• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.245-261
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• 1997

Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

• The korean journal of orthodontics
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• v.27 no.2
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• pp.297-313
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• 1997

The purposes of this study were to compare the soft tissue changes following hard tissue change after surgery between the one jaw and two-jaw surgery in skeletal class III patients and to get the reference of the incisal inclination at presurgical orthodontics. For this study 24 patients for the two-jaw surgery group and 18 patients for one jaw surgery group were selected. Lateral cephalograms were taken at pretreatment, after presurgical orthodontic treatment, immediately after surgical treatment and at least 6 months after surgery. They were traced and analyzed on skeletodental structure and soft tissue. The results were as follows: 1. After surgery, maxilla, maxillary incisors and upper lip were moved anteriorly and superiorly in two-jaw surgery group. Mandible and mandibular incisors were moved posteriorly and superiorly, and thickness of lower lip was increased in both group but there were no statistically significant difference. Anterior facial height was more decreased in two-jaw surgery group (p<0.05). At least 6 months after surgery, by the postorthodontic treatment, maxillary incisors were moved labially 1.44mm, mandible and mandiibular incisors were moved lingually 1.43mrn, 1.26mm respectively in one jaw surgery group. But there was no statistically significant changes of hard tissue in two :jaw surgery group. 2. The correlation coefficients of maxillary hard and soft tissue horizontal changes were high in two jaw surgery group and the ratios for soft tissue to A point were 19% at Sri, 80% at SLS, 82% at LS. The ratios for soft tissue to B point were 92% at LI, 104% at ILS in one jaw surgery group, 89% at LI, 101% at ILS in two-jaw surgery group. 3. The correlation coefficients and change ratios of mandibular incisors and LL HS on lower lip horizontal changes were 0 0.89 and 75%, 85% in one jaw surgery group, 0.93, 0.90 and 76%, 87% in two-jaw surgery group. The correlation coefficients of maxillary incisors and Sn, SLS and LS on upper lip horizontal changes were 072, 0.76 and 0.75 in two jaw surgery group and ratios of changes were 57%, 58% and 59%. 4. The regression equations between skeletal horizontal discrepancy and incisal inclinaton were taken in one jaw surgery group. Those were FMIA=57.48-2.17ANB, U1-SN=-75.02+2.17SNB and $R^2$ were 0.63, 063 respectively. So if there is skeletal horizontal discrepancy by mandibular prognathism in one jaw surgery case, we consider attaining more labial inclination of maxillary incisors than normal and more lingual inclination of mandibular incisors than normal. But correlation coefficient of the regression equations in two jaw surgery group was low, so, that equation was not reliable.

• The korean journal of orthodontics
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• v.27 no.2
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• pp.273-282
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• 1997

The purpose of this study was to evaluate changes in mandibular movement patterns after orthognathic surgery in skeletal Class III patients. The sample consisted of 20 Class III malocclusion patients(9 males, 11 females). Just before and after(2-7months) surgery, maximum opening & closing movement, mandibular border movement on sagittal, frontal and horizontal planes were recorded using Sirognathograph & BioPak EGN. On each record, 21 items were measured and statistically analyzed. The results were as follows 1. Angle of protrusive movement on sagittal plane showed greatest change after surgery. Also, as the incisal guidance was established by surgery, straight path of protrusive movement became curved line. 2. Maximum opening distance and maximum antero-posterior distance on maximum opening & closing movement, maximum opening distance on sagittal plane, angle of left lateral excursion on frontal plane were statistically significant after snrgery(p<0.01). 3. Maximum width of lateral excursion on frontal plane, distane of right lateral excursion and angle of maximum left lateral excursion on horizontal plane were statistiraily significant after surgery(p<0.05). 4. Maximum opening distance and maximum antero-posterior distance on maximum opening & closing movement showed significant differences according to post-surgical time(p<0.05). More recovery of range of movement occured in 5-7month group than in 2-3month group. 5. As the occlusal interferences were removed by orthognathic surgery, irregular opening & closing path became smooth curve.

