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The Difference between Short and Long Intramedullary Nailing as the Treatment for Unstable Intertrochanteric Femoral Fracture (AO/OTA 31-A2) in Elderly Patients (고령환자에서 발생한 불안정성 대퇴골 전자간부 골절(AO/OTA 31-A2)의 치료 시 골수강내 금속정의 길이에 따른 추시 결과)

  • Shin, Won Chul;Lee, Eun Sung;Suh, Kuen Tak
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.25-32
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    • 2017
  • Purpose: The purpose of this study was to analyze the radiological and clinical outcomes in elderly patients with unstable intertrochanteric femur fractures in accordance with the length of intramedullary nail. Materials and Methods: Between August 2009 and December 2014, a total of 139 patients-older than 65 years of age with AO/OTA classification of 31-A2 unstable intertrochanteric femur fracture-who has been followed-up for at least 1 year after the treatment with internal fixation by using an intramedullary nail were enrolled for this retrospective control study. The subjects were classified into two groups according to the length of intramedullary nail: 106 patients in the short group (group I) and 33 patients in the long group (group II). For radiological assessments, the reduction state, time to union, and implant related complications were examined. The clinical outcomes were assessed by preoperative hemoglobin, operating time, intraoperative bleeding amount, blood transfusion rate, hospitalization period, and Charnley hip pain scoring system at the final follow-up. Results: The postoperative radiographs showed good or acceptable reduction in all cases. The mean time of radiologic bone union was 4.8 months, and there was no difference between the two groups. With respect to surgical time, the group II was found to take longer (57.87 minutes) than the group I (45.65 minutes) (p=0.003). The bleeding amount during surgery of the group II was greater (288.78 ml) than that of the group I (209.90 ml) (p=0.046). The clinical results at the final follow-up were found to be satisfactory in both groups. Conclusion: In cases of good reduction of the fracture from the treatment of unstable intertrochanteric femur fracture accompanying the posteromedial fragment in elderly patients, both groups-long and short intramedullary nails-showed satisfactory radiological and clinical outcomes.

Clinical Results of Anterolateral Thigh Perforator Flap for Soft Tissue Reconstruction of the Foot and Ankle (족부 및 족관절부 연부조직 재건을 위한 전외측 대퇴 천공지 피판술의 임상결과)

  • Han, Soo-Hong;Hong, In Tae;Lee, Yohan;Jo, Yong-Gil;Kwon, Young Woo
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.40-48
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    • 2017
  • Purpose: Soft tissue reconstruction of a defect around the foot and ankle is a particularly challenging procedure due to the anatomical and functional characteristics of this area. Hence, only a limited number of treatment options are available. Moreover, if patients wish to avoid additional scars on the ipsilateral lower leg for cosmetic reasons, even fewer options are available for treatment. The authors used an anterolateral thigh perforator flap for soft tissue defects in this area, when other surgical options were inadequate. The aim of this study was to report the clinical results and the efficacy of this procedure. Materials and Methods: Sixteen cases of soft tissue defects around the foot and ankle were included. Participants included 12 male and 4 female subjects, and the mean age was 34 years. The most common cause of defect was acute trauma, and the average follow-up period was 33 months. Flap survival time, surgical complications, and ambulation status at the final follow-up stage were evaluated. Results: All 16 flaps successfully survived, except for one case with partial flap necrosis that was thought to be due to weight bearing earlier than scheduled. All patients were able to walk independently without any aid at the final follow-up stage. No patients showed other significant surgical complications. Conclusion: The anterolateral thigh perforator flap is a good alternative for soft tissue defects of the foot and ankle, when other options are not applicable. This study also demonstrated that surgery using an anterolateral thigh perforator flap is safe and highly reliable.

Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures (Sanders 4형 종골 골절에 대한 관혈적 정복술 및 내고정술과 일차성 거골하 관절 유합술의 치료 결과 비교)

  • Woo, Seung Hun;Chung, Hyung-Jin;Bae, Su-Young;Kim, Sun-Kyu
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.49-58
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    • 2017
  • Purpose: To compare clinical outcome of Sanders type IV intra-articular calcaneal fracture treated with open reduction and internal fixation (ORIF) versus ORIF and primary subtalar arthrodesis (PSTA). Materials and Methods: Between March 2003 and November 2013, 22 patients with 22 Sanders type 4 intra-articular calcaneal fractures were included in this study. Of these, 11 were treated with ORIF (ORIF group), and 11 were treated with ORIF and PSTA (PSTA group). The mean follow-up period was 34.6 months (range, 18-72 months). Clinical outcomes were assessed along with the American Orthopedic Foot and Ankle Society's ankle-hindfoot scale (AOFAS score), and the visual analogue scale pain score (VAS score) at 6-month, 12-month, and last follow-up. Patient satisfaction, return to previous occupation and postoperative complications were also investigated. Results: The results for ORIF did not differ from those for PSTA based on the last follow-up AOFAS scores or the VAS scores (p>0.05). However, patient satisfaction was significantly higher in the PSTA group (p=0.008). Secondary subtalar arthrodesis was conducted in five patients (45.5%) of the ORIF group within 2 years postoperatively. Conclusion: We were unable to demonstrate a significant difference in clinical outcomes between ORIF and PSTA; however, the patient satisfaction was higher in the PSTA group. PSTA may be a suitable choice for patients who need fast recovery to daily activity and to prevent the need for secondary subtalar arthrodesis.

