1.Postoperative Delirium after Reverse Total Shoulder Arthroplasty: Interscalene Block Versus General Anesthesia
Sung Min RHEE ; Soo Young KIM ; Cheol Hwan KIM ; Radhakrishna KANTANAVAR ; Divyanshu Dutt DWIVEDI ; Se Yeon KIM ; Hyun Joo HAM ; Yong Girl RHEE
Clinics in Orthopedic Surgery 2025;17(2):283-290
Background:
This study aimed to assess the severity of postoperative delirium (PD) in elderly patients who underwent reverse total shoulder arthroplasty (rTSA) for irreparable massive rotator cuff tears (mRCTs) under general anesthesia (GA) compared to those under interscalene block (IB).
Methods:
Forty elderly patients aged 65 years or older diagnosed with an irreparable mRCT who underwent rTSA were included in the prospective case-controlled study. Of these, 20 patients were operated under GA and the other 20 under IB. The average age was 77.1 years (range, 65–95 years). The severity of delirious symptoms was evaluated by the Delirium Rating Scale–revised–98 (DRS) score from the patients or guardians before the surgery and at 0, 3, and 7 days and 1, 3, and 6 months after the surgery and compared between the 2 groups.
Results:
Immediately after surgery, the visual analog scale score difference between the groups was statistically significant, with the GA group at 6.25 (standard deviation, ± 0.85) and the IB group at 3.80 (± 0.62) (p < 0.001). On the day of operation, the mean DRS score in the GA and IB groups were 9.10 (± 5.63) and 6.60 (± 5.33), respectively (p = 0.157). On day 3 of surgery, the mean DRS score in the GA group peaked to 9.95 (± 8.73), while in the IB group, it declined to 6.40 (±5.81) (p = 0.138). After 3 days, DRS scores showed a decreasing trend in both groups. When comparing the mean change (∆) from the preoperative baseline scores to the postoperative values, the ∆DRS score was significantly higher with 4.15 (± 4.53) points in the GA group as compared to 1.30 (± 1.92) in the IB group (p = 0.014).
Conclusions
IB can be an attractive and efficient anesthetic choice in preventing PD for elderly patients undergoing rTSA for irreparable mRCTs. The IB group showed lower DRS scores and a peak on day 0 compared to the higher DRS scores and peak on day 3 in the GA group. Additionally, IB showed less pain than GA.
2.Postoperative Delirium after Reverse Total Shoulder Arthroplasty: Interscalene Block Versus General Anesthesia
Sung Min RHEE ; Soo Young KIM ; Cheol Hwan KIM ; Radhakrishna KANTANAVAR ; Divyanshu Dutt DWIVEDI ; Se Yeon KIM ; Hyun Joo HAM ; Yong Girl RHEE
Clinics in Orthopedic Surgery 2025;17(2):283-290
Background:
This study aimed to assess the severity of postoperative delirium (PD) in elderly patients who underwent reverse total shoulder arthroplasty (rTSA) for irreparable massive rotator cuff tears (mRCTs) under general anesthesia (GA) compared to those under interscalene block (IB).
Methods:
Forty elderly patients aged 65 years or older diagnosed with an irreparable mRCT who underwent rTSA were included in the prospective case-controlled study. Of these, 20 patients were operated under GA and the other 20 under IB. The average age was 77.1 years (range, 65–95 years). The severity of delirious symptoms was evaluated by the Delirium Rating Scale–revised–98 (DRS) score from the patients or guardians before the surgery and at 0, 3, and 7 days and 1, 3, and 6 months after the surgery and compared between the 2 groups.
Results:
Immediately after surgery, the visual analog scale score difference between the groups was statistically significant, with the GA group at 6.25 (standard deviation, ± 0.85) and the IB group at 3.80 (± 0.62) (p < 0.001). On the day of operation, the mean DRS score in the GA and IB groups were 9.10 (± 5.63) and 6.60 (± 5.33), respectively (p = 0.157). On day 3 of surgery, the mean DRS score in the GA group peaked to 9.95 (± 8.73), while in the IB group, it declined to 6.40 (±5.81) (p = 0.138). After 3 days, DRS scores showed a decreasing trend in both groups. When comparing the mean change (∆) from the preoperative baseline scores to the postoperative values, the ∆DRS score was significantly higher with 4.15 (± 4.53) points in the GA group as compared to 1.30 (± 1.92) in the IB group (p = 0.014).
Conclusions
IB can be an attractive and efficient anesthetic choice in preventing PD for elderly patients undergoing rTSA for irreparable mRCTs. The IB group showed lower DRS scores and a peak on day 0 compared to the higher DRS scores and peak on day 3 in the GA group. Additionally, IB showed less pain than GA.
