• Title/Summary/Keyword: Stable fracture

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The Importance of the Trauma Surgeon: A Reflection on the Management of Hemodynamically Unstable Pelvic Trauma Patients (혈역학적으로 불안정한 골반외상 환자의 치료를 통해 본 외상전문의의 필요성)

  • Shin, Sung;Kyung, Kyu Hyuk;Kim, Ji Wan;Kim, Jung Jae;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.22 no.2
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    • pp.254-259
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    • 2009
  • Purpose: Pelvic trauma is a serious skeletal injury with high mortality. Especially in cases of severe injury trauma, treatment outcomes depend on early diagnosis and intervention. We expect trauma surgeon to play an important role in the management of severe multiple trauma patients. Methods: A retrospective study was performed on pelvic trauma patients with hemodynamic instability between March 2005 and September 2009. We divided the time period into period I (March 2005~Feburary 2009) and period II (March 2009~September 2009). The trauma surgeon and team started to work from period II. Data were collected regarding demographic characteristics, mechanism of injury, type of pelvic fracture, ISS(injury severity score), treatment modality, transfusion requirement, time to definitive treatment, and mortality. Results: During period I, among 7 hemodynamically unstable patients, 4(57.1%) patients died. However during Period II, only one of 6(16.6%) patients died. The demographic data and injury scores showed no differences between the two time periods, but the time to definitive treatment was very short with trauma team intervention(14.4 hrs vs. 3.9 hrs). Also, the amount of transfusion was less(41.1 U vs. 13.9 U). With arterial embolization, early pelvic external fixation led to less transfusion and made patients more stable. Conclusion: This study demonstrated the importance of the trauma surgeon and the trauma team in cases of hemodynamically unstable pelvic trauma. Even with the same facility and resources, an active trauma team approach can increase the survival of severely injured multiple trauma patients.

Fatigue Crack Growth Characteristics of 9% Ni Steel Welded Joint for LNG Storage Tank at Low Temperature (LNG 저장탱크용 9% Ni강 용접부의 저온피로균열진전 특성)

  • Kim, Jae-Hoon;Shim, Kyue-Taek;Kim, Young-Kyun;Ahn, Byoung-Wook
    • Journal of Welding and Joining
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    • v.28 no.5
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    • pp.45-50
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    • 2010
  • The fatigue crack growth characteristics of base metal and weld joint of 9% Ni steel for LNG storage tank was carried out using CT specimen at room temperature and $-162^{\circ}C$. Fatigue crack growth rate of base and weld metals at RT and $-162^{\circ}C$ was coincided with a single line independent of the change of stress ratio and temperature. In the region of lower stress intensity factor range, fatigue crack growth rate at $-162^{\circ}C$ was slower than that at RT, and the slop of fatigue crack growth rate at $-162^{\circ}C$ increased sharply with propagating of fatigue crack, fatigue crack growth rate at RT and $-162^{\circ}C$ was intersected near the region of $2{\times}10-4\;mm$/cycle, and after the intersection region, fatigue crack growth rate at $-162^{\circ}C$ was faster than that at RT. The micro-fracture mechanism using SEM shows the ductile striation in the stable crack growth region. Also the defects of weld specimen after fatigue testing were detected using the A scan of ultrasonic apparatus.

Characteristics of Acoustic Emission by Expansive Cement Induced Rock Fractures (팽창성 시멘트에 의한 암석균열시의 AE 특성)

  • 김교원
    • The Journal of Engineering Geology
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    • v.8 no.3
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    • pp.207-213
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    • 1998
  • A study was conducted to determine the characteristics of acoustic emission(AE) events generated by the expansive cement induced rock fracturing. The dominant frequency and the maximum amplitude of the AE events are changed in relation to the rate of expansive pressure development in the hole. The dominant frequencies are in the range of 150∼230kHz for the small hole tests and 400∼500kHz for the large hole test. The maximum amplitudes are in the range of 0.015∼0.050cm/sec and 0.025∼0.064cm/sec, respectively. The fact that AE events of higher amplitude with higher frequency on the large hole test and lower amplitude with lower frequency on the small hole tests were detected, may strongly imply that the amount of energy consumed for a macro-crack in both tests may be similar. The expansive cement induced crack propagates stably without any distinguished event having higher amplitude and this implies that a macro-crack is a result of stable growth of micro cracks.

