• Title/Summary/Keyword: Fracture Recovery

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Determination of Total CO2 and Total Alkalinity of Seawater Based on Thermodynamic Carbonate Chemistry (해수중의 총이산화탄소와 총알칼리도 분석을 위한 탄산염 화학 이론 및 측정방법)

  • Mo, Ahra;Son, Juwon;Park, Yongchul
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.18 no.1
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    • pp.1-8
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    • 2015
  • To evaluate accuracy and precision of determination of total alkalinity ($Alk_T$) and carbon dioxide ($TCO_2$) derived from present study, experiment was applied with $CO_2$ CRM (Batch 132, Scripps Institution of Oceanography; $Alk_T=2229.24{\pm}0.39{\mu}mol/kg$, $TCO_2=2032.65{\pm}0.45{\mu}mol/kg$). As the result, average concentration of $Alk_T$ and $TCO_2$ was $2354.09{\mu}mol/kg$ (~5.6% difference with $CO_2$ CRM) and $2089.60{\mu}mol/kg$ (~2.3% difference with $CO_2$ CRM), respectively. For previous method (Gran Titration) by addition $NaHCO_3$ to deionized water($Alk_T$ $2023.33{\mu}mol/kg$), average concentration was $2193.39{\mu}mol/kg$ (sd=57.15, n=7). Whereas, average concentration was $2017.02{\mu}mol/kg$ (sd=10.98, n=7) for the present study. Recovery yield experiments of total alkalinity in deionized water and seawater were implemented by addition of $NaHCO_3$. The recovery yield of deionized water in the range 0 to $4952.39{\mu}mol/kg$ was 100.8% ($R^2$=0.999), and seawater in the range 0 to $2041.32{\mu}mol/kg$ was 102.3% ($R^2$=0.999). Comparison of $pCO_2$ sensor (PSI $CO_2-Pro^{TM}$) with present method showed very meaningful correlation coefficient ($R^2$=0.977) in the range of 427 to $705{\mu}atm$ and 9.16 to $15.24{\mu}mol/kg$ throught elapsed time for two weeks. Field experiment of diurnal variation of total carbon dioxide was accomplished at Sachon harbor in the coastal waters of East Sea of Korea. Concentration of $Alk_T$ and $TCO_2$ was increased during night, and decreased during daylight hours. The results showed mirror type between $TCO_2$ and dissolved oxygen, which was attributable to photosynthesis and respiration of phytoplankton. Also, open ocean field study was performed to obtain vertical profile of $Alk_T$ and $TCO_2$ in C-C zone (Clarion-Clipperton Fracture Zone), Northeastern Pacific. Average concentrations of $Alk_T$ in the surface mixed layer (0~60 m) and deeper layer below 200 m were $2422.38{\mu}mol/kg$ (sd=78.73, n=20) and $2465.87{\mu}mol/kg$ (sd=57.68, n=103), respectively. And average concentrations of $TCO_2$ were $2134.47{\mu}mol/kg$ (sd=65.4, n=20) and $2431.87{\mu}mol/kg$ (sd=65.02, n=103) in the same depth ranges such as $Alk_T$. Vertical distributions of $Alk_T$ and $TCO_2$ concentrations tended to increase with depth, and analyzed concentrations showed slightly higher than those of previous studies in this area.

Comparison of the Outcomes after Primary Total Hip Arthroplasty Using a Short Stem between the Modified Anterolateral Approach and Direct Anterior Approach with a Standard Operation Table (일반 수술 침대와 짧은 대퇴 주대를 이용한 인공 고관절 전 치환술의 직접 전방 도달법과 변형된 전 측방 도달법에 따른 결과 비교)

