• Journal of Veterinary Clinics
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• v.30 no.1
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• pp.45-48
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• 2013

A 12-year-old male poodle weighing 2.0 kg presented for evaluation of right thoracic limb lameness. The owner reported that the dog showed recurrent bilateral shoulder joint luxation after a car accident for a year. Recently, the left shoulder joint appeared well maintained, but right shoulder joint luxation was exacerbated. On physical examination, the dog showed non-weight bearing lameness on the right thoracic limb. Craniocaudal radiographic views revealed medial displacement of the right humerus. Mediolateral radiographic views revealed overlap of the glenoid cavity and humeral head. Muscle atrophy of the right thoracic limb, reduced biceps brachii muscle tendon tone, a tear of the medial glenohumeral ligament, and a rupture of the subscapularis tendon were identified intraoperatively. Transposition of the biceps muscle tendon was performed. However, at 7 days, there was evidence of right shoulder reluxation on radiographs. The second surgery was performed with two $2mm{\times}6mm$ cortical bone anchors and a $4mm{\times}6mm$ cancellous bone anchor placed in the cortical bone of the distal scapula and the cancellous bone of the proximal humerus respectively. Two scapular bone anchors were then connected with a humeral bone anchor using heavy nylon suture to minimize shoulder abduction range of motion. On radiographs right after surgery and 6 weeks after surgery, the affected limb revealed no evidence of medial shoulder luxation. At 6 months, no evidence of lameness was noted on the right thoracic limb.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.6 no.1
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• pp.15-26
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• 2000

Purpose : This study was done to examine the actual effect of the scapular position in these flexibility tests. The purpose of this study was to examine the differences between the measurement of SRT(Sit-and-Reach Test) without intentional abduction of the scapular (pre-test) and with intentional abduction of the scapular (post-test). The hypothesis is: 1. There is no differences in the SRT result of the pre-test and the post-test. 2. There is no differences in the HJA(Hip Joint Angle) result of the pre-test and the post-test. 3. There is no differences in the Spine Motion Test(SMT) result of the pre-test and the post-test. Method : The total 60 people (30 men, 30 women) were participated in this study. In the pre-test, the subjects were asked to sit on the examination table and try the SRT motion; and then the HJA, SRT and the SMT numerical values were taken. In the post-test. the subjects were instructed to intentionally bring the scapula outward from the midline; and the HJA, SRT and the SMT numerical values were taken. Result : In the pre-test. the SRT result averaged 34.17cm. and in the post-test. the SRT result averaged 36.68cm. The difference was about 2.81cm which showed a significant mean statistically (p<0.01). The measurement increased by 8.22%. The HJA was $85.9^{\circ}$ in pre-test, and it was $85.5^{\circ}$ in post-test. giving the $0.4^{\circ}$ differences. Therefore, it didn't have a statistical mean (p>0.05). The SMT value was 69.56cm in the pre-test. and it was 69.28cm in the post-test, about 0.28cm decreased. Therefore, it didn't have a statistical mean (p>0.05). SRT values and HJA values were correlated (p<0.01). SMT values and SRT values (p<0.01), and SMT values and HJA values(p<0.05) were each in counter correlation. Conclusion : The result of the SRT without intentional scapular abduction (34.17cm) and with intentional scapular abduction (36.68cm) showed a significant increase about 8.22% (p<0.01). In SRT, the effect of the intentional scapular abduction on SMT showed no significant means, the pretest value being 69.56cm and the post-test value being 69.28cm (p>0.05).

