• Archives of Plastic Surgery
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• v.43 no.2
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• pp.134-144
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• 2016

In adults, mallet finger is a traumatic zone I lesion of the extensor tendon with either tendon rupture or bony avulsion at the base of the distal phalanx. High-energy mechanisms of injury generally occur in young men, whereas lower energy mechanisms are observed in elderly women. The mechanism of injury is an axial load applied to a straight digit tip, which is then followed by passive extreme distal interphalangeal joint (DIPJ) hyperextension or hyperflexion. Mallet finger is diagnosed clinically, but an X-ray should always be performed. Tubiana's classification takes into account the size of the bony articular fragment and DIPJ subluxation. We propose to stage subluxated fractures as stage III if the subluxation is reducible with a splint and as stage IV if not. Left untreated, mallet finger becomes chronic and leads to a swan-neck deformity and DIPJ osteoarthritis. The goal of treatment is to restore active DIPJ extension. The results of a six- to eight-week conservative course of treatment with a DIPJ splint in slight hyperextension for tendon lesions or straight for bony avulsions depends on patient compliance. Surgical treatments vary in terms of the approach, the reduction technique, and the means of fixation. The risks involved are stiffness, septic arthritis, and osteoarthritis. Given the lack of consensus regarding indications for treatment, we propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which we treat with extra-articular pinning.

• Journal of Korean Neurosurgical Society
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• v.41 no.5
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• pp.295-300
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• 2007

Objective : Unilateral facet dislocation of the cervical spine occurs by flexion and rotation injuries and cannot be easily reduced by axial traction. We analyzed 14 consecutive patients with unilateral facet dislocation of the cervical spine to increase knowledge about anatomical reduction of locked facet and factors for successful reduction. Methods : Fourteen patients [10 men and 4 women] with unilateral facet dislocation of the cervical spine were retrospectively analyzed. Plain X-ray, computerized tomography scan, and magnetic resonance imaging were performed. All patients underwent manual reduction and surgery with anterior interbody fusion and plate fixation. The manual reduction was performed by neck flexion and rotation to the opposite side of dislocation, followed by rotation and flexion of the head toward the side of dislocation and extension with relaxation of traction. Mean follow-up period was 17 months. The level of spine, amount of subluxation, combined facet fracture, and time from injury to initial reduction were analyzed using the data obtained from medical records. Results : Thirteen [93%] patients were reduced successfully. Immediate reduction was achieved in 7 patients but failed in 7 patients. Seven patients underwent delayed closed reduction under general anesthesia, and successful reduction was achieved in 6 patients. Only one patient with bone chips between articular facets failed to achieve anatomical reduction. Conclusion : In order to reduce the locked facet more easily and safely, we recommend manipulative traction with anterior interbody fusion and plate fixation under general anesthesia after being aware of spinal cord injury with magnetic resonance imaging.

• Journal of Auto-vehicle Safety Association
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• v.10 no.1
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• pp.20-26
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• 2018

The fatality of rollover accidents in motor vehicle crashes is high despite their low incidence. Through the investigation of a 12-passenger van rollover accident in which 10 passengers were involved, we intend to analyze the correlation between the severity of the injury and the position of the occupants. We collected accident information from medical records, interviews, photo-images of the damaged van, field surveys, and the results of the Korean New Car Assessment Program (KNCAP). Based on the occupants' position, we classified injury sites and estimated injury severity. Passenger injury severity was evaluated by trauma score calculation. The initiation type of the rollover accident was passenger side 'fall-over' and the Collision Deformation Classification (CDC) code for the damaged van was 00TDZO3. The crash of the van involved 10 passengers, with an average age of $16.3{\pm}4.2years$. Few of the occupants had fastened seat belts at the time of the incident, and there was no airbag installed. One patient sustained severe liver injury and another was diagnosed with a fracture of the right humerus. The most common injuries were at the upper extremities and the neck. The average of Injury Severity Score (ISS) was $4.8{\pm}5.9$, and the average ISS of right-seated, mid-seated and left-seated occupants was $7.5{\pm}9.3$, $1.5{\pm}0.7$, and $3.3{\pm}2.1$ respectively (p>0.05). In the rollover (to-passenger side) accident of occupant unfastened, the average ISS of right-seated occupants (near side) was higher, but there was no statistically significant difference.

• Journal of the Korean Society for Heat Treatment
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• v.13 no.1
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• pp.1-9
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• 2000

The microstructural characteristics and low temperature tensile properties between $25^{\circ}C$ and $-196^{\circ}C$ for as-welded and age hardened specimen by using Al 5083-H321 for base metal, 5083-5356 and 5083-4043 weldments have been investigated. The hardness of 5083-5356 weldment decreases with aging treatment, whereas the weld region of 5083-4043 weldment shows remarkable increase in hardness after aging due to the precipitation of fine Si particle at the grain boundaries and interiors. Low temperature tensile properties of 5083 AI base metal, 5083-5356 and 5083-4043 weldments appear to be the increment of tensile strengths and elongations at the room temperature and $-196^{\circ}C$, while the decrement of tensile properties around $-50^{\circ}C$ is shown. Through the observation of fine serration to fracture in the stress-strain curve and tensile fractography, the increment of localized deformation leading to promote the neck initiation and the increment of the dimple size cause to decrease in tensile strengths and elongations around $-50^{\circ}C$. For the tensile specimen of the 5083 base metal, 5083-5356 and 5083-4043 weldments, the reason to increase in elongation after solution and aging treatment is the diminishment of fine pit, the resolution of Mg into the matrix and the spheridization of the eutectic Si.

