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Postoperative Complications After Arthroscopic Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft (자가 슬개건을 이용한 전방 십자 인대 재건술의 수술 후 합병증)

  • Zhu, Fang Zhen;Yoo, Moon-Jib;Kim, Myung-Ho;Park, Hee-Gon;Bahng, Seung-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.122-127
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    • 2008
  • Purpose: Evaluation and analysis of the incidence of postoperative complications after arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft. Materials and Methods: We reviewed 172 cases of arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft in anterior cruciate ligament tear without meniscal injury. We performed Lysholm knee score and KT-2000 testing, simple radiograph, physical examination as evaluation factor. Also, around knee pain, swelling, limitation of motion, patellofemoral crepitation, paresthesia and pain on kneeling were evaluated. Results: The average follow up period was 49.8 months. In 172 patients, 148 males and 26 femlaes were evaluated. The average age was 34.4 years. The Lysholm knee score improved from 51.9 points preoperatively to 90.8 points at final follow up. Clinical outcome was excellent in 83%, good in 11%, fair in 4% and poor in 2%. There were many cases of complications, 24 cases (14%) of around knee pain, 12 cases (7%) of swelling, 45 cases (26.2%) of patellofemoral crepitation, 52 cases (30%) of donor site paresthesia, 65 cases (38%) of pain on kneeling, 10 cases (5.8%) of limitation of motion at extension, 13 cases (8%) of limitation of motion at flexion and 2cases (1.2%) of patellar fracture. Conclusion: Although arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone had good clinical results, many complications were noted. Some factors in surgical technique were suspected to be related to the complications and long term follow up will be necessary to further evaluated.

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Treatment Outcome of Metastatic Carcinoma of Cervical Lymph Node from an Unknown Primary (원발병소 블명의 경부림프절 전이의 치료결과)

  • Kim Kyubo;Chie EuiKyu;Wu Hong-Gyun;Kim Kwang Hyun;Sung Myung-Whun;Heo Dae Seog;Park Charn Il
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.137-142
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    • 2005
  • Purpose: To analyze the outcome of radiation therapy for patients with a metastatic carcinoma of cervical lymph nodes from an unknown primary (MUO), and identify the prognostic factors for these patients. Materials and Methods: Between July 1981 and June 1999, 39 patients with MUO underwent radiation therapy with curative intent. Twelve patients were treated with radiation therapy alone (Group 1), 8 with neoadjuvant chemotherapy followed by radiation therapy (Group 2), and 19 with either an excision or neck dissection and postoperative radiation therapy (Group 3). There were 31 males and 8 females, with a median age of 55 years, ranging from 25 to 77 ears. The median duration of follow-up was 38 months, ranging from 3 to 249 months. Results: The 5-year overall survival rate was $55\%$. According to the treatment modality, the 5-year disease-free survival rates of Groups 1, 2 and 3 were 48, 19 and $75\%$, respectively (p=0.0324). In addition to the treatment modality, the appearance of the primary site was a significant prognostic factor for disease-free survival (p=0.0085). Conclusion: Surgical resection and radiation therapy achieves a superior disease-free survival compared to radiation therapy alone, either with or without chemotherapy Further investigation Is needed to evaluate the role of chemotherapy in the treatment of MUO.

Postoperative External Beam Radiotherapy for Retroperitoneal Soft Tissue Sarcoma (후복막 연조직 육종의 수술 후 외부 방사선 치료)

  • Jang, Na-Young;Kim, Il-Han;Choi, Jin-Hwa;Park, Charn-Il
    • Radiation Oncology Journal
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    • v.26 no.3
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    • pp.135-141
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    • 2008
  • Purpose: To evaluate the clinical outcomes and prognostic factors in retroperitoneal soft tissue sarcomas treated by postoperative radiotherapy. Materials and Methods: The records of 23 patients with retroperitoneal soft tissue sarcomas, who underwent postoperative radiotherapy between 1985 and 2003, were analyzed. The median follow-up period was 77 months (range, $8{\sim}240$ months). A total of 21 patients presented with primary disease, and two patients presented with recurrent disease. Liposarcomas and leiomyosarcomas represented 78% of the diagnosed tumor cases. Moreover, 17 cases were of high grade (grade 2 or 3). The median tumor size was 13 cm (range, $3{\sim}50\;cm$). Complete excision was achieved in 65% of patients. The median radiation dose was 50.4 Gy (range, 45.0 to 59.4 Gy), with conventional fractionation. Results: The 5-year overall, local recurrence-free, and distant metastasis-free survival rates were 68%, 58%, and 71%, respectively. Eleven patients experienced local recurrence, while 9 patients experienced distant metastasis. The most common site for distant metastasis was the liver. A univariate analysis revealed that adjacent organ invasion and age (>60 years) as the significant risk factors contributing to the prediction of poor overall survival. Moreover, multivariate analyses indicated that adjacent organ invasion remained significantly associated with a higher risk of death. In addition, patient age (>60 years) was the other identified risk factor for local recurrence by univariate and multivariate analyses. Except for one case of grade 3 diarrhea, no patient suffered grade 3 or higher complications. Conclusion: Our results were comparable to previous reports in that adjacent organ invasion and patient age (>60 years) were significant predictors of poor survival and tumor recurrence, respectively.

