• Title/Summary/Keyword: Displaced

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Surgical Management of Comminuted Midshaft Clavicle Fractures Using Reconstruction Plate and Circumferential Wiring: Does the Circumferential Wiring Interfere with the Bone Union? (쇄골 간부 복합 골절에서 재건 금속판 및 환 강선을 이용한 수술적 치료: 환 강선이 골 유합을 방해하는가?)

  • Kim, Kyung-Tae;Shin, Chung-Shik;Park, Young-Chul;Kim, Dong-hyun;Kim, Min-Woo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.245-252
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    • 2021
  • Purpose: This study examined the radiological and clinical outcomes of internal fixation using a reconstruction plate and 21G circumferential wire in comminuted midshaft clavicular fractures. Materials and Methods: A retrospective cohort study was performed on 51 patients between 2005 and 2019. Thirty-two patients underwent internal fixation with a reconstruction plate and a 21G circumferential wire with minimal soft tissue detachment, and 19 patients underwent surgery without a wire. The patients were assessed with the radiographic parameters, the University of California at Los Angeles (UCLA) score, and the visual analogue scale (VAS) pain score. Based on this, patients who operated without a circumferential wire were set as the control group, and the differences in bone union between the two groups were compared. Results: Thirty-two patients were followed-up for an average of 65 weeks, and 19 patients in the control group were followed-up for an average of 56 weeks. The radiological evaluation confirmed the anatomical reduction and bone union in all 32 patients. No case of nonunion was present. The UCLA score was 32.38 on average and 33.11 in the control group (p=0.395). The VAS score was 1.00 on average and 0.84 in the control group (p=0.668). A significant difference in the bony union time was observed between the group who underwent internal fixation with a reconstruction plate and a 21G circumferential wire with minimal soft tissue detachment, and the control group (p=0.015). On the other hand, there was no statistical significance when other variables were controlled (p=0.107). Conclusion: For displaced midshaft clavicular fractures, internal fixation using a reconstruction plate and 21G circumferential wire maintained accurate anatomical reduction. The satisfactory clinical and radiological results mean that internal fixation using a reconstruction plate and 21G circumferential wire may be a good option for surgical treatment.

Outcome of Type 3 Talar Neck Fractures by Means of Medial Malleolar Osteotomy and Large Distractor (족관절 내과 절골술 및 대형신연기를 이용한 제3형 거골 경부 골절의 치료 결과)

  • Park, Sung Hae;Lee, Jun Young;Lee, Jung Woo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.1
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    • pp.45-51
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    • 2019
  • Purpose: The clinical and radiological results of patients with type 3 talar neck fractures treated with the anteromedial approach using medial malleolar osteotomy and large distractor were analyzed retrospectively. Materials and Methods: From March 2009 to August 2016, 12 patients with a type 3 talar neck fracture, who underwent the anteromedial approach using a medial malleolar osteotomy and large distractor and who could be followed-up for more than 12 months after the operation, were examined. The patients were examined for the presence of Hawkins signs by anteroposterior and lateral radiographs and osteonecrosis by magnetic resonance imaging (MRI) on the postoperative 3 months. Subsequently, every 3 months, radiographic union was assessed by a simple radiograph and clinical symptoms. Twelve months postoperatively, posttraumatic arthritis was assessed and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was analyzed. Results: In 7 cases, osteonecrosis was found on MRI performed 3 months after surgery. On the other hand, at the 12 months follow-up, all of them obtained AOFAS scores of 83.86±4.53 without surgical treatment. Radiographic union was achieved in all cases. The mean union period was 5.3 months. In 10 cases, traumatic arthritis was found after the radiographical and clinical evaluation. In addition, all of them could carry on everyday life by conservative treatment. The AOFAS ankle-hindfoot score was measured to be 85.17 on average. Other complications included superficial wound infection in 2 cases. Conclusion: An anteromedial approach using a medial malleolar osteotomy and a large distractor in the surgical treatment of patients with type 3 talar neck fractures can achieve anatomical reduction of the displaced fragment without a lateral dissection. This is considered to be another good surgical option.

