• Clinics in Shoulder and Elbow
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• v.26 no.4
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• pp.373-379
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• 2023

Background: The purpose of this study was to determine the association between smoking and clinical outcomes of hook plate fixation for acute acromioclavicular (AC) joint injuries. Methods: This study retrospectively investigated 82 patients who underwent hook plate fixation for acute AC joint dislocation between March 2014 to June 2022. The patients were grouped by smoking status, with 49 in group N (nonsmokers) and 33 in group S (smokers). Functional scores and active range of motion were compared among the groups at the 1-year follow-up. Coracoclavicular distance (CCD) was measured, and difference with the uninjured side was compared at initial injury and 6 months after implant removal. Results: No significant differences were observed between the two groups in demographic factors such as age and sex, as well as parameters related to initial injury status, which included time from injury to surgery, the preoperative CCD difference value, and the Rockwood classification. However, the postoperative CCD difference was significantly higher in group S (3.1±2.6 mm) compared to group N (1.7±2.4 mm). Multivariate regression analysis indicated that smoking and the preoperative CCD difference independently contributed to an increase in the postoperative CCD difference. Despite the radiographic differences, the postoperative clinical outcome scores and active range of motion measurements were comparable between the groups. Conclusions: Smoking had a detrimental impact on ligament healing after hook plate fixation for acute AC joint dislocations. This finding emphasizes the importance of smoking cessation to optimize reduction maintenance after AC joint injury. Level of evidence: III.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.22 no.1
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• pp.149-160
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• 1992

The purpose of this study was to localize the inferior alveolar canals in relation to the root apices of the mandibular third molars, according to their positions and degrees of impaction using vertical tube shift technique. One hundred three mandibular third molars, from 95 persons consisted of 57 males and 38 females, were clinically and radiographically investigated. The mandibular third molars had no pericoronitis and periapical lesions, and showed an evidence of complete root formation. The obtained results were as follows: 1. In localiztion of the inferior alveolar canals in relation to the root apices of the mandibular third molars, the inferior alveolar canal was located at the buccal side of the root apices of mandibular third molar in 77.7%, below the root apices in 16.5%, and the lingual side of root apices in 5.8%. 2. The positions of the mandibular third molars according to the Winter's Classification were as follows; 36.9% in Class Ⅰ, 21.3% in Class Ⅱ, 14.7% in Class Ⅲ, 4.8% in Class Ⅳ, 1.9% in Class Ⅴ, 17.5% in Class Ⅵ, 2.9% in Class Ⅶ. In localization of the inferior alveolar canals in relation to the root apices of the mandibular third molars according to the Winter's Classification, 92.1 % of Class Ⅰ, 86.4% of Class Ⅱ, 80.0% of Class Ⅲ, and 100.0% of Class Ⅳ and Ⅴ were located at the buccal side. In Class Ⅵ, however, 33.3% was located at the buccal side, 44.5% below the root apices, and 22.2% at the lingual side. 3. The degree of impaction was revealed to be 53.4% in Degree Ⅰ, 36.9% in Degree Ⅱ, and 9.7% in Degree Ⅲ. In localization of the inferior alveolar canals in relation to the root apices of mandibular third molars according to degree of impaction, 98.2% of Degree Ⅰ was located at the buccal side. In Degree Ⅱ, 60.5% was located at the bucal side, 31.6% below the root apices, and 7.9% at the lingual side. In Degree Ⅲ, 30.0% was located at the buccal side, 40.0% below the root apices, and 30.0% at the lingual side.

• Journal of Korean Neurosurgical Society
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• v.64 no.5
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• pp.791-798
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• 2021

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

• Journal of the Korean Orthopaedic Association
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• v.55 no.6
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• pp.495-502
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• 2020

Purpose: The aim of this study was to assess the effectiveness of domestically developed volar locking plate which has the concept of double-tiered subchondral support (DSS) in maintaining the reduction after distal radial fracture surgery. Materials and Methods: From July 2017 to December 2018, 54 patients were assessed. Plain radiographs were obtained immediately after surgery and at the last follow-up, and the radiographic parameters were measured in those images: radial length, radial inclination, volar tilt, ulnar variance, and distal dorsal cortical distance. The patients were subdivided into their age, type of fracture, and the position of the plate to evaluate the influence of each factors on the reduction maintenance. Results: Distal dorsal cortical distance in radiographs after the surgery was 5.91 mm (standard deviation, ±1.95 mm) on average. Significant differences in the radial length (p=0.038) and ulnar variance (p=0.001) were observed between immediately after surgery and at the last follow-up. When the parameters were evaluated by dividing the patients into subgroups according to the three specific factors, the ulnar variance showed a significant increase at the last follow-up when the patients were included 65-years-old or older. AO/OTA type C3 fracture, and Soong classification grade 0 plate position (p=0.007, p=0.012, p=0.046, respectively). Conclusion: Using the domestically developed DSS-type volar locking plate, significant reduction after distal radial fracture surgery could be maintained successfully. On the other hand, further study will be needed to determine about the reduction loss of the lunate facet identified in special cases that deal with fractures in elderly patients, unstable AO/OTA type C3 distal radial fractures, and Soong classification grade 0 plate position.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.26-34
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• 1998

