• Clinics in Shoulder and Elbow
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• v.3 no.1
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• pp.1-9
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• 2000

Purpose: To report the mid-term results of the inferior capsular shift procedure for the multidirectional instability, and to analyze whether the bilateral laxity, the generalized ligamentous laxity and the voluntary instability can influence upon the final outcome. Material and Method: We reviewed 95 patients with 96 shoulders treated by the inferior capsular shift procedure for multidirectional instability through an anterior approach. In total, 49 shoulders(51%) showed generalized ligamentous laxity, 56 shoulders(58%) bilateral laxity, and 65 shoulders(68%) voluntary subluxation. Mean follow-up was 27 months(11-60 months). Result: The final Rowe score was 75 points in patients who had had at least one of the bilateral laxity, generalized ligamentous laxity, or the voluntary subluxation and 84 points without any of these in each element. Seventy-five percent of the bilateral laxity and 87% of the unilateral instability continued to function well without any pain and instability postoperatively. Those with a voluntary(74%), those with an involuntary instability(83%), those with a generalized ligamentous laxity(73%) and without laxity(84%) could do well a daily living activity without instability Eighty-six percent who had had the voluntary instability was eliminated completely the voluntability. Eighty-four percent of the patients stated that they were subjectively satisfied with the status of their shoulder. Nine shoulders(9.4%) had recurrence of symptomatic and disabling instability and theses patients had had at least voluntary instability preoperatively. Seven patients(7.3%) suffered from the stiff shoulder after the inferior capsular shift procedure. Conclusion: The inferior capsular shift procedure in multidirectional instability provided satisfactory results both in objective and subjective terms. Nonetheless, a patient who has a bilateral laxity, a generalized ligamentous laxity or a voluntary instability could be expected less favorable results compared to those with neither of these. A careful selection of the inferior capsular shift procedure for the multidirectional instability is needed before surgery. But our results suggests that a voluntary instability is not always poor candidate for the inferior capsular shift procedure.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.178-186
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• 1999

Twenty-three patients with chronic shoulder pain beyond 6 months after the fracture of the greater tuberosity underwent arthroscopic treatment and were retrospectively assessed after an average of 29 months(range, 22 to 40 months). There were 18 men and 5 women with the average age of 39 years(range, 24 to 61 years). Fourteen were isolated fractures and nine were related to acute anterior instability episode. The average displacement of the fracture was 2.3mm(range, 0 to 4mm) on the anteroposterior view of the plane radiographs. At the time of arthroscopy, all patients had partial thickness rotator cuff tears in the articular surface. The cuff tears were located on the tuberosity fracture area and were an Ellman's grade I to n in depth. With the arthroscopic debridement or repair of the tear depending on the condition of the tear itself, as well as the subacromial decompression, the UCLA score revealed good to excellent results in 20 and fair in 3 patients. Nineteen of the patients had returned to the previous level of activities. The patient with a higher activity demand revealed a lower level of activity return(p=0.034). The partial thickness rotator cuff tear should be considered in patients with chronic shoulder pain after the minimally displaced fracture of the greater tuberosity, and arthroscopic debridement or repair is an appropriate procedure.

• Tuberculosis and Respiratory Diseases
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• v.73 no.2
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• pp.93-99
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• 2012

Background: Local adverse events associated with inhaled corticosteroid use, including dysphonia, pharyngitis and oral candidiasis, can affect adherence for treatment. 'Mouth rinsing method' has been used for reducing local adverse events, but it cannot ensure complete prevention. The goal of this pilot study was to identify whether the 'immediate diet method' can reduce local adverse events in a limited number of patients. Methods: The study was conducted in a total of 98 patients, who had been prescribed a medium-dose fluticasone propionate for the first time, from January to October in 2010. One training nurse had performed the education on how to use the inhaler, including the mouth rinsing method. And with follow-ups at one month intervals, any patient who experienced such adverse events were educated on the immediate diet method, having a meal within 5 minutes after using an inhaler and they were checked on any incurrence of adverse events with one month intervals for 2 months. Results: The mean age of patients was 65.9 years old. The local adverse events had incurred from 18.4% of the study subjects. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet method, 14 patients (77.8%) had shown symptomatic improvements. Three of 4 patients did not show any improvement, in spite of implementing the immediate diet method. The other 1 patient did not practice the immediate diet method properly. Conclusion: The immediate diet method may be useful in reducing the local adverse events, caused by the use of inhaled corticosteroid.

• Tuberculosis and Respiratory Diseases
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• v.65 no.4
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• pp.323-327
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• 2008

Systemic lupus erythematosus (SLE) is a multisystem disorder where the etiology is not clearly known. Symptomatic chronic interstitial pneumonitis is an uncommon manifestation, with a reported prevalence of 3~13%. Achalasia is rare disease that presents with failure in the relaxation of the esophagus sphincter. A 22-year-old woman was admitted to our hospital because of fever, cough and dyspnea. The patient had a history of pericardial effusion and Raynaud's phenomenon. The results of laboratory tests indicated the presence of lymphopenia and included positive antibody tests for antinuclear antibody and anti Sm antibody. A chest X-ray demonstrated the presence of peribronchial infiltration on both lung fields. A Chest CT image showed interlobar septal thickening, ground-glass opacity and a honeycomb appearance in both lung fields and esophageal dilatation with air fluid level. An esophagogram showed the presence of dilated esophagus ends that represented the non-relaxed lower esophageal sphincter. Manometry demonstrated incomplete sphincter relaxation. The case was diagnosed as systemic lupus erythematosus associated with interstitial pneumonia and achalasia.

