• Title/Summary/Keyword: 이상기능활동

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Transmission Dose Estimation Algorithm for Tissue Deficit (조직 결손에 대한 투과선량 계산 알고리즘 보정)

  • Yun Hyong Geun;Chie Eui Kyu;Huh Soon Nyung;Lee Hyoung Koo;Woo Hong Gyun;Shin Kyo Chul;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.186-192
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    • 2002
  • Purpose : Measurement of transmission dose is useful for in vivo dosimetry. In this study, previous algorithm for estimation of transmission dose was modified for use in cases with tissue deficit. Materials and Methods : The beam data was measured with flat solid phantom in various conditions of tissue deficit. New algorithm for correction of transmission dose for tissue deficit was developed by physical reasoning. The algorithm was tested in experimental settings with irregular contours mimicking breast cancer patients using multiple sheets of solid phantoms. Results : The correction algorithm for tissue deficit could accurately reflect the effect of tissue deficit with errors within ${\pm}1.0\%$ in most situations and within ${\pm}3.0\%$ in experimental settings with irregular contours mimicking breast cancer treatment set-up. Conclusion : Developed algorithm could accurately reflect the effect of tissue deficit and irregularly shaped body contour on transmission dosimetry.

The Influence of Obstructive Sleep Apnea on Systemic Blood Pressure, Cardiac Rhythm and the Changes of Urinary (폐쇄성 수면 무호흡이 전신성 혈압, 심조율 및 요 Catecholamines 농도 변화에 미치는 영향)

  • Lo, Dae-Keun;Choi, Young-Mee;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.153-168
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    • 1998
  • Background: The existing data indicate that obstructive sleep apnea syndrome contributes to the development of cardiovascular dysfunction such as systemic hypertension and cardiac arrhythmias, and the cardiovascular dysfunction has a major effect on high long-term mortality rate in obstructive sleep apnea syndrome patients. To a large extent the various studies have helped to clarify the pathophysiology of obstructive sleep apnea, but many basic questions still remain unanswered. Methods: In this study, the influence of obstructive sleep apnea on systemic blood pressure, cardiac rhythm and urinary catecholamines concentration was evaluated. Over-night polysomnography, 24-hour ambulatory blood pressure and ECG monitoring, and measurement of urinary catecholamines, norepinephrine (UNE) and epinephrine (UEP), during waking and sleep were undertaken in obstructive sleep apnea syndrome patients group (OSAS, n=29) and control group (Control, n=25). Results: 1) In OSAS and Control, UNE and UEP concentrations during sleep were significantly lower than during waking (P<0.01). In UNE concentrations during sleep, OSAS showed higher levels compare to Control (P<0.05). 2) In OSAS, there was a increasing tendency of the number of non-dipper of nocturnal blood pressure compare to Control (P=0.089). 3) In both group (n=54), mean systolic blood pressure during waking and sleep showed significant correlation with polysomnographic data including apnea index (AI), apnea-hypopnea index (AHI), arterial oxygen saturation nadir ($SaO_2$ nadir) and degree of oxygen desaturation (DOD). And UNE concentrations during sleep were correlated with AI, AHI, $SaO_2$ nadir, DOD and mean diastolic blood pressure during sleep. 4) In OSAS with AI>20 (n==14), there was a significant difference of heart rates before, during and after apneic events (P<0.01), and these changes of heart rates were correlated with the duration of apnea (P<0.01). The difference of heart rates between apneic and postapneic period (${\Delta}HR$) was significantly correlated with the difference of arterial oxygen saturation between before and after apneic event (${\Delta}SaO_2$) (r=0.223, P<0.001). 5) There was no significant difference in the incidence of cardiac arrhythmias between OSAS and Control In Control, the incidence of ventricular ectopy during sleep was significantly lower than during waking. But in OSAS, there was no difference between during waking and sleep. Conclusion : These results suggested that recurrent hypoxia and arousals from sleep in patients with obstructive sleep apnea syndrome may increase sympathetic nervous system activity, and recurrent hypoxia and increased sympathetic nervous system activity could contribute to the development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac function.

