• Title/Summary/Keyword: evaluation of age

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The Reconstruction with Extracorporeal Irradiated Autograft for Osteosarcoma of Extremities (사지 골육종에서 체외 방사선 조사를 이용한 재건술)

  • Kim, Jae-Do;Lee, Gun-Woo;Chung, So-Hak
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.1-7
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    • 2010
  • Purpose: With advances in various treatment modalities, limb salvage surgery has been commonly used in osteosarcoma of extremities. An alternative method for skeletal reconstruction is reimplantation of the tumor bearing bone following extracorporeal irradiation (ECI). We report the long-term results of ECI autograft in aspect of the oncological and functional outcomes, and complications. Materials and Methods: We retrospectively reviewed 31 osteosarcoma patients who underwent reconstruction with ECI between July 1995 and January 2006. There were 24 males and 7 females with a mean age of 24 (7-74 years) and a mean follow-up of 117 months (17-177 months). Twenty-five cases were reconstructed with ECI autograft, 6 cases with ECI autograft-prosthesis composite. The pathologic subtypes were conventional in 29 cases, periosteal in 1 case, and parosteal in 1 case. The most common location of tumor was distal femur (15 cases) followed by humerus (3), proximal fibula (3) and proximal tibia (3). Musculoskeletal Tumor Society (MSTS) score was used for functional evaluation. The overall survival rate, local recurrence, complications were analyzed. Results: The overall survival rate was 80.6% and the disease-free survival rate was 64.5%. Five patients died of distant metastasis. One patient required above-knee amputation due to local recurrence. All of them, twenty-three complications occurred, which included nonunion in 7 cases, deep infection in 5 cases, joint instability in 4 cases, metal failure in 2 cases, Limb-length discrepancy (LLD) in 2 cases, periprosthetic fracture in 1 case, epiphyseal collapse in 1, local recurrence in 1 case. The mean MSTS functional score was 62.5%. Conclusion: Extracorporeal irradiated autograft can be achieved relatively good result in aspect of oncological and functional aspect, but is needed to be additional research about occurring many complications. The reconstruction with ECI after intercalary or fragmentary resection is effective reconstruction in aspect of oncological and functional result, complications.

Results of the Reconstruction of Anterior Cruciate Ligament with Freshfrozen Achilles Allograft and of the Second-look Arthroscopy (신선 동결 동종 아킬레스건을 이용한 전방 십자인대 재건술 후 2차 관절경소견)

  • Yoo, Jae-Doo;Kim, Sung-Il
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.2
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    • pp.111-116
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    • 2007
  • Purpose: To assess the clinical results of ACL reconstruction with a fresh frozen Achilles allograft, retrospectively and the findings of the graft in second look arthroscopy. Materials and Methods: Twenty-eight ACL reconstructions using fresh frozen Achilles tendon allograft were included in this study between March 1999 and February 2003. The average age was 31.2 years old and the average follow-up was 16.6 months(range: 12-26 months). The clinical evaluation was done by KT-1000 arthrometer, Lysholm knee score, range of motion, Lachman and pivot-shift test. Results: In the last follow-up of Lachman test, 21 cases showed normal, 5 cases grade 1, 2 cases grade 2 and 1 case grade1. The results of pivot-shift test data, 23 cases(82.1%) were normal, 4 cases(14.3%) grade 1, 1 case(3.6%) grade 2. The mean maximum side-to-side difference was improved from 6.75mm preoperatively to 2.46mm in the last follow-up. Lysholm knee score was improved from 73.5 preoperatively to 91.6 in last follow-up. Re-rupture of the ACL graft was found in one case and one case of wound infection in the tibial incision was found. The 6 cases showed the good synovialization of the ACL graft. Conclusion: The anterior stability was restored with ACL reconstruction using fresh frozen Achilles allografts and the good synovialization was found in the second-look arthroscopy

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Long-Term Results for Repair of Pulmonary Atresia with Intact Ventricular Septum (온전한 심실중격를 가진 폐동맥 폐쇄증에 대한 수술적 치료의 장기 결과)

