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A Folktale education that promotes communication between generations considering difference in cultural background (문화적 맥락의 차이에 따른 설화 향유의 한 양상과 세대 간 소통을 위한 설화 교육 시론)

A Proposal for Korean armed forces preparing toward Future war: Examine the U.S. 'Mosaic Warfare' Concept (미래전을 대비한 한국군 발전방향 제언: 미국의 모자이크전 수행개념 고찰을 통하여)

  • Chang, Jin O;Jung, Jae-young
    • Maritime Security
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    • v.1 no.1
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    • pp.215-240
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    • 2020
  • In 2017, the U.S. DARPA coined 'mosaic warfare' as a new way of warfighting. According to the Timothy Grayson, director of DARPA's Strategic Technologies Office, mosaic warfare is a "system of system" approach to warfghting designed around compatible "tiles" of capabilities, rather than uniquely shaped "puzzle pieces" that must be fitted into a specific slot in a battle plan in order for it to work. Prior to cover mosaic warfare theory and recent development, it deals analyze its background and several premises for better understanding. The U.S. DoD officials might acknowledge the current its forces vulnerability to the China's A2/AD assets. Furthermore, the U.S. seeks to complete military superiority even in other nation's territorial domains including sea and air. Given its rapid combat restoration capability and less manpower casualty, the U.S. would be able to ready to endure war of attrition that requires massive resources. The core concept of mosaic warfare is a "decision centric warfare". To embody this idea, it create adaptability for U.S. forces and complexity or uncertainty for the enemy through the rapid composition and recomposition of a more disag g reg ated U.S. military force using human command and machine control. This allows providing more options to friendly forces and collapse adversary's OODA loop eventually. Adaptable kill web, composable force packages, A.I., and context-centric C3 architecture are crucial elements to implement and carry out mosaic warfare. Recently, CSBA showed an compelling assessment of mosaic warfare simulation. In this wargame, there was a significant differences between traditional and mosaic teams. Mosaic team was able to mount more simultaneous actions, creating additional complexity to adversaries and overwhelming their decision-making with less friendly force's human casualty. It increase the speed of the U.S. force's decision-making, enabling commanders to better employ tempo. Consequently, this article finds out and suggests implications for Korea armed forces. First of all, it needs to examine and develop 'mosaic warfare' in terms of our security circumstance. In response to future warfare, reviewing overall force structure and architecture is required which is able to compose force element regardless domain. In regards to insufficient defense resources and budget, "choice" and "concentration" are also essential. It needs to have eyes on the neighboring countries' development of future war concept carefully.

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A Study on the Influence of the Water System on the Location and Spatial Structure of Hongju-seong (수체계가 홍주성의 입지와 공간구조 변천과정에 미친 영향)

  • Lee, Kyung-Chan;Kang, In-Ae
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.38 no.4
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    • pp.12-24
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    • 2020
  • The purpose of this study is to analyze the influence of the water system on the location, spatial structure, and construction method of Hongju-eupseong, centering on Hongjumok-eupchi. During the Joseon Dynasty, the water system in Hongjumok-eupchi is composed of artificially constructed Seong-an Runnel and ponds based on a branch-shaped natural waterways flowing from south to north and west to east. Compiling the results of various literature records, excavations and analysis of map data, it can be seen that the water system has an important influence on the construction of Hongju-seong. Firstly, Hongju-seong from the Goryeo Dynasty to the late Joseon Dynasty is located using a circular shape of topographical structure and a small erosion basin formed on the inner side of the Hongseongcheon and Wolgyecheon streams without significant change in location. In particular, Wolgyecheon and Hongseongcheon are natural moats, which are harmonized with Sohyangcheon and riverside topographical structures, affecting the location and construction method of Hongju-seong, water related facilities, and the spatial structure of eupseong. It is understood that location characteristic of Hongju-seong reflects the urban location structure harmonized with waterways in ancient China and Korea. Secondly in harmony with the water system and topographic structure of Hongju-seong, it is an important factor in deciding the land use of the town, the arrangement of the town hall facilities and inducing various non-subsidiary measures such as the establishment of embankment forest with a secret function and the closure of the south gate. In addition, artificial drainage facilities such as Seongan runnel and ponds are being actively introduced from early on to protect the walls or towns from flooding of Wolgyecheon. Especially there were typical methods for protecting the walls from water damage such as the Joseon Dynasty stone castle structure that was integrated with saturn(soil wall) in the Goryeo Dynasty, retreating wall in the northern gate area in the late Joseon Dynasty, and the method of constructing wall using korean tile and stone floors between reinforced soil layers in the western and northern wall.