  • Park, Myung-Sik;Yoon, Sun-Jung;Choi, Seung-Min;Cho, Hong-Man;Chung, Woochull;Kang, Kyung-Rok
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.3
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    • pp.244-253
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    • 2019
  • Purpose: Total hip arthroplasty was performed using a direct anterior approach (DAA) on an ordinary operation table and a short femoral stem. The clinical radiographic results were evaluated by a comparison with those performed using the modified hardinge (anterolateral approach, ALA) method. Materials and Methods: From January 2013 to November 2015, 102 patients who underwent total hip arthroplasty using DAA (DAA group) and the same number of patients using ALA (ALA group), both performed by a single surgeon, were compared and analyzed retrospectively. The operation time and amounts of bleeding were compared, and the improvement in post-operative pain, ambulatory capacity and functional recovery of the hip joint were checked. The location of insertion of the acetabular cup and femoral stem were evaluated radiologically, and the complications that occurred in the two groups were investigated. Results: The amount of bleeding was significantly smaller in the DAA group (p=0.018). Up to 3 weeks postoperatively, recovery of hip muscle strength was significantly higher in the DAA group (flexion/extension strength p=0.023, abduction strength p=0.031). The Harris hip score was significantly better in the DAA group for up to 3 months (p<0.001) and the Koval score showed significantly better results in the DAA group up to 6 weeks (p≤0.001). The visual analogue scale score improvement was significantly higher in the DAA group by day 7 (p=0.035). The inclination angle (p<0.001) and anteversion angle (p<0.001) of the acetabular cup were located in the safe zone of the DAA group more than in the ALA group, and there was no statistically significant difference in the position of the femur stem and leg length difference. During surgery, two cases of greater trochanter fracture occurred in the DAA group (p=0.155). Conclusion: The DAA performed in the ordinary operation table using a short femoral stem showed post-operative early functional recovery. Because a simple to use fluoroscope was used during surgery with an anatomical position familiar to the surgeon, it is considered to be useful for the insertion of implants into the desired position and for an approach that is useful for the prevention of leg length differences.

Anatomic Double-Bundle Posterior Cruciate Ligament Reconstruction Using Achilles Allograft - Preliminary Report - (이중고리 동종 아킬레스건을 이용한 후방십자인대 재건 - 예비 보고 -)

  • Lim, Hong-Chul;Yoo, Jae-Chul;Han, Sang-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.7-13
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    • 2002
  • Purpose : Preliminary report of the technique and trial of double bundle PCL reconstruction using Achilles allograft. Materials and Methods : From May 1999 to July 2000, 8 cases of PCL insufficient patients were treated with Achilles allograft reconstruction using the double bundle and double femoral tunnel technique. The tibial tunnel was prepared anteromedially. All other combined injuries within the knees were treated accordingly. Minimal follow-up period was 1 year. The results was assessed from the point of function and stability using Lysholm knee score and KT-2000 arthrometer. Results : Up to present follow up. 8 patients showed good sign of recovery with no instability (translation less than 2 mm) except olio that has been grafted-ligament rupture. In addition, none showed any sign of infection nor ROM limitation. Two complications were seen, which one had grafted-bone fracture and the other grafted-ligament rupture. The former occurred during operation and the latter occurred due to improper protection. Conclusion : Presently the follow up period is too short to draw any conclusive opinion but it is essential to select healthy and well sterilized allografts fur successful outcome. Double femoral tunnel technique seems to be more physiologic in PCL reconstruction. With these prerequisites, it seems to be a good alternative to use Achilles allografts fur the reconstruction of PCL. However, a longer follow-up is needed.

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Facial Nerve Decompression for Facial Nerve Palsy with Temporal Bone Fracture: Analysis of 25 Cases (측두골 골절후 발생한 안면마비 환자의 안면신경감압술: 25명 환자들의 증례분석)

