• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.109-114
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• 1999

Purpose : The importance of meniscal repair is well recognized. But transeciton of the posterior horn of the medial meniscus at the posterior tibial attachment is rarely documented and known irreparable. We experienced 9 cases of transection, and present clinical features and pull out suture technique. Methods and Materials : There were 9cases of transection of the posterior horn of medial meniscus from September 1998 to July 1999 in our hospital. Age was 59.3 years in average and ranged from 38 to 70years. Clinical features and MRI made diagnosis in all cases. We confirmed the diagnosis with arthroscopy and repaired the transection with pullout suture technique. Clinical features : Transection of the posterior horn of the medial meniscus at the posterior tibia attachment occurred frequently in middle aged people. They complained posterior knee pain, but they have no history of definitive trauma. Characteristically they had difficulty in full flexion of the knee and in having a squatting position. MRI is very important in diagnosis of transection, especially in coronal view, there is separation of the posterior horn of the meniscus from the posterior tibial attachment. Surgical technique : Pullout suture technique includes debridement of fibrous or scar tissue, exposure of the subchondral bone of the posterior tibial attachment site, suture the transected end of the meniscus with PDS suture, bone tunnel formation from the anteromedial aspect of the proximal tibia, insertion of wire loop through the tibia tunnel, pull the PDS suture through the tibia tunnel out of the joint and stabilize the PDS with post-tie technique to the proximal tibia. Conclusion : Transection of the posterior horn of the medial meniscus at the posterior tibial attachment is not common clinically and rarely documented. Clinical features and MRI are very important in diagnosis of this type tear. Arthroscopic pullout sutures is useful for treatment of this type tear of the meniscus.

• Journal of Chest Surgery
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• v.41 no.1
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• pp.41-48
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• 2008

Background: Accurate assessment of the preload and the fluid responsiveness is of great importance for optimizing cardiac output, especially in those patients with coronary artery occlusive disease (CAOD). In this study, we evaluated the relationship between the parameters of preload with the changes in the stroke volume index (SVI) after fluid loading in patients who were undergoing coronary artery bypass grafting (CABG). The purpose of this study was to find the predictors of fluid responsiveness in order to assess the feasibility of using. certain parameters of preload as a guide to fluid therapy. Material and Method: We studied 96 patients who were undergoing CABG. After induction of anesthesia, the hemodynamic parameters were measured before (T1) and 10 min after volume replacement (T2) by an infusion of 6% hydroxyethyl starch 130/0.4 (10 mL/kg) over 20 min. Result: The right ventricular end-diastolic volume index (RVEDVI), as well as the central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP), failed to demonstrate significant correlation with the changes in the SVI (%). Only the right ventricular ejection fraction (RVEF) measured at T1 showed significant correlation. with the changes of the SVI by linear regression (r=0.272, p=0.017). However, when the area under the curve of receiver operating characteristics (ROC) was evaluated, none of the parameters were over 0.7. The volume-induced increase in the SVI was 10% or greater in 31 patients (responders) and under 10% in 65 patients (non-responders). None of the parameters of preload measured at T1 showed a significant difference between the responders and non-responders, except for the RVEF. Conclusion: The conventional parameters measured with a volumetric pulmonary artery catheter failed to predict the response of SVI following fluid administration in patients suffering with CAOD.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.33-38
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• 2014

Purpose: To determine the therapeutic effectiveness of ultrasound-guided medial branch block (MBB) for the herniated lumbar disc patients who did not relieve their symptoms after percutaneous epidural neuroplasty (PEN). Materials and Methods: From August 2011 to February 2013, 559 patients with herniated lumbar disc have undergone PEN. Among them, ultrasound-guided MBBs were performed for the patients who had sustained low back pain and refered pain to lower extremities. Eighty eight patients were followed at 1 month and 39 patients could be followed at 6 month. All procedures have been performed by the one operator, and 23 G, 10 cm needle was placed and 0.5% lidocaine was injected under ultrasound guide. To target medial branches from L1 to L5, the groove at the root of transverse process and the base of superior articular process has been identified on transverse scan. Patients were evaluated by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) at each follow-up. Significant pain relief was described as a 50% or more reduction in VAS and significant improvement in function was described as at least a 40% reduction in ODI. Results: VAS showed that preprocedure pain ($7.35{\pm}1.68$; $mean{\pm}SD$) significantly decreased 1 month after block ($3.36{\pm}2.98$) and 6 month ($3.05{\pm}2.27$) (p<0.05). ODI also showed that preprocedure score ($32.82{\pm}8.77$) significantly decreased at 1 month ($15.14{\pm}14.01$) and 6 month ($12.97{\pm}8.82$) (p<0.05). Significant pain relief was observed in 64.49% at 1 month and 64.10% at 6 month. Significant functional improvement in 59.81% at 1 month and 61.54% at 6 month. Conclusion: Ultrasound-guided medial branch block may sufficiently treat the facet problems secondary from disc disease.

