• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.319-324
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• 2001

Objectives : The percutaneous vertebroplasty provides a good result in the treatment of osteoporotic vertebral compression fractures. But, the epidural leakage of polymethylmetacrylate(PMMA) after vertebroplasty may decrease the therapeutic effects because of the compression of thecal sac and/or nerve roots. The authors carried out a prospective study to evaluate the causative factors of epidural leakage of PMMA and to assess the influence on the outcome. Methods : This study involved 347 vertebral levels of compression fractures in 159 patients. Among these, the epidural leakages were identified in 92 vertebral levels(26.5%) in 64 patients(40.3%) on post-operative CT scan. Results : The incidence of epidural leakage of PMMA was significantly higher in the level above T7(p=0.001). The large amount of the injected PMMA and the use of an injector also increased the incidence(p=0.03 and p=0.045, respectively). The position of the needle tip in the vertebral body and the pattern of venous drainage did not influence. The immediate post-operative visual analogue scale(VAS) scores and facial scales(FS) were higher in the patients with epidural leakage(p=0.009). But there were no significant differences between the two groups after three months of operation(p=0.541). Conclusions : The incidence of epidural leakage of PMMA after percutaneous vertebroplasty appears to have relationship with the amount of PMMA and the levels injected. The epidural leakage of PMMA reduced the immediate therapeutic effects of vertebroplasty, but did not influence the late outcome. However, the epidural leakage should be avoided because of its potential neurological complications.

• The Journal of Korean Physical Therapy
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• v.13 no.3
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• pp.653-664
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• 2001

Delayed onset muscle soreness (DOMS) was the sensation of discomfort and stiffness in the muscle, often after taking part in unaccustomed physical activity. No universally accepted treatment exist. The aim of this study was to examine the influence of cryotherapy and intermittent compression on the delayed onset muscle soreness. Flexion elbow joint position and extension(Universal Goniometer). pain(Muscle Soreness Rating Scale) and mechanical pain threshold(Algometer) were measured before 30minutes DOMS was induced.The data were analyzed by measure of Mann-Whitney test and Kruskal-Wallis test. The result were as follow; 1. There were no significantly differences between groups or over time in relation to range of motion. 2. Muscle Soreness Rating was significantly high in cryotherapy and intermittent compression at 48, 72 hours after DOMS was induced(p<.05). 3. Mechanical pain threshold begin to increased at 24 hours and significantly in cryotherapy and intermittent compression groups at 48, 72 hours after DOMS was induced(p>.05). 4. A negative Correlation between muscle soreness rating scale and mechanical Pain threshold graphs at 24, 48, and 72 hours after exercise indicated in cryotherapy and intermittent compression groups.

• Journal of Korean Foot and Ankle Society
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• v.20 no.3
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• pp.131-134
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• 2016

Purpose: This study aimed to evaluate the outcomes, including the complications, of open reduction and internal fixation using a headless cannulated compression screw for a fifth metatarsal base fracture. Materials and Methods: We retrospectively investigated 11 patients with 5th metatarsal base fracture who were treated with a headless cannulated compression screw. The mean follow-up period was 13 months (8~15 months), and the mean age was 46.5 years (21~70 years). We analyzed the patients' sex, age, time to union, amount of fracture displacement, and complications. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score was used for clinical assessment. Results: The average amount of displacement decreased significantly from 3.4 mm (2.1~5.2 mm), preoperatively, to 0.4 mm (0~1.3 mm), postoperatively (p<0.001). The average bone union time was 54.1 days (41~68 days). There were no complications, such as a metal failure, irritation, and loss of a reduction. The mean AOFAS midfoot score was 97.7 (90~100) at 6 months, postoperatively. Conclusion: We suggest that a headless cannulated compression screw for 5th metatarsal base fracture is a useful and alternative method for a firm fixation without complications.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.186-191
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• 2014

Purpose: The objectives of this study were to assess pain relief according to the time after kyphoplasty and to evaluate the factors affecting pain relief after kyphoplasty in the treatment of a single-level osteoporotic vertebral compression fracture. Methods: A retrospective review of 34 kyphoplasties for single-level osteoporotic vertebral compression fractures was performed. Pain relief was assessed by using the visual analogue scale (VAS) at preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. Associated factors, including age, sex, pain duration, bone mineral density, and cement leakage, were evaluated using the patients' medical records. Statistical analyses were conducted using the paired t-test to assess pain relief and using the independent t-test and Pearson's correlation coefficient to evaluate the relationship between those factors and pain relief. Results: Preoperatively, the mean VAS score was 7.06. Postoperatively, it declined to 3.66 (p=0.001), 2.81 (p=0.001) and 2.24 (p=0.001) at 6 weeks, 3 months and 6 months, respectively. Also, statistically significant pain relief was observed during the periods from 6 weeks to 3 months (p=0.001) and from 3 months to 6 months (p=0.001). However, reduction of the VAS score showed no significant correlation with age, sex, pain duration, bone mineral density, or cement leakage (p>0.05). Conclusion: Our study suggests that a kyphoplasty may be effective in osteoporotic vertebral compression fracture patients with acute pain and that after the kyphoplasty, pain is reduced remarkably for 6 weeks and then continuously for 6 months.

