• 대한족부족관절학회지
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• 제15권2호
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• pp.51-57
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• 2011

Pilon fractures involving distal tibia remain one of the most difficult therapeutic challenges that confront the orthopedic surgeons because of associated soft tissue injury is common. To introduce and describe the diagnosis, current treatment, results and complications of the pilon fractures. In initial assessment, the correct evaluation of the fracture type through radiographic checkup and examination of the soft tissue envelope is needed to decide appropriate treatment planning of pilon fractures. Even though Ruedi and Allgower reported 74% good and excellent results with primary open reduction and internal fixation, recently the second staged treatment of pilon fractures is preferred to orthopedic traumatologist because of the soft tissue problem is common after primary open reduction and internal fixation. The components of the first stage are focused primarily on stabilization of the soft tissue envelope. If fibula is fractured, fibular open reduction and internal fixation is integral part of initial management for reducing the majority of tibial deformities. Ankle-spanning temporary external fixator is used to restore limb alignment and displaced intraarticular fragments through ligamentotaxis and distraction. And the second stage, definitive open reduction and internal fixation of the tibial component, is undertaken when the soft tissue injury has resolved and no infection sign is seen on pin site of external fixator. The goals of definitive internal fixation should include absolute stability and interfragmentary compression of reduced articular segments, stable fixation of the articular segment to the tibial diaphysis, and restoration of coronal, transverse, and sagittal plane alignments. The location, rigidity, and kinds of the implants are based on each individual fractures. The conventional plate fixation has more advantages in anatomical reduction of intraarticular fractures than locking compression plate. But it has more complications as infection, delayed union and nonunion. The locking compression plate fixation provides greater stability and lesser wound problem than conventional implants. But the locking compression plate remains poorly defined for intraarticular fractures of the distal tibia. Active, active assisted, passive range of motion of the ankle is recommended when postoperative rehabilitation is started. Splinting with the foot in neutral is continued until suture is removed at the 2~3 weeks and weight bearing is delayed for approximately 12 weeks. The recognition of the soft tissue injury has evolved as a critical component of the management of pilon fractures. At this point, the second staged treatment of pilon fractures is good treatment option because of it is designed to promote recovery of the soft tissue envelope in first stage operation and get a good result in definitive reduction and stabilization of the articular surface and axial alignment in second stage operation.

• 한국작물학회지
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• 제43권2호
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• pp.77-82
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• 1998

Aerenchyma development in rice (Oryza sativa L.) roots is quite important for adaptation to waterlogged or reduced soil conditions. Anatomical observations were carried out to clarify the development of schizogenous and lysigenous aerenchyma in elongating crown roots of rice. The crown roots of 3rd and 4th phytomer were taken from rice plants of the 8th leaf stage grown by hydroponic culture. The schizogenous intercellular spaces in the cortex of crown root tip were observed using a light microscope with semi ultra-thin sections and the lysigenous aerenchyma in mature tissue of crown root were observed using a cryo scanning electron microscope (cryo-SEM) with freezing fracture method. The schizogenous intercellular spaces in the root tip exist obviously in the middle portion of cortical cell layers close to the root-root cap junction, but not in root cap, stele and outer cell layers of cortex. The air spaces were formed at the junction of four neighbouring cells of inner cortex in the transverse sections, and between longitudinal cell layer connected along the root axis. Although many of those spaces were filled with liquid, some spaces seem to exist as air spaces. The lysigenous aerenchyma in the cortex, which hardly filled with liquid, emerged at 3-4 cm segment from the root tip and increased toward the basal region of root axis. The developing process of lysigenous aerenchyma was primarily separation of a radial row of cells caused by the shrinking and collapsing of cortical cells and then formation of septa along the radial cell rows by the fusion of cell wall with each other. These results suggest that the schizogenous and lysigenous aerenchyma playa role as a passage for the movement of oxygen into the root tip region where oxygen is required for respiration.

• Journal of Korean Neurosurgical Society
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• 제37권3호
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• pp.201-206
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• 2005

Objective: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. Methods: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 patients. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. Results: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. Conclusion: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.

