• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.71-77
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• 2020

Purpose: To determine if sparing the interspinous and supraspinous ligaments during posterior decompression for lumbar spinal stenosis is significant in preventing postoperative spinal instability. Materials and Methods: A total of 83 patients who underwent posterior decompression for lumbar spinal stenosis between March 2014 and March 2017 with a minimum one-year follow-up period, were studied retrospectively. The subjects were divided into two groups according to the type of surgery. Fifty-six patients who underwent posterior decompression by the port-hole technique were grouped as A, while 27 patients who underwent posterior decompression by a subtotal laminectomy grouped as B. To evaluate the clinical results, the Oswestry disability index (ODI), visual analogue scale (VAS) for both back pain (VAS-B) and radiating pain (VAS-R), and the walking distance of neurogenic intermittent claudication (NIC) were checked pre- and postoperatively, while simple radiographs of the lateral and flexion-extension view in the standing position were taken preoperatively and then every six months after to measure anteroposterior slippage (slip percentage), the difference in anteroposterior slippage between flexion and extension (dynamic slip percentage), angular displacement, and the difference in angular displacement between flexion and extension (dynamic angular displacement) to evaluate the radiological results. Results: The ODI (from 28.1 to 12.8 in group A, from 27.3 to 12.3 in group B), VAS-B (from 7.0 to 2.6 in group A, from 7.7 to 3.2 in group B), VAS-R (from 8.5 to 2.8 in group A, from 8.7 to 2.9 in group B), and walking distance of NIC (from 118.4 m to 1,496.2 m in group A, from 127.6 m to 1,481.6 m in group B) were improved in both groups. On the other hand, while the other radiologic results showed no differences, the dynamic angular displacement between both groups showed a significant difference postoperatively (group A from 6.2° to 6.7°, group B from 6.5° to 8.4°, p-value=0.019). Conclusion: Removal of the posterior ligaments, including the interspinous and supraspinous ligaments, during posterior decompression of lumbar spinal stenosis can cause a postoperative increase in dynamic angular displacement, which can be prevented by the port-hole technique, which spares these posterior ligaments.

• Journal of the Korean Orthopaedic Association
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• v.56 no.1
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• pp.51-60
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• 2021

Purpose: Radiocarpal dislocation (RCD), which is caused by high-energy trauma, often involves radial styloid fractures and short radiolunate ligament (SRLL) injuries. Although SRLL injuries may occur as a simple rupture at the attachment site of radius, it may occur with a relatively large avulsed-fragment in the volar rim of the lunate facet of the radius. This study aimed to differentiate the injury type of SRLL and assess the differences in the treatment results depending on the treatment methods that have been applied in RCD with radial styloid fractures. Materials and Methods: Eighteen patients managed surgically with RCD were enrolled in this study. The patients were classified as Group 1 and Group 2 by using the Dumontier method. In this study, Group 2 was subdivided into 2A (purely ligamentous or small avulsion fracture of the volar rim of lunate facet) and 2B (large avulsed-fragment enough to internal fixation) according to the injury type of SRLL. Groups 2A and 2B were treated with direct repair and screw fixation, respectively. Pain, range of motion of the wrist joint, grip strength, and complications on final radiographs were examined. The outcomes were evaluated using patient-rated wrist evaluation (PRWE), and modified Mayo wrist score (MMWS). Results: All patients were Group 2 (six and twelve patients in 2A and 2B, respectively). The mean flexion to extension arch recovered 79%,and the mean grip strength was 72.9% of the uninjured side. Group 2A showed better recovery in extension, flexion and pronation than Group 2B, but there was no difference in radial deviation, ulnar deviation, supination, grip strength and pain. No differences in the PRWE and MMWS were observed between two groups. Complications included traumatic arthritis in seven patients and residual instability in five patients. Conclusion: When the SRLL was injured, the involvement of a large avulsion fracture on the anterior plane of the radiolunate did not affect the test results. On the other hand, it should be observed cautiously because avulsion fractures tend to disturb the joint's reduction through rotation or displacement. In addition, anatomical reduction and sturdy internal fixation are important for restoring the function of the SRLL.

• Journal of the Korean Orthopaedic Association
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• v.54 no.3
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• pp.244-253
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• 2019

Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

• Korean Journal of Heritage: History & Science
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• v.56 no.2
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• pp.12-26
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• 2023

