Feasibility of a New Desktop Motion Analysis System with a Video Game Console for Assessing Various Three-Dimensional Wrist Motions

BACKGROUND: The restriction of wrist motion results in limited hand function, and the evaluation of the range of wrist motion is related to the evaluation of wrist function. To analyze and compare the wrist motion during four selected tasks, we developed a new desktop motion analysis system using the motion controller for a home video game console. METHODS: Eighteen healthy, right-handed subjects performed 15 trials of selective tasks (dart throwing, hammering, circumduction, and winding thread on a reel) with both wrists. The signals of light-emitting diode markers attached to the hand and forearm were detected by the optic receptor in the motion controller. We compared the results between both wrists and between motions with similar motion paths. RESULTS: The parameters (range of motion, offset, coupling, and orientations of the oblique plane) for wrist motion were not significantly different between both wrists, except for radioulnar deviation for hammering and the orientation for thread winding. In each wrist, the ranges for hammering were larger than those for dart throwing. The offsets and the orientations of the oblique plane were not significantly different between circumduction and thread winding. CONCLUSIONS: The results for the parameters of dart throwing, hammering, and circumduction of our motion analysis system using the motion controller were considerably similar to those of the previous studies with three-dimensional reconstruction with computed tomography, electrogoniometer, and motion capture system. Therefore, our system may be a cost-effective and simple method for wrist motion analysis.

Clinical Application of Solid Model Based on Trabecular Tibia Bone CT Images Created by 3D Printer / 대한의료정보학회지

OBJECTIVES: The aim of this work is to use a 3D solid model to predict the mechanical loads of human bone fracture risk associated with bone disease conditions according to biomechanical engineering parameters. METHODS: We used special image processing tools for image segmentation and three-dimensional (3D) reconstruction to generate meshes, which are necessary for the production of a solid model with a 3D printer from computed tomography (CT) images of the human tibia's trabecular and cortical bones. We examined the defects of the mechanism for the tibia's trabecular bones. RESULTS: Image processing tools and segmentation techniques were used to analyze bone structures and produce a solid model with a 3D printer. CONCLUSIONS: These days, bio-imaging (CT and magnetic resonance imaging) devices are able to display and reconstruct 3D anatomical details, and diagnostics are becoming increasingly vital to the quality of patient treatment planning and clinical treatment. Furthermore, radiographic images are being used to study biomechanical systems with several aims, namely, to describe and simulate the mechanical behavior of certain anatomical systems, to analyze pathological bone conditions, to study tissues structure and properties, and to create a solid model using a 3D printer to support surgical planning and reduce experimental costs. These days, research using image processing tools and segmentation techniques to analyze bone structures to produce a solid model with a 3D printer is rapidly becoming very important.

Targeted Therapy in Metastatic Renal Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: To evaluate the efficacy and safety of targeted therapy in patients with metastatic renal cell carcinoma. MATERIALS AND METHODS: In this retrospective analysis, 43 consecutive patients with metastatic renal cell carcinoma received targeted therapy between December 2005 and December 2007. All patients underwent radical nephrectomy. Twenty-two patients received targeted therapy as a first-line treatment and 21 as a second-line treatment. RESULTS: The median follow-up duration after radical nephrectomy and after the initiation of targeted therapy was 87 and 14 months, respectively. The initial response rate was 74.4% (partial response 37.2%, stable disease 37.2%) and the last response rate was 34.9% (partial response 4.7%, stable disease 30.2%). The median survival was 17 months (95% confidence interval (CI), 11.6-22.4) and the median progression-free survival was 10 months (95% CI, 7.5-12.5). Eleven patients (50%) with synchronous metastasis and 3 (14.3%) with metachronous metastasis died from renal cell carcinoma (p=0.023), but there was no significant difference in terms of median survival (15 months vs. longer than 14 months, p=0.210). Also, there was a significant difference in the overall mortality of the MSKCC risk groups (13.3% vs. 44.4%, p=0.049), but no significant difference in median survival (longer than 14 months vs. 15 months, p=0.236). CONCLUSIONS: Targeted therapy shows promising clinical activity in patients with metastatic renal cell carcinoma. Time to metastasis and MSKCC risk group may be associated with overall survival, and the prognostic implications of those factors should be analyzed in further prospective studies.