  • Nam, Han Ga Wi;Hwang, Hyung Sik;Moon, Seung-Myung;Shin, Il Young;Sheen, Seung Hun;Jeong, Je Hoon
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.131-138
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    • 2013
  • Purpose: The aim of this study is to present a retrospective review of patients who had a sudden onset of facial palsy after trauma and who underwent facial nerve decompression. Methods: The cases of 25 patients who had traumatic facial palsy were reviewed. Facial nerve function was graded according to the House-Brackmann grading scale. According to facial nerve decompression, patients were categorized into the surgical (decompression) group, with 7 patients in the early decompression subgroup and 2 patients in the late decompression subgroup, and the conservative group(16 patients). Results: The facial nerve decompression group included 8 males and 1 female, aged 2 to 86 years old, with a mean age of 40.8. In early facial nerve decompression subgroup, facial palsy was H-B grade I to III in 6 cases (66.7%); H-B grade IV was observed in 1 case(11.1%). In late facial nerve decompression subgroup, 1 patient (11.1%) had no improvement, and the other patient(11.1%) improved to H-B grade III from H-B grade V. A comparison of patients who underwent surgery within 2 weeks to those who underwent surgery 2 weeks later did not show any significant difference in improvement of H-B grades (p>0.05). The conservative management group included 15 males and 1 female, aged 6 to 66 years old, with a mean age of 36. At the last follow up, 15 patients showed H-B grades of I to III(93.7%), and only 1 patient had an H-B grade of IV(6.3%). Conclusion: Generally, we assume that early facial nerve decompression can lead to some recovery from traumatic facial palsy, but a prospective controlled study should and will be prepared to compare of conservative treatment to late decompression.

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.

Application of Ordinary Kriging Interpolation Method for p-Adaptive Finite Element Analysis of 2-D Cracked Plates (2차원 균열판의 p-적응적 유한요소해석을 위한 정규크리깅 보간법의 적용)

  • Woo, Kwang-Sung;Jo, Jun-Hyung;Park, Mi-Young
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.19 no.4 s.74
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    • pp.429-440
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    • 2006
  • This paper comprises two specific objectives. The first is to examine the applicability of ordinary kriging interpolation(OK) to the p-adaptivity of the finite element method that is based on variogram modeling. The second objective Is to present the adaptive procedure by the hierarchical p-refinement in conjunction with a posteriori error estimator using the modified S.P.R. (superconvergent patch recovery) method. The ordinary kriging method that is one of weighted interpolation techniques is applied to obtain the estimated exact solution from the stress data at the Gauss points. The weight factor is determined by experimental and theoretical variograms for interpolation of stress data apart from the conventional interpolation methods that use an equal weight factor. In the p-refinement, the analytical domain has to be refined automatically to obtain an acceptable level of accuracy by increasing the p-level non-uniformly or selectively. To verify the performance of the modified S.P.R. method, the new error estimator based on limit value has been proposed. The validity of the proposed approach has been tested with the help of some benchmark problems of linear elastic fracture mechanics such as a centrally cracked panel, a single edged crack, and a double edged crack.

Effects on postoperative nausea and vomiting of nefopam versus fentanyl following bimaxillary orthognathic surgery: a prospective double-blind randomized controlled trial

