• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.281-293
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• 2020

An anterior cruciate ligament (ACL) reconstruction is one of the most frequent surgical procedures in the knee joint, but despite the better understanding of anatomy and biomechanics, surgical reconstruction procedures still fail to restore rotational stability in 7%-16% of patients. Hence, many studies have attempted to identify the factors for rotational laxity, including the anterolateral ligament (ALL), but still showed controversies. Descriptions of the ALL anatomy are also confused by overlapping nomenclature, but it is usually known as a distinctive fiber running in an anteroinferior and oblique direction from the lateral epicondyle of the femur to the proximal anterolateral tibia, between the fibular head and Gerdy's tubercle. The importance of the ALL as a secondary restraint in the knee has been emphasized for successful ACL reconstructions that can restore rotational stability, but there is still some controversy. Some studies reported that the ALL could be a restraint to the tibial rotation, but not to anterior tibial translation. On the other hand, some studies reported that the role of ALL in rotational stability would be limited as a secondary structure because it bears loads only beyond normal biomechanical motion. The diagnosis of an ALL injury can be performed by a physical examination, radiology examination, and magnetic resonance imaging, but it should be assessed using a multimodal approach. Recently, ALL was considered one of the anterolateral complex structures, as well as the Kaplan fiber in the iliotibial band. Many studies have introduced many indications and treatment options, but there is still some debate. The treatment methods are introduced mainly as ALL reconstructions or lateral extra-articular tenodesis, which can achieve additional benefit to the knee stability. Further studies will be needed on the indications and proper surgical methods of ALL treatment.

• Korean Journal of Animal Reproduction
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• v.26 no.3
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• pp.253-261
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• 2002

This study was carried out to investigate the semen characteristic, motility and viability and sperm motion characteristic by CASA test for establishing the Jindo-dog's semen freezing system. The results obtained are as follow: 1. The semen was collected 63 times. Average volume of semen, concentration of sperm, total number of sperm, progressive motility and viability were 3.8 $m\ell$ 145.6$\times$10$^{6}$ cells/$m\ell$, 396.2 x10$^{8}$ cells, 79.7% and 89.5%, respectively. Also, Fawn (Yellow) Jindo-dog comparing with White Jindo-dog showed better concentration of sperm, total number of sperm, progressive motility and viability. Among all dogs, the results of No. 2 Fawn Jindo-dog were the best. 2. The average progressive motility and viability of semen from 46 times were 73.5%, 82.3% before freezing and 51.1%, 64.9% after freezing. So, the freezing of semen has affected the progressive motility and viability. The progressive motility and viability of Fawn Jindo-dog's semen, before and after freezing, were better than White Jindo-dog. And No. 2 Fawn Jindo-dog showed the best results and showed significantly different among all dogs (P<0.05). 3. The 44 times-tested .esults by CASA system were as follow; MOT (motility) 65.6%. PROG (progressive motility) 54.8%, VAP (average path velocity) 75.3 ${\mu}{\textrm}{m}$/sec, VCL (curve linear velocity) 90.0 ${\mu}{\textrm}{m}$/sec, VSL (straight-line velocity) 69.4 ${\mu}{\textrm}{m}$/sec and ALH (amplitude of lateral head displacement) 4.4 ${\mu}{\textrm}{m}$. Although the motion characteristic of frozen semen were not significantly different between White and Fawn Jindo-dog, No. 2 Fawn Jindo-dog showed the best results and was significantly different among all dogs (P<0.05). 4. The success rate of frozen semen production between White and Fawn Jindo-dog were 43% (13/28), 94% (33/35), respectively, and the total success rate was 73% (46/63). The freezing-ability of Fawn Jindo-dog's semen was better than the other. Conclusively, the present results indicated that the characteristic and motility of Jindo-dog') semen were suitable for processing frozen semen, artificial insemination and mass production system. Also, the selection of suitable dog-breed was so important because the characteristic and freezing-ability of semen were significantly different between White and Fawn Jindo-dogs and among all individual dogs.

