• Journal of Trauma and Injury
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• v.20 no.2
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• pp.130-137
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• 2007

Purpose: Ultrasound is of proven accuracy in abdominal and thoracic trauma and may be useful for diagnosing extremity injury in situations where radiography is not available, such as disasters and military and space applications. However, the diagnosis of fractures is suggested by history and physical examination and is typically confirmed with radiography. As a alternative to radiography, we prospectively evaluated the utility of extremity ultrasound performed by trained residents of emergency medicine (EM) one patient with wrist and ankle extremity injuries. Methods: Initially, residents of EM performed physical examinations for fractures. The emergency ultrasound (EM US) was performed by trained residents, who used a portable ultrasound device with a 10- to 5-MHz linear transducer, on suspected patients before radiography examination. The results of emergency ultrasound and radiography and the final diagnosis were recorded, and correlation among them were determined by using Kappa s test Results: Thirty-nine patients were enrolled in our study. The average age was $36.6\;{\pm}\;19.3$ years. There were radius Fx. (n=21), radius-ulna Fx. (n=1), ulna Fx. (n=1), and contusion (n=2) injuries among the wrist injury and lat.-med. malleolar Fx. (n=13), lat. malleolar Fx. (n=6), and med. malleolar Fx. (n=3) injuries among the ankle injury. Comparing EM US with radiography, we found the sensitivity, specificity, positive predictive value, and negative predictive value of EM US for Fx. diagnosis to be 100%, 66.7%, 97.3%, 100% and those of radiography to be 97.2%, 100%, 100%, and 75%, respectively. Kappa s test for a correlation between the Fx. diagnosis of EM US and the final diagnosis of Fx was performed, and Kappa's value was 0.787 (P = 0.004).Conclusion: EM US for Fx. can be performed quickly and accurately by EM residents with excellent accuracy in remote locations such as disaster areas and in military and aerospace applications. EM US was as useful as radiography in our study and had a high correlation to the final diagnosis of Fx. Therefore, ultrasound should performed on patients with extremity injury to determine whether extremity evaluation should be added to the FAST (focused abdominal sonography trauma) examination.

• Journal of Veterinary Clinics
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• v.29 no.5
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• pp.412-415
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• 2012

A 1-year-old, castrated male Yorkshire terrier (case 1) and a 7-year-old female Poodle (case 2) presented with delayed union fractures. In case 1, the dog had a fractured right distal radius and ulna. In case 2, the dog had a fractured left distal tibia and fibula. A physical examination and radiographs performed in both dogs revealed delayed union fractures with large gaps. The fracture sites were fixed by bone plate and screws. Autogenous cancellous bone graft was applied into the fracture gap. To encourage rapid bone union, we used matrigel containing $20{\mu}g$ of recombinant human bone morphogenetic protein-2 (rhBMP-2) in the fracture site. Radiographs were taken postoperatively to monitor healing. Rapid bone union was noted in both dogs in long-term radiographs. In case 1, the radiographs revealed that the fracture gaps of the radius and ulna were bridged at 2 weeks. Fracture lines were not observed and normal appearance was restored at 20 weeks. In case 2, the radiographs showed that fracture repair had progressed at 11 weeks. The fractures healed faster than expected in these two cases. The results indicate that rhBMP-2 and matrigel may be effective and useful materials to enhance healing of delayed fractures.

• The Korean Journal of Nuclear Medicine
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• v.24 no.1
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• pp.124-132
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• 1990

