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Clinical and Functional Outcomes of the Exeter V40 Short Stem in Primary and Revision Arthroplasty: Does the Indication Affect Outcomes in the Short Term?

  • Nemandra Amir Sandiford;Scott M. Bolam;Irrum Afzal;Sarkhell Radha
    • Hip & pelvis
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    • v.35 no.1
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    • pp.40-46
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    • 2023
  • Purpose: A variety of short Exeter stems designed specifically for use in performance of total hip arthroplasty (THA) in primary and revision settings have recently been introduced. Some have been used 'off label' for hip reconstruction. The aim of this study is to report clinical and radiological results from the Exeter V40 125 mm stem in performance of primary THA and revision THA. Materials and Methods: This study had a retrospective design. Insertion of 58 (24 primary, 34 revision) Exeter V40 125 mm stems was performed between 2015 and 2017. The minimum follow-up period was two years. Assessment of the Oxford hip score (OHS), EuroQol-5 Dimension (EQ-5D), and radiological follow-up was performed at one and two years. Results: In the primary group, the preoperative, mean OHS was 13.29. The mean OHS was 32.86 and 23.39 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were at 0.14, 0.59, and 0.35, preoperatively, at one-year follow-up and two-year follow-up, respectively. In the revision group, the mean preoperative OHS was 19.41. The mean OHS was 30.55 and 26.05 at one-year and two-year post-surgery, respectively. The mean EQ-5D-3L scores were 0.33, 0.61, and 0.48 preoperatively, at one-year follow-up and two-year follow-up, respectively. No progressive or new radiolucent lines were observed around any stem at the time of the final follow-up in all patients in both groups. Conclusion: Encouraging results regarding use of Exeter V40 125 mm stems have been reported up to two years following surgery in primary and revision THA settings.

The Wireless Monitoring System of Respiration Signal (호흡신호 무선 통신 시스템 개발)

  • Son, Byoung-Hee;Jang, Jong-Chan;Yang, Hyo-Sik;Cha, Eun-Jong
    • Journal of the Institute of Convergence Signal Processing
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    • v.12 no.3
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    • pp.157-162
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    • 2011
  • This study is about implementing wireless transferring system in pre-hospital cardiopulmonary resuscitation(CPR). Also, this study includes monitoring based feedback between patient and hospital to increase the survival rate of emergency patient by developing the performance of cardiopulmonary resuscitation in pre-hospital. It minimizes the loss of flow rate or gastric inflation through the space between the airway and the esophagus, which enables the inspiration-expiration rate to be measured more precisely. Due to these reasons this study applied ET insertion based respiratory sensor to measure flow rate. The main indices of artificial ventilation are justified from minute respiration(V), end-tidal $CO_2(E_TCO_2)$, and tracheal pressure($P_{tr}$). The simulation is performed to verify the bandwidth and delay time of transport network for in-hospital monitoring even as transporting images and voice information simultaneously. The total bandwidth is 815 kbps, and WLAN (IEEE 802.11x) is used as communication protocol. The network load is under 1.5% and the transmit delay time is measured under 0.3 seconds.

An Improved Particle Swarm Optimization Algorithm for Care Worker Scheduling

  • Akjiratikarl, Chananes;Yenradee, Pisal;Drake, Paul R.
    • Industrial Engineering and Management Systems
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    • v.7 no.2
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    • pp.171-181
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    • 2008
  • Home care, known also as domiciliary care, is part of the community care service that is a responsibility of the local government authorities in the UK as well as many other countries around the world. The aim is to provide the care and support needed to assist people, particularly older people, people with physical or learning disabilities and people who need assistance due to illness to live as independently as possible in their own homes. It is performed primarily by care workers visiting clients' homes where they provide help with daily activities. This paper is concerned with the dispatching of care workers to clients in an efficient manner. The optimized routine for each care worker determines a schedule to achieve the minimum total cost (in terms of distance traveled) without violating the capacity and time window constraints. A collaborative population-based meta-heuristic called Particle Swarm Optimization (PSO) is applied to solve the problem. A particle is defined as a multi-dimensional point in space which represents the corresponding schedule for care workers and their clients. Each dimension of a particle represents a care activity and the corresponding, allocated care worker. The continuous position value of each dimension determines the care worker to be assigned and also the assignment priority. A heuristic assignment scheme is specially designed to transform the continuous position value to the discrete job schedule. This job schedule represents the potential feasible solution to the problem. The Earliest Start Time Priority with Minimum Distance Assignment (ESTPMDA) technique is developed for generating an initial solution which guides the search direction of the particle. Local improvement procedures (LIP), insertion and swap, are embedded in the PSO algorithm in order to further improve the quality of the solution. The proposed methodology is implemented, tested, and compared with existing solutions for some 'real' problem instances.

