• Korean Journal of Radiology
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• v.24 no.5
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• pp.434-443
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• 2023

Objective: To investigate the association between pelvic bone computed tomography (CT)-derived body composition and patient outcomes in older adult patients who underwent surgery for proximal femur fractures. Materials and Methods: We retrospectively identified consecutive patients aged ≥ 65 years who underwent pelvic bone CT and subsequent surgery for proximal femur fractures between July 2018 and September 2021. Eight CT metrics were calculated from the cross-sectional area and attenuation of the subcutaneous fat and muscle, including the thigh subcutaneous fat (TSF) index, TSF attenuation, thigh muscle (TM) index, TM attenuation, gluteus maximus (GM) index, GM attenuation, gluteus medius and minimus (Gmm) index, and Gmm attenuation. The patients were dichotomized using the median value of each metric. Multivariable Cox regression and logistic regression models were used to determine the association between CT metrics with overall survival (OS) and postsurgical intensive care unit (ICU) admission, respectively. Results: A total of 372 patients (median age, 80.5 years; interquartile range, 76.0-85.0 years; 285 females) were included. TSF attenuation above the median (adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.41-4.05), GM index below the median (adjusted HR, 2.63; 95% CI, 1.33-5.26), and Gmm index below the median (adjusted HR, 2.33; 95% CI, 1.12-4.55) were independently associated with shorter OS. TSF index (adjusted odds ratio [OR], 6.67; 95% CI, 3.13-14.29), GM index (adjusted OR, 3.45; 95% CI, 1.49-7.69), GM attenuation (adjusted OR, 2.33; 95% CI, 1.02-5.56), Gmm index (adjusted OR, 2.70; 95% CI, 1.22-5.88), and Gmm attenuation (adjusted OR, 2.22; 95% CI, 1.01-5.00) below the median were independently associated with ICU admission. Conclusion: In older adult patients who underwent surgery for proximal femur fracture, low muscle indices of the GM and gluteus medius/minimus obtained from their cross-sectional areas on preoperative pelvic bone CT were significant prognostic markers for predicting high mortality and postsurgical ICU admission.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.6 no.1
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• pp.113-119
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• 2011

Objectives: The purpose of this study is to investigate the clinical application of Chungungyukgye-tang(Chuanxiongrougui-tang) to one patient with lumbar burst fracture. Methods: Patient is hopitalized at Dept. of Oriental Internal Medicine, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as lumbar burst fracture and treated mainly with herbal medine ; Chungungyukgye-tang(Chuanxiongrougui-tang). This study was measured by ODI(Oswestry Disability Index) and NRS(Numeric Rating Scale) score. Results: After taking Chungungyukgye-tang(Chuanxiongrougui-tang), the patient's pain was controlled. NRS & ODI score were decreased. Conclusions: As seen in this one case of lumbar burst fracture, Chungungyukgye-tang(Chuanxiongrougui-tang) has a positive effect to control pain with lumbar burst fracture.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.5 no.1
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• pp.49-56
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• 2010

Objectives: The objective of this study is to report the effectiveness of conservative treatment on pelvic fracture accompanied with osteoporosis. Methods: A female patient, 68 years old, who were diagnosed as right iliac wing fracture with osteoporosis by X-ray, bone scan and bone densitometry, were treated with conservative treatment. We evaluated the effectiveness by checking Visual Analog Scale(VAS), Oswestry Disability Index(ODI) and 3D computed tomography. Results: The symptoms of the patient got improved and the 3D computed tomography image showed the fracture were healing. Conclusions: Conservative oriental treatment can be effectively used for a patient with iliac wing fracture and osteoporosis.

