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Short-segment Pedicle Instrumentation of Thoracolumbar Burst-compression Fractures; Short Term Follow-up Results

  • Shin, Tae-Sob;Kim, Hyun-Woo;Park, Keung-Suk;Kim, Jae-Myung;Jung, Chul-Ku
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.265-270
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    • 2007
  • Objective : The current literature implies that the use of short-segment pedicle screw fixation for spinal fractures is dangerous and inappropriate because of its high failure rate, but favorable results have been reported. The purpose of this study is to report the short term results of thoracolumbar burst and compression fractures treated with short-segment pedicle instrumentation. Methods : A retrospective review of all surgically managed thoracolumbar fractures during six years were performed. The 19 surgically managed patients were instrumented by the short-segment technique. Patients' charts, operation notes, preoperative and postoperative radiographs (sagittal index, sagittal plane kyphosis, anterior body compression, vertebral kyphosis, regional kyphosis), computed tomography scans, neurological findings (Frankel functional classification), and follow-up records up to 12-month follow-up were reviewed. Results : No patients showed an increase in neurological deficit. A statistically significant difference existed between the patients preoperative, postoperative and follow-up sagittal index, sagittal plane kyphosis, anterior body compression, vertebral kyphosis and regional kyphosis. One screw pullout resulted in kyphotic angulation, one screw was misplaced and one patient suffered angulation of the proximal segment on follow-up, but these findings were not related to the radiographic findings. Significant bending of screws or hardware breakage were not encountered. Conclusion : Although long term follow-up evaluation needs to verified, the short term follow-up results suggest a favorable outcome for short-segment instrumentation. When applied to patients with isolated spinal fractures who were cooperative with 3-4 months of spinal bracing, short-segment pedicle screw fixation using the posterior approach seems to provide satisfactory result.

Liposuction in the Treatment of Lipedema: A Longitudinal Study

  • Dadras, Mehran;Mallinger, Peter Joachim;Corterier, Cord Christian;Theodosiadi, Sotiria;Ghods, Mojtaba
    • Archives of Plastic Surgery
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    • v.44 no.4
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    • pp.324-331
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    • 2017
  • Background Lipedema is a condition consisting of painful bilateral increases in subcutaneous fat and interstitial fluid in the limbs with secondary lymphedema and fibrosis during later stages. Combined decongestive therapy (CDT) is the standard of care in most countries. Since the introduction of tumescent technique, liposuction has been used as a surgical treatment option. The aim of this study was to determine the outcome of liposuction used as treatment for lipedema. Methods Twenty-five patients who received 72 liposuction procedures for the treatment of lipedema completed a standardized questionnaire. Lipedema-associated complaints and the need for CDT were assessed for the preoperative period and during 2 separate postoperative follow-ups using a visual analog scale and a composite CDT score. The mean follow-up times for the first postoperative follow-up and the second postoperative follow-up were 16 months and 37 months, respectively. Results Patients showed significant reductions in spontaneous pain, sensitivity to pressure, feeling of tension, bruising, cosmetic impairment, and general impairment to quality of life from the preoperative period to the first postoperative follow-up, and these results remained consistent until the second postoperative follow-up. A comparison of the preoperative period to the last postoperative follow-up, after 4 patients without full preoperative CDT were excluded from the analysis, indicated that the need for CDT was reduced significantly. An analysis of the different stages of the disease also indicated that better and more sustainable results could be achieved if patients were treated in earlier stages. Conclusions Liposuction is effective in the treatment of lipedema and leads to an improvement in quality of life and a decrease in the need for conservative therapy.

Method to Determine Elastic Follow-Up Factors to Predict C(t) for Elevated Temperature Structures (이차하중을 받는 고온 구조물의 C(t) 예측을 위한 탄성추종 계수 결정법)

  • Lee, Kuk-Hee;Kim, Yun-Jae
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.36 no.7
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    • pp.759-768
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    • 2012
  • This paper proposes a method to determine the elastic follow-up factors for the $C(t)$-integral under secondary stress. The rate of creep crack growth for transient creep is correlated with the $C(t)$-integral. Elastic follow-up behavior, which occurs in structures under secondary loading, prevents a relaxation of stress during transient creep. Thus, both the values of $C(t)$ and creep crack growth increase as increasing elastic follow-up. An estimation solution for $C(t)$ was proposed by Ainsworth and Dean based on the reference stress method. To predict the value of $C(t)$ using this solution, an independent method to determine the elastic follow-up factors for cracked bodies is needed. This paper proposed that the elastic follow-up factors for $C(t)$ can be determined by elastic-plastic analyses using the plastic-creep analogy. Finite element analyses were performed to verify this method.

