• Title/Summary/Keyword: Additional Joint

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Histological Changes in the Normal Tissues of Rat after Local Application of the Holmium-166-Chitosan Complex attached to Biodegradable Solid Material (생분해성 고형물에 흡착시켜 실험동물에 국소 투여한 홀미움- 166-키토산 복합체의 투여량, 기간 및 부위에 따른 조직의 괴사 정도와 양상)

  • Lee, Jong-Seok;Jeon, Dae-Geun;Cho, Wan-Hyung;Lee, Soo-Yong;Oh, Jung-Moon;Kim, Jin-Wook
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.190-199
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    • 2003
  • Purpose: The aim of this study was to find out a clinically appliable method to insert a biodegradable solid material containing holmium-166-chitosan complex into the surgical field, and to evaluate the histological changes in the normal tissues after ${\beta}$ -ray irradiation from holmium-166 according to the dose, period and type of tissues. Materials and Methods: 3.0 mCi, 50 ${\mu}l$ of the liquid state $^{166}$Ho-chitosan complex was attached to the absorbable gelatin sponge. The radiation activity measured by dose caliberator was 1.5 mCi. These $^{166}$Ho-chitosan complex containing absorbable gelatin sponges were inserted into the thigh muscles and over the femur bones of the Wistar rats. The cases were evaluated at 2 weeks after insertion, and 4, 6 weeks with respect to the histological changes of the soft tissues and bone, the depth of the tissue necrosis, and the changes of the $^{166}$Ho-chitosan complex containing absorbable gelatin sponges. Results: At 2 weeks, the muscles showed coagulation necrosis, degenerating myocytes, regenerating myocytes, intermuscular edema, and inflammatory cells. The necrosis depth was 3.3 mm. In the bones, there was no osteocyte in the lacuna of cortex (empty lacuna), marrow fibrosis, inflammation. The necrosis depth was 2.9 mm. At 4 weeks, in the muscle, calcification and increased fibrosis with necrosis depth by 3.3 mm were the additional findings. In the bone, marrow fibrosis with necrosis depth by 3.3 mm were detected. At 6 weeks, soft tissue shrinkage, increased fibrosis and granulation tissue formation, and nearly resolving inflammatory reaction were the findings. Conclusion: The local application of the $^{166}$Ho-chitosan complex attached to biodegradable gelatin material with surgery in the laboratory animals resulted in no mortality and morbidity, and satisfactory tissue necrosis. Holmium-166 can be applied to the treatment of the malignant tumor patients.

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Outcomes of Diffuse-Type Pigmented Villonodular Synovitis (PVNS) after Open Total Synovectomy (미만형 색소 융모 결절성 활액막염의 관혈적 활막 전 절제술 후 경과)

  • Lee, Mo-Ses;Lee, Soo-Hyun;Suh, Jin-Suck;Yang, Woo-Ik;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.1
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    • pp.27-36
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    • 2010
  • Purpose: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. Materials and Methods: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. Results: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. Conclusion: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.

The Clinical Results of ACL Reconstruction with Tibialis Allograft Using Hybrid Femoral Fixation and $Retroscrew^{(R)}$ (Hybrid 대퇴 고정과 $Retroscrew^{(R)}$를 사용한 동종 경골건 이용 전방 십자 인대 재건술의 임상적 결과)

  • Kim, Doo-Sub;Rah, Jung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.8-13
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    • 2009
  • Purpose: We used tibialis allograft for the reconstruction of ACL and used Hybrid femoral fixation utilizing $Endobutton^{(R)}$ and $Rigidfix^{(R)}$ for femoral fixation, and used $Retroscrew^{(R)}$ and additional fixation for tibial fixation to evaluate the clinical results. Materials and Methods: The ACL reconstruction were performed from February 2004 to February 2007 utilizing Hybrid femoral fixation and $Retroscrew^{(R)}$ and 32 patients, 32 cases which were available for year-long observation (12 to 25 months). The clinical results (Lysholm knee score, IKDC grade) and the radiologic results(bone tunnel expansion, Telos anterior displacement test) were evaluated. Results: The Lysholm knee score was improved from the average of $67.9{\pm}5.4$ points (range: 51~77) before operation and to $94.1{\pm}6.8$ points (range: 68~98) at the last follow up (p<0.05). 22 cases (69%) were evaluated normal (A), 9 cases (28%) were evaluated nearly normal (B) and only 1 case (3%) was evaluated not normal (C) at IKDC final evaluation and no case was evaluated abnormal. From $Telos^{(R)}$ stress x-ray evaluation, difference from the opposite knee was improved average 13.2 mm{\pm}5.8 (range: 6~21 mm) to average $3.4\;mm{\pm}2.8$ (range: 0~11 mm) after operation (p<0.05). The femoral and tibial tunnel were widened by 18.7% and 9.6% in the AP view and 12.4% and 8.5% in the lateral view, respectively (p<0.05). However, any statistic significance was not observed between bone tunnel expansion and knee joint functions (p>0.05). Conclusion: An ACL reconstruction with tibialis allograft using Hybrid femoral fixation and $Retroscrew^{(R)}$ enabled anatomical fixation of the graft tendon with satisfactory clinical results.

