345 results on '"Kyoung Min Lee"'
Search Results
2. Anomalous Gait Feature Classification From 3-D Motion Capture Data
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Seungbum Koo, Kyoung Min Lee, and Suil Jeon
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Artificial neural network ,Foot ,business.industry ,Computer science ,Feature vector ,Genu varum ,Pattern recognition ,Autoencoder ,Motion capture ,Biomechanical Phenomena ,Computer Science Applications ,Machine Learning ,Motion ,Gait (human) ,Health Information Management ,Feature (computer vision) ,Forward head posture ,medicine ,Humans ,Artificial intelligence ,Electrical and Electronic Engineering ,medicine.symptom ,business ,Gait ,Biotechnology - Abstract
The gait kinematics of an individual is affected by various factors, including age, anthropometry, gender, and disease. Detecting anomalous gait features aids in the diagnosis and treatment of gait-related diseases. The objective of this study was to develop a machine learning method for automatically classifying five anomalous gait features, i.e., toe-out, genu varum, pes planus, hindfoot valgus, and forward head posture features, from three-dimensional data on gait kinematics. Gait data and gait feature labels of 488 subjects were acquired. The orientations of the human body segments during a gait cycle were mapped to a low-dimensional latent gait vector using a variational autoencoder. A two-layer neural network was trained to classify five gait features using logistic regression and calculate an anomalous gait feature vector (AGFV). The proposed network showed balanced accuracies of 82.8% for a toe-out, 85.9% for hindfoot valgus, 80.2% for pes planus, 73.2% for genu varum, and 92.9% for forward head posture when the AGFV was rounded to the nearest zero or 1. Multiple anomalous gait features were detectable using the proposed method, which has a practical advantage over current gait indices, including the gait deviation index with a single value. The overall results confirmed the feasibility of using the proposed method for screening subjects with anomalous gait features using three-dimensional motion capture data.
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- 2022
3. National Trends in Pediatric CT Scans in South Korea: A Nationwide Cohort Study
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Moon Seok Park, Kyoung Min Lee, Soon Sun Kwon, Nak Tscheol Kim, and Ki Hyuk Sung
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medicine.medical_specialty ,child ,business.industry ,R895-920 ,computed tomography ,Pediatric ct ,radiation ,Medical physics. Medical radiology. Nuclear medicine ,x-ray ,Emergency medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,National trends ,business ,Cohort study - Abstract
This study evaluated the rates and annual trends of pediatric CT scans in South Korea using a nationwide population-based database.Data regarding pediatric CT scan usage between 2012 and 2017 were retrieved from the health insurance review and assessment service. Data on the age, sex, diagnosis, and the anatomical area of involved patients were also extracted.A total of 576376 CT examinations were performed among 58527528 children aged below 18 years (9.8 scans/1000 children), and the number of CT examinations per 1000 children was noted to have increased by 23.2% from 9.0 in 2012 to 11.0 in 2017. Specifically, the number of CT examinations increased by 32.9% for the 6-12 years of age group (7.4/1000 to 9.8/1000) and by 34.0% for the 13-18 years of age group (11.4/1000 to 15.3/1000). Moreover, majority of the CT scans were limited to the head (39.1%), followed by the extremities (32.5%) and the abdomen (13.7%). Notably, the number of extremity CT scans increased by 83.6% (2.3/1000 to 4.2/1000), and its proportion as compared to other scans increased from 25.3% to 37.7%.CT scans in the pediatric population increased continuously from 2012 to 2017 at an annual rate of 4.4%. Therefore, physicians should balance the benefits of CT with its potential harms from associated radiation exposure in pediatric patients.본 연구는 전국 인구 기반 데이터베이스를 이용하여 국내 소아 전산화단층촬영의 비율과 연간 추세를 평가하였다.2012년부터 2017년까지 국내에서 촬영된 소아 전산화단층촬영에 대한 건강보험 심사평가원의 데이터를 사용하였다. 연령, 성별, 진단명 및 해부학적 위치에 대한 데이터를 같이 추출하여 분석하였다.18세 미만 어린이 58527528명을 대상으로 총 576376건의 전산화단층촬영이 시행되었다(1000명당 9.8회). 어린이 1000명당 전산화단층촬영 횟수는 9.0회에서 11.0회로 23.2% 증가했다. 전산화단층촬영 건수는 6–12세 그룹에서 32.9%(1000명당 7.4회에서 9.8회로 증가), 13–18세 그룹에서 34.0% 증가했다(1000명당 11.4회에서 15.3회로 증가). 부위별 전산화단층촬영의 비율은 두부(39.1%), 사지(32.5%), 복부(13.7%) 순서로 확인되었다. 사지 전산화단층촬영 횟수는 83.6% 증가했으며(1000명당 2.3회에서 4.2회로 증가) 사지 전산화단층촬영의 비율은 25.3%에서 37.7%로 증가했다.소아 환자의 전산화단층촬영은 2012년부터 2017년까지 매년 4.4%의 속도로 지속적으로 증가했다. 따라서 의사는 소아 환자에서 전산화단층촬영으로 인한 이득과 방사선 노출로 인한 잠재적인 피해를 적절히 고려하여 신중하게 촬영을 결정해야 한다.
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- 2022
4. Effect of positioning error on the Hilgenreiner epiphyseal angle and the head-shaft angle compared to the femoral neck-shaft angle in children with cerebral palsy
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Kyoung Min Lee, Agnes G. d’Entremont, David R. Wilson, Kishore Mulpuri, Stacey Miller, Carly E. Jones, Emily S. Sullivan, and Moon Seok Park
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head-shaft angle ,hip ,abduction ,adduction ,neck-shaft angle ,Cerebral palsy ,medicine ,Hip Dislocation ,Humans ,Orthopedics and Sports Medicine ,Femur ,Child ,Femoral neck ,image positioning ,Femur Neck ,Femoral geometry ,business.industry ,Cerebral Palsy ,coxa valga ,Internal rotation ,Gross Motor Function Classification System ,Femoral rotation ,medicine.disease ,Hilgenreiner epiphyseal angle ,body regions ,external rotation ,medicine.anatomical_structure ,internal rotation ,embryonic structures ,Pediatrics, Perinatology and Child Health ,Nuclear medicine ,business ,Epiphyses ,measurement error - Abstract
Children with cerebral palsy (CP) often have changes in proximal femoral geometry. Neck-shaft angle (NSA), Hilgenreiner epiphyseal angle (HEA) and head-shaft angle (HSA) are used to measure these changes. The impact of femoral rotation on HEA/HSA and of ab/adduction on HEA/HSA/NSA is not well known. This study aimed to determine and compare the effect of rotation, ab/adduction and flexion/extension on HEA/HSA/NSA. Radiographic measurements from 384 patients with Gross Motor Function Classification System (GMFCS) levels I-V were utilized. NSA/HSA for affected hips were used with femoral anteversion averages to create three-dimensional models of 694 hips in children with CP. Each hip was rotated, ab/adducted and flexed/extended to simulate malpositioning. HEA/HSA/NSA of each model were measured in each joint position, and differences from correct positioning were determined. Mean HEA error at 20° of internal/external rotations were -0.60°/3.17°, respectively, with the NSA error of -6.56°/9.94° and the HSA error of -3.69°/1.21°. Each degree of ab/adduction added 1° of the HEA error, with no NSA/HSA error. NSA was most sensitive to flexion. Error for all measures increased with increasing GMFCS level. HEA/HSA were minimally impacted by rotation. NSA error was much higher than HEA/HSA in internal rotation and flexion whereas HEA was sensitive to changes in ab/adduction. Given abduction is more easily detectable on imaging than rotation, HEA may be less affected by positioning errors that are common with children with CP than NSA. HSA was least affected by position changes. HEA/HSA could be robust, complementary measures of hip deformities in children with CP.
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- 2021
5. Relationship between radiographic measurements and knee adduction moment using 3D gait analysis
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Kyoung Min Lee, Na Kyoung Lee, Chong Bum Chang, H.-S. Han, Seung Baik Kang, and Seungbum Koo
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Male ,Knee Joint ,Biophysics ,Osteoarthritis ,Standard deviation ,Gait (human) ,Linear regression ,medicine ,Humans ,Knee ,Orthopedics and Sports Medicine ,Gait ,Aged ,Orthodontics ,business.industry ,Rehabilitation ,Regression analysis ,Osteoarthritis, Knee ,medicine.disease ,Biomechanical Phenomena ,medicine.anatomical_structure ,Gait analysis ,Female ,Ankle ,Gait Analysis ,business - Abstract
Radiographic factors estimate the state of the static knee joint, and it is questionable how well these parameters reflect the dynamic knee condition. The external knee adduction moment (KAM) during gait is known to be a kinetic variable contributing to osteoarthritis progression. This study aims to investigate the effects of static radiographic parameters on the dynamic KAM during gait.Overall, 123 patients (mean age, 65.7 years; standard deviation, 8.1 years; 34 men and 89 women) were included. Seven radiographic parameters including the mechanical tibiofemoral angle (mTFA), Kellgren-Lawrence grade, and ankle joint line orientation (AJLO) were measured on radiographs, and the maximum KAM and KAM-time integral in the stance phase were obtained using three-dimensional gait analysis. The correlation and multiple regression analyses were performed for identifying significant radiographic measurements associated with the KAM.Most of the radiographic measurements correlated with the maximum KAM and KAM-time integral. As a result of multiple regression analysis, the mTFA (p 0.001) and AJLO (p = 0.003) were identified as significant factors associated with the KAM-time integral (RThe mTFA and AJLO were significantly associated with the KAM. However, to be used as a surgical indication for corrective osteotomy, a longitudinal study is needed to validate whether the mTFA and AJLO values directly cause osteoarthritis progression as we have suggested.III.
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- 2021
6. What happens to the patella height in patients with cerebral palsy as they age
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Chin Youb Chung, Kyoung Min Lee, Jae Jung Min, Soon Sun Kwon, Hansang Lee, Moon Seok Park, and Ki Hyuk Sung
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medicine.medical_specialty ,business.industry ,Cerebral Palsy ,Retrospective cohort study ,Gross Motor Function Classification System ,Patella ,medicine.disease ,Cerebral palsy ,Radiography ,Child, Preschool ,Reference values ,Internal medicine ,Pediatrics, Perinatology and Child Health ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Bone Diseases ,business ,Retrospective Studies - Abstract
OBJECTIVE We aimed to investigate the progression of patella alta (PA) in patients with cerebral palsy (CP) using the Koshino-Sugimoto (KS) index and assess associated risk factors. METHOD Participants in our retrospective study met the following inclusion criteria: patients with CP who visited our institute from May 2003 to December 2019, were ≤18 years of age, were followed up for >2 years and had at least two lateral knee radiographs. KS indices of both knee radiographs were measured for each patient. A linear mixed model was implemented. RESULTS Our participants included 222 CP patients. KS index values were measured via 652 knee radiographs. Reference values of the KS index for those between 4 and 18 years of age were determined according to Gross Motor Function Classification System (GMFCS) levels. In all GMFCS levels, the KS index decreased with patients' ages (P < 0.0001). In groups where the KS index increased, GMFCS levels IV (P = 0.0045) and V (P = 0.0040) were statistically significant. CONCLUSIONS Change in the KS index values indicates that PA improves as patients age within all GMFCS levels. However, in patients with GMFCS levels of IV and V, progressive PA is expected.
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- 2021
7. Evaluation of factors affecting external tibial torsion in patients with cerebral palsy
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Jae Jung Min, Kyu Tae Kim, Kyoung Min Lee, Ki Hyuk Sung, Soon Sun Kwon, Moon Seok Park, and Young Sang Choi
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Torsion Abnormality ,medicine.medical_specialty ,Sports medicine ,medicine.medical_treatment ,Hemiplegia ,Tibial torsion ,Diseases of the musculoskeletal system ,Cerebral palsy ,Rheumatology ,Internal medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Femur ,Gait ,Gait deviation ,Aged ,Retrospective Studies ,Rehabilitation ,Tibia ,business.industry ,Research ,Gross Motor Function Classification System ,medicine.disease ,musculoskeletal system ,Surgery ,body regions ,RC925-935 ,Orthopedic surgery ,Inclusion and exclusion criteria ,Femoral anteversion ,business - Abstract
BackgroundGait deviation and associated torsional problems are common in patients with cerebral palsy (CP). Although femoral anteversion in CP has been extensively reviewed in previous studies, only a few studies have focused on tibial torsion. Therefore, this study aimed to evaluate tibial torsion in patients with CP and investigate the affecting factors.MethodsConsecutive patients with cerebral palsy who underwent 3-dimensional computed tomography for the assessment of rotational profiles were reviewed. Femoral anteversion and tibial torsion were measured, and the demographic characteristics of the patients were recorded. A linear mixed model was implemented to overcome the retrospective nature of the study.ResultsAfter the implementation of inclusion and exclusion criteria, 472 patients were enrolled for this study. With age, external tibial torsion increased, while femoral anteversion decreased. The factors affecting external tibial torsion were increased femoral anteversion (p = 0.0057), increased age (p p p = 0.0471/p = 0.0047).ConclusionsOlder age, GMFCS level IV/V, hemiplegia, and increased femoral anteversion were the independent risk factors of increasedexternaltibial torsion; therefore, performing an imaging study is recommended for assessing the extent of tibial torsion in patients with such characteristics.
