• 한방재활의학과학회지
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• 제25권4호
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• pp.147-159
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• 2015

Objectives The purpose of this study is to investigate the clinical application of chuna for thoracic in the patients with nuchal pain. Methods Seven patients were treated by chuna for thoracic to evaluate the effect of the treatment. The patient's symptoms were assessed by visual analogue scale (VAS), neck disability index (NDI) and cervical lordotic curvature. Results In all cases, the pain was reduced according to VAS, NDI. Cervical lordotic curvature of 6 cases were improved in terms of Jackson's angle. 5 cases were improved in terms of Depth of cervical curve and Method of Jochumsen. 4 cases were improved in terms of Angle of cervical curve (C2~C7) and Ishihara index. 3 cases were improved in terms of Angle of cervical curve (C1~C7). Conclusions These results suggest that chuna on thoracic might be an effective method to treat nuchal pain with extension malposition of thoracic. But, it's necessary to have more observations and experiments.

• 대한두개안면성형외과학회지
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• 제21권3호
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• pp.156-160
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• 2020

Background: We have reported orbital wall restoration surgery with primary orbital wall fragment in pure blowout fractures using a combination of transorbital and transnasal approach in pure blow out fractures. However, this method was thought to be difficult to use for complex orbital wall fractures, since the sharp screw tip that fixate the maxillary wall increases the risk of balloon ruptures. In this study, we reviewed 23 cases of complex orbital fractures that underwent orbital wall restoration surgery with primary orbital wall fragment and evaluated the result. Methods: A retrospective review was conducted of 23 patients with complex orbital fracture who underwent orbital restoration surgery with primary orbital wall fragments between 2012 and 2019. The patients underwent orbital wall restoration surgery with primary orbital wall fragment with temporary balloon support. The surgical results were evaluated by the Naugle scale and a comparison of preoperative and postoperative orbital volume ratio. Complex fracture type, type of screw used for fixation and complications such as balloon rupture were also investigated. Results: There were 23 patients with complex orbital fracture that used transnasal balloon technique for restoration. 17 cases had a successful outcome with no complications, three patients had postoperative balloon rupture, two patients had soft-tissue infection, and one patient had balloon malposition. Conclusion: The orbital wall restoration technique with temporary balloon support can produce favorable results when done correctly even in complex orbital wall fracture. Seventeen cases had favorable results, six cases had postoperative complications thus additional procedure seems necessary to complement this method.

• Tuberculosis and Respiratory Diseases
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• 제60권6호
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• pp.690-693
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• 2006

중심정맥카테터 삽입 후 생길 수 있는 드문 합병증 중에 하나인 흉수 발생은 카테터와 관련된 혈관벽의 손상을 흉수 발생의 기전으로 설명하고 있다. 저자들은 우측 쇄골하정맥으로 이어지는 이상혈관 내로 카테터가 위치한 후 혈관 파열로 인하여 발생한 흉수 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Journal of Korean Neurosurgical Society
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• 제64권3호
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• pp.447-459
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• 2021

Objective : Oblique lateral interbody fusion (OLIF) is becoming the preferred treatment for degenerative lumbar diseases. As beginners, we performed 143 surgeries over 19 months. In these consecutive cases, we analyzed the learning curve and reviewed the complications in our experience. Methods : This was a retrospective study; however, complications that were well known in the previous literature were strictly recorded prospectively. We followed up the changes in estimated blood loss (EBL), operation time, and transient psoas paresis according to case accumulation to analyze the learning curve. Results : Complication-free patients accounted for 43.6% (12.9%, early stage 70 patients and 74.3%, late stage 70 patients). The most common complication was transient psoas paresis (n=52). Most of these complications occurred in the early stages of learning. C-reactive protein normalization was delayed in seven patients (4.89%). The operation time showed a decreasing trend with the cases; however, EBL did not show any significant change. Notable operation-induced complications were cage malposition, vertebral body fracture, injury to the ureter, and injury to the lumbar vein. Conclusion : According to the learning curve, the operation time and psoas paresis decreased. It is important to select an appropriately sized cage along with clear dissection of the anterior border of the psoas muscle to prevent OLIF-specific complications.