The management of acute acromioclavicular dislocations has usually followed the accepted principles of obtaining an anatomical reduction of the joint and maintaining it until soft tissue healing has occurred. So, the preferred treatment for acute acromioclavicular dislocation is controversial. We analysed operatively treated twenty-eight cases for acute acromioclavicular dislocation between February 1994 and January 1997 and reviewed postoperatively to evaluate the results of three different methods. We collected retrospectively the data via clinical history, associated injury, type of injury, radiographic review, Taft score, and final results. Follow up time averaged 14 months. (range, 12 to 21 ) In according to Rockwood's classification, ]7 cases were type Ⅲ, 1 case was type IV, and 10 cases were type V. Ten cases were treated with the modified Phemister method, ten cases with the modified Bosworth method and eight cases with the modified Weaver-Dunn method. ]n patients treated by modified Phemister method, the Taft score was 9.4 points and 8 cases achieved good or excellent results. In patients treated by modified Bosworth method, the Taft score was 9.8 points and 8 cases achieved good or excellent results. In patients treated by modified Weaver-Dunn method, the Taft score was 10.3 points and 7 cases achieved good or excellent results. The overall Taft score was 9.9 points and 23 cases achieved good or excellent results. There were four complications, such as calcification or metallic loosening or breakage of K-wire, but did not influence late results. In conclusions, there was no significant difference of results regarding the different three methods. However, our results indicated that the coracoclavicular ligament reconstruction by transfer of coracoacromial ligament produced better results.

• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.655-660
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• 2003

Purpose : The relationship between chest X-ray findings and respiratory indices, including the arterial-alveolar oxygen partial pressure ratio($a/APO_2$) and the ventilatory index(VI), indicators of the clinical respiratory status in neonates with respiratory distress syndrome(RDS), was examined in the present study. Methods : The records of 50 neonates, randomly chosen from 174 neonates treated with pulmonary surfactant(PS) in the Neonatal Intensive Care Unit of Kyunghee University Hospital from 1996 to 2000 were analyzed retrospectively. Chest radiographs taken at the time after birth were classified into four groups according to Bomsel's classification. The $a/APO_2$ and VI values were calculated and compared with the corresponding chest radiographs. Results : Among the 50 cases of RDS examined, three cases were classified into grade I(6%), eight cases into grade II(16%), 20 cases into grade III(40%), and 19 cases into grade IV(38%). The mean $a/APO_2$ of the cases classified into grades I or II was 0.32 and the mean $a/APO_2$ of those classified into grades III and IV was 0.18 and 0.09, respectively. The mean VI was 0.049 for the cases classified into grades I or II and 0.076 and 0.161 for those classified into grades III and IV, respectively. Conclusion : The severity of RDS according to chest X-ray findings correlate to the values of respiratory indices, $a/APO_2$ and VI.

• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.4
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• pp.679-684
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• 2007

Odontoma is the most common benign odontogenic tumors, and have been defined as mixed odontogenic tumor composed of epithelial and mesenchymal cells. Odontoma is believed to be hamartomatous rather than neoplastic in nature. The classification by WHO divides odontoma into 2 groups such as complex odontoma and compound odontoma. Compound odontoma comprises dental tissues, resembling the morphology of a tooth and has predilection for the anterior maxilla. In contrast, complex odontoma has unorganized mass, not resembling the normal tooth and has predilection for the posterior mandible. Odontoma is almost asymptomatic, so it is usually found on routine radiographic examination. Common presenting symptom is impacted or unerupted permanent teeth and retained primary teeth, but coexistent odontoma and congenital missing of permanent teeth is a very rare condition. The recommended treatment for an odontoma is conservative surgical excision, with care taken to remove the surrounding soft tissue. This report presents 2 patients with compound odontoma of the mandible who have congenital missing of the permanent teeth.

