• Archives of Reconstructive Microsurgery
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• 제10권1호
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• pp.18-22
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• 2001

Purpose : The purpose of this study was to evaluate stress fracture of vascularized fibular grafts(VFG) by analyzing factors associated with stress fracture and the treatment results. Materials and Methods : From June 1985 to May 1998, 7 patients with stress fractures in the 38 patients with long bone defect who had vascularized fibular graft were evaluated with clinical and radiologic methods including grafted fibular length and hypertrophic index of de Boer. The average age of the patients was 35 years(range, $14{\sim}60$ years). The mean follow-up period was 20 months(range, $16{\sim}32$ months). Results: 7(18.4%) stress fractures occurred in 38 patients. Characteristics of the fractures were (1) all occurred at lower extremity of male patients treated with VFG for long bone defected caused by infected nonunion; (2) all occurred 10 months at the average(range, $4{\sim}17$ months) after VFG; and (3) the length and hypertrophic index of grafted fibula had no influence on the incidence of stress fracture. Union was obtained in 3 patients by conservative treatment. 4 patients obtained union by internal fixation; one at immediately onset of fracture; and three after failure of conservative treatment who had fracture around the knee joint. Conclusion : Stress fracture may occur during the first one year after vascularized fibular graft and more attention must be paid for prevention of it, especially in the cases of infected nonunion. Stress fracture around the knee joint was expected to lead to a good result of early union by operative treatment.

• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.82-89
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• 2008

이상적인 회전근 개 봉합술은 봉합 초기 높은 고정 강도로 봉합 부위 건-골간 간격 형성을 최소화시키며, 재활 과정 중 발생하는 반복적인 부하에도 견디는 기계적 강도를 나타내어 궁극적으로 건-골 조직의 생물학적 치유를 얻을 수 있는 방법이다. 현재 사용되는 회전근 개 봉합술 중 교량형 봉합술식은 회전근 개 부착 부위를 해부학적으로 복원할 수 있으며, 건-골간 압력 접촉 면적을 증가시키고, 방사형의 봉합 형태를 통하여 회전근 개 전체에 균등하게 압력을 분포함으로 부하를 분산시키며 생물학적 치유를 향상시킨다. 또한 건-골간 간격 형성을 최소화하며 전단 및 회전 응력에 저항력을 주어 정상과 동일한 해부학적 복원력으로 빠른 재활 운동을 가능하게 한다. 그러나 비록 교량형 봉합술식이 다른 술식에 비해 우수한 생역학적 특성을 나타내도 임상적으로 더 좋은 결과를 초래한다는 증거는 없으며, 이열 봉합술과는 비슷한 재파열율이 보고되고 있다. 회전근 개봉합술의 선택은 회전근 개 파열 크기, 파열 양상 및 건의 상태 등을 고려하여 적절하게 선택하여야 할 것으로 사료된다.

• Journal of Chest Surgery
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• 제12권4호
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• pp.411-417
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• 1979

During the period of 4 years from August 1, 1975 to August 1, 1979, authors have experienced 100 cases of multiple rib fractures by nonpenetrating injury at Department of Thoracic Surgery, Paik Foundation Hospital in Seoul, Korea. 1. The ratio of male to female patients with multiple rib fracture was 2.6:1 with male predominance and 84% of the total cases were between 20 and 50 years of age. 2. The most common cause of multiple rib fracture was traffic accident and falls accounted for the next largest group. 3. The most common site of rib fracture was 4th rib to 7th rib level on both hemithorax [52%]. 4. Associated injuries were cerebral contusion in 26%, clavicular fracture in 22%, long bone fracture in 22%, pelvic bone fracture in 10%, and scapular fracture in 8%. 5. Early complications and/or result of the multiple rib fractures were lung contusion in 23 cases, subcutaneous emphysema in 21 cases, hemothorax in 21 cases, hemopneumothorax in 6 cases, and flail chest in 12 cases. 6. The flail chests were managed by strapping the chest with adhesive plaster, external traction of flail segment with towel clip, ventilatory assistance for marginal clinical indications, and in cases of complicated with intrathoracic hemorrhage, wire fixation of flail segment through open thoraco-tomy. 7. The principles of therapy for hemothorax and/or pneumothorax were rapid reexpansion of the lungs by thoracentesis [11%] and closed thoracostomy [22%], but open thoracotomy had to be done on 3 cases because of massive bleeding or intrapleural hematoma and diaphragmatic rupture. 8. The over all mortality was 4% [4 among 100 cases] and the cause of all deaths was head injury.

