• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.520-527
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• 2010

Introduction: This study examined the treatment patterns of temporomandibular disorders (TMD) including conservative and surgical procedures. Materials and Methods: Patients with TMD who visited Gangnam Severance Hospital from June 2007 to May 2008 were enrolled in this study. All patients were examined from the orthopantomogram, temporomandibular joint (TMJ) tomography, and a clinical examination. The patients who required a further evaluation were examined by magnetic resonance imaging and/or computed tomography. The treatment patterns were divided into counseling, medication, splint therapy, botulinum toxin injection (BTI) and surgical treatment. Results: Among the 2,464 patients, the average age was 31.8 years (ranging from 6 to 93); 764 (31.0%) were male and 1,700 (69.0%) were female. 2,355 (95.6%) patients were treated with conservative therapy; 1,460 (62.0%) patients were treated with medication, 931 (39.5%) patients were treated with splint, and 46 (2.0%) were treated with BTI. There were 109 (4.4%) patients treated surgically. Eight (0.3%) patients were treated with total temporomandibular joint replacement surgery. Conclusion: Almost all patients with TMD were treated using conservative methods. Those patients who received surgical treatment because of an ineffective response to conservative treatment had definite problems with the internal derangement and/or osteoarthritis or had severe clinical symptoms.

• Journal of Korean Neurosurgical Society
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• 제58권3호
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• pp.225-230
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• 2015

Objective : The clinical outcomes according to the radiological results after cervical total disc replacement (TDR) are not well established. Here, the authors reviewed the clinical results according to the asymmetry in radiographs. Methods : This retrospective analysis included patients after TDR ($Mobi-C^{(R)}$ disc) with at least 12 months follow up, and the clinical and radiological data were obtained preoperatively and postoperatively for 12 months. Clinical outcome measures numerical rating scale (NRS) score for neck pain, visual analog scale (VAS) for arm pain, and the Oswestry disability index (ODI) value. The asymmetries of TDRs were evaluated on the anterior-posterior (AP) and the lateral radiographs, and the radiographic adjacent segment degenerations were evaluated for 12 months. Results : A total of 24 patients (one level cervical TDR; 10 male and 14 female; aged $41.50{\pm}8.35years$) were included in this study. The clinical results including NRS for neck pain, VAS for arm pain, and ODIs were similar between the normal and asymmetrized TDRs in AP and lateral radiographs. The radiographic adjacent segment degenerations were significantly increased in deviated TDRs (AP >10 mm asymmetry and lateral>10 mm asymmetry). Conclusion : Asymmetrical location of TDR is not related to the clinical outcomes, but related to the risk of radiographic adjacent disc segment degeneration.

• 동서간호학연구지
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• 제17권2호
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• pp.96-102
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• 2011

Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=-2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.

• 한국방사선학회논문지
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• 제12권1호
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• pp.107-114
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• 2018

고관절 시행에서 식립각도는 추후 환자의 운동범위나 힘의 분배조건에 따라 폴리에틸렌 라이너의 마모에도 영향을 미친다. 인공관절요소로부터 마모입자는 골괴사나 다른 생화학적으로 많은 합병증을 일으킨다. 이런 점에서 인공고관절에서 마모와 정렬각도를 수술 후 추시를 통해 측정하는 것은 중요하다. 특히 관절면의 마모를 측정하는 것은 그 량이 크지 않아 상당한 정밀도를 요구한다. 현재 널리 쓰이는 상용 소프트웨어는 재현성과 측정방법의 표준화가 되어 있지 않아 사용에 많은 어려움이 있다. 본 논문에서는 일반 병원의 방사선촬영 환경에서 CAD만 추가로 구비하면 행할 수 있는 인공관절면 마모와 식립각 측정법을 제시한다. 인공관절만의 X-ray영상을 이용한 본 방법의 정확도와 정밀도 평가를 수행하였다. 또한 실제 인공고관절환자의 X-ray영상을 가지고 2년추시에 따른 마모와 식립각을 측정하였다. 본 연구에서 제시한 CAD를 이용한 방법은 마모측정에서 정확도 0.06 mm, 정밀도 0.05 mm, 식립각은 $0.27^{\circ}$의 정밀도를 갖는다.