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Influence of Oxygen Concentration on the Food Consumption and Growth of Common Carp, Cyprinus carpio L. (잉어 Cyprinus carpio의 먹이 섭취량과 성장에 미치는 용존산소량의 영향)

  • SAIFABADI Jafar;KIM In-Bae
    • Journal of Aquaculture
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    • v.2 no.2
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    • pp.53-90
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    • 1989
  • Feeding proper level of ration matchable with the appetite of fish will enhance production and also prevent waste of food and its consequence, side effects such as pollution of culture medium. To pursue this goal, elaborate studies on dissolved oxygen concentrations- as the major force in inducing appetite and the growth outcome are necessary. The growth of common carp of 67, 200, 400, 600, and 800 gram size groups was studied at oxygen concentrations ranging from 2.0 to 6 mg/$\iota$ in relation to rations from 1 to as many percent of the initial body weight as could be consumed under constant temperature of $25^{\circ}C$. The results from the experiments are summarized as followings; 1. Appetite: The smaller fish exhibited higher degree of appetite than the bigger ones at the same oxygen concentrations. The bigger the fish the less tolerant it was to the lower oxygen thersholds, and the degree of tolerence decreased as ration level increased. 2. Growth : Growth rate (percent per day) increased - unless consumption was suppressed by low oxygen levels- as the ration was increased to maximum. In case of 67 g fish, it reached the highest point of $5.05\%$ / day at $7\%$ ration under 5.0 mg/$\iota$ of oxygen. In case of 200 g fish, the maximum growth rate of $3.75\%$/day appeared at the maximum ration of $6\%$ under 5.5 mg/$\iota$ of oxygen. In 400 g fish, the highest growth of $3.37\%$/day occurred at the maximum ration of $5\%$ and 6.0 mg/$\iota$ of oxygen. In 600 g fish, the highest growth rate of $2.82\%$ /day was at the maximum ration of $4\%$ under 5.5 mg/$\iota$ oxygen. In case of 800g fish, the highest growth rate of $1.95\%$/day was at maximum tested ration of $3\%$ under 5.0 mg/$\iota$ oxygen. 3. Food Conversion Efficiency: Food conversion efficiency ($\%$ dry feed converted into the fish tissue) first increased as the ration was increased, reached maximum at certain food level, then started decreasing with further increase in the ration. The maximum conversion efficiency stood at higher feeding rate for the smaller fish than the larger ones. In case of 67 g fish, the maximum food conversion efficiency was at $4\%$ ration within 3.0-4.0 mg/$\iota$ oxygen. In 200g fish, the maximum efficiency was at $3\%$ ration within 4.0-4.5 mg/$\iota$ oxygen. In 400g fish, the maximum efficiency was at $2\%$ ration within 4.0 - 4.5 mg/$\iota$ oxygen. In 600 and 800g fish, the maximum conversion efficiency shifted to the lowest ration ($1\%$) and lower oxygen ranges. 4. Behaviour: The fish within uncomfortably low oxygen levels exhibited suppressed appetite and movements and were observed to pass feces quicker and in larger quantity than the ones in normal condition; in untolerably low oxygen the fish were lethargic, vomited, and had their normal skin color changed into pale yellow or grey patches. All these processes contributed to reducing food conversion efficiency. On the other hand, the fish within relatively higher oxygen concentrations exhibited higher degree of movement and their food conversion tended to be depressed when compared with sister groups under corresponding size and ration within relatively low oxyen level. 5. Suitability of Oxygen Ranges to Rations: The oxygen level of 2.0- 2.5 mg/$\iota$ was adequate to sustain appetite at $1\%$ ration in all size groups. As the ration was increased higher oxygen was required to sustain the fish appetite and metabolic activity, particularly in larger fish. In 67g fish, the $2\%$ ration was well supported by 2.0-2.5 mg/$\iota$ range; as the ration increased to $5\%$, higher range of 3.0-4.0 mg/$\iota$ brought better appetite and growth; from 5 till $7\%$ (the last tested ration for 67 g fish) oxygen levels over 4.0 mg/$\iota$ could sustain appetite. In 200 g fish, the 2 and $3\%$ rations brought the best growth and conversion rates at 3.5-4.5 mg/$\iota$ oxygen level; from 3 till $6\%$ (the last tested ration at 200 g fish) oxyge groups over 4.5 mg/$\iota$ were matchable with animal's appetite. In 400, 600, and 800 g fish, all the rations above $2\%$ had to be generally supported with oxygen levels above 4.5 mg/$\iota$.

