• Clinics in Shoulder and Elbow
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• 제23권3호
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• pp.131-135
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• 2020

Background: Resection of the radial head is a surgical indication for comminuted radial head fracture in which internal fixation is inaccessible. Some complications from the surgery can alter the function of the patient's elbow. The objective of this study was to assess functional outcome of the elbow after resection of the radial head. Methods: A retrospective longitudinal study was performed with patients who underwent radial head resection between 2008 and 2018. Elbow function was assessed by the Mayo Elbow Performance Index (MEPI) for 11 patients comprising three women and eight men. The mean follow-up was 47.6 months. The mean age was 41±10.3 years. Results: Nine patients had a stable and painless elbow. The mean extension-flexion arc was 97.73°±16.03°. The mean values of pronation and supination were 76.8° and 74.5°, respectively. The mean MEPI score was 83.2 points, and restoration of overall function was achieved in 81% of the cases. Poor function was noted in one in 10 that presented with a terrible triad. Conclusions: Resection of the radial head restored elbow functionality at a rate of 81%, which was a good outcome for patients.

• Journal of Korean Neurosurgical Society
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• 제45권5호
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• pp.306-308
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• 2009

The Mayfield head clamp is the most frequently used head clamp system in the field of neurosurgery. In many cases, surgery is performed with complete reliance on the safety of the MHC. However, we experienced an extremely rare case in which the MHC accidentally broke while installing this system for immobilization of the head and neck. This is a case report with a brief review of the literature. The patient was a 58-year-old female who was scheduled to undergo cervical laminoplasty under the diagnosis of degenerative spondylotic cervical stenosis. In an attempt to install an MHC, we fixed three pins in the scalp; however, the arm of the MHC system broke when force was applied from both directions. Fortunately, the patient remained in a stable position and did not sustain an injury to the head or neck. Fixation was performed using another MHC, and the surgery was performed successfully. The patient was discharged after surgery with no specific complications related to the MHC system. The authors experienced an extremely rare case of MHC breakage during application and report the importance of properly managing and maintaining the instruments in order to prevent fatal injury.

• 한국의학물리학회지:의학물리
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• 제13권1호
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• pp.9-14
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• 2002

두부 프레임을 지지하는 방식으로 pedestal mounting system과 couch mounting system의 장점을 수용한, 새로운 형태의 분할 정위방사선 치료 시스템을 개발하였다. 두부 고정을 위한 프레임은 두랄루민으로 제작하였고, 카우치에 부착되게 하였다. 프레임 내에서 환자의 두부를 고정하기 위해 치아 고정장치와 3.2 mm 열프라스틱으로 전두부와 후두부에 마스크를 제작할 수 있다. 정위 좌표 구현을 위한 전산화 단층촬영 localizer는 각 병원에서 많이 사용하고 있는 Brown-Roberts-Walls(B.R.W) 시스템을 사용할 수 있게 하여, 개발된 시스템의 신뢰성을 높이고 제작 단가도 낮추고자 하였다. 프레임 mounting system은 pedestal mounting system을 수정, 보완한 형태로 개발하였다. 시스템은 카우치를 지지하는 바닥 면에 고정되어 카우치에 부착된 프레임과 결합할 수 있고, 시스템과 카우치의 잠금 장치를 푼 채 자유롭게 x, y축으로 유동할 수 있다. 프레임 mounting system의 중심축은 상, 하 방향으로 이동 가능한 포인터 형태로 제작하여, 치료기의 구동 정확성을 검증하는 정도 관리에 응용 가능하다. 개발된 시스템의 재현성과 정확도 검증을 위해 아크릴 팬텀과 포인터를 제작하였고, 전산화 단층촬영 영상에서 획득한 팬텀 내 목표점의 정위 좌표를 dial-gauge와 E.C.L 필름으로 검증하였다. 실험의 결과 x축 방향의 재현성 오차는 0.71$\pm$0.19 mm, y축 방향은 0.45$\pm$0.15 mm, z축 방향 재현성 오차는 0.63$\pm$0.18 mm로 나타났고, 최대 1.3 mm 이내의 우수한 재현성을 보였다. 연구 결과로 개발된 분할 정위방사선 치료 시스템은 재현성이 우수하고, 전체 중량이 가벼워 사용하기 쉽게 제작되었다. 특히 수정된 pedestal frame mounting system으로 설계되어 후두부 방사선 조사가 가능한 장점이 있다.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.198-204
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• 1998