  • Lee Chang-Ha;Hwang Seong Wook;Lim Hong Gook;Kim Woong-Han;Kim Chong Whan;Lee Cheul
    • Journal of Chest Surgery
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    • v.38 no.6 s.251
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    • pp.403-409
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    • 2005
  • Pulmonary atresia with intact ventricular septum is morphologically heterogeneous, and the surgical outcome remains suboptimal compared to other complex congenital heart defects. We evaluated the long-term results for repair of pulmonary atresia with intact ventricular septum, Material and Method: Between January 1992 and June 2004, 38 patients underwent repair of pulmonary atresia with intact ventricular septum. The average age was 18 days $(2\~382\;days)$. The average Z-value of the tricuspid annulus diameter was -3.1$(-5.6\~0.8)$. Thirteen $(36\%)$ patients had right ventricle-to-coronary artery fistulas, and $4(11\%)$ patients had right ventricle-dependent coronary circulation. Average follow-up was 55 months $(3\;months\~2.2\;years)$, Result: Twenty-four patients under-went initial right ventricle (RV) decompression and 14 patients underwent systemic-to-pulmonary arterial shunt only. The average size of the tricuspid annulus of the patients who underwent RV decompression was significantly larger than that of the patients who underwent systemic-to-pulmonary arierial shunt only (Z-value -2.2 vs. -4.8, p=0.000). There were $5(13\%)$ early and 1 late deaths. Early deaths occurred in 3 patients who had undergone RV decompression, and in 2 patients who had undergone systemic-to-pulmonary arterial shunt only (p=1.0). Biventricular repair was achieved in $12(32\%)$ patients, single ventricular repair in $8(21\%)$, and one and a half ventricular repair in $4(l1\%)$ patients. Nine $(24\%)$ patients are waiting for the definitive repair. Kaplan-Meier survival at 5 and 8 years was $83.2\%$, respectively. Conclusion: Most of the deaths occurred after the initial palliation. Overall long-term survival was satisfactory. Early mortality should be reduced with careful preoperative evaluation and proper surgical strategy.

Psychological Characteristics of Living Liver Transplantation Donors using MMPI-2 Profiles (MMPI-2를 이용한 생체 간 공여자들의 심리적 특성에 대한 연구)

  • Lee, Jin Hyeok;Choi, Tae Young;Yoon, Seoyoung
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.42-49
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    • 2019
  • Objectives : Living donor liver transplantation (LDLT) is a life-saving therapy for patients with terminal liver disease. Many studies have focused on recipients rather than donors. The aim of this study was to assess the emotional status and personality characteristics of LDLT donors. Methods : We evaluated 218 subjects (126 male, 92 female) who visited Daegu Catholic University Medical Center from August 2012 to July 2018. A retrospective review of their preoperative psychological evaluation was done. We investigated epidemiological data and the Minnesota Multiphasic Personality Inventory-2 questionnaire. Subanalysis was done depending on whether subjects actually underwent surgery, relationship with the recipient, and their gender. Results : Mean age of subjects was $32.19{\pm}10.91years$. 187 subjects received LDLT surgery (actual donors) while 31 subjects didn't (potential donors). Donor-recipient relationship included husband-wife, parent-children, brother-sister etc. Subjects had statistical significance on validity scale L, F, K and all clinical scales compared to the control group. Potential donors had significant difference in F(b), F(p), K, S, Pa, AGGR, PSYC, DISC and NEGE scales compared to actual donors. F, D and NEGE scales were found to be predictive for actual donation. Subanalysis on donor-recipient relationship and gender also showed significant difference in certain scales. Conclusions : Under-reporting of psychological problems should be considered when evaluating living-liver donors. Information about the donor's overall psychosocial background, mental status and donation process should also be acquired.

