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Dual Plate Fixation for Periprosthetic Femur Fracture after Total Knee Arthroplasty (슬관절 전치환술 후 발생한 대퇴골 삽입물 주위 골절의 이중 금속판 고정술)

  • Kim, Dong Hwi;Cha, Dong Hyuk;Ko, Kang Yeol
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.26-33
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    • 2021
  • Purpose: This study evaluated the results of dual plate fixation for periprosthetic femur fracture after total knee arthroplasty (TKA). Materials and Methods: From October 2007 to February 2013, 23 cases of periprosthetic femur fracture after TKA were treated at the author's hospital. There were 13 cases of fixation using a medial and lateral dual plate when the stability of the fracture site could not be achieved by one side fixation with a follow-up of more than one year. The cases included no loosening of the femoral component in fractures that were categorized as Lewis-Rorabeck classification II and supracondylar comminuted fractures and elongation of the fracture line to the lateral epicondyle of the femur or stem in the medullary canal. The mean age was 72 years (65-82 years), and 11 cases were female. Three cases had a stem due to revision. The mean bone marrow density was -3.2 (-1.7 to -4.4), and the mean period from primary TKA to periprosthetic fractures was 28 months (1-108 months). The mean follow-up period was 23 months (12-65 months). The medial fracture site was first exposed via the subvastus approach. Second, the supplementary plate was fixed on the lateral side of the fracture using a minimally invasive plate osteosynthesis technique. The average union time, complications, and Hospital for Special Surgery Knee Score (HSS) at the last follow-up were evaluated. Results: The mean union time was 17.4 weeks (7-40 weeks). Two cases showed delayed bone union and nonunion occurred in one case, in whom bone union was achieved three months later after re-fixation using a dual plate with an autogenous bone graft. The mean varusvalgus angulation was 1.67 degrees (-1.2-4.9 degrees), and the mean anterior-posterior angulation was 2.86 degrees (0-4.9 degrees) at the last follow-up. The mean knee range of motion was 90 degrees, and the HSS score was 85 points (70-95 points) at the last follow-up. Conclusion: Dual plate fixation for periprosthetic femur fractures that had not achieved stability by one side plate fixation after TKA showed a good clinical result that allowed early rehabilitation.

The Impact of Care Workers' Employment Characteristics and Perception of Facility Directors' Transformational Leadership on Quality of Service (요양보호사의 고용특성과 시설장에 대한 변혁적 리더십 인식이 서비스 질에 미치는 영향에 관한 연구)

  • Kim, Hye Ji;Park, Sang Hee;Kim, Bum Jung
    • 한국노년학
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    • v.41 no.2
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    • pp.217-240
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    • 2021
  • The purpose of this study is to examine the effect of care workers' employment characteristics and perception of facility directors' transformational leadership on quality of service through a hierarchical linear model. For this aim, survey data were collected amongst 240 older adults and 200 care workers who are affiliated within 45 long-term care facilities in Seoul, and analyzed using SPSS 26.0 and HLM 8.0. As a result, one's perception of transformational leadership had a positive effect, whereas, among employment characteristics, employment type and working hours had negative effects on quality of service. Regular workers with fewer working hours and higher awareness of transformational leadership toward the director provided higher quality of service. But wage, total experience and tenure didn't meaningfully affect it. Therefore, the following suggestions were presented. First, it is necessary to reorganize incentive, salary systems and budgets, changing the status of temporary workers' hourly wage system into that of regular workers' monthly one in order to strengthen employment security with acknowledging fundamental professional values through reinforcement of expertise. Reinforcement of long-term care's publicness and establishment of base facilities are also suggested. Second, maintaining appropriate hours of work and rest including annual leave under the Labor Standards Act is needed. Also, increasing the salary of and decreasing working hours for night shift workers are required. Third, education and intervention for inspiring transformational leadership of directors and strengthening qualification standards of them are required.

