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Clinical and Radiographic Outcome of Shoulder Function after Unreamed Antegrade Intramedullary Nailing for Humerus Fracture: Ultrasonographic Evaluation for Rotator Cuff Integrity (비확공성 전향적 상완골 금속정 고정술후 견관절 기능에 대한 임상적 및 방사선학적 평가: 초음파를 이용한 회전근 개 추시관찰)

  • Baek, Seung-Hoon;Choi, Chang-Hyuk
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.6 no.1
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    • pp.1-9
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    • 2013
  • Purpose: The purpose is to perform objective evaluation for rotator cuff using ultrasonography and validate factors influencing cuff integrity as well as efficacy of follow-up ultrasonography after unreamed antegrade intramedullary nailing for humerus fracture. Materials and Methods: Seventeen patients with an average age of $55.7{\pm}18.6$ years underwent antegrade intramedullary nailing for humerus fracture and follow-up ultrasonography of shoulder joint. Mean follow-up period was $43.5{\pm}32.2$ months. Intraoperative evaluation for preoperative cuff tear was performed, of which four cuffs were repaired by single row repair technique. Clinical evaluation included visual analogue scale (VAS), range of motion, Korean Shoulder Scoring System (KSS) and American Shoulder and Elbow Society (ASES) score. Ultrasonographic evaluation was performed on cuff integrity and protrusion of proximal nail tip as well. Radiographic evaluation included time to union, protrusion of proximal nail tip and migration of proximal interlocking screw which could affect shoulder joint function. Results: Mean VAS at last follow-up was $1.65{\pm}1.84$ points. Range of motion showed forward flexion of $137.0{\pm}33.5^{\circ}$, external rotation of $43.5{\pm}12.7^{\circ}$ and internal rotation of $16.4{\pm}2.0^{\circ}$ while KSS score and ASES score were $79.6{\pm}20.7$ and $83.7{\pm}17.0$ points, respectively. Bone union was demonstrated in all cases and average time to union was $3.4{\pm}1.3$ months. Migration of proximal interlocking screw was shown in 6 cases (35%). On ultrasonographic evaluation, there were normal in 8 (47%), weaving in 4 (24%), partial tear in 5 cases (29%), but no complete tear. Protrusion of proximal nail tip was demonstrated in 8 cases (47%) on plain radiographs whereas in 11 cases (65%) on ultrasonography and was associated with increasing age (p=0.038). Ultrasonographic weaving and partial tear was associated with protrusion of proximal nail tip (p=006), but not with repair of preoperative tear (p>0.05). Conclusion: Because weaving and partial tear on ultrasonography originated from protrusion of proximal nail tip, careful insertion of nail and meticulous repair of cuff during operation lead to stable fixation with satisfactory recovery of shoulder function follow-up ultrasonography can be a useful tool for evaluating protrusion of nail tip and rotator cuff tear, of which diagnosis is difficult on plain X-ray after antegrade intramedullary nailing for humerus fracture.

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Arthroscopic Treatment of Greater Tuberosity fracture - Preliminary Report - (상완골 대결절 골절 손상에 대한 관절경적 치료 -예비 보고-)

  • Ji, Jong-Hoon;Kim, Young-Yul;Park, Sang-Eun;Ra, Ki-Hang;Do, Jeong-Hun;Kim, Weon-Yoo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.57-65
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    • 2007
  • Purpose: The purpose of this study was to evaluate the clinical result of arthroscopic treatments by using suture anchors or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture. Materials and Methods: From March 2004 to March 2006 we have used suture anchor or suture anchors combined with cannulated screw for 6 cases of the greater tuberosity fracture which include displaced fractures, comminuted fractures and minimally displaced fractures with comcomittent lesions such as rotator cuff tears, stiffness and labral lesion. In this retrospective study, we analyzed the clinical outcomes by using the range of motion, University of California at Los Angeles shoulder rating scale (UCLA) and the ASES shoulder index score (ASES) in the average 6 months follow up. Results: At the last follow up, average range of motion was improved to 154.3 degree, 145.8 degree, 32.6 degree and L1 vertebrae in each forward flexion, abduction, external rotation and internal rotation. Clinically the UCLA rating scales improved to 31.5 and the ASES shoulder index score (ASES) improved to 93.6 in the last follow up. Conclusion: Arthroscopic treatments by using suture anchor or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture is an alternative treatment of the greater tuberosity fracture of the proximal humerus fracture.

