The goal of rotator cuff repairs is to achieve high initial fixation strength, minimize gap formation, maintain mechanical stability under cyclic loading and optimize the biology of the tendon-bone interface until the cuff heals biologically to the bone. Single row repairs are least successful in restoring the footprint of the rotator cuff and are most susceptible to gap formation. Double row repairs have an improved load to failure and minimal gap formation. Transosseous equivalent repairs (suture bridge technique) have the highest ultimate load and resistance to shear and rotational forces and the lowest gap formation. Even though the superior advantages of double row and transosseous equivalent repairs, those techniques take longer surgical time and are more expensive than single row repairs. Therefore single row repairs can be useful in bursal side partial thickness or small size full thickess rotator cuff tear.
A preventive maintenance model, caller FNBM($\alpha$, $\delta$, $\gamma$)model, is proposed to decide an optimal repair number under achieved availability requirements(r) along with taking two types of failures (repairable or irrepairable) into account. In this model, the current system is replaced by a new one in case when it doesn't meet the achieved availability requirement, even though it is repairable failure; Otherwise it is replaced in time of the first irrepairable failure. Assumed that the j-th failure is repairable with probability ${\alpha}_j$ minimal repairs are allowed for repairable failure between replacements. Expected cost rate for preventive maintenance model is developed using NHPP(Non-Homogeneous Poisson Process) in order to determine the optimal number $n^*$, also numerical examples are shown in order to explain the proposed model. Since the proposed FNBM($\alpha$, $\delta$, $\gamma$)model includes Park FNBM model(1979) and Nakagawa FNBM(p)model(1983) this proposed model is thought to be better than previous model, especially for weapon system which requires availability as primary parameter.
A system with $n$ components which functions when at least ${\kappa}$ of the components function is called ${\kappa}$-out-of-$n$ system. Most studies on ${\kappa}$-out-of-$n$ system derive the system reliability based on the assumption that the system has just two states: functioning or failed. However, the system efficiency may depend on the number of functioning components. This paper considers a Multi-state ${\kappa}$-out-of-$n$ system and derives the total system efficiency. In addition, assuming that the system is repairable, the optimal repair policy to maximize the system efficiency is studied. The system efficiency considered in this paper can be regarded as a generalized measure of the mean time to the failure of the system.
Background: Many hyaluronic acid (HA)-based anti-adhesive agents have been commercialized for clinical use in the pharmaceutical market. But their efficacy in arthroscopic rotator cuff repairs remains elusive. To determine their efficacy, we performed a comparative analysis of the effects of two hyaluronate/carboxymethylcellulose (CMC)-based anti-adhesive agents, Protescal and Guardix. Methods: We recruited a total of 256 patients who had received an arthroscopic rotator cuff repair at our hospital between January 2014 and March 2015. Among them, 96 patients fulfilled the study's selection criteria and were enrolled as the final population sample. Thirty patients who had received a postoperative injection of Protescal were allocated into Group A. Another 30 patients who had received a postoperative injection of Guardix were allocated into Group B. As controls, 36 patients who did not receive any injection were allocated into Group C. The patients included in this study were aged between 19 and 75 years. For the clinical assessment, we measured the following clinical parameters-the visual analogue scale for pain (PVAS), the American Shoulder and Elbow Surgeons (ASES) score, and the constant score, as well as passive range of motions (ROMs)-at three time-points (preoperatively, 2-month postoperatively, and 6-month postoperatively). Results: We found that Group A compared to Group B tended to show a swifter recovery in passive anterior elevation and in internal rotation by the 2-month postoperative follow-up, but the differences were not statistically significant. Conclusions: We found that the effects of HA/CMC-based injections were minimal after arthroscopic rotator cuff repairs.
The present study investigates the effects of calcium sulfate graft on the periodontal healing in intrabony periodontal defects of dogs. Following the general anesthesia with 30mg/kg pentobarbital injected intravenously, the first premolar was extracted and full-thickness periodontal flap was elevated from the second premolar to the fourth premolar. The portion of premolars coronal to the alveolar crest was removed and mesial and distal roots were separated. Exposed root canals were sealed with Caviton and covered completely with flaps sutured. Following the healing period of 12 weeks, the surgical sited were uncovered and $4{\times}4mm$ intrabony defects were surgically created. Those defects with calcium sulfate graft following the root planing was designated as the test sites and those with flap surgery-only were designated as control sites. The animals were sacrificed after 8 weeks and the healing was histologically analyzed. The results were as follows. 1. No foreign body reaction or inflammation were observed in either groups. Calcium sulfate was completely resorbed in the test sites. 2. New cementum was observed coronal to the notch in both groups. Connective tissue fibers were oriented parallel to the root surface in the controls. Connective tissues were formed in large amount in the sites. 3. Test sites showed marked amount of new bone formation while the control sites showed minimal bone gain. 4. Root resorption was observed in coronal portions of th control Sites. The results suggest that calcium sulfate is a biocompatible graft material with a potential for new bone and cementum formation.
