Purpose: The clinical and radiological results of patients with type 3 talar neck fractures treated with the anteromedial approach using medial malleolar osteotomy and large distractor were analyzed retrospectively. Materials and Methods: From March 2009 to August 2016, 12 patients with a type 3 talar neck fracture, who underwent the anteromedial approach using a medial malleolar osteotomy and large distractor and who could be followed-up for more than 12 months after the operation, were examined. The patients were examined for the presence of Hawkins signs by anteroposterior and lateral radiographs and osteonecrosis by magnetic resonance imaging (MRI) on the postoperative 3 months. Subsequently, every 3 months, radiographic union was assessed by a simple radiograph and clinical symptoms. Twelve months postoperatively, posttraumatic arthritis was assessed and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was analyzed. Results: In 7 cases, osteonecrosis was found on MRI performed 3 months after surgery. On the other hand, at the 12 months follow-up, all of them obtained AOFAS scores of 83.86±4.53 without surgical treatment. Radiographic union was achieved in all cases. The mean union period was 5.3 months. In 10 cases, traumatic arthritis was found after the radiographical and clinical evaluation. In addition, all of them could carry on everyday life by conservative treatment. The AOFAS ankle-hindfoot score was measured to be 85.17 on average. Other complications included superficial wound infection in 2 cases. Conclusion: An anteromedial approach using a medial malleolar osteotomy and a large distractor in the surgical treatment of patients with type 3 talar neck fractures can achieve anatomical reduction of the displaced fragment without a lateral dissection. This is considered to be another good surgical option.
Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.
Kim, Hui Taek;Kim, In Hee;Cho, Yoon Je;Ahn, Tae Young
Journal of the Korean Orthopaedic Association
/
v.54
no.6
/
pp.547-556
/
2019
Purpose: This study evaluated the results of surgical treatment for residual or recurrent deformity after the conservative treatment of idiopathic clubfoot. Materials and Methods: Fifty-one cases (32 patients), who were followed up to skeletal maturity, were reviewed retrospectively. The mean age at the last follow-up was 18.7 years. The surgical options included selective or comprehensive soft tissue release, tendon lengthening and transfer, and various types of osteotomy. The radiology measurements included the talocalcaneal angle and talo-first metatarsal angle in the anteroposterior (AP) view, and the talocalcaneal angle and calcaneal pitch in the lateral view. The radiology measurements were compared with the normal values for adults. The clinical evaluations were made using the ankle-hindfoot score and the midfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS): excellent (>85), good (71-85), pair (56-70), and poor (<56). Results: At the last follow-up, the percentages of the 51 cases, whose parameter values fell within the normal ranges were as follows: in the AP view, 41.2% (talocalcaneal angle); and 90.2% (talo-first metatarsal angle). In the lateral view, the percentage was 84.3% (talocalcaneal angle). For the calcaneal pitch, the percentages were 61%. The mean AOFAS score was 88.1±10.7 on the ankle-hindfoot score and 86.7±11.5 on the midfoot score. Conclusion: The long-term outcome of patients with idiopathic clubfoot, who underwent surgical treatment after conservative treatment, was found to be 43%-90% of the normal range of radiographic indices. Clinically, the mean AOFAS scores were "excellent". Therefore, a satisfactory result can be obtained by analyzing the elements of deformity more accurately and then using the selective operation method, even if the non-surgical correction method fails.
Purpose: This study analyzed the features of humeral head decentralization in large to massive rotator cuff tears with a shoulder dislocation in the elderly. Moreover, shoulder instability and treatment were reviewed. Materials and Methods: From May 2005 to February 2017, Group A containing 45 cases (45 patients) over 65 years old accompanied by a large or massive rotator cuff tear with a shoulder dislocation and Group B containing 45 cases (45 patients) without a shoulder dislocation were enrolled. The mean ages in Groups A and B were 73.2 and 72.1 years old, and the mean follow-up periods were 30.7 and 31.3 months, respectively. Twenty-one cases (46.7%) in Group A underwent rotator cuff repair, and 8 cases (17.8%) underwent concomitant rotator cuff repair with Bankart repair. Sixteen cases (35.6%) underwent reverse total shoulder arthroplasty for cuff tear arthropathy. 45 cases (100%) in Group B underwent rotator cuff repair. The off-the center and head elevation were measured in the preoperative magnetic resonance imaging (MRI) of Groups A and B. The preoperative and postoperative visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and University of California Los Angeles (UCLA) score in Groups A and B were compared. Results: In Groups A and B, the mean off-the centers were posterior 7.41 mm and posterior 2.02 mm (p=0.03), and the mean head elevations were superior 6.66 mm and superior 2.44 mm (p=0.02), respectively. The mean ASES scores of Groups A and B were 32.8 and 33.4 before surgery, and 77.1 (p=0.02) and 78.1 (p=0.02) after surgery (p=0.18), respectively. The mean UCLA scores of Groups A and B were 13.1 and 12.8 before surgery, and 28.9 (p=0.02) and 29.5 (p=0.01) after surgery (p=0.15), respectively. Conclusion: Patients over 65 years old with a shoulder dislocation in large to massive rotator cuff tears had higher off-the center and head elevation on the preoperative MRI than those without a shoulder dislocation. This measurement can help predict preceding shoulder instability. Early rotator cuff repairs should be performed and other treatments, such as Bankart repair and reverse total shoulder arthroplasty, should also be considered.
