• Title/Summary/Keyword: orthopedic

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Surgical Outcomes According to Dekyphosis in Patients with Ossification of the Posterior Longitudinal Ligament in the Thoracic Spine

  • Kim, Soo Yeon;Hyun, Seung-Jae;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.63 no.1
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    • pp.89-98
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    • 2020
  • Objective : Ossification of posterior longitudinal ligament (OPLL) in the thoracic spine may cause chronic compressive myelopathy that is usually progressive, and unfavorable by conservative treatment. Although surgical intervention is often needed, the standard surgical method has not been established. Recently, it has been reported that posterior decompression with dekyphosis is effective surgical technique for favorable clinical outcome. The purpose of this study was to evaluate the surgical outcomes in patients with thoracic OPLL according to dekyphosis procedure and to identify predictive factors for the surgical results. Methods : A total of 25 patients with thoracic OPLL who underwent surgery for myelopathy from May 2004 to March 2017, were retrospectively reviewed. Patients with cervical myelopathy were excluded. We assessed the clinical outcomes according to various surgical approaches. The modified Japanese orthopedic association (JOA) scores for the thoracic spine (total, 11 points) and JOA recovery rates were used for investigating surgical outcomes. Results : Of the 25 patients, 10 patients were male and the others were female. The mean JOA score was 6.7±2.3 points preoperatively and 8.8±1.8 points postoperatively, yielding a mean recovery rate of 53.8±31.0%. The mean patients' age at surgery was 52.4 years and mean follow-up period was 40.2 months. According to surgical approaches, seven patients underwent anterior approaches, 13 patients underwent posterior approaches, five patients underwent combined approaches. There was no significant difference of the surgical outcomes related with different surgical approaches. Age (≥55 years) and high signal intensity on preoperative magnetic resonance (MR) image in the thoracic spine were significant predictors of the lower recovery rate after surgery (p<0.05). Posterior decompression with dekyphosis procedure was related to the excellent surgical outcomes (p=0.047). Dekyphosis did not affect the complication rates. Conclusion : In this study, our result elucidated that old age (≥55 years) and presence of intramedullary high signal intensity on preoperative MR images were risk factors related to poor surgical outcomes. In the meanwhile, posterior decompression with dekyphosis affected favorable clinical outcome. Posterior approach with dekyphosis procedure can be a recommendable surgical option for favorable results.

Aseptic Humeral Nonunion: What Went Wrong? What to Do? A Retrospective Analysis of 20 Cases

  • Kim, Jinil;Cho, Jae-Woo;Cho, Won-Tae;Cho, Jun-Min;Kim, Namryeol;Kim, Hak Jun;Oh, Jong-Keon;Kim, Jin-Kak
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.129-138
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    • 2016
  • Purpose: Due to recent advances in internal fixation techniques, instrumentation and orthopedic implants there is an increasing number of humeral shaft fracture treated operatively. As a consequence, an increased number nonunion after operative fixation are being referred to our center. The aim of this study is to report the common error during osteosynthesis that may have led to nonunion and present a systematic analytical approach for the management of aseptic humeral shaft nonunion. Methods: In between January 2007 to December 2013, 20 patients with humeral shaft nonunion after operative procedure were treated according to our treatment algorithm. We could analysis x-rays of 12 patients from initial treatment to nonunion. In a subgroup of 12 patients the initial operative procedure were analyzed to determine the error that may have caused nonunion. The following questions were used to examine the cases: 1) Was the fracture biology preserved during the procedure? 2) Does the implant construct have enough stability to allow fracture healing? Results: In 19 out of 20 patients have showed radiographic evidence of union on follow up. One patient has to undergo reoperation because of the technical error with bone graft placement but eventually healed. There were 2 cases wherein the treatment algorithm was not followed. All patients had problems with mechanical stability, and in 13 patients had biologic problems. In the analysis of the initial operative fixation, only one of 12 patients had biologic problems. Conclusion: In our analysis, the common preventable error made during operative fixation of humeral shaft fracture is failure to provide adequate stability for bony union to occur. And with these cases we have demonstrated a systematic analytic management approach that may be used to prevent surgeons from reproducing the same fault and reduce the need for bone grafting.

