• Title/Summary/Keyword: Joint Replacement

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Thin Split-Thickness Toe Nail-Bed Grafts for Nail Bed Defects in Subungal Exostosis: Two Cases Report (얇은 부분층 조갑상 이식을 통한 조갑하 외골종의 치료: 2예 보고)

  • Oh, In Suk;Kim, Chang Hee;Choi, Jong-Sun;Lee, Sang Hyeong
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.83-88
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    • 2012
  • We reviewed the clinical features of 2 patients who underwent surgery for subungal exostosis, focusing on postoperative deformity of the nail. The lesion destroyed the nail bed and was excised with a direct approach. then thin split-thickness sterile matrix graft was done after excision of the tumor because the defect of the nail bed was large. Good postoperative appearance of the nail was obtained by thin split-thickness sterile matrix graft. The use of thin split-thickness sterile matrix graft for the replacement of a nail bed defect can regain a smooth, adherent, and normal-looking nail and avoid donor-site morbidity. Thin split-thickness toe-nail bed graft is a good choice for the prevention of postoperative deformity.

Petrological Characteristics and Deterioration Aspect of the Goryeong Yangjeondong Petroglyph (고령 양전동암각화의 암석학적 특징과 훼손양상 분석)

  • Choi, Gi-Ju;Lee, Sang-Hun
    • Journal of Conservation Science
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    • v.25 no.2
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    • pp.131-145
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    • 2009
  • Goryeong Yangjeondong Petroglyph on the joint face of the bedrock (6m in width, 3m in height) composed of the green sandstone has circles and shield pattern sculptures. The rock is mainly composed of quartz, feldspar, chlorite, illite and calcite with the clay minerals. These clay minerals occur as pore lining, replacement of component and pore fillings. Investigated the weathering aspects including the connection between soluble salt and rock weathering and the stability of the bedrock with petroglyphs. The Major deterioration aspect are grain peel-off, surface exfoliation, cracks and damage. And the bedrock where the joints and cracks advance is interpreted with the fact that has the possibility of the falling rock. For conservation, adhesive need to cover crack and damage and consolidation is necessary in the surface which becomes weak.

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Intermediate-Term Clinical Outcomes after Total Ankle Arthroplasty for End-Stage Rheumatoid Arthritis with Modification of Perioperative Anti-Rheumatic Medication (말기 류마티스성 발목관절염에 대한 인공관절 전치환술 및 항류마티스 약물 조절 후의 중기 추시 임상 결과)

  • Cho, Byung-Ki;Ko, Ban-Suk
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.3
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    • pp.91-99
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    • 2019
  • Purpose: This retrospective study reports the intermediate-term clinical outcomes including the practical function in daily and sports activities after total ankle arthroplasty for end-stage rheumatoid arthritis, as well as the effects of modification of perioperative anti-rheumatic medications. Materials and Methods: Twelve patients were followed for a minimum of 2 years after total ankle replacement for end-stage rheumatoid arthritis. Perioperative anti-rheumatic medications in all patients were modified based on a specific guideline. Clinical evaluations consisted of American Orthopaedic Foot and Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM) scores. Periodic radiographic evaluation was conducted to detect changes in ankle alignment and postoperative complications. Results: Mean AOFAS, FAOS, and FAAM scores improved significantly from 37.5 to 81.2, 39.1 to 72.4, and 33.8 to 64.0 points at final follow-up, respectively (p<0.001). Functional outcomes in daily and sports activities at final follow-up were found to be 76.5 and 55.8 points for the FAOS and 70.5 and 57.5 points for the FAAM, respectively. As early postoperative complications, there was one case of local wound necrosis, one case of medial malleolar fracture, and one case of deep peroneal nerve injury. Radiological evaluation revealed two cases of asymptomatic heterotopic ossification and one case of progressive arthritis in the talonavicular joint. Reoperation was performed in only one patient (8.3%) with a medial soft tissue impingement at a mean of 35.6 months follow-up. Conclusion: Total ankle arthroplasty appears to be an effective surgical option for end-stage rheumatoid arthritis. Practical functions in daily and sports activities were significantly improved at intermediate-term follow-up. Modification of perioperative anti-rheumatic medications can be one of the solutions to reduce the postoperative complication rate.

