The suprascapular nerve entrapment syndrome is a rare neuropathy. Clein described the frist case report of this syndrome and operative procedure in 1975. The cardinal sign is pain in and around the shoulder, weakness of abduction and external rotation and atrophy of the supraspinatus and infraspinatus muscles, This syndrome can be diagnosed by clinical symptoms, physical examination, special roentgenogram and electromyogram. We experienced a case of the suprascapular nerve entrapment syndrome. We treated it by resection of the superior transverse ligament of suapula, and obtained good result.
Atrophy ; Ligaments ; Muscles ; Nerve Compression Syndromes ; Physical Examination ; Shoulder ; Surgical Procedures, Operative

BACKGROUND: Due to severe pain after open thoracotmy, the postoperative pain control is essential to decrease pulmonary complications, and improve a patient's recovery. This study compared the surgical outcome of patients who had undergone open thoracotomy, and been managed with two different analgesic methods. METHODS: A retrospective chart review was carried out regarding 81 patients who had undergone open thoracotomy due to lung cancer. 41 of these patients has received continuous thoracic epidural analgesia with 0.1% bupivacaine and 0.3 mg/ml morphine at a rate of 2 ml/hr for postthoracotomy pain control (CTEA group). The remaining 40 patients has received intravenous patient-controlled analgesia with 1% meperidine (IV-PCA group). We compared the effects of the postoperative pain control in the two groups and the outcomes, including the pulmonary complications and durations of hospital stay. RESULTS: There were no significant differences in demographic data between the two groups. Supplemental analgesic requirements and postoperative pulmonary complications were significantly lower in the CTEA group than in the IV-PCA group. There were no significant statistical differences between the two groups in the durations of their hospital stay. CONCLUSIONS: We conclude that the continuous thoracic epidural infusion provided better postthoracotomy analgesia and surgical outcomes than intravenous patient controlled analgesia.
Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled ; Bupivacaine ; Humans ; Length of Stay ; Lung Neoplasms ; Meperidine ; Morphine ; Pain, Postoperative ; Retrospective Studies ; Thoracotomy*

BACKGROUND: There is a wide spread increase in the use of CAM by patients with rheumatic disease. This study was performed to identify the prevalence of CAM use and determining factors affecting CAM use by patients with rheumatic disease. METHODS: From October 23 to November 31 in 2003, face-to-face structured interviews were conducted in a rheumatology hospital in Seoul. A total of 182 patients with rheumatic disease, who visited the hospital, participated. RESULTS: CAM was used by 59.3% (95% CI=52.1~66.2%) of the patients with rheumatic disease. The most common use of CAM was traditional Chinese medicine such as acupuncture and herbs. Demographic variables were not predictive for the use of CAM. As the duration of disease was longer, probability on CAM use was lower (odd ratio: 0.922, 95% CI=0.855~0.994). CAM use on disabled people who registered were 4.623 (95% CI=1.105~19.348) times higher than non-disabled. CONCLUSION: CAM use is common in patients with rheumatic disease. The duration of disease and physical disability were the influencing factors for using CAM. These findings support a need for outcome studies on the effectiveness of CAM in rheumatic disease, as well as the improvement of providing patients with information on CAM usage.
Acupuncture ; Complementary Therapies* ; Humans ; Korea* ; Medicine, Chinese Traditional ; Outcome Assessment (Health Care) ; Prevalence ; Rheumatic Diseases ; Rheumatology ; Seoul

BACKGROUND: There is a wide spread increase in the use of CAM by patients with rheumatic disease. This study was performed to identify the prevalence of CAM use and determining factors affecting CAM use by patients with rheumatic disease. METHODS: From October 23 to November 31 in 2003, face-to-face structured interviews were conducted in a rheumatology hospital in Seoul. A total of 182 patients with rheumatic disease, who visited the hospital, participated. RESULTS: CAM was used by 59.3% (95% CI=52.1~66.2%) of the patients with rheumatic disease. The most common use of CAM was traditional Chinese medicine such as acupuncture and herbs. Demographic variables were not predictive for the use of CAM. As the duration of disease was longer, probability on CAM use was lower (odd ratio: 0.922, 95% CI=0.855~0.994). CAM use on disabled people who registered were 4.623 (95% CI=1.105~19.348) times higher than non-disabled. CONCLUSION: CAM use is common in patients with rheumatic disease. The duration of disease and physical disability were the influencing factors for using CAM. These findings support a need for outcome studies on the effectiveness of CAM in rheumatic disease, as well as the improvement of providing patients with information on CAM usage.
Acupuncture ; Complementary Therapies* ; Humans ; Korea* ; Medicine, Chinese Traditional ; Outcome Assessment (Health Care) ; Prevalence ; Rheumatic Diseases ; Rheumatology ; Seoul

