• Title/Summary/Keyword: 파열의 크기

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The Analysis and Treatment of Rotator Cuff Tear After Shoulder Dislocation in Middle-Aged and Elderly Patients (중·장년층에서 견관절 탈구 후에 발생한 회전근 개 파열에 대한 분석과 치료)

  • Ji, Jong-Hun;Park, Sang-Eun;Kim, Young-Yul;Shin, Eun-Su;Park, Bo-Youn;Jeong, Jae-Jung
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.20-26
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    • 2010
  • Purpose: To evaluate clinical features and surgical results for rotator cuff tear secondary to shoulder dislocation in middle-aged and elderly patients. Materials and Methods: We reviewed 19 patients over 50 years of age who had rotator cuff tears combined with shoulder dislocation between October 2004 and October 2008. There were 7 males and 12 females with a mean age 64.7 years (range, 50 to 78 years). The average follow-up duration was 22 months (range, 8 to 56 months). We investigated the number of dislocations, the size of the cuff tear, the presence of Bankart lesions and the time interval from dislocation to surgery. We also investigated the ASES score, UCLA score, SST score, and shoulder range of motion before and after surgery. We analyzed clinical outcomes and contributing factors. Results: ASES scores improved from 30.2 preoperatively to 72.3 postoperatively; UCLA scores improved from 12.9 to 26.5; SST scores improved from 2.4 to 7.3. Range of motion improved significantly: forward flexion, abduction, external rotation and internal rotation were, respectively, $110.8({\pm}39.3)^{\circ}$, $107.7({\pm}40)^{\circ}$, $22.5({\pm}17.6)^{\circ}$ and L5 level preoperatively; postoperatively they were $153.6({\pm}20.6)^{\circ}$, $152.1({\pm}20.8)^{\circ}$, $36.4({\pm}22.7)^{\circ}$ and L1 level. Age, the presence of Bankart lesions and the number of dislocations were not correlated with clinical outcomes. But the size of the cuff tear was correlated with clinical results. Also, the duration from dislocation to surgery was correlated with postoperative UCLA and SST scores (p=0.039, p=0.038). Conclusion: For shoulder dislocation, it is important to achieve early diagnoses of rotator cuff tears in middle-aged and elderly patients. If these injuries are both present, early rotator cuff repair should be performed for better clinical results.

가스폭발에 의한 폭풍압의 특성에 관한 연구

  • 박승일;오규형;이진영;라선종
    • Proceedings of the Korean Institute of Industrial Safety Conference
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    • 2002.11a
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    • pp.172-177
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    • 2002
  • 가스폭발 시 폭발 압력에 의해 건물의 일부 또는 전체적인 파괴와 함께 외부에 영향을 미치는 영향은 주로 폭풍파의 압력과 고온의 화염이다. 그 중에서도 폭풍압은 건물에서의 가스폭발 시 파열면을 통과한 급격한 압력 방출에 의해 생겨나는 물리적인 현상으로 그 충격은 때에 따라서 구조물을 붕괴시킬 만큼 크다. 폭발에 의해 발생되는 폭풍압에 의한 피해가 크기 때문에 과거부터 폭풍압에 대한 연구가 계속되어 왔다.(중략)

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Mini-open Rotator Cuff Repair Using Anterolateral Approach - Technical Note - (전외측 도달법을 이용한 소절개 회전근 개 봉합술 - 수술 술기 -)

  • Cho, Chul-Hyun;Sohn, Sung-Won;Bae, Ki-Cheor;Lee, Kyung-Jae;Seo, Hyuk-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.49-52
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    • 2010
  • Purpose: We introduce arthroscopically assisted mini-open rotator cuff repair using anterolateral approach. Operative Technique: Placing lateral decubitus position on general anesthesia, a standard arthroscopic glenohumeral examination is performed to evaluate lesions of shoulder joint through posterior and anterior portal. And then arthroscope is placed in the subacromial space and we evaluate the size of the torn tendon and perform arthroscopic acromioplasty through lateral portal. A 3 to 4 cm skin incision is performed from anterolateral edge of acromion to distal and dissected along to raphe between anterior and middle deltoid. A deltoid retractor is then placed, allowing direct visualization of the rotator cuff and humeral head. As torn tendon is tagged by traction suture, we try to anatomical reduction on the footprint and then perform single row or double row repair of the rotator cuff using suture anchors. To prevent avulsion of the deltoid from the acromion, additional sutures by bone tunnel with acromion and deltoid is performed. Conclusion: This technique is useful procedure to get direct approach to anterior portion of supraspinatus tendon and to need lesser deltoid retraction than portal extension approach due to dividing along to raphe between anterior and middle deltoid. Also it provide better visualization of the superior portion of subscapularis and infraspinatus.

