• Clinics in Shoulder and Elbow
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• v.18 no.3
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• pp.120-127
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• 2015

Background: We prospectively compared the response to blind and ultrasound-guided glenohumeral injection of corticosteroids for treatment of shoulder stiffness. Methods: A total of 77 patients with shoulder stiffness between April 2008 and March 2012 were recruited. Patients were randomized to receive either a blind (group 1, n=39) or ultrasound-guided (group 2, n=38) glenohumeral injection of 40 mg triamcinolone. The clinical outcomes and shoulder range of motion (ROM) before injection, at 3, 6, and 12 months after injection and at the last follow-up were assessed. The same rehabilitation program was applied in both groups during the follow-up period. Results: There was no significant difference in demographic data on age, sex, ROM, and symptom duration before injection between groups (p>0.05). There were no significant differences in ROM including forward flexion, external rotation at the side, external rotation at $90^{\circ}$ abduction, and internal rotation, visual analogue scale for pain and functional outcomes including American Shoulder and Elbow Surgeons score, Simple Shoulder test between the two groups at any time point (p>0.05). Conclusions: Based on the current data, the result of ultrasound-guided glenohumeral injection was not superior to that of blind injection in the treatment of shoulder stiffness. We suggest that ultrasound-guided glenohumeral injection could be performed according to the patient's compliance and the surgeon's preference. Once familiar with the non-imaging-guided glenohumeral injection, it is an efficient and reliable method for the experienced surgeon. Ultrasound could be performed according to the surgeon's preference.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.187-198
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• 1999

Purpose: The authors compared the results of Ender nailing for the proximal humerus fractures with those of the conservative methods radiographically. Materials and Method: Nine patients(mean age: 69 years.) received Ender nailing, and the other nine patients, conservative treatments(mean age: 73 years). All fractures were 2 part fractures. The Ender nails were inserted either through posterior elbow approach or transepicondylar approach. A simple Velpeau bandage was applied to the conservative treatment group. The average follow-up was 15 months. Results: The initial status of the anatomical reduction, i.e., the values of the medial shift, overlapping and the varus agulation, were little changed at follow-up radiographs in both the Ender nailing group and the conservative treatment group. There was no significant difference for the status of anatomical reduction between the Ender nailing group and the conservative treatment group. The stability of fixation by Ender nails, i.e., the degree of fanning out of the nails was poor in most cases. Not a few problems/complications happened in cases of Ender nailing group; back­ing out of the nail in three cases, penetration of the nails into the humeral heads in 3, fractures or cracking of the humerus around the nail insertion area in 4 and reduction loss in one. Conclusion: We could not get better results with the use of Ender nail. We use no longer Ender nails for the proximal humerus fractures. Further studies are needed for the better option for the proximal humerus fractures.

• Journal of the Ergonomics Society of Korea
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• v.35 no.6
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• pp.595-609
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• 2016

Objective: The purpose of this study was to develop and validate the guidelines for Medic Work Table (MWT) based on the anthropometric data of medical technologists. Background: Users' anthropometric data such as sitting height, sitting elbow height, knee height, and so on are significant factors for designing comfortable and useful furniture. Thus, many guidelines for different types of desks and chairs based on the users' anthropometric data have been suggested to many researchers. However, few researches have been conducted to provide design guidelines for MWT for blood collecting task. Medical technologists often use their upper extremities to perform blood collecting task with high repetitions. These repeated motions could be a critical factor in the prevalence rate of Work-related Musculoskeletal Disorders (WMSDs). Therefore, a study on ergonomic design of MWT would be essential in preventing the WMSDs and improving the quality of the working environment of medical technologists. Method: This study suggested design guidelines for ergonomic MWT by focusing on the heights of the upper side and underside, depths of the inside and outside, and width of MWT through anthropometric studies and literature reviews. Afterwards, a new MWT was made using the suggested design guidelines for this study. Five healthy medical technologists participated to evaluate the original MWT and new MWT. All participants took part in the range of motion (ROM) test, electromyography (EMG) muscle activity test, and usability test to validate the suggested guidelines in this study. EMG signals of related muscles (Flexor Carpi Ulnaris, Extensor Carpi Ulnaris, Deltoid Anterior, and Biceps Branchii) were recorded through the surface electromyography system from both the original MWT and the new MWT. The ROM test of the shoulder and elbow flexion was also assessed using motion sensors. Results: The newly designed MWT showed decreased ROMs of the shoulder and elbow up to 22% and 18% compared to the original MWT. The muscle activities in the new MWT also showed a decrease of 13% in Anterior Deltoid, 6% in Biceps Brachii, 5% in Flexor Carpi Ulnaris, and 8% in Extensor Carpi Ulnaris muscle groups, compared to the original MWT. In the usability test, the satisfaction score of the new MWT was also 56.1% higher than that of the original MWT. Conclusion: This study suggested guidelines for designing MWT and validating the guidelines through qualitative and quantitative analyses. The results of motion analysis, muscle activity, and usability tests demonstrated that the newly designed MWT may lead to less physical stress, less awkward posture, and better physical user interface. Application: The recommended guidelines of the MWT would be helpful information for designing an ergonomic MWT that reduces physical loads and improves the performance of many medical technologists.

