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Autogenous Osteochondral Grafts for the Osteochondritis dissecans of the Knee (슬관절 박리성 골연골염에 대한 자가 골연골 이식술)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chun Shun-Wook;Seo Ji-Hyun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.142-148
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    • 2003
  • Purpose: This study was performed to evaluate the operative results of osteochondritis dissecans treated with autogenous osteochondral grafts. Materials and Methods: From May 1990 to May 2000, this study included 13 patients, 17 cases treated with autogenous osteochondral grafts. The mean age of patients at operation was 23.4 years (range,20 to 32 years), all cases were men, and the mean follow-up was for 24.2 months (range, 12 to 110 months). Treatment was done by open or arthroscopic method using with Osteochondral Autograft Transfer System (OATS, Arthrex, USA). Results: Trauma history existed in all cases, and major trauma history in 7 cases, and minor repetitive in 10 cases. The involved sites of lesion were medial femoral condyle in 11 cases, in which extended classic site was 9 cases, inferocentral site was 2 cases, and lateral femoral condyle in 6 cases, in which all cases were inferocentral site. Magnetic resonance imaging (MRI) staging was stage II in 1 case, stage III in 11 cases, stage IV in 5 cases, and arthroscopic staging was stage III in 12 cases, stage IV in 5 cases. The mean lesion size was 3.19$cm^2$ (range, 1 to 8$cm^2$). Clinical results evaluated with grading system by Aichroth, were excellent in 3 cases (18$\%$), good in 11 cases (65$\%$), moderate in 2 cases (12V), poor in 1 case (5$\%$), which revealed satisfactory results in 83$\%$. Congruent articular surface, satisfactory articular thickness, and no loosening or subsidence was evidenced by follow-up MRI or arthroscopic finding. Conclusion: Autogenous osteochondral grafts can be an alternative treatment in lesions larger than 1$cm^2$ in size, unstable lesion, and involvement of weight-bearing articular surface. Long term follow-up will be needed for the final efficacy of autogenous osteochondral grafts.

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Homeland Security Management: A Critical Review of Civil Protection Mechanism in Korea (국가안전관리: 한국의 시민보호(위기재난관리) 체계에 관한 비판적 고찰)

  • Kim, Hak-Kyong
    • Korean Security Journal
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    • no.26
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    • pp.121-144
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    • 2011
  • The Framework Act on the Management of Disasters and Safety 2004(FAMDS) currently underpins Korean civil protection system, and under this FAMDS, Korean civil protection establishes a three-tiered government structure for dealing with crises and disasters: central government, provincial & metropolitan government, and local government tiers. In particular, the concept of Integrated Emergency Management(IEM) emphasizes that emergency response organizations should work and act together to respond to crises and disasters effectively, based on the coordination and cooperation model, not the command and control model. In tune with this trend, civil protection matters are, first, dealt with by local responders at the local level without direct involvement of central or federal government in the UK or USA. In other words, central government intervention is usually implemented in the UK and the USA, only when the scale or complexity of a civil protection issue is so vast, and thus requires a degree of central government coordination and support, resting on the severity and impact of the event. In contrast, it appears that civil protection mechanism in Korea has adopted a rigid centralized system within the command and control model, and for this reason, central government can easily interfere with regional or local command and control arrangements; there is a high level of central government decision-making remote from a local area. The principle of subsidiarity tends to be ignored. Under these circumstances, it is questionable whether such top-down arrangements of civil protection in Korea can manage uncertainty, unfamiliarity and unexpectedness in the age of Risk Society and Post-modern society, where interactive complexity is increasingly growing. In this context, the study argues that Korean civil protection system should move towards the decentralized model, based on coordination and cooperation between responding organizations, loosening the command and control structure, as with the UK or the USA emergency management arrangements. For this argument, the study basically explores mechanisms of civil protection arrangements in Korea under current legislation, and then finally attempts to make theoretical suggestions for the future of the Korean civil protection system.

