• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.3
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• pp.191-200
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• 1998

This study was intended to perform the influence of condyle positional change after surgical correction of skeletal Class III malocclusion after orthognathic surgery in 37 patients(male 13, female 24) using computed tomogram that were taken in centric occlusion before, immediate after, and long term after surgery and lateral cephalogram that were taken in centric occlusion before, 7 days within the period of intermaxillary fixation, at the 24 hours later removing intermaxillary fixation and long term after surgery. 1. Mean intercondylar distance was $84.42{\pm}5.30mm$ and horizontal long axis of condylar angle was $12.79{\pm}4.92^{\circ}$ on the right, $13.53{\pm}5.56^{\circ}$ on the left side. Condylar lateral poles were located about 12mm and medial poles about 7mm away from the reference line(AA') on the axial tomogram. Mean intercondylar distance was $83.15{\pm}4.62mm$ and vertical axis angle of condylar angle was $76.28{\pm}428^{\circ}$ on the right, $78.30{\pm}3.79^{\circ}$ on the left. 2. In amount of set back, We found the condylar change(T2C-T1C) which had increasing tendency in group III (amount of setback : 10-15mm). but there was no statistical significance(p>0.05). 3. There was some correlation between condylar change(T2C-T1C) and TMJ dysfunction. It seemed that postoperative condylar change had influenced postoperative TMJ dysfunction, through there was no statistical significance (p>0.05). As we have observed the change of condylar axis in the group that complained of TMJ dysfunction in cases of large amount of mandibular setback. So we consider that the more trying to conserve condylar position will decrease occurrence rate of post operational TMJ dysfunction.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.53-60
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• 2006

Purpose: This study is to analyze the clinical and radiological results after arthroscopic reduction and internal fixation of intra-articular fractures of lateral tibial plateau. Materials and Methods: The subject of the study are the 13 cases of the patients visited orthopedics surgery during March year 2000 to August year 2004 because of intra-articular fractures of lateral tibial plateau and were treated with arthroscopic reduction and internal fixation. X-rays and CT or MRI were both carried out to identify the precise pattern of fracture and the degree of depression which showed out to be all type 2 by Schatzker fracture classification. And in 9 of the cases, autogenous and allogenous bone grafts were given as bone loss were severe. The average age was 48, age group between 31 and 66, and average follow up period of about 38 months ($13{\sim}65months$). Radiological ratings were given by comparing the X-rays of degree of joint congruency before and after the operation, functional ratings by analyzing IKDC score and Lysholm score. Combined injuries observed after arthroscopy were posterior cruciate ligament injury in 1 case, meniscus injury in 4 cases and medial collateral ligament in 2 cases. Results: During follow up, X-rays showed well-maintained reduction of articular surface in all cases and no complications such as joint depression, fracture reduction loss, angular deformity or malunion were found. Average Lysholm score at last follow up was 87 points ranging from 65 to 97, in 8 of the cases excellent, 3 good, 1 fair and 1 poor according to Lynsholm classification. Average IKDC score was 92 (from 82 to 99). Conclusion: Not only does arthroscopic reduction of lateral tibial plateau fracture bring exact reduction of articular surface, but also, is considered to be a good way of operation to diagnose and treat combined injuries of knee joint using arthroscopy.

• Journal of the Korean Arthroscopy Society
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• v.10 no.1
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• pp.70-76
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• 2006