Effects of Group Art Therapy to Improve Self-esteem and Enhance Self-integrity of Rural Elderly Women (농촌여성노인의 자아존중감 향상 및 자아통합감 증진을 위한 집단미술치료 프로그램 효과)

  • Kim, Jong Hee
    • 한국노년학
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    • v.34 no.2
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    • pp.259-275
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    • 2014
  • The purpose of this study is to check if group art therapy is effective in improving self esteem and self integrity of rural elderly women. Study subjects are forty seven rural elderly women in A-city who have participated in producing specialized products in their rural area. They are divided into experimental group (EG, n=25) who wish to participate in the group art therapy program, a part of the A-city sponsored program named 'Making the Rural Elderly Happy', to improve and enhance the elderly's self esteem and self integrity, and control group (CG, n=22) with no wish to participate. However, only forty four elderly women are selected as the final study subjects for data analysis, due to those who either missed the program session more than once or died of old age during the program period. The group art therapy program was given from March 16 to May 18 of 2010, every Tuesday between 1pm through 3pm for a total of 12 sessions, with the help of two college student assistants in the region and one staff member for the city program. SPSS WIN version 12.0 is adopted to evaluate and analyze the effects of the therapy program, independent t-test for equivalence check of pretests, and frequency check for general characteristics of each group. The study results are obtained by the mean and standard deviation to grasp the changes between pretest and post-test on both groups, together with ANCOVA to evaluate effects of the therapy program with the pre-test as covariant. The results are as follows. First, self esteem of EG is significantly improved than that of CG after intervention of group art therapy. Second, self integrity is significantly higher in EG than CG after the group art therapy intervention. Therefore, it can be claimed that group art therapy is effective in improving and enhancing self esteem and self integrity of the rural elderly women.

Effects of drumming exercise on the autonomic nervous system in overweight women (드러밍 운동이 과체중 여성의 자율신경계에 미치는 영향)

  • Jeong In Kwon;Jae Hoon Lee;Joon Yong Cho;Yoo Sung Oh
    • Journal of the Korean Applied Science and Technology
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    • v.41 no.2
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    • pp.219-232
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    • 2024
  • The aim of this study was to explore the impact of body mass index (BMI) and drumming exercise on autonomic nervous system function in adult women. Ten adult women (aged 30-50) were divided into two groups based on their BMI: a normal BMI group (Low BMI, LBMI < 23 kg/m2) and an overweight BMI group (High BMI, HBMI > 23 kg/m2). Both groups participated in a drumming exercise program, consisting of 50-minute sessions, three times a week, for a duration of 8 weeks. Body composition and heart rate variability were assessed before and after the 8-week exercise period. Heart rate variability was evaluated using linear analysis in the time domain and frequency domain. Additionally, non-linear analysis was conducted using a Poincaré plot. The autonomic nervous system index was determined by measuring parasympathetic nervous system index and sympathetic nervous system index. Following the 8-week intervention, the HBMI group exhibited a significant decrease in weight (p=0.034), BMI (p=0.044), body fat mass (p=0.032), and waist circumference (p=0.013) compared to the LBMI group. Furthermore, the HBMI group demonstrated significant increases in RMSSD (p=0.018) and TP (p=0.033) in linear analysis, as well as SD1 (p=0.018) in non-linear analysis and PNS Index (p=0.040) compared to the LBMI group. RMSSD, SD1, and PNS Index serve as indicators of parasympathetic nervous system activity in linear and non-linear analyses, respectively. These findings indicate that drumming exercise significantly enhances autonomic nervous system function in overweight women.

