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Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.168-175
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    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

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Development of a Small Gamma Camera Using NaI(T1)-Position Sensitive Photomultiplier Tube for Breast Imaging (NaI (T1) 섬광결정과 위치민감형 광전자증배관을 이용한 유방암 진단용 소형 감마카메라 개발)

  • Kim, Jong-Ho;Choi, Yong;Kwon, Hong-Seong;Kim, Hee-Joung;Kim, Sang-Eun;Choe, Yearn-Seong;Lee, Kyung-Han;Kim, Moon-Hae;Joo, Koan-Sik;Kim, Byuug-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.4
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    • pp.365-373
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    • 1998
  • Purpose: The conventional gamma camera is not ideal for scintimammography because of its large detector size (${\sim}500mm$ in width) causing high cost and low image quality. We are developing a small gamma camera dedicated for breast imaging. Materials and Methods: The small gamma camera system consists of a NaI (T1) crystal ($60 mm{\times}60 mm{\times}6 mm$) coupled with a Hamamatsu R3941 Position Sensitive Photomultiplier Tube (PSPMT), a resister chain circuit, preamplifiers, nuclear instrument modules, an analog to digital converter and a personal computer for control and display. The PSPMT was read out using a standard resistive charge division which multiplexes the 34 cross wire anode channels into 4 signals ($X^+,\;X^-,\;Y^+,\;Y^-$). Those signals were individually amplified by four preamplifiers and then, shaped and amplified by amplifiers. The signals were discriminated ana digitized via triggering signal and used to localize the position of an event by applying the Anger logic. Results: The intrinsic sensitivity of the system was approximately 8,000 counts/sec/${\mu}Ci$. High quality flood and hole mask images were obtained. Breast phantom containing $2{\sim}7 mm$ diameter spheres was successfully imaged with a parallel hole collimator The image displayed accurate size and activity distribution over the imaging field of view Conclusion: We have succesfully developed a small gamma camera using NaI(T1)-PSPMT and nuclear Instrument modules. The small gamma camera developed in this study might improve the diagnostic accuracy of scintimammography by optimally imaging the breast.

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Measuring Range of Motion and Muscle Activation of Flower Arrangement Tasks and Application for Improving Upper Limb Function (꽃꽂이 작업의 관절가동범위와 근육활성도 측정 및 상지기능 향상을 위한 적용사례)

  • Lee, Son-Sun;Park, Sin-Ae;Kwon, Oh-Yun;Song, Jong-Eun;Son, Ki-Cheol
    • Horticultural Science & Technology
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    • v.30 no.4
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    • pp.449-462
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    • 2012
  • The objectives of this study were to measure the range of motion for joints and muscle activation of upper limb for flower arrangement tasks for physical rehabilitation and to test horticultural therapy programs using flower arrangement tasks for improving upper limb function of the patients with stroke. Major flower arrangement tasks were classified with eight tasks (cutting 1, thick stem; cutting 2, thin stem; fixing 1, long stem; fixing 2, short stem; rolling a leaf; bending 1, thick stem; bending 2, thin stem; and winding, using a wire) based on the occupational analysis. When eight male university students (mean age $24.1{\pm}2.5$ years) conducted the eight flower arrangement tasks, range of motion for joints and muscle activation of upper limb were measured by a 3D motion analyzer and electromyography, respectively. Based on the results of the range of motion and muscle activation of upper limb, horticultural therapy programs using flower arrangement tasks (total 33 sessions) for improving upper limb function of the patients with stroke was conducted at a rehabilitation hospital, Seoul, South Korea and then the range of motion, grip strength, and upper limb function of the patients were tested. Among the eight flower arrangement tasks, cutting 1, winding, and bending 1 induced the highest value for the range of motion in joints of shoulder, elbow, and wrist, respectively (P < 0.001). In terms of muscle activation, eight flower arrangement tasks performed in this study showed various patterns of muscle activation and several muscles were simultaneously used for each task (P < 0.001). In addition, thickness and length of the materials used in a task had a prominent effect on the range of motion for joints and muscle activation of upper limb (P < 0.001). The stroke patients had positive effects for their range of motion of upper limb (shoulder, forearm, and elbow), grip strength, and overall upper limb function through the horticultural therapy program. Thus, this study suggested that flower arrangement tasks would be a potential horticultural activity for physical rehabilitation program. It would be interesting to apply a customized horticultural therapy program using flower arrangement tasks according to the symptoms of patient for physical rehabilitation.

