• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.245-261
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• 1997

Slipped capital femoral epiphysis(SCFE) is a disorder in which there is a gradual or acute disruption through the capital physeal plate. The physiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The association of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnormality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients(12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic type; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

• Korean Journal of Community Nutrition
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• v.12 no.6
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• pp.826-837
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• 2007

Gallstone composition has changed over the past decades in the Korean with a prominent increase in the prevalence of cholesterol gallstone. This trend is possibly due to the westernization of dietary habits. The purpose of this study was descriptive of GB patient's health related eating behaviors and nutrient consumption patterns. One hundred and six gallstone patients who have had cholecystitis surgery enrolled in this study. Anthropomertic indices, such as height, weight, waist circumference, and hip circumference were measured and calculated BMI and WHR. As the biomarker, TC, TG, LDL-C, HDL-C, FBG level and SBP/DBP were measured and analyzed the relationship with GB stone formation. The structured checklist of health related eating behavior and the semiquantitative food frequency questionnaire after pre-test was used in the face to face interview study. The mean age was $54.9{\pm}13.3$ and gallstone disease was more frequent in the fifties and sixties. Mean BMI was $24.3{\pm}2.8$ in males, and $23.4{\pm}3.9$ in females, the average of waist circumference was $91.1{\pm}7.0cm$ in males and females were $85.4{\pm}9.6cm$. The WHR of men and women was $0.93{\pm}0.0,\;0.90{\pm}0.1$, respectively. The obesity and overweight trend was observed in gallstone patients. The mean blood sugar was researched at $114.5{\pm}35.0mg/dL$. And the ratio of both symptoms DM and gallstone was 26.4%. The rate of dramatic eating repast was significantly higher in the females (p<0.01). Males tended to more frequently consume meat, of high fat content meats and greasy food consumption when eating out. The CPF ratio was 57:16.5:26.5. There was a significant positive correlation between WC and energy (r=0.252, p<0.05), carbohydrate (r=0.255, p<0.05) and niacin (r=0.227, p<0.05). In addition, carbohydrate were significantly correlatied with TC (r=0.230, p<0.05). BMI appeared positive in correlation of protein (r=0.201, p<0.05) and fat (r=0.205, p<0.05). These findings provide a little association that dietary habits are related with cholesterol gallstone formation.

• Journal of Korea Entertainment Industry Association
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• v.14 no.1
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• pp.17-25
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• 2020

The purpose of this study was to examine the effects of coordinative locomotor training (CLT) program on the balance for the promotion of life care of elderly obese women. Ten participants of elderly obese women who were able to walk independently without surgery experience of lumbar, hip or knee joint within the past year were recruited and under went the pretest, CLT (20 sessions), followed by the post-test. The test included BMI test using In-body, joint kinematics using myoVIDEO, muscle activation using surface EMG test (erector spinae (ER), external oblique abdominalis (EO), quadriceps femoris (Quad), hamstring muscle (Ham)) and balance tests including dynamic balance test using forced treadmill, Berg balance scale (BBS) and timed up go (TUG). The CLT program was conducted 60 minutes a day, 5 days a week, over 4 weeks period. As a result of this study, The the trunk and hip joints kinematics during the stance and swing phases of gait were a statistical significance levels were set at p <0.05. The ER and EO muscle activation were significantly improved after intervention (p <0.05). The length of gait line and single support line of change of center of pressure (COP) were significantly increased after intervention (p <0.05). The BBS and TUG were also significantly enhanced after intervention (p <0.05). The results of this study showed that CLT program for the improvement of life care had significant effects on improving postural instability, muscle weakness, reduced balance ability and falling risk of obese elderly women. Therefore, it is recommended to apply CLT program to improve life-care through improving balance ability and preventing fall of obese elderly women.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.31-39
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• 2011

Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

• Journal of the Korean Orthopaedic Association
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• v.55 no.3
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• pp.244-252
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• 2020

