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1.
Article in English | WPRIM | ID: wpr-914115

ABSTRACT

Background@#The purpose of this study was to evaluate the clinical and radiologic outcomes of reverse total shoulder arthroplasty (RTSA) using a small glenoid baseplate in patients with a small glenoid and to analyze the contributing factors to scapular notching. @*Methods@#A total of 71 RTSAs performed using a 25-mm baseplate were evaluated at a mean of 37.0 ± 3.3 months. Shoulder function was evaluated using American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS) for pain, Single Assessment Numeric Evaluation (SANE) for satisfaction, and active range of motion. Scapular neck angle (SNA), prosthesis-scapular neck angle (PSNA), peg glenoid rim distance (PGRD), and sphere bone overhang distance (SBOD) were measured to assess the effects on scapular notching. @*Results@#Shoulder function (ASES: 39.4 ± 13.8 preoperative vs. 76.2 ± 9.5 at last follow-up, p< 0.001), VAS for pain (6.1 ± 1.8 vs. 1.7 ± 1.4, p < 0.001), SANE for satisfaction (7.0 ± 11.8 vs. 83.4 ± 15.3, p < 0.001), and active forward flexion (115.6° ± 40.1° vs. 141.6° ± 17.2°, p< 0.001) were significantly improved. The mean diameter of the inferior glenoid circle was 26.0 ± 3.0 mm and the mean glenoid vault depth was 24.0 ± 4.5 mm. Scapular notching was found in 13 patients (18.3%) and acromial fracture in 2 patients (2.8%). There were no significant differences in preoperative SNA and PSNA at postoperative 3 years between patients with and without scapular notching (101.6° ± 10.5° and 110.8° ± 14.9° vs. 97.3° ± 13.3° and 104.9° ± 12.4°; p = 0.274 and p= 0.142, respectively). PGRD and SBOD were significantly different between patients with scapular notching and without scapular notching (24.8 ± 1.6 mm and 2.6 ± 0.5 mm vs. 21.9 ± 1.9 mm and 5.8 ± 1.9 mm; p < 0.001 and p < 0.001, respectively). @*Conclusions@#RTSA using a 25-mm baseplate in a Korean population who had relatively small glenoids demonstrated low complication rates and significantly improved clinical outcomes. Scapular notching can be prevented by proper positioning of the baseplate and glenosphere overhang using size-matched glenoid baseplates.

2.
Article in English | WPRIM | ID: wpr-899601

ABSTRACT

Purpose@#The purpose of this study was to analyze research trends and find whether Post-Traumatic Stress Disorder (PTSD) of refugees could affect structural or functional changes of brains of those under MRI, focusing on volumes, functional connectivities, and metabolites. @*Methods@#A literature search was done using PubMed, Embase, RISS, and KMBase to identify studies that matched our research purpose. A total of eight studies were identified using Prisma flow diagram by two reviewers independently. @*Results@#Eight studies were identified. Three studies were on North Korean defectors as subjects. The number of studies that observed structural changes, functional changes, and metabolite changes in brains was 2, 5, and 2, respectively. Although each study observed various parts of the brain, anterior cingulate cortex (ACC) was observed commonly in three studies. The PTSD group showed reduction of ACC volume and N-acetyl-aspartate (NAA) metabolite in ACC compared to the non- PTSD group. When exposed to negative stimuli, the PTSD group showed higher neural activity than the non-PTSD group, but not vice versa. @*Conclusion@#ACC showed significant difference in volume, neural activity, and NAA metabolite between the PTSD and the non-PTSD group, resulting in significant differences in structural changes, functional changes, metabolite changes, respectively. This study showed the need for conducting more research using various biomarkers to clarify the relationship between PTSD of refugees and their brain changes.

3.
Article in English | WPRIM | ID: wpr-891897

ABSTRACT

Purpose@#The purpose of this study was to analyze research trends and find whether Post-Traumatic Stress Disorder (PTSD) of refugees could affect structural or functional changes of brains of those under MRI, focusing on volumes, functional connectivities, and metabolites. @*Methods@#A literature search was done using PubMed, Embase, RISS, and KMBase to identify studies that matched our research purpose. A total of eight studies were identified using Prisma flow diagram by two reviewers independently. @*Results@#Eight studies were identified. Three studies were on North Korean defectors as subjects. The number of studies that observed structural changes, functional changes, and metabolite changes in brains was 2, 5, and 2, respectively. Although each study observed various parts of the brain, anterior cingulate cortex (ACC) was observed commonly in three studies. The PTSD group showed reduction of ACC volume and N-acetyl-aspartate (NAA) metabolite in ACC compared to the non- PTSD group. When exposed to negative stimuli, the PTSD group showed higher neural activity than the non-PTSD group, but not vice versa. @*Conclusion@#ACC showed significant difference in volume, neural activity, and NAA metabolite between the PTSD and the non-PTSD group, resulting in significant differences in structural changes, functional changes, metabolite changes, respectively. This study showed the need for conducting more research using various biomarkers to clarify the relationship between PTSD of refugees and their brain changes.