Unstable fractures of the proximal humerus continue to be difficult problems for orthopaedic surgeons. The optimum treatment of these fractures has remained a matter of controversy. We analyzed the clinical results of open reduction and plate fixation underwent for patients of unstable fractures of proximal humerus after minimum 12 months follow up. The purpose of this study is to evaluate the efficacy of open reduction and rigid plate fixation. Twenty-two patients were managed with open reduction and plate fixation. Mean follow up duration was 20.6 months(range, 12 to 28 mon.). Because the age of patient as a maker of degree of osteoporosis was considered the key factor in the success of anatomic reconstruction, we divided into two groups according to age. Group A was comprised of 12 cases with younger than 50 yrs of age. Ten cases of older than 50 yrs of age were Group B. According to Neer's classification, five cases(22%) were two part fracture, 12 cases(64%) were three part fracture, and three cases(14%) were four part fracture. We used the Neer rating system for evaluating the results. In Group A, overall scores were 79.1. In Group B, overall scores were 76.8. Overall scores in two part fracture were 85, overall scores in three part fracture 78.4 and overall scores in three part fracture 68.3. We achieved excellent or good results in nine cases(75%) of Group A and seven cases(70%) of Group B. Also, we obtained excellent or good results in all cases of two part fracture, ten cases(71%) of three fracture and one case(33%) of four part fracture. The complications were three metal loosening, one avascular necrosis of humeral head, one severe stiff shoulder, one superficial wound infection and one ectopic ossification. The results were excellent or good in 16 cases(73%) out of 22 cases. In conclusion, rigid fixation and supervised early exercise would be a good option for unstable fracture of the proximal humerus.

• 대한후두음성언어의학회지
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• 제25권1호
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• pp.36-38
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• 2014

The patient suffered cardiac arrest 8 months before presentation. She has been suffering hoarseness and exertional dyspnea and nocturnal stridor. Upon flexible laryngoscopy, her vocal cords showed no motion and fixed in paramedian position. There was no causal finding on neck CT. EMG showed some muscular activity. Under the suspicion of crico arytenoid fixation, we performed suspension laryngoscopy, and found the arytenoid cartilage was fixed with short and stout scar, which was removed with scissors. Just after surgery she regained her voice and respiration.

• Clinics in Shoulder and Elbow
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• 제17권3호
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• pp.127-133
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• 2014

Heterotopic ossification (HO) within the substance of the subscapularis tendon is a rare lesion which remains a poorly described condition with little known of the exact mechanisms involved. Furthermore, its clinical importance remains still unclear. To our knowledge, there are no studies present to data regarding HO within the substance of the subscapularis tendon, even with resultant isolated complete tear of the subscapularis tendon. Here we present a case of huge HO associated with unusual isolated complete tear of subscapularis tendon concomitant with tear of biceps long head tendon. After arthroscopic debridement for the complete tear site of biceps long head tendon, mini-open excision of the ossification and subscapularis repair with suture anchor fixation were performed. The patient showed complete recovery of strength and function of the subscapularis at subsequent 24 months follow up.

• 대한의용생체공학회:의공학회지
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• 제27권6호
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• pp.365-369
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• 2006

According to the IIHS (Insurance Institute fur Highway Safety), side impacts are made up 30% of all accidents (reported 1998). In the case of auto accidents, head and neck injuries were most common as 58%, injuries to the body's trunk equaled 32%, and injuries to the abdomen were 21%. Therefore in this study, injury of wheelchair occupant in frontal and side impact of wheelchair loaded vehicle was analyzed using computer simulation method. The occupant was restrained at the rear of wheelchair by the lap belt. The detailed fixation and restrain conditions of the wheelchair occupant are referred to SAR J2249's recommendation. We estimated HIC(Head Injury Criteria) and HNIC (Head and Neck Injury Criteria) based on measured data.

• Journal of Veterinary Science
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• 제21권4호
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• pp.62.1-62.7
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• 2020

A 5-month old Shih Tzu was diagnosed with congenital elbow luxation and uniapical complex angular deformity of the radius. Single radial oblique and dynamic ulnar osteotomies were performed, using patient-specific 3D-printed osteotomy guide. External skeletal fixation was maintained for three weeks to prevent re-luxation of elbow joint. Three months after the surgery, objective gait analysis indicated markedly improved limb function. In addition, radiograph showed improved congruity of elbow joint and appropriate bone healing. In dogs with congenital radial head luxation and concurrent complex angular deformity, a single oblique osteotomy might be a viable option to preserve bone length and correct the luxation of elbow joint.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권5호
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• pp.477-482
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• 2006

The new type of orthodontic mini-implant named C-implant can be an effective alternative to conventional one-component mini-implant in the intermaxillary fixation (IMF) cases because of its particular design. The small size, two-part design, efficiency, and low cost of the C-implant make it applicable to various types of IMF cases easily such as fracture reduction and orthognathic surgery. The two part design resists highly to the fracture or deformation during implantation and removal. The long span head allows the patient to easily attach intermaxillary elastics, so that the patient can apply intermaxillary elastics for traction easily. Through this article, we tried to show the possibility of this appliance as a good adjunct for the IMF screw.

• 대한두경부종양학회지
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• 제22권1호
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• pp.36-39
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• 2006

The Neurofibroma is a benign neoplasm originating from neural tissue such as Schwann cell, fibroblast and peripheral fibroblast, which rarely converts to malignancy. About 25-45% of neurofibroma are located in head and neck, and the most common sites are lateral cervical region and mouth. Because of its high vascularity and invasion to the adjacent organs, surgical resection may be confronted and limited, moreover large neurofibroma can cause large defect that needs various kinds of flap. The factors related to clinically suspected malignancy are painlessness, abrupt increase in size, firm fixation, and central ulceration, although the malignancy rate of neurofibroma is low. The complete resection was failed several times at local clinic, the patient was transferred to our hospital. We have successfully removed the retroauricular neurofibroma using transposition flap & free skin graft on its large defects.