• Clinics in Shoulder and Elbow
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• v.20 no.3
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• pp.138-146
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• 2017

Background: Arthroscopic fixations for large and comminuted bony Bankart lesions are technically difficult. We developed an arthroscopic multiple pulled suture (MPS) technique to restore large and comminuted bony Bankart lesions. Methods: Ten patients (mean age, 49.8 years; range, 31-79 years) underwent bony Bankart repair using the illustrated MPS technique and were then followed for a mean of 27.3 months. A plain radiograph series and three-dimensional computed tomography scans were taken at the initial clinical evaluation and 3 months postoperatively. Outcome measurements included the American Shoulder and Elbow Surgeons (ASES) score, Rowe score, University of California at Los Angeles (UCLA) score, and subjective patient satisfaction, along with surgical complications. Results: Union of an osseous fragment with the glenoid rim was confirmed in all patients on a computed tomography scan 3 months after operation. The osseous fragment was restored to proper articular congruence and reduction. The affected shoulder was stable in nine of the 10 patients. One patient presented with a redislocation after a sports injury 3 years postoperatively. The ASES, Rowe, and UCLA scores improved at the final evaluation, and median patient satisfaction at the final follow-up was 9 of 10 points (range, 6-10 points). Conclusions: The arthroscopic MPS technique for bony Bankart lesions with large or comminuted osseous fragments was a relatively easy and safe method for stable fixation of the osseous fragment. Therefore, the arthroscopic MPS technique resulted in good restoration of stability with high patient satisfaction and low complication rates.

• The Korean Journal of Nuclear Medicine
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• v.24 no.1
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• pp.80-86
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• 1990

Fifty seven patients with differentiated thyroid carcinoma were performed radioactive iodine-131 whole body scans after administration of diagnostic dose $(2\sim10\;mCi)$ and therapeutic dose $(30\sim150\;mCi)$ within three months. We evaluated the state of radioactive iodine-131 uptakes in whole body scan to detect correct metastasis of thyroid carcinoma. The results are as follows: 1) In 20 of the 57 patients (35%), the therapeutic scan showed the additional uptakes that were not seen in the diagnostic scan. 2) In 9 (64.2%) of the 14 patients who had been received the thyroid ablation theraphy with I-131 previously, new additional lesions were found in the therapeutic scan but only 11 (25%) of the 32 patients who had not been received the thyroid ablation theraphy disclosed new uptake lesions (p < 0.01). 3) The additional uptake lesions of therapeutic scan were significantly more common in the bony metastatic foci (55.7%) than other areas (p < 0.01). In 11 (55%) of 20 patients, additional uptake regions were anterior neck areas (thyroid bed or regional lymph node). We conclude that diagnostic scan with $2\sim5$ mCi I-131 is inadequate in evaluating residual iodine avid tissues of patients with thyroid carcinoma. Also post-theraphy I-131 whole body scan would be important to evaluate the correct staging and prognosis of thyroid carcinoma, and to follow-up patients.

• Journal of Korean Medical Science
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• v.33 no.50
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• pp.299.1-299.13
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• 2018

Background: Sarcopenia is associated with a poor prognosis in patients with liver cirrhosis. However, it is not known whether the rate of skeletal muscle depletion is also associated with a poor prognosis. We investigated the prognostic impact of the rate of skeletal muscle depletion in patients with liver cirrhosis. Methods: We included retrospectively all patients with liver cirrhosis who underwent both multiple computed tomography scans and hepatic venous pressure gradient (HVPG) measurements. Results: A total of 131 patients with liver cirrhosis were enrolled. The mean age of the patients was 53.7 years and alcoholic liver disease was the most common cause (61.8%). Sixty-four patients (48.9%) were diagnosed with sarcopenia. The median changes in skeletal muscle area per year (${\Delta}SMA/y$) were -0.89%. During a median follow-up period of 46.2 months (range, 3.4-87.6), 45 patients (34.4%) died. In multivariate analyses, age, Child-Pugh score, HVPG, presence of sarcopenia and ${\Delta}SMA/y$ were independently associated with mortality. Cumulative mortality was significantly higher in patients with ${\Delta}SMA/y$ < -2.4% than those with ${\Delta}SMA/y{\geq}-2.4%$ (log-rank test, P < 0.001). Conclusion: Both the presence and rate of change of sarcopenia are independently associated with long-term mortality in patients with liver cirrhosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.2
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• pp.85-93
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• 2022