Preliminary Result of Revision Fusion Surgery for Thoracolumbar Spine Using Revision Rod (Revision Rod를 이용한 흉요추 유합 재수술 예비 결과)

  • Youn, Yung-Hun;Cho, Kyu-Jung;Park, Ye-Su;Park, Jae-Woo;Park, Jin-Sung;Kwon, Won-Hwan
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.6
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    • pp.520-526
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    • 2020
  • Purpose: The need for revision fusion surgery after spinal fusion has increased. A revision rod that connects to the previous rod was newly developed for revision surgery. The purpose of this study was to analyze the clinical and radiological results after spinal fusion revision surgery using revision rods. Materials and Methods: Twenty-one patients who underwent revision fusion surgery after spinal fusion in two university hospitals with minimum 1 year follow-up were reviewed. This study assessed 16 cases of adjacent-segment disease, four cases of thoracolumbar fracture, and one case of ossification of ligament flavum. The Oswestry Disability Index (ODI) and numerical rating scale (NRS) were evaluated as clinical outcomes, and the union rate, lordosis or kyphosis of the revision level, lumbar lordosis, T5-12 kyphosis, and proximal junctional kyphosis angle were evaluated as the radiological outcomes. Results: The average ODI was 54.6±12.5 before surgery and improved to 29.8±16.5 at the final follow-up. The NRS for back pain and leg pain was 5.0±1.7 and 6.4±2.0 before surgery, which changed to 2.9±1.6 and 2.9±2.2 at the final follow-up. Lumbar lordosis was 18.1°±11.9° before surgery and 21.1°±10.3° at the final follow-up. Proximal junctional kyphosis was 10.8°±10.1° before surgery, and 9.2°±10.5° at the final follow-up. These angles were not changed significantly after surgery. Bony union was successful in all cases except for one case who underwent posterolateral fusion. Conclusion: Revision surgery using a newly developed revision rod on the thoracolumbar spine achieved good clinical outcomes with successful bony union. No problems with the newly developed revision rod were encountered.

Correlation of the Deformation of the Kyphotic Angle with the Fat Infiltration Rate of Multifidus and Erector Spinae in Patients with Acute Osteoporotic Fractures of the Lumbar Spine (급성 골다공증성 요추 골절 환자에서 척추 기립근 및 다열근의 지방침투율과 후만각 변형의 연관 관계)

  • Jun, Deuk Soo;Baik, Jong-Min;Baek, Seung Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.208-214
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    • 2021
  • Purpose: Verifying a reliable predictor of the progression of vertebral deformity in patients with acute osteoporotic fractures of the lumbar spine may be useful. A qualitative analysis of the muscle near the spine was performed using magnetic resonance imaging (MRI), and its correlation with a spinal deformity was determined under the hypothesis that the causes of the kyphotic deformity are associated with muscle reduction in the multifidus and erector spinae. Materials and Methods: The study was performed in a retrospective manner using the electronic medical records of patients who presented to the author's institution between January 2007 and March 2018, and were diagnosed with an acute lumbar fracture. The fat infiltration rates of the multifidus and erector spinae were measured using MRI taken at the time of injury, and the mean value was defined as the total fat infiltration rate (TFI). Based on lateral radiographs of the lumbar spine at the one-year follow-up, the loss of height of the vertebral body, the kyphotic angle and the wedge angle were measured. The statistical significance was confirmed by calculating the Pearson correlation coefficient. Results: One hundred twenty-nine patients, of which 30 were male and 99 were female, were examined. The mean age was 71.28 years. The mean T-score was -3.53±0.79 g/cm2, and the mean fat infiltration was 15.20%±11.99%. TFI was positively correlated with age (R=0.373, p<0.001), compression rate (R=0.369, p<0.001), and Cobb's angle (R=0.386, p<0.001) after a one year follow-up, but negatively correlated with the BMD score (R=-0.252, p=0.004). As the fracture progressed to the lower lumbar level, the compression rate (R=-0191, p=0.030) and wedge angle (R=-0.428, p<0.001) at the time of injury tended to decrease. Conclusion: In patients with osteoporotic vertebral fractures, the fat infiltration rate may be an important predictor of conservative treatment. The prognosis of patients with a high-fat infiltration rate should be explained during patient education, and the patients must be monitored closely through short-term outpatient follow-up.