System Reliability Analysis for Multiple Failure Modes of Piezoelectric Energy Harvester Using Generalized Complementary Intersection Method (Generalized Complementary Intersection Method를 이용한 압전 에너지 수확 장치의 다중 파손모드에 대한 시스템 신뢰성 해석)

  • Yoon, Heonjun;Youn, Byeng D.;Kim, Heung-Soo
    • Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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    • 2014.10a
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    • pp.544-544
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    • 2014
  • Energy harvesting technology, which scavenges electric power from ambient, otherwise wasted, energy sources, has been explored to develop self-powered wireless sensors and possibly eliminate the battery replacement cost for wireless sensors. Among ambient energy sources, vibration energy can be converted into electric power through a piezoelectric energy harvester. For the last decade, although tremendous advances have been made in design methodology to maximize harvestable electric power under a given vibration condition, the research in reliability assessment to ensure durability has been stagnant due to the complicated nature of the multiple failure modes of a piezoelectric energy harvester, such as the interfacial delamination, fatigue failure, and dynamic fracture. Therefore, this study presents the first-ever system reliability analysis for multiple failure modes of a piezoelectric energy harvester using the Generalized Complementary Intersection Method (GCIM), while accounts for the energy conversion performance. The GCIM enables to decompose the probabilities of high-order joint failure events into probabilities of complementary intersection events. The electromechanically-coupled analytical model is implemented based on the Kirchhoff plate theory to analyze its output performances of a piezoelectric energy harvester. Since a durable as well as efficient design of a piezoelectric energy harvester is significantly important in sustainably utilizing self-powered electronics, we believe that technical development on system reliability analysis will have an immediate and major impact on piezoelectric energy harvesting technology.

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승모판막질환에 병발한 동맥색전증의 치험 1례

  • Hur, Y.;Kim, B.Y.;Lee, H.S.;Kim, J.E.;Lee, J.H.;Yu, H.S.
    • Journal of Chest Surgery
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    • v.13 no.1
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    • pp.77-81
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    • 1980
  • We present one case of 26-year-old male having saddle block combined with mitral valvular disease [NYHA Class IV] with auricular fibrillation. The most common cause of emboli is atrial fibrillation. The clinical manifestations of saddle emboli are relatively slow due to development of collateral circulation and large size of lumen of the aorta. The 5month duration of saddle emboli in this case led to severe atrophic changes, coldness, peripheral cyanosis on the both lower extremities, and flexion deformity on the knee and ankle joint of the left lower extremity. We planned staged operation for the saddle block and for mitral stenoinsufficiency and tricuspid insufficiency, because of poor general condition of the patient. The thromboembolectomy of aortic bifurcation was performed through the transabdominal approach without trial of Fogarthy catheter embolectomy, because of expectation of the secondary inflammatory changes of the vessel wall and thrombi which was 3 cm X 1 cm X 0.5 cm in size with irregular surfaced solid in consistency. 1 month later, after thromboembolectomy, mitral valve replacement and tricuspid annuloplasty were performed, with successful early operative result. During operation organized thrombi [1 cm X 0.5 cm] in the left auricle was removed. We wonder if simple management using Fogarthy catheter might be possible to remove the thromboemboli instead of thromboembolectomy by aortotomy in this case.

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인공관절의 수명 향상을 위해 Plasma Immersion Ion Implantation & Deposition 공정으로 증착된 NbN 박막에 대한 UHMWPE Liner 소재의 마모량 평가