• Journal of Veterinary Clinics
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• v.28 no.4
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• pp.452-456
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• 2011

5 year-old female Siberian husky which was 27 kg had presented with a recurrent rhinitis with chronic discharge and cough. A nasal foreign material had been suggested by a finding of a bone density ($0.3{\times}0.3$ cm) in the left nasal cavity on X-ray and CT-scanning. Soft tissue opacity in frontal sinus and nasal cavity was increased and foreign material was located beside turbinate bone in the left nasal. We found that there was the increase in the number of eosinophil and mast cell by the nasal cytology test. These results mentioned above indicated that the rhinitis by nasal foreign body was suspicious. We decided that the transfrontal rhinotomy could be the proper procedure to approach the material in this case. After rhinotomy, the foreign body and severe sticky discharge were removed. Drain was placed through the hole and into the frontal sinus and nasal cavity which were flushed two times a day for 7 days. The clinical signs such as cough and nasal discharge were shown to be improved in the every visiting for the re-check. On the $40^{th}$ day after surgery, we could confirm that the most of soft tissue density in the frontal sinus and nasal cavity was decreased by CT-scanning. However, foreign body was not identified by histological examination. For the treatment of chronic rhinitis caused by foreign body, the surgical method such as rhinotomy can be applied, when it is difficult to remove it in the guide of the nasal endoscope.

• The Journal of Korean Society for Radiation Therapy
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• v.17 no.2
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• pp.95-103
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• 2005

Purpose : In the radiosurgery, to obtain CT image to find more accurate tumor position during respiration, and using them, to increase the accuracy of radiation treatment by applying image guided. Materials and Methods : Using the self-made vacuum cushion for the body SRS, CT images were obtained three for each patient during respiration (shallow, inhalation, exhalation). They were transformed to the RTP computer and then were fused. Global GTVs were delineated on the fused images and more appropriated treatment planning was established. Results : We can find the tumor position is moving toward cranio-caudal with max 10 mm margin and volume is transformed. As a result from the comparision of DVH (pre & post radio surgery), we observed about 100% dose to tumor. Conclusion : BSRS was skeptical due to the tumor movement during respiration. More accurate by the combination of the development of immobilization devices and BSRS based on Image Guide, it will be applied to more cases for BSRS.

• Journal of Korean Academy of Nursing
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• v.28 no.3
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• pp.705-717
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• 1998

Ostomates have suffered from many difficulties due to their physical, psychosocial handicaps and changes of life style to include ostoma management that influences their daily and quality of life. An appropriate nursing education for ostoma management is very important. Practical educational materials needs revision because those were developed by pharmaceutical companies and hospital institutions. The purpose of this study is to provide more practical and reasonable education materials for ostomates by doing analysis and survey of educational materials now being used. We surveyed 8 types of educational materials used in 23 university hospitals and medical centers in Seoul ; four of them were developed by department of nursing and the remainder by an Ostomy Company Data, collected from July 14, 1997 through July 31, 1997 were analyzed. The results are as follows ; 1. The analysis of education guide, on ostomate included 14 subcategories : introduction, structure and function of gastrointestinal tracts, definition of stoma, types of ostomy, definition of peristalsis, methods of defecation management, selection of instrument, resolution of problems and general situations following surgery, daily life, where to ask for help, explanations for terms, information about where to buy instrument, explanations for enterostomal therapist, a matter of consultation with doctor, etc. 2. Introduction contained specific contents on practical ostomate management that ostomates would experience through their lives. Ostomate education guides were developed 3 hospitals except one which missed this point. 3. Most ostomate education guides, except one hospital, helped ostomates to understand their physical structure changes with specific explanations on gastrointestinal tracts with figures. 4. Six institutions did not talk about the definition of peristalsis. 5. All institutions, except two, helped ostomates to understand types of ostomy with figures. 6. More detailed explanations on natural defecation are needed. The benefits and pitfalls of natural defecation should be more specified. 7 No psychosocial difficulties of ostomy management were addressed. 8. The efficiency of enema can be better understood through all explanations with figures. Some institutions did not mention items about definition, benefits, pitfalls of enema, sequency of enema, how to wash, cautions performing and enema, skin management, cleaning instrument after enema proper time to spend. 9. There were no detailed contents and what to do in case of not being able to do enema. 10. Only one educational material mentioned emotional aspects after the surgrey. 11. Most institutions explained subcategory of daily life but did not provide specific contents on the difficulties of physical, psychological, and sociocultural controls. 12. The subcategory of ureterostomy education guides included explanations on normal structure and function of urinary tracts, types of ureterostomy, how to manage skin, usage and types of instrument, commercial urostomy, how to manage instrument, daily life, introduced the general contents. However, more specific explanations were needed.