Clinical Significance of Prostate Cancer Diagnosed by 12 Core Biopsy / 대한비뇨기과학회지

PURPOSE: Twelve-core biopsy improves the detection rate of prostate cancer; however,the clinical significance of these additionally detected tumors has not been established. We retrospectively evaluated the clinical difference between prostate cancers detected by only the 12 core biopsy and by the 6 core biopsy from patients underwent radical prostatectomy. MATERIALS AND METHODS: Between February 2000 and April 2005, 124 men underwent radical prostatectomy after 12-core biopsy at Seoul National University College of Medicine, Bundang Seoul National University Hospital, Seoul National University Boramae Hospital. Among the 12-core biopsy group, we compared the subset with standard sextant cores (Group A) and the subset with lateral sextant cores (Group B). The low-risk group was defined as patients with a serum prostate-specific antigen (PSA) level less than 10.0ng/ml, a Gleason score of the final pathologic findings< or =6, no pelvic lymph node metastasis and no lymphadenectomy performed, and a T stage< or =T2a. RESULTS: There was no statistically significant difference between low-risk patients in group A and group B (p=0.0814). Groups A and B were then divided into three groups according to preoperative PSA levels of less than 10.0ng/ml, 10.0ng/ml to less than 20.0ng/ml, and greater than 20.0ng/ml. The results of the subset analysis were the same for all three PSA categories. There was no statistically significant difference when we performed the analysis between group A and group B according to the Gleason score of the final pathologic findings and the TNM stage (p=0.0814), and there was also no statistically significant difference when we performed the analysis between group A and group B according to only the Gleason score of the final pathologic findings (p=0.5026). CONCLUSIONS: The prostate cancers diagnosed by means of 12-core biopsy did not appear to be of a clinically lower risk than those detected with 6-core biopsy. We have firmly shown that 12-core biopsy is a more clinically effective procedure than 6-core biopsy.

RPE Cell Apoptosis by the Combination Treatment of SAHA and Lactacystin

PURPOSE: To establish a new therapeutic strategy for proliferative vitreoretinopathhy (PVR), we examined the effect of combined treatment with HDAC inhibitor SAHA and proteasome inhibitor lactacystin in human retinal pigment epithelial (RPE) cells, ARPE-19. METHODS: Viability was determined by trypan blue exclusion assay. Mitochondrial membrane potential (MMP) was measured by flow cytometry. Proteasome activity was measured by fluorophotometry. The expression and degradation of apoptosis-related proteins were assesssed by Western blotting. Subcellular location of apoptosis-related factors was monitored by confocal miscroscopy. RESULTS: A single treatment with 5 micro M SAHA or 10 micro M lactacystin did not reduce cell viability. However, combination treatment with 5 micro M SAHA and 10 micro M lactacystin substantially reduced the viability, because the mixture induced the reduction of MMP and nuclear condensation or fragmentation. Moreover, the combination treatment triggered the activation of caspase-3 and the production of PARP cleavage products. These data indicate that the combination treatment efficiently induces apoptosis in ARPE-19 cells. However, co-treatment of SAHA did not augment the proteasome inhibitory activity of lactacystin, nor did co-treatment of lactacystin augment acetylation of histones. It is notable that while p53 and CAD were observed in the mitochondria of cells treated with SAHA, they were translocated into the nucleus after the combination treatment. CONCLUSIONS: These results suggest that the combination treatment of SAHA and lactacystin effectively induced apoptosis in ARPE-19 cells. Further work is warranted to develop this combination therapy as a novel therapeutic strategy for PVR.