Analysis of Childhood Rapidly Progressive Glomerulonephritis (소아 급속 진행성 사구체신염의 임상적 고찰)

  • Uhm Ji Hyun;Kim Mi Jin;Lee Young-Mock;Kim Ji Hong;Lee Jae Seung;Kim Pyung-Kil;Hong Soon Won;Jeung Hyeun Joo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.78-86
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    • 2001
  • Purpose: Rapidly progressive glomerulonephritis (RPGN) is characterized by the rapid increase in serum creatitnin and crescents formation involving more than $50\%$ of glomeruli. 10 patients who had been treated for RPGN were studied retrospectively for thier underlying diseases and clinical features Method: Cilinical review was performed on 10 children who were diagnosed with RPGN by clinical features and renal biopsy and followed up at department of pediatrics during tile last 10 years, from May 1990 to May 2000. Result: There were 6 males and 4 females between the ages of 2.1 and 14.3 years (mean $10.9{\pm}3.8$). 3 had Henoch-$Sch{\ddot{o}}nlein$ purpura nephritis; 2, idiopathic rapidly progressive glomerulonephritis; 2, lupus nephritis; 1, hemolytic uremic syndrome; 1, membranous glomerulonephritis and 1, microscopic polyangiitis. The most common chief complaints were gross hematuria and oliguria. Initial clinical features included proteinuria, edema, hypertension, nausea and arthralgia. Mean serum BUN was $74.2{\pm}39.1\;mg/dL$ mean serum creatinin, $3.2{\pm}1.8\;mg/dL$ and mean creatinin clearance, $26.5{\pm}13.2\;mL/min/1.73m^2$. Antineutrophil cytoplasmic antibody was positive only in microscopic polyangiitis. ANA and Anti-DNA antibody were positive in two lupus nephritis patients. Serum complements were decreased in 4 patients. All patients except Hemolytic uremic syndrome received steroid pulse therapy and immunosupressive agents. 3 patients were performed acute peritoneal dialysis and 2 patients were given plasmapheresis. At the last follow up, 1 patient was dead, 4 patients had elevated serum creatinin, 2 of these 4 patients were on chronic ambulatory peritoneal dialysis and 6 patients had normal renal function. Conclusion: Rapidly progressive glomerulonephritis is a medical emergency that requires very rapid diagnosis, classification, and therapy. Appropriate therapy selected on the basis of underlying disease mechanism can substantially improve renal survival. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 78-86)

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A Comparative Analysis of the Clinical and Pathological features of IgA Nephropathy and Thin Glomerular Basement Membrane Disease (IgA 신병증과 비박형 기저막 신증의 임상 및 병리학적 비교 분석 - 사구체 기저막의 비박화를 중심으로 -)

