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Concomitant open distal clavicle excision is associated with greater improvement in range of motion without increased risk of acromial stress fracture after reverse total shoulder arthroplasty: a retrospective cohort study

  • Ajay C. Kanakamedala;Dhruv S. Shankar;Neil Gambhir;Matthew R. Boylan;Michael Boin;Matthew G. Alben;Mandeep S. Virk;Young W. Kwon
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.357-365
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    • 2023
  • Background: The purpose of this study was to evaluate the effect of concomitant open distal clavicle excision (DCE) on postoperative clinical outcomes and incidence of acromial and scapular stress fractures (ASFs) in patients with symptomatic acromioclavicular joint osteoarthritis (ACJ OA) undergoing reverse total shoulder arthroplasty (RTSA). Methods: A single-surgeon retrospective cohort study was conducted including patients who underwent primary elective RTSA with or without DCE from 2015 to 2019 with a minimum 6-month follow-up period. Shoulder active range of motion (AROM) and visual analog scale (VAS) pain were recorded preoperatively and postoperatively. ASFs and other adverse events were identified using postoperative notes and/or radiographs. Characteristics and outcomes were compared between the RTSA and RTSA-DCE groups. Results: Forty-six RTSA patients (mean age, 67.9±8.7 years; 60.9% male; mean follow-up, 24.9±16.6 months) and 70 RTSA-DCE patients (mean age, 70.2±8.9 years; 20.0% male; mean follow-up, 22.7±12.9 months) were included. There were no significant intergroup differences in rates of ASF (RTSA, 0.0% vs. RTSA-DCE, 1.4%; P=1.00), stress reactions (RTSA, 8.7% vs. RTSA-DCE, 11.4%; P=0.76), reoperation, revision, or infection (all P>0.05), or in pre-to-postoperative reduction in VAS pain (P=0.17) at latest follow-up. However, the RTSA-DCE group had greater pre-to-postoperative improvement in flexion AROM (RTSA, 43.7°±38.5° vs. RTSA-DCE, 59.5°±33.4°; P=0.03) and internal rotation (IR) AROM (P=0.02) at latest follow-up. Conclusions: Concomitant DCE in RTSA improves shoulder flexion and IR AROM, alleviates shoulder pain, and does not increase the risk of ASFs. Level of evidence: III.

A fundamental study on the minimize wear of slurry shield TBM sludge bend pipe (이수식 쉴드 TBM 배니곡관 마모 최소화를 위한 기초 연구)

  • Soo-Jin Lee;Hyeon-Do Kim;Yong-Woo Kim;Sang-Hwan Kim
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.26 no.3
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    • pp.243-254
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    • 2024
  • Currently, due to industrial development in domestic regions, buildings are saturated not only in major city centers but also in surrounding urban areas. Accordingly, people's attention has focused on underground spaces, and tunnels are being widely used, especially in urban development. Research on tunnels and tunnel excavation methods is actively underway. However, there is a lack of research on the wear and tear problems of sludge discharge pipes when using a slurry shield TBM. Therefore, in this paper, the L-shaped bend pipe used in the existing sludge discharge pipe was transformed into a T-shaped bend pipe to move sludge. As a result, it was confirmed that compared to the L-shaped bend pipe, the impact of the T-shaped bend pipe on the bend pipe when discharging sludge was reduced. Based on these results, it is expected that wear of the sludge discharge pipe can be minimized by using a T-shaped bend pipe when using slurry shield TBM equipment. This is expected to ultimately lead to economic benefits, such as reducing costs due to replacement of curved pipes or additional welding during tunnel construction.

