The Journal of the Korean bone and joint tumor society
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v.7
no.2
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pp.51-58
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2001
Purpose : In patients having malignant and aggressive bone tumors around knee joint requiring amputation, segmental resection and rotationplasty were performed and the clinical results were analyzed. Materials and Methods : Twenty-six patients underwent segmental resection and rotationplasty between February 1988 and June 1994, because limb salvage with tumor prosthesis after removal of tumor was impossible. The mean follow-up of malignant tumors was 57(6~120) months and the average age of patients was 21.4(5~37) years old. Out of 26 patients, there were 18 osteosarcoma(${\geq}$stage IIB), 2 synovial sarcoma, and 6 giant cell tumor. Results : Clinical results were evaluated by the Shriner's rating system. Four patients were excluded due to death or amputation and remaining 22 patients were included for assessment. Eighteen patients had excellent result, 3 good, and 1 fair. Range of motion of ankle joint was -11(dorsiflexion)~80(plantarflexion) degrees and daily walking activity with prosthesis was possible. Local recurrence developed in 2 patients and distant metastasis in 10. Early complications had 3 thrombosis and 1 sepsis, and late complications had 6 nonunion, 2 malrotation and 1 stiffness of ankle joint. Conclusion : Rotationplasty which is functionally excellent may serve as an effective partial limb salvage procedure, especially in patients less than 10 years old that lower extremity discrepancy or loosening tumor prosthesis due to enlargement of medullary cavity are anticipated or amputation is inevitable for wide resection margin.
LEE, Nam Soo;KIM, Yu Chan;LIM, Joon Beom;KIM, Youngchan
Journal of Korean Society of Transportation
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v.33
no.5
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pp.441-448
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2015
This study aims to suggest a reasonable signal operation method for right-turn traffic management. It was found that the right-turn vehicle supplementary signal is currently operated without clear regulations or criteria. It was also analyzed that right-turn supplementary signals are used without consistency, there is a risk of traffic accidents due to the discordance between supplementary signals and traffic signals of forward vehicles, there is a lack of basis for prohibition of a right turn when right-turn vehicle's supplementary signal is red and the flashing red signal is used in a different sense from the law. In order to see the effect of the installed right-turn vehicle supplementary signals on traffic signal violation, a field investigation was conducted. As the result, there was a high proportion of signal violation on the approach lane with right-turn supplementary signals and this means that right-turn supplementary signals hardly influenced the reduction in proportion of signal violation during a right turn. Additionally, a survey was carried out to see if there were differences in driver's interpretation of traffic signals depending on the installation of right-turn supplementary signals. As the result of the survey, there were no differences in interpretation of traffic signals depending on the installation of right-turn supplementary signals or the types of right-turn supplementary signals. A right turn when the signal was red did not lead to serious traffic accidents, so it is thought that there should be a careful consideration of a total ban on a right turn when the signal is red, in order to prevent driver's confusion due to the change of the signal system. Unless there is a disturbance to cars and pedestrians after a temporary stop when the signal is red, there is a need to specify that vehicles must stop temporarily in the Road Traffic Act to facilitate a right turn. What this study finally suggested is to use tri-colored arrow signals for right-turn car supplementary signals to convey a signal to a driver clearly.
