• The Korean Journal of Nuclear Medicine
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• v.24 no.1
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• pp.124-132
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• 1990

It has been reported that hematoma is one of the most crucial factors in fracture healing since callus formation is disturbed by washing out the hematoma near a fracture site. However, it is not clear why the hamatoma is important and how it plays a role during the fracture healing. In order to investigate the role of hematoma in the process of fracture healing, the osteogenic potential by subperiosteal transplantation have been studied. Experimental fractures by operation were made at the mid-shaft of the tibia in New Zealand white rabbits. Removal of hematoma at the fracture site was done after 2 and 3 days from experimental fracture, and the removed hematoma was transplanted into the subperiosteal area at the mid-shaft of the ulna of each rabbit. As control groups, we have performed 3 different procedures 1) the hematoma was transplanted into the muscular layers at the thigh and forearm; 2) autologous blood clots were transplanted into the subperiosteal area of the ulna; and 3) sham operation without a transplantation into the subperiosteal area. After transplantation, serial bone scintigraphy and simple radiography were performed at 4 days, 1 week, and 2 weeks to detect an abnormality. The results of bone scintigraphy were positive in 5 of 6 experimental group. However, all in three control groups were negative. Histological observation of the positive bone revealed new bone formation with trabeculation. These results suggest the hematoma in fracture site has osteogenic potential in the subperiosteal area which can be demonstrable by bone scintigraphy and histologic findings. Therefore, it is considered that hematoma of the fracture site plays an important role in the process of fracture healing. Further biochemical investigation using various experimental models is mandatory to apply this preliminary result to the treatment of clinical delayed union or nonunion.

• Journal of Korean Neurosurgical Society
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• v.61 no.6
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• pp.680-688
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• 2018

Objective : To mitigate the risk of iatrogenic instability, new posterior decompression techniques able to preserve musculoskeletal structures have been introduced but never extensively investigated from a biomechanical point of view. This study was aimed to investigate the impact on spinal flexibility caused by a unilateral laminotomy for bilateral decompression, in comparison to the intact condition and a laminectomy with preservation of a bony bridge at the vertebral arch. Secondary aims were to investigate the biomechanical effects of two-level decompression and the quantification of the restoration of stability after posterior fixation. Methods : A universal spine tester was used to measure the flexibility of six L2-L5 human spine specimens in intact conditions and after decompression and fixation surgeries. An incremental damage protocol was applied : 1) unilateral laminotomy for bilateral decompression at L3-L4; 2) on three specimens, the unilateral laminotomy was extended to L4-L5; 3) laminectomy with preservation of a bony bridge at the vertebral arch (at L3-L4 in the first three specimens and at L4-L5 in the rest); and 4) pedicle screw fixation at the involved levels. Results : Unilateral laminotomy for bilateral decompression had a minor influence on the lumbar flexibility. In flexion-extension, the median range of motion increased by 8%. The bone-preserving laminectomy did not cause major changes in spinal flexibility. Two-level decompression approximately induced a twofold destabilization compared to the single-level treatment, with greater effect on the lower level. Posterior fixation reduced the flexibility to values lower than in the intact conditions in all cases. Conclusion : In vitro testing of human lumbar specimens revealed that unilateral laminotomy for bilateral decompression and bone-preserving laminectomy induced a minor destabilization at the operated level. In absence of other pathological factors (e.g., clinical instability, spondylolisthesis), both techniques appear to be safe from a biomechanical point of view.

• Journal of Korean Physical Therapy Science
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• v.3 no.4
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• pp.113-120
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• 1996

The purpose of this study was to comparison clinical applied versus theoretical fitness on axillary crutch in human stance phase. Ideal crutch length is defined as the length of the crutch, including accessories, obtained during stance when the crutch tip is 15 cm(about 6inch) lateral and 15 cm(about 6 inch) anterior to the fifth toe and the axillary pad is 5 cm(about 2 inch) below the axillay fold. The participations(volunteers) were 71 inpatients(53 men and 18 women) who have orthopedic and neurological impairment on unilateral and/or bilateral lower extrimities, and mean age was 31.4 year old. Prior to participation, each subject informed the procedures of experiment from researcher and assistant researcher. This measured for axillary crutch using each of the following aspects : (1) length of actual using crutch, (2) length of axillary fold after modified(77% of actual height), (3) angle of elbow flexion after modified(77% of actual height). In order to determine the statistical significance of result, t-test were applied at the 0.05 level of significance. The result were as follows ; 1. There was significant difference between actual crutch and ideal crutch length(77% of actual height)(p<0.05). 2. There was significant difference of length of axillary fold between actual and ideal crutch (77% of actual height)(p<0.05). 3. There was significant difference of angle of elbow flexion between actual and ideal crutch(77% of actual height)(p<0.05).

