• Title/Summary/Keyword: Traumatic

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Accelerated Rehabilitation After Arthroscopic Bankart Repair - A Prospective Randomized Clinical Study - (관절경적 Bankart 봉합술후 적극적 재활치료 - 전향적 임상연구 -)

  • Kim Seung-Ho;Ha Kwon-Ick;Jung Min-Wook;Lim Moon-Sup;Kim Young-Min;Park Jong-Hyuk;Cho Yang-Bum
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.79-88
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    • 2002
  • Purpose: In this prospective, randomized study, we compared the results of early motion versus conventional immobilization after the arthroscopic Bankart repair. Materilal and Methods : We performed an arthroscopic Bankart repair using suture anchors in 62 patients with traumatic anterior shoulder instability and randomized them into two groups; Group 1 (n=28; mean age, 28 years) underwent three-week of immobilization and conventional rehabilitation program, while Group 2 (n=34; mean age, 29 years) underwent an accelerated rehabilitation program with staged range of motion and strengthening exercises starting from the immediate postoperative day. Selected patients were non-athletes with a classic Bankart lesion and a robust labrum. Analysis of outcome included pain scores (6-week and follow-up: 31(9 months), range of motion, return to activity, recurrence, patients’ satisfaction with each program, and shoulder scores (ASES, UCLA, and Rowe). Results : The recurrent rate was not different between the two groups (2 anterior apprehension from each group) (p=0.842). Patients with accelerated rehabilitation resumed functional range-of-motion faster and returned earlier to the functional level of activity (p<0.05). Accelerated rehabilitation decreased postoperative pain and more patients were satisfied with this program (p<0.05). No differences were found between the two groups at the follow-up with regards to the shoulder scores, return to activity, pain score, and the range-of-motion. Conclusions : Early mobilization after arthroscopic Bankart repair does not increase the recurrence rate in selected patients. Although the final outcomes are similar in both groups, the accelerated rehabilitation program promotes functional recovery and reduces postoperative pain, which enables patients an early institution of desired activities.

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The Study of patient rotation angle to get the scapular true lateral image in scapular lateral projection (견갑골 측방향 촬영에서 견갑골 정측면상을 얻기 위한 환자의 회전각도에 관한 연구)

  • Park, Ki-Bong;Kang, In-Hyi;Choi, Nam-Kil;Jang, Young-Il;Jeon, Ju-Seob
    • Journal of radiological science and technology
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    • v.28 no.3
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    • pp.203-209
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    • 2005
  • Objective True lateral scapular image was very important to diagnosis the scapular fracture and dislocation induced by traumatic injury. The aim of this study was to know the patient rotation angle to be showing the scapular true lateral in Korean. Subjects and Materials Thirty patients(22men, 8 women, mean ages 53.4)with scapular pain, had supine anteroposterior projection taken with $32^{\circ}$, $37^{\circ}$, $42^{\circ}$ trunk rotation angle changing the manual angulation material. Radiographs were evaluated independently by 5 experienced observers(1 orthopedics surgery specialist, 1 diagnostic radiology specialist, 3 radiological technologist) They assessed overlab of vertebral border and axillary border of scapular as follows; Totally overlapping of vertebral border and axillary border is 4, partially overlapping is 3, not overlapping is 2 and oblique location with two borders is 1. All observers scored using by PACS monitor. Results $32^{\circ}$ trunk rotation was scored $1.53{\pm}0.39$, $37^{\circ}$ trunk rotation was scored $3.83{\pm}0.15$ and $42^{\circ}$trunk rotation was scored $2.17{\pm}0.43$. There was no difference(p<0.05) between group of more than 100cm of the girth of the chest and group of less than 100cm. Similarly, men and women group showed no difference(p<0.05) with trunk rotation statistically. Conclusions There was no result of trunk rotation angle to radiograph the true scapular lateral image up to date. This studies were summarized as follows; Adaptation of $37^{\circ}$ trunk rotation was the best to show the true scapular lateral image in Korean. Our results were very useful to get the true scapular lateral images in clinic.

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Arthroscopic Treatment using Bioabsorbable Knotless Anchor for Anterior Instability of Shoulder (관절경하 생체흡수형 Knotless Anchor를 이용한 견관절 전방 불안정성의 치료)