4.
Article in Korean | WPRIM | ID: wpr-920262

ABSTRACT

Background and Objectives@#Polylactic-co-glycolic acid (PLGA) plate has been recognized for its biocompatibility and biomechanical properties and used widely in various clinical fields. The aim of this study was to evaluate the usefulness and reliability of PLGA plate as a graft material in septorhinoplasty.Subjects and Method Medical records were retrospectively analyzed for patients who underwent septorhinoplasty including extracorporeal septoplasty from January 2017 to June 2020. We evaluated demographics, diagnosis, operation techniques, and complications of PLGA plate as a graft material used in these patients. @*Results@#A total of 33 patients were enrolled in this study. Twenty-eight were male and 5 were female. The median age was 32 years old. The follow-up period after surgery was 6-32 months, and the mean follow-up period was 18.03 months. The PLGA plate was used in unilateral spreader graft (n=17), bilateral spreader graft (n=10), batten graft (n=3), strengthening of septal extension graft (n=2) and columellar strut graft (n=3), and fixing L-strut during extracorporeal septoplasty (n=12). During the follow-up period, no patient experienced extrusion or exposure of the grafts. Mild complications, such as redness of the columella skin, granulation in the marginal incision site, and pain on the nasal dorsum were observed in three patients; these complications were temporary and patients improved with conservative treatments. @*Conclusion@#The PLGA plate may be a useful graft material in correcting deviated nose especially when the harvested septal cartilage is insufficient and if used carefully in limited locations such as L-strut and columella.

5.
Article in English | WPRIM | ID: wpr-897963

ABSTRACT

Calcific tendinitis is the leading cause of shoulder pain. Among patients with calcific tendinitis, 2.7%–20% are asymptomatic, and 35%–45% of patients whose calcific deposits are inadvertently discovered develop shoulder pain. If symptoms are present, complications such as decreased range of motion of the shoulder joint should be minimized while managing pain. Patients with acute calcific tendinitis respond well to conservative treatment and rarely require surgery. In contrast, patients with chronic calcific tendinitis often do not respond to conservative treatment and do require surgery. Clinical improvement takes time, even after surgical treatment. This review article summarizes the processes related to the diagnosis and treatment of calcific tendinitis with the aim of helping clinicians choose appropriate treatment options for their patients.

7.
Article in English | WPRIM | ID: wpr-890259

ABSTRACT

Calcific tendinitis is the leading cause of shoulder pain. Among patients with calcific tendinitis, 2.7%–20% are asymptomatic, and 35%–45% of patients whose calcific deposits are inadvertently discovered develop shoulder pain. If symptoms are present, complications such as decreased range of motion of the shoulder joint should be minimized while managing pain. Patients with acute calcific tendinitis respond well to conservative treatment and rarely require surgery. In contrast, patients with chronic calcific tendinitis often do not respond to conservative treatment and do require surgery. Clinical improvement takes time, even after surgical treatment. This review article summarizes the processes related to the diagnosis and treatment of calcific tendinitis with the aim of helping clinicians choose appropriate treatment options for their patients.

9.
Article in Korean | WPRIM | ID: wpr-811451

ABSTRACT

PURPOSE: This study aimed to investigate the effect of hospital-based intensive rehabilitation program after ankle ligament operation.METHODS: A total of 35 patients were included in this randomized controlled trial. Fifty-minute sessions of hospital-based rehabilitation were performed three times weekly for 12 weeks in the intervention group. Home-based exercise was conducted in the control group. Outcomes were evaluated at baseline, 12 weeks, and 16 weeks. The primary outcome was measured using the Foot and Ankle Outcome Score (FAOS). Secondary outcomes included the American Orthopedic Foot and Ankle Society (AOFAS) score, ankle strength measured using an isokinetic device, fall index measured using a Tetrax posturography device, and the Berg Balance Scale.RESULTS: Significant improvements in FAOS, AOFAS, ankle strength, and fall index were found in the intervention group after performing the hospital-based rehabilitation (all p<0.05) and these improvements were sustained at T2 (all p<0.05). Between-group comparisons demonstrated significantly greater improvements in FAOS, AOFAS, ankle strength, and fall index in the intervention group than those in the control group at both T1 (all p<0.05), and T2 (all p<0.05).CONCLUSION: The rehabilitation program in this study improved postoperative pain, sports function, quality of life, and strength and balance of the ankle significantly better than home-based self-care. Therefore, we recommend hospital-based systematic rehabilitation programs after surgical treatment for chronic ankle instability.