• Clinical and Experimental Pediatrics
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• v.46 no.2
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• pp.178-182
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• 2003

Purpose : Brain tumors are the second most common tumor in childhood, and medulloblastomas comprise 15-25% of brain tumors. The well known prognostic factors are age at diagnosis, stage of disease, and extent of surgical excision. In this study, we analysed the prognostic factors in patients who received chemotherapy after excision. Methods : We reviewed the medical records of 61 patients who received chemotherapy among the 94 patients who were diagnosed and treated between Jan 1985 and Sep 2001 in the Department of Pediatrics and Neurosurgery at Severance Hospital. Results : Among the total survival rate of patients who underwent chemotherapy, the 3-yr progression-free survival rate was $66.5{\pm}6.3%$ and the 15-yr progression-free survival rate was $60.3{\pm}6.7%$. The progression-free survival rate for patients with age at diagnosis over 3 yrs old and under 3 yrs old, was $64.5{\pm}7.7%$ and $48.2{\pm}12.9%$ respectively and there was no statistically significant difference. The survival rate of the high vs low risk group by staging was $72.7{\pm}10.5%$ and $54.6{\pm}8.3%$ respectively, and there was no significant difference. The survival rate of patients with total removal vs subtotal removal was $65.8{\pm}11.8%$ and $56.8{\pm}8.2%$ respectively, showing no statistical difference. Conclusion : The reason there is no difference in survival rate according to the traditional prognostic factors is that chemotherapy has improved not only the total survival rate but also the survival rate in patients with poor traditional prognostic factors. So, sufficient removal of tumor followed by proper chemotherapy and radiotherapy is an important factor which influences the survival rate of medulloblastoma patients.

• Tuberculosis and Respiratory Diseases
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• v.60 no.5
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• pp.516-522
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• 2006

Background : In contrast to tuberculous pleurisy, tuberculous empyema is a chronic active infectious disease of the pleural cavity that is frequently accompanied by cavitary or advanced pulmonary lesions. The condition requires long-term anti-tuberculous medication with external drainage. The clinical features and treatment outcome of tuberculous empyema are unclear despite the high prevalence of tuberculosis in Korea. Methods : From January 1991 through April 2004, 17 patients diagnosed with tuberculous empyema in Kyungpook National University Hospital were enrolled in this study. Their medical records and chest radiographs were reviewed. Results : Twelve patients(71%) had a history of tuberculosis and six of the 12 patients were under current anti-tuberculous medication. Productive cough, fever, and dyspnea were the main complaints. There was no predominance between the right and left lungs. Nine patients(53%) had far-advanced pulmonary tuberculosis, two(12%) had a cavitary lesion, and seven(41%) had a pyopneumothorax on the chest radiograph. All eight cases in whom the data of pleural fluid WBC differential count was available showed polymorphonuclear leukocyte predominance. Eight patients(47%) had other bacterial infections as well. The overall rates of a positive sputum AFB smear and culture for M. tuberculosis were 71% and 64%, respectively. The positive AFB smear and culture rates for M. tuberculosis from the pleural fluid were 33% and 36%, respectively. Twelve of the 16 patients(75%) were treated successfully. Three underwent additional surgical intervention. Two patients (12%) died during treatment. Conclusion : Tuberculous empyema is frequently accompanied by advanced pulmonary lesions, and polymorphonuclear leukocytes are predominant in the pleural fluid. Other accompanying bacterial infections in the pleural cavity are also common in tuberculous empyema patients. Therefore, tuberculous empyema should be considered in differential diagnosis of patients with polymorphonuclear leukocyte-predominant pleural effusion. In addition, more active effort will be needed to achieve a bacteriological diagnosis in the pleural fluid.

