• Clinics in Shoulder and Elbow
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• 제27권1호
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• pp.18-25
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• 2024

Background: The Discovery Elbow System (DES) utilizes a polyethylene bearing within the ulnar component. An exchange bearing requires preoperative freezing and implantation within 2 minutes of freezer removal to allow insertion. We report our outcomes and experience using this technique. Methods: This was an analysis of a two-surgeon consecutive series of DES bearing exchange. Inclusion criteria included patients in which exchange was attempted with a minimum 1-year follow-up. Clinical and radiographic review was performed 1, 2, 3, 5, 8 and 10 years postoperative. Outcome measures included range of movement, Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complications and requirement for revision surgery. Results: Eleven DESs in 10 patients were included. Indications were bearing wear encountered during humeral component revision (n=5); bearing failure (n=4); and infection treated with debridement, antibiotics and implant retention (DAIR; n=2). Bearing exchange was conducted on the first attempt in 10 cases. One case required a second attempt. One patient developed infection postoperatively managed with two-stage revision. Mean follow-up of the bearing exchange DES was 3 years. No further surgery was required, with no infection recurrence in DAIR cases. Mean elbow flexion-extension and pronosupination arcs were 107°(±22°) and 140° (±26°). Mean OES was 36/48 (±12) and MEPS was 83/100 (±19). Conclusions: Our results support the use of DES bearing exchange in cases of bearing wear with well-fixed stems or acute infection. This series provides surgeons managing DES arthroplasty with management principles, successful and reproducible surgical techniques and expected clinical outcomes in performing DES polyethylene bearing exchange. Level of evidence: IV.

• 기본간호학회지
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• 제4권2호
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• pp.267-282
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• 1997

This study was to test the relationship between regular physical exercise and physical fitness in nursing students. These subjects were 54 volunteers who agreed with intention of this study and were composed of 24 active group and 30 non-active group. The selected physical fitness tests were grip strength and back strength for measuring muscular strength, sargent jump and standing broad jump for measuring power, push-up, sit-up, and heart rate for measuring total endurance, reaction time and side step test for measuring agility, stick test and stork stand for measuring balance, and trunk flexion and trunk extension for measuring flexibility. The conclusion acquired was as follows : 1) Grip strength had significant difference between active group of $29.5{\pm}5.9kg$ and non-active group $25.4{\pm}7.2kg$(t=2.283, p=.027), and back strength between active group of $54.1{\pm}13.7kg$ and non-active group of $44.7{\pm}15.7kg$(t=2.310, p=.025), 2) Sargent jump was lower with non-active group($44.9{\pm}8.6cm$) than with active group($45.3{\pm}8.8cm$), however, was not significant(t=.182, p=.856). Standing broad jump was significantly lower with non-active group of $161.3{\pm}28.7cm$ than with active group of $191.4{\pm}27.0cm$(t=3.939, p=.000). 3) Push-up showed significant difference between active group of $25.3{\pm}12.3times$ and non-active group of $11.5{\pm}5.1times$(t=5.572, p=.000), and sit-up between active group of $21.8{\pm}7.4times$ and non-active group of $17.1{\pm}5.8times$(t=2.631, p=.011), and heart rate between actvie group of $110.5{\pm}12.8$beats/min and non-active group of $121.5{\pm}9.5$beats/min(t=-3.648, p=.001). 4) Reaction time was significantly higher with non-active group of $.300{\pm}.051sec$ than with active group of $.341{\pm}.041sec$(t=-3.285, p=.002). Side step test was lower with non-active group($8.8{\pm}1.1times$) than with active group($9.2{\pm}1.2times$), however, was not significant (t=1.309, p=.196). 5) Stick test showed not significant difference between active group of $25.8{\pm}14.8sec$ and non-active group of $30.7{\pm}17.9sec$(t=-1.058, p=.295), and stork stand between active group of $4.5{\pm}3.2sec$ and non-active group of $3.7{\pm}3.5sec$(t=.918, p=.363). 6) Trunk flexion came out not significant difference between active group of $14.2{\pm}5.0cm$ and non-active group of $15.8{\pm}7.3cm$(t=-.927, p=.358), and trunk extension between active group of $67.1{\pm}6.5cm$ and non-active group of $67.3{\pm}6.6cm$(t=-.140, p=.889). 7) Power was shown to be significantly related to total endurance(r=.717, p=.000 ; r-.739, p=.000). 8) Total endurance was shown to be significantly related to agility(r=-.752, p=.000 ; r=.684, p=.000 ; r=-.664, p=.000 ; r=.598, p=.002 ; r=.864, p=.000 ; r=-.536, p=.007). These results suggest that regular physical exercise is effective in promoting and maintaining physical fitness. As the further study, it is necessary to reinvestigate the effect with more refined design.