  • Chi, Geun-Ha;Ha, Chang-Woo;Kim, Young-Ju;Yoon, Hye-Kyung;Chung, Woo-Yeong
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.147-155
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    • 2001
  • Purpose : IgA nephropathy(IgAN) and thin glomerular basement membrane disease(TGBMD) are common glomerular diseases that cause hematuria in childhood. IgAN has characteristics of IgA deposit as the sole or predominantly localized to the mesangium Recently, it has been reported that thinning of glomerular basement membrane(GBM) is commonly accompanied with precipitation of electron dense deposits in IgAN. We performed this study to examine the frequency of thinning of GBM among children with IgAN and to analysis tile correlation between urinary abnormalities and GBM thickness and furthermore to conduct comparative analysis of the clinical and pathological features of IgAN and TGBMD. Methods : This study summarizes data collected from Department of Pediatrics, Busan Paik Hospital, Inje Medical College. Data include 51 cases who were diagnosed as IgAN from 1995 to 2000, and 26 cases who were diagnosed as TGBMD from 1990 to 2000 by percutaneous renal biopsy. Results : Males accounted for 29/51($56.9\%$) patients with IgAN and 8/26($30.8\%$) of those with TGBMD. The clinical and laboratory features between IgAN and TGBMD were significantly different regarding the incidence of proteinuria(IgAN vs TGBMD: $43.1\%\;vs\;3.8\%$, p=0.001), the incidence of co-appearance of proteinuria with hematuria ($41.2\%\;vs\;3.8\%$, p=0.001), total amount of protein in 24 hours collected urine ($808{\pm}\;mg\;vs\;251{\pm}200.7\;mg$, p=0.001) and the incidence of proteinuria more than 1 gm in 24 hours collected urine ($23.5\%\;vs\;3.8\%$, p=0.01). On the contrary, there were no significant differences in the levels of serum albumin, creatinine, BUN, and Ccr between two groups. The mean thickness of GBM in patients with IgAN was $293.0{\pm}79.2\;nm$(139.7-461.9 nm) and $180.9{\pm}35.8\;nm$(110.5-229.5 nm) in patients with TGBMD. The mean GBM thickness revealed significantly thinner in TGBMD compared than those with IgAN (P=0.0001). The frequency of thickness being less than 250 nm was $37.4{\pm}34.4\%$ in IgAN and $93.0{\pm}7.0\%$ in TGBMD (P=0.0001). But there were no correlations between urinary abnormalities and GBM thickness in patients with IgAN. Conclusion : The thinning of GBM would be one of the common pathological findings in IgAN Moreover, there is no significant correlations between urinary abnormalities and GBM thickness in patients with IgAN, However, patients with IgAN tend to have significantly higher possibilities of proteinuria, co-appearance of proteinuria with hematuria and higher total amount of protein in 24 hours collected urine compared those with TGBMD. These differences might be play all important role as progressive prognostic indicators in patients with IgAN. (J Korean Soc Pediatr Nephrol 2001;5 : 136-46)

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A STUDY ON THE IONOSPHERE AND THERMOSPHERE INTERACTION BASED ON NCAR-TIEGCM: DEPENDENCE OF THE INTERPLANETARY MAGNETIC FIELD (IMF) ON THE MOMENTUM FORCING IN THE HIGH-LATITUDE LOWER THERMOSPHERE (NCAR-TIEGCM을 이용한 이온권과 열권의 상호작용 연구: 행성간 자기장(IMF)에 따른 고위도 하부 열권의 운동량 강제에 대한 연구)

