• 대한관절경학회지
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• 제12권1호
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• pp.1-6
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• 2008

목적: 자가 슬괵건과 자가 슬개건을 이용한 관절경적 전방 십자 인대 재건술의 결과를 비교하였다. 대상 및 방법: 2000년 1월부터 2004년 12월까지 자가 슬괵건과 자가 슬개건을 이용하여 전방 십자인대 재건술을 시행한 각각 60명의 환자군을 대상으로 하였다. 추시기간은 슬건 군은 평균 42개월(범위$24{\sim}69$개월)이였으며 슬개건 군은 평균 51개월(범위 $24{\sim}84$개월)이었다. 술 전과 최종 추시에 이학적 검사로 수술 전 후 관절운동범위를 측정하였으며, Lachman 검사 및 pivot shift 검사를 실시하였다. 환자의 활동도와 만족도, 기능적 상태는 전방 슬관절 통증 여부, Lysholm 점수, IKDC 활동도 등급, Tegner 활동도 점수를 조사하였으며 KT-2000 arthrometer를 이용하여 전방 안정성을 객관적으로 평가하였다. 결과: 최종 추시점에서 자가 슬괵건과 슬개건을 이용하여 관절경적 전방 십자 인대 재건술을 시행한 군들 간의 비교에서, Lachman 검사는 음성 또는 경도의 양성이 각각 51예(85%)와 54예(90%)였으며, Pivot shift 검사에서는 각각 5예(8%)와 3예(5%)에서 양성으로 양군 모두 차이가 없었다.(p>0.05) 최종 추시시 KT-2000 검사에서 건측과 비교한 최대 도수 전방 전위차는 3 mm미만이 각각 51예(85%), 54예(90%)였다. Lysholm 점수는 슬괵건군은 평균 51.0점에서 평균 79.1점으로, 슬개건 군은 평균 52점에서 평균 82.2점으로 호전되었으며, IKDC 활동도 등급은 술후 각각 52예(87%)와 50예(83%)에서 정상 또는 거의 정상 소견을 보였다. Tegner 활동도 검사도 슬괵건 군에서 평균 4.8점에서 평균 7.1점으로, 슬개건 군은 평균 4.5점에서 평균 7.3점으로 호전되었다. 또한 전방 슬관절 동통은 슬괵건군 4예(7%), 슬개건군 6예(10%)에서 관찰되었다. 결론: 자가 슬괵건 또는 자가 슬개건을 이용한 관절경적 전방 십자 인대 재건술 후 추시 결과, 두 군 모두 우수한 결과를 보였으나 두 군 간에 최종 추시시의 결과는 통계적으로 유의한 차이가 없었다.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.107-111
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• 2005

Backgrounds: To evaluate the effectiveness of conservative treatment in osteoporotic thoraco-lumbar compression fractures and to identify the factors influencing the progression of compression. Materials and Methods: From January 2003 to October 2004, Patients who were admitted to our hospital for osteoporotic thoraco-lumbar compression fractures were reviewed retrospectively with follow-up more than 12 months (ave. 14.6 months). With simple x-ray lateral view, we evaluate wedge compression ratio (WCR) and kyphotic angle (KA) at initial and final follow-up. We separate the patients into two groups baesed on the amount of progression of vertebral compression and evaluate a relation with BMD, vertebral fracture level, initial WCR, initial KA. All datas were statistically analyzed. Results: An average of T-score was -3.5 and the changes of KA between initial and final follow-up were average $3.5^{\circ}$. Compression of anterior column were progressed to 8.5%. The changes between initial and final WCR in Group I (N=24) was 17.8%, and Group II (N=18) was 3.3%. T-score in group I was -3.4 and group II was -3.8 (p=0.228). vertebral fracture level were 10 T12, 12 L1, 2 L2 in group I; 6 T12, 6 L1, 6 L2 in group II (p=0.156). Initail WCR was 0.74 in group I, 0.63 in group II, and there was statistical difference between two groups(p=0002). Initial kyphotic angle was $13.9^{\circ}$in group I, $16.2^{\circ}$in group II repectively (p=0.392). Conclusion: The conservative treatment with short-term bed rest and early embulation is effective and valuable method to patients who have osteoporotic thoraco-lumbar compression fractures. There was no statistical difference between two groups according to BMD, vertebral fracture level, KA. But in comparison with initail WCR between two groups, there was statistical difference. That means, in the case of small initial compression of anterior column, the progression of compression was bigger than else. In these patients, more strict use of appropriate brace and careful follow-up should be needed.