• The Korean Journal of Nuclear Medicine
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• v.29 no.3
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• pp.319-327
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• 1995

$^{131}I$-metaiodobenzylguanidine(MIBG) has been used for the diagnosis and treatment of neural crest tumors. We report our experience with this agent in 8 patients[1 multiple endocrine neoplasia(MEN) type IIb; 2 malignant pheochromocytoma; 5 medullary thyroid carcinoma(MTC)]. The therapeutic procedure consisted of 30-200 mCi of $^{131}I-MIBG$ administered by slow I.V. infusion, given at 3-6 months intervals. Commutative activity ranged from 150 mCi to 410 mCi, in 1 to 4 courses. $^{131}I-MIBG$ therapy resulted in significant disease free interval in 1 malignant pheochromocytoma(no measurable lesion) after surgery; complete hormonal and tumoral response in 2 MTC(1 MEN IIb): stable disease in 1 recurred pheochromocytoma(MEN IIb): stable disease but symptomatic improvement in 1 MTC, progressive disease in 1 malignant pheochromocytoma and 2 MTC. The patients who showed progression appeared to have large inoperable tumors or postoperative remnant tumors.

• Journal of Korean Neurosurgical Society
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• v.48 no.6
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• pp.490-495
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• 2010

Objective : Bone cement augmentation procedures such as percutaneous vertebroplasty and balloon kyphoplasty have been shown to be effective treatment for acute or subacute osteoporotic vertebral compression fractures. The purpose of this study was to determine the efficacy of bone cement augmentation procedures for long standing osteoporotic vertebral compression fracture with late vertebral collapse and persistent back pain. Methods : Among 278 single level osteoporotic vertebral compression fractures that were treated by vertebral augmentation procedures at our institute, 18 consecutive patients were included in this study. Study inclusion was limited to initially, minimal compression fractures, but showing a poor prognosis due to late vertebral collapse, intravertebral vacuum clefts and continuous back pain despite conservative treatment for more than one year. The subjects included three men and 15 women. The mean age was 70.7 with a range from 64 to 85 years of age. After postural reduction for two days, bone cement augmentation procedures following intraoperative pressure reduction were performed. Imaging and clinical findings, including the level of the vertebra involved, vertebral height restoration, injected cement volume, local kyphosis, clinical outcome and complications were analyzed. Results : The mean follow-up period after bone cement augmentation procedures was 14.3 months (range 12-27 months). The mean injected cement volume was 4.1 mL (range 2.4-5.9 mL). The unipedicular approach was possible in 15 patients. The mean pain score (visual analogue scale) prior to surgery was 7.1, which decreased to 3.1 at 7 days after the procedure. The pain relief was maintained at the final follow up. The kyphotic angle improved significantly from $21.2{\pm}4.9^{\circ}$ before surgery to $10.4{\pm}3.8^{\circ}$ after surgery. The fraction of vertebral height increased from 30% to 60% after bone cement augmentation, and the restored vertebral height was maintained at the final follow up. There were no serious complications related to cement leakage. Conclusion : In the management of even long-standing osteoporotic vertebral compression fracture for over one year, bone cement augmentation procedures following postural reduction were considered safe and effective treatment in cases of non-healing evidence.

• Journal of Korean Medical classics
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• v.25 no.1
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• pp.89-115
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• 2012

Objective : Blood disease is common these days due to modern man's excessiveness in Yang heat (陽熱) and vulnerability of the Eum blood(陰血). This exposes them to warmheat/ dampness-heat diseases, where pathogenic heat easily penetrates the blood dimension(血分) creating stagnated blood(瘀血). Consequently, pathogenic symptoms in the collateral vessels increase, making it crucial to understand the pathogenic mechanism of the disease. Method : This paper examines the condition and region of the collateral vessel diseases(CVD) according to the blood diseases of Onbyeong, by analyzing each prescription's matching symptom. The disease in question in this paper is 'stagnated blood fixated in the collateral vessels'. Therefore diseases with stagnated blood in the Yang collaterals and Viscera collaterals or viscera themselves from the chapter of "On-Yeok-Ron(溫疫論)", and < Dry Blood-DaeWhangJaChungWhan(大黃蟅蟲丸) > chapter of "Geum-Gue-Yo-Rak(金匱要略)", were examined respectively. Result & Conclusion : The process of CVD according to the blood diseases of Onbyeong can be summarized as follows. First, bleeding in the Yang and Bowel collaterals, then stagnation in the Yang and Bowel collaterals, and finally stagnation in the viscera collaterals or Liver itself. The refractory nature of blood stagnation symptoms of the collateral vessels is mainly due to the characteristics of the collateral vessel itself. In structure, they are very narrow and small, situated at the most terminal part of the body where it is difficult for the Jeong Gi(精氣) to reach. Also, as they are symptomatic of degeneration of Jeong Gi, the root of the disease is very deep. Therefore to resolve blood stagnation in the cases of Ju-Gaek-Gyo and Dry Blood, general approaches using 'Gi communication(行氣)' or 'Blood vitalizing(活血)' medicinals will not suffice. Special medicinals such as crustacean and insects need to be appropriately applied.

