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Reverse total shoulder replacement for patients with "weight-bearing" shoulders

  • Ofer Levy;Georgios Arealis;Oren Tsvieli;Paolo Consigliere;Omri Lubovsky
    • Clinics in Shoulder and Elbow
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    • v.27 no.2
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    • pp.183-195
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    • 2024
  • Background: Reverse total shoulder arthroplasty (rTSA) has gained popularity in recent years and is indicated for a wide variety of shoulder pathologies. However, use of rTSA in patients with "weight-bearing" shoulders that support wheelchair use or crutches has higher risk. The aim of this study was to assess the results of rTSA in such patients. Methods: Between 2005 and 2014, 24 patients (30 shoulders) with weight-bearing shoulders were treated with rTSA at our unit. Patients had cuff arthropathy (n=21), rheumatoid arthritis (n=3), osteoarthritis (n=1), acute fracture (n=3), or fracture sequela (n=2). Postoperatively, patients were advised not to push themselves up and out of their wheelchair for 6 weeks. This study was performed in 2016, and 21 patients (27 shoulders) were available for a mean follow-up of 5.6 years (range, 2-10 years). The mean age at surgery was 78 years (range, 54-90 years). Results: Constant-Murley score improved from 9.4 preoperatively to 59.8 at the final follow-up (P=0.001). Pain score improved from 2/15 to 13.8/15 (P=0.001). Patient satisfaction (Subjective Shoulder Value) improved from 0.6/10 to 8.7/10 (P=0.001). Significant improvement in mean range of motion from 46° to 130° of elevation, 14° to 35° of external rotation, and 29° to 78° internal rotation was recorded (P=0.001). Final mean Activities of Daily Living External and Internal Rotation was 32.4/36. Only three patients showed Sirveaux-Nerot grade-1 (10%) glenoid notching and three grade 2 (10%). Conclusions: rTSA can be used for treatment of patients with weight-bearing shoulders. Such patients reported pain free movement, resumed daily activities, and high satisfaction rates.

Ultrasound-guided needle decompression and steroid injection for calcific tendinitis of the shoulder: risk factors for repeat procedures and outcome analysis

  • Kim, Su Cheol;Lee, Sang Min;Park, Gun Tae;Jang, Min Chang;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • v.24 no.2
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    • pp.55-65
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    • 2021
  • Background: Although ultrasound-guided needle decompression (US-GND) can treat calcific tendinitis of the shoulder effectively, repeat procedures might be required for unresolved symptoms. We evaluated the overall clinical outcomes of US-GND with subacromial steroid injection and the final results and factors predisposing toward repeat procedures. Methods: Ninety-eight patients who underwent US-GND for calcific tendinitis of the supraspinatus/infraspinatus were analyzed between March 2017 and December 2018. The clinical outcomes (pain visual analog scale, functional visual analog scale [FVAS], and American Shoulder and Elbow Surgeons [ASES] score) and final subjective satisfaction were compared between groups A (single US-GND) and B (repeat US-GND). The factors predisposing toward repeated US-GNDs were analyzed. Results: We found that 59.3% (58/98) of patient ASES scores were ≥80, and 73.5% of patients (72/98) were satisfied with the outcome. Group B (n=14) demonstrated a significantly higher rate of dominant-arm involvement compared to group A (78.6% vs. 48.8%, p=0.046). However, initial calcification size, shape, number, density, subscapularis involvement, lavage, and procedure time did not differ significantly between the groups. Group B showed poorer final FVAS (7 [interquartile range, 6-8] vs. 8 [interquartile range, 7-9], p=0.036) and subjective satisfaction compared to group A (satisfied: 5 [35.7%] vs. 67 [79.8%], p<0.001]. Conclusions: US-GND with subacromial steroid injection is a viable treatment option for calcific tendinitis of the shoulder. Dominant-arm involvement was the only independent factor for repeated US-GND. Final outcome of repeated US-GND for unimproved patients was promising; however, these outcomes were poor compared to those of the patients who improved after the first procedure.

