• Clinics in Shoulder and Elbow
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• 제27권1호
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• pp.108-116
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• 2024

Reverse total shoulder arthroplasty (RTSA) is widely popular among shoulder surgeons and patients, and its prevalence has increased dramatically in recent years. With this increased use, the indicated pathologies associated with RTSA are more likely to be encountered, and challenging patient presentations are more likely to be seen. One prominent challenging presentation is RTSA patients with severe glenoid bone loss. Several techniques with varying degrees of invasiveness, including excessive reaming, alternate centerline, bone grafting, and patient-specific implants (PSIs), have been developed to treat patients with this presentation. PSI treatment uses a three-dimensional reconstruction of a computed tomography scan to design a prosthetic implant or component customized to the patient's glenoid morphology, allowing compensation for any significant bone loss. The novelty of this technology implies a paucity of available literature, and although many studies show that PSIs have good potential for solving challenging shoulder problems, some studies have reported questionable and equivocal outcomes. Additional research is needed to explore the indications, outcomes, techniques, and cost-efficiency of this technology to help establish its role in current treatment guidelines and strategies.

• Clinical and Experimental Pediatrics
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• 제50권5호
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• pp.469-475
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• 2007

목 적 : 이차공 심방 중격 결손의 Amplatzer 기구를 이용한 경피적 폐쇄의 안정성, 효용성 및 임상 결과를 수술적 폐쇄법과 비교하기 위하여 본 연구를 시행하였다. 방 법 : 2000년 1월부터 2006년 6월까지 가천의과학대학교 길병원에서 이차공 심방 중격 결손으로 진단 받은 환자 115명을 대상으로 하였다. 그 중 70명에게 결손의 수술적 폐쇄술을 시행하였고, 45명의 환자에게 Amplatzer 기구를 이용한 경피적 폐쇄술을 시행하였다. 수술군과 시술군의 사망율, 합병증, 입원기간과 효용성을 조사하여 결과를 비교분석하였다. 결 과 : 전체 남녀 비는 1:2.4였다. 두 환자군에서 평균 연령과 결손크기는 유의한 차이가 없었다. 성공율은 시술군에서 97.8%, 수술군에서 100%였다. 전체 합병증은 수술군에서 시술군보다 많이 발생하였다(64.0 vs. 15.6%, P<0.05). 입원기간은 시술 군이 수술군보다 짧았다($4.2{\pm}1.2$ vs. $12.4{\pm}4.7days$, P<0.0001). 잔류단락은 시술군(8.9%)에서 수술군(4.3%)에 비해 더 많이 발생하였는데, 3개월후 추적 검사에서는 모두 소실되었다. 결 론 : 이차공 심방 중격 결손증의 Amplatzer 기구를 이용한 경피적 폐쇄는 수술을 대체할 수 있는 안전하고 효과적인 방법이다. 경험이 축적되고 기구가 발전하면서 경피적 폐쇄술의 적용 범위가 점차 확대되고 있다.

• Journal of Chest Surgery
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• 제49권4호
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• pp.250-257
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• 2016

Background: Generalization of standardized surgical techniques to treat aortic valve (AV) and aortic root diseases has benefited large numbers of patients. As a consequence of the proliferation of patients receiving aortic root surgeries, surgeons are more frequently challenged by reoperative aortic root procedures. The aim of this study was to evaluate the outcomes of redo-aortic root replacement (ARR). Methods: We retrospectively reviewed 66 patients (36 male; mean age, $44.5{\pm}9.5years$) who underwent redo-ARR following AV or aortic root procedures between April 1995 and June 2015. Results: Emergency surgeries comprised 43.9% (n=29). Indications for the redo-ARR were aneurysm (n=12), pseudoaneurysm (n=1), or dissection (n=6) of the residual native aortic sinus in 19 patients (28.8%), native AV dysfunction in 8 patients (12.1%), structural dysfunction of an implanted bioprosthetic AV in 19 patients (28.8%), and infection of previously replaced AV or proximal aortic grafts in 30 patients (45.5%). There were 3 early deaths (4.5%). During follow-up (median, 54.65 months; quartile 1-3, 17.93 to 95.71 months), there were 14 late deaths (21.2%), and 9 valve-related complications including reoperation of the aortic root in 1 patient, infective endocarditis in 3 patients, and hemorrhagic events in 5 patients. Overall survival and event-free survival rates at 5 years were $81.5%{\pm}5.1%$ and $76.4%{\pm}5.4%$, respectively. Conclusion: Despite technical challenges and a high rate of emergency conditions in patients requiring redo-ARR, early and late outcomes were acceptable in these patients.

