• Title/Summary/Keyword: 가성 마비

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Comparison between Manifest Refraction and Cycloplegic Refractin for the First-time Spectacle Wearers (최초 안경착용자의 현성굴절검사(MR)와 조절마비굴절검사(CR)의 비교)

  • Kim, Hye-Ran;Choi, Sun-Mi
    • Journal of Korean Ophthalmic Optics Society
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    • v.13 no.4
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    • pp.145-149
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    • 2008
  • Purpose: To study the difference between refractive errors obtained from manifest refraction (MR) and cycloplegic refraction (CR) in first-time spectacle wearers. To study the difference between manifest refractive errors and cycloplegic refractive errors in first-time spectacle wearers. Methods: From January 2002 to December 2002, manifest and cycloplegic refractions were carried out on the patients who visited an ophthalmology clinic for a spectacle prescription for the first-time. The patients were 509 male and 499 female patients aged between from 3 to 15 years old. Results: The cycloplegic refraction showed a less myopia and a more hyperopia compared with the non-cycloplegic refraction. The differences were more in female patients. The CR showed a less myopic and a more hyperopic refractive errors than the MR. The differences were more in female patients. The average results from a pre- and a post-cycloplegic refraction showed a reduction of -0.22D in male, and -0.20D in female for the myopic group. For the myopic group, the myopic refractive errors by MR were -0.22D in male and -0.20D in female higher than the refractive errors by CR. Hyperopic group showed an increase of +0.37D in male, and +0.56D in female. For hyperopic group the hypropic refractive errors by CR were +0.37D in male and +0.56D in female higher than the refractive errors by CR. This difference between the results of a preand a post-cycloplegic refraction was more if the patients were younger. This difference between refractive errors by MR and by CR showed the younger the more and the proportions of pseudo-myopia and or latent hyperopia were also higher with younger patents age. The amounts of with-the-rule astigmatism and the oblique astigmatism were increased for the post-cycloplegic refraction in the CR refraction. Simple astigmatism reduced, but there was no difference found in the amount of astigmatism. The prevalence of simple astigmatism reduced, but there was no difference in the amount of astigmatism. Conclusions: The difference between manifest refraction and cycloplegic refraction was more in younger group. The difference of refrative error between by MR and CR increases with ageing decrease. Pseudo-myopia and latent hyperopia was also found in the younger group. Simple astigmatism reduced after cycloplegic refraction, there was no difference found in the amount of astigmatism. The prevalence of simple astigmatism reduced, but there was no difference in the amount of astigmatism.

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Criteria for Implant Choice of Reverse Total Shoulder Arthroplasty (역행성 인공관절 전치환술 시 임플란트 선택에 대한 기준)

  • Choi, Chang-Hyuk;Kim, Jun-Young
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.377-390
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    • 2021
  • Reverse total shoulder arthroplasty (RTSA) is a surgical method that has recently been conducted in widely irrepairable rotator cuff tears with pseudoparalysis, cuff tear arthropathy, and osteoarthritis of the shoulder joint. Several topics can be described, but this review article provides an opinion on the criteria for the choice of implant in RTSA.

Reverse Total Shoulder Arthroplasty in Patients with Severe Rotator Cuff-Deficient Shoulder - A Minimum Three-Year Follow-up Study - (심한 회전근 개 부전을 동반한 환자에 대한 역형 견관절 전치환술 - 최소 3년 추시 결과 -)

