• Title/Summary/Keyword: 연구 분석

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Tranexamic Acid Reduces Postoperative Blood Loss in Reverse Total Shoulder Arthroplasty (역행성 견관절 전치환술에서 트라넥삼산의 출혈 및 수혈 감소 효과)

  • Park, Kee Young;Kim, In Bo;Kim, Eun Yeol;Lee, Kwang Suk
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.391-397
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    • 2021
  • Purpose: Tranexamic acid (TXA) can reduce perioperative blood loss and the frequency of blood transfusions in lower extremity surgery. On the other hand, the effects of TXA on reverse total shoulder arthroplasty (rTSA) remain undetermined. This study evaluated the efficacy of TXA on perioperative blood loss, transfusion requirements, and the change in the hemotologic index. Materials and Methods: This study evaluated patients who underwent rTSA from September 2009 to July 2020. The patients were classified into two groups. The TXA group were administered TXA intravenously and topical TXA during surgery. The non-TXA group was not administered TXA. The quantity of hemovac drainage, which represented the postoperative blood loss, transfusion requirements, and postoperative change in hemoglobin and hematocrit level, were recorded. Results: The TXA and non-TXA groups consisted of 93 and 84 patients, respectively. The preoperative demographics showed no significant differences in age (72.0±7.0 vs. 71.5±5.8, p=0.656), sex (male:female, 28:65 vs. 23:61, p=0.689) and the prevalence of hypertension and diabetes (hypertension:diabetes:both, 36:3:13 vs. 32:3:8, p=0.806) between the two groups. There were significant differences in the requirements of transfusion (0 vs. 9, p=0.001), hemovac drainage at the 1st (98.8±61.2 ml vs. 162.7±98.8 ml, p<0.001), the 2nd postoperative day (73.8±48.4 ml vs. 91.5±54.5 ml, p=0.024), hemoglobin level at the 1st (11.7±1.2 g/dl vs. 11.2±1.4 g/dl, p=0.048), 3rd (10.9±1.2 g/dl vs. 10.2±1.2 g/dl, p<0.001), and 6th (11.2±1.3 g/dl vs. 10.7±1.3 g/dl, p=0.020) postoperative day, and the hematocrit level at the 1st (35.0%±3.6% vs. 32.5%±3.8%, p=0.001), 3rd (32.3%±5.0% vs. 29.8%±3.6%, p<0.001), and 6th (33.5%±3.8% vs. 31.5%±3.7%, p<0.001) postoperative day between the two groups. Conclusion: Intravenous and topical intra-articular TXA can reduce the transfusion requirement and blood loss in rTSA.

Preliminary Result of Revision Fusion Surgery for Thoracolumbar Spine Using Revision Rod (Revision Rod를 이용한 흉요추 유합 재수술 예비 결과)

  • Youn, Yung-Hun;Cho, Kyu-Jung;Park, Ye-Su;Park, Jae-Woo;Park, Jin-Sung;Kwon, Won-Hwan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.520-526
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    • 2020
  • Purpose: The need for revision fusion surgery after spinal fusion has increased. A revision rod that connects to the previous rod was newly developed for revision surgery. The purpose of this study was to analyze the clinical and radiological results after spinal fusion revision surgery using revision rods. Materials and Methods: Twenty-one patients who underwent revision fusion surgery after spinal fusion in two university hospitals with minimum 1 year follow-up were reviewed. This study assessed 16 cases of adjacent-segment disease, four cases of thoracolumbar fracture, and one case of ossification of ligament flavum. The Oswestry Disability Index (ODI) and numerical rating scale (NRS) were evaluated as clinical outcomes, and the union rate, lordosis or kyphosis of the revision level, lumbar lordosis, T5-12 kyphosis, and proximal junctional kyphosis angle were evaluated as the radiological outcomes. Results: The average ODI was 54.6±12.5 before surgery and improved to 29.8±16.5 at the final follow-up. The NRS for back pain and leg pain was 5.0±1.7 and 6.4±2.0 before surgery, which changed to 2.9±1.6 and 2.9±2.2 at the final follow-up. Lumbar lordosis was 18.1°±11.9° before surgery and 21.1°±10.3° at the final follow-up. Proximal junctional kyphosis was 10.8°±10.1° before surgery, and 9.2°±10.5° at the final follow-up. These angles were not changed significantly after surgery. Bony union was successful in all cases except for one case who underwent posterolateral fusion. Conclusion: Revision surgery using a newly developed revision rod on the thoracolumbar spine achieved good clinical outcomes with successful bony union. No problems with the newly developed revision rod were encountered.

