• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.188-193
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• 2010

Purpose: The purpose of this study was to evaluate the clinical and radiological results of a modified Phemister method reinforcing the 4 strands of an Ethibond sling for acromioclavicular joint dislocation. Materials and Methods: Between September 1999 and May 2007, 30 acromioclavicular joint dislocation cases underwent a modified Phemister method reinforcing the 4 strands of an Ethibond sling. The average follow-up period was 28.2 months (range: 24~33 months). Clinical outcomes were evaluated using the Weitzman classification; the state of coracoclavicular space reduction was done using radiologic findings. Results: According to the Weitzman classification, there were 24 excellent, 4 good and 2 fair case outcomes. The average coracoclavicular distance improved from 16.9 mm to 7.3 mm immediately after surgery. The average ratio of coracoclavicular distance comparing to the contralateral side at the final follow-up was 1.24 (range: 0.68~1.71). Complications included retraction of K-wires in 5 cases and restriction of joint motion in 4 cases. Conclusion: The modified Phemister operation using augmentation of the coracoclavicular ligament by 4 strands of Ethibond is an effective treatment modality in acromioclavicular joint dislocation.

• Journal of the Korean Orthopaedic Association
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• v.54 no.4
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• pp.327-335
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• 2019

Purpose: To investigate the radiological efficacy of polymethylmethacrylate (PMMA) augmentation of pedicle screw operation in osteoporotic vertebral compression fractures (OVCF) patients. Materials and Methods: Twenty OVCF patients, who underwent only posterior fusion using pedicle screws with PMMA augmentation, were included in the study. The mean follow-up period was 15.6 months. The demographic data, bone mineral density (BMD), fusion segments, number of pedicle screws, and amount of PMMA were reviewed as medical records. To analyze the radiological outcomes, the radiologic parameters were measured as the time serial follow-up (preoperation, immediately postoperation, postoperation 6 weeks, 3, 6 months, and 1 year follow-up). Results: A total of 20 patients were examined (16 females [80.0%]; mean age, 69.1±8.9 years). The average BMD was -2.5±0.9 g/cm². The average cement volume per vertebral body was 6.3 ml. The mean preoperative Cobb angle of focal kyphosis was 32.7°±7.0° and was improved significantly to 8.7°±6.9° postoperatively (p<0.001), with maintenance of the correction at the serial follow-up, postoperatively. The Cobb angle of instrumented kyphosis, wedge angle, and sagittal index showed similar patterns. In addition, the anterior part of fractured vertebral body height averaged 11.0±5.0 mm and was improved to 18.5±5.7 mm postoperatively (p=0.006), with maintenance of the improvement at the 3-month, 6-month, and 1-year follow-up. Conclusion: The reinforcement of pedicle screws using PMMA augmentation may be a feasible surgical technique for OVCF. Moreover, it appears to be appropriate for improving the focal thoracolumbar/lumbar kyphosis and is maintained well after surgery.

• Journal of Chest Surgery
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• v.31 no.10
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• pp.995-998
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• 1998

Background: Prolonged air leak is a common complication after thoracoscopic bullectomy. Materials and methods: A technique is described to minimize postoperative air leak in thoracoscopic surgery for the treatment of recurrent or persistent spontaneous pneumothorax. Results: A 3.5cm utility incision is made in the anterior axillary line at the level of the third intercostal space, and blebs and bullae are stapled and sutured without excision, using standard surgical instruments and stapler. Conclusions: This technique may be useful to reduce prolonged air leak after removal of the bleb and bullous lesion, and may minimize the delayed recurrence of ipsilateral pneumothorax.

• Journal of Korean Foot and Ankle Society
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• v.24 no.2
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• pp.98-101
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• 2020

We report on the case of a patient with chronic instability of the ball-and-socket ankle joint. The patient, a 21-year-old male, was diagnosed 10 years previously with chronic instability of the ball-and-socket ankle joint. He underwent Broström procedure and augmentation using a periosteal turn down from the fibula for this chronic instability despite having received conservative treatment since the diagnosis. After the procedure, the clinical symptoms of ankle instability were improved and the patient is being periodically followed-up. We report on this case of using a Broström procedure as a treatment option for patients with instability of the ball-and-socket ankle joint with normal range of foot and normal ankle joint alignment without damage in the joint and cartilage.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.237-243
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• 2010

