The use of 3-dimensional (3D) printing is becoming more common, and its use is increasing in the orthopedic surgery. Currently, there are four major methods of using 3D printing technology in orthopedic surgery. First, surgical planning simulation using 3D printing model; second, patient-specific surgical instruments; third, production of customized prosthesis using 3D printing technique; fourth, patient-specific prosthesis produced by 3D printing. The areas of orthopedic surgery where 3D printing technology can be used are shoulder joint, spine, hip and pelvis, knee joints, ankle joint, and tumors. Since the diseases and characteristics handled by each area are different, the method of using 3D printing technology is also slightly different in each area. However, using 3D printing technology in all areas can increase the efficiency of surgery, shorten the surgery time, and reduce radiation exposure intraoperatively. 3D printing technology can be of great help in treating patients with particularly complex and difficult orthopedic diseases or fractures. Therefore, the orthopedic surgeon should make the most of the benefits of the 3D printing technology so that patient can be treated effectively.
Purpose: This study was to present home-care cases of gangrene sores or prevalent diseases using fake energy salt (FES) water containing energy. Methods: The health functional foods used for disease management were FES Water. Each product was Myeongil Leaf powder, dried yeast, propolis, fermented organic calcium, and royal jelly. Changes were investigated after taking this food. Some of them were combined with hospital treatment, and most of them were experienced by patients at home while managing the affected area. Results: One patient with high fever swine flu, who was treated in a hospital, had a fever dropping to the normal range in 2 hours, and one patient with a leg fracture healed in about six weeks, and one patient had bone adhesion in 2 weeks. Patients with rhinitis recovered after taking FES, and the intraocular pressure of patients with damaged retinopathy fell from 40 mmHg to 20 mmHg after taking FES. One patient with postpartum sequelae was said to have improved their aching limbs four days, and a Covid-19 confirmed patient admitted to the hospital was discharged ten days after starting taking FES during treatment. The size of the gangrene sores in 19 subjects initially ranged from 1 to 7 cm. Most of them were alleviated or healed by continuing to manage them at home with health functional food intake and FES for two weeks to a year. Conclusions: The above results are personal experiences and health functions, such as fake energy salts. It was possible to recognize that food was helpful for health promotion, but no final medical diagnosis was made.
Sarcopenia is a leading cause of increased medical and nursing care costs among the elderly. In Korea, preventive measures for sarcopenia are mostly targeted toward the general elderly population without specific diseases. However, it is also necessary to implement measures for elderly individuals living in nursing homes and hospitals, where the prevalence of sarcopenia is high. Currently, computed tomography and/or magnetic resonance imaging are considered standard diagnostic tools. However, their complexity and time-consuming nature make them unsuitable for clinical use. The exact pathophysiological mechanisms of sarcopenia are unclear, as they involve various molecular biological pathways, including decreased exercise, protein and nutrient intake, changes in testosterone and growth hormone, and inflammation. Sarcopenia symptoms can lead to several diseases, such as osteoporosis, fractures, dementia, diabetes, and cardiovascular disease. Vitamin B deficiency is a significant factor in sarcopenia induction, with B vitamins being directly involved in energy and protein metabolism and nerve function. Vitamin B deficiency can lead to neuromuscular and neurogenic disorders, which often overlap with sarcopenia. Suboptimal intake of B vitamins, malabsorption, and anorexia are common among the elderly. This study aims to provide information on the role of water-soluble B vitamins in preventing and controlling muscle mass loss and deterioration among the elderly with sarcopenia. In addition, we discuss the potential of myokines from the B vitamin family in modulating sarcopenia.
Purpose: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. Materials and Methods: Patients with narrow range of age (21-25. mean $22.8{\pm}1.3$, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed $21.2{\pm}7.3wks$ after trauma. Results: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight hearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). Conclusion: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.
Purpose: In this study, we evaluated the ejection fraction (EF) according to the difference of patient position in Gated Blood Pool (GBP) scan. Material and Methods: The analysis was performed to 80 patients ($51.2{\pm}17.4$ years old) who examined GBP scan in Department of nuclear medicine, National Cancer Center from March 2011 to August 2011. We divided the patients into two groups; one group received conventional position (raise left arm up supine) and supine position (group 1) and the other group received conventional position and left arm back down supine position (group 2). To observe the change EF according to patient position difference, the image was reconstructed and analyzed by Xeleris (GE, USA). We measured body mass index (BMI) of patients. Result: In group 1, EF error less than 3% occurred at a rate of 72.5% (29 of the 40 patients). In group 2, EF error less than 3% occurred at a rate of 79% (32 of the 40 patients). The patient's BMI did not affect ejection fraction. Conclusion: The EF error of left arm back down supine position closer to conventional position than in supine position shows the results.
