Partial Thickness Rotator Cuff Tears of the Shoulder Related to the Sports / 대한정형외과학회잡지

A painful shoulder is common among athletes, particularly those involved in overhead throwing. Professional and recreational athletes in throwing activities have an increased risk of partial thickness tears of the rotator cuff. The manuscript was to reviews the literature on the characteristics of injury, treatment strategies, and their results in throwing athletes.

Ultrasonographic Measurements of the Intramuscular Fluid Collection Using a Phantom: A Preliminary Study / 대한정형외과학회잡지

PURPOSE: The purpose of this study is to check the intermuscular fluid collection in a phantom using ultrasound after comparison with the original injected volume of gel and to evaluate interobserver reliability. MATERIALS AND METHODS: One orthopedic surgeon injected ultrasonographic gel into the muscle of slaughtered cow meat using a syringe and needle, and recorded the injected volume. The injected volume of gel ranged from 1 ml to 5 ml, and total number of trials was 30 times. The volume was calculated using ultrasound by two experienced radiologists. The ultrasonographic measured volme was assessed and interobserver variability was measured. RESULTS: The mean ultrasonographic measured volume was 71.35% of the original injected volume of gel. Thus, the measured volume using ultrasound showed a tendency to underestimate the injected volume into the muscle. For evaluation of interobserver reliability, interclass correlation using SPSS and consistency using Bland and Altman plot were calculated. Interclass correlation was 0.95, and Bland and Altman plot showed that the differences of mean volume measured by two observers were within ±1.96 standard deviation over 95%. Therefore, it showed good interoberver reliability. CONCLUSION: Ultrasonographic measurement of the intramuscular fluid collection in a phantom showed mean 71.35% of the original injected volume of gel, and it tended to be underestimated in proportion to the increased volume of intermuscular gel. This study showed good interobserver reliability.

Compliance with Atovaquone-Proguanil against Malaria of Korean Travelers Abroad

BACKGROUND: Recently, many Korean people travel abroad where malaria is prevalent. However, in Korea, relatively little is known about compliance of chemoprophylaxis against malaria. This study was performed to determine the factors influencing compliance of chemoprophylaxis against malaria in Korean travelers. MATERIALS AND METHODS: Face to face interview, telephone interview and e-mail correspondence were performed to 241 people who were prescribed with atovaquone-proguanil at the international travelers' clinic of National Medical Center between February 2007 and October 2007. RESULTS: Total of 55 people out of 235 reported one or more events of adverse reactions after chemoprophylaxis (total 76 events). However, in 38 adverse events the link between chemoprophylaxis and adverse events were very weak. Compliance of malaria chemoprophylaxis with atovaquone-proguanil was 53.9% in the study group. The predictive factors for non-compliance were package tour, travel of business affair and young age group. Conclusions: Compliance of malaria chemoprophylaxis in Korea travelers was low compared with Dutch and French studies. More efforts to increase compliance are needed, especially in travelers on package tour, business travel and people under age 40.

Compliance with Atovaquone-Proguanil against Malaria of Korean Travelers Abroad

BACKGROUND: Recently, many Korean people travel abroad where malaria is prevalent. However, in Korea, relatively little is known about compliance of chemoprophylaxis against malaria. This study was performed to determine the factors influencing compliance of chemoprophylaxis against malaria in Korean travelers. MATERIALS AND METHODS: Face to face interview, telephone interview and e-mail correspondence were performed to 241 people who were prescribed with atovaquone-proguanil at the international travelers' clinic of National Medical Center between February 2007 and October 2007. RESULTS: Total of 55 people out of 235 reported one or more events of adverse reactions after chemoprophylaxis (total 76 events). However, in 38 adverse events the link between chemoprophylaxis and adverse events were very weak. Compliance of malaria chemoprophylaxis with atovaquone-proguanil was 53.9% in the study group. The predictive factors for non-compliance were package tour, travel of business affair and young age group. Conclusions: Compliance of malaria chemoprophylaxis in Korea travelers was low compared with Dutch and French studies. More efforts to increase compliance are needed, especially in travelers on package tour, business travel and people under age 40.