Comparison With Stress, Depression and Self-Esteem Depending on Adolescent's Sensory Processing Characteristics (청소년들의 감각처리특성에 따른 스트레스, 우울감, 자아존중감과의 비교)

  • Kim, So-Young;Kim, Eun-Kyung;Park, Jin-Seon;Jun, Seo-Hyun;Chang, Moon-Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.11 no.1
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    • pp.39-49
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    • 2013
  • Objective : We studied adolescent's sensory processing characteristics and classification of the depending on the adolescent's sensory processing characteristics degree. And we studied depending on sensory processing characteristics the difference of the general characteristics; sex, health status, hospital visit, the usual sensory problem. In addition, we investigated differences in each group; sensory processing characteristics, stress, depression, and self-esteem. Methods : We have collected 310 for students in Busan, Gyeongsangnam-do region of high school to distribute the questionnaire; Adolescent / Adult sensory profile (AASP), the Korean version Daily Stress Assessment (K-DSI), Beck Depression Inventory (BDI), and Self-Esteem Scale (SES). The questionnaire used in the final study part 310 to part 288 of which corresponds to 92% of the total questionnaire. The data analysis was used SPSS for windows 18.0 statistical analysis. Results : Sensory Seeking of sensory processing characteristics of adolescents in the study was low score. The higher stress score, Sensory Sensitivity and Sensation Avoiding score were higher, and the higher depression score, Low Registration and Sensation Avoiding score were higher. The lower self-esteem score, Sensation Avoiding and Sensory Sensitivity score was higher whereas Sensation Seeking score was lower. Conclusions : Study about Korean's mean in the next studies should be investigate. In addition, a lot of study about adolescents with sensory processing problems should be investigate.

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The relationship among the experiences of chronic diseases, dental health status, and the behaviors in the Korean elderly people (우리나라 노인의 만성질환경험과 구강건강상태 및 행태와의 관련성)

  • Han, Yeo-Jung;Hong, Sun-Hwa;Yu, Mi-Sun
    • Journal of Korean society of Dental Hygiene
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    • v.18 no.1
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    • pp.65-75
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    • 2018
  • Objectives: This study aims to contribute to the prevention of dental diseases and health care in the elderly by investigating the relationship among the experiences of chronic diseases, dental health status, and the behaviors in the Korean elderly people. Methods: A total of 2,856 elderly people aged 65 or older were selected as the final analysis subjects using data from the 6th National Health and Nutrition Examination Survey (2013-2014). Chronic diseases were defined as 'cardiocerebrovascular diseases', 'diabetes', 'chronic respiratory diseases', and 'cancer' diagnosed by the doctors. For the statistical analysis, SPSS 21.0 for Windows was used. Descriptive analysis and a Chi-square test were conducted to investigate the relationship among the experiences of chronic diseases, general characteristics, dental health status, and the behaviors in the Korean elderly. Finally, logistic regression analysis was performed to investigate the relationship among the experiences of chronic diseases, dental health status, and the behaviors. Results:The prevalence of Cardiocerebrovascular diseases was significantly higher in the 3-4 group of community periodontal index with the score of 1.36 (95% CI 1.03-1.00) than in the 0-2 group. The prevalence of Cardiocerebrovascular diseases was significantly higher in the group without dental examination during the past one year with the score of 1.29 (95% CI 1.00-1.66). The prevalence of diabetes was significantly higher in the uncomfortable speaking state group with the score 1.46 (95% CI 1.12-1.91). The prevalence of cancer was significantly higher in the partial denture needs group with the score 1.67 (95% CI 0.98-2.83). Conclusions: Regular dental examinations and dental health care for the elderly with chronic diseases showed that periodontal health and residual teeth could be maintained and managed. Therefore, continuous customized dental health services should be implemented for the elderly with chronic diseases.

