• Title/Summary/Keyword: Failure of fixation

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유아의 감각양식간 전이 - 촉각에서 시각으로의 전이 - (Cross modal Transfer in Infancy : Transfer from Touch to Vision)

  • 홍희영
    • 아동학회지
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    • 제7권1호
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    • pp.67-84
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    • 1986
  • The purpose of the present research was to investigate cross-modal transfer, especially tactual-to-visual transfer in infancy and to study the relation between failure of cross-modal transfer performance and length of familiarization period. The subjects of this study were 60 infants, 10 boys and 10 girls at each level: six, nine, and twelve months of age. All were normal, healthy, full-term babies. The mothers' educational achievement was controlled at more than 12 years of schooling. There were two separate experimental conditions, one 30-sec and one 60-sec familiarization period. Each experimental condition consisted of a tactual familiarization and a visual recognition memory test. Each child was presented with these 2 sets of cross-modal stimuli in one of the 2 experimental conditions. Infants' visual responses in the visual recognition memory test were videotaped for 20 seconds. Visual fixation time to novel and familiar stimuli was observed throughout the test. The data was analyzed with t-test, percentage of total fixation time to novel stimuli, and ANOVA. The results showed that: 1) Significant differences were found in the cross-modal transfer performance from touch to vision between the 3 age groups. This is, 6 and 9 month old infants didn't show cross-modal transfer in the 30-sec condition, but 12 month old infants did show cross-modal transfer in the 30-second. 2) In all 3 age groups, no significant differences were found in cross-modal transfer performance between the two conditions.

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Mg(OH)2 혼입 시멘트 페이스트의 탄산화 저항성에 관한 실험적 연구 (An experimental study on carbonation resistance of Mg(OH)2 mixed cement paste)

  • 진정심;이윤수;이한승
    • 한국건축시공학회:학술대회논문집
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    • 한국건축시공학회 2017년도 춘계 학술논문 발표대회
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    • pp.165-166
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    • 2017
  • Corrosion of reinforcement is the main factors affecting the durability of reinforced concrete in the world which lead to the failure of structures of reinforced concrete buildings. In this research, mixed brucite(Mg(OH)2) into ordinary portland cement paste in ratio of 5, 10 and 15% as a kind of CO2 fixation material. Samples were exposed to an accelerated carbonation enslavement of 20% CO2 concentration, 60% relative humidity, and a temperature of 20℃ until tested at 3d, 7d, 14d and 28d. After 28d CO2 accelerated curing, in the paste containing MH megnesian calcite was found by XRD and SEM-EDX. Meanwhile, paste containing Mg(OH)2 exhibit the better pore distribution than ordinary portland cement paste and relatively good compressive strength.

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Judet's strut를 사용한 늑골 고정술의 임상적 고찰 (Clinical Ewperiences of Rib Fixation Using Judet's Strut)

  • 김재련;임진수
    • Journal of Chest Surgery
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    • 제28권9호
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    • pp.847-850
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    • 1995
  • For the purpose of evaluation of clinical characteristics in multiple rib fracture due to accident , 24 cases treated by surgical rib fixation using Judet`s strut for multiple rib fracture and flail chestduring the period from June 1993 to October 1994 were reviewed. There were 17 males and 7 females.They ranged in age from 19 years old to 56 years old. The causes of rib fracture were traffic accident in 18 cases, fall down in 3 cases, compression in 2 cases stab wound in 1 case. The number of rib fracture were five in 7 cases, six in 5 cases, four in 5 cases, three in 3 cases. Associated intrathoracic injuries were hemopneumothorax in 12 cases, hemothorax in 10 cases, lung laceration or hemorrhagic contusion in 7 cases. Associated extrathoracic injuries were abdominal injuries in 21 cases, orthopedic problem in 7 cases, head trauma in 4 cases. The most common fractured site was posterolateral portion of the ribs. The causes for operation were flail chest, severe rib displacement and pain, hemothorax or hemopneumothorax with continuous air leakage and stab wound. There were 6 postoperative complications ; one with hydrothorax, two with fibrothorax, two with wound infection and one case of death due to multiful organ failure. Postoperatively, all patients became comfortable and complained less painful. Twenty patients restored spontaneous breathing without ventilator support, three patients were ventilated during a day and one patient expired after 2 days. There were no morbidity and mortality related to operation.