Background: Thoracic trauma is one of the leading causes of morbidity and mortality in developing countries. A rib fracture that is secondary to blunt thoracic trauma is an important indicator of the severity of the trauma. The purpose of study was to determine the morbidity and mortality rates and the management of rib fractures. Material and Method: We performed a retrospective study that involved all the blunt trauma patients with rib fractures, excluding those that were transferred to other hospital within 3 days, that were seen at our hospital between May 2002 and December 2008. Of the 474 admitted patients, 454 met the inclusion criteria. There were 356 male and 98 females, and their overall mean age was 53 years (range: 5~90 years). The outcome parameters included the mechanism of injury, the number of fractured ribs, the length of stay in the ICU, the Injury Severity Score (ISS), the length of the hospital stay, the pulmonary complications and the mortality. Result: The mechanism of trauma included traffic accidents in 189 (41.7%) cases, slipping down in 103 (22.7%) cases, falls in 85 (18.7%) cases, cultivator accidents in 30 (6.6%) cases, industrial accidents in 32 (7.0%) cases and assault in 15 (3.3%) cases. Intrathoracic injury was noted such as hemothorax in 269 (59.3%) cases, pneumothorax in 144 (31.7%) cases, pulmonary contusion in 95 (20.9%) cases, subcutaneous emphysema in 29 (6.4%) cases and great vessel injury in 5 (0.1%) cases. Conservative treatment was administered to most of the patients. Tube thoracostomy was administered in 234 (51.5%) cases, whereas thoracotomy was performed in 18 (4.0%) cases. The mean duration of thoracostomy was $5.2{\pm}6.2$ days. Most of the cases with rib fracture were treated in wards and their mean duration of hospital stay was $22.5{\pm}20$ days. The mean Injury Severity Score (ISS) was $14.8{\pm}10.9$ (range: 3~75). The mortality rate was calculated to be 4.8% (n=22). The main factors correlated with an adverse outcome were the number of ribs fractured, the duration of thoracostomy and pulmonary disease. Industrial insurance affected the length of hospitalization. Pulmonary contusion and the Injury Severity Score (ISS) affected the mortality. Conclusion: Rib fractures are a indicator of severe injury. Because of the complication and associated injuries, we believe these patients should be admitted for evaluation and treatment. Recent studies on the impact of rib fractures after blunt trauma have shown that patients as young as 40 years of age demonstrate increased morbidity and mortality with similar injuries as compared to that of older patients. The ISS and pulmonary contusion influenced the mortality rate. Patients with isolated rib fractures should be hospitalized if the number of fractured ribs is one or more.
Purpose : To evaluate the clinical results after anterior cruciate ligament (ACL) reconstruction with hamstring tendon and Ligament Anchor (LA) screw Materials and Methods : 103 patients (104 cases) who were followed up at least more than 2 years after ACL reconstruction were included in this study. The average period of follow-up was 36 months. The clinical results such as physical examination and Lysholm knee score and instrumented anterior laxity test with Telos were evaluated. Results : The Lysholm knee score was 57.9 in average preoeratively and improved to 95.2 in average at follow up. On the Lachman test, there were mild (+) instability in 46 cases $(45\%)$, moderate (++) in 33 $(31\%)$, severe (+++) in 25 $(24\%)$ preoperatively. 90 cases $(87\%)$ were converted to negative and 14 $(13\%)$ to mild at follow up. On Pivot-shift test, there were negative (-) instability in 22 cases $(22\%)$, mild (+) in 62 $(59\%)$, moderate (++) in 12 $(11\%)$ and severe in 8 $(8\%)$ preoperatively. 87 cases $(84\%)$ were converted to negative and 17 $(16\%)$ to mild at follow up. On instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference on 20 lb was $13.4{\pm}5.6$ (7-25) mm in average preoperatively, and was decreased to $3.6{\pm}1.5$ (1-6) mm in average at follow-up. Complications were quadriceps muscle atrophy in 27 $(30.0\%)$, saphenous nerve paresthesia in 19 $(18.3\%)$, anterior knee crepitus in 13 $(12.5\%)$ and over-penetration of screw through lateral femoral cortex in 5 cases $(4.8\%)$. Conclusion : ACL reconstruction with hamstring tendon and LA screw was one of the choice of graft and fixatives in restoring knee stability and in improving clinical results with little complications such as anterior knee pain.
Purpose: We purposed to evaluate clinical results after undergoing arthrocopic surgery of lateral discoid meniscus in children. Materials and Methods: Retrospective evaluation was executed for the 21 cases which showed abnormal findings of knee joint due to lateral discoid meniscus, from Janunary 1 1999 to December 30 2007. Average observation period was 38.4 months (14months~60 months), and average age was 9.5 years old (7~12 years old). The major clinical findings for knee joint extension limitations were the most common with 11 cases, and there were 8 cases of knee joint pain, 6 cases of snapping, and 10 cases of gait abnormality. The forms of lateral discoid meniscus were 14 cases of complete type, 5 cases of incomplete type, and 2 cases of Wrisberg type. All patient had arthroscopic partial menisectomy and some patient who had meniscus tear had arthroscopic meniscus repair. The clinical results were evaluated using Ikeuchi grading system, and the change of knee joint was observed through routine radiography. Results: The peripheral hypermobility of lateral disciform meniscus was observed in 7 cases. The peripheral tear was observed in 4 cases, where partial menisectomy was along with suture at the same time. The final clinical results were 5 cases of Excellent, 12 cases of Good, 4 cases of Fair. Radiologically, there were 5 cases of subchondral sclerosis and narrowness of hardness at the lateral knee joint, and osteochondritis occurred at the joint facet of external femur in 1 case. In clinical result, meanwhile, there were 20 cases of normal or almost normal and only 1 case of abnormal in IKDC score. Conclusion: Knee joint arthroscopic partial menisectomy for treatment of lateral discoid meniscus is useful, and when accompanied by peripheral disruption, suture is thought to be necessary.
