• 제목/요약/키워드: Follow-Up System

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Freiberg병에서 시행한 Weil 절골술 (Weil Osteotomy for Freiberg's Disease)

  • 이화성;권순용;김동욱;정진화
    • 대한족부족관절학회지
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    • 제15권4호
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    • pp.217-222
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    • 2011
  • Purpose: The aim of this study was to evaluate the result of combined Weil and dorsal closing wedge osteotomy for Freiberg's disease. Materials and Methods: We performed combined Weil and dorsal closing wedge osteotomy of the second metatarsal under the diagnosis of Freiberg's disease in 7 patients, 7 feet (2 male and 5 female). The mean age at the time of operation was 29 years and the mean follow-up period was 31 months. Patients had no trauma history and no combined deformity of the foot. The surgical results were evaluated by VAS and weight bearing radiographs in antero-posterior and oblique projection. Results: According to Smillie staging system, there were 1 of stage II, 2 of stage III and 4 of stage IV patients. The osteotomy site was united at 8 weeks and the second metatarsal was shortened in length of average 2.8 mm. Remodeling of the metatarsal head was observed at 24 months. The mean VAS was decreased from 8.2 points preoperatively to 2.7 points at follow-up. And average range of motion of second metatarso-phalangeal joint was increased from 30o preoperatively to 45o at follow-up. There was no transfer metatarsalgia or arthritis of the metatarsal head during follow-up. Conclusion: Combined Weil and dorsal closing wedge osteotomy of the metatarsal appears to be an effective procedure for the treatment of Freiberg's disease with a view to shortening of metatarsal length and elevation of metatarsal head.

탈구를 동반한 족관절 골절에서 수술적 치료 후 최소 2년 추시 결과 (Operative Treatment of the Ankle Fracture with Dislocation: Minimum 2-year Follow Up Results)

  • 조승환;이준영;조성원;박치형
    • 대한족부족관절학회지
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    • 제17권1호
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    • pp.28-33
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    • 2013
  • Purpose: In previous study, the frequency of osteoarthritis and discomfort were high in ankle fracture-dislocation but detail results about ankle fracture-dislocation has rarely been investigated. In this study, we retrospectively analyze the outcome of the operative treatment of ankle fracture with dislocation for over-2 years follow up. Materials and Methods: There were 47 cases of ankle fracture-dislocation in our hospital from March 2007 to May 2010. We investigated 20 patients who underwent operation and were possible for over-2 years follow up. The result was estimated with the direction of dislocation, fracture type, the time of bone union and post-traumatic osteoarthritis with plain radiologic images. In clinical assessment, we statistically evaluated the function and pain through AOFAS score and Olerud & Molander scoring system. Results: By Lauge-Hansen classification, there were 13 cases(65%) of pronation-external rotation and 6 cases(30%) of supination-external rotation, 1 case(5%) of supination-adduction. AOFAS score was 85.5, and Olerud & Molander score was "excellent" in 8 cases, "good" in 5 cases, "fair" in 3 cases and "poor" in 4 cases. Postoperative complications in 4 cases revealed post-traumatic arthritis. All kinds of lateral dislocation of ankle fracture was 15 cases and the most common. Of these, all 3 cases, anterolateral dislocation showed post-traumatic osteoarthritis. Conclusion: In ankle fracture-dislocation, post-traumatic osteoarthritis occurred in 4 of 20 patient(20%). Especially, the possibility of post-traumatic osteoarthritis was more in cases of anterolateral or lateral dislocation. So, it must be needed that deliberate examination, for example, preoperative MRI and sufficient explanation to patient. Also, we have to follow up the patients carefully.