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Titanium Plate Fixation for Sternal Dehiscence in Major Cardiac Surgery

  • Kim, Wan Kee;Kim, Joon Bum;Kim, Gwan Sic;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • 제46권4호
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    • pp.279-284
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    • 2013
  • Background: Sternal dehiscence is one of the most troublesome complications following cardiac surgery. Treatment failure and consequent lethal outcomes are very common. The aim of this study was to evaluate titanium plate fixation as a treatment for sternal dehiscence following major cardiac surgery. Materials and Methods: Between 2010 and 2012, 17 patients underwent sternal reconstruction using horizontal titanium plating for the treatment of post-cardiac-surgery sternal dehiscence. The plates were cut and shaped, and then were fixed to corresponding costal segments using 2-3 titanium screws per each side. Results: The median age of our patients was 66 years (range, 50 to 78 years) and 9 were female. Indications for sternal reconstruction included aseptic sternal dehiscence in 3 patients and osteomyelitis in 14 patients including 6 patients who were diagnosed with mediastinitis. During the operation, sternal resection and autologous flap interposition were combined in 11 patients. One patient died due to sepsis. Two patients required additional soft tissue wound revisions. Another patient presented with a tuberculous wound infection which was resolved using anti-tuberculosis medications. The postoperative course was uncomplicated in the other 13 patients. Conclusion: Titanium plate fixation that combines appropriate debridement and flap interposition is very effective for the treatment of sternal dehiscence following major cardiac surgery.

Predictive Factors for a Kyphosis Recurrence Following Short-Segment Pedicle Screw Fixation Including Fractured Vertebral Body in Unstable Thoracolumbar Burst Fractures

  • Kim, Gun-Woo;Jang, Jae-Won;Hur, Hyuk;Lee, Jung-Kil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • 제56권3호
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    • pp.230-236
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    • 2014
  • Objective : The technique of short segment pedicle screw fixation (SSPSF) has been widely used for stabilization in thoracolumbar burst fractures (TLBFs), but some studies reported high rate of kyphosis recurrence or hardware failure. This study was to evaluate the results of SSPSF including fractured level and to find the risk factors concerned with the kyphosis recurrence in TLBFs. Methods : This study included 42 patients, including 25 males and 17 females, who underwent SSPSF for stabilization of TLBFs between January 2003 and December 2010. For radiologic assessments, Cobb angle (CA), vertebral wedge angle (VWA), vertebral body compression ratio (VBCR), and difference between VWA and Cobb angle (DbVC) were measured. The relationships between kyphosis recurrence and radiologic parameters or demographic features were investigated. Frankel classification and low back outcome score (LBOS) were used for assessment of clinical outcomes. Results : The mean follow-up period was 38.6 months. CA, VWA, and VBCR were improved after SSPSF, and these parameters were well maintained at the final follow-up with minimal degree of correction loss. Kyphosis recurrence showed a significant increase in patients with Denis burst type A, load-sharing classification (LSC) score >6 or DbVC >6 (p<0.05). There were no patients who worsened to clinical outcome, and there was no significant correlation between kyphosis recurrence and clinical outcome in this series. Conclusion : SSPSF including the fractured vertebra is an effective surgical method for restoration and maintenance of vertebral column stability in TLBFs. However, kyphosis recurrence was significantly associated with Denis burst type A fracture, LSC score >6, or DbVC >6.