Purpose: Total femoral replacement (TFR) is an extreme form of limb salvage. Considering the rarity of this procedure, reports have focused on the complications and a proper indication is unclear. This study analyzed 36 patients with TFR who were asked the following: 1) prognostic factors related to survival in patients who underwent TFR with a tumoral cause; 2) overall implant and limb survival; 3) complications, functional outcome, and limb status for patients surviving for more than 3 years. Materials and Methods: According to the causes for TFR, 36 patients were categorized into three groups: extensive primary tumoral involvement (group 1, 15 cases), tumoral contamination by an inadvertent procedure or local recurrence (group 2, 16 cases), and salvage of a failed reconstruction (group 3, 5 cases). The factors that may affect the survival of patients included age, sex, cause of TFR, and tumor volume change after chemotherapy. Results: The overall five-year survival of the 36 patients was 31.5%±16.2%. The five-year survival of 31 patients with tumoral causes was 21.1%±15.6%. The five-year survival of 50.0%±31.0% in patients with a decreased tumor volume after chemotherapy was higher than that of increased tumor volume (p=0.02). The five-year survival of 12 cases with a wide margin was 41.7%±27.9%, whereas that of the marginal margin was 0.0%±0.0% (p=0.03). The ten-year overall implant survival of 36 patients was 85.9%±14.1%. The five-year revision-free survival was 16.6%±18.2%. At the final follow-up, 12 maintained tumor prosthesis, three underwent amputation (rotationplasty, 2; above knee amputation, 1), and the remaining one had knee fusion. Among 16 patients with a follow-up of more than three years, 14 patients underwent surgical intervention and two patients had conservative management. Complications included infection in 10 cases, local recurrences in two cases, and one case each of hip dislocation, bushing fracture, and femoral artery occlusion. Conclusion: Patients showing an increased tumor volume after chemotherapy and having an inadequate surgical margin showed a high chance of early death. In the long-term follow-up, TFR showed a high infection rate and the functional outcome was unsatisfactory. Nevertheless, this procedure is an inevitable option of limb preservation in selected patients.

• Investigative Magnetic Resonance Imaging
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• v.21 no.3
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• pp.177-182
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• 2017

Schwannomas are benign nerve sheath tumors that are typically located in soft tissue. Occasionally, schwannomas involve osseous structures. These intraosseous schwannomas are generally benign neoplasms that account for less than 0.2% of primary bone tumors. Schwannomas are very rarely observed in long bones. We present a case of a schwannoma affecting the proximal femur with a coincident subchondral fracture of the femoral head. A 38-year-old-male presented with left hip pain without deteriorating locomotor function. Plain film radiographs displayed a lobulating contoured lesion within the intertrochanteric portion of the femur. The magnetic resonance imaging (MRI) scans showed a tumor occupying the intertrochanteric region. Diffuse bone marrow edema, especially in the subchondral and head portions of the femur that was possibly due to the subchondral insufficiency fracture was also noted. The lesion was surgically excised and bone grafting was performed. Histologically, there was diffuse infiltrative growth of the elongated, wavy, and tapered cells with collagen fibers, which are findings that are characteristic of intraosseous schwannoma. Although very rare, intraosseous schwannoma should be included in the differential diagnosis of radiographically benign-appearing, non-aggressive lesions arising in the femur. The concomitant subchondral fracture of the femoral head confounded the correct diagnosis of intraosseous schwannoma in this case.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.4
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• pp.289-294
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• 2016

Background: Control of postoperative pain is an important aspect of postoperative patient management. Among the methods of postoperative pain control, patient-controlled analgesia (PCA) has been the most commonly used. This study tested the convenience and safety of a PCA method in which the dose adjusted according to time. Methods: This study included 100 patients who had previously undergone orthognathic surgery, discectomy, or total hip arthroplasty, and wished to control their postoperative pain through PCA. In the test group (n = 50), the rate of infusion was changed over time, while in the control group (n = 50), drugs were administered at a fixed rate. Patients' pain scores on the visual analogue scale, number of rescue analgesic infusions, side effects, and patients' satisfaction with analgesia were compared between the two groups. Results: The patients and controls were matched for age, gender, height, weight, and body mass index. No significant difference in the mount of drug administered was found between the test and control groups at 0-24 h after the operation; however, a significant difference was observed at 24-48 h after the operation between the two groups. No difference was found in the postoperative pain score, number of side effects, and patient satisfaction between the two groups. Conclusions: Patient-controlled anesthesia administered at changing rates of infusion has similar numbers of side effects as infusion performed at a fixed rate; however, the former allows for efficient and safe management of postoperative pain even in small doses.