• The korean journal of orthodontics
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• v.33 no.1 s.96
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• pp.1-9
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• 2003

The purpose of this study was to find out and evaluate discrepancies between preorthodontic prediction values and actual postorthodontic values and factors contributing to it in 45 patients(17 male, 28 female) who were diagnosed as skeletal Class III ma)occlusion and received presurgical orthodontic treatment and orthognathic surgery at Yonsei university dental hospital. Lateral cephalograms were analysed at pretreatment(T1), orthodontic Prediction(T2), immediately before surgery(T3) and designated the landmark as coordinates or X and Y axes. The samples were divided according to ALD, upper and lower incisor inclination(Ul to SN, IMPA), COS, extraction, the position of extracted teeth and the statistical significance was tested to find out the factors contributing to the prediction. The results were as follows: 1. Differences between preorthodontic prediction values and actual postorthodontic values(T2-T3) were statistically significant(p<0.05) in the x coordinates of U6mbc, L1x and in y coordinates of U1i, U1x, U6me, U6mbc, L6mbc 2. The accuracy of prediction is relatively higher in horizontal changes compared to vortical changes. 3. The statistical significance(p<0.05) between prediction and actual values is observed more in the landmarks of the maxilla than the mandible. 4. Differences between prediction and actual values of incisor and first molar were statistically significant(p<0.05) according to extraction vs non-extraction, extraction type, ALD in the maxilla and according to ALD, IMPA in the mandible. Discrepancies between preorthodontic prediction values and actual postorthodontic values and factors contributing to the prediction must be considered in treatment planning of Cl III surgical patients to increase the accuracy of prediction. Furthermore future investigations are needed on the prediction of vortical changes.

• Journal of Gastric Cancer
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• v.9 no.2
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• pp.57-62
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• 2009

Purpose: The use of automatic circular staplers for gastroduodenostomy after distal gastrectomy is now widely accepted. We compared the clinical outcomes of two different methods. Materials and Methods: Between March 2005 and February 2008, 134 patients with gastric cancer underwent distal gastrectomies. Seventy-six consecutive patients received end-to-side gastroduodenostomies (ES) between March 2005 and September 2006. The remaining 58 consecutive patients received end-to-end gastroduodenostomies (EE) between November 2006 and February 2008. We analyzed the surgical outcomes between the two groups (ES versus EE) on the basis of prospectively collected data. Results: Among the clinical factors, there were no differences between the two groups. The overall complication rates were 19.7% in the ES group and 13.8% in the EE group (P=0.489). With respect to anastomosis-related complications, 2 cases had bleeding and 2 cases had stenoses in the ES group, while 2 cases in the EE group had bleeding. Re-operation was needed in the case of intraluminal bleeding in the ES group. There were no mortalities in our study. Conclusion: The two methods for gastroduodenostomy were safe and technically feasible. Although there was no statistical difference in the overall complications, including anastomosis-related complications, we demonstrated better outcomes with respect to anastomotic stenosis in the EE group.

• Investigative Magnetic Resonance Imaging
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• v.13 no.2
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• pp.146-151
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• 2009

Purpose : To evaluate magnetic resonance (MR) imaging features of non-surgically treated tuberculous spondylitis and to evaluate the relationships between these features and clinical outcomes. Materials and Methods : Data from ten patients (male:female=6:4, mean age=45 years) with clinically proven tuberculous spondylitis who were treated nonsurgically over three months were analyzed retrospectively from 2000 to 2007. MRI was performed at least three times for each patient, at baseline, every three or six months, and at the end of treatment. All images were analyzed by two radiologists. Results : The mean follow-up period for the MR examination was 10.1 months (range, 4-17 months). Six patients had clinically complete resolution of tuberculous spondylitis with medication treatment only. Four patients were treated with surgical management alongside medication. All ten patients were divided into two groups by clinical outcome; six patients with complete treatment and four patients with incomplete treatment. In the complete treatment group, follow-up MR findings showed a loss of subligamentous spread of abscesses, decreased size of abscesses, no interval changes in vertebral body heights, and fatty changes in spinal lesions. MR findings in the incomplete treatment group showed bone marrow edema extension to adjacent vertebra, extension of the abscesses, and decreased height of the vertebral bodies. Conclusion : During the nonsurgical management of tuberculous spondylitis, MR imaging may play a role in predicting patient response to antituberculous drug treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.30 no.3
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• pp.373-384
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• 2003