Habitat Restoration Initiative for Endangered Species Parnassius bremeri (Lepidoptera: Papilionidae) in Korea (멸종위기종 붉은점모시나비의 서식지 복원구상)

  • Kim, Do-Sung;Park, Seong-Joon;Shin, Young-Kyu;Park, Doo-Sang
    • Journal of the Korean Institute of Landscape Architecture
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    • v.39 no.6
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    • pp.98-109
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    • 2011
  • Habitat restoration initiative is an important factor for the on-site preservation of butterflies. A new habitat necessitates the investigation of the ecology of the butterfly, the landscape of the habitat, the work process, and a cost analysis. In this study, these factors were analyzed through1) re-consideration of the secured results from three years of field work, and 2) a habitat area estimation conducted according to the presence or absence of larvae and adults via a Parnassius bremeri Bremer survey. The investigation of the natural habitat, done for both larvae and adult butterflies found in South Korea, suggested that multiple patches with a minimum size exceeding $300m^2$ and with an average size of about $1,600m^2$were required for survival of this butterfly. Therefore, more than five patches should be considered for butterfly habitat and patches should have similarity to the present habitat environment with transplantation plans for diet plants and honeydew plants. In addition, to activate the migration of the butterfly, cutting down trees that are obstacles to migration, minimizing the distance between patches and the addition of a stepping patch are also required. A patch connectivity analysis showed that patches should be located within 300m of neighboring patches, as the migration of the butterfly will fail if it is more than 600m. Additionally, more than $10,000m^2$ for a single patch or a patch network composed more than five patches over $1,600m^2$ in size were recommended, with a total patch size of $8,000m^2$. Additionally, neighboring multiple patch networks are more desirable than a single habitat in the event a cyclic habitat pattern arises. In this study, we suggest a habitat restoration and optimal prerequisites for a butterfly habitat. It is expected that this research will lead to the creation of a good model for the restoration of butterfly species.

Perspective of breaking stagnation of soybean yield under monsoon climate

  • Shiraiwa, Tatsuhiko
    • Proceedings of the Korean Society of Crop Science Conference
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    • 2017.06a
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    • pp.8-9
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    • 2017
  • Soybean yield has been low and unstable in Japan and other areas in East Asia, despite long history of cultivation. This is contrasting with consistent increase of yield in North and South America. This presentation tries to describe perspective of breaking stagnation of soybean yield in East Asia, considering the factors of the different yields between regions. Large amount of rainfall with occasional dry-spell in the summer is a nature of monsoon climate and as frequently stated excess water is the factor of low and unstable soybean yield. For example, there exists a great deal of field-to-field variation in yield of 'Tanbaguro' soybean, which is reputed for high market value and thus cultivated intensively and this results in low average yield. According to our field survey, a major portion of yield variation occurs in early growth period. Soybean production on drained paddy fields is also vulnerable to drought stress after flowering. An analysis at the above study site demonstrated a substantial field-to-field variation of canopy transpiration activity in the mid-summer, but the variation of pod-set was not as large as that of early growth. As frequently mentioned by the contest winners of good practice farming, avoidance of excess water problem in the early growth period is of greatest importance. A series of technological development took place in Japan in crop management for stable crop establishment and growth, that includes seed-bed preparation with ridge and/or chisel ploughing, adjustment of seed moisture content, seed treatment with mancozeb+metalaxyl and the water table control system, FOEAS. A unique success is seen in the tidal swamp area in South Sumatra with the Saturated Soil Culture (SSC), which is for managing acidity problem of pyrite soils. In 2016, an average yield of $2.4tha^{-1}$ was recorded for a 450 ha area with SSC (Ghulamahdi 2017, personal communication). This is a sort of raised bed culture and thus the moisture condition is kept markedly stable during growth period. For genetic control, too, many attempts are on-going for better emergence and plant growth after emergence under excess water. There seems to exist two aspects of excess water resistance, one related to phytophthora resistance and the other with better growth under excess water. The improvement for the latter is particularly challenging and genomic approach is expected to be effectively utilized. The crop model simulation would estimate/evaluate the impact of environmental and genetic factors. But comprehensive crop models for soybean are mainly for cultivations on upland fields and crop response to excess water is not fully accounted for. A soybean model for production on drained paddy fields under monsoon climate is demanded to coordinate technological development under changing climate. We recently recognized that the yield potential of recent US cultivars is greater than that of Japanese cultivars and this also may be responsible for different yield trends. Cultivar comparisons proved that higher yields are associated with greater biomass production specifically during early seed filling, in which high and well sustained activity of leaf gas exchange is related. In fact, the leaf stomatal conductance is considered to have been improved during last a couple of decades in the USA through selections for high yield in several crop species. It is suspected that priority to product quality of soybean as food crop, especially large seed size in Japan, did not allow efficient improvement of productivity. We also recently found a substantial variation of yielding performance under an environment of Indonesia among divergent cultivars from tropical and temperate regions through in a part biomass productivity. Gas exchange activity again seems to be involved. Unlike in North America where transpiration adjustment is considered necessary to avoid terminal drought, under the monsoon climate with wet summer plants with higher activity of gas exchange than current level might be advantageous. In order to explore higher or better-adjusted canopy function, the methodological development is demanded for canopy-level evaluation of transpiration activity. The stagnation of soybean yield would be broken through controlling variable water environment and breeding efforts to improve the quality-oriented cultivars for stable and high yield.

