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Seongnam, South Korea

Lee J.K.,Seoul National University | Lee S.,Seoul National University | Kim D.,The Armed Forces Capital Hospital | Lee S.M.,Eulji University | And 3 more authors.
Knee Surgery, Sports Traumatology, Arthroscopy

Purpose: The aims of this retrospective study were to provide the basis for the choice of prosthesis in revision total knee arthroplasty (TKA) and to evaluate the outcome with varus-valgus constrained prosthesis compared with posterior stabilized (PS) prosthesis. Methods: One hundred and five patients (121 knees) received revision TKA; of which thirty-seven patients (42 knees) received PS prosthesis and sixty-eight patients (79 knees) received varus-valgus constrained prosthesis. The mean follow-up duration was 64. 8 ± 31. 5 months and 63. 2 ± 28. 1 months in the PS and varus-valgus constrained groups, respectively. The criterion of prosthesis choice was a subjective laxity assessed by the surgeon intraoperatively. A multivariate analysis was performed to evaluate the preoperative factors in the choice of the prosthesis. Results: The grade of femoral bone defect was the only factor that affected the choice of prosthesis. Clinical results improved significantly in both groups after surgery. There were no significant differences in clinical results between the two groups. Complication rates were 9. 5 % in the PS group and 10. 1 % in the varus-valgus constrained group, and the Kaplan-Meier survivorship analysis revealed 8-year component survival rates of 83. 1 and 93. 0 % in the PS and varus-valgus constrained groups, respectively. Conclusions: Femoral bone defect is an important factor to be considered in the choice of prosthesis for revision TKA. The varus-valgus constrained prosthesis showed an outcome similar to that of the PS prosthesis. For clinical relevance, varus-valgus constrained prosthesis is recommended in revision TKA when the PS prosthesis seems unsuitable for the management of instability. Level of evidence: III. © 2012 Springer-Verlag. Source

Shim J.H.,Gwangmyeong Sung Ae General Hospital | Roh S.Y.,Gwangmyeong Sung Ae General Hospital | Kim J.S.,Gwangmyeong Sung Ae General Hospital | Lee D.C.,Gwangmyeong Sung Ae General Hospital | And 4 more authors.
Archives of Plastic Surgery

Background Measuring grip and pinch strength is an important part of hand injury evaluation. Currently, there are no standardized values of normal grip and pinch strength among the Korean population, and lack of such data prevents objective evaluation of post-surgical recovery in strength. This study was designed to establish the normal values of grip and pinch strength among the healthy Korean population and to identify any dependent variables affecting grip and pinch strength. Methods A cross-sectional study was carried out. The inclusion criterion was being a healthy Korean person without a previous history of hand trauma. The grip strength was measured using a Jamar dynamometer. Pulp and key pinch strength were measured with a hydraulic pinch gauge. Intra-individual and inter-individual variations in these variables were analyzed in a standardized statistical manner. Results There were a total of 336 healthy participants between 13 and 77 years of age. As would be expected in any given population, the mean grip and pinch strength was greater in the right hand than the left. Male participants (137) showed mean strengths greater than female participants (199) when adjusted for age. Among the male participants, anthropometric variables correlated positively with grip strength, but no such correlations were identifiable in female participants in a statistically significant way. Conclusions Objective measurements of hand strength are an important component of hand injury evaluation, and population-specific normative data are essential for clinical and research purposes. This study reports updated normative hand strengths of the South Korean population in the 21st century. © 2013 The Korean Society of Plastic and Reconstructive Surgeons. Source

Kim D.,The Armed Forces Capital Hospital | Seong S.C.,Seoul National University | Lee M.C.,Seoul National University | Lee S.,Seoul National University
Knee Surgery, Sports Traumatology, Arthroscopy

