• Title/Summary/Keyword: Grading system

Search Result 698, Processing Time 0.03 seconds

Treatment of Osteochondritis Dissecans of the Talus (거골 박리성 골연골염의 치료)

  • Hahn, Sung-Ho;Yang, Bo-Kyu;Yi, Seung-Rim;Chung, Shun-Wook;Lee, Dong-Ho;Lee, Chul-Ho
    • Journal of Korean Foot and Ankle Society
    • /
    • v.6 no.2
    • /
    • pp.190-194
    • /
    • 2002
  • Purpose: We present our experience about the clinical aspect and treatment modalities of ostechondritis dissecans of the talus. Material and Method: This study included 35 patients, 38 cases diagnosed as ostechondritis dissecans of the talus that were proved by clinical and radiologic finding. The methods of treatment were conservative (2 cases), multiple drilling (1 case), excision (1 case), excision, curettage & multiple drilling (23 cases), curettage & bone peg fixation (2 cases), curettage & bone graft (2 cases), and autogenous osteochondral transfer(Mosaicplasty) (7 cases). Results: Of the 38 cases, 30 cases were associated with a history of trauma (17 cases of medial lesion, 13 cases of lateral lesion), and 9 cases of which had major trauma history and 21 cases, minor repetitive trauma history. According to O'Farrel grading system, 21 cases (55%) had good results, 11 cases (29%) had fair results, and 6 cases (16%) had poor results. Of the medial lesion 16 cases had good results, 6 cases, fair results, and 2 cases, poor results. Of the lateral lesion 5 cases had good results, 5 cases, fair results, and 4 cases, poor results. Conclusion: There were fair or good results in 84% of patients with surgical treatment. Curettage and multiple drilling reveals a good result in medial lesion in grade I, II, III and lateral lesion in grade I, II. Autogenous osteochondral transfer(Mosaicplasty) is considered for the cases in grade III, IV(medial and lateral), lesion exceeds 1Cm of size and poor result with another treatment modality.

  • PDF

New Carotid Artery Stenosis Measurement Method Using MRA Images (경동맥 MRA 영상을 이용한 새로운 내경 측정 방법)

  • 김도연;박종원
    • Journal of KIISE:Software and Applications
    • /
    • v.30 no.12
    • /
    • pp.1247-1254
    • /
    • 2003
  • Currently. the north american symptomatic carotid endarterectomy trial, european carotid surgery trial, and common carotid method are used to measure the carotid stenosis for determining candidate for carotid endarterectomy using the projection angiography from different modalities such as digital subtraction angiography. rotational angiography, computed tomography angiography and magnetic resonance angiography. A new computerized carotid stenosis measuring system was developed using MR angiography axial image to overcome the drawbacks of conventional carotid stenosis measuring methods, to reduce the variability of inter-observer and intra-observer. The gray-level thresholding is one of the most popular and efficient method for image segmentation. We segmented the carotid artery and lumen from three-dimensional time-of-flight MRA axial image using gray-level thresholding technique. Using the measured intima-media thickness value of common carotid artery for each cases, we separated carotid artery wall from the segmented carotid artery region. After that, the regions of segmented carotid without artery wall were divided into region of blood flow and plaque. The calculation of carotid stenosis degree was performed as the following; carotid stenosis grading is(area measure of plaque/area measure of blood flow region and plaque) * 100%.

Immediate Breast Reconstruction with Deep Inferior Epigastric Perforator Free Flap (심부하복벽천공지 유리피판을 이용한 즉시 유방 재건술)

  • Ryu, Min Hee;Kim, Hyo Heon;Jeong, Jae Ho
    • Archives of Plastic Surgery
    • /
    • v.34 no.2
    • /
    • pp.229-236
    • /
    • 2007
  • Purpose: Breast reconstruction with deep inferior epigastric perforator(DIEP) free flap is known to be the most advanced method of utilizing autologous tissue. The DIEP free flap method saves most of the rectus abdominis muscle as well as anterior rectus sheath. Therefore, the morbidity of the donor site is minimized and the risk of hernia is markedly decreased. Methods: We chose the internal mammary artery and its venae comitantes as recipient vessels, and deep inferior epigastric vessels as donor vessels. The number and location of the perforators derived from medial or lateral branch of deep inferior epigastric artery(DIEA) in 23 DIEP flaps were identified. Ten patients underwent evaluation of their abdominal wall function preoperatively and 6 months postoperatively by using Lacote's muscle grading system. Results: Of the 23 patients, a patient with one perforator from lateral branch of DIEA experienced partial necrosis of flap. Total flap loss occurred in one patient. Mild abdominal bulging was reported in one patient 4 months postoperatively probably because of early vigorous rehabilitational therapy for her frozen shoulder. Postoperative abdominal wall function tests in 10 patients showed almost complete recovery of muscle function upto their preoperative level of upper and lower rectus abdominis and external oblique muscle function at 6 months postoperatively. All patients have been able to resume their daily activities. Conclusion: The breast reconstruction with DIEP free flap is reliable and valuable method which provide ample soft tissue from abdomen without compromising the integrity of abdominal wall. Selection of reliable perforators is important and including more than two perforators may decrease fat necrosis and partial necrosis of flap.