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Comparative Study on the Nurses' Job Satisfaction between the Oriental Medicine Ward and the General Ward (한방병동과 일반병동 간호사의 직무만족도의 비교연구)

  • Byun, Chang-Ja;Choi, Sang-Soon;Paik, Seung-Nam;Lee, Mi-Aie
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.97-111
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    • 1995
  • In our society today, a variety of medical caring system, along with a scientific development in the area of oriental medical science plus national demand, has increased the augmentation and the opening of oriental wards and hospitals (Han Bang), which has come to create an additional requirement of nursing activity at oriental medicine wards should be different from that of the general wards or the same as the other. In view of this, various studies need to be made in this connection. The purpose of this study is to comprehend the number of nurses who want to work at oriental medicine wards and measure job satisfaction in nursing as compared with those working at general wards so as to provide basic materials for future assignment and supplementary training for the nurses. An attempt was made to contribute toward nursing administration on the one hand improving nursing training course on the other hand. A total of 72 nurses currently working at two oriental medicine hospitals available in Seoul and 82 general nurses were selected for this study using the questionaire from December 1993 to January 1994. An instrument for the study was based on the measurement of work satisfaction developed by Paula L. Stamps including 37 questions complemented by Kim for revision (1993) and 14 questions regarding general characteristics and oriental medicine wards. The instrument to test dependability showed Cronbach's=0.7711. The collected data have been processed by computer package SPSS. General characteristics of the two groups and the matters involved in oriental medicine wards were calculated into real figure and percentage an similarities between the two groups were analyzed by t-test and F-test according to the characteristics of variables. The comparative test on work satisfaction among the two groups including general characteristics and work factors were conducted by t-test and F-test. The major findings as a result of the study are as follows : 1. As general characteristics, age group of $26{\sim}30$ years are more than any segment of age. As to marital status, the number of those in single status is slightly higher than the married. Approximately 80% of them are graduates of nursing schools and nursing colleges. They are mostly in service for one to three years. There is no significant difference between the two groups. 2. The number of those who want to work at oriental medicine wards represents 40.3% against 58.4%, being in favor of general wards. 3. The reason for service at oriental medicine wards is that "there is room for potential research" which happened to rank first, followed by "easy job," "good working atmosphere" and "growing interest in oriental medicine." 4. Work satisfactions among nurses who work at oriental medicine wards prove greater than that of nurses who work at general wards. 5. Work satisfaction between the two groups by work factors is reflected with significant difference statistically on task requirement, interaction and doctor-nurse relationships. 6. The general charcateristics and the work satisfaction by work factors prove that there are significant difference in age, marital status, education and the period of work. They tend to be more satisfied with the work as they grow in age. Significant differneces are found in the work factors such as autonomy, adiministration and professional job in the relationship with doctor-nurse. As to marital status, the married are more satisfied than the unmarried. There are significant differneces in the factors respecting administration and doctor-nurse college graduates are highly satisfied with task requirement. However, satisfaction with the professional level has proven the highest degree for those having master degree. The period of work and satisfaction : There are significant differneces in task requirement, administration, interactions, professional level and doctor-nurse relationships. As a general rule, the degree of satisfactions is in proportion to the lengrh of service. The following conclusions are drawn based on the fndings mentioned above. Even though the work satisfaction of the nurse who work at oriental medicine ward is relatively high, it is desired that personal consultation be given as to disposition of nurses when they are assigned to oriental medicine wards. It is also recommended that lectures on oriental medicine be conducted through supplementary training and/or basic nursing course in order that they may be motivated for ingenious activities with an increasing sense of self-esteem which will eventually enhance positive changes for the patients who are in need of oriental medicine nursing and for the medical teams. In addition, joint reseaches involvingclinical care and education should be in constant process for unique and scientific development for those who are subject to oriental medicine nursing care.

