• Journal of East-West Nursing Research
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• v.15 no.1
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• pp.54-62
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• 2009

Purpose: The purpose of this study was to examine the effects of relaxation therapy to reduce anxiety level among spinal anesthesia surgery patients. Methods: The study employed a quasi-experimental pre-and-posttest design with nonequivalent control group. The experimental group was provided with the 15-min muscle relaxation therapy on the day before the surgery and an hour before the spinal anesthesia. Data were collected from 44 patients (22 in experimental and 22 in control group) who were planned to have spinal anesthesia surgery from an orthopedic surgery department at a general hospital in Seoul from January 13 to March 21, 2006. Results: The experimental group reported lower level of state anxiety after the surgery (23.18 vs. 33.64) than did control group but was not statistically significant. There were no significant differences in blood pressure or pulse rate between experimental and control groups after surgery. Conclusions: The further research should be conducted to polish the muscle relaxation therapy for various types of patients and to create more comfortable environment setting for application of the therapy. The muscle relaxation therapy may be a convenient and useful nursing intervention to reduce anxiety among spinal anesthesia surgery patients if more studies prove its effectiveness.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.6
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• pp.644-648
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• 2008

Purpose: The aim of this study was to investigate the clinical cases of subcondylar fracture with intraoral approach. Material and Method: Fifteen patients with unilateral subcondylar fracture were treated in the department of oral and maxillofacial surgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University between 2006 and 2007. Each patients was examined by computed tomography(CT) and panorama. 3D-CT taken when fractured segment was displaced and comminuted. Patients was done intermaxillary fixation to occlusal stability and prevent displacement of fractured segment before general operation. Open reduction and internal fixation(ORIF) accomplished under general anesthesia and used to intraoral approach. We examinated the state of occlusion, maximum opening. Evaluation of the state of occlusion was divided in patient`s subjective evaluation that compare pre-traumatic occlusion with postoperative occlusion, and estimator`s objective evaluation that use articulating paper. Examination was done at 2 weeks, 1, 3, 6 month postoperative by follow up. Result: The ORIF through intraoral approach was good in all patients. In the state of occlusion, all patients recovered pre-traumatic occlusion in 6 month postoperation. Maximum opening was gradually increased. In 3 month postoperative, maximum opening was excessed 40mm. Conclusion: Our study indicate that the intraoral approach is a good technique for subcondylar fracture. Intraoral approach prevent complication that facial nerve damage, scar formation caused by extraoral approach. So, we recommend intraoral approach when subcondylar fracture.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.5
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• pp.447-452
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• 2006

Purpose: In order to clarify the correlation of mandibular setback using bilateral intraoral vertical ramus osteotomy (BIVRO) and post-surgical transverse mandibular width (TMW), this study examined the pre- and postsurgical changes in hard and soft tissues of TMW and the relationship of TMW and the amount of mandibular setback. Patients and Methods: One-hundred seven patients who had undergone BIVRO were evaluated radiographically and clinically. A comparison study of the changes in hard and soft tissue after surgery in all 107 patients was performed with preoperative, 1 month, 3 month, 6 month and 1 year postoperative posteroanterio cephalograms and clinical photographs by tracing. And this changes were evaluated in parts to amounts of mandibular setback. Results: Statistically significant increases of TMW in hard and soft tissue from preoperative to postoperative 1 month were seen. TMW in hard tissue from 1 month to 1 year postopertive were gradually decreased. TMW in soft tissue was not changed uniformly but almost equal to pre-operative width. And there was no significant correlation between TMW and amount of mandibular setback. Conclusions: The results show that mandibular setback using BIVRO did not significantly influence increasing of TMW in soft tissue.

• Journal of Korean Neurosurgical Society
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• v.57 no.2
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• pp.100-107
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• 2015

Objective : To report a minimally invasive treatment option using percutaneous pedicle screw fixation with adjuvant treatment for metastatic thoraco-lumbar and lumbar spinal tumors. Methods : This is a retrospective study of charts of patients with spinal metastases. All were older than 18 years of age and were considered to have more than 3 months of life expectancy. The patients had single or two level lesions, and compression fracture or impending fracture. Exclusion criterion was metastasis showing severe epidural compression with definite neurological symptoms. Usually spinal segments from one level above to below pathology were stabilized. Visual analog scale (VAS) score for pain assessment and Frankel scale for neurological deficit were used, while pre- and post-operative performance status was evaluated using the Eastern Cooperative Oncology Group (ECOG). Results : Twelve patients (nine men, three women; median age 54.29 years) underwent surgery. All patients presented with back pain with/without radicular pain. There were no early complications and perioperative mortalities. Following surgery, a significant difference between average pre- and post-operative VAS scores was found (p=0.003). Overall, 91.8% of patients (11/12) experienced improvement in their ECOG score post-operatively. The mean ambulation time was 196.9 days [95% confidence interval (CI), 86.2-307.6 days; median, 97 days]. During follow-up, nine patients died and the mean overall survival time in enrolled twelve patients was 249.9 days (95% CI, 145.3-354.4 days; median, 176 days). Conclusion : Minimally invasive treatment using percutaneous pedicle screw fixation with adjuvant treatment is a good alternative treatment option for potential instability of the thoraco-lumbar and lumbar spinal metastasis.