  • Lee, Yong-Jae;Lee, Tong-Joo;Lim, Kwang-Yul;Kim, Myung-Ku
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.103-108
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    • 2004
  • Purpose: This study reported the outcomes following the use of bioabsorbable knotless anchor in patients with anterior instability of shoulder. Methods: We studied fifteen cases with traumatic anterior shoulder instability underwent arthroscopic Bankart repair with bioabsorbable knotless suture anchor between January 2003 and June 2003. Among fifteen patients, fourteen were male and one was female, with a mean patient age of 24 years (range 16-42). The mean follow-up was 14 months (range 12-18 months). We compared with operation time of twenty cases of arthroscopic Bankart repair by the suture anchor technique between January 2002 and October 2002. Results: Neither recurrent dislocation nor subluxation was happened in postoperative follow-up. Mean score for functional evaluation by Rowe et al. was 89.4 and that for patient subjective satisfaction was 87,5. At last follow-up period, average shoulder range of motion for flexion and external rotation was 171$^{\circ}$ and 54$^{\circ}$ respectively. All patients were satisfied except three who had an apprehension at the follow up. During Bankart repair, it took an average of 25.5 minutes for one knot with the use of suture anchor technique whereas an average of 16.5 minutes for one knot with the use of bioabsorbable knotless anchor. Significantly, we saved operation time with the use of bioabsorbable knotless anchor (P<0.05).Conclusion: Repairing the Bankart lesion with the use of knotless anchor technique has the advantage of obtaining good capsular tensioning and saving operation time. And it is considered to be very successful in treating shoulder instability without recurrent dislocation or subluxation.

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Personality Characteristics Predicting Depression, Anxiety and Resilience in the Graduate Medical Students (의학전문대학원 학생들의 우울, 불안, 회복력과 연관된 성격 특징)

  • Wee, Sung-Hoon;Lee, So-Jin;Park, Chul-Soo;Kim, Bong-Jo;Lee, Cheol-Soon;Cha, Boseok;Lee, Dongyun;Seo, Ji-Yeoung;Choi, Jae-Won;Ahn, In-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.102-111
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    • 2018
  • Objectives : This study aimed to investigate the relationship between personality characteristics of medical students at their admission and the level of depression, anxiety, and resilience at their third year. Methods : Self-reported questionnaires were conducted to the students at the beginning of the first year and the third year. When the students in their first year, they performed the personality assessment inventory, the Beck depression inventory, and the Beck anxiety inventory. When they were in the third year, the students answered the composite Scale of morningness and Conner-Davidson resilience scale-10 in addition to the BDI and BAI. Multiple linear regression analyses were performed to identify predictors of the level of depression, anxiety, and resilience. Results : Of the subscales of depression in the PAI, the physiological depression (${\beta}=-0.285$, p=0.049) associated with increase in the depression from the first to the third year. Among the anxiety-related disorder subscale in the PAI phobia (${\beta}=0.119$, p=0.022) and traumatic stress (${\beta}=0.375$, p=0.007) associated with the level of depression at third grade. Somatization (${\beta}=0.631$, p<0.001) in the PAI associated with the level of anxiety at third year. The anxiety (${\beta}=-0.531$, p<0.001) in the PAI was positive associated with the resilience at third grade. Conclusions : This study showed that certain personality characteristics at admission had significant relationships with the level of depression, anxiety, and resilience at the third grade medical students.

Estimation of the Optimal Periods for Planting and Felling Larix kaempferi Based on the Period of Its Cambial Activity (형성층 활동 기간을 활용한 일본잎갈나무 식재 및 벌채 적기 추정)

  • YOO, Hye-Ji;JU, Jeong-Deuk;PARK, Jun-Hui;SHIN, Chang-Seob;EOM, Chang-Deuk;SEO, Jeong-Wook
    • Journal of the Korean Wood Science and Technology
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    • v.49 no.5
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    • pp.399-415
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    • 2021
  • This study was conducted to suggest the optimal periods for planting and felling Larix kaempferi tree by monitoring its cambial activity period. In addition, the heat summation to induce the cambial activity of Larix kaempferi was investigated. The study sites were at Mt. Worak and Mt. Midong. After selecting 5 trees at Mt. Worak and Mt. Midong, the cambium samples were collected using a mini trephor with 2 mm diameter from April 7 to October 6, 2017 at Mt. Worak, and from April 7 to September 29, 2017 at Mt. Midong. After the collected cambium samples were embedded in PEG2000, transverse thin sections with a thickness of 10 to 15 ㎛ were prepared using a microtome. One Larix kaempferi sample from each site, Mt. Worak and Mt. Midong, in which the accurate monitoring of cambial activity was impossible due to the formation of traumatic resin canal, was excluded from the study. The observation of the initiation date of cambial activity under a light microscopy revealed that 2 specimens from Mt. Worak and 3 from Mt. Midong showed the initiation on April 28. The remaining 2 specimens of Mt. Worak and 1 specimen of Mt. Midong were initiated on May 4, which was a week later than the others. The heat summation that induced the initiation of cambial activity was 196.4-271.8 at Mt. Worak and 204.7-277.3 at Mt. Midong, which was similar. The termination of cambial activity occurred between August 4 and 25 at Mt. Worak, and between August 4 and September 1 at Mt. Midong. Based on the above results, it was found that the optimal planting period for Larix kaempferi in Mt. Worak and Mt. Midong was before April, about a month before the cambium activity, and the felling period was from October when the cambial activity was completely terminated.

