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Short Term Results of Arthroscopic ACL Reconstruction using Fresh Frozen Achilles Allograft (신선동결 동종 아킬레스건을 이용한 전방십자인대 재건수술의 단기추시 결과)

  • Choi, Ho-Rim;Park, Jong-Seok;Lee, Sang-Seon;Woo, Seung-Han;Hong, Chang-Hwa;Kim, Byung-Heum;Lee, Byung-Ill
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.1
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    • pp.41-44
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    • 2006
  • Purpose: To evaluate the short-term results of arthroscopic ACL reconstruction using fresh frozen Achilles allograft Materials & Methods: From March 2002 to March 2004, arthroscopic ACL reconstructions using fresh frozen Achilles allograft were performed in 25 knees of 25 patients. The average age at operation was 30.1 years (range, 18-50 years) and the average follow-up was 17 months (range, 12 to 27months). Preoperative and follow-up clinical results were evaluated using the Lysholm knee score, IKDC knee rating system, physical examination and KT-2000 arthrometer. Results: The Lachman test was positive in 25 patients preoperatively and 18 patients(72%) had negative results at latest follow-up. The average side-to-side differences of anterior tibial translation using KT-2000 arthrometer under loading of 301b were improved from $7.9{\pm}2.4mm\;to\;2.6{\pm}1.6mm$. The average Lysholm score was improved from $61.1{\pm}13.9\;to\;93.5{\pm}5.3$ points. The IKDC grade was abnormal(C) or severely abnormal(D) in 25 cases preoperatively They improved 22(88%) of normal(A) or nearly normal(B) and 3(12%) of abnormal. Conclusion: Short term results of ACL reconstruction using Achilles allograft was acceptable. Achilles allograft can be a reasonable graft alternative to autograft for ACL reconstruction.

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Change of the Left Atrial Dimension and Transport Function after the Cox-Maze Procedure for Treating Atrial Fibrillation Associated with Mitral Valve Disease: the Short-term and Mid-Term Results (승모판막 질환과 동반된 심방세동에 대한 Cox-Maze 술식 후 좌심방 크기 및 기계적 수축력 변화: 중.단기 경과 관찰 분석)

  • Kim, Hwan-Wook;Lee, Jae-Won;Cho, Won-Chul;Jung, Sung-Ho;Choo, Suk-Jung;Song, Hyun;Chung, Cheol-Hyun
    • Journal of Chest Surgery
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    • v.42 no.3
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    • pp.317-323
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    • 2009
  • Background: Although high efficiency of conversion into sinus rhythm has been demonstrated after performing the Cox-Maze procedure in patients with atrial fibrillation associated with mitral valve disease, the changes in the mechanical function and size of the left atrium have not been determined. The aim of the study was to evaluate the effect of the Maze procedure on the left atrial size and contractile transport function. Material and Method: From July 1997 to July 2008, 647 consecutive patients were operated on for chronic atrial fibrillation associated with mitral valve disease. Among these, 211 patients that (1) were able to be followed up for 2 years after surgery, (2) had sustained normal sinus rhythm, regardless of whether they were taking anti-arrhythmic medications and (3) did not have valvular regurgitation greater than grade III or they did not have moderate grade valvular stenosis were selected for evaluation. The left atrial size and contractile transport function were assessed by transthoracic echocardiography at the postoperative base line (1 year) and at regular follow-up periods (2 years, 3 years, 4 years and 6 year). Result: The left atrial dimension was increased and the contractile transport function was decreased during the follow-up period. The longer the follow-up period, the greater was the statistical significance of the left atrial size increase and contractile transport function decrease. Conclusion: In patients who sustain normal sinus rhythm conversion after a Maze III procedure with a mitral valve operation, there is a gradual increase of the left atrial dimensions and a decrease of contractile transport function during the follow-up period. Therefore, scrupulous follow-up is needed for these patients.

