BACKGROUND: The purpose of this study was to evaluate the efficacy of suction drain use following arthroscopic rotator cuff repair by comparing early pain score and range of motion (ROM) between groups with and without suction drains. METHODS: The study included 153 patients with rotator cuff tears who underwent arthroscopic repairs at our clinic from April 2014 to March 2015. Following surgery, a suction drain was used in 85 patients (group D) and not used in 68 patients (group ND). There was no statistical difference between the groups in terms of age, gender, or total operation time. The clinical outcome with regard to pain (assessed by pain scores and analgesic requests) and passive ROM was assessed preoperatively and postoperatively. RESULTS: Immediate postoperative analgesic requirement was significantly higher in group D (p=0.001), although there was no difference in pain outcomes between the groups during the 3-month follow-up period. A statistically significant difference in passive ROM was observed at the postoperative 2- and 6-week follow-ups (p=0.036, 0.035, and 0.034 in forward elevation (FE), external rotation at the side (ER) and 90 ER at weeks 2, respectively; 0.045 and 0.009 in FE and ER at weeks 6, respectively); however no significant difference was observed at the end of 3 months. During the study period, no complication was reported in either group. CONCLUSIONS: Use of suction drains after arthroscopic rotator cuff repair provided little benefit in terms of ROM or pain in the early postoperative period (up to 3 months).
Arthroscopy ; Follow-Up Studies ; Humans ; Postoperative Period ; Range of Motion, Articular ; Rotator Cuff* ; Shoulder ; Suction* ; Tears

Congenital Ectodermal dysplasia is known to be rare, recently we experienced one case of congenital ectodermal dysplasia of hydrotic tipe in newborn infant due to autosomal dominance. Review of Literatvre was done briefly.
Ectoderm* ; Ectodermal Dysplasia* ; Humans ; Infant, Newborn

BACKGROUND: The incidence of scabies in Korea decreased during the past 20 years. This might have been due to improved personal hygiene and public sanitation. Recently, however, not only the incidence of scabies, but also delayed or missed diagnosis, is likely to increase again. OBJECTIVE: This study was conducted to obtain a better understanding of the clinical characteristics of recent scabietic patients. METHODS: We reviewed the medical records and clinical photographs of 27 outpatients who had been diagnosed with scabies in our department between August 2006 and August 2008. We investigated personal and clinical information, including age, sex, onset, past history and clinical manifestations. RESULTS: Of the 27 patients, 14 (51.9%) were female and 13 (48.1%) were male. Their ages ranged from 4 to 93 years (mean=47.2 years). Over half (51.9%) of the patients had been misdiagnosed at private hospitals. The average time from symptom presentation to diagnosis was 68 days. The most common site of skin lesions was the lower abdomen (77.8%), and the most common primary lesion was erythematous papules (96.3%). Atypical cases of scabies were as follows: 7 nodular scabies (25.9%), 1 crusted scabies (3.7%) and 4 scabies incognito (14.8%). CONCLUSION: Currently, atypical cases of scabies may be increasing and frequently misdiagnosed. We suggest that dermatologists should suspect scabies for any patient who presents with pruritus that is persistent or resistant to treatment.
Abdomen ; Female ; Hospitals, Private ; Humans ; Hygiene ; Incidence ; Korea ; Male ; Medical Records ; Outpatients ; Pruritus ; Sanitation ; Scabies ; Skin

Actinomycotic infections are known to have an association with difficulties in diagnosis and treatment. These infections usually involve the head, neck, thorax, and abdomen. Actinomycosis of the upper lip is a rare condition and an important one as well, because it can imitate other diseases. As the initial impression, it can easily be mistaken for a mucocele, venous lake, or benign neoplasm. An 82-year-old man presented with an asymptomatic normal skin colored nodule on the upper lip. Histopathologic findings showed an abscess and sulfur granules in the dermis. Gram staining results showed a mesh of branching rods. In this report, we present an unusual case of actinomycosis of the upper lip and discuss its characteristics and therapeutic modalities.
Abdomen ; Abscess ; Actinomycosis ; Aged, 80 and over ; Dermis ; Head ; Humans ; Lakes ; Lip ; Mucocele ; Neck ; Skin ; Sulfur ; Thorax

Myositis ossificans is a rare benign ossifying lesion in skeletal muscles which is commonly seen after trauma. However, it has been reported that myositis ossificans can be developed without any history of trauma and surgery. A 37-year-old female presented with a painful progressive swelling in her right femoral area, with no history of trauma or other diseases, which had been developed for 2 weeks. Initial X-rays were normal. An incision biospy specimen showed a lesion of fibroblastic tissue in which areas of osteoid and trabecular bone tissue, which was compatible with the early stage of myositis ossificans. The mass was excised totally and no signs of recurrence have been noted until now.
Adult ; Bone and Bones ; Female ; Fibroblasts ; Humans ; Muscle, Skeletal ; Myositis Ossificans* ; Myositis* ; Quadriceps Muscle* ; Recurrence

