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Risk Factor for Poor Clinical Outcome in Patients with Retear after Repair of the Rotator Cuff (회전근 개 파열 봉합술 후 재파열 환자에서 불량한 임상 결과의 원인 인자)

  • Lee, Hee Jae;Joo, Il Han;Hur, Jeong Min;Oh, Hyun Keun;Lee, Bong Gun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.61-67
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    • 2021
  • Purpose: To evaluate the prognostic factors affecting poor functional outcomes in patients with retear after rotator cuff repair. Materials and Methods: From January 2013 to December 2018, among 631 patients who underwent arthroscopic repair of a rotator cuff tear, 42 patients, who could be followed-up for more than one year and showed a retear of the repaired cuff on magnetic resonance imaging (MRI), were collected retrospectively. The preoperative demographic data, range of motion, American Shoulder and Elbow Surgeons (ASES) score, fatty degeneration, and tear progression on postoperative MRI, as well as other factors that could affect the clinical outcomes, were analyzed. Patients who scored <80 points on the ASES score were allocated to the poor function group. The risk factors for poor clinical outcomes were compared with the group with ASES scores of 80 or above. Results: The postoperative functional results in the group with retear (n=42) after arthroscopic rotator cuff repair showed significant improvement. Univariate analysis revealed the preoperative visual analogue scale (VAS) score and tear progression to have associations with a poor shoulder function. In addition, subscapularis repair was found to be associated with a good shoulder function. The preoperative VAS score and tear progression except for subscapularis repair were independent factors associated with poor clinical outcomes according to multivariate logistic regression analysis. Conclusion: In patients with retear after rotator cuff repair, the preoperative VAS and tear progression in postoperative MRI are factors predicting a poor functional outcome.

Clinical Outcomes of Ultrasound-Guided Transmeniscal Injection in Medial Compartment Knee Osteoarthritis (무릎 내측 구획 골관절염에서 초음파 유도하 경 반월상 연골 주사의 임상적 효과)

  • Jung, Eui Yub;Wang, Joon Ho;Lee, Eui-Sub;Lee, Sung-Sahn;So, Sang-Yeon
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.418-425
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    • 2020
  • Purpose: The purpose of this study was to introduce the ultrasound-guided transmeniscal injection in medial compartment knee osteoarthritis and analyze the clinical outcomes. Materials and Methods: The electronic medical records of 36 patients with medial compartment knee osteoarthritis who were treated with an ultrasound-guided transmeniscal injection from March 2019 to July 2019 were accessed for this retrospective review. Using an ultrasound guided spinal needle, the patients received an intra-articular steroid injection at the medial compartment of the knee. A physical examination was conducted at the initial visit (pre-injection), and at one week, four weeks, and eight weeks after the injection. The numeric pain rating scale (NRS), Lequesne index, and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score were measured at each visit and analyzed over time. The percentage change of the patients who revealed substantial improvement was analyzed. The NRS, Lequesne index, and percentage of patients, who revealed substantial improvement over time classified by osteoarthritis grade, were analyzed. Results: The NRS and Lequesne index decreased at one week, four weeks, and eight weeks after the injection compared to the initial baseline, and the pain-relief effect continued without change until eight weeks. The percentage of patients who showed substantial improvement at one, four, and eight weeks was 50.0%, 47.2%, and 52.8%, respectively. The WOMAC scores decreased at one, four, and eight weeks compared to the initial baseline, and the decrease was continued without any difference until eight weeks. The percentage of patients with osteoarthritis stage 1 or 2 who revealed more than substantial improvement was significantly higher at one, four, and eight weeks than those with osteoarthritis stages 3 or 4 (p<0.05). Conclusion: In patients with medial compartment knee osteoarthritis, the pain reduction and functional improvement persisted for at least eight weeks after the ultrasound-guided transmeniscal injection at the medial compartment. In particular, patients with medial compartment osteoarthritis stage 1 or 2 showed more effective pain reduction.

