• The Korean Journal of Pain
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• v.33 no.1
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• pp.81-89
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• 2020

Background: For children with cleft palates, surgeries at a young age are necessary to reduce feeding or phonation difficulties and reduce complications, especially respiratory tract infections and frequent sinusitis. We hypothesized that dexmedetomidine might prolong the postoperative analgesic duration when added to bupivacaine during nerve blocks. Methods: Eighty patients of 1-5 years old were arbitrarily assigned to two equal groups (forty patients each) to receive bilateral suprazygomatic maxillary nerve blocks. Group A received bilateral 0.2 mL/kg bupivacaine (0.125%; maximum volume 4 mL/side). Group B received bilateral 0.2 mL/kg bupivacaine (0.125%) + 0.5 ㎍/kg dexmedetomidine (maximum volume 4 mL/side). Results: The modified children's hospital of Eastern Ontario pain scale score was significantly lower in group B children after 8 hours of follow-up postoperatively (P < 0.001). Mean values of heart rate and blood pressure were significantly different between the groups, with lower mean values in group B (P < 0.001). Median time to the first analgesic demand in group A children was 10 hours (range 8-12 hr), and no patients needed analgesia in group B. The sedation score assessment was higher in children given dexmedetomidine (P = 0.03) during the first postoperative 30 minutes. Better parent satisfaction scores (5-point Likert scale) were recorded in group B and without serious adverse effects. Conclusions: Addition of dexmedetomidine 0.5 ㎍/kg to bupivacaine 0.125% has accentuated the analgesic efficacy of bilateral suprazygomatic maxillary nerve block in children undergoing primary cleft palate repair with less postoperative supplemental analgesia or untoward effects.

• Clinics in Shoulder and Elbow
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• v.26 no.1
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• pp.64-70
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• 2023

Background: This study aimed to analyze the efficacy of single-dose corticosteroid injection (CSI) administered at 6 weeks postoperative to treat stiffness following arthroscopic rotator cuff repair (ARCR). Methods: In this prospective, multicentric, case-control study, post-ARCR stiffness at 6 weeks was treated with either a single dose of intra-articular CSI (CSI group) or physical therapy with oral analgesics (non-CSI group). Pain intensity according to visual analog scale (VAS), functional outcome using the Constant Murley Shoulder Score, time to return to activities of daily living (ADLs), and retear rate were recorded at 6 weeks, 9 weeks, 12 weeks, 6 months, 12 months, and 18 months postoperatively in both groups. Results: A total of 149 patients (54.5%) in the CSI group and 124 patients (45.5%) in the non-CSI group were included in this study. Pain and function were significantly better in the CSI group at 9-week, 12-week, and 6-month (P<0.001) follow-up, whereas they were not significantly different when the groups were compared at 12- and 18-month follow-up. The mean duration to return to ADLs was significantly shorter (P<0.001) in the CSI group. The incidence of retears was not significantly different (P=0.36) between groups at the end of 18 months of follow-up. Conclusions: Single-dose intra-articular CSI administered at 6 weeks postoperative to treat post-ARCR stiffness significantly improved pain, function, and duration of return to ADLs without increasing the risk of retears compared to patients who did not receive intra-articular CSI. Level of evidence: III.

• Archives of Craniofacial Surgery
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• v.10 no.1
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• pp.23-28
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• 2009

