• Journal of the Korean Arthroscopy Society
• /
• v.9 no.2
• /
• pp.148-153
• /
• 2005

Purpose: To analyze the clinical result of the arthroscopic reduction and fixation for the displaced tibial spine fractures in children and report the utility of the arthroscopic treatment with the review of the literature. Methods: Between December 2000 and July 2004, five patients (average age 9.1 years) received an arthroscopic reduction and fixation of displaced tibial spine fracture. A male-to-female ratio was 3:2 and mean follow-up was 38.2$(13{\sim}56)$ months. All five patients were classified type III by Movers and McKeever classification. The average period from injury to operation was 4.8 days $(3{\sim}8days)$, the avulsed fragment was reduced by operative arthroscopy and fixated by pull-out suture in 3 patients and by cannulated screw in 2 patients. Postoperatively long leg cast was applied for 2 weeks, and then gradual range-of-motion exercise was permitted. Full weight-bearing ambulation was permitted after 6 weeks. The clinical evaluation was performed by range of motion, Lachman and pivot shift test, KT-1000 arthrometer, Lysholm knee score and the modified Feagin score. Results: All five patients had no symptom and recovered full range of motion of the affected knees. Lachman test was positive finding of 1+ laxity in one patient, the others were negative, and all patients were negative findings for pivot shift test. The result of KT-1000 arthrometric assessment is mean maximum side-to-side differences 1.9 mm. Average Lysholm knee score was 99.4. All patients had excellent results in modified Feagin score. Conclusion: Arthroscopic reduction and fixation of displaced tibial spine fracture in children showed excellent result without complication. Both pull-out suture fixation and cannulated fixation provide an effective treatment option for fixation of the displaced anterior tibial spine fracture.

• Journal of the Korean Arthroscopy Society
• /
• v.9 no.2
• /
• pp.206-213
• /
• 2005

Purpose: To evaluate the outcome of symptomatic osteochondritis dissecans of the talus treated with arthroscopic debridement and multiple drilling. Materials and Methods: Between 1997 and 2003, 14 arthroscopic debridement(group I) and 15 arthroscopic multiple drilling(group II) were performed. There are 21 male and 8 female patients. Mean age was 34.4 years(33.8 years in group I, 37.5 years in group II) and average follow-up period was 43.2 months(46.4 months in group I, 40.1 months in group II). Simple radiographs and MRI were performed preoperatively and postoperatively, and the progressive stage of the lesions was evaluated through the arthroscopic surgery. Clinical results were evaluated with ankle-hindfoot scale and scoring scale for subjective and objective functional outcomes. The results were compared between 2 groups. Results: There are 20 medial(7 in group I, 13 in group II), 6 lateral(5 in group I, 1 in group II), and 3 both-side(2 in group I, 1 in group II) lesions. According to the classification of Berndt and Harty, there are 4 stage II(4 in group I, 0 in group II), 19 stage III(9 in group I, 10 in group II), and 6 stage IV(1 in group I, 5 in group II). According to the ankle-hindfoot score, the mean score was significantly improved $53.1{\pm}2.7$ points preoperatively to $85.1{\pm}8.5$ points postoperatively in group I and $54.6{\pm}6.8\;to\;80.7{\pm}8.5$ points group II. Subjective and functional scores was also improved $49.6{\pm}10.5$ points preoperatively to $84.6{\pm}7.7$ points postoperatively in group I and $50.7{\pm}9.2\;to\;83.0{\pm}9.6$ points in group II. But there were no statistical significance between them. Conclusion: Arthroscopic debridement and multiple drilling for the treatment of osteochondral lesions of the talus showed successful results and there was no statistically significant difference between them.

• The Journal of the Korean bone and joint tumor society
• /
• v.9 no.1
• /
• pp.24-30
• /
• 2003