It has been reported that hematoma is one of the most crucial factors in fracture healing since callus formation is disturbed by washing out the hematoma near a fracture site. However, it is not clear why the hamatoma is important and how it plays a role during the fracture healing. In order to investigate the role of hematoma in the process of fracture healing, the osteogenic potential by subperiosteal transplantation have been studied. Experimental fractures by operation were made at the mid-shaft of the tibia in New Zealand white rabbits. Removal of hematoma at the fracture site was done after 2 and 3 days from experimental fracture, and the removed hematoma was transplanted into the subperiosteal area at the mid-shaft of the ulna of each rabbit. As control groups, we have performed 3 different procedures 1) the hematoma was transplanted into the muscular layers at the thigh and forearm; 2) autologous blood clots were transplanted into the subperiosteal area of the ulna; and 3) sham operation without a transplantation into the subperiosteal area. After transplantation, serial bone scintigraphy and simple radiography were performed at 4 days, 1 week, and 2 weeks to detect an abnormality. The results of bone scintigraphy were positive in 5 of 6 experimental group. However, all in three control groups were negative. Histological observation of the positive bone revealed new bone formation with trabeculation. These results suggest the hematoma in fracture site has osteogenic potential in the subperiosteal area which can be demonstrable by bone scintigraphy and histologic findings. Therefore, it is considered that hematoma of the fracture site plays an important role in the process of fracture healing. Further biochemical investigation using various experimental models is mandatory to apply this preliminary result to the treatment of clinical delayed union or nonunion.

• Korean Journal of Ecology and Environment
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• v.42 no.1
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• pp.115-123
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• 2009

Grazing effects of a freshwater bivalve, Unio douglasiae, on both the phytoplankton communities of cold- and warm eutrophic lakes were examined in aquarium with sediment. The animal U. douglasiae used in the study was collected from the Gunsan (Jeonbuk), acclimatized in laboratory aquaria with washed sand from the mussel collection stream, and starved for $2{\sim}3$ days by the experiment. Grazing experiments were performed with the surface waters collected from Lake Ilgam (Seoul) in the cold period (March 31, 2008), and the warm period (June 19, 2008), respectively. Results clearly showed that the concentration of chlorophyll-a (chl-a) and algal abundance were decreased with the increase of mussel-treated density and treated-time. At the same animal density, U. douglasiae effectively decreased the chl-a of cold-lake water (CW), compared to warm-lake water (WW). Increasing the mussel density, the filtering rate (or algal abundance) of the mussel on the CW gradually decreased, while those of WW did not increase or decrease. Major phytoplankton species Synedra ulna and Stephanodiscus hantzschii, and Scenedesmus ecornis in CW, and those of Tetraedron regulare and Pediastrum simplex in WW, were quickly decreased after the mussel stocking. Interestingly, cyanobacterium Microcystis aeruginosa in WW, not dominant species, were less removed. These results suggest that a freshwater bivalve U. douglasiae have a strategic potential to control dense hibernal diatom or green algae, rather than the cyanobacterial bloom in eutrophic water.

• Clinics in Shoulder and Elbow
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• v.1 no.1
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• pp.118-122
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• 1998

This study evaluated the development of osteolysis of Kudo total elbow arthroplasties according to the fixation with or without cement. Twenty-four elbows of nineteen patients of rheumatoid arthritis underwent total elbow arthroplasty from 1986 to 1993. The patients were followed for an average of 42 months ranging from 36 months to 59 months. In cemented humeri, 1 of 13 (7.7%) showed osteolysis. In the humeri of cementless fixation, 5 of II (45.5%) revealed osteolysis, representing higher rate compared to cement fixation (P<0.05). In the ulna, osteolysis was identified in none of 16 (0%) of cement fixation, which was significantly less than the incidence of osteolysis in cement less fixation (3 of 8,37.5%) (P<0.01). It was concluded that the cement fixation result in less osteolysis than the cementless fixation in Kudo type total elbow arthroplasty.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.1
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• pp.60-67
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• 1995

It is difficult to manage the growing deformity of forearm bone caused by hereditary osteochondromatosis in children, because deformity and discrepancy of limb length is progressive. The are many treatment methods of these problems including excisio of osteochondroma, lengthening of ulna, shortening of radius, corrective osteotomy with or without lengthening apparatus. Among many treatment methods, we tried free vascularized epiphyseal transplantation with the proximal fibular epiphysis in 3 patients of hereditary osteochondromatosis for inducement of continuous bone growth and deformity correction. The average duration of follow up was 7 years and 1 month, the shortest duration being to 4 years and 5 months and the longest 10 years and 8 months. Serial radiologic and clinical evaluation were carried out during follow up and there were satisfactory length gain, deformity correction and improvement of adjacent joint motion in 2 cases. According to our follow up evaluation, free vascularized epiphyseal transplantation is valuable procedure in forearm deformity of hereditary osteochondromatosis although it needs skillful and experienced operative technique.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.178-181
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• 2008