  • Kwak, Young-Sil;Richmond, Arthur D.;Ahn, Byung-Ho;Won, Young-In
    • Journal of Astronomy and Space Sciences
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    • v.22 no.2
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    • pp.147-174
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    • 2005
  • To understand the physical processes that control the high-latitude lower thermospheric dynamics, we quantify the forces that are mainly responsible for maintaining the high-latitude lower thermospheric wind system with the aid of the National Center for Atmospheric Research Thermosphere-Ionosphere Electrodynamics General Circulation Model (NCAR-TIEGCM). Momentum forcing is statistically analyzed in magnetic coordinates, and its behavior with respect to the magnitude and orientation of the interplanetary magnetic field (IMF) is further examined. By subtracting the values with zero IMF from those with non-zero IMF, we obtained the difference winds and forces in the high-latitude 1ower thermosphere(<180 km). They show a simple structure over the polar cap and auroral regions for positive($B_y$ > 0.8|$\overline{B}_z$ |) or negative($B_y$ < -0.8|$\overline{B}_z$|) IMF-$\overline{B}_y$ conditions, with maximum values appearing around -80$^{\circ}$ magnetic latitude. Difference winds and difference forces for negative and positive $\overline{B}_y$ have an opposite sign and similar strength each other. For positive($B_z$ > 0.3125|$\overline{B}_y$|) or negative($B_z$ < -0.3125|$\overline{B}_y$|) IMF-$\overline{B}_z$ conditions the difference winds and difference forces are noted to subauroral latitudes. Difference winds and difference forces for negative $\overline{B}_z$ have an opposite sign to positive $\overline{B}_z$ condition. Those for negative $\overline{B}_z$ are stronger than those for positive indicating that negative $\overline{B}_z$ has a stronger effect on the winds and momentum forces than does positive $\overline{B}_z$ At higher altitudes(>125 km) the primary forces that determine the variations of tile neutral winds are the pressure gradient, Coriolis and rotational Pedersen ion drag forces; however, at various locations and times significant contributions can be made by the horizontal advection force. On the other hand, at lower altitudes(108-125 km) the pressure gradient, Coriolis and non-rotational Hall ion drag forces determine the variations of the neutral winds. At lower altitudes(<108 km) it tends to generate a geostrophic motion with the balance between the pressure gradient and Coriolis forces. The northward component of IMF By-dependent average momentum forces act more significantly on the neutral motion except for the ion drag. At lower altitudes(108-425 km) for negative IMF-$\overline{B}_y$ condition the ion drag force tends to generate a warm clockwise circulation with downward vertical motion associated with the adiabatic compress heating in the polar cap region. For positive IMF-$\overline{B}_y$ condition it tends to generate a cold anticlockwise circulation with upward vertical motion associated with the adiabatic expansion cooling in the polar cap region. For negative IMF-$\overline{B}_z$ the ion drag force tends to generate a cold anticlockwise circulation with upward vertical motion in the dawn sector. For positive IMF-$\overline{B}_z$ it tends to generate a warm clockwise circulation with downward vertical motion in the dawn sector.

Study of Patient Teaching in The Clinical Area (간호원의 환자교육 활동에 관한 연구)