• Clinics in Shoulder and Elbow
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• 제17권2호
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• pp.68-76
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• 2014

Background: Recently, reverse total shoulder arthroplasty (RTSA) has been accepted as a main treatment option in irreparable massive rotator cuff tear with cuff arthropathy. The purpose of this study was to evaluate the early complication incidence and the preliminary clinical results of RTSAs performed in single institute. Methods: Fifty-seven RTSAs (56 patients) were performed between April 2011 and March 2013. The indications for RTSA were cuff tear arthropathy and irreparable massive rotator cuff tear with or without pseudoparalysis. Exclusion criteria were revision, preoperative infections and fractures. At final follow-up, 45 shoulders were enrolled. Mean follow-up duration was 12.5 months (range, 6-27 months). The mean age at the time of surgery was 73.6 years (range, 58-87 years). All the patients were functionally accessed via Constant score, American Shoulder and Elbow Surgeons (ASES) score, pain and functional visual analogue scale (VAS) scores and active range of motion. Complications were documented as major and minor. Major complications include fractures, infections, dislocations, nerve palsies, aseptic loosening of humeral or glenoid components, or glenoid screw problems. Minor complications include radiographic scapular notching, hematomas, heterotopic ossification, algodystrophy, intraoperative dislocations, intraoperative cement extravasation, or radiographic lucent lines of the glenoid. Results: The mean Constant score increased from 31.4 to 53.8 (p < 0.001). The pain and functional VAS scores improved (5.2 to 2.7, p < 0.001, 4.0 to 6.7, p < 0.001) and active forward flexion improved from $96.9^{\circ}$ to $125.6^{\circ}$ (p = 0.011). One or more complications occurred in 16 (35.6%) of 45 shoulders, with one failure (2.2%) resulting in the removal of implants by late infection. The single most common complication was scapular notching (9 [20%]). There were 4 (8.9%) axillary nerve palsies postoperatively (n=3: transient n. palsy, n=1: Symptom existed at 11 months postoperatively but improving). Conclusions: In a sort term follow-up, RTSA provided substantial gain in overall function. Most common early complications were scapular notching and postoperative neuropathy. Although overall early complication rate was as high as reported by several authors, most of the complications can be observable without compromise to patients' clinical outcome. Long term follow-up is required to clarify the clinical result and overall complication rate.

• 동의신경정신과학회지
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• 제20권3호
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• pp.15-33
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• 2009

Objectives : To study for classifying indications and procedure of historical changes, as a preliminary study, we collected and arranged prescriptions of headaches in medical documents after "Hwang-Je-Nae-Gyeong". Methods : 1. The researcher reviewed books, as a bibliography, recording to associate with a headaches in "UI-Bu-Jeon-Rok". 2. In reference books, we collected and arranged the herb medicines related to headaches in chapter of them. 3. In case of no chapter associated with headaches in books, we found prescriptions related to headaches and rearranged them. 4. Applied or added herb medicines were excluded, if the chief virtue was not primarily for headaches. 5. Prescriptions for signs to headaches related to dizziness were excluded. 6. Prescriptions for signs to associated with tremor were excluded. 7. We excluded prescriptions of headaches for dermatological disease. Results and conclusions : 1. Thirty seven documents were referred to the section of a headche in "UI-Bu-Jeon-Rok". 2. Prescriptions of "Sang-Han-Ron", which were related to headaches, were repeatedly quoted in chinese medical publications. 3. Nameless prescriptions of headaches were recorded from earlier books to later publications. 4. It started to record prescriptions of headaches separately from "Hawl-In-Seo" in 1107. 5. Described how to discriminate Naesang from Oegam, but prescriptions of headache were not listed in Dongwon Yi's "Nae-Oe-Sang-Byeon-Hok-Ron" which was published in 1247.

• 한국한의학연구원논문집
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• 제13권2호통권20호
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• pp.101-112
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• 2007

Objective : This study was aimed to review the trend of clinical research articles of acupuncture and moxibustion from the year of 1995 to 2006. Methods : The retrieving and analyzing period were from January 1995 to July 2006. Articles were collected by retrieving Pubmed database. Search terms were as follows; 'Acupuncture', 'Acupuncture & Meridian', 'Moxibustion'. After reviewing articles by our pre-defined criteria, Correlation was assessed qualitatively between contents of the final selected articles and those of Korea Institute of Oriental Medicine. Results : The number of acupuncture research articles have increased with higher rate since the year of 2000. In the field of medical devices, the articles were sparsely existed. The percentage of clinical acupuncture research articles was 75%. However, in the category of Korean investigators' researches, it was 46%. Publications by Korean investigators were concentrated to several specific journals of which their impact factor were below 1 point. Conclusion : There needs more qualifying studies in acupuncture studies which are represented by impact factor in Journal Citation Reports. It is necessary to research and develop the medical devices quantatively rating the outcome of acupuncture trials. The secondary research, such as, systematic reviews, meta-analysis, would be a key approach to evaluate the effectiveness and safety of acupuncture treatments. Moxibustion research would be noticeable in regard to its historical effectiveness and its variable indications.