• 한국실내디자인학회논문집
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• 제21권2호
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• pp.92-100
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• 2012

This study was to examine the pattern of visual interpretation in the process of eye-tracking. I categorized the subjects' observation inclination for analysis so that I could find out which element the user observing the space concentrated and explored. First, for 2 minutes of observation, there occurred 171 times of eye-fixations and 9.8 times of observation frequency on average, which showed that the subject, through this observing fixation, spent 44.5% of the entire time performing the visual activity in order to acquire the "visual understanding" of the lobby-space. Second, I found out that there was a consistent observation type as the time passed. I could categorize the subjects observing the space into 6 concentrating types and 3 discontinuing ones of observation types, which category can be utilized as data for analyzing the subjects' characteristics at space-observation. Third, the type, which was so intensive as to get the visual understanding on the space, was mostly of the case that (1) the subject had a kind of high degree of observation type, exploring the space, again having high degree of the observation type [Type A], (2) the subject repeated the concentration from the early part to the latter [Type C], which can be considered to be the observation type generally shared. Fourth, in the case of observing the space, 45.8% of the subjects showed a high rate of concentration at the time of starting the observation and in less than two minutes. The subjects of type A can be considered to understand the space visually by distinctively repeating the concentration and exploration.

• Journal of Korean Neurosurgical Society
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• 제29권9호
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• pp.1262-1266
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• 2000

Objective : Flat back syndrome constitutes a syndrome complex characterized by the loss of normal lumbar lordosis. Various techniques of correction for flat back syndrome have been reported. Posterior extension osteotomy has certain drawbacks. Forceful hyperextension of the spine may result in vascular complications such as rupture of the aorta or the inferior vena cava and stretching of superior mesenteric artery, and pseudoarthrosis. We describe a rationale and technique of transvertebral posterior extension osteotomy to avoid complications of posterior extension osteotomy and to achieve an correction of 30 degrees of flat back syndrome. Method : A 63-year-old woman with degenerative lumbar kyphosis presented with low back pain, thigh pain, knee pain and walking difficulty. Transpedicular fixation from L1 vertebra to S1 vertebra was accomplished for lumbar degenerative kyphosis. After 6 months, the patient presented with flat back syndrome. A second operation was performed with transvertebral posterior extension osteotomy. Result : With short segemental fusion, early bone fusion and correction of 30 degrees were achieved. Conclusion : Transvertebral posterior extension osteotomy provide an 30-60 degrees of correction of flat back syndrome. This technique is considered to be good method for the revision of lumbar degenerative kyphosis.

• Journal of Korean Neurosurgical Society
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• 제48권1호
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• pp.37-45
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• 2010

Objective : Craniovertebral junction (CVJ) consists of the occipital bone that surrounds the foramen magnum, the atlas and the axis vertebrae. The mortality and morbidity is high for irreducible CVJ lesion with cervico-medullary compression. In a clinical retrospective study, the authors reviewed clinical and radiographic results of occipitocervical fusion using a various methods in 32 patients with CVJ instability. Methods : Thirty-two CVJ lesions (18 male and 14 female) were treated in our department for 12 years. Instability resulted from trauma (14 cases), rheumatoid arthritis (8 cases), assimilation of atlas (4 cases), tumor (2 cases), basilar invagination (2 cases) and miscellaneous (2 cases). Thirty-two patients were internally fixed with 7 anterior and posterior decompression with occipitocervical fusion, 15 posterior decompression and occipitocervical fusion with wire-rod, 5 C1-2 transarticular screw fixation, and 5 C1 lateral mass-C2 transpedicular screw. Outcome (mean follow-up period, 38 months) was based on clinical and radiographic review. The clinical outcome was assessed by Japanese Orthopedic Association (JOA) score. Results : Nine neurologically intact patients remained same after surgery. Among 23 patients with cervical myelopathy, clinical improvement was noted in 18 cases (78.3%). One patient died 2 months after the surgery because of pneumonia and sepsis. Fusion was achieved in 27 patients (93%) at last follow-up. No patient developed evidence of new, recurrent, or progressive instability. Conclusion : The authors conclude that early occipitocervical fusion to be recommended in case of reducible CVJ lesion and the appropriate decompression and occipitocervical fusion are recommended in case of irreducible craniovertebral junction lesion.

• Asian-Australasian Journal of Animal Sciences
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• 제28권4호
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• pp.457-466
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• 2015

Taoyuan pig is a native Taiwan breed. According to the historical record, the breed was first introduced to Taiwan from Guangdong province, Southern China, around 1877. The breed played an important role in Taiwan's early swine industry. It was classified as an indigenous breed in 1986. After 1987, a conserved population of Taoyuan pig was collected and reared in isolation. In this study, mitochondrial DNA sequences and 18 microsatellite markers were used to investigate maternal lineage and genetic diversity within the Taoyuan pig population. Population differentiation among Taoyuan, Asian type, and European type pig breeds was also evaluated using differentiation indices. Only one D-loop haplotype of the Taoyuan pig was found. It clustered with Lower Changjiang River Basin and Central China Type pig breeds. Based on the polymorphism of microsatellite markers, a positive fixation index value ($F_{IS}$) indicates that the conserved Taoyuan population suffers from inbreeding. In addition, high $F_{ST}$ values (>0.2105) were obtained, revealing high differentiation among these breeds. Non-metric multi-dimensional scaling showed a clear geometric structure among 7 breeds. Together these results indicate that maternally Taoyuan pig originated in the Lower Changjiang River Basin and Central China; however, since being introduced to Taiwan differentiation has occurred. In addition, Taoyuan pig has lost genetic diversity in both its mitochondrial and nuclear genomes.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권4호
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• pp.327-339
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• 1992