Subject(s)
Ankle , Foot , Humans , Ligaments , Orthopedics , Pain, Postoperative , Quality of Life , Recovery of Function , Rehabilitation , Self Care , Sports
11.
Journal of Rhinology ; : 102-107, 2020.
Article in Korean | WPRIM | ID: wpr-836294

ABSTRACT

Background and Objectives@#Sinonasal inverted papilloma (IP) is a benign tumor with a locally aggressive nature and a propensity to recur. Many risk factors for recurrence have been reported, but they are still controversial. The aim of this study was to comprehensively assess the demographic data, clinical features, and potential risk factors for recurrence of IP.Subjects and Method: This work is a retrospective review of 382 patients diagnosed with and treated for sinonasal inverted papilloma between 1986 and 2017 at a single tertiary medical center. Demographic data, presence of associated malignancy, information about previous surgeries, tumor location, Krouse stage, surgical approach, follow-up duration, and data on recurrence were obtained. @*Results@#In our study, 31 of 382 cases (8.1%) were associated with malignancy. Mean age was significantly higher in patients with associated malignancy compared to the benign IP group. Of the 351 benign cases, 263 (74.9%) were primary, and 88 (25.1%) were revision cases (residual or recurrent disease). Although the proportion of patients with high Krouse stage or multifocal involvement was high in the revision cases, there was no significant difference in recurrence rate. The 226 patients with a minimum follow-up of 1 year were included for recurrence analysis. Recurrence rate was significantly higher in the conventional surgery group (17.4%) compared to that of the endoscopic and combined surgery groups (8.1% and 3.6%, respectively). Also, the recurrence group showed significantly larger proportion of patients with high Krouse stage and multifocal involvement. @*Conclusion@#Risk factors for recurrence of IP found in this study are comparable to those previously published. Generally, the factors associated with recurrence of IP were prior surgery, clinical stage, involved site, and surgical approach. Therefore, surgeons should always consider these risk factors to reduce the chance of recurrence.

12.
Immune Network ; : e17-2020.
Article | WPRIM | ID: wpr-835443

ABSTRACT

We investigated effects of reblastatins on phenotypic changes in monocytes/macrophages induced by 27-hydroxycholesterol (27OHChol). Treatment of THP-1 monocytic cells with reblastatin derivatives, such as 17-demethoxy-reblastatin (17-DR), 18-dehydroxyl-17-demethoxyreblastatin (WK88-1), 18-hydroxyl-17-demethoxyreblastatin (WK88-2), and 18-hydroxyl-17-demethoxy-4,5-dehydroreblastatin (WK88-3), resulted in blockage of CCL2, CCL3, and CCL4 expression at the transcription and protein levels, which, in turn, impaired migration of monocytes/macrophages and Jurkat T cells expressing CCR5, and almost complete inhibition of transcription of M1 marker cytokines, like CXCL10, CXCL11, and TNF-α. Reblastatins also downregulated surface CD14 as well as soluble CD14 along with inhibition of LPS response and matrix metalloprotease-9 expression. Surface levels of mature dendritic cell (mDC)-specific markers, including CD80, CD83, CD88, CD197, and MHC class I and II molecules, were remarkably down-regulated, and 27OHChol-induced decrease of endocytic activity was recovered following treatment with 17-DR, WK88-1, WK88-2, and WK88-3. However, 15-hydroxyl-17-demethoxyreblastatin (DHQ3) did not affect the molecular or functional changes in monocytic cells induced by 27OHChol. Furthermore, surface levels of CD105, CD137, and CD166 were also down-regulated by 17-DR, WK88-1, WK88-2, and WK88-3, but not by DHQ3. Collectively, results of the current study indicate that, except DHQ3, reblastatins regulate the conversion and differentiation of monocytic cells to an immunostimulatory phenotype and mDCs, respectively, which suggests possible applications of reblastatins for immunomodulation in a milieu rich in oxygenated cholesterol molecules.