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Investigation of Daily Life and Consciousness of Longevous People in Korea -(1)The Regional Features of Longevity Areas- (우리나라 장수자(長壽者)의 생활(生活) 및 의식조사(意識調査)에 관한 연구(硏究) -(1) 장수지역(長壽地域)의 지역적(地域的) 특성(特性)-)

  • Choi, Jin-Ho;Pyeun, Jae-Hyeung;Rhim, Chae-Hwan;Yang, Jong-Soon;Kim, Soo-Hyun;Kim, Jeung-Han;Lee, Byeong-Ho;Woo, Soon-Im;Choe, Sun-Nam;Byun, Dae-Seok
    • Journal of the Korean Society of Food Culture
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    • v.1 no.2
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    • pp.116-126
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    • 1986
  • This study was designed to be a link in the chain of the investigation on daily life and consciousness of longevous people in Korea, and to investigate the regional feature of longevity areas. The daily life and consciousness were investigated on 379 subjects(male 121, female 258) of the aged who were above 80 years of age, from June to November in 1985. This paper is to report the results investigated the longevity rate, distribution, classification and weather of longevity districts, and also the actual conditions such as the functions of daily life and educational degree of longevous people. 1. The number of longevous people in Korea was 171,449 (male 42,842, female 128,607), and the average longevity rate was 0.46% against total population in Korea(male 0.23%, female 0.69%). 2. Of the longevity rates of shi and/or do in Korea, Cheju(1.03%) was the highest among these districts, and decreased in the order of Chonnam(0.79%), Chonbuk(0.66%), Kyongbuk(0.65%) and Kyongnam(0.61%), whereas the large cities such as Inchon(0.22%), Seoul(0.23%), Pusan(0.23%) and Taegu(0.28%) were remarkably lower than districts in seasides and mountains. 3. The districts above 1.0% of longevity rate in Korea showed 17-guns, and the distribution of these districts was 10-guns of Chonnam, 2-guns of Kyongbuk and Kyongnam, and 1-gun of Kyonggi, Cho-nbuk and Cheju, respectively. 4. Of these districts, Pukcheju(1.65%) was the highest, and decreased in the order of Namhae(1.56%), Sungju(1.24%), Posong(1.22%) and Koksong(1.20%). The highest figure(male 0.71%, female 2.51%) was observed in Pukcheju as contrasted with 0.23%(male) and 0.69%(female) of the average longevity rate in Korea. 5. The sex ratio of longevous people in Korea showed the female/male ratio of 3.0. It is, therefore, believed that the longevity rate of female was 3 times higher than that of male. 6. The longevity districts were classified into seven districts in seasides, three districts in isolated islands, and seven rural districts in mountains. 7. The situation of weather in longevity districts was in the range of 11.2 to $14.8^{\circ}C$ at annual average temperature, and 878.5 to 1585.9mm at annual average rainfall. 8. Of the educational degree of longevous people, uneducated(71.5%) was the highest, and followed by the order of village school(15.8%) and above elementary school(4.8%). 9. In the functions of daily life, the aged moving actively(53.0%) was the highest among these longevous people, followed by the aged moving a little(23.5%). Therefore, it is believed that health degree of these longevous peoples by the functions of daily life was very gratifying.

