• Archives of Plastic Surgery
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• v.47 no.5
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• pp.451-459
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• 2020

Background For volar soft tissue defects of the proximal interphalangeal (PIP) joint, free flaps are technically challenging, but have more esthetic and functional advantages than local or distant flaps. In this study, we compared the long-term surgical outcomes of arterial (hypothenar, thenar, or second toe plantar) and venous free flaps for volar defects of the PIP joint. Methods This was a single-center retrospective review of free flap coverage of volar defects between the distal interphalangeal and metacarpophalangeal joint from July 2010 to August 2019. Patients with severe crush injuries (degloving, tendon or bone defects, or comminuted/intra-articular fractures), thumb injuries, multiple-joint and finger injuries, dorsal soft tissue defects, and defects >6 cm in length were excluded from the study, as were those lost to follow-up within 6 months. Thirteen patients received arterial (hypothenar, thenar, or second toe plantar) free flaps and 12 received venous free flaps. Patients' age, follow-up period, PIP joint active range of motion (ROM), extension lag, grip-strength ratio of the injured to the uninjured hand, and Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score were compared between the groups. Results Arterial free flaps showed significantly higher PIP joint active ROM (P=0.043) and lower extension lag (P =0.035) than venous free flaps. The differences in flexion, grip strength, and QuickDASH scores were not statistically significant. Conclusions The surgical outcomes of arterial free flaps were superior to those of venous free flaps for volar defects of the PIP joint.

• Journal of Korean Medicine Rehabilitation
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• v.23 no.4
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• pp.185-194
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• 2013

Objectives The aim of this study was to evaluate the efficacy and safety of micro current taping therapy (MTT) on patients with chronic low back pain (CLBP). Methods We included 50 participants who met the inclusion criteria and 5 participants dropped out during the sessions due to the following reasons: 3 participants were personal reasons, 1 participant was taking medication, 1 participant was fore arm fracture. We attached "I" shaped 40 cm, 2 tapes along the erector muscles of the spine starting from both iliac crest and another "I" shaped 30 cm, 1 tape on the painful site horizontally. This procedure was done 8 times and participants visited a total of 9 times including a final visit for evaluation. We measured visual analog scale (VAS), range of motion (ROM) and schober's test on every visit. Participants completed a questionnaire of oswestry disability index (ODI) and Beck's depression inventory (BDI) on the first and last visits. Results In VAS for pain intensity and bothersomeness, there were significant decreases after 1st, 6th treatments. In range of extension, there was significant increase after 3rd treatment at first. In range of flexion, there was significant increase after 2nd treatment at first. In range of left flexion, there was significant increase after 4th treatment at first. In range of right flexion, there was significant increase after 3rd treatment at first. in schober's test, there was significant increase after 2nd treatment at first. In VAS, ROM, schober's test, BDI, ODI, there were significant improvement after all treatments had done. Conclusions There was a significant effect of MTT on CLBP. And there was no adverse effect.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.245-250
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• 1976

A 33 year-old man was admitted with chief complaints of severe sharp pain on left upper interscapular region and motor weakness of left arm for 9 days. He had a history of blunt trauma over left shoulder about 3 years ago. Physical examination showed a ping pong ball sized mass which was located at the left supraclavicular area and was firm, fixed, and nonpulsatile. No bruit or murmur was obtained over the mass. Ipsilaterally, radial, ulnar, and brachial pulse were very weak and ptosis and anhidrosis were noticed. Neurologic examination revealed moderate or severe weakness of flexion and extension of left elbow, wrist and fingers, and anesthesia of the skin in left C8-T1 dermatome and hypalgesia in left C6-C7 dermatome. Retrograde aortography demonstrated complete obstruction of left subclavian artery. An exploratory operation was performed through the left 4th intercostal space. It was found that the mass was a left subclavian aneurysm of traumatic false type. Proximal and distal ligation of the aneurysm were applied and the sac was partially removed. The continuity of the subclavain artery was established by the use of a 6mm. Dacron graft from the root of the subclavian to the axillary artery. Postoperatively the patient was improved from the circulatory and neurologic disturbances.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.217-222
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• 2005

