• Hip & pelvis
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• v.36 no.1
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• pp.26-36
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• 2024

Total hip arthroplasty (THA) is a frequently performed procedure; the objective is restoration of native hip biomechanics and achieving functional range of motion (ROM) through precise positioning of the prosthetic components. Advanced three-dimensional (3D) imaging and computed tomography (CT)-based navigation are valuable tools in both the preoperative planning and intraoperative execution. The aim of this study is to provide a thorough overview on the applications of CT scans in both the preoperative and intraoperative settings of primary THA. Preoperative planning using CT-based 3D imaging enables greater accuracy in prediction of implant sizes, leading to enhancement of surgical workflow with optimization of implant inventory. Surgeons can perform a more thorough assessment of posterior and anterior acetabular wall coverage, acetabular osteophytes, anatomical landmarks, and thus achieve more functional implant positioning. Intraoperative CT-based navigation can facilitate precise execution of the preoperative plan, to attain optimal positioning of the prosthetic components to avoid impingement. Medial reaming can be minimized preserving native bone stock, which can enable restoration of femoral, acetabular, and combined offsets. In addition, it is associated with greater accuracy in leg length adjustment, a critical factor in patients' postoperative satisfaction. Despite the higher costs and radiation exposure, which currently limits its widespread adoption, it offers many benefits, and the increasing interest in robotic surgery has facilitated its integration into routine practice. Conducting additional research on ultra-low-dose CT scans and examining the potential for translation of 3D imaging into improved clinical outcomes will be necessary to warrant its expanded application.

• Korean Journal of Occupational Health Nursing
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• v.11 no.2
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• pp.121-131
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• 2002

Objective: The purpose of this study was to determine the physical load by identifying harmfully working postures and to develop recommendations for improving the existing situation with nurses in ICU, thereby to provide the basis for development of work-related musculoskeletal preventive program. Method: Various types of tasks were recorded with a video camera to chart and analyze different postures by OWAS(Ovako Working Posture Analysing System). Collected data showed that poor postures were adopted, not only for lifting or repositoning a patient, but also for other tasks. Data Analysis: The performed activities were then divided into Nursing Intervention Classification. Altogether 128 postures were selected for analysis. Then they were classified into different OAC (OWAS Action Categories). From all the observation, unhealthy postures, for which corrective measures had to be considered immediately (i.e., 75% classified as OACII+III+IV) were found. Collected data were analyzed in terms of percentage, 2-tail Mann-Whitney U test. Result: Poor postures mainly occur during 'positioning the patient' and 'airway suctioning' in NIC. No difference was found (p=0.060) between the percentage of harmful posture adopted during the patient handling tasks and non-patient handling tasks. Conclusion: This study shows, that in the nursing profession with ICU not only occur during patient handling, but also during other activities. The OWAS method was useful in determining the physical load by locating potential activities due to harmfully working postures, providing a detailed description with analysis, and suggesting successful means to reduce postural load.

• Journal of radiological science and technology
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• v.34 no.3
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• pp.189-193
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• 2011

Sitting position upper extremity X-ray examinations (SUEX) is the most widely used patient positioning method for upper extremity X-ray examinations. For this method, the radiation dose is considerable for relatively less interesting organs. We investigated whether patients need to wear the apron during the examination or not. We also studied the examination methods which can reduce the radiation dose. The results showed that radiation dose was reduced as the distance of source to patient becomes longer and the thickness of object grows higher.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.136-137
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• 2002

We have been researching upgrade version of a stereotactic whole body frame, used for evaluating daily setup accuracy of the patient positioning during fractionated extra-cranial stereotactic radiotherapy. Currently, we are focusing on the development of a new stereotactic whole body frame, and then will handle organ movement produced by breathing at the next stage. MeV-Green is chosen for the best immobilizer possible and the epoxy board is for the frame with the dimension of 110 em in length, 50 cm in width in order to maximize transmission rate of the beam from lateral or posterior direction and to fit CT and PET scanners with an aperture of 55 cm at least. The key point of an upgraded stereotactic whole body frame will be set on the collision-free rotation of the gantry with the frame, and the development of the checking structure for the daily patient repositioning regarding internal target.

• Journal of Chest Surgery
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• v.27 no.4
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• pp.328-330
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• 1994

Brachial plexus injury developing after axillary thoracotomy is an uncommon complication. But if it occurs, it may cause annoying events. We recently experienced 2 patients who developed brachial plexus injury after wedge resection by axillary thoracotomy . The first patient was a 22 year-old man with right spontaneous pneumothorax . After wedge resection of the right upper lung by axillary thoracotomy, he complained total paralysis of the right arm. An electromyogram was obtained at 7 days after operation, with the confirmation of brachial plexus injury. He was discharged at 22days after operation and brachial plexus injury was completely recovered 4 months after discharge. The second patient was a 17 year-old man with recurrent right pneumothorax. He underwent wedge resection of the right upper lung by axillary thoracotomy. Electromyogram confirmed the diagnosis of brachial plexus injury in the immediate postoperative period. He was discharged at 15 days after operation and brachial plexus injury was recovered 2months after discharge.Brachial plexus injury after axillary thoracotomy is caused by stretching around the clavicle and tendon of pectoralis minor by fixation of the abducted arm to the frame. Thus, when we perform wedge resection by axillary thoracotomy, we must avoid over-stretching of the brachial plexus in positioning. If brachial plexus injury develops, immediate attention and management with close rapport are important to avoid possible medicolegal problems.

