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Comparison of Clinical Results in Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft and Tibialis Anterior Tendon Allograft (자가 슬괵건과 동종 전경골건을 이용한 전방 십자 인대 재건술의 임상적 결과 비교)

  • Lee, Hee-Young;Choi, Chul-Jun;Choi, Chong-Hyuk
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.109-114
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    • 2009
  • Purpose: The purpose of this study is to compare the clinical results of ACL reconstruction between two groups using hamstring tendon autograft and tibialis anterior tendon allograft. Materials and Methods: Between January 2006 and June 2007, we analyzed 68 cases of ACL reconstruction, 32 cases using hamstring tendon autograft and 36 cases using tibialis anterior tendon allograft, with a minimum follow-up of 24 months. For the clinical evaluation, we evaluated the Lysholm score, anterior laxity by Telos device and KT-2000 arthrometer. Results: The mean diameter of graft were 8.0 mm (7.0~9.0 mm) in autograft group and 9.1 mm (8.0~10.0 mm) in allograft group. In all cases, the range of motion was above 135 degrees. The average side to side difference in Telos stress test decreased from $7.3{\pm}1.0$ mm to $2.4{\pm}1.1$ mm in autograft group and from $7.4{\pm}1.2$ mm to $2.3{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from $72.6{\pm}3.4$ to $92.3{\pm}3.5$ in autograft group and from $72.3{\pm}3.5$ to $91.6{\pm}3.3$ in allograft group. There was no significant difference between two groups in clinical results. Conclusion: Both hamstring tendon autograft and tibialis anterior tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. We suggest that both hamstring tendon autograft and tibialis anterior tendon allograft will be considered as acceptable graft for anterior cruciate ligament reconstruction.

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A Study of The Regulations on The Use of University Royalties using Delphi Technique (델파이 기법을 활용한 대학의 기술료 사용제도 개선방안 연구)

  • Lee, Jae-Heung;Shin, Jun-Woo
    • Journal of Korea Technology Innovation Society
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    • v.16 no.1
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    • pp.323-345
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    • 2013
  • In this paper, problems with the Korean system regulating the use of university royalties are identified and investigated in order to suggest measures to improve the system in a way that provides a better R&D environment at universities. The Delphi technique was used to gather data from royalty specialists at universities and government ministries. The first Delphi survey conducted used open questions to identify problems in the use of university royalties. Then, closed questions were used for the second Delphi survey. The number of responses and the frequency of answers were analyzed after the first survey, and validity, stability, and reliability analyses were conducted for the second survey. The measures suggested to improve the system regulating the use of university royalties are as follows: First, bonuses for researchers, which are currently 50% or more of collected royalties, need to be decreased, as they are rather high compared to similar bonuses in developed countries, which are around 30% of collected royalties. The guideline for limiting the bonuses, which is explained as XX% or less of collected royalties, is suggested to prevent the excessive use of royalties. Second, rewards for those who contribute to technology transfer and commercialization should be increased. It is also important to build a consensus around the need to reward those who contribute to technology transfer and commercialization. Third, the scale of re-investment into R&D needs to increase. Regulations on royalties should be meaningfully applied to create a positive feedback structure for R&D, which can be described as the process of research, R&D outcomes, technology transfer, collecting royalties, rewarding researchers, and re-investing in R&D. To build a university's R&D capability, re-investment into R&D needs to be regularized as XX% or more of royalties. Fourth, regulations on the royalties of ministries and universities need to be unified. Each category for using royalties needs to be regularized, with detailed matters such as the guideline, process and method for using royalties specified. Also, universities need to make their own specific regulations. Fifth, specific priorities on the use of royalties need to be suggested. Regulation is necessary for the categories that do not have guideline and priorities for the use of royalties. It is hoped that the findings of this research will contribute to reinforcing the R&D capability of universities.

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A Study of the Distinctive Characteristics of Government Funded Research Institutes Engaged in Technological Cooperation with SMEs (중소기업의 기술협력에서 출연연의 차별적 특징에 관한 연구)

