Purpose: To analyze the clinical and radiologic results of the shoulder arthrodesis in brachial plexus injury patients with flail upper extremity. Material and Method: From Aug 1978 to April 2008, 29 shoulders in 29 patients with brachial plexus injury with shoulder fusion, we evaluated 20 shoulders in 20 patients, more than 1 year follow up. The average follow-up period was 6.45years (range: 1year~24years). There were 13 men and 7 women, and the mean age at the time of trauma was 32.0years(2~65 years). The type of injury was a motorcycle accident in 11 patients, in car accident in 5, pedestrian accident in 3, and fall from a height in 1. The lesion of injury was root and trunk in 1 patient, trunk and cord in 1, trunk in 18. Surgery was performed on the whole arm type paralysis in 12 patients, lower arm type paralysis in 8 patients. The preoperative visual analog scale score was 8.7(7~10). When the trapezius and serratus anterior muscle were in function, operation was performed. 18 patients were processed to the additional operation. Gracilis free flap in 6 patients, neurotization in 3, Steindler flexor plasty in 6, and tendon transfer in 3 were performed. Fixation was conducted with cancellous screws in 13 patients, Knoles pins in 5, and cancellous screws and Knoles pins in 2. The position of the arthrodesis at operation was $28.5^{\circ}$($20~45^{\circ}$) in abduction, $30.3^{\circ}$($20~45^{\circ}$) in flexion, and $30.8^{\circ}$($20~40^{\circ}$) in internal rotation. Result: The follow up visual analog scale score was 3.4(0~7). Postoperatively, shoulder spica cast was applied for 15.3weeks(8-20weeks). The median time to bony union was 17.7weeks(9~28weeks). Average range of motion was $32.0^{\circ}$($15~40^{\circ}$) of abduction, $24.0^{\circ}$($10~40^{\circ}$) of flexion, and $18.5^{\circ}$($10~30^{\circ}$)of internal rotation. Conclusion: The shoulder fusion in brachial plexus injury patients is one of the good methods to relieve pain, improve the function and stabilize the flail shoulder joint.
Objectives The purpose of this study was to know the effects of Danggwisayeok-tang (Dangguisinitang) extract (DGSYT) on monosodium iodoacetate (MIA)-induced rat osteoarthritis. Methods For this purpose, rats were divided into 5 groups. Normal group was not injected with MIA and orally administered any medication. Control group was injected with MIA and not orally administered any medication. DGSYT100 group was injected with MIA and orally administered 100 mg/kg of DGSYT. DGSYT300 group was injected with MIA and orally administered 300 mg/kg of DGSYT. JoinsT group was injected with MIA and orally administered 20 mg/kg of Joins tablet. DGSYT100 and DGSYT300 groups were orally administered DGSYT during a week before and 3 weeks after based on the day MIA injected. The changes of hepatotoxicity, nephrotoxicity, relative hind paw weight distribution, cytokine in serum, cytokine messenger ribonucleic acid (mRNA) in joint tissue and histopathological observation (Hematoxylin & Eosin and Safranin-O staining) were measured. Results Alanine aminotransferase (ALT) levels of DGSYT100, DGSYT300 and JoinsT groups were increased significantly, but these results were within normal range. Aspartate aminotransferase (AST) and creatinine levels of all groups were not changed significantly. In the change of relative hind paw weight distribution, DGSYT300 and JoinsT groups were decreased significantly 14 and 21 days after MIA injected. Interleukin-$1{\beta}$ (IL-$1{\beta}$) and Interleukin-6 (IL-6), Leukotriene $B_4$ and Osteocalcin levels of DGSYT300 and JoinsT groups were decreased significantly. In measurement of IL-$1{\beta}$ and nitric oxide synthase-II mRNA relative quantitative of control, DGSYT100, DGSYT300 and JoinsT groups were decreased significantly. In measurement of TNF-${\alpha}$, IL-6 and Cyclooxygenase-2 mRNA relative quantitative of control, DGSYT300 and JoinsT groups was decreased significantly. In histopathological observation of knee, synovial tissue, cartilage and proteoglycan of DGSYT100, DGSYT300 and JoinsT were well preserved compared with control group. Conclusions According to the results, DGSYT has anti-inflammation and pain relief effects. So it should be suppressed progression of arthritis in MIA-induced osteoarthritis rat.