  • 강규숙
    • Journal of Korean Academy of Nursing
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    • v.2 no.1
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    • pp.3-33
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    • 1971
  • Nursing of today has as one of its objectives the solving of problems related to human needs arising from the demands of a rapidly changing society. This nursing objective, I believe, can he attained by the appropriate application of scientific principles in the giving of comprehensive nursing care. Comprehensive nursing care may be defined as nursing care which meets all of the patient's needs. the needs of patients are said to fall into five broad categories: physical needs, psychological needs, environmental needs, socio-economic needs, and teaching needs. Most people who become ill have adjustment problems related to their new situation. Because patient teaching is one of the most important functions of professional nursing, the success of this teaching may be used as a gauge for evaluating comprehensive nursing care. This represents a challenge foe the future. A questionnaire consisting of 67 items was distributed to 200 professional nurses working ill direct patient care at Yonsei University Medical Center in Seoul, Korea. 160 (80,0%) nurses of the total sample returned completed questionnaires 81 (50.6%) nurses were graduates of 3 fear diploma courser 79 (49.4%) nurses were graduates of 4 year collegiate nursing schools in Korea 141 (88,1%) nurses had under 5 years of clinical experience in a medical center, while 19 (11.9%) nurses had more than 5years of clinical experience. Three hypotheses were tested: 1. “Nurses had high levels of concept and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of a statistical method, the mean average. 2. “Nurses graduating from collegiate programs and diploma school programs of nursing show differences in concepts and knowledge toward patient teaching”-This was demonstrated by a statistical method, the mean average, although the results showed little difference between the two groups. 3. “Nurses having different amounts of clinical experience showed differences in concepts and knowledge toward patient teaching”-This was demonstrated by the use of the T-test. Conclusions of this study are as follow: Before attempting the explanation, of the results, the questionnaire will he explained. The questionnaire contained 67 questions divided into 9 sections. These sections were: concept, content, time, prior preparation, method, purpose, condition, evaluation, and recommendations for patient teaching. 1. The nurse's concept of patient teaching: Most of the nurses had high levels of concepts and knowledge toward patient teaching. Though nursing service was task-centered at the turn of the century, the emphasis today is put on patient-centered nursing. But we find some of the nurses (39.4%) still are task-centered. After, patient teaching, only a few of the nurses (14.4%) checked this as “normal teaching.”It seems therefore that patient teaching is often done unconsciously. Accordingly it would he desirable to have correct concepts and knowledge of teaching taught in schools of nursing. 2. Contents of patient teaching: Most nurses (97.5%) had good information about content of patient teaching. They teach their patients during admission about their diseases, tests, treatments, and before discharge give nurses instruction about simple nursing care, personal hygiene, special diets, rest and sleep, elimination etc. 3. Time of patient teaching: Teaching can be accomplished even if there is no time set aside specifically for it. -a large part of the nurse's teaching can be done while she is giving nursing care. If she believes she has to wait for time free from other activities, she may miss many teaching opportunities. But generally proper time for patient teaching is in the midmorning or midafternoon since one and a half or two hours required. Nurses meet their patients in all stages of health: often tile patient is in a condition in which learning is impossible-pain, mental confusion, debilitation, loss of sensory perception, fear and anxiety-any of these conditions may preclude the possibility of successful teaching. 4. Prior preparation for patient teaching: The teaching aids, nurses use are charts (53.1%), periodicals (23.8%), and books (7.0%) Some of the respondents (28.1%) reported that they had had good preparation for the teaching which they were doing, others (27.5%) reported adequate preparation, and others (43.8%) reported that their preparation for teaching was inadequate. If nurses have advance preparation for normal teaching and are aware of their objectives in teaching patients, they can do effective teaching. 5. Method of patient teaching: The methods of individual patient teaching, the nurses in this study used, were conversation (55.6%) and individual discussion (19.2%) . And the methods of group patient teaching they used were demonstration (42.3%) and lecture (26.2%) They should also he prepared to use pamphlet and simple audio-visual aids for their teaching. 6. Purposes of patient teaching: The purposes of patient teaching is to help the patient recover completely, but the majority of the respondents (40.6%) don't know this. So it is necessary for them to understand correctly the purpose of patient teaching and nursing care. 7. Condition of patient teaching: The majority of respondents (75.0%) reported there were some troubles in teaching uncooperative patients. It would seem that the nurse's leaching would be improved if, in her preparation, she was given a better understanding of the patient and communication skills. The majority of respondents in the total group, felt teaching is their responsibility and they should teach their patient's family as well as the patient. The place for teaching is most often at the patient's bedside (95.6%) but the conference room (3.1%) is also used. It is important that privacy be provided in learning situations with involve personal matters. 8. Evaluation of patient teaching: The majority of respondents (76.3%,) felt leaching is a highly systematic and organized function requiring special preparation in a college or university, they have the idea that teaching is a continuous and ever-present activity of all people throughout their lives. The suggestion mentioned the most frequently for improving preparation was a course in patient teaching included in the basic nursing program. 9. Recommendations: 1) It is recommended, that in clinical nursing, patient teaching be emphasized. 2) It is recommended, that insertive education the concepts and purposes of patient teaching he renewed for all nurses. In addition to this new knowledge, methods and materials which can be applied to patient teaching should be given also. 3) It is recommended, in group patient teaching, we try to embark on team teaching.