Changes in Subjective Discomfort, Blinking Rate, Lens Centration and the Light Transmittance of Lens Induced by Exceeding Use of Daily Disposable Circle Contact Lenses in Dry Eyes (일회용 써클소프트렌즈의 일일 초과착용 시 유발되는 건성안의 자각적 불편감, 순목횟수, 중심안정 및 렌즈 광투과율의 변화)

  • Park, Mijung;Kang, Shin Young;Chang, Jung Iee;Han, Arum;Kim, So Ra
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.2
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    • pp.153-162
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    • 2014
  • Purpose: This study was assessed to investigate the change of subjective and/or objective symptoms and the light transmittance of lens caused by the use longer than recommended wearing time of daily disposable circle contact lenses (circle lens) in dry eyes. Methods: Three daily disposable circle lenses made of etafilcon A, hilafilcon B, and nelfilcon A were applied on 30 dry eyes with smaller tear volume than normal eyes in their twenties free from any eye diseases by when subjects complained any kind of discomfort. On the first and the last days of lens wearing, subjective discomfort, blinking rate, lens centration on corneal surface and visible light transmittance of lens were recorded at every case and compared. Results: The circle lens wearers complained subjective discomfort and quit the lens wearing when they wore the circle lens longer than 10 hours even though there were some difference according to the lens materials of daily disposable circle lens. However, around 20% of dry eyes could wear the circle lens made of non-ionic materials longer than 40 hours. Dry eyes showed most sensitive feeling of subjective discomfort against the circle lens made of etafilcon A among three different lens materials. On the last day of lens wearing, the representative subjective discomforts were irritation, stiffness, dryness and tiredness. When the subjects wore circle lens more than the recommended time, blinking rate was significantly increased about 20~30% regardless of lens materials when it compared with the values right after lens wearing. On the last day of lens wearing, the vertical direction of lens centration was shifted to pupil center however, its distribution in horizontal direction was wide compared with the distribution right after lens wearing. Especially, the centration of etafilcon A lens was unstable. Furthermore, the visible light transmittance of 3 different circle lenses in dry eyes has significantly been reduced around 15% averaged. Conclusions: From these results, it was known that the increase of dryness and stiffness caused by overusage of daily disposable circle lens induced excess irritation and decreased visible light transmittance and caused significant more blinking, which provoked lens decentration. It was also revealed that dry eyes showed sensitive reaction subjectively and objectively against the overusage of circle lens made of high water content/ionic lens material even there were some difference of the degree depending on the individual and the lens material. Thus, this research can be suggested as the basic reference for the education about some unexpected problems and the side effect caused by the wearing of circle lens in dry eyes.

A Study on the Change of Corneal Refractive Power before and after Wearing RGP Contact Lenses by Flat Fitting and Alingment Fitting with Diagnostic Method (RGP 콘택트렌즈의 진단적 피팅법에 의한 플랫한 피팅과 얼라인먼트 피팅 착용 전·후 각막 굴절력의 변화에 관한 연구)

  • Lee, Dae-Won;Kim, In-Suk
    • Journal of Korean Ophthalmic Optics Society
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    • v.19 no.2
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    • pp.163-169
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    • 2014
  • Purpose: This study is for compared the change of corneal refractive power before and after wearing of rigid gas permeable contact lense with diagnostic method which is 1 D flatter than alignment fitting on right eye and alignment fitting on left eye for 2 months and investigate the preference. Methods: Twenty middle school and high school students (40 eyes) who had never worn a contact lense before for no corneal topographical change, no ocular disease, no experience of ophthalmic surgery and have normal tear amount were selected for this study and corneal refractive power were examined before wearing rigid gas permeable contact lense and adaptation status and corneal examination were performed after 10 days of wearing and after cheking up the continuation of wearing, all candidate wear contact lens 8 hours per day for 2 month and corneal refractive power were compared. Results: After 2 months of wearing with 1 D flatter than the alignment fitting on right eyes, there was significant difference in the central corneal refractive power was $43.84{\pm}1.33D$, flat K power was $43.05{\pm}1.29D$, and steep K power was $44.61{\pm}1.42D$ decreased than before wearing (p<0.001, 0.001, 0.047). The e-value of the principal meridians also shows statistically significant difference (p=0.037, 0.015). After 2 months of wearing with alignment fitting on left eyes, the central corneal refractive power was $44.40{\pm}1.26D$, flat K power was $43.57{\pm}1.23D$. and flat K e-value was $0.58{\pm}0.05$ which showed no statistically significant difference (p = 0.769, 0.614, 0.181). But steep K power was $45.25{\pm}1.36$, and steep K e-value was $0.45{\pm}0.18$ which shows statistically significant difference (p=0.018, 0.027). Conclusions: Consider the comfort, clear vision, dryness for preference fitting investment, 6 students (30%) prefer right eye which is 1 D flatter fitting, 14 students (70%) prefer left eye which is alignment fitting. For rigid gas permeable fitting needed for accurate examination and should prescribe the alignment fitting which is suitable for each cornea.