Purpose: In arthroscopic rotator cuff repair, the crucial step is secure fixation of Anchor to bone. However, osteoporosis of the tuberosity is frequently encountered in old patients, and can cause insecure fixation of anchors. The Aim of our study was to introduce a technique for anchor hole augmentation with bone cement when fixation failure of an anchor occurs, and to investigate the outcome. Materials and methods: Among 223 rotator cuff repairs performed between 2005 and 2009, anchor hole augmentation with polymethylmethacrylate was performed in 15 cases (all females; mean age of 65 years: range 49~77). Bone cement was injected into the anchor hole in a thick fluid state and the procedure was repeated to make a pot-like cement mantle. The anchor was inserted into the cement mantle while the cement hardened. The outcome was investigated, on average, at 16 months (6~32). Results: Radiographs showed cystic changes of the tuberosity. On follow-up radiographs and MRI, a change in the cement mantle was not noted. The final average UCLA score was 31 (28~35); 6 had excellent, 8 good and 1 fair results (p=0.008). Age-sex matched Constants score was 90 (74~98) (p=0.008). Conclusion: Anchor hole augmentation with bone cement is useful when fixation failure of an anchor is encountered due to bone atrophy. Anchor hole augmentation with bone cement does not negatively influence the outcome.

• The korean journal of orthodontics
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• v.37 no.1 s.120
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• pp.73-84
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• 2007

The maxillary protraction headgear has been widely used in the treatment of skeletal Class III children with maxillary deficiency. A variety of treatment objectives which allow dentoalveolar movements may be established, but when only maxillary protraction without dentoalveolar movement is needed, one of the limitations in maxillary protraction with conventional tooth-borne anchorage is the loss of dental anchorage. This is because a bone remodeling occurs not only at circummaxillary sutures but also within the periodontal tissues. During protraction treatment in the mixed dentition phase, in older children or for the patient with multiple congenitally missing teeth, it is not uncommon to observe undesirable mesial movement of maxillary teeth. Such a side effect can be eliminated or minimized using absolute anchorage such as skeletal anchorage. The purpose of this case report is to introduce a new technique of the maxillary protraction headgear treatment using surgical miniplates.

• Journal of Chest Surgery
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• v.34 no.2
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• pp.148-155
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• 2001

배경: 본 연구는 1987년부터 1997년까지 원자력병원에서 수술을 시행한 500명의 식도암환자를 대상으로 하여 휴향적 방법을 통해 조기 및 장기성적, 재발양상, 예후인자 등을 보고하고자 한다. 대상 및 방법: 대상환자 중에서 발병암이 있는 경우, 인두식도 경계부위나 위식도 경계부위 암, 고식적 우회술 또는 인공식도 삽입예 그리고 시험적 개흉술이나 개복술 만을 시행한 경우는 제외 시켰다. 식도 절제는 대부분 우측 개흉술을 이용한 Ivor Lewis 술식을 사용하였고 대부분의 문합은 stapler를 사용하였다. Extended lymph node dissection은 1994년 8월부터 시행하였고 그 이전에는 standard lymph node dissection을 하였다. 96.8%에서 위를 식도 대체장기로 사용하였고 경부에서 절제 및 재건술을 시행한 경우를 제외한 모든 식도재건은 후종격동을 통해 시행하였다. 결과: 474예(94.8%)가 편평상피 세포암이었고 대부분(58.2%)은 중부식도에 위치하였다. 술후병기는 47.4%가 stage III이었고 25%가 stage IIA이었다. 392예에서 근치적 절제가 가능하였고 74예는 고식적 절제를 시행하였으며, 식도열공을 통한 식도절제술과 경부에서의 유리공장 이식술을 시행한 34예는 위분류에서 제외하였다. 술후 유병율은 38.4%이었고 수술 사망률은 5.8%로 호흡기 감염, 문합부 유출이 주요 원인이었다. 대상환자의 99.8%에서 추적은 가능하였고 수술사망 예를 포함한 전체환자의 1, 2, 5년 생존율은 각각 63.5%, 38.9%, 19.4% 이었다. Standard lymph node dissection 그룹에서의 1, 2, 5년 생존율이 60.7%, 35.9%, 16.9%이었으나 extended lymph node dissection그룹에서는 1, 2, 4년 생존율이 70.2%, 46.5%, 30.9%이었다. 근치적 절제의 경우는 1, 2, 5년 생존률이 69.4%, 43.9%, 21.9%이었고, 고식적 절제의 경우는 37.8%, 17.6%, 7.3%이었다. 수술사망을 제외한 근치적 절제술과 extended lymph node dissection을 함께 시행한 경우의 4년 생존율은 35.6%이었다. 수술후 재발은 226예에서 발견되었고 주로 국소임파절(69%; 경부, 종격동, 복부)이었으며, 전신재발은 간, 폐, 뼈, 뇌 등의 순이었다. 결론: 저자들은 적절한 술후 환자관리가 선행되어야 하지만 근치적 절제와 광범위한 임파절 절제가 장기성적의 향상에 필수적 요소이고, 진행된 식도암에 있어서는 보다 효과적인 보강적 복합치료가 연구되어야 할 것으로 생각된다.