Parameter Optimization of the Marine Gyrocompass Follow-up System (자이로콤파스 추종계통의 최적조정)

  • 이상집
    • Journal of the Korean Institute of Navigation
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    • v.5 no.2
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    • pp.49-58
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    • 1981
  • One of the main purposes of the marine gyrocompass follow-up system is to preserve the sensitive part from the wandering error due to the frictional or torsional torque around the vertical axis. This error can be diminished through the rapid follow-up action, which minimizes the relative azimuthal angular displacement between the sensitive and follow-up parts and shortens the duration of the same displacement. But an excessive rapidity of the follow-up action would result in a sustained oscillation to the system. Therefore, to design a new type of the follow-up system, the theoretical annlysis of the problems concerned should be studied systematically by introducing the control theory. This paper suggest a concrete procedure for the optimal adjustment of the gyrocompass follow-up system, utilizing the mathematic model and the stability informations formerly investiaged by the author. For theoptimal determination of the adjustable paramfter K, the performance index(P.I.), ITSE(Intergral of the Time multiplied by the Squared Error) is proposed, namely, P.I. = $\int_{0}^{\infty} t \cdot e^{2}(t)dt$ where t is time and e(t) means control error. Then, the optimal parameter minimizing the performance index is calculated by means of Parseval's theorem and numerical computation, and the validity of the obtained optimal value of the parameter Ka is examined and confirmed through the simulations and experiments. By using, the proposed method, the optimal adjustment can be performed deterministically. But, this can not be expected in the conventional frequency domain analysis. While the Mps of the original system vary to the extent of from 0.98 to 46.27, Mp of the optimal system is evaluated as 1.1 which satisfies the generally accepted frequency domain specification.

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Effects of steroid injection during rehabilitation after arthroscopic rotator cuff repair

  • Ha, Joong-Won;Kim, Hyunkyo;Kim, Seong Hun
    • Clinics in Shoulder and Elbow
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    • v.24 no.3
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    • pp.166-171
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    • 2021
  • Background: This study aims to compare the clinical outcomes of steroid injections during the rehabilitation period after arthroscopic rotator cuff repair (ACRC). Methods: Among patients who underwent ARCR, 117 patients who met the inclusion and exclusion criteria were enrolled. Pain and range of motion (ROM) recovery at the 3-, 6-, and 24-month follow-up visits and functional outcome at the 24-month follow-up were compared between 45 patients who received ultrasound-guided subacromial steroid injection at postoperative week 4 or 6 and 72 patients who did not. Functional outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) score and Constant score. Healing of the repaired tendon and retear were observed at the 6-month follow-up via magnetic resonance imaging (MRI) or computed tomography (CT) arthrography. Results: At the 3-month follow-up, the steroid injection group showed lower visual analog scale scores than the control group (p<0.05) and showed faster recovery of forward flexion and internal rotation (p<0.05). From the 6-month follow-up, the two groups did not show differences in pain and ROM, and the ASES score and Constant score also did not significantly differ at the 24-month follow-up. The two groups did not differ in retear rate as determined by MRI or CT arthrography at the 6-month follow-up. Conclusions: This study demonstrated that ultrasound-guided subacromial steroid injection at 4 or 6 weeks after ARCR leads to quick pain reduction and ROM recovery until 3 months after surgery. Therefore, subacromial steroid injection is speculated to be an effective and relatively safe method to assist rehabilitation.

Clinical and Functional Outcomes of the Exeter V40 Short Stem in Primary and Revision Arthroplasty: Does the Indication Affect Outcomes in the Short Term?