Surgical Results of Scleral Buckling in Retinal Detachments with Subretinal Traction Band

PURPOSE: To evaluate the surgical results of scleral buckling procedure for rhegmatogenous retinal detachment with subretinal traction bands (SRTB). METHODS: We analyzed the medical records of 25 patients who had undergone only scleral buckling procedures for retinal detachment with SRTB with a minimum follow-up period of 6 months. RESULTS: Mean patient age was 33.7 years (16~80 years) and mean follow-up period was 15.8 months (6~35 months). Successful anatomic reattachment was achieved in 21 eyes (84%), and postoperative visual acuity improved in 12 eyes (48.0%). As for complications, surgical failure of the primary surgery occurred in 4 eyes (16%), temporary elevation of intraocular pressure in 3 eyes (12%), exposure of silicone sponge in 1 eye (4%), and progression of cataract in 1 eye (4%). The causes of primary failure were remaining subretinal fluid in 3 eyes and proliferative vitreoretinopathy in 1 eye. CONCLUSIONS: Scleral buckling procedure is recommended as one of the surgical methods in the management of retinal detachments with SRTB in selected cases.

Lymphoscintigraphy of Eyeball and Ocular Adnexal Malignant Tumors

PURPOSE: To evaluate the usefulness of preoperative or postoperative lymphoscintigraphy for the identification of lymphatic drainage and sentinel lymph node in patients with eyeball and ocular adnexal malignant tumors. METHODS: Lymphoscintigraphy was performed preoperatively or postoperatively in 5 patients with biopsy proven primary eyeball or ocular adnexal malignant tumors. Patients underwent lymphoscintigraphy with 500 micro Ci of technetium-99m antimony trisulfide colloid in a volume of 0.1 ml. We injected intradermally either the outer 1/3 of the upper or lower lid, or the inner 1/3 of the upper or lower lid. Images were taken by Gamma camera and we checked lymphatic drainage and sentinel lymph nodes. RESULTS: Two patients with conjunctival malignant melanoma showed normal lymphatic drainage, but the other two patients had lymphatic drainage to the parotid and submandibular chain, and sentinel lymph nodes were noted as the parotid lymph node and the submandibular lymph node. The patients with sebaceous gland carcinoma injected in the outer 1/3 of the upper lid had submandibular lymphatic chain and the sentinel lymph node proved to be the submandibular lymph node. CONCLUSIONS: Lymphoscintigraphy demonstrated the lymphatic drainage system and successfully identified the sentinel lymph nodes. This should prove to be very helpful to evaluate metastasis of the eyeball and ocular adnexal malignant tumors by selective lymph node biopsy and to decide the degree of surgery.

Surgical Results of Segmental Scleral Buckling in Pseudophakic Retinal Detachments

PURPOSE: To evaluate the surgical results of segmental scleral buckling procedures in pseudophakic retinal detachments. METHODS: We retrospectively analyzed the surgical results of 35 patients (35 eyes) undergoing only segmental scleral buckling procedures in pseudophakic retinal detachments, who had been postoperatively followed up 6 months or longer. RESULTS: The average age of patients was 58.4 +/- 14.8 and twenty-five of the 35 patients were male. Posterior capsule was ruptured in 14 eyes, and among the 14, 5 eyes had vitreous prolapse. The primary success rate of segmental scleral buckling procedures was 100% (21/21 eyes) in intact posterior capsules, and 64.3% (9/14 eyes) in ruptured posterior capsules. The causes of failure were proliferative vitreoretinopathy (2 eyes) and failure to close the retinal breaks (3 eyes). CONCLUSIONS: We suggest that segmental scleral buckling procedure may be an effective method for the management of retinal detachments in pseudophakia if without posterior capsule ruptures.

