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

BACKGROUND: T cell mediated immune destruction is an important mechanism of liver injury in patients with chronic hepatitis C. Serum levels of soluble interleukin-2 receptor(sIL-2R) seem to serve as a marker for the T cell activation and progressive liver injury, This study examined serum levels of sIft-2R and hepatitis C virus (HCV) RNA in patients with chronic HCV infection to determine the correlation with the severity of chronic hepatocellular damage. METHODS: Serum levels of sIft-2R in 73 patients with HCV infection (chronic hepatitis 52, liver cirrhosis 9, hepatocellular carcinoma 12) and 40 healthy controls were measured by sandwich enzyme immunoassay (CELLFREE, T Cell Sciences, USA). HCV RNA was quantified by QUANTIPLEX(TM) HCV RNA 2.0 assay (Chiron, USA) with duplication. This assay is a sandwich nucleic acid hybridization procedure using branched DNA amplification for the quantitation of HCV RNA. RESULTS: The sIL-2R levels of 52 patients with chronic hepatitis (591.4+/-238.7U/mL), 9 with liver cirrhosis(949.4+/-721.9 U/mL), and 12 with hepatocellular carcinoma (1,167.4+/- 554.4 U/mL) were significantly higher than those of healthy controls(370.8+/-71.8 U/mL) (p<0.001). A progressive and significant increase occurred in sIL-2R levels with chronic hepatitis C, liver cirrhosis and hepatocellular carcinoma (HCC) in order (p(0.001). The HCV RNA was detected in all patients and the means of HCV viral load were 3.3 MEq/mL in chronic hepatitis, 2.8 MEq/mL in cirrhosis, and 3.7 MEq/mL in HCC. There was no significant correlation between HCV RNA and the severity of liver injury in chronic HCV infection. There were no correlations among sIL-2R, HCV RNA and serum ALT. CONCLUSIONS: These results suggest that chronic hepatocellular injury by HCV progress mainly by T cell mediated immune response, not by direct cytopathic injury. Also, sIL-2R can be useful as a marker in monitoring the patients with HCV infection at high risk of getting HCC.
Carcinoma, Hepatocellular ; DNA ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis C, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoenzyme Techniques ; Interleukin-2* ; Liver ; Liver Cirrhosis ; Nucleic Acid Hybridization ; RNA ; Viral Load

BACKGROUND: T cell mediated immune destruction is an important mechanism of liver injury in patients with chronic hepatitis C. Serum levels of soluble interleukin-2 receptor(sIL-2R) seem to serve as a marker for the T cell activation and progressive liver injury, This study examined serum levels of sIft-2R and hepatitis C virus (HCV) RNA in patients with chronic HCV infection to determine the correlation with the severity of chronic hepatocellular damage. METHODS: Serum levels of sIft-2R in 73 patients with HCV infection (chronic hepatitis 52, liver cirrhosis 9, hepatocellular carcinoma 12) and 40 healthy controls were measured by sandwich enzyme immunoassay (CELLFREE, T Cell Sciences, USA). HCV RNA was quantified by QUANTIPLEX(TM) HCV RNA 2.0 assay (Chiron, USA) with duplication. This assay is a sandwich nucleic acid hybridization procedure using branched DNA amplification for the quantitation of HCV RNA. RESULTS: The sIL-2R levels of 52 patients with chronic hepatitis (591.4+/-238.7U/mL), 9 with liver cirrhosis(949.4+/-721.9 U/mL), and 12 with hepatocellular carcinoma (1,167.4+/- 554.4 U/mL) were significantly higher than those of healthy controls(370.8+/-71.8 U/mL) (p<0.001). A progressive and significant increase occurred in sIL-2R levels with chronic hepatitis C, liver cirrhosis and hepatocellular carcinoma (HCC) in order (p(0.001). The HCV RNA was detected in all patients and the means of HCV viral load were 3.3 MEq/mL in chronic hepatitis, 2.8 MEq/mL in cirrhosis, and 3.7 MEq/mL in HCC. There was no significant correlation between HCV RNA and the severity of liver injury in chronic HCV infection. There were no correlations among sIL-2R, HCV RNA and serum ALT. CONCLUSIONS: These results suggest that chronic hepatocellular injury by HCV progress mainly by T cell mediated immune response, not by direct cytopathic injury. Also, sIL-2R can be useful as a marker in monitoring the patients with HCV infection at high risk of getting HCC.
Carcinoma, Hepatocellular ; DNA ; Fibrosis ; Hepacivirus* ; Hepatitis C* ; Hepatitis C, Chronic* ; Hepatitis* ; Hepatitis, Chronic* ; Humans ; Immunoenzyme Techniques ; Interleukin-2* ; Liver ; Liver Cirrhosis ; Nucleic Acid Hybridization ; RNA ; Viral Load