Clinical Studies on the General Features and the Obesity-Skinniness of Patients with Bell's Palsy (구안괘사(口眼喎斜)환자의 일반적 특성 및 비수(肥瘦)에 따른 임상적 고찰)

  • Choi, Gyu-Ho;Jang, Sao-Young;Shin, Hyeon-Cheol
    • The Journal of Internal Korean Medicine
    • /
    • v.30 no.1
    • /
    • pp.129-143
    • /
    • 2009
  • Objective : This study was aimed to investigate the general features and differences between obesity and skinniness of patients with Bell's palsy. Methods : We measured the sex, age. BMI. pulse diagnosis and HBGS (House-Brackmann Grading System) of 234 patients who were diagnosed with Bell's palsy. Results and Conclusions : The results with statistical significance were as follows (1) The distribution of age revealed that 40s was the most at 30.8 %: (2) The improvement period in facial palsy patients with sub-paralysis was shorter than whole-paralysis. And in one part the more we treated, the shorter the improvement period was: (3) In distribution of fat rate in facial palsy patients, obesity was the most at 61.37%, low weight 15.88%. So we found that the fatter the patients was. the higher the onset rate was: (4) In distribution of pulse diagnosis in facial palsy patients with obesity. the ratio of Xu mai (虛脈) was 67.06%. Shi mai (實脈) 32.94%. The Xu mai was similar to Qi xu (氣虛). So we found that the facial palsy patients with obesity were more Qi xu than with low weight. In distribution of pulse diagnosis in facial palsy patients with skinniness, the ratio of Chi mai (遲脈) was none. Shuo mai (數脈) was most: (5) In distribution of region in facial palsy patients with obesity-Xu mai. the ratio of left was 45.10%, right 54.90%, but this result was not statistically significant.

  • PDF

Effect of Acupuncture on Inflammatory Lesions and Body Image Disturbance in Patients with Acne Vulgaris (염증성 여드름 환자에 대한 침 치료 효과와 신체이미지 인식에 대한 연구)

  • Lee, Ah-Reum;Lee, In-Seon;Kim, SongYi;Lee, Hyangsook;Park, Hi-Joon;Lee, Hyejung;Chae, Younbyoung
    • Korean Journal of Acupuncture
    • /
    • v.30 no.2
    • /
    • pp.114-121
    • /
    • 2013
  • Objectives : The purpose of this study is to evaluate the efficacy of acupuncture treatment on the inflammatory lesions and body image disturbances in patients with vulgaris acnes. Methods : Fifteen inflammatory acne patients were enrolled and treated with facial acupuncture during 4 treatment sessions. We evaluated the number of papules and nodules using the Korean Acne Grading System (KAGS). We also evaluated patients' general subjective satisfaction and objective changes of inflammatory acnes symptoms using DermaVision-pro. Moreover, we observed the skin quality-of-life scale with skindex-29 and body image disturbance questionnaire (BIDQ) as secondary outcome. Adverse events were recorded as well at every visit. Results : After 4 treatment sessions, there were significant reductions in the number of papules and nodules of the patients. We found that subjective satisfactions of patients were enhanced as well as the objective inflammatory symptoms. We also found significant improvements in the quality of life and BIDQ. No serious treatment-related adverse events were reported. Conclusions : This study demonstrated that standardized facial acupuncture were effective and safe in the treatment of facial inflammatory acnes.

