Acromioclavicular joint dislocations are frequently seen with industrial accident, sports activity and traffic accident. Various operative treatment modalities have been suggested. The purpose of this study is to compare the clinical results of two operative methods in young patients with acromioclavicular dislocation. The authors analyzed the clinical and radiological results of 30 patients with acromioclavicular dislocation, in whom 15 patients were treated by acromioclavicular reduction & fixation with K-wire(Phemister procedure) and 15 patients by acromioclavicular reduction & coracoclavicular fixation by cancellous screw with coracoclavicular ligament repair(Bosworth procedure) from March 1989 to September 1993 at Ansan Hospital, Korea University. They were followed up more than 12 months. The results obtained were as follows: 1. The difference of coracoclavicular distance compared with normal side after operation was 2.6mm in Phemister operations and 1.6 mm in Bosworth operations. And these differences were not changed at follow up significantly. 2. The complications were two K-wire migrations, one superficial infection, and one recurred gross deformity after pin removal in Phemister operations and two mild upward migrations of screw after Bosworth operations. 3. We obtained similar good results after Phemister and Bosworth operations. But less complications were visible, and anatomical reduction and early ROM exercise were possible after Bosworth operations.
Accidents, Occupational ; Accidents, Traffic ; Acromioclavicular Joint ; Congenital Abnormalities ; Dislocations ; Follow-Up Studies ; Gyeonggi-do ; Humans ; Korea ; Ligaments ; Methods ; Sports

No abstract available.
Ligaments* ; Pelvic Organ Prolapse*

Pulmonary involvement is more common in systemic lupus erythematosus (SLE) than in any other connective tissue disease, and more than half of patients with SLE suffer from respiratory dysfunction during the course of their illness. Although sepsis and renal disease are the most common causes of death in SLE, lung disease is the predominant manifestation and is an indicator of overall prognosis. Respiratory disease may be due to direct involvement of the lung or as a secondary consequence of the effect of the disease on other organ systems.
Cause of Death ; Connective Tissue Diseases ; Humans ; Lung ; Lung Diseases ; Lupus Erythematosus, Systemic* ; Prognosis ; Sepsis

No abstract available.
Blood Flow Velocity*

Charcot-Marie-Tooth disease (CMTD) comprises a group of disorders characterized by progressive distal muscle weakness and atrophy. We report the management of a 37-year-old multigravida with CMTD scheduled for Cesarean section. The combined spinal-epidural anesthesia was selected as the anesthetic management and postoperative pain control. Mother and baby had an uneventful recovery and they discharged home on the seventh postoperative day. Combined spinal-epidural anesthesia is thought to be a safe and effective method of anesthesia for Cesarean section in a patient with CMTD.
Adult ; Anesthesia* ; Atrophy ; Cesarean Section* ; Charcot-Marie-Tooth Disease ; Female ; Humans ; Mothers ; Muscle Weakness ; Pain, Postoperative ; Pregnancy

Robotic surgery is considered as one of the advanced treatment modality of minimally invasive surgery for rectal cancer. Robotic rectal surgery has been performed for three decades and its application is gradually expanding along with technology development. It has several technical advantages which include magnified three-dimensional vision, better ergonomics, multiple articulated robotic instruments, and the opportunity to perform remote surgery. The technical benefits of robotic system can help to manipulate more meticulously during technical challenging procedures including total mesorectal excision in narrow pelvis, lateral pelvic node dissection, and intersphincteric resection. It is also reported that robotic rectal surgery have been shown more favorable postoperative functional outcomes. Despite its technical benefits, a majority of studies have been reported that there is rarely clinical or oncologic superiority of robotic surgery for rectal cancer compared to conventional laparoscopic surgery. In addition, robotic rectal surgery showed significantly higher costs than the standard method. Hence, the cost-effectiveness of robotic rectal surgery is still questionable. In order for robotic rectal surgery to further develop in the field of minimally invasive surgery, there should be an obvious cost-effective advantages over laparoscopic surgery, and it is crucial that large-scale prospective randomized trials are required. Positive competition of industries in correlation with technological development may gradually reduce the price of the robotic system, and it will be helpful to increase the cost-effectiveness of robotic rectal surgery.
Cost-Benefit Analysis ; Human Engineering ; Industrial Development ; Laparoscopy ; Methods ; Minimally Invasive Surgical Procedures ; Pelvis ; Prospective Studies ; Rectal Neoplasms ; Robotic Surgical Procedures