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Historical Studies on the Characteristics of Buyongjeong in the Rear Garden of Changdeok Palace (창덕궁 후원 부용정(芙蓉亭)의 조영사적 특성)

  • Song, Suk-ho;Sim, Woo-kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.1
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    • pp.40-52
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    • 2016
  • Buyongjeong, a pavilion in the Rear Garden of Changdeok Palace, was appointed as Treasure No. 1763 on March 2, 2012, by the South Korea government since it shows significant symmetry and proportion on its unique planar shape, spatial configuration, building decoration, and so forth. However, the designation of Treasure selection was mainly evaluated by concrete science, in that the selection has not clearly articulated how and why Buoungjeong was constructed as a present unique form. Therefore, this study aims to clarify the identity of Buyongjeong at the time of construction by considering its historical, ideological, philosophical background and building intention. Summary are as follows: First, Construction backgrounds and characters of Buyongjeong: Right after the enthronement, King Jeongjo had founded Kyujanggak(奎章閣), and sponsored civil ministers who were elected by the national examination, as a part of political reform. In addition, he established his own political system by respecting "Kaksin(閣臣)", Kyujanggak's officials as much as "Kain(家人)", internal family members. King Jeongjo's aggressive political reform finally enabled King's lieges to visit King's Rear Garden. In the reign of King Jeongjo's 16th year(1792), Naekaksangjohoe(內閣賞釣會) based on "Kaksin" was officially launched and the Rear Garden visitation became a regular meeting. The Rear Garden visitation consisted of "Sanghwajoeoyeon(賞花釣魚宴)" - enjoying flowers and fishing, and activities of "Nanjeongsugye". Afterward, it eventually became a huge national event since high rank government officials participated the event. King Jeongjo shared the cultural activities with government officials together to Buyongjeong as a place to fulfill his royal politics. Second, The geographical location and spatial characteristics of Buyongjeong: On the enthronement of King Jeongjo(1776), he renovated Taeksujae. Above all, aligning and linking Gaeyuwa - Taeksujae - a cicular island - Eosumun - Kyujangkak along with the construction axis is an evidence for King Jeongjo to determine how the current Kyujangkak zone was prepared and designed to fulfill King Jeonjo's political ideals. In 17th year(1793) of the reign of King Jeongjo, Taeksujae, originally a square shaped pavilion, was modified and expanded with ranks to provide a place to get along with the King and officials. The northern part of Buyongjeong, placed on pond, was designed for the King's place and constructed one rank higher than others. Discernment on windows and doors were made with "Ajasal" - a special pattern for the King. The western and eastern parts were for government officials. The center part was prepared for a place where government officials were granted an audience with the King, who was located in the nortern part of Buyongjeong. Government officials from the western and eastern parts of Buyongjeong, could enter the central part of the Buyongjeong from the southern part by detouring the corner of Buyongjeong. After all, Buyongjeong is a specially designed garden building, which was constructed to be a royal palace utilizing its minimal space. Third, Cultural Values of Buyongjeong: The Buyongjeong area exhibits a trait that it had been continuously developed and it had reflected complex King's private garden cultures from King Sejo, Injo, Hyunjong, Sukjong, Jeongjo and so forth. In particular, King Jeongjo had succeded physical, social and imaginary environments established by former kings and invited their government officials for his royal politics. As a central place for his royal politics, King Jeongjo completed Buyongjeong. Therefore, the value of Buyongjeong, as a garden building reflecting permanency of the Joseon Dynasty, can be highly evaluated. In addition, as it reflects Confucianism in the pavilion - represented by distinguishing hierarchical ranks, it is a unique example to exhibit its distinctiveness in a royal garden.