VEGF Expression Patterns in Eutopic Endometrium of Patients with Endometriosis (자궁내막증 환자에서 자궁내막의 VEGF 발현 양상)

  • Jeong, Chang-Won;Park, In-Ae;Hong, Min-A;Lee, Gyoung-Hoon;Choi, Young-Min;Ku, Seung-Yup;Jee, Byung-Chul;Suh, Chang-Suk;Kim, Seok-Hyun;Kim, Jung-Gu;Moon, Shin-Yong
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.2
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    • pp.159-168
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    • 2010
  • Objective: The purpose of this study was to evaluate the correlation between the expression pattern of vascular endothelial growth factor (VEGF) in endometrium and the pathogenesis of endometriosis by investigating VEGF expression patterns and their difference between eutopic endometrium of patients with endometriosis and that of normal controls without endometriosis. Methods: Endometrial sections were obtained from 64 hysterectomy specimens from women under age of 40, who had undergone hysterectomies and had histological evidence of endometriosis, with stage 3 and 4 according to the revised American Society for Reproductive Medicine classification. As for controls, 37 sections were gained from women diagnosed as having cervical intraepithelial neoplasia (CIN) of the uterine cervix and without evidence of pelvic endometriosis or adenomyosis during their operation. The VEGF content was evaluated immunohistochemically in the eutopic endometrium from 64 patients with endometriosis and 37 normal controls. Histological semiquantitative score (H-score) was calculated and compared between study group and control group throughout the menstrual cycle. Results: There was no significant difference in the H-score of VEGF in the eutopic endometrium between patients with endometriosis and controls without endometriosis when compared according to the same phase of the cycle, although the H-score of the study group was significantly higher in the secretory phase than the proliferative phase. Conclusion: The VEGF expression in the eutopic endometrium of women with endometriosis was not different from that of women without endometriosis. This study suggests VEGF expression in eutopic endometrium is unlikely associated with the pathogenesis of endometriosis.

Endocrine Function and Growth in Children with Craniopharyngioma (소아 두개인두종 환자에서 치료 전후의 뇌하수체 기능과 성장 및 체중 변화)

  • Chung, Yoo Mi;Shin, Choong Ho;Yang, Sei Won
    • Clinical and Experimental Pediatrics
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    • v.46 no.3
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    • pp.277-283
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    • 2003
  • Purpose : Craniopharyngiomas are often accompanied by severe endocrine disorders. Although there is universal growth hormone deficiency(GHD), the resulting growth pattern is very heterogeneous. We report the growth and endocrine outcome of 44 children with craniopharyngioma, with emphasis on initial symptoms, growth before and during growth hormone(GH) treatment and spontaneous growth in spite of GHD. Methods : We performed a retrospective study of 44 children treated at our centre between 1984 and 2002. Results : About 30% of patients had symptoms suggesting endocrine disorder at diagnosis. After surgery, multiple endocrinopathies were almost universal. Before GH therapy, height velocity was $8.00{\pm}2.71cm/yr$ in the normal growth group(n=11) and $1.79{\pm}1.10cm/yr$ in the subnormal growth group(n=7) during the first year and during the second year, $6.76{\pm}2.49cm/yr$ and $2.29{\pm}1.33cm/yr$, respectively. There was no difference of body mass index(BMI) change between before and after surgery in the two groups. Height standard deviation score(SDS) was $-1.46{\pm}0.74$ in the normal growth group and $-0.43{\pm}0.97$ in the subnormal growth group. Before GH treatment height SDS was $-1.31{\pm}1.25$ and BMI was $20.46{\pm}3.60$. During GH treatment, height SDS increased to $-0.60{\pm}1.37$ in the first, and to $-0.41{\pm}1.54$ in the second year(P<0.05), but BMI did not change significantly. Conclusion : The endocrine morbidity could develop in most children with craniopharyngioma before and after the operation and should be managed properly. Although all treated patients benefit from GH therapy, further studies are necessary to find out the possible mechanism of growth regulation in normally growing children, despite GH deficient.