Unenhanced Breast MRI With Diffusion-Weighted Imaging for Breast Cancer Detection: Effects of Training on Performance and Agreement of Subspecialty Radiologists

  • Yeon Soo Kim;Su Hyun Lee;Soo-Yeon Kim;Eun Sil Kim;Ah Reum Park;Jung Min Chang;Vivian Youngjean Park;Jung Hyun Yoon;Bong Joo Kang;Bo La Yun;Tae Hee Kim;Eun Sook Ko;A Jung Chu;Jin You Kim;Inyoung Youn;Eun Young Chae;Woo Jung Choi;Hee Jeong Kim;Soo Hee Kang;Su Min Ha;Woo Kyung Moon
    • Korean Journal of Radiology
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    • v.25 no.1
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    • pp.11-23
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    • 2024
  • Objective: To investigate whether reader training improves the performance and agreement of radiologists in interpreting unenhanced breast magnetic resonance imaging (MRI) scans using diffusion-weighted imaging (DWI). Materials and Methods: A study of 96 breasts (35 cancers, 24 benign, and 37 negative) in 48 asymptomatic women was performed between June 2019 and October 2020. High-resolution DWI with b-values of 0, 800, and 1200 sec/mm2 was performed using a 3.0-T system. Sixteen breast radiologists independently reviewed the DWI, apparent diffusion coefficient maps, and T1-weighted MRI scans and recorded the Breast Imaging Reporting and Data System (BI-RADS) category for each breast. After a 2-h training session and a 5-month washout period, they re-evaluated the BI-RADS categories. A BI-RADS category of 4 (lesions with at least two suspicious criteria) or 5 (more than two suspicious criteria) was considered positive. The per-breast diagnostic performance of each reader was compared between the first and second reviews. Inter-reader agreement was evaluated using a multi-rater κ analysis and intraclass correlation coefficient (ICC). Results: Before training, the mean sensitivity, specificity, and accuracy of the 16 readers were 70.7% (95% confidence interval [CI]: 59.4-79.9), 90.8% (95% CI: 85.6-94.2), and 83.5% (95% CI: 78.6-87.4), respectively. After training, significant improvements in specificity (95.2%; 95% CI: 90.8-97.5; P = 0.001) and accuracy (85.9%; 95% CI: 80.9-89.8; P = 0.01) were observed, but no difference in sensitivity (69.8%; 95% CI: 58.1-79.4; P = 0.58) was observed. Regarding inter-reader agreement, the κ values were 0.57 (95% CI: 0.52-0.63) before training and 0.68 (95% CI: 0.62-0.74) after training, with a difference of 0.11 (95% CI: 0.02-0.18; P = 0.01). The ICC was 0.73 (95% CI: 0.69-0.74) before training and 0.79 (95% CI: 0.76-0.80) after training (P = 0.002). Conclusion: Brief reader training improved the performance and agreement of interpretations by breast radiologists using unenhanced MRI with DWI.

First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS): A Multicenter Prospective Study

  • Jang-Hyun Baek;Byung Moon Kim;Sang Hyun Suh;Hong-Jun Jeon;Eun Hyun Ihm;Hyungjong Park;Chang-Hyun Kim;Sang-Hoon Cha;Chi-Hoon Choi;Kyung Sik Yi;Jun-Hwee Kim;Sangil Suh;Byungjun Kim;Yoonkyung Chang;So Yeon Kim;Jae Sang Oh;Ji Hoe Heo;Dong Joon Kim;Hyo Suk Nam;Young Dae Kim
    • Korean Journal of Radiology
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    • v.24 no.2
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    • pp.145-154
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    • 2023
  • Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b-3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b-3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0-2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninety-nine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0-35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0-2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0-2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13; 95% confidence interval, 1.59-10.8; p = 0.004). Conclusion: Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0-2, even in patients with successful recanalization.

The change of designation and release of Hapcheon (Gyeongsangnam-do) Swan Sanctuary as Natural Monument (천연기념물 합천 백조도래지의 지정과 해제과정)

  • SIM Keunjeong
    • Korean Journal of Heritage: History & Science
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    • v.57 no.1
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    • pp.162-178
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    • 2024
  • Swans are representative migratory birds that spend winter in East Asia, and have long been considered rare birds. In particular, they were regarded as king of Japan. The process of designating a natural monument in Hapcheon Swan Sanctuary is an interesting story. In this study, the designation and release process of Hapcheon Swan Sancturay ((Bakgok-ji, Yongju-myeon 龍州面 朴谷池), (Jeongyang-ji, Daeyang-myeon 大陽面 正陽池), Gaho, Cheongdeok-myeon 淸德面 嘉湖)) Natural Monument, was examined. These places were designated as a natural monument on August 27, 1934, during the Japanese colonial period, and was lifted on August 14, 1973, after the Cultural Protection Act was enacted after liberation. From the beginning of the new year in 1929, the Japanese Government-General of Korea (朝鮮總督府) decided to capture swans alive to give to the king of Japan. An official of the Japanese Government-General of Korea (統監) decided to offer swans to the king during his New Year's greeting visit. The department in charge of capturing swans was the Gyeongsangnam-do Provincial Police Department, and the execution was the police station of each county (郡). The reason is believed to be that it is easy to forcibly mobilize, control, or urge people, and the capture activity had to be completed as soon as possible. A total of three swans were captured in Hapcheon-gun from January 12 to 14, 1929. At that time, various newspapers published related information. Based on these facts and experiences, it is estimated that the Hapcheon area was selected when designating a natural monument in 1934. Hapcheon Swan Sancturay, Natural Monument lost its function due to excessive human interference of various developments, illegal capture, and use of poison to catch swans. Their number has also significantly decreased. It was thus removed from the natural monument in 1973. One of the three swan sanctuaries (Gaho 嘉湖) has been completely reclaimed, one (Bakgok-ji 朴谷池) has almost no migratory birds due to the conversion of wetlands, and one (Jeongyang-ji 正陽池) has swans flying back. In the case of Jeongyangji (正陽池), It is an encouraging sign that many swans fly as the surrounding environment and growing conditions change. This phenomenon is interpreted to mean that nature and climate are recovering and healing.