Arthroscopic Full-Thickness Rotator Cuff Repair in Elderly Patients (고령 환자의 관절경적 회전근 개 봉합술의 결과)

  • Cheon, Sang Jin;Lee, Dong Ho;Park, Yong Geon;Son, Seung Min
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.38-45
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    • 2020
  • Purpose: To examine the clinical and structural outcomes of an at least two-year follow-up of arthroscopic full-thickness rotator cuff repairs with a single-row or suture-bridge technique in patients more than 65 years of age. Materials and Methods: Patients diagnosed with a full-thickness rotator cuff tear who were more than 65 years of age, underwent arthroscopic rotator cuff repair after at least six months of conservative treatment, agreed to take a follow-up magnetic resonance imaging (MRI) six months postoperatively, and visited outpatient for at least two years were enrolled in this study. Clinical evaluations were done using The University of California Los Angeles score, Constant Shoulder Score, and visual analogue scale evaluated two years after the surgery. The structural integrity was analyzed using follow-up MRI. During surgery, a suture-bridge technique was used if the rotator cuff tendon could cover half of the footprint under constant tension. Otherwise, single-row repair was performed. Results: The samples were 158 cases, consisting of 93 single-repairs and 65 suture-bridge repairs. A preoperative comparison of the age distribution, fatty degeneration of supraspinatus and infraspinatus muscle, medial retraction of torn cuff tendon, and tear size between the two groups were not significant. The clinical scores were improved significantly in all cases. The distribution of the structural integrity by Sugaya classification were 49 cases in type 1 (31.0%), 62 cases in type 2 (39.2%), 30 cases in type 3 (19.0%), 11 cases in type 4 (7.0%), and six cases in type 5 (3.8%). The re-tear rate of the single-row group was 9.7% (nine out of 93 cases) and 12.3% (eight out of 65 cases) for the suture-bridge group. Conclusion: Satisfactory clinical and radiological outcomes were achieved after arthroscopic full-thickness rotator cuff repair in patients more than 65 years of age. Both single-row and suture-bridge techniques would be beneficial for the elderly.

Results of Surgical Treatment of Patella Dislocation (슬개골 탈구의 수술적 치료 결과)

  • Kim, Hui Taek;Cho, Yoon Jae
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.134-141
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    • 2021
  • Purpose: Patellar dislocations have a range of causes. This study examined the results of treatment aimed at balancing soft tissues around the patella. Materials and Methods: Thirty-two patellar dislocations in 28 patients (21 females and seven males) were examined. The mean patient age at the time of surgery was 11.5 years, and the mean follow-up period was 4.6 years. Dislocations were 19 chronic, six habitual, six congenital, and one acute. Soft tissue balancing surgery included lateral capsular release, medial capsular plication, and inferolateral transfer of the vastus medialis obliquus. Medial transfer of the patellar tendon, partial strip of the rectus femoris and patella tendon, and distal femoral osteotomy were also performed selectively. The preoperative Q angle, femoral anteversion angle, tibial external rotation angle, tibial tubercle-trochlear groove distance (TT-TG distance), mechanical femoral-tibial angle, and femoral trochlear dysplasia according to Dejour were measured, and the pre- and postoperative Lysholm-Tegner scores were used to analyze the clinical results. Results: The mean preoperative Q angle, TT-TG distance, femoral anteversion angle, tibial external rotation angle, mechanical femoraltibia angle, and Lysholm-Tegner score were 9.3°, 15.5 mm, 25.6°, 30.4°, 3.0°, and 75.8, respectively. Eleven patients had systemic ligament laxity with a Beighton score of five or more. Twenty-two patients had femoral trochlear dysplasia: four type A (3 patients), 16 type B (15 patients), one type C (1 patient), and four type D (3 patients). Of the 32 cases, 28 were corrected successfully by the first operation. Of four cases of postoperative subluxation, three were corrected by the second operation, and one of them was corrected after a third operation. The last patient is currently being followed-up. The mean Lysholm-Tegner score improved to 85.6 after the operation. Conclusion: Correcting all the causes of patella dislocation simultaneously is difficult. Nevertheless, satisfactory outcomes were obtained with soft tissue balancing surgery around the patella and a corrective osteotomy for an abnormal mechanical axis of the femur-tibia and torsion.