Musculoskeletal Injuries by Weapons in Korean Soldiers: Four-Year Follow-Up (총기 및 폭발물에 의한 군인의 근골격계 손상: 최근 4년간 분석)

  • Yang, Hanbual;Hwang, Il-Ung;Song, Daeguen;Moon, Gi Ho;Lee, Na Rae;Kim, Kyoung-Nam
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.234-244
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    • 2021
  • Purpose: To date, studies of firearm and explosive injuries in the Korean military have been limited compared to its importance. To overcome this, this study examined the characteristics of musculoskeletal damages in soldiers who have suffered firearm and explosive injuries over the past four years. Materials and Methods: From January 2015 to July 2019, military forces who had suffered musculoskeletal injuries from firearms or explosive substances were included. The medical records and radiographs were reviewed retrospectively, and telephone surveys about Short Musculoskeletal Functional Assessment (SMFA) for this group were conducted. To compare the functional outcomes, statistical analysis was performed using a t-test for the types of weapons, and ANOVA for others. Results: Of the 61 patients treated for firearms and explosives injuries, 30 patients (49.2%) were included after undergoing orthopedic treatment due to musculoskeletal injury. The average age at injury was 26.4 years old (21-52 years old). The number of officers and soldiers was similar. Eleven were injured by gunshot and 19 by an explosive device. Sixteen were treated in the Armed Forces Capital Hospital and 10 at private hospitals. More than half of the 16 patients (53.3%) with a fracture had multiple fractures. The most common injury site was the hand (33.3%), followed by the lower leg (30.0%). There were 14 patients (46.7%) with Gustilo-Anderson classification 3B or higher who required a soft tissue reconstruction. Fifteen patients agreed to join the SMFA survey for the functional outcomes. Between officers and soldiers, officers had better scores in the Bother Index compared to soldiers (p=0.0045). Patients treated in the Armed Forces Capital Hospital had better scores in both the Dysfunction and Bother Index compared to private hospitals (p=0.0008, p=0.0149). Conclusion: This is the first study to analyze of weapons injuries in the Korean military. As a result of the study, the orthopedic burden was high in the treating patients with military weapon injuries. In addition, it is necessary to build a military trauma registry, including firearm and explosive injuries, for trauma treatment evaluation and development of military trauma system.

Clinical Presentation and Prognosis of SARS-CoV-2 Infection in Infants Aged ≤90 Days: Insights for Management During Outbreaks

  • Hye Jeong Moon;Mi Seon Han;Kyung Min Kim;Kyung Jin Oh;Ju Young Chang;Seong Yong Lee;Ji Eun Choi
    • Pediatric Infection and Vaccine
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    • v.30 no.2
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    • pp.84-90
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    • 2023
  • Purpose: Infants aged ≤90 days with fever are susceptible to severe infections. This study aimed to analyze the clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in this particular age group. Methods: Infants aged ≤90 days who were diagnosed with coronavirus disease 2019 (COVID-19) and hospitalized between March 1, 2020, and May 1, 2022 were included. Medical records of patients were retrospectively reviewed. Results: A total of 105 infants with COVID-19 were included; 27 (25.7%) neonates aged <28 days, and 48 (45.7%) and 30 (28.6%) infants aged 28-59 days and 60-90 days, respectively. Five (4.7%) patients remained asymptomatic and 68 (62.8%) were febrile, with a median fever duration of 2 days. The most common symptoms were respiratory including cough (66.6%), nasal stuffiness (51.4%), and rhinorrhea (40.9%). Blood cultures were performed in 10 infants but no organisms were detected. Cultures of bag-collected urine specimens from 8 infants were grown, resulting in positive growth for 2 without pyuria. Nine (8.6%) infants were treated with empirical antibiotics for a median duration of 2.3 days (range, 1-7 days). All 105 infants showed improvement without any complications, and there were no fatal cases. Conclusions: In this study, most infants aged ≤90 days with COVID-19 presented with mild symptoms and none of those evaluated had documented bacterial co-infection. The favorable prognosis among young infants with SARS-CoV-2 may aid clinicians in tailoring their approach to evaluation and management during outbreaks.