THE EFFECT OF C-FACTOR AND VOLUME ON MICROLEAKAGE OF COMPOSITE RESIN RESTORATIONS WITH ENAMEL MARGINS (법랑질 변연으로 이루어진 복합레진 수복물의 체적과 C-factor가 미세누출에 미치는 영향)

  • Koo, Bong-Joo;Shin, Dong-Hoon
    • Restorative Dentistry and Endodontics
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    • v.31 no.6
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    • pp.452-459
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    • 2006
  • Competition will usually develop between the opposing walls as the restorative resin shrinks during polymerization. Magnitude of this phenomenon may be depended upon cavity configuration and volume. The purpose of this sturdy was to evaluate the effect of cavity configuration and volume on microleakage of composite resin restoration that has margins on the enamel site only. The labial enamel of forty bovine teeth was ground using a model trimmer to expose a flat enamel surface. Four groups with cylindrical cavities were defined, according to volume and configuration factor(Depth x Diameter / C-factor) - Group I : 1.5 mm ${\times}$ 2.0 mm / 4.0, Group II : 1.5 mm ${\times}$ 6.0 mm / 2.0, Group III : 2.Omm ${\times}$ 1.72 mm / 5.62, Group IV : 2.0 mm ${\times}$ 5.23 mm / 2.54. After treating with fifth-generation one-bottle adhesive - BC Plus$^{TM}$ (Vericom, AnYang, Korea), cavities were bulk flted with microhybrid composite resin - Denfill$^{TM}$ (Vericom). Teeth were stored in distilled water for one day at room temperature and were finished and polished with Sof-Lex system. Specimens were thermocycled 500 times between 5$^{\circ}$C and 55$^{\circ}$C for 30 second at each temperature. Teeth were isolated with two layers of nail varnish except the restoration surface and 1 mm surrounding margins. Electrical conductivity (${\mu}$A) was recorded in distilled water by electrochemical method. Microleakage scores were compared and analyzed using two-way ANOVA at 95% level. The results were as follows: 1. Small cavity volume showed lower microleakage score than large one, however, there was no statistically significant difference. 2. There was no relationship between cavity configuration and microleakage. Factors of cavity configuration and volume did not affect on microleakage of resin restorations with enamel margins only.

Studies on Lipids in Fresh-Water Fishes 8. Comparison of Lipid Components among Wild and Cultured Carp (Cyprinus carpio) and Israeli Carp (Cyprinus carpio nudus) (담수어의 지질에 관한 연구 8. 천연 및 양식 잉어와 이스라엘 잉어의 지질성분 비교)

  • CHOI Jin-Ho;RHIM Chae-Hwan;BAE Tae-Jin;YOON Tai-Heon;LEE Kang-Ho
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.18 no.5
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    • pp.447-454
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    • 1985
  • As a part of serial study for comparing lipid components in freshwater fishes, this work was undertaken to compare the lipid components among wild and cultured carp, Cyprinus carpio, and Israeli carp, Cyprinus carpio nudus. The lipid components of cultured carp were analyzed and compared with those of wild and Israeli carp. In the content of total lipid, the lipid content in cultured carp was slightly lower than that in wild one, but similar to that in Israeli carp. The lipid contents in viscera of wild and cultured carp were 2 times higher than those in edible portion, but the lipid content in viscera of Israeli carp showed a similar trend to that in edible portion. In the fatty acid composition of neutral lipid in edible portion, percentages of $C_{18:1},\;C_{18:2},\;C_{18:3},\;C_{22:5}\;and\;C_{22:6}$ in cultured carp wire higher than those in wild one, while percentages of $C_{16:0},\;C_{18:0},\;C_{16:1},\;C_{20:4}\;and\;C_{20:5}$ lower, and percentage of $C_{18:2}$ in Israeli carp was noticeably higher than that in wild and cultured carp. In the case of phospholipid in edible portion, percentages of $C_{18:0},\;C_{18:1},\;C_{18:2},\;C_{18:3}\;and\;_C{22:6}$ in cultured carp were higher than those in wild one, while percentages of $C_{16:0},\;C_{16:1},\;C_{20:4},\;C_{20:5}\;and\;C_{22:5}$ lower. The unsaturation (TUFA/TSFA) of neutral lipid in cultured carp was slightly higher than that in wild one, but slightly lower than that in Israeli carp. In the case of phospholipid, the unsaturation showed a similar trend to that of neutral lipid. The essential fatty acid content(TEFA) of neutral lipid in edible portion of cultured carp was higher than that of wild one, but that in viscera lower. In the case of phospholipid in edible portion, the essential fatty acid content in Israeli carp was slightly higher than that in wild and cultured carp, and that in wild one was higher than that in cultured one. The w3 highly unsaturated fatty acid contents(w3 HUFA) of neutral lipid almost showed a similar trend to the essential fatty acid contents in wild and cultured carp, and Israeli carp. In the case of phospholipid, the w3 HUFA in Israeli carp was considerably higher than those in cultured and wild carp. In the ratio (A/C) of fatty acid content(A) in cultured carp to that(C) in diet, the A/C ratios of $C_{20:5}\;w3(0.12),\;C_{22:5}\;w6(0.53),\;C_{22:5}\;w3(0.68)\;and\;C_{22:6}\;w3(0.26)$ were much lower and in the ratio (B/C) of fatty acid content (B) in Israeli carp, the B/C ratios of $C_{18:3}\;w3(0.61),\;C_{20:5}\;w3(0.11),\;C_{22:4}\;w6(0.16),\;C_{22:5}\;w6(0.07)\;and\;C_{22:6}\;w3(0.79)$ were also lower than the other fatty acid. Consequently, it is considered that the ratios of w3 HUFA is related to the biosynthesis of polyenoic acid and growth rates of cultured and Israeli carp.