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A Study on the Meaning of Plant Material in the 2016 Korea Garden Show Designer's Garden (2016년 코리아가든쇼 작가정원의 식물 의미에 관한 연구)

  • Lee, Chung-Hee;Jin, Hye-Young;Lee, You-Mi;Song, Yu-Jin
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.3
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    • pp.41-53
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    • 2017
  • This study was performed to determine what the plant material were selected to reflect in the 2016 Korea Garden Show designer's garden. It was analyzed that plant material was used to display the theme of the garden and to create a specific space. Under the given theme of 'K-Garden, Shinhallyu Garden(new style garden culture) with the most Korean taste', the plants were used to highlight the theme in two types: 'representation' and 'expression'. There were two 'representation' gardens that imitate a particular space of Korean taste and four 'expression' gardens that showcase the designer's thoughts with abstract concepts and concrete objects. Three gardens included both types of garden. The way of revealing the subject with plants was used more for 'expression' than for 'representation'. There were eleven spaces for 'representation' of the Korean taste, a vegetable garden, faucet, pond, field, nature, a Hanok court garden, groves of bamboo, tile roof, stone wall, rock and backyard of a Hanok connected to the mountain. The planting material was used in two ways: reflecting only the ecological characteristics of the plant, and considering the ecological and visual characteristics together. Vegetation plantings reflecting the ecological characteristics were observed in all eleven spaces. Nine of the spaces reflected the growth environment of the plants, but the other two did not reflect the ecological characteristics of the plants, unlike the designer's intention. In the case of the four spaces that considered the ecological and visual characteristics together, color and size were considered visual characteristics. The plants in the seven spaces that included 'expression' as the theme were selected to reflect the visual characteristics in the order of color, shape, texture, and size, rather than reflecting ecological characteristics. A group planting method was applied. When the plants were used as materials for creating space, Norman(1989) analyzed three enclosure factors(overhead, vertical, ground plane). Only two deciduous trees were used in the overhead plane while five species of evergreen shrubs and thirty species of various deciduous plants were used in the vertical plane. There were forty-five species (nine trees and thirty-six herbaceous plants) forming the ground plane, and various herbaceous plants were utilized without duplication in each garden. The designer's garden of the Garden Show played a role in introducing new groundcover plants to the public. Three of the nine gardens did not include ornamental plants, and the use of decorative plants in other gardens was few compared to the number of plantings. In the Korea Garden Show designer's garden, most of the plants were being used with the intention of exposing the theme or architectural uses. In the 2016 Korea Garden Show designer's garden, many species of plants were used as materials for showcasing themes rather than for creating spaces. Also, the method of 'expression' was used more than the method of 'representation' in order to highlight the theme. This indicates that the planting materials reflect visual characteristics such as color, shape, texture, size rather than ecological characteristics.

Transformation of Adult Mesenchymal Stem Cells into Cardiomyocytes with 5-azacytidine: Isolated from the Adipose Tissues of Rat (성체 백서의 지방조직에서 추출한 중간엽 줄기세포의 5-azacytidine을 이용한 심근세포 분화 유도)

