BACKGROUND: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. METHODS: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged > or =40 years. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. RESULTS: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. CONCLUSIONS: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.
Arthrography ; Arthroscopy ; California ; Elbow ; Follow-Up Studies ; Humans ; Patient Selection ; Range of Motion, Articular ; Shoulder ; Visual Analog Scale

BACKGROUND: In South Korea, indigenous malaria has been reappeared since 1993 and more than 350 cases diagnosed in 1996. For the diagnosis of malaria the classic methods such as thin and thick blood smears with Giemsa or Wright stain has been routinely used. Since recently fluorochrome staining has been shown to be more sensitive, easy to do, and less time-consuming, we applied the new method, Acridine orange stain, for diagnosis of clinically suspected cases. METHODS: Thin and thick blood smears were prepared from civilian patients of Kyunggi Province (n=20) and Republic Of Korea army patients pre- (n=67) and post-treatment (n=13) of malaria. The slides were fixed by methanol and stained by either Giemsa or Acridine orange solution (10-50 g/mL). For comparison, an expert on malaria diagnosis examined them by light and fluorescent microscope, respectively. RESULT: Acridine orange stain was found to be a rapid technique, and as sensitive (83%) as thick smears (83%) for diagnosis of malaria. The detection limit of acridine orange stain was 23.5 parasites/ul of blood. The staining time was much shorter (30 sec) than that of Giemsa stain (30-60min). CONCLUSION: Acridine orange stain is evaluated as a simple, rapid, and sensitive method for malaria diagnosis compared with Giemsa stain.
Acridine Orange* ; Azure Stains ; Diagnosis* ; Gyeonggi-do ; Humans ; Korea ; Limit of Detection ; Malaria* ; Methanol ; Republic of Korea

Cerebral vasospasm is one of most serious complication after subarachnoid hemorrhage due to aneurysmal rupture and a very important cause affecting to prognosis. The most reliable diagnostic assessment of cerebral vasospasm is angiography, but this is limited to perform because of complications such as neurological deficits or death, especially to repeat studdy. It seems likely that assessment of evoked elective, a much simpler and safer than the repeated study of angiography, will be of use in following the condition of patients with clinical vasospasm following SAH. In order to study relationship between clinical vasospasm and electrical activity, we traced SSEP from upper extremity by median nerve stimulation and lower extremity by posterior tibial stimulation which manifest the neurophysiologic function of cerebral ischemia. MN(Me-dian n.) and PTN(Posterior tibial n.)were performed simultaneously. Over 2 years period (1986 through 1988), 41 patients were performed SSEP and evaluated the relationship between SSEP and clinical or angiographic vasospasm in patients of SAH.
Aneurysm ; Angiography ; Brain Ischemia ; Humans ; Lower Extremity ; Median Nerve ; Prognosis ; Rupture ; Subarachnoid Hemorrhage ; Upper Extremity ; Vasospasm, Intracranial

BACKGROUND: Repair of superior labral anterior to posterior (SLAP) lesion in patients older than 40 years is controversial. The purpose of this study was to evaluate clinical outcomes of arthroscopic repair of SLAP lesions between younger and older patient groups. METHODS: We reviewed 50 patients with isolated type II SLAP lesions who underwent arthroscopic repair. Patients were divided into 2 groups: group 1 included 20 patients aged <40 years, and group 2 included 30 patients aged > or =40 years. Functional outcome at the final follow-up was assessed using a visual analog scale for pain and satisfaction, American Shoulder and Elbow Surgeons form, Constant score, University of California at Los Angeles score, and periodic change in range of motion (ROM). Anatomical outcome was evaluated using computed tomography (CT) arthrography at least 1 year after surgery. RESULTS: No significant differences in functional scores or postoperative ROM were observed between the 2 groups. In group 2, later recovery of ROM (forward flexion, p=0.025; internal rotation, p=0.034) and lower satisfaction score (p=0.06) were observed for atraumatic patients (n=16) compared to patients with traumatic injury (n=14). Fifteen patients in group 1 (15/17, 88%) and 21 patients in group 2 (21/26, 81%) demonstrated a healed labrum on postoperative CT arthrography, and this difference was not significant. CONCLUSIONS: The results of this study suggest that arthroscopic repair of type II SLAP lesions can yield good functional and anatomical outcomes regardless of age, if patient selection is adequate. However, the delay in ROM recovery and lower satisfaction, particularly in older patients without traumatic injury, should be considered.
Arthrography ; Arthroscopy ; California ; Elbow ; Follow-Up Studies ; Humans ; Patient Selection ; Range of Motion, Articular ; Shoulder ; Visual Analog Scale