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- 2021
8. Comparison of Bone Mineral Density and Markers of Bone Turnover in Osteoporotic Women after 6-Month Treatment with Alendronate or Bazedoxifene: A Randomized Controlled Trial
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Sung Hee Cho, Ki Hyuk Sung, Kyoung Min Lee, Hee Soo Han, and Moon Seok Park
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0301 basic medicine ,medicine.medical_specialty ,Bone density ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Urology ,Bone resorption ,030209 endocrinology & metabolism ,Bazedoxifene ,Bone remodeling ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,N-terminal telopeptide ,Osteogenesis ,Medicine ,Bone mineral ,Alendronate ,biology ,business.industry ,Bisphosphonate ,Osteocalcin ,biology.protein ,Original Article ,030101 anatomy & morphology ,Selective estrogen receptor modulators ,business ,medicine.drug - Abstract
Background In a randomized controlled trial, we compared the bone mineral densities (BMDs) and blood markers of bone turnover during short-term treatment of osteoporotic women with bisphosphonate alendronate or bazedoxifene, a selective estrogen receptor modulator. Methods Ten and eleven patients were randomized to the alendronate and bazedoxifene groups, respectively. BMDs were measured before and after 6 months of treatment. Blood tests were used to measure the levels of osteocalcin (OC), C-terminal telopeptide of type I collagen (CTX), vitamin D3, and parathyroid hormone pretreatment and after 3 and 6 months of treatment. The variables were compared statistically. Results The alendronate group showed decreases in blood levels of both OC and CTX during the study period (P
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- 2021
9. Prevalence of Gait Features in Healthy Adolescents and Adults
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Ki Hyuk Sung, Kyoung Min Lee, Nak Tscheol Kim, Moon Seok Park, Seung Jun Moon, Kug Jin Choi, and Woo Young Choi
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medicine.medical_specialty ,Gait (human) ,Physical medicine and rehabilitation ,business.industry ,medicine ,business - Published
- 2021
10. Longitudinal Changes in Layered Retinal Thickness during Axial Elongation in Healthy Myopic Eyes
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Seok Hwan Kim, Martha Kim, Kyoung Min Lee, Ho Kyung Choung, Sohee Oh, and Min Seob Park
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Ophthalmology ,medicine.medical_specialty ,chemistry.chemical_compound ,chemistry ,business.industry ,medicine ,Retinal ,business ,Axial elongation - Published
- 2021
11. A two-way coupled CFD-DQMOM approach for long-term dynamic simulation of a fluidized bed reactor
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Kyoung Min Lee, Youngseok Bak, Minjun Kim, and Jong Min Lee
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Computer science ,business.industry ,General Chemical Engineering ,Flow (psychology) ,02 engineering and technology ,General Chemistry ,Mechanics ,Method of moments (statistics) ,Computational fluid dynamics ,021001 nanoscience & nanotechnology ,Term (time) ,Dynamic simulation ,020401 chemical engineering ,Fluidized bed ,Nyström method ,0204 chemical engineering ,0210 nano-technology ,MATLAB ,business ,computer ,computer.programming_language - Abstract
For the long-term dynamic simulation of a fluidized bed reactor (FBR), a two-way coupled computational fluid dynamics (CFD)-direct quadrature method of moments (DQMOM) approach is proposed. In this approach, CFD is first used only for hydrodynamic information without simulating any other chemical reactions or physical phenomena. Subsequently, the derived information is applied to the DQMOM calculation in MATLAB. From the calculation, a particle size distribution is obtained and subsequently adopted in a new CFD model to reflect the flow change caused by a change in the particle size distribution. Through several iterative calculations, long-term dynamic simulations are performed. To evaluate the efficacy of the proposed approach, the results from the suggested approach are compared for 60 s with those of the CFD-quadrature method of moments (QMOM) approach, which calculates hydrodynamics and physical phenomena simultaneously in CFD. The proposed approach successfully simulated the FBR for 6 h. The results confirmed that the proposed method can simulate complex flow patterns, which cannot be obtained in conventional CFD models. Another advantage of the approach is that it can be applied to various industrial multiphase reactors without any tuning parameters.
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- 2021
12. Changes in the bony alignment of the foot after tendo-Achilles lengthening in patients with planovalgus deformity
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Ohsang Kwon, Ki Hyuk Sung, Kyoung Min Lee, Nak Tscheol Kim, Moon Seok Park, and Young Tae Lee
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Adult ,Male ,medicine.medical_specialty ,Tendo achilles lengthening ,lcsh:Diseases of the musculoskeletal system ,Adolescent ,Achilles Tendon ,Cerebral palsy ,Bony alignment ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,lcsh:Orthopedic surgery ,Planovalgus foot deformity ,medicine ,Deformity ,Tendo-Achilles lengthening ,Humans ,Orthopedics and Sports Medicine ,Achilles tendon contracture ,In patient ,Child ,skin and connective tissue diseases ,Foot deformity ,Metatarsal Bones ,Orthodontics ,030222 orthopedics ,business.industry ,Age Factors ,030229 sport sciences ,medicine.disease ,Flatfoot ,Calcaneus ,lcsh:RD701-811 ,Tenotomy ,Child, Preschool ,Orthopedic surgery ,Surgery ,Female ,sense organs ,medicine.symptom ,lcsh:RC925-935 ,business ,Foot (unit) ,Research Article - Abstract
Background This study was performed to investigate the change in the bony alignment of the foot after tendo-Achilles lengthening (TAL) and the factors that affect these changes in patients with planovalgus foot deformity. Methods Consecutive 97 patients (150 feet; mean age 10 years; range 5.1–35.7) with Achilles tendon contracture (ATC) and planovalgus foot deformity who underwent TAL were included. All patients underwent preoperative and postoperative weight-bearing anteroposterior (AP) or lateral (LAT) foot radiographics. Changes in AP talo-1st metatarsal angle, AP talo-2nd metatarsal angle, LAT talo-1st metatarsal angle, and calcaneal pitch angle and the factors affecting such changes after TAL were analyzed using lineal mixed model. Results There were no significant change in AP talo-1st metatarsal angle and AP talo-2nd metatarsal angle after TAL in patients with cerebral palsy (CP) (p = 0.236 and 0.212). However, LAT talo-1st metatarsal angle and calcaneal pitch angle were significantly improved after TAL (13.0°, p < 0.001 and 4.5°, p < 0.001). Age was significantly associated with the change in LAT talo-1st metatarsal angle after TAL (p = 0.028). The changes in AP talo-1st metatarsal angle, AP talo-2nd metatarsal angle, and calcaneal pitch angle after TAL were not significantly associated with the diagnosis (p = 0.879, 0.903, and 0.056). However, patients with CP showed more improvement in LAT talo-1st metatarsal angle (− 5.0°, p = 0.034) than those with idiopathic cause. Conclusion This study showed that TAL can improve the bony alignment of the foot in patients with planovalgus and ATC. We recommend that physicians should consider this study’s findings when planning operative treatment for such patients.
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- 2021
13. Remodelling of femoral head deformity after hip reconstructive surgery in patients with cerebral palsy
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Ki Hyuk Sung, Soon Sun Kwon, Kyoung Min Lee, Moon Seok Park, Chin Youb Chung, and Jae Jung Min
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Male ,Reconstructive surgery ,medicine.medical_specialty ,Mose hip ratio ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,Femoral Head Deformity ,Femoral head deformity ,Annular ligament reconstruction ,Hip Dislocation ,Humans ,Medicine ,Hip reconstructive surgery ,Orthopedics and Sports Medicine ,Displacement (orthopedic surgery) ,In patient ,030212 general & internal medicine ,Child ,Retrospective Studies ,030222 orthopedics ,business.industry ,Cerebral Palsy ,Open reduction ,Femur Head ,Children’s Orthopaedics ,Plastic Surgery Procedures ,medicine.disease ,Ulnar osteotomy ,Osteotomy ,Surgery ,CP hip displacement ,Chronic Monteggia ,Female ,Bone Remodeling ,business - Abstract
Aims Hip displacement, common in patients with cerebral palsy (CP), causes pain and hinders adequate care. Hip reconstructive surgery (HRS) is performed to treat hip displacement; however, only a few studies have quantitatively assessed femoral head sphericity after HRS. The aim of this study was to quantitatively assess improvement in hip sphericity after HRS in patients with CP. Methods We retrospectively analyzed hip radiographs of patients who had undergone HRS because of CP-associated hip displacement. The pre- and postoperative migration percentage (MP), femoral neck-shaft angle (NSA), and sphericity, as determined by the Mose hip ratio (MHR), age at surgery, Gross Motor Function Classification System level, surgical history including Dega pelvic osteotomy, and triradiate cartilage status were studied. Regression analyses using linear mixed model were performed to identify factors affecting hip sphericity improvement. Results A total of 108 patients were enrolled. The mean preoperative MP was 58.3% (SD 31.7%), which improved to 9.1% (SD 15.6%) at the last follow-up. NSA and MHR improved from 156.5° (SD 11.5°) and 82.3% (SD 8.6%) to 126.0° (SD 18.5°) and 89.1% (SD 9.0%), respectively. Factors affecting the postoperative MHR were preoperative MP (p = 0.005), immediate postoperative MP (p = 0.032), and history of Dega osteotomy (p = 0.046). Conclusion We found that hip sphericity improves with HRS. Preoperative MP, reduction quality, and acetabular coverage influence femoral head remodelling. We recommend that surgeons should consider intervention early before hip displacement progresses and that during HRS, definite reduction and coverage of the femoral head should be obtained. Cite this article: Bone Joint J 2021;103-B(1):198–203.
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- 2021
14. Patients’ perspectives on the conventional synthetic cast vs a newly developed open cast for ankle sprains
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Kyoung Min Lee, Chin Youb Chung, Ji Soo Yoon, Byung Cho Min, Moon Seok Park, and Ki Hyuk Sung
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030222 orthopedics ,medicine.medical_specialty ,business.industry ,education ,030229 sport sciences ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Physical therapy ,Medicine ,Orthopedics and Sports Medicine ,Ankle ,business ,Ankle sprain ,human activities - Abstract
Patients’ perspectives on the conventional synthetic cast vs a newly developed open cast for ankle sprains
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- 2020
15. A system-level approach identifies HIF-2α as a critical regulator of chondrosarcoma progression
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Hyun Guy Kang, Yi Jun Kim, Kyoung Min Lee, Yongsik Cho, Jin-Hong Kim, Moon Jong Chang, Chong Bum Chang, Donghyeon Cheon, Hyeon Seop Kim, Hyeonkyeong Kim, Donghyun Kang, and Seung Baik Kang
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musculoskeletal diseases ,0301 basic medicine ,animal structures ,Science ,Chondrosarcoma ,Regulator ,Mice, Nude ,General Physics and Astronomy ,Bone Neoplasms ,Malignancy ,Article ,General Biochemistry, Genetics and Molecular Biology ,Metastasis ,03 medical and health sciences ,Targeted therapies ,0302 clinical medicine ,Cell Line, Tumor ,Antineoplastic Combined Chemotherapy Protocols ,Basic Helix-Loop-Helix Transcription Factors ,medicine ,Animals ,Humans ,Gene Regulatory Networks ,lcsh:Science ,Regulation of gene expression ,Multidisciplinary ,business.industry ,EPAS1 Gene ,Cancer ,Sarcoma ,General Chemistry ,musculoskeletal system ,medicine.disease ,Xenograft Model Antitumor Assays ,Isocitrate Dehydrogenase ,Gene Expression Regulation, Neoplastic ,030104 developmental biology ,Tumor progression ,030220 oncology & carcinogenesis ,embryonic structures ,Cancer research ,Benzimidazoles ,Female ,lcsh:Q ,Cisplatin ,business - Abstract
Chondrosarcomas, malignant cartilaginous neoplasms, are capable of transitioning to highly aggressive, metastatic, and treatment-refractory states, resulting in significant patient mortality. Here, we aim to uncover the transcriptional program directing such tumor progression in chondrosarcomas. We conduct weighted correlation network analysis to extract a characteristic gene module underlying chondrosarcoma malignancy. Hypoxia-inducible factor-2α (HIF-2α, encoded by EPAS1) is identified as an upstream regulator that governs the malignancy gene module. HIF-2α is upregulated in high-grade chondrosarcoma biopsies and EPAS1 gene amplification is associated with poor prognosis in chondrosarcoma patients. Using tumor xenograft mouse models, we demonstrate that HIF-2α confers chondrosarcomas the capacities required for tumor growth, local invasion, and metastasis. Meanwhile, pharmacological inhibition of HIF-2α, in conjunction with the chemotherapy agents, synergistically enhances chondrosarcoma cell apoptosis and abolishes malignant signatures of chondrosarcoma in mice. We expect that our insights into the pathogenesis of chondrosarcoma will provide guidelines for the development of molecular targeted therapeutics for chondrosarcoma., Chondrosarcomas are frequently aggressive, understanding the transcriptional changes associated with progression may help in developing new treatments. Here, the authors show that HIF-2α is increased in expression on progression and pharmacological inhibition of the protein together with chemotherapy is a useful strategy for controlling tumour growth in mice.