A Retrospective Study on Profile Having Favorable Response to Face Mask (상악 전방 견인 치료에 양호하게 반응하는 안모형태의 후향적 연구)

  • Hwang, Chung-Ju;Moon, Jeong-Lyon
    • The korean journal of orthodontics
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    • v.29 no.2 s.73
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    • pp.147-156
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    • 1999
  • Skeletal Cl III malocclusion is an orthopedic appliance mainly used for growing children with maxillary undergrowth, which largely entails skeletal Cl III malocclusion. It improves anterior crossbite and maxillary position and thus, enables patients to attain favorable Profile but often involves unfavorable profile with protrusive upper and lower lips. Therefore, if orthodontists have knowledge of which condition helps obtain favorable occlusion and profile, they are able to predict the prognosis and limitation of the treatment. This study was done in order to help obtain favorable Profile after treating growing skeletal Cl III children. In the study, we classified childern into two groups, the one with favorable profile(Group 1, n=12) and the other with unfavorable profile(Group 2, n=14) and, with retrospective study using pre- and post-treatment lateral cephalogram, drew the following conclusions. 1. As patients had more serious labioversion of upper incisors, they were more unlikely to have favorable profiles after the treatment. Protrusion of prosthion, which was related with maxillary incisors, also affected profiles. 2. As the NL-ML angle before the treatment was small, it was more likely to get favorable profile. 3. As the degree of lower lip protrusion was high, it was likely to have bialveolar protrusion after the treatment. 4. As the degree of downward and backward rotation of mandible was high, it was likely to get unfavorable profile.

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The Effects of Taekwondo Traing Causing Leg-muscular Strength for Elementary School Children (태권도 수련이 초등학생 하지근력에 미치는 영향)

  • Yoon, Young-Cho;Jung, Jae-Min;Kim, Tae-Ho;Bae, Sung-Soo
    • Journal of the Korean Society of Physical Medicine
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    • v.4 no.3
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    • pp.175-182
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    • 2009
  • Purpose:The purpose of this study is to investigate the effects of Taekwondo training causing leg-muscular strength for elementary school children. Methods:The subjects were Taekwondo group (n=20) and non-Taekwondo group (n=20) from 5-6 graders of elementary school. The Tkd group exercised Taekwondo and the non-Taekwondo group exercised free gymnastics. The subjects were measured 3 times(pre, mid and after)during the 8weeks program. The leg muscular strength peak torque and average power were measured. And the extension-flection of angular speed 60 deg/sec and 180 deg/sec was measured. Results:The results of this study can be summarized as follows: 1. Compared with the Tkd group, the non-Tkd group showed no significant difference in tests statistically in case of right-left of pre-4weeks. The leg muscle's peak torque did not show significant difference in the extension angular 60 deg/sec(p>.05). 2. The score of flection angular speed 60deg/sec was not different in tests leg strength of right-left to pre-4weeks(p<.05), but the muscle was increased according to the amount of time spent in case of the 4-8weeks. 3. Compared with the Tkd group, the non-Tkd group showed no significant difference in tests statistically in case of right-left of pre-4weeks. The leg muscle's peak torque did not show significant difference in the extension angular 180deg/sec(p>.05). The right leg muscular strength was increased in case of the 4-8weeks. The left leg showed no difference. 4. Leg muscular strength was increased in the case of the pre-4weeks in the right of flection angular speed 180deg/sec. The left did not show difference. The right leg muscle in case of the 4-8weeks showed no difference. The left showed significant difference. Conclusion:Taekwondo training is effective for leg-muscular strengthing for elementary school children.

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Life-Style and Eating Behaviors of the Stomach Cancer Patients in Daegu and Kyungpook Area in Korea (대구.경북지역 위암환자의 일상 생활 패턴 및 식행동)

  • 서수원;구보경;이혜성;최용환
    • Journal of Nutrition and Health
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    • v.35 no.3
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    • pp.380-393
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    • 2002
  • The purpose of this study was to investigate the lift-style and eating behavior of stomach cancer patients in the Daegu and Kyungpook area, and to collect basic data for nutrition education designed to prevent stomach cancer in this community. The subjects of the study were 102 patients who were recently diagnosed as having stomach cancer at the Kyungpook National University Hospital. The control subjects were 105 persons who did not have any gastrointestinal disease, and included patients from the Department of Orthopedic Surgery and healthy volunteers. The survey, which covered the personal characteristics and eating behavior of the subjects, was conducted by individual interviews using questionnaires. It was found that the stomach cancer patients (case group) had experienced a significantly higher level of stress in their daily lives than the control group. A significantly higher proportion of the case group subjects recognized their personality as pessimistic, and had family histories of cancer, compared with the control group subjects. The cancer patients had higher preferences for salty and hot tasting foods, and tended to ingest meals faster without enough chewing, compared with the control subjects. The level of nutritional knowledge of the case group was lower than the control group, and there was a positive correlation between subjects' nutritional knowledge scores and nutritional attitude scores. Subjects' estimates of their food intake frequencies during the decade before the cancer was diagnosed revealed that the case group consumed significantly higher amounts of pickled fish, soybean paste soup and stew, cooked vegetables, beef and pork, charcoal broiled meat and alcohol, while consuming significantly lower amounts of green tea than the control group. In summary, the results of the study suggest that the stress of daily life, a family history of cancer, and a pessimistic personality might be the risk factors for the development of stomach cancer. Dietary factors which were suspected as risk factors for stomach cancer in the present study included strong preferences to salty and hot lasting foods, poor eating habits, and frequent consumption of pickled fish, soybean paste soup, cooked vegetables, beef and pork, charcoal broiled meat and alcohol. A high consumption of green tea seemed to be a protective factor against stomach cancer. The results of the study appear to provide useful data for nutritional education focussed on the prevention on stomach rancor in local residents.

