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Tumor Prosthetic Arthroplasty and Arthroplasty with Bone Cement for the Metastatic Malignant Bone Tumor in the lower Extremity (하지 관절 부위에 발생한 전이성 종양 환자의 종양 대치물 및 골시멘트와 인공관절 삽입술)

  • Yang, Jun-Young;Lee, June-Kyu;Hwang, Deuk-Soo;Shin, Hyun-Dae;Kwak, Sang-Koo;Kim, Kyung-Cheon;Nam, Dae-Cheul
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.12-17
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    • 2003
  • Purpose: In this report we are going to discuss about the functional evaluation and the outcome of treatment of metastatic tumor in the lower extremities treated with tumor prosthetic arthroplasty. Materials and Methods: This report is based on nine patients diagnosed as a metastatic tumor and treated by tumor prosthetic arthroplasty, from June 1998 to December 2001. Age of the patients ranged from 49 to 63 with the average of 56.3. The average follow up period was 23.4 months. Two patients had lung cancer, three had breast cancer, two had renal cancer, one colon cancer, and one had multiple myeloma. All these were primary cancers. The site of metastasis were six in proximal femur, two in distal femur, and one in proximal tibia. Tumor excision was performed after biopsy in following the principle of primary tumor management. Excision with wide surgical margin was tried as possible could. Six cases were treated with tumor prosthesis, and the other three cases were reconstructed with bone cement and arthroplasty. Results: The functional evaluation in the extremities at the last follow up was performed on Enneking evaluation score with 6 categories. The highest scored 26, and the lowest scored 10, with an average of 19.5. A case in which the patient died 15 days after the operation was excluded from the evaluation. Among the categories, emotional acceptance to postoperative function and pain relief were highly scored. At the final follow up, seven patients survived, and one colon cancer patient died 68 days after operation. Conclusion: Metastatic tumor occurring in joints of lower extremities could be treated in accordance to the treatment principle of primary tumor. By insertion of tumor prosthesis, we can get satisfactory results of function in the lower extremity and pain relief especially. So, this aspect of medical favor must be considered in treating patients.

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Compressive Behavior of Precast Concrete Column with Hollow Corresponding to Hollow Ratio (중공비율에 따른 중공 프리캐스트 철근콘크리트 기둥의 압축거동)

  • Lee, Seung-Jun;Seo, Soo-Yeon;Pei, Wenlong;Kim, Kang-Su
    • Journal of the Korea Concrete Institute
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    • v.26 no.4
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    • pp.441-448
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    • 2014
  • From several researches, recently, it was found that using hollowed precast concrete (HPC) column made more compact concrete casting in joint region possible than using normal solid PC (Precast concrete) column. Therefore, the rigidity of joints can be improved like those of monolithic reinforced concrete (RC). After filling the hollow with grout concrete, however, it is expected that the HPC column behaviors like composite structure since PC element and grout concrete have different materials as well as there is a contact surface between two elements. These may affect the structural behavior and strength of the composite column. A compressive strength test was performed for the HPC column with parameter of hollow ratio for the case with and without grout in the hollow and the result is presented in this paper. The hollow ratios in the test are 35, 50 and 59% of whole section of column. Concentrated axial force was applied to top of the specimens supported as pin connection for both ends. In addition, finite element (FE) analysis was performed to simulate the failure behavior of HPC column for axial compression. As a result, it was found that the hollow ratio did not affect the initial stiffness of HPC filled with grout regardless of the strength difference of HPC and grout. However the strength was increased inversely corresponding to the hollow ratio. The structural capacity of HPC without grout closely related to the hollow size. Especially, the local collapse governs the overall failure when the thickness of HPC is too thin. Based on these effect, a suitable equation was suggested for calculation of the compressive strength of HPC column with or without grout. FE analysis considering the contact surface between HPC and grout produced a good result matched to the test result.

