• Title, Summary, Keyword: Early reconstruction

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

  • Lee, Soo Won;Kim, Sung Hwan;Kim, Yoon Gi
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.34-39
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    • 2012
  • Purpose: This study performed to compare degree of joint stiffness and clinical results between early and delayed reconstruction of acute anterior cruciate ligament (ACL) injuries. Materials and Methods: Thirty-four Patients who underwent ACL reconstruction between March 2008 and October 2010 enrolled this study. We divided the patient into 2 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 including self exercise. We checked range of motion, the Lachman test, the pivot shift test, 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 91.82 in the early group and 94.83 in the delayed group. All the cases were rated above B (near normal) on IKDC score (P=0.217, P=0.845). The Tegner score was 6.7 in the early reconstruction group and 7.1 in the delayed group (P=0.840), there was no difference between the groups for the range of motion (P=0.873, P=0.873), no complication such as deep vein thrombosis or infection, no difference in the Lachman test, pivot shift test (P=0.606, P=0.118). Conclusion: We could obtain satisfactory clinical results in both the early and delayed reconstruction groups of acute ACL injuries. Therefore, the early reconstruction of ACL performed before a week could be one of the treatment options for acute ACL injury.

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A comparison of delayed versus immediate reconstruction following lower-extremity sarcoma resection

  • Zhou, Sarah;Azzi, Alain J;Safran, Tyler;Zadeh, Teanoosh
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.49-53
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    • 2020
  • Background Identifying patients who may be at high risk for wound complications postsarcoma resection and reconstruction is essential for improving functional outcomes and quality of life. Currently, the effect of timing on sarcoma reconstruction has been poorly investigated. The purpose of this study was to compare outcomes of delayed and immediate reconstruction in the setting of sarcoma resection requiring flap reconstruction in the lower extremity. Methods A retrospective review of the senior author's sarcoma reconstruction patients from January 2005 to July 2017 was completed. All patients undergoing flap reconstruction of the lower extremity were included. Complications in the early postoperative period were compared between delayed and immediate reconstructive procedures. Results A total of 32 patients (7 delayed, 25 immediate) were included in this study. There was a significantly increased rate of overall complications (100% vs. 28.0%, P=0.001) and rate of hematomas (28.6% vs. 0.0%, P=0.042) in the delayed reconstruction group. Other complications including dehiscence, seroma, infection, venous thrombosis, and total/partial flap loss were also increased in the delayed reconstruction group, but this was not considered to be significant. Conclusions This study suggests that delayed reconstruction following sarcoma resection of the lower extremity had a higher incidence of overall complications and hematoma formation. We emphasize the importance of early plastic and reconstructive surgeon referral and the necessity to closely monitor delayed reconstruction patients for complications.

A Study on CM Process Model for Reconstuction Project (주택 재건축 정비사업의 건설사업관리(CM) 적용 모델 구축)

  • Ahn, Kyung-Hwan;Cha, Woo-Chul;Chun, Jae-Youl
    • Proceedings of the Korean Institute Of Construction Engineering and Management
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    • pp.295-298
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    • 2007
  • Recently, various problems have been occurred in Apartment reconstruction process. Such as, delaying schedule, additional cost increasing, etc. Those were caused by decision making which is lack of professionality in early phase of reconstruction process. Therefore, in this study proposed improvement plan by application of project management and construction management process in Apartment reconstruction project.

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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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A Study on the Making Period and Historic Values of the "Kyeongbokgung-Baechido" held by the Korea University Museum (고려대학교 박물관 소장 "경복궁배치도"의 제작시기와 사료가치(史料價値)에 대한 연구)

