• Journal of The Korean Society of Inherited Metabolic disease
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• v.15 no.1
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• pp.49-54
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• 2015

Multiple epiphyseal dysplasia (MED) is one of the more common skeletal dysplasias. MED is characterized by joint pain and stiffness, a waddling gait, and/or mild short stature in childhood. Radiographic findings include delayed and irregular ossification of the epiphyses in multiple joints. Mutations in at least six different genes (COMP, MATN3, COL9A1, COL9A2, COL9A3, and DTDST) can cause MED, and it can be either dominant or recessive inheritance. Molecular diagnosis is important for accurate prognosis and genetic counselling. COMP mutation is the most common form of MED in Western. But, MATN3 mutation was reported as the most common type of MED in Korea. Here, we describe a boy who was diagnosed as MED by clinical and radiological features. Hip radiograph of the patient was suggested MATN3 mutation. But knee radiograph was suggested COMP mutation. MATN3 and COMP mutations direct sequencing, but were no mutation. So we tested whole exome sequencing, but significant variant was not detected as known MED six genes mutations. The patient was diagnosed as having MED clinically and radiologically. Further study to identify the other responsible genes for MED is needed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.5
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• pp.447-452
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• 2001

Hyperbaric oxygen therapy(HBO) is defined as breathing 100% oxygen while in an enclosed system pressurized to greater than on atmosphere(sea level). This increased oxygen delivery furthers your body's ability to kill germs and to increase healing. HBO is a supplemental therapy to be used in addition to the current medical and surgical therapy you are receiving. HBO typically is used to complement treatments of medical problems such as bone infections, complication of radiotherapy, and certain chronic, non-healing wounds. On an emergency basis, the chamber also is used to treat problems such as carbon monoxide poisoning and the decompression sickness. We analysed stastically cases which are treated by hyperbaric oxygen therapy in point of oral and maxillofacial region on the Kangnam General Hospital for aid in comprehension and application of this therapy. Total 760 patients were treated at Gangnam General Hospital from July 1996 to September 1999. They were classified by region to Decompression sickness(DCS), Carbon monoxide poisoning(CO), General surgery(GS), Orthopedics(OS), Oral and Maxillofacial surgery(OMFS), others. Patients of Oral and Maxillofacial surgery were divided by diseses to Osteomyelitis, Osteoradionecrosis, Reconstruction, Bone graft, Difficult wounds, others. The results were as follows. 1. This institute conducts HBO therapy for DCS which takes up 62% and 10.5% for OMF region. 2. In OMF region, Osteomyelitis is 40%, Osteoradionecrosis is next, Bone graft, and Reconstruction is a row. 3. According to our precious study, HBO has been frequently conducted in OMF region compared to past, however, it is less actively conducted in this area for research than other conturies. Therefore, We need further application to the clinical use.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.1
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• pp.13-17
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• 2009

Purpose: The purpose of this study was to know the cause of the tenderness at pes anserinus. Materials and Methods: Out of 24 patients with tenderness at pes anserinus, 23 patients were female and 1 patient was male, and their average age was 65.9 years old. We checked the tenderness at pes anserinus by history taking & physical examniation and then, checked the pes anserinus for the presence of bursitis by US in outpatient clinic. With no evidence of bursitis by US, we injected steroid-lidocaine mixture intraarticularly and checked whether the tenderness disappeared after 2~3 minutes. Results: There was no case with bursitis at pes anserinus by US. The tenderness at pes anserinus diminished in 2-3 minutes after the intraarticular injection of the steroid-lidocaine mixture. After 6 weeks follow up, 16 patients(66.7%) had little or no tenderness at pes anserinus. 8 cases had the recurrence of tenderness recurred, 4 cases underwent arthroscopic operation on the meniscal tear, and 1 case underwent total knee arthroplasty. All cases underwent any operations had the tenderness at pes anserinus disappeared. The others 3 cases did not undergo total knee arthroplasty despite of radiologic obliteration of knee joint adequate for Kellgren-Lawrence grade IV. Conclusion: Without the bursitis at Pes Anserinus, patients the osteoarthritis may have the tenderness due to the referred pain.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.1
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• pp.7-12
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• 2009

Purpose: The purpose of this study was to correlate the degree of sonographic medial meniscal extrusion with MRI and arthroscopic findings. Materials and Methods: Out of these 32 patients, with medial meniscal tear who went on arthroscopic surgery, 14 patients had the medial meniscal tear and 18 patients had both lateral and medial meniscal tear. The extent of meniscal extrusion without meniscal tear was assesed in 24 patients who did not show meniscal tear on MRI. The extent of meniscal extrusion was measured between tibial medial joint line (excluded osteophyte) and the outer margin of the medial meniscus. Kellgren-Lawrence grading scale was assessed in plain X-ray image and the location of lesion was assessed during arthroscopic surgery. We also measured the extent of meniscal extrusion on MRI and sonography respectively, and compared each other. Results: There was significant difference between patients with medial meniscal tear and both lateral and medial meniscal tear, patients with medial meniscal tear, patients with both medial and lateral meniscal tear, patients without meniscal tear (P value<0.05). Conclusion: The Meniscus tear must be considered when sonography shows the meniscal extrusion more than 5 mm in length.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.3 no.2
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• pp.59-64
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• 2010