A Study on the Selection of the Recommended Safety Distance Between Marine Structures and Ships Based on AIS Data (AIS 기반 해양시설물과 선박간 권고 안전이격거리 선정에 관한 연구)

  • Son, Woo-ju;Lee, Jeong-seok;Lee, Bo-kyeong;Cho, Ik-soon
    • Journal of Navigation and Port Research
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    • v.43 no.6
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    • pp.420-428
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    • 2019
  • Although marine structures are a risk factor interfering with the passage of ships, there are no obvious guidelines on the required safety distance between ships and marine structures under regulations and laws. In this study, the width of the shipping route width was set based on the AIS data to analyze the separation distance between marine structures and ships, and the ships were classified by the length of each ship. By analyzing the distribution at marine structures, this study confirmed that the ships' traffic volume was in the form of normal distribution. To statistically analyze the separation distance between the traffic distribution results and the normal distribution of ships in this study, the traffic pattern analysis around the marine structures was performed. As a result, the traffic pattern was different by length and the recommended safety distance for each length is presented accordingly. Referring to the IMO (International Maritime Organization) the standard turning circle and reference of safety separation distance between ships and offshore wind turbines of the CESMA (Confederation of European Shipmasters' Associations) and P IANC (World Association for Waterborne Transport Infrastructures), the analysis was conducted on ships that did not follow the set distance among the AIS data by setting the distance within the recommended ship safety distance to 5-7 overall length. As a result, the 5.5 length over all of the safety recommendations were selected as appropriate, and based on the above results, the two cases recommending ship safety distance were proposed.

The Long-term Results of a Modified Maze Procedure with Using Cryoablation (냉동 절제를 이용한 변형된 Maze술 식의 중장기 결과)

  • Park, Kwon-Jae;Woo, Jong-Soo;Bang, Jung-Hee
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.710-717
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    • 2008
  • Background: Atrial fibrillation is associated with several complications such as cerebro-vascular accidents and peripheral arterial embolism. Most of the patients who have this arrhythmia chronically feel their heart beating and so they are frightened; therefore, the quality of a patient's life is decreased. The purpose of this article is to determine the long term results of a modified Maze procedure and the factors that influence the success of the procedure. Material and Method: This study enrolled 88 patients who underwent the modified Maze with using cryoablation between June, 2001 and February, 2007. The 88 consecutive patients were divided into two groups ac cording to how the pulmonary veins were isolated, that is, with or without cryoablation. There were 58 patients who were isolated by cutting and sewing in the right pulmonary veins and by cyroablation in the left pulmonary veins in group 1 (group 1, n=58), and 30 patients who underwent isolation by cryoablation in the right & left pulmonary veins were placed in group 2 (group 2, n=30). The ECG was checked at discharge to determine the sinus conversion rate and we followed up the patients to determine whether or not the patients maintained sinus rhythm. We also checked the ECG at the last visit to determine the patients' heart rhythm. Result: The mean follow up time was $44.3{\pm}19.2$ months. At discharge, 72.4% of the patients in group 1 were in proper sinus rhythm and 66.7% of the patients in group 2 were in proper sinus rhythm. At the last follow up, 81% of the patients in group 1 were in normal sinus rhythm and 60% of the patients in group 2 were in normal sinus rhythm. When we analyzed the data via the Kaplan-Meier method, 86.5% of the patients were free from atrial fibrillation (% free from AF) at 1 year, 80% of the patients were free from atrial fibrillation at 5 year in group 1 and 70% of the patients were free from atrial fibrillation at 1 year and 51 % of the patients in group 2 were free from atrial fibrillation at 5 year. Conclusion: The modified Maze technique using cryoablation was a simple and effective procedure. But the success rate of the Maze technique using cryoblation is lower than that of the standard Maze III. The method using cryoablation shorten the operation time, but we must conduct more studies to get a better result of the modified Maze technique with using cryoablation.

Clinical Results of Arthroscopic Anterior Cruciate Ligament Reconstruction using Hamstring Tendon (슬괵건을 이용한 관절경적 전방십자인대 재건술)