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A Study of both Femurs Bone Densitometry's Difference for Exercise (운동유무에 따른 양측 대퇴골 골밀도 차이에 관한 연구)

  • Jang, Eun-Ju;Kim, Eun-Hye;Kim, Ho-Sung;Shin, Sang-Ki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.73-76
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    • 2009
  • Purpose: Bone mineral densitometry test region advised by ISCD (International Society for Clinical Densitometry) is both site in case of femur, whereas our medical center measures left femur except for few extraordinary cases. It is said that right-handers had higher mean femur BMD in the left side than in the right side, but the factor influence the femur BMD is unknown. Thus, we investigate whether testing left femur only is a adequate clinical diagnosis. Materials and Methods: Subjects were 209 right-handers and 20 left-handers patient in Asan Medical Center from July to August, 30 to 70 years of age ($51{\pm}6.7$). Subjects fill out the questionnaire on hand preference and taking regular exercise. Total BMDs of bilateral femur were measured with GE Lunar Prodigy advance densitometer, and the statistical soft ware SPSS 12.0 for windows was used for statistical analysis. Results: In the total sample of the exercise group (n=127), the difference of both femur mean BMDs are $0.001{\pm}0.127\;g/cm^2$ and the non-exercise group's (n=102) both femur difference is $0.002{\pm}0.126\;g/cm^2$, there is no significant difference. And in exercise group, classified according to hand preference, each t-value is shown at right handers (n=114) are 0.65, left handers (n=13) are -0.39. Also, In non-exercise group, right handers (n=95) are -0.78, left handers (n=7) are -0.64. In the 95% confidence limit, there was no statistically significant difference (p>0.05). Conclusions: In recently researchs, there have been differences between both femurs according to hand preference. However, Our study have no significant difference both femurs BMDs. Therefore we suggest that BMD measurement of femur has no problem only one side, except for particular case like femur operation.

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Quality and Affecting Factor of Care for Patients Hospitalized with Pneumonia (폐렴 입원환자 진료과정의 질적 수준과 이에 영향을 미치는 요인: 임상질지표를 중심으로)

  • Moon, Sangjun;Lee, Jin-Seok;Kim, Yoon;You, Sun-Ju;Choi, Yun-Kyoung;Suh, Soo Kyung;Kim, Yong-Ik
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.300-308
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    • 2009
  • Background: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. Methods: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. Results: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. Conclusion: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

An Analysis of Process-oriented Design in the Invited Entries of International Competition for the Master Plan of the Yongsan Park, Korea (용산공원 설계 국제공모 출품작에 나타난 프로세스적 설계 분석)