Evaluation of the Usefulness of Virtual Reality Equipment for Relieving Patients' Anxiety during Whole-Body Bone Scan (전신 뼈 검사 환자의 불안감 해소를 위한 가상현실 장비의 유용성 평가)

  • Kim, Hae-Rin;Kim, Jung-Yul;Lee, Seung-Jae;Baek, Song-Ee;Kim, Jin-Gu;Kim, Ga-Yoon;Nam-Koong, Hyuk;Kang, Chun-Goo;Kim, Jae-Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.1
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    • pp.27-32
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    • 2022
  • Purpose When performing a whole-body bone scan, many patients are experiencing psychological difficulties due to the close distance to the detector. Recently, in the medical field, there is a report that using virtual reality (VR) equipment can give pain relief to pediatric patients with weak concentration or patients receiving severe treatment through a distraction method. Therefore, in this paper, VR equipment was used to provide psychological stability to patients during nuclear medicine tests, and it is intended to evaluate whether it can be used in clinical practice. Materials and Methods As VR equipment, ALLIP Z6 VR (ALLIP, Korea) was used and the experiment was conducted after connecting to a mobile phone. The subjects were 30 patients who underwent whole-body bone examination from September 1, 2021 to September 30, 2021. After intravenous injection of 99mTc-HDP, 3 to 6 hours later, VR equipment was put on and whole body images were obtained. After the test, a survey was conducted, and a Likert scale of 5 points was used for psychological anxiety and satisfaction with VR equipment. Hypothesis verification and reliability of the survey were analyzed using SPSS Statistics 25 (IBM, Corp., Armonk, NY, USA). Results Anxiety about the existing whole-body bone test was 3.03±1.53, whereas that of anxiety after wearing VR equipment was 2.0±1.21, indicating that anxiety decreased to 34%. When regression analysis of the effect of the patient's concentration on VR equipment on anxiety about the test, the B value was 0.750 (P<0.01) and the t value was 6.181 (P<0.01). decreased and showed an influence of 75%. In addition, overall satisfaction with VR equipment was 3.76±1.28, and the intention to reuse was 66%. The Cronbach α value of the reliability coefficient of the questionnaire was 0.901. Conclusion When using VR equipment, patients' attention was dispersed, anxiety was reduced, and psychological stability was found. In the future, as VR equipment technology develops, it is thought that if the equipment can be miniaturized and the resolution of VR content images is increased, it can be used in various clinical settings if it provides more realistic stability to the patient.

Characterization of Antidiabetic Compounds from Extract of Torreya nucifera (비자나무 추출물의 항당뇨 활성물질의 특성 연구)

  • Kim, Ji Won;Kim, Dong-Seob;Lee, Hwasin;Park, Bobae;Yu, Sun-Nyoung;Hwang, You-Lim;Kim, Sang Hun;Ahn, Soon-Cheol
    • Journal of Life Science
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    • v.32 no.1
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    • pp.1-10
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    • 2022
  • Natural products have gained increasing attention due to their advantage of long-term safety and low toxicity for a very long time. Torreya nucifera is widespread in southern Korea and Jeju Island and its seeds are commonly used as edible food. Oriental ingredients have often been reported for their insecticidal, antioxidant and antibacterial properties, but there have not yet been any studies on their antidiabetic effect. In this study, we investigated several biological activities of T. nucifera pericarp (TNP) and seeds (TNS) extracts and proceeded to characterize the antidiabetic compounds of TNS. The initial results suggested that TNS extract at 15 and 10 ㎍/ml concentration has inhibitory effects on α-glucosidase and protein tyrosine phosphatase 1B, that is 14.5 and 4.35 times higher than TNP, respectively. Thus, the stronger antidiabetic TNS was selected for the subsequent experiments to characterize its active compounds. Ultrafiltration was used to determine the apparent molecular weight of the active compounds, showing 300 kDa or more. Finally the mixture was then partially purified using Diaion HP-20 column chromatography by eluting with 50~100% methanol. Therefore we concluded that the active compounds of TNS have potential as therapeutic agents in functional food or supplemental treatment to improve diabetic diseases.