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- 2020
16. Factors Affecting Subjective Symptoms in Children with Pes Planovalgus Deformity
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Jae Jung Min, Moon Seok Park, Kyoung Min Lee, Ki Hyuk Sung, Soon Sun Kwon, and Chin Youb Chung
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Male ,medicine.medical_specialty ,Adolescent ,Radiography ,Severity of Illness Index ,Diagnostic Self Evaluation ,Deformity ,Humans ,Medicine ,Orthopedics and Sports Medicine ,In patient ,Child ,Retrospective Studies ,biology ,business.industry ,Forefoot ,General Medicine ,biology.organism_classification ,Flatfoot ,body regions ,Valgus ,medicine.anatomical_structure ,Physical therapy ,Female ,Surgery ,Self Report ,Ankle ,medicine.symptom ,business ,Foot (unit) ,Pes planovalgus - Abstract
BACKGROUND Idiopathic pes planovalgus is one of the most common foot deformities in children and adolescents. However, there is a discrepancy between subjective symptoms and radiographic severity in idiopathic planovalgus deformity, and very few studies have investigated this aspect. Further, the assessment of subjective symptoms in patients with pes planovalgus requires a quantitative scoring system for making meaningful comparisons, such as the Oxford Ankle Foot Questionnaire for Children (OxAFQ-c) and that for parents (OxAFQ-p). Therefore, the purpose of this study was to evaluate the factors affecting the symptoms of idiopathic planovalgus using the OxAFQ. METHODS All patients who were ≤18 years of age, had visited our clinic for the evaluation of pes planovalgus deformity, and had completed the OxAFQ were included in this study. The anteroposterior talo-first metatarsal, lateral talo-first metatarsal, and hallux valgus angles were measured on weight-bearing radiographs. The data were analyzed using a multiple regression model, with age, sex, and radiographic indices as explanatory variables. RESULTS Overall, 123 patients were enrolled in this study, and 246 standing foot radiographs were evaluated along with scores in each domain of the OxAFQ. The factors affecting physical domain scores in the OxAFQ-c were female sex (p = 0.047) and the anteroposterior talo-first metatarsal angle (p = 0.033). Age of ≥10 years was a significant factor (p < 0.05) affecting all domains in both the OxAFQ-c and OxAFQ-p other than the physical domain score. CONCLUSIONS Although pes planovalgus deformity is 3-dimensional, the forefoot abduction component of the deformity should be carefully assessed as it is closely related to subjective symptoms. Further, in female patients with a more severe anteroposterior talo-first metatarsal angle, an aggravation of symptoms with aging should be expected when managing pes planovalgus deformity. LEVEL OF EVIDENCE Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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- 2020
17. Surgical outcomes after single event multilevel surgery in cerebral palsy patients with mid-stance knee hyperextension
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Ki Hyuk Sung, Moon Seok Park, Chin Youb Chung, Kyoung Min Lee, and Soon Sun Kwon
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Male ,musculoskeletal diseases ,medicine.medical_specialty ,Adolescent ,Knee Joint ,Biophysics ,Hyperextension ,Multilevel surgery ,Hamstring Muscles ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Postoperative Period ,Child ,Muscle, Skeletal ,Retrospective Studies ,business.industry ,Cerebral Palsy ,Rehabilitation ,030229 sport sciences ,musculoskeletal system ,medicine.disease ,Sagittal plane ,Biomechanical Phenomena ,Surgery ,Tenotomy ,Treatment Outcome ,medicine.anatomical_structure ,Child, Preschool ,Gait analysis ,Standing Position ,Female ,Ankle ,Gait Analysis ,business ,Ankle Joint ,030217 neurology & neurosurgery ,Hamstring lengthening - Abstract
Background Some patients with cerebral palsy (CP) exhibit excessive knee flexion at initial contact followed by knee hyperextension (KE) in mid-stance. Research question This study investigated the change in sagittal kinematics after distal hamstring lengthening (DHL) and triceps surae lengthening procedures in CP patients with KE, and compared it to those without KE. In addition, the risk factors for the worsening of postoperative KE were analyzed. Methods Consecutive 312 patients (596 limbs) with CP who underwent DHL and triceps surae lengthening were included. All patients underwent preoperative and 1-year postoperative three-dimensional gait analysis. Patients’ limbs were divided into the KE and knee flexion (KF) groups, according to preoperative minimum knee flexion in stance. KE was defined as minimum knee flexion in stance less than 0°. Results The KE and KF groups included 130 and 466 limbs, respectively. Knee and ankle sagittal kinematics significantly improved after surgery in both groups. Minimum knee flexion in stance significantly increased from -6.6˚ to 0.5˚ in the KE group, but decreased from 14.6˚ to 7.8˚ in the KF group. Among the KE group, minimum knee flexion in stance improved in 103 limbs (79.2 %), but worsened in 27 limbs (20.8 %). Degree of preoperative KE was the only factor significantly associated with postoperative worsening of KE (p=0.002). The cutoff value for the worsening of KE was -5.8˚ of preoperative minimum knee flexion in stance. Significance This study demonstrated that the sagittal kinematics of the knee and ankle joints improved after DHL and triceps surae lengthening procedures in CP patients with and without KE. Preoperative degree of KE was a risk factor for the worsening of KE after surgery. Therefore, careful selection for indication of DHL is required to prevent postoperative KE due to overlengthening of the hamstrings, particularly in patients with severe preoperative KE.
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- 2020
18. Radiographic changes of the mid-tarsal joint after calcaneal lengthening for planovalgus foot deformity
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Moon Seok Park, Ki Hyuk Sung, Chin Youb Chung, Soon Sun Kwon, and Kyoung Min Lee
- Subjects
Foot Deformities ,musculoskeletal diseases ,medicine.medical_specialty ,Adolescent ,Radiography ,Arthritis ,Tarsal Joints ,Young Adult ,Risk Factors ,Deformity ,medicine ,Humans ,Orthopedics and Sports Medicine ,Child ,Foot deformity ,Retrospective Studies ,Subluxation ,business.industry ,Tarsal Joint ,Surgical correction ,medicine.disease ,Surgery ,Calcaneus ,Child, Preschool ,Female ,sense organs ,medicine.symptom ,business - Abstract
Background This study evaluate the radiographic changes in the mid-tarsal joint, including the calcaneocuboid and talonavicular (TN) joints after calcaneal lengthening for planovalgus deformity in children. Methods This study included 38 patients (68 feet) who underwent calcaneal lengthening for planovalgus deformity. Radiographic osteoarthritic changes at the CC or TN joint were defined as modified Kellgren–Lawrence grade of ≥1. Results Among the 68 feet, 31 feet (45.6%) showed radiographic osteoarthritic changes at the CC joint and 20 (29.4%) showed changes at the TN joint. Risk of radiographic osteoarthritic changes at the CC joint was associated with increased age at surgery (OR = 1.2, p = 0.038). Risk of radiographic osteoarthritic changes at the TN joint was associated with increased age at surgery (OR = 2.2; p = 0.002), preoperative AP talus-1st metatarsal angle (OR = 1.1; p = 0.044), and degree of CC subluxation (OR = 2.1; p = 0.007). Conclusions Surgeons should consider the risk factors in the surgical correction of planovalgus deformity to prevent mid-tarsal arthritis.
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- 2020
19. Effects of soft tissue surgery on transverse kinematics in patients with cerebral palsy
- Author
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Seong Hee Cho, Moon Seok Park, Byeong Seop Park, Kyoung Min Lee, Ki Hyuk Sung, and Chin Youb Chung
- Subjects
Male ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,Adolescent ,Transverse kinematics ,Cerebral palsy ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Multilevel surgery ,Rheumatology ,Internal medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Child ,Retrospective Studies ,Gait Disturbance ,business.industry ,Soft tissue ,030229 sport sciences ,medicine.disease ,Gait ,Sagittal plane ,Surgery ,Biomechanical Phenomena ,medicine.anatomical_structure ,Treatment Outcome ,Gait analysis ,Child, Preschool ,Orthopedic surgery ,Female ,lcsh:RC925-935 ,business ,Soft tissue surgery ,030217 neurology & neurosurgery ,Research Article - Abstract
Background Gait disturbances, including flexed knee gait, stiff knee gait, and tip-toeing gait, are common in patients with cerebral palsy (CP). There has been no reports regarding kinematic changes in the transverse plane after soft tissue surgeries, such as distal hamstring lengthening (DHL), rectus femoris transfer (RFT), and tendo-Achilles lengthening (TAL). This study aimed to evaluate changes in the transverse plane after soft tissue surgery in patients with CP by assessing the effects of the DHL, RFT, and TAL. Methods The study enrolled 156 consecutive patients (mean age, 8.4 years; range, 4.4 to 20.9), representing 213 operated limbs, who underwent soft tissue surgery including DHL with semitendinosus transfer, RFT, and TAL. All patients were assessed by preoperative and 1-year postoperative three-dimensional gait analysis. Changes in transverse plane kinematics after soft tissue surgery and affecting factors were analyzed. Results Sagittal kinematics including knee flexion at initial contact, ankle dorsiflexion at initial contact, and mean ankle dorsiflexion in the stance phase were significantly improved after single event multilevel surgery (all p p = 0.004 and − 9.5°, p p = 0.010) and the foot progression angle was significantly improved to a more external angle by TAL (− 3.9°, p = 0.028). Conclusions This study found that the transverse kinematics were improved to a more external angle after soft tissue surgery in patients with CP. Therefore, clinicians should consider that soft tissue surgery can affect the transverse plane kinematics in patients with CP. To confirm our findings, further research regarding the natural history of femoral and tibial torsion in children with CP is needed.
- Published
- 2019
20. Analysis of three-dimensional computed tomography talar morphology in relation to pediatric pes planovalgus deformity
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Moon Seok Park, Seungbum Koo, Soon Do Wang, Ki Hyuk Sung, Kyoung Min Lee, Ki Jin Jung, Chin Youb Chung, and Sang Il Moon
- Subjects
Male ,Radiography ,Pes planus ,Talus ,03 medical and health sciences ,Imaging, Three-Dimensional ,0302 clinical medicine ,Deformity ,Humans ,Medicine ,Orthopedics and Sports Medicine ,Child ,Retrospective Studies ,Orthodontics ,030222 orthopedics ,business.industry ,Cerebral Palsy ,Biomechanics ,Flatfoot ,Sagittal plane ,body regions ,Tarsal Bone ,medicine.anatomical_structure ,Coronal plane ,Pediatrics, Perinatology and Child Health ,Female ,medicine.symptom ,Ankle ,Tomography, X-Ray Computed ,business ,human activities ,030217 neurology & neurosurgery - Abstract
Intraosseous alignment of the tarsal bone has not been investigated in relation to various foot deformities. This study aimed to investigate three-dimensional computed tomography (3D CT) talar morphology in children with idiopathic and neuromuscular pes planovalgus. Eleven children [nine boys, two girls; mean (SD) age: 10.5 (2.8) years] with idiopathic pes planovalgus and 15 children [three boys, 12 girls; mean (SD) age: 10.8 (3.4) years] with neuromuscular pes planovalgus were included. All patients underwent 3D CT and weight-bearing anteroposterior, lateral, and axial radiography. Demographic data and talar 3D CT and radiographic measurements were compared between both groups. The correlation between the measurements was also analyzed. The neuromuscular group showed significantly more severe deformity than the idiopathic group in the radiographic and 3D sagittal talus measurements. The 3D coronal talus measurement showed a significant negative correlation with the axial hindfoot alignment in the idiopathic group while the 3D transverse talus measurement was significantly correlated with the lateral talocalcaneal angle in the neuromuscular group. 3D intraosseous alignment of the talus is correlated with pes planus deformity. Longitudinal and biomechanical studies including a control group are necessary to elucidate the role of 3D talar morphology on a dynamic imbalance in pes planovalgus.