Objectives: The aim of this study was to compare morbidities and duration of surgery, as well as bone formation in alveolar defects reconstructed with symphysis bone combined with allograft and iliac crest bone graft in patients with cleft palate. Patients and Methods: This randomized clinical trial was performed with 22 patients with unilateral alveolar cleft with a follow-up period of 12 months. In 12 patients, alveolar defects were reconstructed with chin bone graft plus allograft (Group A), while for the other 10 patients, iliac bone crest was used as donor site (Group B). Duration of surgery as well as occurrence of morbidities and complications were recorded. In addition, cone-beam computed tomographic (CBCT) scans were performed before surgery and 12 months after surgical procedures in order to compare bone formation between the two groups. Results: Postoperative CBCT demonstrated a mean bone fill percentage of 76.9% of the alveolar defect in Group A, compared with 77.0% in Group B. Paresthesia in the lower lip or chin did not occur in any patients of Group A. The mean duration of the surgical process was significantly shorter for Group A (40 minutes vs 76 minutes, P<0.001). In addition, patients in Group A regained normal gait faster than patients in Group B (1 day vs 9.5 days). Conclusion: Mandibular symphysis bone graft in combination with allograft results in favorable outcomes in patients with unilateral alveolar clefts.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1289-1300
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• 2022

Background: The purpose of this study was to report the improvement of a patient with one-and-a-half syndrome, vertigo, and paresthesia caused by acute primary pontine hemorrhage (PPH) after a combination treatment of traditional Korean and Western medicine. Case report: A 51-year-old female with one-and-a-half syndrome, vertigo, and paresthesia after PPH was treated with Korean medicine, including herbal medication, acupuncture, and moxibustion, and Western medicine, including medication and rehabilitation therapy during hospitalization. Her progress was evaluated by checking for changes in symptoms with the extraocular muscle (EOM) function test, numeral rating scale (NRS), and follow-up brain computed tomography scans and magnetic resonance imaging (MRI). After 41 days of treatment, the EOM movement was improved, leaving limited abduction of the left eye. The NRS scores for vertigo and paresthesia decreased from 10 to 5 and from 10 to 3, respectively. Improvement was noted in hematoma in MRI, but a new ischemic lesion was also discovered. Conclusion: This case reports the clinical course of one-and-a-half syndrome and suggests that a combined therapy of traditional Korean and Western medicine can be useful for PPH patients with one-and-a-half syndrome, vertigo, and paresthesia. However, studies of larger populations are required.

• The korean journal of orthodontics
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• v.52 no.2
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• pp.123-130
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• 2022

Objective: To evaluate if a remote digital monitoring system added at the end of orthodontic treatment could positively influence the retention phase by reducing the occurrence of misfit of removable appliances, number of emergency appointments (EA), and orthodontic relapse. Methods: Twenty-seven patients who completed active orthodontic treatment were divided into the study and control groups. In addition to the standard chairside follow-up appointments at month 1 (T1), month 3 (T2), month 6 (T3), the study group patients were monitored using Dental Monitoring^® with monthly intra-oral scans. Occurrence of misfit of removable retainers, number of EAs, and intercanine width change were recorded for both groups. Differences in EAs and retainer fit were assessed using the chi-square test. Intra-group and inter-group differences in the intercanine width were assessed with Friedman test and Mann-Whitney U test, respectively (α = 0.05). Results: The study group showed a significantly lower occurrence of misfit of removable retainers (p = 0.027) compared to the control group. No significant inter- and intra-group difference was found in the EAs and intercanine width change at each time-point. Conclusions: Integrating remote monitoring systems, such as Dental Monitoring^®, to the retention phase of the orthodontic treatment may lower the occurrence of misfit of removable retainers. However, a small sample size and a short observation period limit the strength of this evidence. These preliminary results tentatively suggest that remote monitoring technologies may be beneficial, especially during the COVID-19 pandemic, when the regularity of in-office visits might be disrupted.

• Journal of Veterinary Clinics
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• v.40 no.3
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• pp.230-237
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• 2023

A 6-year-old intact male Cane Corso dog weighing 40 kg with a 2-month history of dysuria, dyschezia, anorexia, intermittent panting, and penile discharge presented to the Veterinary Medical Teaching Hospital of Jeju National University. Examination revealed a giant paraprostatic cyst (PPC) that occupied a large part of the abdomen and caused displacement of organs. Radiography, ultrasound, and computed tomography (CT) scans confirmed that the PPC had spread to the pelvic regions. Subtotal resection was performed, leaving two sites with PPC remnants. One site was the prostate gland, which communicated with, and adhered to, the PPC; the other site was the pelvic region, where the PPC had spread. The reason for leaving two remnants was that an anatomical approach for complete resection was difficult, and to avoid complications associated with prostatic urethra damage. Routine omentalization and castration were performed. Partial cystectomy was performed because of the presence of a diverticulum-like lesion in the ventral part of the urinary bladder. The patient's clinical symptoms, including dysuria, completely resolved, and voluntary urination was possible 1 day post-operatively. Histopathological examination revealed osseous metaplasia of the PPC. The patient was well-managed and had no post-operative complications or recurrence until day 180 of follow-up.