This study was undertaken to investigate the effect of orthognathic surgery on occlusal force. The maximum bite force was measured in 26 dentofacial deformity patients, aged 14-26(mean age 20.3) years, before surgery and at IMF removal, 3, 6, and 12months postsurgery. To grope the correlation of bite force and skeletal change after orthognathic surgery, the cephalometric headplates were measured, tabulated and statistically analyzed. The results were as follows. 1. The presurgical maximum bite force was 13.7kg in upper first molar(rt. Side 12.7kg, it. Side 14.6kg). There was remarkable difference with that of normal occlusion. 2. The recovery of bite force was very significant in according to the operation method and the duration of IMF that was 7.6kg at IMF removal, 14.2kg at 3 months, 19.7kg at 6 months. 26.1kg at 12 months postsurgery. 3. To fasten the recovery and to increase the bite force after orthognathic surgery, the long IMF time and the injury to the masticatory muscle should be avoided by the internal rigid fixation and early physical exercise. 4. The bite force was positively correlated to the changes of mandibular plane angle, the angle between platatal plane and mandibular plan, the angle between occlusal plane and mandibular plane, and negatively correlated to the changes of mandibular body length in craniofacial structure. 5. There was no correlationship between bit force and mesial inclination of tooth long axis of first molar in this subject. 6. There was no correlation between the changes of bite force and the changes of mechanical advantage of the temporal and masseter muscle.

• 대한족부족관절학회지
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• 제7권1호
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• pp.119-125
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• 2003

Purpose: The purpose of this study fracture. Materials and Methods: The clinical and radiological analysis were performed on 19 cases of the talus neck fractures who had been treated with conservative treatment or variable methods of operative treatment. Each cases followed up more than 1 year and 6 months from May 1989 to June 2001. The clinical results were analyzed according to the age, cause of injury, fracture type of Hawkins classification, associated soft tissue injury, method of treatments, complications, and Hawkins scoring system. Results: According to Hawkins classification, type I was 6 cases(32%), type II was 5 cases(26%), typeIII was 7 cases(37%), and typeIV was 1 case(5%). In all cases, complete bony union was obtained. According to the Hawkins scoring system, 8 cases(42%) were excellent and good. Avascular necrosis was 4 cases(25%). Traumatic arthritis was 10 cases which were occurred in type II, III and IV. An ankle fusion was 1 case. Conclusion: In talar neck fractures, non-displaced fracture treated by the cast immobilization and displaced fracture treated by early open reduction and internal fixation were expected good results. The complications were 77% of traumatic arthritis and 31% of avascular necrosis in type II, III and IV. We should preoperatively explain to the patient for high complication rates of traumatic osteoarthritis and avascular necrosis in the talus neck fractures.

• Archives of Plastic Surgery
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• 제35권2호
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• pp.152-158
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• 2008

Purpose: Mandibulotomy approach and mandible sparing approach are most common methods for oropharyngeal cancer surgery. Good surgical view and convenience of flap inset are advantages of mandibulotomy approach but deformity of mandible contour, postoperative malocclusion and radionecrosis are its limitations. To make up for the limitations, mandible sparing method is commonly performed, but limited surgical view and difficulties of flap inset are the weak points of this approach. The purpose of the study is to compare mandibulotomy and mandible sparing approaches in postoperative complications and progression of the treatment in oropharyngeal cancer operation and reconstruction. Methods: Single reconstructive microsurgeon operated for oropharyngeal cancer patients with different surgeons of head and neck department who prefer mandibulotomy and mandible sparing approach respectively, and we compared the frequency of postoperative complication, operation time, duration of hospitalization and recurrence rate between two different surgical approaches. Results: Mandibulotomy approach was used in 18 patients and mandible sparing approach was used in 15 patients. In mandibulotomy approach, there happened one case of teeth injury and one case of necrosis of skin and gingiva, but there happened no malocclusion and radionecrosis. In mandible sparing approach, there were 3 cases of fistula and 2 cases of infection which are significantly higher than mandibulotomy approach. There were no significant differences between early regional recurrence and duration of hospitalization. Conclusion: In this study we compared two different methods for the surgical approach in oropharyngeal cancer surgery. As mandible sparing approach has difficulties of limited surgical view, it can be used for the limited indications of anterior tongue and mouth floor cancer. Mandibulotomy approach has advantages of good surgical view and convenience of flap inset. In this method preservation of gingival tissue, watertight fashion suture, delicate osteotomy and plate fixation to maintain occlusion are the key points for the successful results.