The Characteristics of Rural Population, Korea, 1960~1995: Population Composition and Internal Migration (농촌인구의 특성과 그 변화, 1960~1995: 인구구성 및 인구이동)

  • 김태헌
    • Korea journal of population studies
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    • v.19 no.2
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    • pp.77-105
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    • 1996
  • The rural problems which we are facing start from the extremely small sized population and the skewed population structure by age and sex. Thus we analyzed the change of the rural population. And we analyzed the recent return migration to the rural areas by comparing the recent in-migrants with out-migrants to rural areas. And by analyzing the rural village survey data which was to show the current characteristics of rural population, we found out the effects of the in-migrants to the rural areas and predicted the futures of rural villages by characteristics. The changes of rural population composition by age was very clear. As the out-migrants towards cities carried on, the population composition of young children aged 0~4 years was low and the aged became thick. The proportion of the population aged 0~4 years was 45.1% of the total population in 1970 and dropped down to 20.4% in 1995, which is predicted to become under 20% from now on. In the same period(1970~1995), the population aged 65 years and over rose from 4.2% to 11.9%. In 1960, before industrialization, the proportion of the population aged 0~4 years in rural areas was higher than that of cities. As the rural young population continuously moves to cities it became lower than that in urban areas from 1975 and the gap grew till 1990. But the proportion of rural population aged 0~4 years in 1995 became 6.2% and the gap reduced. We can say this is the change of the characteristics of in-migrants and out-migrants in the rural areas. Also considering the composition of the population by age group moving from urban to rural area in the late 1980s, 51.8% of the total migrants concentrates upon age group of 20~34 years and these people's educational level was higher than that of out-migrants to urban areas. This fact predicted the changes of the rural population, and the results will turn out as a change in the rural society. However, after comparing the population structure between the pure rural village of Boeun-gun and suburban village of Paju-gun which was agriculture centered village but recently changed rapidly, the recent change of the rural population structure which the in-migrants to rural areas becomes younger is just a phenomenon in the suburban rural areas, not the change of the total rural areas in general. From the characteristics of the population structure of rural village from the field survey on these villages, we can see that in the pure rural villages without any effects from cities the regidents are highly aged, while industrialization and urbanization are making a progress in suburban villages. Therefore, the recent partial change of the rural population structure and the change of characteristics of the in-migrants toward rural areas is effecting and being effected by the population change of areas like suburban rural villages. Although there are return migrants to rural areas to change their jobs into agriculture, this is too minor to appear as a statistic effect.

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Chinese Communist Party's Management of Records & Archives during the Chinese Revolution Period (혁명시기 중국공산당의 문서당안관리)

  • Lee, Won-Kyu
    • The Korean Journal of Archival Studies
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    • no.22
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    • pp.157-199
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    • 2009
  • The organization for managing records and archives did not emerge together with the founding of the Chinese Communist Party. Such management became active with the establishment of the Department of Documents (文書科) and its affiliated offices overseeing reading and safekeeping of official papers, after the formation of the Central Secretariat(中央秘書處) in 1926. Improving the work of the Secretariat's organization became the focus of critical discussions in the early 1930s. The main criticism was that the Secretariat had failed to be cognizant of its political role and degenerated into a mere "functional organization." The solution to this was the "politicization of the Secretariat's work." Moreover, influenced by the "Rectification Movement" in the 1940s, the party emphasized the responsibility of the Resources Department (材料科) that extended beyond managing documents to collecting, organizing and providing various kinds of important information data. In the mean time, maintaining security with regard to composing documents continued to be emphasized through such methods as using different names for figures and organizations or employing special inks for document production. In addition, communications between the central political organs and regional offices were emphasized through regular reports on work activities and situations of the local areas. The General Secretary not only composed the drafts of the major official documents but also handled the reading and examination of all documents, and thus played a central role in record processing. The records, called archives after undergoing document processing, were placed in safekeeping. This function was handled by the "Document Safekeeping Office(文件保管處)" of the Central Secretariat's Department of Documents. Although the Document Safekeeping Office, also called the "Central Repository(中央文庫)", could no longer accept, beginning in the early 1930s, additional archive transfers, the Resources Department continued to strengthen throughout the 1940s its role of safekeeping and providing documents and publication materials. In particular, collections of materials for research and study were carried out, and with the recovery of regions which had been under the Japanese rule, massive amounts of archive and document materials were collected. After being stipulated by rules in 1931, the archive classification and cataloguing methods became actively systematized, especially in the 1940s. Basically, "subject" classification methods and fundamental cataloguing techniques were adopted. The principle of assuming "importance" and "confidentiality" as the criteria of management emerged from a relatively early period, but the concept or process of evaluation that differentiated preservation and discarding of documents was not clear. While implementing a system of secure management and restricted access for confidential information, the critical view on providing use of archive materials was very strong, as can be seen in the slogan, "the unification of preservation and use." Even during the revolutionary movement and wars, the Chinese Communist Party continued their efforts to strengthen management and preservation of records & archives. The results were not always desirable nor were there any reasons for such experiences to lead to stable development. The historical conditions in which the Chinese Communist Party found itself probably made it inevitable. The most pronounced characteristics of this process can be found in the fact that they not only pursued efficiency of records & archives management at the functional level but, while strengthening their self-awareness of the political significance impacting the Chinese Communist Party's revolution movement, they also paid attention to the value possessed by archive materials as actual evidence for revolutionary policy research and as historical evidence of the Chinese Communist Party.