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.186-193
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• 2005

Purpose: To determine whether it is possible to differentiate between ALPSA(anterior labroligamentous periosteal sleeve avulsion) lesion and Bankart lesion using arthroscopic findings and to investigate the clinical significance of ALPSA lesion. Materials and Methods: This study was performed on 66 cases that underwent arthroscopic Bankart repair for the anterior instability of the shoulder. By the readings of MRI, there were 56 cases(85%) of Bankart lesion and ten cases(15%) of ALPSA lesion. Arthroscopic findings of Each cases were classified and their average follow-up period was 22 months. Results: It was observed that ALPSA lesions developed in younger age groups than Bankart lesions. Under the arthroscope, ALPSA lesions showed various forms, especially there were five cases of severe inferomedial displacements. Within Bankart lesion, 21 cases were observed to be severely displaced and from the arthroscopic findings, it was difficult to distinguish the difference of Bankart lesion cases displaced inferomedially from the neck of scapula without severe lateral displacements and ALPSA lesion. Regarding the recurrence, there were no redislocation but apprehension shows in two cases(20%) with severe inferomedial displacement in ALPSA group. In Bankart lesion, there were four recurrent cases(7.1%); one of redislocation; one case of subluxation; two of apprehension. Conclusion: It was difficult to differentiate Bankart lesion and ALPSA lesion with severe inferomedial displacement and severely displaced ALPSA lesion showed high rate of recurrence. Thus, complete detachment of ALPSA lesion should be performed more carefully to reduce the recurrence rate.

• The Journal of Korean Medicine
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• v.21 no.4
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• pp.148-158
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• 2000

Objective : The purpose of this study was to investigate the back shape of school children using the phase-shifting scanning grating projection moire interferometer, which was developed by the Korea Advanced Institute of Science and Technology and is useful in evaluating three dimensional back shape. Methods : In this study the subjects consisted of 1,358 pupils [711 boys(52.36%), 647 girls(47.64%)] attending elementary and middle schools in Seoul. Their ages ranged from nine to fifteen and the average age was 12.2. With the phase-shifting scanning grating projection moire interferometer, the posterior view of the body were taken to see if there are correlations of moire fringe number, width difference between left and right, and correlation between differences in moire fringe number and width on both sides in the scapular, lumbar and gluteal regions. Results : The results were as follows : I. More frequent findings of fringe were observed on the right in all regions : in the scapular region, 309 boys(43.4%) and 156 girls(24.2%) had more fringe numbers on the right side; in the lumbar region, 68 boys(9.5%) and 11 girls(1.7%); and in the gluteal region, 160 boys(22.4%) and 63 girls(9.8%). Such tendency was striking especially in the scapular and lumbar regions, and in boys rather than in girls. In the scapula, 661 subjects(48.7%) with one moire fringe on either side need further attention and 110 subjects(8.I %) with two or more are required to do follow-up radiography for scoliosis. 2. In an analysis of width difference in the trunk, the left side is wider in all regions except for the gluteal region in boys : in the scapular region 21 boys(3.0%) and 103 girls(15.9%); in the lumbar region, 87 boys(12.2%) and 250 girls(38.6%); and in the gluteal region 197 girls(30.4%) had a wider left side and 45 boys(6.3%) showed a wider right side. 3. In correlation analysis of the number of moire fringe and width difference in each region, the side where more moire fringes were observed was significantly wider in the lumbar and gluteal regions, but not in the scapular region.(p<0.01) Conclusions : From these results, it is concluded that the back shape of elementary and middle school students in Seoul shows that the right side had more moire fringes; the left side was wider; and especially in the lumbar and gluteal regions the side where more moire fringes were observed was wider.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.301-307
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• 2004