• Korean Journal of Radiology
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• v.24 no.9
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• pp.890-902
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• 2023

Objective: The clinical impact of artificial intelligence-based computer-aided detection (AI-CAD) beyond diagnostic accuracy remains uncertain. We aimed to investigate the influence of the clinical implementation of AI-CAD for chest radiograph (CR) interpretation in daily practice on the rate of referral for chest computed tomography (CT). Materials and Methods: AI-CAD was implemented in clinical practice at the Seoul National University Hospital. CRs obtained from patients who visited the pulmonology outpatient clinics before (January-December 2019) and after (January-December 2020) implementation were included in this study. After implementation, the referring pulmonologist requested CRs with or without AI-CAD analysis. We conducted multivariable logistic regression analyses to evaluate the associations between using AI-CAD and the following study outcomes: the rate of chest CT referral, defined as request and actual acquisition of chest CT within 30 days after CR acquisition, and the CT referral rates separately for subsequent positive and negative CT results. Multivariable analyses included various covariates such as patient age and sex, time of CR acquisition (before versus after AI-CAD implementation), referring pulmonologist, nature of the CR examination (baseline versus follow-up examination), and radiology reports presence at the time of the pulmonology visit. Results: A total of 28546 CRs from 14565 patients (mean age: 67 years; 7130 males) and 25888 CRs from 12929 patients (mean age: 67 years; 6435 males) before and after AI-CAD implementation were included. The use of AI-CAD was independently associated with increased chest CT referrals (odds ratio [OR], 1.33; P = 0.008) and referrals with subsequent negative chest CT results (OR, 1.46; P = 0.005). Meanwhile, referrals with positive chest CT results were not significantly associated with AI-CAD use (OR, 1.08; P = 0.647). Conclusion: The use of AI-CAD for CR interpretation in pulmonology outpatients was independently associated with an increased frequency of overall referrals for chest CT scans and referrals with subsequent negative results.

• The korean journal of orthodontics
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• v.54 no.2
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• pp.128-135
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• 2024

Objective: The number of three-piece maxillary osteotomies has increased over the years; however, the literature remains controversial. The objective of this study was to evaluate the skeletal stability of this surgical modality compared with that of one-piece maxillary osteotomy. Methods: This retrospective cohort study included 39 individuals who underwent Le Fort I maxillary osteotomies and were divided into two groups: group 1 (three pieces, n = 22) and group 2 (one piece, n = 17). Three cone-beam computed tomography scans from each patient (T1, pre-surgical; T2, post-surgical; and T3, follow-up) were used to evaluate the three-dimensional skeletal changes. Results: The differences within groups were statistically significant only for group 1 in terms of surgical changes (T2-T1) with a mean difference in the canine region of 3.09 mm and the posterior region of 3.08 mm. No significant differences in surgical stability were identified between or within the groups. The mean values of the differences between groups were 0.05 mm (posterior region) and -0.39 mm (canine region). Conclusions: Our findings suggest that one- and three-piece maxillary osteotomies result in similar post-surgical skeletal stability.

• Korean Journal of Radiology
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• v.20 no.5
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• pp.773-780
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• 2019

Objective: To assess segmental liver stiffness (LS) with MRI before and after endovascular intervention in patients with Budd-Chiari syndrome (BCS). Materials and Methods: Twenty-three patients (13 males and 10 females; mean age, 42.6 ± 12.6 years; age range, 31-56 years) with BCS as a primary liver disease were recruited for this study. Two consecutive magnetic resonance elastography (MRE) examinations were performed before the endovascular treatment. Fifteen patients who underwent endovascular intervention treatment also had follow-up MRE scans within three days after the procedure. LS was measured in three liver segments: the right posterior, right anterior, and left medial segments. Inter-reader and inter-exam repeatability were analyzed with intraclass correlation coefficients (ICCs) and Bland-Altman analysis. Segmental LS and clinical characteristics before and after the intervention were also compared. Results: Within three days of the endovascular intervention, all three segmental LS values decreased: LS of the right posterior segment = 7.23 ± 0.88 kPa (before) vs. 4.94 ± 0.84 kPa (after), LS of the right anterior segment = 7.30 ± 1.06 kPa (before) vs. 4.77 ± 0.85 kPa (after), and LS of the left medial segment = 7.22 ± 0.87 kPa (before) vs. 4.87 ± 0.72 kPa (after) (all p = 0.001). There was a significant correlation between LS changes and venous pressure gradient changes before and after treatments (r = 0.651, p = 0.009). The clinical manifestations of all 15 patients significantly improved after therapy. The MRE repeatability was excellent, with insignificant variations (inter-reader, ICC = 0.839-0.943: inter-examination, ICC = 0.765-0.869). Bland-Altman analysis confirmed excellent agreement (limits of agreement, 13.4-19.4%). Conclusion: Segmental LS measured by MRE is a promising repeatable quantitative biomarker for monitoring the treatment response to minimally invasive endovascular intervention in patients with BCS.