• The Journal of Korean Physical Therapy
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• v.19 no.1
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• pp.23-31
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• 2007

Purpose: As a preliminary study, the purpose of this study was to examine the indirect estimation of the lumbar intervertebral disc size by two anthropometric methods, in order to compare these indirect methods with the direct analysis by radiological imaging. Methods: The wrist, elbow, knee, and ankle joint (both right and left) diameters were measured in 52 volunteers, and then intervertebral disc size was calculated using two anthropometric methods (Colombini and modified Colombini). The data were analysed with independent t-test to assess clinical usefulness. Results: When using right and left joint diameter, there was no significant difference in the estimation value of the L4-5 and L5-S1 intervetebral disc sizes. However, the study has shown that male subjects have significantly larger L4-5 and L5-S1 intervertebral disc sizes, compared with those of female subjects. In addition, disc sizes calculated by Colombini's formula were significantly larger than modified Colombini's formula. Conclusion: The indirect estimation of the intervertebral disc size by anthropometric method can be considered as a clinically useful method. However, further study should be conducted to compare anthropometric values with other radiological imaging.

• The Journal of the Korea institute of electronic communication sciences
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• v.17 no.4
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• pp.703-708
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• 2022

K-means clustering is a representative clustering technique. However, there is a limitation in not being able to integrate the performance evaluation scale and the method of determining the minimum number of clusters. In this paper, a method for numerically determining the minimum number of clusters is introduced. The explained variance is presented as an integrated measure. We propose that the k-means clustering method should be performed in the subspace of the PCA in order to simultaneously satisfy the minimum number of clusters and the threshold of the explained variance. It aims to present an explanation in principle why principal component analysis and k-means clustering are sequentially performed in pattern recognition and machine learning.

• Clinics in Shoulder and Elbow
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• v.16 no.1
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• pp.58-62
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• 2013

Purpose: Among the numerous clinical researches and following articles, there are few cases that apply proper methodology, which guarantees high reliability. By understanding the right concept and randomization of proper methods, research bias could be minimized. Materials and Methods: By reviewing the recently published articles about randomization, the basic concept and the necessity of applying the technique was described. Then proper methodologies for good randomization such as simple randomization, permuted-block randomization, and stratification were briefly introduced with examples. Results and Conclusion: Randomization lowers the possibility of bias and leads to higher reliability in clinical research. To obtain more reliable research results, understanding the right concept and proposition of proper methodologies of randomization is essential for researchers.

• Clinics in Shoulder and Elbow
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• v.21 no.2
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• pp.67-74
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• 2018

Background: Fatty degeneration of rotator cuff is a well-known predictor of postoperative outcome. The purpose of this study was to evaluate the clinical features of rotator cuff tears involving subscapularis, and investigate whether fatty degeneration quantified from only the upper subscapularis correlates better with clinical outcomes than quantified from the whole subscapularis. Methods: We retrospectively analyzed 315 consecutive patients who underwent arthroscopic repair for rotator cuff tears involving subscapularis with a minimum follow-up of 1 year. Preoperative and postoperative visual analogue score for pain, range of motion and functional scores were assessed. Integrity of the repaired tendon was assessed at the 1-year follow-up with either magnetic resonance imaging or ultrasonography. Results: The mean Goutallier grade of whole cross-section was significantly lower than that of upper cross-section (1.59 vs. 1.71, p<0.05), but significantly higher than that of lower cross-section (1.59 vs. 1.01, p<0.05). In analysis of 37 re-tears, the occupancy of severe fatty degeneration in upper cross-section was 86.5%, which was significantly higher than that seen in whole cross-section (56.8%, p<0.05). We calculated the cut-off tear size for prediction of re-tears as 19.0 mm for retraction and 11.0 mm for superior-inferior. The cut-off Goutallier grade was 2.5 for both whole and upper cross-sections, but area under the curve was greater in the upper cross-section than the whole (0.911 vs. 0.807). Conclusions: As fatty degeneration of upper subscapularis demonstrated a more distinct spectrum than whole subscapularis, we suggest that measuring fatty degeneration of upper subscapularis can be a more useful method to predict clinical prognosis.

