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Treatment of Osteochonritis Dissecans of Femoral Condyle (대퇴골과 박리성 골연골염의 치료)

  • Lee Dong-Chul;Kwon Soon;Son Wook-Jin
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.49-54
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    • 2002
  • Purpose : To analyze the clinical results of treatment for the osteochondritis dissecans of femoral condyle by age, the type of lesion and method of treatment. Methods : From March 1991 to February 2000, 17 patients (20 cases) with osteochondritis dissecans of the femoral condyle were followed up over 1 year. Three patients had bilateral lesion. There were 12 cases with trauma history (9 cases with sports injury and 3 cases with direct trauma). The initial symptoms were pain, clicking, locking, giving way in the order of frequency, pain was revealed in all cases. Clinical evaluation of IKDC and Hughston method were used for subjective and objective function. Results : The number of male patient was 12, and the mean age was 19.8 year old (11$\~$50). The location of the lesion was 14 cases in medial femoral condyle and 6 cases in lateral femoral condyle. The arthroscopic findings of the lesion in 15 cases were as follows, early separation in 6 cases, partially detachment in 4 cases, and crators and complete detachment in 5 cases. 5 cases were treated with mutiple drilling and 5 cases with Herbert screw fixation, 3 cases with Herbert screw fixation and bone graft. In early stage, 7 cases were treated with conservative method. In the grading of Hughston score, 6 cases were graded as excellent, 9 cases as good, 15 cases were graded as good to excellent. Based on the IKDC scale, 1 case was graded as normal, 6 as nearly normal, and 10 as abnormal. Conclusions : The trauma seemed to be important factor in occurrence of osteochondritis dissecans of the femoral condyle. The clinical results of juvenile period showed better than adolescence and adult period, it is necessary to detect the lesion as soon as possible. The result of subjective evaluation was worse than the Hughston evaluation. It was caused by limiting involvement of sports activity and limited activity in the adolescence.

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Study on snack intakes in obese elementary students in Jeju city (제주시 지역 일부 초등학교 비만아동의 간식 섭취 실태)

  • Ko, Yangsook;Lee, You-Yeong;Chae, Insook;Lee, Yunkyoung;Jekal, Yoonsuk;Park, Hyeung-Keun
    • Journal of Nutrition and Health
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    • v.50 no.1
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    • pp.85-97
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    • 2017
  • Purpose: This study was conducted to investigate dietary habits related to weight reduction and snack intake habits of $4^{th}$ to $5^{th}$ grade elementary students located in Jeju-si, Jeju, South Korea. Methods: The $4^{th}$ and $5^{th}$ grade elementary school students (total n = 234, equally matched numbers of normal weight children and overweight/obese children (n = 117/group)) were surveyed using a questionnaire and a 24-hour dietary recall method in Oct 2015. Results: The percentage of students who experienced reduced food intake to control weight was 26.3% in the normal weight group (NG) and 77.6% in the obese group (OG). Most frequently answered meal for reduced intake was snacks in the NG and dinner in the OG. Percentages of daily calorie intake among subjects were 17.2% for breakfast, 33.8% for lunch, 29.7% for dinner, and 19.3% for snacks. Frequency of snack intake was 2.1 times a week in NG and 1.6 times a week in OG, which showed a statistical difference between body weight groups. Types of snack foods were distinctly different depending on where children consumed them, although no difference was observed between NG and OG. In addition, snack intake level of low energy and nutrient-dense foods was significantly lower in the OG compared to the NG, whereas snack intake level of energy dense and low-nutritive foods was not different between the OG and NG. Conclusion: Taken together, snack intake level with consideration of frequency and amount of snack intake showed that children in the OG consumed significantly less low energy and nutrient-dense foods compared to the NG. Therefore, nutritional education for choosing healthy snack foods for children regardless of body weight status is crucial based on family-school links.

