PURPOSE: To evaluate the findings of subchondral cyst of the humeral head, as seen on shoulder MRarthrography MATERIALS AND METHODS: Sixty-three patients( M:F=62:1 ; mean age 23 years) who underwent shoulder MRarthrography between September 1996 and May 1998 were retrospectively reviewed. No patient had a history of eithershoulder dislocation or certain diseases known to be commonl accompanied by subchondral cysts. All MR images wereobtained using a 1.5 Tesla unit after intraarticular injection of 20ml of diluted contrast material. T1 andT2-weighted axial, oblique coronal, and oblique sagittal images were analysed for the presence, location, number,shape, size, and connection to the joint cavity of subchondral cysts. RESULTS: We identified 58 subchondral cystsin 43(71.7%) of 63 cases. All were located in the posterolateral portion of the humeral head, and on the physealline. Twenty-eight patients(65.1%) had one cyst, and 15(34.9%) had two. Thirty-four cysts(58.6%) were round orovoid in shape and, 2-8mm in diameter(average, 3.9mm) ; 24(41.4%) were lobulated and 3-10mm in diameter(average5.3mm). Fifty-three cysts(91.4%) were connected to the joint cavity. CONCLUSIONS: In symptomatic patients, the incidence of subchondral cyst of the humeral head was 71.7%. All were located in the posterolateral portion, andon the physeal line. Most subchondral cysts were connected with the joint cavity.
Bone Cysts* ; Dislocations ; Humans ; Humeral Head* ; Incidence ; Injections, Intra-Articular ; Joints ; Magnetic Resonance Imaging* ; Retrospective Studies ; Shoulder

PURPOSE: To evaluate by means of MR arthrography the causal relationship between anterior capsularattach-ment type and anterior instability of the glenohumeral joint. MATERIALS AND METHODS: Sixty-five patients (M:F=64:1; mean age, 23 years), who had undergone shoulder MR arthrography were retrospectively reviewed. There wasno history of traumatic dislocation, and medical records relating to anterior instability were available. Physicalexamination revealed anterior instability in 25 patients(Group A), while in 40 (Group B), this was eithersuspicious or absent. With the aid of general anesthe-sia, 32 patients who had undergone surgery were physicallyexamined. Anterior instability was evident in 16 patients(Group C), and suspicious or absent in the remaining 16(Group D). All images were obtained after in-traarticular injection of Gd-DTPA. Fat-suppressed T1 axial imagingwas used to evaluate anterior capsular at-tachment type at mid and distal three-fourths levels of the glenoidfossa. The causal relationship between ante-rior capsular attachment types and anterior instability was analyzedusing the x2 test RESULTS: In group A, type I was most common at distal three-fourths level, and types I and IIwere equal and more common than type III at mid level. In group B, type I anterior capsular attachment type wasmost com-mon at both mid and distal three-fourths level. In these groups, no statistical significance was notedbetween anterior capsular attachment type and anterior instability (p value 0.611: 0.567). In group C, types I andII were equal and more common than type III at both mid and distal three-fourths level, while in group D, type IIwas most common at mid level, and type I was most common at distal three-fourths level. In these groups, nostatistical significance was noted between anterior capsular attachment type and anterior instability (p val-ue,0.772). CONCLUSION: There was no statistically significant difference between anterior capsular attachment typeand anterior instability of the shoulder joint.
Arthrography* ; Dislocations ; Gadolinium DTPA ; Humans ; Medical Records ; Retrospective Studies ; Shoulder ; Shoulder Joint*

It is well known that the Ebstein-Barr virus causes not only infectious mononucleosis in the most cases, but also occasionally causes a variety of hematologic disorders such as anemia (hemolytic anemia or aplastic anemia), thrombocytopenia, neutropenia and malignancies such as Burkitt lymphoma and nasopharyngeal carcinoma. Furthermore, recently it is has been reported that it causes leukemia even though very rarely. The authors report a case of erythroleukemia possibly related to chronic Ebstein-Barr virus infection in a 14-year-old boy with brief review of related literatures.
Adolescent ; Anemia ; Burkitt Lymphoma ; Humans ; Infectious Mononucleosis ; Leukemia ; Leukemia, Erythroblastic, Acute* ; Male ; Neutropenia ; Thrombocytopenia