  • Choi, Eunhye;Karm, Myong-Hwan;So, Eunsun;Choi, Yoon Ji;Park, Sookyung;Oh, Yul;Yun, Hye Joo;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.19 no.1
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    • pp.55-66
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    • 2019
  • Background: Postoperative nausea and vomiting (PONV) frequently occurs following bimaxillary orthognathic surgeries. Compared to opioids, Nefopam is associated with lower incidences of PONV, and does not induce gastrointestinal tract injury, coagulopathy, nephrotoxicity, or fracture healing dysfunction, which are common side effects of Nonsteroidal anti-inflammatory drugs. We compared nefopam- and fentanyl-induced incidence of PONV in patients with access to patient-controlled analgesia (PCA) following bimaxillary orthognathic surgeries. Methods: Patients undergoing bimaxillary orthognathic surgeries were randomly divided into nefopam and fentanyl groups. Nefopam 120 mg or fentanyl $700{\mu}g$ was mixed with normal saline to a final volume of 120 mL. Patients were given access to nefopam or fentanyl via PCA. Postoperative pain intensity and PONV were measured at 30 minutes and 1 hour after surgery in the recovery room and at 8, 24, 48, and 72 hours after surgery in the ward. The frequency of bolus delivery was compared at each time point. Results: Eighty-nine patients were enrolled in this study, with 48 in the nefopam (N) group and 41 in the fentanyl (F) group. PONV occurred in 13 patients (27.7%) in the N group and 7 patients (17.1%) in the F group at 8 hours post-surgery (P = 0.568), and there were no significant differences between the two groups at any of the time points. VAS scores were $4.4{\pm}2.0$ and $3.7{\pm}1.9$ in the N and F groups, respectively, at 8 hours after surgery (P = 0.122), and cumulative bolus delivery was $10.7{\pm}13.7$ and $8.6{\pm}8.5$, respectively (P = 0.408). There were no significant differences in pain or bolus delivery at any of the remaining time points. Conclusion: Patients who underwent bimaxillary orthognathic surgery and were given nefopam via PCA did not experience a lower rate of PONV compared to those that received fentanyl via PCA. Furthermore, nefopam and fentanyl did not provide significantly different postoperative pain control.

Double Tension Band Osteosynthesis in Intra-articular Fractures of the Distal Humerus (AO type C) in Elderly Osteoporotic Patients (고령 환자의 상완골 원위부 AO-C형 골절에서 이중 강선 장력대 고정술)

  • Cheon, Sang Jin;Lee, Dong Ho;Goh, Tae Sik
    • Clinics in Shoulder and Elbow
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    • v.16 no.1
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    • pp.33-39
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    • 2013
  • Purpose: The aim of this study is to evaluate the clinical result of intra-articular fractures of the distal humerus (AO type C) in elderly osteoporotic patients treated with double tension band osteosynthesis. Materials and Methods: From January 2006 to December 2010, 10 elderly osteoporotic patients(1 male, 9 females) with intra-articular fractures of the distal humerus (AO type C) were treated with double tension band osteosynthesis. The mean age of patients at the time of surgery was 74.6(66~84) years and the mean follow-up period was 39.2(20~74) months. The fracture union and complications were assessed and the functional result was evaluated by the rating system of Jupiter et al. and the Mayo elbow performance index. Results: Bone union was achieved in all patients with no secondary displacement. The mean time for union was 16.6(13~22) weeks. The average postoperative arc of elbow flexion was 119(100~140) degrees with a mean flexion contracture of 8.5(0~15) degrees. The recovery in two patients was rated as excellent, in 7 as good, and in 1 as fair in terms of the Mayo elbow performance index with average value of 82(70~90) points. Seven patients were rated as excellent, 1 as good, and 2 as fair in terms of the rating system of Jupiter et al. Changing tension band wiring was performed in one patient as skin irritation was noticed due to tension band knots. Heterotopic ossification developed in one patient but had no symptom. Conclusion: Double tension band osteosynthesis in intra-articular fractures of distal humerus (AO type C) in elderly osteoporotic patients can provide sufficient and secure stability to allow early rehabilitation.

The biologic effects of safflower(Carthamus tinctorius $Linn\acute{e}$) extract and Dipsasi Radix extract on periodontal ligament cells and osteoblastic cells (홍화 추출물이 치주인대세포, 조골세포 활성도에 미치는 영향)