  • Park, Won-Ung;Kim, Eun-Gyeom;Jeon, Jun-Hong;Choe, Jin-Yeong;Mun, Seon-U;Im, Sang-Ho;Han, Seung-Hui
    • Proceedings of the Korean Vacuum Society Conference
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    • 2012.02a
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    • pp.137-137
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    • 2012
  • 인공관절은 노인성 질환이나 자가 면역질환, 신체적인 외상 등으로 인하여 발생하는 관절의 손상 부위를 대체하기 위하여 고안된 관절의 인공 대용물이다. 인공 관절 중 인공 고관절의 경우 라이너(Liner)와 헤드(Head) 부분이 직접적인 마모 운동을 수행하게 되므로, 이 부분의 소재 특성에 따라 인공관절의 수명이 결정 되게 된다. 현재 헤드 소재로서는 Co-Cr-Mo 합금이, 라이너 소재로서는 고분자 소재인 UHMWPE (Ultra High Molecular Weight Polyethylene)가 주로 사용되고 있다. 이러한 MOP (Metal-On-Polymer) 구조의 인공관절의 경우, 충격흡수의 장점이 있는 반면, 관절 운동시 발생하는 UHMWPE 의wear debris에 의해 골용해가 발생하게 되어 인공관절의 수명이 저하되는 문제점이 있으며, 금속 헤드의 마모로 인한 금속이온의 용출은 세포 독성의 문제를 야기하여 인공관절의 수명을 저하시키는 또 다른 원인이 되고 있다. 따라서 본 연구에서는 PIII&D (Plasma Immersion Ion Implantation & Deposition) 공정을 이용하여 금속 (Co-Cr-Mo 합금)소재 위에 세라믹 (niobium nitride) 박막을 증착하여 상대재인 UHMWPE의 마모를 줄이고자 하는 연구를 진행하였다. 금속 소재 위에 증착된 세라믹 박막은 상대재인 UHMWPE의 마모량을 줄여줄 뿐만 아니라 금속이온의 용출을 막아준다는 장점이 있으나, 장시간의 마모 운동에 의하여 발생하는 박막의 박리 현상은 인공관절의 수명을 급격히 저하시키는 또 다른 원인이 된다. 이러한 단점을 해결하기 위하여, 박막의 증착 초기에 이온주입과 증착을 동시에 수행하는 dynamic ion mixing공정을 수행하였다. Dynamic ion mixing 공정을 수행함에 따라 박막과 금속 사이의 접착력이 증가하게 되어, UHMWPE의 마모량이 2배 가까이 감소하는 것을 확인할 수 있었으며, 장시간의 마모시험에서도 우수한 결과를 얻을 수 있었다. 또한 UHMWPE의 마모량을 감소시키기 위하여 박막을 증착하기 전에 금속 소재에 질소 이온주입을 수행하는 pre-ion implantation 공정을 도입하였다. 질소 이온주입 결과 Co-Cr-Mo 합금 표면에 부분적으로 CrN, Cr2N의 세라믹 상이 형성 되는 것을 확인할 수 있었으며, 그에 따라 UHMWPE의 마모량이 2배 이상 감소 되는 것을 확인 할 수 있었다.

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Classification of Waterfalls in Jeju Island Based on Properties of a Lava Flow (용암류 특성에 의한 제주도 폭포의 유형화)

  • Kim, Tae-Ho
    • Journal of the Korean association of regional geographers
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    • v.18 no.2
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    • pp.129-140
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    • 2012
  • In order to examine geomorphic characteristics such as form and retreat process of waterfalls in Jeju Island, 26 waterfalls were classified based upon materials forming a fall face. The waterfalls could be categorized into three types such as single unit, multiple units and basal soft-rock based upon the number and type of a lava flow. A block fall, composed of a pile of large blocks, could be added to the typology of waterfalls in Jeju Island. While the single unit fall is distributed in a region of trachyte or trachyandecite, the multiple units fall and basal soft-rock fall are largely developed in a region of basalt or trachybasalt. A retreat process of the single unit fall is an inclination or a replacement, but the basal soft-rock fall shows a parallel retreat. The multiple units fall exhibits three types of a retreat process according to the physical properties of a lava flow. The fall face is generally vertical due to well-developed vertical joints of a lava flow.

