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The Analysis of the Treatment Outcomes of Proximal Humeral Fractures with Locking Plates

  • Lee, Kwang-Won;Hwang, Yoon-Sub;Kim, Choon-Myeon;Yang, Dae-Suk;Park, Tae-Soo
    • Clinics in Shoulder and Elbow
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    • v.17 no.1
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    • pp.10-17
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    • 2014
  • Background: The aim of this study was to assess the clinical outcomes after treatment of proximal humeral fractures with locking plates, and to determine which factors influence the clinical and radiological outcomes. Methods: Fifty six patients who were treated with locking plates for proximal humeral fractures and had been followed for more than 1 year were enrolled in this study. We performed functional evaluation using the Constant score and analyzed radiographic results. The following factors that may potentially influence the clinical outcomes were assessed: age, gender, type of fracture, presence of medial metaphyseal comminution, bone mineral density, anatomical reduction, restoration of medial mechanical support, and postoperative complications. Results: The mean Constant score was 70.1 points at the final follow-up. Female gender, 4-part fractures, AO type-C fractures, and fractures with medial metaphyseal comminution were associated with a poor clinical outcome. On the other hand, restoration of medial mechanical support and accurate anatomical reduction had a positive influence on clinical outcomes. Postoperative complications resulted in 3 patients (intra-articular screw perforation: 1 patient, varus deformity with screw loosening: 1 patient, nonunion: 1 patient). Conclusions: When treating proximal humeral fractures with locking plate fixation, following factors: a female gender, Neer type 4-part fracture, AO type C fracture, and medial metaphyseal comminution are important risk factors that surgeons should take into consideration. Factors that contribute to better clinical outcomes of operative treatment for humeral fractures are accurate anatomical reduction and restoration of medial mechanical support.

Development of Decision Tree Program based on Web for Analyzing Clinical Information of Sasang Constitutional Medicine (사상체질 임상정보 분석을 위한 웹 기반의 의사결정 나무 프로그램 개발)

  • Jin, Hee-Jeong;Kim, Myoung-Geun;Kim, Jong-Yeol
    • Korean Journal of Oriental Medicine
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    • v.14 no.3
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    • pp.81-87
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    • 2008
  • Sasanag Contitution Medicine(SCM) is the traditional medicine theory based on constitutional medicine in Korea. It is most import ant that a personal SCM type is determined accurately ahead of applying any Sasang treatments. For this, many researches have been studied to diagnose the SCM type using constitutional clinical data. The decision tree is a tree-structured data-mining methodology. Recently, in the Korean traditional medicine society, there have been several efforts to find diagnosing tools using the decision tree method. So, we developed a decision tree program based on web for analyzing constitutional clinical information. It can use various clinical data as input data, offer filtering function to select clinical data to be used. We can find useful factor to be influential on SCM types using this program.

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Clinical and genetic characteristics of Gaucher disease according to phenotypic subgroups

  • Lee, Ju-Young;Lee, Beom-Hee;Kim, Gu-Hwan;Jung, Chang-Woo;Lee, Jin;Choi, Jin-Ho;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.55 no.2
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    • pp.48-53
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    • 2012
  • Purpose: Gaucher disease is caused by a ${\beta}$-glucocerebrosidase (GBA) deficiency. The aim of this study is to investigate the clinical and genetic characteristics according to subtypes of Gaucher disease in the Korean population. Methods: Clinical findings at diagnosis, $GBA$ mutations, and clinical courses were reviewed in 20 patients diagnosed with Gaucher disease. Results: Eleven patients were diagnosed with non-neuronopathic type, 2 with acute neuronopathic type, and 7 with chronic neuronopathic type. Most patients presented with hepatosplenomegaly, thrombocytopenia, and short stature. In the neuronopathic group, variable neurological features, such as seizure, tremor, gaze palsy, and hypotonia, were noted at age $8.7{\pm}4.3$ years. B cell lymphoma, protein-losing enteropathy, and hydrops fetalis were the atypical manifestations. Biomarkers, including chitotriosidase, acid phosphatase, and angiotensin-converting enzyme, increased at the initial evaluation and subsequently decreased with enzyme replacement treatment (ERT). The clinical findings, including hepatosplenomegaly, thrombocytopenia, and skeletal findings, improved following ERT, except for the neurological manifestations. L444P was the most common mutation in our cohort. One novel mutation, R277C, was found. Conclusion: Although the clinical outcome for Gaucher disease improved remarkably following ERT, the outcome differed according to subtype. Considering the high proportion of the neuronopathic form in the Korean population, new therapeutic strategies targeting the central nervous system are needed, with the development of a new scoring system and biomarkers representing clinical courses in a more comprehensive manner.