An exploratory study on Social Network Services in the context of Web 2.0 period (웹 2.0 시대의 SNS(Social Network Service)에 관한 고찰)

  • Lee, Seok-Yong;Jung, Lee-Sang
    • Management & Information Systems Review
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    • v.29 no.4
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    • pp.143-167
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    • 2010
  • Diverse research topics relating to Social Network Services (SNS) such as, social affective factors in relationships among internet users, social capital value of SNS, comparing attributes why users are intending to participate in SNS, user's lifestyle and their preferences, and the exploratory seeking potential of SNS as a social capital need to be focused on. However, these researches that have been undertaken only consider facts at a particular period of the changing computing environment. In accordance with this indispensability, the integrated view on what technical, social and business characteristics and attributes need to be acknowledged. The purpose of this study is to analyze the evolving attributes and characteristics of SNS from Web 1.0 to Mobile web 2.0 through the Web 2.0 and Mobile 1.0 period. Based on the relevant literature, the attributes that drive the changing technological, social and business aspects of SNS have been developed and analyzed. This exploratory study analyzed major attributes and relationships between SNS and users by changing the paradigms which represented each period. It classified and chronicled each period by representing paradigms and deducted the attributes by considering three aspects such as technological, social and business administration. The major findings of this study are, firstly, the web based computing environment has been changed into the platform attribute for users in the aspect of technology. Users can only read, listen and view information through the web site in the early stages, but now it is possible that users can create, modify and distribute all kinds of information. Secondly, the few knowledge producers of web services have been changed into a collective intelligence by groups of people in the aspect of society. Information authority has been distributed and there is no limit to its spread. Many businesses recognized the potential of the SNS and they are considering how to utilize these advantages toward channel of promotion and marketing. Thirdly, the conventional marketing channel has been changed into oral transmission by using SNS. The market of innovative mobile technology such as smart phones, which provide convenience and access-ability toward customers, has been enlarged. New opportunities to build friendly relationship between business and customers as a new marketing chance have been created. Finally, the role of the consumer has been changed into the leading role of a prosumer. Users can create, modify and distribute information, and are performing the dual role of customer and producer.