• Journal of Korean Foot and Ankle Society
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• v.26 no.4
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• pp.171-176
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• 2022

Purpose: This study reports on a series of patients with chronic lateral ankle instability that underwent the Brostrom procedure with suture tape augmentation and allowed early unrestricted weight-bearing in a simple stirrup brace. Materials and Methods: This retrospective study was conducted on 36 patients (22 males and 14 females of mean age 34 years [range 23~48 years]) with chronic lateral ankle instability treated using the Brostrom procedure using suture tape augmentation and inferior extensor retinaculum reinforcement with a fiber-wire connected to a SwiveLock screw inserted into the talus. When possible, patients started unrestricted weight-bearing in a stirrup brace from the third postoperative day. Demographics and functional outcomes, including American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, visual analogue scale (VAS), and satisfaction scores, were recorded. In addition, varus stress radiographs obtained before and 24 months after surgery were compared. Patients were followed for a mean 29 months (range 25~40 months). Results: Mean AOFAS ankle-hindfoot scores increased from 51 points preoperatively to 92 points at final follow-up, and mean VAS decreased from 6.8 to 1.2 points. Mean patient satisfaction scores were 8.7 at 12 months and 9.6 at 24 months. Stress radiographs demonstrated that talar tilt decreased from a mean 18 degrees preoperatively to 7 degrees at 24 months. Conclusion: Early unrestricted weight-bearing in a stirrup brace following the Brostrom procedure with suture tape augmentation is a successful protocol for treating chronic lateral ankle instability.

• The korean journal of orthodontics
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• v.36 no.4
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• pp.308-320
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• 2006

Rapid canine retraction, first introduced by Liou, is a distraction osteogenesis applied to the periodontal ligament tissue. Rapid tooth movement was facilitated by establishing minimal bony resistance on the distal surface of the canine by socket preparation and by osteogenesis on the mesial side in response to the periodontal distraction. Since undesired buccal tipping or extrusion of the canine during retraction tends to occur, it is crucial to maintain the firm path of movement and the axis of the canine during retraction. In order to improve the predictability of the canine movement, lingually extended distraction screws with heavy labial guiding wires were designed. Prefabricated plastic canine models for the estimation of socket depth and miniscrew implants for anchorage reinforcement were also devised. Applying these devices to a female patient with Class II anterior protrusion, the whole treatment was effectively finished in 13 months. Loss of vitality or periodontal problems did not occur throughout treatment, and stable occlusion was maintained during 10 months of retention. This case report demonstrates that a predictable rapid canine retraction can be achieved through the use of this modified technique.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.2
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• pp.305-309
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• 2009

Dens evaginatus is a dental anomaly most commonly seen in premolar teeth in which a tubercle or protuberance projects from either the center of the occlusal surface or the buccal triangular ridge. These tubercles are easily fractured from mastication as the tooth erupts and frequently leads to pulp necrosis as a common complication. To prevent these sequelae, prophylactic treatment soon after the tooth starts erupting is essential. These preventive treatments include, selective grinding and protection of the tubercle by pit and fissure sealant. When the tooth does shows signs of pulp necrosis and apical periodontitis, endodontic procedures are needed. Apexification and apexogenesis are usually the treatment of choice for the affected teeth which have immature apices. Apexogenesis is a vital pulp therapy procedure performed to encourage continued physiological development and formation of the root end. It involves removal of the inflamed pulp and the placement of calcium hydroxide on the remaining healthy pulp tissue. This case report describes an atypical apexogenesis of a mandibular premolar which showed to be a dens evaginatus. The tooth which was treated with calcium hydroxide shows good results and is planned for permanent root canal filling.