  • Rhyu, In-Chul;Lee, Yong-Moo;Ku, Young;Bae, Ki-Whan;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.27 no.4
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    • pp.867-882
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    • 1997
  • Safflower(Carthamus tinctorius $Linn\acute{e}$ has been traditionally used for the treatment of blood stasis, and Dipsasi Radix has been used as a drug for fracture in Chinese medicine. The purpose of present study was to examine the biologic effects of safflower extract and Disasi radix extracts on the periodontal. ligament cells and osteoblastic cells and on the wound healing of rat calvarial defect. The ethanolic extract of safflower blossom, safflower seed and Dipsasi Radix(125, 250, and 500 ${\mu}g/ml$) were prepared as test group, and PDGF-BB(lOng/ml) and unsafonifiable fraction of Zea Mays L.(125, 250, and 500 ${\mu}g/ml$) were employed as positive control. The effects of each agents on the growth and survival, ALPase activity, expression of PDGF-BB receptor, chemotactic response of PDL cell and ATCC human osteosarcoma MG63 cells in vitro were examined. The tissue regenerative effect of each extracts was evaluated by histomorphometric measuring of newly formed bone on the 8mm defect in rat calvaria after oral administration of 3 different dosages groups : 0.02, 0.1 and 0.35g/kg, per day. It was also employed the same dosages of unsaponifiable fraction of Zea Mays L. as positive controls. Safflower blossom extract, safflower seed extract, and Dipsasi Radix extract stimulate the cellular activity of MG63 cells in concentration range of $125-500{\mu}g/ml$, and safflower bolssom extract and safflower seed extract stimulate also the cellular activity of periodontal ligament cells in concentration range of $250-500{\mu}g/ml$. In activity of ALPase, $250-500{\mu}g/ml$ of safflower blossom extracts showed significant stimulating effects on MG63 cells, and the same concentration range of safflower seed extracts showed significant effect on periodontal ligament cells. In the recovery on PDGF-BB receptor expression which was depressed by $IL-1{\beta}$, $125-250{\mu}g/ml$ of safflower blossom extracts and $250-500{\mu}g/ml$ of safflower seed extracts showed significant increasing effect on MG63 cells, and $500{\mu}g/ml$ of safflower blossom extract and $250-500{\mu}g/ml$ of safflower seed extracts showed significant effect on periodontal ligament cells. In chemotactic response, among all tested group, safflower seed extracts only were chemotactic to MG63 cells and periodontal ligament cells in concentration range of $125-500{\mu}g/ml$. Also in the view of bone regeneration in rat calvarial defect model, the only group that was orally administrated 0.35g/kg, day of safflower seed extract showed significant new bone formation. These results suggested that safflower extracts might have a potential possibilities as an useful drug for adjunct to treatment for regeneration of periodontal defect.

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Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures (Sanders 4형 종골 골절에 대한 관혈적 정복술 및 내고정술과 일차성 거골하 관절 유합술의 치료 결과 비교)

  • Woo, Seung Hun;Chung, Hyung-Jin;Bae, Su-Young;Kim, Sun-Kyu
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.49-58
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    • 2017
  • Purpose: To compare clinical outcome of Sanders type IV intra-articular calcaneal fracture treated with open reduction and internal fixation (ORIF) versus ORIF and primary subtalar arthrodesis (PSTA). Materials and Methods: Between March 2003 and November 2013, 22 patients with 22 Sanders type 4 intra-articular calcaneal fractures were included in this study. Of these, 11 were treated with ORIF (ORIF group), and 11 were treated with ORIF and PSTA (PSTA group). The mean follow-up period was 34.6 months (range, 18-72 months). Clinical outcomes were assessed along with the American Orthopedic Foot and Ankle Society's ankle-hindfoot scale (AOFAS score), and the visual analogue scale pain score (VAS score) at 6-month, 12-month, and last follow-up. Patient satisfaction, return to previous occupation and postoperative complications were also investigated. Results: The results for ORIF did not differ from those for PSTA based on the last follow-up AOFAS scores or the VAS scores (p>0.05). However, patient satisfaction was significantly higher in the PSTA group (p=0.008). Secondary subtalar arthrodesis was conducted in five patients (45.5%) of the ORIF group within 2 years postoperatively. Conclusion: We were unable to demonstrate a significant difference in clinical outcomes between ORIF and PSTA; however, the patient satisfaction was higher in the PSTA group. PSTA may be a suitable choice for patients who need fast recovery to daily activity and to prevent the need for secondary subtalar arthrodesis.