Germination and Growth of Oaks (Quercus serrata, Q. mongolica, Q. variabilis) Seedlings by Gradient of Light Intensity and Soil Moisture (광도와 토양수분 구배(勾配)에 따른 참나무류(Quercus Serrata, Q. mongolica, Q. variabilis)치수(稚樹)의 발아 및 성장)

  • Beon Mu-Sup
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.2 no.4
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    • pp.183-189
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    • 2000
  • This study was carried out to analyze ecophysiological responses for seedling of Quercus serrata, Quercus mongolica and Quercus variabilis that are the typical species of deciduous broadleaved forests in Korea. And executed experiments in the climatic control room to provide necessary information to ecological forest management and methods of natural regeneration through the analysis of seedling responses. The details of experimental analysis were growth processes of 4 months after seeding that vary with the condition of three light intensity[relative light intensity(RLI) 8%, 20%, 52%] and three soil moisture[water suction(WS) Ψ=100 hPa, Ψ=280 hPa, Ψ=330 hPa] gradient, growth factors after harvesting and the nutrition condition of leaves. The results of this study are followings: 1) Early growth was prosperous after germination for the species which have more weight of acorn. 2) The formation of lammas shoot was favourable with Q. variabilis and Q. mongolica. And the rate of the occurrence was the highest in the RLI 20%, and it was remarkably reduced in the RLI 8%. 3) As the height growth of seedling of all 3 species were greater in the RLI 20% and 8% than that of the RLI 52%, they showed strong shade tolerance. 4) The increase of light intensity promoted the diameter at root collar growth, and development of main and lateral roots with all 3 species. 5) It showed that the increase of light intensity in the experimental radiation condition raised special leaf area weight(mg/cm$^2$) and leaf area productivity(mg/cm$^2$). Consequently, these resulted in the increase of leaf thickness and total dry biomass per the unit area of leaf. 6) As the increase of light intensity, the minerals contents of leaves such as N, P and K were lowered, and the increase of soil moisture resulted in the increase of P, K, Ca and Mg.

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The Comparison of $45^{\circ}$ and $55^{\circ}$ Anteroposterior Oblique View for Observating the Intervertebral Foramen (경추 추간공 관찰을 위한 촬영법의 고찰)

  • Jeon, Ju-Seob;Eun, Sung-Jong;Kim, Hye-Ran;An, Seung-Hyun;Choi, Nam-Kin;Kim, Young-Keun
    • Journal of radiological science and technology
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    • v.28 no.2
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    • pp.91-95
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    • 2005
  • The cervical spine of anteroposterior oblique view is essential to observe the intervertebral foramen(IVF). The morphologic changes of IVFs were proved to be abnormal with nerve roots and peripheral structures. The purpose of this study is to evaluate the effective projection angle for observing the IVFs in the Korean adults. In a prospective clinical study of 100 normal persons, $45^{\circ}$, $50^{\circ}$ and $55^{\circ}$ oblique views were compared by measuring the maximal transverse diameter of all the cervical IVFs. $45^{\circ}$ oblique views provided slightly better visualization of upper cervical level(C2-C3, C3-C4, C4-C5), but the lower cervical level(C5-C6, C6-C7, C7-T1) of IVF transverse diameters were substantially increased on the $55^{\circ}$ AP oblique projection. In the comprasion of mean differences between 8 obese person(BMI > 25) and 58 normal person(18.5 < BMI < 22.9) proved to be statistically not significant. Consequently this study shows that $55^{\circ}$AP oblique(tube angle $15^{\circ}$cephalad) view is optimal for evaluating the lower cervical IVFs.