• Physical Therapy Korea
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• v.3 no.1
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• pp.1-11
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• 1996

The purpose of this study was to analyse the subtalar joint movement characteristics in human stance phase. The data of subtalar joint movement patterns are collected by CTA(calcaneus to tibia angle) measurements. CTA is defined as a angle formed between the bisect of the posterior shank and bisect of the posterior heel, as determined by placement of the retroreflective markers. The angle measured in degrees. The participants are 74 healthy individuals (37 men and 37 women) who have no orthopedic and neurological impairment, aged from 19 to 29 years(mean 22.95). Prior to participation, each subjecct informed the procedures of experiment from researcher and assistant researcher. The equipments of this study are walking grid, marking tapes, goniometer, video camera, monitor and ink for foot print are used in the study. In order to determine the statistical significance of result, the paired t-test and Pearson correlation were applied at the 0.05 level of significance. The results were as follows : 1. The reliability of measured CTA value are showed a high correlation, ranged from .86 - .94. 2. The mean value of step width are 7.67cm in men and 6cm in women. So, significant difference between men and women in 0.05 level of significance. 3. There was significant difference between man and women's TOA(toe out angle)(p<0.05). 4. The CTA of female's is more higher than male's one, however not statistical difference between man and women(p>0.05). 5. The CTA is reduced according to increasing TOA(p<0.05).

• Journal of Preventive Medicine and Public Health
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• v.32 no.1
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• pp.40-47
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• 1999

Objectives. The health examination survey was conducted in order to estimate the prevalence of major chronic diseases in a community Methods. A multi-stage stratified probability sample of 1,656 persons, aged from 20 to 69 years, was drawn out from Kuri City. All sampled persons were personally informed of the purpose, content and procedures of the survey and mobile examination center was run between 6 AM and 9 PM for the convenience of the participants. Results. 854 persons (339 males and 515 females) completed this survey with a response rate of 53.4%. Prevalent diseases in male were hypertension(19.0%), HBs Ag carrier(9.8%), impaired glucose tolerance(8.7%), diabetes mellitus(6.3%), hypercholesterolemia(3.4%), anemia(2.7%) and degenerative arthritis(2.6%) in order of prevalence rate. Prevalent diseases in female were osteoporosis(22.5%), impaired glucose tolerance(17.3%), anemia(12.8%), hypertension(12.4%), degenerative arthritis (6.6%), HBs Ag carrier(5.8%), diabetes mellitus(5.4%) and hypercholesterolemia(3.5%) in order of prevalence rate. Conclusions. This results suggest that hypertension was most prevalent in adult male whereas diabetes mellitus including IGT, osteoporosis were most prevalent in adult female, in Kuri City.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.159-166
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• 2008

Articular cartilage is a unique tissue with no vascular, nerve, or lymphatic supply. This uniqueness may be one of the reasons why chondral injuries will hardly heal and may progress to osteoarthritis over time. Currently, there are several surgical options for the treatment of articular cartilage lesions. Although there is some discrepancy as to which procedures work best in certain patients. The spectrum of treatment alternatives for articular cartilage defects can range from simple lavage and debridement, drilling, micro-fracturing, and abrasion to osteochondral grafting and autologous chondrocyte implantation. In 1984, for the first time, results of autologous chondrocyte implantation in a rabbit model were presented, showing hyaline cartilage repair. Clinical study using autologous cultured chondrocyte implantation in chondral defects of the human knee has been reported in 23 patients in 1994. In 14 out of 16 patients treated for chondral injuries on the femoral condyles, the results were good to excellent. It is important for the surgeon to understand the autologous chondrocyte implantation technique and to be aware on the postoperative management. Attention to surgical technique and selection of appropriate patient for the autologous chondrocyte implantation will provide with the best results.

• Archives of Reconstructive Microsurgery
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• v.15 no.1
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• pp.10-16
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• 2006

We retrospectively evaluated our results of replantations of distal digital amputations and analyzed the factors deterrent to the survival of replanted digits. From January 2004 to 2005 June, we performed 101 cases of replantations following complete amputations at or distal to interphalangeal joint level. The study included 98 patients with a mean age of 35.6 years (range 1 to 63 years). Amputation level correlated to zone I (distal to the lunula)in 47 cases and zone II (lunula to distal interphalangeal joint) in 54 cases according to Yamano's classification. According to the mechanism of amputation, 24 cases (22.9%) suffered from guillotine type injury, 27 cases (27.1 %) from avulsion type injury and 50 cases (50%) from crush type injury. In all cases, a single arterial anastomosis was performed. Venous anastomosis on either volar or dorsal side was performed in 12 cases of amputation in zone II. Salvage procedure for venous drainage was performed in 98 cases. The mean duration of salvage procedures was 5.9 days (ranging from 4 to 14 days). Successful replantation was achieved in 96 cases (95.1%), which included 93.7% cases in zone I amputations and 96.3% cases in zone II amputations. A single venous anastomosis was performed in 12 cases of amputation in zone II. All of them survived completely. Among the 5 cases that failed to survive, 3 cases were related with avulsion injury in zone I. Initial mechanism of injury determines the survival rate of amputated parts as it is directly related with the status of vessels and soft tissues. Meticulous precaution during the salvage procedure may affect the overall survival rate of distal digital replantations.