Availability of Positron Emission Tomography-Computed Tomography for the Diagnosis of the Soft Tissue Tumor through Ultrasound-Guided Biopsy (초음파 유도하 침 생검을 이용한 연부조직 종양의 진단에 있어 양전자방출 컴퓨터 단층촬영술의 유용성)

  • Jun, Se Bin;Kim, Jeung Il;Lee, In Sook;Song, You Seon;Choi, Kyung Un
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.398-403
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    • 2021
  • Purpose: A biopsy is needed to diagnose soft tissue tumors. However, it is extremely difficult to pinpoint the site of a tumor due to the heterogeneity of sarcomas. Thus, even when an open biopsy is conducted, it is difficult to diagnose a soft tissue tumor. In such cases, an ultrasound (US)-guided biopsy is used to improve the diagnostic accuracy. This study evaluated the accuracy of US-guided biopsy for a diagnosis of soft tissue tumors found initially in a magnetic resonance (MR) perfusion and assessed the availability of positron emission tomography-computed tomography (PET-CT) for a diagnosis of soft tissue tumors. Materials and Methods: From January 2014 to December 2018, the US-guided biopsy was performed on 152 patients with a suspected soft tissue tumor found in an MR perfusion and 86 cases were definitively diagnosed with a soft tissue tumor. The accuracy of the US-guided biopsy was assessed retrospectively. Among the 86 cases, only MR perfusion was used before the biopsy in 50 cases, while both MR perfusion and PET-CT was conducted on 36 cases. The accuracy was analyzed to determine if the PET-CT could improve the precision of a biopsy. Results: From 86 cases, 34 out of 50 cases, in which only MR perfusion had been conducted, matched the result of the definitive diagnosis and the US-guided biopsy. 32 out of 36 cases, in which both PET-CT and MR perfusion were conducted, matched the definitive diagnosis and the US-guided biopsy. These results show significant differences in the accuracy of US-guided biopsy. In the case of soft tissue sarcomas, 6 out of 12 cases, in which only MR perfusion had been conducted, matched the result of the definitive diagnosis and the US-guided biopsy. 17 out of 18 cases, in which both PET-CT and MR perfusion were conducted, matched the definitive diagnosis. Moreover US-guided biopsy also showed significant differences in the accuracy of US-guided biopsy. Conclusion: In diagnosing soft tissue tumors, a US-guided biopsy is a well-known tool for its high accuracy. However, the heterogeneity of sarcoma makes it difficult to locate the exact site for a biopsy using only MR perfusion. Thus, the use of PET-CT will meaningfully improve the accuracy of a diagnosis by precisely targeting the site for the US-guided biopsy.

Diagnosis and Treatment of Brown Tumor (Brown 종양의 진단 및 치료)

  • Cho, Yong Jin;Cho, Yung Min;Na, Seung Min;Jung, Sung-Taek
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.54-61
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    • 2020
  • Purpose: Brown tumor is a tumor-like disease that can occur as a linked disease of hyperparathyroidism which can causes osteoporosis, osteitis fibrosa cystica, pathologic fractures. Brown tumor has been reported as a case report, but there is no comprehensive report on the exact diagnosis and principle of management for osseous lesion. The purpose of this study is to report the treatment and results of osseous lesions through 5 cases. Materials and Methods: From February 2004 to May 2015, five cases of Brown tumor were diagnosed in Chosun University Hospital and Chonnam National University Hospital orthopedic department. Medical records and radiographs were reviewed retrospectively. Parathyroid tumors were surgically removed, and surgical treatment and observation were performed for orthopedic osseous lesions. Results: The mean length of the long axis of the symptomatic osseous lesion was 6.2 cm (4.5-9.0 cm). An average of 7.6 (range, 3 to 14) of high uptake osseous lesion showed in whole body bone scan. The absolute value, T-score and Z-score of the vertebrae and proximal femur were adequate for diagnosis of osteoporosis using dual energy X-ray absorptiometry bone mineral density at diagnosis and recovered to normal at the last follow-up. In laboratory tests, serum concentrations of total calcium, ionized calcium, inorganic phosphorus, serum alkaline phosphatase, and parathyroid hormone were helpful to diagnosis and normalized upon successful removal of parathyroid adenoma or cancer. Conclusion: For accurate diagnosis of Brown tumor, it should be accompanied by systemic examination as well as clinical symptoms, laboratory tests and radiologic examination for osseous lesions. And a good prognosis can be expected if the hyperparathyroidism is treated together with the comprehensive treatment of osseous lesions.