• Journal of Acupuncture Research
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• 제26권4호
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• pp.29-37
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• 2009

Objectives : This study was to investigate the effectiveness of Bee Venom Pharmacopuncture complex therapy on peripheral facial paralysis. Methods : We investigated 30 cases of patients with Peripheral Facial Paralysis, and devided patients into two groups : We treated one group by complex oriental medical treatment with Bee Venom Pharmacopuncture therapy, and did the other group by complex oriental medical treatment without Bee Venom pharmacopuncture therapy. To investigate the effectiveness of treatment applied for two groups, we used Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System at baseline, 3 weeks and final. Results : 1. Male, Female is same ratio in distribution of sex, the number of left side is more than that of right side in distribution of lesion, the average age is 49.33. 2. Pain back of the ear showed the highest frequency among Bell's palsy related symptoms at onset, the overwork was a major cause of Bell's palsy in distribution of cause. 3. As a result of evaluation by using Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System, treatment score after 3weeks was marked higher than that before treatment and treatment score after final treatment was also marked higher than that after 3weeks within each group. 4. After final treatment, Bee Venom Pharmacopuncture therapy group showed signficant difference on Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System compared with Acupuncture therapy group. Conclusions : Bee Venom Pharmacopuncture therapy can be available for relieving symptoms related with peripheral facial paralysis.

• Clinics in Shoulder and Elbow
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• 제20권4호
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• pp.230-235
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• 2017

Background: Neer type II distal clavicle fractures have the drawback of coracoclavicular instability and insufficient distal bony fragment, thereby making it difficult to achieve adequate fixation. Although various surgical treatments have been described for Neer type II fracture, the optimal treatment remains controversial. This study reports the clinical results and usefulness of anatomical locking plate with additional K-wire fixation. Methods: A totally of 21 patients with type II distal clavicle fracture were included in the study. The surgical procedure reduced the fracture temporarily; it included insertion of one or two K-wire from the lateral margin of the distal fragment to the proximal fragment through the fracture site, followed by application and fixation of the locking plate. The bony union and migration of K-wire was evaluated in the follow-up radiography. The coracoclavicular distance and acromioclavicular joint arthrosis were assessed at the final follow-up. The Constant Score (CS) and Korean Shoulder Score (KSS) were evaluated for clinical scoring. Results: Bone union was achieved in all cases. At the final follow-up, coracoclavicular distance of the injured shoulder was increased, as compared to the intact shoulder (p=0.002), with no accompanying clinical symptoms. No K-wire migration was observed. At the final follow-up, K-wire irritation was observed in two cases and acromioclavicular arthrosis in one case, with no other adverse effects. Pain visual analogue scale, CS, and KSS were improved in all cases. Conclusions: The method of anatomical locking plate with additional K-wire fixation could be useful in achieving beneficial clinical results.

• Clinical and Experimental Pediatrics
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• 제61권7호
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• pp.221-225
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• 2018

Purpose: Congenital hypothyroidism (CH) is the most common endocrine disorder in children. Thyroid hormone deprivation results not only in mental retardation but also growth retardation. This study investigates the final height (FH) in Korean patients with CH detected by newborn screening and examines factors that may affect the FH. Methods: The medical records of Korean CH patients (n=45) were reviewed. The FH was examined and target height (TH) was calculated based on mid-parental height. The FH z score (FHZ) and TH z score (THZ) were computed using the 2007 Korean National Growth Chart. The FHZ and THZ were compared with a Student t test. The impact of the etiology of CH (athyreosis, dyshormonogenesis, ectopic thyoid, hypoplastic thyroid), initial serum thyroid stimulating hormone (TSH) level, initial free thyroxine (T4) level, and time of therapy initiation based on FH was assessed. Results: The mean FHZ was $0.10{\pm}1.01$ for male patients and $-0.11{\pm}1.09$ for female patients. There were no significant differences between FHZ and THZ for both female (P=0.356) and male patients (P=0.237). No significant relationship was found between FH and the etiology of CH, initial TSH level, initial free T4 level, and the time of therapy initiation. Conclusion: Early intervention and satisfactory management do not appear to impede growth in Korean patients with CH. Thus, early detection and proper management of patients with CH detected by newborn screening program are necessary.

• Journal of Korean Neurosurgical Society
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• 제41권5호
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• pp.291-294
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• 2007

Objective : The purpose of this retrospective clinical study was to describe a treatment for osteoporotic burst fracture in the setting of severe fractures involving fragmentation of the posterior wall and neural compromise with symptoms of cord compression. Methods : Indication for microscopic decompression and open kyphoplasty were intractable pain at the level of a known osteoporotic burst fractures involving neural compression or posterior wall fragmentation. A total of 18 patients [mean age, 74.6 years] with osteoporotic thoracolumbar burst fractures [3 males, 15 females] were included in this study. In all cases, microscopic decompressive laminectomy was followed by open kyphoplasty. Clinical outcome using VAS score and modified MacNab's grade was assessed on last clinical follow up [mean 6.7 months]. Radiological analysis of sagittal alignment was assessed preoperatively, immediately postoperatively, and at final follow up. Results : One level augmentation and 1.8 level microscopic decompression were performed. Mean blood loss was less than 100 ml and there were no major complications. The mean pain score before operation and at final follow up was 7.2 and 1.9, respectively. Fourteen of 18 patients were graded as excellent and good according to the modified MacNab's criteria. Overall, 6.0 degrees of sagittal correction was obtained at final follow-up. Conclusion : The combined thoracolumbar microscopic decompression and open kyphoplasty for severe osteoporotic fractures involving fragmentation of posterior wall and neural compromise provide direct visualization of neural elements, allowing safe cement augmentation of burst fractures. Decompressive surgery is possible and risk of epidural cement leakage is controlled intraoperatively.