How to Treat Peripheral Arteriovenous Malformations

  • Ran Kim;Young Soo Do;Kwang Bo Park
    • Korean Journal of Radiology
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    • v.22 no.4
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    • pp.568-576
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    • 2021
  • Arteriovenous malformations (AVMs) are direct communications between primitive reticular networks of dysplastic vessels that have failed to mature into capillary vessels. Based on angiographic findings, peripheral AVMs can be classified into six types: type I, type IIa, type IIb, type IIc, type IIIa, and type IIIb. Treatment strategies vary with the types. Type I is treated by embolizing the fistula between the artery and the vein with coils. Type II (IIa, IIb, and IIc) AVM is treated as follows: first, reduce the blood flow velocity in the venous segment of the AVM with coils; second, perform ethanol embolotherapy of the residual shunts. Type IIIa is treated by transarterial catheterization of the feeding arteries and injection of diluted ethanol. Type IIIb is treated by transarterial or direct puncture approaches. A high concentration of ethanol is injected through the transarterial catheter or direct puncture needle. When the fistula is large, coil insertion is required to reduce the amount of ethanol. Type I and type II AVMs showed the best clinical results; type IIIb showed a satisfactory response rate. However, type IIIa showed the poorest response rate, either alone or in combination with other types. Clinical success can be achieved by using different treatment strategies for different angiographic AVM types.

Korean Review on the S.Minuchin's Structural Family Therapy Theory (S.Minuchin 의 구조적 가족치료이론의 한국적 재조명)

  • 손정영;김순옥
    • Journal of Families and Better Life
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    • v.9 no.2
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    • pp.345-366
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    • 1991
  • The concrete purpose of this study is to examine the possibility of applying S.Minuchin's structural family therapy theory to each clinical families so that it can solve efficiently the clinical problems Korean family. The test results are as follows: 1)The Results of Question I : Types of Korean family problems can be divide into six. Then the most frequent type of problem was marital problem. 2) The Results of Question II: Korean normal family showed rater difussed boundary and higher rate of wife dominant type than that of husband dominant type in aspect of boundary and power, and had low tendency toward alignment and neutral adjustment. 3)The Results of Quesion III; Amidst the clinical families, family structural traits of the families which have marital problems showed a clear boundary, the tendency toward alignment, and higher tate of husband dominant type than that of wife dominant type. And family structural traits of children problem family had the tendency of alignment and showed little wife-dominanted families in power. Finally, mother-in -law and daughter-in-law problemed family had several characters such as diffused boundary, the tendency of alignment and high adjustment. 4)The Results of Question IV : As a result of camparing problemed families with normal families in family structure, there was high adaptability of S.Minuchin's structural theory to the two family groups; the groups of marital problems and those of children problem.

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Structural Equation Analysis of Social Support, Impaired Fasting Glucose, and Type 2 Diabetes

  • Kang, Yun-Jung;Park, Sang-Nam;Yoon, Ki Nam
    • Biomedical Science Letters
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    • v.25 no.4
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    • pp.357-366
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    • 2019
  • This study is to identify how the social support influences the impaired fasting glucose and type 2 diabetes as structural equation analysis reflects the health behavior and psychological path. It investigates participants who give consents to participate in the Korean Health Examine Cohort (KOEX), which collects surveys and biological samples at eight university hospitals nationwide. Of the 53,767 adults over 30 years of age enrolled in the 2nd to 7th KOEX study from 2004 to 2010 (1st to 7th), 18,618 participants with a history of chronic diseases related to type 2 diabetes, the main variable, were excluded. The number of participants were 34,316 with enough data on social support and diabetes, which are the main variables. The results show that social support affects health behaviors and lowers fasting blood sugar. Therefore, not only the management of risk factors of individuals, but also the practice of healthy behavior with the attention of social relations such as social support, etc., can prevent type 2 diabetes.

Clinical Pearls and Advances in Molecular Researches of Epilepsy-Associated Tumors

  • Phi, Ji Hoon;Kim, Seung-Ki
    • Journal of Korean Neurosurgical Society
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    • v.62 no.3
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    • pp.313-320
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    • 2019
  • Brain tumors are the second most common type of structural brain lesion that causes chronic epilepsy. Patients with low-grade brain tumors often experience chronic drug-resistant epilepsy starting in childhood, which led to the concept of long-term epilepsy-associated tumors (LEATs). Dysembryoplastic neuroepithelial tumor and ganglioglioma are representative LEATs and are characterized by young age of onset, frequent temporal lobe location, benign tumor biology, and chronic epilepsy. Although highly relevant in clinical epileptology, the concept of LEATs has been criticized in the neuro-oncology field. Recent genomic and molecular studies have challenged traditional views on LEATs and low-grade gliomas. Molecular studies have revealed that low-grade gliomas can largely be divided into three groups : LEATs, pediatric-type diffuse low-grade glioma (DLGG; astrocytoma and oligodendroglioma), and adult-type DLGG. There is substantial overlap between conventional LEATs and pediatric-type DLGG in regard to clinical features, histology, and molecular characteristics. LEATs and pediatric-type DLGG are characterized by mutations in BRAF, FGFR1, and MYB/MYBL1, which converge on the RAS-RAF-MAPK pathway. Gene (mutation)-centered classification of epilepsy-associated tumors could provide new insight into these heterogeneous and diverse neoplasms and may lead to novel molecular targeted therapies for epilepsy in the near future.