The Journal of the Korean bone and joint tumor society
/
v.7
no.2
/
pp.51-58
/
2001
Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.
The Journal of the Korean bone and joint tumor society
/
v.9
no.1
/
pp.18-23
/
2003
Purpose: Delay in the diagnosis of the primary malignant bone tumors may critically influence the chance of the patients' survival and the limb sparing, but the primary malignant bone tumors are so rare that most doctors have little experience in these challenging diseases. The purpose of the current study is to examine the initial symptoms of osteosarcoma and chondrosarcoma, and to shorten the delay of diagnosis. Materials and Methods: The data was based on the questionnaires and the medical records from 139 patients whose histological diagnoses were confirmed in the authors' institution. There were 108 patients of osteosarcoma and 31 patients of chondrosarcoma. Eighty-six were male and fifty-three were female. The mean age of the patients was 20.2 years in osteosarcoma, and 42.4 years in chondrosarcoma. Results: The most common symptom that the patient consult the doctor was pain (93.5% of osteosarcoma patients and 61.3% of chondrosarcoma patients). Among them, 76.2% of osteosarcoma and 57.8% of chondrosarcoma patients complained the night pain. The history of trauma was evident in 48.5% of osteosarcoma patients and one patient of chondrosarcoma. At the first medical visit, the malignant bone tumor was suspected in 61.1% of osteosarcoma and 64.5% of chondrosarcoma patients. Fracture was the most common misdiagnosis in osteosarcoma (16.7%), and the osteomyelitis in chondrosarcoma (19.4%). Initial radiographic examination and the adult age were shown to increase the rate of correct diagnosis of both diseases (p<0.05). Patient's delay and doctor's delay were significantly longer in chondrosarcoma patients than in osteosarcoma. Initial radiography led to shorten the doctor's delay, and the axial location of the tumor lengthened the doctor's delay. Trauma and the young age were believed to shorten the patient's delay. Conclusion: Careful history taking, including the night pain and trauma, would be mandatory for the early diagnosis of the primary malignant bone tumors, and the initial radiographic examination and periodic follow-up can increase the rate of correct diagnosis.
Kim, Han Yong;Park, Jae Hong;Kim, Myoung Young;Hwang, Sang Won
Journal of Chest Surgery
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v.42
no.1
/
pp.46-52
/
2009
Background: Vascular injuries to the extremities are potentially devastating and they can lead to limb loss and mortality if they are not appropriately managed. The vascular trauma caused by traffic and industrial accidents has recently increased according to the developing industry and transport system in Korea. Early recognition and treatment of these injuries are mandatory to achieve satisfactory outcomes. Material and Method: We retrospective reviewed 43 patients with vascular injuries that were due to blunt and penetrating trauma and they underwent emergency operations from January of 1998 to December of 2006. Result: There were 38 men and 5 women patients with a mean age of $42.0{\pm}16.8$ years (range: 17~77). The cause of vascular injuries were 28 traffic accidents (65%), 6 industrial accidents (14%), 6 glass injuries (14%) and 3 knife injuries (7%). The average time from admission to the operating room was $319.0{\pm}482.2$ minutes (range: 27~2,400 minutes). The average time from admission to discharge was $53.1{\pm}56.0$ days (range: 2~265 days). The anatomic injuries included the femoral artery in 16 cases (37%), the popliteal artery in 8 cases (19%), the brachial artery in 8 cases (19%), and the subclavian and axillary arteries in 7 cases (16%). The associated injuries were 23 bone fractures (53%), 18 muscle injuries (42%) 5 nerve injuries (12%) and 11 vein injuries (26%). The operation methods were 20 end to end anastomoses (46%), 16 interposition grafts (36%), 2 repairs with using patches (5%) and 5 others (12%). The number of amputations and cases of mortality were 3 cases (7%) and 4 cases (9%), respectively. Conclusion: Minimizing ischemia is an important factor for maximizing salvage of extremities. Prompt diagnosis and treatment can reduce the amputation and mortality rates.