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- 2019
21. Morphological Characteristics of Os Subfibulare Related to Failure of Conservative Treatment of Chronic Lateral Ankle Instability
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Jae Hee Lee, Doo Jae Lee, Dong Yeon Lee, Kyoung Min Lee, Min Gyu Kyung, and Hyuck Soo Shin
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Adult ,Joint Instability ,Male ,medicine.medical_specialty ,Lateral ankle ,Adolescent ,Radiography ,Usually asymptomatic ,Conservative Treatment ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Treatment Failure ,Aged ,Retrospective Studies ,030222 orthopedics ,business.industry ,030229 sport sciences ,Middle Aged ,Conservative treatment ,Fibula ,Female ,Surgery ,Radiology ,Lateral Ligament, Ankle ,business - Abstract
Background: The os subfibulare is usually asymptomatic and found incidentally on radiographs. However, sometimes it may cause subfibular pain and may be associated with chronic lateral ankle instability (CLAI). We hypothesized that os subfibulare could interrupt the talofibular space causing impingement, resulting in chronic pain and functional instability around the lateral malleolus. The purposes of this study were to analyze morphologic characteristics of os subfibulare, and to evaluate the clinical significance of the os subfibulare in patients with CLAI. Methods: Between November 2011 and April 2015, 70 patients who had both computed tomography (CT) and magnetic resonance imaging (MRI) among 252 patients who visited our hospital with the symptom of lateral ankle instability were included in this study. The location of the ossicle was classified into 3 zones in reference to the attachment site of the lateral ankle ligaments. The impingement was classified into 2 groups according to the presence of talofibular encroachment. Digital radiographs were used to measure the ossicle width and shape determined by the length and width on an magnetic resonance (MR) image. Results: The most common shape of ossicles was oval, and the most common location of ossicles was at the anterior talofibular ligament (ATFL) attachment site. Sixty-one percent of patients showed talofibular impingement on coronal MR images. In 48 cases, the dimension of fibula plus os subfibulare was larger than that of the contralateral normal fibula. The larger size and talofibular impingement of the ossicle were associated with greater need for operative treatment in patients with ankle instability. Conclusion: The morphologic analysis of the os subfibulare revealed that there might be impingement of the talofibular space by the ossicle in some patients. We suggest that morphologic characteristics of the os subfibulare should be considered when selecting treatment options in patients with CLAI and os subfibulare. Level of Evidence: Level III, retrospective comparative series.
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- 2019
22. Lengthening and deformity correction in vascularized fibular autograft for a patient with Ewing sarcoma
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Kyoung Min Lee, Moon Seok Park, Ki Hyuk Sung, Ki Bum Kwon, and Chin Youb Chung
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musculoskeletal diseases ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Nonunion ,Sarcoma, Ewing ,Bone Lengthening ,Deformity ,medicine ,Humans ,Outpatient clinic ,Tibia ,Autografts ,Child ,Varus deformity ,Orthopedic surgery ,Osteosynthesis ,business.industry ,medicine.disease ,musculoskeletal system ,Surgery ,Treatment Outcome ,surgical procedures, operative ,Fibula ,Distraction osteogenesis ,Female ,medicine.symptom ,business ,RD701-811 ,Corticotomy - Abstract
We report the case of a pediatric patient with Ewing’s sarcoma of the tibia treated with vascularized fibular autograft where the resulting limb deformity and leg length discrepancy (LLD) were corrected using Ilizarov external fixator. A 14-year-old girl presented to our outpatient clinic with a deformity of the right proximal and distal tibia and an 11.7 cm of LLD after tumor reconstruction surgery. Deformity correction and limb lengthening were simultaneously performed using double corticotomy on the right proximal and distal tibia. One year postoperatively, the union of the right proximal tibia had progressed, but nonunion was observed at the right distal corticotomy site. To address this, osteosynthesis with tricortical iliac bone allograft was performed after the removal of the Ilizarov external fixator. After 6 months, the union of the distal tibia was confirmed, and the varus deformity of proximal and distal tibia improved. The LLD was also decreased, but the left lower limb was still longer by 3 cm. This report shows that vascularized fibular autografts can potentially be used for the gradual correction of LLD and deformities. However, for the treatment of multiple deformities in bones previously reconstructed with vascularized fibular graft, the possibility of impaired bone forming potential of the fibular graft should be considered.
- Published
- 2021
23. Relationship between ankle varus moment during gait and radiographic measurements in patients with medial ankle osteoarthritis
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Young Jin Park, Kyoung Min Lee, Seungbum Koo, Hee Soo Han, Ji Hye Choi, and Taeyong Lee
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Male ,Physiology ,medicine.medical_treatment ,Radiography ,Osteoarthritis ,0302 clinical medicine ,Mathematical and Statistical Techniques ,Skeletal Joints ,Medicine and Health Sciences ,Biomechanics ,Prospective Studies ,Musculoskeletal System ,Gait ,Orthodontics ,030222 orthopedics ,Multidisciplinary ,Feet ,Statistics ,Middle Aged ,musculoskeletal system ,Ankle Joints ,Biomechanical Phenomena ,medicine.anatomical_structure ,Physical Sciences ,Medicine ,Legs ,Regression Analysis ,Female ,Anatomy ,Gait Analysis ,Research Article ,musculoskeletal diseases ,Tomography Scanners, X-Ray Computed ,Science ,Surgical and Invasive Medical Procedures ,Research and Analysis Methods ,03 medical and health sciences ,Rheumatology ,medicine ,Humans ,Statistical Methods ,Skeleton ,Balance (ability) ,Aged ,business.industry ,Biological Locomotion ,Arthritis ,Ankles ,Biology and Life Sciences ,030229 sport sciences ,medicine.disease ,Arthroplasty ,Gait analysis ,Body Limbs ,Ankle ,business ,Mathematics ,Ankle Joint - Abstract
Background Kinetic data obtained during gait can be used to clarify the biomechanical pathogenesis of osteoarthritis of the lower extremity. This study aimed to investigate the difference in ankle varus moment between the varus angulation and medial translation types of medial ankle osteoarthritis, and to identify the radiographic measurements associated with ankle varus moment. Methods Twenty-four consecutive patients [mean age 65.8 (SD) 8.0 years; 9 men and 15 women] with medial ankle osteoarthritis were included. Fourteen and 10 patients had the varus angulation (tibiotalar tilt angle≥3 degrees) and medial translation (tibiotalar tilt angle Results The mean tibial plafond inclination, tibiotalar tilt angle, talar dome inclination, lateral talo-first metatarsal angle, and maximum ankle varus moment were 6.4 degrees (SD 3.3 degrees), 5.0 degrees (SD 4.6 degrees), 11.4 degrees (SD 5.2 degrees), -6.5 degrees (SD 11.7 degrees), and 0.185 (SD 0.082) Nm/kg, respectively. The varus angulation type showed a greater maximum ankle varus moment than the medial translation type (p = .005). The lateral talo-first metatarsal angle was significantly associated with the maximum ankle varus moment (p = .041) in the multiple regression analysis. Conclusion The varus angulation type of medial ankle osteoarthritis is considered to be more imbalanced biomechanically than the medial displacement type. The lateral talo-first metatarsal angle, being significantly associated with the ankle varus moment, should be considered for correction during motion-preserving surgeries for medial ankle osteoarthritis to restore the biomechanical balance of the ankle.
- Published
- 2021
24. Differential response to scrambler therapy by neuropathic pain phenotypes
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Young Gi Min, Yoon-Ho Hong, Hyun Seok Baek, and Kyoung Min Lee
- Subjects
Male ,medicine.medical_specialty ,Neurology ,Science ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Rating scale ,Scrambler therapy ,Internal medicine ,Cluster Analysis ,Humans ,Pain Management ,Medicine ,Brief Pain Inventory ,Aged ,Pain Measurement ,Multidisciplinary ,business.industry ,Electroanalgesia ,Middle Aged ,Phenotype ,Treatment Outcome ,030220 oncology & carcinogenesis ,Neuropathic pain ,Etiology ,Neuralgia ,Female ,Disease Susceptibility ,Symptom Assessment ,business ,030217 neurology & neurosurgery - Abstract
Scrambler therapy is a noninvasive electroanalgesia technique designed to remodulate the pain system. Despite growing evidence of its efficacy in patients with neuropathic pain, little is known about the clinical factors associated with treatment outcome. We conducted a prospective, open-label, single-arm trial to assess the efficacy and safety of scrambler therapy in patients with chronic neuropathic pain of various etiologies. A post-hoc analysis was performed to investigate whether cluster analysis of the Neuropathic Pain Symptom Inventory (NPSI) profiles could identify a subgroup of patients regarding neuropathic pain phenotype and treatment outcome. Scrambler therapy resulted in a significant decrease in the pain numerical rating scale (NRS) score over 2 weeks of treatment (least squares mean of percentage change from baseline, − 15%; 95% CI − 28% to − 2.4%; p
- Published
- 2021
25. Foot and Ankle Radiographic Parameters in Korean Adults Vary by Sex and Age
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Eo Jin Kim, Doo Jae Lee, Dong Yeon Lee, Kyoung Min Lee, Kang Baek Kim, Dong Oh Lee, and Kee Jeong Bae
- Subjects
Adult ,Male ,medicine.medical_specialty ,Radiography ,Asymptomatic ,Weight-Bearing ,Young Adult ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Asian People ,Reference Values ,Republic of Korea ,medicine ,Deformity ,Humans ,Body Weights and Measures ,Orthopedics and Sports Medicine ,Young adult ,Aged ,030203 arthritis & rheumatology ,Orthodontics ,030222 orthopedics ,biology ,Foot ,business.industry ,Age Factors ,Middle Aged ,biology.organism_classification ,Surgery ,Valgus ,medicine.anatomical_structure ,Reference values ,Female ,Ankle ,medicine.symptom ,business ,Foot (unit) - Abstract
Although many radiographic measurements of the foot and ankle have been used, reference values for normal functional groups are rarely reported. These can change according to sex and age; therefore, this study aimed to: (1) determine reference values for radiographic foot and ankle angles in an asymptomatic healthy Korean population, and (2) compare differences in the measurements according to sex and age. A total of 200 healthy volunteers were recruited, including 100 young adults (50 males, 50 females) aged 20 to 35 years, and 100 older adults (50 males, 50 females) aged 60 to 69 years. Weightbearing ankle anteroposterior views, talar tilt, and tibiotalar angles were measured. On the weightbearing foot anteroposterior views, the hallux valgus, hallux interphalangeal, and talo-first metatarsal angles were measured. On the weightbearing lateral foot views, the calcaneal pitch, lateral talo-calcaneal, lateral talo-first metatarsal, and lateral calcaneo-first metatarsal angles were measured. Values were stratified by sex and age, and statistically compared. The hallux valgus, calcaneal pitch, and lateral calcaneo-first metatarsal angles were affected by both sex and age; the hallux interphalangeal angle was affected by age and the lateral talo-first metatarsal angle by sex. We presented reference values for foot and ankle radiographic measurements in a healthy Korean population; several radiographic indices varied significantly by sex or age, which were grossly similar to previous studies based on white race. The study data can serve as a basis for evaluation of foot and ankle disorders.
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- 2019
26. Natural progression of radiographic indices in juvenile hallux valgus deformity
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Jonghyun Ahn, Moon Seok Park, Ki Hyuk Sung, Seung Yeol Lee, Soon Sun Kwon, and Kyoung Min Lee
- Subjects
Male ,Metatarsophalangeal Joint ,Aging ,Adolescent ,Radiography ,Annual change ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Deformity ,Humans ,Juvenile ,Orthopedics and Sports Medicine ,Hallux Valgus ,Child ,Metatarsal Bones ,Retrospective Studies ,Valgus deformity ,030203 arthritis & rheumatology ,Orthodontics ,030222 orthopedics ,biology ,business.industry ,medicine.disease ,biology.organism_classification ,Valgus ,Disease Progression ,Female ,medicine.symptom ,business ,Follow-Up Studies - Abstract
This study aimed to estimate the annual change in radiographic indices for juvenile hallux valgus (JHV) and to analyze the factors that influence deformity progression.Patients aged15 years who had JHV and were followed up for at least 1 year were included. Hallux valgus angle (HVA), hallux interphalangeal angle, intermetatarsal angle, metatarsus adductus angle, distal metatarsal articular angle, anteroposterior talo-first metatarsal angle, and lateral talo-first metatarsal angle were evaluated. The progression rate of HVA was adjusted by multiple factors by using a linear mixed model.A total of 133 feet were included. The HVA and distal metatarsal articular angle both increased by 0.8° per year (p0.001 and p=0.003, respectively). HVA increased by 1.5° per year (p0.001) at under the age of 10, and the HVA progression in the older patients was not statistically significant.JHV deformity could progress with aging. Most deformity progression could occur before the age of 10 years.
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- 2019
27. Immediate Lower Extremity Reconstruction Using an Anterolateral Thigh Free Flap With Simultaneous Interposition Graft of Descending Branches of Lateral Circumflex Femoral Vessels
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Heeyeon Kwon, Kyoung Min Lee, Joonho Lim, and Changsik Pak
- Subjects
Male ,medicine.medical_specialty ,Soft Tissue Injuries ,Computed Tomography Angiography ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Free flap ,Revascularization ,Free Tissue Flaps ,Time-to-Treatment ,Fractures, Open ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Injury Severity Score ,0302 clinical medicine ,Fracture Fixation ,medicine ,Humans ,Circumflex ,Interposition graft ,Aged ,Wound Healing ,business.industry ,Accidents, Traffic ,Soft tissue ,General Medicine ,Plastic Surgery Procedures ,Anterolateral thigh ,Microsurgery ,Limb Salvage ,Surgery ,Femoral Artery ,Tibial Fractures ,Bridge (graph theory) ,Thigh ,Fibula ,business ,Follow-Up Studies ,Leg Injuries - Abstract
In a severely injured leg with acute limb ischemia, both immediate revascularization of an endangered part and coverage of soft tissue defect are crucial to limb salvage. In this article, we report a case of an anterolateral thigh free flap with interposition graft of descending branches of the lateral circumflex femoral vessels. A 18-cm-long graft was harvested and used to replace the injured anterior tibial vessels. One month later, a duplex sonogram revealed intact circulation to both the interposition graft and the flap. Despite anatomic inconstancy, the anterolateral thigh free flap is commonly utilized in reconstructive surgeries. When descending branches of the lateral femoral circumflex vessels were included sufficiently, its pedicle can be used to bridge a vascular defect in the extremity while covering soft tissue defect.