Purpose: To clarify the results of simple bone cyst (SBC) treatment in children by percutaneous autologous bone marrow grafting and xenografting. Materials and Methods: We studied seven cases (4 males, 3 females) of SBC, which were treated by percutaneous autologous marrow and heterograft bone grafting from January 1996 to February 1999. Their mean age at surgery was 10 years (6 to 15), and the mean follow-up period was 35.6 months (20 to 52). Three cases were located in the proximal and middle humerus; three cases were in the proximal femur; and one case occurred in the ilium. Mean volume was 14.7 $cm^2$ (10 to 23). Six cases were active, and one was inactive. Five patients had a history of receiving a mean of 3.2 steroid injections. The mean quantity of bone marrow used in treatment was 14.3 ml (10 to 20), and the mean amount of $Lubboc^{(R)}$ heterograft bone (Transphyto S.A. Clermont Ferrand, France) used was 6.4 blocks (5 to 10). Results were analyzed using the modified Neer classification. Results: Five cases completely healed with obliteration of the cyst cavity (Grade IV). Two cases demonstrated sclerosis around a partially visible cyst (Grade III). All treatment results were satisfactory and without intraoperative or postoperative complications. Conclusione: Percutaneous autologous marrow and heterograft bone grafting is recommended as an effective treatment method for simple bone cyst. It offers ease of operative technique, a high rate of healing, a low recurrence rate, low morbidity, a low incidence of postoperative complications, and free from bone graft donor site problems.

• Journal of Korean Neurosurgical Society
• /
• v.29 no.11
• /
• pp.1437-1444
• /
• 2000

Objectives : Traditionally intracranial meningiomas are regarded as benign and curable tumors. About half of all intracranial meningiomas locate in the skull base region. However, surgical removal of these tumors may be challenging and require special considerations. Here general aspects of skull base meningiomas including clinical presentation, surgical approaches, complications and their recurrence rate are discussed based on our experiences. Methods : A retrospective analysis of 61 consecutive patients with skull base meningioma among 210 patients of meningioma between 1989 and 1998 were done. Results : There were 41 women and 20 men ranging from 13 to 74 years(mean 52 years). These tumors were divided into seven categories according to location : olfactory groove(n＝9), sphenoid ridge(n＝16), cavernous sinus(n ＝2), tuberculum sellae(n＝8), tentorium(n＝13), cerebellopontine angle(n＝12), and foramen magnum meningiomas (n＝1). Surgical approaches were selected on the basis of the tumor attachment, size and extension on preoperative radiologic findings. Total removal(Simpson grade I and II) was achieved in 50 cases(82%), and subtotal removal (Simpson grade III) in 11 patients(18%). According to WHO classification, there were 52 of cases of benign meningioma( 86%), 6 atypical cases(10%), and 3 malignant cases(5%). The most common postoperative complications were CSF leakage(23.0%) and cranial nerve injury(8.2%). Three patient died related with tumor(one was due to surgical complication and the other two due to recurrence) but three patients died from other systemic causes. Mean follow-up period was 51.7 months after surgery. Recurrence occurred in six patients(10.9%) ; three with tentorial meningioma, two with sphenoid ridge, and one in cerebellopontine angle. Conclusion : With advances in neuroradiology and microsurgical techniques, the surgical outcome of miningiomas has been markedly improved with acceptable morbidity and mortality rates. Overall, our surgical results of skull base meningiomas is comparable to other reports. Therefore, with the appropriate operative strategy and techniques, these tumors can be completely removed and good surgical results can be expected.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.8 no.1
• /
• pp.33-38
• /
• 2009

Purpose: We wanted to report the clinical characteristics and arthroscopic findings of radial tear in medial meniscus posterior horn insertion, commonly occurs in patient over middle age with documentary review. Materials and Methods: Retrograde study using hospital records was done to 40 cases in 40 patients who visited our hospital and had been performed knee arthroscopic surgery due to medial meniscus posterior horn insertion tear between January, 2005 to April, 2007. Seven cases were male and 33 cases were female with the mean age of 61 (range, 47-80). Trauma history, stage of arthritis, period between pain and operation, MRI findings, clinical symptoms and operation methods were evaluated. Results : Six cases had trauma history while 34 cases didn't. In simple x-ray, using Kellgren-Lawrence classification, 31 cases were between stage 0 and II while 9 cases were stage III. In arthroscopic exam, there were 17 cases of Outerbridge grade IV, 4 cases of grade III, 9 cases of grade II, 9 cases of grade I. The mean duration of pain was 5.3 months. In MRI, at least one finding of cleft in axial or coronal view or ghost sign in sagittal view was found in all cases. The shape of meniscus tears were blunt in 18 cases, transverse in 12 and degenerative tear in 10. Subtotal meniscectomy was performed in 16 cases, partial meniscectomy in 10 cases and meniscal repair in 14 cases. Conclusion : Medial meniscus posterior horn insertion tear occurs in patients over middle age is rarely related to trauma history but causes painful mechanical symptom and usually accompany arthritis. Meniscectomy can be done for the treatment but repair can be considered is some cases. Further study on the treatment result will be needed.

