• Archives of Plastic Surgery
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• 제48권4호
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• pp.384-388
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• 2021

Adequate positioning of the hand is a critical step in hand fracture operative repair that can impact both the clinical outcome and the efficiency of the operation. In this paper, we introduce the use of a thermoplastic splint with an added thumb stabilizing component as a means to increase the surgeon's autonomy and to streamline the patient care pathway. The thermoplastic splint is custom fabricated preoperatively by the specialist hand therapist. The splint is used prior, during, and post operation with minimal modification. The thumb component assists maintaining the forearm in a stable pronated position whilst drilling and affixing metal work. This is demonstrated in the video of removal of metal work and open reduction and internal fixation of a metacarpal fracture.

• Journal of Yeungnam Medical Science
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• 제13권2호
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• pp.234-242
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• 1996

영남대학교 의과대학 부속병원 신경외과에서 1994년 l월부터 1994년 12월까지 1년간 흉요추접합부 파열골절로 입원한 환자중 전측방경유법으로 10례를 수술로 치료경험 하였던 바, 척추골절이 척수원추 상부이면서 전방의 골편에 의해 척수신경이 압박되고 있는 불안정 파열골절시는 전방도달술에 의한 늑골 골융합 및 Kaneda기기내고정술로 좋은 결과를 기대할 수 있겠고, 척수 후주의 심한 손상이나 또는 3 column을 전체가 손상된 불안정 파열골절의 경우에는 후방접근법이나 후측방접근법으로 신경감압 및 내고정술 시행하는 것이 좋은 치료법이라 할 수 있겠다.

• Restorative Dentistry and Endodontics
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• 제34권5호
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• pp.424-429
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• 2009

본 연구의 목적은 니켈 티타늄 전동파일의 피로 파절에 파일의 단면 형태가 미치는 영향을 평가하고자 하였다. 6 종의 ProFile (Dentsply), Mtwo (VDW), K3 (SybronEndo), Heroshaper (MicroMega), NRT (Mani), Alpha system (KOMET) 니켈-티타늄 전동 파일(ISO 30 size/.04 taper)을 각 10개씩 실험군으로 배정하고 실험을 진행하였다. 니켈 티타늄 전동파일에 반복적인 장력과 압축력을 재현시킬 수 있는 피로파절 실험기(Denbotix)와 연결된 토크 조절 전동모터(Aseptico)에 각 군의 파일을 연결하여 300rpm 속도로 만곡도가 60도이고 5mm의 반경을 가진 인공 금속 근관 내를 6 mm pecking depth로 작동시켰다. 각 파일의 파절시간을 측정하고 통계 분석하여 유의성을 분석하였으며, 각 군의 파절된 모든 파일의 파절면을 주사전자현미경을 이용한 fractographic analysis를 통해 파절 역학을 규명하였다. 또한 각 군에서 3개의 사용하지 않은 새 파일을 clear resin에 매몰하고tip에서부터 3mm 지점을 횡절단하여 Image-Pro Plus (Imagej 1.34n, NIH) 소프트웨어로 절단면의 단면적을 측정하고 단면적의 크기와 피로 파절과의 상관성도 평가하였다. 실험 결과 NRT와 ProFile이 다른 실험군에 비해서 유의성 있게 높은 피로 파절 저항성을 보였다(P < .05). 또한 파일의 단면적은 피로파절 저항성과 통계학적인 유의성은 보이지 않았다. Fractographic analysis 결과 모든 시편에서 파절면은 ductile fracture와 brittle fracture가 혼재된 양상으로 나타났다. 결론적으로 니켈 티타늄 전동 파일의 단면적의 크기는 피로파절 저항과는 상관성이 적었다.

