• Journal of Sasang Constitutional Medicine
• /
• v.21 no.2
• /
• pp.27-41
• /
• 2009

1. Objectives : This research was proposed to find our the pathology of Soeumin in Sasang Constitutional Medicine(SCM). 2. Methods : The related contents of the pathology of Soeumin were selected in Je-Ma Lee's literatures such as "Dongmu-YuGo(東武遺稿)"(DYG), "Donguisusebowon-SaSangchobongyun(東醫壽世保元四象草本卷)"(DSS), "Donguisusebowon-GabObon(東醫壽世保元甲午本)"(DGO), "Donguisusebowon-ShinChukbon(東醫壽世保元辛丑本)"(DSC), and the research was written in order to find out the physiology and pathology of Soeumin in SCM. 3. Results and Conclusions : The chronical change of pathologic concept in Soeumin diseases as follows: Pathology in Soeumin diseases was much Cold Qi(寒氣), and more descending Qi, less ascending Qi in DYG, DSS. In "Discourse on the viscera and bowels" of DGO and DSC, Soeumin has a circulation of Water-Food Hot Qi of Spleen Group(脾黨) and Water-Food Cold Qi of Kidney Group(腎黨). Exterior Disease(表病) was the injury of Exterior-Qi such as eye-shoulder Qi(目膂氣) by Pleasure-Nature-Qi(樂性氣), and Interior Disease(裏病) was the injury of Interior-Qi such as spleen-stomach Qi(脾胃氣) by Joy-Emotion-Qi(喜情氣). All diseases of Soeumin are caused by insufficient Warm Yang Qi(陽煖之氣) in Spleen Group(脾黨), so the pathology of Soeumin was focused on Requisite energy(保命之主) and each small viscera and bowels(偏小之臟). In this viewpoint, the schema of Soeumin diseases such as Ulkwang-syndrome(鬱狂證), Mangyang-syndrome(亡陽證), Taeum-syndrome(太陰證) and Soeum-syndrome(少陰證) were designed to explain the mechanism of each syndrome.

• Archives of Plastic Surgery
• /
• v.50 no.4
• /
• pp.415-421
• /
• 2023

The revision of the Korea Organ Transplantation Act (KOTA) in 2018 included hand/arm among the organs that can be transplanted. The first hand transplantation since the revision of KOTA took place in January 2021. A 62-year-old male patient experienced hand amputation on July 13, 2018, by a catapult injury. The patient first visited our institute 3 months after the injury. After serial interviews and an overall evaluation, the patient was registered on the hand transplantation waiting list in January 2020. On January 9, 2021, the patient underwent hand transplantation at the right distal forearm level. The total operation time was 17 hours 15 minutes, and the cold ischemic time was 4 hours 9 minutes. Postoperative immunosuppression was administered based on the protocol used for kidney transplantation. Two acute rejection episodes occurred, on postoperative days 33 and 41. Both rejection episodes were reversible with rescue therapy of a higher tacrolimus trough level, steroid pulse therapy, and topical immunosuppressants. Controlled passive range of motion exercise was started on postoperative day 10. Dynamic splint was applied on postoperative day 18. At 1 year, graft maintenance and functional improvement were satisfactory, and the patient showed a Disabilities of Arm, Shoulder and Hand score of 25.8. We successfully performed the first hand transplantation surgery under the KOTA amendment. It came from the organic and effective cooperation of plastic, orthopaedic, and transplantation departments and we believe it will guarantee the future ongoing success.

• Journal of Chest Surgery
• /
• v.56 no.6
• /
• pp.431-434
• /
• 2023

Background: The first 3 ribs are anatomically well-protected, shielded by the large thoracic muscles, the shoulder girdle, and the arm. A significant force is required to fracture these ribs; thus, such fractures suggest a high-energy trauma and are associated with injuries to vital organs of the thorax, such as the aorta, the heart, the lungs and the great vessels. Methods: A retrospective analysis was conducted over a 10-year period at a single hospital. The study assessed patients with fractures of the second rib, including their concurrent injuries and the overall severity of their trauma. Results: Among the 76 patients included in the study, the average age was 47.35 years, 81.5% were men, and 19.5% were women. Thirteen patients (17.1%) survived their injuries. The most common causes of injury were road traffic accidents (63%) and pedestrian injuries (22%). The patients who did not survive sustained injuries to an average of 5 additional organs, while survivors had injuries to an average of 2.07 additional organs. Left rib fractures were the most frequently observed (46%). The most serious concurrent injuries reported were to the aorta (5.26%), heart (10.52%), lung (52.36%), head (57.89%), liver (30.2%), spleen (26.31%), and kidney (17.1%). Conclusion: As indicators of serious injury to vital endothoracic organs, isolated fractures of the second rib should be considered equal to first rib fractures in clinical importance.

• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.167-174
• /
• 2010

Purpose: Anatomical repair of massive rotator cuff tear has been technically challenging because of medial retraction, muscle atrophy and fatty degeneration. Among several treatment options for massive rotator cuff tear, we reviewed rotator cuff repairs and investigated modalities for improvement of clinical outcomes, decreasing the re-tear rate, and increasing healing. Materials and Methods: Patient-related factors and rotator cuff-related factors were the two major groups of factors we considered when choosing a treatment plan. Results: Mobilization of a massive rotator cuff tear was increased by soft tissue release and by the interval slide technique. After meticulous soft tissue release, anatomical repair could be achieved. If the injury was not amenable to anatomical repair, alternative treatment options such as partial repair, the margin convergence technique and augmentation with a tenotomized biceps tendon were considered. Many reports of massive rotator cuff repair demonstrated satisfactory clinical outcomes, decreased pain, recovery of shoulder functions, and increases in muscle strength. However, the re-tear rate had been reported to be relatively high in long-term follow-up. Conclusion: Despite a high re-tear rate after massive rotator cuff repair, a better understanding of the pathogenesis, progression and clinical symptoms of massive rotator cuff tear and improved surgical materials and techniques will lead to satisfactory clinical outcomes.

• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.1-6
• /
• 2010

Purpose: To evaluate the results and complications of antegrade intramedullary interlocking nailing in humerus shaft fractures. Materials and Methods: We evaluated the clinical outcomes, radiologic results and complications in 47 patients with humerus shaft fracture treated with antegrade intramedullary interlocking nailing, and followed up until bony union. Bony union was confirmed by serial plain radiographs and the clinical outcomes were assessed according to the ASES scoring system. Results: Bony union was confirmed in 41 (87.2%) out of a total 47 patients, and the mean union period was 14.5 weeks. Major complications were as follows: 6 non-union, 3 delayed union, 2 intraoperative posterior cortex fracture in the distal humerus and 2 permanent shoulder pain, including 1 case of adhesive capsulitis. The clinical outcomes were as follows: 29 excellent, 11 good, 4 fair and 3 poor. Satisfactory outcomes were demonstrated in 40 patients (85.1%). Conclusion: Anterograde intramedullary interlocking nailing as treatment for humerus shaft fracture showed satisfactory bony union and clinical outcomes. It is considered an efficacious treatment, especially in patients with associated injury, such as multiple fractures and segmental fracture.

• Korean Journal of Applied Biomechanics
• /
• v.18 no.4
• /
• pp.151-159
• /
• 2008

In this research, kinematic comparative analysis was performed on strokes of abscission and spinal cord injured athletes who participated in 2008 Beijing Paralympics wheelchair table tennis games. Strokes of all situations were collected under real match-like conditions. Among those, three major forehand stroke motions and backhand stroke motions were drawn Data collected by 9 infrared cameras were expressed in angular motions using graphic program LabVIEW7.0. As a result, forehand stroke of spin handicap athlete from analyzed images, the rotations of the trunk happened with the rotations of shoulder and the flexion extensions of elbow nearly at the same time. According to these results, insufficient turning force or speed of rackets is recompensed using flexion. backhand stroke of spin handicap athlete from analyzed images, the rotations of the trunk, the flexion extensions of the elbow and the flexion extensions of the shoulder were lined up on the prolongations of ping-pong balls. Forehand stroke of abscission athletes was done by outward rotation of the arm using backswing and inner rotation. As for backhand stroke, backswing was made by inner rotation in the spin of shoulder and waist. And after the backswing, impact was formed in wide outer rotation towards the ball.

