• Journal of Chest Surgery
• /
• v.43 no.6
• /
• pp.655-662
• /
• 2010

Background: Despite the rapid expansion of percutaneous endovascular repair, open surgical repair is still recognized as an option to achieve a cure. We retrospectively analyzed over a 6 year period the surgical outcomes, the complications and the mortality-related factors for patients with abdominal aortic aneurysms. Material and Method: We analyzed 36 patients who underwent surgery for abdominal aortic aneurysms between May 2001 and June 2005, and between April 2007 and November 2009. The indications for surgery were rupture, a maximal aortic diameter > 50 mm, and medically intractable hypertension or pain. Result: The mean patient age was $69.67{\pm}6.97$ years (range: 57 to 84 years). Thirty two patients (88.9%) were males and 4 patients (11.1%) were females. Extension to the iliac artery existed in 28 patients (77.8%). Thirteen patients (36.1%) had ruptured aortic aneurysms. The mean maximal diameter of the aorta was $73.7{\pm}13.3$ mm (60 to 100 mm). Surgery was performed by a midline laparotomy and 10 patients (27.8%) underwent emergency surgery. The mortality rate was 8.3%; the mortality rate for the patients with ruptured aneurysms was 23.1 % and the mortality rate for patients with unruptured aneurysms was 0%. The postoperative complications included wound infection (3 cases), sepsis (2 cases), renal failure (2 cases) and pneumonia (1 case). Unstable vital signs, pre-operative transfusion, ruptured aneurysm, emergency surgery, comorbidity (DM and syncope) and complications (sepsis and renal failure) were the statistically significant mortality-related factors (p < 0.05). Conclusion: Emergency surgery for ruptured aortic aneurysms continues to have high mortality, but the unruptured cases are repaired with relative safety. Even though endovascular aortic repair is the trend for abdominal aortic aneurysms, an elective operation of the unruptured aneurysms could decrease the procedure's morbidity and the inconvenient for repeat evaluation with good surgical results.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.4 no.1
• /
• pp.36-42
• /
• 2005

Purpose: To investigate the arthroscopic findings, and to evaluate the clinical outcomes of the treatment of posterior internal impingement of the shoulder in baseball players. Materials and Methods: We followed up 5 cases who were diagnosed as posterior internal impingement for the mean 15 months. All of the cases complained of the pain in the posterior shoulder at late cocking, and were positive in the relocation test added by hyper-horizontal abduction at $120^{\circ}$ abduction of the arm. We sutured posterior labral tear and SLAP lesion arthroscopically, and conducted debridement for rotator cuff. Three cases were performed of anterior capsular plication and the other two were performed of thermal capsular shrinkage. Pain, range of motion, and level of return to sports activity were assessed for the results. Results: As to the arthroscopic findings, all the five cases showed the fraying in posterosuperior labrum, and two of them was accompanied with the flap tear in posterosuperior labrum and the other one was accompanied with type 2 SLAP lesion. All the cases showed the fraying in supraspinatus, and one case showed partial tear. Meanwhile, in all the cases, the rotator cuff was impinged to the labrum at $90^{\circ}{\sim}120^{\circ}$ of abduction and external rotation. As to the postoperative results, all the cases did not complain of pain or instability while pitching, and the competition was recovered to be the mean 88%($80{\sim}100%$) of that before the injury. Conclusion: Definite diagnosis for the posterior internal impingement would be possible through arthroscopic examination. Favorable outcomes could be obtained with capsular plication or shrinkage for anterior microinstability and stretching exercise for posterior capsule tightness inducing the internal impingement.

• Journal of the Korean Geotechnical Society
• /
• v.24 no.8
• /
• pp.89-97
• /
• 2008

A series of field tests were performed to investigate the behavior of jacket anchor and to evaluate the ultimate bond stress of jacket anchor. From twelve sets of field tests on the jacket anchor and general type ground anchor, it was observed that the pullout resistance of jacket anchor is significantly larger than that of the ground anchor and that the plastic deformation of jacket anchor is significantly smaller than that of general ground anchor at the same loading cycle. Especially in gravel layers, the jacket anchor provides more than 250% increase in ultimate resistance and more than 600% reduction in plastic deformation, compared with the general ground anchor. Finally, the relationship between the injection pressure and overburden pressure is proposed to determine the optimum injection pressure, based on additional field test results.

• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.53-57
• /
• 2010

Purpose: The goal of this study was to evaluate differences in strength deficits between (i) patients with stage 1 or 2 impingement syndrome and (ii) patients with rotator cuff tears. Materials and Methods: We enrolled 43 patients with stage 1 or 2 impingement syndrome (group 1) and 21 patients with rotator cuff tears (group 2). The isokinetic strength of both groups was evaluated at $60^{\circ}/sec$ for external rotation, internal rotation, adduction and abduction. We measured the peak torque, total work, average power of bilateral sides, peak torque relationship to body weight, and the ratio between unilateral agonist and antagonist. Results: The isokinetic strength deficits assessed in ratio of peak torque to body weight for group 1 and group 2 respectively were; $28.48{\pm}23.76%$ and $29.12{\pm}32.81%$ for abduction (p=0.929), $7.20{\pm}13.98%$ and $18.94{\pm}19.52%$; for adduction (p=0.021), $16.88{\pm}13.76%$ and $25.80{\pm}24.07%$; for external rotation (p=0.221), and $14.1{\pm}25.67%$ and $29.02{\pm}35.06%$ for internal rotation (p=0.059). For average power and total work, group 2 showed a significantly greater deficit for adduction and internal rotation than group 1. Conclusion: Those with rotator cuff tears have more isokinetic muscle strength deficits than those with stage 1 or 2 impingement syndrome. Progression from stage 1 and 2 impingement syndrome to stage 3 may result in greatest changes in strength deficits for internal rotation and adduction.

• Journal of the Korean Arthroscopy Society
• /
• v.3 no.2
• /
• pp.109-114
• /
• 1999

Purpose : The importance of meniscal repair is well recognized. But transeciton of the posterior horn of the medial meniscus at the posterior tibial attachment is rarely documented and known irreparable. We experienced 9 cases of transection, and present clinical features and pull out suture technique. Methods and Materials : There were 9cases of transection of the posterior horn of medial meniscus from September 1998 to July 1999 in our hospital. Age was 59.3 years in average and ranged from 38 to 70years. Clinical features and MRI made diagnosis in all cases. We confirmed the diagnosis with arthroscopy and repaired the transection with pullout suture technique. Clinical features : Transection of the posterior horn of the medial meniscus at the posterior tibia attachment occurred frequently in middle aged people. They complained posterior knee pain, but they have no history of definitive trauma. Characteristically they had difficulty in full flexion of the knee and in having a squatting position. MRI is very important in diagnosis of transection, especially in coronal view, there is separation of the posterior horn of the meniscus from the posterior tibial attachment. Surgical technique : Pullout suture technique includes debridement of fibrous or scar tissue, exposure of the subchondral bone of the posterior tibial attachment site, suture the transected end of the meniscus with PDS suture, bone tunnel formation from the anteromedial aspect of the proximal tibia, insertion of wire loop through the tibia tunnel, pull the PDS suture through the tibia tunnel out of the joint and stabilize the PDS with post-tie technique to the proximal tibia. Conclusion : Transection of the posterior horn of the medial meniscus at the posterior tibial attachment is not common clinically and rarely documented. Clinical features and MRI are very important in diagnosis of this type tear. Arthroscopic pullout sutures is useful for treatment of this type tear of the meniscus.

• Journal of the Korean Arthroscopy Society
• /
• v.12 no.3
• /
• pp.172-179
• /
• 2008

Purpose: To evaluate the functional and structural results of arthroscopic double-row repair using combined knot-tying and knotless suture anchors in rotator cuff tears. Materials and Methods: From March 2006 to June 2007, twenty-one patients (15 males, 6 females; mean age 55.6 years; range 48 to 67) were included who underwent arthroscopic double-row repair for full-thickness tears of the rotator cuff following conservative treatment for a mean of 6.5 months (range 3 to 11). The tear size was carefully inspected arthroscopically and we found 2 small, 13 medium and 6 large-sized rotator cuff tears, with a mean tear size of 2.5cm(range 1.8 to 3.2). The repair constructs were consisted of horizontal mattress sutures using conventional knot-tying suture anchors medially and simple suture at the same level of medial row stitch with Bioknotless RC anchors (DePuy Mitek, Norwood, MA) as lateral row. Clinical and functional evaluations were made according to the range of motion, the ASES, UCLA scale and the isokinetic strength testing. Postoperative cuff integrity was determined through magnetic resonance imaging. The mean follow-up was 15 months (range 13 to 24). Results: The average clinical outcome scores and strength were all improved significantly at the time of the final follow-up (p < 0.01). Nineteen patients (90%) were satisfied with the result of the treatment. In 17 of 21 patients (81%) were judged to reveal healed tendon on magnetic resonance imaging at a mean of 7 months postoperatively. There were no significant functional differences according to the preoperative tear size (p<0.01), but large-sized tear shows less favorable structural results in 3 out of 6 cases(50%). Conclusion: Our results document the usefulness and variability of arthroscopic double-row rotator cuff repairs comparable to the results of the other types of double-row repairs.