• Journal of the Korean Orthopaedic Association
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• v.53 no.6
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• pp.498-504
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• 2018

Purpose: To evaluate the clinical and radiological outcomes, and the complications of unicompartmental knee arthroplasty (UKA) using a fixed bearing prosthesis after 5-year follow-up. Materials and Methods: Twenty-six knees (25 patients) that underwent fixed bearing UKA between May 2003 and August 2011 were included. The subjects were 3 males (3 knees) and 22 females (23 knees), and the average age was 63.5 years. The preoperative diagnosis was osteoarthritis (23 knees) and osteonecrosis (3 knees). The mean follow-up duration was 67 months (from 60 to 149 months). The clinical evaluation included pre- and postoperative American knee society knee and function score, and range of motion. The radiology evaluation included standing antero-posterior, lateral view, and fluoroscopic film to analyze the postoperative alignment and osteolysis. Results: The mean American Knee Society knee score and function score were improved from 42.0 and 57.5 to 87.9 and 85.0, respectively (p<0.001). The mean preoperative and postoperative range of motion was $132.9^{\circ}$ and $132.5^{\circ}$, respectively. The mean femorotibial angle were varus $0.5^{\circ}$ preoperatively and valgus $2.2^{\circ}$ postoperatively. A radiolucent line was observed in 2 knees; one knee had a stable implant, while in the other knee, patellofemoral arthritis was identified during UKA. Diffuse pain of the knee joint with tenderness of the medial joint line was identified at the follow-up, so conversion to total knee arthroplasty was recommended. No other complications, such as osteolysis, infections, postoperative stiffness, and dislocation, were encountered. Conclusion: The midterm results of fixed bearing UKA were clinically and radiologically satisfactory.

• The Korean Journal of Petroleum Geology
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• v.8 no.1_2 s.9
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• pp.1-43
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• 2000

A comparison study for understanding a stratigraphic response to tectonic evolution of sedimentary basins in the Yellow Sea and adjacent areas was carried out by using an integrated stratigraphic technology. As an interim result, we propose a stratigraphic framework that allows temporal and spatial correlation of the sedimentary successions in the basins. This stratigraphic framework will use as a new stratigraphic paradigm for hydrocarbon exploration in the Yellow Sea and adjacent areas. Integrated stratigraphic analysis in conjunction with sequence-keyed biostratigraphy allows us to define nine stratigraphic units in the basins: Cambro-Ordovician, Carboniferous-Triassic, early to middle Jurassic, late Jurassic-early Cretaceous, late Cretaceous, Paleocene-Eocene, Oligocene, early Miocene, and middle Miocene-Pliocene. They are tectono-stratigraphic units that provide time-sliced information on basin-forming tectonics, sedimentation, and basin-modifying tectonics of sedimentary basins in the Yellow Sea and adjacent area. In the Paleozoic, the South Yellow Sea basin was initiated as a marginal sag basin in the northern margin of the South China Block. Siliciclastic and carbonate sediments were deposited in the basin, showing cyclic fashions due to relative sea-level fluctuations. During the Devonian, however, the basin was once uplifted and deformed due to the Caledonian Orogeny, which resulted in an unconformity between the Cambro-Ordovician and the Carboniferous-Triassic units. The second orogenic event, Indosinian Orogeny, occurred in the late Permian-late Triassic, when the North China block began to collide with the South China block. Collision of the North and South China blocks produced the Qinling-Dabie-Sulu-Imjin foldbelts and led to the uplift and deformation of the Paleozoic strata. Subsequent rapid subsidence of the foreland parallel to the foldbelts formed the Bohai and the West Korean Bay basins where infilled with the early to middle Jurassic molasse sediments. Also Piggyback basins locally developed along the thrust. The later intensive Yanshanian (first) Orogeny modified these foreland and Piggyback basins in the late Jurassic. The South Yellow Sea basin, however, was likely to be a continental interior sag basin during the early to middle Jurassic. The early to middle Jurassic unit in the South Yellow Sea basin is characterized by fluvial to lacustrine sandstone and shale with a thick basal quartz conglomerate that contains well-sorted and well-rounded gravels. Meanwhile, the Tan-Lu fault system underwent a sinistrai strike-slip wrench movement in the late Triassic and continued into the Jurassic and Cretaceous until the early Tertiary. In the late Jurassic, development of second- or third-order wrench faults along the Tan-Lu fault system probably initiated a series of small-scale strike-slip extensional basins. Continued sinistral movement of the Tan-Lu fault until the late Eocene caused a megashear in the South Yellow Sea basin, forming a large-scale pull-apart basin. However, the Bohai basin was uplifted and severely modified during this period. h pronounced Yanshanian Orogeny (second and third) was marked by the unconformity between the early Cretaceous and late Eocene in the Bohai basin. In the late Eocene, the Indian Plate began to collide with the Eurasian Plate, forming a megasuture zone. This orogenic event, namely the Himalayan Orogeny, was probably responsible for the change of motion of the Tan-Lu fault system from left-lateral to right-lateral. The right-lateral strike-slip movement of the Tan-Lu fault caused the tectonic inversion of the South Yellow Sea basin and the pull-apart opening of the Bohai basin. Thus, the Oligocene was the main period of sedimentation in the Bohai basin as well as severe tectonic modification of the South Yellow Sea basin. After the Oligocene, the Yellow Sea and Bohai basins have maintained thermal subsidence up to the present with short periods of marine transgressions extending into the land part of the present basins.

