• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.150-158
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• 2009

Purpose: With the better understanding of cuff function, partial repair or "force couple repair" for treating massive irreparable rotator cuff tear has gained some popularity. However, there were few reports on the results of partial repair. The purpose of this study was to report the clinical outcome of massive irreparable rotator cuff tears who received arthroscopic force-couple repair or partial repair. Materials and Methods: From June 2005 to Feb 2008, arthroscopic partial repairs were performed for 16 irreparable rotator cuff tears among the 101 large to massive rotator cuff tears that were operated on. Clinical and radiographic evaluation were done at the final follow-up. Results: There were 7 men and 9 women with a mean age of 66.6 years. The mean follow-up period was 27.3 month (range: 15-46). The pain VAS improved from 4.4 ($\pm2.50$) to 2.1 ($\pm2.26$) and the functional VAS improved from 46.9 ($\pm16.64$) to 70.0 ($\pm22.80$). The ASES score improved from 39.0 ($\pm10.80$) to 80.3 ($\pm16.78$) and the KSS score was 81.9 ($\pm16.74$) at the final follow-up. The acromio-humeral distance was 6.6 cm ($\pm1.74$) preoperatively and 6.2 cm ($\pm1.69$) postoperatively without significant change (p=0.3874). The degenerative changes had no statistically progressed (p=0.2663). Conclusion: Partial repair for massive rotator cuff injury patients showed improvement in the clinical score without progression of arthritic change at a mean of 2.3 years follow-up.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.25-32
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• 2017

Purpose: The purpose of this study was to analyze the radiological and clinical outcomes in elderly patients with unstable intertrochanteric femur fractures in accordance with the length of intramedullary nail. Materials and Methods: Between August 2009 and December 2014, a total of 139 patients-older than 65 years of age with AO/OTA classification of 31-A2 unstable intertrochanteric femur fracture-who has been followed-up for at least 1 year after the treatment with internal fixation by using an intramedullary nail were enrolled for this retrospective control study. The subjects were classified into two groups according to the length of intramedullary nail: 106 patients in the short group (group I) and 33 patients in the long group (group II). For radiological assessments, the reduction state, time to union, and implant related complications were examined. The clinical outcomes were assessed by preoperative hemoglobin, operating time, intraoperative bleeding amount, blood transfusion rate, hospitalization period, and Charnley hip pain scoring system at the final follow-up. Results: The postoperative radiographs showed good or acceptable reduction in all cases. The mean time of radiologic bone union was 4.8 months, and there was no difference between the two groups. With respect to surgical time, the group II was found to take longer (57.87 minutes) than the group I (45.65 minutes) (p=0.003). The bleeding amount during surgery of the group II was greater (288.78 ml) than that of the group I (209.90 ml) (p=0.046). The clinical results at the final follow-up were found to be satisfactory in both groups. Conclusion: In cases of good reduction of the fracture from the treatment of unstable intertrochanteric femur fracture accompanying the posteromedial fragment in elderly patients, both groups-long and short intramedullary nails-showed satisfactory radiological and clinical outcomes.

• Tuberculosis and Respiratory Diseases
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• v.57 no.4
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• pp.329-335
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• 2004

Background : The Sequential Organ Failure Assessment (SOFA) score can help to assess organ failure over time and is useful to evaluate morbidity. The aim of this study is to evaluate the performance of SOFA score as a descriptor of multiple organ failure in critically ill patients in a local unit hospital, and to compare with APACHE III scoring system. Methods : This study was carried out prospectively. A total of ninety one patients were included who admitted to the medical intensive care unit (ICU) in Chuncheon Sacred Heart Hospital from May 1 through June 30, 2000. We excluded patients with a length of stay in the ICU less than 2 days following scheduled procedure, admissions for ECG monitoring, other department and patients transferred to other hospital. The SOFA score and APACHE III score were calculated on admission and then consecutively every 24 hours until ICU discharge. Results : The ICU mortality rate was 20%. The non-survivors had a higher SOFA score within 24 hours after admission. The number of organ failure was associated with increased mortality. The evaluation of a subgroup of 74 patients who stayed in the ICU for at least 48 hours showed that survivors and non-survivors followed a different course. In this subgroup, the total SOFA score increased in 81% of the non-survivors but in only 21% of the survivors. Conversely, the total SOFA score decreased in 48% of the survivors compared with 6% of the non-survivors. The non-survivors also had a higher APACHE III score within 24 hours and there was a correlation between SOFA score and APACHE III score. Conclusion : The SOFA score is a simple, but effective method to assess organ failure and to predict mortality in critically ill patients. Regular and repeated scoring enables patient's condition and clinical course to be monitored and better understood. The SOFA score well correlates with APACHE III score.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.51-57
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• 2011