• Journal of Veterinary Clinics
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• v.18 no.3
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• pp.243-248
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• 2001

Radiographic findings of degenerative joint disease (DJD) in the coxofemoral joints were studied in 108 dogs referred to Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Seoul National University. Radiographic findings were identified with a extended ventrodorsal projection. Clinical signs such as pain in the affected joint, exercise intolerance, lameness, crepitation on flexion and extension of the joint and decreased range of motion, were shown in 40% and radiographic changes of bilateral coxofemoral joints were identified in 69% of a group of dogs. There are no sex predilections. Thirty-seven dogs were diagnosed as canine hip dysplasia (CHD; 10 cases), avascular necrosis of the femoral head (Legg-Calves-Perthes disease [LCPD]; 12 cases), fracture of the acetabulum (1 case), luxation(10 cases) and subluxation (15 cases), however, luxation and subluxation were identified in 11 dogs affected with CHD and LCPD. Causes of DJD in others (71case) were not identified. Radio-graphic findings identified included osteophyte formation at the attachment of the joint capsule (70%), sclerosis of the subchondral bone of the cranial acetabular edge (47%), remodeling of the femoral head (34%), thickening of the femoral neck(31%), perichondral osteophyte formation (31%), joint laxity (30%) and so on. All of the dogs diagnosed as CHD were large breed such as Retriever, Germain Shepherd, and Weimaraner and their age was under 1 year. This condition occurred bilaterally in 70% of affected animals. Dogs diagnosed as LCPD were young (under 1 year), small breed dogs. The incidence of LCPD is greater in Yorkshire Terrier, Miniature Pinscher and Poodle. This condition occurred unilaterally in 67% of affected animals. Clinical signs of dogs with unknown cause were shown in 15% and this condition occurred bilaterally in 75% of affected animals. Radiographic findings varied with patient's age and breed, however, the most common finding was osteophyte formation at the attachment of the joint capsule.

• Journal of Trauma and Injury
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• v.21 no.1
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• pp.15-21
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• 2008

Purpose: National Emergency X-Radiography Utilization Study (NEXUS) criteria and the Canadian Cervical Spine rule (CCR) are commonly used in cervical trauma patients to determine whether a plain cervical X-ray should be performed. However, plain cervical X-rays are so inaccurate that cervical spine computed tomography (CT) is often considered as a screening test. We studied the usefulness of the NEXUS criteria and the CCR for determining the need for a CT evaluation in the emergency department (ED). Methods: This prospective observational study was conducted from January 2007 to March 2008. Plain X-ray and CT scans of the cervical spine were performed on blunt trauma patients with neck pain. The relevancy of CT was examined using the NEXUS criteria and the CCR. Sensitivity, specificity, positive predicted value, and negative predicted value analyses were performed to diagnose the cervical spine injury. Results: During the study period, 284 patients were enrolled in this study. The sensitivity, specificity, positive predicted value, and negative predicted value of the NEXUS criteria were 87.5%, 1.1%, 5.0%, and 60.0% respectively, while those of the CCR were 87.5%, 8.2%, 5.3%, and 91.6%. There were two missed fracture cases when the NEXUS criteria and the CCR were applied independently, however, no cases were missed when both were applied. Conclusion: This study suggests the NEXUS and the CCR in combination can be used as a guide to CT evaluation for cervical spine injury in the ED.

• Nutrition Research and Practice
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• v.14 no.1
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• pp.55-61
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• 2020

BACKGROUND/OBJECTIVES: Osteoporosis is characterized by low bone mass and results in vulnerability to fracture. Calcium and vitamin D are known to play an important role in bone health. Recently, potassium has been identified as another important factor in skeletal health. We examined the link between potassium intake and bone health among the Korean older adult population. SUBJECTS/METHODS: This retrospective, cross-sectional study included 8,732 men and postmenopausal women over 50 years old who completed the Korean National Health and Nutrition Survey (KNHANES) between 2008 and 2011. Potassium consumption was evaluated using a 24-hour recall method. Bone mineral density (BMD) was measured at three sites (total hip, femur neck, and lumbar spine) by dual-energy X-ray absorptiometry (DEXA). Multinomial logistic regression was used to examine the link between potassium intake and prevalence of osteoporosis and osteopenia, after controlling for potential confounding variables. RESULTS: The BMD of the total femur and Ward's triangle were significantly different according to the potassium intake among men (P = 0.031 and P = 0.010, respectively). Women in the top tertile for potassium intake showed higher BMD than those in the bottom tertile at all measurement sites (all P < 0.05). Daily potassium intake was significantly related to a decreased risk of osteoporosis at the lumbar spine in postmenopausal women (odds ratios: 0.68, 95% confidence interval: 0.48-0.96, P trend = 0.031). However, the dietary potassium level was not related to the risk of osteoporosis in men. CONCLUSION: Current findings indicate that higher dietary potassium levels have a favorable effect on bone health and preventing osteoporosis in older Korean women.