  • Jun, Seung-pyo;Park, Hun;Yoo, Jae Young
    • Journal of Korea Technology Innovation Society
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    • v.20 no.3
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    • pp.607-641
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    • 2017
  • Recently, there has been an increase in government-wide demand for technological cooperation between government funded research institutes (GFRIs) and small and medium-sized enterprises (SMEs), while there remain a tension between positive and negative views regarding the support given by GFRIs to encourage the technological innovation of SMEs. Although preceding studies have found that the support given by GFRIs to SMEs tends to have the effect of enhancing the technological innovation outcomes of SMEs, this study examines the question of why the agent that provides technological cooperation to SMEs should be limited to GFRIs. To answer this question, in this study, we first examined the qualitative changes in the external technological cooperation behavior of SMEs over time, from 2007 to 2014. Next, we performed cluster analysis to examine whether there were distinctive characteristics of SMEs that engage in technological cooperation with GFRIs, compared to the various other alternatives available as technological cooperation partners for SMEs. Lastly, to help us identify the characteristics of the companies that technologically cooperate with GFRIs and to facilitate the administrative or practical effort to find companies that would be strong candidates for technological cooperation with GFRIs, we used discriminant analysis to define a discriminant formula for such companies likely to engage in technological cooperation. The results of this study were as follows. First, GFRIs were the most competitive -- as demonstrated by the highest level of satisfaction, etc. - compared to the other alternatives for external technological cooperation available to SMEs. This confirmed the necessity for GFRIs to provide technological cooperation to SMEs. Secondly, the issue of whether the small and medium-sized enterprise had engaged in technological cooperation specifically with GFRIs was found not to be a very significant factor in distinguishing these companies. It was found, however, that SMEs engaged in technological cooperation were distinctive, regardless of the type of institution involved in the technological cooperation. Thirdly, SMEs that were in technological cooperation with GFRIs had the characteristics of being already active in joint research and already familiar with utilizing the systems available for governmental support. The findings of this study offers various insights relevant to establishing national R&D strategies using GFRIs and improving the efficiency of policies and administrative practices intended to help GFRIs assist SMEs.

A STUDY OF THE EFFECTIVENESS OF THE BEREAVEMENT PROGRAM OF SEVERANCE HOSPICE (세브란스 호스피스 추후관리 프로그램의 효과에 관한 연구)

  • Wang, Mae-Ryeon
    • The Korean Nurse
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    • v.31 no.2
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    • pp.51-69
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    • 1992
  • Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

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Comparison of IVF-ET Outcomes between GnRH Antagonist Multiple Dose Protocol and GnRH Agonist Long Protocol in Patients with High Basal FSH Level or Advanced Age (높은 기저 난포 자극 호르몬 수치를 가지는 환자와 고령 환자의 체외수정시술을 위한 과배란 유도에서 GnRH antagonist 다회 투여법과 GnRH agonist 장기요법의 효용성에 대한 연구)

  • Kim, JY;Kim, NK;Yoon, TK;Cha, SH;Kim, YS;Won, HJ;Cho, JH;Cha, SK;Chung, MK;Choi, DH
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.4
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    • pp.315-324
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    • 2005
  • Objectives: To compare the efficacy of GnRH antagonist multiple dose protocol (MDP) with that of GnRH agonist long protocol (LP) in controlled ovarian hyperstimulation for in vitro fertilization in patients with high basal FSH (follicle stimulating hormone) level or old age, a retrospective analysis was done. Methods: Two hundred ninety four infertile women (328 cycles) who were older than 41 years of age or had elevated basal FSH level (> 8.5 mIU/mL) were enrolled in this study. The patients had undergone IVF-ET after controlled ovarian hyperstimulation using GnRH antagonist multiple dose protocol (n=108, 118 cycles) or GnRH agonist long protocol (n=186, 210 cycles). The main outcome measurements were cycle cancellation rate, consumption of gonadotropins, the number of follicles recruited and total oocytes retrieved. The number of fertilized oocytes and transferred embryos, the clinical pregnancy rates, and the implantation rates were also reviewed. And enrolled patients were divided into three groups according to their age and basal FSH levels; Group A - those who were older than 41 years of age, Group B - those with elevated basal FSH level (> 8.5 mIU/mL) and Group C - those who were older than 41 years of age and with elevated basal FSH level (> 8.5 mIU/mL). Poor responders were classified as patients who had less than 4 retrieved oocytes, or those with $E_2$ level <500 pg/mL on the day of hCG injection or those who required more than 45 ampules of exogenous gonadotropin for stimulation. Results: The cancellation rate was lower in the GnRH antagonist group than in GnRH agonist group, but not statistically significant (6.8% vs. 9.5%, p=NS). The amount of used gonadotropins was significantly lower in GnRH antagonist group than in agonist group ($34.8{\pm}11.3$ ampules vs. $44.1{\pm}13.4$ ampules, p<0.001). The number of follicles > 14 mm in diameter was significantly higher in agonist group than in antagonist group ($6.7{\pm}4.6$ vs. $5.0{\pm}3.4$, p<0.01). But, there were no significant differences in clinical pregnancy rate (24.5% in antagonist group vs. 27.4% in agonist group, p=NS) and implantation rate (11.4% in antagonist group vs. 12.0% in agonist group, p=NS) between two groups. Mean number of retrieved oocytes was significantly higher in GnRH agonist LP group than in GnRH antagonist MDP group ($5.4{\pm}3.5$ vs. $6.6{\pm}5.0$, p<0.0001). But, the number of mature and fertilized oocytes, and the number of good quality (grade I and II) and transferred embryos were not different between two groups. In each group A, B, and C, the rate of poor response did not differ according to stimulation protocols. Conclusions: In conclusion, for infertile women expected poor ovarian response such as who are old age or has elevated basal FSH level, a protocol including a controlled ovarian hyperstimulation using GnRH antagonist appears at least as effective as that using a GnRH agonist, and may offer the advantage of reducing gonadotropin consumption and treatment period. However, much work remains to be done in optimizing the GnRH antagonist protocols and individualizing these to different cycle characteristics.