Purpose: This study presents 5 patients who had metallic anchor protrusion on glenoid after Bankart repair in anterior shoulder instability and reviewed the cause, clinical feature and arthroscopic removal technique. Method and Materials: 5 male with average age of 22 years (range 19 to 25 years) were included. 4 patients had arthroscopic Bankart repair and 1 patient had open repair for anterior shoulder instability. They had protruded metallic suture anchors on glenoid and the protruded suture anchors were removed arthroscopically using larger suture anchor empty inserter. Results: 4 patients had painful clicking sound with motion of abduction and external rotation and 1 patient showed shoulder instability. The ROM showed normal except mild degrees loss of external rotation. The position of protruded metallic anchor was 2, 3 and 5 O'clock in three patients and 4 O'clock in 2 patients. In 2 patients, the metallic suture anchor was malpositioned about 5mm off on the medial side from the anterior glenoid edge. All had Outerbrige classification Grade II-III chondral damage on humeral head and 1 patient showed glenoid cartilage destruction. None had shoulder instability after 2 years of follow-up. Constant score was 65 preoperatively and 89 postoperatively. ASES score was 67 preoperatively and 88 postoperatively. Conclusion: Symptoms of protruded suture anchor are not combined with instability. Most of symptoms were revealed from the rehabilitation period and confused with postoperative pain. Prompt diagnosis and early arthroscopic removal or impaction of protruded metallic suture anchor is recommended because of serious glenohumeral cartilage destruction. This is easy and simple and reproducible method to remove protruded metallic suture anchor arthroscopically.

• Journal of the Korean Arthroscopy Society
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• v.12 no.2
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• pp.112-117
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• 2008

Purpose: Double-bundle reconstruction of anterior cruciate ligament(ACL) has the advantage of restoring the isometry and original function of ACL. The purpose of this study is to evaluate the clinical results following double-bundle reconstruction of ACL using autogenous hamstring grafts through an accessory anteromedial portal. Materials and Methods: From January 2005 to July 2006, sixty patients(52 males, 8 females) underwent double-bundle ACL reconstruction using autogenous hamstring tendons..The mean age was 31.7 years($20{\sim}51$ years). The mean follow up period was 13.4 months($12{\sim}16$ months). We made a horizontal-oblique skin incision just medial to tibial tuberosity and harvested semitendinosus and gracilis tendon. Tibial tunnel for posterolateral bundle was made near its anatomical position. By modifying an anatomic reconstruction of ACL by Yasuda et al., we made a femoral tunnel for posterolateral bundle through accessory anteromedial portal. Tunnels for anteromedial bundle were made with conventional method. We reconstructed anteromedial bundle with semitendinosus tendon and posterolateral bundle with gracilis tendon. Clinical results at last follow up were evaluated by range of motion, extent of anterior displacement(KT-1000 arthrometer), pivot-shift test. Functional evaluation of clinical outcomes were evaluated by Lysholm score and modified Feagin Scoring System. Results: There was no limitation of motion of knee joint at last follow up. Mean side to side difference of anterior displacement of tibia by KT-1000 arthrometer was improved from 8.4 mm preoperatively to 1.7 mm postoperatively(p<0.05). Average Lysholm score was improved from 64.1 preoperatively to 92.2 postoperatively(p<0.05). In modified Feagin Scoring System, 90% of cases were rated as good or excellent. Conclusion: Double-bundle reconstruction of ACL using autogenous hamstring grafts through accessory anteromedial portal results in good clinical outcomes.

• Korean Journal of Applied Biomechanics
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• v.12 no.1
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• pp.63-87
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• 2002

