• Journal of Trauma and Injury
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• 제37권2호
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• pp.114-123
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• 2024

Purpose: Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients. Methods: Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma. Results: In total, 1,038 patients were divided into two groups: those with complications (822 patients, 79.2%) and those with no complications (216 patients, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P<0.001). The proportion of head trauma patients was higher (58.3% vs. 24.6%, P<0.001) and the Glasgow Coma Scale score was worse (median [interquartile range], 12 [6.5-15] vs. 15 [14-15]; P<0.001) in the complications group. The number of rib fractures, the degree of rib fracture displacement, and the severity of pulmonary contusions were also higher in the complications group. In the area under the ROC curve analysis, the TTSS showed the highest predictive value for the entire group (0.731), head trauma group (0.715), and no head trauma group (0.730), while RibScore had the poorest performance (0.643, 0.622, and 0.622, respectively) Conclusions: Early injury severity detection and grading are crucial for patients with blunt chest trauma. The chest trauma scoring systems introduced to date, including the TTSS, are not acceptable for clinical use, especially in polytrauma patients with traumatic brain injury. Therefore, further revisions and analyses of chest trauma scoring systems are recommended.

• Hip & pelvis
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• 제34권1호
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• pp.10-17
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• 2022

Purpose: This study was conducted in order to assess changes in hip muscles by comparing results of preoperative and postoperative computed tomography (CT) in older patients who underwent surgery for treatment of hip fracture. Materials and Methods: A total of 50 patients (aged ≥65 years) who underwent surgery for treatment of intertrochanteric fractures (25 patients) and femoral neck fractures (25 patients) between February 2013 and February 2019 and underwent preoperative and postoperative pelvic CT were enrolled in the study. The cross-sectional area, attenuation and estimates of muscle mass of the gluteus medius, gluteus minimus, iliopsoas, and rectus femoris on the uninjured side were measured. Basic patient data (sex, age, height, weight, body mass index [BMI], bone mineral density [BMD], Harris hip score [HHS], and length of follow-up) were collected from medical records. Results: No significant differences in sex, age, height, weight, BMI, BMD, HHS, and length of follow-up were observed between the two groups. No significant difference in the cross-sectional areas and attenuations of gluteus medius and gluteus minimus was observed after surgery; however, a statistically significant decrease was observed in those of iliopsoas and rectus femoris after surgery. Lower estimates with statistical significance of muscle mass of the iliopsoas and rectus femoris were observed on postoperative CT. Conclusion: Muscle mass of the hip flexor (iliopsoas, rectus femoris) showed significant decreases on postoperative CT compared with preoperative CT. Based on these findings, selective strengthening exercise for hip flexor should be beneficial in rehabilitation of hip fractures.

• Geomechanics and Engineering
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• 제38권3호
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• pp.215-229
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• 2024

Because of the various patterns of deep-water inrush and complicated mechanisms, accurately predicting mine water inflows is always a difficult problem for coal mine geologists. In study presented in this paper, the water inrush channels were divided into four basic water diversion structures: aquifer, rock fracture zone, fracture zone and goaf. The fluid flow characteristics in each water-conducting structure were investigated by laboratory tests, and multistructure and multisystem coupling flow analysis models of different water-conducting structures were established to describe the entire water inrush process. Based on the research of the water inrush flow paths, the analysis model of different water inrush space structures was established and applied to the prediction of mine water inrush inflow. The results prove that the conduction sequence of different water-conducting structures and the changing rule of permeability caused by stress changes before and after the peak have important influences on the characteristics of mine water-gushing. Influenced by the differences in geological structure and combined with rock mass RQD and fault conductivity characteristics and other mine exploration data, the prediction of mine water inflow can be realized accurately. Taking the water transmitting path in the multistructure as the research object of water inrush, breaking through the limitation of traditional stratigraphic structure division, the prediction of water inflow and the estimation of potentially flooded area was realized, and water bursting intensity was predicted. It is of great significance in making reasonable emergency plans.