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Methods of Application and Beneficial Effects of Silicate-Coating Rice Seeds (볍씨의 규산코팅방법에 따른 이용특성과 육묘효과)

  • Kang, Yang-Soon;Kim, Wan Joong;Hwang, Duck Sang;Kim, Hee Kyu
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.65 no.1
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    • pp.30-39
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    • 2020
  • A new silicate coating technology was developed which reduces the impact of dust and loosening during seeding compared to existing silicate-coatings (Seed/Si/Zeolite), and therefore can lower the production costs of rice cultivation. In this method, 100 g of rice seed is coated with 18 mL of liquid silicic acid and then dressed with a mixture containing 80 g of dolomite and 5 g of iron. To determine the most effective method of application and ensure that seedlings developed healthily, a series of experiments were carried out. Infected seeds scattered in seedling boxes and pots (soil and hydroponic) were coated dry, without disinfection. In comparison to the seed which were not treated with the silicate-coating, the new seed (A) were 1.84 times heavier in weight, and were also improved in terms of coating strength and coating color. Compared to the seedlings grown from the non-coated seed, those grown from the new silicate-coated seed were of significantly higher quality (weight/length) and had erect, dark greenish leaves, which are ideal plant characteristics. This was most likely due to increased silicate uptake. The symptoms of bakanae disease in the non-coated seed peaked after 38 days to 54.2%, whereas the control value was 68.8% in the new silicate-coated seed (A). In the infected seedlings grown from the new silicate-coated rice seed, subnormal macro-conidia, namely, a sickle shape spore without a septum; a straight oblong shape spore without a septum and with a thick cell wall; and inter-septal necrosis of a normal spore were detected. It is believed that the strong alkalinity of silicic acid have acted as unfavorable conditions for pathogenicity. In seedlings grown from the new silicate coated rice seed under hydroponic conditions without nutrients, normal root activity and growth was maintained without leaf senescence. Therefore, it was possible to reduce the rate of fertilization. In the future, a new silicate-coated rice seed was required for the study of minimal nutrition for anti-aging of seedlings.

Evaluation of Prosthetic Reconstruction in Lower Extremity (하지 골 종양에서 종양 대치물을 이용한 사지 구제술의 평가)

  • Lee, Sang-Hoon;Oh, Joo-Han;Yoo, Kwang-Hyun;Suh, Sung-Wook;Koo, Ki-Hyoung;Kim, Han-Soo;Lim, Soo-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.8 no.1
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    • pp.1-11
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    • 2002
  • Purpose : We evaluated the radiological and functional results of prosthetic reconstruction for locally aggressive benign and malignant tumor in the lower extremity. Materials and Methods : Eighty eight patients were followed up for an average 76 months(22~174). We examined the survival rate of prosthesis, and evaluated the final result by MSTS functional score and ISOLS radiological implants evaluation system. They were statistically analyzed according to the age(<20 year vs. ${\geq}$20 year), fixation methods, amount of bony resection, chemotherapy, local recurrence, and presence of metastasis. Results : The 5 year prosthetic survival rates were 100% in the proximal femur, 83.3% in the distal femur, 81.9% in the proximal tibia. Mean total functional scores were 73.3%, 72%, 68.7%, respectively. In distal femur, the non-chemotherapeutic group was superior in the prosthetic survival rate. Recurrence or metastasis affected the functions in the distal femur and proximal tibia. In the radiological evaluation of the distal femur, older patients over 20 years of age and with cement fixation were superior in bone remodeling(p<0.05). Postoperative infection and radiological loosening were the main causes of the prosthetic failure. Conclusion : The prosthetic reconstruction in the lower extremity led to good clinical and radiological results. Amount of bony resection, chemotherapy, recurrence and metastasis seemed to influence the prosthetic survival, and long-term follow-up will be necessary to investigate more significant prognostic factors.