  • Kim, Myung-Sun;Yeo, Je-Hyoung
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.73-83
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    • 2013
  • Purpose: The goal of this study is to evaluate the minimum three-year follow-up results of reverse total shoulder arthroplasty (RTSA) for glenohumeral (GH) arthritic and pseudoparalytic patients with severe rotator cuff deficiency. Materials and Methods: We evaluated 13 patients (three males and 10 females) who underwent RTSA from July 2007 to July 2010. The average follow-up duration was 54.2 months (range, 37~74 months). Clinical results were evaluated using the Visual Analog Scale (VAS) for pain, active Range of Motion (ROM): active forward flexion (aFF); active external rotation at the side (aERs); active internal rotation to the back (aIRb), American Shoulder and Elbow Surgeons (ASES) score, Korean Shoulder Score (KSS), and intraoperative and postoperative complications. Results: VAS score improved from 7.5(6~10) points to 1.5(0~4), and ROM of active forward elevation improved from $42.7(10{\sim}100)^{\circ}$ to $129.1(110{\sim}180)^{\circ}$. In addition, ASES score improved from preoperative 32.9 (11.7~46.7) points to 80.2(58.3~95.0) postoperatively, and KSS score improved from 36.8(24~47) points to 78.4 (61~92). Twelve out of 13 cases showed various degrees of scapular notching at the last follow-up. There was one case of intraoperative anterior glenoid fracture and two cases of temporary nerve injury. Revision surgery was performed in two cases for treatment of delayed postoperative deep infection. Conclusion: According to minimum three-year follow-up results, RTSA may be an effective treatment option for glenohumeral (GH) arthritic and pseudoparalytic patients. However, considering the possibility of complications related to delayed deep infection or surgeon's technique, RTSA should be judiciously and carefully indicated by expert surgeons.

ORAL MANIFESTATIONS OF THE AXENFELD-RIEGER SYNDROME (Axenfeld-Rieger 증후군의 치과적 소견)

  • Kang, Tae-Sung;Choi, Byung-Jai;Kim, Seong-Oh;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.510-514
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    • 2003
  • The Axenfeld-Rieger syndrome is a rare autosomal dominant disorder characterized by dental and ocular abnormalities. The essential ocular features include partial or complete bilateral hypoplasia of the iris stroma, abnormalities of the angle structures with congenital iris adhesions, and anterior displacement of Schwalbe's corpuscles. Common oral findings are hypodontia(especially in anterior maxillary segment), microdontia, misshaped teeth, delayed eruption of the teeth. Additionally, other systemic symptoms can be seen and early detection by the pedodontist through dental diagnosis should prevent visual impairment.

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Massive Rotator Cuff Tears: Arthroplasty (광범위 회전근 개 파열에서 관절 성형술)

  • Kim, Myung-Sun;Moon, Eun-Sun
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.132-140
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    • 2010
  • Purpose: Surgical treatment of massive rotator cuff tear is challenging and there are various surgical options. The purpose of this article is to describe arthroplasty for the treatment of massive rotator cuff tear. Materials and Methods: We reviewed all publications that focused on and/or mentioned arthroplasty as a treatment option for massive rotator cuff tear. Results: Arthroplasty can be used as primary treatment and represents a salvage option for irreparable rotator cuff tear. Hemi-arthroplasty can provide satisfactory results by Neer's limited goals criteria in patients with intact coracoacromial arch. In addition, reverse total shoulder arthroplasty can be a salvage option for pain relief and restoration of active flexion in elderly patients with pseudoparalysis. Conclusion: In patients with massive rotator cuff tear, proper selection of arthroplasty can provide pain relief and restoration of functional range of motion in shoulder joints.

CLINICAL STUDY ON SURGICAL MANAGEMENT OF MANDIBULAR CONDYLAR FRACTURES (하악 과두 골절의 외과적 처치에 관한 임상적 연구)

  • Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.19 no.2
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    • pp.167-180
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    • 1997
  • 79 surgically managed mandibular condylar fracture patients included the 25 patients treated with Dr, Nam's method were analysed the postoperative resluts in Oral and Maxillofcial Surgery, School of Dentistry, Wonkwang University since 1993 to 1995. Mean patient's age is 32.5 years (range, 8 to 65 years), and follow-up periods were a minimum of 3 months to 28 months. 19% condylar fractures were associated with mostly symphysis portion. According to the patient's age, severity of condylar fractures, clinical signs and symptoms, radiographic findings, treatmenet plans had been performed. Rigid fixation have performed greatly, and then fragment removal of fractured mesial pole of proximal segment of the condylar and little cases of reshaping and eminoplasty and lag screw have been applied. Two cases of the both condylar resorption and deviated condyle posteriorly in Dr. Nam's method. None of infection or necrosis signs of treated condyle surgically. In my opinion, whenever possible, displaced condylar fracture can be managed surgically with rigid fixation, but not Dr. Nam's method. Usually if perform the surgical management of condylar fractures you should maintain maxillomandibular fixation for 2 weeks, or more and has to follow-up functional mandibular exercise should be kept continuously.

