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Treatment of the Septic Shoulder after Arthroscopic Rotator Cuff Repair in Diabetes Mellitus - A Case Report - (당뇨병 환자에서 관절경적 회전근 개 봉합술 후 발생한 화농성 견관절염의 치료 - 증례 보고 -)

  • Park, Jae-Hyun;Choi, Won-Ki;Kim, Se-Sik;Choi, Chang-Hyuk
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.72-76
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    • 2009
  • Two diabetes mellitus patients treated by arthroscopy and associated procedure for an infection after arthroscopic rotator cuff repair were involved. The time interval from rotator cuff repair to symptom development was 18 days in average and arthroscopic debridement and associated procedure for infection applied in average 65 days after symptom development. Patient evaluation was done according to the KSS, ASES, UCLA and Constant Score. We used antibiotics for average 22.5 days after arthroscopic debridement and associated procedure, the infection was treated in average 4 months. At final follow-up, the mean KSS score was 82 points, the mean UCLA score was 33 points, the mean ASES score was 91 points, the mean Constant score was 71 points. All infections following arthroscopic rotator cuff repair were cured by arthroscopy and associated procedure. ROM and functional results were much improved, the pain and satisfaction were also much improved.

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Development of Eligibility Criteria for Comprehensive Medication Management Programs in Long-term Care Facilities Using RAND/UCLA Appropriateness Method (RAND/UCLA Appropriateness Method를 이용한 요양시설의 포괄적 약물관리 프로그램의 대상자 기준 개발)

  • Jang, Suhyun;Kang, Cinoo;Ah, Youngmi;Lee, Ju-Yeun;Kim, Jung-Ha;Jang, Sunmee
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.260-269
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    • 2022
  • Background: Comprehensive medication management is essential to achieve safe and optimal drug use for the elderly in long-term care facilities (LTCF). This study aimed to develop eligibility criteria for "Comprehensive medication management program in LTCF" using the RAND/UCLA Appropriateness Method (RAM). Furthermore, we attempted to estimate the number of beneficiaries who met the criteria by analyzing the National Health Insurance claims data. Methods: Twelve criteria were selected initially. We composed a panel of 14 experts with expertise in long-term care. We conducted two survey rounds to reach a consensus. Rating for appropriateness and decision regarding agreement were applied per RAM. We analyzed the National Health Insurance data to estimate the number of LTCF residents who met each eligibility criterion. Results: Of the 11 items agreed upon, ten items were determined to be appropriate. In 2018, 83.6% of 165,994 residents of LTCF met one or more eligibility criteria. The largest number of subjects met the "New residents of LTCF" criterion, followed by "Take high-alert drugs" and "Chronic excessive polypharmacy." Since the items evaluated as most appropriate by the expert panel and those with a large number of subjects were similar, we confirmed the external validity of our criteria. Conclusion: It is worth noting that this is the first attempt to establish the eligibility criteria for medication management in LTCF. Further preliminary research is needed to identify the selected subjects' drug-related problems and revise the criteria according to the results.

The Short Term Clinical Follow-up Study for Hemiarthroplasty in Proximal Humeral Fracture (상완골 근위부 분쇄 골절에서의 상완골 두 치환술의 단기 추시 결과)

  • Sung, Chang-Meen;Cho, Se-Hyun;Jung, Soon-Taek;Hwang, Sun-Chul;Park, Hyung-Bin
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.92-98
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    • 2007
  • Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.

Evauation of Injury Mechanism and Clinical Outcome Between Non-Traumatic and Traumatic Type II Slap Lesions (제 2형 SLAP 병변의 외상 유무에 따른 손상 기전 및 치료 결과의 분석)

  • Kim, Yong-Ju;Jeong, Hoon;Ha, Jong-Kyoung;Lee, Kwan-Hee;Choi, Sung-Hyun
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.244-249
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    • 2010
  • Purpose: Our goal of this study was to compare the mechanism of injury and the clinical outcomes between the non-traumatic and traumatic type II SLAP lesions. Materials and Methods: From January 2007 to May 2009, the sunjects of this study were 27 patients who had undergone operations for isolated type II SLAP lesions. The lesions were classified according to Burkhart's method. The lesions that were located on the anterior-superior labrum were classified as type I, those lesions located on the posterior-superior labrum were classified as type II and those lesions located on the anterior-posterior labrum were classified as type III. The clinical outcomes were evaluated by the UCLA score and the KSS score preoperatively and postoperatively. Results: Of the 27 cases, 16 cases were traumatic and eleven cases were non-traumatic. In the traumatic group, there were 12, 2 and 2 cases of type I, type II and type III, respectively (p=0.013). In non-traumatic group, there were 2, 6 and 3 cases of type I, type II and type III (p=0.026). Anterior lesions were more frequent in the traumatic group and posterior lesions were more frequent in the non-traumatic group. For the clinical outcomes, the mean preoperative UCLA score and KSS score were 18 (range: 14~23) and 48 (range: 32~76), respectively, and the postoperative UCLA score and KSS score were 32 (range: 28~33) and 86 (range: 71~92), respectively, in the traumatic group, and the preoperative UCLA score and KSS score were 21 (18~25) and 58 (41~68), respectively, and the postoperative UCLA score and KSS score were 29 (26~31) and 81 (68~89), respectively in the non-traumatic group. There was no significant statistical difference of clinical outcomes between the two groups (p=0.317, 0.405). Conclusion: In this study, the anatomical feature of type II SLAP lesion was associated with a trauma mechanism. Therefore, a trauma mechanism must be considered when planning the surgical treatment for type II SLAP lesions.