• Korean Journal of Occupational Health Nursing
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• v.14 no.2
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• pp.164-170
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• 2005

Purpose: The present study attempted to find subjective musculoskeletal symptoms of operating room nurses (OR nurses) and then to use them as basic data for prevention and management of musculoskeletal symptoms of OR nurses. Method: This study was an exploratory research, and data were collected from OR nurses working in 8 polyclinics in Korea from July 26 to August 19, 2004, using a self-report questionnaire. The questionnaire contains items concerned with subjective musculoskeletal symptoms include ones with the presence of symptoms and with the degree of discomfort, in the joints such as neck, shoulder, arm/elbow, hand/wrist/finger and waist. For data collection, the aim of the study was explained to the operating room managers to obtain their help, and these questionnaires were sent to hospitals, and were retrieved by post. 271(90.3%) questionnaires were returned among those sent to 300 nurses. 249 questionnaires excluding 22 insufficient ones such as no response were used for data analysis. Data were analyzed using SPSS WIN 12.0. Subjective musculoskeletal symptoms were analyzed in the number and percentage. Result: 187(75.1%) nurses said they 'had' subjective musculoskeletal symptoms and 62 (24.9%) said they had 'nothing'. 130(52.2%), 125 (50.2%), 113 (45.4%), 86(34.5%), and 42 (16.9%) nurses had subjective musculoskeletal symptoms in waist, shoulder, hand/wrist/finger, neck, and arm/elbow, respectively. 51(27.3%) and 136 (72.7%) nurses complained of the pain in one site, and in two or more sites, respectively. In particular, 51% and 47.4% nurses said that they were 'discomforted' due to the pain in waist and in shoulder, respectively. Conclusion: Subjective musculoskeletal symptoms which OR nurses complained of were significant. This may cause difficulty in nursing tasks in the operating room. So various arrangements have to be made for OR nurse with subjective musculoskeletal symptoms at an early stage.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.66-71
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• 1998

The fractures of lateral end of clavicle can be treated by conservative or operative treatment, but many authors report the higher rate of non-union with conservative treatment and that the operative treatment is more effective for the type II fractures. The authors reviewed and analysed 15 cases of lateral end fracture of clavicle which had been treated at Department of Orthopedic Surgery, Kyungpook National University Hospital from 1991 to 1996. The results were as follows; 1. Among the 15 patients, male was 6,female 9 and the average age was 46.2 years ranged from 21 to 72 years. 2. According to the classification by Rockwood, type II a was 8 cases and II b was 7 cases. 3. We treated operatively 12 cases, 9 cases with tension band wiring and 3 cases with intramedul-Iary K-wire fixation. And we treated conservatively 3 cases with Velpeau cast, but I case of nonunion was treated with tension band wiring. 4. The average follow-up was 3.2 years ranged from 2.1 to 4.7 years. 5. The functional results were evaluated with Weitzman's classification. 6. In the operatively treated cases, there were 4 cases(30.7%) in excellent, 7 cases(53.8%) in good and 2 cases(15.3%) in fair result. But, in the conservatively treated cases, there were 2 cases in good and I case in poor result, and the poor case did not united and had open reduction and internal fixation. 7. In conclusion, the operative treatment revealed good functional results in most cases (10/12) and early open reduction and internal fixation was better method than conservative treatment.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.1-7
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• 1999

Purpose : There has been considerable controversy as to the method of the treatment of acute acromioclavicular joint dislocation classified to type III injury. The purpose of this study is to compare the conservative and operative treatment of the type III acute acromioclavicular joint dislocation in terms of clinical and radiological results. Materials and Methods: We treated 31 cases of acute, type III acromioclavicular joint dislocation, 17 cases were treated by operative methods and 14 patients by conservative treatment, and 1 year minimum follow-up was done from January 1990 to January 1996. We used UCLA Shoulder Rating Scale for clinical results. And for the radiological results coracoclaviclar distance were measured. We used Fisher's exact test for statistical analysis of results between the two treatment methods. Results: Fifteen(88.2%) of seventeen patients in operative treatment and eleven(78.6%) of fourteen patients in nonoperative treatment were rated excellent or good on the UCLA rating scale. In radiographic evaluation, the average coracoclavicular distances of preoperative state, immediate postoperation(or postreduction) and last follow-up were as follows. In operative cases, it was 1.75±0.21mm, 1.14±0.24mm and 1.33± 0.22mm respectively. In nonoperative cases, it was 1.65±0.14mm, 1.26±0.26mm, and 1.42±0.27mm respectively. Conclusion : This study demonstrated that there was no significant difference in clinical and radiological results between the operative and nonoperative treatment groups. So, nonoperative treatment is recommended for acute type III acromioclavicular dislocation as general rule.