13.
Article | WPRIM | ID: wpr-835278

ABSTRACT

Background@#When an arteriovenous fistula (AVF) is created using the basilic or deep cephalic vein, it is additionally necessary to transfer the vessels to a position where needling is easy; however, many patients develop wound-related postsurgical complications due to the long surgical wounds resulting from conventional superficialization of a deep AVF or basilic vein transposition. Thus, to address this problem, we performed videoscopic surgery with small surgical incisions. @*Methods@#Data from 16 patients who underwent additional videoscopic radiocephalic superficialization, brachiocephalic superficialization, and brachiobasilic transposition after AVF formation at our institution in 2018 were retrospectively reviewed. @*Results@#Needling was successful in all patients. No wound-related complications occurred. The mean vessel size and blood flow of the AVF just before the first needling were 0.73±0.16 mm and 1,516.25±791.26 mL/min, respectively. The mean vessel depth after surgery was 0.26±0.10 cm. Percutaneous angioplasty was additionally performed in 25% of the patients. Primary patency was observed in 100% of patients during the follow-up period (262.44±73.49 days). @*Conclusion@#Videoscopic surgery for AVF dramatically reduced the incidence of postoperative complications without interrupting patency; moreover, such procedures may increase the use of native vessels for vascular access. In addition, dissection using a videoscope compared to blind dissection using only a skip incision dramatically increased the success rate of displacement by reducing damage to the dissected vessels.

14.
Article | WPRIM | ID: wpr-834915

ABSTRACT

Objective@#This study examined the clinical manifestations, treatment, and prognostic factors of hydrogen sulfide intoxication. @*Methods@#Twelve cases of hydrogen sulfide leaking from a wastewater treatment company in Sasang-gu, Busan were reviewed. The demographic characteristics, initial symptoms, treatment, complications, and long-term prognosis were reviewed. The Life Science Ethics Review Committee approved this study. @*Results@#The majority of the 12 cases were male (83%) with an average age of 38 years. Three of the 12 cases, who had been exposed to hydrogen sulfide, died (25%), and four had poor outcomes (33%). The incidence of pulmonary edema was significantly higher in the poor prognosis group, but the incidence of conjunctivitis and pre-hospital cardiac arrest was similar. The lactic acid concentration in the poor prognosis group was higher than the good prognosis group. In the poor prognosis group, the Glasgow coma scale was lower than that in the good prognosis group. @*Conclusion@#A poor outcome occurred in 33% of the 12 people exposed to hydrogen sulfide in Busan 2018. In the poor outcome group, the initial Glasgow Coma Scale was lower, the pulmonary edema rate and the initial serum lactate level were higher than in the good outcome group.

15.
Article in English | WPRIM | ID: wpr-763307

ABSTRACT

Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to provide guidance on the implementation of a surgical treatment of oral cancer. MEDLINE databases were searched for articles on subjects related to “surgical management of oral cancer” published in English. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. The quality of evidence was rated with use RoBANS (Risk of Bias Assessment Tool for Nonrandomized Studies) and AMSTAR (A Measurement Tool to Assess the Methodological Quality of Systematic Reviews). Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. Additional directives are provided as expert opinions and Delphi questionnaire when insufficient evidence existed. The Committee developed 68 evidence-based recommendations in 34 categories intended to assist clinicians and patients and counselors, and health policy-makers. Proper surgical treatment selection for oral cancer, which is directed by patient- and subsite-specific factors, remains the greatest predictor of successful treatment outcomes. These guidelines are intended for use in conjunction with the individual patient's treatment goals.


Subject(s)
Advisory Committees , Bias , Carcinoma, Squamous Cell , Counseling , Expert Testimony , Humans , Mouth Neoplasms , Neck , Republic of Korea
16.
Asian Spine Journal ; : 313-317, 2019.
Article in English | WPRIM | ID: wpr-762920

ABSTRACT

STUDY DESIGN: Retrospective study (level of evidence: level 3). PURPOSE: To study the anatomy of the conus medullaris in Koreans. OVERVIEW OF LITERATURE: The anatomical position of the conus medullaris is well-documented in anatomy textbooks; however, the shape of the conus in the canal rarely described. Furthermore, to our knowledge, no study in Korea has not yet assessed the shape of the conus as well as its position in the canal via cadavaric dissection and/or magnetic resonance imaging (MRI). METHODS: MRI findings of 189 Korean patients aged 2–94 years (93 men and 94 women) were assessed. No subjects from other ethnicities were included. The method proposed by Arai and colleagues was used to assess the termination point and shape of the conus in the canal. The position of the intervertebral disc trisection of the vertebral body closest to the tip of the conus was recorded at the canal level. RESULTS: The tip of the conus medullaris was positioned from the upper T12 body to the L2–L3 disc, mostly in L1 bodies (52.4%), followed by the L2 bodies (22.5%), the L1–L2 disc, and the L2–L3 disc (1.1%). The shape of the conus was classified as type A in 74 (39.6%), type B in 58 (31%), and type C in 55 patients (29.4%). The conus did not terminate at the L3 body in any patient. In the first decade ones (five children) conus positioned rather lowly from L1 bodies to L2–L3 disc, and no type A conus shape, and mostly type B (80%). CONCLUSIONS: The conus medullaris was positioned mostly in the lower one-third of L1 and it in the first decades terminated lowly. No type A in the first decade one, and type B was mostly frequently formed which was followed by type C.