Tibial Torsion in Children of the Jeju Area (제주지역 소아의 경골 염전)

  • Song, Dong Ho;Eun, Baik-Lin;Park, Sang Hee;Lee, Joon Young;Tockgo, Young Chang
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.75-80
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    • 2005
  • Purpose : Internal tibial torsion is prevalent in East Asian countries such as Korea and Japan, where sitting on the floor is common behavior. Internal tibial torsion or excessive lateral tibial torsion may cause esthetical, functional, or psychological problems and also may induce degenerative arthritis in older age. The purpose of this study is to measure the tibial torsion in children of the Jeju area. Methods : Tibial torsion was measured in 1,042 lower extremities of 521 children from one to 12 years of age. The values of transmalleolar angles were analyzed for each age group divided by 6 months. Quadratic and linear regression models were used to fit patterns of changes in mean values of transmalleolar angles. The age at seven, which provides the highest coefficient of determination for quadratic regression analysis, was used as a cut-off point to fit different statistical models. Results : The mean transmalleolar angle was $0.10{\pm}5.79^{\circ}$ in all children,$ 0.90{\pm}5.49^{\circ}$ in males, and $-0.80{\pm}5.97^{\circ}$ in females. The value was $4.25{\pm}4.04$ in 1 year of age, gradually decreased to the lowest level of $-1.98^{\circ}$ in four years and seven months of age, increased again with age until it reached $0.67{\pm}1.10^{\circ}$ at seven years of age, and stayed at that level thereafter. Conclusion : Internal tibial torsion in infancy is known to correct spontaneously in the normal developing process. But in this study, the mean transmalleolar angle in children of Jeju area annually decreased after one year of age; to the lowest angle at four years and seven months of age; increased again gradually to the age of seven; and persisted in that level, about $10^{\circ}$ less than western children, not correcting further thereafter. These findings suggest tibial torsion might be caused by lifestyle, especially sitting on feet. To prevent abnormalities of joints and gaits, early diagnosis of tibial torsion in childhood and posture correction or early treatment when needed, seems to be necessary.

Determination of Equivalent Hydraulic Conductivity of Rock Mass Using Three-Dimensional Discontinuity Network (삼차원 불연속면 연결망을 이용한 암반의 등가수리전도도 결정에 대한 연구)

  • 방상혁;전석원;최종근
    • Tunnel and Underground Space
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    • v.13 no.1
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    • pp.52-63
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    • 2003
  • Discontinuities such as faults, fractures and joints in rock mass play the dominant role in the mechanical and hydraulic properties of the rock mass. The key factors that influence on the flow of groundwater are hydraulic and geometric characteristics of discontinuities and their connectivity. In this study, a program that analyzes groundwater flow in the 3D discontinuity network was developed on the assumption that the discontinuity characteristics such as density, trace length, orientation and aperture have particular distribution functions. This program generates discontinuities in a three-dimensional space and analyzes their connectivity and groundwater flow. Due to the limited computing capacity In this study, REV was not exactly determined, but it was inferred to be greater than 25$\times$25$\times$25 ㎥. By calculating the extent of aperture that influences on the groundwater flow, it was found that the discontinuities with the aperture smaller than 30% of the mean aperture had little influence on the groundwater flow. In addition, there was little difference in the equivalent hydraulic conductivity for the the two cases when considering and not considering the boundary effect. It was because the groundwater flow was mostly influenced by the discontinuities with large aperture. Among the parameters considered in this study, the length, aperture, and orientation of discontinuities had the greatest influence on the equivalent hydraulic conductivity of rock mass in their order. In case of existence of a fault in rock mass, elements of the equivalent hydraulic conductivity tensor parallel to the fault fairly increased in their magnitude but those perpendicular to the fault were increased in a very small amount at the first stage and then converged.

The Etiology and Clinical Features of Acute Osteoarthritis in Children; 2003-2009 (최근 6년간 소아청소년기 급성 화농성 골관절염의 원인균과 임상 양상; 2003-2009)

  • Choi, Jin Hyoung;Choe, Young June;Hong, Ki Bae;Lee, Jina;Yoo, Won Joon;Kim, Han Soo;Park, Moon Seok;Cho, Tae Joon;Chung, Chin Youb;Lee, Hoan Jong;Choi, In Ho;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.18 no.1
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    • pp.31-39
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    • 2011
  • Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.

