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Transient postoperative inferior subluxation of the shoulder after surgical stabilization of recurrent anterior dislocation in a patient with myasthenia gravis: a case report

  • Samuel Baek;Geum-Ho Lee;Myung Ho Shin;Tae Min Kim;Kyung-Soo Oh;Seok Won Chung
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.302-305
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    • 2023
  • The authors present a case of transient postoperative inferior subluxation of the shoulder after arthroscopic surgical stabilization for recurrent anterior dislocation. The patient was a 61-year-old woman with myasthenia gravis (MG). The first anterior shoulder dislocation occurred because of a fall to the ground. Despite a successful closed reduction, two more dislocations occurred in 3 weeks. Magnetic resonance imaging revealed an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion, an engaging Hill-Sachs lesion, and large tears of the supraspinatus and infraspinatus tendons. The patient underwent arthroscopic rotator cuff repair and ALPSA repair with a remplissage procedure. Intraoperatively, no tendency for instability was found; however, a widened glenohumeral joint space and inferior subluxation of the humeral head without functional compromise was observed on the day after surgery and disappeared spontaneously on radiographs 2 weeks later. To the authors' knowledge, this is the first report documenting the occurrence of transient postoperative inferior subluxation of the shoulder in a patient with MG.

Adaptive Fault Accommodation Control for Flexible-Joint Robots (유연 관절 로봇의 적응 고장 수용 제어)

  • Yoo, Sung Jin
    • Journal of the Korean Institute of Intelligent Systems
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    • v.23 no.1
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    • pp.46-50
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    • 2013
  • This paper proposes an adaptive fault accommodation control approach for flexible-joint (FJ) robots with multiple actuator faults. It is assumed that the value and occurrence time of multiple actuator faults are unknown. An adaptive fault accommodation control scheme with prescribed performance bounds, which characterize the convergence rate and maximum overshoot of tracking errors, is designed to accommodate the actuator faults. From the Lyapunov stability theorem, it is proved that all signals of the closed-loop system are semi-globally uniformly ultimately bounded and tracking errors are preserved within prescribed performance bounds regardless of actuator faults.

A Study on the Major Issues and Legislative Considerations of CCTV Installation in an Operating Room (수술실 CCTV 설치의 쟁점과 입법방향에 관한 소고(小考))

  • Kim, Sungeun;Choe, A Reum;Bae, Kyounghee
    • The Korean Society of Law and Medicine
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    • v.22 no.2
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    • pp.111-138
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    • 2021
  • 'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.

Identify the Type of Exercise to Prevent Falls for Healthy Elderly Life (고령자의 건강한 삶을 위한 낙상 예방 운동유형 확인)

  • Park, Yang-Sun;Kim, Mi-Ye;Park, Seong-Won;Lee, Ok-Jin
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.7
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    • pp.361-373
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    • 2019
  • Falls are a threat to the physical health of the elderly as well as to their overall quality of life. The purpose of this study was to identify which type of exercise is effective for improving the balance of the elderly, and to obtain the basic data for developing the falls prevention exercise intervention program for the elderly. We compared to the differential effects between rhythmic step exercise and core muscle strengthening exercise in terms of functional balance test and self-reported balance test. Women older than 65 years and under 80 years of age were assigned to one of the step exercise group(21), core muscle exercise group(20), and control group(21), and for 8 weeks, twice per week, 20-30 minutes of exercise were treated. All participants performed one foot static balance test with open and closed eyes. And they responded to self-reported balance test, such as Fall Efficacy Scale(FES) and Activities-specific Balance Confidence(ABC) Scale. The results of statistical analysis are summarized as follows. First, rhythmic stepping exercise was more effective in improving functional balance than core muscle strengthening exercise. In particular, the effect of step exercise was obvious in the one-foot static balance test with open eyes. Second, the self-reported balance test showed better step exercise than core muscle exercise. Specifically, rhythmic step exercise was more effective in enhancing fall efficacy than core muscle exercise. In conclusion, the rhythmic step exercise was more effective in improving the balance ability of the elderly than the core muscle exercise. The rhythmic step exercise is more related to the lower extremity muscles, and especially since the rhythmic step exercise is performed in various ground changes, it seems to have a high similarity to the fall occurrence situation. For future research, we recommended the development of task-oriented ankle proprioceptive exercise intervention program and exercise equipment based on the specific motion situation in which the fall accident occurs in the elderly.