Object : This study is designed to evaluate the correlation between the data of DITI(Digital Inrared Thermographic Imaging) examination and the changes of clinical symptoms after the therapy of acupuncture in the patients with spondylolisthesis. Contents : The conservative therapy with acupuncture was performed during 3-4weeks. The acupuncture points of BL23, BL24, BL25, BL40, BL57, BL60, BL62, GB30, GB31, ST36, TE3 was used. In the pre- and post therapy, DITI examinations were performed in patients who had spondylolisthes in L-spine X-ray and were treated by acupuncttare simultaneously, and then tried to correlate the results of clinical symptoms with the difference of thermographic findings at pre-and post acupuncture. Setting : The standard routine thermographic exanninations were performed with thermography (DITI) in the 22 patients with spondylolisthesis at pre- and post acupuncture. Patients : Thermographic imaging of 22 cases was analyzed. They had diagnosed spondylolisthes in L-spine X-ray. They were treated by acupuncture and moxibustion therapy in Wonkwang Oriental Hospital from May, 1998 to May, 2000. Results : 1) The causes were congenital (4.5%), overwork (31.85%), trauma (13.65%), degenerative factor(50%) 2) The DITI results showed 45.4% below $0.3^{\circ}C$, 36.4% between 0.3 and $0.5^{\circ}C$, 4.5% between 0.5 and $0.7^{\circ}C$, 9.1% between 0.7 and $0.9^{\circ}C$, and 4.5% over $0.9^{\circ}C$. 3) The results of treatment using pain scale showes that 27.3% of patientsachieved excellent recovery and 54.6% achieved good recovery. After compairing the DITI results before and after treatment, we found 45.4% of patients achieved excellent recovery and 36.4% achieved good recovery. Conclusion : Acupuncture showed good results over 81.9% in clinical evaluation and 81.8% in DITI. Thermographic examination was valuable in the evaluation of therapeutic effect of acupuncture treatment.
Objectives Objective of this study is to investigate the role of paraspinal muscles by examining the correlation between slip percentage (SP) of spondylolisthesis and fatty infiltration of lumbar paraspinal muscle. Methods Retrospective analysis was performed on 45 patients diagnosed with spondylolisthesis based on medical records. Using T2-weighted axial magnetic resonance imaging, cross-sectional areas (CSAs) of psoas major (PM), multifidus (MU) and erector spinae (ES) were calculated and divided by CSA of lower level vertebral body (VB). SP was measured using sagittal T2-weighted images. Correlation of SP with muscle relative cross-sectional area (RCSA) and muscle fatty infiltration by Goutallier classification was respectively analyzed using Spearman correlation. Statistic assessment conducted by Wilcoxon signed rank test and paired t-test using program GraphPad prism 5 (GraphPad Software, Inc., San Diego, CA, USA). Results Spondylolisthesis forward slip percentage by Taillard's method was negatively associated with both side MU RCSAs. No significant correlation was found between PM RCSA, ES RCSA and SP. Forward slippage was significantly correlated with fatty infiltration of lumbar paraspinal muscle measured by Goutallier classification. Conclusions This study is to understand the role of paraspinal muscle affecting spinal instability by investigating correlation between statistical deviation of lumbar muscle characters (RCSA, fatty infiltration of lumbar muscle) and SP. We found that spondylolisthesis SP is positively related to fatty infiltration of lumbar paraspinal muscle. and is negatively associated with both side MU RCSAs.
Purpose : The purpose of this study was to compare the results of ACL reconstruction using bone-patellar tendon-bone to hamstring. Materials and Methods : Thirty-two ACL reconstructions with autogenous BPTB and eighteen reconstructions with hamstring were compared in terms of functional outcome, stability and tunnel expansion. Results : The functional score of BPTB group was higher than hamstring group in OAK(Orthopadishe Arbeitsguppe Knie) and IKDC(International Knee Documentation Committee) system. In BPTB group, OAK scores were 71.6$({\pm}10.0)$ preoperatively and 88.5$({\pm}7.9)$ finally. In hamstring group, OAK scores were 73.9$({\pm}11.5)$ and 82.5$({\pm}12.9)$ respectively. There was no difference in stability checked by either $KT-1000^{TM}$ or stress view. Anterior tibial translation measured by $KT-1000^{TM}$ were 2.4$({\pm}1.8)$mm in BPTB and 2.3$({\pm}2.4)$mm in hamstring group. Anterior tibial translation in stress view were 2.8$({\pm}3.4)$mm in BPTB and 2.8$({\pm}2.5)$mm in hamstring group. There was no difference in tibial tunnel expansion but femoral tunnel was more enlarged in hamstring group than BPTB (P=0.03). Conclusion : As there was no difference in stability between two groups, it seems prudent to select either graft defend on such factors as anterior knee pain, skeletal maturity and cosmetic concern. Tunnel expansion seems not to affect stability, but further study is needed to confirm that decrease of which might improve stability.
Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.
Heo, Youn Moo;Kim, Tae Gyun;Song, Jae Hwang;Jang, Min Gu;Lee, Seok Won
Journal of the Korean Orthopaedic Association
/
v.56
no.1
/
pp.51-60
/
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.
Soft tissue changes that occurred between presurgery to 5-years post-surgery in 49 orthognathic surgery patients whose maxillae were moved upward by Le Fort I osteotomy were examined by lateral cephalometric film. The objective of this paper was to document soft tissue changes at long-term follow-up after superior repositioning of the maxilla and to relate soft tissue and hard tissue changes in this group. The results were as follows. 1. On average, soft tissue landmarks in the nose and the upper lip were not changed statistically significantly except superior movement of superior labial sulcus and forward movement of pronasale between presurgery and 5 years postsurgery. 2. Upward and forward movement of the lower lip were found at 5 years postsurgery in comparison with presurgery and genioplasty added this effects. 3. Upper lip length and vertical dimension of upper vermilion didn't show any significant changes, but increase of lower lip length and decrease of vertical dimension of lower vermilion were statistically significant between presurgery and 5 years post-surgery. 4. The decrease of upper incisor exposure and interlabial distance from presurgery to 1 year were continued from 1 year to 5 years and the amount of the decrease was more than that of vertical movement of the maxilla by surgery. 5. Long term changes in soft tissue landmarks from 1 to 5 years postsurgery exceeded hard tissue changes, meaning soft tissue moved down more than skeletal changes.
In order to elucidate seasonal sedimentary characteristics and depositional environment after construction of seawall on macrotidal flat, a seasonal observations of surface sediments (total 450) and sedimentation rates on 4 transects have been investigated for 2 years. The eastern area of Iwon tidal flat, has been changed from semi-closed coast to open coast by construction of seawall, shows general seasonal changes similar to characteristics of open coast type, which represented both fining and bad sorted distribution due to deposition of fine sediments under low energy condition in the summer, and relatively coarser and better sorted distribution because of erosion of fine sediments in the winter. In considering angles of transects, distribution patterns of surface sediments, the northern and southern parts of eastern tidal flat are dominantly influenced by wave and tidal effects, respectively. As time goes by, the eastern tidal flat shows coarsening-trend of surface sediments caused by direct effect of tidal current, were and typhoon. Meanwhile the western area of seawall, which has been re-formed by construction seawall, is sheltered from northwesterly seasonal wind. The seasonal change pattern of western area of seawall is slightly different from that of eastern tidal flat. Mean grain size and sorting of surface sediments during spring is finer and worse than those during summer. This seasonal change pattern maybe influenced by topographic effects caused from the construction of seawall. In consideration of all result, the transport of fine sediments in the study area, which is supplied to limited sediments, shows clockwise circulation pattern that fine sediments are transported from the eastern tidal flat to the western area of seawall because of blocking of seawall in the winter and are transported reversed direction the summer. As a result, many changes have been observed in the study area after construction of seawall; however, this change is still in progress and is expected to need continuous monitoring.
This paper was written to investigate the narrative traits of Lee Ae-rim's Comic Books. Lee Ae-rim arrived on the scene with the boom of comic book magazines in the 1990s. Although she started her career as a Comic Book writer, she expanded her own area gradually and has been working actively as an animation director as well. The superficial characteristics of Lee Ae-rim's works can be summed up as sexuality, grotesqueness, and fantasy. In other words, Lee Ae-rim's comic books are mainly characterized by the visualization of sexual, grotesque, and fantastic shapes. Lee Ae-rim has faced challenges with her own overwhelming and compelling images like no one else. For that reason, it is true that people haven't paid careful attention to the hidden stories behind her pictures. This paper considers that looking back on the narratives that Lee Ae-rim has been interested in, from early days to recent days, that is to say, the contexts of stories, is a shortcut to reveal a point of contact between her past, present, and future. Especially, this paper focused on the properties of the circulated and repeated stories, the stories ruled by fate and coincidence, and the stories in which elements of fantasy encounter an attempt of violation. As a result, it was found that the narratives of Lee Ae-rim's comic books demand us to face suppressed desires in a new way, by wrapping up the most fundamental aspects of human being in universality and constancy with specificity and grotesqueness. The reason why Lee Ae-rim has continued the avant-garde and omnidirectional works thus far explains what our society suppresses, inversely. Moreover, the narratives of Lee Ae-rim are significant, by being devoted to the right function of art not only to disclose suppressed desires but to satisfy them. Making an in-depth investigation of the narratives of Lee Ae-rim's comic books in various contexts, this research is intended to establish a diversity of Korean comic books, by adding meaning to the creative values of individual writers.
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