Critical Temperature for Grain Filling of Japonica Rice in Korea (우리나라 자포니카 벼 품종의 등숙 한계온도 분석)

  • Woonho Yang;Shingu Kang;Dae-Woo Lee;Mi-jin Chae
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.68 no.4
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    • pp.225-235
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    • 2023
  • Critical temperature for grain filling of three Korean japonica rice varieties was analyzed by late transplantation to induce a low temperature during grain filling period in a field study. The grain filling percentage (GFP) and grain dry weight (GDW) showed a sigmoid development for the first and second transplants in 2020 and first to third transplants in 2021. For the third transplant in 2020 and fourth transplant in 2021, the GFP and GDW reached a peak at 42 days after heading (DAH), and then decreased or remained unchanged. In non-linear regression analyses, 95% of the final GFP and GDW appeared at 49 - 62 DAH for the second transplant in 2020 and at 37 - 46 DAH and 30 - 36 DAH for the second and third transplants in 2021, respectively. At these time points, the critical seven-day moving temperature (7dMovT) was 8.4~9.4℃ for the second transplant in 2020 and 9.4~10.9℃ for the second and third transplants in 2021, depending on the grain filling traits and varieties of rice. The lowest 7dMovT was 8.4 - 8.7℃ in the three varieties. The observed lowest 7-day mean temperature (7dMT) accompanying increases in the GFP and GDW was 9.4 - 10.1℃, depending on the varieties in the third transplant of 2020 and fourth transplant of 2021. In the two transplants mentioned above, the highest 7dMT that showed no increase or decrease in grain filling traits was 8.7 - 9.1℃. The critical temperature for grain filling of japonica rice was 8.4 - 8.7℃ based on the 7dMovT and 9.1 - 9.4℃ based on the 7dMT. The previous 7dMT of 10℃ is recommended to determine the marginal harvest time for safe rice cropping since the temperature was the highest among the lowest temperature that accompanied an increase in grain filling traits.

Influence of Increased Carbon Dioxide Concentration on the Bioluminescence and Cell Density of Marine Bacteria Vibrio fischeri (이산화탄소 농도 증가에 따른 발광미생물의 상대발광량과 밀도변화에 대한 연구)

  • Sung, Chan-Gyoung;Moom, Seong-Dae;Kim, Hye-Jin;Choi, Tae-Seob;Lee, Kyu-Tae;Lee, Jung-Suk;Kang, Seong-Gil
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.15 no.1
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    • pp.8-15
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    • 2010
  • An experiment was conducted to evaluate the biologically adverse effect of increased carbon dioxide in seawater on marine bacteria, Vibrio fischeri. We measured the bioluminescence and cell density at every 6 hours for 24 hours of the whole incubation period after exposing test microbes to a range of $CO_2$ concentration such as 380(Control), 1,000, 3,000, 10,000 and 30,000 ppm, respectively. Significant effect on relative luminescence(RLU) of V. fischeri was observed in treatments with $CO_2$ concentration higher than 3,000 ppm at t=12 h. However, the difference of RLU among treatments significantly decreased with the incubation time until t=24 h. Similar trend was observed for the variation of cell density, which was measured as optical density using spectrophotometer. The results showed that a significant relationship between $CO_2$ concentration and bioluminescence of test microbes was observed for the mean time. However, the inhibition of relative bioluminescence and also cell density could be recovered at the concentration levels higher than 3,000 ppm. The dissolved $CO_2$ can be absorbed directly by cell and it can decrease the intracellular pH. Our results implied that microbes might be adversely affected at the initial growing phase by increased $CO_2$. However, they could adapt by increasing ion transport including bicarbonate and then could make their pH back to normal level. Results of this study could be supported to understand the possible influence on marine bacteria by atmospheric increase of $CO_2$ in near future and also by released $CO_2$ during the marine $CO_2$ sequestration activity.