Effect of Heat Insulation on Decomposition of Ricestraw Pile in the P.E.Film House during Winter Season (겨울철 비닐하우스내의 볏짚퇴비더미의 온도변화와 부숙효과)

  • Lee, Yun Hwan;Kim, Yong Yeon
    • Korean Journal of Soil Science and Fertilizer
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    • v.18 no.1
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    • pp.27-31
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    • 1985
  • To get well matured farm yard manure from ricestraw as quickly as possible during winter season, straw piles wrapped with polyethylene film and/or straw thatch were stored in the vinyl house or open air. Their maturities and changes of temperature in heap were investigated from the beginning of December 1983 to March of next year. Heat increment in vinyl house was high $2-5^{\circ}C$ than at open air at the lowest temperature but it didn't rise over the freezing point. However, the highest temperature was arisen over than $20^{\circ}C$ averagely at the vinylhouse compared to those of open air during three months. Temperature in piles of straw manure was reached to about $70^{\circ}C$ in maximum and rose again very rapidly after repiling in the vinyl house, whereas increment of temperature after repiling was delayed and took long times to reach the maximum temperature at open air. Wrapping with P.E. film also affected the insulation of decomposing heat of straw pile and promoted the repeat of piling even at open air. By these results, ricestraw would be decomposed rapidly by insulation with P.E. film in the vinyl house and could be reached to matured compost for application to field on next spring season. P.E. film covered for vinyl house was endured until May of next year without tear by weathering.

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Why A Multimedia Approach to English Education\ulcorner