• Radiation Oncology Journal
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• v.28 no.3
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• pp.155-165
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• 2010

Purpose: In order to evaluate the positional uncertainty of internal organs during radiation therapy for treatment of liver cancer, we measured differences in inter- and intra-fractional variation of the tumor position and tidal amplitude using 4-dimentional computed radiograph (DCT) images and gated orthogonal setup kilovolt (KV) images taken on every treatment using the on board imaging (OBI) and real time position management (RPM) system. Materials and Methods: Twenty consecutive patients who underwent 3-dimensional (3D) conformal radiation therapy for treatment of liver cancer participated in this study. All patients received a 4DCT simulation with an RT16 scanner and an RPM system. Lipiodol, which was updated near the target volume after transarterial chemoembolization or diaphragm was chosen as a surrogate for the evaluation of the position difference of internal organs. Two reference orthogonal (anterior and lateral) digital reconstructed radiograph (DRR) images were generated using CT image sets of 0% and 50% into the respiratory phases. The maximum tidal amplitude of the surrogate was measured from 3D conformal treatment planning. After setting the patient up with laser markings on the skin, orthogonal gated setup images at 50% into the respiratory phase were acquired at each treatment session with OBI and registered on reference DRR images by setting each beam center. Online inter-fractional variation was determined with the surrogate. After adjusting the patient setup error, orthogonal setup images at 0% and 50% into the respiratory phases were obtained and tidal amplitude of the surrogate was measured. Measured tidal amplitude was compared with data from 4DCT. For evaluation of intra-fractional variation, an orthogonal gated setup image at 50% into the respiratory phase was promptly acquired after treatment and compared with the same image taken just before treatment. In addition, a statistical analysis for the quantitative evaluation was performed. Results: Medians of inter-fractional variation for twenty patients were 0.00 cm (range, -0.50 to 0.90 cm), 0.00 cm (range, -2.40 to 1.60 cm), and 0.00 cm (range, -1.10 to 0.50 cm) in the X (transaxial), Y (superior-inferior), and Z (anterior-posterior) directions, respectively. Significant inter-fractional variations over 0.5 cm were observed in four patients. Min addition, the median tidal amplitude differences between 4DCTs and the gated orthogonal setup images were -0.05 cm (range, -0.83 to 0.60 cm), -0.15 cm (range, -2.58 to 1.18 cm), and -0.02 cm (range, -1.37 to 0.59 cm) in the X, Y, and Z directions, respectively. Large differences of over 1 cm were detected in 3 patients in the Y direction, while differences of more than 0.5 but less than 1 cm were observed in 5 patients in Y and Z directions. Median intra-fractional variation was 0.00 cm (range, -0.30 to 0.40 cm), -0.03 cm (range, -1.14 to 0.50 cm), 0.05 cm (range, -0.30 to 0.50 cm) in the X, Y, and Z directions, respectively. Significant intra-fractional variation of over 1 cm was observed in 2 patients in Y direction. Conclusion: Gated setup images provided a clear image quality for the detection of organ motion without a motion artifact. Significant intra- and inter-fractional variation and tidal amplitude differences between 4DCT and gated setup images were detected in some patients during the radiation treatment period, and therefore, should be considered when setting up the target margin. Monitoring of positional uncertainty and its adaptive feedback system can enhance the accuracy of treatments.