경부운동훈련이 외상 후 스트레스 장애 환자의 경부통증 수준, 우울 요인에 미치는 영향 (The Impact of The Cervical Exercise Training on Post-traumatic Stress Disorder Patient's Cervical Pain Levels and Depression Factor)

  • 박성두;신영일;김명준
    • 대한정형도수물리치료학회지
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    • 제21권1호
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    • pp.37-42
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    • 2015
  • Background: This study investigates the impact of the cervical musculoskeletal intervention on post-traumatic stress disorder patient's cervical pain levels and depression factor. Methods: Thrty neck pain patients diagnosed with post-traumatic stress disorder were enrolled. Neck exercise training using a sling system was applied to the experimental group and self-neck movement exercise, modification of the McKenzie exercise, was applied to the control group. Both groups were checked every week whether they performed or not. Both groups performed their exercise for 35 minutes for a time and 3 times per week. Total period of the intervention was 6 weeks. To compare the effects of interventions, threshold of cervical tenderness and depression level were measured before and after the each intervention and also measured at follow-up. Results: Painthreshold of left trapezius showed a significant difference between two groups at three points. It increased 19.71% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 20.06% in the experimental group. Pain threshold of right trapezius showed a significant difference at three points. It increased 18.35% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 15.93% in the experimental group. According to the result interaction between groups and measurement time in both side of trapezius was valid. Depression level showed significant difference in the experimental group between three points. It decreased 18.07% after the intervention compared to before the intervention and decreased 15.21% at follow-up. According to the result interaction between groups and measurement time in depression level was valid. Conclusions: This study has important implications as the therapeutic strategy, high potent of improving symptoms, shows effect to a subject who has psychological problem such as posttraumatic stress disorder (PTSD).

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치성 각화 낭종의 술후 재발양상과 추적관찰 기간의 제안 (POSTOPERATIVE RECURRENCES OF ODONTOGENIC KERATOCYST : THE BEHAVIOR AND PROPOSAL OF CRITICAL FOLLOW-UP PERIOD)

  • 박세현;김남균;김기호;강상훈;박형식;김형준;차인호;남웅
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권4호
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    • pp.456-459
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    • 2008
  • Post-operative recurrence of cystic lesion is a great concern for clinician, patients, and their family, especially in case of odontogenic keratocyst, which has aggressive behavior and high recurrence rate. The purpose of this study was to evaluation clinical characters of OKC, focusing of the recurrence rate and proposed critical follow-up period. 58 cases (aged 9 to 66, 33 males and 25 females) of OKC were reviewed for sex of patients, location, size, operative procedure type, radiographic findings, histopathologic findings, post-operative recurrence time, from 2000 to 2005 at Yonsei Medical Center, were selected. The computerized statistical analysis was carried out with SAS system. 18 of 58 cases (31.03%) were recurred and this study revealed no statistically significant difference in recurrence rate for sex, location, size, radiographic findings, histopatologic findings, operative procedure type, recurrence timing. 3 out of 18 cases (16.7%) showed one or more recurrence. This was statistically significant difference (P=.0264). In this study, 15 of 18 cases (83.3%) were observed recurrence during 4 years after removal of the OKCs, we suggest critical follow-up period during 4 years after operation.

봉합 불가능한 광범위 회전근 개 파열에서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 장기 추적 관찰 결과 (Result of a Long-Term Follow-Up of Arthroscopic Partial Repair for Massive Irreparable Rotator Cuff Tears Using a Biceps Long Head Auto Graft)

