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

STATEMENT OF PROBLEM: In spite of increasing dental treatment for the disabled, there was no collected data on prosthodontic treatment status and dentists' perceptions in Korea. PURPOSE: The purpose of this study was to research the dentists' perceptions about current prosthodontic treatment status for the disabled in Korea and to suggest public health policies for the disabled. MATERIAL AND METHODS: Total of 68 dentists who have regularly treated the disabled were asked to fill questionnaires regarding prosthodontic treatment for the disabled. RESULTS: 1. 45.6% of dentists felt the necessity of an esthetic prosthesis for the disabled. However, 54.3% of dentists reported the improvement of access to implant,orthodontic and esthetic treatment is needed. 2. Most (79.4%) of the dentists thought it is imperative for the government to support the disabled to maintain adequate oral health by providing at least 50% of charge in their prosthesis. CONCLUSION: Through this research, 97.1% of dentists answered that the current prosthodontic treatment status for the disabled in Korea is poor. This indicated the necessity of the financial support from the government for the disabled.
Dentists ; Fees and Charges ; Financial Support ; Humans ; Korea ; Oral Health ; Prostheses and Implants ; Prosthodontics ; Public Health ; Surveys and Questionnaires

Background: Cryolipolysis, a preferred method for minimally invasive body contouring, involves the noninvasive cooling of adipocytes to induce lipolysis without damaging other tissues. This study aimed to evaluate the safety and efficacy of cryolipolysis for the treatment of excessive fat tissue. Methods: Between May 2014 and December 2017, 231 patients with 448 areas of interest were enrolled and their records were retrospectively reviewed. We used five different vacuum applicators, and the best-fitting applicator was used for each area. One cycle of cryolipolysis was applied at a cooling intensity factor of 41.6. The efficacy was evaluated 12 weeks after treatment via review of clinical photographs, the pinch test, and ultrasonographic measurements of fat thickness. The occurrence of any complications was also assessed. Results: The volume was reduced in all of the areas to which cryolipolysis was applied. The rate of reduction of the fat layer as measured via the pinch test was 19.2%, and the rate of the decrease in fat layer thickness as measured via ultrasonography was 22.8%. Fat reduction of the upper arm differed significantly from that of the abdomen and flank, but no significant difference was found between sexes. The side effects were limited to erythema, edema, bruising, and numbness at the treatment site and resolved without treatment. Conclusions Cryolipolysis, with new and better-fitting applicators, is safe, fast, and effective for the reduction of excessive fat tissue on the abdomen, back, flank, and extremities. It is a good option for treating excess adipose tissue in Asian patients.

BACKGROUND: Vascular endothelial dysfunction (VED) plays a pivotal role in the pathogenesis of atherosclerosis and is associated with insulin resistance and with visceral obesity. Therefore, in this study the predicting factor of vascular endothelial dysfunction was investigated in healthy premenopausal obese women by pulse-wave analysis (PWA) combined with provocative pharmacological testing. METHODS: Thirty three obese women (BMI> or =25), aged 20~45 y and 25 age-matched control subjects (BMI; 18.5~22.9) were examined. All women were sedentary (<1 hr/wk of physical activity), non-smoker and were excluded if they had type 2 diabetes melitus, hypertension, hyperlipidemia, cardiovascular disease, or acute inflammatory disease and were studied in folicullar phase of the cycle, within the first week after cessation of menstrual bleeding. They underwent determination of anthropometric measurements, metabolic variables, adipose tissue regional distribution, and endothelial function by performing pulse-wave analysis (PWA) combined with provocative pharmacological testing. RESULTS: Augmentation Index (AIx) fell significantly after the administration of salbutamol, which causes endothelium-dependent vasodilatation, but response was significantly reduced in obese women compared with controls (10.28 6.72% vs 17.2 6.84%, P=0.0003). The change in after Nitroglycerin, which causes endothelium-independent vasodilatation, did not differ significantly (30.86 9.67% vs 30.6 10.11%, P=0.9172). In our obese subjects, visceral adipose tissue area was independently a significant predictor of vascular endothelial dysfunction (beta= 0.1381, P=0.0038, Adj-R2=0.348). CONCLUSION: Increased abdominal adiposity is a powerful independent predictor of VED in obese healthy women. Future studies of vascular endothelial function should account for the independent effects of abdominal fat.
Abdominal Fat ; Adipose Tissue ; Adiposity ; Albuterol ; Atherosclerosis ; Cardiovascular Diseases ; Female ; Hemorrhage ; Humans ; Hyperlipidemias ; Hypertension ; Insulin Resistance ; Intra-Abdominal Fat ; Nitroglycerin ; Obesity, Abdominal ; Vasodilation