Clinical and Radiological Results of Treating Unstable Distal Radial Fractures with a Domestically Developed Volar Locking Plate That Has the Characteristic of Double-Tiered Subchondral Support (불안정성 원위 요골 골절의 치료에 있어 한국형 이중 연골하지지고정 전방 금속판의 임상적 및 방사선학적 결과)

  • Lee, Chul-Hyung;Jung, Deukhee;An, Chung-Han;Jeong, Uitak
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.495-502
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    • 2020
  • Purpose: The aim of this study was to assess the effectiveness of domestically developed volar locking plate which has the concept of double-tiered subchondral support (DSS) in maintaining the reduction after distal radial fracture surgery. Materials and Methods: From July 2017 to December 2018, 54 patients were assessed. Plain radiographs were obtained immediately after surgery and at the last follow-up, and the radiographic parameters were measured in those images: radial length, radial inclination, volar tilt, ulnar variance, and distal dorsal cortical distance. The patients were subdivided into their age, type of fracture, and the position of the plate to evaluate the influence of each factors on the reduction maintenance. Results: Distal dorsal cortical distance in radiographs after the surgery was 5.91 mm (standard deviation, ±1.95 mm) on average. Significant differences in the radial length (p=0.038) and ulnar variance (p=0.001) were observed between immediately after surgery and at the last follow-up. When the parameters were evaluated by dividing the patients into subgroups according to the three specific factors, the ulnar variance showed a significant increase at the last follow-up when the patients were included 65-years-old or older. AO/OTA type C3 fracture, and Soong classification grade 0 plate position (p=0.007, p=0.012, p=0.046, respectively). Conclusion: Using the domestically developed DSS-type volar locking plate, significant reduction after distal radial fracture surgery could be maintained successfully. On the other hand, further study will be needed to determine about the reduction loss of the lunate facet identified in special cases that deal with fractures in elderly patients, unstable AO/OTA type C3 distal radial fractures, and Soong classification grade 0 plate position.

Comparison of the Morphometric Changes in the Cervical Foramen: Anterior Cervical Discectomy and Fusion versus Posterior Foraminotomy (전방 경유 디스크 절제술 및 유합술과 후방 추간공 절제술에서의 경추 추간공의 형태학적 변화 비교)

  • Chung, Sung-Soo;Sun, Woo-Sung;Chung, Jong-Chul;Heo, Ki-Sung;Kim, Hyun-Min
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.6
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    • pp.512-518
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    • 2021
  • Purpose: This study compared the change in foraminal space on magnetic resonance imaging (MRI) and the clinical outcome after anterior cervical discectomy and fusion (ACDF) versus foraminotomy in cervical foraminal stenosis. Materials and Methods: A retrospective case-control study was conducted from January 2018 to March 2019 on 186 patients who underwent ACDF and foraminotomy. One hundred and two cases were selected considering age, sex, and body mass index. MRI was performed before and on the 5th day after surgery to compare the changes in the foraminal diameter between the ACDF group (group A-51) and foraminotomy group (group B-51). Results: Between groups A and B, the average change in foraminal vertical diameter was 1.7 mm and 1.2 mm, respectively; group A was 0.5 mm larger difference (p=0.042). The average change in foraminal transverse diameter was 1.2 mm and 1.8mm, respectively; group B showed a 0.6 mm larger change (p=0.21). Both the neck disability index (NDI) and Japanese orthopaedic association (JOA) scores improved in both groups. Group A showed more improvement, but there was no significant difference (p=0.356, p=0.607, respectively). Conclusion: Foraminotomy is a useful option for patients with foraminal stenosis of the cervical spine because it showed comparable clinical and morphological results to ACDF and could minimize motion segment loss and muscle and ligament damage.

