BACKGROUND: The aim of this study was to analyze the questions in the shoulder and elbow section of the Korean Orthopaedic In-Training Examination (KOITE) and compare them with those of the US Orthopaedic In-Training Examination (US OITE). METHODS: Twenty-nine questions in the shoulder and elbow section of the KOITE from 2010 to 2014 were analyzed and compared with those of the US OITE (80 questions) by literature review. A thorough analysis of the contents was performed after categorizing as topics, diagnostic tools, treatment modalities, taxonomic classification, and references. RESULTS: The shoulder and elbow section of the KOITE was 5.8% weight which was similar to the US OITE (5.9%). The most commonly appearing topic was anterior labral injury (17.2%) on the KOITE compared to instability and arthritis (21.3%, each) on the US OITE. Magnetic resonance imaging was most frequently appeared imaging modality on the KOITE (41.0%) compared to the radiograph on the US OITE (43.0%). The Latarjet procedure was the most commonly asked treatment modality (22.2%) on the KOITE, whereas arthroplasty (33.3%) on the US OITE. The KOITE showed an even taxonomic classification distribution compared to the US OITE. Campbell's operative orthopaedics covered 96.6% questions as a reference on the KOITE compared to the Journal of Bone and Joint Surgery, American Volume on the US OITE, which covered 45.0%. CONCLUSIONS: This specific analysis shows us current trends of the shoulder and elbow section of the KOITE and it might be developed for use in the educational curricula for the trainee.
Arthritis ; Arthroplasty ; Classification ; Curriculum ; Elbow* ; Joints ; Magnetic Resonance Imaging ; Orthopedics* ; Shoulder*

Myoclonus epilepsy and ragged-red fiber (MERRF) syndrome is one of the common etiologies of progressive myoclonus epilepsy. The clinical features of MERRF syndrome are myoclonus, seizure, dementia, ataxia, neuropathy, myopathy, deafness, and lipouta. The patients with MERRF syndrome have a point mutation in mitochondrial DNA at 8344 or 8356 nucleotide. We are reporting a patient who developed myoclonus and seizure at the age of eighteen. He later showed cerebellar ataxia, peripheral neuropathy, and cognitive dysfunction. Skeletal muscle biopsy failed to demonstrate ragged-red fibers. He was diagnosed as MERRF syndrome by the mitochondrial DNA analysis. He had 86% mutant mitochondrial genomes (A-)G(8%) mutation) in leukocytes, and his asymptomatic mother had 66%. The absence of ragged-red fibers does not rule out the possibility of MERRF syndrome. Demonstration of mitochondrial DNA mutation is the most convincing method for establishing the diagnosis of MERRF.
Ataxia ; Biopsy ; Cerebellar Ataxia ; Deafness ; Dementia ; Diagnosis ; DNA, Mitochondrial ; Epilepsies, Myoclonic* ; Genome, Mitochondrial ; Humans ; Leukocytes ; MERRF Syndrome ; Mothers ; Muscle, Skeletal ; Muscular Diseases ; Myoclonic Epilepsies, Progressive ; Myoclonus* ; Peripheral Nervous System Diseases ; Point Mutation ; Seizures

Radial artery cannulation is a well established clinical technique for continuous monitoring of arterial blood pressure and serial sampling of arterial blood in critically ill patients. This method is regarded generally as safe, but complications are reported uncommonly. We report a case of false aneurysm of the radial artery following repeated puncture and catheter indweling for 8 days, and discuss briefly about the complication of arterial cannulation. It should be remembered that in arterial cannulation, we must use aseptic techniques, and the catheter must not be indwelt at one point for a long time.
Aneurysm* ; Aneurysm, False ; Arterial Pressure ; Catheterization ; Catheters* ; Critical Illness ; Humans ; Kidney Failure, Chronic* ; Punctures ; Radial Artery*

