• Clinics in Shoulder and Elbow
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• 제5권2호
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• pp.110-117
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• 2002

Purpose: We compared the results of open and arthroscopic Bankart repair in traumatic recurrent anterior dislocation ,3f the shoulder. Materials and methods: We analysed 7 cases underwent open Bankart repair (group I) and 13 cases underwent arthroscopic Bankart repair (group Ⅱ). The average follow-up period was 68.1 months (51-113 months) in group I and 41.1 months (16~57 months) in group Ⅱ. All patients in group I and Ⅱ were non-athletes. We analyzed statistically objective evaluation, such as the stability of shoulder joint, the range of motion, pain, impaired throwing, Bankart rating system by Rowe and subjective evaluation, visual analog scale (VAS) between two groups. Results: In terms of dominant and non-dominant shoulders, the age at initial episode of dislocation, the elapsed time from injury to surgery, the number of preoperative dislocations associated with susceptibility to apprehension. respectively, there was no statistically significant differences between two groups. In group I the average Rowe's scortls was 84.3 and 3 cases (43%) had excellent results,4 cases (S7cfo), good ones. In group H the average Rowe's scores was 87.3 and 7 cases (54%) had excellent results,6 cases, good ones. There was tendency to show more excellent results in group ll, but there was no statistically significant differences. The average VAS were 90.3 points in group I and 88 points in group Ⅱ, which showed also no statistically significant differences. Conclusion: Open and arthroscopic Bankart repairs had no significant difference and showed also good results in travinatic recurrent anterior dislocation of shoulder.

• Journal of Hospice and Palliative Care
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• 제10권1호
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• pp.21-28
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• 2007

본 고에서는 보다 수준 높은 호스피스 케어를 위해서는 고통에 대한 포괄적인 이해와 영적 접근에 대한 의식확장이 전제되어야 한다는 가정 하에 관련된 문헌을 살펴보았다. 최근 건강관련분야 특히 만성적 건강문제에 접근하는 기본 패러다임으로 총체적 모델에 대한 관심이 증대하고 있는데 이는 인간에 대한 존엄과 인간을 몸과 마음 그리고 영적인 요소가 하나로 통합된 존재로 보는 이론체계를 수용한다. 따라서 전인적, 총체적으로 인간을 이해하는 것은 죽음을 앞둔 대상자의 건강과 관련된 의사결정과 치유과정에 필수적인 요소라 할 수 있으며 이 때 제기될 수 있는 윤리적 관점은 또다른 차원의 문제인 것이다. 인간은 죽음을 체험하면서 궁극적인 고통과 대면하게 되는데 이러한 문제를 해결하기 위해서는 의료적 조치인 이성의 힘만이 아니라 절대자인 신(God : 하느님 : 우주)과의 관계 안에서의 모색이 연결되어져야 할 것이라고 본다. 죽음의 고통을 겪고 있는 대상자들은 의료인의 따뜻한 마음과 전인적인 포용력을 요구하는 인간적인 특성을 소지하고 있다. 호스피스에 관심을 갖는 의료인들은 인간의 마음 속 깊은 곳에 자리하고 있는 종교심 또는 영적 영역의 장을 인정하고 애정어린 몸짓으로 대상자의 고통에 함께 함으로써 보다 수준 높은 호스피스 케어가 이루어질 수 있으므로 그들의 곁에 있다는 것을 느끼게 해주는 한편 고통에 대한 의식을 확장하고 발전시키고자 하는 신념을 소지할 필요가 있다.

• Clinics in Shoulder and Elbow
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• 제20권4호
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• pp.222-229
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• 2017

Background: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. Methods: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. Results: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were $156.7^{\circ}$, $152.2^{\circ}$, $61.1^{\circ}$, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. Conclusions: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.

• Journal of Chest Surgery
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• 제23권1호
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• pp.73-80
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• 1990

A total of 129 patients with a confirmed diagnosis of primary lung cancer were treated at Dep. of Thoracic k Cardiovascular Surgery, National Medical Center, Seoul, Korea, between July, 1981 and Dec., 1988. Particular emphasis was given in this review to the 72 patients that underwent surgical resection of their primary lung lesion. Factors such as histology, type of resection, sex, age, staging, and degree of dissemination were considered possible influences on survival. The age group of fifty k sixty decade occupied 55.8 %, and the youngest being 24 years and oldest 78 years. The incidence ratio of male to female was 3,2:1. The subjective symptoms of the patients were coughing [72.6%], chest pain [48.2%] and hemoptysis [35.6%], which were due to primary local influence. The confirmed diagnostic procedures were bronchoscopic biopsy, sputum cytology needle aspiration biopsy, open lung biopsy, anterior mediastinotomy & lymph node biopsy. By pathologic classifications, the squamous cell carcinoma was the most prevalent, 67 cases [51.9 %], and the adenocarcinoma in 36 cases [27.9%], undifferentiated small cell carcinoma in 13 cases [10.1 %], undifferentiated large cell carcinoma in 9 cases [6.9%], bronchioloalveolar carcinoma was 4 cases [3.1%]. The lymph node dissection with pneumonectomy [42 cases], lobectomy [14 cases] and pneumonectomy [6 cases], lobectomy [9 cases] without lymph node dissection were performed. The post operative TNM Staging[AJC] in 72 cases were Stage I in 24 cases, Stage II in 27 cases, and Stage III in 21 cases. Overall resectable was possible in 72 cases [55.8 %], and the operation mortality was 5.6 % [4 cases].

