• Title/Summary/Keyword: Early fixation

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The Early Result of Anterior Rotational Osteotomy in the Treatment of Osteonecrosis of the Femoral Head (대퇴골두 무혈성괴사의 치료에서 전방 회전 절골술의 조기 추시 결과)

  • Kim, Se-Dong;Shin, Duk-Seop;Jang, Woo-Seok
    • Journal of Yeungnam Medical Science
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    • v.11 no.2
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    • pp.284-292
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    • 1994
  • In transtrochanteric rotational osteotomy to treat osteonecrosis of the femoral head, the necrotic superior anterior femoral head is rotated anteriorly around the longitudinal neck axis so that the weight bearing force is transferred to the intact posterior surface. The ratio of transposed intact articular surface of the femoral head to the weight-bearing surface of the acetabulum on postoperative anteroposterior view of the hip roentgenograph is the most important indicator of the prognosis. During the period from December 1992 to June 1994, we treated 31 hips in 28 patients who were indicated for the anterior rotational osteotomy among the patients of osteoncrosis of the femoral head. Among the patients, male were 27 and female was one. Age distribution was from 13 to 62 years old and mean age was 44.3. According to the Ficat and Arlet classification, II A was most in number as 16 II B was 7 and III was 8. As their etiolgic factors, alcohol was most in number as 18, steroid was 3, idiopathic was 5 and trauma was 2. The mean rate of the intact area of the posterior part of the femoral head to the total articular surface on the preoperative lateral view of the hip roentgenograph was 41.8%, The mean ratio of transposed intact articular surface of the femoral head to the weight bearing surface of the acetabulum was 53.8%, Fixation devices were screws or dynamic hip screw.

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A STUDY ON THE RESPONSES OF OSTEOBLASTS TO VARIOUS SURFACE-TREATED TITANIUM

  • Lee Joung-Min;Kim Yung-Soo;Kim Chang-Whe;Jang Kyung-Soo;Lim Young-Jun
    • The Journal of Korean Academy of Prosthodontics
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    • v.42 no.3
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    • pp.307-326
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    • 2004
  • Statement of problem. The long-term success of implants is the development of a stable direct connection between bone and implant surface, which must be structural and functional. To improve a direct implant fixation to the bone, various strategies have been developed focusing on the surface of materials. Among them, altering the surface properties can modify cellular responses such as cell adhesion, cell motility and bone deposition. Purpose. This study was to evaluate the cellular behaviors on the surface-modified titanium by morphological observation, cellular proliferation and differentiation. Material and methods. Specimens were divided into five groups, depending on their surface treatment: electropolishing(EP) anoclizing(AN), machining(MA), blasting with hydroxyapatite particle(RBM) and electrical discharge machining(EDM). Physicochemical properties and microstructures of the specimens were examined and the responses of osteoblast-like cells were investigated. The microtopography of specimens was observed by scanning electron microscopy(SEM). Surface roughness was measured by a three-dimensional roughness measuring system. The microstructure was analyzed by X-ray diffractometer(XRD) and scanning auger electron microscopy(AES). To evaluate cellular responses to modified titanium surfaces, osteoblasts isolated from neonatal rat were cultured. The cellular morphology and total protein amounts of osteoblast-like cell were taken as the marker for cellular proliferation, while the expression of alkaline phosphatase was used as the early differentiation marker for osteoblast. In addition, the type I collagen production was determined to be a reliable indicator of bone matrix synthesis. Results. 1. Each prepared specimen showed specific microtopography at SEM examination. The RBM group had a rough and irregular pattern with reticulated appearance. The EDM-treated surface had evident cracks and was heterogeneous consisting of broad sheet or plate with smooth edges and clusters of small grains, deep pores or craters. 2. Surface roughness values were, from the lowest to the highest, electropolished group, anodized group, machined group, RBM group and EDM group. 3. All groups showed amorphous structures. Especially anodized group was found to have increased surface oxide thickness and EDM group had titaniumcarbide(TiC) structure. 4. Cells on electropolished, anodized and machined surfaces developed flattened cell shape and cells on RBM appeared spherical and EDM showed both. After 14 days, the cells cultured from all groups were formed to be confluent and exhibited multilayer proliferation, often overlapped or stratified. 5. Total protein amounts were formed to be quite similar among all the group at 48 hours. At 14 days, the electropolished group and the anodized group induced more total protein amount than the RBM group(P<.05). 6. There was no significant difference among five groups for alkaline phosphatase(ALP) activity at 48 hours. The AN group showed significantly higher ALP activity than any other groups at 14 days(P<.05). 7. All the groups showed similar collagen synthesis except the EDM group. The amount of collagen on the electropolished and anodized surfaces were higher than that on the EDM surface(P<.05).

Treatment of Tibial Fractures by Interlocking Intramedullary Nailing (Interlocking Intramedullary Nail을 이용한 경골 골절의 치료)

  • Jung, Kwang-Yeoung;Lee, Dong-Chul;Suh, Jae-Sung;Kim, Se-Dong
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.388-399
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    • 1993
  • The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993, 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft fractures. 3. The Interlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of fracture and then made early joint motion exercise and ambulation.