The purpose of this study was to compare in vitro interfacial relationship of restorations bonded with three self-etching primer adhesives and one self-etching adhesive. Class I cavity preparations were prepared on twenty extracted human molars. Prepared teeth were divided into four groups and restored with four adhesives and composites: Clearfil SE Bond/Clearfil(TM) AP-X (SE), UniFil Bond/UniFil(R) F (UF), FL Bond/Filtek(TM) Z 250 (FL) and Prompt L-Pop/Filtek(TM) Z 250 (LP) After storing in distilled water of room temperature for 24 hours, the specimens were vertically sectioned and decalcified. Morphological patterns between the enamel/dentin and adhesives were observed under SEM. The results of this study were as follows; 1. They showed close adaptation between enamel and SE, UF and FL except for LP. 2. The hybrid layer in dentin was 2 microm thick in SE, 1.5 microm thick in UF, and 0.4 microm in both FL and LP. So, the hybrid layers of SE and UF were slightly thicker than that of FL and LP. 3. The lengths and diameters of resin tags in UF and FL were similar, but those of LP were slightly shorter and slenderer than those of SE. 4. The resin tags were long rod shape in SE, and funnel shape in other groups. Within the limitations of this study, it was concluded that self-etching primer adhesives showed close adaptation on enamel. In addition, the thickness of hybrid layer ranged from 0.4-1.5 microm between adhesives and dentin. The resin tags were long rod or funnel shape, and dimension of them was similar or different among adhesives.
Adhesives* ; Dental Enamel ; Dentin ; Humans ; Molar ; Tooth* ; Water

During the arthroscopic surgery of the shoulder, there was extravasation of fluid into the surrounding soft tissue due to the use of pressure pump irrigator. Clinically, the shoulder region became tense and intramuscular pressure of the deltoid could be elevated. To analyze the change of the intramuscular pressure of the deltoid and the efficiency of cryotherapy in the shoulder arthroscopy with pressure pump, we studied 35 consecutive patients who underwent various arthroscopic shoulder procedures at the Dankook University Hospital. We monitored intramuscular pressure using spinal needle connected to the patient monitoring system during arthroscopic procedures and postoperative period until return to preoperative pressure level. Twenty-seven patients were fitted with a cryotherapy. device in the operating room, and 8 were not according to the patient opinions. We evaluated the effect of cryotherapy with visual analog scales and amounts of analgisics for 3 days postoperatively. The results were followed; 1. Intraoperative highest intramuscular deltoid pressure was 293mmHg (average 169+/-68mmHg, 71293mmHg). 2. Immediate postoperative deltoid pressure was average 58.3+/-28.1mmHg (24-145mmHg). 3. Average time that the pressure had returned to the preoperative level was 114.3+/-38.6 minutes (p<0.05). There were no statistically significant between two groups, 113.9+/-41.1 min in the cryotherapy group and 115.7+/-32.6 min in the non-cryotherapy group. 4. Shoulder pain was less in the cryotherapy cases until second postoperative day. In conclusion, arthroscopic surgery of the shoulder can be performed with minimal complication in spite of high intramuscular deltoid pressure. More than 60 minutes may be needed for returning to normal intramuscular deltoid pressure. Cryotherapy is eftective in the pain relief but cannot minimize swelling postoperatively.
Arthroscopy* ; Cryotherapy* ; Humans ; Monitoring, Physiologic ; Needles ; Operating Rooms ; Postoperative Period ; Shoulder Pain ; Shoulder* ; Transcutaneous Electric Nerve Stimulation ; Visual Analog Scale

Diagnostic peritoneal lavage is a accurate and safe method confirming the intraabdominal injury with head trauma, unstable multiple injuried patients. But the development of imaging technique and the trend in noninvasive diagnostic value is decreasing now. In the emergency room, the emergency physicians are required the rapidity and accuracy' in intial assessment and the decisions for the operation or not. So emergency physicians have been investigating the diagnostic method for intraabdomial injury that is more rapid, safe and accurate. Many diagnostic tools are developed and now accepted and used widely, among them the diagnostic peritoneal lavage is still the best method for unsatble or head injuries patients. But the positive diagnostic criterias are variable by many authors and still remain imperfectly. So our study was reviewed by medical record of patients who were undertaken the diagnostic peritoneal lavage for the diagnosis intraabdominal injury and statistical analyasis was done compared with many criteria of red blood cell and white blood cell for the more actuate way. A retrospective study of diagnostic peritoneal lavage was done of 90 patients with blunt abdominal trauma during 2 years from January, 1996 to December, 1997 and summerized our experience. The results were as follows; 1) There are 73 males and 17 females in sex. The most common type of injury was the traffic accident. 2) With many variable criteria of RBC and WBC, the accuracy and the false positive and false negative were not different in statistical results. The average accuracy was 80.1%. 3) The operations were done in 30(33.3%) cases, and the most frequent injuried organ was the small bowel, 20 cases(66.7%).
Accidents, Traffic ; Craniocerebral Trauma ; Diagnosis ; Emergencies ; Emergency Service, Hospital ; Erythrocytes ; Female ; Humans ; Leukocytes ; Male ; Medical Records ; Peritoneal Lavage* ; Retrospective Studies

