BACKGROUND: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs). METHODS: Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups. RESULTS: Mean pain VAS improved, from 6.6+/-1.2 to 2.7+/-0.9 (p=0.001), and the mean functional VAS from 35.7+/-4.2 to 73.3+/-5.4 (p=0.006). The mean ASES score improved from 37.2+/-2.8 to 75.0+/-3.8 (p=0.012). The mean KSS improved from 36.5+/-7.2 to 75.6+/-5.4 (p=0.009), the mean forward elevation from 66.3+/-4.7 to 135.6+/-8.4 (p=0.0001), and the mean abduction from 45.2+/-4.2 to 119.0+/-6.5o (p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture. CONCLUSIONS: RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in short-term follow-up.
Arthroplasty* ; Clavicle ; Dislocations ; Elbow ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder* ; Visual Analog Scale

The localized type of tenosynovial giant cell tumor usually occurs on the palmar side of fingers and toes. Tenosynovial giant cell tumors of the tendon sheath are rarely intra-articular. We report a giant cell tumor of the tendon sheath arising from femoral attachment of the anterior cruciate ligament and its treatment with arthroscopy in a 28-year-old man.
Adult ; Anterior Cruciate Ligament/pathology/surgery ; Arthroscopy ; Femur ; Giant Cell Tumors/diagnosis/surgery ; Humans ; Knee ; Male ; Synovitis, Pigmented Villonodular/diagnosis/*surgery ; Tendons/*pathology

The objective of this study was to investigate how to improve job satisfaction for dietitians and nutrition teachers by identifying influencing factors in Daejeon and Chungnam Province, South Korea. A survey was conducted among school foodservice dietitians and nutrition teachers from selected primary, middle and high school in the area. This survey consisted of general characteristics, status of their job, job satisfaction, work satisfaction and work performance. In this study we found current state of general characteristics and status of their job according to frequency analysis and the level of work satisfaction, work performance and job satisfaction using descriptive statistics. The t-test, ANOVA and Duncan-test were also conducted in order to searching for tendency of job satisfaction according to the general characteristics and the status of their job. Pearson's correlation was carried out in order to find correlation with job satisfaction. Also, factors, which influenced job satisfaction according to regression analysis, were drawn. We describe the difference of job satisfaction between irregular dietitians and nutrition teachers as well. Besides we discussed the improvement of dietitians' (nutrition teachers') work environment to raise their job satisfaction through this study.
Humans ; Job Satisfaction ; Republic of Korea

Airway Obstruction ; Child ; Cicatrix ; Head ; Hemangioma ; Humans ; Injections, Intralesional ; Lymphangioma ; Lymphatic System ; Mouth Floor ; Neck ; Picibanil ; Sclerosing Solutions ; Sex Distribution ; Tongue

BACKGROUND: We retrospectively investigated the prevalence of femoral anterior notching and risk factors after total knee arthroplasty (TKA) using an image-free navigation system. METHODS: We retrospectively reviewed 148 consecutive TKAs in 130 patients beginning in July 2005. Seventy knees (62 patients) underwent conventional TKA, and 78 knees (68 patients) received navigated TKA. We investigated the prevalence of femoral anterior notching and measured notching depth by conventional and navigated TKA. Additionally, the navigated TKA group was categorized into two subgroups according to whether anterior femoral notching had occurred. The degree of preoperative varus deformity, femoral bowing, and mediolateral suitability of the size of the femoral component were determined by reviewing preoperative and postoperative radiographs. The resection angle on the sagittal plane and the angle of external rotation that was set by the navigation system were checked when resecting the distal femur. Clinical outcomes were compared using range of motion (ROM) and the Hospital for Special Surgery (HSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAX) scores between the two groups. RESULTS: The prevalence of anterior femoral notching by conventional TKA was 5.7%, and that for navigated TKA was 16.7% (p = 0.037). Mean notching depth by conventional TKA was 2.92 +/- 1.18 mm (range, 1.8 to 4.5 mm) and 3.32 +/- 1.54 mm (range, 1.55 to 6.93 mm) by navigated TKA. Preoperative anterior femoral bowing was observed in 61.5% (p = 0.047) and both anterior and lateral femoral bowing in five cases in notching group during navigated TKA (p = 0.021). Oversized femoral components were inserted in 53.8% of cases (p = 0.035). No differences in clinical outcomes for ROM or the HSS and WOMAX scores were observed between the groups. A periprosthetic fracture, which was considered a notching-related side effect, occurred in one case each in the conventional and navigated TKA groups. CONCLUSIONS: Surgeons should be aware of the risks associated with anterior femoral notching when using a navigation system for TKA. A modification of the femoral cut should be considered when remarkable femoral bowing is observed.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/*methods ; Female ; *Femur/injuries ; Humans ; Middle Aged ; Postoperative Complications/*epidemiology/physiopathology/radiography ; Prevalence ; Range of Motion, Articular ; Retrospective Studies ; Risk Factors