Subject(s)
Asian Continental Ancestry Group , Conus Snail , Humans , Intervertebral Disc , Korea , Magnetic Resonance Imaging , Male , Methods , Retrospective Studies , Spinal Cord
18.
Article in Korean | WPRIM | ID: wpr-758514

ABSTRACT

Solitary neurofibroma of the glottis is extremely rare and accounts for only 0.1–1.5% of benign laryngeal tumors. Aryepiglottic fold is the most frequent involved site followed by arytenoids and ventricular folds. There have been few reports of neurofibroma of the true vocal cord. We report a case of neurofibroma which was deeply embedded in the vocal cord and misdiagnosed as muscle tension dysphonia with a review of literatures.


Subject(s)
Dysphonia , Glottis , Larynx , Muscle Tonus , Neurofibroma , Vocal Cords
19.
Article in English | WPRIM | ID: wpr-760637

ABSTRACT

BACKGROUND/OBJECTIVES: This study evaluated whether a mobile health (mHealth) application can instigate healthy behavioral changes and improvements in metabolic disorders in individuals with metabolic abnormalities. SUBJECTS/METHODS: Participants were divided into an mHealth intervention group (IG), which used a mobile app for 24 weeks, and a conventional IG. All mobile apps featured activity monitors, with blood pressure and glucose monitors, and body-composition measuring devices. The two groups were compared after 24 weeks in terms of health-behavior practice rate and changes in the proportion of people with health risks, and health behaviors performed by the IG that contributed to reductions in more than one health risk factor were analyzed using multiple logistic regression. RESULTS: Preference for low-sodium diet, reading nutritional facts, having breakfast, and performing moderate physical activity significantly increased in the mHealth IG. Furthermore, the mHealth IG showed a significant increase of eight items in the mini-dietary assessment; particularly, the items “I eat at least two types of vegetables of various colors at every meal” and “I consume dairies, such as milk, yogurt, and cheese, every day.” The proportion of people with health risks, with the exception of fasting glucose, significantly decreased in the mHealth IG, while only the proportion of people with at-risk triglycerides and waist circumference of females significantly decreased in the control group. Finally, compared to those who did not show improvements of health risks, those who showed improvements of health risks in the mHealth IG had an odds ratio of 1.61 for moderate to vigorous physical activity, 1.65 for “I do not add more salt or soy sauce in my food,” and 1.77 for “I remove fat in my meat before eating.” CONCLUSIONS: The findings suggest that the additional use of a community-based mHealth service through a mobile application is effective for improving health behaviors and lowering metabolic risks in Koreans.


Subject(s)
Blood Pressure , Breakfast , Cheese , Delivery of Health Care , Diet , Diet, Sodium-Restricted , Disease Management , Fasting , Female , Glucose , Health Behavior , Humans , Logistic Models , Meat , Milk , Mobile Applications , Motor Activity , Odds Ratio , Public Health , Risk Factors , Smartphone , Soy Foods , Telemedicine , Triglycerides , Vegetables , Waist Circumference , Yogurt
20.
Article in English | WPRIM | ID: wpr-760345

ABSTRACT

A 6-year-old intact male Maltese dog presented with a history of blindness and ataxia. Neuro-ophthalmic examination revealed dilated pupils with absent pupillary light reflexes and menace response in both eyes. Mild peripapillary edema was noted in the fundus of the right eye. After magnetic resonance imaging, the dog was provisionally diagnosed with meningoencephalitis of unknown etiology. Follow-up funduscopy was performed to monitor the condition of the optic discs for three years. Despite of the treatment with prednisolone, the optic nerve progressed to atrophy and the dog couldn't restore vision.


Subject(s)
Animals , Ataxia , Atrophy , Blindness , Child , Dogs , Edema , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Meningoencephalitis , Optic Nerve , Optic Neuritis , Prednisolone , Pupil , Reflex
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