• 대한정형외과학회지
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• 제55권4호
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• pp.318-323
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• 2020

목적: 근감소증에 중요한 요소인 척추 주변 근육 감소를 수치화한 총 지방 침윤율(total fat infiltration rate, TFI rate)과 골다공증성 척추 압박 골절(osteoporotic vertebral compression fracture) 및 관련 수치와의 상관 관계를 찾는 것을 목표로 하였다. 대상 및 방법: 2012년 1월부터 2016년 12월까지 요추의 압박 골절 진료를 본 환자들 중 1) 골밀도(bone mineral density, BMD) T score -2.5 g/cm² 미만으로 골다공증을 진단받고, 2) 요추 골절로 경피적 척추성형술(vertebroplasty) 또는 경피적 풍선척추성형술(kyphoplasty)을 받았으며, 3) 요추의 한 분절만 골절된 4) 1년 이상 추시한 환자 98명을 대상으로 후향적 연구를 시행하였다. TFI는 Image J 프로그램으로 자기공명영상을 분석하여 확인하였다. 이를 바탕으로 다열근(multifidus) 및 척추기립근(erector spinae)의 TFI와 골다공증 요소들과의 연관성을 분석하였다. 결과: 다열근및 척추기립근의 평균 TFI는 14.66±10.16이었다. 척추 BMD는 고관절 BMD와 통계적으로 유의한 양의 상관 관계를 보였으나 TFI와 음의 상관 관계를 보였다. 고관절 BMD는 체질량지수(body mass index)와 유의한 양의 상관 관계를 보였다. 또한 비타민 D 수치는 척추 BMD와 고관절 BMD에서 모두 양의 상관 관계를 보였으나, TFI와는 음의 상관 관계를 보였다. 결론: 근육량은 근감소증 환자뿐만 아니라 골다공증 환자의 치료에 있어서도 도움이 되므로 주의깊게 보아야 할 것이다. 또한 비타민 D를 증가시키는 것은 근육 위축의 진행을 늦출 수 있으므로 이로써 골절을 예방하는 효과를 가져올 수 있다.

• 대한토목학회논문집
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• 제8권2호
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• pp.109-116
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• 1988

구조(構造)의 강도(强度)와 하중(荷重)은 시간(時間)이 경과함에 따라 변하며 확률과정(確率過程)이 된다. 이들의 상호관련성(相互關聯性)으로부터 신뢰도(信賴度)의 추정(推定)이 가능하다. 따라서 안정성(安定性)을 확보(確保)하기 위한 안전(安全)의 여유를 고려하는 경우 허용응력(許用應力)은 신뢰성(信賴性)에 근거한 안전율(安全率)로부터 구하는 것이 합리적(合理的)이다. 본(本) 연구(硏究)에서는 장기적(長期的)으로 피로하중(疲勞荷重)을 받는 철도(鐵道)레일을 대상(對象)으로 해서 신뢰성(信賴性)의 지표(指標)인 파괴확률(破壞確率)을 구하는 방법(方法)을 적용(適用)해 보았다. 신뢰도(信賴度)의 추정(推定)에 있어서 모수(母數)의 추정(推定)이 어려운 경우 파괴확률(破壞確率)의 수치계산(數値計算)은 의미가 없다. 이와 같은 문제점을 극복하기 위하여 상대적(相對的)인 신뢰성(信賴性)을 구하는 관용설계법(慣用設計法)이 제안(提案)되었다. 본(本) 연구(硏究)에서는 Cornell의 관용설계법(慣用設計法)을 적용(適用)하였다. 불확정요소(不確定要素)로서는 강도(强度)와 하중(荷重)의 변동계수(變動係數)를 사용하였고 이들의 파괴확률(破壞確率)에 대한 영향과 신뢰성(信賴性)에 근접(根接)한 안전율(安全率)을 검토하였다. 본(本) 연구(硏究)의 결과는 다음과 같다. 신뢰성(信賴性)에 있어서 용접재(鎔接材)는 강도변동(强度變動)의 영향을 크게 받고 모재(母材)는 하중변동(荷重變動)의 영향을 크게 받았다. 신뢰도(信賴度)에 근접(根接)한 안전율(安全率)로 구한 허용응력범위(許用應力範圍)는 안전측(安全側)에 있음을 확인(確認)하였다.