Molecular and Phenotypic Characteristics of Patients with Pseudohypoparathyroidism: Single Center's Experience (가성부갑상선기능저하증 환자의 분자유전학적 및 임상적 특징: 단일기관의 경험)

  • Kim, Min-ji;Yoon, Ju Young;Yoo, Sukdong;Lee, Jun;Cheon, Chong Kun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.21 no.1
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    • pp.7-14
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    • 2021
  • Purpose: Pseudohypoparathyroidism (PHP) is caused by genetic and epigenetic alteration in the GNAS locus, and characterized by the resistance to multiple hormones and the Albright's hereditary osteodystrophy (AHO) phenotype. This study investigated the phenotypic characteristics and molecular features of PHP. Methods: Eight patients who diagnosed as PHP were enrolled at Pusan National University Children's hospital and clinical features, biochemical and genetic findings were retrospectively reviewed. Results: Of a total of 8 patients, 5 were diagnosed with PHP1a, and 3 were diagnosed with PHP1b. Patients with PHP1a had three different mutations in the GNAS gene, and patients with PHPIb had imprinting defect in differentially methylated regions (DMRs) of the GNAS locus. Two novel GNAS variants were identified in patients with PHP1a, including c.313-2A>T and c.1094G>A. All patients with PHP1a displayed AHO features; short stature (80%), brachydactyly (80%), a round face (80%), obesity (40%), heterotopic ossification (60%), and intellectual disability (60%), whereas only one patient (33.3%) with PHP1b showed AHO feature such as a round face. When phenotypic features between PHP1a and PHP1b patients were compared, patients with PHP1b showed a tendency of higher current height standard deviation scores (SDS) compared to patients with PHP1a, (-3.2±2.1 vs.-1.1±0.8; P=0.06) Conclusions: This study summarizes the phenotypic and genetic features of the PHP patients. Although we found considerable clinical overlap between PHP1a and PHP1b, further long-term follow-up is needed to evaluate the growth and development of children with PHP, as well as the effects of end-organ resistances to endocrine hormones.

Research on the Importance-Satisfaction Perception of Users of Private-Initiated Park Development Project - Focused on Jikdong Neighborhood Parks in Uijeongbu City - (민간공원 특례사업 추진 대상지 이용객의 중요도-만족도 인식에 관한 연구 - 의정부 직동근린공원을 대상으로 -)

  • Kim, Jong-Ho;Kim, Gun-Woo
    • Journal of the Korean Institute of Landscape Architecture
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    • v.50 no.4
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    • pp.63-76
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    • 2022
  • This study was conducted to compare the perceptions of the park use status, importance, and satisfaction of users in the first implemented and completed Uijeongbu Jikdong Neighborhood Park among the private park special projects carried out as a countermeasure for long-term non-execution of urban parks. To this end, in the initiated project, apartment residents and non-residents were classified according to the promotion plan, and a questionnaire research on importance and satisfaction was conducted to analyze the park use status and IPA(importance-performance analysis). First, as a result of the analysis of the current situation in terms of locational characteristics that occur during the promotion of special projects for private parks, unlike the mountainous areas, the targeted site was close to flat land, indicating that users' satisfaction with the landscape was high. Second, the access of the apartment residents in the initiated project site was easy. Thus, the use rate of residents was relatively higher than that of the non-residents. Third, differences in perception by item were identified through the analysis of IPA and the establishment of strategies. In quadrant I, among the facilities and services, installing restrooms was the priority for residents, and parking facilities and rest facilities were the priority than installing restrooms for non-residents. In quadrant II, overall scores for residents and non-residents were similar, but the distance to the park was in quadrant III due to the low level of satisfaction among non-residents. In this study, the difference in perception between residents and non-residents may cause problems in access and facilities in managing the park in the future. Therefore, it would be necessary to find a way to improve it by establishing a management strategy that takes into account the difference in the perception of residents after construction. In addition, through the results of this study, it was judged that the purpose of park development, the selection of types of parks, and the selection of plans and management indicators for each kind would be significant in the promotion of initiated projects in the planning of park development.

Comparison of ESG Evaluation Methods: Focusing on the K-ESG Guideline (ESG 평가방법 비교: K-ESG 가이드라인을 중심으로)