3.Postoperative Delirium after Reverse Total Shoulder Arthroplasty: Interscalene Block Versus General Anesthesia
Sung Min RHEE ; Soo Young KIM ; Cheol Hwan KIM ; Radhakrishna KANTANAVAR ; Divyanshu Dutt DWIVEDI ; Se Yeon KIM ; Hyun Joo HAM ; Yong Girl RHEE
Clinics in Orthopedic Surgery 2025;17(2):283-290
Background:
This study aimed to assess the severity of postoperative delirium (PD) in elderly patients who underwent reverse total shoulder arthroplasty (rTSA) for irreparable massive rotator cuff tears (mRCTs) under general anesthesia (GA) compared to those under interscalene block (IB).
Methods:
Forty elderly patients aged 65 years or older diagnosed with an irreparable mRCT who underwent rTSA were included in the prospective case-controlled study. Of these, 20 patients were operated under GA and the other 20 under IB. The average age was 77.1 years (range, 65–95 years). The severity of delirious symptoms was evaluated by the Delirium Rating Scale–revised–98 (DRS) score from the patients or guardians before the surgery and at 0, 3, and 7 days and 1, 3, and 6 months after the surgery and compared between the 2 groups.
Results:
Immediately after surgery, the visual analog scale score difference between the groups was statistically significant, with the GA group at 6.25 (standard deviation, ± 0.85) and the IB group at 3.80 (± 0.62) (p < 0.001). On the day of operation, the mean DRS score in the GA and IB groups were 9.10 (± 5.63) and 6.60 (± 5.33), respectively (p = 0.157). On day 3 of surgery, the mean DRS score in the GA group peaked to 9.95 (± 8.73), while in the IB group, it declined to 6.40 (±5.81) (p = 0.138). After 3 days, DRS scores showed a decreasing trend in both groups. When comparing the mean change (∆) from the preoperative baseline scores to the postoperative values, the ∆DRS score was significantly higher with 4.15 (± 4.53) points in the GA group as compared to 1.30 (± 1.92) in the IB group (p = 0.014).
Conclusions
IB can be an attractive and efficient anesthetic choice in preventing PD for elderly patients undergoing rTSA for irreparable mRCTs. The IB group showed lower DRS scores and a peak on day 0 compared to the higher DRS scores and peak on day 3 in the GA group. Additionally, IB showed less pain than GA.
4.Postoperative Delirium after Reverse Total Shoulder Arthroplasty: Interscalene Block Versus General Anesthesia
Sung Min RHEE ; Soo Young KIM ; Cheol Hwan KIM ; Radhakrishna KANTANAVAR ; Divyanshu Dutt DWIVEDI ; Se Yeon KIM ; Hyun Joo HAM ; Yong Girl RHEE
Clinics in Orthopedic Surgery 2025;17(2):283-290
Background:
This study aimed to assess the severity of postoperative delirium (PD) in elderly patients who underwent reverse total shoulder arthroplasty (rTSA) for irreparable massive rotator cuff tears (mRCTs) under general anesthesia (GA) compared to those under interscalene block (IB).
Methods:
Forty elderly patients aged 65 years or older diagnosed with an irreparable mRCT who underwent rTSA were included in the prospective case-controlled study. Of these, 20 patients were operated under GA and the other 20 under IB. The average age was 77.1 years (range, 65–95 years). The severity of delirious symptoms was evaluated by the Delirium Rating Scale–revised–98 (DRS) score from the patients or guardians before the surgery and at 0, 3, and 7 days and 1, 3, and 6 months after the surgery and compared between the 2 groups.
Results:
Immediately after surgery, the visual analog scale score difference between the groups was statistically significant, with the GA group at 6.25 (standard deviation, ± 0.85) and the IB group at 3.80 (± 0.62) (p < 0.001). On the day of operation, the mean DRS score in the GA and IB groups were 9.10 (± 5.63) and 6.60 (± 5.33), respectively (p = 0.157). On day 3 of surgery, the mean DRS score in the GA group peaked to 9.95 (± 8.73), while in the IB group, it declined to 6.40 (±5.81) (p = 0.138). After 3 days, DRS scores showed a decreasing trend in both groups. When comparing the mean change (∆) from the preoperative baseline scores to the postoperative values, the ∆DRS score was significantly higher with 4.15 (± 4.53) points in the GA group as compared to 1.30 (± 1.92) in the IB group (p = 0.014).
Conclusions
IB can be an attractive and efficient anesthetic choice in preventing PD for elderly patients undergoing rTSA for irreparable mRCTs. The IB group showed lower DRS scores and a peak on day 0 compared to the higher DRS scores and peak on day 3 in the GA group. Additionally, IB showed less pain than GA.