• Tuberculosis and Respiratory Diseases
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• v.48 no.3
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• pp.339-346
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• 2000

Background : The moot important prognostic factor in non-small cell lung cancer is the TNM stage. Even after complete resection in early non-small cell lung cancer, the five-year survival rate is still low. However, new prognostic factors, including molecular biologic factors, have recently been found to guide the treatment of patients with non-small cell lung cancer. We evaluated the prognostic value of the loss of blood-group antigen A in tumor tissue, which has been implicated as an important prognostic factor for overall survival and the timing of the disease progression. Methods : The loss of blood-group antigen A was assessed immunohistochemically in paraffin-embedded tumor samples from 26 patients with blood types A or AB, who had undergone curative surgery. Monoclonal antibody was used to detect the blood group antigen A expression. Results : Fifteen patients (58%) expressed antigen A in their tumor tissue, whereas 11 patients (42%) did not show antigen A. The median survival time of the blood A antigen positive group was 11 months, while the median survival time of the blood A antigen negative group was 18 months. The difference in survival between the two groups was not statistically significant. Conclusion : The loss of blood-group antigen A in tumor tissue was not found to be a significant prognostic factor in patients with non-small cell lung cancer. This study needs to be extended for further evaluation.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.1
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• pp.66-72
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• 2004

Purpose: To evaluate the compensatory mechanism in vivo and develop the treatment guide by performing the comprehensive functional tests of the posterior cruciate ligament (PCL) deficient subjects. Material and Methods: 10 PCL deficient subjects and 10 healthy control group were evaluated. Performed functional tests were range of motion, posterior drawer test, Telos, 30$^{\circ}$ flexion wt-bearing view, KT-1000 arthrometer, gait analysis, EMG test and isokinetic tests. Results: Physical, KT-1000, Telos posterior tests showed significant differences, but 300 full weight bearing lateral view, muscle strength test revealed no difference between two groups. Less knee flexion at initial contact and reduced maximum valgus moment were observed in PCL deficient group. In vertical drop landing, PCL group had increased plantar flexion angle at initial contact. Conclusion: Compensatory mechanisms such as reduced unstable components and absorbing the maximal load of the joint were occurred after PCL insufficiency, which result in good clinical and functional outcomes. Further investigations would be needed to understand the functional adaptations of PCL deficient subjects.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.341-348
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• 2015

Background: There have been various results from studies concerning the predictors of recurrence in early-stage nonsmall cell lung cancer (NSCLC). Therefore, an accurate assessment is needed to guide effective adjuvant therapy. We investigated the predictors of a recurrence in patients with resected, early-stage NSCLC and the risk factors associated with locoregional or distant recurrence. Methods: This retrospective study was conducted on patients at the Pusan National University Hospital from January 2006 to December 2011. Patients with pathological stages I or II were included in this study, as based on the seventh edition TNM staging system. Multivariate Cox proportional hazard models were used to identify factors associated with recurrence. Results: Two hundred and forty-nine patients were included. Among them, 180 patients were stage I, and 69 were stage II. Overall, by multivariate analysis, the independent factors associated with a 5-year total recurrence were the presence of visceral pleural invasion (VPI) (p=0.018) and maximal standardized uptake values (SUVs) of tumors on positron emission tomography (PET) >4.5 (p=0.037). The VPI was the only independent risk factor associated with both locoregional and distant recurrence, in the analysis of the patterns of tumor recurrence and their risk factors. In the subgroup analysis of stage I patients, three variables (male, VPI and resection margin positive) were significantly associated with a 5-year recurrence. Conclusion: The independent factors associated with postoperative recurrence in early-stage NSCLC were as follows: PET SUV >4.5 and the presence of VPI. For patients with those factors adjuvant therapy should be recommended as a more efficacious treatment.

• Journal of Bone Metabolism
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• v.25 no.4
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• pp.195-211
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• 2018

Background: To develop guidelines and recommendations to prevent and treat glucocorticoid (GC)-induced osteoporosis (GIOP) in Korea. Methods: The Korean Society for Bone and Mineral Research and the Korean College of Rheumatology have developed this guideline based on Guidance for the Development of Clinical Practice Guidelines ver. 1.0 established by the National Evidence-Based Healthcare Collaborating Agency. This guideline was developed by adapting previously published guidelines, and a systematic review and quality assessment were performed. Results: This guideline applies to adults aged ${\geq}19years$ who are using or plan to use GCs. It does not include children and adolescents. An initial assessment of fracture risk should be performed within 6 months of initial GC use. Fracture risk should be estimated using the fracture-risk assessment tool (FRAX) after adjustments for GC dose, history of osteoporotic fractures, and bone mineral density (BMD) results. All patients administered with prednisolone or an equivalent medication at a dose ${\geq}2.5mg/day$ for ${\geq}3months$ are recommended to use adequate calcium and vitamin D during treatment. Patients showing a moderate-to-high fracture risk should be treated with additional medication for osteoporosis. All patients continuing GC therapy should undergo annual BMD testing, vertebral X-ray, and fracture risk assessment using FRAX. When treatment failure is suspected, switching to another drug should be considered. Conclusions: This guideline is intended to guide clinicians in the prevention and treatment of GIOP.