• Archives of Reconstructive Microsurgery
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• v.20 no.1
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• pp.43-50
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• 2011

Lunate revascularization with the vascularized bone grafts is a current concept in the treatment of Kienbo${\ddot{o}}$ck disease. The aim of this study is to present our experience and preliminary results of the treatment using the fourth extensor compartment artery (4 ECA) vascularized bone graft for Kienbo${\ddot{o}}$ck disease. Between May 2009 and June 2010, five patients (3 men and 2 women) with Kienbo${\ddot{o}}$ck disease were treated with 4 ECA vascularized bone grafts. The mean age was 32.8 years and mean follow-up time was 13 months. The patients were composed of two patients in stage II and three patients in stage IIIa according to Lichtman's classification. Modified Mayo wrist score including pain, grip strength, range of motion and functional status and radiographic parameters such as carpal height ratio and radioscaphoid angle were evaluated at a final follow-up. Pain was markedly diminished and modified Mayo wrist score was 82 at last follow up period. There were no or little changes in carpal height ratio and radioscaphoid angle. All patients showed satisfactory bony union and no further lunate collapse on follow-up radiographs. The 4 ECA vascularized bone graft is a reliable alternative procedures among revascularization procedures for treatment of Kienbo${\ddot{o}}$ck's disease. It is less invasive and has low risk of kinking of pedicle compared to the 4+5 ECA vascularized bone graft. However, long term follow-up and MRI evaluation at follow up period should be needed for the future.

• The korean journal of orthodontics
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• v.22 no.1
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• pp.109-121
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• 1992

Temporomandibular joint is a major structure to play an important role in the function & stability of the occlusion as well as the stomatognathic system. Therefore, the TMJ is the structure that requires the complete analysis for diagnosing and planning treatment of pathologic changes by TMJ dysfunction and malocclusion. So, in this study, to evaluate TMJ situation in Korean malocclusion, based on the previous accomplishments, students of the dental college of Won-Kwang Univ. are surveyed and selected in terms of Angle's classification of malocclusion, whose TMJ radiographs were taken in the centric occlusion and centric relation. In each maiocclusion groups, the mean and standard deviation of anterior, posterior and superior joint space of the right, left and both side in CO & CR are evaluated and also those of the fossa height and the articular eminence angle of the right, left and both sides are evaluated. The obtained results were as follows: 1. In the correlation coefficient between the malocclusion groups, no other items except the posterior joint space of the right side in CR between in class I and class III are significant. 2. In the correlation coefficient between the right and left side, the each joint space in class I malocclusion group and class II malocclusion group are significant. 3. In the change of each joint space during the transmit from CO to CR, there is a tendency of increasing anterior joint space and decreasing posterior, superior joint spaces in class I, II malocclusion and increasing superior joint space and decreasing anterior, posterior joint space in class III malocclusion, which is significant in the correlation coefficient, but not significant in the T-test. 4. In each malocclusion group, the correlation coefficient between the posterior joint space and the superior joint space in C.R is highly significant. 5. The fossa height of class II malocclusion group is lesser than that of class I or class III, which is not significant in T-test. 6. In the correlation coefficient between Rt. and Lt. side in the fossa height, it is not significant in class I and class III group, but significant in class II malocclusion group. 7. The articular eminence angle of class II malocclusion group is larger then that of class I or class III groups, which is fairly significant. 8. In the correlation coefficient between Rt. and Lt. side in the articular eminence angle, it is significant in each malocclusion group.

• Journal of Korean Neurosurgical Society
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• v.46 no.4
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• pp.322-327
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• 2009

Objective : Posterior lumbar interbody fusion (PLIF) is considered to have the best theoretical potential in promoting bony fusion of unstable vertebral segments by way of a load sharing effect of the anterior column. This study was undertaken to investigate the efficacy of PLIF with cages in chronic degenerative disc disease with Modic degeneration (changes of vertebral end plate). Methods : A total of 597 patients underwent a PLIF with threaded fusion cages (TFC) from 1993 to 2000. Three-hundred-fifty-one patients, who could be followed for more than 3 years, were enrolled in this study. Patients were grouped into 4 categories according to Modic classification (no degeneration : 259, type 1 : 26, type 2 : 55, type 3 : 11). Clinical and radiographic data were evaluated retrospectively. Results : The clinical success rate according to the Prolo's functional and economic outcome scale was 86% in patients without degeneration and 83% in patients with Modic degeneration. The clinical outcomes in each group were 88% in type 1, 84% in type 2, and 73% in type 3. The bony fusion rate was 97% in patients without degeneration and 83% in patients with Modic degeneration. The bony fusion rate in each group was 81% in type 1, 84% in type 2, and 55% in type 3. The clinical success and fusion rates were significantly lower in patients with type 3 degeneration. Conclusion : The PLIF with TFC has been found to be an effective procedure for lumbar spine fusion. But, the clinical outcome and bony fusion rates were significantly low in the patients with Modic type 3. The authors suggest that PLIF combined with pedicle screw fixation would be the better for them.