• Title/Summary/Keyword: Large tear

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Anatomic factors associated with degeneration and fraying of the coracoacromial ligament

  • Ryan Lopez;Jaspal Singh;Mohammad Ghoraishian;Thema Nicholson;Stephen Gates;Surena Namdari
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.26-31
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    • 2024
  • Background: The coracoacromial ligament (CAL) is frequently observed to be damaged during arthroscopy and it is unclear how demographic, anatomic, and radiographic factors are related to CAL degeneration in full-thickness rotator cuff tears. Methods: A prospective study was conducted of patients at a single institution undergoing shoulder arthroscopy for first-time, full-thickness rotator cuff tears. We evaluated preoperative anteroposterior radiographs to obtain critical shoulder angle, glenoid inclination, acromial index, acromiohumeral distance, lateral acromial angle, and acromial morphology. We documented CAL quality, rotator cuff tear size and pattern during arthroscopy. Multiple logistic regression was used to identify predictive factors for encountering severe CAL fraying during arthroscopy. Results: Shoulders had mild CAL degeneration in 58.1% of cases, whereas severe CAL degeneration was present in 41.9% of shoulders. Patients with severe CAL attrition were significantly older (62.0 years vs. 58.0 years, P=0.042). Shoulders with severe CAL attrition had large rotator cuff tears in 54.1% of cases (P<0.001), and tears involving the infraspinatus (63.2% vs. 29.6%, P=0.003). The severe degeneration group was more likely to have a larger critical shoulder angle measurement on preoperative radiographs than those in the mild attrition group (36.1°±3.6° [range, 30°-45°] vs. 34.1°±3.8° [range, 26°-45°], P=0.037). Conclusions: While the clinical impact of CAL degeneration remains uncertain, increased severity of CAL degeneration is associated with older age, larger rotator cuff tear size, presence of infraspinatus tearing, and increased preoperative critical shoulder angle. Level of evidence: III.

Spotlighting Engineering Service Business in Korea (각광받는 한국의 기술용역업)

  • Cho Kyu Shim
    • Proceedings of the Korean Professional Engineer Association Conference
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    • 1987.12a
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    • pp.65-71
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    • 1987
  • All Korean professional engineer′s great joy Is to welcome the Japanese professional engineers and relevant guests to the 1987 Japan-Korea Professional Engineers Joint Convention organized by the Korean Professional Engineers Association. As there exists an effort of blood, sweat and tear behind a succeeded theatrical stage, so an exquisite devotion with drawing up a master plan, investigation, supervision and etc by engineering firms is soaked through every part of huge construction projects and large unit factory buildings. It is over 14 years that the Engineering Service Promotion Law has been enacted by the Ministry of Science and Technology. In the meantime, the domestic engineering (engineering service) have reached a remarkable higher level while the number of engineering firms participating in overseas market has gradually been increasing. From a small scale of under water investigation to a large scale planning of atomic reactor or petrochemical plant, engineering service business can be said "The Software of Total Industry." Engineering service is what is called a higher business which offers specialized engineering know-how and experience. Engineering service compaines offer Its specialized knowledge and experience to government, industry and commerce. Whether the task is to modernize plant equipment, to design a building or to manage construction, an engineering company will develop and implement the most appropriate and cost effective solution. Clients use the engineering service of firm knowing that the engineer′s professional judgement is not influenced or biased by other commercial affiliations. While benefiting from the diverse experience that professional engineers can apply to a specific problem, government and industry also reduce the need for permanent in-house engineering staff. Engineering firms may be specialized or multi-disciplinary.

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Comparison of Arthroscopic versus Mini Open Repair in Rotator Cuff Tear (회전근 개 파열에 대한 관절경적 봉합술과 소 절개 봉합술의 비교)