The effect of the mother's modeling and feeding practices on the eating behavior of young children (어머니의 모델링과 식사 지도가 유아의 식행동에 미치는 영향)

  • Sim, Hyeonmi;Han, Youngshin;Lee, Kyung A
    • Journal of Nutrition and Health
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    • v.55 no.2
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    • pp.296-308
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    • 2022
  • Purpose: To investigate the effect of a mother's modeling and feeding practices on the eating behavior of the children. Methods: From April to June 2018, 1,036 young children aged 2 to 6 years and their mothers in Gyeongsan, Gyeongsangbuk-do, were examined for their eating behavior and feeding practices using a verified dietary behavior test (DBT). The children's dietary behavior was classified into four categories: "access evasiveness", "sensory acuity", "hyperactivity", and "irregularity". The mother's eating behavior was classified into three categories: "pickiness", "negligence", and "irregularity", and feeding practice types were classified into two categories: "responsibility/monitoring", and "restriction/pressure". The differences between the groups were tested using the t-test, ANOVA, and Duncan's multiple range test. The influence of feeding practices on the children's eating behavior was analyzed by hierarchical regression analysis while controlling for the mother's modeling. Results: The problem rates of irregularity, negligence and pickiness in the mother's modeling were 33.7%, 22.8%, and 20.7%, respectively. An analysis of the mother's feeding practices revealed that responsibility/monitoring had a middle, high and low significance in 74.2%, 17.3%, and 8.5% of respondents, respectively and the risk rate of restriction/pressure when guiding children to eat was 15.3%. The problem rates for sensory acuity, access evasiveness, irregularity, and hyperactivity in children were 27.9%, 26.1%, 24.8%, and 22.0%, respectively. Among the four eating behavior characteristics of children, the child's access evasiveness and sensory acuity were more affected by their pickiness rather than the mother's feeding practices, and the child's hyperactivity was more influenced by feeding practices than the mother's eating behavior. The child's irregularity was similarly affected by the mother's eating behavior and feeding practices. Conclusion: Since the mother's eating behavior and feeding practices affect the children's eating behavior, a diet improvement program for children should consider not only the nutrition education of children but also the mother's eating behavior and provide the necessary intervention for feeding practices.

Effect of Pre-harvest Irradiation of UV-A and UV-B LED in Ginsenosides Content of Ginseng Sprouts (새싹 인삼의 수확 전 UV-A 및 -B LED의 조사에 의한 진세노사이드의 영향)

  • Jang, Seong-Nam;Lee, Ga-Oun;Sim, Han-Sol;Bae, Jin-Su;Lee, Ae-Ryeon;Cho, Du-Yong;Cho, Kye-Man;Son, Ki-Ho
    • Journal of Bio-Environment Control
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    • v.31 no.1
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    • pp.28-34
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    • 2022
  • This study was conducted to determine the changes in ginsenosides content according to additional UV-A, and UV-B LED irradiation before harvesting the ginseng sprouts. One-year-old ginseng seedlings (n=100) were transplanted in a tray containing a ginseng medium. The ginseng sprouts were grown for 37 days at a temperature of 20℃ (24h), a humidity of 70%, and an average light intensity of 80 µmol·m-2·s-1 (photoperiod; 24h) in a container-type plant factory. Ginseng sprouts were then transferred to a custom chamber equipped with UV-A (370 nm; 12.90 W·m-2) and UV-B (300 nm; 0.31 W·m-2) LEDs and treated for 3 days. Growth parameters and ginsenoside contents in shoot and root were conducted by harvesting on days 0 (control), 1, 2, and 3 of UV treatments, respectively. The growth parameters showed non-significant differences between the control and the UV treatments (wavelengths or the number of days). Ginsenoside contents of the shoot was highly improved by 186% in UV-A treatment compared to the control in 3 days of the treatment time. The ginsenoside contents of the roots was more improved in UV-A 1-day treatment and UV-B 3-day treatment, compared to the control by 171% and 160%, respectively. As a result of this experiment, it is thought that UV LED irradiation before harvesting can produce sprout ginseng with high ginsenoside contents in a plant factory.