• 한국언론정보학보
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• 제52권
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• pp.90-110
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• 2010

십대를 탈정치화된 문화소비자로 우려하거나 의식화된 정치 행위자로 찬미하는 기존의 거친 이분법에 문제제기하며, 이 연구는 십대 소녀.소년들의 정치 참여의 문화적 의미를 2008년 촛불광장을 중심으로 탐구한다. 말걸기와 듣기를 통한 성찰적 방법론으로서 심층인터뷰를 실시하여, 십대가 일상적으로 겪은 고통과 불안의 감정이 자아의 윤리로 성장하는 과정, 개인적인 가치와 신념이 또래집단 내에서 소통적 관계로 확장되고 집합화되는 방식, 그리고 세대/젠더적 감수성이 운동 세력 내부에서 차이들의 정치로 다층화되고 활성화되는 역동을 읽어내었다. 주변화된 타자로서 십대가 윤리적.소통적.정치적 주체로 ‘되어가는’ 과정으로 촛불운동을 이해함으로써, 촛불광장을 단지 일시적인 이벤트로 단편화하는 대신, 새로운 정치세대의 성장이라는 역사적 과정으로 맥락화할 것을 제안한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권6호
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• pp.488-496
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• 2004

Oral & Maxillofacial surgery can lead to complications that result in abnormal sensation or movement. Inferior alveolar nerve(IAN) injury can result in dysesthesia, paresthsia of the lower lip and chin, so patients presenting with IAN damage suffer from sensory loss. But diagnosis of the nerve injury is largely limited to the subjective statements made by the patient. Distribution of sympathetic nerves parallels the distribution of the somatosensory nerves. Loss of sensory tone causes a concomitant loss of sympathetic activity, resulting in vasodilation of the cutaneous blood vessels that demonstrates greater heat loss. Digital infrared thermographic imaging(DITI) detects infra-red radiation given off by body. DITI can detect minute difference in temperature from different parts of the body and translates the amount of heat into quantitative data. The area of different temperature correlated with pain or disease can be visualized by corresponding color. The objective of this study was to determine the efficacy of DITI in objectively assessing IAN injury. The 19 normal subjects and the 14 patients underwent DITI scan. The normal subjects received unilateral IAN block anesthesia with 2 ml of 2% lidocaine (IAN bolck group) to evaluate temporary alteration in nerve function. Patient group were patients with unilateral IAN damage (dysesthesia or paresthesia) after surgical treatment(Mn. 3rd molar Extraction, etc.). The surgical procedure performed within 6 months of test. The results were as follows. 1. No significant differences in temperature were found between left and right sides of the lower lip and chin in the control group. 2. Significant temperature differences were found between the anesthetized and non-anesthetized sides of the lower lip and chin in the IAN block group. 3. Significant temperature differences were found between the involved and uninvolved sides of the lower lip and chin areas of the experimental group. The results of the study show that DITI can be an useful and effective means of objectively assessing and visualizing IAN damage.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.101-106
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• 2006

The purpose of this study was to analyze the mid to long-term clinical and radiological outcome of vascularized pronator quadratus-wrapped radial bone flap arthroplasty for symptomatic advanced $Kienb{\ddot{o}}ck's$ disease. Between 1982 and 2000, 41 cases of advanced $Kienb{\ddot{o}}ck's$ disease were treated with vascularized pronator quadratus wrapped radial bone flap arthroplasty. There were 17 men and 24 women, with a mean age of 39 years at the time of operation. According to Lichtman's classification, there were 13 stage IIIb and 28 stage IV patients. The duration of follow-up averaged 6.1 ($3{\sim}22$) years. We assessed the clinical outcome by subjective pain and active range of motion of the wrist, and evaluated the radiologic outcome by using carpal height ratio and radioscaphoid angle. Postoperatively, all patient reported an improvement in their symptoms. The mean active extension and flexion were improved by $9^{\circ}$ and $6^{\circ}$, respectively (p<0.05). The carpal height ratio was decreased from a mean of 0.52 to 0.48, and the radioscahpoid angle was increased from a mean of $61^{\circ}$ to $66^{\circ}$, but the differences were not significant statistically. Vascularized pronator quadratus-wrapped radial bone flap arthroplasty improves the wrist motion and may prevent serious carpal collapse in advanced $Kienb{\ddot{o}}ck's$ Disease.

