The Journal of the Korean bone and joint tumor society
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v.3
no.1
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pp.32-38
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1997
PURPOSE : For the reconstruction of large bone defect after tumor resection, it is possible to reuse the bone involved by tumor with some treatment to it. Several bone-reusing methods have been reported such as autoclaving, low-heat treatment(pasteurization) and intraoperative radiotherapy. We have used extracorporeally radiated autogenous bone graft for reconstruction after tumor resection, and analyzed the periods for junctional union, functional results and complications to know the indications of this method. METHODS : From Dec. 1993 to Sept. 1995, nine patients had taken autogenous bone graft with extracorporeal irradiation. Eight cases were osteosarcoma and 1 giant cell tumor. The graft sites were 5 in femur, 3 proximal tibia and 1 femur and tibia. Stage 3 was 1 case(GCT), Stage IIB 3 and Stage IIIB 5. After wide resection, surrounding soft tissue and intramedullary and extramedullary portion of the tumor were removed. Radiation was done in 5000cGy to the resected bone. Ender nails and bone cement were inserted and filled into the medulla to prevent fracture. RESULTS : Average follow-up period was 12.3(4 to 21) months. Average junctional union period in simple X-ray was 6.5 months in 4 cases. Average functional score following Enneking's criteria was 19(12-27). Complications were as follows ; condylar fractures and femur neck fracture in 4 cases, subluxation of the knee joint 3 and infection 1. Although local recurrence was detected in 1 case, the site of recurrence was not in the radiated bone but surrounding soft tissue. At final follow-up, no recurrence was found in one case(GCT), CDF 2, AWD 2, DOD 3, and died of chemotherapy related sepsis 1. CONCLUSIONS : Extracorporeally radiated bone autograft is considered to be a method for reconstruction of the large bone defect made by tumor resection, especially in the reconstruction around the joint.
This study used numerical modeling to investigate the stability of railway roadbed in areas with various underground cavities and rock conditions associated with mining activities. It compared combined loads from both passenger and freight trains with loads from only passenger trains. Stability was assessed with reference to the Korean government standards for railway subsidence allowance and railway warping repair. Sufficient stability regarding the railway subsidence allowance standard was not achieved when cavities were at depths of <5 m. The criteria for requiring railway warping repair were met when cavities were at depths of <15 m, depending on the rock fracture condition. This study provides the first report on systematic analysis land subsidence related to cavity size and rock fracture conditions associated with mining activities. We expect that this study could serve as an important reference for railway construction in mining areas.
Purpose: Evaluate the clinical results of humerus neck nonunion treated with Polarus intramedullary nail. Materials and Methods: 8 patients who underwent surgery for nonunion of humerus surgical neck fracture were included. All patients were female, the average age was 65 years. 5 out the total 8 cases initially received surgery, open reduction and internal fixation with metal plate in 1 case, Ender nail insertion in 2 cases, external fixator in 1 case and closed reduction and percutaneous pinning in 1 case. The other 3 non union cases initial received conservative managemnent. The average period of nonunion was 9 months in the operated group and 6.2 months in the conservative group. All 8 cases received closed reduction with intrameedullary Polarus nail and auto iliac bone graft. Union was confirmed radiologically, and functional evaluation was done with the UCLA functional criteria. Results: All 8 cases showed union on radiologic evaluation. Average time to union was 3.5 months, average follow up period was 27 months. Average UCLA shoulder evaluation score was 7.6 points preoperatively which improved to 26.3 points after surgery. Active shoulder flexion was 40.7 degrees preoperatiely which increased to 104 degrees after surgery. Shoulder abduction improved from 32.9 degrees preoperatively to 96.3 degrees after surgery. UCLA functional criteria was good in 5 cases and fair in 3 cases, which no poor cases. Conclusion: Polarus IM nailing and AIBG is a useful method for treating nonunion of humerus neck fracture with improvement in union and function.
Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.
Depending on the plastic deformation capacity required, structural steel design under the current codes can be classified into three categories: elastic, plastic, and seismic design. Most of the current steel codes explicitly forbid the use of a steel material with a yield strength higher than 450 MPa in the plastic design because of the concerns about its low plastic deformation capacity as well as the lack of test data on local and lateral torsional buckling behavior. In this study, flexural tests on full-scale H-shape members built with SM490A (ordinary steel or benchmark material) and HSB800 (high-strength steel) were carried out. The primary objective was to investigate the appropriateness of extrapolating the local buckling criterion of the current codes, which was originally developed for normal-strength steel, to the case of high-strength steel. All the SM490A specimens performed consistently with the current code criteria and exhibited sufficient strength and ductility. The performance of the HSB800 specimens was also very satisfactory from the strength perspective; even the specimens with a noncompact and slender flange developed the plastic moment capacity. The HSB800 specimens, however, showed an inferior plastic rotation capacity due to the premature tensile fracture of the beam bottom flange beneath the vertical stiffener at the loading point. The plastic rotation capacity that was achieved was less than 3 (or the minimum level required for a plastic design). Although the test results in this study indicate that the extrapolation of the current flange local-buckling criterion to the case of high-strength steel is conservative from the elastic design perspective, further testing together with an associated analytical study is required to identify the causes of the tensile fracture and to establish a flange slenderness criterion that is more appropriate for high-strength steel.