In contrast to ganglion of the soft tissue, periosteal ganglion occurring within or beneath the periosteum is a rare disorder. The differential diagnosis includes periosteal chondroma, lipoma, giant cell tumor of tendon sheath and periosteal osteosarcoma. Most common location for periosteal ganglion is the tibia, followed by radius, femur and ulna. To our knowledge, only 1 case of periosteal ganglion of the fibula has been reported in the literature. We report a case of periosteal ganglion of the distal fibula in a thirty-year-old woman treated with excision of the cyst and the adjacent periosteum.

• Advances in biomechanics and applications
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• v.1 no.3
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• pp.143-158
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• 2014

Forearm fractures in children are very common among all pediatric fractures. However, biomechanical investigations on the pediatric forearm are rather scarce, partially due to the complex anatomy, closely situated, interrelated structures, highly dynamic movement patterns, and lack of appropriate tools. The purpose of this study is to develop a computational tool for child forearm investigation and characterize the mechanical responses of a backward fall using the computational model. A three-dimensional 10-year-old child forearm finite element (FE) model, which includes the ulna, radius, carpal bones, metacarpals, phalanges, cartilages and ligaments, was developed. The high-quality hexahedral FE meshes were created using a multi-block approach to ensure computational accuracy. The material properties of the FE model were obtained by scaling reported adult experimental data. The design of computational experiments was performed to investigate material sensitivity and the effects of relevant parameters in backward fall. Numerical results provided a spectrum of child forearm responses with various effective masses and forearm angles. In addition, a conceptual L-shape wrist guard design was simulated and found to be able to reduce child distal radius fracture.

• Archives of Reconstructive Microsurgery
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• v.12 no.2
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• pp.93-98
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• 2003

Purpose : The purpose of this study is to investigate an occurrence of valgus deformity of ankle joint after vascularized fibular graft in children. Materials and Methods : Four children under 15 years who were surgically treated with vascularized fibular graft were studied. The age of the patients was from 4 years to 13 years, the follow-up period was from 24 months to 108 months. The causes of vascularized fibular graft were open fracture (1 case), congenital psuedarthrosis (2 cases), hypoplastic ulna (1 case). The tibiofibular synostosis was done in 3 cases and not in 1 case. We measured the tibiotalar angle and bimalleolar angle at immediately postoperative and final radiography, and checked ankle motion, pain, and instability of ankle joint. Results : The A-P mortise angle was not different between initial and final radiography in all cases. The intermalleolar angle increased in all cases at the final radiography. There were no pain, instability and limitation of ankle motion. Conclusion: We consider the tibiofibular synostosis can prevent from ankle valgus deformity after vascularized fibular graft in children.

• Journal of Veterinary Clinics
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• v.21 no.4
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• pp.406-408
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• 2004

A nine-month-old male Jindo with non weight-bearing on the right forelimb in flexed position, pain and edema of the elbow, and resist elbow extension was brought to the Veterinary Teaching Hospital, Chungbuk National University. Elbow radiographs showed loss of humeroradial joint space and lateral displacement of the radius and ulna. Closed reduction was reported the best therapy in most cases of luxation of the elbow but conservative reduction was impossible. Open reduction of the luxated elbow was performed and ruptured collateral ligaments were identified. Displaced elbow was required bloody surgical operation and gentle reduction to restore elbow joint. Internal reduction of choice for elbow luxation with rupture of collateral ligament in the dog was a double locking-loop suture pattern. To ensure secure grasping of parallel bundles of ligament fibers to transverse bites of each suture were placed superficial to the longitudinal bites. All ligaments were repaired with 3-metric (size 2 USP) monofilament polypropylene suture. No complications have been noted during a five-month follow up.