The Merits of Mannitol in the Repair of Orbital Blowout Fracture

  • Shin, Kyung Jin;Lee, Dong Geun;Park, Hyun Min;Choi, Mi Young;Bae, Jin Ho;Lee, Eui Tae
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.721-727
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    • 2013
  • Background One of the main concerns in orbital blowout fracture repair is a narrow operation field, due mainly to the innate complex three dimensions of the orbit; however, a deep location and extensive area of the fracture and soft tissue edema can also cause concern. Swelling of the orbital contents progresses as the operation continues. Mannitol has been used empirically in glaucoma, cerebral hemorrhage, and orbital compartment syndrome for decompression. The authors adopted mannitol for the control of intraorbital edema and pressure in orbital blowout fracture repair. Methods This prospective study included 108 consecutive patients who were treated for a pure blowout fracture from January 2007 to October 2012. For group I, mannitol was administered during the operation. Under general anesthesia, all patients underwent surgery by open reduction and insertion of an absorbable mesh implant. The authors compared postoperative complications, the reoperation rate, operation time, and surgical field improvement between the two groups. Results In patients who received intraoperative administration of mannitol, the reoperation rate and operation time were decreased; however, the difference was not statistically significant. The total postoperative complication rates did not differ. Panel assessment for the intraoperative surgical field video recordings showed significantly improved vision in group I. Conclusions For six years, mannitol proved itself an effective, reliable, and safe adjunctive drug in the repair of orbital blowout fractures. With its rapid onset and short duration of action, mannitol could be one of the best methods for obtaining a wider surgical field in blowout fracture defects.

Routine Shunting is Safe and Reliable for Cerebral Perfusion during Carotid Endarterectomy in Symptomatic Carotid Stenosis

  • Kim, Tae-Yun;Choi, Jong-Bum;Kim, Kyung-Hwa;Kim, Min-Ho;Shin, Byoung-Soo;Park, Hyun-Kyu
    • Journal of Chest Surgery
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    • v.45 no.2
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    • pp.95-100
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    • 2012
  • Background: The purpose of this report is to describe the perioperative outcomes of standard carotid endarterectomy (CEA) with general anesthesia, routine shunting, and tissue patching in symptomatic carotid stenoses. Materials and Methods: Between October 2007 and July 2011, 22 patients with symptomatic carotid stenosis (male/female, 19/3; mean age, $67.2{\pm}9.4$ years) underwent a combined total of 23 CEAs using a standardized technique. The strict surgical protocol included general anesthesia and standard carotid bifurcation endarterectomy with routine shunting. The 8-French Pruitt-Inahara shunt was used in all the patients. Results: During the ischemic time, the shunts were inserted within 2.5 minutes, and 5 patients (22.7%) revealed ischemic cerebral signals (flat wave) in electroencephalographic monitoring but recovered soon after insertion of the shunt. The mean shunting time for CEA was $59.1{\pm}10.3$ minutes. There was no perioperative mortality or even minor stroke. All patients woke up in the operating room or the operative care room before being moved to the ward. One patient had difficulty swallowing due to hypoglossal nerve palsy, but had completely recovered by 1 month postsurgery. Conclusion: Routine shunting is suggested to be a safe and reliable method of brain perfusion and protection during CEA in symptomatic carotid stenoses.

A Systematic Review of Acupuncture-Moxibustion Treatments for Nonspecific Chronic Neck Pain (비특이적 목 통증에 사용된 침구치료에 대한 체계적 문헌고찰)