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Brief Observation on Arbitration Agreement and Arbitral Award - Focusing on Construction Disputes - (중재합의와 중재판정에 관한 소고 -건설분쟁을 중심으로-)

  • Cho Dae-Yun
    • Journal of Arbitration Studies
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    • v.14 no.1
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    • pp.273-314
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    • 2004
  • There is a belief in the construction industry that the traditional court system may not be an ideal forum to effectively and efficiently resolve construction disputes due to the protracted proceedings and the three tier appeal system resulting in a long delay in the final and conclusive settlement of the dispute, relatively high costs involved, the lack of requisite knowledge and experience in the relevant industry, etc. Hence, they assert that certain alternative dispute resolution ('ADR') methods, such as mediation, conciliation, arbitration or a new system for dispute settlement in the form of any combination thereof should be developed and employed for construction disputes so as to resolve them more promptly and efficiently to the satisfaction of all the disputants concerned. This paper discusses certain merits of such assertions and the need for additional considerations for effective resolution of the construction disputes in light of the complexity of the case, importance of expert witnesses, parties' relationship and non-level playing field of the construction industry and so on. At the same time, however, given the inherent nature of disputes rendering the parties involved in an adversarial position, it would rather be difficult, if not practically impossible, to satisfy all the parties concerned in the dispute. Accordingly, in this study, it is also purported to address the demerits of such assertions by studying the situation from a more balanced perspective, in particular, in relation to the operation of such ADRs. In fact, most of such ADRs as stipulated by special acts, such as the Construction Industry Basic Act of Korea, in the form of mediation or conciliation, have failed to get support from the industry, and as a result, such ADRs are seldom used in practice. Tn contrast, the court system has been greatly improved by implementing a new concentrated review system and establishing several tribunals designed to specialize in the review and resolution of specific types of disputes, including the construction disputes. These improvements of the court system have been warmly received by the industry. Arbitration is another forum for settlement of construction disputes, which has grown and is expected to grow as the most effective ADR with the support from the construction industry. In this regard, the Korean Commercial Arbitration Board ('KCAB') has established a set of internal rules end procedures in operation to efficiently handle construction disputes. Considering the foregoing, this paper addresses the most important elements of the arbitration, i.e., arbitration agreement and arbitral award, primarily focusing on the domestic arbitrations before the KCAB. However, since this parer is prepared for presentation at the construction disputes seminar for the public audience, it is not intended for academic purposes, nor does it delve into any specific acadcmic issues. Likewise, although this paper addresses certain controversial issues by way of introduction, it mainly purports to facilitate the understanding of the general public, including the prospective arbitrators on the KCAB roster without the relevant legal education and background, concerning the importance of the integrity of the arbitration agreement and the arbitral award. In sum, what is purported in this study is simply to note that there are still many outstanding issues with mediation, conciliation and arbitration, as a matter of system, institutional operation or otherwise, for further study and consideration so as to enhance them as effective means for settlement of construction disputes, in replacement of or in conjunction with the court proceeding. For this purpose, it is essential for all the relevant parties, including lawyers, engineers, owners, contractors and social activists aiming to protect consumers' and subcontractors' interests, to conduct joint efforts to study the complicated nature of construction works and to develop effective means for examination and handling of the disputes of a technical nature, including the accumulation of the relevant industrial data. Based on the foregoing, the parties may be in a better position to select the appropriate dispute resolution mechanism, a court proceeding or in its stead, an effective ADR, considering the relevant factors of the subject construction works or the contract structure, such as the bargaining position of the parties, their financial status, confidentiality requirements, technical or commercial complexity of the case at hand, urgency for settlements, etc.

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Glomus Tumor in Soft Tissue (연부 조직에 발생한 사구종)