Increase of L-type Calcium Current by cGMP-dependent Protein Kinase Regulates in Rabbit Ventricular Myocytes

  • Han, Jin;Kim, Na-Ri;Kim, Eui-Yong;Ho, Won-Kyung;Earm, Yung-E;Kim, Han-Kyoun
    • The Korean Journal of Physiology and Pharmacology
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    • v.2 no.6
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    • pp.733-742
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    • 1998
  • Background: We have previously reported that not only cGMP but also 8-Br-cGMP or 8-pCPT-cGMP, specific and potent stimulators of cGMP-dependent protein kinase (cGMP-PK), increased basal L-type calcium current $(I_{Ca})$ in rabbit ventricular myocytes. Our findings in rabbit ventricular myocytes were entirely different from the earlier findings in different species, suggesting that the activation of cGMP-PK is involved in the facilitation of $I_{Ca}}$ by cGMP. However, there is no direct evidence that cGMP-PK can stimulate $I_{Ca}}$ in rabbit ventricular myocytes. In this report, we focused on the direct effect of cGMP-PK on $I_{Ca}}$ in rabbit ventricular myocytes. Methods and Results: We isolated single ventricular myocytes of rabbit hearts by using enzymatic dissociation. Regulation of $I_{Ca}}$ by cGMP-PK was investigated in rabbit ventricular myocytes using whole-cell voltage clamp method. $I_{Ca}}$ was elicited by a depolarizing pulse to +10 mV from a holding potential of -40 mV. Extracellular 8-(4-Chlorophenylthio)-guanosine-3',5'-cyclic monophosphate (8-pCPT-cGMP), potent stimulator of cGMP-dependent protein kinase (cGMP-PK), increased basal $I_{Ca}}$. cGMP-PK also increased basal $I_{Ca}}$. The stimulation of basal $I_{Ca}}$ by cGMP-PK required both 8-Br-cGMP in low concentration and intracellular ATP to be present. The stimulation of basal $I_{Ca}}$ by cGMP-PK was blocked by heat inactivation of the cGMP-PK and by bath application of 8-(4-chlorophenylthio)-guanosine-3',5'-cyclic monophosphate, Rp-isomer (Rp-pCPT-cGMP), a phosphodiesterase-resistant cGMP-PK inhibitor. When $I_{Ca}}$ was increased by internal application of cGMP-PK, IBMX resulted in an additional stimulation of $I_{Ca}}$. In the presence of cGMP-PK, already increased $I_{Ca}}$ was potentiated by bath application of isoprenaline or forskolin or intracellular application of cAMP. Conclusions: We present evidence that cGMP-PK stimulated basal $I_{Ca}}$ by a direct phosphorylation of L-type calcium channel or associated regulatory protein in rabbit ventricular myocytes.

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MR Imaging Measurement of the Femoral Anteversional Angle as a PACS Image Viewer (MR 영상에서의 PACS Image Viewer를 이용한 대퇴골 전염각 측정)

  • Kweon, Dae-Cheol;Yang, Sung-Hwan;Park, Peom
    • Journal of radiological science and technology
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    • v.26 no.1
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    • pp.83-89
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    • 2003
  • The accurate measurement of the femoral anteversion is very important to the practice of orthopedic and osteotomy. It is measured by means of the axis of head and neck of the femur and the knee axis. At the present time, widely used computed tomography method of measuring anteversion on femoral necks of patients. Measurement by the manual method and image viewer of computed tomography to determine the anteversion of femoral head were carried out on both femurs. In September and October 2002, 5 patients 28 to 36 years of age were randomly selected from Seoul National University Hospital. The purpose of this paper was to introduce a new method to measure femoral anteversion angle utilizing PACS image viewer program in the MR imaging. Significant difference was observed between the right and left side the image viewer measurement of femoral anteversion. In conclusion, MR imaging very usefulness in the measured the angle of the femoral anteversion.