• Proceedings of the KOSOMBE Conference
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• v.1995 no.11
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• pp.34-38
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• 1995

Using a 3-D finite element method (FEM), the biomechanical characteristics of a threaded truncated acetabular component and a porous coated hemispherical acetabular component were studied. The Von-Mises stress/strain patterns in the acetabulum reconstructed with these two different types of cementless acetabular cups were investigated. The geometry and dimensions of human hemi-pelvis used in the present shape modeling for finite element analysis were scanned with a 3-D laser scanner(TDS-9000, Cyberware, USA). The scanned data was numerically handled with a shape modelling software 'Pro-Engineer'. Using 19836, 16853 tetrahedral elements, respectively, the stress and displacement field of the acetabulum reconstructed with the two different types of the acetabular components were computed. While the hemi-sphere component was found to show a relatively similar stress/strain patterns to those in the normal hip, the results with the threaded cup showed a considerably different patterns from those in the normal condition. Several regions in cancellous bone near the threads and the edge of the truncated cup was found to be overstressed, especially in the superior-lateral part of the acetabulum. It was postulated that the excessive reaming-out of subchondral bone layer when the truncated cup was used can cause the presence of these overstressed regions of cancellous bone. This theoretical prediction for the implanted acetabulum appeared to consistent with the pathological observation of proximal/medial migration of the threaded truncated acetabular prostheses in the previous publications.

• Journal of Yeungnam Medical Science
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• v.31 no.1
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• pp.61-64
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• 2014

Craniopharyngiomas are rare primary intracranial tumors. Despite their benign histological appearance, they are often associated with an unfavorable prognosis. The typical manifestations upon diagnosis are headache, visual impairment, polyuria/polydypsia, growth retardation, disturbance of pubertal development, and significant weight gain. The treatment options include radical surgery or radiotherapy, or a combination of these modalities. Slipped capital femoral epiphysis (SCFE) is the most common adolescent hip disorder. SCFE occurs when the capital femoral epiphysis displaces posteriorly on the femoral neck at the level of the physis. The etiology of SCFE is thought to be multifactorial and may include obesity, growth surges, and less common endocrine disorders. The related endocrine disorders include hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism. Reported herein is a case of panhypopituitarism caused by craniopharyngioma combined with SCFE.

• Korean Journal of Community Nutrition
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• v.2 no.5
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• pp.695-700
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• 1997

This study was conducted to investigate the effect of an energy restriction program on the weight loss and changes of the biochemical nutritional status for 35 obese women. The energy restriction program took place over a 3-week period that was devided into two parts. The first part consisted of 750-800kcal diet and the second part of 800-1000kcal. Subjects were provided a low energy formula and a menu for the recommended diet. Anthropometric and biochemical measurement before and after the energy restriction program were estimated. Mean weight loss was 3.0kg, accordingly the obestiy rate was lowered from 40.2 to 34.4, BMI from 29.2 to 28.9 and fat weight from 23.3kg to 21.0kg( <0.01. <0.05). Waist circumference loss was most prominent(4.4%) compared to triceps(21% loss)and hip circumference(2.2%loss). Mean RBC count, hemoglobin and hematocrit were significantly lowered( <0.01) but they were in the normal range. Systolic blood pressure was significantly decreased from 124.1mmHg to 113.1mmHg . Mean SGOT and SGPT were lowered from 29.3u/L to 20.0u/L and from 28.7u/L to 16.6u/L, respectively. It seems that the 3 weeks of energy restriction program used in this study was effective in improving anthropometric measurements without producing deficiency of iron or other susceptible nutrients.(Korean J community Nutrition 2(5) : 695-700,1997)