• Clinics in Shoulder and Elbow
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• v.25 no.2
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• pp.93-100
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• 2022

Background: Subscapularis tendon insertion at the first facet has separate layers (deep and superficial). The purpose of this study is to evaluate postoperative clinical outcomes and radiological healing according to each layer of detachment in the first facet involving subscapularis tendon tear. Methods: Eighty-three patients who underwent arthroscopic repair due to First facet involving the scapularis tendon tear accompanying small to medium sized posterosuperior cuff tear were classified into three groups (group A: deep layer partial detachment, group B: deep layer complete detachment, but no superficial layer detachment, and group C: deep layer and superficial layer complete detachment). Subscapularis tendon healing was evaluated using computed tomography arthrogram and clinical result was evaluated using American Shoulder and Elbow Surgeons (ASES) shoulder score, Constant score and University of California Los Angeles (UCLA) shoulder score. Results: Retear rate of the subscapularis tendon was 2.2%, 18.2%, and 33.3% in group A, group B, and group C, respectively. These rates showed statistically significant difference among the three groups, which were classified by deep and superficial layer detachment in the first facet (p=0.003). Group A showed significant difference in subscapularis tendon healing compared with group B and group C (p=0.018 and p<0.001, respectively), but there was no statistical difference between group B and group C (p=0.292). Regarding clinical outcomes, there was no significant difference among three groups in ASES and UCLA score at final follow-up (p=0.070 and p=0.106, respectively). Conclusions: Complete detachment of deep layer may be related with retear occurrence regardless with detachment of superficial layer, but clinical outcome may not be related with each layer detachment in the first facet involving subscapularis tendon tear.

• Clinics in Shoulder and Elbow
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• v.24 no.3
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• pp.125-134
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• 2021

Background: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up. Methods: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with minimum 2 years follow-up were enrolled. We evaluated the clinical and radiological outcomes, and complications at the last follow-up. In addition, we divided these patients into notching and no-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients. Results: Visual analogue scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles Shoulder Scale, and Simple Shoulder Test scores improved significantly from preoperative (5.00, 3.93, 1.72, 3.94) to postoperative (1.72, 78.91, 28.34, 7.66) (p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20 of 38 patients (53%). In the comparison between notching and no-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications included three metaphyseal fractures and one inferior screw malposition. Postoperative complications included ectopic ossification, scapular neck stress fracture, humeral stem relaxation, and late infection in one case each. Conclusions: BIO-RSA showed improved clinical outcomes at mid-term follow-up in Asian population. However, we observed higher scapular notching compared to the previous studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.

• Journal of Gastric Cancer
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• v.23 no.2
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• pp.289-302
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• 2023

Purpose: Liver metastasis (LM) is reported in approximately 40% of patients with advanced/metastatic gastric/gastroesophageal junction adenocarcinoma (metastatic esophagogastric adenocarcinoma; mGEA) and is associated with a worse prognosis. This post-hoc analysis from the RAINBOW trial reported the efficacy, safety, and biomarker outcomes of ramucirumab and paclitaxel combination treatment (RAM+PAC) in patients with (LM+) and without (LM-) LM at baseline. Materials and Methods: Patients (n=665) were randomly assigned on a 1:1 basis to receive either RAM+PAC (LM+: 150, LM-: 180) or placebo and paclitaxel (PL+PAC) (LM+: 138, LM-: 197). The overall survival (OS) and progression-free survival (PFS) were evaluated using stratified Kaplan-Meier and Cox regression models. The correlation of dichotomized biomarkers (VEGF-C, D; VEGFR-1,2) with efficacy in the LM+ versus LM- subgroups was analyzed using the Cox regression model with reported interaction P-values. Results: The presence of LM was associated with earlier progression than those without LM, particularly in patients receiving PL+PAC (hazard ratio [HR], 1.68). RAM+PAC treatment improved OS and PFS irrespective of LM status but showed greater improvement in LM+ than that in LM- (OS HR, 0.71 [LM+] vs. 0.88 [LM-]; PFS HR, 0.47 [LM+] vs. 0.76 [LM-]). Treatment-emergent adverse events were similar between patients with and without LM. No predictive relationship was observed between biomarker levels (VEGF-C, D; VEGFR-1,2) and efficacy outcome (OS, PFS) (all interaction P-values >0.05). Conclusions: RAM provided a significant benefit, irrespective of LM status; however, its effect was numerically stronger in patients with LM. Therefore, RAM+PAC is a clinically meaningful therapeutic option for patients with mGEA and LM.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.1
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• pp.50-58
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• 2022