• Clinics in Shoulder and Elbow
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• 제21권3호
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• pp.127-133
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• 2018

Background: This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. Methods: This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant's score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. Results: Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34-74). Mean follow-up duration was 24 months (range, 12-40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up ($p{\leq}0.001$ for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. Conclusions: Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.

• 대한족부족관절학회지
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• 제9권1호
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• pp.52-58
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• 2005

Purpose: To analyze the overall clinical outcome, overall assessment, and patient's satisfaction rate of subtalar arthrodesis using the cannulated compression screw. Materials and Methods: This study is based on 17 patients, 17 feet who underwent subtalar arthrodesis using the cannulated compression screw from March, 1997 to March, 2004 with at least 1 year follow-up. The average follow-up period was 33.0 months (12 to 72 months). Functional results were assessed using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS) score, and Visual Analysis Scale (VAS) pain score, patients' returning to previous occupation and patients' satisfaction rate were also evaluated. Results: The mean AOFAS scores at final follow-up were 80.4 points (range $66{\sim}92$). The satisfactory rates were as follow. Thirteen patients (76.4%) were at least satisfied with surgical result at final follow-up. Patients' VAS pain score was average 2.8 points ($1{\sim}6$). Fourteen (82.3%) patients returned to previous job at mean postoperative period of 11.3 months (range 3-18 months). Patients' work efficiency after returning to previous occupation was 68.7% (range $33{\sim}100%$). There were 9 complications which were 3 cases of sural nerve injury, 1 case of valgus malunion, and 5 cases of the hindfoot residual pain. Conclusion: We obtained the satisfactory functional results with relatively high patient satisfaction rate of 76%. So we conclude that subtalar arthrodesis using the cannulated compression screw is a reliable method for addressing the painful end-stage subtalar osteoarthritis and unreconstructible comminuted calcaneal fractures. However we also found out that average 11 months were necessary for patients to return to their job.

• 대한족부족관절학회지
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• 제14권2호
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• pp.123-129
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• 2010

Purpose: To evaluate the efficacy of the arthroscopic exploration combined with modified Brostrom operation (MBO) for the treatment of chronic lateral ankle instability (CAI). Materials and Methods: Sixty patients who diagnosed a CAI were performed MBO. We divided to 2 groups, whether simultaneously inspected by arthroscopy (group B) or not (group A). The both group's results were compared according to American Orthopedic Foot and Ankle Society Ankle-hindfoot score (AOFAS), functional ankle score and visual analog scale (VAS) at preoperative and final follow-up period. Results: There were no significant differences of AOFAS, functional ankle score and VAS between both groups at final follow-up. However, in group A, 2 cases associated with medial ankle instability and syndesmotic injuries were did not diagnosed preoperatively, showed poor prognosis. In group B, one case had a permanent peroneal nerve symptom. The match rate of intra-articular lesions between preoperative diagnosis and postoperative arthroscopic diagnosis was 30% in group B. Conclusion: Combination of arthroscopic exploration and MBO is effective strategy for intra-operatively discrimination of intra-articular associated lesions for CAI.

• 한국식품영양학회지
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• 제29권5호
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• pp.818-827
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• 2016

This study was conducted to develop and validate the Sugar Intake Reduction Test (SIRT) for young children, and included eating behaviors, attitude, and nutritional knowledge about sugars. A draft version of the SIRT was developed after literature review. The final draft of the SIRT was established after two pilot tests of 5 year old children and an expert group's review, and is comprised of a one on one test between an investigator and a child using picture tools. It contained of 20 questions which included 3 components: eating behaviors (5 items), preference for sugar sweetened food (10 items), and nutritional knowledge about sugars (5 items). The final SIRT was conducted on 181 children 5 (n=100) to 6 (n=81) years old, to examine its item and test adequacies. The passing rate of most items significantly increased with increasing age, and most of the item discrimination also differed significantly between the below and upper score groups. The content validity was given a high score by professionals (mean score 3.9 out of 4). Reliability of all the items in the SIRT was high (Cronbach's ${\alpha}=0.82$). Moreover, the total component and the sub-component scores of the SIRT correlated significantly. Our results indicate that the SIRT is a valid tool to measure sugar intake reduction in young children aged 5~6 years.