• Journal of Korean Neurosurgical Society
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• v.47 no.4
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• pp.247-251
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• 2010

Objective : Selective neurotomy is generally a safe, effective, and long-lasting treatment for patients with spastic equinovarus foot deformity. We retrospectively analyzed the results of microsurgical selective tibial neurotomy (STN) for spastic feet in adults and children. Methods : A neurosurgeon selected 32 patients with 45 spastic feet (adults : 13, children : 32) to undergo microsurgical STN between October 1998 and September 2007. A physician of rehabilitation assessed spasticity pre- and postoperatively, that was based on the Ashworth scale, ankle clonus, and the amplitude of ankle dorsiflexion. The mean postoperative follow-up period was 36.7 months in adults and 42.5 months in children. Results : Spastic components of the feet were corrected immediately after surgery in both the adult and child groups. The mean Ashworth's grade changed from $3.6{\pm}0.40$ to $1.6{\pm}0.70$ in adults and from $3.7{\pm}0.69$ to $1.4{\pm}0.49$ in children. Mean ankle clonus decreased markedly, from $1.6{\pm}0.79$ to $0.3{\pm}0.42$ in adults and from $1.7{\pm}0.65$ to $0.3{\pm}0.56$ in children. The mean amplitude of ankle dorsiflexion was improved, but eight (adults: 4, children: 4) contracted feet needed complementary orthopedic correction for acceptable results. Conclusion : STN can be effective in the long-term for improving lower limb function and reduction of equinovarus deformity. Our results demonstrate that STN might be an effective procedure for treating localized harmful spastic feet in adults and children.

• Journal of Korean Neurosurgical Society
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• v.48 no.5
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• pp.419-422
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• 2010

Objective : To analyze the clinical outcomes of computed tomography (CT) fluoroscopy-guided selective neve root block (SNRB) for severe arm pain caused by acute cervical disc herniation. Methods : The authors analyzed the data obtained from 25 consecutive patients who underwent CT fluoroscopy-guided SNRB for severe arm pain, i.e., a visual analogue scale (VAS) score of 8 points or more, caused by acute soft cervical disc herniation. Patients with chronic arm pain, motor weakness, and/or hard disc herniation were excluded. Results : The series comprised 19 men and 6 women whose mean age was 48.1 years (range 35-72 years). The mean symptom duration was 17.5 days (range 4-56 days) and the treated level was at C5-6 in 13 patients, C6-7 in 9, and both C5-6 and C6-7 in 3. Twenty-three patients underwent SNRB in 1 session and 2 underwent the procedure in 2 sessions. No complications related to the procedures occurred. At a mean follow-up duration of 11.5 months (range 6-22 months), the mean VAS score and NDI significantly improved from 9 and 58.2 to 3.4 and 28.1, respectively. Eighteen out of 25 patients (72%) showed successful clinical results. Seven patients (28%) did not improve after the procedure, and 5 of these 7 underwent subsequent anterior cervical discectomy and fusion. Conclusion : CT fluoroscopy-guided SNRB may play a role as a primary conservative treatment for severe arm pain caused by acute cervical disc herniation.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.146-152
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• 2011

Purpose: To describe the recent clinical results and complications of total elbow arthroplasty based on the literature review. Materials and Methods: The indications of total elbow arthroplasty include rheumatoid or inflammatory arthritis, posttraumatic arthritis, anklylosed elbow, tumor resection which cannot recover elbow function by other reconstructive procedures, and comminuted distal humerus fracture in elderly patients. Complications are aspetic loosening, infection, prosthesis fracture, periprosthetic fracture, ulnar neuropathy, ectopic ossification, triceps insufficiency, dislocation, and bushing wear. Results and Conclusion: Mean 10 year survival rate following total elbow arthroplasty has been reported 85% on the basis of revision. The prognosis in patients with an inflammatory arthritis is reported to be best, and loosening rate in patients with a posttraumatic arthritis tends to be high. Complication rate is known to be higher than that of other joint arthroplasty. In particular, deep infection occurs in 3~5% of the patients. Total elbow arthroplasty provide satisfactory results when it is performed properly in selected patients who have an elbow joint with irreversible dysfunction and low level activities.