  • Yang, Chang-Sop;Kim, Ick-Tae;Kim, Young-Eun;Kim, Bo-Young;Seo, Bok-Nam;Park, Ji-Eun
    • Korean Journal of Acupuncture
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    • v.34 no.4
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    • pp.209-230
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    • 2017
  • Objectives : The aim of this study was to describe the details and to assess the clinical evidence of acupuncture and moxibustion for non-specific chronic neck pain. Methods : We searched seven databases including Korean, English, and Chinese databases through July 2016. Studies using acupuncture, moxibustion, pharmacopuncture, electroacupuncture, auricular-acupuncture, acupressure for non-specific chronic neck pain were included. Only controlled clinical trials or randomized clinical trials were assessed. Study design, number of subject, inclusion criteria, intervention, and results were extracted. In addition, details of intervention including needle type, retention time, acupoints were analyzed. Results : Total 64 studies(39 acupuncture, 9 laser, 6 pharmaco-acupuncture, 3 electro-acupuncture, 3 auricular-acupuncture, 3 moxibustion, 1 acupressure) were included. Among 39 acupuncture studies, 35 used acupuncture as sole intervention. Sham treatment was the most common intervention for control group, followed by no intervention. Various outcome including pain, disability, quality of life, range of motion was used as outcome measurement. The effect of acupuncture and moxibustion was different depending on the type of control and outcome measurement. The most commonly used method in acupuncture for neck pain was GB21, SI3, GB20, LI4, BL11 acupoints, 10~30 mm insertion depth, 20~30 retention time, and 1~2 times per week. Conclusions : Analyzing the details of acupuncture and moxibustion treatment could be helpful for researches and clinics. Further studies should consider the characteristics of study design, intervention, and outcome to assess the effect of TKM.

Breast Reconstruction after Modified Radical Mastectomy with Becker Permanent Tissue Expander (변형 근치 유방절제술 후 Becker 확장형 보형물을 이용한 유방 재건술)

  • Hong, Yong Taek;Yoon, Eul Sik;Choi, Kyu Jin;Dhong, Eun Sang;Son, Gil Soo
    • Archives of Plastic Surgery
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    • v.34 no.2
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    • pp.222-228
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    • 2007
  • Purpose: Report of the good results of breast reconstruction using Becker permanent tissue expander that showed a short operation time and a quick post-operation recovery time, little side effects and usually superb aesthetic results without the need for additional incisions or donor site morbidity. The authors, after carrying out breast reconstruction operations using Becker permanent tissue expander on patients with appropriate indications, attempted to analyze several factors such as complication rates and patient satisfaction measurements. Methods: 11 cases of breast reconstruction using Becker expander implants were carried out on a total of 10 patients between March 2000 and February 2003. The patients were followed up at outpatient visit for an average of 6 months. Results: The most common post-operation complication was pain resulting from saline injection into the expanders, complained by 5 patients(50%). rib fractures, skin necrosis, implant removal due to infection, and breast cancer recurrence each occurred in 1 patient (9.9%). There was no occurrence of skin contracture complications which occurs frequently in case of silicone implant insertion. Patient complacency was surveyed by patient interviews made right after the operations and during outpatient follow-up periods: 5(50%) patients out of 10 showed excellent, 3(30%) good, and 2(20%) showed fair, leaving no patients who were disappointed with operation results. On routine follow-up, 80% of patients expressed satisfaction with the cosmetic outcome of their post-mastectomy beast reconstruction. Conclusion: Breast reconstruction using the Becker expander is a reliable alternative to other reconstructive methods but good patient selection is essential for satisfactory results.

Retrospective long-term analysis of bone level changes after horizontal alveolar crest reconstruction with autologous bone grafts harvested from the posterior region of the mandible

  • Voss, Jan Oliver;Dieke, Tobias;Doll, Christian;Sachse, Claudia;Nelson, Katja;Raguse, Jan-Dirk;Nahles, Susanne
    • Journal of Periodontal and Implant Science
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    • v.46 no.2
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    • pp.72-83
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    • 2016
  • Purpose: The goal of this study was to evaluate the long-term success of horizontal alveolar crest augmentation of the retromolar region of the mandible with particulated bone, as well as factors affecting subsequent peri-implant bone loss. Methods: A total of 109 patients (68 female, 41 male) suffering from alveolar ridge deficiencies of the maxilla and mandible were included in this study. All patients were treated with particulated retromolar bone grafts from the mandible prior to the insertion of endosseous dental implants. Mesial and distal peri-implant crestal bone changes were assessed at six time points. Several parameters, including implant survival and the influence of age, gender, localisation of the implant, diameter, covering procedures, and time points of implant placement, were analysed to identify associations with bone level changes using the Mann-Whitney U-test, the Kruskal-Wallis test, and Spearman's rank-order correlation coefficient. Results: A total of 164 dental implants were placed in the maxilla (n=97) and in the mandible (n=67). The mean observation period was $105.26{\pm}21.58$ months after implantation. The overall survival rate was 97.6% after 10 years. Overall, peri-implant bone loss was highest during the first year, but decreased over time. The mean amount of bone loss after 10 years was 2.47 mm mesially and 2.50 mm distally. Bone loss was significantly influenced by implant type and primary stability. Conclusions: The use of particulated autologous retromolar bone grafts is a reliable technique for the horizontal reconstruction of local alveolar ridge deficiencies. Our results demonstrate that implants placed in augmented bone demonstrated similar bone level changes compared to implants inserted in non-augmented regions.