• Korean Journal of Cleft Lip And Palate
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• v.12 no.1
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• pp.1-6
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• 2009

Oronasal fistula are a well-known complication of surgical treatment of cleft palate, occurring most frequently in the alveolus and hard palate. Previous reports have demonstrated that oronasal fistulas, particularly if greater than l cm in diameter, had an adverse effect on speech. The aim of this study was to demonstrate the relationship between the size of the fistula and the influence on velopharyngeal function. The site and size of the fistula were indicated on graph paper with calipers and measured in $mm^2$. Speech assessment was carried out using a Nasometer, VPI articulation differential test, spectrography. Patient whose fistulas affected their speech had significantly larger fistulas than those whose fistulas did not. The study shows that the larger the fistula, the greater the risk of hypernasality and nasal emission, but even small fistulas can cause speech problems. If obstruction of the nasal passage is eliminated in a patient with a previously asymptomatic fistula, it may result in a fistula becoming symptomatic, resulting in hypernasality and nasal emission. In conclusion, even small fistulas can influence speech production and should be considered before any treatment is planned. The study lends support to early closure of oronasal fistulas, particularly before pharyngeal flap surgery is contemplated.

• The Journal of Korean Medicine
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• v.17 no.1 s.31
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• pp.171-189
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• 1996

Background and Purpose: The greater part of patients to visit Hospital of Oriental Medicine suffer from cerebrovascular accident(CVA). There is transcranial Doppler(TCD) in the diagnostic method to confirm cerebrovascular accident(CVA). Transcranial Doppler(TCD) is an accurate method of monitoring the blood flow velocities of the cerebral vessels and have been generally used to prevent symptomatic vasospasm and confirm cerebral infarction. So we studied, in the crebrovascular accident(CVA), to estimate whether transcranial Doppler(TCD) is useful to. Methods: Using transcranial doppler(Multigon Model 500M Transcranial Doppler System), we measured the mean and peak velocity and the direction of blood flow in 10 cerebrovascular accident(CVA)'s subjects who had been examined by Computed Tomography(CT) or Magnetic Resonance Imaging (MRI). Results : As an anticipation, in cerebrovascular accident(CVA)'s subject with Cb-infarction, the mean and peak velocity of blood flow fell down remarkably and the direction of blood flow was change or irritable. But didn't find out any signal in lacunar infarction. Also, in case with spontaneous hemorrhage, the velocity and direction of blood flow was change but this signal was short of diagnosis for Cb-hemorrhage. Besides, we found signals about embolism, stenosis, thrombosis and occlusion in cerebrovascular accident(CVA)'s subjects. Conclusion: In Cb-infarction, the result of TCD was equal to diagnosis with Computed Tomography(CT) or Magnetic Resonance Imaging (MRI). But about lacunar infarction or spontaneous hemorrhage, signals of TCD couldn't be found out or was insufficient more than Computed Tomography(CT) or Magnetic Resonance Imaging(MRI). In cerebrovascular accident(CVA)'s subject with embolism, stenosis, thrombosis or occlusion, signals of TCD were found out more than Computed Tomography(CT) or Magnetic Resonance Imaging(MRI). Therefore transcranial doppler(TCD) is necessary method which makes a diagnosis of cerebrovascular accident(CVA), with Computed Tomography(CT) or Magnetic Resonance Imaging(MRI).

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.1 no.2
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• pp.86-90
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• 2008

Purpose: To evaluate the differences between blindly and ultrasonography (US)-guided during multiple needling and dextrose injection technique for calcific tendinitis of shoulder. Materials and Methods: We chose 36 symptomatic calcific tendinitis patients, whose age ranged from 27 to 69. Our procedures were multiple needling and injection of dextrose over the lesion of calcific deposits. The bind injection group were 19 patients whose age ranged from 27 to 64-year-old (mean 52.2), and the US-guided injection group were 17 patients ranged from 31 to 69-year-old (mean 49.0). We compare these groups by VAS (visual analogue scale) and range of motion before and after procedures. Results: There is no difference between two groups in VAS and ROM before procedure (p>0.05). Two groups revealed significant improvement without limitation of shoulder function, however, the group under US-guided revealed better results than under blind (VAS:p=0.001, Flexion:p=0.000, Abduction:p=0.000, External rotation: p=0.016). Conclusion: Ultrasonography-guided procedure showed better results than blind, so the use of ultrasonography is more promising procedure.