BACKGROUND: Several studies have demonstrated that quantitation of hepatitis B virus (HBV) DNA in sera of HBsAg-positive patients is more useful test for the assessment of infectivity and for the evaluation of disease status than previously utilized numerous serological markers and qualitative polymerase chain reaction for the detection of HBV DNA. We tried to measure serum HBV DNA using a branched DNA (bDNA) signal amplification assay, which is recently introduced and known to be a simple and nonradioisotopic method. METHODS: Total forty patients with HBsAg were randomly selected and serum HBV DNA was measured with duplication using bDNA signal amplification assay (QUANTIPLEXTM HBV DNA ASSAY, Chiron, USA). Quantitation was determined from a standard curve and expressed as HBV DNA equivalents/mL (Eq/mL; 1 Eq = 1 molecule of the primary HBV DNA standard). Serum HBeAg, aspartate aminotransferase (AST), alanine aminotransferase (ALT) , and soluble interleukin-2 receptor (sIL-2R) were compared with HBV DNA. RESULTS: Serum HBV DNA was quantitated in 13 patients (32.5%) (range 6.4x106-7.4x109 Eq/mL, mean 1.8x109 Eq/mL, CV 8.1%). All eleven patients (100%) with both HBsAg and HBeAg an4 2 of 29 patients (6.9%) with HBsAg but not with HBeAg showed measurable HBV DNA (p < 0.001). In addition, serum levels of AST, ALT, and sIL-2R were significantly higher in HBV DNA measured patients compared with those of unmeasured patients. CONCLUSIONS: Above results show that more than half the HBsAg-positive patients do not have enough HBV DNA which is measurable with boNA signal amplification assay but all of HBeAg-positive patients and some of HBeAg-negative patients do. In addition, HBV DNA quantitation might be correlated with the disease activity in HBsAg-positive patients because serum levels of AST, ALT, and sIL-2R are higher in patients measured with HBV DNA than unmeasured.
Alanine Transaminase ; Aspartate Aminotransferases ; Branched DNA Signal Amplification Assay* ; DNA ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans ; Interleukin-2 ; Polymerase Chain Reaction

Nasopharyngeal angiofibroma is a relatively rare, but is a well known tumor that occurs almost in male, most frequently during the adolescent stage. Its character is histologically benign but clinically malignant because of locally invasive character to the adjascent structures, massive bleeding tendency during surgical procedure and high recurrence rate after treatment. Recently many advancements diagnostic method and surgical technique has reached satisfactory result in treating this difficult tumor. The authors present a case of nasopharyngeal angiofibroma in 16 years old male patient, who was received surgical removal of the tumor through the transpalatal approach after full diagnostic evaluation and preoperative hormonal therapy.
Adolescent ; Angiofibroma* ; Hemorrhage ; Humans ; Male ; Methods ; Recurrence