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TREATMENT OF CLASS II MALOCCLUSION WITH FR-II : A CASE REPORT (FR-II를 이용한 II급 부정교합의 치험례)

  • Pak, Eun-Kyung;Choi, Yeong-Chul;Kim, Kwang-Chul;Park, Jae-Hong;Choi, Seong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.1
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    • pp.108-113
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    • 2009
  • The functional regulator(FR) appliances act to remove the restrictive forces that prevent the normal maturation of the maxilla and mandible. FR appliances are different from other functional jaw orthopedic appliances(e.g., the twin block, bionator, and activator). $Fr{\ddot{a}}nkel$ has based his treatment philosophy on the concept that the capacity to regulate growth residues in the soft tissue environment, and that adequate space must be available for the proper development of the hard tissue. In class II malocclusion with mandibular retrusion, FR-II treatment is not only the change in the postural position of mandible, but also expansion of the dental arches. By balancing the neuromuscular environment, not only can severe malocclusions be treated successfully, but also the tendency toward relapse is minimized because the neural and soft tissue factors associated with the skeletal malocclusion have been addressed as well. We report cases using by FR-II that is applicated in cases of Class II malocclusion without fixed appliance, only FR-II and space supervision.

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Evaluation of Palatal Rugae Following Orthopedic Treatment Using Rapid Maxillary Expander and Facemask (구개확장장치와 facemask를 이용한 교정치료 환자의 구개주름 평가)

  • Park, Sehee;Choi, Namki;Kim, Seonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.2
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    • pp.167-175
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    • 2020
  • The purpose of this study was to determine whether the palatal rugae could be used as an appropriate reference area for serial model superimposition following Rapid maxillary expansion(RME) and facemask treatment. A total of 52 pediatric patients who had undergone RME and facemask treatment were selected. Palate and palatal rugae in the pre- and post- treatment casts from the patients were measured. In spite of dentoalveolar changes occurred by RME and facemask, anteroposterior changes in palate and palatal rugae were not significant. Anatomical changes of palate and palatal rugae were mostly shown in the transverse dimension. The soft tissue of the palatal rugae stretches in adaptation to hard tissue movement. Among the evaluated landmarks, the medial point of the third palatal rugae seemed to be the most stable. The observed alterations in the palatal rugae demonstrated the potential of medial points of third palatal rugae as a reference point in model superimpositions to evaluate dental movement within the maxillary arch following RME and facemask treatment.

Differentiation of Malignant from Benign Soft-Tissue Solid Tumors: Clinical and MR Finding Complex (연조직고형종양의 악성과 양성 감별: 임상과 자기공명영상 복합소견)

  • Moon, Tae-Yong;Kim, Jung-Il;Shin, Su-Mi;Choo, Hye-Jeung;Choi, Hyun-Wook;Kim, Soo-Jin
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.79-87
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    • 2004
  • Purpose: The recent development of MR has made to possible radiological diagnosis in various soft tssue tumors. But multifarious components within soft tissue tumors and their periodic change have made to difficult even differentiation of malignant from benign soft tissue tumors solely on the MR. So authors retry to differentiate malignant from benign soft tissue tumors with clinical and MR finding complex. Materials and methods: We were analysed 82 pathologically confirmed soft tissue solid tumors (37 cases as malignancy including intermediate tumors and 45 cases as benign including inflammatory masses) which are correlated with clinical findings such as age, size, and location, MR findings such as tumor border, texture on T2 and contrast-T1 images, and enhancement area retrospectively. Many typical lipoma and cysts including of ganglion and abscess are rejected in the benign soft tissue tumor group because not difficult to diagnose on MR. Results: Malignant soft tissue tumors were more frequent in 21~40 and 61~80 years old of the age, above 3.0 cm of the size, trunk-pelvis-lower extremities of the location, and MR findings with irregular border and above 50% of the enhancement area than those of benign soft tissue tumors. Conclusion: The clinical finding that divided to two locations as trunk-pelvis-lower extremities and upper extremities-shoulder-spine was statistically significant to differentiate malignant from benign soft tissue solid tumors. However, the others would provide some useful informations to differentiate them never specific.

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