  • Yi, Hye-Won
    • Journal of architectural history
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    • v.17 no.4
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    • pp.43-64
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    • 2008
  • Kyeongbokgung succeeded in regaining its status as a royal palace after the reconstruction that began in the second year of King Gojong(1865) only to have most of its buildings taken down in the early 20th century. Fortunately, however, there is the Pukkwoldohyong(Map of North Palace), which drew out each of the buildings of Kyeongbokgung and their arrangement in details in 1907 when the royal palace lost its original appearance. And there is another plot plan of the royal palace at the Korea University Museum, which labeled it Kyeongbokgung-Baechido(Planning Map of Kyeongbokgung Palace). The map presents almost the same plan as Pukkwoldohyong in terms of making and expressive methods, being estimated to have been made in 1888 since its building arrangement doesn't show the changes made after 1890. The map also offers more information about the uses of each building than Pukkwoldohyong and matches the excavation results of the relics. Kyeongbokgung-Jeondo(Map of Kyeongbokgung Palace), which is recorded to be made during the reconstruction of the palace in the early years of King Gojong in historical materials, describes the shapes and arrangements of the buildings in a concrete and realistic fashion. The Kyeongbokgung-Baechido seems to be one of the plans made in the process of restoring and repairing buildings that were lost or destroyed in fire. The Kyeongbokgung-Baschido has the following historic values; 1) it provides dues to estimate the early state of the palace after the reconstruction during the reign of King Gojong. In fact the Sujeongjeon and Heungbokjeon show the early state of the reconstruction; 2) it contains data with which to understand the changes to the palace after 1890, around which they added Hamhwadang and Jibokjae; and 3) it offers information about the uses of the palace's buildings from 1885 to 1880 with its descriptions of the building purposes and relationships regarding the life in the palace.

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Surgical Treatment of Pulmonary Atresia with Intact Ventricular Septum (심실중격결손을 동반하지 않은 폐동맥폐쇄증에서의 교정수술)

  • Park, Seong-Hyeok;Kim, Yong-Jin;Seo, Gyeong-Pil
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.22 no.2
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    • pp.348-356
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    • 1989
  • Seventeen patients of pulmonary atresia with intact ventricular septum were underwent operation during 4.8years period from Jan. 1983 to Aug. 1988 at Seoul National university Hospital. The patients were composed of 8 males and 9 females, aging 1day to 2.5 years [mean 88 days]. We classified pulmonary atresia according to right ventricular morphology; those with tripartite ventricles in 12, those with no trabecular portion to the cavity in 0, and those with inlet portion only in 5. The tripartite approach to right ventricular morphology is helpful in selecting the type of initial palliative procedures. Palliative procedures were as follows; pulmonary valvotomy in 5 with 3 early survivors, mod B-T shunt in 4 with 3 early survivors, and palliative right ventricular outflow tract reconstruction in 4 with 1 early survivor. Effective preliminary palliation of pulmonary atresia are pulmonary valvotomy or palliative right ventricular outflow tract reconstruction in those with tripartite right ventricle, and modified Blalock-Taussig shunt in those with no infundibular portion. The approach to definitive repair is based primarily on the actual size of the tricuspid annulus and the right ventricular cavity. Definitive repair was as follows: definitive right ventricular outflow tract reconstruction in 4 with all survivors and mod. Fontan operation in 2 with one survivors. Right ventricular outflow tract reconstruction can be done as complete repair for patients who had adequate tricuspid annulus and right ventricular cavitary size and mod. Fontan operation for patients who severely hypoplastic tricuspid valve annulus or small right ventricular cavity.

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A Review on the Reconstruction of Jeonju Eupsung during the early years of King Young-Joe (영조초년(英祖初年)의 전주읍성(全州邑城) 개축공사(改築工事)에 관한 재고찰(再考察))

  • Seo, Chi-Sang;Cho, Hyung-Rai
    • Journal of architectural history
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    • v.16 no.6
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    • pp.27-46
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    • 2007
  • Through reinvestigations of early years of King Young-Joe provincial castles, Jeonju Eupsung, this study seeks to broaden the understanding of castle construction of the later period of Chosun Dynasty. Jeonju Eupsung was established by reform-minded king and his loyalist Cho, Hyun Myung. Their new conceptual framework for reconstruction of Jeonju Eupsung was affected by Yoo, Hyung Won, a realist scholar of 17th century. It is obvious that adopted new administrative systems of financing, building and maintaining of Jeonju Eupsung were based on the his theories of castle. This study demonstrates that Jeonju Eupsung built by Cho, Hyun Myung, during the early years of King Young-Joe were based on those new concepts and systems of the new age. The study shows that the designer of this castle had in mind efficient construction design and execution and effective defense of provincial towns located on flat ground. And, the study explains how those original designer sought higher productivity through greater localization of securing resources and more detailed and improved organization of construction responsibilities. In short, this study seeks to prove that the provincial castles of the early 18th century reflected the new thinking on practicality that was spreading throughout the society of Chosun Dynasty at the time.