Objective: To achieve optimal fit of implant, it is necessary to bend the implant during spine surgery. Bending procedure may decrease stiffness of plate especially made of titanium and stainless steel. Typically titanium suffers adverse effects including early crack propagation when it is bent. We investigate whether 6 degree bending of titanium plates would decrease the stiffness after full cyclic loading by comparing with non-bending titanium plates group. Methods: Authors experimented 40 titanium alloy plates of 57mm in length, manufactured by 5 different companies. Total 40 plates were divided into two groups (20 bent plates for experimental group and 20 non-bent plates for control group). Twenty plates of experimental group were bent to 6 degree with 3-point bending technique and verified with image analyzer. Using the electron microscope, we sought for a initial crack before and after 3-point bending. Mechanical testing by means of 6000 cyclic axial-compression loading of 35N in compression with moment arm of 35mm-1.1 Nm was conducted on each plate and followed by the electron microscopic examination to detect crack or fissure on plates. Results: The stiffness was decreased after 6000 cyclic loading, but there was no statistically significant difference in stiffness between experimental and control group. There was no evidence of change in grain structure on the electron microscopic magnification. Conclusion: The titanium cervical plates can be bent to 6 degree without any crack or weakness of plate. We also assume that minimal bending may increase the resistance to fatigue fracture in cervical flexion-extension movement.

• Journal of the Korean Society for Precision Engineering
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• v.26 no.7
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• pp.134-141
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• 2009

Recently, many researchers have tried to develop wearable robots for various fields such as medical and military purposes. We have been studying robotic exoskeletons to assist the motion of persons who have problems with their muscle function in daily activities and rehabilitation. The upper-limb motions (shoulder, elbow and wrist motion) are especially important for such persons to perform daily activities. Generally for shoulder motion 300F is needed to describe its motion(extension/flexion, abduction/adduction, internal/external rotation) but we have used a redundant actuator thus making a 4 DOF system. In this paper, we proposed the mechanism design of the exoskeleton which consists of 4-DOF for shoulder and 1-DOF for elbow robotic exoskeleton to assist upper-limb motion. Then we compared the new mechanism design and prototype mechanism design. Here we also analyze the proposed system kinematically to find out and to avoid the singular point. This research will ensure that the proposed wearable robot system make human's motion more powerfully and more easily.

• Clinics in Shoulder and Elbow
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• v.23 no.1
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• pp.20-26
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• 2020

Background: High complication rate after open reduction and internal fixation can lead to use of primary total elbow replacement (TER) in treatment of complex distal humerus fractures in elderly patients. The purpose of this study was to investigate the short-term outcomes and complications after primary TER in patients with complex distal humerus fracture. Methods: Nine patients with acute complex distal humerus fracture were treated by primary TER using the semiconstrained Coonrad-Morrey prosthesis. The mean age of patients was 72.7 years (range, 63-85 years). Clinical and radiographic outcomes were evaluated over a mean follow-up of 29.0 months (range, 12-65 months) using visual analog scale (VAS) score for pain; Mayo elbow performance score (MEPS); Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) score; and serial plain radiographs. Complications were also evaluated. Results: At the final follow-up, mean VAS, MEPS, and Quick-DASH scores were 1.2, 80.5, and 20, respectively. The mean range of motion was 127.7° of flexion, 13.8° of extension, 73.3° of pronation, and 74.4° of supination. There was no evidence of bushing wear or high-grade implant loosening on serial plain radiographs. Three complications (33.3%) comprising two periprosthetic fractures and one ulnar neuropathy were observed. Conclusions: Primary TER for treatment of complex distal humerus fractures in elderly patients yielded satisfactory short-term outcomes. However, surgeons should consider the high complication rate after primary TER.

• Investigative Magnetic Resonance Imaging
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• v.10 no.1
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• pp.26-31
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• 2006

Purpose : To evaluate the effect of global scaling analysis on brain activation for sensory and motor functional MR imaging study. Materials and methods : Four normal subjects without abnormal neurological history were included. Arm extension-flexion movement was used for motor function and 1KHz pure tone stimulation was used for auditory function. Functional magnetic resonance imaging was performed at 3T MRI (GE, Milwaukee, USA) using BOLD-EPI technique and SPM2 was employed for data analysis. On data analysis, the brain activation images were obtained with and without global scaling by fixing other parameters such as motion correction and realignment. Results : The difference in brain activation between no scaling and global scaling was not large in case of right upper extremity movement (p<0.000001). For auditory test, brain activation with global scaling showed larger activation than that of without global scaling (p<0.05). Conclusion : A caution must be taken into account when analyzing functional imaging data with global scaling especially for functional study of small local BOLD signal change.