• International Journal of Concrete Structures and Materials
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• v.11 no.1
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• pp.135-149
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• 2017

The prediction of the actual ultimate capacity of confined concrete columns requires partial confinement utilization under eccentric loading. This is attributed to the reduction in compression zone compared to columns under pure axial compression. Modern codes and standards are introducing the need to perform extreme event analysis under static loads. There has been a number of studies that focused on the analysis and testing of concentric columns. On the other hand, the augmentation of compressive strength due to partial confinement has not been treated before. The higher eccentricity causes smaller confined concrete region in compression yielding smaller increase in strength of concrete. Accordingly, the ultimate eccentric confined strength is gradually reduced from the fully confined value $f_{cc}$ (at zero eccentricity) to the unconfined value $f^{\prime}_c$ (at infinite eccentricity) as a function of the ratio of compression area to total area of each eccentricity. This approach is used to implement an adaptive Mander model for analyzing eccentrically loaded columns. Generalization of the 3D moment of area approach is implemented based on proportional loading, fiber model and the secant stiffness approach, in an incremental-iterative numerical procedure to achieve the equilibrium path of $P-{\varepsilon}$ and $M-{\varphi}$ response up to failure. This numerical analysis is adapted to assess the confining effect in rectangular columns confined with conventional lateral steel. This analysis is validated against experimental data found in the literature showing good correlation to the partial confinement model while rendering the full confinement treatment unsafe.

• Journal of Korean Neurosurgical Society
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• v.30 no.2
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• pp.186-193
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• 2001

Objectives : Trigeminal neuralgia and hemifacial spasm are caused by vascular compression of the REZ(root entry or exit zone) of the 5th and the 7th cranial nerve. Preoperative detection of neurovascular compression is essential for accurate diagnosis, appropriate treatment, and the good operative results. Three dimensional Fourier Transformation-Constructive Interference in Steady State(3DFT-CISS) images are known to give good contrast between CSF, nerve, and vessels. We applied a 3DFT-CISS imaging technique for the preoperative evaluation of patients with these diseases and estimated the diagnostic accuracy and usefulness of this study. Methods : A series of 71 patients with trigeminal neuralgia and hemifacial spasm were treated by microvascular decompression. Among them 34 patients with trigeminal neuralgia and 24 patients with hemifacial spasm had preoperative CISS images. We compared the radiologic finding with the operative finding, and analysed the diagnostic usefulness of 3DFT-CISS imaging. Results : The sensitivity of CISS images of detecting the neurovascular compression was 90.3% in trigeminal neuralgia and 100% in hemifacial spasm. There were one false-positive and three false-negative cases in trigeminal neuralgia, and one false-positive case in hemifacial spasm. The accuracy in diagnosing the causative vessel was 73.5% in trigeminal neuralgia and 83.3% in hemifacial spasm. Conclusion : CISS image is very useful diagnostic tool for preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia and hemifacial spasm. No additional neuroradiologic examination other than CISS image and MRA is needed for preoperative evaluation of patients with trigeminal neuralgia and hemifacial spasm.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.944-949
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• 2021