PURPOSE: We analysed the therapeutic results of 2,585 cases (2,456 patients) of urinary calculi, treated by extracorporeal shock wave lithotripsy (ESWL), using a Dornier MPL 9200X lithotriptor. MATERIALS AND METHODS: The records of all the patients, in whom urinary calculi were treated by ESWL, between October, 1997 and October, 2002, were retrospectively reviewed. The patients were defined as successful if there was no concrement on the X-ray (plain film) or residual fragments Fever ; Hematuria ; Humans ; Kidney ; Lithotripsy* ; Renal Colic ; Retrospective Studies ; Shock* ; Stents ; Ureter ; Urinary Calculi

Cartilage, Articular ; Cell Line ; Chondrocytes ; Electrophoresis ; Interleukin-2 ; Mass Screening ; Phosphotransferases ; Proteome ; Temporomandibular Joint ; Temporomandibular Joint Disorders

Cyclosporin A-induced gingival hyperplasia is frequently found in the patients who have been received an immunosuppressant for the organ transplantation. However, its exact mechanism is still unknown. The expression of FGF-5 and FGF-7 were studied in cyclosporine A-induced gingival hyperplasia (CGH) and inflammatory gingival hyperplasia (IGH). Immunohistochemistry and in situ hybridization were used for localization of protein and mRNA. The expression of FGF-5 and FGF-7 was different from CGH and IGH. FGF-5 and FGF-7 was strongly expressed in fibroblast in CGH (P<0.005 and P<0.05, respectively). FGF-5 mRNA was localized in the middle portion of connective tissue. FGF-7 mRNA was also identified in fibroblasts and mast cells. In conclusion, FGF-5 and FGF-7 were produced excessively by fibroblasts in CGH. Considering their known functions, their expression in CGH is important for production of collagen and proliferation of fibroblasts.
Collagen ; Connective Tissue ; Cyclosporine* ; Fibroblasts ; Gingival Hyperplasia* ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Mast Cells ; Organ Transplantation ; RNA, Messenger ; Transplants

Superficial siderosis is a rare condition characterized by hemosiderin deposition in leptomeninges, subpial tissue, brainstem, cerebellum, spinal cord, and cranial nerves. Slowly progressive hearing loss and gait ataxia are invariable clinical manifestations. We report three patients with their clinical and radiological features. All patients presented with hearing loss and cognitive dysfunction. Two showed gait ataxia and myelopathic symptoms and signs. Decreased visual acuity, hand tremor, limb ataxia, dysarthria, and nystagmus were also present. All patients showed typical MRI findings: marked linear hypointensities around the cerebellum, brainstem, and the surface of the cerebral cortex, especially in sylvian fissures. Two patients had brain tumors : pituitary adenoma and oligodendroglioma. Another patient had no definite bleeding source. Hemosiderin deposition is caused by chronic and recurrent subarachnoid hemorrhage derived from tumor, vascular malformation, aneurysm, posthemispherectomy, and unknown bleeding sources. Diagnosis is easily made by characteristic clinical manifestations and MRI findings. The selective vulnerability of the cerebellum and the 8th cranial nerve depends upon their own histological and biochemical characteristics. Benefits of the iron chelating agents are questionable. Removal of the possible bleeding sources is the most reliable strategy to prevent the disease progression.
Adenoma ; Aneurysm ; Ataxia ; Brain Neoplasms ; Brain Stem ; Cerebellum ; Cerebral Cortex ; Cranial Nerves ; Diagnosis ; Disease Progression ; Dysarthria ; Gait Ataxia ; Hand ; Hearing Loss ; Hemorrhage ; Hemosiderin ; Humans ; Iron Chelating Agents ; Magnetic Resonance Imaging ; Oligodendroglioma ; Pituitary Neoplasms ; Siderosis* ; Spinal Cord ; Subarachnoid Hemorrhage ; Tremor ; Vascular Malformations ; Visual Acuity