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Anterior Longitudinal Ligament Reconstruction to Reduce Hypermobility of Cervical and Lumbar Disc Arthroplasty

  • Mobbs, Ralph J.;Li, Jia Xi Julian;Phan, Kevin
    • Asian Spine Journal
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    • v.11 no.6
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    • pp.943-950
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    • 2017
  • Study Design: Retrospective case series Purpose: This study aims to present the early clinical and radiological outcomes of anterior longitudinal ligament (ALL) reconstruction following disc arthroplasty. Overview of Literature: Although cervical and lumbar disc arthroplasty have entered the clinical setting, there are still concerns regarding the short and long term complications arising from hypermobility of current prosthesis designs. Reconstruction of the ALL is a potential solution to disc arthroplasty hypermobility. Methods: ALL reconstruction following disc arthroplasty have been performed by the senior author over a 24 month period. Ligament replacements used include allograft and synthetic, ligament advanced reinforcement system (LARS) ligaments. Methods of fixation used include titanium staples, bone anchors and suture fixation. Radiological follow-up pre- and postoperative Oswestry disability index, Neck Disability Index, Patient Satisfaction index scores were recorded on all patients. Results: A total of 18 ALL reconstructions were performed. There have been no cases of early complications, revision surgery for recurrent symptoms or implant failure. Of the 6 patients receiving a minimum of 15 months follow-up, 4 patients received an allograft, 2 patients received the LARS ligament. Favourable, postoperative clinical and radiographic outcomes have been demonstrated. Conclusions: ALL reconstruction following cervical and lumbar disc arthroplasty is a promising solution to addressing non-physiological kinematics of current disc arthroplasty devices. Randomized, controlled studies with larger study samples and long-term follow-up are required to establish these conclusions.

Right Ventricular Outflow Tract Reconstruction with Bovine Jugular Venous Valved Conduit. (소경정맥 판막도관을 이용한 우심실 유출로 재건술)

  • 박형주
    • The Korean Journal of Thoracic and Cardiovascular Surgery
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    • v.33 no.10
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    • pp.830-833
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    • 2000
  • Homograft has been the conduit of choice in various types of congenital malformations which require right ventricular outflow tract reconstruction. However it has been proven to be less than ideal in young age group because of early failure of the conduite due to valve dysfunction and calcification. Furthermore limitation of availability of homograft particularly small sized conduits for neonates and infants is the most serious problem. A 19 month old female patient with pulmonary atresia and ventricular septal defect was operated on with a bovine jugular venous valved conduit as an alternative to the homograft for her right ventricular outflow tract reconstruction. Postoperative hemodynamic performance of the conduit was excellent without pressure gradient or valve regurgitation. With this early result bovine jugular venous valved conduit seems to be another excellent conduit because of good hemodynamics and size availability but long term follow up is necessary.

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Case Studies of the Life Cycle Cost Analysis for Rehabilitation of Deteriorated Expressway Concrete Pavements (고속도로 노후 콘크리트 포장 보강의 경제성 분석 사례 연구)

  • Suh, Young-Chan;Park, Ji-Won;Kim, Chan-Woo
    • International Journal of Highway Engineering
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    • v.18 no.3
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    • pp.33-45
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    • 2016
  • PURPOSES : Concrete pavement has been used in the construction of the Jungbu expressway in 1987. More than 60% of the pavement on the expressway is currently made of concrete, but most has been used far beyond their design life. Pavement life has been extended through routine maintenance or overlay. However, the structural capacity of the pavement has reached its limit, and extensive rehabilitation/reconstruction with long time traffic blocking should be considered. The three following issues on concrete rehabilitation/reconstruction will be discussed: (1) economic comparison of asphalt inlay and asphalt overlay, (2) economic comparison preventive overlay on a section which is currently good and routine overlay on the section which will be poor, and (3) economic analysis of early-strength concrete when it is used in concrete reconstruction. METHODS : First, various life cycle cost analysis tools were compared, and the proper tool for the extensive rehabilitation/reconstruction was selected. Second, a sensitivity analysis of the selected tool was performed to find the influential input variables, which should be carefully selected in the analysis. Third, three case studies, which can be issues in the rehabilitation/reconstruction of the expressway concrete pavement in Korea, were performed. RESULTS : Asphalt overlay without milling the deteriorated concrete showed 18~25% lower life cycle cost than the current asphalt inlay with milling. The good current preventive overlay on the section was economically justified within the scope of this study. The construction cost limit of the early strength concrete was suggested to be economical for 1, 3, and 7 days of construction alternative opening. CONCLUSIONS : CA4PRS was a viable tool for comparing various rehabilitation/reconstruction issue alternatives. Several concrete issues associated with the rehabilitation/reconstruction of the deteriorated concrete pavement were discussed as mentioned above.