Purpose: The anatomical landmark for the anteroposterior (AP) axis of the proximal tibia and its variability was investigated in order to determine whether a certain landmark could be employed as a reference axis for the proximal tibia after the rotating platform mobile bearing and fixed bearing total knee arthroplasties (TKAs). Methods: Eighty primary osteoarthritic knees were randomized to undergo either rotating platform mobile bearing (Group A, n = 40) or fixed bearing (Group B, n = 40) TKAs, and were followed up for 31 and 30 months, respectively. The AP axes were defined for the distal femur, proximal tibia, ankle, and each TKA component on the reconstructed CT scan and the angles between the distal femoral AP axis and those of each bone or component were estimated. Clinical and radiographic outcomes were evaluated during the follow up. Results: A significant difference was seen between the preoperative and postoperative rotational position of the proximal tibia relative to the distal femur following rotating platform mobile bearing TKA (P = 0. 014) whereas no such difference was seen after fixed bearing TKA. The mean postoperative alignment of the tibia differed between the two groups (Group A:Group B = -2. 9:0. 2, P = 0. 010) and its variability was significantly greater in group A (P <0. 001). There were no differences in the clinical outcomes including range of motion, knee society score, function score, HSS, and WOMAC score as well as the mean postoperative coronal tibiofemoral alignment between the two groups. Conclusion: The unpredictable change in the rotational axis of the tibia and its broad variability after rotating platform mobile bearing TKA may provide a warning against the use of a fixed landmark for establishing tibial rotational alignment. Level of evidence: Prospective comparative study, Level II. © 2011 Springer-Verlag. Source

Park J.Y.,The Armed Forces Capital Hospital | Ahn R.S.,CHA Medical University

An exaggerated inflammatory process is considered an important pathophysiological feature of complex regional pain syndrome type 1 (CRPS-1). The hypothalamic-pituitary-adrenal (HPA) axis serves as a negative feedback mechanism for inflammatory processes. The present study examined the HPA axis function in patients with CRPS-1 by a determination of cortisol concentrations in saliva. Three sets of saliva samples were sequentially collected from 24 patients with CRPS-1 during medication (on-Med), 72. h after stopping medication (off-Med) and 8. h after the oral administration of 1. mg dexamethasone. One set of saliva samples was collected from healthy controls. The cortisol awakening response (CAR) and diurnal cortisol decline (DCD) were used as indices for HPA axis function. Cortisol levels during the post-awakening period in patients were increased following withdrawal of medications. The CAR during the off-Med condition was disappeared after administration of dexamethasone. Among the examined CRPS-related numerical variables, the frequency of spontaneous pain attacks showed relationships with the indices of HPA axis function. After classifying the patients into two subgroups, we observed that the CAR and DCD in patient who had a relatively high frequency of spontaneous pain attacks (subgroup 5≤) were lower and less steep than those in patient who had a relatively low frequency of spontaneous pain attacks (subgroup 0-4) for the on- and off-Med conditions. The CAR and DCD in subgroup 5≤ during their off-Med condition were comparable to those in controls. These results suggest that the increase in frequency of spontaneous pain attacks is associated with a reduced CAR and flattened DCD in patients CRPS-1. © 2012 Elsevier Ltd. Source

Lee S.,Seoul National University | Cho B.-K.,The Armed Forces Capital Hospital | Kim H.,Catholic University of Korea
Journal of Korean Neurosurgical Society

Presented here is a 36-year-old male with arterial hypertension who developed brainstem edema and intracranial hemorrhage. Magnetic resonance scan revealed diffuse brainstem hyperintensity in T2-weighted and fluid-attenuated inversion-recovery images, with an increase in apparent diffusion coefficient values. After a reduction in blood pressure, rapid resolution of the brainstem edema was observed on follow-up. The patient's condition was thus interpreted as hypertensive brainstem encephalopathy. While many consider this a vasogenic phenomenon, induced by sudden, severe hypertension, the precise mechanism remains unclear. Prompt recognition and aggressive antihypertensive treatment in such patients are essential to prevent permanent or life-threatening neurologic injury. © 2013 The Korean Neurosurgical Society. Source

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