PURPOSE: To assess the accuracy of magnetic resonance(MR) arthrography in the diagnosis of anterior labral tear of the shoulder. MATERIALS AND METHODS: Between Semptember 1996 and February 2000, MR arthrography of the shoulder was performed in 281 patients with a history of shoulder pain or instability. Among this total, only 157 shoulders in 154 patients who underwent arthroscopy or open surgery 0 to 230 (average, 20.9) days after MR arthrography were included in this study; the subjects comprised of 150 males and 4 females with an average age of 23.3 years. MR arthrographs of these 154 patients were analyzed for the presence of anterior labral tears, and the findings were correlated with the arthroscopic and surgical findings. Anterior labral tear was classified as A to D according to its location, as determined by arthroscopy and surgery. (A=4 to 6 o 'clock direction, anteroinferior; B=2 to 4 o 'clock direction, central; C=12 to 2 o 'clock direction, anterosuperior; D= SLAP lesions). The retrospective analysis of MR arthrographs showing false-positive and negative findings was also undertaken. RESULTS: In the diagnosis of anterior labral tear, MR arthrography showed a sensitivity of 94%, a specificity of 90% and an accuracy of 91%. Anterior labral tears were confirmed by arthroscopy or surgery in 62 of the 157 shoulders (39%). Among 62 lesions, two (3%) were observed in area A, 32(52%) in area A+B, nine (15%) in area A+B+C, one(2%) in area A+B+D, 13(21%) in area A+B+C+D, two (3%) in area B+C, one(2%) in area B+D, and two(3%) in area C. Among ten false-positive cases, seven were focal lesions (two, three and two lesions in area A, B and C, respectively), and in the remaining three cases, located in area A+B, MR arthrography revealed thickening and deformation. All four false negatives were focal lesions (two in area A and two in area C). CONCLUSION: Other than in focal lesions, in which accuracy was relatively low, MR arthrography showed high sensitivity, specificity and accuracy in the diagnosis of anterior labral tear of the shoulder.
Arthrography* ; Arthroscopy ; Diagnosis ; Female ; Humans ; Male ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder Pain ; Shoulder*

Systemic lupus erythematosus(SLE), a rheumatic disease of unknown causes, is characterized by autoantibodies directed against self-antigens, resulting in inflammatory damages to target organs including kidney, blood-forming cells, and central nervous system. The prevalence rates are higher in Native Americans, Asians, Latin Americans and black people. A female to male ratio of approximately 2 : 1 occurs before puberty, and 4 : 1 after puberty. Children of SLE most frequently present with fever, fatigue, arthralgia or arthritis, and rashes. The diagnosis is confirmed by clinical and also laboratory manifestations satisfying at least 4 out of 11 criteria. A central nervous system is not rarely involved in children of SLE with the prevalence rate of 23-44%. However, cerebral infarcts are not a common phenomenon and can be seen only for 6% of children with SLE. There have been no cases reported in Korea. This is why we present a case of basal ganglia infarct associated with SLE in a 19-month old girl. We report this case with a brief review of related literature.
Adolescent ; Arthralgia ; Arthritis ; Asian Continental Ancestry Group ; Autoantibodies ; Autoantigens ; Basal Ganglia* ; Central Nervous System ; Child ; Diagnosis ; Exanthema ; Fatigue ; Female ; Fever ; Humans ; Indians, North American ; Infant ; Kidney ; Korea ; Lupus Erythematosus, Systemic ; Male ; Prevalence ; Puberty ; Rheumatic Diseases

The aim of this study was to investigate the relationship between retirement preparation and depressive symptoms among Koreans 50 years of age or older. We used data from the 2009 to 2013 Korean Retirement and Income Panel Study (KReIS), which included data from the 365 baseline participants of 50 years of age or older. Our sample included only newly retired participants who worked in 2009, but had retired in the 2011 and 2013. To monitor the change in depressive symptoms according to retirement preparation, we used repeated measurement data. We measured depressive symptoms using the Center for Epidemiological Studies Depression (CES-D) 20-item scale. In addition, we measured retirement preparation using a single self-report question asking whether the participant was financially ready for retirement. We evaluated relationship between retirement preparation and depressive symptoms after multivariable adjustment. Compared to subjects who had prepared for retirement (reference group), participants who had not prepared for retirement had increased depression scores (β = 2.49, P < 0.001). In addition, individuals who had not prepared for retirement and who had low household income had the highest increase in depression scores (β = 4.43, P < 0.001). Individuals, who had not prepared for retirement and without a national pension showed a considerable increase in depression scores (β = 3.02, P < 0.001). It is suggested that guaranteed retirement preparation is especially important for mental health of retired elderly individuals with low economic strata.
Aged* ; Depression* ; Epidemiologic Studies ; Family Characteristics ; Humans ; Mental Health ; Pensions ; Retirement*

Evidence-based studies have begun to identify the most promising interventions for use with disaster survivors. Interventions are provided in a staged sequence across a timeline. Relationship among agencies associated with a disaster, training professionals and prepared programs for disaster will be needed in pre-disaster stage. After a disaster, children's mental health needs range from support utilizing psychological first aid to psycho-education. The skills for psychological recovery, trauma focused cognitive behavioral therapy, and cognitive behavioral intervention for trauma school will also be needed when children and adolescents keep suffering from various psychiatric symptoms such as insomnia, anxiety, depressive mood, re-experience, and so on. Evaluation and consideration of the developmental needs of children and adolescents, as well as the needs of parents, families, and schools is also important. Domestic standardization of intervention and psychotherapeutic treatment should be performed for more effective interventions for a disaster in Korea.
Adolescent* ; Anxiety ; Child* ; Cognitive Therapy ; Disasters* ; First Aid ; Humans ; Korea ; Mental Health ; Parents ; Sleep Initiation and Maintenance Disorders ; Survivors

