• Journal of Chest Surgery
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• v.39 no.3 s.260
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• pp.214-219
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• 2006

Background: Perforation of esophagus is relatively uncommon. but it is associated with high morbidity and mortality. Treatment and outcome are largely determined by the time of presentation. We performed a retrospective review of patients with esophageal perforation to assess the outcome of current management techniques. Material and Method: A retrospective chart review was performed on all patients treated for perforation of esophagus from March 1990 to March 2005. There were 28 patients (22 men and 6 women: mean age 51 years, range 17 to 82 years) The causes of the perforations were as follows: foreign body retention (9 patients), trauma (7 patients), spontaneous rupture (7 patients), and iatrogenic (5 pati-ients). 18 patients were presented within 24 hours and 10 patients were presented after 24 hours., Esophageal repair was performed in 21 ($75\%$) of them, 4 patients were treated with esophagectomy, 3 patients were treated with feeding gastrostomy and drainage. Result: Hospital mortality was $18\%$ and iatrogenic was increase the mortality rate (p < 0.05). Site of perforation, time from perforation, and treatment method had no influence on mortality. Postoprative leaks occurred in 4 patients after primary repair and were treated conservatively. Conclusion: Esophageal perforation remains a devastating event which is difficult to diagnose and manage. Primary repair can be performed in most patients with esophageal perforation regardless of time to presentation with a low mortality. Accurate diagnosis and early treatment are essential to the successful management of patients.

• Journal of Korean Foot and Ankle Society
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• v.27 no.3
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• pp.93-98
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• 2023

Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally invasive plate osteosynthesis (MIPO) for distal tibia shaft fractures. Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were enrolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively. Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respectively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001). Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.

• Journal of Trauma and Injury
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• v.18 no.2
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• pp.155-160
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• 2005

Background: Falls are a major cause of emergency room visits. Injury secondary to falls is a largely preventable public health problem. This study helps to better understand the epidemiology of falls from height, then develops prevention strategies. Methods: We reviewed the medical records of 192 patients admitted to the emergency department of Konyang university hospital with a history of falls from January 2004 to December 2004. Collected data included the patient's age, gender, height of fall and method, outcome of management, Injury Severity Score(ISS). Results: According to the characteristics of height of fall, the ISS was higher when the patient fell from height of 2 meters or more($13.79{\pm}12.17$) than not($8.13{\pm}9.25$)(p<0.05). There were positive correlation between mean age and ISS(p<0.001, r=0.7). To gender, ISS was higher in the male group($12.73{\pm}11.78$) than the female group($8.48{\pm}10.00$)(p<0.05). Conclusion: Falls often results from multiple concurrent problems including environmental and behavioral factors. This study suggests that we need to improve the occupational environment, especially above 2meters, for decreasing injuries of fall from heights. Also we consider the prevention of children from injuries of fall from heights.

• Journal of Korean Neurosurgical Society
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• v.30 no.11
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• pp.1284-1290
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• 2001

Objective : PCB cervical instrument is a newly introduced fusion device which comprises cervical plate, cage (spacer) and screw system. It is developed to enhance fusion rate and stability, as well as to reduce complications related to hardware failure. We investigated the efficacy of clinical and radiological results of PCB instrument and Lubboc bone. Methods : From August, 1998 to October, 1999, authors performed 54 cases of anterior cervical interbody fusion with PCB instrument and Lubboc bone. Retrospective analysis was undertaken based on clinical and radiological findings. Clinical improvement was evaluated according to Odom's criteria. Cervical plain films and tomography were taken every 2 months to evaluate the degree of interbody fusion and disc height changes. Results : Bone fusion was observed in 36 cases(90%) over 6 months after operation, and during which time there was no significant interval change. There were 3 cases of hardware dislodgement. Disc height was increased significantly and preserved in all cases. Clinical outcome over good degree was seen more than 94% of patients. Conclusion : Longer follow-up period and comparative studies to similar instrument appear to be necessary, but this instrumentation system has shown high fusion rate and fewer adverse effects in our series. We believe this system might be indicated for the treatment of cervical trauma and degenerative disease in selective cases.