  • Park, Ji-Kang;Park, Kyoung-Jin;Kim, Yong-Min;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Im, Se-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.35-40
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    • 2010
  • Purpose: To compare the outcome of patients who underwent rotator cuff repair using all-arthroscopic mini-open repair techniques. Materials and Methods: We retrospectively reviewed 44 patients who underwent either arthroscopic (group I) or mini-open (group II) rotator cuff repair. 23 patients underwent an arthroscopic repair and 21 patients had a mini-open repair. The mean age was 50.4 years in the arthroscopic group and 56.7 years in the mini-open group. The outcomes for the 2 groups were evaluated using ROM, VAS, ASES, UCLA scale. Statistical analysis was performed using correlations, T-test, Paired T-test. The mean follow-up period in the arthroscopic and mini-open groups were 24.1months and 26.1months, respectively. Results: The group I (arthroscopic group) had 2 small-sized tears, 10 medium sized tears, and 11 large sized tears (3~5 cm). The group II (mini-open group) had 1 small sized tears, 8 medium sized tears, and 12 large sized tears. The mean cuff tear size of the group I and Group II were 3.8 cm and 4.2 cm, respectively. At last follow-up periods, ROM and functional scores were improved. In the group I and group II, there were no significant difference in ROM, VAS, ASES, UCLA score. Conclusion: The size of the tear did not produce different results at arthroscopic repair group but larger tear size was associated with a worse outcome in mini-open group. There were no significant clinical results between the arthroscopic and mini-open group.

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Magnetic Resonance Imaging Assessment of Acromion Morphology and Superior Displacement of the Humeral Head in the Impingement Syndrome (충돌 증후군에서 견봉 형태 및 상완골 두 상방 전위의 자기공명영상 분석)

  • Koo Bon Seop;Kim Kyung Chul;Oh Jung Hee
    • Clinics in Shoulder and Elbow
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    • v.2 no.1
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    • pp.28-34
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    • 1999
  • Purpose: We studied magnetic resonance imaging of acromion morphology and superior displacement of the humeral head in the patients with diagnosis of rotator cuff impingement syndrome, and also documented the relationship of type Ⅲ acromion to the rotator cuff tear. Materials and Methods: We reviewed retrospectively 40 patients(40 shoulders) who had arthroscopic treatment for the diagnosis of stage II impingement or rotator cuff partial tear and did not have other risk lesions except acromion factor. The mean age was 48.7 years at operation. 21 men(2l shoulders), mean age of 26 years, were used as controls. Acromial type, tilt, and superior displacement of humeral head in sagittal plane, and acromial lateral angulation in coronal plane were measured. Four parameters of the patients were compared with those of control group. And then, the data were subdivided and analyzed with respect to acromial type and patient age in the impingement group. Student t test and multi-way ANOVA were used. Results: In impingement group, Farley's type I acromion, 33%, type Ⅱ, 38%, type Ⅲ, 27% and type Ⅳ, 2%. Superior displacement of humeral head( 4.8mm) were characteristic in the impingement group compared with the control group(1.3mm)(p<0.05). But acromial tilt and lateral angulation were not statistically different. In the analysis of the impingement group, the change of 4 parameters was not significant with respect to age(p>0.05), but lateral angulation in type I acromion(18 degree) and superior displacement of humeral head in type Ⅲ acromion(6.3mm) were significantly increased(p<0.05). All 4 parameters were not different between two subdivided types of type Ⅲ acromion. Conclusion: All types of acromian and large lateral angulatian cauld develop impingement syndrame, but acromial tilt was nat risk factar. Appearance of type Ⅲ acromian and increased superiar displacement of humeral head were characteristic findings in the impingement syndrame. Superiar displacement of humeral head as a result of degenerative change of rotatar cuff was probably primary cause far impingement. The type Ⅲ acromian might be an acquired farm, which cauld be expected to accelerate the tear of rotatar cuff as a cansequence.

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A Design of Diakoptic Method based on Sparse Vector Method for the Power System (스파스 벡터 기법을 이용한 전력계통 분할 알고리즘의 개발)

  • Lee, C.M.;Cho, I.S.;Shin, M.C.
    • Proceedings of the KIEE Conference
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    • 1991.07a
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    • pp.426-431
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    • 1991
  • Diakoptic method applied to analyze large power system, always require the efficient tearing algorithm. But conventional tearing methods is not suitable to apply practical power system. This paper presents new tearing algorithm based on factorization path concept of sparse vector method, and applied MPRLD, a kind of optimal ordering algorithm, in ordering step to improve the efficiency of tearing algorithm. Test result of model systems shows that new proposed method in this paper is enable to tear power systems not to be teared by heuristic cluster method, reduces computing time and memory size.