The purpose of this study was to analyze the kinematic variables when Uchi-mata(inner thigh reaping throw) performing by Kumi-kata(engagement position, basic hold) types A, B(A: grasping part-behind neck lapel, B: chest lapel) in Judo with three dimensional analysis technique DLT method by videography. The subjects were four male judokas who have been training in Yong-In University(YIU), on Korean Representative level and Uchi-mata is their tokui-nage(favorite technique), the throwing form was filmed on two S-VHS 16mm video camera( 30frame/sec. Panasonic). Kinematic variables were temporal, posture, and COG. The data collection was performing by Uchi-mata. Six good trials were collected for each condition (type A, B) among over 10 trials. The mean values and the standard deviation for each variable were obtained and used as basic factors for examining characteristics of Uchi-mata by Kumi-kata types. The results of this analysis were as follows : 1) Temporal variables The total time elapsed(TE) by Uchi-mata of types A, B were 1.45, 1.56 sec. respectively. Types A shorter than B. 2) Posture variables In performing of Uchi-mata, the range of flexion in type A, left elbow was $45^{\circ}$ and B was $89^{\circ}$ from Event 2(E2) to Event 6(E6). Type A and B were quite different in right elbow angle in Event1(E1). Left shoulder angle of type A was extended and type B was flexed in E4. Both types right shoulder angles were showed similar pattern. Also both hip angles(right/left) were showed similar pattern. When type A performed Uchi-mata the knee-angle of supporting foot showed $142^{\circ}$in the 1st stage of kake phase[KP], and extended to $147^{\circ}$in the 2nd stage of KP. And the foot-ankle angle of supporting foot showed $83^{\circ}$in the 1st stage of KP, and extended to $86^{\circ}$in the 2nd stage of KP. moreover, The knee angle of attacking foot showed $126^{\circ}$in the 1st stage of KP, and extended to $132^{\circ}$in the 2nd stage of KP, and the foot-ankle angle of attacking foot showed $106^{\circ}$in the 1st stage of KP, and extended to $121^{\circ}$in the 2nd stage of KP. When type B performed Uchi-mata the knee-angle of supporting foot showed $144^{\circ}$in the 1st stage of KP, and extended to $154^{\circ}$in the 2nd stage of KP. And the foot-ankle angle of supporting foot showed $83^{\circ}$in the 1st stage of KP, and extended to $92^{\circ}$in the 2nd stage of KP. moreover, The knee angle of attacking foot showed $132^{\circ}$in the 1st stage of KP, and extended to $140^{\circ}$in the 2nd stage of KP, and the foot-ankle angle of attacking foot showed $103^{\circ}$in the 1st stage of KP, and extended to $115^{\circ}$in the 2nd stage of KP. During Uchi-mata performing, type A showed pulling pattern and type B showed lift-pulling pattern. As Kumi-kata types, it were different to upper body(elbow, shoulder angle), but mostly similar to lower body(hip, knee, ankle angle) on both types. 3) C. O. G. variables When the subjects performed Uchi-mata, COG of type A, B up and down in vertical aspect was 71cm, 73.8cm in height from the foot in the 2nd stage of KP. As Kumi-kata types, it were different on medial-lateral direction aspect but weren't different in Kuzushi phase on vertical direction aspect.

• Radiation Oncology Journal
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• v.3 no.2
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• pp.95-101
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• 1985

From July 1979 through March 1985,112 patients with carcinoma of the uterine cervix were treated by whole pelvis irradiation and intracavitary radiation with Cs-137. The treatment consisted of 3600rad-5200rad to the whole pelvis by parallel opposing portals, 5 days per week, 180-200rad per day. Parametrial boost with 400-800rad was given in 60 patients. 2 intracavitary Cs-137 radiation using TAO applicator were done with 7-10 days interval. Total treatment times were 40-65 days with average 52 days. Total dose of radiation to point A varied from 6820 to 10500rad with average 8388rad and to point B from 4850 to 6899ra0 with average 5898rad. All patients had follow up from 6 months to 75 months and median follow up of 31 months. $9(8\%)$ had stage $14(12.5\%)$ had stage IIa, $50(44.6\%)$ had stage IIb, $33(29.5\%)$ had stage III, $6(5.4\%)$ had stage IV. 110 patients had squamous cell carcinoma and 2 patients had adenocarcinoma. 5 year actuarial survival rates were $61.8\%$ for the entire group, $84.6\%$ for stage Ib,$77.8\%$ for stage IIa, $56.7\%$ for stage IIb, $60\%$ for stage III, $33.3\%$ for stage IV. RT dose to medial parametrium (point A) below 8000rad resulted in $7/18(38.9\%)$ failure (=death) in contrast to 25/94 $(26.5\%)$ failure with dose over 8000rad. RT dose to lateral parametrium (point B) below 6000ra0 yielded 20/63 $(34.9\%)$ failure compared to $10/49(20.4\%)$ failure with dose over 6000rad. Poor survival group of age were between 40-49 years with failure of $14/41(34.1\%)$. There was no increased failure rate below age of 40 with failure of $2111(13.9\%)$. The results suggest that survival is as good as other published data, and that higher doses over 8000rad to point A and 6000rad to point B should be delivered.