  • Keem, Sung-uk
    • Proceedings of the KSPS conference
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    • 1997.07a
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    • pp.176-178
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    • 1997
  • To make a long story short I made up my mind to experiment with a multimedia approach to my classroom presentations two years ago because my ways of giving instructions bored the pants off me as well as my students. My favorite ways used to be sometimes referred to as classical or traditional ones, heavily dependent on the three elements: teacher's mouth, books, and chalk. Some call it the 'MBC method'. To top it off, I tried audio-visuals such as tape recorders, cassette players, VTR, pictures, and you name it, that could help improve my teaching method. And yet I have been unhappy about the results by a trial and error approach. I was determined to look for a better way that would ensure my satisfaction in the first place. What really turned me on was a multimedia CD ROM title, ELLIS (English Language Learning Instructional Systems) developed by Dr. Frank Otto. This is an integrated system of learning English based on advanced computer technology. Inspired by the utility and potential of such a multimedia system for regular classroom or lab instructions, I designed a simple but practical multimedia language learning laboratory in 1994 for the first time in Korea(perhaps for the first time in the world). It was high time that the conventional type of language laboratory(audio-passive) at Hahnnam be replaced because of wear and tear. Prior to this development, in 1991, I put a first CALL(Computer Assisted Language Learning) laboratory equipped with 35 personal computers(286), where students were encouraged to practise English typing, word processing and study English grammar, English vocabulary, and English composition. The first multimedia language learning laboratory was composed of 1) a multimedia personal computer(486DX2 then, now 586), 2) VGA multipliers that enable simultaneous viewing of the screen at control of the instructor, 3) an amplifIer, 4) loud speakers, 5)student monitors, 6) student tables to seat three students(a monitor for two students is more realistic, though), 7) student chairs, 8) an instructor table, and 9) cables. It was augmented later with an Internet hookup. The beauty of this type of multimedia language learning laboratory is the economy of furnishing and maintaining it. There is no need of darkening the facilities, which is a must when an LCD/beam projector is preferred in the laboratory. It is headset free, which proved to make students exasperated when worn more than- twenty minutes. In the previous semester I taught three different subjects: Freshman English Lab, English Phonetics, and Listening Comprehension Intermediate. I used CD ROM titles like ELLIS, Master Pronunciation, English Tripple Play Plus, English Arcade, Living Books, Q-Steps, English Discoveries, Compton's Encyclopedia. On the other hand, I managed to put all teaching materials into PowerPoint, where letters, photo, graphic, animation, audio, and video files are orderly stored in terms of slides. It takes time for me to prepare my teaching materials via PowerPoint, but it is a wonderful tool for the sake of presentations. And it is worth trying as long as I can entertain my students in such a way. Once everything is put into the computer, I feel relaxed and a bit excited watching my students enjoy my presentations. It appears to be great fun for students because they have never experienced this type of instruction. This is how I freed myself from having to manipulate a cassette tape player, VTR, and write on the board. The student monitors in front of them seem to help them concentrate on what they see, combined with what they hear. All I have to do is to simply click a mouse to give presentations and explanations, when necessary. I use a remote mouse, which prevents me from sitting at the instructor table. Instead, I can walk around in the room and enjoy freer interactions with students. Using this instrument, I can also have my students participate in the presentation. In particular, I invite my students to manipulate the computer using the remote mouse from the student's seat not from the instructor's seat. Every student appears to be fascinated with my multimedia approach to English teaching because of its unique nature as a new teaching tool as we face the 21st century. They all agree that the multimedia way is an interesting and fascinating way of learning to satisfy their needs. Above all, it helps lighten their drudgery in the classroom. They feel other subjects taught by other teachers should be treated in the same fashion. A multimedia approach to education is impossible without the advent of hi-tech computers, of which multi functions are integrated into a unified system, i.e., a personal computer. If you have computer-phobia, make quick friends with it; the sooner, the better. It can be a wonderful assistant to you. It is the Internet that I pay close attention to in conjunction with the multimedia approach to English education. Via e-mail system, I encourage my students to write to me in English. I encourage them to enjoy chatting with people all over the world. I also encourage them to visit the sites where they offer study courses in English conversation, vocabulary, idiomatic expressions, reading, and writing. I help them search any subject they want to via World Wide Web. Some day in the near future it will be the hub of learning for everybody. It will eventually free students from books, teachers, libraries, classrooms, and boredom. I will keep exploring better ways to give satisfying instructions to my students who deserve my entertainment.

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Effects of Intercrops on Growth and Yield of Paeonia Lactiflora PALLAS. (간작물(間作物)이 작약(芍藥)의 생육(生育) 및 수양(收量)에 미치는 영향(影響))

  • Hwang, Hyung-Baek;Kim, Jae-Chul;Park, So-Deug;Chol, Boo-Sull;Lim, Joo-Rag
    • Korean Journal of Medicinal Crop Science
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    • v.4 no.3
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    • pp.212-217
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    • 1996
  • This study was carried out to select proper intercrops in peony cultivation because peo­ny is damaged easily by disease and cannot make proper income with it's single crop system, so it needs rational intercropping system to raise it's productivity and income. The results of this study are as follows. The kinds of soil nematodes were Meloidogyne sp, Pratyienchus sp, Aphelenchoides sp, Ditylenchus sp, Xiphinema sp, and damaging dominant nematode was Meloidogyne sp. The density of Meloidogyne sp wa suppressed remarkably in the combination of peony+sesame, and peony + job's tears. This study shows that sesame and job's tear were most resistant crops to the IvIeloi­dogyne sp. The quanity of herbaceous peony was the best in the combination of peony+red pepper. The results of income analysis per lOa for three years shows next conclusion. Peony+red pepper combination and peony+ sesame combination were most effective when it's compared with single cropping of peony (1,490 thousand won). But red pepper was damaged easily by soil nematode, therefore, sesame was the most stable and high yield crop as a intercrop in the cultivation of herbaceous peony.