Purpose: Blow out fracture can present tenderness, swelling, enophthalmos, extraoccular muscle limitation, paresthesia, diplopia according to severity of injury, so reconstruction of blow out fracture is important. Orbital soft tissue should be in orbit and defected orbital wall should be corrected by autologus tissue or alloplastic implants. Every implants have their merits and faults, every implants are used various. This study was designed to compare the sequelae of blow-out fracture repair using the alloplastic implants: micro-titanium mesh(Micro Dynamic titanium $mesh^{(R)}$, Leibinger, Germany), porous polyethylene ($Medpor^{(R)}$, Porex, USA), absorbable mesh plate(Biosorb $FX^{(R)}$ . Bionx Implants Ltd, Finland). Methods: Between January 2006 and April 2008, 52 patients were included in a retrospective study analysing the outcome of corrected inferior orbital wall fracture with various kind of implants. Implants were inserted through subciliary incision. Twenty patients were operated with micro-titanium mesh, fourteen patients with porous polyethylene and eighteen patients with absorbable mesh plate. In comparative category, enophthalmos, diplopia, range of motion of extraoccular muscle, inferior orbital nerve injury were more on frequently statistically in patients. Results: Fourteen of 18 patients underwent surgical repair to improve diplopia, 11 of 17 patients to improve parasthesia, 11 of 15 patients to improve enophthalmos, 8 of 9 patients to improve extraoccular muscle limitation. Duration of follow-up time ranged from 6 months to 12 months(mean, 7.4 months). There was no statistic difference of sequelae between micro titanium mesh and porous polyethylene and absorbable mesh plate in blowout fracture, inferior wall. Conclusion: There is no difference of sequelae between micro-titanium mesh, porous polyethylene and absorbable mesh plate in blow-out fracture, inferior wall. The other factors such as defect size, location, surgeon's technique, may influence the outcome of blow-out fracture repair.

• Journal of the Korean Society of Manufacturing Process Engineers
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• v.20 no.4
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• pp.119-126
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• 2021

During the development of a weapon system, the concept of maintainability is used for quantitatively predicting and analyzing the maintenance time. However, owing to the complexity of a weapon system, the standard maintenance time predicted during the system's development differs significantly from the measured time during the operation of the equipment after the system's development. According to the analysis presented in this paper, the maintenance time can be predicted by considering the system's complexity on the basis of the military specifications, and the procedure can be Part B of Procedure II and Method B of Procedure V. The maintenance work elements affected by the system complexity were identified by the analytic hierarchy process technique, and the system-complexity-reflecting weights of the maintenance work elements were calculated by the Delphi method, which involves expert surveys. Based on MIL-HDBK-470A and MIL-HDBK-472, it is going to present a Korean-style maintainability prediction method that reflects system complexity of weapons systems.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.1
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• pp.81-86
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• 2004

Objectives: To assess the functional outcome of Bankart repair and rotator cuff repair using miniopen technique in patients with recurrent shoulder dislocation(8 cases) with rotator cuff tears and Bankart lesion of over 40 years. Materials and Methods: From May 1991 to January 2002, twenty two patients were available to participate in the study. Mean age was 52 years old(41-67), Follow-up evaluations averaged 50.5months(10-147). Results: The patients(22 cases) were divided into two groups. Group 1: with recurrent shoulder dislocation(8 cases) with rotator cuff tears and Bankart lesion in patients over 40 years old. Group 2: without Bankart lesion(14 cases). In Group 1, mean average of forward flexion and abduction improved from 122 degrees to 154 degrees at the final follow-up and from 115 degrees to 161 degrees respectively. In terms of University of Pennsylvania patient self-assessment of pain score and VAS, scores improved from 11.0 to 5.5 and from 5.4 to 2.5 respectively. In terms of UCLA score & Constant score, scores also improved from 20.2 to 29.6 and from 48.6 to 69.0 respectively. Functional outcome of Group 1: two patients with excellent, four patients with good, and two patients with fair. Functional outcome of Group 2: two patients with excellent, six patients with good, five patients with fair, and one patient with poor. But they had no statistical significance between the two groups. All cases were improved shoulder pain at the final follow up. And six patients were satisfied with the outcome of shoulder function. Conclusions: This study demonstrates the effectiveness of Bankart repair and rotator cuff repair using miniopen technique in patients with recurrent shoulder dislocation(8 cases) with tears of rotator cuff and Bankart lesion older than 40 years. We recommend Bankart repair and rotator cuff repair at the same time.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.32 no.2
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• pp.171-178
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• 2009

Logistic support activities for weapon systems play an important role at maintenance activities in modern warfares. These activities are essential for keeping weapon systems ready at all time. However, maintenance supplies can be delayed without a proper information system. Further, increases of mean time to repair (MTTR) and unavailability of weapon systems can be occurred. In this study, a web based information system is developed for logistic chains of class 9 supplies. Utilizing web database technologies, the developed system can provide an environment for data exchange and sharing among various participants in the supply chain.