Contributing Factors of Radial Nerve Palsy Associated with Humeral Shaft Fracture

PURPOSE: To analyze related factors of radial nerve palsy in patients with humeral shaft fractures. MATERIALS AND METHODS: We reviewed 107 paients with humeral shaft fracture between January 2000 and June 2007. Thirteen patients had radial nerve palsy after trauma and 9 patients after the operation. We analyzed contributing factors of radial nerve palsy associated with humeral shaft fracture including the cause of trauma, location and pattern of fracture, surgical approach and tourniquet application in cases of plate fixation, the exploration for the nerve and the time for operation. RESULTS: The difference in the incidences of radial nerve palsy after trauma and operation was not significant according to the location and pattern of fracture. The tendency of higher rate of radial nerve palsy after trauma in oblique or comminuted fractures, and after operation in spiral fractures was observed. The operation using intramedullary nailing and radial nerve exploration significantly reduced the incidence of radial nerve palsy after operation (p=0.01 and p=0.02). Posterior approach in open reduction and plate fixation showed a tendency of lower incidence of radial nerve palsy after operation (p=0.78). In logistic regression analysis, radial nerve exploration was the only significant factor that reduced the possibility of radial nerve palsy after operation (17.27: odds ratio, p=0.02). CONCLUSION: In humeral shaft fractures, we should take into consideration whether intramedullary nailing is possible or not. In cases of anterior or anterolateral approach of open reduction and plate fixation, radial nerve should be carefully inspected. In most cases, we recommend radial nerve exploration in order to minimize the possibility of radial nerve palsy after operation.

A Clinical Study of Adverse Reactions after Taking Mefloquine

BACKGROUND: Mefloquine is widely used for a chemoprophylactic agent against malaria, however, there is a tendency to avoid mefloquine as preventive medicine due to its side effects. Therefore, we carried out this study to provide travelers with safety information regarding consumption of mefloquine through a prospective research for adverse reactions. MATERIALS AND METHODS: The study had been estimated for the relationship between administration of mefloquine and symptoms of which person had been prescribed of mefloquine at the International Clinic of National Medical Center from May 1, 2006 to October 30, 2006 by phone interviews every three days prior to departure and 4 times every week following a return from the travel. RESULTS: Adverse reactions had been reported in 73 (18.6%) persons among 393 travelers who had taken mefloquine with the figure of 38 (52.1%) males, 35 (47.9%) females and 98 (24.9%) occurrences of adverse reactions. The most common adverse reaction was febrile sensation. Most (96%) of adverse reactions had been detected in 3 weeks after being taken mefloquine and there was no difference between sex and age. Most of travelers who had complained the symptoms got better spontaneously or through the symptomatic treatment. Some travelers had taken other medicines and had gotten several vaccinations concurrently. Only 3 cases that took medicine for hypothyroidism were related to adverse reactions of mefloquine (P<0.05). CONCLUSION: There were adverse reactions which were reported in 18.6% of travelers after taking mefloquine and malraria hasn't occurred. So mefloquine is considered as a primary preventive agent against malaria.

A Clinical Study of Adverse Reactions after Taking Mefloquine

BACKGROUND: Mefloquine is widely used for a chemoprophylactic agent against malaria, however, there is a tendency to avoid mefloquine as preventive medicine due to its side effects. Therefore, we carried out this study to provide travelers with safety information regarding consumption of mefloquine through a prospective research for adverse reactions. MATERIALS AND METHODS: The study had been estimated for the relationship between administration of mefloquine and symptoms of which person had been prescribed of mefloquine at the International Clinic of National Medical Center from May 1, 2006 to October 30, 2006 by phone interviews every three days prior to departure and 4 times every week following a return from the travel. RESULTS: Adverse reactions had been reported in 73 (18.6%) persons among 393 travelers who had taken mefloquine with the figure of 38 (52.1%) males, 35 (47.9%) females and 98 (24.9%) occurrences of adverse reactions. The most common adverse reaction was febrile sensation. Most (96%) of adverse reactions had been detected in 3 weeks after being taken mefloquine and there was no difference between sex and age. Most of travelers who had complained the symptoms got better spontaneously or through the symptomatic treatment. Some travelers had taken other medicines and had gotten several vaccinations concurrently. Only 3 cases that took medicine for hypothyroidism were related to adverse reactions of mefloquine (P<0.05). CONCLUSION: There were adverse reactions which were reported in 18.6% of travelers after taking mefloquine and malraria hasn't occurred. So mefloquine is considered as a primary preventive agent against malaria.