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Usefulness of Three-phasic Bone Scan in Young Male Patients Suspected of Post-traumatic Reflex Sympathetic Dystrophy Syndrome (외상후 교감신경 이영양증이 의심되는 젊은 남자 환자들에서 삼상 골스캔의 유용성)

  • Lee, Won-Woo;Kim, Tae-Uk;Kim, Tae-Hoon;Jung, Cheoul-Yun;Moon, Jin-Ho
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.1
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    • pp.52-60
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    • 2001
  • Purpose: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. Materials and Methods: Patients with narrow range of age (21-25. mean $22.8{\pm}1.3$, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed $21.2{\pm}7.3wks$ after trauma. Results: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight hearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). Conclusion: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.

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Bio-Degradable Plastic Mulching in Sweetpotato Cultivation (생분해성 멀칭필름을 이용한 고구마 재배)

  • Lee, Joon-Seol;Jeong, Kwang-Ho;Kim, Hag-Sin;Kim, Jeong-Ju;Song, Yeon-Sang;Bang, Jin-Ki
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.54 no.2
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    • pp.135-142
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    • 2009
  • This experiment was conducted to determine the usability of biodegradable plastic in the mulching cultivation of sweetpotato. For this, we investigated the physical characteristics, biodegradability, leaching, yield, workability, etc. of biodegradable films. Compared with general mulching materials, biodegradable Poly butyleneadipate-co-butylene succinate (PBSA) and PLC+starch showed $2{\sim}27$% higher tensile strength, but $2{\sim}22$% lower elongation and $2{\sim}6$% lower tear strength. In the leaching test on the biodegradable films, heavy metals were detected very little or not at all. As to difference in ground temperature according to mulching material, the temperature was high in order of PLC+starch > PBSA > Low Density Polyethylene (LDPE) > Control during the period from late June to mid July, but in order of LDPE > PLC+starch > PBSA > None during the period from late July to late September. In the mulching cultivation of sweet potato, biodegradable films PBSA (EA, EB, EC) and PLC+starch (DD, DE, DF) began to degrade after 60 days from the cut planting of sweet potato, and over 95% degraded after 120 days. The quantity of roots was 3,070 kg/10a for PBSA, 3,093 kg/10a for PLC-starch, and 2,946 kg/l10a for LDPE, showing no significant difference according to mulching material. Considering the physical characteristics, biodegradability, environment, convenience in harvesting work, yield, etc. of the films in the mulching cultivation of sweet potato, biodegradable films are expected to be very useful.

Short-term Outcomes of Arthroscopic Transtendinous Repair in Partial Articular Side Tears of the Rotator Cuff (회전근 개 부분 관절측 파열에 대한 관절경적 경 건 봉합술의 단기 결과)

  • Shin, Sung-Ryong;Yoo, Yon-Sik;Kim, Do-Young;Lee, Sang-Soo;Jeong, Un-Seob;Choi, Hyun-Seok
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.112-117
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    • 2008
  • Purpose: This study prospectively evaluated the outcome of arthroscopic transtendinous repair as a treatment for partial articular side tears of the rotator cuff. Materials and Methods: Fifteen patients with symptomatic, partial articular side tears of the rotator cuff underwent modified transtendinous repair. The patient's mean age was 52.5 years and the mean duration of symptoms was 33.7 weeks. The visual analogue scale (VAS), the ASES score, the active ROM of the shoulder and the patient's satisfaction were evaluated both preoperatively and postoperatively. The clinical results were analyzed using the Wilcoxon's signed rank test. Results: The mean VAS was $6.6\pm1.1$ before treatment and $0.4\pm0.6$ at 6 month, and the ASES scores for all the patients were significantly better over the six-month period of follow-up (p<0.05). The mean active ROM in abduction was $94.3\pm22.3$ before treatment, $108.7\pm16.3$ at 1 month (p=0.0041) and $164.3\pm5.3$ at six months (p=0.0006). In flexion, it was $105.0\pm23.8$ before treatment, $119.0\pm17.4$ at 1 month(p=0.0075) and $174.3\pm5.3$ at six months (p=0.0006). At the final follow-up, 94% of patients were satisfied or very satisfied after operation. Conclusion: We experienced satisfactory clinical results after a short-term follow-up of arthroscopic transtendinous repair, and we believed this to be an effective procedure for patients with partial articular side tears of the rotator cuff.