  • Kim, Do-Yeon;Lee, Soo-Hyun;Kim, Min-Ju;Shin, Kyoo-Ho
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.34-43
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    • 2009
  • Purpose: Glomus tumors are rare benign vascular tumors, usually located in the skin or soft tissue of extremities. Approximately 30-50% of glomus tumors occur in subungal area, but glomus tumors have been described in every location even where glomus bodies are not or rarely present. The purpose of this study was to identify clinical, histologic and MRI characteristics of soft tissue glomus tumor. Materials and Methods: Between 1993 and 2008, eight patients underwent surgery of soft tissue Glomus tumor at our institution. Exclusion criteria were patients with Glomus tumors in digits, stomach, trachea and glomus tympanicum. We analyzed medical records, interviews, physical examinations, MR findings and histolocial types retrospectively. Results: There were four men and four women. The mean age was fourty-seven years. The mean prevalence time was eight-point-nine years. In the classic triad of symptoms, all eight patients had pain and tenderness. Two patients complained of cold sensitivity. Two showed skin color changes. After surgery, two showed symptom improvement (VAS $9^{\circ}{\rightarrow}8$, $8^{\circ}{\rightarrow}5$) and?six showed complete disappearance of symptoms. Slightly symptom improvemented (VAS $9^{\circ}{\rightarrow}8$) one had additional surgery two times after first surgery due to relapse/remaining Glomus tumor. The mean size was 13.9 mm. In histology, six were 'solid glomus tumor', one was a mixture of 'solid glomus tumor' and 'lomangioma' and one was 'malignant glomus tumor'. MR findings showed isointense signal on T1 image, high signal on T2 image and strong enhancement on the Gadolinium enhanced image. Conclusion: Glomus tumor has low recurrence rate and malignant change, rapid diagnosis and surgical excision is critical in treatment to prevent unnecessary pain of patient.

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The Effectiveness of Buprenorphine Transdermal Patch on Patients with Shoulder Pain: Short-Term Follow-up Study (견관절 통증을 동반한 동결견 환자에게서 Buprenorphine transdermal patch의 효과: 단기 추시 결과)

  • Hong, Jin Ho;Park, Yong Bok;Ryu, Ho Young;Jeon, Sang Jun;Park, Won Ha;Yoo, Jae Chul
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.7-12
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    • 2014
  • Purpose:The effectiveness of transdermal buprenorphine patch on the patients with frozen state of frozen shoulder was evaluated. Materials and Methods: Between March and September in 2013, 127 patients with pain and limited range of motion in shoulder joint over 6 months were included. Every patient was confirmed the diagnosis through MRI or ultrasonogram and each patient received intra-articular injection of steroid once. After 2~4 weeks, every patient was interviewed via telephone survey and finally 105 patients were included, 54 patients received only oral NSAIDs (NP group) while 51 patients received additional transdermal buprenorphine patch (BP group). Pain and functional visual analog scale (PVAS, FVAS), American Shoulder Elbow Society (ASES) score was checked. Results: Generally, every outcome variables showed improvements in both groups (p<0.001). PVAS score after treatment showed superior result in NP group but it was not significant (p=0.088). In ASES score, NP group had superior result than BP group and it had significant difference. Similarly in FVAS, NP group showed superior result but the data before treatment was significantly different (p=0.028) Conclusion: Transdermal buprenorphine patch didn't show superior treatment result in the patient with frozen state of frozen shoulder which was applied with oral NSAIDs after single intra-articular glenohumeral steroid injection in short-term follow-up.

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The Death Orientation of nursing students in Korea and China (한국과 중국 간호대학생의 죽음에 대한 의식)

  • Li, Zhen-Shu;Choe, Wha-Sook
    • Korean Journal of Hospice Care
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    • v.8 no.1
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    • pp.1-12
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    • 2008
  • Perpose: The purpose of this study was to investigate the perception of death between Korean and Chinese nursing students. And it will help develop curriculum for preparing death, the quality of hospice care, as well as nursing education and practice. Methods: Data was collected from 492 nursing students participated(248 Korean and 244 Chinese) by questionnaire designed for examining Death Orientation (Thorson & Powell, 1988). They were analyzed using Cronbach's Alpha coefficients, factor analysis, t-test, ANOVA and regression analysis (SPSS; win 12.0 version) Results: More than half of the Korean nursing students followed a religion (58.5%) while the majority of Chinese nursing students did not follow a religion (93.9%). In the view of the afterlife, nursing students in China had two views. 'I really don't know what happens after a person dies (30.3%)' and ‘There is no afterlife and death is the end (29.5%)’. On the other hand the Korean nursing students’ answer were, 'After dying, a person goes to heaven or hell (27.3%)' and 'I really don't know what happens after a person dies. (22.9%)' The study also found that the average of 25 items in Death Orientation is 2.36points of nursing students in Korea and 2.50points of nursing students in China. This means that the concern, anxiety and fear were of the middle level for the Chinese Students and were higher than Korean students (t=3.51, p=.000). In the low factor of death orientation, those in Korea had higher 'anxiety of burden to family' than those in China (t=-3.50, p=.001). The nursing students in China had higher 'anxiety of the unknown (t=4.96, p=.000)', 'fear of suffering (t=6.88, p=.000), 'fear of extinction body and life (t=5.20, p=.000), 'fear of lost self-control(t=2.12, p=.034)', and 'anxiety of future existence and nonexistence (t=2.33, p=.020)' than those in Korea. There was no statistically significant difference for the 'concern of body and fear of identity lost' category. The death orientation of Korean nursing students had statistically significant differences according to age (t=3.20, p=.002), religion (t=2.56, p=.011), and afterlife (F=4.64, p=.000). The contribution of Death Orientation had a statistically significant difference, the afterlife variable (0.735, p=0.001). The death orientation of Chinese nursing students did not have any statistically significant differences. Conclusion: In conclusion, there were differences in death orientation between Korean and Chinese nursing students. In particular, those who believed in afterlife showed acceptance of death. The results of this study suggest that nursing curricula should include education program on death and spiritual nursing. Additional studies are needed to establish death education in China with careful considerations on Chinese policies, cultures and social systems.