Arthroscopically Assisted En Bloc Resection of the Distal Clavicle in the Acromioclavicular Joint Lesion / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical results of arthroscopically assisted operation of the acromioclavicluar joint lesion with the rotator cuff lesion. MATERIALS AND METHODS: We evaluated the clinical results in eighteen consecutive patients with osteoarthritis of the acromioclavicular joint and rotator cuff lesion, who were treated arthroscopically assisted en bloc resection of the distal clavicle and arthroscopic acromioplasty. The average age of the patients at the time of operation was fifty six years. The average duration of follow-up was one year and ten months. The UCLA shoulder rating scale was used to evaluate the clinical results. RESULTS: Pain score was improved from 2.1+/-1.1 preoperatively to 9.2+/-1.0 postoperatively. Function score was improved from 4.2+/-1.7 to 9.4+/-0.9, active forward flexion score, from 3.7+/-0.5 to 5 and strength score, from 4.0+/-0.9 to 4.9+/-0.2. On follow-up radiographic examination, there was no specific complication, including heterotopic ossification, remnant bony fragment of distal clavicle, and superior migration of the clavicle. CONCLUSION: It is considered that arthroscopically assisted en bloc resection of the distal clavicle and acromioplasty is recommendable method for symptomatic acromioclavicular joint lesion and rotator cuff lesion, which could get the satisfactory clinical results.

Arthrographic Pitfalls in the Diagnosis of Full-Thickness Tears of the Rotator Cuff: A Case Report / 대한정형외과학회잡지

We report a case of full-thickness rotator cuff tear with operative confirmation, which was arthrographically intact. In this case, there was a discrepancy between conventional arthrography and magnetic resonance imaging (MRI), which suggested a full-thickness tear of the rotator cuff. The cause was confirmed to be an intact synovial capsule of the shoulder joint with a torn rotator cuff.

Comparative Analysis between Rheumatic and Non-rheumatic Disease Patients after Posterolateral Fusion of the Lumbar Spine: Spinal Fusion in Rheumatic Disease Patients / 대한류마티스학회지

OBJECTIVE: To evaluate the clinical and radiological results and to compare the results of posterolateral lumbar fusion in rheumatic and non-rheumatic disease. METHODS: A retrospective review of results was carried out in 20 patients who had posterolateral lumbar fusion with rheumatic disease from Jul. 1996 to Aug. 2002. And same cases of non-rheumatic disease were compared. The diagnosis of rheumatic disease was confirmed by the ARA revised criteria. Bony union was evaluated by Lenke's criteria and the clinical results by Katz's satisfaction degree. Statistical analysis was performed by paired T-test and ANOVA test. RESULTS: In rheumatic disease group, there were 7 males and 13 females. Mean age was 56.6 (20~68) years and mean fused segments were 2.7 (1~7). Mean follow-up period was 41 months (12~80) after surgery. In non-rheumatic group, there was 6 males and 14 females. Mean age was 57.1 (35~71) years and mean fusion segments were 2.9 (1~4), Mean follow-up period was 40.2 (12~88) months. In age and fusion segments between two group, there was no statistical difference. In rheumatic disease group, the diagnosis were rheumatoid arthritis in 18 patients, ankylosing spondylitis in 1, and systemic lupus erythematosus in 1 patient. The other operations for combined disease were 8 total knee arthroplasty and 3 total hip arthroplasty. There were no statistical differences in operation time (p=0.527), perioperative bleeding (p=0.653) and postoperative (p=0.830) bleeding between two group. In radiological bony union, all patients of two groups showed A and B grade by Lenke's criteria. Bony union was complete at 5.5 (5~8), 5.1 (4~7) months after surgery. There was no significant difference in clinical satisfaction (p=0.756). CONCLUSION: There were no significant differences in clinical and radiological results between the rheumatic and non-rheumatic patients with disease of the lumbar spine.

Simultaneous Rupture of the Quadriceps Tendon and the Contralateral Patellar Tendon: A Case Report

No Abstract Available.

Localized Pigmented Villonodular Synovitis of the Knee with Concomitant Intra- and Extra- Articular Lesion: A Case Report

No Abstract Available.