PURPOSE: The purpose of this study was aimed to disclose main affected organisms in patients with perforated appendicitis and to analyze correlations between culture-sensitivity test and infectious complication. METHODS: In 26 of 421 patients who had undergone appendectomy due to acute appendicitis from April 1996 to March 1999, we performed culture-sensitivity test. The clinical records of these patients were collected and reviewed about clinicopathological features and results of culture-sensitivity test, retrospectively. Culture material was collected in BBL transport media with cotton swab and cultured by MacConkey agar plate. The method of MIC by VITEK was used for sensitivity test. RESULTS: Cultured organisms were E. coli (18 cases), Pseudomonas (4), Enterobacter (2), Enterococcus (1), and Proteus (1). In sensitivity test, sensitive antibiotics against all cultured organism were amikacin, ceftriaxone, imipenem and cefotetan. But ampicillin, sulfametoxazole/trimethoprim and piperacillin were mostly resistant. Infectious complications occurred in 11 of 26 patients (42.3%) and consisted of 9 wound infection and 2 intraabdominal abscess. Especially, 13 of 18 cases in which E. coli were isolated, were resistant to ampicillin. And they had infectious complications statistically more than those who were not resistant to ampicillin (p=0.036). CONCLUSIONS: E. coli was a main organism in perforated appendicitis. In case of ampicillin-resistant E. coli, the patients were susceptible to infectious complication such as wound infection and intraabdominal abscess.
Abscess ; Agar ; Amikacin ; Ampicillin ; Anti-Bacterial Agents ; Appendectomy ; Appendicitis* ; Cefotetan ; Ceftriaxone ; Enterobacter ; Enterococcus ; Humans ; Imipenem ; Piperacillin ; Proteus ; Pseudomonas ; Retrospective Studies ; Wound Infection

BACKGROUND: At present, there are many instruments to diagnose anxiety and depression. However, most of the instruments have a number of questions. Therefore, we have many difficulties in applying them to the primary care. The purpose of this study was to measure the reliability and the validity of a Korean-translated Goldberg s short screening scale for anxiety and depression, which were developed for screening of anxiety and depression in primary care. METHODS: 178 asymtomatic subjects and 58 patients(anxiety 15, depression 43) aged from 18 to 64 years old were selected. The patients were diagnosed by psychiatrist according to DSM-IV criteria. This study was performed for 3 months, from May to August 1996. The reliability of this instrument was measured by internal consistency reliability. The validity of this instrument was measured by three methods. The first method was the comparison of the score between the patients and the control group. The second method was to measure the relationships of this instrument with the other instruments such as Self-rating Depression Scale and State-Trait Anxiety Inventory. The last method was to measure the relationship of this instrument with Comprehensive Global Assessment. In addition, we calculated the sensituvity and specificity at the cut off values. RESULTS: The Cronbach's a value was 0.736 for the anxiety and 0.749 for the depression. Goldberg anxiety scale was significantly associated with state in STAI(r=0.279, P<0.001), and trait in STAI(r=0.125, P=0.041). However, Goldberg depression scale was not sigficantly associated with SDS. Goldberg anxiety scale as well as Goldberg depression scale were significantly associated with CGA(r=0.433, P=0.001; r=0.695, P=0.001). The seore of Goldberg anxiety scale was significantly higher in the anxious patients than in the control group(P=0.047). The score of Goldberg depression scale was significantly higher in the depressive patients than in the control group(P<0.001). For anxiety scale of Goldberg scale, the sensitivity and the specificity was 60% and 68% at score 3. For depression scale of Goldberg scale, the sensitivity and the specificity was 80% and 68% at score 2. CONCLUSIONS: We concluded that the value of Cronbach's a in Goldberg scale was 0.736 for anxiety and 0.749 for depression. For the validity, the scores of Goldberg scale were higher in patient group than in asymptomatic group. However, the relationships of Goldberg scale with other screening instruments were variable. So further study for the validity of Goldberg scale is requested.
Anxiety* ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Mass Screening* ; Middle Aged ; Primary Health Care ; Psychiatry ; Sensitivity and Specificity

Anisakiasis is a parasitic disease caused by an infection of Anisakinae larvae. It occurs when the live larvae are introduced to the human gastrointestinal tract by eating infected raw fish. The endoscopic features of the gastric mucosa adjacent to the worms include redness, edematous, which are sometimes hemorrhagic and erosive. Gastric anisakiasis forming submucosal tumor, due to unobserved endoscopy, larva is very rare. 2 cases of submucosal tumors caused by gastric anisakiasis were found by endoscopic examination. The well demarcated mass lesion was seen in the submucosal layer of the stomach using endoscopic ultrasonography, and confirmed by laparoscopic wedge resection.
Anisakiasis* ; Eating ; Endoscopy ; Endosonography ; Gastric Mucosa ; Gastrointestinal Tract ; Humans ; Larva ; Parasitic Diseases ; Stomach

Isolated left brachiocephalic artery with right aortic arch is extremely rare congenital anormaly. This malformation can cause subclavian steal phenomenon. We report the duplex sonographic and conventional angiographic findings of isolated left brachiocephalic artery in a 22-year-old female presented with dizziness.
Aorta, Thoracic ; Arteries ; Dizziness ; Female ; Humans ; Subclavian Steal Syndrome ; Young Adult

Macrophage activation syndrome (MAS) is a severe, potentially life-threatening complication of childhood systemic inflammatory disorder, primarily systemic onset juvenile rheumatoid arthritis (SoJRA). It is characterized by pancytopenia, liver insufficiency, coagulopathy, and neurologic symptoms. The clinical manifestations are caused by the activation and uncontrolled proliferation of T lymphocytes and macrophages, leading to cytokine overproduction including tumor necrosis factor-alpha (TNF-alpha). Methylprednisolone pulse therapy and cyclosporine A have made a considerable progress in the treatment of MAS. However, the mortality rate remains high suggesting the need of another therapeutic agent. Several cases of MAS successfully treated with TNF-alpha inhibitor (etanercept) have been reported. We report the first Korean case of MAS successfully treated with combination therapy of corticosteroid, cyclosporine A and etanercept.
Arthritis, Juvenile Rheumatoid ; Cyclosporine ; Hepatic Insufficiency ; Immunoglobulin G ; Macrophage Activation Syndrome ; Macrophages ; Methylprednisolone ; Neurologic Manifestations ; Pancytopenia ; Receptors, Tumor Necrosis Factor ; T-Lymphocytes ; Tumor Necrosis Factor-alpha ; Etanercept