• Clinics in Shoulder and Elbow
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• v.22 no.1
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• pp.29-36
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• 2019

Background: The execution of fibular allograft augmentation in unstable proximal humerus fractures (PHFs) was technically demanding. In this study, the authors evaluated the clinical and radiographic outcomes after tricortical iliac allograft (TIA) augmentation in PHFs. Methods: We retrospectively assessed 38 PHF patients treated with locking-plate fixation and TIA augmentation. Insertion of a TIA was indicated when an unstable PHF showed a large cavitary defect and poor medial column support after open reduction, regardless of the presence of medial cortical comminution in preoperative images. Radiographic imaging parameters (humeral head height, HHH; humeral neck-shaft angle, HNSA; head mediolateral offset, HMLO; and status of the union), Constant score, and range of motion were evaluated. Patients were grouped according to whether the medial column support after open reduction was poor or not (groups A and B, respectively); clinical outcomes were compared for all parameters. Results: All fractures healed radiologically (average duration to complete union, 5.8 months). At final evaluation, the average Constant score was 73 points and the mean active forward flexion was $148^{\circ}$. Based on the Paavolainen assessment method, 33 patients had good results and 5 patients showed fair results. The mean loss of reduction was 1.32 mm in HHH and 5.02% in HMLO. None of the parameters evaluated showed a statistically significant difference between the two groups (poor and not poor medial column support). Conclusions: In unstable PHFs, TIA augmentation can provide good clinical and radiological results when there are poor medial column support and a large cavitary defect after open reduction.

• Clinical and Experimental Pediatrics
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• v.62 no.3
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• pp.90-94
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• 2019

Purpose: Several published policy statements have warned against the risks associated with trampoline use and recommended safety guidelines. However, few studies have focused on trampoline-related injuries in Korea. This study aimed to assess the incidence and characteristics of pediatric trampoline-related injuries presented to Ulsan University Hospital. Methods: We retrospectively reviewed the medical records of children aged <16 years with trampoline-related injuries who visited our Emergency Department between 2008 and 2017. Results: Over the 10-year period, 178 trampoline-related injuries were reported, which represented a significant increase (P=0.016). Most (87.6%) of the injuries occurred during the last 5 study years, and a rapid increase in injuries was observed in children aged <6 years. Lower extremity injuries (62.4%) were the most common, followed by injuries of the upper extremities, head and face, and trunk, including injuries to the neck and spine. Sixty-seven children (37.6%) had fractures, and proximal tibia fractures were the most common. Fractures were significantly more common in younger children (<6 years old) than in older children (P=0.026). Conclusion: In Korea, the mechanism of trampoline injury is similar to that of injuries incurred in indoor trampoline parks but is characterized by smaller spaces and multiple users. Trampoline use and the incidence of trampoline-related injuries in children aged <6 years are increasing rapidly. Prohibiting the use of trampolines for children aged <6 years, restricting simultaneous use by multiple children, and ensuring adult supervision should be strictly emphasized. Public awareness and policy guidelines are needed to reduce the incidence of trampoline-related injuries.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.5
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• pp.369-376
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• 2022

Background: Nonobstetric surgery is sometimes required during pregnancy, and neck abscess or facial bone fracture surgery cannot be postponed in pregnant women. However, dental surgery can be stressful and can cause inflammation, and the inflammatory response is a well-known major cause of preterm labor. Propofol is an intravenous anesthetic commonly used for general anesthesia and sedation. Studies investigating the effect of propofol on human amnion are rare. The current study investigated the effects of propofol on lipopolysaccharide (LPS)-induced inflammatory responses in human amnion-derived WISH cells. Methods: WISH cells were exposed to LPS for 24 h and co-treated with various concentrations of propofol (0.01-1 ㎍/ml). Cell viability was measured using the MTT assay. Nitric oxide (NO) production was analyzed using a microassay based on the Griess reaction. The protein expression of cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE 2), p38, and phospho-p38 was analyzed using western blotting. Results: Propofol did not affect the viability and NO production of WISH cells. Co-treatment with LPS and propofol reduced COX-2 and PGE₂ protein expression and inhibited p38 phosphorylation in WISH cells. Conclusion: Propofol does not affect the viability of WISH cells and inhibits LPS-induced expression of inflammatory factors. The inhibitory effect of propofol on inflammatory factor expression is likely mediated by the inhibition of p38 activation.