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Autogenous Low Heat Treated Bone Graft for Bone Reconstruction in Bone and Soft Tissue Tumors (골연부 종양에서 저온 열처리한 자가골을 이용한 재건술)

  • Jeon, Dae-Geun;Lee, Jong-Seok;Kim, Sug-Jun;Cho, Wan-Hyeong;Kwag, Bong-Jun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.4 no.2
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    • pp.81-87
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    • 1998
  • Although autoclaved autogenous bone reconstruction is one of the established procedures, it may have some problems in bone regeneration and mechanical property. The purpose of this study is to evaluate the efficacy of more biologic and anatomical reconstruction where allograft is not readily available. From Aug.1991 to Feb. 1996 the authors analyzed 32 cases of reconstruction with autogenous low heat treated bone. Autogenous graft sites were humerus 4, tibia 4, pelvis 9, and 15 femur. Average follow-up period was 23(range;12-51) months. There were 49 graft-host junctional sites. Diaphysis was 22, metaphysis 10, and flat bone 17. Average duration of healing for the 38 united sites was 7 months. Average union time for each anatomical area 8 months in 19 diaphysis, 12 months in 7 metaphysis, and 12.7 months in 12 flat bone(pelvis). Eleven nonunion sites consisted of 3 diaphysis(3/22), 3 metaphysis(3/10), and 5 flat bone(5/17). Complications other than nonunion were local recurrence(4), bone resorption(3), graft fracture(2), osteomyelitis(1), metal failure(2), and wound infection(1). Initial bone quality and stable fixation technique was important for union rate. Plate and screw is a good method for diaphyseal lesion. Metaphyseal and flat bone are weak area for rigid fixation and one stage augmentation with iliac bone graft can be a salvage procedure.

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Saw-tooth softening/stiffening - a stable computational procedure for RC structures

  • Rots, Jan G.;Invernizzi, Stefano;Belletti, Beatrice
    • Computers and Concrete
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    • v.3 no.4
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    • pp.213-233
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    • 2006
  • Over the past years techniques for non-linear analysis have been enhanced significantly via improved solution procedures, extended finite element techniques and increased robustness of constitutive models. Nevertheless, problems remain, especially for real world structures of softening materials like concrete. The softening gives negative stiffness and risk of bifurcations due to multiple cracks that compete to survive. Incremental-iterative techniques have difficulties in selecting and handling the local peaks and snap-backs. In this contribution, an alternative method is proposed. The softening diagram of negative slope is replaced by a saw-tooth diagram of positive slopes. The incremental-iterative Newton method is replaced by a series of linear analyses using a special scaling technique with subsequent stiffness/strength reduction per critical element. It is shown that this event-by-event strategy is robust and reliable. First, the model is shown to be objective with respect to mesh refinement. Next, the example of a large-scale dog-bone specimen in direct tension is analyzed using an isotropic version of the saw-tooth model. The model is capable of automatically providing the snap-back response. Subsequently, the saw-tooth model is extended to include anisotropy for fixed crack directions to accommodate both tensile cracking and compression strut action for reinforced concrete. Three different reinforced concrete structures are analyzed, a tension-pull specimen, a slender beam and a slab. In all cases, the model naturally provides the local peaks and snap-backs associated with the subsequent development of primary cracks starting from the rebar. The secant saw-tooth stiffness is always positive and the analysis always 'converges'. Bifurcations are prevented due to the scaling technique.

Strength of Stainless Steel Pin-reinforced Composite Single-lap Joints (금속 핀으로 보강된 복합재 단일겹침 체결부의 강도 연구)

  • Lee, Byeong-Hee;Park, Yong-Bin;Kweon, Jin-Hwe;Choi, Jin-Ho;Choi, Ik-Hyeon;Chang, Sung-Tae
    • Composites Research
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    • v.25 no.3
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    • pp.65-69
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    • 2012
  • The main objective of this study is to investigate the effect of metal z-pinning on the failure behavior of cocured composite single-lap joints. Three different pin diameters (0.3, 0.5, and 0.7 mm) and three pin areal densities (0.5, 2.0, and 4.0%) were examined. The specimens were fabricated by T700-12K-31E#2510 unidirectional prepreg from Toray. Stainless steel pins were used for z-pinning. Test results showed that except one case with extremely low pin density of 0.5%, all other z-pinned joints exhibited lower initial crack stresses than those of the unpinned joint. However the ultimate strength of the z-pinned joint increased up to 45% at most. Furthermore, even after the complete failure of the joint, the z-pins sustained the carried load to a certain degree experiencing large deformation and provided the stable fracture behavior for the composite joint.

Short Scarf Osteotomy for Moderate Hallux Valgus (중등도 무지외반증에서 시행한 단축 스카프 절골술)

  • Kwon, Soon-Yong;Gil, Ho-Jin;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.4
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    • pp.235-240
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    • 2012
  • Purpose: The aim of this study was to evaluate the radiographic and clinical results of short scarf osteotomy that has minimized longitudinal cut for moderate hallux valgus. Materials and Methods: Total 12 patients (12 feet) were reviewed by medical records and radiographs. All patients were female and the mean age at the time of operation was 41.5 years. The mean followup time was 21.2 months. We modified original scarf osteotomy by shortening the longitudinal cut to 15~20 mm in length. Additionally, Akin osteotomy of the first proximal phalanx was done in 7 feet and Weil osteotomy of the second metatarsal was done in 4 feet. First-second intermetatarsal and hallux valgus angles were analyzed radiographically before and after the operation. And the clinical result was assessed by AOFAS (American Orthopaedic Foot and Ankle Society) hallux score. Results: First-second intermetatarsal and hallux valgus angles were reduced from the mean preoperative values of $14.6^{\circ}$ and $32.8^{\circ}$ to $6.5^{\circ}$ and $11.2^{\circ}$, respectively. The mean AOFAS hallux score was increased from 52.4 points preoperatively to 88.2 points at followup. Three complications were found: metatarsal fracture during the operation, painful scar around second metatarsal head after Weil osteotomy and postoperative neuralgia. There was no transfer metatarsalgia or recurrence of hallux valgus during followup. Conclusion: Short scarf osteotomy would be an effective surgical procedure for moderate hallux valgus with the benefits of minimized soft tissue dissection and stable fixation.

