• Title/Summary/Keyword: stiffness of joint

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A Comparison of Outcomes after Early and Delayed Reconstruction in the Acute Posterior Cruciate Ligament Injuries (급성 후방십자인대 손상 환자에서 조기 재건군과 지연 재건군의 결과 비교)

  • Lee, Yong Sik;Lee, Soo Won;Seo, Byung Ho;Kim, Yoon Gi
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.31-37
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    • 2013
  • Purpose: This study performed to compare degree of joint stiffness and clinical results between early and delayed reconstruction of acute posterior cruciate ligament (PCL) injuries. Materials and Methods: Thirty-two Patients who underwent PCL reconstruction between March 2008 and October 2011 enrolled this study. We performed transtibial single bundle reconstruction using the allo-achilles tendon in all cases. We divided the patient into two groups, early reconstruction group underwent surgery before a week, delayed reconstruction group underwent surgery after 3 weeks, before 6 weeks. All the patients underwent aggressive joint motion exercise till surgery and enrolled post operative rehabilitation program. We checked posterior drawer stress radiography, range of motion, the Lysholm score, the International Knee Documentation Committee (IKDC) score and the Tegner score to evaluate the results. Results: At the final follow up the Lysholm score was 92.1 in the early group and 93.8 in the delayed group. All the cases were rated above B (near normal) on IKDC score (p=0.808, p=0.722). The Tegner score was 6.6 in the early reconstruction group and 6.2 in the delayed group (p=0.480), The average of maximum flexion and extension angle was $133.9^{\circ}$, $1.4^{\circ}$ in the early group and $133.6^{\circ}$, $1.1^{\circ}$ in the delayed group (p=0.560, p=0.581), no complication such as deep vein thrombosis or infection, no difference in posterior drawer stress radiography (p=0.750). Conclusion: We could obtain satisfactory clinical results in both the early and delayed reconstruction groups of acute PCL injuries. Therefore, the early reconstruction of PCL performed before a week could be one of the treatment options for acute PCL injury.

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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.

A Case Report of Novel Mutation in GNPTAB in Two Siblings with Mucolipidosis Type III Alpha/beta (GNPTAB 유전자에서 새로운 돌연변이가 확인된 뮤코지방증 III형 남매)

  • Kim, Min-Sun;Park, Esther;Song, Ari;Im, Minji;Park, Hyung-Doo;Cho, Sung Yoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.18 no.3
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    • pp.99-106
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    • 2018
  • Mucolipidosis type III (pseudo-Hurler polydystrophy) is a mucolipids degrading disorder caused by a mutation in the GNPTAB gene and is inherited by autosomal recessive. It is diagnosed by examining highly concentrated mucolipids in blood and the diagnosis can be confirmed by genetic testing. Mucolipidosis type III is a rare and progressive metabolic disorder. Its initial signs and symptoms usually occur around 3 years of age. Clinical manifestations of the disease include slow growth, joint stiffness, arthralgia, skeletal abnormalities, heart valve abnormalities, recurrent respiratory infection, distinctive facial features, and mild intellectual disability. Here, we are presenting two siblings of mucolipidosis type III, a 4-year-old female and a 2 years and 7 months old male with features of delayed growth and coarse face. The diagnosis was confirmed by [c.2715+1G>A(p.Glu906Leufs*4), c.2544del(p.Glu849Lysfs*22)] mutation in targeted gene panel sequencing. In this case, c.2544del is a heterozygote newly identified mutation in mucolipidosis type III and was not found in the control group including the genome aggregation database. And it is interpreted as a pathogenic variant considering the association with phenotype. Here, we report a Korean mucolipidosis type III patients with novel mutations in GNPTAB gene who have been treated since early childhood. Owing to recent development of molecular genetic techniques, it was possible to make early diagnosis and treatment with pamidronate was initiated appropriately in case 1. In addition to these supportive therapies, efforts must be made to develop fundamental treatment for patients with early diagnosis of mucolipidosis.

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The Short Term Clinical Follow-up Study for Hemiarthroplasty in Proximal Humeral Fracture (상완골 근위부 분쇄 골절에서의 상완골 두 치환술의 단기 추시 결과)

  • Sung, Chang-Meen;Cho, Se-Hyun;Jung, Soon-Taek;Hwang, Sun-Chul;Park, Hyung-Bin
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.92-98
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    • 2007
  • Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.

Cyclic Behavior of Wall-Slab Joints with Lap Splices of Coldly Straightened Re-bars and with Mechanical Splices (굽힌 후 편 철근의 겹침 이음 및 기계적 이음을 갖는 벽-슬래브 접합부의 반복하중에 대한 거동)

  • Chun, Sung-Chul;Lee, Jin-Gon;Ha, Tae-Hun
    • Journal of the Korea Concrete Institute
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    • v.24 no.3
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    • pp.275-283
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    • 2012
  • Steel Plate for Rebar Connection was recently developed to splice rebars in delayed slab-wall joints in high-rise building, slurry wall-slab joints, temporary openings, etc. It consists of several couplers and a thin steel plate with shear key. Cyclic loading tests on slab-wall joints were conducted to verify structural behavior of the joints having Steel Plate for Rebar Connection. For comparison, joints with Rebend Connection and without splices were also tested. The joints with Steel Plate for Rebar Connection showed typical flexural behavior in the sequence of tension re-bar yielding, sufficient flexural deformation, crushing of compression concrete, and compression rebar buckling. However, the joints with Rebend Connection had more bond cracks in slabs faces and spalling in side cover-concrete, even though elastic behavior of the joints was similar to that of the joints with Steel Plate for Re-bar Connection. Consequently, the joints with Rebend Connection had less strengths and deformation capacities than the joints with Steel Plate for Re-bar Connection. In addition, stiffness of the joints with Rebend Connection degraded more rapidly than the other joints as cyclic loads were applied. This may be caused by low elastic modulus of re-straightened rebars and restraightening of kinked bar. For two types of diameters (13mm and 16mm) and two types of grades (SD300 and SD400) of rebars, the joints with Steel Plate for Rebar Connection had higher strength than nominal strength calculated from actual material properties. On the contrary, strengths of the joints with Rebend Connection decreased as bar diameter increased and as grade becames higher. Therefore, Rebend Connection should be used with caution in design and construction.