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Identification and Characterization of Three Isolates of Cucumber mosaic virus Isolated from Weed Hosts (잡초에서 분리한 3종 Cucumber mosaic virus의 동정과 특성)

  • Lee, Hyeok-Geun;Kim, Sung-Ryul;Jeon, Yong-Woon;Kwon, Soon-Bae;Ryu, Ki-Hyun;Choi, Jang-Kyung
    • Research in Plant Disease
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    • v.14 no.1
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    • pp.15-20
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    • 2008
  • Three isolates of Cucumber mosaic virus (CMV) were isolated from weed hosts showing typical mosaic symptoms, and some properties of the viruses were investigated. CMV isolates, designated as Is-CMV, Jd-CMV and Pla-CMV from Isodon inflexus, Jeffersonia dubia and Phryma leptostachya var. asiatica, respectively, were identified and characterized by biological reaction in several host plants, serological property, dsRNA analysis, reverse transcription-polymerase chain reaction (RT-PCR), restriction fragment-length polymorphism (RFLP). All isolates systemically infected in Nicotiana benthamiana, Cucurbita pepo cv. Black beauty and Cucumis sativus, and did not reveal any differences in these host plants between the isolates. However, remarkable difference in the symptoms was found between the CMVs in Capsicum annuum. Is-CMV induced an asymptomatic symptoms, while Jd-CMV and Pla-CMV produced severe mosaic symptoms in C. annuum plants. In dsRNA analysis, all isolates revealed four major bands with estimated molecular size of 3.4, 3.2, 2.1 and 1.0 kbp. The cDNAs of coat protein gene of the isolates were amplified by RT-PCR using a genus-specific single pair primers that designed to amplify a DNA fragment of approximately ranging from 938 to 966 bp. By restriction mapping analysis using RFLP of the RT-PCR products as well as by serological properties of gel diffusion test, the CMV isolates belong to a typical members of CMV subgroup IA. This is the first report on the occurrence of CMV in the three weed hosts.

Aortopulmonary Window (대동맥폐동맥창)

  • Kim Dong-Jin;Min Sun-Kyung;Kim Woong-Han;Lee Jeong-Sang;Kim Yong-Jin;Lee Jeong-Ryul
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.275-280
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    • 2006
  • Background: Aortopulmonary window (APW) is a very rare congenital heart anomaly, often associated with other cardiac anomalies. It causes a significant systemic to pulmonary artery shunt, which requires early surgical correction. Accurate diagnosis and surgical correction will bring good outcomes. The purpose of this study was to describe our 20-year experience of aortopulmonary window. Material and Method: Between March 1985 and January 2005, 16 patients with APW underwent surgical repair. Mean age at operation was $157.8{\pm}245.3$ ($15.0{\sim}994.0$) days and mean weight was $4.8{\pm}2.5$ ($1.7{\sim}10.7$) kg. Patent ductus arteriosus (8), atrial septal defect (7), interruptedaortic arch (5), ventricular septal defect (4), patent foramen ovate (3), tricuspid valve regurgitation (3), mitral valve regurgitation (2), aortic valve regurgitation (1), coarctation of aorta (1), left superior vena cavae (1), and dextrocardia (1) were associated. Repair methods included 1) division of the APW with primary closure or patch closure of aorta and pulmonary artery primary closure or patch closure (11) and 2) intra-arterial patch closure (3). 3) Division of the window and descending aorta to APW anastomosis (2) in the patients with interrupted aortic arch or coarctation. Result: There was one death. The patient had 2.5 cm long severe tracheal stenosis from carina with tracheal bronchus supplying right upper lobe. The patient died at 5th post operative day due to massive tracheal bleeding. Patients with complex aortopulmonary window had longer intensive care unit and hospital stay and showed more morbidities and higher reoperation rates. 5 patients had reoperations due to left pulmonary artery stenosis (4), right pulmonary artery stenosis (2), and main pulmonary artery stenosis (1). The mean follow-up period was $6.8{\pm}5.6$ (57.0 days$\sim$16.7 years)years and all patients belonged to NYHA class 1. Conclusion: With early and prompt correction of APW, excellent surgical outcome can be expected. However, optimal surgical method needs to be established to decrease the rate of stenosis of pulmonary arteries.