• Investigative Magnetic Resonance Imaging
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• v.3 no.1
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• pp.66-72
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• 1999

Purpose : To evaluate the usefulness of Dual Echo in Steady State(DESS) image in the diagnosis of chondromalacia of the knee compared with turbo spin-echo MR images Materials and Methods : We included 26 patients with chondromalacia of the knee. MR imaging was obtained with a 1.5T imager. Sagittal and coronal double echo T2 weighted images(TR/TE 3000-4200/16-96msec, FOV $140-160{\times}140-160mm$, matrix size $180{\times}256$, slice thickness 4.0mm, interslice gap 0.5mm), and sagittal DESS image(TR/TE 25.4/9.0msec, flip angle $35-45^{\circ}$, FOV $150-160{\times}150-160mm,{\;}matrix{\;}size{\;}192{\times}256$, effective slice thickness 1.5mm) were obtained. Cartilage lesions were staged according to a modified scheme proposed by Outerbirdge: grade 0, normal; grade 1, softening or/and swelling; grade 2, mild surface fibrillation or/and less than 50% of cartilage thickness; grade 3, severe surface fibrillation or/and loss of more than 50% of cartilage thickness but without exposure of subchondral bone; and grade 4, complete loss of cartilage with subchondral bone exposure. Gradings were determined by two readers with consensus, and patellofemoral, medial and lateral tibiofemoral compartments were evaluated. Results : Arthroscopic findings revealed grade 1 in seven cases, grade 2 in 21 cases, grade 3 in six cases, and grade 4 in 18 cases. Sensitivity of turbo spin-echo MR image was as follows; 0%, 14%, 0%, 61% in each grade, and sensitivity of DESS image was as follows; 0%, 33%, 50%, 67%, in each grade(p=0.001). In the detection of chondromalacic lesions regardless of gradings, sensitivity, specificity and accuracy of conventional MR image were 59.6% 88.6% 78.8%, and of DESS image, 73.1% 88.4%, 82.2%(p=0.007). Conclusion : For chondromalacia of knee joints, DESS images showed higher sensitivity than turbo spin-echo MR images. Therefore, DESS images will be helpful for diagnosis of chondromalacia of knee joints.

• Journal of Chest Surgery
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• v.32 no.7
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• pp.613-620
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• 1999

Background: Recently, regional or isolated organ perfusion is being studied again as a drug administration modality which is able to reduce systemic toxicity while delivering high-dose chemotherapeutic agents. This research was planned to evaluate the pharmacokinetics and long-term pathologic changes of the lung in isolated lung perfusion (ILP) with cisplatin. Material and Method: Twenty-five New Zealand white rabbits were divided into 2 groups (Group I: 10, Group II: 15). The groups were then subdivided into 2 and 3 subgroups of 5 rabbits. In group I, tissue samples of the lung and kidney, and systemic blood for platinum concentration measurement were taken 30 minutes after systemic intravenous infusion of cisplatin (5 mg/kg) and isolated lung perfusion in each 5 rabbits. In 2 subgroups of group II, lung tissues for pathologic exams were taken 30 minutes and 1 week after ILP in each 5 rabbits, which received 10% pentastarch solution only and cisplatin, respectively. In the other subgroups, lung biopsy was undertaken 4 weeks after ILP with cisplatin. Result: When cisplatin was infused via systemic vein, the platinum concentration in the lung, kidney and plasma were 1.50${\pm}$0.43 $\mu\textrm{g}$/g, 7.65${\pm}$2.49 $\mu\textrm{g}$/g, 1.19${\pm}$0.03 $\mu\textrm{g}$/ml, respectively. However, the platinum concentration in the lung was about 50 times higher (75.43${\pm}$11.47 $\mu\textrm{g}$/g) than that of intravenous infusion group, and those in the kidney and plasma were decreased (1.30${\pm}$ 0.35 $\mu\textrm{g}$/g, 0.13${\pm}$0.02 $\mu\textrm{g}$/ml) when cisplatin was introduced through ILP. Pathologic change in the treated lung with ILP was characterized by the medial hypertrophy of the pulmonary arterioles and interstitial eosinophilic infiltration, which was not dependent on cisplatin