Reliability of Modified Ashworth Scale Using a Haptic Robot Finger Simulating Finger Spasticity (손가락 경직을 모사하는 로봇 시뮬레이터를 이용한 경직도 검진의 신뢰도 평가)

  • Ha, Dokyeong;Park, Hyung-Soon
    • Transactions of the Korean Society of Mechanical Engineers B
    • /
    • v.41 no.2
    • /
    • pp.125-133
    • /
    • 2017
  • This paper presents the inter-rater reliability of finger spasticity assessment tested realized by using finger simulator that mimics finger spasticity of patients after a stroke. For controlling the simulator torque, finger spasticity was modeled, and the model parameters were obtained by measuring quantitative data while grading based on Modified Ashworth Scale (MAS). A robotic finger simulator was designed for mimicking finger spasticity. Evaluation of this simulator with the help of seven rehabilitation doctors showed that the simulator had a Cohen's kappa value of 0.619 for Metacarpophalangeal Joint and 0.514 for Proximal Interphalangeal Joint. Fleiss' kappa between raters is 0.513 for Metacarpophalangeal Joint and 0.486 for Proximal Interphalangeal Joint. Therefore, the spasticity assessment made by MAS grade system is not reliable owing to the subjectivity of the assessment. The proposed robotic simulator can be used as a training tool for improving the reliability of the spasticity assessment.

Facial reanimation using the hypoglossal nerve and ansa cervicalis: a short-term retrospective analysis of surgical outcomes

  • Koo, Won Young;Park, Seong Oh;Ahn, Hee Chang;Ryu, Soo Rack
    • Archives of Craniofacial Surgery
    • /
    • v.22 no.6
    • /
    • pp.303-309
    • /
    • 2021
  • Background: Transferring the hypoglossal nerve to the facial nerve using an end-to-end method is very effective for improving facial motor function. However, this technique may result in hemitongue atrophy. The ansa cervicalis, which arises from the cervical plexus, is also used for facial reanimation. We retrospectively reviewed cases where facial reanimation was performed using the ansa cervicalis to overcome the shortcomings of existing techniques of hypoglossal nerve transfer. Methods: The records of 15 patients who underwent hypoglossal nerve transfer were retrospectively reviewed. Three methods were used: facial reanimation with hypoglossal nerve transfer (group 1), facial nerve reanimation using the ansa cervicalis (group 2), and sural nerve interposition grafting between the hypoglossal nerve and facial nerve (group 3). In group 1, the ansa cervicalis was coapted to neurotize the distal stump of the hypoglossal nerve in a subset of patients. Clinical outcomes were evaluated using the House-Brackmann (H-B) grading system and Emotrics software. Results: All patients in group 1 (n= 4) achieved H-B grade IV facial function and showed improvements in the oral commissure angle at rest (preoperative vs. postoperative difference, 6.48° ± 0.77°) and while smiling (13.88° ± 2.00°). In groups 2 and 3, the oral commissure angle slightly improved at rest (group 2: 0.95° ± 0.53°, group 3: 1.35° ± 1.02°) and while smiling (group 2: 2.06° ± 0.67°, group 3: 1.23° ± 0.56°). In group 1, reduced tongue morbidity was found in patients who underwent ansa cervicalis transfer. Conclusion: Facial reanimation with hypoglossal nerve transfer, in combination with hypoglossal nerve neurotization using the ansa cervicalis for complete facial palsy patients, might enable favorable facial reanimation outcomes and reduce tongue morbidity. Facial reanimation using the ansa cervicalis or sural nerve for incomplete facial palsy patients did not lead to remarkable improvements, but it warrants further investigation.

Clinical Effectiveness of Traditional Herbal Medicine in the Treatment of Central Post-Stroke Pain and Thalamic Syndrome: a Systemic Review and Meta-analysis of Randomized Clinical Trials Based on Traditional Chinese Medicine Journals (뇌졸중 후 중추성 통증 및 시상증후군에 대한 한약치료의 효과 : 체계적 고찰 및 메타분석 - 중의학 저널을 중심으로)