BACKGROUND: This study was intended to look into the characteristics and problems when FACES III are used as tools to evaluate family function of adolescents. METHODS: From May to June 1996, self-reported questionnaires for FACES III were conducted on 2,430 middle school and high school students (males:1,190, females:1,240) in Seoul and Yangpyung, Kyunggi-Do. There were eight schools (four middle schools, four high schools) in Seoul and two schools (one middle school, one high school) in Yangpyung, Kyunggi-Do in this study. Also, educational level of parents, occupational status of parents, family types (extended/nuclear), number of family member and numbers of siblings were assessed. RESULTS: The mean values of adaptability were significantly higher in Seoul students, in females, and in nuclear families. The mean values were higher in single sibling than two or more and in parents with higher education. The mean values of cohesion were significantly higher in Seoul students, in middle school students and in family members of 5 and under. The mean values were higher in those without a sibling and in those with above college education. In stepwise regression analysis, educational level of parents, gender, area, occupational status of mother and grade were associated significantly with the mean values of adaptability and educational level of parents, grade and numbers of siblings were significantly associated with the mean values of cohesion. CONCLUSIONS: We consider that there are problems in deciding the cut-off point and in the questionnaires of survey when the FACES III is used as a tool for evaluating family function of adolescents. Trials of combining other tools of family function or consideration of lower concepts are needed in other to be applicable to the individual conversation and the clinical surroundings.
Adolescent* ; Education ; Employment ; Female ; Gyeonggi-do ; Humans ; Mothers ; Nuclear Family ; Parents ; Seoul ; Siblings ; Surveys and Questionnaires

Lowe syndrome is a rare genetic disease that appears to cause various clinical symptoms involving the eye, nervous system, and kidney. While a mutation of the OCRL1 gene is known to be responsible for this syndrome, the exact pathophysiology remains unclear. Various multi-organ symptoms are characteristic of Lowe syndrome, but skin lesions have rarely been described. Recently, mechanisms for the association of Lowe syndrome and skin lesions have been proposed. We report this case of Lowe syndrome involving multiple epidermal cysts on the scalp in a 6-year-old male child.
Child ; Epidermal Cyst ; Eye ; Humans ; Kidney ; Male ; Nervous System ; Oculocerebrorenal Syndrome ; Scalp ; Skin

The effects of acidosis and alkalosis on vascular smooth muscle contractions were studied. Ring segments(3-4 mm in length) of rabbit abdominal aorta and pulmonary artery were mounted in the tissue bath(for respiratory study) and superfusion device(for metabolic study) for isometric tension recording. Respiratory acidosis and alkalosis were obtained by increasing and lowering the PCO2(80 and 15 mmHg, respectively). Metabolic acidosis and alkalosis were obtained by lowering and increasing the HCO3 concentration(12 and 50 mEq/l, respectively). After precontraction with norepinephrine(10-7 M), Vessels were exposed to acidosis and alkalosis for 30 minutes. The study was done with and without endothelium. The mechanism of vasorelaxation and vasoconstriction were confirmed with Ca2+ activated K+ channel blocker and Ca2+ free Krebs solution. The results were as follows: 1) Respiratory and metabolic acidosis induced significant vasorelaxation in both group of abdominal aorta and pulmonary artery(p<0.05). In endothelium intact group, vasorelaxation was greater than endothelium removed group. especially in respiratory acidosis was statistically significant(p<0.05). 2) Respiratory and metabolic alkalosis induced significant vasoconstriction in both group of abdominal aorta and pulmonary artery(p<0.05). In endothelium intact group, vasoconstriction was lesser than endothelium removed group, but was not statistically significant. 3) Acidosis induced vasorelaxation was blocked by tetraethylammonium(TEA). 4) Alkalosis induced vasoconstriction was blocked by Ca2+ free Krebs solution. These results suggested that: 1) Acidosis induced vasorelaxation. 2) alkalosis induced vasoconstriction 3) Vasorelaxation during acidosis was induced by K+ efflux through the Ca2+ activated K' channel. 4) Vasoconstriction during alkalosis was induced by Ca2+ influx.
Acid-Base Equilibrium* ; Acidosis ; Acidosis, Respiratory ; Alkalosis ; Aorta, Abdominal ; Endothelium ; Muscle, Smooth, Vascular ; Pulmonary Artery ; Vasoconstriction ; Vasodilation

