Purpose: This study evaluated the results of dual plate fixation for periprosthetic femur fracture after total knee arthroplasty (TKA). Materials and Methods: From October 2007 to February 2013, 23 cases of periprosthetic femur fracture after TKA were treated at the author's hospital. There were 13 cases of fixation using a medial and lateral dual plate when the stability of the fracture site could not be achieved by one side fixation with a follow-up of more than one year. The cases included no loosening of the femoral component in fractures that were categorized as Lewis-Rorabeck classification II and supracondylar comminuted fractures and elongation of the fracture line to the lateral epicondyle of the femur or stem in the medullary canal. The mean age was 72 years (65-82 years), and 11 cases were female. Three cases had a stem due to revision. The mean bone marrow density was -3.2 (-1.7 to -4.4), and the mean period from primary TKA to periprosthetic fractures was 28 months (1-108 months). The mean follow-up period was 23 months (12-65 months). The medial fracture site was first exposed via the subvastus approach. Second, the supplementary plate was fixed on the lateral side of the fracture using a minimally invasive plate osteosynthesis technique. The average union time, complications, and Hospital for Special Surgery Knee Score (HSS) at the last follow-up were evaluated. Results: The mean union time was 17.4 weeks (7-40 weeks). Two cases showed delayed bone union and nonunion occurred in one case, in whom bone union was achieved three months later after re-fixation using a dual plate with an autogenous bone graft. The mean varusvalgus angulation was 1.67 degrees (-1.2-4.9 degrees), and the mean anterior-posterior angulation was 2.86 degrees (0-4.9 degrees) at the last follow-up. The mean knee range of motion was 90 degrees, and the HSS score was 85 points (70-95 points) at the last follow-up. Conclusion: Dual plate fixation for periprosthetic femur fractures that had not achieved stability by one side plate fixation after TKA showed a good clinical result that allowed early rehabilitation.
Kim, Young Sung;Lee, Ho Min;Kim, Jong Pil;Chung, Phil Hyun;Park, Soon Young
Journal of the Korean Orthopaedic Association
/
v.56
no.4
/
pp.317-325
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2021
Purpose: This study compared the functional and radiologic outcomes of intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) for tibia fractures in distal tibial spiral fractures combined with posterior malleolar fractures, as well as the functional and radiologic outcomes with and without fixation for posterior malleolar fractures. Materials and Methods: From January 2010 to December 2018 the radiological and clinical outcomes of 30 skeletally mature patients with tibial spiral fractures (AO Foundation/Orthopaedic Trauma Association classification 42-A1, B1, C1) combined with posterior malleolar fractures were analyzed. Sixteen patients were treated with IMN, and 14 patients were treated with MIPO. Depending on the surgical methods, the radiologic and clinical outcomes were compared by evaluating the bone union time, postoperative alignment, postoperative displacement of the posterior malleolar fragment, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, the functional and clinical outcomes with and without fixation for posterior malleolar fractures were compared. Results: The mean bone union time was 21.8 weeks in the IMN group and 23.1 weeks in the MIPO group (p=0.500). At the final follow up, the mean alignment was coronal angulation of 1.8°, sagittal angulation of 1.6° in the IMN group and coronal angulation of 1.2° and sagittal angulation of 1.7° in the MIPO group (conoral angulation: p=0.131, sagittal angulation: p=0.850). The postoperative and final radiologic evaluation showed no displacement of the posterior malleolar fragment and excellent joint congruity in all cases. At the final follow-up, the mean AOFAS score was 88.0 on average in the IMN group and 87.6 on average in the MIPO group (p=0.905). The ankle range of motion and AOFAS score were similar in the fixation group and no fixation group for posterior malleolar fractures. Conclusion: Both IMN and MIPO for tibial spiral fractures combined with posterior malleolar fractures result in satisfactory radiological and clinical outcomes.