• Annals of Geriatric Medicine and Research
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• v.20 no.3
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• pp.125-130
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• 2016

Background: Conventionally, elderly hip fracture patients are assessed by orthopedists to decide whether they need geriatric intervention. We aimed to evaluate the effect of perioperative geriatric intervention on healthcare outcomes in patients undergoing surgery for hip fractures. Methods: Our care model for hip fracture surgery resembles a combination of a routine geriatric consultation model and a geriatric ward model. We retrospectively reviewed the medical records of patients aged ${\geq}65years$ undergoing surgery for hip fracture at a single tertiary hospital from January 2010 to December 2013. We assessed comorbidity, indwelling status, fracture type, and mode of anesthesia. We also evaluated in-hospital expenditure, duration of admission, disposition at discharge and 1-year mortality as clinical outcomes. We developed a propensity score model using the variables of age, cholesterol, and creatinine and examined the effect of perioperative geriatric intervention on intergroup differences of clinical variables. Results: Among 639 patients, 138 patients received the geriatric intervention and 501 patients received the usual care. Univariate analysis showed that factors such as age; Charlson comorbidity index; and serum levels of cholesterol, albumin, and creatinine differed significantly between these 2 groups. There was no significant difference between the groups in terms of 1-year mortality, disposition at discharge, and in-hospital expenditure in the propensity matched model. However, the duration of hospitalization was shorter in the intervention group ($8.9{\pm}0.8days$) than in the usual care group ($14.2{\pm}3.7days$, p=0.006). Conclusion: This care model of geriatric intervention for patients with hip fracture is associated with reduced hospitalization duration.

• Archives of Craniofacial Surgery
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• v.22 no.3
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• pp.148-153
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• 2021

Background: The zygomaticomaxillary complex (ZMC) has a protruded, convex shape and plays a vital role in determining the contour by affecting the width of the middle face. This study aimed to evaluate the efficiency of ZMC fracture reduction and explore detailed directions for outcome improvement. Methods: We conducted a retrospective study of patients diagnosed with unilateral ZMC fracture who underwent ZMC reduction surgery at a single hospital between January 2015 and May 2020. The primary outcome variable was facial asymmetry using the difference in the bilateral malar eminence (ME) position measured by computed tomography scan. The 3-dimensional distance (I_A, asymmetry index) and the distance in each dimension, D_x (anteroposterior distance), D_y (mediolateral distance), and D_z (superoinferior distance) were compared. Results: A total of 101 patients with ZMC fractures and 54 non-fracture patients were enrolled in the study. The mean age of the study sample was 43.49 years (control sample, 43.35 years), and the male-to-female ratio was 66.3:33.7 (control sample, 64.8:35.2). There were 53 and 48 patients with right and left ZMC fractures, respectively. The I_A was not statistically different between the two groups. In terms of position in each dimension, only D_x was significantly different between the two groups. Conclusion: The results show that overall facial asymmetry was recovered after ZMC reduction, but in certain dimension significant difference in ME position has still remained. For further improvement, treatment should be performed to relieve malar depression in the anteroposterior dimension.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.24-29
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• 2019

Purpose: To evaluate the characteristics and the risk factors of early onset subsequent vertebral compression fractures after percutaneous vertebroplasty. Materials and Methods: A total of 44 patients, who had a new subsequent vertebral fracture after percutaneous vertebroplasty for an osteoporotic vertebral compression fracture between January 2013 and December 2015, were recruited. The patients were divided into two groups according to the onset period of subsequent fracture. The number of patients who had a fracture within 3 months following vertebroplasty were 22 cases (Group A); after 3 months were 22 cases (Group B). Variables, including age, sex, bone mineral density (BMD), body mass index (BMI), preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, injected cement volume, restoration of vertebral body height, and correction of kyphosis, in the two groups were analyzed and compared retrospectively. Results: The age, sex, BMD, BMI, preexisting vertebral compression fracture, location of the initial fracture, intradiscal cement leakage, and correction of kyphosis were similar in the two groups. Both a greater volume of bone cement injected and a greater degree of vertebral height restoration contributed significantly to the risk of fracture within 3 months. Conclusion: The cement volume and degree of height restoration are risk factors for early onset fracture at the adjacent vertebrae after percutaneous vertebroplasty and close attention is needed during the follow-up period.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.20 no.7
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• pp.2087-2096
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• 1996