Short-segment Pedicle Instrumentation of Thoracolumbar Burst-compression Fractures; Short Term Follow-up Results

  • Shin, Tae-Sob;Kim, Hyun-Woo;Park, Keung-Suk;Kim, Jae-Myung;Jung, Chul-Ku
    • Journal of Korean Neurosurgical Society
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    • 제42권4호
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    • pp.265-270
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    • 2007
  • Objective : The current literature implies that the use of short-segment pedicle screw fixation for spinal fractures is dangerous and inappropriate because of its high failure rate, but favorable results have been reported. The purpose of this study is to report the short term results of thoracolumbar burst and compression fractures treated with short-segment pedicle instrumentation. Methods : A retrospective review of all surgically managed thoracolumbar fractures during six years were performed. The 19 surgically managed patients were instrumented by the short-segment technique. Patients' charts, operation notes, preoperative and postoperative radiographs (sagittal index, sagittal plane kyphosis, anterior body compression, vertebral kyphosis, regional kyphosis), computed tomography scans, neurological findings (Frankel functional classification), and follow-up records up to 12-month follow-up were reviewed. Results : No patients showed an increase in neurological deficit. A statistically significant difference existed between the patients preoperative, postoperative and follow-up sagittal index, sagittal plane kyphosis, anterior body compression, vertebral kyphosis and regional kyphosis. One screw pullout resulted in kyphotic angulation, one screw was misplaced and one patient suffered angulation of the proximal segment on follow-up, but these findings were not related to the radiographic findings. Significant bending of screws or hardware breakage were not encountered. Conclusion : Although long term follow-up evaluation needs to verified, the short term follow-up results suggest a favorable outcome for short-segment instrumentation. When applied to patients with isolated spinal fractures who were cooperative with 3-4 months of spinal bracing, short-segment pedicle screw fixation using the posterior approach seems to provide satisfactory result.

도관 나사못을 이용한 경골 과간 융기 골절의 관절경적 견인 봉합술 (Arthroscopic Pull-out Wire Fixation Using Cannulated Screw of Tibial Eminence Fractures)

  • 김종민;김형규;박병문;송경섭;정성훈;노행기;윤종주
    • 대한관절경학회지
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    • 제13권3호
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    • pp.254-258
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    • 2009
  • 경골 과간 융기부 골절은 슬관절의 뒤틀림, 과도한 굴곡 및 신전, 내반 및 외반 손상으로 인한 견열 골절의 형태로 발생을 하며 정확한 해부학적 정복이 이루어지지 않을 경우 슬관절의 불안정성과 관절 운동 제한을 초래할 수 있다. 최근 관절경을 이용한 정복과 다양한 고정 방법이 시행되고 있으며, 저자들은 이 중 견인 봉합술을 시행함에 있어서 도관 나사못을 이용한 터널을 만들어 기존에 시행되어지던 술기에 비해 보다 쉽고 편리하게 내고정을 얻을 수 있었으며, 이에 수술방법의 소개와 증례를 보고하고자 한다.

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Targeting a Safe Entry Point for C2 Pedicle Screw Fixation in Patients with Atlantoaxial Instability

  • Chun, Hyoung-Joon;Bak, Koang-Hum
    • Journal of Korean Neurosurgical Society
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    • 제49권6호
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    • pp.351-354
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    • 2011
  • Objective : This investigation was conducted to evaluate a new, safe entry point for the C2 pedicle screw, determined using the anatomical landmarks of the C2 lateral mass, the lamina, and the isthmus of the pars interarticularis. Methods : Fifteen patients underwent bilateral C1 lateral mass-C2 pedicle screw fixation, combined with posterior wiring. The C2 pedicle screw was inserted at the entry point determined using the following method : 4 mm lateral to and 4 mm inferior to the transitional point (from the superior end line of the lamina to the isthmus of the pars interarticularis). After a small hole was made with a high-speed drill, the taper was inserted with a 30 degree convergence in the cephalad direction. Other surgical procedures were performed according to Harm's description. Preoperatively, careful evaluation was performed with a cervical X-ray for C1-C2 alignment, magnetic resonance imaging for spinal cord and ligamentous structures, and a contrast-enhanced 3-dimensional computed tomogram (3-D CT) for bony anatomy and the course of the vertebral artery. A 3-D CT was checked postoperatively to evaluate screw placement Results : Bone fusion was achieved in all 15 patients (100%) without screw violation into the spinal canal, vertebral artery injury, or hardware failure. Occipital neuralgia developed in one patient, but this subsided after a C2 ganglion block. Conclusion : C2 transpedicular screw fixation can be easily and safely performed using the entry point of the present study. However, careful preoperative radiographic evaluation, regardless of methods, is mandatory.