• Journal of Life Science
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• v.20 no.4
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• pp.543-548
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• 2010

The purpose of this study was to examine the differences in kinetics between 6 months of rehabilitation training and 12 months of rehabilitation training after total hip arthroplasty. 10 unilateral THA participants performed kinetic tests. Three dimensional kinematics and hip flexors and abductors electromyography (EMG) were collected during each trial. T-test was used for statistical analysis (p<0.05). There was no significant difference in EMG data between the two groups, but the mean comparison EMG data was higher in the 12 months rehabilitation training group than the 6 months rehabilitation training group. The moment value was found with motion-dependent interaction analyzing method which was used by Feltner and Dapena. There was no significant difference between moment values of the two groups. There was no significant difference between ground reaction forces of the two groups; however, there were some differences shown in Fz (vertical reaction force) between the two groups ($892{\pm}104\;N$, $820{\pm}87\;N$). The first peak impact force was about 9% lower in the 12 months group compared to the 6 months group. The second peak active force was nearly equal between the two groups. More research is necessary to determine exactly what constitutes optimal rehabilitation training biomechanics for patients with total hip arthroplasty.

• The Journal of Korean Society for Radiation Therapy
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• v.27 no.1
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• pp.73-78
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• 2015

Purpose : Under the assumption of change to the amplitude based sorting, the study will use four dimensional computed tomography imaging (4DCT) arrayed using the phase based sorting to analyze the respiratory phase difference. Materials and Methods : The study analyzed the 4DCT (4-dimensional computed tomography) images of 10 liver cancer patients that were treated with respiratory gated radiotherapy from 2015 February to March. Using RPM respiratory gating (RPM 1.7.5, Varian, USA) equipment, imaging according to respiratory cycle of phase based sorting was acquired and using a treatment planning system (Pinnacle 9.2, Philips, USA) the acquired imaging according to respiratory cycle was used to measure the abdominal movement value by respiratory cycle. The measuring point was the point where the center point of the Marker Block and the body surface met in the 50% phase image and here the coordinate values Lateral, Vertical, Longitudinal (X, Y, Z) were set as reference points, and on the X, Z plane identical to the reference point, using the identical method the Y axis coordinate value of each 0%, 30%, 40%, 50%, 60%, 80% phase images were acquired to quantitatively measure the variation of distance to the Y axis. The abdominal movement value according to respiration was applied to the theoretical model that the value decreases linearly from maximum inhalation to maximum exhalation to divide the variation of my value to predict as amplitude value by respiratory cycle and conversely the variation in amplitude was recalculated with the phase variation deviation value to analyze. Results : The deviation value between expected value and actual location was the largest in the 30% phase with 0.24 cm, and standard deviation was also the largest in 30% phase with 0.13 cm. The effective value of the deviation value derived from the average of the deviation squared value of each patient appeared as minimum 0.7 cm, maximum 0.18 cm, average 0.12 cm, and standard deviation 0.4 cm. Also by dividing the actual movement distance value with the peak expiration value then converting it into %Phase, the deviation value with actual phase 16.5% in 30% phase, 10.0% and 40% phase, 10.0% and 60% phase, 15.4% and 80% phase, and overall average about 13%, and arraying based on amplitude, phase shift occurred and further it was from peak expiration the chance of deviation occurrence was increasingly measured. Conclusion : Based on the results of the study there were differences between value acquired based on theoretical model and actual value. Therefore in respiratory gated radiotherapy using external surrogates, there needs to be establishment of respiration gated radiation system that avoids the combination of two Sorting methods considering that there will be occurrence of treatment and corresponding clinical differences due to the phase difference that occur due to the Amplitude based Phase Sorting.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.172-179
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• 2008