• 한국방사선학회논문지
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• 제12권3호
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• pp.397-402
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• 2018

본 연구는 엉치엉덩관절의 골절, 탈구, 엉치엉덩 퇴행성관절염 진단을 위한 가장 좋은 영상을 얻기 위해 골반 팬톰과 엑스선관을 각도 변화를 주어 엉치엉덩관절의 Joint space 가장 잘 나타내는 영상을 얻어 방사선사에게 주관적 평가를 받아 보았다. 평가 결과 결론으로 엉치엉덩관절염과 퇴행성 관절염 발견을 위한 단순촬영에서는 엎드린상태에서 촬영은 검사반대쪽 엉덩이를 $25^{\circ}{\sim}30^{\circ}$ 들어올리고 엑스선관을 앞엉덩뼈가 시에서 2.5 cm 안쪽을 지나는 시상면에 대해 수직촬영 하고 누운자세에서는 검사쪽 엉덩이를 $25^{\circ}{\sim}30^{\circ}$ 들어 올리고 위앞엉덩뼈가시가 중앙에서 위앞엉덩뼈가시가 중앙에 대해 엑스선관 각도를 발쪽으로 $5^{\circ}$ 촬영 하며 반드시 양쪽 엉치엉덩관절후전사방향(RAO,LAO) 및 전후사방향(RPO, LPO) 모두 촬영을 하게 되면 관절염 진단을 내리는데 있어 많은 도움이 되리라 본다.

• Archives of Reconstructive Microsurgery
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• 제7권1호
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• pp.54-61
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• 1998

Free vascularized fibular is the most usuful bony donor of the long bone reconstruction in reconstructive microsurgical field. It has many benifits such as very strong strut tubular bone, very reliable vascular anatomy with large vascular diameter with long pedicle, minimal donor site morbity too. In that situations of the huge long bone defects in distal femur or proximal tibia, the defective bony shape and strength of the transplanted fibular bone is not enough if only one strut of the fibula is transfered. The bony circulation of the fibula has two ways, one from nutrient artery via peroneal artery through nutrient foramen which makes endosteal arterial network inside of the fibula, another way is periosteal network through outside encircling vascular network of the bone which distributed in muscle sleeves of the fibular diaphysis. Authors modified free vascularized fibular bone graft with transverse osteotomy is made from the anterolateral aspect of the fibular shaft just distal to entry of the nutrient artery. This produces two vascularized bone struts that may be folded pararell to each other but that remain connected by the periosteum and muscle cuff surrounding the peroneal artery and veins. The proximal strut is vascularized by both a periosteal and endosteal blood supply, whereas the distal strut is vascularized by a periosteal blood supply alone. This procedure can call "doule barrel" free vascularized fibular graft. We performed 7 cases of doule barrel fashined fibular transplantation on distal femur and proximal tibial large defects. Average bone union time takes 7 months from that procedure. There were no significant bone union time differences between both proximal and distal struts. After solid union of the transfered double barrel fibular graft, there were no stress fracture in our series. We can propose double barrel free vascualized fibular graft is usuful method in that cases with very large bone defect on large long bones especially metaphyseal defects.

• Archives of Plastic Surgery
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• 제48권6호
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• pp.635-640
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• 2021

Background Injuries to the proximal interphalangeal (PIP) joint are common and complex. However, the treatment of osteochondral defects of the head of the proximal phalanx has rarely been described. Herein, we propose a new technique for the management of unicondylar defects of the proximal phalanx that can restore joint amplitudes and provide PIP stability. Methods In this cadaveric feasibility study, unicondylar defects were generated using striking wedges and chisels. First, a transverse tunnel measuring 2 mm in diameter passing through the head of the proximal phalanx was made. A second tunnel at the base of the middle phalanx with the same diameter was then created. The hemitendon of the flexor carpi radialis graft was passed through each of these tunnels. The proximal end of the graft was interposed in the area with a loss of bone substance. The ligamentoplasty was then tensed and fixed by two anchors on the proximal phalanx. Joint amplitudes and frontal stability were measured preoperatively and postoperatively. Results There was no significant change in the joint's range of motion: preoperatively, the mean mobility arcs were -2° to 113.80°, and they were -2° to 110° after the procedure (P=0.999). There was no significant difference in joint stability (P>0.05). Conclusions Ligamentoplasty with PIP interposition appears to be a possible solution for the management of unicondylar defects of the proximal phalanx. An evaluation of clinical results is planned in order to definitively confirm the validity of this procedure.