  • 고상훈;박기봉;박길영;권순환;김명서;박선재
    • 대한정형외과학회지
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    • 제55권2호
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    • pp.135-142
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    • 2020
  • 목적: 본 연구에서는 봉합 불가능한 광범위 회전근 개 파열에 있어서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 임상적 유용성 및 장기 추시 결과를 발표하고자 한다. 대상 및 방법: 봉합 불가능한 광범위 회전근 개 파열 환자 중 상완 이두근 건 장두에 50% 미만의 파열이 있는 41명의 환자를 대상으로 상완 이두근 건 장두를 이용하여 관절경하 부분 봉합술을 시행받은 1군과 파열되지 않은 상완 이두근 건 장두가 있으나 자가 이식건을 이용하지 않고 관절경하 부분 봉합술만을 시행한 2군으로 나누었다. 임상 점수는 시각통증점수(visual analogue pain scale, VAS), 운동범위(range of motion, ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES) 및 Korean Shoulder Scoring System (KSS) 점수로 측정하였으며 최종 추시에 측정된 점수가 사용되었다. 수술 전과 최종 추시에 촬영한 단순 방사선 사진을 이용하여 견봉상완거리(acromiohumeral interval, AHI)를 측정하였고 최종 추시에 시행한 초음파 또는 자기공명영상 검사를 이용하여 재파열 여부를 평가하였다. 결과: 환자의 평균 연령은 62.1±12.7세였으며, 평균 추시 기간은 90.3±16.8개월이었다. 1군과 2군 간에 VAS와 ROM (전방 거상, 외회전, 내회전)의 유의한 차이는 없었다(p=0.179, p=0.129, p=0.098, p=0.155). UCLA, ASES 및 KSS 점수는 2군과 비교해 1군에서 기능적 개선을 보였다(p=0.041, p=0.023, p=0.019). 최종 추시 시 AHI는 1군 9.46±0.41 mm, 2군 6.86±0.64 mm로 측정되었다(p=0.032). 재파열은 1군 21예 중 6예(28.6%), 2군 20예 중 9예(45.0%)에서 발견되었다. 1군의 경우 2군에 비하여 유의하게 낮은 재파열률을 보였다(p=0.011). 결론: 본 연구에서는 봉합이 불가능한 광범위 회전근 개 파열이 있는 환자들에게 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술을 시행하여 장기 추시한 결과, 상완 이두근 건 장두를 사용하지 않은 군에 비하여 기능적 향상 및 낮은 재파열률을 보인다. 따라서 이는 봉합 불가능한 광범위 회전근 개 파열이 있는 환자에서 좋은 수술적 방법으로 생각된다.

Novalis Shaped Beam Radiation Treatment for Craniopharyngiomas

  • Yee, Gi-Taek;Han, Seong-Rok;Yoon, Sang-Won;Choi, Chan-Young;Lee, Dong-Joon;Whang, Choong-Jin
    • Journal of Korean Neurosurgical Society
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    • 제40권4호
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    • pp.245-248
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    • 2006
  • Objective : To evaluate the effectiveness of Novalis shaped beam radiation treatment as an adjuvant treatment in patients with craniopharyngiomas. Methods : We reviewed 8 patients with craniopharyngiomas who had recurring tumors during follow-up or had residual lesions after primary surgery. Three of 8 patients were found to have recurrence after gross total excision of the tumor and 5 patents had residual lesions after subtotal resection. All patients were treated with fractionated stereotactic radiation treatment[FSRT] using Novalis system. The mean age of patients was 28 years [range $16{\sim}52$]. The median irradiation dose per fraction was 17Gy [range $1.7{\sim}2.0$]. The median fraction number was 23 [range $15{\sim}25$], and the median total dose was 39.1 Gy [range $25.5{\sim}42.5$]. Follow-up included MR imaging, and ophthalmologic and endocrine examinations. Results : The median follow-up period was 23 months [range $12{\sim}43$]. The local tumor control rate was 87.5%. One patient had a recurring tumor, in which cystic change developed 2 months after FSRT. Four patients showed a decrease in size of their tumor, while 3 patients remained stable. Seven out of 8 patients had hormonal dysfunction that remained unchanged after initial surgery. No further progression of visual impairment was observed. Conclusion : FSRT using Novais system is effective and safe for the treatment of recurring or residual craniopharyngiomas without toxicity like optic neuropathy.

남북상사중재 제도 활성화를 위한 남북협력방안 -북한의 대외경제중재법(1980) 평가를 중심으로- (A Study on Cooperation Ways of South-North Korea for Revitalization of Inter-Korean Commercial Arbitration System - Centering around Evaluation of the Foreign Economic Arbitration Act(2008) of North Korea -)

  • 김광수
    • 한국중재학회지:중재연구
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    • 제21권1호
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    • pp.259-277
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    • 2011
  • In 2008, North Korea revised its Foreign Economic Arbitration Act. To some extent, the new Act reflected such international standard of arbitration as UNCITRAL Arbitration Rules. In this paper, the said Act will be evaluated, and then cooperation ways of South-North Korea on Inter-Korean Commercial Arbitration will be suggested. In 2007, the Ministry of Unification has designated the Korean Commercial Arbitration Board as Inter-Korean Arbitration Committee and has made efforts to prepare follow-up measures on the two Agreements of Inter-Korean Commercial Arbitration. In 2008 however, the follow-up measures has in fact been suspended. In order to revitalize the Inter-Korean commercial arbitration, some prerequisites must be satisfied. First, Inter-Korean Arbitration Committee for Inter-Korean commercial arbitration should re-open as soon as possible. Second, as North Korea recently shows interest in joining the New York Convention on the Recognition and Enforcement of Foreign Arbitral Awards(now so called New York Convention), Governmental Authority of Rep. of Korea should also actively assist and support their joining in New York Convention. Third, both Korean governments should carry out joint study on raising the efficiency of the arbitration system which they will use. Fourth, comparative study on arbitration systems used in both countries should be conducted. Also, it may is very timely to discuss the issue in international arbitration community such as "North-East Asia International Arbitration Conference" or other similar events. In conclusion, continuous study on prevention of commercial disputes between South-North Korea and ways to resolve disputes when they arise should be conducted.