As public awareness of the various warning signs of malignancy increases, so does the concern evoked by the self identified finding of mass in the head and neck area. Not all the palpable masses are always significantly abnormal, but any nontender mass especially to the adult is significant enough to warrant further full investigation and follow up, the object of which should be to determine the possibility of malignancy and urgency of treatment. Approach to the diagnosis of the neck mass is so important in that it affects decision regarding further evaluation would lead to the determination of the most efficacious mode of therapy, eventually to the good prognosis. So, it should be emphasized that approach to the diagnosis of neck mass should be planned, systematic and thorough, this begins with the taking careful history following performance of complete examination of the head and neck especially to the nasopharynx, tongue base, pyriform sinus, palatine tonsil and larynx. Then a number of laboratory and radiologic studies are available, following triple endoscopy under general anesthesia and blind biopsy if needed. The most important rule to keep is that any biopsy procedures should be delayed to the last modality of effort to the diagnosis and if it should be done, under the plan of radical neck dissection.
Adult ; Anesthesia, General ; Biopsy ; Diagnosis ; Endoscopy ; Follow-Up Studies ; Head ; Humans ; Larynx ; Nasopharynx ; Neck Dissection ; Neck* ; Palatine Tonsil ; Prognosis ; Pyriform Sinus ; Tongue

No abstract available.
Fatigue* ; Sciatica*

No abstract available.

PURPOSE & METHOD: The authors analyzed the morphology of upper eyelid of 480 normal eyes of medical college students, nurses, and officers in our hospital. RESULT: The height of eyelid fissure was 8.33 mm in right eye, 8.43 mm in left eye in men and 9.05 mm in right eye, 9.14 mm in left eye in women. Intercanthal distance was 36.96 mm in men and 36.52 mm in women. The length of palpebral fissure was 27.43 mm in right eye, 27.66 mm in left eye in men and 27.82 mm in right eye, 27.87 mm in left eye in women. The epicanthal fold was found in 15.0% of men and in 10.0% of women. Most frequent type of epicanthal fold was epicanthus tarsalis. The upper eyelid crease was found in 24.2% of total participants, and 16.7% in men and 31.7% in women. The levator function according to Berke's method was 13.46 mm in right eye, 13.43 mm in left eye in men and 13.74 mm in right eye, 13.67 mm in left eye in women. MRD1 was 2.39 mm in right eye, 2.42 mm in left eye in men and 2.70 mm in right eye, 2.65 mm in left eye in women. The MLD as similar values in the evaluation of levator function was 5.89 mm in right eye, 6.08 mm in left eye in men and 4.99 mm in right eye, 5.01 mm in left eye in women. CONCLUSION: In this study we could conclude that morphological values of eyelid and levator function were measured similarly to those in western people although values such as MRD1 was noted different. We suggest that our data were helpful to decision of the standard values of Korean adult and young people.
Adult* ; Eyelids* ; Female ; Humans ; Male

OBJECTIVE: To evaluate the changing pattern of serum leptin level and the correlation between estradiol level during the clomiphene citrate challenge test(CCCT) or controlled ovarian hyperstimulation(COH) cycle. METHODS: Twenty-seven women who underwent CCCT and fourteen women who underwent controlled ovarian hyperstimulation were recruited to measure the serum leptin level. After correction of serum concentration with body mass index(BMI), changes of leptin level and correlation with serum estradiol level during CCCT and COH cycle were analyzed. RESULTS: Circulating leptin levels were significantly correlated with BMI at each time point in CCCT cycle(P<0.01). In CCCT cycle, leptin/BMI level was significantly increased at midluteal phase compared to that of menstrual cycle day 3 and 10(p<0.05). In women with regular menstruation, leptin/BMI level at midluteal phase was significantly higher than that of menstrual day 3 and 10, but this difference was not seen in women with irregular menstruation. The leptin/BMI level in COH cycle showed increasing tendency throughout ovarian stimulation. But there was no significant correlation between leptin/BMI and estradiol level in CCCT and COH cycle. CONCLUSION: There is a significant correlation between BMI and circulating leptin level. Midluteal leptin level is significantly higher than that of follicular phase in CCCT cycle, and there is an increasing tendency in leptin level after ovarian stimulation in CCCT and COH cycle without statistical significance. These findings suggest that circulating estradiol concentration has no major influence on circulating leptin level.
Clomiphene* ; Estradiol ; Female ; Follicular Phase ; Humans ; Leptin* ; Menstrual Cycle ; Menstruation ; Ovulation Induction