Arthroscopic Management and Manipulation of Chronic Idiopathic Adhesive Capsulitis of the Shoulder / 대한정형외과학회잡지

PURPOSE: To describe the clinical efficacy of arthroscopic management followed by manipulation under anesthesia in chronic idiopathic adhesive capsulitis of the shoulder. MATERIALS AND METHODS: We evaluated nineteen patients who had a mean follow-up period of 3 years 1 month using the UCLA shoulder rating score. Arthroscopic management included an arthroscopic examination and debridement of the glenohumeral joint and the subacromial space, as well as the release of the rotator interval, the capsule, the glenohumeral ligaments and the inferior recess. Manipulation was performed after the arthroscopic procedures. RESULTS: Thirteen patients (68%) were completely free from pain. The forward elevation was im-proved from 97 degrees to 175 degrees, the abduction from 69 degrees to 170 degrees, the external rotation from 8 degrees to 51 degrees, and the internal rotation from the range of the buttock and the 3rd-4th lumbar spinous process to the level of the 7th-9th thoracic spinous process. The average UCLA shoulder rating score was 9 points before the operation and 34 points after the operation. CONCLUSION: Our clinical findings suggest that arthroscopic management followed by manipulation is an effective method for the treatment of chronic idiopathic adhesive capsulitis of the shoulder.

MR Imaging of Medullary Streaks in Osteosclerosis: A Case Report

We present a case of medullary sclerosis of the appendicular skeleton in a patient with chronic renal insufficiency for whom MR imaging findings were char-acteristic. T1- and T2-weighted MR images showed multiple vertical lines (medullary streaks) of low signal intensity in the metaphyses and diaphyses of the distal femur and proximal tibia.

The Effect of Using Head Mounted Display on Human Eyes

In order to investigate the effect of head mounted display (HMD) on the human eye, the authors performed ophthalmologic examination on normal persons, dry eye patients and strabismus patients before and after use of Glastron, i-glasses, LGHMD(PT),LGHMD10 for two hours once or for five consecutive days, respectively. There were no substantial changes in visual acuity, color vision, intraocu-lar pressure, and tear secretion before and after use of HMD. There were transient changes in terms of corneal curvature, refraction, stereopsis, the angle of strabismus, and accommodation. There existed no difference according to the kinds of HMD. In conclusion, there was no permanent ocular changes with use of four kinds of HMD for two hours once or for five consecutive days.

Arthroscopic Treatment of Chronic Multiple Tophaceous Gouty Arthritis: Report of 2 Cases / 대한정형외과학회잡지

In chronic tophaceous gouty arthritis, the treatment may be very difficult due to eroding, replacing and absorbing articular cartilage, deforming arthritis, and fibrous ankylosis by deposition of sodium urate crystals. We reported two cases of chronic tophaceous gouty arthritis which were satisfactorily treated by arthroscopic chondroplasty, debridement of the pannus of granulation tissue and urate salts in the joint, as well as excision of tophi around the joints.

Arthroscopic Repair of Bankart Lesion for the Treatment of the Traumatic Anterior Shoulder Instability / 대한정형외과학회잡지

The purpose of this retrospective study was to evaluate the efficacy of arthroscopic repair of Bankart lesion using the biodegradable polyglyconate implant(Suretac) for the treatment of traumatic anterior shoulder instability. Although the arthroscopic procedure using the Suretac device has some technical advantages over others, there have been reports of the higher failure rate than open procedure. Eight shoulders in 8 patients who had traumatic anterior instability of the shoulder with Bankart lesion were managed with this procedure. They were followed up for average 2 years (range 1 year 4 months to 2 years 5 months). During the follow-up period, all the patients showed full range of motion of the shoulder without recurrence of instability. It was our impression that success rate of the procedure could be improved by careful selection of the patient, the accurate arthroscopic technique, and the good rehabilitation program.