In the companion paper (Model Development), an analytical model estimating the available rotation capacity of fully restrained beam-column connections in special steel moment-resisting frames was proposed. In this paper, two limit states were considered as the connection rotation capacity criteria: (i) strength degradation failure when the strength falls below the nominal plastic strength due to the local buckling of the beam's cross-section and (ii) low-cycle fatigue fracture caused by plastic strain accumulation at the buckled flange after only a few cycles of high-amplitude deformation. A series of analyses are conducted using the proposed model with two limit states under monotonic and cyclic loadings. Beam section geometric parameters, such as flange and web slenderness ratios, varied over the practical ranges of H-shapedbeams to observe their effect on the rotation capacity and low-cycle fatigue life of pre-qualified WUF-W connections.
Statement of problem : Porcelain restorations are widely used in restorative dentistry with a high degree of general success. However, porcelain is brittle and may fracture intraorally. Sometimes a repair may be attempted using composite resin and bonding system available. Color stability of porcelain repair resins affects esthetics and prognosis of prosthesis, so that provides important criteria for the choice of porcelain repair resins. Purpose : The purpose of this study was to investigate the color stability of composite resins used widely as porcelain repair system. Materials and method : Composite resins used for this study were Carisma(Kulzer, Germany), Tetric ceram(Ivoclar, Liechtenstein), Filtek Z250(3M, USA), and Arabesk Top(VOCO, Germany). Thirty disc-shaped specimens($10{\times}2mm$) were fabricated from each composite resin. Color changes of specimens after treatment using thermocycling system(KD-TCS30, Kwang-duk F.A. Korea) and after immersion in methylene blue(0.05% by Wt) were measured with colorimeter(Model Tc-6Fx, Tokyo Denshoku Co.) and obtained data were analyzed. Results and Conclusion: The results obtained from this study were as fo11ows. 1. The color change of Filtek Z250 was lesser than those of Tetric ceram and Arabesk Top after thermocycling (12000 times). 2. All of the composite resins in this study showed increase of color change according to increase of thermocycling frequency. 3. After treatment with methylene blue, the color change of Arabesk Top was greater than those of Carisma and Tetric ceram, and Tetric ceram was more stable than others.
PURPOSE. The prospective follow-up aimed to assess the performance of lithium disilicate crowns and clinical reasons of adverse events compromising survival and quality. MATERIALS AND METHODS. 58 patients were treated with 375 heat-pressed monolithic crowns, which were bonded with resin cement. Annual recalls up to five years included a complete dental examination as well as quality assessment using CDA-criteria. Any need for clinical intervention led to higher complication rate and any failure compromised the survival rate. Kaplan-Meier-method was applied to all crowns and a dataset containing one randomly selected crown from each patient. RESULTS. Due to drop-outs, 45 patients (31 females, 14 males) with the average age of 43 years (range = 17-73) who had 327 crowns (176 anterior, 151 posterior; 203 upper jaw, 124 lower jaw) were observed and evaluated for between 4 and 51 months (median = 28). Observation revealed 4 chippings, 3 losses of retention, 3 fractures, 3 secondary caries, 1 endodontic problem, and 1 tooth fracture. Four crowns had to be removed. Survival and complication rate was estimated 98.2% and 5.4% at 24 months, and 96.8% and 7.1% at 48 months. The complication rate was significantly higher for root canal treated teeth (12%, P<.01) at 24 months. At the last observation, over 90% of all crowns showed excellent ratings (CDA-rating Alfa) for color, marginal fit, and caries. CONCLUSION. Heat pressed lithium disilicate crowns showed an excellent performance. Besides a careful luting, dentists should be aware of patients' biological prerequisites (grade of caries, oral hygiene) to reach full success with these crowns.
Flexural tests on full-scale H-shaped beams, built up from high-strength steels (HSB800 and HSA800) with a nominal tensile strength of 800 MPa, was carried out to study the effect of flange slenderness of high-strength steel on flexural strength and rotation capacity. The primary objective was to investigate the appropriateness of extrapolating current stability criteria (originally developed for ordinary steel) to high-strength steel. The performance of high-strength steel specimens was very satisfactory from the strength, but not from the rotation capacity, perspective. The inferior rotation capacity of high-strength steel beams was shown to be directly attributable to the absence of a distinct yield plateau and the high yield ratio of the material. Residual stress measurements reconfirmed that the magnitude of the residual stress is almost independent of the yield stress of the base metal.
Background: Lumbar radicular pain is a frequent and often debilitating event. Although many treatment methods have been described in several studies, the available evidences regarding efficacy is not sufficient enough to draw definitive conclusions on an optimal therapy regime. Pulsed radiofrequency (RF) treatment was found to exert a beneficial effect on intractable radicular pain in individuals. The purpose of this study was to assess the efficacy of pulsed RF of the dorsal root ganglion for chronic lumbar radicular pain. Methods: Twenty five patients with chronic lumbar radicular pain that was refractory to selective nerve root blockage met the inclusion criteria of our study and received pulsed RF treatment. The average numeric rating scale (NRS) for leg pain during usual activities and the Oswestry disability index (ODI) were measured at 1 and 3 months after the procedure. Results: Of the 25 patients accepted for pulsed RF treatment, one dropped out due to a vertebral compression fracture during this study. ODI and NRS showed a positive trend in favor of the pulsed RF treatment. No significant complications were observed during the study period. Conclusions: It appears that pulsed RF treatment of the lumbar spinal dorsal root ganglion may be an effective treatment method for patients suffering from lumbar radicular pain, and who were not responsive to selective nerve root blockage.
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