• 대한관절경학회지
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• 제16권1호
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• pp.40-46
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• 2012

목적: 주관절의 원발성 골성 관절염의 치료로 관절경적 전방 변연 절제술 및 최소 절개를 이용한 후방 골극 절제술을 시행하여 이 술식의 유용성을 알아보고자 하였다. 대상 및 방법: 2003년 3월부터 2010년 2월까지 불응성 주관절 골성 관절염의 치료로 관절경적 전방 변연 절제술 및 최소 절개 하 후방 골극 절제술을 시행한 19예를 대상으로 하였다. 추시 기간은 평균 19개월이었으며, 평균 연령은 49세였다. 결과는 Andrew-Carson Rating Scale (ACRS)과 Mayo Elbow Performance Score (MEPS)를 이용하여 평가하였다. 결과: 운동 범위는 굴곡 구축이 수술 전 $28.7^{\circ}$에서 수술 후 $17.9^{\circ}$, 후속 굴곡은 $105.1^{\circ}$에서 $121.8^{\circ}$로 증가하였다. MEPS는 51.1점에서 수술 후 87.9점으로 호전되어 우수 3예, 양호 13 예, 보통 3예를 보였다. ACRS는 92.9점에서 수술 후 168.2점으로 호전되어 우수 3예, 양호 14예, 보통 2예를 보였다. 1예를 제외한 전 예에서 일상생활에 지장이 없이 이전 직업으로 복귀하였다. 결론: 불응성 주관절 골성 관절염의 치료로 관절경적 전방 변연 절제술 및 최소 절개 하 후방 골극 절제술은 동통 완화 및 기능 회복에 도움이 되는 술식이라 생각된다. 그러나 골극의 재발이나 관절염의 진행 여부는 장기적 추시가 필요할 것으로 사료된다.

• 한국전문물리치료학회지
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• 제12권4호
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• pp.41-47
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• 2005

The purpose of this study was to determine the intra-rater and inter-rater reliability of various forward head posture measurements. Ten healthy adults (age, $20.4{\pm}2.2$ yrs; height, $164.0{\pm}5.5$ cm; weight, $58.7{\pm}7.3$ kg) participated in the study. They were free of injury and neurologic deficits in the upper extremities and neck at the time of testing. The subjects were asked to perform head forward posture by under the guidance of physical therapists. Markers were placed on the C7 spinous process, mastoid process, tragus of the ear, outer canthus, and forehead. Measurement 1 for forward head posture assessment was measured as the angle between the horizontal line through C7 and the line connecting the C7 spinous process with the tragus of the ear. Measurement 2 was measured as the angle between the C7 spinous process, the mastoid process and the outer canthus. Measurement 3 was measured as two kinds of angles the HT (head tilt) angle is between the line from the midpoint of forehead to the tragus line and Y-axis at the tragus point. The NF (neck flexion) angle is between the line from the tragus to the C7 line and the Y-axis at the C7. Intra-rater, inter-rater reliability and coefficient of variation was assessed by comparing the measured values from three kinds of measurements of forward head posture. The intra-rater reliability was indicated by intraclass correlation coefficients [ICC(1,1)] and inter-rater reliability was shown by intraclass correlation coefficients [ICC(3,k)]. The results of study were as follows: ICC(1,1) values for intra-rater reliability of three measurements were in the 'excellent' category. ICC(3,k) values for inter-rater reliability of three measurements were also in the 'excellent' category. The coefficient of variation of method 2 had a lower value than method 1 and method 3. This data means that the measured value of method 2 was less scattered. Further research is needed to determine whether the validity of all measurements is revealed in the 'excellent' category.

• Korean Journal of Acupuncture
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• 제25권2호
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• pp.125-141
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• 2008

Objective : The aim of this study is to investigate the curative effect of Bee Venom Acupuncture Therapy for pain and limited R.O.M (range of motion) of shoulder in stroke patients. Methods : The subjects of this study were 6 patients with shoulder pain in stroke sequelae. Routine Oriental Medical programs (Acupunture, moxibustion, herbal medicine and physical therapy) were maintained for each subject throughout this study. Single subject ABABAB design was adopted. Each period was 4 days as a rule. Only during the treatment period, Bee Venom Acupuncture Therapy was provided as intervention at the acupoints of LI15(Gyeonu),　TE14(Gyeollyo), GB21(Gyeonjeong), LI14(Bino). The change of pain was measured with a Visual Analogue Scale(VAS). The pain threshold was measured using pressure algometer at the same acupoints where Bee Venom Acupuncture Therapy was provided. And the R.O.M of shoulder joint (flexion, extension, abduction, adduction, external rotation, internal rotation) was measured as well. Analysis was performed by Bayesian analysis using WinBUGS for the comparison of treatment(Bee Venom Acupuncture Therapy) and non-treatment. Results : The median overall improvement for difference in VAS was -2.219(-3.213, -1.175), for difference in external rotation of shoulder R.O.M was 9.992(-2.298, 18.49), for difference in tenderness score of LI14(Bino) by pressure algometer was 5.05(0.6283, 7.762). 95% credibility intervals being shown in brackets. However, the median overall improvement for difference in the other measurements was not significant. Conclusion : This study suggests that Bee Venom Therapy may be applicable to decrease pain and improve R.O.M of shoulder in hemiplegia patients with stroke. Further elaborated single subject designs need to be accumulated to confirm the effects of Bee Venom Acupunture Therapy on shoulder pain in patients with stroke sequelae.