Analyses of Community Structure of Phytoplankton in Reservoirs Located in the Geum River Watershed in South Korea (금강 유역 호소에서 출현하는 식물플랑크톤 군집구조 특성 분석)

  • Choi, Yong Bum;Shin, Yoon Keun
    • Korean Journal of Ecology and Environment
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    • v.54 no.4
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    • pp.280-290
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    • 2021
  • The present study investigated species richness and phytoplankton community structure in lakes in the Geum River Basin during autumn and spring seasons. Surveys were conducted between September and November 2019, and between April and May 2020, which corresponded to the autumn and spring seasons, respectively, to explore the distribution characteristics of the species. A total of 49 species of phytoplankton belonging to 31 genera and seven classes were identified in Cho Pyeong-ji, 51 species belonging to 29 genera and six classes were identified in Song Ak-ji, 49 species belonging to 32 genera and seven classes were identified in Cheong Cheon-ji, 82 species belonging to 45 genera and six classes were identified in Ye Dangji, and 70 species belonging to 40 genera and six classes were identified in Ganwol Lake. A total of 43 species belonging to 74 genera and seven classes were identified. The ranges of phytoplankton standing crop were as follows: 223~3533 cells mL-1 in Cho Pyeong-ji, 881~176018 cells mL-1 in Song Ak-ji, 402~6139 cells mL-1 in Cheong Cheon-ji, 262~10460 cells mL-1 in Ye Dang-ji, and 20413~330695 cells mL-1 in Ganwol Lake. Phytoplankton diversity in Cho Pyeong-ji, Song Ak-ji, Cheong Cheon-ji, Ye Dang-ji, and Ganwol Lake were 1.10~2.60, 0.56~2.03, 0.21~2.03, 0.65~2.57, and 0.44~1.12, respectively. Phytoplankton species richness in Cho Pyeong-ji, Song Ak-ji, Cheong Cheon-ji, Ye Dang-ji, and Ganwol Lake were 1.91~4.99, 1.82~3.26, 1.26~4.17, 2.07~5.37, and 1.90~2.43, respectively. Phytoplankton evenness indices in Cho Pyeong-ji, Song Ak-ji, Cheong Cheon-ji, Ye Dang-ji, and Ganwol Lake were 0.38~0.78, 0.18~0.69, 0.08~0.71, 0.22~0.72, and 0.14~0.38, respectively. Phytoplankton dominance indices in Cho Pyeong-ji, Song Ak-ji, Cheong Cheon-ji, Ye Dang-ji, and Ganwol Lake were 0.40~0.83, 0.55~0.96, 0.44~0.99, 0.42~0.93, and 0.89~0.97, respectively.

New Functional Properties of Passion Fruit Extract on Skin (패션 프룻 추출물이 피부에 미치는 새로운 기능적 효과)

  • Jeong, Mi Suk;Kim, Soon-Rae;Han, Chang Woo;Kim, Hyeon Jin;Jang, Se Bok
    • Journal of Life Science
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    • v.32 no.2
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    • pp.101-107
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    • 2022
  • In this research, the anti-inflammatory, antioxidant, antiaging, and skin whitening properties of pulp and seed extracts of passion fruit were studied. The result of the primary skin irritation test using a skin-attached patch determined the skin irritation index to be 0.00 for the passion fruit extract. In addition, RAW 264.7 macrophages produce NO by stimulation of lipopolysaccharides, and the application of extracts to this resulted in significantly lower NOs, confirming the excellent anti-inflammatory properties of passion fruit extracts. The 2,2-diphenyl-1-picrylhydrazyl test further confirmed that the passion fruit extract exhibits a good 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonate radical scavenging ability of 5.11% and strong antioxidant properties. The presence of collagen type I in the skin is a measure of aging and various skin diseases. The results obtained from the analysis of the activity of human procollagen I alpha 1 confirmed that the passion fruit extract reduces the synthesis of procollagen. In addition, the skin whitening property of the passion fruit extract was confirmed by the melanin inhibition test, and a sample was obtained that contained more than 2% of arbutin, a whitening agent approved by the Ministry of Food and Drug Safety, which is generally present in the form of a white powder and is used as a functional ingredient. This confirms that the whitening efficacy of the passion fruit extract obtained from nature contributes to the development of functional raw materials for cosmetics and food.