- Published
- 2018
28. 18F-THK5351 PET Imaging in Nonfluent-Agrammatic Variant Primary Progressive Aphasia
- Author
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Cindy W. Yoon, Seongho Seo, Hye Jin Jeong, Kee Hyung Park, Kyoung Min Lee, Nobuyuki Okamura, Sang-Yoon Lee, Jae-Hyeok Heo, Young Noh, Mee Kyung Suh, and Yeong Bae Lee
- Subjects
3 Tesla Magnetic Resonance Imaging ,medicine.diagnostic_test ,biology ,business.industry ,Tau protein ,tau Protein ,Neuropsychology ,Neurofibrillary Tangles ,medicine.disease ,030218 nuclear medicine & medical imaging ,Primary progressive aphasia ,03 medical and health sciences ,0302 clinical medicine ,Progressive nonfluent aphasia ,Positron emission tomography ,Region of interest ,Basal ganglia ,medicine ,biology.protein ,Original Article ,Primary Progressive Nonfluent Aphasia ,Nuclear medicine ,business ,030217 neurology & neurosurgery ,Positron Emission Tomography - Abstract
Background and purpose To analyze 18F-THK5351 positron emission tomography (PET) scans of patients with clinically diagnosed nonfluent/agrammatic variant primary progressive aphasia (navPPA). Methods Thirty-one participants, including those with Alzheimer's disease (AD, n=13), navPPA (n=3), and those with normal control (NC, n=15) who completed 3 Tesla magnetic resonance imaging, 18F-THK5351 PET scans, and detailed neuropsychological tests, were included. Voxel-based and region of interest (ROI)-based analyses were performed to evaluate retention of 18F-THK5351 in navPPA patients. Results In ROI-based analysis, patients with navPPA had higher levels of THK retention in the Broca's area, bilateral inferior frontal lobes, bilateral precentral gyri, and bilateral basal ganglia. Patients with navPPA showed higher levels of THK retention in bilateral frontal lobes (mainly left side) compared than NC in voxel-wise analysis. Conclusions In our study, THK retention in navPPA patients was mainly distributed at the frontal region which was well correlated with functional-radiological distribution of navPPA. Our results suggest that tau PET imaging could be a supportive tool for diagnosis of navPPA in combination with a clinical history.
- Published
- 2018
29. Short-Term Outcomes and Influencing Factors After Ankle Fracture Surgery
- Author
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Kyoung Min Lee, Seung Yeol Lee, Muhyun Nam, Soon Sun Kwon, Jae Hong Jung, Moon Seok Park, Yeo Hon Yun, and Ki Hyuk Sung
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Radiography ,Ankle Fractures ,Implant removal ,Fracture Fixation, Internal ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,Range of Motion, Articular ,Ao classification ,Aged ,Retrospective Studies ,Orthodontics ,030222 orthopedics ,Univariate analysis ,business.industry ,Medical record ,030229 sport sciences ,Middle Aged ,Ankle fracture surgery ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Regression Analysis ,Female ,Ankle ,Tomography, X-Ray Computed ,business ,Lauge-Hansen classification - Abstract
The present study investigated the factors influencing the early clinical outcomes after ankle fracture surgery. We included 88 patients, who had undergone implant removal surgery at 1 year after ankle fracture surgery, with ankle computed tomographic (CT) scans obtained before ankle fracture surgery and at implant removal available. We collected demographic information, including age, sex, the presence of diabetes mellitus, level of trauma energy, and fracture classification from the medical records. We also recorded the fracture height using the radiographs and CT images. The medial joint space and articular incongruity were assessed on the follow-up radiographs and CT scans. Bone attenuation was measured by placing a circular region of interest around the ankle joint on the preoperative CT image. The postimplant removal outcomes were assessed using 2 functional questionnaires, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and Foot and Ankle Outcome Score (FAOS). Significant factors related to the AOFAS ankle-hindfoot scale scores and FAOS were identified through univariate analysis using age, sex, radiographic measurements, and CT findings as explanatory variables, followed by multiple regression analysis. On multiple regression analysis, the total FAOS was independently related to the AO classification (p = .003) and Lauge-Hansen classification (p = .003). The total AOFAS ankle-hindfoot scale score was related to articular incongruity (p = .044). The early clinical outcomes after ankle fracture surgery were affected by involvement of the ankle joint fracture rather than the lateral malleolus fracture height. Female sex and the presence of postoperative articular incongruity correlated with inferior early clinical outcomes.
- Published
- 2018
30. Leg length discrepancy, overgrowth, and associated risk factors after a pediatric tibial shaft fracture
- Author
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Hyon Soo Jung, Woo Young Choi, Kug Jin Choi, Ki Hyuk Sung, Kyoung Min Lee, and Moon Seok Park
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Sports medicine ,Fracture site ,Bone Nails ,Overgrowth ,Cohort Studies ,03 medical and health sciences ,Postoperative Complications ,Sex Factors ,0302 clinical medicine ,lcsh:Orthopedic surgery ,Fracture Fixation ,Risk Factors ,Internal medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,030212 general & internal medicine ,Child ,Pediatric ,Titanium ,030222 orthopedics ,business.industry ,Leg length ,Age Factors ,Infant ,Treatment method ,Rheumatology ,Leg Length Inequality ,Surgery ,Tibial shaft fracture ,Tibial Fractures ,lcsh:RD701-811 ,Casts, Surgical ,Leg length discrepancy ,Child, Preschool ,Orthopedic surgery ,Original Article ,Female ,Diaphyses ,Level iii ,business - Abstract
Background This study was performed to investigate leg length discrepancy (LLD), overgrowth, and associated risk factors after pediatric tibial shaft fractures. Materials and methods This study included 103 patients younger than 14 years of age (mean age 7.1 years; 75 boys, 28 girls) with unilateral tibial shaft fracture and a minimum follow-up of 24 months. LLD was calculated as the difference between the lengths of the injured and uninjured limbs. Overgrowth was calculated by adding the fracture site shortening from the LLD. Risk factors were assessed in patients with LLD Results Casting and titanium elastic nailing (TEN) were performed on 64 and 39 patients, respectively. The mean LLD and overgrowth were 5.6 and 6.4 mm, respectively. There were significant differences in sex (p = 0.018), age (p = 0.041), fibular involvement (p = 0.005), injury mechanism (p = 0.006), and treatment methods (p p = 0.029), fibular involvement (p = 0.002), injury mechanism (p = 0.008), and treatment methods (p Conclusions Patients undergoing TEN showed greater LLD and overgrowth than those undergoing casting, with boys showing greater LLD and overgrowth than girls. Surgeons should consider the possibility of LLD and overgrowth after pediatric tibial shaft fractures, especially when performing TEN for boys. Level of evidence Level III
- Published
- 2021
31. Radiographic differences in the concomitant deformities in two types of medial ankle osteoarthritis
- Author
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Kyoung Min Lee, Sang Hoon Lee, Woo Young Choi, Chin Youb Chung, and Moon Seok Park
- Subjects
Male ,Knee Joint ,Radiography ,Knees ,Health Care Providers ,Osteoarthritis ,Tibial plafond ,0302 clinical medicine ,Skeletal Joints ,Medicine and Health Sciences ,Biomechanics ,Medical Personnel ,Arthrography ,Musculoskeletal System ,Orthodontics ,030222 orthopedics ,Multidisciplinary ,Feet ,Middle Aged ,Ankle Joints ,Professions ,medicine.anatomical_structure ,Medicine ,Legs ,Female ,Anatomy ,Research Article ,Ankle osteoarthritis ,Science ,Surgical and Invasive Medical Procedures ,03 medical and health sciences ,Rheumatology ,Physicians ,medicine ,Humans ,Foot deformity ,Skeleton ,Aged ,030203 arthritis & rheumatology ,Surgeons ,business.industry ,Arthritis ,Ankles ,Biology and Life Sciences ,medicine.disease ,Health Care ,Concomitant ,Body Limbs ,Logistic analysis ,People and Places ,Population Groupings ,Ankle ,business ,Ankle Joint - Abstract
Objectives Motion preserving surgeries could be unsuccessful because of underestimation of deformities of the foot and knee in ankle osteoarthritis. This study aimed to investigate the concomitant deformities in medial ankle osteoarthritis and the difference between the two types, varus angulation and medial translation. Methods A retrospective study was conducted using medical records and radiographic data. Patients with medial ankle osteoarthritis that underwent weight-bearing X ray imaging and radiographic measurements including tibial plafond inclination (TPI), tibiotalar tilt angle (TT), lateral talo-first metatarsal angle, naviculo-cuboid overlap, and mechanical tibiofemoral angle (mTFA) were studied. The patients were categorized into two groups, the varus angulation group (TT ≥4°) and medial translation group (TT Results A total of 102 patients (male = 44; female = 58) were included; the mean age was 64.9 years (SD 8.3 years). The varus rotation group (N = 66) showed a significantly smaller lateral talo-first metatarsal angle (p Conclusions Varus angulation of the ankle was correlated with knee alignment and foot deformity. Radiographic indices were different between the varus angulation and medial translation groups. The role of concomitant deformities needs to be further investigated in terms of a causal relationship. Surgeons need to pay attention to concomitant deformities in the treatment of medial ankle osteoarthritis.
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- 2021
32. Principles of OCT Imaging
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Kyoung Min Lee
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genetic structures ,Optical coherence tomography ,medicine.diagnostic_test ,Computer science ,business.industry ,Daily practice ,medicine ,Computer vision ,sense organs ,Artificial intelligence ,business ,eye diseases - Abstract
Optical coherence tomography (OCT) uses the interference between the light waves reflected by the reference and sample arms to obtain spatial information on tissue microstructure, which is used to construct an in-vivo cross-sectional image. OCT has become an essential part of daily practice in the field of ophthalmology and glaucoma over the past 30 years. This success was possible by tremendous advances of its technology toward better sensitivity and faster scan speed from Time-domain to Spectral-domain and Swept-source OCT. This chapter was written to describe the basic principles of OCT and how they enable its various applications, which are crucial to understand how such advances of OCT have been possible in the past, and why OCT still has boundless potential for future growth.
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- 2021
33. Growth arrest and its risk factors after physeal fracture of the distal tibia in children and adolescents
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Kug Jin Choi, Woo Young Choi, Ki Hyuk Sung, Moon Seok Park, Hyon Soo Jung, and Kyoung Min Lee
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medicine.medical_specialty ,Adolescent ,Radiography ,03 medical and health sciences ,0302 clinical medicine ,Physeal fracture ,Risk Factors ,Growth arrest ,Medicine ,Humans ,Displacement (orthopedic surgery) ,Growth Plate ,Child ,General Environmental Science ,030222 orthopedics ,Tibia ,business.industry ,Incidence (epidemiology) ,Leg length ,030208 emergency & critical care medicine ,Distal tibia ,Surgery ,Leg Length Inequality ,Tibial Fractures ,medicine.anatomical_structure ,General Earth and Planetary Sciences ,Ankle ,business - Abstract
This study performed to investigate the incidence of growth arrest such as leg length discrepancy (LLD) and ankle joint angular deformity and its risk factors after physeal fracture of the distal tibia in children and adolescents.. Consecutive 78 patients (mean age 11.4 ± 2.0 years; mean follow-up period 2.0 ± 1.2 years) treated for the distal tibia physeal fracture were included. All patients underwent preoperative ankle radiographs, three-dimensional computed tomography (CT) scans, and postoperative follow-up teleradiogram. Patients were divided into two groups according to the LLD and the difference of lateral distal tibial angle (LDTA) with the contralateral limb as follows: Group 1 (growth arrest), patients with LLD ≥ 1cm or difference of LDTA ≥ 5°; Group 2 (normal growth), patients with LLD1cm and difference of LDTA5°.. The overall incidence of growth arrest was 12.8% (10 of 78). The mean displacement measured using CT scan was 4.4 ± 3.2 mm (range, 0.8-14.9). Of the total 78 fractures, 65 were treated surgically and 13 fractures were treated conservatively. The initial fracture displacement was significantly different between the two groups (p0.001). However, there were no statistically significant differences between the two groups with respect to other factors. Initial displacement was the only significant risk factor for growth arrest (p0.003). The cutoff values of initial displacement between the two groups were 5.2mm.. This study showed that degree of initial displacement was the only significant risk factor for growth arrest after physeal fracture of the distal tibia in children and adolescents. Therefore, physicians should consider the possibility of growth arrest for patients with severely displaced physeal fractures of the distal tibia.