PURPOSE: The purpose of this study was to assess the effectiveness and complications of an ultrasound-guided axillary brachial plexus block performed by orthopedic surgeons. MATERIALS AND METHODS: From March to May 2017, an ultrasound-guided axillary brachial plexus block was performed on a total of 103 cases of surgery. A VF13-5 transducer from Siemens Acuson X300 was used. The surgical site was included in the range of the anatomic sensory distribution of the blocked nerve, except for the case where an operation time of more than 2 hours was expected due to multiple injuries and the operation of the upper arm. The procedure was performed by 2 orthopedic surgeons in the same method using 50 ml of solution (20 ml of lidocaine HCl in 2%, 20 ml of ropivacaine in 0.75%, 10 ml of normal saline in 0.9%). The success rate of anesthesia induction during surgery, anesthetic induction time, anatomical range of operation, duration of postoperative analgesia and complications were investigated. RESULTS: The results from the 2 practices were similar. The anesthesia was successful in 100 out of 103 patients (97.1%). In these patients, the average needling time was 5.5 minutes (2.5–13.2 minutes), the average induction time to complete anesthesia was 18.4 minutes (5–40 minutes), and the average duration of postoperative analgesia was 402.8 minutes (141–540 minutes). The post-anesthesia immediate complications were dizziness in 1 case, nausea and vomiting in 4 cases, and peri-oral numbness in 2 cases, but surgery was performed without problems. All these 7 cases with complications recovered on the same day. A total of 3 cases failed with anesthesia, and they were treated by an injection with local anesthesia in the operation room in 2 cases and switched to general anesthesia in 1 case. CONCLUSION: An ultrasound-guided axillary brachial plexus block, which was performed by orthopedic surgeons allows anesthesia in a brief period and the high success rates of anesthesia for certain surgeries of the elbow and surgeries on forearm, wrist and hand. Therefore, it can reduce the waiting time to the operating room. This technique is a relatively safe procedure and dose selective anesthesia is possible.
Analgesia ; Anesthesia ; Anesthesia, General ; Anesthesia, Local ; Arm ; Brachial Plexus Block* ; Brachial Plexus* ; Dizziness ; Elbow ; Forearm ; Hand ; Humans ; Hypesthesia ; Lidocaine ; Methods ; Multiple Trauma ; Nausea ; Operating Rooms ; Orthopedics* ; Surgeons* ; Transducers ; Vomiting ; Wrist

BACKGROUND/AIMS: Although there is growing interest in hospice-palliative care, little information is available on the effects of such care in South Korea. Addressing this research gap, i.e., determining the cost-effectiveness of hospice-palliative care in South Korea, will help guide policy. Thus, the aim of this study was to evaluate the cost-effectiveness analysis of hospice-palliative care in adults diagnosed with terminal cancer. METHODS: We used a Markov model to construct a decision tree, for an analysis comparing the general ward with the hospice-palliative ward in terms of patient quality of life and cost-effectiveness. Cost and quality of life were estimated based on published Korean studies. Cost-effectiveness was calculated as the incremental cost relative to the incremental effect. Additionally, a one-way sensitivity analysis was performed to test the robustness of the results. RESULTS: Hospice-palliative ward care was more cost-effective than general ward care. The incremental cost was 290,401 Korean won (KRW) and the incremental effect was −0.25. The incremental cost-effectiveness ratio was −1,174,045 KRW. A similar pattern of results was obtained in the sensitivity analysis. CONCLUSIONS: Our results suggest that hospice-palliative ward care is more cost-effective than general ward care.
Adult ; Cost-Benefit Analysis ; Decision Trees ; Hospice Care ; Humans ; Korea ; Patients' Rooms ; Quality of Life

BACKGROUND/AIMS: Although there is growing interest in hospice-palliative care, little information is available on the effects of such care in South Korea. Addressing this research gap, i.e., determining the cost-effectiveness of hospice-palliative care in South Korea, will help guide policy. Thus, the aim of this study was to evaluate the cost-effectiveness analysis of hospice-palliative care in adults diagnosed with terminal cancer. METHODS: We used a Markov model to construct a decision tree, for an analysis comparing the general ward with the hospice-palliative ward in terms of patient quality of life and cost-effectiveness. Cost and quality of life were estimated based on published Korean studies. Cost-effectiveness was calculated as the incremental cost relative to the incremental effect. Additionally, a one-way sensitivity analysis was performed to test the robustness of the results. RESULTS: Hospice-palliative ward care was more cost-effective than general ward care. The incremental cost was 290,401 Korean won (KRW) and the incremental effect was −0.25. The incremental cost-effectiveness ratio was −1,174,045 KRW. A similar pattern of results was obtained in the sensitivity analysis. CONCLUSIONS Our results suggest that hospice-palliative ward care is more cost-effective than general ward care.