• 척추신경추나의학회지
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• 제15권2호
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• pp.19-31
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• 2020

Objectives This study was conducted to survey the trends of Korean medicine clinical research using radiological measurements of the musculoskeletal system. Methods We searched four domestic research databases (OASIS, NDSL, RISS, KISS) and three academic journals (Journal of Korean Medicine Rehabilitation, The Journal of Korea CHUNA Manual Medicine for Spine & Nerves, and Journal of Acupuncture Research). Selected studies were classified by publishing year, journal, the purpose of studies, and body region mainly researched in studies. Additionally, we analyzed the radiological measurements used in each body region. Results A total of 80 studies were selected. Most of the studies were published since2000. Most studies were published in the Journal of Korean Medicine Rehabilitation. The mainly researched body region was the lumbar spine. The main purpose of the studies was to analyze the characteristics of the disease. Conclusions Further research is needed about other different fields of Korean Medicine using X-ray on various body region and studies with purpose of analyzing radiological measurements need to be researched more.

• Clinics in Shoulder and Elbow
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• 제24권3호
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• pp.125-134
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• 2021

Background: To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in the Asian population at mid-term follow-up. Methods: From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with minimum 2 years follow-up were enrolled. We evaluated the clinical and radiological outcomes, and complications at the last follow-up. In addition, we divided these patients into notching and no-notching groups and compared the demographics, preoperative, and postoperative characteristics of patients. Results: Visual analogue scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles Shoulder Scale, and Simple Shoulder Test scores improved significantly from preoperative (5.00, 3.93, 1.72, 3.94) to postoperative (1.72, 78.91, 28.34, 7.66) (p<0.05) outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft was well-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20 of 38 patients (53%). In the comparison between notching and no-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications included three metaphyseal fractures and one inferior screw malposition. Postoperative complications included ectopic ossification, scapular neck stress fracture, humeral stem relaxation, and late infection in one case each. Conclusions: BIO-RSA showed improved clinical outcomes at mid-term follow-up in Asian population. However, we observed higher scapular notching compared to the previous studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (AT distance) might reduce scapular notching.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.206-209
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• 2023

Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

• Journal of Korean Neurosurgical Society
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• 제67권4호
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• pp.467-476
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• 2024

Objective : To evaluate the usefulness of a cranial implantable chemoport, the H-port, as an alternative to the Ommaya reservoir for intraventricular chemotherapy/cerebrospinal fluid (CSF) access in patients with leptomeningeal metastasis (LM). Methods : One hundred fifty-two consecutive patients with a diagnosis of LM and who underwent H-port installation between 2015 and 2021 were evaluated. Adverse events associated with installation and intraventricular chemotherapy, and the rate of increased intracranial pressure (ICP) control via the port were evaluated for safety and efficacy. These indices were compared with published data of Ommaya (n=89), from our institution. Results : Time-to-install and installation-related complications of intracranial hemorrhage (n=2) and catheter malposition (n=5) were not significantly different between the two groups. Intraventricular chemotherapy-related complications of CSF leakage occurred more frequently in the Ommaya than in the H-port group (13/89 vs. 3/152, respectively, p<0.001). Intracranial hemorrhage during chemotherapy occurred only in the Ommaya group (n=4). The CSF infection rate was not statistically different between groups (14/152 vs. 12/89, respectively). The ICP control rate according to reservoir type revealed a significantly higher ICP control rate with the H-port (40/67), compared with the Ommaya result (12/58, p<0.001). Analyzing the ICP control rate based on the CSF drainage method, continuous extraventricular drainage (implemented only with the H-port), found a significantly higher ICP control rate than with intermittent CSF drainage (33/40 vs. 6/56, respectively, p<0.0001). Conclusion : The H-port for intraventricular chemotherapy in patients with LM was superior for ICP control; it had equal or lower complication rates than the Ommaya reservoir.