The flap considered at first for the reconstruction of large maxillary defect, especially mid-face defect, is scapular free flap, because it provides ample composite tissue which can be designed 3-dimensionally for orbital, facial and oral reconstruction. In case of maxillary defect involving hard palate, however, this flap has some limitations. First, its bulk prevents oral function and physio-anatomic reconstruction of nasal and oral cavity. Second, mobility and thickness of cutaneous paddle covering the alveolar area reduce retention of tissue-supported denture and give rise to peri-implantitis when implant is installed. Third, lateral border of scapula that is to reconstruct maxillary arch and hold implants is straight, not U-shaped maxillary arch form. To overcome these problems, new concept of step prefabrication technique was provided to a 27-year-old male patient who had been suffering from a complete hard palate and maxillary alveolar ridge defect. In the first stage, scapular osteomuscular flap was elevated, tailored to fit the maxillary defect, particulated autologous bone was placed subperiosteally to simulate U-shaped alveolar process, and then wrapped up with split thickness skin graft(STSG, 0.3mm thickness). Two months later, thus prefabricated new flap was elevated and microtransferred to the palato-maxillary defect. After 6 months, 10 implant fixtures were installed along the reconstructed maxillary alveolus, with following final prosthetic rehabilitation. The procedure was very successful and patient is enjoying normal rigid diet and speech.

• Proceedings of the Korean Society of Computer Information Conference
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• 2017.01a
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• pp.235-238
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• 2017

This study was to develop a portable digital radiography (PDR) system with a function measuring the X-ray source-with-detector angle (SDA) and to evaluate the imaging performance for the diagnosis of chest imaging. The SDA device consisted of an Arduino, an accelerometer and gyro sensor, and a Bluetooth module. According to different angle degrees, five anatomical landmarks on chest images were assessed using a 5-point scale. Mean signal-to-noise ratio and contrast-to-noise ratio were 182.47 and 141.43. Spatial resolution (10% MTF) and entrance surface dose were 3.17 lp/mm ($157{\mu}m$) and 0.266mGy. The angle values of SDA device were not significant difference as compared to those of the digital angle meter. In chest imaging, SNR and CNR values were not significantly different according to different angle degrees (repeated-measures ANOVA, p>0.05). The visibility scores of the border of heart, 5th rib and scapula showed significant differences according to different angles (rmANOVA, p<0.05), whereas the scores of the clavicle and 1st rib were not significant. It is noticeable that the increase in SDA degree was consistent with the increase of visibility score. Our PDR with SDA device would be useful to be applicable to clinical radiography setting according to the standard radiography guideline at various fields.

• Journal of Digital Convergence
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• v.15 no.8
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• pp.465-476
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• 2017

This study attempted to investigate the effects of gold therapy on myofascial pain syndrome(MPS) in the neck, back and shoulder in comparison to stone therapy and verify its availability as an efficient nursing mediator in clinical trials. For this, therapy was given to a total of 20 women in two groups (gold therapy group, stone therapy group: 10 persons each) living in the capital region three times a week (40 min. at a time) for two weeks. In both groups, a statistically significant decrease was found in the following after the treatment: neck circumference, shoulder width, width of the inferior angle of scapula, shoulder thickness and waist circumference (p<0.001). In terms of differences, the gold therapy group was greater than the stone therapy group. In both groups, a statistically significant increase was observed after treatment in the following: cervical lateral bending (right), cervical lateral bending (left), cervical flexion and cervical extension angle (p<0.001). In terms of differences, the gold therapy group was greater than the stone therapy group. In conclusion, this study seems to show that gold therapy is a nursing intervention option having effective fascial relaxation and pain relief for the neck, back and shoulder. Therefore, it would be valuable as safe, non-invasive therapy.

• Clinics in Shoulder and Elbow
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• v.1 no.2
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• pp.221-229
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• 1998

We measured, with manual goniometer, the active and passive arc of motion of the shoulder in 31 healthy male subjects who were right-hand dominant and who ranged in age from twenty to thirty-one years. Among ten directions through the four motion plane, the range of motion on the dominant side were significantly smaller than those on the non-dominant side in the motion of six directions. We also measured the motion fraction of the glenohumeral and scapulothoracic movement using fluoroscope in 30-degree intervals of arm elevation in the scapular plane. The ratio of glenohumeral to scapulothoracic movement(θGH/θST) was 1.6 for the full range of motion in scapular plane. At the lower angles of abduction, scapulothoracic movement was slight compared with glenohumeral movement. The motion fraction of scapulothoracic joint was increased from 60-degree to 150 degree of arm angle especially between 120 to 150 degree. During arm elevation, scapula was also extended from 42 degrees to 20 degrees tilting as well as internal rotation. The measuring technique of glenohumeral to scapulothoracic movement(θGH/θST) with fluoroscopy could be applied to the simple radiographic measurement at the out-patient clinic in order to identify the pathology and recovery of shoulder motion after treatment.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.105-110
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• 2011