Efficacy of Self-manipulation Technique in the Treatment of Patients with Anterior Disc Displacement without Reduction (비정복성 관절원판 전방변위 환자의 치료에 있어서 자가 수조작술의 효과에 대한 연구)

  • Kim, Ju-Sik;Lee, Chae-Hoon;Kim, Young-Ku
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.441-447
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    • 2007
  • Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.

Regional Development And Dam Construction in Korea (한국의 지역개발과 댐건설)

  • 안경모
    • Water for future
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    • v.9 no.1
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    • pp.38-42
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    • 1976
  • Because of differences in thoughts and ideology, our country, Korea has been deprived of national unity for some thirty years of time and tide. To achieve peaceful unification, the cultivation of national strength is of paramount importance. This national strength is also essential if Korea is to take rightful place in the international societies and to have the confidence of these societies. However, national strength can never be achieved in a short time. The fundamental elements in economic development that are directly conducive to the cultivation of national strength can be said to lie in -a stable political system, -exertion of powerful leadership, -cultivation of a spirit of diligence, self-help and cooperation, -modernization of human brain power, and -establishment of a scientific and well planned economic policy and strong enforcement of this policy. Our country, Korea, has attained brilliant economic development in the past 15 years under the strong leadership of president Park Chung Hee. However, there are still many problems to be solved. A few of them are: -housing and home problems, -increasing demand for employment, -increasing demand for staple food and -the need to improve international balance of payment. Solution of the above mentioned problems requires step by step scientific development of each sector and region of our contry. As a spearhead project in regional development, the Saemaul Campaign or new village movement can be cited. The campaign is now spreading throughout the country like a grass fire. However, such campaigns need considerable encouragement and support and the means for the desired development must be provided if the regional and sectoral development program is to sucdceed. The construction of large multipurpose dams in major river basin plays significant role in all aspects of national, regional and sectoral development. It ensures that the water resource, for which there is no substitute, is retained and utilized for irrigation of agricultural areas, production of power for industry, provision of water for domestic and industrial uses and control of river water. Water is the very essence of life and we must conserve and utilize what we have for the betterment of our peoples and their heir. The regional and social impact of construction of a large dam is enormous. It is intended to, and does, dras tically improve the "without-project" socio-economic conditions. A good example of this is the Soyanggang multipurpose dam. This project will significantly contribute to our national strength by utilizing the stored water for the benefit of human life and relief of flood and drought damages. Annual average precipitation in Korea is 1160mm, a comparatively abundant amount. The catchment areas of the Han River, Keum River, and Youngsan River are $62,755\textrm{km}^2$, accounting for 64% of the national total. Approximately 62% of the national population inhabits in this area, and 67% of the national gross product comes from the area. The annual population growth rate of the country is currently estimated at 1.7%, and every year the population growth in urban area increases at a rising rate. The population of Seoul, Pusan, and Taegu, the three major cities in Korea, is equal to one third of our national total. According to the census conducted on October 1, 1975, the population in the urban areas has increased by 384,000, whereas that in rural areas has decreased by 59,000,000 in the past five years. The composition of population between urban and rural areas varied from 41%~59% in 1959 to 48%~52% in 1975. To mitigate this treand towards concentration of population in urban areas, employment opportunities must be provided in regional and rural areas. However, heavy and chemical industries, which mitigate production and employment problems at the same time, must have abundant water and energy. Also increase in staple food production cannot be attained without water. At this point in time, when water demand is rapidly growing, it is essential for the country to provide as much a reservoir capacity as possible to capture the monsoon rainfall, which concentarated in the rainy seaon from June to Septesmber, and conserve the water for year round use. The floods, which at one time we called "the devil" have now become a source of immense benefit to Korea. Let me explain the topographic condition in Korea. In northern and eastern areas we have high mountains and rugged country. Our rivers originate in these mountains and flow in a general southerly or westerly direction throught ancient plains. These plains were formed by progressive deposition of sediments from the mountains and provide our country with large areas of fertile land, emminently suited to settlement and irrigated agricultural development. It is, therefore, quite natural that these areas should become the polar point for our regional development program. Hower, we are fortunate in that we have an additional area or areas, which can be used for agricultural production and settlement of our peoples, particularly those peoples who may be displaced by the formation of our reservoirs. I am speaking of the tidelands along the western and southern coasts. The other day the Ministry of Agriculture and Fishery informed the public of a tideland reclamation of which 400,000 hectares will be used for growing rice as part of our national food self-sufficiency programme. Now, again, we arrive at the need for water, as without it we cannot realize this ambitious programme. And again we need those dams to provide it. As I mentioned before, dams not only provide us with essential water for agriculture, domestic and industrial use, but provide us with electrical energy, as it is generally extremely economical to use the water being release for the former purposes to drive turbines and generators. At the present time we have 13 hydro-electric power plants with an installed capacity of 711,000 kilowatts equal to 16% of our national total. There are about 110 potential dams ites in the country, which could yield about 2,300,000 kilowatts of hydro-electric power. There are about 54 sites suitable for pumped storage which could produce a further 38,600,000 kilowatts of power. All available if we carefully develop our water resources. To summarize, water resource development is essential to the regional development program and the welfare of our people, it must proceed hand-in-hand with other aspects of regional development such as land impovement, high way extension, development of our forests, erosion control, and develop ment of heavy and chemical industries. Through the successful implementation of such an integrated regional development program, we can look forward to a period of national strength, and due recognition of our country by the worlds societies.