Purpose: To evaluate the functional and structural results of arthroscopic double-row repair using combined knot-tying and knotless suture anchors in rotator cuff tears. Materials and Methods: From March 2006 to June 2007, twenty-one patients (15 males, 6 females; mean age 55.6 years; range 48 to 67) were included who underwent arthroscopic double-row repair for full-thickness tears of the rotator cuff following conservative treatment for a mean of 6.5 months (range 3 to 11). The tear size was carefully inspected arthroscopically and we found 2 small, 13 medium and 6 large-sized rotator cuff tears, with a mean tear size of 2.5cm(range 1.8 to 3.2). The repair constructs were consisted of horizontal mattress sutures using conventional knot-tying suture anchors medially and simple suture at the same level of medial row stitch with Bioknotless RC anchors (DePuy Mitek, Norwood, MA) as lateral row. Clinical and functional evaluations were made according to the range of motion, the ASES, UCLA scale and the isokinetic strength testing. Postoperative cuff integrity was determined through magnetic resonance imaging. The mean follow-up was 15 months (range 13 to 24). Results: The average clinical outcome scores and strength were all improved significantly at the time of the final follow-up (p < 0.01). Nineteen patients (90%) were satisfied with the result of the treatment. In 17 of 21 patients (81%) were judged to reveal healed tendon on magnetic resonance imaging at a mean of 7 months postoperatively. There were no significant functional differences according to the preoperative tear size (p<0.01), but large-sized tear shows less favorable structural results in 3 out of 6 cases(50%). Conclusion: Our results document the usefulness and variability of arthroscopic double-row rotator cuff repairs comparable to the results of the other types of double-row repairs.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.67-72
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• 2011

Purpose: There are various known methods for arthroscopic rotator cuff repair. The purpose of this retrospective study is to report on the clinical results and anatomical results of UU repair surgery, which is a new repair method. Materials and Methods: We enrolled 156 patients (88 men and 68 women) who underwent UU repair for rotator cuff tears from January 2009 to May 2010 in our hospital. Their average age was 55 years old (range: 38~75 years old) and the average follow-up period was 12 months (range: 6~23 months). For determining the results, we evaluated the VAS for pain, the daily living index (ADL) in the ASES scores, the UCLA and KSS scores, and all these tests were conducted at the first hospital visit and 6 months and 1 year after surgery and at the final follow-up. During the follow-up period, MRI was performed 3 and 6 months after surgery only in the patients who consented to MRI scans to confirm the presence of re-rupture. Results: The average scores of the VAS as a pain indicator decreased from 7.0 before surgery to 2.7 after surgery (p<0.05). The UCLA and KSS scores increased from 22.2 to 32.5 and from 83.7 to 91.5, and the changes was significant (p<0.05). For the active joint range of motion, the average forward flexion was improved from 125 to 175 degrees, the average lateral external rotation was improved from 38 to 58 degrees, and the average abduction was improved from 104 to 169 degrees. Out of a total of 156 patients, re-rupture was observed in 4 cases (3%) of 117 cases (75%) for which MRI was performed (with consent) between 3 and 6 months after surgery. Conclusion: UU repair surgery as arthroscopic repair of rotator cuff tear is a good repair method that shows excellent clinical results and a low re-rupture rate.

• Journal of Korean Academy of Nursing
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• v.25 no.3
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• pp.597-607
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• 1995