  • Nemandra Amir Sandiford;Scott M. Bolam;Irrum Afzal;Sarkhell Radha
    • Hip & pelvis
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    • v.35 no.1
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    • pp.40-46
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    • 2023
  • Purpose: A variety of short Exeter stems designed specifically for use in performance of total hip arthroplasty (THA) in primary and revision settings have recently been introduced. Some have been used 'off label' for hip reconstruction. The aim of this study is to report clinical and radiological results from the Exeter V40 125 mm stem in performance of primary THA and revision THA. Materials and Methods: This study had a retrospective design. Insertion of 58 (24 primary, 34 revision) Exeter V40 125 mm stems was performed between 2015 and 2017. The minimum follow-up period was two years. Assessment of the Oxford hip score (OHS), EuroQol-5 Dimension (EQ-5D), and radiological follow-up was performed at one and two years. Results: In the primary group, the preoperative, mean OHS was 13.29. The mean OHS was 32.86 and 23.39 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were at 0.14, 0.59, and 0.35, preoperatively, at one-year follow-up and two-year follow-up, respectively. In the revision group, the mean preoperative OHS was 19.41. The mean OHS was 30.55 and 26.05 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were 0.33, 0.61, and 0.48 preoperatively, at one-year follow-up and two-year follow-up, respectively. No progressive or new radiolucent lines were observed around any stem at the time of the final follow-up in all patients in both groups. Conclusion: Encouraging results regarding use of Exeter V40 125 mm stems have been reported up to two years following surgery in primary and revision THA settings.

Follow-Up Intervals for Breast Imaging Reporting and Data System Category 3 Lesions on Screening Ultrasound in Screening and Tertiary Referral Centers

  • Sun Huh;Hee Jung Suh;Eun-Kyung Kim;Min Jung Kim;Jung Hyun Yoon;Vivian Youngjean Park;Hee Jung Moon
    • Korean Journal of Radiology
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    • v.21 no.9
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    • pp.1027-1035
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    • 2020
  • Objective: To assess the appropriate follow-up interval, and rate and timepoint of cancer detection in women with Breast Imaging Reporting and Data System (BI-RADS) 3 lesions on screening ultrasonography (US) according to the type of institution. Materials and Methods: A total of 1451 asymptomatic women who had negative or benign findings on screening mammogram, BI-RADS 3 assessment on screening US, and at least 6 months of follow-up were included. The median follow-up interval was 30.8 months (range, 6.8-52.9 months). The cancer detection rate, cancer detection timepoint, risk factors, and clinicopathological characteristics were compared between the screening and tertiary centers. Nominal variables were compared using the chi-square or Fisher's exact test and continuous variables were compared using the independent t test or Mann-Whitney U test. Results: In 1451 women, 19 cancers (1.3%) were detected; two (0.1%) were diagnosed at 6 months and 17 (1.2%) were diagnosed after 12.3 months. The malignancy rates were both 1.3% in the screening (9 of 699) and tertiary (10 of 752) centers. In the screening center, all nine cancers were invasive cancers and diagnosed after 12.3 months. In the tertiary center, two were ductal carcinomas in situ and eight were invasive cancers. Two of the invasive cancers were diagnosed at 6 months and the remaining eight cancers newly developed after 13.1 months. Conclusion: One-year follow-up rather than 6-month follow-up may be suitable for BI-RADS 3 lesions on screening US found in screening centers. However, more caution is needed regarding similar findings in tertiary centers where 6-month follow-up may be more appropriate.

Long-Term Follow-Up Ultrasonographic Findings of Intrathyroidal Thymus in Children