Broden photographing method for Calcaneus Subtentaculum tali observation of Ankle plaster patient (발목부상을 당한 석고환자의 발꿈치뼈·목말받침돌기 관찰을 위한 Broden 촬영법 연구)

  • An, Byeongju
    • Journal of the Korean Society of Radiology
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    • v.7 no.2
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    • pp.107-112
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    • 2013
  • There is an Ankle Oblique(Broden' low) as an examination for the patient whose ankle was encased in orthopedic plaster. Some types of Ankle Joint coalition - Calcaneonavicular coalition, Talocalcaneal coalition and Naviculocuneiform coalition. This study is focused on the relation between Ankle Joints and the structural change of soft tissues, also finding the most proper angle to obtain good images of Ankle Joint from the patient who wore a plaster on his ankle, when we x-ray with Harris-Beath View($30^{\circ}{\sim}55^{\circ}$) - for observing Subtalar joint, Calcaneus Fracture, Subtentaculum, Tali Fracture and Talocalcaneal coalition. We intend to get the angle which makes us achieve the good image that shows Calcaneus Fracture, Subtentaculum, and Tali Fracture by changing internal angles of the patient's ankle. We evaluated the images obtained from 51 patients with PACS monitor. The result of the evaluation, subtalar joint was not seperated but opened, and Subtentaculum Tali Fracture was seen overlaid. at the angle 30, we could observe Calcaneus Fracture, Subtentaculum Tali Frature and the front part of behind side of subtalar joint well. And Calcaneo Navicularcoalition, Talocal Canealcoalition, Naviculo Cuneiform coalition condition were clearly seen at that angle. At the angle 35, we could achieve the clear images of subtalar comminuted fracture, talus, the behind joint of heel bone and get the high definition image on the degree of talocalcaneal joint separation. In addition to, We could obtain the good wide image of Sinus Tarsi. At the area of 45, We can distinguish the soft tissues from gyps separation. The outer-talus and density of the bone were definitely seen and Calcaneus is more separated than that of at the angle of 35, but this image is distorted. Calcaneus, Subtentaculum Tali show $1.20{\pm}0.414$ at the angle 25, $2.47{\pm}0.516$ at the angle 30, $2.27{\pm}0.458$ at the angle 45. This difference is statistically meaningful. (p<0.05). Including the degree of distortion, The distortion appears less at the area of $30^{\circ}$ but at the area of 40, there is heavy distortion. So, We could get the best image for making a diagnosis. At the $30{\sim}35^{\circ}$ degree for X-raying ankle. and at the $30{\sim}40^{\circ}$ for Calcaneus Fracture, Subtentaculum Tali Fracture.

Role of Ascorbic Acid in the Depolymerization of Hyaluronic Acid by $Fe^{++}$ and $H_2O_2$ ($Fe^{++}$$H_2O_2$에 의한 hyaluronic acid 분해에 있어서 ascorbic acid의 역할)

  • Lee, Jung-Soo;Chung, Myung-Hee;Lim, Jung-Kyoo;Park, Chan-Woong;Cha, In-Joon
    • The Korean Journal of Pharmacology
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    • v.21 no.1
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    • pp.62-77
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    • 1985
  • In tile Iron-catalyzed Haber-Weiss reaction to produce OH., the requirement for $O^{-}_{2}{\cdot}$ is only to reduce $Fe^{+++}$. Possibly, the role of $O^{-}_{2}{\cdot}$ can be replaced by other reducing agents. Ascorbate is one of them in biological system. In the present study, the ability of ascorbate to produce $OH{\cdot}$ in the presence of $Fe^{++}$ and $H_2O_2$ was investigated by observing the degradation of hyaluronic acid and ethylene production from methional. Ascorbate stimulated the degradation of hyaluronic by $Fe^{++}$ and $H_2O_2$. That was confirmed by both viscosity change and gel-permeation chromatographic analysis. The observed degradation was almost completely prevented by catalase and $OH{\cdot}$ scavengers. In support of the above results, ascorbate enhanced the prouction of ethylene from methional in the presence of $Fe^{++}$ and $H_2O_2$. Other reducing agents (cysteine, glutathione, NADH and NADPH) showed similar activities to ascorbate in the degradation of hyaluronic acid and ethylene production. But no stimulatory effects were observed with their oxidized forms such as NAD and NADP. Thus, it appears that reduction of the metal ion was needed for $OH{\cdot}$ production. Among the metal ions tested, $Fe^{++}$ showed most potent catalytic action in the production of $OH{\cdot}$ The results obtained support that ascorbate can substitute $O^{-}_{2}{\cdot}$ in the metal-catalyzed reactions, particularly with $Fe^{++}$ by which $OH{\cdot}$ is produced with $H_2O_2$. The significance of the ascorbate-dependent production of $OH{\cdot}$ was considered with respect to possible role of ascorbate in the damage of inflamed joints.