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Fatigue fracture of different dental implant system under cyclic loading (반복하중에 따른 수종 임플란트의 피로파절에 관한 연구)

  • Park, Won-Ju;Cho, In-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.4
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    • pp.424-434
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    • 2009
  • Statement of problem: Problems such as loosening and fractures of retained screws and fracture of implant fixture have been frequently reported in implant prosthesis. Purpose: Implant has weak mechanical properties against lateral loading compared to vertical occlusal loading, and therefore, stress analysis of implant fixture depending on its material and geometric features is needed. Material and methods: Total 28 of external hexed implants were divided into 7 of 4 groups; Group A (3i, FULL $OSSEOTITE^{(R)}$Implant), Group B (Nobelbiocare, $Br{\aa}nemark$ $System^{(R)}$Mk III Groovy RP), Group C (Neobiotec, $SinusQuick^{TM}$ EB), Group D (Osstem, US-II). The type III gold alloy prostheses were fabricated using adequate UCLA gold abutments. Fixture, abutment screw, and abutment were connected and cross-sectioned vertically. Hardness test was conducted using MXT-$\alpha$. For fatigue fracture test, with MTS 810, the specimens were loaded to the extent of 60-600 N until fracture occurred. The fracture pattern of abutment screw and fixture was observed under scanning electron microscope. A comparative study of stress distribution and fracture area of abutment screw and fixture was carried out through finite element analysis Results: 1. In Vicker's hardness test of abutment screw, the highest value was measured in group A and lowest value was measured in group D. 2. In all implant groups, implant fixture fractures occurred mainly at the 3-4th fixture thread valley where tensile stress was concentrated. When the fatigue life was compared, significant difference was found between the group A, B, C and D (P<.05). 3. The fracture patterns of group B and group D showed complex failure type, a fracture behavior including transverse and longitudinal failure patterns in both fixture and abutment screw. In Group A and C, however, the transverse failure of fixture was only observed. 4. The finite element analysis infers that a fatigue crack started at the fixture surface. Conclusion: The maximum tensile stress was found in the implant fixture at the level of cortical bone. The fatigue fracture occurred when the dead space of implant fixture coincides with jig surface where the maximum tensile stress was generated. To increase implant durability, prevention of surrounding bone resorption is important. However, if the bone resorption progresses to the level of dead space, the frequency of implant fracture would increase. Thus, proper management is needed.

Comparison of removal torque between prefabricated and customized abutment screw (기성품과 맞춤형 임플란트 지대주 나사의 풀림 토크 비교)

  • Jamiyandorj, Otgonbold;Kim, Jee-Hwan;Kim, Mu-Seong;Park, Young-Bum;Shim, June-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.4
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    • pp.243-248
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    • 2012
  • Purpose: The purpose of this study is to compare the removal torque between prefabricated and customized implant abutment screw. Materials and methods: Three types of implant system (Osstem, Astra, Zimmer) were used. For each system, prefabricated abutment screw (control group) and customized abutment screw (test group) were used to connect the fixture and the abutment (n = 6). Digital torque gauze was used to control the tightening torque and the screws were tightened under each manufacturer's recommendation. 10 minutes after the connection the same tightening torque was applied, and 5 minutes after the second connection, the removal torque was measured. This procedure was repeated 10 times. In the cyclic loading test, 10 minutes after the first connection to the 6 groups (n = 3), the same tightening torque was applied, and a total of 1,000,000 time loading was applied at 30 degree angle to long axis with 50 N load. Repeated measures of ANOVA test (${\alpha}$=.05) was used as statistics to evaluate the effect of repeated loading number on the removal torque. Independent t-test was used to evaluate the difference in removal torque after cyclic loading. Results: The removal torque significantly decreased as the number of loading repetition increased (P<.05). In the 10 time repetition test, there was no significant difference between the prefabricated and customized implant abutment screw of the 3 implant system (P<.05). Also in the cyclic loading test, there was no significant difference between the prefabricated and customized implant abutment screw of the 3 implant system (P<.05). Conclusion: Within the limitation of this study, there was no significant difference in the removal torque between the prefabricated abutment screw and customized abutment screws.