  • Song, Eun-Kyoo;Seo, Hyoung-Yeon;Lee, Geun-Bae;Yoon, Taek-Rim;Shim, Sang-Don
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.17-23
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    • 1999
  • Purpose : We intend to review clinical results after Anterior cruciate ligament(ACL) reconstruction using hamstring tendon arthroscopically. Materials & Methods : Sixty two patients who had underwent arthroscopic ACL reconstruction using hamstring tendon from Mar. 1996 to Mar. 1997 were reviewed. The average follow-up was 16 months and average age at operation was 27 years old. Clinical results were evaluated with physical examination, Lysholm Knee score and instrumented anterior laxity test with Telos Results : The average preoperative Lysholm knee score was 57.0 and postoperative average of that was 91.8. All cases of 62 patients had normal range of motion of knee and were able to walk with no problems at follow-up. On the Lachmann test, there were mild(+) instability in 24 cases, moderate(++) in 24 cases, severe(+++) in 14 cases preoperatively and 48 cases were converted to negative, 14 cases mild postoperatively. On instrumented anterior laxity test with Telos, difference between normal and affected knee on 20 lb which was 13.4mm preoperatively was decreased to 4.7mm at follow-up and anterior stability was regained(P<0.05). Parapatellar complications such as crepitus in 18 cases(29.5%), atrophy of quadriceps in 23 cases(36.5%) were observed. There were 2 cases of inaccuracy of guide pin of semifix screw intraoperatively and 3 cases of malposition of semifix screw postoperatively. Conclusion : ACL reconstruction using hamstring tendon seems to be a effective procedure to establish the stability of knee joint but is technically demanding procedure and leaves some parapatellar complications.

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Functional Result of Limb Salvage Surgery with Tumor Prosthesis for Osteosarcoma of Proximal Tibia (근위 경골 골육종의 종양대치물을 이용한 사지 구제술 후의 기능 평가)

  • Bahk, Won-Jong;Sohn, Jong-Min;Chung, Yang-Guk;Kang, Yong-Koo
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.4
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    • pp.139-143
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    • 2001
  • Purpose : Limb salvage for osteosarcoma of proximal tibia is challenging problem due to difficulties in mobilizing or retracting the main neurovascular structure, inadequate soft tissue coverage, and unsolved problem of patellar tendon reattachment to endoprosthesis. The authors analyzed the functional result of limb salvage using tumor prosthesis with medial gastrocnemius rotation plasty for osteosarcama of the proximal tibia. Materials and Methods : Eleven patients with histologically proven osteosarcoma of the proximal tibia, treated with adjuvant and neoadjuvant chemotherapy and limb salvage operation with tumor prosthesis between January 1992 and December 1998 at our Medical Center, were selected. There were 6 male and 5 female. Age ranged from 15 years to 23.7 years with an average of 23.7 years. Follow-up period ranged from 1 year to 4.5 years with an average of 2.5 years. The final functional result was evaluated using the method by ISOLS, 1993. The factors include pain, functional activities, emotional acceptance, use of external supports, walking ability and gait. Each of the factors has been scored from 0 to 5 depending on the appropriate description or data. The rating score is determined by dividing the individual factor scores into the total score and indicates percentage of normal function. Results : The overall functional result ranged from 53,3% to 86.7% with an average of 68.3% of normal function. In details, the averages were 82.5% for pain, 62.5% for functional activities, 67.5% for emotional acceptance, 77.5% for use of external supports, 62.5% for walking ability, and 57.5% for gait. The average range of motion of the knee joint was $5^{\circ}$ extension and $85^{\circ}$ flexion. Five patients have extension lag ranged from $5^{\circ}$ to $15^{\circ}$ with an average of $10^{\circ}$. Two patients suffered postoperative infection. One was treated with antibiotics injection only, but the other needed removal of the prosthesis and knee fusion. Both of them showed unsatisfactory result. C o n c l u s i o n : The overall functional result after limb salvage using tumor prosthesis with medial gastrocnemius rotational flap for osteosarcoma of the proximal tibia was relatively satisfactory in case of no postoperative infection. The patients were less satisfactory in functional activities, emotional acceptance and gait than pain, use of external supports due to limitation of motion and extension lag. More aggressive postoperative physical therapy and protection with brace for 6~9 months as well as surgical technique is mandatory for more satisfactory result.