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A Study on the Damages of Head Works by the Storm Flood in the Area of Cheong Ju and Boeun -Emphasis onFactors Influenced on the Disasters and their Countermeasures- (淸州 및 報恩地方의 頭首工洪水災害에 關한 調査硏究(II) -災害原因 및 對策方案을 中心으로-)

  • Nam, Seong-Woo;Kim, Choul-Kee
    • Magazine of the Korean Society of Agricultural Engineers
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    • v.24 no.2
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    • pp.49-55
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    • 1982
  • The purpose of this study is to classify the factors influenced on the damages of head works suffered from the storm flood occurred on July 22 1980 in both Musim and Bochong rivers and to find out an integral counter measures against the causes influenced on the disaster of head works in the engineering aspect of planning, design, construction and maintenance. In this survey, number of samples was taken 25 head Works, and the counter measures against the causes of their disasters summarized was as follows, 1. In the aspect of planning a. As the flood water level after the establishment of head works is more increased than the level before setting of head works owing to having more gentle slope of river bed between the head works than nature slope of river bed. Number of head works should be reduced for the appropriate annexation of them b. In the place where head works is established on the curved point of levee, the destruction of levee becomes severe by the strong deflective current. Therefore the setting of head works on the curved point should be kept off as long as possible and in case of unavoidable circumstances the construction method such as reinforced concrete wall or stone wall filed with concrete and anchored bank revetments should be considered. 2. In the aspect of design a. As scoring phenomena at up stream is serious around the weir Where the concentration of strong current is present in such a place, up stream apron having impermeability should be designed to resist and prevent scoring. b. As the length of apron and protected bed is too short to prevent scoring as down stream bed, the design length should be taken somewhat more than the calculated value, but in the case the calculated length becomes too long to be profitable, a device of water cushion should be considered. c. The structure of protected river bed should be improved to make stone mesh bags fixed to apron and to have vinyl mattress laid on river bed together with the improvement for increasing the stability of stone mesh bags and preventing the sucked sand from the river bed. d. As the shortage of cut-off length, especialy in case of the cutoffs conneting both shore sides of river makes the cause of destruction of embankment and weir body, the culculation of cut-off length should be taken enough length based on seepage length. 3. In the aspect of design and constructions a. The overturing destruction of weir by piping action was based on the jet water through cracks at the construction and expansion joints. therefore the expansion joint should be designed and constructed with the insertion of water proof plate and asphalt filling, and the construction joint, with concaved shape structure and steel reinforcement. b. As the wrong design and construction of the weep holes on apron will cause water piping and weir destruction, the design and construction of filter based on the rule of filter should be kept for weep holes. c. The wrong design and construction of bank revetment caused the severe destruction of levee and weir body resulting from scoring and impulse by strong current and formation of water route behind the revetment. Therefore bank revetment should be designod and constructed with stone wall filled with concrete and anchored, or reinforced concrete wall to prevent the formation of water flow route behind the wall and to resist against the scoring and impulse of strong stream. 4. In the aspect of maintenance When the damaged parts occurred at head works the authorities and farmers concerned should find and mend them as soon as possible with mutual cooperation, and on the other hand public citizen should be guided for good use of public property.