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A Study on the View on Nature in Ch'o-Jung's Three-Verse Poems(Sijo) (초정(艸丁) 김상옥(金相沃) 시조(時調)에 나타난 자연관(自然觀))

  • Choi, Heung-Yeol
    • Sijohaknonchong
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    • v.30
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    • pp.263-300
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    • 2009
  • Adoration for nature constitutes one of the primary subjects that literature has tackled since the origin of human history. Nature expressed through a poet's subjective imagination is the internalized and reorganized nature. This study examines the view on nature enacted in Ch'o-Jung's three-verse poems (sijo) in light of the traditional views on nature implicated in the ancient three-verse poems (koshijo), which is in line with the long-established Oriental view on nature. To dignitaris(sadaebu) in the Chosun Dynasty, nature appeared as the idealistic subject for moral culture ($shims{\breve{o}}ngsuyang$), which also becomes the literary space where the purity and justice of the world view of Neo-Confucianism(Sungrihak) is contained in the form of the three-verse poem, the lyrical poetic space where the "I" is united with nature by way of "enjoying of wind and moon"($umpungnongw{\breve{o}}i$) and "living in quiet retiremen"($yuyuchaj{\breve{o}}k$), and the object for the poetical perception of the surrounding world. Ch'o-Jung' s three-verse odes are found in Reed pipe ($Ch'oj{\breve{o}}k$), Sixty Five Pieces of Three-Verse Odes (Samhaengshi-$yukshipopy{\breve{o}}n$), Autumn Fragrance ($Hyangginam{\check{u}}n-ga{\check{u}}l$), and The Words of Zelko va Tree ($N{\check{u}}tinamu{\check{u}}i-mal$). This study analyzes 212 pieces of Ch'o-Jung' s three-verse poems chosen from theses books. In Ch'o-Jung's poems, the traditional view on nature expressed in the ancient three-verse poems is rendered in such a way that metaphysical understanding of nature is indirectly transmitted through the objective correlatives found nature. Nature is no longer the object of straightforward utterance, but transformed, displaced, and removed: that way, nature gets objectified to form a complicated and multi-layered structure. In conclusion, the view on nature manifested in Ch'o-Jung's three-verse poems is based on traditional metaphysics. Second, nature is the object of lyrical nostalgia and adoration. Third, nature is imbued with the fundamental affection for parents. Fourth, nature is associated with organic life. Fifth, the nature in Ch'o-Jung's poems reveals the beauty of stillness endorsed in Lao-tse's and Chung-tze's philosophy. And last, nature is the agent for self-realization and meditation.