Purpose: The aim of this study is to identify clinical usefulness of Wide Beam Reconstruction (WBR) which is called Xpress.cardiac$^{TM}$ to confirm the agreement between segmental perfusion and regional wall motion in myocardium compared to conventional OSEM method. Materials and Methods: Subjects were separated two groups. First group was composed of 20 normal control group. Second group was composed of 10 patients (abnormal group) who had coronary artery disease. Subjects underwent myocardial perfusion SPECT ($^{201}Tl$ rest and $^{99m}Tc$-MIBI stress). Image acquisition and reconstruction were that rest stage was each step per 30, 15 seconds and stress stage was each step per 25, 13 seconds, OSEM and WBR methods were applied. Segmental perfusion and regional wall motion were applied 20-segment model of QPS, QGS algorithm in AutoQuant. Status of perfusion was composed of 5 point scoring system (0=normal, 1=mild, 2=moderate, 3=severe hypokinesia, 4=dyskinesia). Status of regional wall motion was also composed of 5 point scoring (0=normal, 1=mild, 2=moderate, 3=severe hypokinesia, 4=dyskinesia). We evaluated the agreement between conventional OSEM and WBR through automatic quantification value. Results: The agreement of rest segmental perfusion between conventional OSEM and WBR in normal patients was 99% (396/400, k=0.662, p<0.0001) and one of rest regional wall motion was 83.8% (335/400, k=0.283), the agreement of stress segmental perfusion was 95.8%(383/400, k=0.656), one of stress regional wall motion was 87.3% (349/400, k=0.390). The match rate of rest segmental perfusion in abnormal patients was 83% (166/200, k=0.605, p<0.0001) and one of rest regional wall motion was 55.5% (111/200, k=0.385), the agreement of stress segmental perfusion was 79.5% (159/200, k=0.682), one of stress regional wall motion was 63.5% (127/200, k=0.486). Conclusion: Compared to conventional OSEM, WBR method had a good agreement of segmental perfusion in myocardium in normal and abnormal groups. However regional wall motion showed meaningful low agreement. Although WBR offers high resolution and contrast ratio, it is not useful method for gated myocardial perfusion SPECT.

• Tuberculosis and Respiratory Diseases
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• v.50 no.2
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• pp.236-244
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• 2001

Background : Most current research using prognostic scoring systems in critically ill patients have focused on prediction using the first intensive care unit (ICU) day data or daily updated data. Usually the mean ICU length of stay in Korea is longer than in the western world. Consequently, a more cost-effective and practical prognostic parameter is required. The principal aim of this study was to assess the prognostic value of the seventh day(7th day : the average mean ICU length of stay) APACHE III score in a medical intensive care unit. Methods : 241 medical ICU patients from July 1997 to April 1998 were enrolled. The 1st and 7th scores were measured by using the APACHE III scoring system and compared between survivors and non-survivors. Logistic regression analysis was performed to determine the relationship between the $1^{st}$ and $7^{th}$ APACHE III scores and the mortality risk. Results : 1 )The mean length of stay in the ICU was $10.3{\pm}13.8$ days. 2)The mean $1^{st}$ and $7^{th}$ day APACHE III scores were $59.7{\pm}30.9$ and $37.9{\pm}27.7$. 3) The mean $1^{st}$ day APACHE III score was significantly lower in survivors than in non- survivors($49.9{\pm}23.8$ vs $86.3{\pm}32.3$, P<0.0001). 4)The mean $7^{th}$ day APACHE III score was significantly lower in survivors than in non- survivors($30.1{\pm}18.5$ vs $80.1{\pm}30.4$, P<0.0001). 5)The odds ratios among the $1^{st}$ and $7^{th}$ day APACHE III scores and the mortality rate were 1.0507 and 1.0779 respectively. Conclusion : These results suggest that the seventh day APACHE III score is as useful in predicting the outcome as is such like the first day APACHE III score. Therefore, in comparison to the daily APACHE III score, measuring the $1^{st}$ and $7^{th}$ day APACHE III scores are also useful for predicting the prognosis of critically ill patients in terms of cost-effectiveness. It is suggested that the $7^{th}$ day APACHE III score is useful for predicting the clinical outcome.