Development of Korean Patient Classification System for Neonatal Care Nurses (한국형 신생아중환자간호 분류도구 개발)

  • Yu, Mi;Kim, Dong Yeon;Yoo, Cheong Suk
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.2
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    • pp.205-216
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    • 2016
  • Purpose: This study was performed to develop a valid and reliable Korean Patient Classification System for Neonatal care nurses (KPCSN). Methods: The study was conducted in tertiary and general hospitals with 1~2 grade according to nursing fee differentiation policy for NICU (neonatal intensive care unit) nurse staffing. The reliability was evaluated for the classification of 218 patients by 10 nurse managers and 56 staff nurses working in NICUs from 10 hospitals. To verify construct validity, 208 patients were classified and compared for the type of stay, gestational age, birth weight, and current body weight. Nursing time was measured by nurses, nurse managers, and nurse aids. For the calculation of conversion index (total nursing time divided by the KPCSN score), 426 patients were classified using the KPCSN. Data were collected from September 5 to October 28, 2015, and analyzed using t-test, ANOVA, intraclass correlation coefficient, and non-hierarchial cluster analysis. Results: The final KPCSN consisted of 11 nursing categories, 71 nursing activities and 111 criteria. The reliability of the KPCSN was r=.83 (p<.001). The construct validity was established. The KPCSN score was classified into four groups; group $1:{\leq}57points$, group 2: 58~80 points, group 3: 81~108 points, and group $4:{\geq}109points$ in the KPSCN score. The conversion index was calculated as 7.45 minutes/classification score. Conclusion: The KPCSN can be utilized to measure specific and complex nursing demands for infants receiving care in the NICUs.

The Clinical Results of Conservative Treatment of Frozen Shoulder Using Continuous Passive Motion

  • Chung, Hoe-Jeong;Kim, Doo-Sup;Yoon, Yeo-Seung;Lee, Dong-Woo;Hong, Kyung-Jin
    • Clinics in Shoulder and Elbow
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    • v.18 no.4
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    • pp.217-220
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    • 2015
  • Background: The purpose of this study is to administer conservative treatment in 30 patients diagnosed with idiopathic frozen shoulder, following the suggested frozen shoulder rehabilitation program and to assess the clinical outcome using a prospective study. Methods: Thirty patients diagnosed with idiopathic frozen shoulder, treated with steroid hormone injection on the articular joint with an intra-articular steroid (triamcinolone 40 mg+lidocaine 4 ml) injection and started on stepwise shoulder extension exercise were chosen. The subjects were divided into two groups of 15 people each with one group undergoing rehabilitation with continuous passive motion (CPM) and the other group without it. Follow-ups were done before rehabilitation and at 4-week intervals with the 24th being the final week. At every follow-up, passive range of motion (ROM) was measured and surveys on pain and clinical score were administered. Results: In the last follow-up, both groups showed statistically significant improvements in all evaluation criteria. However, no statistical difference in all values of the ROM and Constant score evaluation criteria was observed between the groups. Only in the last follow-up, group 1 had a visual analog scale (VAS) score of $2.4{\pm}2.1$ points, which was lower, with statistical significance, than the VAS score of group 2, which was $4.4{\pm}3.1$ points (p<0.001). Conclusions: Study using CPM in treatment of frozen shoulder has been inadequate, meaning that there is still room for improvement and need for more study on setting a more specific protocol and guidelines for this procedure.

The effect of oral function improvement with oral exercise program by elderly people (노인의 입체조 운동이 구강기능 향상에 미치는 효과)

  • Kim, Young-Soon;Shin, Kyoung-hee;Park, Jeong-Ran;Chung, Soon-hee;Choi, Hye Sook
    • Journal of Korean society of Dental Hygiene
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    • v.16 no.4
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    • pp.559-566
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    • 2016
  • Objectives: This research has executed a new oral health promotion program among the elderly residents of a long-term care center, which purpose was to verify its effectiveness of oral health promotion through the improvement of their oral function. Methods: This study has selected the elderly over the age of 65, capable of communication, who use a long-term care center over the period of two months between July and September 2014. The subjects who remained until the final analysis numbered 50 excluding the dropouts during the program session (experimental: 33, control : 17). The oral stretching program was exercised two days a week, for total of two months. Each function was assessed by the standardized methods and measurement equipment. Also the sum of each function was converted into the oral health grade. Results: The oral function score of the experimental group also showed a statistically significant difference after the execution of the program, where the oral function score of experimental group increased $6.70{\pm}1.30$ from $4.95{\pm}0.89$ after the execution of the program (p<0.05), while the comparison group showed no valid statistical difference with the score result of $5.00{\pm}0.87$ down from $5.11{\pm}0.93$ after the execution of the program (p>0.05). Conclusions: Therefore if the oral health promotion program is reflected to the welfare policy in the future, it can be said that it contributes to the improved health status of the elderly who reside in the long-term care centers.