Journal of the korean academy of Pediatric Dentistry
/
v.42
no.3
/
pp.242-248
/
2015
Maximum mouth opening is regarded as an important tool used to evaluate the clinical function of temporomandibular joint and the masticatory system. It has been reported that children can also exhibit severe dysfunction or pain in some cases of temporomandibular disorder. The purpose of this study was to measure the normal maximum mouth opening in Korean children and to analyze the correlations between mouth opening and the associated factors. Maximum mouth opening was measured from 151 healthy children between the ages of 2 and 6 years old. Age, height, weight, and mouth width were also recorded. As a result, the mean maximum mouth-opening was $37.72{\pm}5.10mm$. While the values were greater in boys than in girls without statistical significance, the increases of maximum mouth opening based on age, height, weight, and mouth width were significant (p < 0.05). In children, positive correlation coefficients were observed between maximum mouth opening and the associated factors and height showed the highest correlation. In conclusion, we collected data of the normal range of maximum mouth opening in Korean children, and this study can be utilized as a basis in diagnosing pediatric temporomandibular disorder and safety standard of mouth opening during dental procedures.
Study of the fourteen meridians that include name of P'ung(風) point. The results were summarized as follows. 1. Pyongp'ung(秉風) is located middle of the supraspinatous fossa(Small intestine Meridian, 手太陽小腸經). we can cute the local area disease and also use to cure the pathway of the Arm greater yang small intestine which is attacked by P'ung(風) disease. 2. Yep'ung(翳風) is located behind the lobule of the auricle, in the depression between the mastoid process and the mandible(Triple Energizer Meridian, 手少陽三焦經). we can cure the local area disease especially hyper yang disease and also use to cure the pathway of the Arm lesser yang triple energizer which is attacked by P'ung(風) and Yo'l(熱) disease. 3. P'ungmun(風門) is located 1.5 chon beside the lower end of the spine of the second thoracic vertebra(Bladder Meridian, 足太陽膀胱經). we can cure the local area disease and also use to cure the pathway of the Leg greater yang bladder which is attacked by P'ung(風) disease. 4. P'ungbu(風府) is located 1 chon above the middle of natural line of the hair at the back of the head, in the depression below the occiptal protuberance(Governor meridian, 督脈). It connects (Liver meridian, 足厥陰肝經) and Yin Link Vessel(陽維脈). we can cure the rigidity and pain in head and nape which is related Yin Link Vessel(陽維脈). 5. P'ungshi(風市) is located on the lateral part of the thigh, 7 hon above the patella(From the greater trochanter to the knee joint is 19 chon, Gallbladder Meridian (足少陽膽經). we can cure the local area disease(leg, knee, etc). 6. P'ungji(風池) is located Below the occipital bone, in the depression on the outer part of the trapezius muscle(Gallbladder Meridian, 足少陽膽經) on a level with P'ungbu(風府) (Governor vessel, 督脈). we can cure the local area disease and also use to cure the pathway of the Leg lesser yang gall bladder which is attacked by P'ung(風) disease.
Objectives : The Purpose of this study is to report in patient with common peroneal nerve palsy, who improved by oriental medical treatament. Methods : We Checked the temperature of a leg by Digital Infrared Thermal Imaging(DITI) at intervals of 10 days, angle of active dorsiflexion and range of active motion for estimating the improvement of symptoms. We used the Visual Analogue Scale(VAS) for estimating the degree of pain, too. Results : After 4 weeks treatment, the movement and power of ankle joint improved to nearly normal range. The degree of active dorsiflexion of the ankle increased from $-40^{\circ}\;to\;15^{\circ}$ and range of active motion increased from Gr III to Gr I. The difference of temperature between the both legs decreased remarkably. Conclusion : In this case we experienced improvement of symptoms by conservative oriental medical therapy, e.g acupuncture stimulation, herbal medication, physical therapy. It should be needed further investigation on common peroneal nerve palsy and its symptoms in order to set up a reasonable standard about a surgical operation.
Rheumatoid arthritis(RA) is a general, chronic, inflammatory and auto-immune disease and it can lead to joint edema, pain, stiffness which are caused by an inflammation in synovium covering our joints. Ulmus davidiana Planchon is a traditional herb used for the treatment on various inflammations, gastrointestinal trouble, ENT(ear, nose, and throat) disease, edema, cancer etc. and it works effectively on arthritis as well. In these study to search for the treatment efficacy of Ulmus davidiana Planchon in RA, I measure manifestation of cytokine gene in synoviocyte treated with Ulmus davidiana Planchon herbal acupuncture and in EL-4 cell, manifestation of cytokine gene cell related to T-cell. And after Ulmus davidiana Planchon herbal acupuncture treatment in Collagen induced arthritis(CIA) which has been known by a general model of RA, DBA mice, I observed foot thickness, general shape of synovium, early cytokine induce CIA and, generation and mutation of cytokine related to the control of T-cell specialization. It comes to conclusion as belows. 1. In synovium treated with Ulmus davidiana Planchon herbal acupuncture, there was the decrease in MIF mRNA does-dependently. Incase of CIA mice treated with Ulmus davidiana Planchon herbal acupuncture, there were the decrease in the damage in synovium and generation of the MIF which is related to induction of the early RA cytokine and IL-6 proinflammatory cytokine. 2. In case of EL-4 treated with Ulmus davidiana Planchon herbal acupuncture, there were decrease in the manifestation of the IL-2 mRNA, but the increase in the manifestation of the IL-4 does-dependently. 3. In the synovium of CIA mice treated with Ulmus davidiana Planchon herbal acupuncture, there were the decrease in generation of IL-2, IL-12 and CD-28, but the increase in generation of IL-4. These result suggest that Ulmus davidiana Planchon can block the process of the early RA by Inhibiting MIF activation, and mitigate Rheumatoid Arthritis by controlling Tcell specialization.