Aseptic Humeral Nonunion: What Went Wrong? What to Do? A Retrospective Analysis of 20 Cases

  • Kim, Jinil;Cho, Jae-Woo;Cho, Won-Tae;Cho, Jun-Min;Kim, Namryeol;Kim, Hak Jun;Oh, Jong-Keon;Kim, Jin-Kak
    • Journal of Trauma and Injury
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    • 제29권4호
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    • pp.129-138
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    • 2016
  • Purpose: Due to recent advances in internal fixation techniques, instrumentation and orthopedic implants there is an increasing number of humeral shaft fracture treated operatively. As a consequence, an increased number nonunion after operative fixation are being referred to our center. The aim of this study is to report the common error during osteosynthesis that may have led to nonunion and present a systematic analytical approach for the management of aseptic humeral shaft nonunion. Methods: In between January 2007 to December 2013, 20 patients with humeral shaft nonunion after operative procedure were treated according to our treatment algorithm. We could analysis x-rays of 12 patients from initial treatment to nonunion. In a subgroup of 12 patients the initial operative procedure were analyzed to determine the error that may have caused nonunion. The following questions were used to examine the cases: 1) Was the fracture biology preserved during the procedure? 2) Does the implant construct have enough stability to allow fracture healing? Results: In 19 out of 20 patients have showed radiographic evidence of union on follow up. One patient has to undergo reoperation because of the technical error with bone graft placement but eventually healed. There were 2 cases wherein the treatment algorithm was not followed. All patients had problems with mechanical stability, and in 13 patients had biologic problems. In the analysis of the initial operative fixation, only one of 12 patients had biologic problems. Conclusion: In our analysis, the common preventable error made during operative fixation of humeral shaft fracture is failure to provide adequate stability for bony union to occur. And with these cases we have demonstrated a systematic analytic management approach that may be used to prevent surgeons from reproducing the same fault and reduce the need for bone grafting.

척추교정 티타늄 앵커나사 파단 손상원인 분석 (Failure Analysis of Ti alloy Screws in Fixing Fractured Spines)

  • 최병학;김문규;김승언;심윤임;이영진;정효태;최원열
    • 대한금속재료학회지
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    • 제49권12호
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    • pp.983-988
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    • 2011
  • Failure analyses of the screws in spinal fixation devices were carried out. The fractured screws were retrieved from a patient who had spinal surgery in the thoracic vertebrae from number 10 to 15. The failure occurred one month after the removal of the braces. Microstructures and fracture surfaces were examined by optical and scanning electron microscopy. The microstructures of the screws corresponded to annealed Ti-6Al-4V bar. However, in the vicinity of the screw surface, there was an insufficient number of fine precipitates. Fracture surfaces showed typical fatigue failure modes. Regarding the fact that no machining defects were detected, fatigue crack initiation might have been caused by the lack of precipitates near the screw surfaces. Only the fourth of five fixed screws was severely stress-concentrated by the action of the spinal bones, while the stress of the 4th screw was decreased to half of its acceptable level when the screw was supplemented by one more, which might have been fixed in the 6th vertebra under the 5th position by the switching of its position. The stress simulation was conducted by ANSYS with 3D CAD of PRO/E in order to understand the stress concentration behavior and to provide an effective spinal surgery guide.