• Journal of Korean Orthopaedic Sports Medicine
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• v.5 no.1
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• pp.75-80
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• 2006

Purpose: To evaluate the efficiency of Acutrak screw fixation for radial head fracture (Mason type 2) without considering the safe Bone of radial head. Materials and Methods: Consecutive seven radial head fracture of Mason type II underwent internal fixation with Acutrak screws from May 2001 to February 2003. The mean follow-up period was 1.2years (ranged, $6 months{\sim}2.5 years$). The mean age of patients was 47 years old (ranged, $36{\sim}60years$ old). The cause of injury were fall down -4 cases and traffic accident -3 cases. The results were evaluated by Mayo Clinic results scoring system. Results: Functional Rating Index of Mayo Clinic was excellent- 2 cases and good- 5 cases. There were no nonunion, loosening, heterotopic ossification, infection or degenerative changes. The postoperative range of motion in elbow joint is nearly full for flexion, extension, pronation and supination in this study Conclusion: Consideration of safe zone is not necessary when Acutrak screws are used for radial head fracture. It seems to be a useful method that Acutrak screw fixation for radial head fracture (Mason type II) could achieve good radiologic and clinical results without influencing proximal radio-ulnar joint and has powerful fixation.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.20-25
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• 2008

Purpose: The purpose of this study is comparison of radiological and clinical outcomes between proximal metatarsal osteotomy and distal chevron osteotomy for the correction of hallux valgus. Materials and Methods: In this retrospective study, we included subjects who underwent the correction of hallux valgus in our institution between March 2001 and August 2006, with a minimum follow-up of 12 months. The group of proximal metatarsal osteotomy was 23 patients (34 feet); the group of distal chevron osteotomy was 20 patients (26 feet). The group of proximal metatarsal osteotomy was composed of 26 severe cases (76.5%) and 8 moderate cases (23.5%); the group of distal chevron osteotomy was composed of 13 severe cases (50.0%) and 13 moderate cases (50.0%). Results: Compared to preoperative values, the hallux valgus angle, the first-second intermetatarsal angle and the distance of first-fifth metatarsal head were significantly decreased in two groups (p<0.05). In each parameter, the hallux valgus angle was decreased 66.3% (proximal metatarsal osteotomy) versus 49.6% (distal chevron osteotomy), which were significant (p=0.037). The first-second intermetatarsal angle and the distance of first-fifth metatarsal head were not significant. Mayo clinic forefoot scoring system (FFSS) score was significantly improved in two groups (p<0.05). The ratio of improvement was not significant (p=0.762). In severe group, hallux valgus angle and the first-second intermetatarsal angle was significantly decreased in proximal metatarsal osteotomy group compared to distal chevron osteotomy group (p<0.05), but the difference of the distance of first-fifth metatarsal head and FFSS score was not significant in both groups. In moderate group, the difference of all parameters was not significant in both groups. Conclusion: Although both proximal metatarsal osteotomy and distal chevron osteotomy showed satisfactory result in FFSS, proximal metatarsal osteotomy was more proper operative technique than distal chevron osteotomy in severe group, because of superiority of correction in radiological parameters.

• Korean Journal of Poultry Science
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• v.36 no.3
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• pp.239-246
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• 2009

Animal welfare is of considerable importance to European consumers and citizens, this being most recently confirmed in EU barometer studies. Researchers and others have long proposed that animal-based measures (measures taken on animals, e.g. their health and behaviour) can provide a valid indicator of animal welfare; since welfare is a characteristic of the individual animal. Therefore, a welfare assessment can be essentially based on animal-based measures, but with use of resource measures to provide the capacity to assess 'risk factors'. The first goal of this project was to develop a welfare monitoring system that enables assessment of welfare status through standardised conversion of welfare measures into accessible and understandable information. The acquired information on one hand provides feedback to animal unit managers about the welfare status of their animals, and on the other, information on the welfare status of animal-related products for consumers and retailers. The second goal of Welfare $Quality^{(R)}$ was to improve animal welfare by minimising the occurrence of harmful behavioural and physiological states, improving human-animal relationships, and providing animals with safe and stimulating environments. The different measurable aspects of welfare to be covered are turned into welfare criteria. The criteria reflect what is meaningful to animals as understood by animal welfare science. Once all the measures have been performed on an animal unit, a bottom-up approach is followed to produce an overall assessment of animal welfare on that particular unit: first the data collected (i.e. values obtained for the different measures on the animal unit) are combined to calculate criterion-scores; then criterion-scores are combined to calculate principle-scores; and finally the animal unit is assigned to a welfare category according to the principle-scores it obtained.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2527-2530
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• 2015