Yang, Hanbual;Hwang, Il-Ung;Song, Daeguen;Moon, Gi Ho;Lee, Na Rae;Kim, Kyoung-Nam
Journal of the Korean Orthopaedic Association
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v.56
no.3
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pp.234-244
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2021
Purpose: To date, studies of firearm and explosive injuries in the Korean military have been limited compared to its importance. To overcome this, this study examined the characteristics of musculoskeletal damages in soldiers who have suffered firearm and explosive injuries over the past four years. Materials and Methods: From January 2015 to July 2019, military forces who had suffered musculoskeletal injuries from firearms or explosive substances were included. The medical records and radiographs were reviewed retrospectively, and telephone surveys about Short Musculoskeletal Functional Assessment (SMFA) for this group were conducted. To compare the functional outcomes, statistical analysis was performed using a t-test for the types of weapons, and ANOVA for others. Results: Of the 61 patients treated for firearms and explosives injuries, 30 patients (49.2%) were included after undergoing orthopedic treatment due to musculoskeletal injury. The average age at injury was 26.4 years old (21-52 years old). The number of officers and soldiers was similar. Eleven were injured by gunshot and 19 by an explosive device. Sixteen were treated in the Armed Forces Capital Hospital and 10 at private hospitals. More than half of the 16 patients (53.3%) with a fracture had multiple fractures. The most common injury site was the hand (33.3%), followed by the lower leg (30.0%). There were 14 patients (46.7%) with Gustilo-Anderson classification 3B or higher who required a soft tissue reconstruction. Fifteen patients agreed to join the SMFA survey for the functional outcomes. Between officers and soldiers, officers had better scores in the Bother Index compared to soldiers (p=0.0045). Patients treated in the Armed Forces Capital Hospital had better scores in both the Dysfunction and Bother Index compared to private hospitals (p=0.0008, p=0.0149). Conclusion: This is the first study to analyze of weapons injuries in the Korean military. As a result of the study, the orthopedic burden was high in the treating patients with military weapon injuries. In addition, it is necessary to build a military trauma registry, including firearm and explosive injuries, for trauma treatment evaluation and development of military trauma system.
Lee, Jun Oh;Lee, Geun Dong;Kim, Hyeong Ryul;Kim, Dong Kwan;Park, Seung-Il;Cho, Jong Ho;Kim, Hong Kwan;Choi, Yong Soo;Kim, Jhingook;Shim, Young Mog;Park, Samina;Park, In Kyu;Kang, Chang Hyun;Kim, Young Tae;Park, Seong Yong;Lee, Chang Young;Lee, Jin Gu;Kim, Dae Joon;Paik, Hyo Chae;the Korean Association for Research on the Thymus,
Journal of Chest Surgery
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v.55
no.2
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pp.126-142
/
2022
Background: Thymic epithelial tumors (TETs) are rare, and information regarding their surgical outcomes and prognostic factors has rapidly changed in the past few decades. We analyzed surgical treatment practices for TETs and outcomes in terms of overall survival (OS) and freedom from recurrence (FFR) during a 13-year period in Korea. Methods: In total, 1,298 patients with surgically resected TETs between 2000 and 2013 were enrolled retrospectively. OS and FFR were calculated using the Kaplan-Meier method and evaluated with the log-rank test. Prognostic factors for OS and FFR were analyzed with multivariable Cox regression. Results: A total of 1,098 patients were diagnosed with thymoma, and 200 patients were diagnosed with thymic carcinoma. Over the study period, the total number of patients with surgically treated TETs and the proportion of patients who underwent minimally invasive thymic surgery (MITS) increased annually. The 5-year and 10-year survival rates of surgically treated TETs were 91.0% and 82.1%, respectively. The 5-year and 10-year recurrence rates were 86.3% and 80.0%, respectively. The outcomes of surgically treated TETs improved over time. Multivariable Cox hazards analysis for OS, age, tumor size, and Masaoka-Koga stage were independent predictors of prognosis. The World Health Organization classification and tumor-node-metastasis (TNM) staging were also related to the prognosis of TETs. Conclusion: Surgical treatment of TETs achieved a good prognosis with a recent increase in MITS. The M-K stage was the most important prognostic factor for OS and FFR. The new TNM stage could also be an effective predictor of the outcomes of TETs.
The color and optical properties of seawater are determined by the interaction between dissolved organic and inorganic substances and plankton contained in it. The Ieodo - Ocean Research Institute (I-ORS), located in the East China Sea, is affected by the low salinity of the Yangtze River in the west and the Tsushima Warm Current in the south. Thus, it is a suitable site for analyzing the fluctuations in circulation and optical properties around the Korean Peninsula. In this study, seawater surrounding the I-ORS was classified according to its optical characteristics using the satellite remote reflectance observed with Moderate Resolution Imaging Spectroradiometer (MODIS)/Aqua and National Aeronautics and Space Administration (NASA) bio-Optical Marine Algorithm Dataset (NOMAD) from January 2016 to December 2020. Additionally, the variation characteristics of optical water types (OWTs) from different seasons were presented. A total of 59,532 satellite match-up data (d ≤ 10 km) collected from seawater surrounding the I-ORS were classified into 23 types using the spectral angle mapper. The OWTs appearing in relatively clear waters surrounding the I-ORS were observed to be greater than 50% of the total. The maximum OWTs frequency in summer and winter was opposite according to season. In particular, the OWTs corresponding to optically clear seawater were primarily present in the summer. However, the same OWTs were lower than overall 1% rate in winter. Considering the OWTs fluctuations in the East China Sea, the I-ORS is inferred to be located in the transition zone of seawater. This study contributes in understanding the optical characteristics of seawater and improving the accuracy of satellite ocean color variables.