Lower cellular metabolic power can be an explanation for obesity trend in Tae-Eum type: hypothesis and clinical observation

  • Shim, Eun Bo;Leem, Chae Hun;Kim, Joong Jae;Kim, Jong Yeol
    • Integrative Medicine Research
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    • v.6 no.3
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    • pp.254-259
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    • 2017
  • Background: Those classified as Tae-Eum (TE)-type people in Sasang constitutional medicine (SCM) are prone to obesity. Although extensive clinical observations have confirmed this tendency, the underlying physiological mechanisms are unknown. Here, we propose a novel hypothesis using integrative physiology to explain this phenomenon. Methods: Hypoactive lung function in the TE type indicates that respiration is attenuated at the cellular level - specifically, mitochondrial oxygen consumption. Because a functional reduction in cellular energy metabolism is suggestive of intrinsic hypoactivity in the consumption (or production) of metabolic energy, we reasoned that this tendency can readily cause weight gain via an increase in anabolism. Thus, this relationship can be derived from the graph of cellular metabolic power plotted against body weight. We analyzed the clinical data of 548 individuals to test this hypothesis. Results: The statistical analysis revealed that the cellular metabolic rate was lower in TEtype individuals and that their percentage of obesity (body mass index >25) was significantly higher compared to other constitutional groups. Conclusion: Lower cellular metabolic power can be an explanation for the obesity trend in TE type people.

Analysis of the statistical validity of clinical effectiveness data of a systemic titrated extract of Zea Mays L. unsaponifiable fraction chemotherapeutic agent (Insadol) (경구용 옥수수불검화정량추출물 치료제(인사돌)의 임상적 유효성 데이터의 통계적 타당성에 대한 연구)

  • Choi, Yong-Geun;Eckert, Steven E;Lee, Jeong-Yol;Shin, Sang-Wan
    • The Journal of the Korean dental association
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    • v.53 no.7
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    • pp.476-484
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    • 2015
  • Purpose: This study intended to analyze the validity of clinical effectiveness data of clinical trials testing systemic titrated extract of Zea Mays L. unsaponifiable fraction chemotherapeutic agent. Material and Methods: Among 5 clinical trials claimed as proof of clinical effectiveness on the Web site of the manufacturer of this chemotherapeutic agent, a review of 4 clinical trials, written in either Korean or English, was conducted. Data were extracted from studies for the following variables: year of publication, age, sample size, follow-up period, combination with contemporary periodontal treatments, randomization, randomization check, blinded measurement, and statistical test type. Results: The study subjects' age intervals were too diverse to decide a common target population to generalize the findings. No study stated clearly the rationale for the sample size determination. Follow-up period to observe the start of clinical effectiveness was inconsistent and decided without any rationale of pathophysiological latent period. Randomization to make the comparisons on the same start line was performed but failed in a study. Randomization effect was not checked in 4 studies. Performance of blinded measurement of clinical outcomes to prevent bias was unclear in 2 studies. Type of statistical test was inappropriate in 3 studies. Conclusions: Based on the analysis of the validity of data on clinical and demographic variables, the four available clinical trials have not demonstrated compelling evidence of therapeutic effectiveness of systemic titrated extract of Zea Mays L. unsaponifiable fraction chemotherapeutic agent to improve prognosis of periodontal disease either with the contemporary periodontal treatment or without it.

Hemodynamic Interpretation of Various Extraanatomical Bypasses: Clinical & Engineering Views

  • Lee, Byung-Boong;Kim, Young-Wook;Suh, Sang-Ho;Roh, Hyung-Woon;Kim, Dong-Ik;Yoo, Sang-Sin;Cho, Min-Tae;Huh, Sung
    • International Journal of Vascular Biomedical Engineering
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    • v.1 no.1
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    • pp.32-40
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    • 2003
  • Axillo-bifemoral (Ax-Fem) bypass are now well accepted for bilateral iliac artery occlusion as the second best option. This extra-anatomical (unnatural) bypasses, however, have various hemodynamic liabilities affecting the patency. Hemodynamic conditions of each different type of Ax-Fem bypass were assessed with computer simulation model to determine the hemodynamically more sound type. Simulation models of five different types of Ax-Fem bypass were constructed. Our investigation based on the computer simulation models have shown distinct differences between two most popular Lazy-S type and Inverted-C type on the distribution of flow volume, shear stress and recirculation zone, etc., though both types have shown similar clinical results. Lazy-S type has shown better hemodyanmic status than inverted-C type. The theoretical advantage of "Lazy-S" type has never been adequately proved for its superiority clinically over the inverted-C type. Inverted-C type is now in more favor with clinically better results in spite of many hemodynamic liabilities including retrograde flow to the branching graft. The improvement of over-all long-term patency rate of various extra-anatomical bypasses is still warranted through proper correction of the hemodynamic liability. Even though clinical outcome of the extra-anatomical bypass has been equal regardless of the type of crossover femoral graft configuration, there are distinct differences on the hemodynamic characteristics among various types of configuration. Further hemodynamic study in the pulsatile flow status is warranted to correct hemodynamic defects with proper modification of various hemodynamic factors of each model.

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