A Hybrid of Rule based Method and Memory based Loaming for Korean Text Chunking (한국어 구 단위화를 위한 규칙 기반 방법과 기억 기반 학습의 결합)

  • 박성배;장병탁
    • Journal of KIISE:Software and Applications
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    • v.31 no.3
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    • pp.369-378
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    • 2004
  • In partially free word order languages like Korean and Japanese, the rule-based method is effective for text chunking, and shows the performance as high as machine learning methods even with a few rules due to the well-developed overt Postpositions and endings. However, it has no ability to handle the exceptions of the rules. Exception handling is an important work in natural language processing, and the exceptions can be efficiently processed in memory-based teaming. In this paper, we propose a hybrid of rule-based method and memory-based learning for Korean text chunking. The proposed method is primarily based on the rules, and then the chunks estimated by the rules are verified by memory-based classifier. An evaluation of the proposed method on Korean STEP 2000 corpus yields the improvement in F-score over the rules or various machine teaming methods alone. The final F-score is 94.19, while those of the rules and SVMs, the best machine learning method for this task, are just 91.87 and 92.54 respectively.

Aircraft Combat Survivability Analysis based on the Random Variable Weighted Score Algorithm (확률변수 가중치 환산법 기반 군용 항공기 생존성 분석기법)

  • Yang, Ju-Suk;Lee, Kyung-Tae;Jee, Cheol-Kyu
    • Journal of the Korean Society for Aeronautical & Space Sciences
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    • v.41 no.11
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    • pp.883-890
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    • 2013
  • Aircraft combat survivability analysis is essential process for the development of combat aircraft. M&S methodology is the typical procedure for the aircraft combat survivability analysis, and the last step is the expensive Live Fire Test if it is necessary. This study introduced cost and time effective survivability analysis methodology based on the random variable weighted score algorithm in conceptual design phase. For this study, essential element and event analysis (E3A) is used to define the random variables and Monte-Carlo simulation is implemented to estimate weighted score and the final value of survivability.

The Cyclosporine-A Treatment does not have Harmful Effect on the Linear Growth of Pediatric Patients with Steroid-dependent and Steroid-resistant Nephrotic Syndrome

  • Lee, Sang Soo;Kim, Ji Hoon;Kim, Chung Ho;Cho, Byoung-Soo;Kim, Deog Yoon;Hong, Il Ki;Suh, Jin-Soon
    • Childhood Kidney Diseases
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    • v.20 no.2
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    • pp.45-49
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    • 2016
  • Purpose: This study was performed to evaluate the effects of cyclosporine-A (CsA) on linear growth in pediatric patients with steroid-dependent (SDNS) or resistant nephrotic syndrome (SRNS). Methods: Thirty-five pediatric patients with SDNS or SRNS undergoing glucocorticoid (GC) and/or CsA treatment were retrospectively reviewed. Seventeen patients were treated with GC alone and 18 were treated with GC and CsA. The cumulative doses of GC and CsA were quantified (mg/kg/day). Linear growth during the follow-up period was defined as the difference in Z-score between the initial and final height according to the follow-up period (${\Delta}$ height Z score/year). The associations between linear growth and clinical parameters were analyzed. Results: The linear growth of patients in the two groups was not significantly different (P=0.262). The ${\Delta}$ height Z score/year did not show a significant correlation with the cumulative doses of CsA, but was negatively correlated with the cumulative dose of GC and positively correlated with the Z score for height at the time of diagnosis. Conclusion: In children with SDNS or SRNS undergoing GC therapy, added CsA treatment may not have harmful effects on linear growth.