Echocardiographic Follow-up after Arterial Switch Operation for Transposition of the Great Arteries (동맥전환술을 시행한 대혈관전위 환자에서 심초음파를 이용한 술후 추적)

  • 한승세;정태은;이동협;오정훈;이정철
    • Journal of Chest Surgery
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    • v.34 no.10
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    • pp.754-762
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    • 2001
  • Background: To evaluate the efficacy of arterial switch operation for transposition of great arteries, serial echocardiographic studies were performed in 8 patients who underwent the surgery between 1989 and 1998 at Dept. of Thoracic & Cardiovascular Surgery, Yeungnam University Hospital in Daegu City, Korea. Material and Method: Follow-up period ranged from 6 months to 11 years(average of 4.1 years). Body weight ranged from 2.6kg to 4.8kg, with average of 3.6kg. 5 of 8 patients were preoperatively diagnosed as TGA+VSD, and 3 as TGA+IVS. LV function was evaluated by the measurement of LV shortening fraction, LVSTI, and LVEF. RVSTI was also measured. Postoperative function of valve and growth of great vessels were analyzed by the measurement of PSPGV, valvular regurgitation, LA/AO ratio, root dimension of aorta and pulmonary artery, comparing with the age matched controls, respectively. Result: LVEF had an average of 65.0+9.03% which is tended to increase serially. LVAOPG had an average of 15.9mmHg. RVPAPG, 27.5mmHg. From the measurement of aortic root dimension of 6 patients at end-systole, aortic root growth was assumed to increase more than the mean value of normal growth. PA root dimension at end-systole showed a similar growth progress when compared with age matched normal controls. Postoperative pulmonic valve regurgitation was noted in 5 of total 8 patients, in which 1 patient who showed grade 2 and 4 showed below grade 1. AR, in 6 patients and all grade 1 Except 1 patient, all the valvular regurgitations were below grade 1, which was presumed to be clinically insignificant.

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Effect of Modified Ultrafiltration on the Postoperative State after Pediatric Open Heart Surgery. (소아 개심술에 있어서 변형 초여과법(Modified Ultrafiltration)이 술후 상태에 미치는 영향)

  • 방종경;천종록;김규태
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.456-465
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    • 1998
  • Cardiopulmonary bypass(CPB) in children is associated with the accumulation of body water after cardiac operation, as a consequence of an inflammatory capillary leak. Following work by Elliott in 1991, modified ultrafiltration(MUF) was introduced after bypass as a means of hemoconcentrating patients and a potential way of removing water from the tissues. We have carried out a prospective randomized study of 20 children undergoing open heart surgery, comparing MUF with nonfiltered controls. MUF was carried out for a mean of 18.9 minutes after completion of CPB to a hematocrit of 37.1%(mean). The mean water volulme removed by the ultrafiltration was 38.4 ml/kg and the mean blood volume retransfused from the oxygenator during the ultrafiltration was 32.1 ml/kg. Fluid balance, hemodynamics, hematocrit, osmolarity and dosage of drug treatment were recorded for 4∼12 hours postoperatively. The results were analyzed using Student t-test and ANOVA, comparing controls(n=10) to MUF(n=10). Blood loss(ml/kg/24hr) was 14.5(mean) in MUF versus 13.7 in controls; blood transfused(ml/kg/24hr) 6.6 in MUF versus 15.2 in controls; plasma transfused(ml/kg/24hr) 65.7 in MUF versus 59.6 in controls. There was rise in arterial blood pressure and hematocrit during MUF. Percent rise of systolic blood pressure was 28.8% in MUF versus 18.7% in controls(p=0.366); percent rise of diastolic blood pressure was 28.8% in MUF versus 8.5% in controls(p=0.135); and percent rise of mean blood pressure was 36.2% in MUF versus 8.2% in controls (p=0.086). Percent rise of hematocrit was 40.0% in MUF versus 23.5% in controls(p=0.002). There was no significant difference in the inotropic requirement and the postoperative serum osmolarity between two groups. The number of days on the ventilator, the duration of stay in the intensive care unit, and the postoperative hospital stay were not significantly different between the two groups.