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- 2020
34. Clinical, Imaging, and Laboratory Markers of Premanifest Spinocerebellar Ataxia 1, 2, 3, and 6: A Systematic Review
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Dong Hoi Kim, Kyoung Min Lee, Ryul Kim, and Jee Young Lee
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Pathology ,medicine.medical_specialty ,Ataxia ,medicine.medical_treatment ,Review ,03 medical and health sciences ,0302 clinical medicine ,spinocerebellar ataxia ,systematic review ,medicine ,030212 general & internal medicine ,marker ,business.industry ,premanifest ,Hyporeflexia ,medicine.disease ,Gait ,Transcranial magnetic stimulation ,presymptomatic ,Neurology ,Somatosensory evoked potential ,Spinocerebellar ataxia ,Neurology (clinical) ,Brainstem ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Muscle cramp - Abstract
Background and purpose Premanifest mutation carriers with spinocerebellar ataxia (SCA) can exhibit subtle abnormalities before developing ataxia. We summarized the preataxic manifestations of SCA1, -2, -3, and -6, and their associations with ataxia onset. Methods We included studies of the premanifest carriers of SCA published between January 1998 and December 2019 identified in Scopus and PubMed by searching for terms including 'spinocerebellar ataxia' and several synonyms of 'preataxic manifestation'. We systematically reviewed the results obtained in studies categorized based on clinical, imaging, and laboratory markers. Results We finally performed a qualitative analysis of 48 papers. Common preataxic manifestations appearing in multiple SCA subtypes were muscle cramps, abnormal muscle reflexes, instability in gait and posture, lower Composite Cerebellar Functional Severity scores, abnormalities in video-oculography and transcranial magnetic stimulation, and gray-matter loss and volume reduction in the brainstem and cerebellar structures. Also, decreased sensory amplitudes in nerve conduction studies were observed in SCA2. Eotaxin and neurofilament light-chain levels were revealed as sensitive blood biomarkers in SCA3. Concerning potential predictive markers, hyporeflexia and abnormalities of somatosensory evoked potentials showed correlations with the time to ataxia onset in SCA2 carriers. However, no longitudinal data were found for the other SCA gene carriers. Conclusions Our results suggest that preataxic manifestations vary among SCA1, -2, -3, and -6, with some subtypes sharing specific features. Combining various markers into a standardized index for premanifest carriers may be useful for early screening and assessing the risk of disease progression in SCA carriers.
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- 2020
35. Short foveo-disc distance in situs inversus of optic disc
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Young In Shin, Martha Kim, Seok Hwan Kim, Kyoung Min Lee, and Sohee Oh
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0301 basic medicine ,Male ,Retinal Ganglion Cells ,Fovea Centralis ,genetic structures ,Posterior pole ,Optic Disk ,Nerve fiber layer ,lcsh:Medicine ,Developmental neurogenesis ,Eye ,Article ,Retina ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Nerve Fibers ,medicine ,Humans ,lcsh:Science ,Aged ,Multidisciplinary ,business.industry ,lcsh:R ,Vertical distance ,Retinal ,Anatomy ,Middle Aged ,medicine.disease ,Situs Inversus ,eye diseases ,Situs inversus ,030104 developmental biology ,medicine.anatomical_structure ,chemistry ,Regional Blood Flow ,030221 ophthalmology & optometry ,Optic nerve ,lcsh:Q ,Female ,sense organs ,Abnormality ,Visual system ,business ,Optic disc - Abstract
Situs inversus of optic disc (SIOD) is thought to be a congenital optic disc abnormality that is caused by dysversion of optic nerve insertion. SIOD, however, has many additional features that cannot be explained by abnormal optic-nerve-insertion directionality. In this study, we measured the distance between the fovea and disc in 22 eyes of 15 SIOD patients. For comparison, two control eyes were matched with each SIOD eye by age and axial length. The vertical distance between the temporal vascular arcades also was measured. The foveo-disc distance was shorter in the SIOD eyes than in the control eyes, while the inter-arcade distance did not differ. Further, we measured the circumpapillary retinal nerve fiber layer thickness, which showed nasal crowding of two humps in the SIOD eyes. This nasal crowding disappeared when we shifted the circle scan by the mean difference (465 μm) of the foveal-disc distance between the two groups. Our findings suggest that the optic disc was located closer to the fovea than it would have been normally. Thus, SIOD might reflect incomplete expansion of the posterior pole in the direction of the fovea-disc axis.
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- 2020
36. Hemisphere opposite to vascular trunk deviation is earlier affected by glaucomatous damage in myopic high-tension glaucoma
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Kyoung Min Lee, Martha Kim, Seok Hwan Kim, and Sohee Oh
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Male ,Retinal Ganglion Cells ,Intraocular pressure ,Lamina ,genetic structures ,Eye Diseases ,Visual Acuity ,Glaucoma ,Pathology and Laboratory Medicine ,Diagnostic Radiology ,0302 clinical medicine ,Optic Nerve Diseases ,Medicine and Health Sciences ,Myopia ,Tomography ,Visual Impairments ,Multidisciplinary ,Radiology and Imaging ,Middle Aged ,Visual field ,medicine.anatomical_structure ,Optic nerve ,Medicine ,Female ,Anatomy ,Tomography, Optical Coherence ,Research Article ,Adult ,medicine.medical_specialty ,Imaging Techniques ,Science ,Ocular Anatomy ,Optic Disk ,Research and Analysis Methods ,03 medical and health sciences ,Tonometry, Ocular ,Signs and Symptoms ,Ocular System ,Diagnostic Medicine ,Ophthalmology ,medicine ,Humans ,Intraocular Pressure ,High tension glaucoma ,Aged ,business.industry ,Choroid ,Biology and Life Sciences ,Retinal Vessels ,Optic Nerve ,medicine.disease ,Trunk ,eye diseases ,Axons ,030221 ophthalmology & optometry ,Eyes ,Visual Field Tests ,Atrophy ,Visual Fields ,business ,Head ,030217 neurology & neurosurgery - Abstract
Purpose To investigate whether the position of the central vascular trunk, as a surrogate of lamina cribrosa (LC) shift, is associated with the initial hemisphere of visual field defect in myopic high-tension glaucoma (HTG) eyes. Methods The deviation of the central vascular trunk was measured from the center of the Bruch’s membrane opening (BMO), which was delineated by OCT imaging. The angular deviation was measured with the horizontal nasal midline as 0° and the superior location as a positive value. The initial hemisphere developing visual field defect was defined as three connected abnormal points (having a P value with less than 0.5% probability of being normal) appearing in only one hemisphere in pattern deviation plots. If those points were observed in both hemispheres initially, the eye was classified as bi-hemispheric visual field defect. Results Initially, 36 eyes (44%) had superior visual field defects, 27 (33%) inferior visual field defects, and 18 (22%) bi-hemispheric visual field defects. After a mean follow-up of 5 years, the number of bi-hemispheric visual field defects had increased to 34 (42%). A logistic regression analysis revealed that inferior deviation of vascular trunk was the only factor associated with initial inferior visual field defect (P = 0.001), while initial bi-hemispheric visual field defects were associated with worse mean deviation at initial visits (P
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- 2020
37. Aggravation of Ankle Varus Incongruency Following Total Knee Replacement Correcting ≥10° of Genu Varum Deformity: A Radiographic Assessment
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Kyoung Min Lee, Chong Bum Chang, Moon Seok Park, Chin Youb Chung, Jong Seop Kim, and Ji Hye Choi
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musculoskeletal diseases ,Male ,Knee Joint ,Radiography ,Total knee replacement ,Genu varum ,Osteoarthritis ,Genu Varum ,Deformity ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Ankle pain ,Arthroplasty, Replacement, Knee ,Child ,Orthodontics ,Tibia ,business.industry ,Osteoarthritis, Knee ,medicine.disease ,medicine.anatomical_structure ,Female ,medicine.symptom ,Ankle ,business ,Ankle Joint - Abstract
Background This study aimed to investigate the change in ankle varus incongruencies following total knee replacement (TKR) in patients with preoperative genu varum deformity of ≥10°. Methods The study cohort was composed of patients who underwent TKR in a single institution for knee osteoarthritis with preoperative genu varum deformity of ≥10° and concomitant varus ankle incongruencies. Eight radiographic measurements were evaluated preoperatively and postoperatively: mechanical tibiofemoral angle, mechanical lateral distal femoral angle, medial proximal tibial angle, lateral distal tibial angle, tibial plafond inclination, talar inclination, tibiotalar tilt angle (TTTA), and tibia-mechanical axis angle. Of these, TTTA represented the quantitative degree of ankle joint incongruency. Results A total of 110 patients (male = 2; female = 108) were included in the analysis. The mean patient age was 68.9 (standard deviation [SD] 7.2) years at the time of TKR. All radiographic measurements showed significant changes postoperatively, representing the appropriate correction of genu varum deformity and restoration of the mechanical axis. Nineteen patients (17.3%) showed postoperative decrease in TTTA, 2 (1.8%) remained the same, and 89 (80.9%) showed increase. Overall, mean preoperative and postoperative TTTA were 3.3° (SD 2.2°) and 4.7° (SD 2.9°), respectively (P Conclusion Varus ankle incongruencies showed aggravation following TKR despite correction of genu varum deformity and restoration of the mechanical axis. This could be an important cause of postoperative increase or development of ankle pain following TKR. Therefore, patients with preoperative varus ankle incongruencies need to be warned of possible aggravation of ankle symptoms and be evaluated before TKR. Level of Evidence Prognostic level III.
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- 2020
38. Discrepancy between true ankle dorsiflexion and gait kinematics and its association with severity of planovalgus foot deformity
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Kyoung Min Lee, Ki Bum Kwon, Jeong Hyun Lee, Chin Youb Chung, Moon Seok Park, and Ki Hyuk Sung
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Male ,lcsh:Diseases of the musculoskeletal system ,Sports medicine ,Severity of Illness Index ,Weight-Bearing ,0302 clinical medicine ,Gait (human) ,Ankle dorsiflexion ,Medicine ,Orthopedics and Sports Medicine ,Child ,Gait ,Orthodontics ,030222 orthopedics ,medicine.diagnostic_test ,Biomechanical Phenomena ,Child, Preschool ,Female ,medicine.symptom ,Gait Analysis ,Research Article ,Adult ,Foot Deformities ,medicine.medical_specialty ,Adolescent ,Physical examination ,macromolecular substances ,03 medical and health sciences ,Young Adult ,Rheumatology ,3-dimensional gait analysis ,Deformity ,Humans ,Foot deformity ,Retrospective Studies ,business.industry ,Foot ,Cerebral Palsy ,Foot Bones ,030229 sport sciences ,medicine.disease ,Radiography ,Planovalgus ,Gait analysis ,Orthopedic surgery ,Contracture ,lcsh:RC925-935 ,Ankle ,business ,human activities ,Ankle Joint - Abstract
Background In planovalgus deformity with triceps contracture, a midfoot break happens, and ankle dorsiflexion (ADF) occurs at the mid-tarsal joint during gait. Results of standard 3D gait analysis may misinterpret the true ankle dorsiflexion because it recognizes the entire foot as a single rigid segment. We performed this study to investigate whether the severity of planovalgus deformity is associated with the discrepancy between the value of ADF evaluated by physical examination and 3-dimensional (3D) gait analysis. In addition, we aimed to identify the radiographic parameters associated with this discrepancy and their relationships. Methods Consecutive 40 patients with 65 limbs (mean age, 11.7 ± 5.5 years) with planovalgus foot deformity and triceps surae contracture were included. All patients underwent 3D gait analysis, and weightbearing anteroposterior (AP) and lateral (LAT) foot radiographs. ADF with knee extension was measured using a goniometer with the patient’s foot in an inverted position. Results Twenty-one limbs underwent operation for planovalgus foot deformity, and 56 limbs underwent operation for equinus deformity. The difference between ADF on physical examination and ADF at initial contact on gait analysis was 17.5 ± 8.4°. Differences between ADF on physical examination and ADF at initial contact on gait analysis were significantly associated with the LAT talus-first metatarsal angle (p = 0.008) and calcaneal pitch angle (p = 0.006), but not associated with the AP talus-first metatarsal angle (p = 0.113), talonavicular coverage angle (p = 0.190), talocalcaneal angle (p = 0.946), and naviculocuboid overlap (p = 0.136). Conclusion The discrepancy between ADF on physical examination and 3D gait analysis was associated with the severity of planovalgus deformity, which was evaluated on weightbearing LAT foot radiographs. Therefore, physicians should be cautious about interpreting results from 3D gait analysis and perform a careful physical examination to assess the degree of equinus deformity in patients with planovalgus foot deformity.