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.114-120
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• 2012

Purpose: The purpose of the study was to evaluate the usefulness and the stability of the superficial medial collateral ligament (MCL) release in posterior medial meniscus root repair. Materials and Methods: We compared 20 patients who underwent posterior medial meniscus root repair with superficial MCL preserved (PM) and 32 patients who underwent posterior medial meniscus root repair combined with superficial MCL release (RM) from April 2006 to September 2010. We excluded the patients combined with other surgery. To evaluate the postoperative valgus instability in RM group, we examined direct tenderness on MCL insertion, the subjective feeling of instability and valgus stress test at 3 months and 1 year follow-up. We compared the tourniquet time between PM group and RM group, and the clinical results were assessed by Lysholm score and International Knee Documentation Committee (IKDC) for the usefulness. Results: All patients had no clinically significant complication related to the superficial MCL release. Three months and 1 year follow-up, there were no positive tenderness test, no subjective symptoms and no significant increase of valgus instability although 5 patients examined grade I valgus instability. The mean tourniquet time was $41.3{\pm}12.7$ minutes in RM group and $53.5{\pm}13.6$ minutes in PM group. There was a significant difference in the tourniquet time between the two groups (P<0.05). Average Lysholm score was $56.8{\pm}5.5$ (range, 44-70) preoperatively and $85.1{\pm}5.8$ (range, 77-94) postoperatively in PM group, and was $56.2{\pm}5.4$ (range, 45-67) preoperatively and $87.4{\pm}3.9$ (range, 82-95) postoperatively in RM group (P<0.001). No significant difference of Lysholm score was found in both groups (P<0.05). Average IKDC scores was $42.6{\pm}3.9$ (range, 30-53) preoperatively and $77.2{\pm}6.3$ (range, 68-92) postoperatively in PM group, and was $42.7{\pm}5.7$ (range, 30-53) preoperatively and $89.6{\pm}2.9$ (range, 84-95) postoperatively in RM group (P<0.05). There was also no significant difference of IKDC score in both groups (P<0.05). Conclusion: The superficial MCL release in posterior medial meniscus root repair is useful to gain a wide surgical field and reduces the tourniquet time and does not lead to postoperative valgus instability. It can be considered clinically useful and safe procedure in medial meniscus posterior root repair.

• Journal of Chest Surgery
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• v.28 no.5
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• pp.453-463
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• 1995

During 42 month period 91 consecutive patient underwent coronary artery bypass surgery. The mean age of these patient was 57 years [range from 28 to 78 years . There were 57 men and 34 women. The preoperative risk factors that include beyond the 50 % of total patients were male sex, obesity, hypo-high-density lipoproteinemia, smoking, hypercholesterolemia, hyper-low-density lipoproteinemia, hypertriglyceridemia and hypertension. Preoperatively 27 patients had stable angina pectoris and 39 patients of unstable angina pectoris. Twenty five patients had previous myocardial infarction history. The patterns of disease were 8 patients of single vessel involvement, 18 patients of double vessel involvement, 54 patients of triple vessel involvement and 11 patients of left main coronary artery disease. Fifty five patients were in Canadian Cardiovascular Society functional class III. Myocardial revascularization was performed under emergency conditions in 5 patients. Nine percent of patients had previous PTCA history. We performed 16 cases of sequential anastomosis, internal mammary artery harvest in 86 percent of total patients and total 284 distal anastomoses[mean 3.1 anastomosis per patient . The mean ACC time was 60.5 minutes and ECC time was mean 110 minutes. The combined surgeries were 16 cases of endarterectomy, 2 cases of LV aneurysmectomy, 1 case of Bentall operation, 1 case of repair of sinus of Valsalva, 1 case of ligation of coronary AV fistula and 1 case of excision of breast mass. The most common complication was wound infection[12 cases, 13 % . There was one hospital death due to postoperative respiratory failure and low output syndrome in patient with postinfarction VSD, LV aneurysm. Postoperative 88 patients were in Functional class I or II. The 99mTc-MIBI myocardial perfusion scan that used as evaluation of postoperative state was well correlated with patient`s symptoms instead of some disadvantages.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.172-179
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• 2008