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Investigation of the Signal Characteristics of a Small Gamma Camera System Using NaI(Tl)-Position Sensitive Photomultiplier Tube (NaI(Tl) 섬광결정과 위치민감형 광전자증배관을 이용한 소형 감마카메라의 신호 특성 고찰)

  • Choi, Yong;Kim, Jong-Ho;Kim, Joon-Young;Im, Ki-Chun;Kim, Sang-Eun;Choe, Yearn-Seong;Lee, Kyung-Han;Joo, Koan-Sik;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.1
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    • pp.82-93
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    • 2000
  • Purpose: We characterized the signals obtained from the components of a small gamma camera using Nal(Tl)-position sensitive photomultiplier tube (PSPMT) and optimized the parameters employed in the modules of the system. Materials and Methods: The small gamma camera system consists of a Nal(Tl) crystal ($60{\times}60{\times}6mm^3$) coupled with a Hamamatsu R3941 PSPMT, a resister chain circuit, preamplifiers, nuclear instrument modules (NIMs), an analog to digital converter and a personal computer for control and display. The PSPMT was read out using a resistive charge division circuit which multiplexes the 34 cross wire anode channels into 4 signals (X+, X-, Y+, Y -). Those signals were individually amplified by four preamplifiers and then, shaped and amplified by amplifiers. The signals were discriminated and digitized via triggering signal and used to localize the position of an event by applying the Anger logic. The gamma camera control and image display was performed by a program implemented using a graphic software. Results: The characteristics of signal and the parameters employed in each module of the system were presented. The intrinsic sensitivity of the system was approximately $8{\times}10^3$ counts/sec/${\mu}Ci$. The intrinsic energy resolution of the system was 18% FWHM at 140 keV. The spatial resolution obtained using a line-slit mask and $^{99m}Tc$ point source were, respectively, 2.2 and 2.3 mm FWHM in X and Y directions. Breast phantom containing $2{\sim}7mm$ diameter spheres was successfully imaged with a parallel hole collimator. The image displayed accurate size and activity distribution over the imaging field of view Conclusion: We proposed a simple method for development of a small gamma camera and presented the characteristics of the signals from the system and the optimized parameters used in the modules of the small gamma camera.