Seo, Jin-Hyeok;Woo, Young-Ha;Jeong, Ju-Seon;Kim, Do-Hun;Kim, Ok-Gul;Lee, Sang-Wook;Park, Chan-Ho
Journal of the Korean Orthopaedic Association
/
v.54
no.5
/
pp.435-439
/
2019
Purpose: This study evaluated the efficacy of blood mixed cement for osteoporotic vertebral compression fractures in reducing the complications of percutaneous vertebroplasty using conventional cement. Materials and Methods: This study was performed retrospectively in 80 patients, from January 2016 to January 2017. Porous cement was formed by mixing 2, 4, and 6 ml of blood with 20 g of cement used previously. A tube with a diameter and length of 2.8 mm and 215 mm, respectively, was used and the polymerization temperature, setting time, and optimal passing-time were measured and compared with those using only conventional cement. Radiologically, the results were evaluated and compared. Results: The polymerization temperature was 70.3℃, 55.3℃, 52.7℃, and 45.5℃ in the conventional cement (R), 2 ml (B2), 4 ml (B4), and 6 ml (B6), respectively, and the corresponding setting time decreased from 960 seconds (R) to 558 seconds (B2), 533 seconds (B4), and 500 seconds (B6). The optimal passing-time was 45 seconds (B2), 60 seconds (B4), and 78 seconds (B6) at 73 seconds (R), respectively and as the amount of blood increased, it was similar to the cement passing-time. The radiological results showed that the height restoration rates and the vertebral subsidence rates similar among the groups. Two cases of adjacent vertebral compression fractures in the R group and one in the B2 and B4 groups were encountered, and the leakage rate of the cement was approximately two times higher than that in the conventional cement group. Conclusion: In conventional percutaneous vertebroplasty, the procedure of using autologous blood with cement decreased the polymerization temperature, reduced the setting time, and the incidence of cement leakage was low. These properties may contribute to more favorable mechanical properties that can reduce the complications compared to conventional cements alone.
Purpose: This study analyzed the treatment effects of drain insertion in the posteromedial portal after an arthroscopic synovectomy and posterior septum resection for pyogenic arthritis. Materials and Methods: From June 2005 to December 2016, 56 cases (55 patients, 1 case of bilateral knee) were diagnosed with pyogenic arthritis and arthroscopic treatment was performed. Fourteen patients (25.0%) were identified with causative organisms. The average follow-up period was 12.3 months, and the mean age was 67.8 years old. Twenty-four cases were males and 31 cases were females. Kellgrene-Lawrence grade (K-L grade) I was 6 patients, II was 20 patients, III was 11 patients, and IV was 18 patients. Surgery was performed through six portal. The posterior septum was removed and a drainage tube was inserted from the posterior medial side to the posterior side of the joint. The Lysholm score was used after surgery for a functional evaluation. The K-L grade at the time of admission and at the last follow-up were compared for a radiological evaluation. Results: The mean normalization period of the C-reactive protein was 59.8 days (6-164 days). Intravenous antibiotics were used for an average of 37.1 days. The results of the functional evaluation revealed a mean Lysholm score of 64.5 (30-98) in a total of 56 cases. Two reoperations was performed, but the treatment was completed with same method in all patients. The K-L grade was similar at the time of surgery and at the last follow-up (p>0.05). Conclusion: The method of drain insertion in the posteromedial portal after arthroscopic synovectomy and posterior septum resection for pyogenic arthritis is an effective technique that can obtain satisfactory results by inducing proper exudate discharge.
With the development of information and communications technology (ICT) and big data technology, anyone can easily obtain and utilize vast amounts of data through the Internet. Therefore, the capability of selecting high-quality data from a large amount of information is becoming more important than the capability of just collecting them. This trend continues in academia; literature reviews, such as systematic and non-systematic reviews, have been conducted in various research fields to construct a healthy knowledge structure by selecting high-quality research from accumulated research materials. Meanwhile, after the COVID-19 pandemic, remote healthcare services, which have not been agreed upon, are allowed to a limited extent, and new healthcare services such as health recommender systems (HRS) equipped with artificial intelligence (AI) and big data technologies are in the spotlight. Although, in practice, HRS are considered one of the most important technologies to lead the future healthcare industry, literature review on HRS is relatively rare compared to other fields. In addition, although HRS are fields of convergence with a strong interdisciplinary nature, prior literature review studies have mainly applied either systematic or non-systematic review methods; hence, there are limitations in analyzing interactions or dynamic relationships with other research fields. Therefore, in this study, the overall network structure of HRS and surrounding research fields were identified using citation network analysis (CNA). Additionally, in this process, in order to address the problem that the latest papers are underestimated in their citation relationships, the GraphSAGE algorithm was applied. As a result, this study identified 'recommender system', 'wireless & IoT', 'computer vision', and 'text mining' as increasingly important research fields related to HRS research, and confirmed that 'personalization' and 'privacy' are emerging issues in HRS research. The study findings would provide both academic and practical insights into identifying the structure of the HRS research community, examining related research trends, and designing future HRS research directions.