Recently, 『Gyeongja(庚子)/Daetongryeok(大統曆)』(1600), a memorandum record of Yu Seong-ryong during the reign of King Seonjo(宣祖) of the Joseon Dynasty, was returned to Korea from Japan, and about 4,000 letters in cursive characters have been interpreted by Ro Seung-suk. The contents for 203 days written in the margin of 『Gyeongja(庚子)/Daetongryeok(大統曆)』 are mostly new, and are meaningful in understanding Yu's life and social association circumstances. There are daily routines of each day, contemporary figures, diseases and oriental medicine prescriptions. In particular, the combat record of Admiral Yi Sun-shin in 83 letters on the cover is very important to understand the situation in those days. It seems that the reason for writing the combat situations a year and a few months after Admiral Yi died in war was to honor his distinguished military service for a long time by King Seonjo's order according to the public opinion of the royal court. The record can be classified into two categories. First, Admiral Yi sighed when he heard about Yu's dismissal from the office in Gogeumdo, and was always alert with clear water on the boat after the Battle of Waekyo Castle. Second, he was killed by bullets shot by the enemy while directly encouraging battle, not listening to his men who tried to dissuade him from leading the naval battle at Noryang. This only contained contents of devoting his life desperately, which is an important proof of the theory of his death in war. It also contains nine methods for making liquor and another method that wasn't known to the public, and seems to include popular alcohol brewing methods or newly devised ones. In addition, there is a detail that Heo Jun, the author of 『Donguibogam』, introduced medicine to Yu, along with being unable to attend ancestral rites and relieving the poor written in red. There are also stories about Kang Hang(姜沆) returning to Korea after being captured by Japan and Lee Deok-hong(李德弘)'s son, who introduced Gugapseondo(龜甲船圖, the first picture of the Turtle Ship in Korea) to King Seonjo. In the light of the above, 『Gyeongja(庚子)/Daetongryeok(大統曆)』is an important historical record to empirically research not only figures related to Yu but also the circumstances of those days since it contains new facts that are not in the existing literature. In particular, the big accomplishment of this study is to correct the mistakenly known theory of Admiral Yi's suicide and to find out the new fact that Heo Jun provided medical information. In this respect, this book is expected to serve as a testament to the future study of the history and characters related to Yu in the mid-Joseon period.

• Journal of Korean Society of Forest Science
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• v.98 no.1
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• pp.66-81
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• 2009

From a new perspective of "humans and the culture of forming and conserving the environment", the sustainable forest management can be reformulated under the concept of "cultural sustainability". Cultural sustainability is based on the emphasis of the high contribution to sustainability of the culture of forming and conserving the environment. This study extracts the implications to cultural sustainability for the modern world by investigating a historical case of the culturo-social pine forestry in the Joseon period of Korea. In the legendary and recorded acts by the first king Taejo, Seonggye Yi, Korean red pine (Pinus densiflora) was the "Royal tree" of Joseon and also the "Sajik tree" related intimately with the Great Sajik Ritual valued as the top rank within the national ritual regime that sustained the Royal Virtue Politics in Confucian political ideology. Into the Neo-Confucian faith and royal rituals of Joseon, elements of geomancy (Feng shui), folk religion, and Buddhism had been amalgamated. The deities worshipped or revered at the Sajik shrine were Earth-god (Sa) and crop-god (Jik). And it is the Earth god and the concrete entity, Sajik tree, that contains the legacy of sylvan religion descended from the ancient times and had been incorporated into the Confucian faith and ritual regime. Korean red pine as the Royal-Sajik tree played a critical role of sustaining the religio-political justification for the rule of the Joseon's Royalty. The religio-political symbolism of Korean red pine was represented in diverse ways. The same pine was used as the timber material of shrine buildings established for the national rituals under Neo-Confucian faith by the royal court of Joseon kingdom before the modern Korea. The symbolic role of pine had also been expressed in the forms of royal tomb forests, the Imposition Forest (Bongsan) for royal coffin timber (Whangjangmok), and the creation, protection, conservation and bureaucratic management of the pine forests in the Inner-four and Outer-four mountains for the capital fortress at Seoul, where the king and his family inhabit. The religio-political management system of pine forests parallels well with the kingdom's economic forest management system, called "Pine Policy", with an array of pine cultivation forests and Prohibition Forests (Geumsan) in the earlier period, and that of Imposition Forests in the later period. The royal pine culture with the economic forest management system had influenced on the public consciousness and the common people seem to have coined Malrimgat, a pure Korean word that is interchangeable with the Chinesecharacter words of prohibition-cultivation land or forest (禁養地, 禁養林) practiced in the royal tomb forests, and Prohibition and Imposition Forests, which contained prohibition landmarks (Geumpyo) made of stone and rock on the boundaries. A culturo-social forestry, in which Sajik altar, royal tomb forests, Whangjang pine Prohibition and Imposition forests and the capital Inner-four and Outer-four mountain forests consist, was being put into practice in Joseon. In Joseon dynastry, the Neo-Confucian faith and royal rituals with geomancy, folk religion, and Buddhism incorporated has also played a critical humanistic role for the culturo-social pine forestry, the one higher in values than that of the economic pine forestry. The implications have been extracted from the historical case study on the Royal-Sajik tree and culturo-social forestry of Joseon : Cultural sustainability, in which the interaction between humans and environment maintains a long-term culturo-natural equilibrium or balance for many generations, emphasizes the importance that the modern humans who form and conserve environment need to rediscover and transform their culturo-natural legacy into conservation for many generations and produce knowledge of sustainability science, the transdisciplinary knowledge for the interaction between environment and humans, which fulfills the cultural, social and spiritual needs.