• Clinics in Shoulder and Elbow
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• 제13권1호
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• pp.47-52
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• 2010

목적: 재발성 견관절 불안정성에 대한 관절경 하 후방 관절낭 유합술과 극하근 건 고정술로 이루어진 'Remplissage' 술기를 이용한 Hill-Sachs 병변 복원술을 시행 후 최소 6개월 이상 추시가가능하였던 환자들의 견관절의 안정성 및 임상적, 기능적 결과를 평가하고자 하였다. 재료 및 방법: 2008년 8월부터 2009년 8월까지 본원에서 시술된 'Remplissage' 술기를 시행하였던 7예를 대상으로 하였다. 평균 연령은 28.6세였으며 전 례에서 남성이었고, 평균 추시 기간은 10개월이었다. 평가는 견관절의 운동 범위, ASES 점수, KSSI 점수, ROWE 점수, 그리고 술 후 자기공명영상 촬영을 포함하였다. 결과: 술 후 평균 10개월에 견관절 기능적 평가에서 ASES 점수는 술 전 평균 51.4점에서 술 후 평균 76.8점으로, KSSI 점수는 술 전 평균 46.5점에서 술 후 평균 76점으로, ROWE 점수는 술 전 평균 43.5점에서 술 후 평균 76.3점으로 각각 향상되었고, 모든 환자에서 견관절 운동범위는 전방 거상 170도 이상이었으며, 외회전은 45도 이상으로 나타났다. 결론: 광범위한 Hill-Sachs 병변이 동반된 재발성 견관절 불안정성에 대한 'Remplissage' 술기를 시행 후 6개월 이상 추시 결과 견관절의 안정성 및 임상적, 기능적으로 양호한 결과를 보여주었다.

• Journal of Korean Neurosurgical Society
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• 제42권4호
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• pp.311-316
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• 2007

Objective : The objective of this study is to investigate the safety, surgical efficacy, and advantages of a polyaxial screw-rod system for posterior occipitocervicothoracic arthrodesis. Methods : Charts and radiographs of 32 patients who underwent posterior cervical fixation between October 2004 and February 2006 were retrospectively reviewed. Posterior cervical polyaxial screw-rod fixation was applied on the cervical spine and/or upper thoracic spine. The surgical indication was fracture or dislocation in 18, C1-2 ligamentous injury with trauma in 5, atlantoaxial instability by rheumatoid arthritis (RA) or diffuse idiopathic skeletal hyperostosis (DISH) in 4, cervical spondylosis with myelopathy in 4, and spinal metastatic tumor in 1. The patients were followed up and evaluated based on their clinical status and radiographs at 1, 3, 6 months and 1 year after surgery. Results : A total of 189 screws were implanted in 32 patients. Fixation was carried out over an average of 3.3 spinal segment (range, 2 to 7). The mean follow-up interval was 20.2 months. This system allowed for screw placement in the occiput, C1 lateral mass, C2 pars, C3-7 lateral masses, as well as the lower cervical and upper thoracic pedicles. Satisfactory bony fusion and reduction were achieved and confirmed in postoperative flexion-extension lateral radiographs and computed tomography (CT) scans in all cases. Revision surgery was required in two cases due to deep wound infection. One case needed a skin graft due to necrotic change. There was one case of kyphotic change due to adjacent segmental degeneration. There were no other complications, such as cord or vertebral artery injury, cerebrospinal fluid leak, screw malposition or back-out, or implant failure, and there were no cases of postoperative radiculopathy due to foraminal stenosis. Conclusion : Posterior cervical stabilization with a polyaxial screw-rod system is a safe and reliable technique that appears to offer several advantages over existing methods. Further biomechanical testings and clinical experiences are needed in order to determine the true benefits of this procedure.