PURPOSE: To compare clinical and radiologic results after total knee arthroplasty (TKA) with posterior cruciate sacrificing (PCS) and posterior cruciate substitution (PS). MATERIALS AND METHODS: Of 66 knees in 53 patients with degenerative arthritis, we completed both practical and radiological evaluations for 27 patients with PCS TKA (30 knees) and 31 patients with PS TKA (36 knees). RESULTS: The knee score improved from 33 to 81.9 for PCS TKA and from 35 to 86.6 for PS TKA. Preoperative flexion was 104.5degrees in the PCS TKA group and 104.7degrees in the PS TKA group.These scores significantly improved to 113.9degrees and 104.7degrees respectively (p<0.05 for each). However, there was no significant difference between the two groups when comparing postoperative results and improvements (p>0.05). On radiological evaluation, the alpha angle was found to be 98.9degrees, the beta angle 89.9degrees , the gamma angle 5.0degrees, and the delta angle 39.2degrees for PCS TKA. Also, the alpha angle was 95.6degrees, beta angle 89.0degrees, gamma angle 9.0degrees, and delta angle 88.4degrees for PS TKA (p>0.05). Loosening was not encountered in either type. Postoperative complications were few; there was 1 knee (1.5%) with a polyethylene insert spin-out for the PCS TKA group and 1 knee (1.5%) with a periprosthetic fracture for the PS TKA group. CONCLUSION: On both clinical and radiological evaluations, PCS TKA and PS TKA demonstrated satisfactory results out to 4.5 years of follow up, which also indicated a lack of any significant difference between these two types.
Arthroplasty ; Follow-Up Studies ; Humans ; Knee ; Osteoarthritis ; Periprosthetic Fractures ; Polyethylene ; Postoperative Complications

Objective: : Post-stroke shoulder pain (PSSP) is a common complication that limits the range of motion (ROM) of the shoulder, the patient’s rehabilitation and in turn, affects the patients’ quality of life (QoL). Several treatment modalities such as sling, positioning, strapping, functional electrical stimulation, and nerve block have been suggested in literatures, however none of the treatments had long-term effects for PSSP. In this study, the authors evaluated clinical efficacy of pulsed radiofrequency (PRF) neuromodulation on the suprascapular nerve for PSSP, and suggested it as a potential treatment with long-term effect. Methods: : This retrospective case series was conducted at a single center, a private practice institution. From 2013 to 2021, 13 patients with PSSP underwent PRF neuromodulation of the suprascapular nerve. The primary outcome measure was the Visual analog scale (VAS) score. The secondary outcome measurements included the shoulder ROM, Disability assessment scale (DAS), modified Ashworth scale, modified Rankin scale (mRS), and EuroQol-5 dimension-3L questionnaire (EQ-5D-3L) scores. These parameters were evaluated before PRF modulation, immediately after PRF modulation, and every 3 months until the final follow-up visit. Results: : Six men and seven women were enrolled, and all patients were followed-up for a minimum of 12 months. The mean VAS score was 7.07 points before PRF neuromodulation and 2.38 points immediately post-procedure. Shoulder ROM for abduction and flexion, DAS for pain, mRS, and EQ-5D-3L demonstrated marked improvement. No complications were reported. Conclusion : PRF neuromodulation of the suprascapular nerve is an effective modality in patients with PSSP, and has long-term effect of pain relief, improvement of QoL.

Objective: : Post-stroke shoulder pain (PSSP) is a common complication that limits the range of motion (ROM) of the shoulder, the patient’s rehabilitation and in turn, affects the patients’ quality of life (QoL). Several treatment modalities such as sling, positioning, strapping, functional electrical stimulation, and nerve block have been suggested in literatures, however none of the treatments had long-term effects for PSSP. In this study, the authors evaluated clinical efficacy of pulsed radiofrequency (PRF) neuromodulation on the suprascapular nerve for PSSP, and suggested it as a potential treatment with long-term effect. Methods: : This retrospective case series was conducted at a single center, a private practice institution. From 2013 to 2021, 13 patients with PSSP underwent PRF neuromodulation of the suprascapular nerve. The primary outcome measure was the Visual analog scale (VAS) score. The secondary outcome measurements included the shoulder ROM, Disability assessment scale (DAS), modified Ashworth scale, modified Rankin scale (mRS), and EuroQol-5 dimension-3L questionnaire (EQ-5D-3L) scores. These parameters were evaluated before PRF modulation, immediately after PRF modulation, and every 3 months until the final follow-up visit. Results: : Six men and seven women were enrolled, and all patients were followed-up for a minimum of 12 months. The mean VAS score was 7.07 points before PRF neuromodulation and 2.38 points immediately post-procedure. Shoulder ROM for abduction and flexion, DAS for pain, mRS, and EQ-5D-3L demonstrated marked improvement. No complications were reported. Conclusion : PRF neuromodulation of the suprascapular nerve is an effective modality in patients with PSSP, and has long-term effect of pain relief, improvement of QoL.