Kim, Sora;Song, Jungeun;Park, Chunhee;Min, Suhui;Hong, Sunghee;Yun, Junhyuk;Son, Yeongmo
Journal of Korean Society of Forest Science
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v.111
no.2
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pp.311-318
/
2022
We conducted this study to derive the site index, which is a criterion for the planting of Robinia pseudoacacia, a honey plant, and to investigate the diameter distribution change by derived site index. We applied the Chapman-Richards equation model to estimate the site index of the Robinia pseudoacacia stand. The site index was distributed within the range of 16-22 when the base age was 30 years. The fitness index of the site index estimation model was low, but we judged that there was no problem in the application because the residual distribution of the equation had not shifted to one side. We used the Weibull diameter distribution function to determine the diameter distribution of the Robinia pseudoacacia stand by site index. We used the mean diameter and the dominant tree height as independent variables to present the diameter distribution, and our analysis procedure was to estimate and recover the parameters of the Weibull diameter distribution function. We used the mean diameter and the dominant tree height of the Robinia pseudoacacia stand to show distribution by diameter class, and the fitness index for dbh distribution estimation was about 80.5%. As a result of schematizing the diameter distribution by site indices as a 30-year-old, we found that the higher the site index, the more the curve of the diameter distribution moved to the right. This suggests that if the plantation were to be established in a high site index stand, considering the suitable trees on the site, the growth of Robinia pseudoacacia woul d become active, and not onl y the production of wood but al so the production of honey would increase. We therefore anticipate that the site index classification table and curve of this Robinia pseudoacacia stand will become the standard for decision making in the plantation and management of this tree.
Kim, Ji-Dong;Lee, Hye-Jeong;Lee, Dong-Hyuk;Byeon, Jun Gi;Park, Byeong Joo;Heo, Tae-Im
Journal of Korean Society of Forest Science
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v.111
no.2
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pp.201-223
/
2022
Currently, species extinctions are increasing due to climate change and continued anthropogenic impact. We selected 300 species for conservation with emphasis on plants co-occurring in the Baekdudaegan area, which is a large ecological axis of Korea. We aimed to investigate the vegetation community and environmental characteristics of Zabelia tyaihyonii in the limestone habitat among the target plant species in the Baekdudaegan region to derive effective conservation strategies. In Danyang-gun, Yeongwol-gun, and Jecheon-si, we selected 36 investigation sites where Z. tyaihyonii was present. We investigated the vegetation, flora, soil and physical environment. We also found notable plants such as Thalictrum petaloideum, Sillaphyton podagraria, and Neillia uekii at the investigation sites. We classified forest vegetation community types into 4 vegetation units and 7 species group types. With canonical correspondence analysis (CCA) of the vegetation community and habitat factors, we determined the overall explanatory power to be 75.2%, and we classified the environmental characteristics of the habitat of Z. tyaihyonii into a grouping of three. Among these, we detected a relationship between the environmental factors elevation, slope, organic matter, rock ratio, pH, potassium, and sodium. We identified numerous rare and endemic plants, including Thalictrum petaloideum, in the investigation site, and determined that these groups needed to be preserved at the habitat level. In the classification of the vegetation units analyzed based on the emerging plants and the CCA, we reaffirmed the uniqueness and specificity of the vegetation community in the habitat of Z. tyaihyonii. We anticipate that our results will be used as scientific evidence for the empirical conservation of the native habitats of Z. tyaihyonii.