  • So, Jin;Sung, Jong-Sang;Pae, Jeong-Hann
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.2
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    • pp.11-26
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    • 2013
  • Designing large parks such as Yongsan Park requires the open-ended process-oriented design approach in complex layers rather than the conventional self-completed master plan method. This study aims to examine the characteristics of process-oriented design in the eight invited entries of "International Competition for the Master Plan of the Yongsan Park, Korea"(2012). For this purpose, it analyzed each entry according to three criteria: objects of process-oriented approach, time factor and its features of phasing plan, and presentation method of the process. This analysis can not only critically review the current level of the process-centered design methodology but also suggest strategic future directions for Yongsan Park. The objects of process-oriented design in the eight works were order of physical space development, restoration process of ecosystem, recovering process of publicity, and economic operation and management. Main considerations in the objects were connections to adjacent urban fabrics, links to regional green and water system, reuse of existing buildings and infrastructures in the site. The temporal criteria of the phasing plan had two aspects. One was planning a certain time and period, and the other was just establishing an order of phases. Most of the presentation method of process was the phasing plan, but some of the entries suggested a scenario plan. The eight works of "International Competition for the Master Plan of Yongsan Park" did not attempt process-oriented designs entirely and completely. Rather, they tried to introduce the phasing plan as part of a process-centered design. Also, they took an eclectic approach between master plan and process-oriented design instead of rejecting the conventional master plan approach.

Vertical Profiles and Assessment of Trace Metals in Sediment Cores From Outer Sea of Lake Shihwa, Korea (시화호 외측 해역 주상 퇴적물 내 미량금속 수직분포 특성 및 오염도 평가)

  • Ra, Kongtae;Kim, Joung-Keun;Kim, Eun-Soo;Kim, Kyung-Tae;Lee, Jung-Moo;Kim, Eu-Yeol
    • Journal of the Korean Society for Marine Environment & Energy
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    • v.16 no.2
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    • pp.71-81
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    • 2013
  • Trace metal concentration in sediment cores from the outer sea of Lake Shihwa were determined to study the vertical profiles of metal concentrations and to evaluate the levels of metal contamination. Sediment pollution assessment was carried out using enrichment factor (EF) and geo-accumulation index (Igeo). The mean concentration of metals were 58.8 mg/kg for Cr, 10.3 mg/kg for Co, 22.8 mg/kg for Ni, 18.1 mg/kg for Cu, 74.0 mg/kg for Zn, 6.75 mg/kg for As, 0.14 mg/kg for Cd, 27.4 mg/kg for Pb and 0.026 mg/kg for Hg, respectively. The mean EF values for Cu, Zn, As, Cd and Hg were greater than 1.5 in sediment cores, indicating that these metals in sediments are slightly enriched by anthropogenic activities. The geo-accumulation index (Igeo) suggested unpolluted status for metals of sediments collected from outer see of Lake Shihwa. Igeo values for Cu and Hg nearby LNG station (site C, D, E) ranged from 1 to 2, indicating moderately to unpolluted pollution status for those metals. Even if the higher concentrations of trace metals nearby LNG station were observed, there is significantly positive relationship between Al and trace metals. Thus, the sediment grain size plays an important roles in influencing the distribution of trace metals in sediment cores from the outer sea of Lake Shihwa. Based on the comparison with sediment quality guidelines such as threshold effect level and probable effect level in Korea, the concentration of metals in sediments from outer sea of Lake Shihwa are likely to result in no harmful effects on sediment-dwelling organisms.

An analysis of the Domestic Interior Materials as the Ecological Design Aspects (친환경측면에서 본 국내 실내건축자재의 현황 조사 및 분석)

  • Chun Jin-Hie;Kim Jung-Ah
    • Archives of design research
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    • v.19 no.4 s.66
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    • pp.133-144
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    • 2006
  • According to the latest report by the Customer Protection Board, those who moved into newly constructed buildings are complaining about unidentified pains, asking for more careful selection of constructive materials for prevention of such potential problems. It is internationally recognized today that ecological materials can serve a significant factor for users' health, environmental protection and better industrial competitiveness. This study examined eco-design aspects of each interior material through web site search, in order to help customers learn about and capitalize on eco materials in a proper manner. As a result, 1. It turned out that the domestic industry are giving an impetus to releasing new eco items focusing on lower VOCs emission or addition of functional components as part of the marketing strategy. However, it is recommended that company understand significance of life cycle, and produce eco-concept materials. 2. The reliable standard for choosing the domestic material is EL, HB, GR marks. It is desirable to enhance recycling technologies and expand the sustainable consumption. customer class, since many recycled items are not developed. 3. The sourcing is a vulnerable part in terms of the concept of being environment-friendly material. Therefore, many manufacturers should design the easy knock-down products and produce the good items using recycled materials instead of new raw materials. Also solutions for making the energy from burning material should be studied. 4. The guidebook or manual with correct information about eco-materials is required to promote production and consumption with sustainable concept. 5. Many manufacturers are emphasizing ecological materials for customers, but some of them intended to disrupt customers' proper selection by promoting even unverified items to be environment-friendly.

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