• Journal of Korean Neurosurgical Society
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• 제50권3호
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• pp.224-230
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• 2011

Objective : This study aimed to show the possibility of neural canal enlargement and restoration of bony fragments through laminectomy and minimal facetectomy without pediculectomy or an anterior approach, and also to prove the adequacy of posterior stabilization of vertebral deformities after thoracolumbar bursting fracture. Methods : From January 2003 to June 2009, we experienced 45 patients with thoracolumbar burst fractures. All patients enrolled were presented with either a neural canal compromise of more than 40% with a Benzel-Larson Grade of VI, or more than 30% compromise with less than a Benzel-Larson Grade of V. Most important characteristic of our surgical procedure was repositioning retropulsed bone fragments using custom-designed instruments via laminectomy and minimal facetectomy without removing the fractured bone fragments. Beneath the dural sac, these custom-designed instruments could push the retropulsed bone fragments within the neural canal after the decompression and bone fragment repositioning. Results : The mean kyphotic deformities measured preoperatively and at follow-up within 12 months were 17.7 degrees (${\pm}6.4$ degrees) and 9.6 degrees (${\pm}5.2$ degrees), respectively. The mean midsagittal diameter improved from 8.8 mm (${\pm}2.8$ mm) before surgery to 14.2 mm (${\pm}1.6$ mm) at follow-up. The mean traumatic vertebral body height before surgery was 41.3% (${\pm}12.6%$). At follow-up assessment within 12 months, this score showed a statistically significant increase to 68.3% (${\pm}12.8%$). Neurological improvement occurred in all patients. Conclusion : Though controversy exists in the treatment of severe thoracolumbar burst fracture, we achieved effective radiological and clinical results in the cases of burst fractures causing severe canal compromise and spinal deformity by using this novel custom-designed instruments, via posterior approach alone.

• Restorative Dentistry and Endodontics
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• 제15권2호
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• pp.104-114
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• 1990

The purpose of this study was to evaluate the adaptation of root canal filling material to the dentinal wall of root canal and to compare the sealing ability of the root canal filling materials using ultrasonic endodontic instrument with injection-molded thermoplasticized gutta-percha filling method and lateral condensation method. Fifty fresh human single root exlracted for orthodontic treatment, were randomly selected, and instrumented by step-back technique. And then, the teeth were divided into 5 groups according to each root canal filling methods. In the experimental group 1 and group 2, the root canals were filled with gutta perdia cases using ultrasonic instrument with and without sealer. In the experimental group 3 and 4, using jection-moldeed thermoplasticized gutta-percha method by obtul$^{(R)}$ canals were filled with and without sealer. In the control group, the canals were filled with sealer by lateral candensation. And then, 5 teeth of each group were immersed in black Indian ink, decalcified and cleared. The depth of dye penetration into the root canal were evaluated with stereoscope (Reichert Ltd., USA). Among the 5 teeth remaining in each group, the single longituding grooves were made on the labial and lingual root surfaces and then immersed in the liquid nitrogen to fracture the teeth spontaneously without any distortions of gutta-percha. Each specimens were examined with X-650 Scanning Electron Microscope(Hitachi ltd, Japan) to show the adaptation to the canal wall, void, homogenicity of filling material and location of gutta-percha or sealer in the dentinal tubules of the root canal. The observations were as follows : 1. The experimental group 1 showed smaller mean dye penetration than control group, and showed the penetraton of sealer in the dentinal tubules of apical third of the root canal. 2. The experimental group 2 and group 4 showed the penetration of gutta-percha in the dentinal tubules of root canals. 3. The experimental group 1 and group 3 showed less mean dye penetration than the experimental group 2 and group 4. 4. The experimental group 1 and group 2 showed better adaptation of filling materials than control group.

• 대한족부족관절학회지
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• 제19권4호
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• pp.181-187
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• 2015

Purpose: The purpose of this study is to retrospectively analyze the clinical results of screws and Kirschner wire (K-wire) fixation in patients with fracture dislocation of Lisfranc joint and the consequence of screw breakage. Materials and Methods: Sixty patients underwent Lisfranc joint open reduction and removal of internal fixators from January 2007 to December 2011. Forty-nine cases (81.7%) underwent operations with screw alone, and 11 cases (18.3%) underwent operations with both screws and K-wires. Type of internal fixators, duration of internal fixator removal, breakage of internal fixators and satisfaction with reduction were investigated. Additionally, American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scales were analyzed. Results: The internal fixator was broken in 5 cases (8.3%). The average duration of instrument removal was 154 days in the non-broken screw group and 268.6 days in the broken screw group (p<0.05). The average AOFAS midfoot scale was 77.4 in the non-broken screw group and 74.2 in the broken screw group. The most commonly damaged portion was the first tarsometatarsal (Lisfranc) joint. Conclusion: Treatment with screws and K-wires was effective in patients with fracture dislocation of Lisfranc joint. The appropriate time for screw removal should be considered.