A Clinical Study of Posterior Segment Injuries of Non-penetrating Ocular Trauma

Posterior segment injuries due to non-penetrating ocular trauma have protean ocular manifestations. Vision may be unaffected or completely lost according to the injured area. Although most cases require no specific treatment, early accurate diagnosis and appropriate prophylactic treatment will prevent some patients from late visual loss. We analyzed retrospectively 36 eyes of 36 patients with non-penetrating posterior segment trauma who had visited our clinic from August, 1994 to February, 1997. Thirty two of the patients(88.8%) were male and the peak age group was in the third decade. Thirteen of the patients(21%) had Berlin`s edema, which was one of the most common findings seen in the posterior segment. The most common anterior segment finding associated with non-penetrating ocular trauma was hyphema(20%). The most common cause of non-penetrating trauma was violence(first, foot)(38.8%). Final visual acuity was better in eyes without the lesion involving the macula.

Result of Schwind Excimer Photoastigmatic Refractive Keratectomy(One year follow up)

We evaluated the safety and efficacy of photo-astigmatic refractive keratectomy(PARK) with Schwind excimer laser for one year. We performed PARK procedures on 28 eyes with compound myopic astigmatism. Twenty eight eyes were divided into two groups according to their astigmatism: low(up to -1.5D, 15 eyes), high(over -1.5, 13 eyes). Mean preoperative astigmatism was 1.17+/-0.28 in low astigmatism group and 2.67+/-0.90 in high astigmatism group. Mean one year postoperative astigmatism was 0.40+/-0.39 in low astigmatism group and 0.48+/-0.56 in high astigmatism group. Correction rate of astigmatism was 62.3% in low astigmatism group and 79.4% in high astigmatism group. Complications were loss of best corrected visual acuity 2 line or more(2 eyes), temporary increased intraocular pressure(4 eyes), over 0.25mm eccentric ablation(2 eyes). We concluded that the Schwind excimer laser PARK appeared to be a safe and relatively accurate proceudre to correct myopic astigmatism, especially predictability of astigmatism correction was very satisfactory.

Characteristecs of Visual Field Progression in Normal Tension Glaucoma

We performed a retrospective study on the characteristics of visual field progression among 76 eyes of 41 patients who were diagnosed for normal tension glaucoma, using linear regression analysis of global indices(MD, CPSD), mean thresholds of 10 GHT clusters, and thresholds of 52 individual locations. Those patients were identified who had taken seven of more threshold visual field tests over a period of at least 2 years. The results were as follos; 1. There were 18 eyes(23.7%) of 13 patients where MD, CPSD, one or more clusters, of one or more locations was deteriorated. Linear regression of global indices identified 5 subjects(6.6%) with significant decline in MD and 3 subjects(3.9%) with significant progression of CPSD. Twelve sujects(15.8%) had more than one progressive GHT cluster. Fourteen subjects(18.5%) had more than one progressive individual test locations. 2. Deterioration of 2dB or more per year was found in the superior fields more frequently than inferior and there was increasing frequency of visual field progression in superior and inferior fields. The spatial distribution of individual locations that deteriorated was similar to that of clusters. 3. Age, mean IOP, IOP reduction rate and drug used was not related to visual field progression in normal tension glaucoma. These findings suggest that linear regression is a method to detect progression and estimat the magnitude of increase in field loss objectively and has the potential to identify those persons whose trend is sufficiently strong enough to exceed the variability in the data. It is thought that long-term follow-up and appropriate frequency of visual field testing give important information on the clinical characteristics of field progression in glaucoma.

Changes in IOP and HIstopathology Following Contact Transscleral Cyclophotocoagulation with Diode Laser in High Tension Rabbit Eyes

We evaluated the acute and long term intraocular pressure(IOP) lowering effect of diode laser contact transscleral cyclophotocoagulation by applying G probe to argon laser induced high tension pigmented rabbits through the changes in IOP and histopathology. Eighteen eyes of 18 high tension pigmented rabbits were treated with diode laser contact transscleral cyclophotocoagulation (24-30 application) 0.5mm posterior to the limbus over 360degrees and the other eyes were used as controls. The rabbits were divided into 3 groups according to the energy levels of diode laser (1st group; 0.8J of energy, 2nd; 1.0J of energy, and 3rd; 1.2J of energy). There were mean decrease in IOP of 24.4%, 38.4%, and 38.7% in 1st, 2nd, and 3rd groups respectively during 5 weeks after tratment (p<0.05). After treatment, microendoscopic findings of the ciliary body revealed blenching in 1.0 and 1.2J groups. Light microscopy 1 day after treatment revealed coagulation necrosis of the pigmented and nonpigmented ciliary epithelium, congestion of vessels, thrombosis, and pigment dispersion in all energy groups, with destruction increasing in relation to power. Five weeks after treatment, atrophy and fibrosis of the ciliary nonpigmented and pigmented epithelium and stroma were observed in all groups.