• 한국식품과학회지
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• 제16권4호
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• pp.429-436
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• 1984

스낵가공을 위한 보리의 압출성형특성을 조사하였고 가공조건이 제품의 품질에 미치는 영향을 분석하여 다음과 같은 결과를 얻었다. 압출성형을 위한 원료 보리의 적정 수분함량은 20%였으며 extrudate의 수분함량은 extrusion 온도가 증가할수록 die 크기가 감소할수록 낮았으며 Harper의 실험식에 의한 예측수분함량과 잘 일치하였다. Die swell은 0.98-2.18 정도의 값을 나타내었으며, $150^{\circ}C$ 이상에서 온도가 증가함에 따라 감소하였다. Extrudate의 밀도는 온도가 높을수록 die 크기가 작을수록 감소하였다. 또한 색택은 온도가 증가함에 따라 L, a, b 치가 큰 값을 나타내었다. 흡수율과 용해율은 $180^{\circ}C$에서 최대치를 나타내었으며 호화도는 온도가 증가함에 따라 증가하였다. Extrudate의 파괴응력, 영률, 최대응력은 온도가 높을수록 die 크기가 작을수록 감소하였으며 파괴점까지의 변형은 반대양상을 나타내었다. 또한 온도가 증가함에 따라 extrudate의 내부기공의 크기 및 비율이 증가하였다. 이상의 결과를 종합하여 볼때, 보리 스낵가공을 위한 최적 extrusion 조건은 스크류 회전속도 160 rpm에서 원료수분함량 20%, 온도 $180^{\circ}C$, die 크기 4.5 mm인 경우이었다.

• 한국안광학회지
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• 제13권4호
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• pp.89-94
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• 2008

목적: 각종 기계 부품에 주로 사용되는 9% Ni 합금강의 고온 크리프 시험과 그 시편들의 파단면을 관찰하고 Larson-Miller 변수를 적용하여 상수 C값을 결정하여 합금강의 수명을 예측하는데 있다. 방법: 본 시험의 장치는 Andrade와 F. Garofalo 등이 고안한 레버-빔 형으로 제작되었고, 크리프시험 설정조건은 시험편에 미치는 영향을 알아보기 위하여 4가지의 온도조건과 4가지 응력조건을 설정하여 16가지의 조건 하에서 시험을 실시하였다. 결과: 크리프 시험온도가 증가함에 따라 크리프 변형에 따른 응력의 멱지수(n)는 3.97에서 3.55로 점진적으로 감소하는 경향을 보였다. 크리프 변형의 활성화에너지는 응력이 증가함에 따라 90.39에서 83.64 kcal/mol로 점진적으로 감소하였다. Larson-Miller 변수의 계산에 의한 상수 C값은 약 22로 계산되었으며, 사용온도가 제시되면 그 수명을 예측할 수 있다. 파단면의 SEM 측정결과 저온과 고온의 경우는 입내파단에 의한 취성파괴 현상이 나타났으며, 중간정도 온도영역에서는 입계파단에 의한 연성파괴현상이 나타났으며, 일부에서는 딤풀현상도 나타났다. 결론: 9% Ni 합금강에 대한 고온 크리프시험과 그 시편들의 파단면을 관찰한 결과를 제시하여 그 파괴현상을 분석함으로써 설비분야의 부품활용에 대한 기초설계 자료를 구축하여 장비의 수명예측에 유용하게 응용될 수 있다.

• Clinics in Shoulder and Elbow
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• 제19권4호
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• pp.229-236
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• 2016

Background: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. Methods: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was $36.50{\pm}10.22years$. The mean follow-up duration was $54.80{\pm}32.50months$. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. Results: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were $9.72^{\circ}{\pm}3.95^{\circ}$, $27.67^{\circ}{\pm}10.75^{\circ}$, and $6.92%{\pm}3.40%$, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were $14.73^{\circ}{\pm}2.97^{\circ}$, $11.55^{\circ}{\pm}3.26^{\circ}$, and $11.33%{\pm}6.39%$, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. Conclusions: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults.

• 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.

• Journal of Korean Neurosurgical Society
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• 제53권3호
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• pp.145-149
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• 2013

Objective : We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. Methods : We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. Results : PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were $3.6{\pm}2.9$ and $5.4{\pm}6.4$ in the unresected PARS group, $5.8{\pm}2.1$ and $11.3{\pm}7.1$ in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. Conclusion : The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.