• Journal of the Korean Arthroscopy Society
• /
• v.7 no.2
• /
• pp.201-205
• /
• 2003

Purpose : Authors experienced cases of chronic ACL tear with spur-like lesion on the tibial condyle which is different from the lateral capsular sign and degenerative change and evaluated the significance of 'spur-like lesion' in relations with chronic ACL injury. Material and Method : We have 5 patients with spur-like lesion on the lateral tibial condyle in simple radiogram. The location, shape and size of the lesion were studied using radiogram and MRI. Cause of injury, associated injury and chronicity of the ACL tear were analyzed. All 5 patients were male, and mean age was 33.8 $(17\~46)$ years. Result : The spur-like lesion was located from 3.8 mm(avg.) below the articular surface of the lateral tibial condyle to the apex of the fibular head and protruded laterally or inferolaterally from just posterior to the Gerdy's tubercle with a round or sharp-end triangular shape. Average length was 6 mm and average width ortho base was 9.2 mm. The cause of injury were sports jnjury 4 cases and traffic accident in one. The chronicity of the ACL tear was average 10.7(8 months$\~$23 years) years and medial meniscus tear was shown in all cases and lateral meniscus tear in three. Conclusion : We suggest that a patient who has a history of trauma with spur-like lesion on the lateral tibial condyle of the knee is expected to have chronic ACL tear.

• Journal of the Korean Arthroscopy Society
• /
• v.15 no.1
• /
• pp.58-68
• /
• 2011

Acromioclavicular (AC) joint dislocations are common injuries in active individuals secondary to direct force on the lateral aspect of the adducted shoulder. Complete disruption of the acromioclavicular and coracoclavicular (CC) ligaments may occur, depending on the magnitude of the insulting force. Most of these injuries are successfully treated without surgery. However, for the treatment of cases in which surgical management is warranted, there are more than 100 surgical techniques available without a gold standard technique. We review the anatomy of the acromioclavicular joint, the diagnosis of disorders of this joint, and the different treatment options in this article.

• Journal of Chest Surgery
• /
• v.42 no.2
• /
• pp.263-267
• /
• 2009

A pancreatico-pleural fistula (PPF), caused by rupture of a pancreatic pseudocyststectomy or obstruction of the pancreatic duct, is a rare condition. A 48-year-old man with chronic alcoholism was admitted with a massive pleural effusion. Pleural fluid studies revealed elevated amylase and lipase. A PPF complicated by a ruptured pancreatic pseudocyststectomy was diagnosed by computerized tomography scan. Although the symptoms improved with conservative management, (chest tube drainage, NPO, total parenteral nutrition, and a pancreatic secretion inhibitor), a distal pancreatectomy, including a pseudocystectomy and thoracotomy, were performed for an increasing size of the hemorrhagic pancreatic pseudocyststectomy and a recurrent hemorrhagic pleural effusion. There were no post-operative complications and the patient was discharged on post-operative day 27.

• Journal of the Korean Society of Manufacturing Process Engineers
• /
• v.16 no.5
• /
• pp.13-18
• /
• 2017

In this work the augmented safety of Type 4 composite vessel in accordance with uniform-stress design has been demonstrated through a series of burst tests and structural analyses. For this end, three sample vessels were used: (1) designed as guided by the isotensoid dome theory (called iso-dome cylinder); (2) with dome longer compared to uniform-stress design (called prolate cylinder); and (3) with dome wider than uniform-stress design (called oblate cylinder). Structural analyses have been performed using ABAQUS finite element code based on the periodic symmetry to circumferential direction. As a result, the maximum stresses are induced around the bodies of all three cylinders. However, the analyses, with the assumption of possible defect demonstrate that the maximum stresses are induced around the dome knuckles for the prolate and the oblate cylinders. The results of the burst tests for the three cylinders show that the burst initiates from the cylinder body of the iso-dome cylinder and from the dome knuckles of the prolate and the oblate cylinders. Finally, it is recommended that, to comply with DOT CFFC 2007, the dome shape should be designed and fabricated as guided by the isotensoid dome theory.