Chi, I hyun;Han, Kyu won;Choi, Yae jin;Son, Jeong Sook;Kim, Ji-Hern
The Korean Journal of Franchise Management
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v.5
no.1
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pp.27-47
/
2014
This research was conducted on the purpose of seeking the measures of how to cope with the changing industry of Topokki franchises. Despite of the fact the number of Kukdae Topokki's stores is quite smaller than that of its competitors, such as Jaws Topokki and Addal Topokki, Kukdae Topokki is recognized as one of the front-runners in the industry. But the competition in the topokki industry has become fiercer, as the market became saturated. To find a desirable solutions, this study analyzes past-to-current status of the Topokki industry by dividing it into 4 stages and provides few strategies that Kukdae Topokki can apply to the 4th stage where 'brand awareness' is very important. To this end, few drawbacks of Kukdae Topokki are proposed as the following. First, the brand image that Kukdae Topokki pursue does not correspondent with the image in consumer's mind. Second, Kukdae Topokki has selected the wrong targeting group. It aims for the image of 'retro' to target people in their 30-40s. However, most of the consumers are people in their 20-30s. Third, the taste of Kukdae Topokki is not uniform among franchises. Fourth, the awareness and accessability are low. To provide a proactive actions for the next stages, several solutions are proposed as following. First, By managing consistent Kukdae Topokki's Brand Touch point, consumers may have a strong image on the brand by communicating with consumers consistently at all touch points. Second, instead of the existing guide from the head office(franchiser), a standardized criteria for the usage of materials and periodical education for franchisee are needed. Third, to raise the awareness of Kukdae Topokki, open many branches in the area where the main consumers(20-30s women) are mostly spread out.
Yi, Na Hyun;Kim, Sung Bae;Kim, Jang-Ho Jay;Choi, Jong Kwon
KSCE Journal of Civil and Environmental Engineering Research
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v.29
no.5A
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pp.557-564
/
2009
In recent years, there have been numerous explosion-related accidents due to military and terrorist activities. Such incidents caused not only damages to structures but also human casualties, especially in urban areas. To protect structures and save human lives against explosion accidents, better understanding of the explosion effect on structures is needed. In an explosion, the blast overpressure is applied to concrete structures as an impulsive load of extremely short duration with very high pressure and heat. Generally, concrete is known to have a relatively high blast resistance compared to other construction materials. However, information and test results related to the blast experiment of internal and external have been limited due to military and national security reasons. Therefore, in this paper, to evaluate blast effect on reinforced have concrete structure and its protective performance, blast tests are carried out with $1.0m{\times}1.0m{\times}150mm$ reinforce concrete slab structure at the Agency for Defence Development. The standoff blast distance is 1.5 m and the preliminary tests consists with TNT 9 lbs and TNT 35 lbs and the main tests used ANFO 35 lbs. It is the first ever blast experiment for nonmilitary purposes domestically. In this paper, based on the basic experiment procedure and measurement details for acquiring structural behavior data, the blast experimental measurement system and procedure are established details. The procedure of blast experiments are based on the established measurement system which consists of sensor, signal conditioner, DAQ system, software. It can be used as basic research references for related research areas, which include protective design and effective behavior measurements of structure under blast loading.
The purpose of this study is to explore the formal and content features of the material for the Changgeuk album , which was produced and released in 1971. Changgeuk album was produced and published as a headword for "Changgeuk". However, it differs from the style of Changgeuk which is treated as a stage drama in that the narrative is developed around the commentary and dialogue in the formal aspect and the Pansori is only partially used. The styles of Changgeuk, implemented through gramophone record, radio broadcasts and television broadcasts, varied widely, unlike those of Changgeuk established in the 1930s. Pansori music wasn't the only center, and traditional performers weren't even the main members of the play. The characteristic form of the Changgeuk album is an experiment of Changgeuk that emerged naturally with radio reading and the advent of radio dramas in the 1950s and 1960s. So it is necessary to pay attention to the Changgeuk album in that it shows diverse forms of experiments conducted by Changgeuk in the newly introduced culture and media in the middle and late 20th century As for the contents of the Changgeuk album , the work embraces Lee Jong ik 's novel (1957), but develops the narrative centering on the life of Saint Sa-myung(四溟大師). And it is faithfully portraying the life of a Buddhist monk and the national salvation hero who pursued the original work. This content composition can be understood in the will of singer Lee Yong bae, the soundman who produced the album, and in the flow of historical dramas that summon the historical hero of the old country of the time to the stage. Singer Lee Yong bae reflects on his life in the past when he was full of greed and conceit through his life as a monk of Saint Sa-myung(四溟大師) and is greatly impressed by the personal aspect of Saint Sa-myung(四溟大師), and these emotions encouraged his creative will. Also, the Changgeuk record is meaningful in that it is one of the specific materials that embodies the national hero as a record and a traditional play under the discourse of the people, the nation in the 1970s.
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