  • Chanhi Cho;Hyoung-Yong Lee
    • Journal of Intelligence and Information Systems
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    • v.29 no.1
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    • pp.1-25
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    • 2023
  • ESG management is becoming a necessity of the times, but there are about 600 ESG evaluation indicators worldwide, causing confusion in the market as different ESG ratings were assigned to individual companies according to evaluation agencies. In addition, since the method of applying ESG was not disclosed, there were not many ways for companies that wanted to introduce ESG management to get help. Accordingly, the Ministry of Trade, Industry and Energy announced the K-ESG guideline jointly with the ministries. In previous studies, there were few studies on the comparison of evaluation grades by ESG evaluation company or the application of evaluation diagnostic items. Therefore, in this study, the ease of application and improvement of the K-ESG guideline was attempted by applying the K-ESG guideline to companies that already have ESG ratings. The position of the K-ESG guideline is also confirmed by comparing the scores calculated through the K-ESG guideline for companies that have ESG ratings from global ESG evaluation agencies and domestic ESG evaluation agencies. As a result of the analysis, first, the K-ESG guideline provide clear and detailed standards for individual companies to set their own ESG goals and set the direction of ESG practice. Second, the K-ESG guideline is suitable for domestic and global ESG evaluation standards as it has 61 diagnostic items and 12 additional diagnostic items covering the evaluation indicators of global representative ESG evaluation agencies and KCGS in Korea. Third, the ESG rating of the K-ESG guideline was higher than that of a global ESG rating company and lower than or similar to that of a domestic ESG rating company. Fourth, the ease of application of the K-ESG guideline is judged to be high. Fifth, the point to be improved in the K-ESG guideline is that the government needs to compile industry average statistics on diagnostic items in the K-ESG environment area and publish them on the government's ESG-only site. In addition, the applied weights of E, S, and G by industry should be determined and disclosed. This study will help ESG evaluation agencies, corporate management, and ESG managers interested in ESG management in establishing ESG management strategies and contributing to providing improvements to be referenced when revising the K-ESG guideline in the future.

Association between sleep duration, sleep quality, time use and dietary quality of high school students in Chungnam (충남지역 일부 고등학생의 수면 시간과 질, 생활시간 사용 및 식사의 질과의 관련성)

  • Ji-Eun Shin;Mi-Kyeong Choi
    • Journal of Nutrition and Health
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    • v.55 no.6
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    • pp.656-669
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    • 2022
  • Purpose: This study investigates the relationship between sleep duration, sleep quality, time use, and dietary quality of adolescents. Methods: A cross-sectional study was conducted, enrolling 423 high school students (112 male and 311 female students) in Chungnam using a questionnaire comprising general characteristics, sleep status, use of time, and Nutrition Quotient for Korean Adolescents (NQ-A). Results: On weekdays, male students reported getting 6.6 hours of sleep, which was significantly higher than the 5.8 hours reported by female students. The sleep quality score between male and female students was not significantly different on weekdays and weekends. Comparing the students categorized as getting 6 hours of sleep duration on weekdays and 8 hours on weekends, a significantly higher total NQ-A score was obtained for the long sleep duration group of female students on weekdays. In male students who reported increased screen time on weekdays and study time on weekends, there was a greater frequency of short sleep duration. Our data also revealed that the longer the sleep duration higher the NQ-A score. In addition, higher NQ-A scores were determined with shorter screen time and more prolonged exercise time. Conclusion: Our results suggest that intense study time and excessive use of smartphones have a negative effect on sleep in high school students. In addition, poor sleep quality and lack of sleep are likely to affect eating habits and nutritional status. Therefore, there is a need to provide nutritional education to adolescents imparting knowledge that associates desirable sleep habits and the correct use of time.

A Study on the Principle of Making-Music of the Chaegut ("Stroke Music") in Farmers' Band Music (풍물굿 채굿 가락의 형성원리에 관한 연구)