Contrasting Styles of Gold and Silver Mineralization in the Central and Southeastern Korea (한국 중부와 동남부지역 금·은광화작용의 성인적 특성)

  • Choi, Seon-Gyu;Choi, Sang-Hoon
    • Economic and Environmental Geology
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    • v.28 no.6
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    • pp.587-597
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    • 1995
  • Two distinct precious-metal mineralizations actively occur at central and southeastern Korea which display consistent relationships among geologic, geochemical and genetic environments. A large number of preciousmetal vein deposits in the central Korea occur in or near Mesozoic granite batholiths elongated in a NE-SW direction. Whereas, gold and/or silver deposits in the southeastern Korea occur within Cretaceous volcanic and sedimentary rocks. However, most of the precious-metal deposits in the southeastern Korea show characteristics of the silver-rich deposits than the gold-rich deposits in the central Korea. Two epochs of main igneous activities are recognized: a) Jurassic Daebo igneous activity between 121 and 183 Ma, and b) Cretaceous Bulgugsa igneous activity between 60 and 110 Ma. Precious-metal mineralization took place between 158 and 71 Ma, coinciding with portions of the two magmatic activities. Contrasts in the style of mineralization, together with radiometric age data and differences in geologic settings reflect the genetically variable natures of hydrothermal activities from middle Jurassic to late Cretaceous time. The compilation and re-evaluation of these data suggest that the genetic types of hydrothermal precious-metal vein deposits in the central and southeastern Korea varied with time. The Jurassic and early Cretaceous mineralizations are characterized by the Au-dominant type, but tend to change to the Au-Ag and/or Ag-dominant types at late Cretaceous. The Jurassic Au-dominant deposits commonly show several characteristics; prominent associations with pegmatites, simple massive vein morphologies, high fmeness values in ore-concentrating parts, and a distinctively simple ore mineralogy such as Fe-rich sphalerite, galena, chalcopyrite, Au-rich electrum, pyrrhotite and/or pyrite. The Cretaceous precious-metal deposits are generally characterized by some- features such as complex vein morphologies, low to medium fmeness values in the ore concentrates, and abundance of ore minerals including Ag sulfosalts, Ag sulfides, Ag tellurides and native silver. Mineralogical and fluid inclusion studies indicate that the Jurassic Au-dominant deposits in the central area were formed at the high temperature (about $300^{\circ}$ to $500^{\circ}C$) and pressure (about 4 to 5 kbars), whereas mineralizations of the Cretaceous Au-Ag and Ag-dominant deposits were occurred at the low temperature (about $200^{\circ}$ to $350^{\circ}C$) and pressure (<0.5 kbars) from the ore fluids containing more amounts of less-evolved meteoric waters.

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EVALUATION OF PIT AND FISSURE SEALANTS RETENTION BETWEEN DIFFERENT OPERATORS USING DIFFERENT ISOLATION TECHNIQUES (시술자와 방습법에 따른 치면열구전색제의 유지에 관한 연구)

  • Cho, Jae-Yong;Kim, Jung-Wook;Jang, Ki-Taeg;Kim, Chong-Chul;Hahn, Se-Hyun;Lee, Sang-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.415-422
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    • 2003
  • Currently, 'National program of dental sealant' has begun in Korea, but various isolation techniques and preparation is performing. The aim of the present study was to compare pit and fissure sealant retention rates between different operators using two different isolation techniques. Additionally, the failed surface was examined. One examiner performed the examination after one year of the initial operation. The population consisted of 119 children(mean age $8.59{\pm}0.772$) of which the total sealed number was 279 permanent first molars. Pediatric dentists sealed 131 molars using the rubber dam isolation technique (Group 1), general practitioners sealed 80 molars using the rubber dam isolation technique (Group 2), and dental hygienists sealed 69 molars using the cotton roll isolation (Group 3). The results were as follows ; 1. The complete retention rate between Group 1 (90.8%) and 2 (85.0%) showed no significant statistical difference (P>0.05). However, there were significant statistical different retention rates between Group 1 and Group 3(64.7%) and between Group 2 and Group 3 (p<0.05). 2. In comparing retention rates between maxilla and mandible, Only Group 3 showed a significantly lower complete retention rate in mandible than maxilla (p<0.05). 3. In failed surface analysis, occlusal failed surface was 58.3%, buccal/palatal failed surface was 41.7%.