• Journal of Acupuncture Research
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• 제24권4호
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• pp.143-155
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• 2007

Objectives: To observe the effect of acupuncture and nerve block combination treatment on adhesive capsulitis patients. Methods : 59 voluntary patients were randomly assigned to acupuncture treatment group(E group, n=22), nerve block treatment group(W group, n=17) and acupuncture and nerve block combination treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, $TE_{14}$, $GB_{21}$ and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received the same treatment as the W group and after 5minutes of rest, successively received the treatment identical to that of E group. All three groups were instructed to practice groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after 1, 2, 3 and 4week treatment. Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), Range of Motion(ROM), the patient's treatment satisfaction measured by Visual Analogue Scale(VAS) and Digital Infrared Thermographic Imaging(DITI) were used as assessment tools. The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Adduction and Extension improved significantly(p<0.05). The W group showed significant improvement(p<0.05) on CSA, SPADI, VAS and DITI. As for ROM, Abduction and Extension improved significantly. The EW group showed significant improvement(p<0.05) on CSA, SPADI and VAS. As for ROM, Adduction, Abduction, Extension and Flexion improved significantly. The improvement of CSA, VAS and Abduction ROM in the EW group was significantly(p<0.05) superior compared to the groups treated with single type of treatment. Conclusion : It is suggested that acupuncture and nerve block combination treatment for adhesive capsulitis patients is more effective than the two single treatments. Through further studies, the acupuncture and nerve block combination treatment model may be developed into East-West Collaboration Model in treating adhesive capsulitis.

• 한방재활의학과학회지
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• 제26권2호
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• pp.123-132
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• 2016

Objectives The aim of this study done as pilot study is to analyze the current state of patients who have low back pain through registry. Methods This study is done under approval of Gil Oriental Medical Hospital of Gachon University, Oriental Medical Hospital of Sangji University, Jecheon Oriental Medical Hospital of Se-Myung University IRB. Among subjects who signed the consent form by their own will, we decided whom to register as subjects of this study by the standard of selection and exception. We collected the sociological investigation, character of low pack pain, degree of symptom which they felt before and after the hospitalization from registered subjects. Results 1. The number of the subjects is 16. The average age is 41.0. 9 of them are female, 7 of them are male. Most of the subjects have history illness which has connection with low pack pain. 2. According to the patient's free description of the back pain, 6 of them suffered throbbing pain. And 8 of the patients have chronic pain, 6 of them have intermittent pain of back pain analysing the character of the low back pain. They answered the pain lasted for 47.6 minutes on average. 3. About the change on the average R.O.M. of L-spine, R.O.M. of Lateral bending, Extension, Flexion, Rotation has increased after leaving the hospital compared with before hospitalization. 4. The amount of discomfort or strength of pain, which was checked by VAS on the day of leaving the hospital, has decreased than they were before the hospitalization. And there was the improvement on the dysfunction score and EQ-5D. Conclusions Through this study, we specifically analyzed the symptoms of the low back pain by accumulating the analysis about the symptoms using several indicators and description which is freely spoken by patients about their symptoms. Further research is expected to complete multi-center registry by building registry and by using it, to get various epidemiologic informations about low back pain.

• PNF and Movement
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• 제4권1호
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• pp.45-50
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• 2006

발뒤꿈치 닿기 시 족관절은 약간 족저굴곡 위치에 있다가 발바닥 닿기까지 족저굴곡이 진행된다. 몸체가 지지하는 중간입각기동안 빨리 배굴로 변하고 입각기 말기에 발뒤꿈치 떼기 후에는 다시 저굴이 일어난다. 유각기의 시작인 발가락 떼기에서는 저굴이 되다가 유각기 중기에는 배굴로 바뀌고 발뒤꿈치 닿기에서는 약간 저굴로 변한다. 후족부의 운동은 발뒤꿈치 닿기 시에 편안히 서있을 때보다 더 회내되어 있고 발뒤꿈치 닿기 직후는 회내되고 중간입각기동안 다시 회내되는 양상을 보인다. 발끝떼기 시에 최대로 회내가 이루어진다. 발에서 일어나는 중요한 요소는 체중과 지면 반발력과의 충격을 흡수하는 역할이라 할 수 있다. 족관절 저굴은 뒤꿈치에 의한 초기 바닥 닿기의 즉각적인 반응으로 대부분의 최후 $10^{\circ}$는 짧은 발의 떨어짐으로 일어난다. 경골 전면 근육들의 활동은 동작을 유의하게 제한하고 즉각적으로 나타난다기보다는 오히려 보행주기에 8% 지점까지 전족에 의한 바닥접촉을 지연시킨다. 떨어지는 체중은 점차감소되고 두 번째로 충격을 흡수하는 기전은 슬관절에서 흡수한다. 위와 같이 보행 시에 발과 족관절의 운동성은 다양하다. 그러나 아직 임상에서는 발과 족관절에 대한 연구가 미흡하다. 따라서 발의 역학적인 범위의 다양성과 발의 내적인, 외적인 부하 사이의 관련성을 위한 더 많은 연구가 필요할 것으로 생각된다.