Kim, Kap-Jung;Lee, Sang-Ki;Choy, Won-Sik;Seo, Dong-Wook
The Journal of the Korean bone and joint tumor society
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v.15
no.1
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pp.44-51
/
2009
Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.
Kim, Young Bok;Kim, Young Chang;Kim, Ji Wan;Lee, Sang Jin;Lee, Sang Won;Choi, Hong Joon;Lee, Dong Hyun;Kim, Joo Young
Clinics in Shoulder and Elbow
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v.17
no.2
/
pp.50-56
/
2014
Background: To assess the clinical outcomes of short-term oral corticosteroid therapy for impingement syndrome of the shoulder and determine whether it can be substituted as an alternative to the intra-articular injection. Methods: The clinical outcomes of the 173 patients, the oral steroid group (n=88) and the injection group (n=85), were measured at 3 weeks, 2, 4, and 6 months postoperatively. The clinical outcomes were assessed by measuring the the University of California at Los Angeles (UCLA) score, visual analog scale (VAS) and range of motion (ROM) at every follow-up. Any complications and recurrence rate were noted. A relationship between the treatment outcomes and factors such as demographic factors, clinical symptoms and radiographic findings were determined. Results: No difference was observed in VAS and UCLA scores between the two groups, but forward flexion and internal rotation of ROM were significantly improved in the injection group at the 2nd and 4th postoperative month (p < 0.05). At 6th postoperative month, recurrence rate of symptoms was 26% in the oral steroid group and 22% in the injection group. No major adverse effects were observed. When the clinical outcomes of the oral steroid group were compared to either demographic, clinical symptoms, or radiographic findings, UCLA score was found to be significantly low (p < 0.05) in patients with joint stiffness and UCLA score, whereas VAS score was significantly improved in patients with night pain (p < 0.05). Conclusions: Short-term low-dose oral corticosteroid therapy of impingement syndrome showed comparable clinical outcomes to intra-articular injection without any remarkable adverse effects. Low-dose oral steroids can be regarded as a partial alternative to intra-articular injection for the initial therapy of impingement syndrome of the shoulder.
Purpose: The distal clavicle has a biomechanical structure different from that of the proximal or middle 1/3 clavicle, and delayed union or nonunion occurs frequently in a distal clavicle fracture. The authors obtained favorable results from an open reduction and bone grafting of the distal clavicle nonunion. We report the results together with review of the relevant literature. Materials and Methods: The subjects were 8 patients(average age, 38.9) who had undergone surgery for distal clavicle nonunion from August 2003 to May 2006. Nonunion occurred after surgical treatment in 4 cases, and after conservative treatment in the other 4. In all cases, the patients complained of pain. Results: The mean follow-up duration was 14 months, and radiological union was observed in 8 weeks on average. In all cases, the range of shoulder joint motion was normal at the end of the follow-up observation. In the functional evaluation, 7 cases showed excellent results and 1 case showed good results. Conclusion: Surgical treatment is a safe and reliable treatment for distal clavicle fracture nonunion because it can achieve early rehabilitation and union.
Journal of the Korea Academia-Industrial cooperation Society
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v.21
no.1
/
pp.284-290
/
2020
This study was undertaken to determine the effects of SNAGs (sustained natural apophyseal glides) and visual convergence biofeedback on the proprioception and neck disability of patients with chronic neck dysfunction. A total of 31 patients with neck dysfunction were assigned to either SNAGs (n = 16) or biofeedback (n = 15). The groups were assessed for proprioception and neck disability, before and after the intervention. The SNAGs were performed using belt with flexion, extension and right-left rotation, whereas biofeedback training included visual feedback training with deep neck flexor. Intervention was implemented for 20 minutes, twice a week for 4 weeks. Biofeedback training a showed significant effect on the joint position sense (left and right rotation) as compared to the SNAGs group (p< 0.05), whereas neck disability index was significantly effective for SNAGs (p< 0.05). Ed. Notes: The previous statement lacked clarity. I have suggested the edit as per my understanding. Please review and revise appropriately, if required. Therefore, the SNAGs technique is effective for neck function, and biofeedback training is a positive intervention method for enhancing the proprioceptive sensation. In future studies on patients with neck pain, it may be possible to select an intervention method based on the characteristics of the disease.
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