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Adult Patients with Congenital Muscular Torticollis Treated with Bipolar Release : Report of 31 Cases

  • Lee, Gun Sang;Lee, Myung Ki;Kim, Woo Jae;Kim, Ho Sang;Kim, Jeong Ho;Kim, Yun-Suk
    • Journal of Korean Neurosurgical Society
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    • 제60권1호
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    • pp.82-88
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    • 2017
  • Objective : We assessed the surgical results of bipolar release in 31 adult patients with uncorrected congenital muscular torticollis (CMT) and more than 12 months of follow-up. Methods : Thirty-one patients underwent a bipolar release of the sternocleidomastoid muscle (SCM) and were retrospectively analyzed. The mean follow-up period was 14.9 months (range, 12-30). The mean age at time of surgery was 30.3 years (range, 20-54). Patients were evaluated with a modified Lee's scoring system, cervicomandibular angle (CMA) measurement, and a global satisfaction rating scale using patient self-reporting. Results : The modified Lee's scoring system indicated excellent results in 4 (12.9%) patients, good in 18 (58.1%), and fair in 9 (29.0%) at the last follow-up after surgery. The improvements in neck movement and head tilt were statistically significant (p<0.05). The preoperative mean CMA was $15.4^{\circ}$ (range, 5.4-29.0), which was reduced to a mean of CMA of $6.3^{\circ}$ (range, 0-25) after surgery (p<0.05). The global satisfaction rating scale was 93.7% (range, 90-100). A transient sensory deficit on the ipsilateral lower ear lobe was noted in three cases. No significant permanent complications occurred. Conclusion : Bipolar release of the SCM is a safe and reliable technique for the treatment of CMT in adults.

노부모 부양자 교육프로그램의 적용과 효과 (A Study on the Implementation of an Educational Program for Caregivers)

  • 이성희;이승미
    • 가정과삶의질연구
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    • 제21권1호
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    • pp.25-36
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    • 2003
  • This study was conducted to reconstitute a family life education program for caregivers and to analyze the system of implementation. Based largely on a pre-existing program for caregiving families, I developed a new educational program. Personal time management and personal needs management were added in the content of the program order to help enhance self-esteem and internal control. The reconstituted educational program, which consists of 6 sessions, was implemented on a small group of caregivers in Jeollabukdo Province who support their elderly parents. The effectiveness of the program was evaluated by a pre-test, a post-test, a follow-up test and open-questionnaire reports. The results from the post-test suggest that the program has been effective in improving the knowledge on aging process, internal control and self-esteem. But the follow-up test results show the program has been effective only in improving the knowledge on aging process. According to the open-questionnaire reports, the program seems to have been effective in improving interpersonal relationships and changing attitudes toward their elderly parents.

부부폭력 개입 프로그램의 과정평가와 추후평가 (Procedure Evaluation and Follow-up Evaluation on the Conjugal Violence Intervention Program)

  • 이정연
    • 한국생활과학회지
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    • 제12권5호
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    • pp.647-658
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    • 2003
  • This research was focused on evaluating the intervention program for preventing the recurrence of conjugal violence. It was based on family system perspectives because the conjugal violence was considered as the result of dysfunctional interactions between spouses. Especially, a follow-up study was conducted by the telephone interview one year later after the program ended. There were some findings as follows: First, the physical violent behaviors never reoccurred, but the verbal ones still continued. Second, this program had an effect on decreasing the recurrence of conjugal violence.

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