  • Lee, Yong-Shik
    • (The) Research of the performance art and culture
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    • no.39
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    • pp.669-700
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    • 2019
  • Farmers' band music is a religious ritual in Korea. It is a solemn ritual to exhibit the auspicious holiness of the people to the God. Most of the ritual is accomplished by music. The music of the farmers 'band, in this sense, has its meaning as the expression of holiness by sound. In this paper, I will explore the principle to make various rhythms of farmers' band music, especially focusing on the chaegut (lit. "stroke music"). It is very symbolic because the name of the music shows the strokes of the gong, called jing, in a rhythmic phrase. In this sense, the chaegut is man-made music based on the specific principles in accordance with the strokes of the gong. Among many chaegut rhythms, samchae (lit. "three strokes") to chilchae (lit. "seven strokes") are the main rhythms. They were made after the principle of 'forward with drums, backward with gongs' in Five way procession. It the basic principle of military procession from the early Joseon Dynasty. The procession follows with the sound of the drums and gongs. There was always a principle of "five strokes" to control the procession. The "five strokes" became the basis of the making of chaegut rhythms. The rhythms of the samchae to chilchae are based on the rhythm of samchae. The samchae has three gong strokes in a cycle, which exhibits the chaotic moment with the rhythmic noise. The name of the rhythm exhibits the correspondence of the signifiant, that is the name "three strokes" and the signifié, that is the real three strokes of gongs in music. Other four rhythms has made up from the samchae with half cycles are added in accordance with the strokes of the gongs. In this way, the chaegut shows the principle of "five strokes" in the military procession. The rhythm of ochae jilgut is a mixture of ochae (lit. "five strokes") and jilgut (lit. "road music") which is usually performed on the road to a mountain shrine. The musical structure of ochae jilgut corresponds to the colotomic structure of Southeast Asian music and the 15th-century music of old musical scores. The rhythm of gilgunak chilchae is a mixture of gilgunak (lit. "road military music") and chilchae (lit. "seven strokes"). The rhythmic structure is similar to other regional music, sijo ("short song") of the literati music and norae garak (lit. "some melody") of the shaman music. In sum, the chaegut is very artistic music made from the military procession of the Joseon Dynasty. The name of the rhythm corresponds with the strokes of the gong in a cycle. In this way, the chaegut shows the principle of music-making to exhibit the ritual characteristics of the Korean people.

Export Prediction Using Separated Learning Method and Recommendation of Potential Export Countries (분리학습 모델을 이용한 수출액 예측 및 수출 유망국가 추천)

  • Jang, Yeongjin;Won, Jongkwan;Lee, Chaerok
    • Journal of Intelligence and Information Systems
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    • v.28 no.1
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    • pp.69-88
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    • 2022
  • One of the characteristics of South Korea's economic structure is that it is highly dependent on exports. Thus, many businesses are closely related to the global economy and diplomatic situation. In addition, small and medium-sized enterprises(SMEs) specialized in exporting are struggling due to the spread of COVID-19. Therefore, this study aimed to develop a model to forecast exports for next year to support SMEs' export strategy and decision making. Also, this study proposed a strategy to recommend promising export countries of each item based on the forecasting model. We analyzed important variables used in previous studies such as country-specific, item-specific, and macro-economic variables and collected those variables to train our prediction model. Next, through the exploratory data analysis(EDA) it was found that exports, which is a target variable, have a highly skewed distribution. To deal with this issue and improve predictive performance, we suggest a separated learning method. In a separated learning method, the whole dataset is divided into homogeneous subgroups and a prediction algorithm is applied to each group. Thus, characteristics of each group can be more precisely trained using different input variables and algorithms. In this study, we divided the dataset into five subgroups based on the exports to decrease skewness of the target variable. After the separation, we found that each group has different characteristics in countries and goods. For example, In Group 1, most of the exporting countries are developing countries and the majority of exporting goods are low value products such as glass and prints. On the other hand, major exporting countries of South Korea such as China, USA, and Vietnam are included in Group 4 and Group 5 and most exporting goods in these groups are high value products. Then we used LightGBM(LGBM) and Exponential Moving Average(EMA) for prediction. Considering the characteristics of each group, models were built using LGBM for Group 1 to 4 and EMA for Group 5. To evaluate the performance of the model, we compare different model structures and algorithms. As a result, it was found that the separated learning model had best performance compared to other models. After the model was built, we also provided variable importance of each group using SHAP-value to add explainability of our model. Based on the prediction model, we proposed a second-stage recommendation strategy for potential export countries. In the first phase, BCG matrix was used to find Star and Question Mark markets that are expected to grow rapidly. In the second phase, we calculated scores for each country and recommendations were made according to ranking. Using this recommendation framework, potential export countries were selected and information about those countries for each item was presented. There are several implications of this study. First of all, most of the preceding studies have conducted research on the specific situation or country. However, this study use various variables and develops a machine learning model for a wide range of countries and items. Second, as to our knowledge, it is the first attempt to adopt a separated learning method for exports prediction. By separating the dataset into 5 homogeneous subgroups, we could enhance the predictive performance of the model. Also, more detailed explanation of models by group is provided using SHAP values. Lastly, this study has several practical implications. There are some platforms which serve trade information including KOTRA, but most of them are based on past data. Therefore, it is not easy for companies to predict future trends. By utilizing the model and recommendation strategy in this research, trade related services in each platform can be improved so that companies including SMEs can fully utilize the service when making strategies and decisions for exports.