• Archives of Plastic Surgery
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• 제38권6호
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• pp.861-866
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• 2011

Purpose: Together with the breast, buttocks are an important element of attractive body contour. To make a beautiful buttocks, improvement of body contour around the buttock as well as buttock augmentation and lifting is also important. The authors investigated characteristic features of buttocks in Koreans and report about the results of liposculpture and autologous fat injection for improving buttock's contour. Methods: We performed a retrospective study of 21 patients who would like to gluteal reshaping. We checked about buttock's ptosis, projection, depression, gluteal retraction and excessive fat accumulation around buttocks. Depending on it, we performed liposculpture and autologous fat injection. Under general anesthesia, we harvested fat from excessive fat accumulation areas around buttocks, and injected into buttocks medio-superiorly. Postoperatively, pillows were positioned on the bed not to press the buttocks which were injected with the fat. Results: Based on the shape of buttocks, A-shape is seen in 4 cases (19%), V-shape 3 cases (14%), squareshape 9 cases (43%), round-shape 5 cases (24%). Based on the Gonzalez's ptosis grading method, 1 degree ptosis is 1 case (4%), 2 degree ptosis is 6 cases (29%), 3 degree ptosis is 8 cases (38%), 4 degree ptosis is 6 cases (29%). There were no complications such as infection, hematoma, pain, dysparethesia. The subjective assessment of surgical results by patients was excellent. Conclusion: To make a beautiful buttock, improvement of body contour around the buttock as well as buttock augmentation and lifting is also important. Liposculpture and autologous fat grafting are very safe, useful and easy methods for improving buttock's contour.

• 대한예방한의학회지
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• 제13권3호
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• pp.87-99
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• 2009

Objectives : The study was to examine the empirical evidence concerning the effects of massage intervention for the laboring women and to investigate the effect sizes related to the characteristics of intervention. Methods : Meta analysis was performed. A total of 11 trials related to massage intervention between 2000 and 2007 were reviewed. Results : Massage intervention showed a beneficial effect on length of labor(1st stage : U=46.75, p=0.00, 2nd stage : U=6.13, p=0.01), perception of childbirth experience(U=12.57, p=0.00), intensity of uterine contraction at the active(U=6.34, p=0.01) and the transition phases(U=24.83, p=0.00), and interval of uterine contraction at the active phase(U=4.83, p=0.03). Massage decreased systolic(U=10.81, p=0.00) and diastolic blood pressure at the transition phase(U=10.60, p=0.00). However, massage had no effect on subjective and objective labor pain and anxiety. No differences were found in effectiveness of massage according to characteristics of intervention(massage material, massager, and massage site) except for anxiety(QB=4.82, p=0.03) and diastolic blood pressure at the active phase by massage site(QB=4.52, p=0.03). Conclusions :We found that massage intervention for the laboring women had an empirical evidence on improving perception of childbirth experience and shortening length of labor. These results should be interpreted with caution due to the lack of studies. More full-scale randomized clinical trials with reliable designs are recommended to further warrant the effectiveness of massage.

• Journal of Chest Surgery
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• 제21권3호
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• pp.510-517
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• 1988

With the ligation of a patent ductus arteriosus by Gross in 1938, surgeons first entered the field of congenital heart disease, and treatment of the patent ductus is representative of the rapid advance made in thoracic surgery in the last 40 years. We have had clinical experiences about 36 cases of this in the department of Thoracic & Cardiovascular surgery, Pusan Paik Hospital, Inje medical college from March 1891 to June 1987. And the results were summarized as follows. 1. There were 11 males, 25 females. The age range of the patients were from 8 months to 36 years with the mean age of 7.9 years. 2. The chief complaints of the patients on admission were frequent URI[50%], dyspnea on exertion[29.8%], chest pain[11.1% k 1%], growth retardation[2%], cough[2.8%], anorexia[2.8%]. But there were 11 patients[30.6%] having no subjective symptoms. 3. In auscultation, the usual continuous machinery murmur was noticed in 30 patients[83.3%], only systolic murmur in 6[16.7%]. 4. In the preoperative chest P-A views, there were noticed cardiomegaly in 20 cases, enlarged pulmonary conus and / or pulmonary plethora in 22 patients[61.1%]. 5. In the preoperative EGG findings, there were noticed pattern of LVH in 8 patients[22.2`], RVH in 2[5.6%], BVH in 4[11.5%] and normal in 19[52.89o]. 6. The size of PDA[mean] was 9.5 mm[length] and 8.8 mm[width], the range of length was from 4 to 29 mm and the range of width was from 4 to 18 mm. 7. There were noticed 6 cases which were combined with other anomalies[VSD in 2 cases, Coarctation of aorta in 2, Mitral regurgitation in 1, and AP window in 1]. 8. On operation, simple ligation of the ductus was performed in 30 cases[83.3%], division and suture-ligation in 5[13.9%]. 9. Postoperative complications were noticed in 4 cases[pneumonia in one case, wound infection or disruption in 3], but there were no mortality.