• Journal of Acupuncture Research
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• v.23 no.4
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• pp.69-80
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• 2006

Objectives : The occurrence of shoulder pain after attack of stroke varies from 15% to about 80% in patients. Hemiplegic shoulder pain has been shown to affect stroke outcome in a negative way that it interferes with recovery after a stroke. These following processes have been all postulated as causes of a shoulder pain: glenohumeral subluxation, spasticity, impingement, soft tissue trauma, glenohumeral capsulitis, shoulder hand syndrome. And stroke patients may suffer from pain caused by stroke itself(central post-stroke pain). The aim of this study is to investigate the effectiveness of Bee venom therapy for shoulder pain in stroke patients. Methods : To evaluate the effectiveness of Bee Venom Acupuncture Therapy, 40 patients were allocated into control and treatment group. They were monitored for 3 weeks and followed up with VAS score(with the interval of Initial(YAS1)), 1 week later(VAS2), 2 weeks later(VAS3), 3 weeks later(VAS4), Motor Grade and Passive ROM. Results : VAS score decrease in treatment group compared to control group. Bee Venom Acupuncture Therapy seems to decrease hemiplegic shoulder pain and this effect was statistically significant after 3 weeks. Therefore this therapy could be recommended for the treatment of patients with shoulder pain after stroke and further extensive clinical studies are expected. Conclusion : We suggest that GDS oral administration and electro-acupuncture at $BL_{52}$ & $GB_{39}$ are available for prevention and curing about the postmenopausal osteoporosis.

• The korean journal of orthodontics
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• v.32 no.6 s.95
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• pp.395-400
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• 2002

This paper outlines the case of a 56 year-old man undertaking treatment by means of luxation and forced eruption of an ankylosed canine. At the time of diagnosis, the ankylosis of the tooth was not suspected, because there were not signs of intrusive luxation nor horizontal diaplacement. Only after the application of a vertical elastic force failed to erupt the maxillary left canine, was the ankylosis of that tooth suspected. At the time of reevaluation, the maxillary left canine hads no physiologic tooth mobility and emitted a sharp, ringing sound upon percussion. Hence, the maxillary left canine was considered ankylosed. The treatment course then changed to the extrusion of the canine through the surgical luxation of the tooth and the prompt application of vertical extrusive forces. The above outcome was successful for the patient not only in the orthodontic aspect, but also in terms of the periodontal considerations

• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.75-78
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• 2015

High-pressure (HP) injection injury to the upper extremity often causes a very serious clinical problem, leading to poor outcomes, including amputation, so that a true surgical emergency is required. The outcomes can be improved with emergent wide surgical debridement. However the diagnosis of these injuries is often delayed due to underestimated evaluation at first appearance and lack of common knowledge of the seriousness of this injury. The type and pressure of the infecting material is an important factor in prognosis and organic solvents infected pressure injury can cause poor outcome and increased amputation rate. In this case, we report on reconstruction of HP oil-based paint injection injuries of the finger using T-shaped pedicles and multiple venous anastomoses. In this concept, arterial flow can be maintained by the reverse flow of distal anastomosis when there is difficulty with the proximal anastomosis. And venous flow can be preserved by deep and superficial vein anastomosis. This concept has various advantages including preserving patency of the pedicle in chronic vasculopathy or trauma cases and maintaining the arterial flow by the reverse flow of distal anastomosis and can improve the free flap survival by a two vascular anastomosis system.