1960년대 이후 인공호흡기(mechanical ventilator)의 보급과 최근 의료과학의 발달, 간호의 질적 향상의 결과로 저체중출생아를 포함한 고위험 신생아의 생존율이 높아져왔다. 호흡장애증후군(RDS)은 일차적으로 폐포의 완전한 확장을 위해 필요한 계면활성물질(surfactant)의 부족, 미발달된 심폐기능에 의한 병리적 현상으로 저체중아의 가장 큰 원인이 되어왔다. RDS로 인해 인공호흡기에 의존해 있는 저체중아의 경우 적절한 산소공급과 이를 위한 호흡의 유지는 치료의 가장 큰 핵심이 되며, 이를 위한 기관내 흑은 비인두 흡인 (nasopharyngeal suction)은 신생아 중환자실(NICU)의 가장 중요한 간호행위가 되어왔다. 인공호흡기를 위한 기관삽관은 그 자체가 기도의 성모운동을 방해하고 기침반사를 억제시켜 폐 분비물의 효과적 배출을 억제하며, 특히 저체중아의 경우 조산과 관련하여 미발달된 흥곽운등과 심폐기능은 폐분비물의 이동을 저해하는 요소이다. 따라서 기도내의 분비물의 이동을 효과적으로 하여 흡인 시에 최대한의 효과를 돕기 위해 흥곽 물리요법(chest physiotheraphy : CPT)의 한 형태인 흉곽진동법 (Chest Vibration : CV)가 행해져 왔다. 그러나 저체중아를 위한CV의 임상적 적용은 그 대상의 생리적 특성, CV의 적용부위(site)와 기간(duration)에 대한 과학적 근거 없이 만성감염이나 폐질환을 가진 성인이나 cystic fibrosis환자를 위한 CV protocol을 무분별하게 채택하여 저체중아에게 행하여져 왔다 이에 본 연구자는 저체중아에 대한 CV의 안전성을 평가하고, 이에 기초하여 저체중아에게 바람직한CV의 형태를 알아보고자 본 연구를 시작하였다. 연구설계는 CV의 안전성을 평가하기 위한 실험연구이다. CV의 안전성은 RDS치료의 가장 일차적 목표인 oxygenation변화에 의해 평가될 수 있으므로, 본 실험 연구에서는 Pulse oximeter에 의해 계속적으로 측정된 산소포화 변화(oxygen saturation change)를 측정하였다. 실험대상은 미국동부에 위치한 대학병원의 NICU에 입원하여 RDS와 관련된 호흡장애로 인공호흡기에 의존해 있는 10명의 저체중아였다. 인공호흡기에 의존된 모든 저체중아는 Pulse oximeter와 심폐기능 측정기(cardiopulmonary monitor)에 의해 산소공급과 호흡상태가 계속 측정되고 있었다. 실험대상의 평균 출생시 몸무게는 평균 1,3050gm(SD=580.6)이었고, 임신월령 은 평균 28.6주(SD=3.1)였다. RDS가 그들의 일차적 진단명이었고, 그중 4명은 pneumonia, atelectasis의 합병증을 가지고 있었다. 10명중 6명은 intermittent mandatory ventilation(IMV)의 형태로, 4명은 continuous positive airway pressure(CPAP)의 형태로 인공호흡기에 의존되어 있었고 CV시의 FiO2는 평균 42.3(SD=21.2)였다. CV는 중환아용 소형진동기 (minivibrator)를 이용해 가각 10명 의 간호사에 의해 행하여 졌고, 최소 22초에서 최대 100초 동안 실시되었다. 50%의 간호사는 30초에서 40초간 CV를 실시하였으며, CV의 적용부위도, 전후 흉곽부위, 혹은 병변이 있는 좌 우측, 흑은 양쪽 흉벽 등으로 다양했고, 적용방법도 원형으로 돌려가며(circular motion), 혹은 아래에서 위로, 혹은 아무런 기준없이 간호사의 기호에 따라 다양하게 적용되었다. 산소포화의 변화는 CV가 행해지기 전.후로 5초동안 관찰되었다. 연구의 결과, 산소포화 변화는 비 모수통계(non parametric statistics)의 일종인 Matched Paired Wilcoxon test로 분석 한 결과 CV후에 3%의 감소를 보였다(P<.05). 저체중아에 있어 산소포화의 3%감소는 임상적으로 중요한 의미가 없다고 사료되어지며, 실제 흡인전의 과도호흡에 의해 CV를 행하기 이전의 산소공급수준으로 돌아 왔다. CV실시 기간과 산소포화와의 상관관계는 비 모수통계인 Spearman rho correlation coefficient를 이용하여 분석하였는데, 이 두 변수는 서로 관계가 없는 것으로 나타났다(P>.05) 또한 CV와 흡인 후에 각각의 간호사들에게 CV를 필요로 한 저체중아의 기준, 적용부위, 기간, 방법등에 대한 기준을 물었으나 대상의 특성에 따른 간호사정에 의존하기보다는 간호사 각자의 선호하는 방법이나 습관에 라 행하는 것으로 나타났다. 결론적으로 CV와 산소포화 변화와의 관계, NICU에서 관찰된 CV의 임상적 적용을 기초로 저체중아에게 안전한 CV protocol은 신생아용 소형 진동기를 이용하여, 양쪽 흉곽의 늑골하측 변연 부위(low lateral costal margin)에서 시작하여 흉골 중앙부위 방향으로 30초 동안 진동기를 적용하는 것이 좋은 것으로 나타났다. 이에 CV의 효과를 평가하기 위한 보다 과학적인 접근방법으로, CV와 흡인의 결과인 가래(sputum)에 대한 연구를 제언하는 바이다.