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Arthroscopic Rotator Cuff Repair: Double Rows & Suture Bridge Technique (관절경적 회전근 개 봉합술: 이열 봉합술 및 교량형 봉합술식)

  • Shin, Sang-Jin
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.82-89
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    • 2008
  • Ideal rotator cuff repair is to maintain high fixation strength and minimize gap formation for optimizing the environment of biologic healing of tendon to bone. Among the current repair techniques, the suture bridge technique is superior to single- or double-row repair in ultimate load to failure, gap formation, restoring anatomical footprint and achieving pressurized contact area. The suture bridge technique also minimizes gap formation and has rotational and torsional resistances allowing early rehabilitation. However, despite superior biomechanical characteristics of the suture bridge technique, there is no evidence that these mechanical advantages result in better clinical outcomes. Furthermore, there is no difference in failure rates between the double-row repair and suture bridge techniques. An appropriate repair technique should be determined based on tear size and pattern and tendon quality.

Load transfer test of circular anchorage system according to ETAG 013 (ETAG 013 규정에 따른 원형 정착구의 하중전달실험)

  • Kim, Bum-Joon;Kim, Hyun-Gi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.5
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    • pp.167-175
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    • 2018
  • Load transfer experiments have been carried out to evaluate the performance of the anchorage and it has been stated that the specimens were manufactured and tested according to ETAG 013. On the other hand, the amount of spiral reinforcement and auxiliary reinforcement exceeded the amount specified in ETAG 013. In this study, the load transfer test method and the criteria specified in ETAG 013 were considered and the PT anchorage system was applied to manufacture specimens with high strength concrete and a high tensile prestressing strand. A load transfer test according to ETAG 013 was performed to evaluate the performance of the circular anchorage. As a result, it was confirmed that ETAG 013 is a very strict specification that does not satisfy the performance of an anchorage unless the specimens of an appropriate size and spiral reinforcement are used. To assess the stability of the specimens, increasing the size of the specimen by 15%, rather than increasing the amount of auxiliary reinforcement, is considered to be the correct method in accordance with ETAG 013.

A Development of Intelligent Decision System by Safely Distance of GAS Storage Tank (가스 저장탱크 안전거리의 지적 결정 시스템 개발)

  • Leem Sa-Hwan;Huh Yong-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.7 no.4
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    • pp.721-726
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    • 2006
  • This paper is on intelligent decision system by safety distance of gas storage tank(IDSG). The safety distance fixed up by law is used to prevent from the injury by explosion of storage tank on the spot. However, it is not easy for a layman to decide a proper safety distance considering the size, shape and place of the storage tank. Therefore, this thesis shows the user-friendly intelligent decision system which a layman can decide the Bas related law, the size, shape and place of the storage tank by the intelligent decision, and it is to make assurance doubly sure for safety supervision on the spot. Also, the paper can make the data for the damage influence distance of overpressure by the explosion of the storage tank calculated by the scaling law of Hopkinson with the fixed distance by law, and safety range can be grasped with the graphic which is printed by the PHAST(Process Hazard Analysis Software Tool) model using this data.

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Oxygen Transport in Axisymmetric Thrombosed Aneurysm (혈전이 있는 축대칭 동맥류에서의 산소전달현상)

  • 김한일;태기식;김영호
    • Journal of Biomedical Engineering Research
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    • v.23 no.4
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    • pp.295-300
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    • 2002
  • Localized hypoxia, due to the diminished $O_2$supply, is reported to cause necrosis of the arterial cell and to significantly decrease resistances to physiologic distending pressures. In the present study, in order to understand the mechanism of localized hypoxia which might result in the rupture of the aneurysm. $O_2$ transport phenomena across intraluminal thrombus in axisymmetric aneurysms under steady laminar flow condition were numerically analyzed using the Fick's law and the analogy with the fluid-solid heat transfer. For computational models, varying the thickness of intraluminal thrombus, numerical results showed that for the axisymmetric aneurysm with intraluminal thrombus. $O_2$ concentration became minimal at the aneurysm wall. With increased thickness of the intraluminal thrombus in the aneurysm. regions of low $O_2$ concentration were widely distributed near the aneurysm wall, which resulted in the possibility of localized hypoxia. The present study verifis that intraluminal thrombus influences $O_2$ transport to the aneurysm wall. depending on its size and structure.