This study investigated the antioxidant activity of methanol (MeOH) and water extracts from roots of Cirsium japonicum in vitro. MeOH extract showed a stronger free radical scavenging activity than water extract. However, both of extracts showed a concentration dependent hydroxyl radical scavenging activity, reducing power and metal chelating ability. MeOH extract had greater phenolic and flavonoid contents than water extract. The antidiabetic activity of these two extracts was evaluated by the alpha-glucosidase inhibition assay. The water extract showed a considerable alpha-glucosidase inhibitory activity. To our knowledge, this may be the first time to report the antioxidant and antidiabetic activities in Cirsium japonicum roots.
alpha-Glucosidases ; Cirsium ; Hydroxyl Radical ; Methanol ; Phenol ; Water

A 67-year-old man developed compartment syndrome of the thigh following manipulation for treatment of knee stiffness after a total knee arthroplasty. Three months earlier, he had undergone arthroscopic synovectomies twice for treatment of septic arthritis in the same leg. Manipulation for treatment of stiffness concomitant with periarticular inflammation is a possible risk factor of compartment syndrome.
Aged ; Arthritis, Infectious ; Arthroplasty* ; Compartment Syndromes* ; Humans ; Inflammation ; Knee* ; Leg ; Risk Factors ; Thigh*

Diabetic muscle infarction is a rare complication of diabetes mellitus that is not clearly defined in the orthopedic literature. In addition, acute compartment syndrome in association with diabetic muscle infarction is a rarer disease, which has had only a few cases have been reported up to date. A large and painful swelling was noticed in the thigh of a 55-year-old female, who had not experienced trauma. The patient was diagnosed as having compartment syndrome with diabetic muscle infarction by magnetic resonance imaging. The patient underwent immediate fasciotomy, and recovered without any complications.
Compartment Syndromes ; Diabetes Mellitus ; Female ; Humans ; Infarction ; Magnetic Resonance Imaging ; Middle Aged ; Muscles ; Orthopedics ; Thigh

Epidural analgesia is one of the effective methods for pain management after total knee arthroplasty. Although epidural analgesia has been reported to have very low epidural abscess rates, infection could be serious and life-threatening, if there is no early diagnosis and treatment. We report on a patient who developed an epidural abscess following epidural catheterization after total knee arthroplasty.
Analgesia, Epidural ; Arthroplasty* ; Catheterization* ; Catheters* ; Early Diagnosis ; Epidural Abscess* ; Humans ; Knee* ; Pain Management

PURPOSE: To diagnose the extent of soft tissue damage with MRI, and to evaluate the relationship between soft tissue damage and a spinal cord injury in an extension injury to the lower cervical spine trauma. MATERIALS AND METHODS: Eighty-one patients who treated surgically for an anextension injury to the cervical spine over the past 5 years, were analyzed. All patients had undergone MRI after the injury, and for the specific grading of soft tissue damage, the grades were defined from grades 1 to 5. RESULTS: The spinal cord injury developed with more than grade 3 soft tissue damage associated with a rupture of the posterior longitudinal ligament (p<0.01). The changes in signal intensity of the spinal cord also developed according to the severity of soft tissue damage (p<0.01). There was no relationship between the soft tissue damage and the spinal cord injury in spinal stenosis (p=0.75). CONCLUSION: The extent of soft tissue damage was diagnosed precisely with MRI, and there was an close relationship between the soft tissue damage and spinal cord injury in the distractive- extension injury to the lower cervical spine trauma.
Humans ; Longitudinal Ligaments ; Magnetic Resonance Imaging ; Rupture ; Spinal Cord ; Spinal Cord Injuries ; Spinal Stenosis ; Spine*