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Multifilament Cable Wire versus Conventional Wire for Sternal Closure in Patients Undergoing Major Cardiac Surgery

  • Oh, You Na;Ha, Keong Jun;Kim, Joon Bum;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.48 no.4
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    • pp.265-271
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    • 2015
  • Background: Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery. Methods: Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics. Results: Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction (1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068). Conclusion: The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.

Treatment of Combat-related Gunshot and Explosive Injuries to the Extremities (전투 상황에서 발생한 사지 총상 및 폭발창의 치료)

  • Lee, Jung Eun;Lee, Young Ho;Baek, Goo Hyun;Lee, Kyung-Hag;Cho, Young Jae;Kim, Yeong Cheol;Suh, Gil Joon
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.111-124
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    • 2013
  • Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.

Effects of Cutting on Nodule Development and Nitrogen Fixation in Alfalfa (예취가 알팔파 근류의 발달과 질소고정활성에 미치는 영향)

  • Jong Won Ryoo;Ho Jin Lee
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.7 no.3
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    • pp.128-134
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    • 1987
  • This experiment was conducted to evaluate the effects of cutting in field and solution culture. Periodical samplings of alfalfa in cutting and uncutting plots were taken to measure nodule development and nodule activity. Regrowth of plant and nodule development after shoot cutting by different heights and nodule removal at different levels were investigated in solution culture of alfalfa plant. 1. Nodule weight in the field was reduced 30% after the first cutting and 25% after the second cutting, but during the following 30 days after second cutting, there was no significant difference between cutting and uncutting plots. 2. Specific nodule activities of cutting plots at the beginning of June and at the beginning of September were 80% and loo%, higher than those of uncutting plots respectively. Total nodule activities of cutting plots in late August and early September were 40% higher than those of uncutting plot. The decrease of nodule activity can be prevented by cutting at flowering stage. 3. The decrease of nodules in solution culture when 50% of the shoot was cut, was as much as that when shoot was not cut or flower buds were removered. But when 90% of the shoot was cut, the number of the nodules were decreased more remarkably than the above treatments. New nodules, when 90% of the shoot was cut, were reformed slowly and did not grow fully until 15 days after cutting.

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A study on biological treatment of abandoned acidic mine drainage using sewage sludge and papermill sludge as carbon sources (하수슬러지와 제지슬러지를 탄소원으로 이용한 폐탄광페수의 생물학적 처리에 관한 연구)

  • 김은호;장성호
    • Journal of Korea Soil Environment Society
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    • v.4 no.2
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    • pp.63-75
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    • 1999
  • This study was performed to investigate applicabilities of sewage sludge and papermill sludge as carbon sources in biologically treating abandoned acidic mine drainage, and effects of limestone. In spite of ranging average 3.3 in influent pH, SRB(Sulfate Reducing Bacteria) was well grown. because effluent pH was maintained by alkalinity a little under for whole stages. TCODcr was high in effluent with washing out in early stage. but its concentration was low with passed time and did not cause the problem of secondary pollution. Removal rate of Mn was remarkably low, but in case of heavy metals such as Fe, the fixation trends showed high as the volume of ${SO_4}^2$ reduction increased. In case of mixing sewage sludge and papermill sludge, when their mixing ratio were 1 : 1 and 2 : 1 respectively, rate of ${SO_4}^2$ reduction and removal rate of heavy metals were high. The mixing ratio 1 : 1 was considered as the most appropriate, because degradability of swewage sludge under short time was higher than that of papermill sludge. As a result of investigating efficiencies of limestone and biological treatment, biological treatment excelled limestone in neutralization and removal rate of heavy metals.

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Three-Dimensional Analysis of the Mesophyll Plastids Using Ultra High Voltage Electron Microscopy (초고압전자현미경에 의한 엽육세포 색소체 미세구조의 3차원적 분석)

  • Kim, In-Sun;Park, Sang-Chan;Han, Sung-Sik;Kim, Eun-Soo
    • Applied Microscopy
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    • v.36 no.3
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    • pp.217-226
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    • 2006
  • Image processing by ultra high voltage electron microscopy (UHVEM) and tomography has offered major contributions to research in the field of cellular ultrastructure. Furthermore, such advancements also have enabled the improved analysis of three-dimensional cellular structures in botany. In the present study. using UHVEM and tomography, we attempted to reconstruct the three-dimensional images of plastid inclusions that probably differentiate during photosynthesis. The foliar tissues were studied Primarily with the TEM and further examined with UHVEM. The spatial relationship between tubular elements and the thylakoidal membrane and/or starch grains within plastids mainly have been investigated in CAM-performing Sedum as well as in $C_4$ Salsola species. The inclusion bodies were found to occur only in early development in the former, while they were found only in mesophyll cells in the latter. The specimens were tilted every two degrees to obtain two-dimensional images with UHVEM and subsequently comparison has been made between the two types. Digital image processing was performed on the elements of the inclusion body using tilting, tomography, and IMOD program to generate and reconstruct three-dimensional images on the cellular level. In Sedum plastids, the inclusion bodies consisted of tubular elements exhibiting about 20 nm distance between elements. However, in Salsola, plastid inclusion bodies demonstrated quite different element structure, displaying pattern, and origin relative to those of the Sedum. The inclusion bodies had an integrative relationship with the starch grains in both species.

