Line Mutation ; Humans ; Li-Fraumeni Syndrome/*diagnosis/genetics/therapy ; Mutation, Missense ; Pedigree ; Tumor Suppressor Protein p53/*genetics

BACKGROUND: Lidocaine or verapamil are used as an antiarrhythmic agent or agent blunting the cardiovascular changes induced by intubation or extubation during anesthesia. After recovery from general anesthesia with muscle relaxants, most patients remained in a residual paralytic state, hence it might develop easily recurarization by factors that affect neuromuscular transmission. Lidocaine and verapamil are well known as agents to potentiate the neuromuscular block. We investigated the effects of lidocaine or verapamil on neuromuscular transmission in vitro. METHODS: Square wave, 0.2 ms duration at a frequency of 0.1 Hz supramaximal or train of four stimuli was applied and the twitch height response was recorded mechanomyographically on rat phrenic nerve hemidiaphragm preparations. Dose responses of rocuronium, lidocaine, verapamil, rocuronium pretreated with lidocaine or verapamil, lidocaine pretreated with rocuronium, and verapamil pretreated with rocuronium were observed by cumulative method, and effective doses (Lag dose, ED50 and ED95) between a pretreated and nonpretreated agent were compared statistically. TOF ratios were observed at 80, 70, 40 and 30% of the control twitch height value during the observation of dose responses. RESULTS: Lag dose, ED50 and ED95 of rocuronium were reduced significantly after pretreatment of lidocaine, verapamil or their mixture, and the dose response of lidocaine, verapamil or their mixture were also reduced significantly by rocuronium pretreatment. TOF ratios at the point of each twitch height decreased significantly after pretreatment. CONCLUSIONS: Lidocaine or verapamil itself did not affect the neuromuscular transmission but might have potentiated the neuromuscular blocking effect induced by rocuronium. However, in excessive doses, these agents produced neuromuscular blockade. Consequently, in the residual neuromuscular block induced by rocuronium, lidocaine or verapamil may enhance recurarization.
Anesthesia ; Anesthesia, General ; Animals ; Humans ; Intubation ; Lidocaine* ; Neuromuscular Blockade* ; Phrenic Nerve ; Rats ; Verapamil*

The characteristics of radionuclide brain scan imaging of intracranial lesion are determined, in part, by the rate and quantity of radioactive material in the region of involvement, which is associated with alterations in the blood brain barrier. Findings, noted on the blood flow studies, often serve to direct attention to forthcoming imaging of specific pathological change on the status studies, e.g, carotid artery occlusion and cerebral infarction. We have seen that the 62 year old woman with left side hemiparesis shows typical "Flip-Flap" pattern in brain scan imaging, thought to be due to carotid artery occlusion.
Blood-Brain Barrier ; Brain ; Carotid Arteries ; Cerebral Infarction ; Female ; Humans ; Middle Aged ; Paresis

Endoscopic sphincterotomy(EST) is now an established therapeutic procedure for various disorder of the pailla of Vater, the biliary tract, and the pancreas. From November 1992 to September l993, 123 cases of E.S.T were performed in our hospital. The success rate of EST was 97.8%, and choledocholithiasis was the indication for EST in 63. 4% of cases. Among 78 cases of choledocholithiasis, 47 cases were presence of gall bladder with stone (16 cases) or without stone (31 cases), especially 46 cases were assisted with needle type papillotome and 23 cases were assisted with guidewire. EST hae relatively low complications and is the therapy of choice for choledocholithiasis and various diisease of biliary tract. Guidewire assisted stanard papillotome probable reduce the use of needle type papillotome in the difficult cases that EST with pull type papillotome was impossible.
Biliary Tract ; Choledocholithiasis ; Needles ; Pancreas ; Sphincterotomy, Endoscopic* ; Urinary Bladder

BACKGROUND: Anaphylaxis is a systematic allergic reaction, which may be fatal. However, despite its seriousness, its low level of incidence has prevented in depth studies. Thus, we analyzed the causes of anaphylactic shock in patients admitted in a tertiary hospital, observed its clinical symptoms, and formed a basis for adequate emergency treatment, as well preventive methods. METHODS: The patients who visited Ajou university hospitals from June 1994 to May 2000(7 years) and who met the 1974 JAMA definition were selected for this retrospective study. The analysis of causative agents was made on the basis of clinical symptoms and the patients' chief complaints at the time of admission. Patients diagnosed with anaphylactic shock included those showing at least two types of IgEmediated symptoms; and those with a simple rash or breathing difficulties were excluded from the study. RESULTS: Of 36 patients, 22 were male and 14 female, Those below the age of 20 comprised 16.7% of the patients(6 patients), between 20 and 29 comprised 16.7%(6 patients), 30 and 39 comprised 25%(9 patients), 40 and 49 comprised 27.8%(10 patients), over 50 comprised 14%(5 patients). The overall percentage show 70% of the patients in active adult age group. Rash was the most common clinical symptoms(89%, 32 patients) and hypotension the second(75%, 27 patients), followed by respiratory distress, fainting, and arrhythmia. Causative agents were insect bites, including bee stings(15 patients), medication(12 patients), food(8 patients), and unknown(1 patients). Nine(9) of the 36 case, were diagnosed as having an atopic origin. CONCLUSION: Bee sting was the single most common cause in the insect criteria while penicillin and NSAIDs accounted for most of medication-induced cases. Food showed a varied distribution. An atopic origin was not a basis for anaphylactic shock, but did show a two-fold increase of prevalence. This study is the first of its kind in addressing anaphylactic shock, a potentially severe illness, over a period of 7 years.
Adult ; Anaphylaxis* ; Anti-Inflammatory Agents, Non-Steroidal ; Arrhythmias, Cardiac ; Bees ; Bites and Stings ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Exanthema ; Female ; Hospitals, University ; Humans ; Hypersensitivity ; Hypotension ; Incidence ; Insect Bites and Stings ; Insects ; Male ; Penicillins ; Prevalence ; Respiration ; Retrospective Studies ; Syncope ; Tertiary Care Centers*