• Herbal Formula Science
• /
• v.11 no.2
• /
• pp.1-18
• /
• 2003

The Theory for Monarch, Minister, Adjuvant and Dispatcher (or the Theory of Principal, Assistant, Adjuvant and Guiding Korean Oriental Herbal Medicines) has served as a standard principle for newly developed prescription formulas as well as established ones. Despite its significance, however, this theory hasn't been thoroughly studied and covered in the academic journals of Korean Oriental Herbal Medicines (KOHM) yet. This paper inquires into the origin of the theory while presenting the definitions and functions of Principal, Assistant, Adjuvant, and Guiding KOHM. In the end, the recommended doses and number of the KOHM comprising each of Principal, Assistant, Adjuvant, and Guiding KOHM are suggested. The compatibility theory of Principal, Assistant, Adjuvant, and Guiding KOHM can be traced back to the Warring States Period during which it was recorded in the treatise of the various schools of thoughts and their exponents. The theory was firmly established as a full system in ${\ulcorner}Shinnong's\;Pharmacopoeia{\lrcorner}\;and\;{\ulcorner}Yellow\;Emperor's\;Cannon\;of\;Internal\;Medicine{\lrcorner}$. While ${\ulcorner}Shinnong's\;Pharmacopoeia{\lrcorner}$ focuses on the classification of the properties of KOHM, ${\ulcorner}Yellow\;Emperor's\;Cannon\;of\;Internal\;Medicine{\lrcorner}$ mainly deals with the principles for writing prescriptions. In this regard, it is ${\ulcorner}Yellow\;Emperor's\;Cannon\;of\;Internal\;Medicine{\lrcorner}$ that systemized the Theory of Principal, Assistant, Adjuvant, and Guiding KOHM in a real sense. Principal KOHM aims at the causes of diseases and treat main symptoms. The doses are greater than Assistant, Adjuvant and Guiding KOHM. With their comprehensive effects, Principal KOHM is a leading ingredient of any prescription formula. Assistant KOHM are similar to Principal KOHM in its natures and flavors. Although its natures, flavors as well as efficacies may slightly differ from those of Principal KOHM, Assistant KOHM strengthens the therapeutic effects, jointly working with Principal KOHM. They mainly treat accompanying diseases and symptoms. Adjuvant KOHM is divided into two types: facilitator and inhibitor. Facilitators with the similar properties to those of Principal and Assistant KOHM help strengthen the therapeutic effects. Since they usually treat accompanying symptoms or secondary accompanying symptoms (minor accompanying symptoms), there are two kinds of facilitators. (1) The first kind of facilitators assists Principal KOHM, targeting accompanying symptoms. (2) The second ones supporting Assistant KOHM are for accompanying or secondary accompanying symptoms (or minor accompanying symptoms). Inhibitors counteract and thereby complement Principal and Assistant KOHM. Some of them inhibit the side effects or toxicity of Principal KOHM for the sake of the safety of the whole prescription formula while the others generate induced interactions. Guiding KOHM can be used for two purposes: guiding and mediating. The Guiding KOHM for the former purpose leads the other KOHM in a prescription formula to the lesion. But, the Guiding KOHM for mediating coodinate and harmonize all the ingredients in a prescription formula. The number of KOHM for those Principal, Assistant, Adjuvant and Guiding KOHM and their doses are different, depending on the types of prescriptions: classical prescriptions, prescriptions after ${\ulcorner}$Treatise of Cold-Induced Diseases${\lrcorner}$ and prescriptions of Sasang Constitutions Medicines. In the case of the prescriptions after ${\ulcorner}$Treatise of Cold-Induced Diseases${\lrcorner}$, it is highly recommended to follow the view of ${\ulcorner}$Thesaurus of Korean Oriental Medicine Doctors in Chosun Dynasty${\lrcorner}$ for the number of KOHM to be used. For the doses, however, ${\ulcorner}$Elementary Course for Medicine${\lrcorner}$, is found to be more accurate. The most appropriate number of KOHM per prescription is 11-13. To be more specific, for one prescription formula, it is recommended to administer one kind of KOHM for Principal KOHM, 2-3 for Assistant KOHM, 3-4 for Adjuvant KOHM and 5 for Guiding KOHM. As for the proportion of the doses, when 10 units are to be administered for Principal KOHM in a formula, the doses for the other three should be 7-8 units for Assistant KOHM, 5-6 for Adjuvant KOHM and 3-4 for Guiding KOHM. The doses of the KOHM added to or taken out of the prescription correspond to those of Adjuvant and Guiding KOHM.