• Restorative Dentistry and Endodontics
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• 제32권2호
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• pp.130-137
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• 2007

본 연구의 목적은 니켈티타늄 전동파일의 피로파절에 있어서 표면 결함의 역할을 규명하고자 fatigue tester에서 반복적 인 fatigue force를 부여한 후 파절된 단면을 주사전자현미 경으로 관찰하여 파절 역학을 규명하는 것이다. 총 45개의 #30/.04 taper와 21 mm의 HEROShaper 니켈-티타늄 전동파일을 15개씩 3개의 군으로 분류하였다. 제 1군은 결함이 없는 새 HEROShaper파일, 제 2군은 제조과정에서 metal rollover나 machining marks와 같은 표면결함을 갖는 HEROShaper파일, 제 3군은 임상에서 4- 6개의 구치부 근관의 확대에 사용한 HEROShaper 파일을 사용하였다. 모든 파일들은 회전속도(300 rpm)와 pecking distance (3 mm)가 일정하게 맞춘 fatigue tester에서 파절될 때까지 시간을 측정한 후 통계분석을 통해 각 군간의 유의성을 분석하였고, 파절 단면의 farctographic analysis를 통해 파절역학을 규명하고자 하였다 실험결과 평균 파절시간에 있어서 group 1과 2, group 1과 3사이에는 통계학적으로 유의할 만한 차이가 있었으나 (p<0.05), group 2와 3사이에는 통계학적인 차이가 없었다. Fractographic analysis 결과 대부분의 파절면에서 microvoid와 dimple 소견을 갖는 ductile fracture양상이 관찰되었다. 또한 brittle fracture가 일어난 파절면에서는 파절선 전방에 수 많은 striation들이 관찰되었고 transgranular 및 intergranular cleavage 소견도 보였다. 표면결함이 있는 제 2, 3 군의 파절단면에서는 모든 시편에서 표면결함이 관찰되었다. 이와 같은 결과로 미루어 보아 표면결함이 반복 피로파절에서 미세균열의 기시점으로 중요한 역할을 하며 fractography분석법은 Ni-Ti 파일의 파절역학을 규명하는데 유용함을 알 수 있었다.

• 한국소음진동공학회논문집
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• 제24권6호
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• pp.452-461
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• 2014

Two stroke low speed diesel engines that have many advantages such as high thermal efficiency and durability have been widely used for marine engine. However, it is also true that many problems have occurred due to the high explosion pressure and severe operating environment. Especially problems of shaft damage etc. intensively occurred due to the phenomenon of crankshaft exceeding the allowable stress, including the shaft vibration of the engine model in the early stage. In this study, the crankshaft fracture phenomenon of early engine model was evaluated and analyzed by using up-to-date torsional vibration calculation program and measurement instrument. And this was numerically shown.

• 한국컴퓨터정보학회논문지
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• 제24권4호
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• pp.161-167
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• 2019

In this paper, we propose a study on awareness of first aid of scuba diver. In order to achieve this purpose, a total of 310 customers over the age of 20 were selected as study participants form diving pools and dive resort in Seoul, Gyeonggi, Gangwon, Gyeongsang province area using the convenience sampling method However, only data from 295 customers were used after screening the data for reliability. The instrument for data collection was a questionnaire, and descriptive statistics, inter-item consistency reliability, pearson chi-square test were conducted on the data using the SPSS 21.0 version statistical package program. The followings are the results: The level differ significantly according hemorrhage, abrasion, sprain, fracture, fever, arrest, airway obstruction. As a result of analyzing the difference of first aid recognition according to the level of scuba diver, we found bleeding patients, abrasions, sprains, fractures, high heat exposure patients, cardiac arrest patients. There was a statistically significant difference in the level of airway obstruction due to food.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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• pp.58-65
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• 2000

Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.