• 한국임상약학회지
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• 제24권1호
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• pp.1-8
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• 2014

Objective: Currently, rivaroxaban is widely used clinically for thromboprophylaxis after surgery. However, there are concerns on effectiveness and safety of rivaroxaban for its proper use. We aimed to evaluate the effectiveness and safety of rivaroxaban in orthopaedic patients after total hip replacement surgery in a large medical centre after the preferred formulary was switched from enoxaparin to rivaroxaban. Methods: The study was conducted on the patients who underwent hip arthroplasty surgery at the department of Orthopaedic Surgery at Seoul St. Mary's Hospital, South Korea. Electronic medical records were retrospectively reviewed to identify patients treated with rivaroxaban following total hip replacement between February 2011 and March 2012. Evaluation criteria included indications for use, dose, initiation and duration of therapy, drug interactions, adverse reactions, and status of health care reimbursement. The patients who were on enoxaparin were also reviewed as a reference. Results: We identified 57 patients who received rivaroxaban and 50 who received enoxaparin. All patients were prescribed the drugs for Korean Food and Drug Administration-approved indications. No thromboembolic or bleeding events were observed in either group. However, only 5.3% of rivaroxaban- treated patients had an appropriate length of prophylaxis and only 3.5% began rivaroxaban treatment at the recommended time. Surprisingly, 47.4% of rivaroxaban-treated patients received rivaroxaban despite being ineligible for reimbursement benefits. Conclusion: Rivaroxaban was generally well tolerated clinically. However, the duration of treatment, the time of initiation and patient eligibility for reimbursement require improvements, emphasising the need for education which indicates the area of pharmacists' involvement.

• 근관절건강학회지
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• 제21권3호
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• pp.215-223
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• 2014

Purpose: The purpose of this study was to examine the effect of a progressive lower-extremity exercise program on pain, efficacy of exercise, and the life satisfaction among older women with TKRA. Methods: This study was a nonequivalent control group non synchronized design and was conducted from 12 September 2012 to 05 February 2014 in G-university hospital located in J-city. The sample was composed of an experimental group (n=20) and a control group (n=20). The progressive lower extremity exercise program was applied to the experimental group for 13 days. NRS scale was used to measure the pain, self-efficacy of exercise was measured by Exercise Self Efficacy, and life satisfaction was measured by 8 item questionnaire. Results: The experimental group was significantly lower in the degree of pain (F=73.53, p<.001), higher in the degree of self-efficacy of exercise (F=61.42, p<.001) and life satisfaction (F=80.91, p<.001) than the control group. Conclusion: The progressive lower-extremity exercise program for TKRA patients was useful to reduce pain and improve self-efficacy of exercise and life satisfaction, To reduce the pain and th improve the life satisfaction of older women with TKRA, we need to provide the progressive exercise at bedside during the postoperative recovery phase.

• 대한정형외과학회지
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• 제54권2호
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• pp.110-119
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• 2019

상완골 근위부 골절은 상완골의 외과적 경부 또는 근위부에 발생하는 골절로 정의할 수 있으며, 적절한 치료에도 불구하고 다양한 합병증 및 후유증이 발생할 수 있어 그 치료가 매우 까다롭고 견관절 치환술 등의 수술적 치료를 요하는 경우가 많다. 상완골 근위부 골절 후 후유증은 Boileau가 제시한 분류법이 가장 많이 사용되며, 2개의 카테고리 및 4가지의 타입으로 분류할 수가 있다. 카테고리 I은 관절 내 감입 골절로 결절들과 상완골 두 사이에 저명한 해부학적 변형이 동반되지 않아 결절 절골술을 시행하지 않고도 해부학적 치환물을 사용할 수 있는 경우로서 결절의 불유합이 거의 없이 두경부의 붕괴(cephalic collapse)나 괴사가 있는 타입 1과 잠김 탈구(locked dislocation) 또는 골절-탈구와 관련이 있는 타입 2로 나눌 수 있다. 카테고리 II는 관절 외 골절이며 결절들과 상완골 두 사이에 육안적인 변형이 있는 경우로서 해부학적 치환물을 사용하기 위해서는 결절 절골술을 시행해야 하며, 외과적 경부의 불유합이 동반된 타입 3와 심각한 결절의 부정유합이 동반된 타입 4로 분류할 수 있다. 각 타입별 치료를 위해서 타입 1의 경우에는 결절 절골술을 시행하지 않고 비구속형 치환술을 우선적으로 고려해야 하지만, 타입 1C, 1D와 같이 외반이나 내반 변형이 동반되거나 회전근 개의 지방 변성이 심할 경우에는 역행성 견관절 전치환술 또한 고려해야 한다. 타입 2는 일반적으로 비구속형 치환술로 좋은 결과를 기대할 수 있으나 관절와 골 결손이 없으며 회전근 개의 결손이 동반된 경우 역행성 견관절 전치환술 또한 하나의 치료 방법으로 고려할 수 있다. 타입 3는 견관절 치환술보다는 골쐐기 이식 등을 함께 시행하여 내고정을 시행하는 것이 효과적일 것으로 보이며, 최근 역행성 견관절 전치환술의 결과에 대한 보고 또한 점차 증가하고 있는 추세이다. 마지막으로 타입 4는 역행성 견관절 전치환술이 우선적으로 고려되어야 할 것으로 보인다.

