• Journal of Yeungnam Medical Science
• /
• v.38 no.4
• /
• pp.289-307
• /
• 2021

Avulsion injuries result from the application of a tensile force to a musculoskeletal unit or ligament. Although injuries tend to occur more commonly in skeletally immature populations due to the weakness of their apophysis, adults may also be subject to avulsion fractures, particularly those with osteoporotic bones. The most common sites of avulsion injuries in adolescents and children are apophyses of the pelvis and knee. In adults, avulsion injuries commonly occur within the tendon due to underlying degeneration or tendinosis. However, any location can be involved in avulsion injuries. Radiography is the first imaging modality to diagnose avulsion injury, although advanced imaging modalities are occasionally required to identify subtle lesions or to fully delineate the extent of the injury. Ultrasonography has a high spatial resolution with a dynamic assessment potential and allows the comparison of a bone avulsion with the opposite side. Computed tomography is more sensitive for depicting a tiny osseous fragment located adjacent to the expected attachment site of a ligament, tendon, or capsule. Moreover, magnetic resonance imaging is the best imaging modality for the evaluation of soft tissue abnormalities, especially the affected muscles, tendons, and ligaments. Acute avulsion injuries usually manifest as avulsed bone fragments. In contrast, chronic injuries can easily mimic other disease processes, such as infections or neoplasms. Therefore, recognizing the vulnerable sites and characteristic imaging features of avulsion fractures would be helpful in ensuring accurate diagnosis and appropriate patient management. To this end, familiarity with musculoskeletal anatomy and mechanism of injury is necessary.

• Clinical and Experimental Reproductive Medicine
• /
• v.47 no.4
• /
• pp.237-244
• /
• 2020

Endometrial cancer (EC) in young women tends to be early-stage and low-grade; therefore, such cases have good prognoses. Fertility-sparing treatment with progestin is a potential alternative to definitive treatment (i.e., total hysterectomy, bilateral salpingo-oophorectomy, pelvic washing, and/or lymphadenectomy) for selected patients. However, no evidence-based consensus or guidelines yet exist, and this topic is subject to much debate. Generally, the ideal candidates for fertility-sparing treatment have been suggested to be young women with grade 1 endometrioid adenocarcinoma confined to the endometrium. Magnetic resonance imaging should be performed to rule out myometrial invasion and extrauterine disease before initiating fertility-sparing treatment. Although various fertility-sparing treatment methods exist, including the levonorgestrel-intrauterine system, metformin, gonadotropin-releasing hormone agonists, photodynamic therapy, and hysteroscopic resection, the most common method is high-dose oral progestin (medroxyprogesterone acetate at 500-600 mg daily or megestrol acetate at 160 mg daily). During treatment, re-evaluation of the endometrium with dilation and curettage at 3 months is recommended. Although no consensus exists regarding the ideal duration of maintenance treatment after achieving regression, it is reasonable to consider maintaining the progestin therapy until pregnancy with individualization. According to the literature, the ovarian stimulation drugs used for fertility treatments appear safe. Hysterectomy should be performed after childbearing, and hysterectomy without oophorectomy can also be considered for young women. The available evidence suggests that fertility-sparing treatment is effective and does not appear to worsen the prognosis. If an eligible patient strongly desires fertility despite the risk of recurrence, the clinician should consider fertility-sparing treatment with close follow-up.

• Cross-Cultural Studies
• /
• v.27
• /
• pp.167-195
• /
• 2012

A Chinese female writer Linhaiyin(林海音) and Chengnanjiushi(城南舊事), her representative work, have never been studied in Korea before although she and her literary works stand high and are well known in the history of the modern Chinese literature. Thus, in this paper, I analyze her and her novels included in Chengnanjiushi and study their literary value and meaning. To analyze and study them, I mainly consider novels Anhuiguan, Womenkanhaiqu, Lanyiniang, $L{\acute{\ddot{u}}}dagunr$, and Babadehuarluole included in Chengnanjiushi. Firstly, I look into her attitude and mode to observe children and women's life as a writer. Such attitude and mode succeeded to the spirit of the '5.4 literature'. Secondly, I evaluate Linhaiyin's 'Both sides complex' and its value in the history of literature. From this evaluation, the meaning of Linhaiyin's literature is highlighted. She was free from 'Both sides complex' occurred due to the circumstance of the times and played a role of a bridge so as not to break off literature of China and Taiwan. When her and her works are evaluated, this is one of the most important values. The characteristic of her writing mode is that she did not seek a compelling climax, a surprising reversal, or an exclusive plot or character in her works. In her works, plain description or unwitting conversation and story often imply deep meanings. Thus, at unexpected moment after reading her novels, readers truly listen to deep resonance for her attitude and mode to observe people's life. This is exactly her potential energy that makes readers sink into her literary world regardless of time and space.