Relationship between Traumatic Spinal Canal Stenosis and Neurologic Deficits in Thoracolumbar Burst Fractures / 대한정형외과학회잡지

In the assessment of thoracolumbar burst fractures, computed tomography(CT) is superior to other imaging modalities, especially when a more definitive assessment of the posterior elements of the spine or the nueral canal is desired. A few authors have reported the relationship between traumatic spinal canal stenosis and neurologic deficits. Authors analysed 64 patients with thoracolumbar burst fractures about the relationship between traumatic spinal canal stenosis and neurologic deficits using plane x-ray findings and CT scans. The results were as follows; 1. There was no difference of kyphotic angle and anterior vertebral height loss between neurologic deficit group on lateral plane x-ray findings. 2. The incidence of injury of the superior endplate was 100%(64/64); of the inferior endplate 53%(36/64); of the posterior element 45.3%(29/64). 3. Twenty(69.0%) of 29 patients with disruption of posterior element had neurologic deficits, while fourteen(40.0%) of 35 patients without disruption had neurologic deficits. 4. Spinal canal ratio of 35.3% or more at the epiconus level, 56.0% or more at the conus medullaris level, and 65.3% or more at the cauda equine level were significant factors for neurologic deficits in thoracolumbar burst fractures. Spinal canal ratio of 22.0% or less at the epiconus level, 34.5% or less at the conus medullaris level, and 43.1% or less at the cauda equine level were not accompanied with neurologic dieficit in thoracolumbar burst fractures. 5. Fifteen(68%) of 22 patients with neurologic deficit in epiconus and conus medullarsis level had the horsehoe or crescent shape of patient spinal canal, eight (66.7%) of 12 patients with neurologic deficit in cauda equine level had the horsehoe or crescent shape of spinal canal.

Nationwide Incidence Estimation of Uterine Cervix Cancer among Korean Women / 예방의학회지

To estimate the incidence of uterine cervix cancer among Korean women, we have conducted a study using the claim data on the beneficiaries of Korea Medical Insurance Corporation(KMIC). All medical records of the potential cases with diagnosis of ICD-9 180, 181, 182, 199, 219, 233 in the claims sent by medical care institutions in the whole country to the KMIC from January 1988 to December 1989, were abstracted and Gynecology specialist reviewed the records to identify the new cases of uterine cervix cancer among the potential cases during the corresponding period. Using these data, the incidence of uterine cervix cancer among Korean women was estimated as of July 1, 1988 to June 30, 1989. The crude rate was estimated to be 17.34(95% CI: 16.76~17.92) per 100,000 and the cumulative rates for the ages 0~64 and 0~74 were 1.7% and 2.2%, respectively. The age-adjusted rate for the world population was 19.93 per 100,000 which was higher than those of other Asian countries including China and Japan in 1983~1987. The truncated rate for ages 35~64 was 52.05 per 100,000 which was one of the highest in the world. With increasing age, the incidence rate increased to 78.11 per 100,000 in women aged 55~59 years, then it decreased in the older groups. This finding suggests that detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to detecting rate of uterine cervix cancer may decrease in women aged 60 years or older due to inadequate medical care seeking behavior. In the geographical area, the SIR of Jeju province was significantly low but it might be due to statistical unstability by small case numbers.

Clinical Analysis of Metastatic Bone Tumor / 대한정형외과학회잡지

A retrospective review of 102 patients with metastatic bone tumor seen at Hanyang University Hospital from 1986 to 1990 was performed. We analyzed the cases in the aspects of primary lesions, age and sex distributions, locations and number of metastatic foci, compared with those in the previous reports in Korea. l. 54.9% of the patients were male and 45.1% were female. The incidence of the metastatic bone tumors in female compared with the previous incidence before 1980's years was relatively increased. The peak age was in the 6th decade. The incidence younger than 50 years was decreased, and the incidence older than the 7th decade was relatively increased. 2. The main primary cancers were lung(40.2%), liver(11.8%), breast(10.8%), unknown(8.8%), and uterine cervix(6.9%) etc. In cases of lung cancer, the frequent histologic types were adenocarci noma, squamous cell carcinoma, and small cell carcinoma. 3. The vertebrae(56.9%), ribs(40.2%), femur(17.6%), pelvis(15.7%) were relatively frequent sites of metastasis which involved multiple metastasis. 4. Single metastasis(62.4%) was more frequent than multiple metastasis(37.6%). 5. In the primary cancers, the incidence in hepatoma of male was increasing, the incidence in lung cancer of female was relatively increasing, but the incidence in stomach cancer was decreasing.