Analysis of Bone Mineral Density of Ankle Fracture Patients (족관절 골절 환자의 골밀도 분석)

  • Kim, Tae Hyung;Lee, Jae Hyung;Park, Seung-Hwan
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.334-340
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    • 2021
  • Purpose: This study analyzed the bone mineral densities of the lumbar vertebrae and femurs of patients with ankle fractures to determine the correlation between ankle fractures and osteoporosis. Materials and Methods: From April 2002 to July 2014, one hundred consecutive ankle fracture patients with bone mineral density tests performed within post-traumatic one year were enrolled. The patients were divided into three age groups according to their age at the time of injury (group 1: <50, group 2: 50-69, group 3: ≥70). The types of ankle fractures were classified into unimalleolar, bimalleolar and trimalleolar fractures. The bone mineral density was analyzed using the T score, Z score, absolute value (g/cm2) of the lumbar spine (L1-L4), femur neck, femur intertrochanter, and total femur. Results: There were 3.2 times more females with ankle fractures than males, and the prevalence of osteoporosis according to age group was 0% in the group under 50 years, 24.2% in the 50 to 69-year-old group, and 15% in the group over 70 years. Osteoporosis was found in 30% of patients with a trimalleolar fracture in the 50 to 69-year-old group. In all patient groups, a lower age indicated a higher frequency of unimalleolar fractures. The relationship between the bone mineral density and the type of fracture is that the frequency of trimalleolar fracture increased with decreasing T score of the lumbar vertebrae and the absolute value of bone mineral density (g/cm2) and the Z score of the femur neck, but there were no other indicators. Conclusion: Among the 100 patients with ankle fractures, females were more common than males, because osteoporosis was less severe in males. The incidence of unimalleolar fracture was higher than that of trimalleolar fracture. On the other hand, the correlation between the ankle fractures and the bone mineral density of the femur and lumbar spine was not significant.

Playing Trauma -A Study on the Representation of History in Taiwan Horror Game Detention (플레잉 트라우마 -대만 호러게임 <반교>의 역사 재현 연구)

  • Bae, Ju-Yeon
    • Journal of Popular Narrative
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    • v.26 no.2
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    • pp.87-122
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    • 2020
  • This study explores the method of representation of traumatic history in 2D horror game Detention developed by Taiwan game production company Red Candle through an analysis of its method of storytelling. Unlike conventional public media, video/digital games are based on interactivity, in which game players engage in the narratives. Thus, the relationship between players and the history in the game world may also change. This research investigates how the players build their way of remembering and recognizing the past in a different relationship. Detention, which was well received, not only in Taiwan but also around the world upon its launch in 2017, is set in a middle school during the martial law era in Taiwan in the 1960s. In the game, the main character encounters her lost memories in the process of following clues and game rules, and finally realizes she is implicated in the 1960s' event. Detention was cinematized after the success of the game. The film achieved enormous popularity both in terms of box office success and criticism. In this paper, the strategy of the game's storytelling is introduced in comparison to the film's approach in the representation of historical events. In particular, the paper explores elements such as the interactivity of the game medium, narrative fragmentation, quests, hints and cues, and the horror genre, that asks users to understand history beyond the game world differently from the point of view of other media. Though this study, it can be considered that the digital game is a medium exploring history in a serious manner. In particular, Detention invokes the matter of game-mnemonics as well as cine-mnemonics. Compared to plentiful research in cine-mnemonics, game-mnemonics has not been extensively studied to date. Therefore, through the analysis of Detention, this paper explores the relationship between digital games, history and memory.

Comparison of the Outcomes according to the Injury Type of the Short Radiolunate Ligament in Fracture-Dislocation of the Radiocarpal Joint (요수근 관절의 골절-탈구에서 단요월상인대의 손상 형태에 따른 치료 결과의 비교)