  • Jung, Yu-jin;Kang, Eun-jin;Hong, Sang-hoon
    • The Journal of Internal Korean Medicine
    • /
    • v.40 no.3
    • /
    • pp.295-311
    • /
    • 2019
  • Objectives: This research aimed to investigate Chinese clinical studies on the treatment of central post-stroke pain (CPSP) and thalamic syndrome after stroke with traditional herbal medicine (THM). Methods: Randomized controlled trials verifying the effects of herbal medicine on treating CPSP and thalamic syndrome after stroke were included in the study. Electrical and hand search were conducted in the China National Knowledge Infrastructure (CNKI), National Discovery for Science Leaders (NDSL), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (Oasis) for CPSP and thalamic syndrome after stroke. A literature search was performed in the Chinese and Korean databases for papers published from January 1, 2010 to October 1, 2018. The selected literature was assessed by Cochrane's risk of bias. Results: Twelve reports on randomized controlled trials met the inclusion criteria from the 227 identified reports. Effective rate, comparison of visual analogy scale, present pain intensity, pain grading index, recurrence rate, follow-up, and a 36-item short form survey instrument were used to evaluate the treatments. The effective rate of the treatment group was significantly higher than that of the control group in all papers. Side effects occurred less frequently in the treatment group than in the western medicine control group. Conclusions: The treatment of CPSP and thalamic syndrome after stroke with THM was shown to be highly effective. Additional well-designed clinical trials are needed. This study can be used as a basis for further research on the treatment of CPSP and thalamic syndrome after stroke.

A Study on the Quantitative and Evaluation Weights of National Greenhouse Gas Emission Factors in the Mineral Industry (광물산업의 국가온실가스배출계수 정량·평가항목 가중치에 관한 연구)

  • Yoon, Yoongjoong;Cho, Changsang;Jeon, Eui Chan
    • Journal of Climate Change Research
    • /
    • v.9 no.1
    • /
    • pp.81-90
    • /
    • 2018
  • "The Framework Act on Low-Carbon Green Growth" specifies the requirements for the development and verification of emission factors for establishing reliable national greenhouse gas statistics. The scope of the regulations covers the development and validation of energy, industrial processes, solvents and other product use, agriculture, land use, land use change and emission and absorption coefficients of the forestry and waste sector as defined in the 1996 IPCC Guideline and GPG 2000, The minerals sector to be covered in this study belongs to industrial processes. As a representative method for quantifying and evaluating GHG emission factors, there are emission grade quality grading and DARS (Data Rating Rating System) in the 'Procedures for Preparing Emission Factor Documents (1997)' reported by US-EPA. However, the above two methods are not specific and comprehensive, and lack the details for accurate emission factor verification. Therefore, there is a need for a method for verifying and quantifying certified greenhouse gas emission factors that reflects characteristics of each industry sector in Korea and accord with IPCC G/L and GHG target management. In this study, we conducted a weighted study on quantitative and evaluation lists of emission factor using questionnaires to develop a more accurate methodology for quantifying national greenhouse gas emission factors in the mineral sector. Quantification and evaluation of emission factor are classified into essential verification and quality evaluation. The essential verifications are : administrative compatibility, method of determining emission factors, emission characteristics, sampling methods and analysis methods, representativeness of data. The quality evaluations consisted of the quality control of the data, the accuracy of the measurement and analysis, the level of uncertainty, not directly affect the emission factor, but consisted of factors that determine data quality.

A Case of Delayed Facial Palsy and Dizziness in Miller-Fisher Syndrome (Miller-Fisher 증후군에서 나타난 지연형 안면마비 및 현훈 치험 1례)

  • Song, Mi-Sa;Yoon, Hwa-Jung;Ko, Woo-Shin
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
    • /
    • v.32 no.3
    • /
    • pp.254-261
    • /
    • 2019
  • Objective : Miller-Fisher syndrome(MFS) is a type of acute inflammatory polyneuropathy, a disease characterized by abnormal muscle coordination, absence of tendon reflexes, and paralysis of the eye muscle. This study is to report a case of delayed facial palsy and dizziness in Miller-Fisher syndrome, treated with traditional Korean medicine. Methods : A 57-year-old male was diagnosed with Miller-Fisher syndrome accompanied by neurological symptoms such as right facial palsy and dizziness. He received traditional Korean medicine treatment such as acupuncture(including pharmacopuncture, needle embedding therapy, electroacupuncture) and herbal medicine for 17 days. Results : Each neurological symptoms were improved after traditional Korean medicine. In case of facial palsy, House Brackmann Grading System was reduced form grade 3 to grade 2, and Sunnybrook Scale was improved from 39 to 55. Also, other symptoms such as dizziness and headache was also improved. Conclusions : This case report suggests that traditional Korean medicine may have a role in treating neurological symptoms such as facial palsy and dizziness in patient diagnosed with Miller-Fisher syndrome.