Sleep Duration and Cancer Risk: a Systematic Review and Meta-analysis of Prospective Studies

  • Zhao, Hao;Yin, Jie-Yun;Yang, Wan-Shui;Qin, Qin;Li, Ting-Ting;Shi, Yun;Deng, Qin;Wei, Sheng;Liu, Li;Wang, Xin;Nie, Shao-Fa
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7509-7515
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    • 2013
  • To assess the risk of cancers associated with sleep duration using meta-analysis of published cohort studies, we performed a comprehensive search using PubMed, Embase and Web of Science through October 2013. We combined hazard ratios (HRs) from individual studies using meta-analysis approaches. A random effect dose-response analysis was used to evaluate the relationship between sleep duration and cancer risk. Subgroup analyses and sensitivity analyses were also performed. Publication bias was evaluated using Funnel plots and Begg's test. A total of 13 cohorts from 12 studies were included in this meta-analysis, which included 723, 337 participants with 15, 156 reported cancer outcomes during a follow-up period ranging from 7.5 to 22 years. The pooled adjusted HRs were 1.06 (95% CI: 0.92, 1.23; P for heterogeneity =0.003) for short sleep duration, 0.91 (95% CI: 0.78, 1.07; P for heterogeneity <0.0001) for long sleep duration. In subgroup analyses stratified by cancer type, long duration of sleep showed an inverse relation with hormone-related cancer (HR=0.79; 95% CI: 0.65, 0.97; P for heterogeneity =0.009) and a greater risk of colorectal cancer (HR=1.29; 95% CI: 1.09, 1.52; P for heterogeneity =0.346). Further meta-analysis on dose-response relationships showed that the relative risks of cancer were 1.00 (95% CI: 0.99, 1.01; P for linear trend=0.9151) for one hour of sleep increment per day, and 1.00 (95% CI: 0.98, 1.01; P for linear trend=0.7749) for one hour of sleep increment per night. No significant dose-response relationship between sleep duration and cancer was found on non-linearity testing (P=0.5053). Our meta-analysis suggests a positive association between long sleep duration and colorectal cancer, and an inverse association with incidence of hormone related cancers like those in the breast. Studies with larger sample size, longer follow-up times, more cancer types and detailed measure of sleep duration are warranted to confirm these results.

7 to 22Y Follow-up of Anterior Cruciate Ligament Reconstruction : from the standpoint of OA (전방 십자 인대 재건술 7년에서 22년 장기 추시: 관절염 관점에서)

  • Yang, Sang-Hoon;Sim, Jae-Ang;Kwak, Ji-Hoon;Kim, Byung-Kag;Ahn, Byung-Moon;Lee, Beom-Koo
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.20-24
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    • 2010
  • Purpose: To evaluate the long term outcomes of the ACL reconstruction from the standpoint of osteoarthritis. Materials and Methods: We evaluated 31 patients who underwent ACL reconstruction from April 1986 to April 1999 and could be followed-up more than 7 years. Mean follow-up period was 10.1 years (7~22 years). In terms of the graft, 11 cases were treated with the ACL reconstruction using a autologous hamstring tendon graft, 20 cases were treated with using a autologous bone patellar tendon bone graft. For femoral tunnel, 11 cases were placed through transtibial tunnel, 20 cases were placed through anteromedial portal using mini-open arthrotomy. Functional and radiographic evaluation was performed. Results: Mean Lysholm score was $89.2{\pm}11.7$ points. Patients had KT-2000 side-to-side differences were $2.1{\pm}1.9\;mm$. IKDC ligament evaluation showed 38.7% type A, 48.3% type B, 6.5% type C and 6.5% type D. Femoral tunnel were placed at 11 or 1 o'clock position in transtibial technique and placed 10 to 10:30 or 2 to 2:30 o'clock position in technique using anteromedial portal. Radiographic analysis for degenerative arthritis revealed that in group using anteromedial tunnel, 50.0% were excellent, 25.0% were good. In group using transtibial tunnel 18.2% were excellent, 18.2% were good. Conclusion: More than 87.1% of cases, long term result of the ACL reconstruction showed good and excellent result in IKDC score. Especially, the group using tunnel through anteromedial portal showed good results for degenerative arthritis.