Journal of the Korean Institute of Rural Architecture
/
v.22
no.2
/
pp.1-8
/
2020
This study is intended to derive the adaptive reuse techniques through the history and aspects of new construction, extension, repair, and other works, limited to the deep and narrow lots facing Seongan-gil and Nammun-gil in Nammun-ro 2 ga of Cheongju, the historic urban area. The results are as follows. 1) In the case of newly built reinforced concrete buildings, the central part of the top floor of the residence or all floors are opened to the open space(void) to facilitate lighting and ventilation. This is developed as a convection phenomenon due to the temperature difference from the slits between buildings, which affects the entire air flow of the block. 2) The buildings of extension and repair are composed of two-story masonry or steel frame, both the front store facing the road and the house on the back, but it looks like one because it is in contact with each other. If only a small gap between the front and rear buildings is restored to an external space or a space equipped with sun light, a small breath can be provided in lighting and ventilation. 3) The existing two-story wooden stores and houses have lost their external space due to repairs. With minimal intervention to restore the small courtyard, slits, and space under the eaves, it will not only improve lighting and ventilation, but also create a unique appearance as a segment of the elongated store.
Background: Injectable hydrogels have been extensively researched for the use as scaffolds or as carriers of therapeutic agents such as drugs, cells, proteins, and bioactive molecules in the treatment of diseases and cancers and the repair and regeneration of tissues. It is because they have the injectability with minimal invasiveness and usability for irregularly shaped sites, in addition to typical advantages of conventional hydrogels such as biocompatibility, permeability to oxygen and nutrient, properties similar to the characteristics of the native extracellular matrix, and porous structure allowing therapeutic agents to be loaded. Main body: In this article, recent studies of injectable hydrogel systems applicable for therapeutic agent delivery, disease/cancer therapy, and tissue engineering have reviewed in terms of the various factors physically and chemically contributing to sol-gel transition via which gels have been formed. The various factors are as follows: several different non-covalent interactions resulting in physical crosslinking (the electrostatic interactions (e.g., the ionic and hydrogen bonds), hydrophobic interactions, ${\pi}$-interactions, and van der Waals forces), in-situ chemical reactions inducing chemical crosslinking (the Diels Alder click reactions, Michael reactions, Schiff base reactions, or enzyme-or photo-mediated reactions), and external stimuli (temperatures, pHs, lights, electric/magnetic fields, ultrasounds, or biomolecular species (e.g., enzyme)). Finally, their applications with accompanying therapeutic agents and notable properties used were reviewed as well. Conclusion: Injectable hydrogels, of which network morphology and properties could be tuned, have shown to control the load and release of therapeutic agents, consequently producing significant therapeutic efficacy. Accordingly, they are believed to be successful and promising biomaterials as scaffolds and carriers of therapeutic agents for disease and cancer therapy and tissue engineering.
Minimal invasive surgery (MIS) has rapidly gained acceptance for the management of a wide variety of pediatric diseases. A questionnaire was sent to all members of the Korean Association of Pediatric Surgeons. Thirty one members (25.4%) took part in the survey that included data for the year 2012: demographic details, opinion regarding minimal invasive surgery and robotic surgery, spectrum of minimally invasive operations, and quantity of procedures. 48.4% of the respondents had more than 10 years experience, 35.5% less than 10 years experience, and 16.1 % had no experience. The respondents of the recommend MIS and perform MIS for surgical procedures are as follow; inguinal hernia (61.3%), simple appendicitis (87.1%), complicated appendicitis (80.6%), reduction of intussusceptions (83.9%), pyloromyotomy (90.3%), fundoplication (96.8%), biopsy and corrective surgery of Hirschsprung's disease (93.5%/90.3%), imperforate anus (77.4%), congenital diaphragmatic hernia (80.6%), and esophageal atresia (74.2%). The MIS procedures with more than 70% were lung resection (100%), cholecystectomy (100%), appendectomy (96.2%), ovarian torsion (86.7%), fundoplication (86.8%), hiatal hernia repair (82.6%), and splenectomy (71.4%). The MIS procedures with less than 30% were congenial diaphragmatic hernia reapir (29.6%), esophageal atresia (26.2%), correction of malroatation (24.4%), inguinal hernia repair (11.4%), anorectal malformation (6.8%), Kasai operation (3.6%).