The change of conditions of hydroxyapatite synthesis can affect not oniy the material properties, but also the body reaction to the hydroxyapatite implants. To find out conditions for preparing more biocompatible hydroxyapatite implants as bone graft substitute. we evaluated the biologic response to the dense synthetic hydroxyapatite implants, made with various synthetic conditions, placed in corticocancellous defects of rabbits' long bone. The hydroxyapatites were synthesized with coprecipitation technique using Ca(NO3) 4H2O and (NH4)2HPO4, made with various Ca/P ratio and aging temperatures. Four kinds of hydroxyapatites were selected to use as implants(HA I: Ca/P ratio 1.5, aging temperature 90degrees C; HA V :1.5 , 30degrees C; HA VI: 1.83, 30degrees C; and HA lX: 1.67, 30degrees C). These hydroxyapatites were pressed and sintered at l300degrees C to fabricate dense plates. Biomechanical test and rnorphological examination were performed using Instron, light microscope and electron microscope. The characteristics of hydroxyapatite powder and sintered body were more significantly affected by siarting Ca/P ratios. The bonding strength of HA IX(1.67, 30degrees C) with bone was grcatest at 4 or 8 weeks after implantation with statistically significant difference(p<0.05). Bonding behavior betweeb HA IX and bone was most excellent in terms of new bone formation and new bone ingrowth into resorbed surface of hydroxyapatite plate.
Aging ; Durapatite* ; Hydroxyapatites ; Osteogenesis ; Transplants

BACKGROUND: Screening of donor blood for malaria has not been activated in Korea yet in spite of the recent resurgence of tertian malaria among Korean army soldiers in Delimited Militarized Zone areas. Prospective donors (travelers, immigrants, refugees, citizens or residents) following a visit to or coming from an endemic area who have had malaria or taken antimalarial prophylaxis should be deferred for 3 years after cessation of therapy or after departure from malarial area. We studied the risk of the transmission of malaria, especially through army blood donation which comprised up to 57.8% of whole blood donation in Korea. METHODS: The data were collected by personal interview and review of donation records of Korea Red Cross Center and medical records from 174 army soldiers with malaria who admitted to Army Hospital from May 1995 to October 1996. We analyzed the time interval between onset of illness and blood donation, and geographic distribution of the patients. RESULTS: About 70.7% (123/174) of the patients donated blood before the onset of illness, and the interval between blood donation and onset of illness ranged from 2 days to 2,750 days (mean 377, standard deviation 488). Patients who donated blood within 3 years before onset of illness were 87.8%(n=108) of the total blood donation. All donation (n=18) after treatment were within 3 years from 46 days to 342 days (mean 138, standard deviation 80.7). The frequent of blood donations were from the prevalent areas of malaria such as Pajoo City (40%), Younchon Kun (29%), Cholwon Kun (15.5%) and others(15.5%). CONCLUSION: We showed that donated army blood a risk of malaria transmission. Therefore the blood bank needs to set strict guidelines for blood donation especially from Korean army soldiers to control malaria transmission.
Blood Banks ; Blood Donors* ; Emigrants and Immigrants ; Hospitals, Military ; Humans ; Korea* ; Malaria* ; Mass Screening ; Medical Records ; Military Personnel* ; Red Cross ; Refugees ; Tissue Donors

Somatosensory evoked potential(SSEP) has been recorded during 31 operations for intracranial aneurysm. We had monitored the SSEP in each stage of aneurysm surgery(preoperative, anesthetic induction, dura opening, temporary vascular occlusion, aneurysm neck clipping and 30 minute after aneurysm neck clipping). Temporary occlusion of intracranial arteries have performed in 21 cases. In cortical amplitude of more than 50% as compared with induction was considered to be "significant" SSEP change. Eleven out of 21 cases of temporary vascular occlusion showed significant decrease of amplitude. Three out of 4 cases with flat wave had new neurologic deficits postoperatively. We studied the relationship between SSEP changes and postoperative neurologic deficit and concluded as follows: 1) The monitoring of amplitude of SSEP may help control the duration and number of application in temporary clipping during aneurysm surgery. 2) Decreased in amplitude with temporary clipping, especially flat wave, is a strong suggestion of the postoperative neurologic deficit. These results indicate that monitoring of SSEP during aneurysm surgery would be helpful to reduce the incidence of postoperative neurologic deficits.
Aneurysm* ; Arteries ; Incidence ; Intracranial Aneurysm ; Neck ; Neurologic Manifestations