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Medial Retracted Large Rotator Cuff Tears (내측으로 퇴축된 대범위 회전근 개 파열)

  • Ko, Sang-Hun;Cha, Jae-Ryong;Kim, Tae-Won
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.3
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    • pp.212-219
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    • 2009
  • Medially retracted large-sized rotator cuff tears includes large-sized tears, massive tears and irreparable tears. Generally arthroscopic repair or open repair of rotator cuff tears is used in reparable tears. However, arthroscopic repair requires long period practice and endurance. In irreparable tears, arthroscopic debridement, partial repair, latissimus dorsi transfer and retrograde arthroplasty can be the option. Arthoscopic debridement gives temporal relief who experienced improvement in pain and increase in range of motion after subacromial local anesthetic injection. Also arthroscopic partial repair gives good results in irreparable cases, especially in suprascapular nerve traction neurapraxia. Tendon transfer can be used in mild to moderate muscle weakness in shoulder abduction for long term treatment. Pectoralis major transfer can be used in anterosupeior tears and latissimus dorsi transfer can be used in posterosuperior tears. Reverse shoulder prosthesis is used in extreamly weakened shoulder pseudoparalysis. The authors discussed the method of arthroscopic repair in irreparable tears. The debridement, partial repair, and tendon transfer could be used in medially retracted large-sized rotator cuff tears.

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Surgical Treatment of Thoracoabdominal Aortic Aneurysm (흉복부 대동맥류의 외과적 치료)

  • Ahn, Hyuk;Kim, Jun-Seok
    • Journal of Chest Surgery
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    • v.29 no.2
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    • pp.177-184
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    • 1996
  • Between 1987 and 1994, 21 patients were treated surgically for aortic aneurysm involving the thoracoabdominal aorta. There were 11 males and 10 females, and their age ranged from 20 to 67 years old and mean age was 41.5 years. Many complained of back pain, chest pain or discomfort, and flank pain, but three patients were asymptomatic. 15 patients had chronic dissection (71.4%) and 6 had nondissecting fusiform or saccular aneurysm(28.5%), and of those 15 patients with chronic dissection, 6(28.5%) had atherosclerosis assniated with hypertension, 5 (23.8%) were Martian syndrome, and 2 (9.5%) were associated with pregnancy. The diameter of an aneurysm ranged from 6cm to 12cm, and their extent was classified as type I in 7(33.3%), type II in 8(38.1%), type III in 3(14.3%), and type IV in 3(14.3%) patients based on Crawford classification for TAA . Diseased aorta was replaced with artificial vascular graft in all but one patient. In whom the aortic tear site due to pseudoaneurysm was closed by primary suture. For the spinal cord protection during the operation, we used partial cardiopulmonary bypass (FV-FA or PA-FA bypass) in 12 patients (57.1%), Biopump (LA-FA bypass) in 4(19.0%), total circulartory arrest and CPB in 2 (9.5%), Gott's heparinized shunt in 1(4.7%), and simple aortic cross clamping in 2 (9.5%). The most common complication after the operation was hoarseness due to unilateral vocal cord palsy which onured in 5 patients (23.8%), and the next common complication was wound infection in 4 patients(19.0%), paraplegia in 2 patients (9.5%), chylothorax in 1 patient(4.7%). The hospital mortality rate was 9.5% (2deaths), and there was no late death. Our experience shows that the graft replacement of TAAA had reasonable rate of mortality, low rate of serious complication, and provided good post operative state of the pati nts, and since the thoracoabdominal aortic operation is not a high risky procedure anymore, we recommend a radical operation for the indicated patients.

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