• Clinics in Shoulder and Elbow
• /
• v.21 no.4
• /
• pp.200-206
• /
• 2018

Background: The purpose of this study was to assess the relevance of preoperative magnetic resonance imaging (MRI) evaluation by occupation ratio (OR) at maximum diameter of supraspinatus muscle. Methods: Patients from the Inje University Sanggye Paik Hospital who received rotator cuff repair and underwent pre- and postoperative MRI were selected as subjects of this study. On T1-weighted MRIs, OR of fat and muscle at Y-shaped view, OR at a location on supraspinatus muscle where its diameter was maximum on coronal view, and pre- and postoperative Goutallier Classification and changes in the tangent sign were measured. Statistical significance of postoperative OR was assessed regarding time from symptom onset to surgery, size of rotator cuff tear, preoperative OR, and the difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view. Results: Preoperative OR at Y-shaped view was $52.28{\pm}8.57$ (32.5-65.3). Preoperative OR difference between maximum diameter and Y-shaped view was $13.76{\pm}10.51$ (2.38-42.04), and Pearson correlation coefficient was 0.604 (p=0.001). Postoperative OR at Y-shaped view was $63.77{\pm}9.35$ (37.3-76.1). Pearson correlation coefficient of pre- and postoperative Goutallier Classification was -0.579 (p=0.002) and Pearson correlation coefficient of the postoperative difference between ORs measured at maximum diameter of supraspinatus muscle and Y-shaped view was -0.386 (p=0.047). Conclusions: Fatty degeneration of supraspinatus muscle in rotator cuff tear patients should be evaluated not only in the conventional Y-shaped view, but also at location of maximum diameter of supraspinatus muscle to establish patients' therapeutic plan.

• Journal of Aerospace System Engineering
• /
• v.13 no.4
• /
• pp.66-73
• /
• 2019

The objective of this study was to evaluate the structural safety of the basic design for the linear actuator for the flap control of aircrafts. The kinetic behavior of the linear actuator was determined using the multi-body dynamics (MBD) analysis, and the contact force was calculated to be used as input data for the structural analysis based on the finite element analysis. In the structural analysis, the thermal and static behaviors of the linear actuator satisfying the designed velocity were examined, and the structural safety of the linear actuator evaluated. Moreover, the dynamic behaviors of the key components of the linear actuator were investigated by the modal analysis. The actuation rod linearly moved with about 5 mm/s when the motor operated at 225 rpm and the maximum contact force of 32.83 N occurred between two driving gears. Meanwhile, the structural analysis revealed that the maximum thermal and static stresses were 1.57% and 78% of the yield strength of steel, respectively, and they were in a safe range of the structure. In addition, the linear actuator for the basic design is stable to the resonance by avoiding the natural frequencies of the components.

• Clinics in Shoulder and Elbow
• /
• v.22 no.2
• /
• pp.61-69
• /
• 2019

Background: The purpose of this study is to compare the clinical outcomes of the control group and platelet-rich plasma (PRP) group among the patients who failed to respond to conservative treatment as outpatient-based therapy for rotator cuff tendinopathy, and to compare the clinical results of leukocyte-poor (LP) PRP and leukocyte-rich (LR) PRP. Methods: Inclusion criteria are (1) over 18-year-old, (2) patients with rotator cuff tendinopathy, no rotator cuff tear by radiologic diagnosis (ultrasonography or magnetic resonance imaging) within the last 3 months, and (3) not effective to conservative treatment for more than 1 month. Of the final 60 subjects, 33 patients in the exercise treatment group and 27 patients in the PRP injection group (LP-PRP, 13; LR-PRP, 14) were included. Clinical evaluation was carried out by assessing the outcomes of treatment using the Numeric Rating Scale pain score, the American Shoulder and Elbow Society (ASES) score, and the Constant score at baseline and at 3 and 6 months after the procedure. Results: There was a statistically significant difference in ${\Delta}ASES_{3months}$ ($ASES_{3months}-ASES_{first}$) score between the control and PRP groups (p=0.006). However, there was no statistical significance between LP-PRP and LR-PRP groups (p>0.05). Conclusions: This study showed that PRP injection was more effective than exercise therapy for the first 3 months. However, there was no difference between the LP-PRP group and the LR-PRP group. Regardless of the type of PRP, clinical application of PRP injection in patients with rotator cuff tendinopathy seems to be effective in early treatment.