• 대한한의학방제학회지
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• 제23권1호
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• pp.67-76
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• 2015

Objectives : This Study aims to search for the actual prescriptions worth being Insured Herbal Mixture Extracts(IHME), which frequently used frequently in the clinical settings by comparing clinical prescriptions with the list of prescriptions covered under the national health insurance system. Methods : By making comparisons of the herb weight ratios of IHME with those recorded in EMR, the frequency is measured on the basis of the IHME and the frequency indication is computed for the clinical prescriptions with lower level of differences. Results & Conclusions : On the basis of the details of the clinical prescriptions used at the EMR, we have found out that many clinical prescriptions of EMR are similar for banhasasim-tang, banhabaekchulcheonmatang, bojungikgi-tang and jaeumganghwa-tang in the national health insurance system. And we could analyze indications of those prescriptions. So, if we can make a similarity criteria of prescriptions and this methods are used at nationwide research, we will be able to obtain a satisfactory result in study, medical industry and clinics.

• Journal of Korean Neurosurgical Society
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• 제48권4호
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• pp.347-353
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• 2010

Objective : Iliac screw fixation has been used to prevent premature loosening of sacral fixation and to provide more rigid fixation of the sacropelvic unit. We describe our technique for iliac screw placement and review our experience with this technique. Methods : Thirteen consecutive patients who underwent spinopelvic fixation using iliac screws were enrolled. The indications for spinopelvic fixation included long segment fusions for spinal deformity and post-operative flat-back syndrome, symptomatic pseudoarthrosis of previous lumbosacral fusions, high-grade lumbosacral spondylolisthesis, lumbosacral tumors, and sacral fractures. Radiographic outcomes were assessed using plain radiographs, and computed tomographic scans. Clinical outcomes were assessed using the Oswestry Disability Index (ODI) and questionnaire about buttock pain. Results : The median follow-up period was 33 months (range, 13-54 months). Radiographic fusion across the lumbosacral junction was obtained in all 13 patients. The average pre- and post-operative ODI scores were 40.0 and 17.5, respectively. The questionnaire for buttock pain revealed the following : 9 patients (69%) perceived improvement; 3 patients (23%) reported no change; and 1 patient (7.6%) had aggravation of pain. Two patients complained of prominence of the iliac hardware. The complications included one violation of the greater sciatic notch and one deep wound infection. Conclusion : Iliac screw fixation is a safe and valuable technique that provides added structural support to S1 screws in long-segment spinal fusions. Iliac screw fixation is an extensive surgical procedure with potential complications, but high success rates can be achieved when it is performed systematically and in appropriately selected patients.

• 대한한의정보학회지
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• 제16권2호
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• pp.163-187
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• 2010

The concept of latent-gi(伏氣) was first mentioned in Yellow Emperor's Canon of Internal Medicine. For example, Elementary Questions states, "Damage by cold in winter necessarily engenders warm disease in the spring." Zhang Zhong-Jing of Han Dynasty in On Cold Damage and Miscellaneous Diseases mentions warm disease, stating, for example, "Greater yang disease with heat effusion and cough and without aversion to cold is warm disease. If sweating is applied, and there is generalized heat, this is wind warmth." However, the concept of warm disease was not central to his systematic presentation of externally contracted disease which placed the emphasis on wind and cold as the major causes of these diseases. Zhang Zhong-Jing's theories centuries after in the Sung Dynasty were to become the focus of the cold damage school, whereas the concept of warm disease was to become the focus of a rival school, the warm disease school. In the Sui-Tang Period, The Origin and Indications of Disease mentions warm diseases, their causes, patterns, and major principles of treatment. Successive generations of doctors wrote about warm disease, and in the Ming Dynasty writings on the subject become more prolific. This development is attributable on the one hand to the opening up of the south of China where febrile diseases tended to be of a different nature than in the north, and on the other to pestilences arising as a result of wars. In this period, Wu You-Xing in On Warm Epidemics explained in detail the laws governing the origin, development and pattern identification of warm epidemics. Notably, he posed the etiological notion of a contagious perverse gi.

• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6093-6095
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• 2012

Background: Phytoestrogens may be an alternative therapy in control of menopausal symptoms but their definite effects on breast tissue must be determined. Our study aimed to define the clinical and ultrasonographic changes of the breast after use of soy isoflavones in menopausal women. Materials and Methods: Menopausal women with hot flashes were randomly grouped as cases and controls and cases received soy isoflavones for 12 weeks. Breast examination (BE) and ultrasonography (US) were done at 0, 6 and 12 weeks. Tenderness and nodularity on BE were graded 1-4 by breast surgeons. Results: There were 30 women in the case and 26 in the control group. The mean age was 51.3 years and the mean age of menopause was 49.2 years. There was no change in the BE and US at 6 weeks in controls. In the case group, 10% had grade 1 tenderness and 13.3% grade 2 tenderness and grade 1 nodularity in BE accompanied with diffuse small cysts in US. At 12 weeks, there was no change in BE and US in the 2 groups. Conclusions: There was no statistically significant difference in the BE of the 2 groups at 6 and 12 weeks (p value=0.36 and 0.41 for nodularity and tenderness respectively) and in the US results. Although the literature contains many facts concerning PEs and the breast, further prospective studies are needed to identify structural breast changes produced by PEs in order to identify the appropriate dosage and indications of use.