Background: The cancer of the prostate risk assessment (CAPRA) score has been defined to predict prostate cancer recurrence based on the pre-clinical data, then pathological data have also been incorporated. Thus, CAPRA post-surgical (CAPRA-S) score has been developed based on six criteria (prostate specific antigen (PSA) at diagnosis, pathological Gleason score, and information on surgical margin, seminal vesicle invasion, extracapsular extension and lymph node involvement) for the prediction of post-surgical recurrences. In the present study, biochemical recurrence (BCR)-free probabilities after open retropubic radical prostatectomy (RP) were evaluated by the CAPRA-S scoring system and its three-risk level model. Materials and Methods: CAPRA-S scores (0-12) of our 240 radical prostatectomies performed between January 2000-May 2011 were calculated. Patients were distributed into CAPRA-S score groups and also into three-risk groups as low, intermediate and high. BCR-free probabilities were assessed and compared using Kaplan-Meier analysis and Cox proportional hazards regression. Ability of CAPRA-S in BCR detection was evaluated by concordance index (c-index). Results: BCR was present in 41 of total 240 patients (17.1%) and the mean follow-up time was $51.7{\pm}33.0$ months. Mean BCR-free survival time was 98.3 months (95% CI: 92.3-104.2). Of the patients in low, intermediate and high risk groups, 5.4%, 22.0% and 58.8% had BCR, respectively and the difference among the three groups was significant (P = 0.0001). C-indices of CAPRA-S score and three-risk groups for detecting BCR-free probabilities in 5-yr were 0.87 and 0.81, respectively. Conclusions: Both CAPRA-S score and its three-risk level model well predicted BCR after RP with high c-index levels in our center. Therefore, it is a clinically reliable post-operative risk stratifier and disease recurrence predictor for prostate cancer.

• Journal of the Korean Arthroscopy Society
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• v.2 no.2
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• pp.135-140
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• 1998

From 1989 to 1994, authors have reconstructed the posterior cruciate ligament(PCL) in 51 knees with an autogenous central one-third of the patellar tendon by transtibial two tunnel technique, but there were not a few cases of unfavorable results. So from January 1995, we have reconstructed the PCL deficient knees by "modified tibial inlay technique" to avoid the grafted tendon abrasion at the posterior opening of the tibial tunnel(killer turn). Purpose of this study was to compare the results of two surgical techniques and what its advantages and disadvantages are. We could follow up 39 cases of transtibial two tunnel techique group(group A) more than one year, average being 23.7 months and 21 cases of modified tibial inlay technique group(group B) more than 12 months, average being 14.7 months. The clinical results were evaluated by the OAK knee scoring system ($M{\ddot{u}}ller$'s criteria) and the posteror stress roentgenography (push view) with Telos stress device compared with the uninjured knees. The arthroscopic second-look findings were also evaluated. In group A : The $M{\ddot{u}}ller$'s knee score was average 80.1 points, the posteror displacement in push view was average 4.4mm at the last follow up. There were 17 cases(44%) of unfavorable results which showed unstable posterior displacement more than 4mm compared with the uninjured knee in push view. Among the 19 cases of arthroscopic second look examinations, nearly normal PCL appearances of the grafted tendons were noted only in 9 cases(47%). In group B : The $M{\ddot{u}}ller$'s knee score was average 86.7 points, the posterior displacemnet in push view was average 3.6mm at the last follow up. There were 5 cases(23.8%) of unfavorable results which showed unstable posterior displacement more than 4mm compared with the uninjured knee in push view but 4 out of 5 cases showed 6mm posterior displacement in push views. Among the 7 cases of arthroscopic second-look examinations, 6 cases(86%) showed nearly normal PCL appearances of the grafted tendons. In modified tibial inlay technique of PCL reconstruction, it was easier to pull out the BPTB and in cases of remained laxed meniscofemoral ligament it was easier to preserve the remained structures than transtibial two tunnel technique. We expect the "modified tibial inlay technique" may solve the problem of grafted patellar tendon abrasion at the posterior orifice of tibial tunnel and may contribute to the successful PCL reconstruction.