5.Digital Guided Implant Placement using Sinus Lift with Iliac Bone Graft: A Case Report
Euntae JOO ; Yootaek SHIN ; Sang Min HAM ; Jee Hwan KIM ; Jun-Young KIM
Journal of implantology and applied sciences 2024;28(2):88-95
To restore masticatory function, dental implants require adequate bone support. For extensive maxillary bone loss, sinus lift surgery with bone grafting is often employed, favoring the autogenous iliac crest bone for better implant integration. Guides aid in the precise placement of implants and can reduce surgery time. In this context, an approach that combines of sinus lifting, bone grafting, and implant placement can be beneficial. In April 2020, a 58-year-old male presented with severe left maxillary alveolar bone atrophy and peri-implantitis of the right maxilla. Implants #15i, # 16i, and # 17i were removed, followed by bilateral sinus lift, bone grafting, and implant placement. During the 2-year follow-up after prosthesis placement, both the graft material and implants remained stable without complications. Iliac bone grafts exhibit greater resorption than other graft materials. In this case, implant positioning based on virtual planning and modifications guided by experience was performed without complications.
6.Digital Guided Implant Placement using Sinus Lift with Iliac Bone Graft: A Case Report
Euntae JOO ; Yootaek SHIN ; Sang Min HAM ; Jee Hwan KIM ; Jun-Young KIM
Journal of implantology and applied sciences 2024;28(2):88-95
To restore masticatory function, dental implants require adequate bone support. For extensive maxillary bone loss, sinus lift surgery with bone grafting is often employed, favoring the autogenous iliac crest bone for better implant integration. Guides aid in the precise placement of implants and can reduce surgery time. In this context, an approach that combines of sinus lifting, bone grafting, and implant placement can be beneficial. In April 2020, a 58-year-old male presented with severe left maxillary alveolar bone atrophy and peri-implantitis of the right maxilla. Implants #15i, # 16i, and # 17i were removed, followed by bilateral sinus lift, bone grafting, and implant placement. During the 2-year follow-up after prosthesis placement, both the graft material and implants remained stable without complications. Iliac bone grafts exhibit greater resorption than other graft materials. In this case, implant positioning based on virtual planning and modifications guided by experience was performed without complications.
7.Digital Guided Implant Placement using Sinus Lift with Iliac Bone Graft: A Case Report
Euntae JOO ; Yootaek SHIN ; Sang Min HAM ; Jee Hwan KIM ; Jun-Young KIM
Journal of implantology and applied sciences 2024;28(2):88-95
To restore masticatory function, dental implants require adequate bone support. For extensive maxillary bone loss, sinus lift surgery with bone grafting is often employed, favoring the autogenous iliac crest bone for better implant integration. Guides aid in the precise placement of implants and can reduce surgery time. In this context, an approach that combines of sinus lifting, bone grafting, and implant placement can be beneficial. In April 2020, a 58-year-old male presented with severe left maxillary alveolar bone atrophy and peri-implantitis of the right maxilla. Implants #15i, # 16i, and # 17i were removed, followed by bilateral sinus lift, bone grafting, and implant placement. During the 2-year follow-up after prosthesis placement, both the graft material and implants remained stable without complications. Iliac bone grafts exhibit greater resorption than other graft materials. In this case, implant positioning based on virtual planning and modifications guided by experience was performed without complications.
8.Erratum: Correction of Affiliations in the Article “Establishment of a Nationwide Korean Imaging Cohort of Coronavirus Disease 2019”
Soon Ho YOON ; Soo-Youn HAM ; Bo Da NAM ; Kum Ju CHAE ; Dabee LEE ; Jin Young YOO ; So Hyeon BAK ; Jin Young KIM ; Jin Hwan KIM ; Ki Beom KIM ; Jung Im JUNG ; Jae-Kwang LIM ; Jong Eun LEE ; Myung Jin CHUNG ; Young Kyung LEE ; Young Seon KIM ; Ji Eun JO ; Sang Min LEE ; Woocheol KWON ; Chang Min PARK ; Yun-Hyeon KIM ; Yeon Joo JEONG
Journal of Korean Medical Science 2023;38(34):e298-
9.Development and Validation of a Model Using Radiomics Features from an Apparent Diffusion Coefficient Map to Diagnose Local Tumor Recurrence in Patients Treated for Head and Neck Squamous Cell Carcinoma
Minjae KIM ; Jeong Hyun LEE ; Leehi JOO ; Boryeong JEONG ; Seonok KIM ; Sungwon HAM ; Jihye YUN ; NamKug KIM ; Sae Rom CHUNG ; Young Jun CHOI ; Jung Hwan BAEK ; Ji Ye LEE ; Ji-hoon KIM
Korean Journal of Radiology 2022;23(11):1078-1088
Objective:
To develop and validate a model using radiomics features from apparent diffusion coefficient (ADC) map to diagnose local tumor recurrence in head and neck squamous cell carcinoma (HNSCC).