Objectives: Osteoarthritis (OA) is the most prevalent and disabling joint disease in the world. Temporomandibular joint (TMJ) exercise is a widely used treatment and could be a beneficial and long-term tool for treating TMJ OA. The present study aims to evaluate the effects of therapeutic exercise in the conservative treatment of TMJ OA. Materials and Methods: A single-group experimental pre-post test was performed. We included patients who met the diagnostic criteria for TMJ OA. Outcome variables were pain intensity (visual analogue scale), functionality (Helkimo index), and structural changes (ultrasound). Follow-up periods were at months 1, 3, and 6. The intervention included a home-based program with thermotherapy, manual therapy, and therapeutic exercise during the entire follow-up period. Results: We included 15 patients and 26 joints, all women with a median age of 57 years (range, 49-62 years). Median change in pain intensity on joint palpation, mouth opening, and at rest at the first month was 47.5 mm, 51 mm, and 60 mm, respectively, and 48 mm, 49.5 mm, and 42.5 mm, at six months (P=0.001). The Helkimo index showed significant improvement in medians from baseline severe dysfunction (17 points) to minimal dysfunction at three and six months (2 points) (P=0.001). Ultrasound showed improved disc position. Conclusion: This study demonstrated significant improvements in pain, function, and joint disc position and represents a valuable tool for the long-term treatment of patients with TMJ OA.

• Proceedings of the Korea Water Resources Association Conference
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• 2020.06a
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• pp.182-182
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• 2020

최근 지구 온난화나 기상이변으로 인해 세계각지에서 많은 자연재해가 발생하고 있고 우리나라도 최근 전국 각지에서 국지성호우에 의한 많은 피해가 발생하고 있다. 특히 국지성호우로 인해 발생하는 산간지역의 토석류는 많은 재산피해를 일으키고 있다. 최근 토석, 토사, 혹은 부유 잡목 등의 유출로 인한 피해를 막기 위해 많은 사방댐을 축조하고 있으나 표면침식에 의해서 유출되는 토석량 혹은 토사량을 정확히 예측하지 못한다면 축조된 사방댐은 금방 제구실을 못할 수 있거나 혹은 과대 설계 및 시공되어 건설비를 낭비할 수 있다. 따라서 최적의 사방댐 건설을 위해 정확한 토석량의 산정은 매우 중요한 전제조건이라 할 수 있다. 본 연구에서는 강원도 인제군 산간지역 4곳의 사방댐유역에 대해 토석량 예측모형 MSDPM(Multi-Sequence Debris Prediction Model)과 LADMP(Los Angeles District Method for Prediction of sediments yield)를 이용하여 산정한 토석량과 실제 준설량을 비교하였다. 이를 위해 강원 산간지역에 맞도록 예측모형을 보정하였으며 토석류 유발 강우강도(Threshold Maximum 1-hr Rainfall Intensity)와 토석류 유발 최소강우량(Total Minimum Rainfall Amount)개념을 도입하여 예측모형식을 적용하였다. 위 식이 갖고 있는 대표적 특징 중 하나인 산불계수를 사용해야 하지만 본 연구지역은 산불 피해규모가 미미하여 산불의 영향은 고려하지 않고 토석량을 산정하였다. 두 예측모형의 계산결과와 실제 준설량을 비교해본 결과, MSDPM의 결과가 LADMP의 결과보다 준설량과 더 일치하는 것으로 나타났다. 실제 준설량과 MSDPM의 계산결과는 평균 17.37%의 차이를 나타냈고 LADMP의 계산결과는 평균 41.87%의 차이를 나타냈다. 본 연구에서 사용된 토석량 예측 모형은 앞으로 많은 산지유역의 토석량 예측에 사용이 가능 할 것으로 판단된다. 하지만 본 연구에서 사용된 자료의 제한성 때문에 앞으로 많은 실측 준설자료를 통하여 예측모형식을 보정하는 작업이 우선되어야 할 것으로 판단된다. 이를 위해서 많은 산지유역의 토석량을 장시간 실측하여 데이터를 축적하고 이를 사용하여 다양한 토석량 예측모형을 검보정하는 노력이 필요할 것으로 판단된다.