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- 2020
39. Factors affecting GDI improvement after single event multilevel surgery in patients with cerebral palsy
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Chin Youb Chung, Soon Sun Kwon, Ki Hyuk Sung, Jae Jung Min, Moon Seok Park, and Kyoung Min Lee
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Male ,Gait deviation ,Adolescent ,medicine.medical_treatment ,Biophysics ,Multilevel surgery ,Osteotomy ,Cerebral palsy ,Quadriceps Muscle ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Orthopedics and Sports Medicine ,In patient ,Femur ,Postoperative Period ,Child ,Gait Disorders, Neurologic ,Retrospective Studies ,business.industry ,Cerebral Palsy ,Rehabilitation ,Gross Motor Function Classification System ,030229 sport sciences ,medicine.disease ,Gait ,Treatment Outcome ,Anesthesia ,Child, Preschool ,Female ,Level iii ,business ,Gait Analysis ,030217 neurology & neurosurgery - Abstract
Background Pathologic gait is common in patients with cerebral palsy (CP). Single-event multilevel surgery (SEMLS) is a combination of surgical procedures to improve pathologic gait in patients with CP. However, the effect of each procedure is difficult to predict. The gait deviation index (GDI) is useful in comparing pre- and postoperative improvement. Research question In this study, we evaluated the degree of GDI improvement in patients with CP and analyzed factors related to surgical outcomes. Methods We screened patients seen between May 2003 and December 2019 via a clinical data warehouse to identify those with CP who had been followed up for >1 year and who had undergone SEMLS. The inclusion criteria were (1) CP patients with GMFCS levels I, II and III, (2) patients who underwent SEMLS, (3) and patients who underwent 3D gait analyses preoperatively and at least 1 year postoperatively. A linear mixed model was used to model GDI improvement, assess effects of covariates, and examine factors that contributed to improvement. Results Overall, 544 patients were included. The average improvement in overall GDI was 8.9 ± 12.3, 9.6 ± 12.0, and 6.4 ± 8.6 in Gross Motor Function Classification System (GMFCS) levels I, II, and III, respectively. In GMFCS level II patients, GDI improvement decreased by 0.26 points with a 1-year delay in surgery (p = 0.0022). Within each group of GMFCS levels, femoral derotation osteotomy (FDO) was a significant factor in GDI improvement in GMFCS levels I and II. Rectus femoris transfer (RFT) and supracondylar extension osteotomy (SCO) were significant factors in GMFCS level II. No single procedure was shown to affect improvement in GMFCS level III. Significance Postoperative GDI improved in all levels of GMFCS. Particular procedures especially affected postoperative improvement in GDI in levels I and II. Our data do not mean to set an indication for particular procedures; however, in GMFCS levels I, II patients, particular procedures, such as FDO, yielded a greater GDI improvement in our data set.
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- 2020
40. Progression of planovalgus deformity in patients with cerebral palsy
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Jae Jung Min, Chin Youb Chung, Kyoung Min Lee, Soon Sun Kwon, Ki Hyuk Sung, and Moon Seok Park
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Male ,medicine.medical_specialty ,lcsh:Diseases of the musculoskeletal system ,Adolescent ,Sports medicine ,Radiography ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Internal medicine ,Deformity ,medicine ,Humans ,Orthopedics and Sports Medicine ,Pes planovalgus ,Child ,Retrospective Studies ,030222 orthopedics ,Progression ,biology ,Talo-first metatarsal angle ,business.industry ,Cerebral Palsy ,Gross Motor Function Classification System ,030229 sport sciences ,biology.organism_classification ,medicine.disease ,Flatfoot ,Surgery ,Valgus ,Child, Preschool ,Orthopedic surgery ,Disease Progression ,Talo-second metatarsal angle ,Female ,lcsh:RC925-935 ,medicine.symptom ,business ,Research Article ,Follow-Up Studies - Abstract
Background Analyzing radiographic changes of pes planovalgus(PV) deformity of cerebral palsy(CP) patients according to age and influencing factors. Methods CP patients with PV deformity younger than 18 years old who had undergone more than a year of follow-up with at least two standing foot radiographs were included. Anteroposterior and lateral talo-first metatarsal(talo-1stMT), talo-second metatarsal(talo-2ndMT), and hallux valgus(HV) angles were measured on the radiographs. The rate of progression was adjusted by multiple factors using the linear mixed model, with the Gross Motor Function Classification System(GMFCS) level as the fixed effect and age and each subject as random effects. Results Overall, 194 patients were enrolled in this study, and 1272 standing foot radiographs were evaluated. The AP talo-2ndMT angle progressed by 0.59° (p p = 0.0007) in GMFCS level II and III patients, respectively; however, there was no significant change in GMFCS level I patients (p = 0.3269). HV was significantly affected by age in all three GMFCS groups; it increased by 0.48° (p p stMT angle (p = 0.0535). Conclusions The GMFCS level was the single most important factor influencing the progression of radiographic indices in PV deformity in CP. The AP talo-1stMT and talo-2ndMT angles progressed in patients with GMFCS levels II and III. Physicians should take this result into consideration when planning the timing of the surgery. Level of evidence Prognostic Level IV.
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- 2020
41. Shielding effect of radiation dose reduction fiber during the use of C-arm fluoroscopy: a phantom study
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Kyoung Min Lee, Kyeyoung Cho, Hyemi Cha, Kisung Lee, Moon Seok Park, and Ki Hyuk Sung
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Materials science ,C arm fluoroscopy ,Health, Toxicology and Mutagenesis ,medicine.medical_treatment ,Radiation ,Radiation Dosage ,Imaging phantom ,030218 nuclear medicine & medical imaging ,dose reduction fiber ,03 medical and health sciences ,C-arm fluoroscopy ,0302 clinical medicine ,Radiation Protection ,medicine ,Regular Paper ,Image Processing, Computer-Assisted ,Shielding effect ,Fluoroscopy ,Radiology, Nuclear Medicine and imaging ,Reduction (orthopedic surgery) ,Dosimeter ,medicine.diagnostic_test ,business.industry ,Phantoms, Imaging ,Contrast resolution ,Absorption, Radiation ,Dose-Response Relationship, Radiation ,030220 oncology & carcinogenesis ,AcademicSubjects/SCI00960 ,Barium Sulfate ,Nuclear medicine ,business ,radiation dose ,Whole-Body Irradiation - Abstract
This study evaluated the shielding effect of a newly developed dose-reduction fiber (DRF) made from barium sulfate, in terms of radiation doses delivered to patients’ radiosensitive organs and operator during C-arm fluoroscopy and its impact on the quality of images. A C-arm fluoroscopy unit was placed beside a whole-body phantom. Radiophotoluminescent glass dosimeters were attached to the back and front of the whole-body phantom at 20 cm intervals. Radiation doses were measured without DRF and with it applied to the back (position 1), front (position 2) or both sides (position 3) of the phantom. To investigate the impact of DRF on the quality of fluoroscopic images, step-wedge and modulation transfer function phantoms were used. The absorbed radiation doses to the back of the phantom significantly decreased by 25.3–88.8% after applying DRF to positions 1 and 3. The absorbed radiation doses to the front of the phantom significantly decreased by 55.3–93.6% after applying DRF to positions 2 and 3. The contrast resolution values for each adjacent step area fell in the range 0.0119–0.0209, 0.0128–0.0271, 0.0135–0.0339 and 0.0152–0.0339 without and with DRF applied to positions 1, 2 and 3, respectively. The investigated DRF effectively reduces absorbed radiation doses to patients and operators without decreasing the quality of C-arm fluoroscopic images. Therefore, routine clinical use of the DRF is recommended during the use of C-arm fluoroscopy.
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- 2020
42. Functionality-Driven Musculature Retargeting
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Min Seok Kim, Seungwhan Lee, Hoseok Ryu, Moon Seok Park, Jehee Lee, and Kyoung Min Lee
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FOS: Computer and information sciences ,Computer science ,business.industry ,Geometric configuration ,Animation ,Computer Graphics and Computer-Aided Design ,Motion capture ,Graphics (cs.GR) ,Computer Science - Graphics ,Retargeting ,Jump ,Computer vision ,Artificial intelligence ,business ,Physically based animation ,ComputingMethodologies_COMPUTERGRAPHICS - Abstract
We present a novel retargeting algorithm that transfers the musculature of a reference anatomical model to new bodies with different sizes, body proportions, muscle capability, and joint range of motion while preserving the functionality of the original musculature as closely as possible. The geometric configuration and physiological parameters of musculotendon units are estimated and optimized to adapt to new bodies. The range of motion around joints is estimated from a motion capture dataset and edited further for individual models. The retargeted model is simulation-ready, so we can physically simulate muscle-actuated motor skills with the model. Our system is capable of generating a wide variety of anatomical bodies that can be simulated to walk, run, jump and dance while maintaining balance under gravity. We will also demonstrate the construction of individualized musculoskeletal models from bi-planar X-ray images and medical examinations., Comment: 15 pages, 20 figures
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- 2020
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43. Characteristics of and Factors Contributing to Immediate Postoperative Pain After Ankle Fracture Surgery
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Chin Youb Chung, Sung Hun Won, Seung Yeol Lee, Kyoung Min Lee, Moon Seok Park, and You Sung Suh
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Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Postoperative pain ,Ankle Fractures ,Fracture Fixation, Internal ,03 medical and health sciences ,0302 clinical medicine ,Pain control ,Risk Factors ,Rating scale ,medicine ,Humans ,Orthopedics and Sports Medicine ,Ankle pain ,Aged ,Retrospective Studies ,Pain, Postoperative ,030222 orthopedics ,business.industry ,Analgesia, Patient-Controlled ,030208 emergency & critical care medicine ,Middle Aged ,Pain management ,Ankle fracture surgery ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Linear Models ,Female ,Ankle ,business - Abstract
To build an appropriate strategy of pain management after ankle fracture surgery, surgeons need to know the characteristics of postoperative ankle pain and its contributing factors. The aim of the present study was to investigate the maximum pain period after ankle fracture surgery and the factors affecting postoperative pain using a linear mixed model when patient-controlled analgesia (PCA) was used as a basic modality. A total of 219 adult patients (108 males and 111 females; mean age 51.2 ± 15.9 years) who had undergone operative treatment for ankle fractures were included. Data on fracture severity, causes of injury, interval between injury and surgery, anesthesia method, American Society of Anesthesiologists classification, and operative time were collected. Pain intensity was measured using an 11-point pain intensity numerical rating scale preoperatively and postoperatively every 8 hours. Intravenous PCA was prescribed to all patients. The chronologic pattern of postoperative pain and factors affecting it were statistically analyzed using a linear mixed model. Maximum postoperative pain was observed at 8 hours postoperatively, and the maximum pain numerical rating scale score was 3.92, measured at 8-hour intervals. The severity of fracture ( p = .01) was the only significant factor contributing to postoperative pain after ankle fracture surgery on multivariate analysis. Clinicians should consider the chronologic pattern of postoperative pain after ankle fracture surgery during postoperative pain management. Interventions for pain control, in addition to PCA, might be needed at ~8 hours postoperatively, especially for those with severe ankle fractures.
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- 2018
44. Positional Change of Optic Nerve Head Vasculature during Axial Elongation as Evidence of Lamina Cribrosa Shifting
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Ho Kyung Choung, Martha Kim, Seok Hwan Kim, Kyoung Min Lee, and Sohee Oh
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medicine.medical_specialty ,Arterial trunk ,business.industry ,Posterior pole ,Glaucoma ,Retinal ,medicine.disease ,Trunk ,03 medical and health sciences ,Ophthalmology ,chemistry.chemical_compound ,0302 clinical medicine ,medicine.anatomical_structure ,chemistry ,030221 ophthalmology & optometry ,Optic nerve ,Medicine ,sense organs ,business ,030217 neurology & neurosurgery ,Dioptre ,Optic disc - Abstract
Purpose To investigate the positional change of central retinal vasculature and vascular trunk to deduce the change in the lamina cribrosa (LC) during axial elongation. Design Prospective cohort study. Participants Twenty-three healthy myopic children (46 eyes). Methods Participants had undergone a full ophthalmologic examination and axial length measurement every 6 months for 2 years. Using spectral-domain OCT, circle scans centered around the optic disc in the glaucoma progression analysis mode, which enabled capturing of the same positions throughout the entire study period, and enhanced depth imaging of the deep optic nerve head complex were performed. Infrared imaging of the circle scans was used to measure the changes in the angles between the first and final visits. The angle between the major superior and inferior retinal arteries was measured along the circle scan twice: from the center of the circle scan and from the central retinal vascular trunk, respectively. The positional change of the retinal vascular trunk also was measured. Main Outcome Measures Change in vascular angle and position of vascular trunk with axial elongation and associated factors. Results The vascular angle measured from the center of the circle scan did not change ( P = 0.247), whereas the angle measured from the central retinal arterial trunk decreased with axial elongation ( P P = 0.004) and vascular trunk dragging ( P P P = 0.053), but the extent of dragging could not be explained fully by their combination. The major directionality of dragging was mostly to the nasal side of the optic disc, with large variations among participants. Conclusions During axial elongation, the retinal vasculature at the posterior pole was unchanged, whereas the position of the central vascular trunk was dragged nasally. Because the central retinal vascular trunk is embedded in the LC, its dragging indicates nasal shifting of the LC, which could explain the vulnerability of myopic eyes to glaucomatous optic neuropathy.