PURPOSE: Abdominal obesity is encountered as a risk factor for cardiovascular diseases. However, the anthropometric cut-off value to estimate the cardiovascular risk, has not been suggested. This study was designed to find the relationship between the abdominal fat and various parameters of obesity to find the cardiovascular risk factors related to abdominal obesity and to establish practical methods to measure them. METHODS: Twenty seven obese Korean adolescents of moderate to severe degree and 22 healthy adolescents were enrolled. The body mass index (BMI), arm circumference and skinfold thickness were measured. Furthermore, blood lipid, sugar, insulin and four different cytokines' levels were checked and the distribution of body composition was measured by bioelectrical impedance analysis. The subcutaneous and intra-abdominal fat thickness by abdominal ultrasonography (US) and the total and intra-abdominal fat area by abdominal computerized tomography (CT) were measured in the obese group. RESULTS: The most accurate method to measure abdominal fat in children is abdominal CT and the fat mass measured by bioelectrical impedance was strongly correlated with it (r=0.954). It was also correlated with arm circumference, fat thickness measured by abdominal US, BMI, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and triglyceride level. CONCLUSION: Abdominal CT is the most accurate method to measure intra-abdominal fat, and it can be replaced by abdominal US for cost effectiveness. The screening methods that can be used at school or in outpatient basis include bioelectrical impedance, waist/hip ratio, and arm circumference. The cardiovascular risk factors include leptin, triglyceride and insulin level.
Abdominal Fat ; Adolescent ; Alanine Transaminase ; Arm ; Aspartate Aminotransferases ; Body Composition ; Body Mass Index ; Cardiovascular Diseases ; Child ; Cost-Benefit Analysis ; Diagnosis* ; Electric Impedance ; Humans ; Insulin ; Intra-Abdominal Fat ; Leptin ; Mass Screening ; Obesity* ; Obesity, Abdominal ; Outpatients ; Pediatric Obesity* ; Risk Factors ; Skinfold Thickness ; Tomography, X-Ray Computed ; Triglycerides ; Ultrasonography

PURPOSE: Unstable bladder has been known to be one of the reasons for the genesis and persistance of primary vesicoureteral reflux(VUR) in children. And treatment of unstable bladder by anticholinergic agent may contribute to the resolution of primary VUR. We evaluated the effect of an anticholinergic agent(oxybutynin) on the resolution of primary VUR in children with different toilet training and voiding functions. METHODS: 152 children with persistant primary VUR after one year of follow up were randomly assigned to the oxybutynin group(n=59, oxybutynin 0.2 mg/kg twice daily) and the control group(n=93, no oxybutynin) at Ewha Womans University Mok-Dong Hospital from October 1996 to April 2002. The resolution rate of the VUR and the difference according to the status of toilet training and voiding dysfunction were analyzed. Statistical analysis was done by the Chi-square test and a P-value of less than 0.05 was considered as significant. RESULTS: VUR was resolved in 49.2%, improved in 20.3% and not changed in 30.5% in the oxybutynin group(n=59) which was not significantly different to 45.2%, 16.1%, 38.7% in the control group(n=93), respectively. In the non-toilet trained young children, VUR was resolved in 50.0%, improved in 23.5% and not changed in 26.5% in the oxybutynin group(n=34) which was not significantly different to 44.2%, 19.2%, 36.6% in the control group(n=52), respectively. In the toilet trained older children, VUR was resolved in 48.0%, improved in 16.0% and not changed in 36.0% in the oxybutynin group(n=25) which was not significantly different to 46.3%, 12.2%, 41.5% in the control group(n=41), respectively. In the toilet trained older children with no voiding dysfunction, VUR was resolved in 33.3%, improved in 11.1% and not changed in 55.6% in the oxybutynin group(n=9) which was not significantly different to 53.6 %, 10.7%, 35.7% in the control group(n=28), respectively. In the toilet trained older children with voiding dysfunction, VUR was resolved in 56.3%, improved in 18.7% and not changed in 25.0% in the oxybutynin group(n=16), which looked higher than 30.7%, 15.4%, 53.9% in the control group(n=13), respectively, but these were not significantly different either. CONCLUSION: Oxybutynin was not effective in the resolution of primary VUR in non-toilet trained young children and toilet trained older children. Oxybutynin showed slightly higher tendency of reflux resolution in toilet-trained older children with voiding dysfunction but the difference was not statistically significant. Judicious use of oxybutynin is required in selected older children with VUR and voiding dysfunction.
Child ; Female ; Follow-Up Studies ; Humans ; Toilet Training ; Urinary Bladder ; Vesico-Ureteral Reflux*