Purpose: To evaluate the functional and structural results of arthroscopic double-row repair using combined knot-tying and knotless suture anchors in rotator cuff tears. Materials and Methods: From March 2006 to June 2007, twenty-one patients (15 males, 6 females; mean age 55.6 years; range 48 to 67) were included who underwent arthroscopic double-row repair for full-thickness tears of the rotator cuff following conservative treatment for a mean of 6.5 months (range 3 to 11). The tear size was carefully inspected arthroscopically and we found 2 small, 13 medium and 6 large-sized rotator cuff tears, with a mean tear size of 2.5cm(range 1.8 to 3.2). The repair constructs were consisted of horizontal mattress sutures using conventional knot-tying suture anchors medially and simple suture at the same level of medial row stitch with Bioknotless RC anchors (DePuy Mitek, Norwood, MA) as lateral row. Clinical and functional evaluations were made according to the range of motion, the ASES, UCLA scale and the isokinetic strength testing. Postoperative cuff integrity was determined through magnetic resonance imaging. The mean follow-up was 15 months (range 13 to 24). Results: The average clinical outcome scores and strength were all improved significantly at the time of the final follow-up (p < 0.01). Nineteen patients (90%) were satisfied with the result of the treatment. In 17 of 21 patients (81%) were judged to reveal healed tendon on magnetic resonance imaging at a mean of 7 months postoperatively. There were no significant functional differences according to the preoperative tear size (p<0.01), but large-sized tear shows less favorable structural results in 3 out of 6 cases(50%). Conclusion: Our results document the usefulness and variability of arthroscopic double-row rotator cuff repairs comparable to the results of the other types of double-row repairs.

• Journal of Korean Neurosurgical Society
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• v.58 no.1
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• pp.60-64
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• 2015

Objective : To present the incidence and management of dural tears and cerebrospinal fluid leakage during corrective osteotomy [Pedicle Subtraction Osteotomy (PSO) or Smith-Petersen Osteotomy (SPO)] for ankylosing spondylitis with kyphotic deformity. Methods : A retrospective study was performed for ankylosing spondylitis patients with fixed sagittal imbalance, who had undergone corrective osteotomy (PSO or SPO) at lumbar level. 87 patients were included in this study. 55 patients underwent PSO, 32 patients underwent SPO. The mean age of the patients at the time of surgery was 41.7 years (21-70 years). Of the 87 patients, 15 patients had intraoperative dural tears. Results : The overall incidence of dural tears was 17.2%. The incidence of dural tears during PSO was 20.0%, SPO was 12.5%. There was significant difference in the incidence of dural tears based on surgical procedures ( PSO vs. SPO) (p<0.05). The dural tears ranged in size from 12 to $221mm^2$. A nine of 15 patients had the relatively small dural tears, underwent direct repair via watertight closure. The remaining 6 patients had the large dural tears, consequently direct repair was impossible. The large dural tears were repaired with an on-lay graft of muscle, fascia or fat harvested from the adjacent operation site. All patients had a successful repair with no patient requiring reoperation for the cerebrospinal fluid leak. Conclusion : The overall incidence of dural tears during PSO or SPO for ankylosing spondylitis with kyphotic deformity was 17.2%. The risk factor of dural tears was complexity of surgery. All dural tears were repaired primarily using direct suture, muscle, fascia or fat graft.