Development of rapidly hardening seal material applicable to steel pipe multistage grouting (강관다단 그라우팅에 적용하는 속경성 실링재 개발)

  • Shin, Hyunkang;Jung, Hyuksang;Kim, Donghyun;Ryu, Yongsun;Kim, Donghoon
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.21 no.2
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    • pp.301-321
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    • 2019
  • The development of a rapidly hardening seal material applicable to steel pipe multistage grouting is described in this paper. In the multistage technique, seal materials are inserted to prevent the backflow of main grouting material. The grouting material must be inserted only after sufficient time has passed for the seal material to reach a gel state. Otherwise, the fluid seal material mixes with the main grouting material and a backflow of the grouting material occurs, thereby making its in situ insertion difficult. Furthermore, if the seal material remains in the gel state for too long a time, it solidifies; and the main grouting material will not be able to seep into the soil. The gel time, i.e., the time needed for the fluid seal material to turn into a gel state, determines the construction period of steel pipe multistage grouting. The gel time is one of the important factors in this technique, because it impacts the total tunnel construction period significantly. This study develops a rapidly hardening calcium aluminate material, which can reduce the gel time and shorten the construction period while retaining proper sealing function. It also presents a method to determine whether the seal material has reached the gel state as well as the quality standard and bleeding rate testing method for the seal material in the gel state.

The Effect of Intradermal Acupuncture on The Patients suffering from Insomnia after Stroke (중풍환자(中風患者)의 불면증(不眠症)에 피내침(皮內針)의 유효성(有效性) 및 적응증(適應證) 평가(評價))

  • Lee Sang-Ho;Kim Eun-Ju;Kim Lee-Dong;Yun Sang-Pil;Lee Cha-Ro;Hong Jin-Woo;Jeong Dong-Won;Moon Sang-Kwan;Cho Ki-Ho;Kim Young-Suk
    • The Journal of Internal Korean Medicine
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    • v.25 no.1
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    • pp.138-148
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    • 2004
  • Objective : Insomnia is the disorder of initiation or maintenance in sleeping that results in daytime sleepiness and dysfunction, and it arises from multiple psychological, physiological and environmental factors. A number of stroke patients suffer from insomnia are classified as sleep disorder patients with physical illness. In addition, insomnia may have profound deleterious effects on the natural course of stroke. We are to assess the effectiveness of intradermal acupucture on stroke combined with insomnia. Methods : We recruited hospitalized patients with insomnia after stroke. Then, the subjects were allocated into a treatment group and a control group by randomization. The treatment group received intradermal acupuncture therapy at He-7(神門), EH-6(內關) correctly. However in control group, intradermal acupuncture were just attached to He-7(神門), EH-6(內關) without insertion. Treatment over time at first day and second day a various indexes were repeatedly checked such as sleep latency, total sleep time, sleep quality, condition on awakening, ability of concentration, morning sleepiness, Insomnia Severity Index, and Athens Insomnia Scale. In the second analysis, we divided the treatment group into a response and a non-response group by their response to intradermal acupuncture. With the acupuncture treatment, accompanied symptoms were checked Results : Among thirty two subjects, two of them were dropped out: One complained the pain from needle insertion, and the other underwent the change of his herbal medication. At baseline investigation with the residual 30 subjects, the control and the treatment group were assessed to have an equal comparability. In the treatment group, sleep latency, total sleeping time, a number of awakenings, sleep quality and ability of concentration showed improvement significantly compared with the control group. The non-response Group showed symptoms such as nausea and halitosis, belching and acid regurgitation, abundant expectoration, while Responder Group showed palpitation, oppressed feelings in chest and sleep disorder. Conclusions: The result of this clinical study suggests that the intradermal acupuncture at He-7(神門), EH-6(內關) is one of the effective treatments for the insomnia after stroke.

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