BACKGROUND: To study the distribution of the polymorphism of apo E and angiotensin converting enzyme genotypes in type 2 diabetic patients and to evaluate possible association between the apo E genotypes and angiotensin converting enzyme genotypes and intima-media thickness of the common carotid artery. METHODS: Study participants were 206 type 2 diabetic patients (112 men and 94 women), aged 18-81 years. HbA1C, albuminuria, and lipid status were assessed by standard laboratory techniques ; the apo E genotypes were assessed by modified amplification refractory mutation system of polymerase chain reaction technique and the angiotensin converting enzyme genotypes were assessed by multiplex polymerase chain reaction technique. The intima-media thickness was measured by high-resolution ultrasonography. RESULTS: The apo E allele frequencies of patients were E2 11%, E3 72%, and E4 17%. Mean HDL-cholesterol was lower in E4 carrier (n=35) than E2 (n=148) and E3 (n=35) carrier. E2 carriers has less common carotid intima-media thickness than E3 and E4 carriers (p< 0.05). The angiotensin converting enzyme genotypes were distributed as follows ; II 38%, ID 47%, DD 15%. The intima-media thickness value did not differ among patients with various genotypes. Multiple logistic regression analysis showed that only apo E polymorphism was determinant for the intima-media thickness. CONCLUSION: Our results suggested that apo E polymorphism was associated with carotid artery intima-media thickness in type 2 diabetic patients. But we could not find an association between carotid artery intima-media thickness and angiotensin converting enzyme genotype in this patients population.
Albuminuria ; Angiotensins* ; Apolipoproteins E ; Apolipoproteins* ; Carotid Arteries* ; Carotid Artery, Common ; Carotid Intima-Media Thickness ; Diabetes Mellitus* ; Gene Frequency ; Genotype ; Humans ; Logistic Models ; Male ; Multiplex Polymerase Chain Reaction ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Ultrasonography

Meckel's diverticulum is a remnant of the vitelline duct located in the distal ileum, and it is the most common cause of small bowel bleeding in patients who are under the age of 25 years. The ectopic gastric mucosa in Meckel's diverticulum causes ulceration and acute gastrointestinal bleeding. Capsule endoscopy is now a valuable tool for diagnosing obscure gastrointestinal bleeding. However, the identification of a Meckel's diverticulum by wireless capsule endoscopy has rarely been reported on. An 18-year-old man was admitted for recurrent melena and anemia. He underwent a small bowel series that showed a jejunal diverticulum, and capsule endoscopy then revealed a jejunal diverticulum with multiple ulcerations. After 2 months, he had fresh hematochezia and so he underwent small bowel segemental resection that included the jejunal diverticulum. The operation revealed Meckels' diverticulum at 180 cm distant from the ileocecal valve at the mesenteric side. We report here on a case of bleeding Meckel's diverticulum that was diagnosed by wireless capsule endoscopy, and we include a review of the relevant literature.
Adolescent ; Anemia ; Capsule Endoscopy* ; Diverticulum ; Gastric Mucosa ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Ileocecal Valve ; Ileum ; Meckel Diverticulum ; Melena ; Ulcer ; Vitelline Duct

Meckel's diverticulum is a remnant of the vitelline duct located in the distal ileum, and it is the most common cause of small bowel bleeding in patients who are under the age of 25 years. The ectopic gastric mucosa in Meckel's diverticulum causes ulceration and acute gastrointestinal bleeding. Capsule endoscopy is now a valuable tool for diagnosing obscure gastrointestinal bleeding. However, the identification of a Meckel's diverticulum by wireless capsule endoscopy has rarely been reported on. An 18-year-old man was admitted for recurrent melena and anemia. He underwent a small bowel series that showed a jejunal diverticulum, and capsule endoscopy then revealed a jejunal diverticulum with multiple ulcerations. After 2 months, he had fresh hematochezia and so he underwent small bowel segemental resection that included the jejunal diverticulum. The operation revealed Meckels' diverticulum at 180 cm distant from the ileocecal valve at the mesenteric side. We report here on a case of bleeding Meckel's diverticulum that was diagnosed by wireless capsule endoscopy, and we include a review of the relevant literature.
Adolescent ; Anemia ; Capsule Endoscopy* ; Diverticulum ; Gastric Mucosa ; Gastrointestinal Hemorrhage ; Hemorrhage* ; Humans ; Ileocecal Valve ; Ileum ; Meckel Diverticulum ; Melena ; Ulcer ; Vitelline Duct