• Clinics in Shoulder and Elbow
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• v.20 no.2
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• pp.84-89
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• 2017

Background: Common and effective treatments for calcific tendinitis involve needling procedures. However, it has been widespread practice to refer patients with calcific tendinitis, which is a predominantly orthopedic condition, to radiology department. The purpose of this study was to compare clinical and radiological outcomes after ultrasound-guided needling for calcific tendinitis between the orthopedics and radiology department. Methods: Seventy-seven shoulders (Group 1) and 38 shoulders (Group 2) treated in the radiology and orthopedic department, respectively. A fellowship-trained orthopedic surgeon and a musculoskeletal radiologist each performed the procedure of ultrasound-guided needle decompression with subacromial steroid injection. Clinical outcomes was evaluated using the visual analogue scale for pain (pVAS) and the American Shoulder and Elbow Surgeons (ASES) shoulder score before treatment and at each follow-up. The pre- and postneedling size and shape of the calcific deposits were compared between the two groups. Results: We analyzed a total of 56 shoulders for Group 1 and 32 shoulders for Group 2. The mean age and sex ratio of the patients no significantly different. We found that the mean decrease in the diameter of calcification between pre- and post-needling was 9.0 mm for Group 1 and 13.1 mm for Group 2; the difference was significantly larger in Group 2 than in Group 1. Both groups showed improved pVAS and ASES scores after needling but the extent of these improvements did not differ with the type of operator. Conclusions: Needling decompression performed by orthopedic surgeons could a viable option for the treatment of calcific tendinitis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.81-85
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• 2009

As panfacial fractures are involved multiple fracture, there are possibility of many pre-operative & postoperative complications. It is necessary to do exact pre-operative evaluation, appropriate operation and care, for preventing and treating these complications, especially related to optic nerve injury. The complication occurs rarely after periorbital facial bone fracture, and indirect injuries may occur as a result of impact shearing force transmitted into the optic nerve axons or to the nutrient vessels of the optic nerve. Also indirect injuries may occur after the force of impact because of vasospasm and swelling of the optic nerve within the confines of the nonexpansile optic canal. It is necessary to active evaluation and treatments involving decompression of the orbit surgically and high dose steroid therapy in relation to panfacial fracture. But sometimes this treatments are limited due to severe swelling of the face and related multiple bone fractures in the body. This case showed the delayed neuropathy, at last visual loss, in spite of megadose methylprednisolone administration. The purpose of this article is to present indirect traumatic optic neuropathy that is one of many complications in panfacial bone fracture.

• Journal of Gastric Cancer
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• v.3 no.2
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• pp.104-111
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• 2003

Purpose: The prognostic significance of peri-operative serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA)19-9 determination in patients with gastric cancer has been controversial. This study was performed to evaluate the significance of CEA and CA19-9 as clinical predictors of prognosis. Materials and Methods: The correlations between peri-operative serum CEA/CA19-9 levels and clinicopathologic factors were evaluated retrospectively in gastric cancer patients who had undergone curative surgery during the period from January 1995 to December 1998 at the Department of Surgery, Yonsei University College of Medicine. Results: The positive rates for CEA and CA19-9 were $17.9\%$ and $18.4\%$, respectively. The CEA positivity was related to the depth of invasion (P=0.040), lymph-node metastasis (P=0.000), and stage (P=0.001). The CA19-9 positivity was significantly related to the depth of invasion (P=0.000), lymph-node status (P=0.000), and stage (P=0.000). The positive rate of combined assay of pre-operative CEA and CA19-9 was $30.0\%$ There were statistically significant correlations with stage, depth of invasion, or degree of lymphnode metastasis in the combined assay. The survival rates according to the positivity of CEA and to the positivity of CA19-9 were clearly different (P=0.000). Conclusion: It should be stressed that even a simple blood test prior to surgery could be useful in establishing the depth of invasion, the status of lymph-node involvement, and the prognosis. For improved survival, an aggressive lymphadenectomy and adjuvant chemotherapy should be considered for patients with positive levels of pre-operative CA19- 9.