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Preoperative Risk Factors for the Prognosis of Mitral Regurgitation in Patients with Coronary Artery Stenosis and Mitral Regurgitation Who Underwent Coronary Artery Bypass Surgery Alone (승모판폐쇄부전증을 동반한 관상동맥협착증 환자에서 시행한 단독 관상동맥우회술 후 승모판폐쇄부전증의 예후에 영향을 미치는 수술 전 요인)

  • Jin, Ung;Park, Chan-Beom;Choi, Si-Young;Kim, Chi-Kyung
    • Journal of Chest Surgery
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    • v.37 no.5
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    • pp.410-415
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    • 2004
  • Background: In the operation for coronary artery stenosis, the procedures for mitral regurgitation are restricted to cases of more than moderate mitral regurgitation or for the lesions in leaflets. This is based on the belief that the less than mild regurgitation are a form of reversible change results from ischemia with coronary artery stenosis. We studied the changes and prognostic factors of mitral regurgitation in patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone. Material and Method: We reviewed the medical records of 90 patients with coronary artery stenosis and mitral regurgitation who underwent coronary artery bypass surgery alone by a single surgeon from Jan. 1995 to Dec. 2002, We grouped the patients according to the postoperative changes of mitral regurgitation, and then we statistically compared the findings of echocardiogram between preoperative and last follow up. Result: There were 24 cases with progression of mitral regurgitation, 12 cases without changes, 54 cases with improvements of mitral regurgitation in total 90 patients. The bypass to LAD was proven as the significant prognostic factor of mitral regurgitation. The preoperative end diastolic left ventricular volume index were higher in aggravated group with 105.38$\pm$38.89 $m\ell$ compared to 71.75$\pm$28,45 $m\ell$ in improvement group, and 84.00$\pm$11.66 $m\ell$ in no change group. The grade of preoperative mitral regurgitation did not show significant differences among the groups. Conclusion: The mitral regurgitation in patient with coronary artery stenosis can be improved after the coronary artery bypass surgery alone. However, the expectation of improvements based on the degree of preparative mitral regurgitation can not be justified, therefore, the procedures for mitral regurgitation should be aggressively considered even in the cases of mild mitral regurgitation. Also, further study should be performed to identify the exact prognostic factors of mitral regurgitation including the left ventricular volume index, and whether the left anterior descending artery has been bypassed.

Central Nervous System Complications of Coronary Artery Bypass Grafting - Comparison Between Off-Pump CABG and Conventional CABG (관상동맥 우회술 후의 중추신경계 합병증 - 심폐바이패스를 사용하지 않은 관상동맥 우회술과 기존의 관상동맥 우회술의 비교)

  • Chang, Ji-Min;Lee, Jeong-Sang;Kim, Ki-Bong;Ahn, Hyuk;Yoon, Byung-Woo;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.33 no.12
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    • pp.941-947
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    • 2000
  • Background: Central nervous system complication after coronary artery bypass grafting(CABG) is one of the major prognostic determinants and the use of the cardiopulmonary bypass(CPB) may increase the incidence of this devastating complication. In this study, the outcomes after off-pump CABG were studied and compared with those following the conventional CABG using CPB. Material and Method: Among the consecutive isolated CABG's performed in SNUH during Feb. 1995 and Jun. 1999, 338 coronary artery bypass grafting were divided into two groups. 223 patients underwent CABG using the CPB(Group I), and 115 patients underwent CABG without CPB(OPCAB)(Group II). All patients enrolled in this study received extensive preoperative examinations including thorough neurologic examination before and after surgery, transcranial doppler study, carotid duplex ultrasonography, and magnetic resonance angiography if necessary. Central nervous system(CNS) complications were defined as stroke, seizure, metabolic or hypoxic encephalopathy and transient delirium after surgery. Result: There were 61 cases(27.3%) who developed postoperative CNS complication in Group I, whereas 8 cases(7.0%) of CNS complications developed postoperatively in group II(p<0.05). Statistically significant predictors of postoperative CNS complications in group I were age and the use of cardiac assist devices perioperatively. Conclusion: This study suggested that omitting the use of CPB in CABG resulted in significant decrease of the postoperative CNS complications. OPCAB should be more widely applied especially to the elderly who have preexisting cerebrovascular disease.

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