The purpose of the study was to improve the efficiency of Breath & Forced Vital Capacity(FVC) of Stroke Patients Using Record Playing Focused on Breath Training. The Training of Forced Vital Capacity(FVC) is focused on trunk muscles reinforce for Breathing. So the study tried to play Recorder for reinforcing FVC. The play included the two parts. One was for solo play, the other was play in concert base on solo play using Korea country song, Arirang. The Recorder play used abdominal breath, Pursed-lip & Paced methods. The course of play included Long Tone, Staccato, Crescendo, Decrescendo and throughout the course we tried to improve the efficiency & Quantity of breathe. Experiment performed at Social welfare institute for the old. They played & checked FVC, $FEV_1$, $FEV_1/FVC$ before & after breathe 19 times for 6 weeks using Spirovit SP-1, Schiller. After experiment we performed statical process(p<0.05) using statical Package software. The findings were as follows: Analysis for Experiment showed the numerical Value of increasing Of FVC, $FEV_1$, $FEV_1/FVC$. Increasing Percentage of Measured/Predicted FVC, $FEV_1$ (or calculated based on theory) ration was 25%, 13% and Quantity of FVC, $FEV_1$ 35%, 40%. Also $FEV_1/FVC$ Ratio(showed efficiency of breathe) raised 13%. And experiment data was confirmed by statical process. The experiment data was valuable under p<0.05. In Conclusion we think the results of experiment showed the efficiency of Music therapy for Breathe(FVC, $FEV_1$, $FEV_1/FVC$) reinforce.
Journal of the Korean Institute of Landscape Architecture
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v.41
no.2
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pp.69-82
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2013
The purpose of this study is to evaluate the effect of Dulegil in Bukhansan National Park in dispersing peak climbing hikers, characterize each section of Dulegil and suggest ideas of improvement. This study was conducted based on the survey completed by visitors in all 21 sections of Dulegil. After the construction of Dulegil, the number of visit to Dulegil grew and it was analyzed that Dulegil attracted new visitors given that the rate of young people(aged 19~30) who visited for the first time was quite high. Regarding the frequency of peak climbing, 7.6% of the respondents said "decreased" and 46.2% said "increased", showing that Dulegil's effect to disperse peak climbing hikers is nominal. Seven qualities were evaluated regarding Dulegil's level of satisfaction. Out of those seven, the quality of recreational place and taking a walk achieved high scores of 3.74 and 3.61 respectively. The quality of culture and history scored the lowest with 3.09. The analysis on the characteristic of each section of Dulegil, reason of visit, and the visitors' level of satisfaction showed that Dulegil is now regarded as a place where they can improve their health through light exercise and walking. In addition, a positive effect can be expected for a long time since there are different ways of utilizing the resources of the National Park, such as getting in touch with nature, preserving ecology, learning history and enjoying beautiful landscapes. If infrastructure and programs specific to each section of Dulegil were improved in a long-term perspective, it would be effective to encourage peak climbers and enjoy the lower parts of the mountain.