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Minimally Invasive Repair of Pectus Excavatum Based on the Nuss Principle: An Evolution of Techniques and Early Results on 322 Patients (Nuss 술식에 기초한 누두흉의 최소 침습 수술: 수술 수기의 개발 및 322예의 조기 성적)

  • Park, Hyun-Joo;Song, Cheol-Min;Her, Keun;Jeon, Cheol-Woo;Chang, Won-Ho;Park, Han-Gyu;Lee, Seock-Yeol;Lee, Cheol-Sae;Youm, Wook;Lee, Kihl-Roh
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.164-174
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    • 2003
  • Background: The Nuss procedure is a recently developed technique for minimally invasive repair of pectus excavatum using a metal bar. Although its technical simplicity and cosmetic advantages are remarkable, applications have been limited to children with standard pectus excavatum. We report a single center experience of the technique that has been evolving in order to correct asymmetric pectus configurations and adult patients. Material and Method: Between August 1999 and June 2002, 322 consecutive patients un-derwent repair by the Nuss technique and its modifications. Among them, 71 (22%) were adults. For the precise correction, morphology of the pectus was classified as symmetric and asymmetric types. Asymmetric type was subdivided into eccentric and unbalanced types. In repair, differently shaped bars were applied to individual types of pectus to achieve symmetric correction. Result: Symmetric type was 57.5% (185/322) and asymmetric type was 42.5% (137/322). Eccentric, unbalanced, and combined types were 71, 47 and 19, respectively, Major modifications were bar shaping and fixation. In asymmetric group, different shapes of asymmetric bars were applied (n=125, 38.8%). For adult patients, double bar or compound bar technique was used (n=51, 15.8%). To prevent bar rotation, multipoint wire fixations to ribs were used. Major postoperative complications were pneumothorax (n=24, 7.5%) and bar displacement (n=11, 3.4%). 42 patients had bar removal 2 years after the initial procedure. Conclusion: The Nuss procedure is safe and effective. Modifications of the techniques in accordance with precise morphological classification enabled the correction of all variety of pectus excavatum including asymmetric types and adult patients.

Arthroscopic Transosseous Suture Repair for Bankart Lesion with a Flexible Drill Device - An Experimental and Preliminary Clinical Report - (유연성 천공기를 이용한 Bankart 병변의 골관통식 봉합 - 동물 실험 및 예비 임상 결과 보고 -)

  • Park, Jin-Su;Won, Ye-Yeon;Yoo, Jung-Han;Park, Yong-Wook;Noh, Kyu-Chul;Chung, Kuk-Jin;Kim, Hong-Kyun;Hwang, Ji-Hyo;Lee, Young-Bum;Suh, Il-Woo
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.72-78
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    • 2010
  • Purpose: Too develop a flexible drill device that can be inserted into the shoulder joint so that arthroscopic transosseous suture repair for Bankart lesion is possible. Materials and Methods: We created a device composed of a flexible drill unit and a guide pipe unit. The flexible drill unit was made of flexible multifilament wires (1.2 mm in diameter) that was twisted into one cord so that it can flex in any direction and a drill bit (1.2 mm in diameter) that is attached onto one end of the flexible wire. The guide pipe unit was a 150 mm long metal pipe (2.0 mm in inner diameter and 3.0 mm in outer diameter), with one end bent to 30 degrees. The flexible drill set was inserted into the shoulder joint through the posterior portal of the joint. The guide pipe component was placed onto the medial wall of the glenoid so that the pipe was placed 5 mm posterior to the margin of the anterior glenoid rim. The flexible drill was driven through the glenoid by the power drill so that holes were made in the glenoid. A non- absorbable suture was passed through the hole. Tying of a sliding knot tying was accomplished over the capsule and labrum after making a stitch through the capsule and labrum with a suture hook loaded with suture passer. The same procedures were done at the 2 and 4 O'Clock positions of the glenoid. Results: Five cases with Bankart lesion received arthroscopic transosseous repair with our flexible drill device. There were no intraoperative problems. Neither redislocation nor subluxation was reported at final follow-up. Conclusion: Arthroscopic transosseous suture repair without suture anchors and easy tying of a sliding knot are possible with a flexible drill set.

Safety education needs among the dental technology-major college students to prevent injuries in their laboratory classes (치기공과 학생들의 실습 중 안전에 대한 안전교육 요구도 특성)