Materials and Methods:
This retrospective study included 285 patients (mean age ± standard deviation, 62 ± 12 years; 220 male, 77.2%), including 215 for training (n = 161) and internal validation (n = 54) and 70 others for external validation, with newly developed contrast-enhancing lesions at the primary cancer site on the surveillance MRI following definitive treatment of HNSCC between January 2014 and October 2019. Of the 215 and 70 patients, 127 and 34, respectively, had local tumor recurrence. Radiomics models using radiomics scores were created separately for T2-weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE-T1WI), and ADC maps using non-zero coefficients from the least absolute shrinkage and selection operator in the training set. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of each radiomics score and known clinical parameter (age, sex, and clinical stage) in the internal and external validation sets.
Results:
Five radiomics features from T2WI, six from CE-T1WI, and nine from ADC maps were selected and used to develop the respective radiomics models. The area under ROC curve (AUROC) of ADC radiomics score was 0.76 (95% confidence interval [CI], 0.62–0.89) and 0.77 (95% CI, 0.65–0.88) in the internal and external validation sets, respectively. These were significantly higher than the AUROC values of T2WI (0.53 [95% CI, 0.40–0.67], p = 0.006), CE-T1WI (0.53 [95% CI, 0.40– 0.67], p = 0.012), and clinical parameters (0.53 [95% CI, 0.39–0.67], p = 0.021) in the external validation set.
Conclusion
The radiomics model using ADC maps exhibited higher diagnostic performance than those of the radiomics models using T2WI or CE-T1WI and clinical parameters in the diagnosis of local tumor recurrence in HNSCC following definitive treatment.
10.Establishment of a Nationwide Korean Imaging Cohort of Coronavirus Disease 2019
Soon Ho YOON ; Soo-Youn HAM ; Bo Da NAM ; Kum Ju CHAE ; Dabee LEE ; Jin Young YOO ; So Hyeon BAK ; Jin Young KIM ; Jin Hwan KIM ; Ki Beom KIM ; Jung Im JUNG ; Jae-Kwang LIM ; Jong Eun LEE ; Myung Jin CHUNG ; Young Kyung LEE ; Young Seon KIM ; Ji Eun JO ; Sang Min LEE ; Woocheol KWON ; Chang Min PARK ; Yun-Hyeon KIM ; Yeon Joo JEONG
Journal of Korean Medical Science 2020;35(46):e413-
Background:
The Korean Society of Thoracic Radiology (KSTR) recently constructed a nation-wide coronavirus disease 2019 (COVID-19) database and imaging repository, referred to the Korean imaging cohort of COVID-19 (KICC-19) based on the collaborative efforts of its members. The purpose of this study was to provide a summary of the clinico-epidemiological data and imaging data of the KICC-19.
Methods:
The KSTR members at 17 COVID-19 referral centers retrospectively collected imaging data and clinical information of consecutive patients with reverse transcription polymerase chain reaction-proven COVID-19 in respiratory specimens from February 2020 through May 2020 who underwent diagnostic chest computed tomography (CT) or radiograph in each participating hospital.
Results:
The cohort consisted of 239 men and 283 women (mean age, 52.3 years; age range, 11–97 years). Of the 522 subjects, 201 (38.5%) had an underlying disease. The most common symptoms were fever (n = 292) and cough (n = 245). The 151 patients (28.9%) had lymphocytopenia, 86 had (16.5%) thrombocytopenia, and 227 patients (43.5%) had an elevated CRP at admission. The 121 (23.4%) needed nasal oxygen therapy or mechanical ventilation (n = 38; 7.3%), and 49 patients (9.4%) were admitted to an intensive care unit.Although most patients had cured, 21 patients (4.0%) died. The 465 (89.1%) subjects underwent a low to standard-dose chest CT scan at least once during hospitalization, resulting in a total of 658 CT scans. The 497 subjects (95.2%) underwent chest radiography at least once during hospitalization, which resulted in a total of 1,475 chest radiographs.
Conclusion
The KICC-19 was successfully established and comprised of 658 CT scans and 1,475 chest radiographs of 522 hospitalized Korean COVID-19 patients. The KICC-19 will provide a more comprehensive understanding of the clinical, epidemiological, and radiologic characteristics of patients with COVID-19.

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