In urban areas, the impermeable area continues to increase due to urbanization, which interferes with the surface penetrating and infiltrating of rainwater, causing most rainwater runoff to the surface, deepening the distortion of water circulation. Distortion of water circulation affects not only flood disasters caused by rainfall and runoff, but also various aspects such as dry stream phenomenon, deterioration of water quality, and destruction of ecosystem balance, and the Ministry of Environment strongly recommends the use of Low Impact development (LID) techniques. In order to apply the LID technique, it is necessary to set a rainwater management target to handle the increase in outflow after the development of the target site, and the current standard sets the rainwater management target using the 10-year daily rainfall. In this study, the difference from the current standards was analyzed through statistical analysis and classification of independent rainfall ideas using inter-event time definition (IETD) in setting the target amount of rainwater management to improve water circulation. Using 30-year rainfall data from 1991 to 2020, methods such as autocorrelation coefficient (AC) analysis, variation coefficient (VC) analysis, and annual average number of rainfall event (NRE) analysis were applied, and IETD was selected according to the target rainfall period. The more samples the population had, the more IETD tended to increase. In addition, by analyzing the duration and time distribution of independent rainfall according to the IETD, a plan was proposed to calculate the standard design rainfall according to the rainwater management target amount. Therefore, it is expected that it will be possible to set an improved rainwater management target amount if sufficient samples of independent rainfall ideas are used through the selection of IETD as in this study.
Choe, Su-Jeong;Pham, Van Chien;Lee, Won-Ju;Kim, Jun-Soo;Kim, Jeong-Kuk;Park, Hoyong;Lim, In Gweon;Choi, Jae-Hyuk
Journal of the Korean Society of Marine Environment & Safety
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v.28
no.6
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pp.1092-1099
/
2022
Research on exhaust aftertreatment devices to reduce air pollutants and greenhouse gas emissions is being actively conducted. However, in the case of the particulate matters/nitrogen oxides (PM/NOx) simultaneous reduction device for ships, the problem of back pressure on the diesel engine and replacement of the filter carrier is occurring. In this study, for the optimal design of the integrated device that can simultaneously reduce PM/NOx, an appropriate standard was presented by studying the flow inside the device and change in back pressure through the inlet/outlet pressure. Ansys Fluent was used to apply porous media conditions to a diesel particulate filter (DPF) and selective catalytic reduction (SCR) by setting porosity to 30%, 40%, 50%, 60%, and 70%. In addition, the ef ect on back pressure was analyzed by applying the inlet velocity according to the engine load to 7.4 m/s, 10.3 m/s, 13.1 m/s, and 26.2 m/s as boundary conditions. As a result of a computational fluid dynamics analysis, the rate of change for back pressure by changing the inlet velocity was greater than when inlet temperature was changed, and the maximum rate of change was 27.4 mbar. This was evaluated as a suitable device for ships of 1800kW because the back pressure in all boundary conditions did not exceed the classification standard of 68mbar.
This study empirically analyzed the value conflicts of cultural administration based on the needs of axiological discussions and the differences in intersubjectivity among the cultural administration groups and the contradicting attributes of culture and administration. The study classified the stakeholders into administrative staff, planners, and artists to compare their value priorities of publicness in cultural administration. A classification analysis was also conducted based on the normative by each group and the value distribution on a 2×2 value matrix between autonomy and accountability and fairness and efficiency. Based on the results of the quantitative study, the awareness of the relationships among the groups and cause and effects of value conflicts was analyzed through in-depth interviews. Thus, the study aimed to identify the directions for value distribution wherein the values of administration and culture can coexist and determine the implications of expanding this mutual understanding. The results revealed that in the conflict between autonomy and accountability, all groups had a greater awareness of accountability. In terms of normative aspects, it was possible to see a normative value line with an emphasis on autonomy, rather than on accountability from the lower stages on the budget hierarchy (administrators at the top, followed by planners and artists). In the conflict between autonomy and accountability, the size of dissonance between appropriateness and reality was the largest among the groups in the lower stages of the budget hierarchy, and became larger along the order of administrators, planners, and artists. In the conflict between efficiency and fairness, all groups had a greater awareness of efficiency. In terms of fairness in normative aspects, emphasis was placed on was artists, administrators, and planners, in that order. The size of dissonance between efficiency and fairness by groups became larger along the order of budget hierarchy-administrators, planners, and artists. Based on the results, the study compared and analyzed the 2×2 value matrix between the normative and actualities by groups. The normative value distribution emphasized Type 1 (accountability x fairness) as seeking communitarianism values through culture and Type 2 (autonomy x fairness) as seeking balanced values of cultural freedom of individualsonabalance. However, in actualities, although the communitarianism values of Type 1 were considered important, there were no distributions to the liberal values of Type 2, rather to the economic values of culture from Type 4 (accountability x efficiency). In summary, the Korean cultural administration isunderapressureof value distribution to emphasize the communitarianism and economic rather than liberal values, through bureaucratic control in actualities compared with the normative. This study will have significant implications on value distribution decision-making by groups and political implementations within the purview of cultural administration.
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