Yoo, Eun Jung;Kim, Eun Young;Kook, Hoon;Woo, Young Jong
Journal of The Korean Society of Inherited Metabolic disease
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v.5
no.1
/
pp.33-43
/
2005
Purpose: X-linked adrenoleukodystrophy(ALD) is a rare disorder that shows a great deal of phenotypic variability. We subdivided chidhood X-linked ALD patients into several phenotypes by the age at onset, the sites of most severe clinical involvement and the rate of progression of neurologic symptoms. Methods: Thirteen patients who had been diagnosed as X-linked ALD and followed up for at least one year were enrolled from 1996 to 2003. Results: 1. Ten had childhood cerebral ALD, who showed first neurologic symptoms at 7.02 years and progressed rapidly: interval between first symptoms and vegetative state was 1.35 years, and interval from initial symptoms to death was 3.35 years. Treatment with Lorenzo's oil did not prevent neurologic progression. Two patients who underwent umbilical cord blood transplantation died. 2. Two had adolescent cerebral ALD. They had first symptoms at 11.5 years, and showed tendency to progress less rapidly than childhood cerebral form patients. 3. One "Addison only" patient who had adrenal insufficiency without nervous system involvement remained asymptomatic during Lorenzo's oil treatment. 4. All cerebral form patients except one showed the lesions in both parieto-ocipital white matter in brain magnetic resonance imaging. Conclusion: The cerebral ALD was the most common form in childhood and was asoociated with a serious prognosis.
Kim, Yoo-Ill;Kim, Jung-Gyu;An, Jin-Sung;Choi, A-Hyun
Journal of the Korean Institute of Landscape Architecture
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v.38
no.3
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pp.62-74
/
2010
This study aims to examine what factors citizens value in urban parks and green spaces in terms of usage and aesthetic value and to find ways to deal with the changing patterns of user satisfaction for these various green elements. To achieve this, the study developed a dynamic model employing a transactional approach to evaluate environmental quality for 1999 and 2007 in Anyang City as well as a conceptual model of parks and greens satisfaction. This study relied on an empirical study method including the 1999 and 2007 green conditional survey and citizen questionnaires totaling 573 in the year 1999 and 982 in the year 2007. As a result, first, the factor 'urban parks' is the most important factor and 'cityscape' is the second most important factor in parks and greens satisfaction(PGS). Second, PGS in turn causes environmental quality satisfaction(EQS), which is related to two items--'urban livability' and 'aesthetic quality'--in the model. This means that PGS is the intervening variable of urban livability. Third, the factor analysis resulted in six factors: cityscape, urban green, linear facilities, urban parks, riverside green, and urban forest. 'Riverside green' emerged as a factor in 2007 as a result of public participation in the 'Anyang River Revitalization Project'. Fourth, through a transactional view, the environmental changes result in either a change in or stability of public attitude. The levels of satisfaction were elevated but patterns of satisfied-unsatisfied items remained unchanged for most factors. The perception of riverside a greenway and linear surface facilities(pedestrian walkways, biking and jogging trails, etc.) have changed positively. PGS changed significantly in 2007, as a result of urban events and development, including parks, rivers and greenways which were built through the joint effort of the local government and civic participation.
Purpose: The postoperative hospital stay after gastric cancer surgery is usually 8 to 14 days. The main reason for a prolonged hospital stay may be the 3 to 4 day period of postoperative starvation. The aim of this study is to investigate the feasibility of a critical pathway for early recovery after gastric cancer surgery, and this pathway included early postoperative feeding. Materials and Methods: One hundred three consecutive patients who underwent gastric resection and reconstruction for gastric cancer from October 2007 to June 2008 at St. Mary's Hospital were prospectively enrolled in a fast-track critical pathway. The pathway included minimal preoperative procedures, optimal pain relief, proper fluid administration, early mobilization and early enteral nutrition at postoperative 1 day. The exclusion criteria were determined preoperatively, intraoperatively and postoperatively. Results: Of the 103 patients, 19 patients were excluded for preoperative (5), intraoperative (7) and postoperative (7) reasons. Eighty-four patients (81.6%) were included in the fast-track critical pathway. Sixty-eight (88.6%) of 84 patients were discharged at the planned 8 day after surgery during the initial period of the study, and the postoperative hospital stay was shortened up to 6 days during the more recent period. Postoperative complications occurred in 22 patients (26.2%), and these were gastrointestinal track-related complications in 6 cases (3 cases of ileus, 1 case of stasis and 2 cases of leakage) and infection-related complications in 8 cases. There was no statistical difference in the incidence of morbidity according to the clinic-operative features that included age, gender, stomach resection and lymphadenectomy. Conclusion: The fast-track critical pathway with using the available exclusion criteria was a valid option for patients who underwent gastric cancer surgery.
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