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.206-213
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• 2005

Purpose: To evaluate the outcome of symptomatic osteochondritis dissecans of the talus treated with arthroscopic debridement and multiple drilling. Materials and Methods: Between 1997 and 2003, 14 arthroscopic debridement(group I) and 15 arthroscopic multiple drilling(group II) were performed. There are 21 male and 8 female patients. Mean age was 34.4 years(33.8 years in group I, 37.5 years in group II) and average follow-up period was 43.2 months(46.4 months in group I, 40.1 months in group II). Simple radiographs and MRI were performed preoperatively and postoperatively, and the progressive stage of the lesions was evaluated through the arthroscopic surgery. Clinical results were evaluated with ankle-hindfoot scale and scoring scale for subjective and objective functional outcomes. The results were compared between 2 groups. Results: There are 20 medial(7 in group I, 13 in group II), 6 lateral(5 in group I, 1 in group II), and 3 both-side(2 in group I, 1 in group II) lesions. According to the classification of Berndt and Harty, there are 4 stage II(4 in group I, 0 in group II), 19 stage III(9 in group I, 10 in group II), and 6 stage IV(1 in group I, 5 in group II). According to the ankle-hindfoot score, the mean score was significantly improved $53.1{\pm}2.7$ points preoperatively to $85.1{\pm}8.5$ points postoperatively in group I and $54.6{\pm}6.8\;to\;80.7{\pm}8.5$ points group II. Subjective and functional scores was also improved $49.6{\pm}10.5$ points preoperatively to $84.6{\pm}7.7$ points postoperatively in group I and $50.7{\pm}9.2\;to\;83.0{\pm}9.6$ points in group II. But there were no statistical significance between them. Conclusion: Arthroscopic debridement and multiple drilling for the treatment of osteochondral lesions of the talus showed successful results and there was no statistically significant difference between them.

• Journal of the Korean Arthroscopy Society
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• v.6 no.2
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• pp.101-108
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• 2002

Purpose: To evaluate the clinical results of anterior cruciate ligament (ACL) reconstruction and to know the results of physeal injury by transphyseal tunnel in adolescents who had remaining growth potential. Materials and Methods : This study involved 12 patients under 19 years old out of 445 patients, who underwent ACL reconstruction between 1993 and 2001. The mean age at the time of operation was 15.9 $(13.1\~16.9)$ years and fellow-up period was 45.1 $(24\~120.6)$ months in avrarge. Autologous quadrupled hamstring tendon was used as graft in 11 cases and bone-patellar tendon-bone in 1 case. Clinical results were evaluated by Lysholm Knee Scoring Scale, range of motion and return to preinjury sports activities. Radiologic results were evaluated by $Telos^{\circledR}$ device. Bone maturity were analyzed by chronological age, standing height and the width of growth plate in AP and lateral view of knee joint at preoperatively. The growth disturbances were evaluated by measuring femorotibial angle, anatomical and mechanical lateral distal femoral angle, mechanical medial proximal tibial angle and leg length and by comparing those of uninjured site in last follow-up teleoroentgenogram. Results : The mean Lysholm Knee score was 51 $(25\~63)$points preoperatively and 98 $(94\~100)$ points at last follow up. The mean anterior displacement of the tibia by using $Telos^{\circledR}$ device was improved from 13.5 $(6\~27)$ mm to 2.9 $(1\~4)$ mm and there were no significant instabilities of the knee in all cases. There were no leg length discrepancies over 1 cm and no statistically significant abnormal alignment of the knee joint in all cases. Conclusion: ACL reconstruction using transphyseal tunnel for restoring stability and knee function is assumed as a good mettled of treatment without significant leg length discrepancy and abnormal alignment of the knee joint.