Background: Blunt chest trauma accounts for 90% of all chest traumas in Europe and the United States and this causes 20% of all trauma-related deaths. The major cause of morbidity and mortality after blunt chest trauma is undetected injuries. For this reason, chest computerized tomography has gained popularity for the evaluation of trauma, but it is expensive and it exposes patients to radiation. This study identified the clinical features associated with the diagnosic information obtained on a CT chest scan, as compared with a standard chest X-ray, for patients who sustained blunt trauma to the chest. This study also evaluated the role of a routine computed tomographic (CT) scan for these patients. The patients who had chest computed tomography done after the initial chest x-ray were analyzed separately for the presence of occult injuries. Material and Method: We studied 100 consecutive patients from November 2006 to July 2007: 74 patients after motor vehicle crashes and 26 patients after a fall from a height >2m. Simultaneous with the initial clinical evaluation, an anteroposterior chest radiograph and a helical chest CT scan were obtained for all the patients. The data extracted from the medical record included the vital signs, the interventions and the type and severity of injury (RTS). Result: Among the 100 cases, 79 patients showed at least more than one pathologic sign on their chest radiograph, and 21 patients had a normal chest radiograph. For 17 of the patients who had a normal chest X ray, the CT scan showed multiple injuries, which were pneumothorax, hemothorax, lung contusion, sternal fracture etc. This represents that a CT scan is statistically superior to a chest radiograph to diagnose the pathologic signs. But on the other hand, as for treatment, only 31 patients were diagnosed by CT scan and they were treated with chest tube insertion ect. 42 patients needed ony conservative management without invasive thoracosurgical treatment such as chest tube insertion or open thoracotomy. 27 patients were treated based on the diagnosis made by the chest radiograph and physical examination. Conclusion: Chest computerized tomography was significantly more effective than routine chest X-ray for detecting lung contusion, pneumothorax and mediastinal hematoma, as well as fractured ribs, scapula and, sternum. Although the occult findings increased, the number of patients who needed treatment was small. Therefore, we suggest making selective use of a CT scan to avoid its overuse in ERs.
Purpose: The purpose of this study is to provide the clinical outcomes of arthroscopic type II SLAP repair in non-athletes, and to compare the clinical outcomes between those who had isolated type II SLAP lesion and those who had combined partial thickness supraspinatus tear that did not required a combined repair. Materials and Methods: From July 2005 to January 2007, 142 consecutive type II SLAP lesions were treated with arthroscopic surgery. The inclusion criteria for the study were; (1) younger than 50 years old; and (2) non-athletes. Exclusion criteria were; (1) prior surgery, fracture or combined recurrent dislocation history on the affected shoulder; (2) combined full thickness rotator cuff tear or PTST (>50% thickness) patient that needed repair; and (3) combined infection, arthritis or inflammatory disease. Remaining 19 patients meet the criteria. Among them, 13 had combined PTRCT that did not require repair (Group I), and 6 had isolated type II SLAP lesion without combined supraspinatus tear (Group II). The mean age was 36.7 years (29~49 years), mean symptom duration was 39.1 months (3~216 months) and mean follow-up was 19.0 months (12~27 months). In all patients, the range of motion of affected shoulder, pain and function visual analogue scale (PVAS, FVAS), the Constant score and UCLA score were evaluated preoperatively and postoperatively. Results: In group I, external rotation at side was decreased significantly (p=0.003),but there were no statistical significant change at the remains(p>0.05). And there were no differences between groups (p>0.05). At the final follow-up, all clinical outcome measurements improved after surgery with statistical significance (p<0.05): UCLA score, $22.8{\pm}5.2$ to $32.8{\pm}2.1$; Constant score, $79.4{\pm}8.6$ to $94.9{\pm}4.3$; PVAS $5.4{\pm}2.7$ to $1.1{\pm}1.4$; FVAS $63.2{\pm}15.3$ to $93.4{\pm}7.3$. But, in group comparison of the mean UCLA score and Constant score, there were no statistical significant differences between two groups. Conclusion: Arthroscopic repair of type II SLAP lesion provided good clinical outcomes in nonathletic population. Combined partial thickness supraspinatus tear does not seem to hamper the final outcome at minimal 1 year follow-up.
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