• Journal of Korean Foot and Ankle Society
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• v.19 no.4
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• pp.151-155
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• 2015

Purpose: The purpose of this study was to analyze the frequency and patterns of intra-articular lesions detected during ankle fracture surgery using ankle arthroscopy. Materials and Methods: Thirty patients (31 ankles) who underwent open reduction and internal fixation combined with ankle arthroscopy for acute ankle fracture at Inje University Busan Paik Hospital from June 2011 to September 2013 were evaluated. The ankle fractures were classified according to the AO/OTA (AO Foundation and Orthopaedic Trauma Association) classification and the intraarticular injuries were identified by ankle arthroscopy. Osteochondral lesions of the talus were divided into nine subtypes based on their locations, and the ligament injuries were classified according to avulsion fracture and rupture. Results: Using arthroscopy, abnormality in the distal tibiofibular ligament was found in 21 cases and osteochondral lesions and defects of the talus larger than 5 mm were detected in 26 cases. Among ligament injuries, anterior inferior tibio-fibular ligament injury was found in 14 cases, posterior inferior tibio-fibular ligament injury was found in two cases, deep deltoid ligament injury was found in three cases, and deep transverse tibio-fibular ligament injury was found in five cases. The locations of the osteochondral lesions were on the antero-lateral, antero-medial, centro-medial, centro-central, centro-lateral, and postero-lateral talus in 11, one, two, one, two, and nine cases, respectively. Conclusion: With early diagnosis and treatment arthroscopy performed at the time of intra-articular fracture surgery is expected to result in a good outcome.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.83-92
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• 1998

Fractures of the clavicles are extremely common, accounting for 5 to 10% of all injuries in the adult skeletal trauma. Despite this, nonunions and symptomatic malunions after clavicular fracture are uncommon. When these complications occur, however, they may be associated with 11 pattern of disability that includes not only pain but also impairment of upper extremity function. The purpose of this study was to clarify the outcome of clavicular fractures treated by conservatively, and emphasize treatment and factors that possibly predispose a clavicular fracture to poor function or nonunion. We evaluated 9] consecutive fractures of the middle-third of the clavicle in adults which had been treated conservatively. There were 59 males and 33 females ranging in age from 17 to 80 years (average 36.8 years). Nine of the 91 fractures (10%) had developed nonunion, and 4 fractures (4.4%) reported unsatisfactory results. No patients had significant impairment of range of motion or strength as a result of the injury. We found that initial shortening at the fracture of≥20mm(6 cases) had a highly significantly association with nonunion(P<0.0001). Final shortening of 20mm or more (4 cases) was associated with an unsatisfactory result, but not with nonunion(P<0.0001). Our results have led us to recommend the open reduction and internal fixation of severely displaced fractures of the middle third of the clavicle in adults patients.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.304-308
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• 2010

Purpose: Many causes for triggering or locking of the fingers have been discussed in other literatures. The most common one is known stenosing tenosynovitis, which causes, a mismatch between the volume of the flexor tendon sheath and its contents. However, repeated trauma to the hand is uncommon cause of trigger finger. Therefore, we present a case of a rare condition of stenosing tenosynovitis which developed from a repeated relatively weak superficial flexor tendon injury. Methods: The patient was a 62-year-old woman who showed a painless, fixed and round mass on her right hand with no particular cause. Active and passive range of motion of the metacarpophalangeal joint of long finger was limited in flexion and extension. Ultrasonographic finding showed injured flexor digitorum superficialis tendon had fibrillar architecture with swelling between hyperechoic synovial membrane and hypoechoic surrounding area. Surgical exploration revealed that a bunched portion of the flexor digitorum superficialis and A1 pulley cause triggering during operation after adhesiolysis of scar tissue. Results: After releasing the A1 pulley, the range of motion of the metacarpophalangeal joint of long finger showed no limitation and histological examination of the subcutaneous tissue revealed fibrous fatty degeneration. In this case, releasing the A1 pulley with adhesiolysis of the subcutaneous scar tissue was successful and we obtained good functional outcome. Conclusion: We examined a patient in whom a repetitive impact forces to the palm caused longitudinal tear of the flexor tendon, leading to trigger finger. We experienced a rare case of stenosing tenosynovitis and trigger finger caused after close injury to flexor digitorum superficialis and its degenerative changes that caused mass like effect. To the best of authors' knowledge, our case of close injury to the flexor digitorum superficialis and unique morphologic change before rupture of tendon is rarely to be reported.