• Clinics in Shoulder and Elbow
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• 제6권1호
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• pp.37-43
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• 2003

Purpose: To evaluate the results in patients who received total elbow replacement for posttraumatic destroyed or unreduced elbow joint. Materials and Methods: Six patients with posttraumatic destroyed, or unreduced elbow joint, who were nearly impossible to move actively and had pain and grossly unstable joint, were followed up average 42 months. 3 cases were soft tissue injuries and bone defects which were caused by severe comminuted fracture, 1 was a nonunion with comminuted fracture, and 2 were unreduced elbow joint. Total elbow replacement was performed average 10 months after the injury. All the cases were used by semiconstrained prosthesis, and the results were estimated by Mayo elbow perfomance score. Results: Pain was decreased in all the cases postoperatively. Average ranges of motion were improved with active extension 20° and flexion 120°. Mayo elbow performance scores were pain 42.5 points, range of motion 17.5 points, stability 8.3 points, function 19.2 points and totally 87.5 points, and final results were 3 excellent and 3 good. Loosening of prosthesis was not found in all the cases by final follow-up radiograph. Conclusicon: Semiconstrained TER can be used as a effective treatment improving pain and active ranges of motion caused by posttraumatic destroyed or unreduced elbow joint, however, long term follow-up is needed because early loosening of TER can be occurred due to severe bone defects.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2001년도 춘계학술대회논문집A
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• pp.951-955
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• 2001

The experimental comparison between bonded and unbonded types stem-cement interface was carried out on axisymmetric stem-cement-aluminum model of the femoral component of a total hip replacement. Human femur was modeled in non-tapered and tapered($7.5^{\circ}$) aluminum hollow cylinders to emulate the diaphyseal and metaphyseal segments of the femur. For unbonded type, we tested stems with three different taper angles($5^{\circ},\;7.5^{\circ},\;10^{\circ}$). In every case, the cement-aluminum interface was designed to endure 8MPa shear strength. (a measured value at cement-bone interface) We tested aluminum models under axial loading for both cases. As an experimental result, it was found that unbonded stem sustained more axial load as bonded stem in both cases, diaphyseal and metaphyseal models. The unbonded types failed in cement mantle under axial compressive load, while the bonded ones failed in shear at cement-aluminum interface. These results suggest that a polished stem will sustain much higher axial load than a roughened stem. And a polished stem will make more stable cement-bone interface that may promote better osteosythesis around the stem.

• 대한정형외과학회지
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• 제52권1호
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• pp.92-96
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• 2017

슬관절 전치환술 후 감염은 큰 관심을 가지는 문제로 국소 부위 및 전신적 감염의 형태로 나타날 수 있으며, 때로는 패혈증으로 진행되는 사례가 보고되고 있다. 이러한 패혈증은 신체의 다양한 부위로 전파될 수 있으며 사망에까지 이르게 하는 중대한 합병증이다. 하지만 감염 후 척추로 전이된 경우는 임상 증상이 뚜렷하지 않아 진단이 어려우며, 이러한 증례에 대한 보고는 어떠한 문헌에도 없었다. 이에 양측 슬관절 전치환술 후 감염으로 인하여 패혈증으로 진행되어 척추로 전이된 증례를 보고하고자 한다.