• 한국구조물진단유지관리공학회 논문집
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• 제25권6호
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• pp.68-75
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• 2021

본 연구에서는 반복하중을 받는 외부 보-기둥 접합부에 정착된 57mm 확대머리철근의 정착성능을 평가하였다. 총 4개의 외부 보-기둥 접합부 실험체를 계획하였으며, 콘크리트 압축강도, 측면피복두께, 횡보강근비 및 파괴유형을 주요 실험 변수로 설정하여 정착성능평가를 수행하였다. 성능평가 결과, 접합부에 정착된 대구경 확대머리철근의 정착성능에 가장 큰 영향을 주는 요소는 측면피복두께 및 횡보강근으로 나타났으며, 외부 보-기둥 접합부에 정착된 57mm 대구경 확대머리철근은 반복하중하에서도 충분한 정착성능이 발현되는 것을 확인할 수 있었다.

• 대한금속재료학회지
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• 제47권9호
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• pp.542-549
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• 2009

Zr-based amorphous alloy matrix composites reinforced with tantalum continuous fibers were fabricated by the liquid pressing process, and their anisotropic mechanical properties were investigated by tensile and compressive tests of $0^{\circ}$(longitudinal)-, $45^{\circ}$-, and $90^{\circ}$(transverse)-orientation specimens. About 60 vol.% of tantalum fibers were homogeneously distributed inside the amorphous matrix, which contained a small amount of polygonal crystalline particles. The ductility of the tantalum-continuous-fiber-reinforced composite under tensile or compressive loading was dramatically improved over that of the monolithic amorphous alloy, while maintaining high strength. When the fiber direction was not matched with the loading direction, the reduction of the strength and ductility was not serious because of excellent fiber/matrix interfacial strength. Observation of the anisotropic deformation and fracture behavior showed the formation of multiple shear bands, the obstruction of crack propagation by fibers, and the deformation of fibers themselves, thereby resulting in tensile elongation of 3%~4% and compressive elongation of 15%~30%. These results suggest that the liquid pressing process was useful for the development of amorphous matrix composites with excellent ductility and anisotropic mechanical properties.

• Nuclear Engineering and Technology
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• 제54권11호
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• pp.4072-4083
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• 2022

Ultrasonic impact treatment (UIT) is carried out on the Ni-based alloy stainless steel pipe gas tungsten arc welding (GTAW) girth weld, the differences of microstructure, microhardness and shear strength distribution of the joint before and after ultrasonic shock are studied by microhardness test and shear punch test. The results show that after UIT, the plastic deformation layer is formed on the outside surface of the Ni-based alloy overlayer, single-phase austenite and γ type precipitates are formed in the overlayer, and a large number of columnar crystals are formed on the bottom side of the overlayer. The average microhardness of the overlayer increased from 221 H V to 254 H V by 14.9%, the shear strength increased from 696 MPa to 882 MPa with an increase of 26.7% and the transverse average residual stress decreased from 102.71 MPa (tensile stress) to -18.33 MPa (compressive stress), the longitudinal average residual stress decreased from 114.87 MPa (tensile stress) to -84.64 MPa (compressive stress). The fracture surface has been appeared obvious shear lip marks and a few dimples. The element migrates at the fusion boundary between the Ni-based alloy overlayer and the austenitic stainless steel joint, which is leaded to form a local martensite zone and appear hot cracks. The welded joint is cooled by FA solidification mode, which is forming a large number of late and skeleton ferrite phase with an average microhardness of 190 H V and no obvious change in shear strength. The base metal is all austenitic phase with an average microhardness of 206 H V and shear strength of 696 MPa.

• 대한토목학회논문집
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• 제26권4A호
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• pp.611-620
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• 2006

강합성 플레이트 2-거더교는 피로균열에 의해 한 개의 거더에 심각한 손상이 발생되는 경우 교량의 붕괴가 유발되는 단재 하경로 구조로 인식되고 있다. 본 논문에서는 강합성 2-거더교의 거더 손상시 교량의 여유도를 평가하기 위한 해석적 연구를 수행하였다. 여유도 평가는 단경간 및 3경간 연속교를 대상으로 하였으며, 수직브레이싱은 I-단면 가로보로 적용하고 하부 수평브레이싱이 설치되는 경우와 설치되지 않는 경우를 고려하였다. 정상 상태 및 손상 상태의 교량에 대해 하부 수평브레이싱의 유 무에 따른 내하 성능을 재료 및 기하비선형 해석으로 구하고 각 경우의 여유도를 비교 평가하였다. 해석 결과에 따르면 정상 상태의 2-거더 교량은 단순교와 연속교 모두 수평브레이싱이 없어도 여유도가 충분하며, 손상 상태의 교량에서는 수평브레이싱이 여유도 향상에 중요한 역할을 하는 것으로 분석되었다.