Purpose: The purpose of this article is to identify and understand the complications of RTSA and to review the current methods of preventing and treating this malady. Materials and Methods: Previous constrained prostheses (ball-and-socket or reverse ball-and-socket designs) have failed because their center of rotation remained lateral to the scapula, which has limited of the motion of the prostheses and produced excessive torque on the glenoid component, and this leads to early loosening. The Grammont reverse prosthesis imposes a new biomechanical environment for the deltoid muscle to act, thus allowing it to compensate for the deficient rotator cuff muscles. Results: The clinical experience does live up to the lofty biomechanical concept and expectations: the reverse prosthesis restores active elevation above $90^{\circ}$ in patients with a cuff-deficient shoulder. However, external rotation often remains limited and particularly in patients with an absent or fat-infiltrated teres minor. Internal rotation is also rarely restored after a reverse prosthesis. Failure to restore sufficient tension in the deltoid may result in prosthetic instability. Conclusion: Finally, surgeons must be aware that the results are less predictable and the complication/revision rates are higher in revision surgery than that in the first surgery. A standardized monitoring tool that has clear definitions and assessment instructions is surely needed to document and then prevent complications after revision surgery.

• Journal of Trauma and Injury
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• v.22 no.1
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• pp.37-43
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• 2009

Purpose: A missed fracture is a very common occurrence in the Emergency Department (ED) and can have serious results because of delays in treatment, resulting in long-term disability. It is also one of the most common causes leading to medical legal issues. We analyzed the causes of missed fractures by using a bone scan which is known to be an effective tool for diagnosing bony lesions. Methods: We reviewed the medical records of trauma patients who underwent a bone scan after being discharged the ED from September 2006 to March 2008. Cases of missed fractures were identified by using electronic medical records to review each diagnosis. Definition of missed fracture was read after bone scan by radiologist. We decided that there was no fracture if we read 'trauma-related lesion' or 'cannot rule out fracture' on a bone scan read by a radiologist. Enrolled patients were analyzed by age, sex, time until bone scan and Injury Severity Score (ISS). Patients were divided into two groups, alert mentality and not-alert mentality, so there were split between a diagnosis group and a missed fracture group. ISS was also used in determining the severity of the patient's injury upon discharge from the ED. Results: A total of 532 patients were enrolled in this study. Of those, 487 patients were in the diagnosis group, and 45 patients (8.4%) were discovered to have had a fracture. Of the 45 missed fracture patients, 34 patients (6.4%) had one-site fractures, 8 patients (1.5%) had two-site fractures, and 3 patients (0.6%) had three-site fractures. The most commonly missed fracture was multiple rib fractures (18 patients, 30.5%), followed by lumbosacral (LS) spine fractures (10 patients, 16.9%), thoracic spine fractures (8 patients, 13.6%), and clavicle fractures (6 patients, 10.2%). Mean age was $50.12{\pm}18.54$ years in the diagnosis group and $57.38{\pm}16.88$ years in the missed fracture group. For the diagnosis group, the mean ISS was $9.03{\pm}8.26$, but in the missed fracture group it was $17.53{\pm}9.69$. Missed fractures were much more frequent in the not-alert mentality (p<0.01) and in the high (ISS$ ISS{\geq}16$) group (p<0.01). Conclusion: Missed fractures occur most frequent in patients of old age, not-alert mentality, and high ISS. Multiple rib and spine fractures were found to be the most frequent missed fractures, regardless of trauma severity. This study also shows a high possibility of clavicle and scapula fractures in patients with severe trauma.