Information-Theoretic Approaches for Sensor Selection and Placement in Sensor Networks for Target Localization and Tracking

  • Wang Hanbiao;Yao Kung;Estrin Deborah
    • Journal of Communications and Networks
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    • v.7 no.4
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    • pp.438-449
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    • 2005
  • In this paper, we describes the information-theoretic approaches to sensor selection and sensor placement in sensor net­works for target localization and tracking. We have developed a sensor selection heuristic to activate the most informative candidate sensor for collaborative target localization and tracking. The fusion of the observation by the selected sensor with the prior target location distribution yields nearly the greatest reduction of the entropy of the expected posterior target location distribution. Our sensor selection heuristic is computationally less complex and thus more suitable to sensor networks with moderate computing power than the mutual information sensor selection criteria. We have also developed a method to compute the posterior target location distribution with the minimum entropy that could be achieved by the fusion of observations of the sensor network with a given deployment geometry. We have found that the covariance matrix of the posterior target location distribution with the minimum entropy is consistent with the Cramer-Rao lower bound (CRB) of the target location estimate. Using the minimum entropy of the posterior target location distribution, we have characterized the effect of the sensor placement geometry on the localization accuracy.

An Acoustic and Aerodynamic Study of Consonants in Cheju

  • Cho, Tae-Hong;Jun, Sun-Ah;Ladefoged, Peter
    • Speech Sciences
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    • v.7 no.1
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    • pp.109-141
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    • 2000
  • Acoustic and aerodynamic characteristics of Cheju consonants were examined with the focus on the well-known three-way distinction among stops (i.e., lenis, fortis, aspirated) and the two-way distinction between sand s*. Acoustic parameters examined for the stops included VOT, relative stop burst energy, Fo at the vowel onset, H1-H2, and H1-F2 at the vowel onset. For the fricatives s and s*, acoustic parameters were fricative duration, Fo, centroid of the fricative noise, RMS energy of the frication, H1-H2 and Hl-F2 at the onset of the following vowel. In investigating aerodynamics, intraoral pressure and oral flow were included for the bilabial stops. Results indicate that, although Cheju and Korean are not mutually intelligible, acoustic and aerodynamic properties of Cheju consonants are very similar in every respect to those of the standard Korean. Among other findings there are three crucial points worth recapitulating. First, stops are systematically differentiated by the voice quality of the following vowel. Second, stops are also differentiated by aerodynamic mechanisms. The aspirated and fortis stops are similar in supralaryngeal articulation, but employ a different relation between intraoral pressure and flow. Finally, our study suggests that the fricative s is better categorized as 'lenis' than as 'aspirated' in terms of its phonetic realization.

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Relativistic Radiation Belt Electron Responses to GEM Magnetic Storms: Comparison of CRRES Observations with 3-D VERB Simulations

  • Kim, Kyung-Chan;Shprits, Yuri;Subbotin, Dmitriy;Ni, Binbin
    • The Bulletin of The Korean Astronomical Society
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    • v.37 no.1
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    • pp.90.1-90.1
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    • 2012
  • Understanding the dynamics of relativistic electron acceleration, loss, and transport in the Earth's radiation belt during magnetic storms is a challenging task. The U.S. National Science Foundation's Geospace Environment Modeling (GEM) has identified five magnetic storms for in-depth study that occurred during the second half of the Combined Release and Radiation Effects Satellite (CRRES) mission in the year 1991. In this study, we show the responses of relativistic radiation belt electrons to the magnetic storms by comparing the time-dependent 3-D Versatile Electron Radiation Belt (VERB) simulations with the CRRES MEA 1 MeV electron observations in order to investigate the relative roles of the competing effects of previously proposed scattering mechanisms at different storm phases, as well as to examine the extent to which the simulations can reproduce observations. The major scattering processes in our model are radial transport due to Ultra Low Frequency (ULF) electromagnetic fluctuations, pitch-angle and energy diffusion including mixed diffusion by whistler mode chorus waves outside the plasmasphere, and pitch-angle scattering by plasmaspheric hiss inside the plasmasphere. We provide a detailed description of simulations for each of the GEM storm events.

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Modulation of Inflammatory Pathways and Adipogenesis by the Action of Gentisic Acid in RAW 264.7 and 3T3-L1 Cell Lines

  • Kang, Min-jae;Choi, Woosuk;Yoo, Seung Hyun;Nam, Soo-Wan;Shin, Pyung-Gyun;Kim, Keun Ki;Kim, Gun-Do
    • Journal of Microbiology and Biotechnology
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    • v.31 no.8
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    • pp.1079-1087
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    • 2021
  • Gentisic acid (GA), a benzoic acid derivative present in various food ingredients, has been shown to have diverse pharmaceutical activities such as anti-carcinogenic, antioxidant, and hepatoprotective effects. In this study, we used a co-culture system to investigate the mechanisms of the anti-inflammatory and anti-adipogenic effects of GA on macrophages and adipocytes, respectively, as well as its effect on obesity-related chronic inflammation. We found that GA effectively suppressed lipopolysaccharide-stimulated inflammatory responses by controlling the production of nitric oxide and pro-inflammatory cytokines and modulating inflammation-related protein pathways. GA treatment also inhibited lipid accumulation in adipocytes by modulating the expression of major adipogenic transcription factors and their upstream protein pathways. Furthermore, in the macrophage-adipocyte co-culture system, GA decreased the production of obesity-related cytokines. These results indicate that GA possesses effective anti-inflammatory and anti-adipogenic activities and may be used in developing treatments for the management of obesity-related chronic inflammatory diseases.