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Is it Possible to predict the Characteristics of Calcific Deposition in Calcific Tendinitis of Shoulder Joint? (단순 방사선 검사를 이용하여 석회성 건염에서 발생하는 석회 침착물의 성상에 대한 예측이 가능한가?)

  • Kim, Sung-Jae;Lee, Hee Jae;Lee, Kwang-Hyun;Park, Dong-Hyeok;Lee, Bong Geun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.77-83
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    • 2014
  • Purpose: The purpose of current study was to evaluate the validity of the existing radiological classifications as a diagnostic modality for predicting characteristics of calcific deposition in calcific tendinitis of the shoulder joint. For that purpose, we determined the inter-observer reliability for evaluating diagnostic precisions of the classification and also evaluated diagnostic accuracy of predicting the toothpaste type calcific deposition. Materials and Methods: We performed retrospective study with total 26 patients surgically treated with calcific tendinitis of the shoulder joint from March 2010 to October 2013. Two independent observers reviewed preoperative radiographs of shoulder joints, and classified the characteristics of calcific depositions according to the criteria of Gartner, DePalma and Patte. Cohen's kappa were calculated for each classifications to evaluate inter-observer reliability. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were determined for type of calcific depositions with Gartner type III, DePalma type I, and Patte type II for predicting toothpaste type calcific deposition. Results: The values of Cohen's kappa were the highest in the classification of Patte, 0.62, and the values for the classifications of DePalma and Gartner were 0.56 and 0.36, respectively. The sensitivities for predicting toothpaste type calcific deposition in Gartner Type III, DePalma type I and Patte type II were 83.3%, 91.7%, and 58.3%, respectively. Specificities were 85.7% 50.0% and 64%, positive likelihood ratios were 5.833, 1.833 and 1.633, negative likelihood ratios were 0.194, 0.167 and 0.648, and diagnostic odds ratios were 30.00, 11.00 and 2.52, respectively. Conclusion: There were no radiologic classifications of calcific tendinitis which has both high precision and accuracy. Further studies with other diagnostic modalities such as ultrasonography are needed for predicting characteristics of calcific deposition in calcific tendinitis of the shoulder joint.

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Quaternary Geology and Paleoecology of Hominid Occupation of Imjin Basin (임진강유역 구석기 공작의 고생태학적 배경)

  • Seonbok Yi
    • The Korean Journal of Quaternary Research
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    • v.2 no.1
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    • pp.25-50
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    • 1988
  • The survival of rich evidence of palaeolithic occupation found in the Imjin-Hant'an River basin was possible due to many fortuitous geological conditions provided there. Formation of the basalt plain in a narrow valley system which developed during the late Mesozoic insured the appearance of a basin of sedimentation in which archaeological sites would be preserved with relatively minor post-depositional disturbance. Geomagnetic and K-Ar dating indicates that lava flows occurred during the Brunes Normal Epoch. During and after the process of basin sedimentation, erosion of the plain was confined to the major channel of the present river system which developed along the structural joints formed by the lava flow. Due to characteristic columnar structure and platy cleavage of the basalt bedrock, erosion of the basalt bedrock occurred mainly in vertical direction, developing deep but narrow entrenched valleys cut into the bedrock. Consequently, the large portion of the site area remained intact. Cultural deposits formed on top of the basalt plain were left unmodified by later fluvial disturbances due to changes in the Hant'an River base-level, since they were formed about 20 to 40m above the modern floodplain. Sedimentological evidence of cultural deposits and palynological analysis of lacustrine bed formed in the tributary basin of the Hant'an River indicate that hominid occupation occurred in this basin under rapidly deteriorating climatic conditions. From three thermoluminescence dates, the timing of hominid occupation as represented by 'Acheulian-like' bifaces apparently occur sometime during 45,000 BP. Thus, deposition of cultural layers in this basin approximately coincides with the beginning of the second stadial of the final glacial, during which the Korean Peninsula must have had provided a sanctuary for prolonged human occupation.

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