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Remote Cerebellar Hemorrhage after Lumbar Spinal Surgery

  • Nam, Taek-Kyun;Park, Seung-Won;Min, Byung-Kook;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.501-504
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    • 2009
  • Remote cerebellar hemorrhage (RCH) is rare but potentially lethal as a complication of spinal surgery. We recently experienced a case of RCH in a 61-year-old man who showed mental deterioration after lumbar spinal surgery. There was dural tearing with subsequent cerebrospinal fluid (CSF) loss during the surgery. Brain computed tomography scan revealed cerebellar hemorrhage, 3rd and 4th ventricular hemorrhage and pneumocephalus. He underwent suboccipital craniectomy and hematoma removal. The most important pathomechanism leading to RCH after spinal surgery has been known to be venous bleeding due to caudal sagging of cerebellum by rapid leak of large amount of CSF which seems to be related with this case. Dural repair and minimizing CSF loss after intraoperative dural tearing would be helpful to prevent postoperative RCH.

Damage Estimation of Cables using PZT (압전소자를 이용한 케이블의 손상평가)

  • Park, Kang-Geun;Kim, Ie-Sung;Kim, Wha-Jung
    • Proceedings of the Korean Institute of Building Construction Conference
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    • 2008.11a
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    • pp.235-239
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    • 2008
  • Cable systems are a construction of elements carrying only tension and no compression or bending in membrane structure. Tensile membrane structures are most often used as roofs as they can economically and attractively span large distances. But cable systems have weaknesses to vibration by earthquake, wind and vehicle loads. Damage detection of cable systems by using existing safety diagnosis is difficult to detect the characteristic change of overall structural action. If cable snaps are occurred to cable release and tear in tension structures, these are set up a vibration. So, we used piezo-electric materials, and The principle of operation of a piezoelectric sensor is that a physical dimension, transformed into a force, acts on two opposing faces of the sensing element. In this study, the development on test method of cable system is proposed and tested by tensile strength using piezo-electric materials.

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Experimental Study of Stiffness transition zone by using Moving Wheel Loads (이동하중에 의한 지지강성 변화구간에 대한 실험적 연구)

  • Lee, Jin-Wook;Choi, Chan-Yong;Lee, Seong-Hyeok;Park, Tae-Hwan
    • Proceedings of the KSR Conference
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    • 2007.05a
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    • pp.1056-1061
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    • 2007
  • Railroad roadbed was consisted into structure types that earthwork, tunnel, bridge and joint sections. Joint section was affected a large factor confidence and safety of the train running by stiffness transition zone that track substructure stiffness change section as like between tunnel and earthwork from ballast track to concrete track. These problems are the results of increased dynamic wheel loads, which also lead to wear and tear on vehicle components and contribute to poor ride quality. The study presented in this paper was conducted on model test by using Wheel Moving Loading System.

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Acute Type 1 Aortic Dissection Involving Right Coronary Artery (우관상동맥 침범한 급성 대동맥 박리증 치험 1례)

  • Min, Gyeong-Seok;Lee, Jae-Won;Song, Myeong-Geun
    • Journal of Chest Surgery
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    • v.28 no.2
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    • pp.188-192
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    • 1995
  • A 50 year old man with acute aortic dissection DeBakey type I, involving right coronary artery and aortic valve, underwent replacement of the ascending aorta and aorto-right coronary bypass grafting. The operative findings showed a large transverse intimal tear was at about 4cm above the aortic valve. The dissection extended out into the proximal right coronary artery. And we found that the right coronary artery originated from the left sinus of Valsalva, run transversally in the aortic wall, with partial rupture. Postoperatively he had no ischemic cardiac symptoms and neurologic complications. He was discharged on postoperative 9th day with good result.

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Subarachnoid-Pleural fistula after Excision of Posterior Mediastinal Mass (후종력동종양제거술후 발생한 척추지주막하늑막강루)

  • 신지승;최영호;김현구;조성준;김학제
    • Journal of Chest Surgery
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    • v.33 no.6
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    • pp.525-527
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    • 2000
  • Subarachnoid-pleural fistula after routine thoracotomy is a rare complication but a very serious problem. Twenty one cases have been reported in the literature. We report a care of subarchnoid-pleural fistula that dveloped after the esecation of posterior mediastinal neurogenic tumor. The patient presented with large amount of clear pleural fluid with mild headache and dizziness. Surgical intervention following a trial of conservative therapy was undertaken because we strongly suspected subarachnoid-pleural fistula. A dural tear was found at the level of resected intercostal nerve root. The dura was closed by way of direct suture and fibrin glue. In this case, the recognition of subarachnoid-pleural fistula formation is difficult because the patient had not presented any neurologic deficit.

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