  • Yun-Woo Chang;Hee Min Kang;Eun Ji Lee
    • Korean Journal of Radiology
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    • v.21 no.11
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    • pp.1248-1255
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    • 2020
  • Objective: To analyze long-term follow-up sonographic findings of intrathyroidal thymus in children. Materials and Methods: Among 1259 patients with congenital hypothyroidism under 15 years of age who underwent thyroid ultrasonography (US), 41 patients were diagnosed with an intrathyroidal thymus based on US criteria, i.e., hypoechoic solid lesion with punctate and linear echogenicity. In 26 patients aged one to 14 years old, the last follow-up US was performed after 6 to 132 months and compared with the initial US. The lesion was considered to decrease in size if there was a change of more than 2 mm in any dimension. The margin change was divided into well-defined and indistinct, blurred. When the echogenicity changed to a hyperechoic from a characteristic thymic echogenicity pattern, the pattern was considered a hyperechogenic. The changes in size were compared with the changes in shape, margin, and echogenicity pattern. The changes in size, shape, margin, and echogenicity were analyzed the association with the age of last follow-up. Statistical analysis was conducted using the chi-squared test and logistic regression. Results: Fifteen (57.7%) cases were stable in size, and 11 (42.3%) decreased in size, including one that disappeared. Ten (38.5%) cases changed to indistinct margins from initially well-defined margins including one case of initially indistinct margin. Six (23.1%) changed to hyperechogenic, from initially characteristic thymic echogenicity patterns. When follow-up change was compared, decreases in size were significantly associated with lesion changes to indistinct margins (p = 0.004). The age at last follow-up was significantly associated with change to hyperechogenicity (odd ratio, 2.141; 95% confidence interval, 1.144-4.010, p = 0.017). Conclusion: On follow-up US, an intrathyroidal thymus may be decreased in size, with indistinct margins, or show changes to a hyperechoic mass. Decreases in size may be associated with changing to indistinct margins, and changes to hyperechogenicity may be associated with increasing age.

Comparison of Dental Outcomes after General Anesthesia According to the Follow-up Pattern in Special Health Care Needs Patients (장애인 환자의 전신마취 하 치과 치료 후 정기검진 패턴에 따른 치과치료 결과 비교)

  • Kim, Jihyun;Nam, Okhyung;Kim, Misun;Lee, Hyoseol;Choi, Sungchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.43 no.2
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    • pp.145-150
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    • 2016
  • Special Health Care Needs (SHCN) patients need regular follow-up because of high incidence and severity of oral disease. The aim of this study was to evaluate the dental treatment outcomes of SHCN patients according to follow-up patterns. SHCN patients who were treated under general anesthesia (GA) at Kyung Hee University Dental Hospital from 2006 to 2014 were included in this study. The final samples comprised of 53 patients that were divided into regular (33 patients) and irregular (20 patients) follow-up groups according to their follow-up patterns. The type of dental treatment after GA during the follow-up periods were compared. In the irregular group, aggressive treatment including endodontic, prosthetic treatment, and extraction were predominant, compared with the regular group (p < 0.05). In addition, all patients who had dental treatment under GA in follow-up periods were in the irregular group (p < 0.05). In conclusion, the results of this study provide the importance of regular follow-ups with SHCN patients and emphasize responsibilities of dentists for educating patients and their guardians.

THE EFFECT AND RELAPSE PATTERN OF FACEMASK THERAPY FOR CLASS III MALOCCLUSION CHILDREN (유치열기 3급 부정교합 환아에서 facemask의 효과와 재발 양상)

  • Kim, Ji-Yeon;Yoo, Seung-Eun;Lee, Ji-Hyun;Ki-Tae, Ki-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.3
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    • pp.420-426
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    • 2009
  • The purpose of this study was to evaluate skeletal and soft tissue changes that occur after using a facemask for treatment of skeletal class III malocclusion, and to assess the relapse pattern when no retention appliance was used. Fifteen skeletal class III malocclusion patients were treated with a facemask for an average of 12 months. No retention appliance was used during the 1 year follow-up period. Cephalograms were taken during pretreatment, posttreatment, and the 1 year follow-up. Cephalograms were traced, analyzed, and the results were compared between cephalograms. All patients showed significant sagittal skeletal changes after treatment, but they also showed a significant relapse during the 1 year follow-up period when no retention appliance was used. Despite the relapse, the sagittal skeletal changes that remained were still significant. Vertical skeletal change was also significant after treatment, but the total change was not significant after a 1 year follow-up due to relapse. In soft tissue changes, facial convexity and upper lip position improved after treatment and this change remained significant after the 1 year follow-up period. Facemask therapy is therefore an effective method for treatment of skeletal class III malocclusion, however, retention is imperative to maintain the treatment effect.

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