• Clinical Endoscopy
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• v.56 no.1
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• pp.38-49
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• 2023

Background/Aims: Patients with Barrett's esophagus are at increased risk of developing esophageal adenocarcinoma. Endoscopic therapies aim to eradicate dysplastic and metaplastic tissues. Hybrid argon plasma coagulation (hybrid-APC) utilizes submucosal fluid injection to create a protective cushion prior to ablation that shields the submucosa from injury. We performed a pooled meta-analysis to evaluate the safety and efficacy of hybrid-APC. Methods: We conducted a systematic search of major electronic databases in April 2022. Studies that included patients with dysplastic and non-dysplastic Barrett's esophagus undergoing treatment with hybrid-APC were eligible for inclusion. Outcome measures included complete remission of intestinal metaplasia (CR-IM), stricture formation, serious adverse events, and number of sessions necessary to achieve CR-IM. Results: Overall pooled CR-IM rate for patients undergoing hybrid-APC was 90.8% (95% confidence interval [CI], 0.872-0.939; I²=0%). Pooled stricture rate was 2.0% (95% CI, 0.005-0.042; I²=0%). Overall serious adverse event rate was 2.7% (95% CI, 0.007-0.055; I²=0%). Conclusions: Results of the current meta-analysis suggest that hybrid-APC is associated with high rates of CR-IM and a favorable safety profile. Interpretation of these results is limited by the inclusion of retrospective cohort and case series data. Randomized controlled trials that standardize treatment and outcome evaluation protocols are necessary to understand how this treatment option is comparable to the current standards of care.

• The Journal of Engineering Geology
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• v.34 no.1
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• pp.67-105
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• 2024

This study compares the quartzites of four quartzite units: The Fagfog Quartzite, Dunga Quartzite (member of the Robang Formation), Pandrang Quartzite (member of the Kalitar Formation) and the Chisapani Quartzite. The analysis shows variations in flakiness and elongation, as the Fagfog Quartzite displays low flakiness whereas the Pandrang and the Chisapani have moderate and the Dunga Quartzite has shown variations. The density values of the four quartzite units remain consistent, indicating uniform physical properties and porosity levels. However, bulk density values differ among the quartzites, suggesting variations in particle arrangement, porosity, and density. Regarding strength measures, the Pandrang and the Chisapani Quartzite have higher strength characteristics as compared to the Fagfog and the Dunga Quartzites. The Pandrang Quartzite has the highest average point load strength index, classifying it as "Extremely Strong". The resistance to impact and crushing forces varies among the quartzites, with lower Aggregate Impact Value (AIV) and Aggregate Crushing Value (ACV) indicating higher strength and durability. Durability tests show that the Fagfog Quartzite has high durability against slaking, with a slight decrease observed after the fifth cycle. The Dunga Quartzite shows varying degrees of weathering, while the Pandrang and the Chisapani Quartzite have minimal weight changes, indicating strong resistance to weathering. Magnesium sulfate soundness tests indicate high durability and resistance to degradation for all four units. The Los Angeles abrasion value (LAAV) tests indicate favorable resistance to abrasion for the majority of the Fagfog, Dunga, and the Pandrang Quartzites samples, while Chisapani Quartzite shows more variability in LAAV values. The Pandrang Quartzite shows a higher proportion of elongated particles but lower flakiness index values as compared to Fagfog and Dunga Quartzites while Chisapani Quartzite stands out with a significantly higher presence of flaky particles and lower elongation index values. Mechanically, the Fagfog and Dunga Quartzite show higher strength and better resistance to abrasion and freeze and thaw. The Pandrang Quartzite shows moderate resistance to crushing and sudden effect, while the Chisapani Quartzite has variable resistance to effect. This comparative study emphasizes the diversity and complexity of quartzite rock types, showing the need for comprehensive characterization and assessment to determine their suitability for specific applications.