Analysis of Causality of the Increase in the Port Congestion due to the COVID-19 Pandemic and BDI(Baltic Dry Index) (COVID-19 팬데믹으로 인한 체선율 증가와 부정기선 운임지수의 인과성 분석)

  • Lee, Choong-Ho;Park, Keun-Sik
    • Journal of Korea Port Economic Association
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    • v.37 no.4
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    • pp.161-173
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    • 2021
  • The shipping industry plummeted and was depressed due to the global economic crisis caused by the bankruptcy of Lehman Brothers in the US in 2008. In 2020, the shipping market also suffered from a collapse in the unstable global economic situation due to the COVID-19 pandemic, but unexpectedly, it changed to an upward trend from the end of 2020, and in 2021, it exceeded the market of the boom period of 2008. According to the Clarksons report published in May 2021, the decrease in cargo volume due to the COVID-19 pandemic in 2020 has returned to the pre-corona level by the end of 2020, and the tramper bulk carrier capacity of 103~104% of the Panamax has been in the ports due to congestion. Earnings across the bulker segments have risen to ten-year highs in recent months. In this study, as factors affecting BDI, the capacity and congestion ratio of Cape and Panamax ships on the supply side, iron ore and coal seaborne tonnge on the demand side and Granger causality test, IRF(Impulse Response Function) and FEVD(Forecast Error Variance Decomposition) were performed using VAR model to analyze the impact on BDI by congestion caused by strengthen quarantine at the port due to the COVID-19 pandemic and the loading and discharging operation delay due to the infection of the stevedore, etc and to predict the shipping market after the pandemic. As a result of the Granger causality test of variables and BDI using time series data from January 2016 to July 2021, causality was found in the Fleet and Congestion variables, and as a result of the Impulse Response Function, Congestion variable was found to have significant at both upper and lower limit of the confidence interval. As a result of the Forecast Error Variance Decomposition, Congestion variable showed an explanatory power upto 25% for the change in BDI. If the congestion in ports decreases after With Corona, it is expected that there is down-risk in the shipping market. The COVID-19 pandemic occurred not from economic factors but from an ecological factor by the pandemic is different from the past economic crisis. It is necessary to analyze from a different point of view than the past economic crisis. This study has meaningful to analyze the causality and explanatory power of Congestion factor by pandemic.

The effect of the mother's modeling and feeding practices on the eating behavior of young children (어머니의 모델링과 식사 지도가 유아의 식행동에 미치는 영향)

  • Sim, Hyeonmi;Han, Youngshin;Lee, Kyung A
    • Journal of Nutrition and Health
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    • v.55 no.2
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    • pp.296-308
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    • 2022
  • Purpose: To investigate the effect of a mother's modeling and feeding practices on the eating behavior of the children. Methods: From April to June 2018, 1,036 young children aged 2 to 6 years and their mothers in Gyeongsan, Gyeongsangbuk-do, were examined for their eating behavior and feeding practices using a verified dietary behavior test (DBT). The children's dietary behavior was classified into four categories: "access evasiveness", "sensory acuity", "hyperactivity", and "irregularity". The mother's eating behavior was classified into three categories: "pickiness", "negligence", and "irregularity", and feeding practice types were classified into two categories: "responsibility/monitoring", and "restriction/pressure". The differences between the groups were tested using the t-test, ANOVA, and Duncan's multiple range test. The influence of feeding practices on the children's eating behavior was analyzed by hierarchical regression analysis while controlling for the mother's modeling. Results: The problem rates of irregularity, negligence and pickiness in the mother's modeling were 33.7%, 22.8%, and 20.7%, respectively. An analysis of the mother's feeding practices revealed that responsibility/monitoring had a middle, high and low significance in 74.2%, 17.3%, and 8.5% of respondents, respectively and the risk rate of restriction/pressure when guiding children to eat was 15.3%. The problem rates for sensory acuity, access evasiveness, irregularity, and hyperactivity in children were 27.9%, 26.1%, 24.8%, and 22.0%, respectively. Among the four eating behavior characteristics of children, the child's access evasiveness and sensory acuity were more affected by their pickiness rather than the mother's feeding practices, and the child's hyperactivity was more influenced by feeding practices than the mother's eating behavior. The child's irregularity was similarly affected by the mother's eating behavior and feeding practices. Conclusion: Since the mother's eating behavior and feeding practices affect the children's eating behavior, a diet improvement program for children should consider not only the nutrition education of children but also the mother's eating behavior and provide the necessary intervention for feeding practices.