Objective : The stability is an important factor to decide the treatment plan in thoracolumbar burst fracture patients. Patients with an unstable burst fracture generally need operative management. Decrease in vertebral body height, local kyphosis, involvement of posterior column, and/or canal compromise are considered important factors to determine the treatment plan. On the other hand, in thoracolumbar injury classification system (TLICS), surgery is recommended in patients with TLICS of more than 5 points. The purpose of this study was to apply the TLICS score in patients with thoracolumbar burst fractures and to distinguish the differences of treatment plan on burst fracture. Methods : All patients, diagnosed as a thoracolumbar burst fracture between January 2006 and February 2019 were included in this study. Unstable thoracolumbar burst fracture was defined as burst fracture with neurologic deficit, three-column injury, kyphosis over 30 degrees, decrease of anterior body height over 40 percent and canal comprise more than 50%. TLICS score was measured with morphology, neurological involvement and posterior ligamentous complex integrity. The existence of instability was compared with TLICS score. Results : Total 233 patients (131 men, 102 women) were included in this study. In Denis classification, 51 patients (21.9%) diagnosed as stable burst fracture while 182 patients (78.1%) had unstable burst fracture. According to TLICS, 72 patients (30.9%) scored less than 4, while 161 patients (69.1%) scored 4 or more. All the patients with stable burst fracture scored 2 in TLICS. Twenty-one patients (9.0) scored 2 in TLICS but diagnosed as unstable burst fracture. Thirteen patients had over 40% of vertebra body compression, four patients had more than 50% of canal compromise, three patients had both body compression over 40% and kyphosis over 30 degrees, one patients had both body compression and canal compromise. Fifteen patients presented kyphosis over 30 degrees, and three (20%) of them scored 2 in TLICS. Seventy-three patients presented vertebral body compression over 40% and 17 (23.3%) of them scored 2 in TLICS. Fifty-three patients presented spinal canal compromise more than 50%, and five (9.4%) of them scored 2 in TLICS. Conclusion : Although the instability of thoracolumbar burst fracture was regarded as a critical factor for operability, therapeutic strategies by TLICS do not exactly match with the concept of instability. According to the concept of TLICS, it should be reconsidered whether the unstable burst fracture truly unstable to do operation.

• The Journal of Korean Physical Therapy
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• v.21 no.4
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• pp.103-109
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• 2009

Purpose: Cases of male external genitalia lymphedema are relatively uncommon in the clinical physical therapy field. Of more than two thousand clinical cases treated by the author in the lymphedema treatment center, only 4~5 cases of male external genitalia lymphedema were encountered. The present case report presents the experience and treatment results of male external genitalia lymphedema from urological cancer. Method: This case was a 47-year-old man, who was treated with complex decongestive physical therapy consisting of manual lymph drainage, compression bandage (including the external genitalia), remedial exercise, skin care. Result: The results were relatively good. The clinical experience would suggest that early treatment and education can reduce the external genitalia lymphedema. However, the treatment efficacy remains limited. Therefore, early treatment is vital for more successful outcomes. Conclusion: The relief of symptoms and a decrease in male external genitalia lymphedema may be the best result from long-term conservative management.

• Knee surgery & related research
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• v.30 no.4
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• pp.284-292
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• 2018

Purpose: As the number of total knee arthroplasties (TKAs) increases, the incidence of femoral periprosthetic fractures after TKA is also increasing. This review aimed to suggest a new surgically oriented classification system for femoral periprosthetic fractures. Methods: We investigated the classifications, and current treatment trends for femoral periprosthetic fractures after TKA by means of a thorough review of the relevant literature. Results: Numerous studies reported good results of surgical treatment with modern fixatives including locking compression plates and retrograde intramedullary nails. However, few classifications of femoral periprosthetic fractures reflect the recent developments in surgical treatment. Conclusions: We recommend that surgical management be considered the first-line treatment for femoral periprosthetic fractures after TKA. Our new classification will help in deciding the surgical treatment option for femoral periprosthetic fractures after TKA.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.11
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• pp.4875-4883
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• 2016

Background and objective: Breast cancer-related lymphoedema (BCRL) is a disabling complication with long term impact on quality on life after breast cancer treatment. Its management remains a major challenge for patients and health care professionals; the goal of this overview was to summarize effects of different treatment strategies for patients with BCRL. Methods: A thorough search was undertaken to allow a systematic review or meta-analysis of treatments for BCRL. Two investigators independently selected studies and abstracted the data. Results: Combined physical therapy (CPT) with different combinations of surgery, oral pharmaceuticals, low-level laser therapy, weight reduction, mesenchymal stem cell therapy, kinesio tex taping, and acupuncture might be effective in reducing lymphoedema, but exercise demonstrated no obvious benefit. The results of direct comparisons showed CPT might be more effective than standard physiotherapy (ST). Manual lymphatic drainage (MLD) may not offer additional benefits to ST for swelling reduction, but could facilitate compression bandaging. MLD seemed to have similar effects with self-administered simple lymphatic drainage (SLD) or using an intermittent pneumatic compression pump (IPC). IPC might also not be associated with additional effectiveness for CPT. Efficacy of stem cell therapy vs. compression sleeve or CPT, as well as the effects of daflon and coumarin could not be established. Conclusion: Although many treatments for BCRL might reduce lymphoedema volume, their effects were not well established. The quality of many of the original studies in the included reviews was not optimal, so that in future randomized control trials are a high priority.