Purpose: The purpose of this study was to analyze the correlation between medial joint space on Rosenberg view and the degree of ultrasonographic medial meniscal extrusion. Materials and Methods: Three hundred ninety knees with medial joint tenderness examined by ultrasonography were reviewed between January 2009 and May 2010. Medial joint space was divided into Grade I (${\geq}$ 4 mm), Grade II (3~4 mm), Grade III (2~3 mm), Grade IV (1~2 mm) and Grade V (0~1 mm). Then sonographaphic mid-medial extrusion of the medial meniscus was measured in each patient. After dividing into Group A that didn't have large osteophytes (${\geq}$ 3 mm, medial joint at tibia) and Group B that had them, the correlation between the medial joint space and medial meniscal extrusion were analyzed in each group. One-way ANOVA & Scheffe test on the SAS program were used for the statistical analysis (p<0.05). Results: There was a positive correlation between grade of the joint space and medial meniscal extrusion in Group A, but there was no positive correlation in Group B (p<0.05). Conclusion: To the patients who didn't have advanced osteoarthritis, the narrowing of the medial joint space was one of the predictive factors for mid-medial extrusion of the medial meniscus.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.73-77
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• 2008

Purpose: The purpose of this study was to describe the method of dynamic sonographic measurements in the evaluation of the MCL injury of the knee joint while applying valgus and varus stress. Materials and Methods: Seven cases of MCL injury from January to April of 2008 was used for the study. For the evaluation of the medial instability, sonography was used immediately after injury, 6 weeks and 12 weeks after conservative treatment with limited motion brace. The length between the foot of the medial femoral epicondyle and the most proximal point of the tibial cortex was measured in 30 degrees flexion with valgus and varus stress of the knee joint. Results: The foot of the medial epicondyle and the starting point of the proximal tibial cortex underneath the round portion of the articular cartilage were always able to be seen on ultrasonography, even in varus and valgus stress with gravity in 30 degrees flexion of the knee joint. The results of measurements were always constant. Conclusion: Sonography can be used in evaluation of medial instability under the dynamic valgus and varus stress of the knee joint without further injury.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.86-90
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• 2008

Purpose: To evaluate the differences between blindly and ultrasonography (US)-guided during multiple needling and dextrose injection technique for calcific tendinitis of shoulder. Materials and Methods: We chose 36 symptomatic calcific tendinitis patients, whose age ranged from 27 to 69. Our procedures were multiple needling and injection of dextrose over the lesion of calcific deposits. The bind injection group were 19 patients whose age ranged from 27 to 64-year-old (mean 52.2), and the US-guided injection group were 17 patients ranged from 31 to 69-year-old (mean 49.0). We compare these groups by VAS (visual analogue scale) and range of motion before and after procedures. Results: There is no difference between two groups in VAS and ROM before procedure (p>0.05). Two groups revealed significant improvement without limitation of shoulder function, however, the group under US-guided revealed better results than under blind (VAS:p=0.001, Flexion:p=0.000, Abduction:p=0.000, External rotation: p=0.016). Conclusion: Ultrasonography-guided procedure showed better results than blind, so the use of ultrasonography is more promising procedure.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.2
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• pp.53-59
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• 2013

Purpose: The aim of this study wasto evaluate the comparison of CT arthrography and ultrasonography, confirmed by the arthroscopic finding in patients with rotator cuff disease. Materials and Methods: We evaluated fifty seven patients with rotator cuff disease underwent CTA and arthroscopy, and twenty eight patients had taken ultrasonographyadditionally. The diagnostic value and prediction for tear size between CTA and ultrasonography were evaluated, as compared to arthroscopic findings. Results: CTA showed a sensitivity of 86.2% and a specificity of 100% in full thickness tear ofsupraspinatus, a sensitivity of 58.3% and a specificity of 87.8% in partial-thickness tear. CTA demonstrated good diagnostic value for full thickness tear, but there was relatively lower value for partial-thickness tear. Ultrasonography showed a sensitivity of 84.6% and a specificity of 86.7% for diagnosing in full thickness tear, a sensitivity of 84.6% and a specificity of 73.3% in partial-thickness tear. Ultrasonography provided good diagnostic value, but, there is lesser accurate result for prediction of tear size. Conclusion: CTA showedgood diagnostic tool of detection full-thickness tear of rotator cuff disease and predicting of tear size. Comparing with ultrasonography, CTA was inferior for detection of partial-thickness tear, but, provided better estimation for tear size.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.2
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• pp.45-52
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• 2013

Purpose: We wanted to compare the accuracy between the blind anterior approach and ultrasound guided posterior approach, which are preferred in the present clinical practice for the glenohumeral joint injection. Materials and Methods: The consecutive 95 cases were included in that the glenohumeral joint injection was done in the university hospital and the medical record and ultrasonography were available. There were 52 cases which were injected by blind anterior approach (group I) and 43 cases who were injected by ultrasound guided posterior approach (group II). The injection was decided as accurate if the fluid was visualized in the posterior joint under the ultrasound. We evaluated the range of motion before and after 2 weeks of injection. A subjective satisfaction of the patients was interviewed at the 2 weeks after injection. Results: The accuracy of the glenohumeral joint injections of the group I and group II was 80.8% and 90.7%, respectively. The range of motion was improved for the all cases regardless of the approaches. At the 2 weeks after injection, the subjective satisfaction (better than good) was achieved in 73.7%. Conclusion: The accuracy of the blind anterior approach for the glenohumeral joint injection was 80.8%. The accuracy of the ultrasound guided posterior approach was 90.7%. In this comparative study by the one physician, the ultrasound guided posterior approach showed the better accuracy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.2
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• pp.133-139
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• 2012

This is a review regarding Mulliken's Modification using the Millard rotation-advancement principle for the repair of unilateral complete cleft lip and nasal deformity. All patients underwent prior labionasal adhesion and dentofacial orthopedics with a pin-retained (Latham) appliance used for infants with a cleft of the lip and palate. Technical variations concerning the operation are described. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column through the advancement flap. The orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. The authors believe the technical refinements described herein contribute favorably to the outcome of repair regarding unilateral cleft lip and nasal distortion.