Operative Treatment of Terrible Triad in Elbow of Adults (성인 주관절의 요골두와 구상돌기 골절을 동반한 탈구의 수술 적 치료 (성인 주관절에 발생한 위험3증주의 수술적 치료))

  • Kim, Byung-Heum;Park, Jong-Seok;Choi, Ho-Rim;Lee, Sang-Sun;Rah, Soo-Kyun;Lee, Hyun-Wook
    • Clinics in Shoulder and Elbow
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    • v.9 no.1
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    • pp.50-59
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    • 2006
  • Purpose: The nonoperative outcome of elbow dislocations with associated radial head and coronoid fractures are often unsatisfactory because of chronic instability and stiffness from proloned immobilization, Therefore we managed these injuries with well programed surgical appproaches. Method: Ten patients with this injury were evaluated retrospectively from May 1998 to June 2004 after a minimum of 12 months. These injuries include elbow dislocation and associated fractures of both the radial head and the coronoid process. All ten patients were treated by one clinic operatively with similar scheduled surgical methods which started on the lateral side and terminated on the medial side of the elbow. Radial head and neck fractures were classified Mason types, as two and three types respectively with six and four cases and six cases were fixated. Coronoid process were fixated with screws anteroposterior directly or anchor suture in all cases, each type was classified one, two and three. where were three type one, four type two, and three type three were according to Regan and Morrey classification. Results: The outcome was three resulting in excellent, four good, two normaland and the remaining case was one poor according to the Mayo Elbow Performance score. At a terminal follow up, the range of motion of the elbow averaged flection contracture, $6^{\circ}(0{\sim}20^{\circ})$ and further flection, $129^{\circ}(115{\sim}140^{\circ})$. Two patients had complications requiring additional care. One, displaced coronoid process which was repaired with capsule and the other patient experienced, palsy of ulnar nerve and contracted elbow joint. Conclusions: Usage of early operation as the minimum injury of medial ligaments complex and the rigid fixation of fractures to prompt motion with our scheduled management for elbow dislocations with associated radial head and coracoid fractures provided excellent results.

An Ultrastructural Study on the Epithelial Cells of the Rabbit Gallbladder after Common Bile Duct Ligation (총담관 결찰후 집토끼 담낭상피세포의 미세구조적 변화)

  • Yim, Soo-Jae;Yang, Nam-Gil;Ahn, E-Tay;Ko, Jeong-Sik;Park, Kyung-Ho;Kim, Jin-Gook
    • Applied Microscopy
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    • v.22 no.2
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    • pp.15-29
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    • 1992
  • The gallbladder is known to have the function of the storage and the concentration of the bile produced by the liver. This function is carried out by the removal of water and inorganic electrolytes. Extrahepatic cholestasis or the impairment of excretion of the bile leads to the distension and loss of the function of the gallbladder. The purpose of this study was to examine the ultrastructural characteristics of the normal gallbladder epithelial cells, and their structural changes induced by the ligation of common bile duct of the rabbit. Common bile duct ligation was performed under ether anesthesia. The rabbits were sacrificed on the 1st, 3rd, 5th, 7th and 14th day, respectively after operations. The tissue blocks of the gallbladder were fixed in 2.5% glutaraldehyde-1.5% paraformaldehyde prior to fixation in 1% osmium tetroxide, and embedded in the araldite mixture, and observed with JEM 100 CX-II electron microscope. The results were as follows: 1. The normal gallbladder epithelium of adult rabbit demonstrated two cell types, the ordinary epthelial cell and the dark cell. The dark cells have electron dense cytoplasm, and were found much infrequently, whereas ordinary epthelial cells were found quite numerous. 2. The ordinary epthelial cells of normal gallbladder were provided with the regular microvilli at the free surface and the images of pinocytotic activities in the apical cytoplasm, and exhibit highly convoluted lateral surfaces with elaborated microfolds. These figures of the cells suggest that they are resorptive in functional activity. 3. In the early stages (1st, 3rd, 5th day groups) following the ligation, the apical cytoplasm of some cells is protruding from the free surface and lost their microvilli. Numerous mucous granules filled in the apical and supranuclear cytoplasm compactly. 4. In the late stages (7th, 14th day groups) following the ligation, many light cells containing mumerous mucous granules are seen, between the ordinary epthelial cells. Mucous granules are fused each other, and are discharged into the lumen from the apical cytoplasm. The lateral membranes are straight or undulating without any interdigitations. From the above results, it was concluded that in the cholestasis induced by the common bile duct ligation, there is a tendency for the mucosal epithelium of the rabbit gallbladder to have secretory rather than an absorptive function.

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