• Clinics in Shoulder and Elbow
• /
• v.1 no.2
• /
• pp.205-211
• /
• 1998

The comminuted fracture and dislocation of the proximal humerus occur more frequently in older patient group and operative treatment is difficult due to poor bone quality. Based on Neer's work, hemiarthroplasty has now become widly accepted for the management of the three-part fracture and four-part fracture-dislocation of the proximal humerus in old age group. The purpose of this study is to evaluate function, pain relief, and patient satisfaction after hemiarthroplasty for proximal humerus fractures and dislocations. Authors reviewed and analyzed 14 prosthetic replacement in comminuted proximal humeral fracture and dislocation at the Department of Orthopaedic Surgery, Yonsei University Wonju College of Medicine from March, 1988 to May, 1997. The results were as follows the average age was 58.9years and the ratio of males and females was 5:9. The most common cause of injury was traffic accident(43%). According to the classification of Neer, three part fracture were three(21%), four-part fracture and four-part fracture-dislocation were eleven(79%). The prosthetic replacement was performed within two weeks in eight patient and six were performed after two weeks. The results were analysed according to Neer's criteria and five cases showed satisfactory results. We concluded that hemiarthroplasty for fracture and dislocation of the proximal humerus facilitated the restoration of humerus length and pain relief, thereby allowing earlier motion to prevent the development of painful shoulder: stiffness.

• Clinics in Shoulder and Elbow
• /
• v.20 no.3
• /
• pp.133-137
• /
• 2017

Background: To determine the natural progression of conservatively treated rotator cuff tears, we evaluated changes in radiologic and clinical parameters in patients whose recalcitrant tears were neglected after conservative treatment. Methods: A total of 73 patients with recalcitrant rotator cuff tears in spite of conservative treatment were included in this study. We measured changes in tear size and in the extent of fatty infiltration of the rotator cuff by comparing the initial and final follow-up magnetic resonance imagings (MRIs). To determine factors influencing the change in tear size, we collected the medical history of patients taken at the time of initial admission. Results: The average follow-up period was 20.1 months, and the average increase in tear size across this period was 6.2 mm. In terms of steroid injection, we found that the increases in tear size of the steroid injection group (p=0.049) and of the sub-group that had received more than three steroid injections (p=0.010) were significantly greater than that of the non-steroid injection group. Conclusions: We found that the increase in cuff tear size was on average 6.2 mm across the follow-up period, indicating that neglecting cuff tears may cause them to progress into more severe tears. We also observed that a history of steroid injection might be a possible risk factor for a worse prognosis of cuff tears. Therefore, we suggest that patients with rotator cuff tears and a history of steroid injection are recommended aggressive modes of treatment such as surgery.

• Journal of the Korean Arthroscopy Society
• /
• v.12 no.2
• /
• pp.82-86
• /
• 2008

Many rotator cuff tears are operatively treated in recent years. Postoperative rehabilitation of rotator cuff repair is as important as diagnosis of disease or surgery itself. And it is a crucial factor on the prognosis of the surgery. For appropriate rehabilitation, surgeon should have knowledge about the anatomy and biomechanics of shoulder. The purposes of postoperative rehabilitation are to avoid additional injury, to decrease inflammation, to help healing process of collagen, to strengthen weak muscle, to recover decreased range of motion, to increase endurance of muscle and to protect the repair site and deltoid. These protocols must be individualized according to the condition of the patients.

• Journal of the Korean Society of Physical Medicine
• /
• v.5 no.4
• /
• pp.685-692
• /
• 2010

Purpose : The purpose of this study was to investigate effects of repetitive hand task on upper extremity proprioception and dexterity. Methods : Experimental group who had done hand task since last 1 year and young adult control group was recruited this study. Proprioception was measured positioning errors of elbow and wrist on three dimensional coordinate system by Winarm software(Zebris Medcal GmbH, Germany). And dexterity was measured by box and block test. Statistical analysis was used independent t -test. Results : When elbow moved from flexion to extension, there were significant difference on error of x axis in wrist location and erros of x, z axis in shoulder location(p<.05). When wrist moved from flexion to extension, there was significant difference on y axis in finger location error(p<.05). And there significant difference on dexterity(p<.05). Conclusion : In conclusion, repetitive hand task increase upper extremity proprioception and dexterity. The physical therapy in industrial workers should inhibit overuse injury.