• Archives of Plastic Surgery
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• v.44 no.1
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• pp.80-84
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• 2017

Defects involving specialised areas with characteristic anatomical features, such as the nipple, upper eyelid, and lip, benefit greatly from the use of sharing procedures. The vulva, a complex 3-dimensional structure, can also be reconstructed through a sharing procedure drawing upon the contralateral vulva. In this report, we present the interesting case of a patient with chronic, massive, localised lymphedema of her left labia majora that was resected in 2011. Five years later, she presented with squamous cell carcinoma over the left vulva region, which is rarely associated with chronic lymphedema. To the best of our knowledge, our management of the radical vulvectomy defect with a labia majora sharing procedure is novel and has not been previously described. The labia major flap presented in this report is a shared flap; that is, a transposition flap based on the dorsal clitoral artery, which has consistent vascular anatomy, making this flap durable and reliable. This procedure epitomises the principle of replacing like with like, does not interfere with leg movement or patient positioning, has minimal donor site morbidity, and preserves other locoregional flap options for future reconstruction. One limitation is the need for a lax contralateral vulva. This labia majora sharing procedure is a viable option in carefully selected patients.

• International Journal of CAD/CAM
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• v.9 no.1
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• pp.121-128
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• 2010

The purpose of this study is to clarify the mechanical behavior of human lumbar vertebrae (L3/L4) with and without fusion bone under physiological axial compression. The author has developed the program code to build the patient specific three-dimensional geometric model from the computed tomography (CT) images. The developed three-dimensional model provides the necessary information to the physicians and surgeons to visually interact with the model and if needed, plan the way of surgery in advance. The processed data of the model is versatile and compatible with the commercial computer aided design (CAD), finite element analysis (FEA) software and rapid prototyping technology. The actual physical model is manufactured using rapid prototyping technique to confirm the executable competence of the processed data from the developed program code. The patient specific model of L3/L4 vertebrae is analyzed under compressive loading condition by the FEA approach. By varying the spacer position and fusion bone with and without pedicle instrumentation, simulations were carried out to find the increasing axial stiffness so as to ensure the success of fusion technique. The finding was helpful in positioning the fusion bone graft and to predict the mechanical stress and deformation of body organ indicating the critical section.

• The Korean Journal of Pain
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• v.21 no.2
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• pp.150-154
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• 2008

Pulsed or conventional radiofrequency (RF) denervation of the third occipital nerve (TON) is considered to be a safe and effective alternative for the treatment of pain originating from the cervical 2-3 facet joint, including cervicogenic headache. However, proper positioning of the RF probe in the TON can be difficult and time consuming due to the possible involvement of various lesions along the target nerve. We found that bipolar RF is easier to perform and more convenient than unipolar RF when administering a lumbar medial branch block. Here, we report the successful treatment of a patient with a cervicogenic headache by pulsed RF (PRF) denervation of the TON, using a bipolar probe. We believe that bipolar PRF denervation of the TON is an effective alternative to unipolar RF or PRF for the treatment of pain originating from the cervical 2-3 facet joint.

• Parasites, Hosts and Diseases
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• v.58 no.6
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• pp.689-694
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• 2020

Strongyloidiasis is caused by Strongyloides stercoralis and is one of the most neglected tropical diseases in tropical and subtropical regions. Although several strongyloidiasis cases have been reported in Korea, genetic analysis of Korean isolates is still incomplete. In this study, a parasite was isolated from a 61-year-old man diagnosed with strongyloidiasis during the treatment of lymphoma on his retroperitoneal lymph node. Diffuse symmetric wall thickening from the ascending to descending colon and a nematode-infected intestine was observed following microscopic examination. Genomic DNA was isolated from a patient tissue block, and S. stercoralis was identified by PCR and sequencing (18S rDNA). In order to determine phylogenetic location of a Korean isolate (named KS1), we analyzed cox1 gene (500-bp) and compared it with that from 47 previous S. stercoralis isolates (28 human isolates and 19 canid isolates) from Asian countries. Our results showed that phylogenetic tree could clearly be divided into 5 different groups according to hosts and regions. KS1 was most closely related with the Chinese isolates in terms of genetic distance.

• Journal of Yeungnam Medical Science
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• v.39 no.3
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• pp.181-189
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• 2022

Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative condition characterized by loss of motor neurons, resulting in motor weakness of the limbs and/or bulbar muscles. Pain is a prevalent but neglected symptom of ALS, and it has a significant negative impact on the quality of life of patients and their caregivers. This review outlines the epidemiology, clinical characteristics, underlying mechanisms, and management strategies of pain in ALS to improve clinical practice and patient outcomes related to pain. Pain is a prevalent symptom among patients with ALS, with a variable reported prevalence. It may occur at any stage of the disease and can involve any part of the body without a specific pattern. Primary pain includes neuropathic pain and pain from spasticity or cramps, while secondary pain is mainly nociceptive, occurring with the progression of muscle weakness and atrophy, prolonged immobility causing degenerative changes in joints and connective tissue, and long-term home mechanical ventilation. Prior to treatment, the exact patterns and causes of pain must first be identified, and the treatment should be tailored to each patient. Treatment options can be classified into pharmacological treatments, including nonsteroidal anti-inflammatory drugs, antiepileptic drugs, drugs for cramps or spasticity, and opioid; and nonpharmacological treatments, including positioning, splints, joint injections, and physical therapy. The development of standardized and specific assessment tools for pain-specific to ALS is required, as are further studies on treatments to reduce pain, diminish suffering, and improve the quality of life of patients with ALS.