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The Origin of Changseung and Ongjung Stone (장승의 기원과 옹중석)

  • Chung, Seung Mo
    • Korean Journal of Heritage: History & Science
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    • v.46 no.1
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    • pp.160-175
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    • 2013
  • There is the need to make a sharp distinction as regards JANGSEUNGs (Korean traditional totem poles) that are different in origin, history and function. This study is to identify the functions of the figures, as well as to trace stone JANGSEUNGs to their origins. In this regard, researched were conducted into the origins of JANGSEUNGs and their changes in history. There was a tradition in the GORYEO Dynasty (an ancient dynasty in the Korean Peninsula) that it erected JANGSAENGs (the archaic name of JANGSEUNGs) or allied stone figures within temples; especially, 'TONGDOSA GUKJANGSAENG SEOKPYO (a stone JANGSAENG that was erected by the royal command and is at the entrance of TONGDO Temple located in YANGSAN, South GYEONGSANG Province, South Korea)' functions as a stone monument rather than as a stone sign. In the engraved inscription, it is written that it should be erected in the form of PANA as before. 'PANA' refers to 'ZHONGKUI', a god in Chinese Taoism believed to exorcise devils that spread diseases. The inscription is to define the territory of TONGDO Temple. The article on HAN JUN GYEOM in a book 'WORAKGI (a travelogue on WORAK Mountain in North CHUNGCHEONG Province, South Korea)' written by HEO MOK makes it possible to guess the scale of GUKJANGSAENGs erected in DOGAP Temple. The stones, on which 'GUKJANGSAENG' or 'HWANGJANGSAENG' were engraved, are not JANGSAENGs but are demarcation posts. In the JOSEON Dynasty (the last dynasty in the Korean Peninsula) JANGSAENGs functioned as signposts. Unlike JANGSAENGs in temples, they were made of wood. At first, the word 'JANGSAENG' was written '長生' in Chinese characters, but in the JOSEON Dynasty another character '木 (wood)' was added to them, and thus the orthography was likely to change into 'JANGSEUNG.' In the JOSEON Dynasty, in addition, optative or geomantic figures were not called 'JANGSEUNG.' Historically, for instance, there has been no case where 'DOL HARBANGs (stone figures found only in JEJU ISLAND, South Korea)' are called 'JANGSEUNG.' In a book 'TAMRA GINYEON (a historical record on JEJU Island, South Korea)' it is written that KIM MONG GYU, JEJU governor, erected ONGJUNG Stones outside the fortress gate. ONGJUNG Stones usually refer to stone statues erected in front of ancient kings or dignitaries' mausoleums. Moreover, they were geomantic figures erected to suppress miasma. A magazine 'GWANGJUEUPJI (a journal on old GWANGJU, South Korea, 1899)' shows that two two ONGJUNG Stones were so erected that they might look at each other to suppress miasma from a pathway through which lucks lose. On the two stone figures located in BUAN-EUP, North JEOLLA Province, South Korea, inscriptions 'SANGWON JUJANGGUN' and 'HAWON DANGJANGGUN' were engraved. The words are to identify the figures' sexes. They are a kind of optative geomantic figures, and therefore there is no reason to call them 'JANGSAENG' or 'JANGSEUNG' or 'DANGSAN.' The words 'SANGWON' and 'HAWON' are closely associated with Taoism. Since then, the words have been widely used as inscriptions on stone figures in temples, and subsequently are used for JANGSEUNGs. A hatted ONGJUNG Stone, found in BUKANSAN Fortress, disappeared and other ones may be being buried somewhere. Meanwhile, ONGJUNG Stones in JEJU Island and stone figures in BUAN-EUP have hardly been displaced and thus have properly functioned. Stone figures, made in those days, seem to be most similar in function to JANGSAENGs made during the GORYEO Dynasty. Specifically, like earlier JANGSAENGs, stone figures made during the early to mid-18th century were likely to function not only as optative figures but as boundary stones. Most of stone figures in temples were made whenever the land use survey was conducted throughout the nation, but given that at the same period of time, the commonalty filed many lawsuits against grave sites, temples might erect many stone figures to mark their territories. Currently, wooden or stone figures are commonly called 'JANGSEUNG', but they were erected in different epochs and for different reasons. Their origins are to be sought in stone figures that functioned not only as optative figures in temples but as boundary stones during the GORYEO Dynasty.