• 대한영상의학회지
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• 제81권4호
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• pp.863-885
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• 2020

의료기구들이 발달하면서 복부 및 골반 내에 이식되거나 거치되는 의료기구들이 다양해졌다. 흔하게 사용되는 기구들의 영상의학 소견은 영상의학과 의사들에게 매우 익숙하지만, 상대적으로 사용 빈도가 낮거나 새로운 형태의 기구들의 영상의학 소견은 잘 알려져 있지 않다. 또한 환자에 대한 임상정보가 제한적일 경우 이런 새로운 형태의 의료기구들은 잘못 해석되거나 놓치기 쉽다. 그러므로 복부 및 골반 내 의료기구들의 영상의학 소견을 인지하는 것은 기구들의 올바른 위치를 평가하고, 이와 관련된 합병증을 평가하는데 있어 매우 중요하다. 본 논문에서는 다양한 복부 및 골반 내 의료기구들과 이와 관련된 합병증의 영상의학 소견을 소개하고자 한다.

• 대한정형외과스포츠의학회지
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• 제10권2호
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• pp.47-53
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• 2011

목적: 전방십자인대 재건술의 수가 증가하면서, 재건술의 실패로 인한 재재건술의 빈도 또한 증가하고 있다. 따라서 저자는 전방십자인대 재건술 후 발생한 이식건 실패의 원인 및 전방십자인대 재재건술 후의 임상적 결과를 분석하였다. 대상 및 방법: 1998년 2월부터 2010년 7월까지 전방십자인대 재건술 실패에 대하여 전방십자인대 재재건술을 시술받은 후 최소 12개월 이상 추시가 가능하였던 36예를 대상으로 하였다. 재건술 후 재재건술까지의 평균기간은 60(5~334)개월이었으며, 처음 전방십자인대 재건술을 시술 시 23예(63.9%)에서 동종 이식건을, 13예(36.1%)에서 자가 이식건을 사용하였다. 전방십자인대 재건술 실패의 주증상으로 불안정성이 가장 많았으며, 전방십자인대 재건술을 한번 시행 받았던 경우가 35예(97.5%), 두 번 시행 받았던 경우가 1예(2.5%)였다. 임상적 결과는 Lysholm 슬관절 점수, Tegner activity 점수를 이용하여 평가하였으며, 안정성은 Lachman 및 pivot shift 검사와 Telos device를 이용하여 평가하였다. 결과: 환자의 평균 추시 기간은 21(12~40)개월이었으며, 전방십자인대 재건술의 실패원인으로는 외상이 19예(52.8%)로 가장 많았고, 대퇴 터널의 부정위치가 13예(36.1%), 경골부 터널의 부정위치가 1예(2.8%), 골융합의 실패 3예(8.4%)로 나타났다. 전방십자인대 재재건술을 시행할 시 34예(94%)에서 동종이식건을, 2예(6%)에서 자가 이식건을 사용하였으며, 21예에서 반월상 연골판 손상이 동반되었다(내측 반월상 연골판 손상 14예, 외측 반월상 연골판 손상 7예). Lysholm 슬관절 점수는 술전 66.5점에서 술후 최종 추시시 92점으로 호전되었다(p<0.01). 환자의 대부분은 수술 결과에 만족(92%)하고 있었다. Tegner activity 점수는 술전 2.0점에서 술후 6.2점으로 호전되었다(p<0.01). Lachman 및 pivot shift 검사에서 33예, 30예가 Gr I 이하로 호전되었으며, Telos device를 이용한 안정성 검사에서는 양측 차이 정도는 술전 평균 15.5 mm에서 술후 최종 추시시 4.5 mm로 의미있게 호전되었다(p<0.01). 환자의 대부분은 수술 결과에 만족(92%)하고 있었다. 결론: 전방십자인대 재 재건술은 1년 이상 추시 결과 약간의 전방 불안정성이 존재하였으나, 임상적 결과 및 환자의 주관적 만족도에 있어서는 우수한 결과를 보였다.