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An exploratory study on the characteristics of technology innovation persistence of Korean firms (한국 기업의 기술혁신 지속 특성에 대한 탐색적 연구)

  • Song, Changhyeon;Lee, Jungwoo;Jang, Pilseong
    • Journal of Technology Innovation
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    • v.29 no.3
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    • pp.1-31
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    • 2021
  • With the growing importance of technology innovation as a key factor for firms' competitive advantage, 'innovation persistence' became also an important research subject. 'Innovation Persistence' is a concept that indicates whether or not firms' innovation activity or performance continues. However, the data used for innovation studies are carried out as cross-sectional surveys in most countries. For this reason, studies dealing with longitudinal aspect of innovation persistence are rare. In particular, there is almost no research on innovation persistence using Korean innovation survey data. This study reviews the concepts and characteristics of innovation persistence based on extant literature, and perform an empirical analysis on the status and features of Korean firms' technology innovation persistence. Based on the data of the Korean Innovation Survey (KIS) conducted every other year from 2012 to 2018, panel data on 3,379 firms which observed multiple times are constructed. As a result, only part of the firms with persistent innovation were observed (for innovation performance 10~12%, for innovation activity 15~17%), and it was found that the persistence of non-innovation was remarkable(about 52~57%). And it was confirmed that the persistence of innovation activities is stronger than that of innovation performance. Besides, some features by sub-types of innovation appeared. Product innovation showed higher persistence than process innovation, and internal R&D also showed higher persistence than joint/external R&D. As a result of additional logit analysis to identify factors, it was found that radical or gradual product innovation is the most influential factor in persisting innovation in the next period. Since the sample selection bias due to a limitations of raw data might exist in the panel data constructed in this study, it should be noted that faulty generalization of the results are not allowed. Nevertheless, this is the first study to examine the technology innovation persistence targeting Korean firms and is expected to be a starting point for follow-up studies. It is anticipated that advanced research results will be drawn through the establishment of official panel data and improved methodologies.

Anterolateral Ligament of the Knee: Anatomy, Biomechanics, Techniques, and Clinical Outcome (슬관절 전외측인대의 해부학, 생역학, 수술법 및 임상적 결과)

  • Kim, Seong Hwan;Lee, Tae-Hyub;Park, Yong-Beom
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.281-293
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    • 2020
  • An anterior cruciate ligament (ACL) reconstruction is one of the most frequent surgical procedures in the knee joint, but despite the better understanding of anatomy and biomechanics, surgical reconstruction procedures still fail to restore rotational stability in 7%-16% of patients. Hence, many studies have attempted to identify the factors for rotational laxity, including the anterolateral ligament (ALL), but still showed controversies. Descriptions of the ALL anatomy are also confused by overlapping nomenclature, but it is usually known as a distinctive fiber running in an anteroinferior and oblique direction from the lateral epicondyle of the femur to the proximal anterolateral tibia, between the fibular head and Gerdy's tubercle. The importance of the ALL as a secondary restraint in the knee has been emphasized for successful ACL reconstructions that can restore rotational stability, but there is still some controversy. Some studies reported that the ALL could be a restraint to the tibial rotation, but not to anterior tibial translation. On the other hand, some studies reported that the role of ALL in rotational stability would be limited as a secondary structure because it bears loads only beyond normal biomechanical motion. The diagnosis of an ALL injury can be performed by a physical examination, radiology examination, and magnetic resonance imaging, but it should be assessed using a multimodal approach. Recently, ALL was considered one of the anterolateral complex structures, as well as the Kaplan fiber in the iliotibial band. Many studies have introduced many indications and treatment options, but there is still some debate. The treatment methods are introduced mainly as ALL reconstructions or lateral extra-articular tenodesis, which can achieve additional benefit to the knee stability. Further studies will be needed on the indications and proper surgical methods of ALL treatment.