• Korean Journal of Mathematics
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• v.32 no.1
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• pp.43-57
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• 2024

Given a domain X and a collection H of functions h : X → {0, 1}, the Vapnik-Chervonenkis (VC) dimension of H measures its complexity in an appropriate sense. In particular, the fundamental theorem of statistical learning says that a hypothesis class with finite VC-dimension is PAC learnable. Recent work by Fitzpatrick, Wyman, the fourth and seventh named authors studied the VC-dimension of a natural family of functions ℋ'²_t(E) : 𝔽²_q → {0, 1}, corresponding to indicator functions of circles centered at points in a subset E ⊆ 𝔽²_q. They showed that when |E| is large enough, the VC-dimension of ℋ'²_t(E) is the same as in the case that E = 𝔽²_q. We study a related hypothesis class, ℋ^d_t(E), corresponding to intersections of spheres in 𝔽^d_q, and ask how large E ⊆ 𝔽^d_q needs to be to ensure the maximum possible VC-dimension. We resolve this problem in all dimensions, proving that whenever |E| ≥ C_dq^d-1/(d-1) for d ≥ 3, the VC-dimension of ℋ^d_t(E) is as large as possible. We get a slightly stronger result if d = 3: this result holds as long as |E| ≥ C_3q^7/3. Furthermore, when d = 2 the result holds when |E| ≥ C_2q^7/4.

• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.296-301
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• 2023

Background: A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR. Methods: We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance. Results: The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data. Conclusions: Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.

• Hip & pelvis
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• v.34 no.4
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• pp.219-226
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• 2022

Purpose: The purpose of this study was to examine the clinical outcomes and efficacy of hip resurfacing arthroplasty (HRA) in patients with osteonecrosis of the femoral head after the failure of porous tantalum rod insertion without rod removal. Materials and Methods: Conversion to hip resurfacing arthroplasty was performed in 10 patients (11 hips) with a mean period of 14.9 months after the primary surgery. The mean follow-up period was 73.7 months. Analysis of pre and postoperative range of motion (ROM), University of California at Los Angeles (UCLA) activity score, modified Harris hip score, and visual analog scale (VAS) pain score was performed. Radiographic analysis of component loosening and osteolysis was performed. Results: The postoperative ROM showed significant improvement (P<0.05), excluding flexion contracture. The modified Harris hip score showed improvement from 65.82 to 96.18, the UCLA score showed improvement from 4.18 to 8.00, and the VAS pain score was reduced from 6.09 to 1.80. All scores showed statistically significant improvement (P<0.05). No component loosening or osteolysis was detected by radiographic analysis. Conclusion: Satisfactory results were obtained from conversion hip resurfacing arthroplasty after failure of porous tantalum rod insertion without rod removal. The findings of this study demonstrate the advantages of HRA, including no risk of trochanteric fracture and no bone loss around the tantalum rod. In addition, the remaining porous tantalum rod provided mechanical support, which reduced the potential risk of femoral neck fracture or loosening. This technique can be regarded as a favorable treatment option.