BACKGROUND: Steroid therapy has been considered as co-analgesic for palliative treatment of metastatic bone pain in terminal cancer. We designed prospective study to observe analgesic efficacy of dexamethasone, to evaluate different analgesic assessment methods and its correlation to actual improvement of quality of life. METHODS: Thirty seven men with symptomatic bone pain of prostate cancer were treated with dexamethasone infusions (10mg twice a day) for 2 weeks. Response to treatment was assessed by daily analgesic intake, by the McGill-Melzack pain questionnaire (MPQ), and by a series of 17 linear analog self-assessment scales (LASA) relating to pain and to various aspects of quality of life. Biochemical and radiological markers were measured. RESULTS: Fourteen patients (38%) had improvement in indices used to assess pain at 2 weeks after starting dexamethasone. Reduction in pain indices was associated with improvement in other dimensions of quality of life and in the scale for overall well-being. Even though radiological and biochemical markers showed no correlation, symptomatic relief of pain was associated with a decrease in serum concentration of adrenal androgens. CONCLUSION:g We conclude that 1) dexamethasone treatment may cause useful relief of pain in some of patients with bone pain of prostate cancer; 2) this relief of pain is associated with suppression of adrenal androgens; 3) measures of pain and quality of life can be used to assess benefits of systemic therapy with dexamethasone; and 4) this effects of dexamethasone should be further investigated in bone pain of other metastatic cancer.
Androgens ; Biomarkers ; Dexamethasone* ; Humans ; Male ; Palliative Care ; Prospective Studies ; Prostate* ; Prostatic Neoplasms* ; Quality of Life* ; Self-Assessment ; Weights and Measures

OBJECTIVE: To identify the differences in the movement of the hyoid bone and the vocal cord with and without electrical stimulation in normal subjects. METHODS: Two-dimensional motion analysis using a videofluoroscopic swallowing study with and without electrical stimulation was performed. Surface electrical stimulation was applied during swallowing using electrodes placed at three different locations on each subject. All subjects were analyzed three times using the following electrode placements: with one pair of electrodes on the suprahyoid muscles and a second pair on the infrahyoid muscles (SI); with placement of the electrode pairs on only the infrahyoid muscles (IO); and with the electrode pairs placed vertically on the suprahyoid and infrahyoid muscles (SIV). RESULTS: The main outcomes of this study demonstrated an initial downward displacement as well as different movements of the hyoid bone with the three electrode placements used for electrical stimulation. The initial positions of the hyoid bone with the SI and IO placements resulted in an inferior and anterior displaced position. During swallowing, the hyoid bone moved in a more superior and less anterior direction, resulting in almost the same peak position compared with no electrical stimulation. CONCLUSION: These results demonstrate that electrical stimulation caused an initial depression of the hyoid bone, which had nearly the same peak position during swallowing. Electrical stimulation during swallowing was not dependent on the position of the electrode on the neck, such as on the infrahyoid or on both the suprahyoid and infrahyoid muscles.
Deglutition ; Deglutition Disorders ; Depression ; Electric Stimulation* ; Electrodes ; Hyoid Bone ; Jupiter ; Muscles ; Neck ; Neck Muscles ; Vocal Cords

PURPOSE: The purpose of this study is to compare the clinical results of spleen preserving laparoscopic distal pancreatectomy (SPLDP) with en bloc laparoscopic distal pancreatectomy (LDP). METHODS: From March 2005 to August 2008, 52 cases of SPLDP and 84 LDPs were performed at our institution and we retrospectively compared these cases. The enrollment period were chronologically divided to four eras of 10.5 months each. RESULTS: The demographics, including the patients' age, gender and BMI, were not different between the two groups. The final pathologic diagnosis was diverse, and it included cystic tumor, SPT, IPMT, cancer, endocrine tumor, etc and there was no difference between the two groups. The tumor location, operative time, tumor size, perioperative transfusion requirement, the length of the hospital stay and the postoperative complications were not different between the two groups. The mean operative time was gradually shortened by eras (Era 1: 236.3 min, Era 2: 223.6 min, Era 3: 188.8 min, Era 4: 187.9 min) and the proportion of SPLDP was increased by eras from 1.9% to 9.6%, 42.3% and 46.2%, respectively. CONCLUSION: SPLDP might be technically more difficult than LDP, and especially in the initial learning stage of performing laparoscopic pancreatic surgery. After overcoming the learning curve, SPLDP can be performed safely and possibly within a shorter time. SPLDP should be tried whenever possible so that the patients get the maximal benefits of minimal invasive surgery and especially for resecting the more distal pancreatic lesions.
Demography ; Endocrine Gland Neoplasms ; Humans ; Laparoscopy ; Learning ; Learning Curve ; Length of Stay ; Operative Time ; Pancreatectomy ; Postoperative Complications ; Retrospective Studies ; Spleen