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Moisturizing Effect and Durability of Sun Protection Factor (UVA/B) Activity with Multiple Emulsion (W/O/W) System (멀티플 에멀전(W/O/W) 시스템을 이용한 자외선차단성능(UVA/B)의 내수성과 보습효과)

  • Lee, Myoung-Hee;Kim, In-Young
    • Journal of the Korean Applied Science and Technology
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    • v.32 no.2
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    • pp.339-347
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    • 2015
  • This study is to evaluate moisturizing effect and durability of UV A/B blocking activity with multiple (W/O/W) emulsion system. Most of the sun protective products come to be hot issue having both high SPF and long-lasting activity as using special products when is going out, mountain climbing and sports. Also, many consumers prefer the products which have the excellent waterproofing activity of sun care cosmetics as well as the non-sticky feeling that carried out the study of the sensorial science and texture preference. Therefore, development of the specific formulation using this multiple (W/O/W) emulsion technology, it has O/W type hydro skin feel having soft and moist texture when it is treated on the skin. Finally, this formulation is instantly changed to W/O type feel after adsorbed into the skin. The purpose of this study is to get high SPF lasting effect having high water resistance tactivity with high functional multiple (W/O/W) emulsion cream. We used major ingredients, UV-B absorbers were selected with ethylhexyl methoxycinnamate, isoamyl-p-methoxycinnamate, ethylhexylsalicylate, and octocrylene, UV-A absorbers were selected with butylmethoxydibenzoylmethane, bis-ethylhexyloxyphenol methoxy phenyltriazine. SPF effect of O/W type cream was 34.1. SPF effect of W/O/W type cream was 40.6 (increased about 19%). Water resistance effect after 4 hours, SPF effect of O/W type cream was 3.6 (quickly drop down). SPF effect of W/O/W type cream having 81.0 % waterproofing effect was 32.7 (decreased about SPF 7.9). Moisturizing effect of O/W cream at first was superior comparing multiple emulsion. But after 3 hours quickly was drop-down. Moisturizing effect of multiple emulsion was high comparing O/W type and other sun block creams after 4 hours was constantly maintaining water-content.

The Effect of a Tibial Remnant Preservation Technique on the Synovialization of the Graft Tendon in Anterior Cruciate Ligament Reconstruction - Based on the Second Look Arthroscopic Findings - (전방십자인대 재건술시 잔류 조직 보존술이 이식 인대의 활막화(synovialization)에 미치는 영향 - 2차 관절경 소견을 중심으로 -)

  • Ahn, Gil Yeong;Nam, Il Hyun;Moon, Gi Hyuk;Lee, Yeong Hyun;Choi, Seong Pil;Yoo, Jong Yeon
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.11-17
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    • 2013
  • Purpose: The purpose of this study is to evaluate the effect of preservation of the tibial remnant on the synovialization of graft tendon after the reconstruction of anterior cruciate ligament (ACL) based on the second look arthroscopic findings. Materials and Methods: From May 2005 to May 2012, among sixty three patients having ACL reconstruction with the four-strand hamstring using a bioabsorbable cross pin (RigidFix$^{(R)}$) for the femoral tunnel, nineteen patients who had second look arthroscopy were analyzed. We classified them into three groups according to the tibial remnant of the torn ACL for arthroscopic findings. Group 1 had less than 5 mm of a remnant tissue, Group 2 had from 6 mm to 10 mm of it, and Group 3 had more than 11 mm. We estimated the percentage of synovial coverage on the graft tendon during second look arthroscopy. We evaluated Lysholm score and Tegner activity score preoperatively and in the last follow-up. Results: At the time of ACL reconstruction, the mean length of preserved tibial remnant of torn ACL was 2.3 mm in Group 1, 7.4 mm in Group 2, and 13.7 mm in Group 3. In the second look arthroscopy, the average percentage of synovial coverage was 55.4% in Group 1, and 77.9% in Group 2, and 89.7% in Group 3. Lysholm score and Tegner activity score improved from 74.2 and 7.3 preoperatively to 94.1 and 8.5 in the last follow-up. Conclusion: The preservation of tibial remnant of torn ACL influenced the synovial coverage of the graft tendon and the volume of preserved remnant in accordance with the surface of synovial coverage. It would have a good effect on graft healing and preservation of proprioceptive function.

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