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Evaluation of Worker's Health and Occupational Exposure to Perchloroethylene in Laundries (Perchlotoethylene을 사용하는 세탁소 작업자들의 직업성 폭로와 건강에 관한 연구)

  • An, Sun-Hee;Lee, Jong-Hwoa;Park, Jong-An
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.4 no.2
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    • pp.224-239
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    • 1994
  • In this study we examined several subjective symptoms in an exposed group and an unexposed group to perchloroethylene. The exposed group consists to 30 workers employed in 23 dry-cleaning establishments located in Chung Cheung Do, whereas the unexposed group consists of 42 officers employed in a certain university. This study was conducted from October, 1993 to March, 1994. Also we investigated personal exposure levels and area concentration of PCE, and performed hematological and biochemical examination in blood and urine samples from the exposed group. The results are : 1. The exposed group highly complains several subjective symptoms, particularly in neuropsychiatry, eye, respiratory system and digestive system, compared with the unexposed group. But complaint rates in the exposed group are not related with PCE exposure levels. 2. PCE exposure levels for all dry-cleaning establishment varied widely, from 0.18 to 37.58ppm. The mean exposure level for centers of chain was 16.85ppm, and for local laundries was 8.83ppm, while for self-service establishment it was 3.07ppm. Eighty three percent of the workers were exposed less than the half-level(25.0ppm) of the Korea 50.0ppm standard for eight-hour PCE exposure. Seventeen percent of them exceeded the half-level of the Korea TLV. 3. Statistical correlation exists between the work load(number of operation cycles of equipment and the mass of processed textiles) and the personal exposure levels to be observed. 4. In hematological examination the values of WBC, RBC, Hgb, Hct, MCV, MCH, MCHC and PLT in the exposed group were within normal ranges. In biochemical examination(GOT, GPT, ALP, U-A and LDH) most of the items were within normal ranges. From this surveys conducted on 23 dry-cleaning establishments, the complaint rates of the exposed group to PCE in several subjective symptoms were higher than those of the unexposed group, and PCE exposure levels in all dry-cleaning establishment were below the Koera standard 50.0ppm. In hematological and biochemical examination the significant abnormalities by occupational exposure to PCE were not observed. However, the workers employed in dry-cleaning establishments are always faced with risk, becauses they are also exposed to several organic solvents used to remove stains. Therefore, various measures to improve occupational environment in dry-cleaning establishment should be considered.

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Priority Analysis of Cause Factors of Safety Valve Failure Mode Using Analytical Hierarchy Process (AHP를 활용한 안전밸브(PSV) 고장모드의 Cause Factors 우선순위 분석)

  • Kim, Myung Chul;Lee, Mi Jeong;Lee, Dong Geon;Baek, Jong-Bae
    • Korean Chemical Engineering Research
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    • v.60 no.3
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    • pp.347-355
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    • 2022
  • The safety valve (PSV) is a safety device that automatically releases a spring when the pressure generated by various causes reaches the set pressure, and is restored to a normal state when the pressure falls below a certain level. Periodic inspection and monitoring of safety valves are essential so that they can operate normally in abnormal conditions such as pressure rise. However, as the current safety inspection is performed only at a set period, it is difficult to ensure the safety of normal operation. Therefore, evaluation items were developed by finding failure modes and causative factors of safety valves required for safety management. In addition, it is intended to provide decision-making information for securing safety by deriving the priority of items. To this end, a Delphi survey was conducted three times to derive evaluation factors that were judged to be important in relation to the Failure Mode Cause Factor (FMCFs) of the safety valve (PSV) targeting 15 experts. As a result, 6 failure modes of the safety valve and 22 evaluation factors of its sub-factors were selected. In order to analyze the priorities of the evaluation factors selected in this way, the hierarchical structure was schematized, and the hierarchical decision-making method (AHP) was applied to the priority calculation. As a result of the analysis, the failure mode priorities of FMCFs were 'Leakage' (0.226), 'Fail to open' (0.201), 'Fail to relieve req'd capacity' (0.152), 'Open above set pressure' (0.149), 'Spuriously' 'open' (0.146) and 'Stuck open' (0.127) were confirmed in the order. The lower priority of FMCFs is 'PSV component rupture' (0.109), 'Fail to PSV size calculation' (0.068), 'PSV Spring aging' (0.065), 'Erratic opening' (0.059), 'Damage caused by improper installation and handling' (0.058), 'Fail to spring' (0.053), etc. were checked in the order. It is expected that through efficient management of FMCFs that have been prioritized, it will be possible to identify vulnerabilities of safety valves and contribute to improving safety.