Result of Intraarticular Fracture of the Calcaneus by Open Reduction / 대한정형외과학회잡지

The Fracture of the os calcis is quite common in relation to fracture in other tarsal bone, and fractures involving the subtalar joint may cause serious and persistant disabilities. The treatment of these calcaneal fractures remains controversial So there is no universal agreement in the treatment of these fractures, especially involving the subtalar joint. Twenty displaced intraarticular fractures of calcaneus in 15 patients were treated by open reduction and internal fixation with a plate and screws and bone graft through a lateral approach to elevate the depressed lateral portion of the posterior facet at the Inchon Chritian Hospital from Jan., 1990 to Dec, 1991. Twenty feet in 15 patients of calcaneal fractures involving the subtalal joint were treated and were clinically analysed and following result were obtained. 1. The 20 cases were classified according to the Sanders classification, 9 in type II, 9 in type III and 2 in type IV. 2. The 20 cases were treated by open reduction andinteranl fixation with plate and screws and iliac bone graft through an Sanders lateral approach. The bone graft is packed under the elevated posterior to prevent late collapse of the central fragment and to supply structral stability. 3. The preoperative average Böhler's angle was 0.4°. The post operative average Böhler's angle was 23.4° which was increased significantly. 4. Based on assessment of result of Salama, excellenwas 6, good was 7, fair was 4 and poor was 3. 5. The most common complication after treatment was persistant pain, especially beneath the lateral malleolus.

Clinical comparative study between flexible intramedullary nail and rigid intramedullary nail in the treatment of the tibial shaft fracture / 대한정형외과학회잡지

No abstract available.

A clinical study of the femoral neck fracture / 대한정형외과학회잡지

No abstract available.

Xanthoma of the achilles tendon / 대한정형외과학회잡지

No abstract available.

The Clinical Study of Pyogenic Arthritis: Pathogeny and Complication / 대한정형외과학회잡지

After developement of antimicrobial chemotherapy, morbidity and mortality from pyogenic arthritis has been reduced dramatically, but still this disease has remained as a serious and life threatening infectious disease of childhood or late sequelae in surviving patients. For the period of 6 years from January 1978 to December 1983, seventy nine patients, eigthy one cases who were treated as pyogenic arthritis at Severance Hospital and Yong Dong Hospital were studied retrospectively and the results are summerized as follows. 1. We thought that the main pathogeny of septic arthritis of knee joint are trauma and direct invasion of microorganism, because the frequency of pyogenic arthritis in knee joint are proportional to the age and history of accupuncture therapy and trauma are common. 2. In thirty three cases (40.7%) underlying causes were found, composed of infectious focus in eleven cases(13.6%) correspondent to hematologic transmission, osteomyelitis in seven cases(8.7%), trauma and accupuncture in six cases(7.4%) and eight cases(9.9%) corresponding to direct invasion. 3. In forty five cases(55.6%) microorganism are identified, among which coagulase positive staphylococci are in forty cases(88.9%) . 4. Tc-99m-MDP(Medronate) whole body bone scan were taken at twelve patients and positive findings were eleven cases. 5. In thirty eight cases(46.9%) the complications were appeared: Osteomyelitis of tibia in ankle joint and periarticular or subarticular bone defects in knee joints were common. 6. There were complications in every cases that the duration was more than eleven days, no exceptional.

Clinical Study on Surgical Treatment of Spondylolisthesis / 대한정형외과학회잡지

No abstract available in English.