• Radiation Oncology Journal
• /
• v.13 no.2
• /
• pp.191-198
• /
• 1995

Purpose: This analysis was to compare the result of radiation alone and chemoradiation in cervical cancer in terms of response, survival, failure, and complication. Materials and Methods: A retrospective analysis of 135 cervical cancer patients treated with definitive radiotherapy from November 1985 to December 1991 was performed. Fifty-six patients were treated with radiation alone and 79 patients were treated with cisplatin-based chemotherapy plus radiation. Follow-up period ranged from 5 to 105 months with a median 47 months. According to the FIGO classification, the patients were subdivided into 18 $(13.3\%)$ stage IB, 7 $(5.2\%)$ stage IIA, 97 $(71.9\%)$ stage IIB, and 9 $(6.7\%)$ stage IIIB. Results: A complete response was noted in 51 patients $(91.1\%)$ of the radiation alone group, and 68 patients $(86.1\%)$ of the chemoradiation group. There was no statistical difference in complete response rate between the two groups. Overall survival rate at 5 years was $73.3\%$. According to stage, overall survival rates at 5 years were $88.9\%$ in stage IB, $85.7\%$ in stage IIA, $73.8\%$ in stage IIB, and $37.5\%$ in stage IIIB, respectively. According to treatment modality, overall survival rates at 5 years were $81.9\%$ in the radiation alone group, $67.0\%$ in the chemoradiation group (p=0.22). Disease-free survival rate at 5 years were $70.4\%$ in the radiation alone group. $68.5\%$ in the chemoradiation group (p=0.85) Locoregional control rates at 5 years were $76.1\%$ in the radiation alone group, $73.8\%$ In the chemoradiation group (p=0.70). Distant disease-free survival rates at 5 years were $83.9\%$ in the radiation alone group, $90.3\%$ in the chemoradiation group (p=0.59). Treatment-related bone marrow suppressions were noted in 3 $(5.4\%)$ patients of the radiation alone group, 14 patients $(17.7\%)$ of the chemoradiation group (p(0.05). Grade 2 vesical complications were noted in 14 patients of the radiation alone group. and 10 Patients of the chemoradiation group. Grade 2 rectal complications were noted in 2 patients of the radiation alone group, and 3 Patients of the chemoradiation group. One case of rectal perforation was noted in the chemoradiation group, and grade 2 small bowel obstructions were noted in 2 patients of the radiation alone group. There were no statistical differences in the incidence of vesicar, rectal, and small bowel complicaions between the two groups. Conclusion: No statistical difference was found between the radiation alone group and the chemoradiation group in terms of response, survival, and failure. but the incidence of bone marrow suppression was higher in the chemoradiation group.

• Korean Journal of Environmental Biology
• /
• v.24 no.4
• /
• pp.392-407
• /
• 2006

This study was seasonally undertaken to investigate the benthic polychaetous community along the South-eastern coast of Geoje Is., in February 2004 to November. The macrobenthic fauna showed mean density of 953 md. $m^{-2}$ in February, 1,193 ind. $m^{-2}$ in May, 1,130 ind. $m^{-2}$ in September and 991 ind. $m^{-2}$ in November. Major faunal groups are polychaetes, crustaceans and mollusks, corresponding to 81.6%, 7.9%, 7.0% in total mean density during the sampling seasons, respectively. There was significant difference (two-way ANOVA, p<0.001) among stations in densities of polychaetes. But no significant relationship could be found between the densities of polychaetes and sampling seasons (two-way ANOVA, p>0.05). The density and the species number of polychaetes were high in the coastal area near the Jisepo port, independent of sampling seasons. Several indicator species for the organically enriched environments such as Lumbrineris longifolia, Tharyx sp., Heteromastus filiformis showed high densities during all study periods. Also Magelona japonica included in Ecolgical group I was the most abundant in the whole study period except for February. Cluster analysis on the basis of the species composition showed that the study area could be divided into 3 regions. The density of benthic polychaetes in the coastal area near Jisepo was higher than that in the other assemblages of the study area, due to some predominant opportunistic species, such as Lumbrineris longifolia, Tharyx sp. and Heteromastus filiformis. In addition, the two-way ANOVA showed significant differences among the distribution of AMBI (AZTI's Marine Biotic Index) values, both in sampling stations (p<0.001) and seasons (p<0.01). According to the classification proposed by Borja et at. (2000), the study area was slightly disturbed site.