The purpose of this study was to evaluate the eruption pattern of a cyst-associated mandibular premolar after marsupialization of a dentigerous cyst in children. The result from the twenty two pairs of normalized panoramic radiographs of twenty two patients who underwent neither extraction nor orthodontic traction of the cyst-associated mandibular after marsupialization were as follows. 1. The eruption speed of a cyst-associated premolar was 3.5 times faster than that of the normal contra-lateral premolar(p<0.05). The angulation change of test group was an average of $2.7^{\circ}$ per month. 2. In the change of the level of root formation, the group which had a little root maturity tended to be faster in the eruption speed(p>0.05) and the R1/4 group had a great change in the angulation change(p>0.05). 3. In the change to be with the cusp position index, the eruption speeds were increased to the 30% deviation groups. But, the eruption speed was decreased above that(p>0.05). 4. Group with cyst diminishment rate of more than $80mm^2$ per month showed the fastest eruption speed of all(p<0.05). 5. The mesial angulated teeth in the test group were decreased more rapidly than the distal angulated teeth in the eruption speed(p>0.05). But, increased in the angulation change(p<0.05). 6. There was a tendency of faster tooth eruption with less deviation of tooth axis. Group with tooth axis deviation of less than $15^{\circ}$ showed the fastest angulation change of all(p<0.05). 7. The eruption speed and the angulation change rapidly decreased during the first 6 months following marsupialization. Based on the results of this study, a cyst-associated mandibular premolar erupted more rapidly after marsupializaton. We thought so that it's prognosis was good if the tooth had a little root maturity, a little devitation and cyst lesion healed faster. We recommend that if there is enough space for eruption, orthodontic traction and surgical treatment of the cyst-associated tooth should be postponed 6 months after marsupialization.

• Journal of Life Science
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• v.14 no.3
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• pp.484-489
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• 2004

Artificial joint replacement is one of the major surgical advances of the 21th century. The primary purpose of a TKA (Total Knee Arthroplasty) is to restore normal knee Auction. Therefore, ideally, a TKA should: (a) maintain the natural leverage of the knee joint muscles to ensure generating adequate knee muscle moments to accomplish daily tasks such as rising from a chair or climbing stairs;(b) allow the same range of motion as an complete knee; and (c) provide adequate knee joint stability. Four individuals (2 peoples after surgery one year and 2 peoples after surgery three years) participated in this study. All they were prescreened for health and functional status by the same surgeon who performed the operations. Two days of accommodation practice occurred prior to the actual strength testing. The isometric strength (KIN-COM III) of the quadriceps and hamstring were measured at 60$^\circ$ and 30$^\circ$ of knee flexion, respectively. During isokinetic concentric testing, the range of motion was between 10$^\circ$ to 80$^\circ$ of knee flexion (stand-to-sit) and extension (sit-to-stand). for a given test, the trial exhibiting maximum torque was analyzed. A 16-channel MYOPACTM EMG system (Run Technologies, Inc.) was used to collect the differential input surface electromyographic (EMG) signals of the vastus medialis (VM), vastus lateralis(VL), rectus femoris (RF) during sit-to-stand and stand-to-sit tests. Disposable electrodes (Blue SensorTM, Medicotest, Inc.) were used to collect the EMG signals. The results were as follows; 1. Less maximum concentric (16% and 21% less for 1 yew man and 3 years mm, respectively) and isometric (12% and 29%, respectively) quadriceps torque for both participants. 2.14% less maximum hamstrings concentric torque for 1 year man but 16% greater torque for 3 years mm. However, 1 year man had similar hamstring isometric peak torque for both knees. 3. Less quadriceps co-contraction by 1 year man except for the VM at 10$^\circ$-20$^\circ$ and 30$^\circ$-50$^\circ$ range of knee flexion.