• Journal of radiological science and technology
• /
• v.44 no.6
• /
• pp.635-643
• /
• 2021

The results of empirical researches on the diagnosis of lung cancer are insufficient, so it is limited to objectively judge the clinical possibility and utilization according to the accuracy of diagnosis. Thus, this study retrospectively analyzed the lung cancer diagnostic performance of PET-MRI (Positron Emission Tomography-Magnetic Resonance Imaging) by using the decision matrix. This study selected and experimented total 165 patients who received both hematological CEA (Carcinoembryonic Antigen) test and hybrid PET-MRI (¹⁸F-FDG, 5.18 MBq/kg / Body TIM coil. VIVE-Dixon). After setting up the result of CEA (positive:>4 ㎍/ℓ. negative:<2.5㎍/ℓ) as golden data, the lung cancer was found in the image of PET-MRI, and then the SUV_max (positive:>4, negative:<1.5) was measured, and then evaluated the correlation and significance of results of relative diagnostic performance of PET-MRI compared to CEA through the statistical verification (t-test, P>0.05). Through this, the PET-MRI was analyzed as 96.29% of sensitivity, 95.23% of specificity, 3.70% of false negative rate, 4.76% of false positive rate, and 95.75% of accuracy. The false negative rate was 1.06% lower than the false positive rate. The PET-MRI that significant accuracy of diagnosis through high sensitivity and specificity, and low false negative rate and false positive rate of lung cancer, could acquire the fusion image of specialized soft tissue by combining the radio-pharmaceuticals with various sequences, so its clinical value and usefulness are regarded as latently sufficient.

• Journal of the Korea institute for structural maintenance and inspection
• /
• v.26 no.1
• /
• pp.39-48
• /
• 2022

In earthquake situations, broadcasting and communication services are directly linked to rapid on-site rescue and effective restoration works. Recently, a variety of base isolation devices are widely introduced on building floors to avoid critical seismic damages of telecommunication facilities. However, in buildings with long fundamental periods, those devices may have undesirable amplification of seismic responses due to resonance effect between the building floors and base isolation devices. This study performs the seismic safety evaluation of two types of base isolation devices deployed for telecommunication facilities in mid- and high-rise buildings through numerical and experimental approaches. It is found that mid- and high-rise buildings can have low-frequency dynamic responses at the top floor when being subjected to design basis earthquake loading. Furthermore, bi-directional shake table testing demonstrated that the selected base isolation devices can exhibit unstable dynamic behaviors under such low-frequency excitations of the floor.

• The Journal of Internal Korean Medicine
• /
• v.43 no.4
• /
• pp.751-760
• /
• 2022

Objective: To show a decrease in tumor recurrence and improvement in quality of life in patients with recurrent cervical cancer. Method: A 58-year-old female patient diagnosed with recurrent cervical cancer in February 2021 was treated for 14 months with integrative cancer treatment (ICT) to decrease the tumor size and improve chemotherapy-induced peripheral neuropathy (CIPN) and nausea. The patient underwent chemotherapy or concomitant chemoradiation therapy (CCRT) with ICT. Radiologic outcomes were assessed by abdomen & pelvis computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT) based on the Response Evaluation Criteria in Solid Tumors (RECIST) protocol. Clinical outcomes were assessed by the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), Eastern Cooperative Oncology Group (ECOG), and a numeric rating scale (NRS). Result: During the 14 months of treatment, the size and metabolic activity of the recurrent tumor decreased and underwent partial remission based on RECIST. The NRS scores for CIPN and nausea were improved, and the ECOG score improved from grade 2 to 1. No serious side effects of grade 3 or higher were noted on the NCI-CTCAE test. Conclusion: This case suggests that ICT may have a synergetic effect with chemotherapy or radiotherapy for recurrent cervical cancer.

• Korean Journal of Veterinary Service
• /
• v.45 no.2
• /
• pp.139-143
• /
• 2022

A 10-year-old, spayed female miniature schnauzer was referred to the Veterinary Medical Teaching Hospital of Chungnam National University due to evaluation of sudden polyuria (PU) and, polydipsia (PD) (540 mL/kg/day) with severe anemia and weight loss. Blood examination results were normal except for severe anemia (hematocrit, [HCT]: 11.8%). Urinalysis revealed a urine specific gravity (USG) of 1.003, whereas urine sediment was not specific. Urine osmolality was 90 mOsm (reference range: 800~2500 mOsm), and plasma osmolality was 303 mOsm. No specific lesions were found using diagnostic imaging including radiography, ultrasonography and magnetic resonance imaging (MRI). The serum cortisol level was normal in cosyntropin stimulation test. Plasma arginine vasopressin (AVP) concentration was <0.4 pg/mL (reference range: 3.49~5.45 pg/mL). Blood transfusion was initiated in addition to an oral prescription of desmopressin acetate (DDAVP, 0.1 mg/head) thrice a day for one week. The patient was rechecked for clinical signs, urine osmolality, and USG; the clinical signs of PU/PD were resolved, urine osmolality increased to 1106 mOsm, and, USG increased to 1.021. Considering the improved clinical signs, and increased urine osmolality, and USG after DDAVP treatment, the dog was diagnosed with central diabetes insipidus. USG and urine osmolality increased to >1.030 and 2200 mOsm, respectively. Anemia also gradually improved and HCT increased to >37%. DDAVP was tapered to 0.1 mg/head twice a day and all clinical signs in the patient have completely resolved.