  • Park, Jong-Hee
    • Journal of Technologic Dentistry
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    • v.28 no.1
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    • pp.177-198
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    • 2006
  • This study purposed to offer basic data for safety education of the dental laboratory technology after the investigation of how much the students in the dept. of dental laboratory technology are aware of the danger of each instrument, equipment or laboratory procedure that they use during laboratory and how much they demand safety education for this. The objects for this study were 423 students who were in the dept. of dental laboratory technology. In this regard, four colleges which have the dept. of dental laboratory technology were randomly selected to do a questionnaire survey. SPSS 12.0 was used to analyze the collected data. The results were as follows: As for satisfaction with their major, the respondents answered Satisfied (59.1%), Average (35.5%) and Dissatisfied (5.4%). In terms of the production process of a partial denture, they considered casting, polishing the casting body, polishing denture and burn out were most dangerous in order. As for the production process of a full denture, what they regarded as the most dangerous in order was polishing denture, deflasking and wax wash. Regarding the laboratory procedures of porcelain material, casting, trimming casting body, polishing porcelain material and burn out were the most dangerous procedures that they perceived. With regard to materials for use, alcohol, polishing, metal and wire were the most dangerous ones they thought. As for the handling characteristics of each material, small towns showed a higher demand for safety of the handling characteristics of alcohol. In terms of school year and sex, juniors and girls had higher scores in the demand for safety of the handling characteristics of acid. Regarding the handling characteristics of each equipment and instrument, all of small towns, juniors and girls showed the highest demand for safety of the handling characteristics of alcohol lamps. With regard to scores in the demand for safety of other characteristics, all of small towns, juniors and girls had the highest demand for safety of emergency treatment. Concerning the demand for safety education by the completion of safety education, in terms of each material, highest was the demand for safety of acid from the group which completed safety education. In regard to equipments and instruments, when it came to the demand for safety of the handling characteristics of casting machine, the educated group's demand for safety of acid was higher. Regarding other characteristics, the group which was not educated gained higher scores in the demand for safety of emergency treatment. 11. In all areas(materials, machines and others), small towns, girls and juniors showed higher scores in the demand for safety. Based on the above results, it was found that when students conduct the laboratory of dental technology, they would think that many materials, instruments or equipments for use are very dangerous. However, safety education was not fully given to them. Regarding the scores in the damned for safety education, the highest was 4.16 and the lowest was 3.43, which suggests that the scores were generally very high. In this regard, it is necessary to continue delivering a systematic safety education of materials, equipments or instruments used during the laboratory of dental technology. Therefore, through the analysis of each material, instruments or facility used in every laboratory and each process, safety accident types and accident risk factors should be investigated to develop educational materials for this. Moreover, it is required to open safety education as a single course of study or insert safety contents of all materials and machines into the class of dental laboratory instrument or dental materials for the purpose of a systematic and thorough safety education to prevent a safety accident during laboratory.

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FACTORS AFFECTING THE FORMATION OF SOLUBLE GLUCAN BY LACTOCOCCUS LACTIS 1370 (유산구균 1370의 수용성 글루캔 형성에 영향을 미치는 인자)

  • Oh, In-Gyun;Yang, Kyu-Ho;Chung, Jin;Oh, Jong-Suk
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.185-191
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    • 2000
  • The water-soluble glucan produced by Lactococcus lactis 1370 affects the formation of dental plaque by Streptococcus mutans. In this study the factors affecting the formation of water-soluble glucan were assessed as the optical density of culture supernatant of Lactococcus lactis 1370 in the spectrophotometer. 1. The optical density of culture supernatant was high when Lactococcus lactis 1370 was cultured in M17 broth with 5% sucrose, while being low in culture supernatant of Streptococcus mutans. 2. The optical density of culture supernatant was higher when Lactococcus lactis 1370 was cultured in M17 broth with 10% sucrose than when being cultured without sucrose (p<0.05), and was higher at pH 7 than pH 5 (p<0.05). 3. The optical density of culture supernatant was the highest at $37^{\circ}C$ among $32^{\circ}C,\;37^{\circ}C\;and\;42^{\circ}C$, and was higher in the anaerobic incubator than in the aerobic incubator (p<0.05). 4. The optical density of culture supernatant was the highest in the media containing 1.0mM $CaCl_2$ (p<0.05), 2.5mM KCl (p<0.05), and 1.6mM $MgCl_2$. 5. When Streptococcus mutans was cultured in the media containing a quarter culture supernatant of Lactococcus lactis 1370 grown in M17 broth, the mean weight of produced artificial plaque was 103.0mg on the wire, whereas being significantly reduced to 5.6mg in the media containing a quarter culture supernatant of Lactococcus lactis 1370 grown in M17 broth containing 5% sucrose (p<0.05). These results indicate that the water-soluble glucan is more formed by Lactococcus lactis 1370 in the media containing sucrose or under the adequate conditions for the growth of bacteria, and inhibits the formation of artificial plaque by Streptococcus mutans.

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