Characterization of Myostatin Gene Variants in Jeju Horses (제주마에서 Myostatin 유전자 변이 특성 구명)

  • Choi, Jae-Young;Shin, Kwang-Yun;Lee, Jongan;Shin, Sang-Min;Kang, Yong-Jun;Shin, Moon-Cheol;Cho, In-Cheol;Yang, Byoung-Chul;Kim, Nam-Young
    • Journal of Life Science
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    • v.31 no.12
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    • pp.1088-1093
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    • 2021
  • Jeju horse (Equus ferus caballus) is a Korean horse breed that has been native to Jeju Island for a long time. Jeju horses are used as racehorses, and their racing ability is a major economic trait. The role of the myostatin (MSTN) gene in skeletal muscle mass has been studied in various mammals, and mutations in the MSTN gene are known to affect the racing ability and stamina of thoroughbreds. In this study, we compared the frequency of mutations in the MSTN gene in several horse breeds, including 1,433 Jeju horses. Among the mutations (ECA18 g.66493737C>T) in the MSTN gene, the long-distance aptitude genotype (TT) was found to have a frequency of 0.826 in Jeju horses, which was higher than that in Halla horses (0.285) and thoroughbreds (0.252). The genotypes and arrival records of Jeju horses were compared according to various distances (400 m, 800 m, 900 m, 1,000 m, 1,110 m, and 1,200 m). According to the results, the CT type showed a faster-reaching record than the TT type in races of less than 1,000 m. However, almost identical results were confirmed in races over 1,110 m. This study suggests that the MSTN mutation in Jeju horses may be related to race distance aptitude. In future research, the data in this study can be used for developing markers related to race distance aptitude and racing abilities in Jeju horses.

Assessment of Region Specific Angstrom-Prescott Coefficients on Uncertainties of Crop Yield Estimates using CERES-Rice Model (작물모형 입력자료용 일사량 추정을 위한 지역 특이적 AP 계수 평가)

  • Young Sang, Joh;Jaemin, Jung;Shinwoo, Hyun;Kwang Soo, Kim
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.24 no.4
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    • pp.256-266
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    • 2022
  • Empirical models including the Angstrom-Prescott (AP) model have been used to estimate solar radiation at sites, which would support a wide use of crop models. The objective of this study was to estimate two sets of solar radiation estimates using the AP coefficients derived for climate zone (APFrere) and specific site (APChoi), respectively. The daily solar radiation was estimated at 18 sites in Korea where long-term measurements of solar radiation were available. In the present study, daily solar radiation and sunshine duration were collected for the period from 2012 to 2021. Daily weather data including maximum and minimum temperatures and rainfall were also obtained to prepare input data to a process-based crop model, CERES-Rice model included in Decision Support System for Agrotechnology Transfer (DSSAT). It was found that the daily estimates of solar radiation using the climate zone specific coefficient, SFrere, had significantly less error than those using site-specific coefficients SChoi (p<0.05). The cumulative values of SFrere for the period from march to September also had less error at 55% of study sites than those of SChoi. Still, the use of SFrere and SChoi as inputs to the CERES-Rice model resulted in slight differences between the outcomes of crop growth simulations, which had no significant difference between these outputs. These results suggested that the AP coefficients for the temperate climate zone would be preferable for the estimation of solar radiation. This merits further evaluation studies to compare the AP model with other sophisticated approaches such as models based on satellite data.