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Assessment of Vascularization within Hydroxyapatite Ocular Implant by Bone Scintigraphy: Comparative Analysis of Planar and SPECT Imaging (Hydroxyapatite 안구보충물삽입술 후 골신티그라피를 이용한 섬유혈관증식 평가: 평면영상과 SPECT 영상에서의 비교)

  • Lim, Seok-Tae;Sohn, Myung-Hee;Park, Soon-Ah
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.6
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    • pp.475-483
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    • 1999
  • Purpose: Complete fibrovascular ingrowth within the hydroxyapatite ocular implant is necessary for peg drilling which is performed to Prevent infection and to provide motility to the ocular prosthesis. We compared planar bone scintigraphy and SPECT for the evaluation of the vascularization within hydroxyapatite ocular implants. Materials and Methods: Seventeen patients (M:F: 12:5, mean age; $50.4{\pm}17.5$ years) who had received a coralline hydroxyapatite ocular implant after enucleation surgery were enrolled. Patients underwent Tc-99m MDP planar bone and SPECT imaging by dual head gamma camera after their implant surgery (interval: $197{\pm}81$ days). Uptake on planar and SPECT images was graded visually as less than (grade 1), equal to (grade 2), and greater than (grade 3) nasal bridge activity. Quantitative ratio of implanted to non-implanted intraorbital activity was also measured. Vascularization within hydroxyapatite implants was confirmed by slit lamp examination and ocular movement. Results: All but three patients were considered to be vascularized within hydroxyapatite implants. In visual analysis of planar image and SPECT, grade 1 was noted in 9/18 (50%) and 6/18 (33%), respectively. Grade 2 pattern was 7/18 (39%) and 4/18 (22%), and grade 3 pattern was 2/18 (11%) and 8/18 (44%) respectively. When grade 2 or 3 was considered to be positive for vascularization, the sensitivity of planar and SPECT imaging were 60% (9/15) and 80% (12/15), respectively. In 3 patients with incomplete vascularization, both planar and SPECT showed grade 1 uptake The orbital activity ratios on planar imaging were not significantly different between complete and incomplete vascularization ($1.96{\pm}0.87$ vs $1.17{\pm}0.08$, p>0.05), however, it was significantly higher on SPECT in patients with complete vascularization ($8.44{\pm}5.45$ vs $2.20{\pm}0.87$, p<0.05). Conclusion: In the assessment of fibrovascular ingrowth within ocular implants by Tc-99m MDP bone scintigraphy, SPECT image appears to be more effective than planar scintigraphy.

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Cardiac Injury due to Thoracic Trauma (흉부외상에 의한 심장손상)

  • Kim, Han-Yong;Kim, Myoung-Young;Park, Jae-Hong;Chei, Chang-Seck;Hwang, Sang-Won
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.831-836
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    • 2007
  • Background: Cardiac injuries are the most commonly overlooked injuries in patients who die from trauma. Patients who survive blunt cardiac rupture or penetrating injuries are rare and the incidence is not well defined. Many patients require urgent or emergency operations and operative mortality is very high. Material and Method: A retrospective review of 26 patients with cardiac injuries due to thoracic trauma undergoing emergency thoracotomy from January 1997 to December 2005. Result: There were 17 male and 9 female patients, with a mean age of $45.3{\pm}16.2\;(range:\;17{\sim}80)$. Thirteen patients (50%) were injured in motor vehicle accidents, and five patients (19%) in motorcycle accidents. Six patients (23%) were injured by knives, and two patients (8%) were injured by falling. Anatomic injuries included right atrium (12 [46%]), left atrium (1 [4%]), right ventricle (5 [19%]), left ventricle (5 [19%]), and cardiac chambers (2 [7%]). Diagnosis was made by computer tomography in 12 patients and sonography in 14 patients. The average times from admission to operating room was $89.2{\pm}86.7\;min\;(range:\;10{\sim}335)$. The average time for diagnosis was $51.3{\pm}13.6\;min\;(range:\;5{\sim}280)$. The mean Revised Trauma Score (RTS) was $6.7{\pm}0.8$, and the Glasgow Coma Scale (GCS), was $12.8{\pm}2.8$. The overall mortality rate was 12% (3 out of 26 patients). Conclusion: The mortality rate from cardiac injury is very high. The survival rate can be increased only by a high index of suspicion, aggressive expeditious diagnostic evaluation, and prompt appropriate surgical management.