Purpose: The purpose of this study is to provide the clinical outcomes of arthroscopic type II SLAP repair in non-athletes, and to compare the clinical outcomes between those who had isolated type II SLAP lesion and those who had combined partial thickness supraspinatus tear that did not required a combined repair. Materials and Methods: From July 2005 to January 2007, 142 consecutive type II SLAP lesions were treated with arthroscopic surgery. The inclusion criteria for the study were; (1) younger than 50 years old; and (2) non-athletes. Exclusion criteria were; (1) prior surgery, fracture or combined recurrent dislocation history on the affected shoulder; (2) combined full thickness rotator cuff tear or PTST (>50% thickness) patient that needed repair; and (3) combined infection, arthritis or inflammatory disease. Remaining 19 patients meet the criteria. Among them, 13 had combined PTRCT that did not require repair (Group I), and 6 had isolated type II SLAP lesion without combined supraspinatus tear (Group II). The mean age was 36.7 years (29~49 years), mean symptom duration was 39.1 months (3~216 months) and mean follow-up was 19.0 months (12~27 months). In all patients, the range of motion of affected shoulder, pain and function visual analogue scale (PVAS, FVAS), the Constant score and UCLA score were evaluated preoperatively and postoperatively. Results: In group I, external rotation at side was decreased significantly (p=0.003),but there were no statistical significant change at the remains(p>0.05). And there were no differences between groups (p>0.05). At the final follow-up, all clinical outcome measurements improved after surgery with statistical significance (p<0.05): UCLA score, $22.8{\pm}5.2$ to $32.8{\pm}2.1$; Constant score, $79.4{\pm}8.6$ to $94.9{\pm}4.3$; PVAS $5.4{\pm}2.7$ to $1.1{\pm}1.4$; FVAS $63.2{\pm}15.3$ to $93.4{\pm}7.3$. But, in group comparison of the mean UCLA score and Constant score, there were no statistical significant differences between two groups. Conclusion: Arthroscopic repair of type II SLAP lesion provided good clinical outcomes in nonathletic population. Combined partial thickness supraspinatus tear does not seem to hamper the final outcome at minimal 1 year follow-up.
Purpose: We try to evaluate the functional outcomes of the ankle with isokinetic plantaflexion torque for acute achilles tendon rupture cases those treated by primary repair with the Krackow suture technique and early rehabilization. Materials and Method: The authors studied retrospectively, 15 patients of acute achilles tendon rupture treated and followed over six months, from July 1997 to May 2001. There were 12 men and 3 women, and mean age was 39.6year. The repair method of ruptured tendon was single or double Krackow suture technique. One week(5days-2weeks) after operation, early ROM with ankle-foot orthosis was started. We used Arner-Lindholm Scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. We analyzed the dorsiflexion peak torque and plantarflexion peak torque of the ankle statistically with strength test with Cybex dynamometer. Result: In clinical results, we had 11 excellent cases(73%) and 3 good cases(20%). In patients satisfaction degree, 11 excellent cases(66.6%), 3 good cases(20%) and 2 fair cases(13.4%). And in strength deficit, 3 none deficit (20%), 9 minimal deficit(60%). We evaluated the isokinetic plantar flexion torque in 3months or 6months after operation. After 3 months, isokinetic test showed the mean functional deficits, 32% and 25% at $30^{\circ}$ and $120^{\circ}/sec$, in 7 cases(46.6%) of 15 cases respectively. After 6 months, the mean deficits were in 21%, 24% at 30. and $120^{\circ}/sec$, respectively. At 3 and 6 months' follow up, absolute value of isokinetic test showed increase of 25. 31bs to 421bs and 19.61bs to 271bs at $30^{\circ}$ and $120^{\circ}/sec$, respectively. Conclusion: We had good result for acute achilles tendon rupture treated by Krakow suture technique and early range of motion exercise of the ankle. After 6 months, strength deficit was 21% in all of cases but were able to return pre-injured state. This study shows Krakow suture technique was recommended method for primary repair and early rehabilization of achilles tendon ruptue.
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