BACKGROUND: Patient-controlled analgesia (PCA) provides excellent pain relief in the management of postoperative pain, but is associated with unpleasant side effects such as nausea and vomiting. The transdermal scopolamine patch (TSP) has been shown to have effective antiemetic actions. We evaluated the effectiveness of TSP in patients receiving morphine and fentanyl via intravenous PCA. METHODS: Sixty patients were scheduled for an elective intra-abdominal gynecologic surgery under general anesthesia, and had elected to receive intravenous PCA postoperatively. Soon after their arrival in the operating room, the patients were randomised to receive either a placebo patch (group P) or TSP (group S) on the right postauricular area. Nausea, vomiting and sedation were scored at the postoperative care unit (PACU) and at 12, 24, 48, and 72 h postoperatively. Patients were treated with metoclopramide as deemed necessary by the primary care nurse. RESULTS: No differences were found between the groups in scores and incidence of nausea and vomiting at the PACU and at 12, 24, 48, and 72 h postoperatively. The patients who received metoclopramide were significantly fewer in group S than in group P (6.7% vs 43.3%, P < 0.05). The sedation score was significantly lower in group S than in group P (1.3 0.5 vs 1.8 0.9, P < 0.05) at 12h postoperatively. CONCLUSIONS: TSP did not reduce the incidence and score of nausea and vomiting in postoperative patients during intravenous PCA. However, patients who received TSP required less antiemetic medication. TSP appears to be effective for supplemental antiemetic medication.
Analgesia, Patient-Controlled* ; Anesthesia, General ; Female ; Fentanyl ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Metoclopramide ; Morphine ; Nausea ; Operating Rooms ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Care ; Postoperative Nausea and Vomiting* ; Primary Health Care ; Scopolamine Hydrobromide* ; Vomiting

BACKGROUND: Patient-controlled analgesia (PCA) provides excellent pain relief in the management of postoperative pain, but is associated with unpleasant side effects such as nausea and vomiting. The transdermal scopolamine patch (TSP) has been shown to have effective antiemetic actions. We evaluated the effectiveness of TSP in patients receiving morphine and fentanyl via intravenous PCA. METHODS: Sixty patients were scheduled for an elective intra-abdominal gynecologic surgery under general anesthesia, and had elected to receive intravenous PCA postoperatively. Soon after their arrival in the operating room, the patients were randomised to receive either a placebo patch (group P) or TSP (group S) on the right postauricular area. Nausea, vomiting and sedation were scored at the postoperative care unit (PACU) and at 12, 24, 48, and 72 h postoperatively. Patients were treated with metoclopramide as deemed necessary by the primary care nurse. RESULTS: No differences were found between the groups in scores and incidence of nausea and vomiting at the PACU and at 12, 24, 48, and 72 h postoperatively. The patients who received metoclopramide were significantly fewer in group S than in group P (6.7% vs 43.3%, P < 0.05). The sedation score was significantly lower in group S than in group P (1.3 0.5 vs 1.8 0.9, P < 0.05) at 12h postoperatively. CONCLUSIONS: TSP did not reduce the incidence and score of nausea and vomiting in postoperative patients during intravenous PCA. However, patients who received TSP required less antiemetic medication. TSP appears to be effective for supplemental antiemetic medication.
Analgesia, Patient-Controlled* ; Anesthesia, General ; Female ; Fentanyl ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Metoclopramide ; Morphine ; Nausea ; Operating Rooms ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Care ; Postoperative Nausea and Vomiting* ; Primary Health Care ; Scopolamine Hydrobromide* ; Vomiting

OBJECTIVE: To determine post-operative physical performance factors associated with gait speed in patients surgically treated for hip fracture. METHODS: Cross-sectional data from 59 patients (16 males and 43 females; mean age, 79.2±9.1 years) who underwent hip fracture surgery were enrolled. Patients completed a 10-meter walk test (10MWT) to assess gait speed. Additional physical performance tests included the Timed Up and Go test (TUG), the Berg Balance Scale (BBS), maximum voluntary isometric contraction (MVIC) of the knee extensors and flexors on the operated and non-operated sides as well as of the hip abductors (all tested using air-resistance weight machines), and analysis of spatio-temporal gait parameters at about 6 weeks after hip surgery. RESULTS: Bivariate analyses revealed a significant positive correlation between the post-operative 10MWT and the post-operative TUG, age, swing phase duration, and gait cycle duration along with a significant negative correlation between post-operative BBS score, MVIC of the knee extensors and flexors on the operated and non-operated sides, MVIC of the hip abductors, and cadence and stance phase duration. Linear regression analyses revealed that the post-operative TUG (β=0.85, p<0.01), gait cycle duration (β=0.17, p=0.02), and osteoporosis (β=-0.18, p=0.02) were associated with the post-operative 10MWT. CONCLUSION: The presence of osteoporosis, post-operative balance, and isometric muscle strength in the operated and non-operated legs were statistically associated with post-operative gait speed early after hip fracture surgery.
Cross-Sectional Studies ; Female ; Gait ; Hip Fractures ; Hip ; Humans ; Isometric Contraction ; Knee ; Leg ; Linear Models ; Male ; Muscle Strength ; Osteoporosis ; Rehabilitation