Retrospective Evaluation of Implant Retained Overdentures Using Two Implants and Locator Attachments in the Edentulous Mandibles (Locator attachment를 이용한 하악 임플란트 유지 피개의치의 후향적 평가)

  • Lee, Ju-Hyoung;Sohn, Dong-Seok;Lee, Cheong-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.2
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    • pp.153-162
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    • 2013
  • This study compared the marginal bone loss around dental implants that were placed in the canine areas of the mandibles and finded the survival rate of the implants, marginal bone loss around implants and prosthetic complications in 20 patients treated with overdentures retained with Locator attachments. Implants placed in this study showed a 95% survival rate and the average marginal bone loss was 1.21 mm($SD{\pm}0.60mm$) in 94.3 weeks of functional loading. Implant-retained overdentures had various prosthetic complications such as male change, metal cap loosening, Locator attachment loosening, denture teeth change, relining and denture fracture. Implant-retained overdentures using two implants and Locator attachments in the edentulous mandibles is considered as a stable way for long terms because of minimal invasive operation, simple prosthetic process and easy repair.

Comparison of Mechanical Stability between Fibular Free Flap Reconstruction versus Locking Mandibular Reconstruction Plate Fixation

  • Chung, Jae-Hyun;Yoon, Eul-Sik;Park, Seung-Ha;Lee, Byung-Il;Kim, Hyon-Surk;You, Hi-Jin
    • Archives of Craniofacial Surgery
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    • v.15 no.2
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    • pp.75-81
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    • 2014
  • Background: The fibular free flap has been used as the standard methods of segmental mandibular reconstruction. The objective of mandibular reconstruction not only includes restored continuity of the mandible but also the recovery of optimal function. This paper emphasizes the advantage of the fibular free flap reconstruction over that of locking mandibular reconstruction plate fixation. Methods: The hospital charts of all patients (n=20) who had a mandibular reconstruction between 1994 and 2013 were retrospectively reviewed. Eight patients had plateonly fixation of the mandible, and the remaining 12 had vascularized fibular free flap reconstruction. Complications and outcomes were reviewed and compared between the 2 groups via statistical analysis. Results: Overall complication rates were significantly lower in the fibular flap group (8.3%) than in the plate fixation group (87.5%; p =0.001). Most (7/8) patients in the plate fixation group had experienced plate-related late complications, including plate fracture or exposure. In the fibular flap group, no complications were observed, except for a single case of donor-site wound dehiscence (1/12). Conclusion: The fibular free flap provides a more stable support and additional soft tissue support for the plate, thereby minimizing the risk of plate-related complications. Fibular free flap is the most reliable option for mandibular reconstruction, and we believe that the flap should be performed primarily whenever possible.

Experimental study on propagation behavior of three-dimensional cracks influenced by intermediate principal stress

  • Sun, Xi Z.;Shen, B.;Zhang, Bao L.
    • Geomechanics and Engineering
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    • v.14 no.2
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    • pp.195-202
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    • 2018
  • Many laboratory experiments on crack propagation under uniaxial loading and biaxial loading have been conducted in the past using transparent materials such as resin, polymethyl methacrylate (PMMA), etc. However, propagation behaviors of three-dimensional (3D) cracks in rock or rock-like materials under tri-axial loading are often considerably different. In this study, a series of true tri-axial loading tests on the rock-like material with two semi-ellipse pre-existing cracks were performed in laboratory to investigate the acoustic emission (AE) characteristics and propagation characteristics of 3D crack groups influenced by intermediate principal stress. Compared with previous experiments under uniaxial loading and biaxial loading, the tests under true tri-axial loading showed that shear cracks, anti-wing cracks and secondary cracks were the main failure mechanisms, and the initiation and propagation of tensile cracks were limited. Shear cracks propagated in the direction parallel to pre-existing crack plane. With the increase of intermediate principal stress, the critical stress of crack initiation increased gradually, and secondary shear cracks may no longer coalesce in the rock bridge. Crack aperture decreased with the increase of intermediate principal stress, and the failure is dominated by shear fracturing. There are two stages of fracture development: stable propagation stage and unstable failure stage. The AE events occurred in a zone parallel to pre-existing crack plane, and the AE zone increased gradually with the increase of intermediate principal stress, eventually forming obvious shear rupture planes. This shows that shear cracks initiated and propagated in the pre-existing crack direction, forming a shear rupture plane inside the specimens. The paths of fracturing inside the specimens were observed using the Computerized Tomography (CT) scanning and reconstruction.