  • Heo, Youn Moo;Kim, Tae Gyun;Song, Jae Hwang;Jang, Min Gu;Lee, Seok Won
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.51-60
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    • 2021
  • Purpose: Radiocarpal dislocation (RCD), which is caused by high-energy trauma, often involves radial styloid fractures and short radiolunate ligament (SRLL) injuries. Although SRLL injuries may occur as a simple rupture at the attachment site of radius, it may occur with a relatively large avulsed-fragment in the volar rim of the lunate facet of the radius. This study aimed to differentiate the injury type of SRLL and assess the differences in the treatment results depending on the treatment methods that have been applied in RCD with radial styloid fractures. Materials and Methods: Eighteen patients managed surgically with RCD were enrolled in this study. The patients were classified as Group 1 and Group 2 by using the Dumontier method. In this study, Group 2 was subdivided into 2A (purely ligamentous or small avulsion fracture of the volar rim of lunate facet) and 2B (large avulsed-fragment enough to internal fixation) according to the injury type of SRLL. Groups 2A and 2B were treated with direct repair and screw fixation, respectively. Pain, range of motion of the wrist joint, grip strength, and complications on final radiographs were examined. The outcomes were evaluated using patient-rated wrist evaluation (PRWE), and modified Mayo wrist score (MMWS). Results: All patients were Group 2 (six and twelve patients in 2A and 2B, respectively). The mean flexion to extension arch recovered 79%,and the mean grip strength was 72.9% of the uninjured side. Group 2A showed better recovery in extension, flexion and pronation than Group 2B, but there was no difference in radial deviation, ulnar deviation, supination, grip strength and pain. No differences in the PRWE and MMWS were observed between two groups. Complications included traumatic arthritis in seven patients and residual instability in five patients. Conclusion: When the SRLL was injured, the involvement of a large avulsion fracture on the anterior plane of the radiolunate did not affect the test results. On the other hand, it should be observed cautiously because avulsion fractures tend to disturb the joint's reduction through rotation or displacement. In addition, anatomical reduction and sturdy internal fixation are important for restoring the function of the SRLL.

Outcome of Type 3 Talar Neck Fractures by Means of Medial Malleolar Osteotomy and Large Distractor (족관절 내과 절골술 및 대형신연기를 이용한 제3형 거골 경부 골절의 치료 결과)

  • Park, Sung Hae;Lee, Jun Young;Lee, Jung Woo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.45-51
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    • 2019
  • Purpose: The clinical and radiological results of patients with type 3 talar neck fractures treated with the anteromedial approach using medial malleolar osteotomy and large distractor were analyzed retrospectively. Materials and Methods: From March 2009 to August 2016, 12 patients with a type 3 talar neck fracture, who underwent the anteromedial approach using a medial malleolar osteotomy and large distractor and who could be followed-up for more than 12 months after the operation, were examined. The patients were examined for the presence of Hawkins signs by anteroposterior and lateral radiographs and osteonecrosis by magnetic resonance imaging (MRI) on the postoperative 3 months. Subsequently, every 3 months, radiographic union was assessed by a simple radiograph and clinical symptoms. Twelve months postoperatively, posttraumatic arthritis was assessed and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was analyzed. Results: In 7 cases, osteonecrosis was found on MRI performed 3 months after surgery. On the other hand, at the 12 months follow-up, all of them obtained AOFAS scores of 83.86±4.53 without surgical treatment. Radiographic union was achieved in all cases. The mean union period was 5.3 months. In 10 cases, traumatic arthritis was found after the radiographical and clinical evaluation. In addition, all of them could carry on everyday life by conservative treatment. The AOFAS ankle-hindfoot score was measured to be 85.17 on average. Other complications included superficial wound infection in 2 cases. Conclusion: An anteromedial approach using a medial malleolar osteotomy and a large distractor in the surgical treatment of patients with type 3 talar neck fractures can achieve anatomical reduction of the displaced fragment without a lateral dissection. This is considered to be another good surgical option.

Structural and Resting-State Brain Alterations in Trauma-Exposed Firefighters: Preliminary Results (외상에 노출된 소방관들의 뇌 구조 및 휴식기 뇌기능 변화: 예비 결과)

  • Yae Won Park;Suhnyoung Jun;Juwhan Noh;Seok Jong Chung;Sanghoon Han;Phil Hyu Lee;Changsoo Kim;Seung-Koo Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.676-687
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    • 2020
  • Purpose To analyze the altered brain regions and intrinsic brain activity patterns in trauma-exposed firefighters without posttraumatic stress disorder (PTSD). Materials and Methods Resting-state functional MRI (rsfMRI) was performed for all subjects. Thirty-one firefighters over 40 years of age without PTSD (31 men; mean age, 49.8 ± 4.7 years) were included. Twenty-six non-traumatized healthy controls (HCs) (26 men; mean age, 65.3 ± 7.84 years) were also included. Voxel-based morphometry was performed to investigate focal differences in the brain anatomy. Seed-based functional connectivity analysis was performed to investigate differences in spontaneous brain characteristics. Results The mean z-scores of the Seoul Verbal Learning Test for immediate and delayed recall, Controlled Oral Word Association Test (COWAT) score for animals, and COWAT phonemic fluency were significantly lower in the firefighter group than in the HCs, indicating decreased neurocognitive function. Compared to HCs, firefighters showed reduced gray matter volume in the left superior parietal gyrus and left inferior temporal gyrus. Further, in contrast to HCs, firefighters showed alterations in rsfMRI values in multiple regions, including the fusiform gyrus and cerebellum. Conclusion Structural and resting-state functional abnormalities in the brain may be useful imaging biomarkers for identifying alterations in trauma-exposed firefighters without PTSD.