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- 2018
45. Longitudinal Changes of Optic Nerve Head and Peripapillary Structure during Childhood Myopia Progression on OCT
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Martha Kim, Seok Hwan Kim, Kyoung Min Lee, Ho Kyung Choung, and Sohee Oh
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0301 basic medicine ,medicine.medical_specialty ,genetic structures ,medicine.diagnostic_test ,business.industry ,Fundus photography ,Glaucoma ,Parapapillary atrophy ,Axial length ,medicine.disease ,eye diseases ,03 medical and health sciences ,Ophthalmology ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,030221 ophthalmology & optometry ,medicine ,Optic nerve ,sense organs ,business ,Prospective cohort study ,Cohort study ,Optic disc - Abstract
Purpose To delineate longitudinal changes in the optic nerve head (ONH) and peripapillary structure during myopia progression in childhood using spectral-domain (SD) OCT and to explore the factors associated with myopic ONH and peripapillary changes. Design Prospective cohort study. Participants Twenty-three healthy children with myopia (46 eyes). Methods The participants underwent fundus photography, SD OCT, and axial length (AXL) measurements every 6 months for 2 years. Based on the morphologic changes of the ONH and β-zone parapapillary atrophy (PPA), eyes were classified as group A (ONH unchanged without β-zone PPA; 11 eyes), group B (ONH changed without β-zone PPA at baseline; 10 eyes), group C (ONH changed with β-zone PPA at baseline; 15 eyes), and group D (ONH unchanged with β-zone PPA; 10 eyes). The configuration of the border tissue (BT) at the temporal margin of the ONH was assessed, and the ONH parameters, including Bruch's membrane opening distance (BMOD), border length (BL), and BT angle (BTA), were measured on horizontal SD OCT scans. Main Outcome Measures Changes in ONH parameters and associated factors. Results Group B showed the greatest AXL increase per year (group B > group C > group A = group D; P P P P = 0.100, respectively). In the multivariate analysis using the generalized linear mixed-effect model, the changes of BL and BTA were associated with axial elongation ( P = 0.028 and P = 0.010, respectively). Conclusions Development of myopic optic disc and γ-zone PPA during myopia progression was delineated using SD OCT images. During the ONH and peripapillary changes, the BL was increased nasally and the BTA was decreased, whereas the BMOD remained relatively stable. The association of axial elongation with ONH and peripapillary tissue changes may facilitate understanding of the relationship between myopia and glaucoma.
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- 2018
46. Relative movement on the articular surfaces of the tibiotalar and subtalar joints during walking
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Cong-Bo Phan, Duc-Phong Nguyen, Kyoung Min Lee, and Seungbum Koo
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Orthodontics ,Articular surfaces ,Movement (music) ,business.industry ,0206 medical engineering ,02 engineering and technology ,Kinematics ,020601 biomedical engineering ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Orthopedics and Sports Medicine ,Surgery ,business ,030217 neurology & neurosurgery - Abstract
ObjectivesThe objective of this study was to quantify the relative movement between the articular surfaces in the tibiotalar and subtalar joints during normal walking in asymptomatic individuals.Methods3D movement data of the ankle joint complex were acquired from 18 subjects using a biplanar fluoroscopic system and 3D-to-2D registration of bone models obtained from CT images. Surface relative velocity vectors (SRVVs) of the articular surfaces of the tibiotalar and subtalar joints were calculated. The relative movement of the articulating surfaces was quantified as the mean relative speed (RS) and synchronization index (SIENT) of the SRVVs.ResultsSIENTand mean RS data showed that the tibiotalar joint exhibited translational movement throughout the stance, with a mean SIENTof 0.54 (sd 0.21). The mean RS of the tibiotalar joint during the 0% to 20% post heel-strike phase was 36.0 mm/s (sd 14.2), which was higher than for the rest of the stance period. The subtalar joint had a mean SIENTvalue of 0.43 (sd 0.21) during the stance phase and exhibited a greater degree of rotational movement than the tibiotalar joint. The mean relative speeds of the subtalar joint in early (0% to 10%) and late (80% to 90%) stance were 23.9 mm/s (sd 11.3) and 25.1 mm/s (sd 9.5), respectively, which were significantly higher than the mean RS during mid-stance (10% to 80%).ConclusionThe tibiotalar and subtalar joints exhibited significant translational and rotational movement in the initial stance, whereas only the subtalar joint exhibited significant rotational movement during the late stance. The relative movement on the articular surfaces provided deeper insight into the interactions between articular surfaces, which are unobtainable using the joint coordinate system. Cite this article: C-B. Phan, D-P. Nguyen, K. M. Lee, S. Koo. Relative movement on the articular surfaces of the tibiotalar and subtalar joints during walking. Bone Joint Res 2018;7:501–507. DOI: 10.1302/2046-3758.78.BJR-2018-0014.R1.
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- 2018
47. Long-term outcomes over 10 years after femoral derotation osteotomy in ambulatory children with cerebral palsy
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Moon Seok Park, Soon Sun Kwon, Gyeong Hee Cho, Chin Youb Chung, Kyoung Min Lee, and Ki Hyuk Sung
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Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Biophysics ,Osteotomy ,Cerebral palsy ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Long term outcomes ,Deformity ,Humans ,Orthopedics and Sports Medicine ,Femur ,Postoperative Period ,Range of Motion, Articular ,Child ,Gait ,Gait Disorders, Neurologic ,Retrospective Studies ,030222 orthopedics ,Foot ,business.industry ,Cerebral Palsy ,Rehabilitation ,medicine.disease ,Surgery ,Prone position ,Treatment Outcome ,Child, Preschool ,Gait analysis ,Ambulatory ,Female ,Hip Joint ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Femoral derotation osteotomy (FDO) is generally reported to be excellent for correcting the hip rotation and foot progression angles in children with cerebral palsy (CP). However, it is unclear how long the favorable outcomes are maintained.This study was performed to evaluate the long-term outcomes at more than 10 years after FDO in children with CP.FDO, as part of single event multilevel surgery to improve gait function, was performed at the intertrochanteric level with the patient in the prone position. The goal of the index surgery was femoral anteversion of 15°, measured using a modified trochanteric prominence angle test intraoperatively. All patients underwent three-dimensional gait analysis preoperatively and at 1 year and over 10 years postoperatively.Thirty-four ambulatory patients (53 hips) with CP undergoing FDO were included. The mean age at surgery was 7.8 years (SD = 3.0 years) and mean follow-up duration was 12.9 years (SD = 2.7 years). The mean hip rotation decreased significantly from 9.6° preoperatively to 3.1° at 1 year postoperatively (p = 0.004), and decreased significantly to -5.9° at the final follow-up (p 0.001). The mean foot progression in stance decreased from 7.9° preoperatively to -7.4° at 1 year postoperatively (p 0.001), and was maintained at -10.9° at the final follow-up. The GDI significantly improved from 68.2 preoperatively to 83.4 1 year postoperatively (p 0.001), and was maintained at 82.3 at the final follow-up. No patients underwent revision surgery due to recurrence of rotation deformity.Proximal FDO performed in the prone position provides favorable long-term outcomes at more than 10 years postoperatively, without recurrence of rotation deformity. To avoid under-correction or recurrence due to insufficient derotation, surgeons should consider not only dynamic gait analysis findings but also the measurement of anatomic femoral anteversion during intraoperative derotation.
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- 2018
48. Case report: what gives the myopic tilted disc an oval appearance?
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Seok Hwan Kim, Kyoung Min Lee, and Martha Kim
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genetic structures ,Posterior pole ,Optic Disk ,Myopic tilted disc ,Case Report ,Fundus (eye) ,Curvature ,Ovality ,Boramae myopia cohort study ,lcsh:Ophthalmology ,Optical coherence tomography ,medicine ,Myopia ,Humans ,Eye Abnormalities ,Child ,Tilt ,medicine.diagnostic_test ,business.industry ,General Medicine ,Anatomy ,eye diseases ,Ophthalmology ,Axial Length, Eye ,Tilt (optics) ,medicine.anatomical_structure ,lcsh:RE1-994 ,Optic nerve ,Female ,sense organs ,Astrophysics::Earth and Planetary Astrophysics ,business ,Tomography, Optical Coherence ,Optic disc - Abstract
Background Myopic tilted disc, observed as an oval disc, has been alleged to be a funduscopic en-face manifestation of excessive optic nerve head (ONH) sloping or tilting. Here, we report the case of a myopic child showing a developing oval disc in fundus photos during axial elongation, but without progressive tilting in spectral-domain optical coherence tomography (SD-OCT) images. Case presentation By merging B-scan SD-OCT images of the ONH and macula, the curvature of the posterior pole, including both the fovea and ONH, was reconstructed and compared before and after 2 years of axial elongation. Despite the marked increase of disc ovality, the posterior polar curvature was rarely changed. The preponderance of optic disc change was induced by the shift of the temporal disc margin in the nasal direction. This shifting alone imitated an increase of tilt angle but one that was still far smaller than the required degree of tilt for ONH-tilt-based disc ovality. To clarify, we calculated the required extent of axial elongation to obtain a substantial degree of ONH tilt when considering the adjacency of the fovea and the ONH. Without a focal increase of posterior polar curvature, which is to say posterior staphyloma, such change is not possible until the axial length increases extraordinarily. Conclusion The most prominent change in the development of myopic tilted disc, which change gives it an oval appearance and imitates a tilt when measured, is actually not a tilt but rather a shift of the temporal disc margin.
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- 2019
49. Opposite Association Between Radiographic Lateral Ankle Instability and Osteochondral Lesions of the Talus in Patients with Ankle Inversion Injuries
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Won-keun Park, Byeong-Seop Park, Kyoung Min Lee, Seungbum Koo, and Ki-bum Kwon
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Orthodontics ,bony predisposition ,Lateral ankle ,business.industry ,Radiography ,Ankle inversion ,ankle instability ,OLT ,Instability ,Article ,lcsh:RD701-811 ,opposite association ,lcsh:Orthopedic surgery ,Medicine ,In patient ,business - Abstract
Category: Ankle Introduction/Purpose: Insufficient bony coverage surrounding the talus could cause considerable mechanical ankle instability, whereas excessive bony coverage could cause bone contusion at the time of injury and subsequent osteochondral lesions of the talus (OLT). This study aimed to investigate the relationship between radiographic lateral ankle instability and OLT in patients that sustained ankle inversion injuries. Methods: One-hundred-ninety-five patients (113 men and 83 women; mean age, 38.7 years; standard deviation, 8.8 years) with a history of ankle inversion injuries were included. All patients underwent ankle magnetic resonance imaging (MRI) and stress X-ray (varus stress and anterior drawer) examination. The tibiotalar tilt angle on varus stress X-ray, anterior translation of the talus on anterior-drawer lateral X-rays, bimalleolar tilt angle, and fibular position were radiographically determined. The anatomical grade of the lateral ankle ligament injury and the presence of OLTs were determined from MRI findings. Results: A greater lateral ankle ligament grade tends to increase the tibiotalar tilt angle (p=0.074), significantly affecting the anterior translation of the talus (p=0.036). The presence of radiographic lateral ankle instability (tibiotalar tilt angle =10°) showed opposite associations with the presence of OLT in the chi-square test (p=0.003). OLT was a negative significant factor (p=0.011) affecting the tibiotalar tilt angle in the multiple regression analysis (Table 1) and was negatively affected by the tibiotalar tilt angle (p=0.016) in the binary logistic regression analysis. Conclusion: This study showed an opposite association between lateral ankle instability and the development of OLT following ankle inversion injury. The role of bony predisposition in the development of sports injuries in the ankle should be considered and investigated further.
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- 2019
50. A Suspicious Atypical Fracture of 5th Metatarsal Bone: A Case Report
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Kyoung Min Lee, Byeong-Seop Park, Seungbum Koo, Ki-bum Kwon, and Won-keun Park
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Orthodontics ,business.industry ,metatarsal bone ,Article ,lcsh:RD701-811 ,lcsh:Orthopedic surgery ,Fracture (geology) ,biosphosphonate ,Medicine ,atypical fracture ,Orthopedics and Sports Medicine ,Surgery ,Metatarsal bones ,business - Abstract
Category: Trauma Introduction/Purpose: Long-term usage of bisphosphonate can severely suppress bone turnover and alter bone mechanical properties, thereby resulting in atypical fractures that mainly occur at the femur.We present a rare case of suspicious atypical fracture of the metatarsal bone. Methods: A 63-year-old woman presented to our clinic with a primary complain of a one-week history of pain in her right foot. The patient had no history of trauma to the right foot and denied any strenuous activity. She experienced lateral foot pain while walking within her home. She was on alendronate therapy for osteoporosis for a decade. X ray and CT examination revealed a fifth metatarsal fracture whose features were compatible with those of atypical femoral fractures (Figure 1). Results: The patient was advised to discontinue alendronate and underwent percutaneous surgical fixation of the fracture via a proximal approach using a 4.0-mm half-threaded cannulated screw. Postoperatively, a short leg cast was created and the patients performed non-weight bearing ambulation until the cast was removed at the sixth postoperative week. Radiography in the sixth postoperative week revealed callus formation. Conclusion: Our findings suggest that physicians must keep in mind that atypical fractures could possibly occur at bones other than the femur.
- Published
- 2019
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