• Clinics in Shoulder and Elbow
• /
• v.15 no.2
• /
• pp.130-137
• /
• 2012

Purpose: To evaluate and report the clinical outcome after surgical treatment of intra-articular comminuted fracture of distal humerus in the elderly with osteoporosis. Materials and Methods: From January 2007 to October 2009, 24 patients aged older than 65 years with intra-articular comminuted fracture of distal humerus underwent surgical treatment. 18 patients (Group I) were managed using primary open reduction and internal fixation (OR IF) through the modified posterior approach and 6 patients (Group II) were taken primary total elbow arthroplasty. The average follow up period was 17.2 months. According to the AO classification, there were 8 C2, 16 C3 type fractures. All enrolled patients were evaluated radiographically and clinically. Clinical outcomes were assessed with the Mayo Elbow Performance, Disabilities of Arm and Shoulder and Hand, and Musculoskeletal Functional Assessment functional questionnaires. Results: The bony union was observed in 18 patients in group I at average 14 weeks. There were 2 patients with neurapraxia of whom the ulnar nerve symptom did not improve despite of anterior transposition. And non-union at osteotomy sites was seen in 2 patients. The mean Mayo Elbow Performance score was 87.0. The mean DASH score was 32.4. The average arc of elbow flexion was $121.0^{\circ}$ (range, $95{\sim}145^{\circ}$) with mean flexion-contracture of $12.0^{\circ}$ (range, 0 to 35). 6 patients in Group II showed no complication during follow up periods. The mean Mayo Elbow Performance score was 89.1. The mean DASH score was 44.3. The average arc of elbow flexion was $125.1^{\circ}$ (range, $100{\sim}145^{\circ}$) with mean flexion-contracture of $12.6^{\circ}$ (range, 0 to 30). Conclusions: With careful patient selection, Total elbow arthroplasty as well as OR IF could achieve good outcomes in elderly of comminuted intra-articular distal humerus fracture with osteoporosis.

• Clinical and Experimental Pediatrics
• /
• v.48 no.10
• /
• pp.1061-1067
• /
• 2005

Purpose : We studied a clinical analysis of pediatric patients who visited the emergency medical center of Yeungnam University Hospital to compare the characteristics of pediatric emergency patients after year 2000 with the previous studies. Methods : We reviewed 7,034 children under the age of 15 years who visited the emergency medical center of Yeungnam University Hospital during the 2 year period from January 2001 to December 2002, and then we performed a clinical and statistical analysis. We analyzed the pediatric patients according to gender, age, season, day of the week, time of the visit, the disease classification and the final disposition of the patients. Results : Among the patients who visited the emergency room, 15.6% of the total emergency patients were under the age of 15. The male to female ratio was 1.6 : 1. Among the 7,034 pediatric patients, the most common age group was between 1 year and under 3 years of age(26.9%). The peak seasonal incidence was early summer and spring, especially during June(11.2%) and May(10.6 %). The peak incidence day of the week was Sunday(24.8%) and the peak time when the emergency pediatric patients visited the emergency room was between 20 and 24 o'clock(28.8%). The distribution of diseases, according to ICD-10 system, were injury and poisoning(30.4%), diseases of the respiratory system(22.8%), and diseases of the digestive system(14.6%). 30% of total pediatric patients were admitted to the hospital. Conclusion : After year 2000, as compared with the previous studies, the proportions of emergency pediatric patients has decreased. The distribution of diseases was not much different from the previous studies and the proportions of non-urgent diseases, such as acute nasopharyngitis or acute gastroenteritis, were still high. These result have come about due to the declining birth rate and changes of the medical system in Korea.