• Clinics in Shoulder and Elbow
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• v.21 no.3
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• pp.120-126
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• 2018

Background: Treatment of distal humerus fractures in osteoporotic elderly patients is often challenging. For non-reconstructible fractures with open reduction and internal fixation, total elbow arthroplasty (TEA) is an acceptable alternative. However, the relatively high complication rates and lifelong activity restrictions make TEA less ideal for elderly or low-demand patients. Efforts to identify or develop alternate procedures that benefit relatively young, high-demand patients have resulted in increased interest in hemiarthroplasty. This systematic review reports the clinical outcomes of hemiarthroplasty for distal humeral fractures. Methods: We systematically reviewed the databases of PubMed, Ovid MEDLINE, and Cochrane Library. All English-language studies published before June 2017 were considered for possible inclusion. Search terms included 'distal humerus fracture' and 'hemiarthroplasty'. Studies reporting outcomes (and a minimum of 1 year clinical follow-up) in human subjects after hemiarthroplasty (Latitude system) for distal humeral fractures were assessed for inclusion. Patient demographics, clinical and radiographic outcomes, and complications were recorded, and homogenous outcome measures were analyzed. Results: Nine studies with a total of 115 patients met the inclusion criteria. Among the included studies, the weighted mean follow-up time was 35.4 months. Furthermore, the weighted mean of the postoperative range of motion ($107.6^{\circ}$ flexion-extension, $157.5^{\circ}$ for pronation-supination) and functional outcomes (Mayo elbow performance scores: 85.8, Disabilities of the Arm, Shoulder and Hand score: 19.6) were within the acceptable range. Conclusions: Our study indicates that hemiarthroplasty is a viable option for comminuted distal humerus fracture. Satisfactory functional outcomes were observed in most patients.

• Clinics in Shoulder and Elbow
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• v.23 no.2
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• pp.94-99
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• 2020

Background: Intra-articular distal humeral fractures can be surgically challenging. It remains under discussion whether open reduction and internal fixation (ORIF) or total elbow arthroplasty (TEA) is more beneficial for treatment of the elderly. This study aimed to compare the clinical and functional outcomes of ORIF and TEA for managing intra-articular distal humerus fractures in patients aged 65 years or older. Methods: Patients who underwent ORIF (n=28) or TEA (n=43) for in intra-articular distal humerus fracture between May 2008 and December 2018 were reviewed. Range of motion, Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, radiologic outcomes, and surgical complications were evaluated at the final follow-up visit. Results: The ORIF and TEA groups showed a mean arc of flexion-extension of 97°±21° and 101°±12°, respectively. The mean MEPS and DASH scores were 94±15 and 27±12 points, respectively, in the ORIF group and 81±27 and 47±28 points in the TEA group. This difference was statistically significant. The incidence of total complications was similar between the groups. Conclusions: In patients older than 65 years with intra-articular distal humerus fracture, ORIF had better outcomes than TEA.

• Journal of Oral Medicine and Pain
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• v.19 no.1
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• pp.137-149
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• 1994

This study was performed to investigate the relationship between Forward Head Posture(FHP) and Craniomandlbular Disorders(CMDs). Many studies reported that there was some relationship between them, however, there is still controversy. So It Is necessary to observe and compare many more patients with CMDs wirh normal controls. For the study 85 patients with CMDs and 37 dental students were selected as experimentals and controls, respectively. And the experimentals were classified Into two groups, that is, TMJ internal derangement group and muscle disorders group according to clinical diagnosis. For measuring the FHP, CROM(Cervical-Range-of-Notion)was used. This goniometer is composed of three part. First, gravity goniometer for flexion and extension. Second, magnetic compass and yoke for rotational movement. And last, forward head arm and vertebra locator for forward head posture. Next T-Scan, electronic occlusal analyzer, was used for recording of occlusal contact state. Other items such as maximum opening, lateral excursion, Helkimo's anamnestic index, and muscle palpation point from Friction's craniomandibular index were checked clinically by one examiner. The result of this study were as follows : 1. In male, control group showed much more measurement in resting forward head posture than did experimental group. But there were not significant differences between groups in female subject. From this results, the author contended that CROM is new measuring system and differ from other goniometers in some aspect, so that results should be re-evaluated 2. Mean value of maximum mouth opening in nearly all groups were greater than 40mm. and mouth opening had a significant correlation with occlusal force and with anamnestic index both sex. 3. Mean value of palpation point had not any correlationship with forward head posture in both sex, but there was significant difference between upper and lower group by rounded shouldes. 4. In summary, there was no significant relationship between forward head posture and sign and symptom of Craniomandibular Disorders.