A Study on the Blood Flow Characteristics in the Abodminal Aortic Aneurysm (대동맥류 내부 혈류 유동 특성에 관한 연구)

  • 오태헌;김상욱;이계한
    • Journal of Biomedical Engineering Research
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    • v.20 no.5
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    • pp.601-608
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    • 1999
  • 동맥의 일부분의 팽창하는 동맥류는 높은 사망률을 야기하는 혈관계 질환이다. 동맥류의 발생 및 파열에는 동맥류 내부의 혈류의 유동에 의한 혈관벽 전단 응력 및 압력이 주용한 원인 중 하나로 의심되고 있다. 복부대동맥류 내부의 혈류 유동 특성을 밝히기 위해서 동맥류의 최대 확장부가 복부동맥의 1.5배, 2배인 유리 모델을 제작하였다. 정상류 상태에서 다양한 레이놀즈수에 대해서 속도 및 난동도를 입자영상속도계를 이용하여 측정하였다. 경계층 박리로 인한 재순환 부분이 끝나는 재부착점은 동맥류 최대 확장부 후부에서 발생하였으며, 이 위치는 레이놀즈수의 변화에 따라 바뀌었다. 축방향 속도의 난동은 최대 확장부 후부에서 크게 나타났으며, 이 위치에서 난동에 의한 부가적 응력이 크며 혈관벽 구조변화가 발생하리라 예측된다. 동맥류 내부의 압력분포는 수치해석에 의해 계산되었다. 동맥류 내부 압력은 크기가 증가함에 따라 커졌으며 압력은 동맥류 최대 확장부 후부에서 발생하는 재부착점에서 최대값을 나타내었다. 동맥류 최대확장부 후부는 압력이 최대값을 가지며, 전단력의 변화 및 난동이 큰 지역이므로 동맥류의 파열이 발생하기 쉬운 지역으로 예측된다.

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Spur-like Lesion on the Lateral Tibial Condyle - A Sign of Chronic ACL tear - (경골 외과의 골극 유사 병변 - 만성 전방 십자 인대 파열의 징후 -)

  • Cho Sung-Do;Ko Sang-Hun;Hwang Su-Yeon;Yang Jung-Hun
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.201-205
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    • 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.

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Clinical Assessments and MRI Findings Suggesting Early Surgical Treatment for Patients with Medial Epicondylitis (내측상과염 환자의 임상항목과 자기공명영상 항목 중 조기 수술적 치료가 필요한 환자군이 갖는 인자에 관한 분석)

  • Hyungin Park;Seok Hahn;Jisook Yi;Jin-Young Bang;Youngbok Kim;Hyung Kyung Jung;Jiyeon Baik
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.613-623
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    • 2021
  • Purpose To evaluate the MRI findings and clinical factors that are characteristic of patients who ultimately undergo surgery for medial epicondylitis. Materials and Methods Fifty-two consecutive patients who were diagnosed with medial epicondylitis and underwent an elbow MRI between March 2010 and December 2018 were included in this retrospective study. The patients' demographic information, clinical data, and MRI findings were evaluated. All variables were compared between the conservative treatment and surgical treatment groups. Logistic regression analyses were conducted to identify which factors were associated with surgical treatment. Results Common flexor tear (CFT) tear size showed a statistically significant difference in both the transverse and longitudinal planes (p < 0.001, p = 0.013). The CFT abnormality grade significantly differed in both the transverse and longitudinal planes (p = 0.022, p = 0.003). A significant difference was also found in the medial collateral ligament abnormality (p = 0.025). Logistic regression analyses showed that only the transverse diameter of the CFT tear size (odds ratio: 1.864; 95% confidence interval: 1.264-2.750) was correlated with surgical treatment. Conclusion Of patients diagnosed with medial epicondylitis, patients with a larger transverse CFT tear size tend to undergo surgical treatment ultimately.