Clinical Evaluation of Implant-Supported Fixed Prostheses (임플란트-지지 고정성 보철물의 임상적 상태에 대한 평가)

  • Park, Chan-Yong;Yun, Mi-Jung;Huh, Jung-Bo;Jeong, Chang-Mo;Jeon, Yeong-Chan
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.4
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    • pp.317-326
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    • 2013
  • This study was to compare the cumulative survival rate of implant-supported fixed prostheses and to analyze association between risk factors and cumulative survival rate of implant-supported fixed prostheses. In order to assess the clinical status of implant-supported fixed prostheses, individuals who treated in the Department of Prosthodontics, Pusan National University Dental Hospital, between 2000 to 2007 were examined. The results of this study were as follows: 1. Length of service of implant-supported fixed prostheses was $6.6{\pm}32.0$ years (mean), 11.7 years (median). 2. Age and sex of patient was found to have no statistically significant influence on longevity of implant-supported fixed prostheses (P>.05). 3. Reason of tooth extraction wax found to have statistically significant influence on implant-supported fixed prostheses (P<.05). The longevity of fixed prostheses was low in tooth extraction case due to periodontal disease (median:9.0 years). 4. Location of implant-supported fixed prostheses was found to have statistically significant influence on longevity of fixed prostheses (P<.05). The longevity of fixed prostheses was low in molar region (median:8.8 years). 5. Number of units in implant-supported fixed prostheses was found to have no statistically significant influence on longevity of fixed prostheses (P>.05). 6. Condition of opposing dentition was found to have no statistically significant influence on longevity of implant-supported fixed prostheses (P>.05). 7. Food impaction (40.5%), porcelain fracture (25.8%), screw loosening (23.6%) were frequent complications.

Prioritization of Species Selection Criteria for Urban Fine Dust Reduction Planting (도시 미세먼지 저감 식재를 위한 수종 선정 기준의 우선순위 도출)

  • Cho, Dong-Gil
    • Korean Journal of Environment and Ecology
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    • v.33 no.4
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    • pp.472-480
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    • 2019
  • Selection of the plant material for planting to reduce fine dust should comprehensively consider the visual characteristics, such as the shape and texture of the plant leaves and form of bark, which affect the adsorption function of the plant. However, previous studies on reduction of fine dust through plants have focused on the absorption function rather than the adsorption function of plants and on foliage plants, which are indoor plants, rather than the outdoor plants. In particular, the criterion for selection of fine dust reduction species is not specific, so research on the selection criteria for plant materials for fine dust reduction in urban areas is needed. The purpose of this study is to identify the priorities of eight indicators that affect the fine dust reduction by using the fuzzy multi-criteria decision-making model (MCDM) and establish the tree selection criteria for the urban planting to reduce fine dust. For the purpose, we conducted a questionnaire survey of those who majored in fine dust-related academic fields and those with experience of researching fine dust. A result of the survey showed that the area of leaf and the tree species received the highest score as the factors that affect the fine dust reduction. They were followed by the surface roughness of leaves, tree height, growth rate, complexity of leaves, edge shape of leaves, and bark feature in that order. When selecting the species that have leaves with the coarse surface, it is better to select the trees with wooly, glossy, and waxy layers on the leaves. When considering the shape of the leaves, it is better to select the two-type or three-type leaves and palm-shaped leaves than the single-type leaves and to select the serrated leaves than the smooth edged leaves to increase the surface area for adsorbing fine dust in the air on the surface of the leaves. When considering the characteristics of the bark, it is better to select trees that have cork layers or show or are likely to show the bark loosening or cracks than to select those with lenticel or patterned barks. This study is significant in that it presents the priorities of the selection criteria of plant material based on the visual characteristics that affect the adsorption of fine dust for the planning of planting to reduce fine dust in the urban area. The results of this study can be used as basic data for the selection of trees for plantation planning in the urban area.