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Association between Type D Personality and the Somatic Symptom Complaints in Depressive Patients (우울증 환자에서 D형 인격과 신체 증상 호소와의 관련성)

  • Park, Wu-Ri;Jeong, Seong-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.1
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    • pp.18-26
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    • 2013
  • Objectives : Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. Methods : Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. Results : More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, $p=8.2{\times}10^{-7}$). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age($p=1.5{\times}10^{-3}$) and NA score($p=1.5{\times}10^{-7}$) were found to be statistically significant. Conclusions : The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.

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Follow-up of children with isolated microscopic hematuria detected in a mass school urine screening test (학교집단소변검사에서 발견된 단독 현미경적 혈뇨의 추적 관찰)

  • Yum, Mi-sun;Yoon, Hoe Soo;Lee, Joo Hoon;Hahn, Hyewon;Park, Young Seo
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.82-86
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    • 2006
  • Purpose : The isolated microscopic hematuria is the most common abnormality detected by school urinary screening, but there is no consensus about the range of investigations and long-term outcomes of isolated hematuria in children yet. This study aims to elucidate the prognosis of hematuria and the range of diagnostic studies by follow-up results. Methods : Students with isolated hematuria who were referred to the Department of Pediatrics, Asan Medical Center from Aug. 1990 to Feb. 2004 were analysed retrospectively. Cases that presented Through significant proteinuria(>250 mg/day), other symptoms of nephritis or renal dysfunction (creatinine clearance <85 mL/min/$1.73m^2$) were excluded. Follow-up was done every six months with checking urinalysis, serum creatinine, protein and albumin. When albuminuria was detected, 24 hour urine protein was checked. Renal biopsy was done when urine protein was over 500 mg/day. Results : A total of 331 students were enrolled in this study. There were 157 males and 174 females. The mean age at presentation was $9.9{\pm}2.3$ years(7-15 years) and mean follow-up period was $2.2{\pm}1.6$ years(1-10 years). Seventy five(22.7 percent) patients showed the resolution of microscopic hematuria. The mean resolution period was $2.6{\pm}1.7$ years(1-8 years). Eight(2.4 percent) patients developed significant proteinuria and renal biopsy was done in four of them. Two cases of mild IgA nephropathy and two of minimal change were detected. None of them developed hypertension. At the end of the follow-up, renal function had remained stable in all subsets of patients. Conclusion : The prognosis of isolated microscopic hematuria was good. This study suggests that invasive studies including renal biopsy are not necessary and a regular follow-up of urinalysis is enough for children with isolated microscopic hematuria.

Clinical and Laboratory Features of Korean Mucopolysaccharidoses (MPSs) (한국 뮤코 다당체 침착증 환자에 대한 임상적 고찰)

  • Sohn, Woo Yun;Lee, Jee Hyun;Paik, Kyung Hoon;Kwon, Eun Kyoung;Kim, Ahn Hee;Jin, Dong Kyu
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1132-1138
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    • 2005
  • Purpose : The mucopolysaccharidoses (MPSs) are a heterogeneous group of lysosomal storage disorders. They are caused by a deficiency of the enzymes involved in the degradation of glycosaminoglycans. Early recognition is important because recombinant enzyme replacement therapy is now available for MPS. We studied the clinical characteristics of 80 MPS children with the object of determining the epidemiological, clinical and radiological features in Korean MPS children. Methods : Diagnosis of MPS was confirmed by skin fibroblast enzyme analysis in 80 patients between February 1995 and December 2004. Charts were retrospectively reviewed for clinical and radiological findings, as well as for intelligence and speech evaluations. Results : Hunter syndrome (MPS type II) was the most prevalent type, appearing in 51/80 cases (64 %), followed by Sanfilippo syndrome (MPS III-18%), Hurler syndrome (MPS I-15%), and Morquio syndrome (MPS IV-4%). The average age at diagnosis was 5.5 years (range 1 to 20), and the male-to-female ratio was 4.7 : 1. Typical radiographic changes were observed in 45/54 cases (83%). Mitral regurgitation was the most common cardiac defect. Moderate to profound mental retardation and hearing loss were present in 14/35 cases (56%) and 33/38 cases (82%), respectively. Four MPS II patients had bone marrow transplantation, with mixed outcomes. Five MPS I patients are currently on enzyme replacement therapy. Conclusion : Our study showed a high proportion of MPS II cases (64%), which may represent population variability. By studying the clinical features of these patients, we hope to alert pediatricians of the warning signs of MPS.