• Archives of Plastic Surgery
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• v.49 no.3
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• pp.304-309
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• 2022

Background Laminin 5, which is found in the basement membrane of dermal-epidermal junction (DEJ), is a major adhesive component and associated with proliferating and migrating keratinocytes. In this study, we hypothesized that the topical application of the skin care products containing the novel peptides might restore the DEJ structure by deriving deposition of laminin 5 and promoting the keratinocyte migration. Here, we evaluated the restoration of DEJ by measuring the skin thickness. Methods Single-center retrospective analysis was performed on a total of 13 patients who underwent skin care using Baume L.C.E. (France, Laboratories d' Anjou) between January and March 2021. All patients applied the skin care agent for 2 weeks only on their left hand dorsum. Before the initiation of the application and after 2 weeks, both their hands were evaluated on photography and ultrasound. And the patients were asked to rate their satisfaction with the questionnaire after 2 weeks. Results There was no obvious improvement in photographic assessment and questionnaire. The post-pre difference of skin thickness in ultrasound images was, in left hand, 0.1 ± 0.37 in distal point and 0.1 ± 0.35 in proximal point; and, in right hand, 0 ± 0.17 in distal point and 0 ± 0.15 in proximal point, respectively. The pre-post difference was statistically significant in proximal point (p = 0.035). Conclusion Topical application of novel peptide derivative comprising laminin 5 demonstrated cutaneous changes including skin thickness, as assessed by ultrasound. Further studies using other modalities including dermal density measurement, three-dimensional photography, optical coherence tomography, or skin biopsy would be helpful to determine the skin-improving effects.

• Clinics in Shoulder and Elbow
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• v.25 no.1
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• pp.57-64
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• 2022

Background: There are various conservative treatment options for lateral epicondylitis (LE). The aim is to evaluate pain, daily functioning, and complications after ultrasound-standardized autologous blood injections in patients with LE. Methods: For this prospective cohort study, consecutive patients (>18 years) diagnosed with LE were included. Autologous blood was injected using a medical device containing an injection disposable with 12 small needles (Instant Tennis Elbow Cure [ITEC]) device. Patient-Rated Tennis Elbow Evaluation (PRTEE), subjective elbow score (SES), palpation and provocation pain, satisfaction, and complications of treatment were measured at baseline and two months after treatment. Paired t-tests and Fisher's exact tests were used for calculating the difference between pre- and post-treatment outcomes. Results: Fifty-five elbows were analyzed. Mean time between pre- and post-treatment was 11.1 weeks (standard deviation [SD], 8.9 weeks). The mean PRTEE score decreased from 68.2 (SD, 15.7) before surgery to 53.2 (SD, 25.9; p<0.001) after. The mean SES improved from 36.9 (SD, 20.8) to 51.7 (SD, 27.4; p<0.001). Despite this improvement, only 44.7% of patients showed relevant clinical improvement in PRTEE, and 37.3% showed significant clinical improvement based on SES. Four patients reported a complication and the injection disposable failed three times. Conclusions: Ultrasound-standardized autologous blood injection using the ITEC device is not an effective tool in reducing symptoms related to LE. This study showed that only half of all patients experienced a positive effect. In this heterogeneous cohort of patients, we showed no added value of ultrasound standardization.

• Hip & pelvis
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• v.35 no.3
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• pp.157-163
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• 2023

Purpose: This study examined the methods for treatment of femoral neck fracture (FNF) preferred by members of the Korean Hip Society (KHS) and identified factors that influence decisions regarding the surgical intervention of choice. Materials and Methods: A total of 97 members of the KHS responded to the 16-question survey which included questions about the mean number of surgeries performed each month for treatment of femoral neck fractures, the cut-off age for deciding between internal fixation and arthroplasty, the implant used most often, usage of cement, and factors influencing each decision. Results: The mean cut-off age used when deciding between internal fixation and arthroplasty was 64 years old. Hemiarthroplasty (HA) (70%) was the most preferred option for treatment of displaced FNFs in cases where arthroplasty was indicated (total hip arthroplasty [THA] 19% and dual mobility THA 11%). The main reasons for selection of arthroplasty over reduction with internal fixation were age and pre-fracture ambulatory status. Pre-trauma ambulatory status and/or sports activity were the main factors in selection of HA over THA. Cement was used by 33% of responders. Poor bone quality and a broad femoral canal were factors that influenced the usage of cement. Conclusion: Management of FNFs in the elderly is a major health problem worldwide; thus, remaining alert to current trends in treatment is essential for surgeons. The mean cut-off age used in deciding between internal fixation and arthroplasty was 64 years old. HA is the preferred method for treatment of displaced FNFs for members of the KHS.