Dual Plate Fixation for Periprosthetic Femur Fracture after Total Knee Arthroplasty (슬관절 전치환술 후 발생한 대퇴골 삽입물 주위 골절의 이중 금속판 고정술)

  • Kim, Dong Hwi;Cha, Dong Hyuk;Ko, Kang Yeol
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.26-33
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    • 2021
  • Purpose: This study evaluated the results of dual plate fixation for periprosthetic femur fracture after total knee arthroplasty (TKA). Materials and Methods: From October 2007 to February 2013, 23 cases of periprosthetic femur fracture after TKA were treated at the author's hospital. There were 13 cases of fixation using a medial and lateral dual plate when the stability of the fracture site could not be achieved by one side fixation with a follow-up of more than one year. The cases included no loosening of the femoral component in fractures that were categorized as Lewis-Rorabeck classification II and supracondylar comminuted fractures and elongation of the fracture line to the lateral epicondyle of the femur or stem in the medullary canal. The mean age was 72 years (65-82 years), and 11 cases were female. Three cases had a stem due to revision. The mean bone marrow density was -3.2 (-1.7 to -4.4), and the mean period from primary TKA to periprosthetic fractures was 28 months (1-108 months). The mean follow-up period was 23 months (12-65 months). The medial fracture site was first exposed via the subvastus approach. Second, the supplementary plate was fixed on the lateral side of the fracture using a minimally invasive plate osteosynthesis technique. The average union time, complications, and Hospital for Special Surgery Knee Score (HSS) at the last follow-up were evaluated. Results: The mean union time was 17.4 weeks (7-40 weeks). Two cases showed delayed bone union and nonunion occurred in one case, in whom bone union was achieved three months later after re-fixation using a dual plate with an autogenous bone graft. The mean varusvalgus angulation was 1.67 degrees (-1.2-4.9 degrees), and the mean anterior-posterior angulation was 2.86 degrees (0-4.9 degrees) at the last follow-up. The mean knee range of motion was 90 degrees, and the HSS score was 85 points (70-95 points) at the last follow-up. Conclusion: Dual plate fixation for periprosthetic femur fractures that had not achieved stability by one side plate fixation after TKA showed a good clinical result that allowed early rehabilitation.

Clinical Results of Medial Unicompartmental Knee Arthroplasty in Elderly Patients Older than 70 Years of Age (70세 이상의 고령 환자에서 시행한 내측 슬관절 단일구획치환술의 임상 결과)

  • Kim, Kyung Tae;Lee, Song;Kim, Jin Hak;Lee, Ho Young;Kim, Myung Jin
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.34-41
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    • 2021
  • Purpose: To evaluate the long-term clinical results and survivorship of unicompartmental knee arthroplasty (UKA) in elderly patients older than 70 years by analyzing cases that have been implanted for >10 years ago. Materials and Methods: The long-term follow-up results were evaluated in 39 patients (46 cases) who underwent medial UKA from March 2002 to February 2004. The mean age of the patients at the time of surgery was 74.0 years, and the preoperative diagnosis was degenerative arthritis of the knee in all cases. Results: Of the 46 cases, reoperation occurred due to the complications in four cases. In 22 cases without 14 cases of death and six cases of follow-up loss, follow-up more than 10 years was possible. The mean Knee Society knee and function scores improved significantly from 53.0 and 52.5 points pre-operatively to 89.4 and 80.9 points at the last follow-up, respectively (p<0.001). The mean range of motion of the knee recovered to 132.5°, and the mean tibiofemoral angle changed to 5.9° of valgus at the last follow-up. Complications following the UKA occurred in four cases; the most prevalent complication was mobile bearing dislocation (n=2). One case of failure occurred due to aseptic loosening and degenerative arthritis of the lateral compartment, respectively. The cumulative survival rate of the implants was 95.0% at 10 years and 85.7% at 15 years. Of the 40 cases, excluding six cases of follow-up loss, 36 cases (90.0%) could be used without reoperation until death or at the last follow-up after surgery. Conclusion: These results showed the outstanding functions of the knee and satisfactory long-term survivorship after UKA. Therefore, UKA could be a useful method for the treatment of osteoarthritis of the knee in elderly patients older than 70 years of age.