Recentrly advantages in composite and light weight material techniques have led to the increased use of bonded dissimilar materials such as ceramics/metal bonded joints, IC package, brazing, coating and soldering in the various industries. It is required to analyze the evaluation method of fracture strength and design methodology of bonded joints in dissimilar materials. Stress singularity according to changes of scarf angles for bonded scarf joints in dissimilar materials was investigated by the boundary element method and static experiments. In this paper, effect of the stress singularity factors at the interface edges of scarf joints on various dissmilar materials combinations were investigated by analysis of its stress and stress singularity index using 2-dimensional elastic program of boundary element method. And the variations of stress singularity index by changes for Young's modulus ratios of materials and scarf angles were investigated. Also, it is found that stress singularities at bonded interface edges are disappeared for certain combination of scarf angle in a pair of bonded dissimilar materials. As the results, it is proposed that the strength evaluation by using stress singularity factors, $\Gamma$, considering stress singularity at the interface edges of bonded dissimilar materials, is very useful.

• Journal of Trauma and Injury
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• v.35 no.4
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• pp.268-276
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• 2022

Purpose: Rib fractures are common injuries that can lead to morbidity and mortality. Methods: Data on all patients with rib fractures admitted to a single trauma center between January 1, 2008 and December 31, 2018 were reviewed. Results: A total of 1,671 admissions for rib fracture were examined. Patients' median age was 57 years, the median Injury Severity Score (ISS) was 14, and the median number of fractured ribs was three. The in-hospital mortality rate was 4%. Age, the number of rib fractures, and Charlson Comorbidity Index scores were poor predictors of mortality, while the ISS was a slightly better predictor, with area under the receiver operating characteristic curve values of 0.60, 0.55, 0.58, and 0.74, respectively. Multivariate regression showed that age, ISS, and Charlson Comorbidity Index score, but not the number of rib fractures, were associated with significantly elevated adjusted odds ratios for mortality (1.03, 1.14, and 1.28, respectively). Conclusions: Age, ISS, and comorbidities were independently associated with the risk of mortality; however, they were not accurate predictors of death. The factors associated with rib fracture mortality are complex and cannot be explained by a single variable. Interventions to improve outcomes must be multifaceted.

• Steel and Composite Structures
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• v.51 no.3
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• pp.289-304
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• 2024

The seismic performance of traditional steel frame-shear wall structures was significantly improved by the application of self-centering steel-reinforced concrete (SRC) wall-panel structures in the steel frames. This novel resilience functionality can rapidly restore the structure after an earthquake. The presented steel frame with steel-reinforced concrete self-centering wall-panel structures (SF-SCW) was validated, indicating its excellent seismic performance. The seismic design method based on bear capacity cannot correctly predict the elastic-plastic performance of the structure, especially certain weak floors that might be caused by a major fracture. A four-level seismic performance index, including intact function, continued utilization, life safety, and near-collapse, was established to achieve the ideal failure mode. The seismic design method, based on structural displacement, was proposed by considering performance objectives of the different seismic action levels. The pushover analysis of a six-floor SF-SCW structure was carried out under the proposed design method and the results showed that this six-floor structure could achieve the predicted failure mode.

• Structural Engineering and Mechanics
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• v.64 no.6
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• pp.819-826
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• 2017

The effects of thermocycling procedure and material shade on the mechanical properties and wear resistance of resin-based dental restorative materials are investigated. The modulus of elasticity, hardness, plasticity index and wear resistance are determined for the conventional composite, the nanohybrid composite and the nanofilled dental composites. Disc-shape samples are prepared from each material to investigate the effects of thermocycling procedure on the mechanical properties and wear resistance of different types of dental restorative materials. In this respect, a group of samples is thermocycled and the other group is stored in ambient conditions. Then nano-indentation and nano-scratch tests are performed on the samples to measure their mechanical properties and wear resistance. Results show that the A1E shade of the dental nanocomposite possesses higher modulus of elasticity and hardness values compared to the two other shades. According to the experimental results, the mean values for the modulus of elasticity and hardness of the A1E shade of the nanocomposite are 13.71 GPa and 1.08 GPa, respectively. The modulus of elasticity and hardness of the conventional dental composite increase around 30 percent in the oral environment due to the moisture and temperature changes. The wear resistance of the dental composites is also significantly affected by moisture and temperature changes in the oral conditions. It is observed that thermocycling has no significant effect on the hardness, plasticity index and wear resistance of the nanohybrid composite and the nanocomposite dental materials.