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Analysis of the Current State of Home Health Nursing for Elderly Patients in Advanced General Hospital (일 상급종합병원 노인 환자의 가정간호 서비스 이용 현황 분석)

  • Park, Sung Hye;Jang, Yeon Soo;Kim, Su Jin
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.3
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    • pp.275-284
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    • 2019
  • Purpose: The purpose of this study was to analyze the current state of home health nursing (HHN) for elders and to provide basic data on policy alternatives for establishing home medical care in the advanced general hospital. Methods: This study was conducted as a secondary data analysis, using electronic medical record (EMR) data of older patients who received HHN more than once from the S advanced general hospital between January 2016 and December 2018. Results: A total of 1,790 patients received HHN visits, with 22,477 visits being made. The mean age was 76.8±7.3 years old, 96.0% of elders had health insurance and 24.6% had orthopedics problems. Of the 1,168 people who visited emergency rooms, the most frequent symptom was pain (23.4%) and all patients visited the hospital at least once and at most 163 times outpatient care during HHN. Causative diseases were degenerative knee joint osteoarthritis (0.6%), surgery for right knee replacement (4.0%), and for dressings (9.7%) in the HHN service content analysis. Conclusion: The progress towards an aging society and the introduction of community care are expected to further enhance the need for HHN which should be able to provide comprehensive and continuous visiting health care services to the older patients. The results of this study are expected to help doctors solve problems not solved by HHN, reduce unnecessary emergency room or outpatient visits, and readmission, while at the same time contributing to the improvement of patient quality of life through efficient patient health care.

Effects of Chuna Manual Therapy after Hip Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (고관절 치환술 후 추나치료 효과: 체계적 문헌고찰 및 메타분석)

  • Lee, Eun-Byeol;Kim, Hyeon-Ji;Kim, Chae-Young;Ahn, Hee-Duk
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.2
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    • pp.95-103
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    • 2022
  • Objectives This study was conducted to assess the effect of chuna manual therapy after hip arthroplasty. Methods We searched across 9 electronic databases (PubMed, Cochrane Library, Wangfang data, China National Knowledge Infrastructure [CNKI], Oriental Medicine Advanced Searching Integrated System [OASIS], National Digital Science Library [NDSL], Korean Medical Database [KMBASE], Koreanstudies Information Service System [KISS], Research Information Sharing Service [RISS]) to find randomized controlled clinical trials for chuna manual therapy after hip arthroplasty. Results On inclusion criteria, 11 appropriate studies were included and analyzed. The deep vein thrombosis incidence of the chuna manual therapy group was statistically lower than the conventional treatment group (p=0.0002). Chuna manual therapy significantly improved the Harris hip score compared with conventional treatment (p<0.00001). Also, chuna manual therapy combined with herbal fumigation therapy significantly elevated the hip joint function score of Harris hip score compared with the conventional therapy group (p<0.00001). Conclusions The systematic review showed that chuna manual therapy had significant effects on hip arthroplasty. Nonetheless, considering the high risk of bias and geographic bias, further research with well-designed studies is required to support the effectiveness of chuna manual therapy.

Behaviour and design of bolted endplate joints between composite walls and steel beams

  • Li, Dongxu;Uy, Brian;Mo, Jun;Thai, Huu-Tai
    • Steel and Composite Structures
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    • v.44 no.1
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    • pp.33-47
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    • 2022
  • This paper presents a finite element model for predicting the monotonic behaviour of bolted endplate joints connecting steel-concrete composite walls and steel beams. The demountable Hollo-bolts are utilised to facilitate the quick installation and dismantling for replacement and reuse. In the developed model, material and geometric nonlinearities were included. The accuracy of the developed model was assessed by comparing the numerical results with previous experimental tests on hollow/composite column-to-steel beam joints that incorporated endplates and Hollo-bolts. In particular, the Hollo-bolts were modelled with the expanded sleeves involved, and different material properties of the Hollo-bolt shank and sleeves were considered based on the information provided by the manufacture. The developed models, therefore, can be applied in the present study to simulate the wall-to-beam joints with similar structural components and characteristics. Based on the validated model, the authors herein compared the behaviour of wall-to-beam joints of two commonly utilised composite walling systems (Case 1: flat steel plates with headed studs; Case 2: lipped channel section with partition plates). Considering the ease of manufacturing, onsite erection and the pertinent costs, composite walling system with flat steel plates and conventional headed studs (Case 1) was the focus of present study. Specifically, additional headed studs were pre-welded inside the front wall plates to enhance the joint performance. On this basis, a series of parametric studies were conducted to assess the influences of five design parameters on the behaviour of bolted endplate wall-to-beam joints. The initial stiffness, plastic moment capacity, as well as the rotational capacity of the composite wall-to-beam joints based on the numerical analysis were further compared with the current design provision.