  • Choe Ju-Won;Kim Yong-In;Oh Tae-Yun;Cho Dai-Yoon;Sohn Dong-Suep;Lee Tae-Jin
    • Journal of Chest Surgery
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    • v.39 no.7 s.264
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    • pp.511-519
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    • 2006
  • Background: Loss of cardiomyocytes in the myocardial infarction leads to regional contractile dysfunction, and necrotized cardiomyocytes in infracted ventricular tissues are progressively replaced by fibroblasts forming scar tissue. Although cardiomyoplasty, or implantation of ventricular assist device or artificial heart was tried in refractory heart failure, the cardiac transplantation was the only therapeutic modality because these other therapeutic strategies were not permanent. Cell transplantation is tried instead of cardiac transplantation, especially bone marrow is the most popular donated organ. But because bone marrow aspiration procedure is invasive and painful, and it had the fewer amounts of cellular population, the adipose tissue is recommended for harvesting of mesenchymal stem cells. Material and Method: After adipose tissues were extracted from abdominal subcutaneous adipose tissue and intra-abdominal adipose tissue individually, the cellular components were obtained by same method. These cellular components were tried to transformation with the various titers of 5-azacytidine to descript the appropriate concentration of 5-azacytidine and possibility of transformation ability of adipose tissue. Group 1 is abdominal subcutaneous adipose tissue and Group 2 is intra-abdominal adipose tissue-retroperitoneal adipose tissue and omentum. Cellular components were extracted by collagenase and $NH_4Cl$ et al, and these components were cultured by non-induction media - DMEM media containing 10% FBS and inducted by none, $3{\mu}mol/L,\;6{\mu}mol/L,\;and\;9{\mu}mol/L$ 5-azacytidine after the 1st and 2nd subculture. After 4 weeks incubation, tile cell blocks were made, immunostaining was done with the antibodies of CD34, heavy myosin chain, troponin T, and SMA. Result: Immunostaining of the transformed cells for troponin T was positive in the $6{\mu}mol/L\;&\;9{\mu}mol/L$ 5-azacytidine of Group 1 & 2, but CD34 and heavy myosin chain antibodies were negative and SMA antibody was positive in the $3{\mu}mol/L\;&\;6{\mu}mol/L$ 5-azacytidne of Group 2. Conclusion: These observations confirm that adult mesenchymal stem cells isolated from the abdominal subcutaneous adipose tissues and intra-abdominal adipose tissues can be chemically transformed into cardiomyocytes. This can potentially be a source of autologous cells for myocardial repair.

The Outcome of Anterior Cruciate Ligament Reconstruction in Patients with Meniscal Injury (반월판 연골 손상이 동반된 환자에서 전방 십자 인대 재건술의 임상적 결과)

  • Lee Kwang Won;Park Jae Guk;Jung Yu Hun;Kim Byung Sung;Kim Ha Yong;Choy Won Sik
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.160-168
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    • 2003
  • Purpose : To analyze the anterior stability and functional results after the arthroscopic ACL reconstruction and meniscectomy based on meniscus status at the time of surgery. Materials and Methods : From October 1997 to October 2002, 78 patients (male 64 female 14) were treated by arthroscopic ACL reconstruction and meniscectomy and followed more than 12 months (range, $12\~72$ months, average: 32 months). Average age was 32 years old (range, $18\~57$ years old). We divided the patients into 4 groups; Both menisci was intact (BMI, control group), lateral meniscus removed (LMR), medial meniscus removed (MMR) and both menisci removed (BMR). Anterior passive displacement (objective stability) was estimated using KT-2000 arthrometer under the loading of 15lb,20lb and 30lb and evaluated anterior drawer test, Lachman test, range of motion, thigh circumference. Functional evaluation system of IKDC, OAK and Lysholm knee score was used. Results : Average anterior displacement under the loading of 30lb were 2.47 mm, 2.96 mm, 2.96 mm and 3.57 mm in each group(BMI, LMR, MMR, BMR) and it was statistically significant difference (p<0.05). There is no statistically significant difference in average anterior displacement under the loading of 15lb and 20lb in each group but it has showed decreasing tendency in meniscal removed groups. The mean anterior displacement was within 3 mm in 21 cases, 15 cases, 24 cases and 12 cases (total 72 cases, $94\%$) under the loading of 15lb and 20 cases, 15 cases, 24 cases and 11 cases (total 70 cases, $91\%$) under the loading 20lb of in each group and postoperative knee joint stability has showed increasing tendency (p>0.05). The mean score was 94.5, 93.2, 92.2 and 90.4 points in each group and 71 cases $(91\%)$ were more than excellent or good with a OAK score and fair results were noted 4 cases in both meniscal removed group. There were 65 cases $(83\%)$ with a Lysholm knee score more than excellent or good, and IKDC grading were more than normal or nearly normal in 74 cases $(95\%)$ except 4 cases (2 cases in MMR group and 2 cases in BMR group). Conclusion : Long-term anterior stability and functional results of a successful ACL reconstruction affected by tile status of the menisci at the time of surgery and KT-2000 arthrometer was good for estimation of objective follow up.

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