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The Use of Arthroscopic UU Stich for Rotator Cuff Tear and Clinical Results (회전근 개 파열의 관절경하 봉합에서 새로운 봉합 방법의 이용)

  • Ko, Sang-Hun;Shin, Seung-Myeong;Choi, Young-Jin;Cha, Jae-Ryong;Park, Han-Chang
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.67-72
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    • 2011
  • Purpose: There are various known methods for arthroscopic rotator cuff repair. The purpose of this retrospective study is to report on the clinical results and anatomical results of UU repair surgery, which is a new repair method. Materials and Methods: We enrolled 156 patients (88 men and 68 women) who underwent UU repair for rotator cuff tears from January 2009 to May 2010 in our hospital. Their average age was 55 years old (range: 38~75 years old) and the average follow-up period was 12 months (range: 6~23 months). For determining the results, we evaluated the VAS for pain, the daily living index (ADL) in the ASES scores, the UCLA and KSS scores, and all these tests were conducted at the first hospital visit and 6 months and 1 year after surgery and at the final follow-up. During the follow-up period, MRI was performed 3 and 6 months after surgery only in the patients who consented to MRI scans to confirm the presence of re-rupture. Results: The average scores of the VAS as a pain indicator decreased from 7.0 before surgery to 2.7 after surgery (p<0.05). The UCLA and KSS scores increased from 22.2 to 32.5 and from 83.7 to 91.5, and the changes was significant (p<0.05). For the active joint range of motion, the average forward flexion was improved from 125 to 175 degrees, the average lateral external rotation was improved from 38 to 58 degrees, and the average abduction was improved from 104 to 169 degrees. Out of a total of 156 patients, re-rupture was observed in 4 cases (3%) of 117 cases (75%) for which MRI was performed (with consent) between 3 and 6 months after surgery. Conclusion: UU repair surgery as arthroscopic repair of rotator cuff tear is a good repair method that shows excellent clinical results and a low re-rupture rate.

Development an Artificial Neural Network to Predict Infectious Bronchitis Virus Infection in Laying Hen Flocks (산란계의 전염성 기관지염을 예측하기 위한 인공신경망 모형의 개발)

  • Pak Son-Il;Kwon Hyuk-Moo
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.105-110
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    • 2006
  • A three-layer, feed-forward artificial neural network (ANN) with sixteen input neurons, three hidden neurons, and one output neuron was developed to identify the presence of infectious bronchitis (IB) infection as early as possible in laying hen flocks. Retrospective data from flocks that enrolled IB surveillance program between May 2003 and November 2005 were used to build the ANN. Data set of 86 flocks was divided randomly into two sets: 77 cases for training set and 9 cases for testing set. Input factors were 16 epidemiological findings including characteristics of the layer house, management practice, flock size, and the output was either presence or absence of IB. ANN was trained using training set with a back-propagation algorithm and test set was used to determine the network's capability to predict outcomes that it has never seen. Diagnostic performance of the trained network was evaluated by constructing receiver operating characteristic (ROC) curve with the area under the curve (AUC), which were also used to determine the best positivity criterion for the model. Several different ANNs with different structures were created. The best-fitted trained network, IBV_D1, was able to predict IB in 73 cases out of 77 (diagnostic accuracy 94.8%) in the training set. Sensitivity and specificity of the trained neural network was 95.5% (42/44, 95% CI, 84.5-99.4) and 93.9% (31/33, 95% CI, 79.8-99.3), respectively. For testing set, AVC of the ROC curve for the IBV_D1 network was 0.948 (SE=0.086, 95% CI 0.592-0.961) in recognizing IB infection status accurately. At a criterion of 0.7149, the diagnostic accuracy was the highest with a 88.9% with the highest sensitivity of 100%. With this value of sensitivity and specificity together with assumed 44% of IB prevalence, IBV_D1 network showed a PPV of 80% and an NPV of 100%. Based on these findings, the authors conclude that neural network can be successfully applied to the development of a screening model for identifying IB infection in laying hen flocks.

Harmonization of Hemolysis Index in Clinical Chemistry Laboratory and Its Application as a Result Verification Tool (화학검사 결과의 검증을 위한 용혈 지수 일치화 도구 개발)

  • Pyo, Sang Shin;Nam, Hyun Su;Cha, Young Jong;Lee, Seungkwan;Lee, Hae Kyung
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.4
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    • pp.350-358
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    • 2017
  • The hemolysis index (HI) is semi-quantitative marker for hemolysis. Because the characteristics of the HI vary from one commercial platform to another, no standardization or harmonization of the HI is currently available. Specimens (N=40) randomly selected from clinical patients were artificially hemolyzed in vitro. The serum of the specimens was then diluted with a 20 mg/dL difference between 0~300 mg/dL based on serum hemoglobin measured using the XE-2100 hematology automation equipment (Sysmex, Japan). Diluted serum was measured using the Hitachi-7600 biochemical automation equipment (Hitachi, Japan) to differentiate between HI and serum hemoglobin. The data showed linearity between HI and serum hemoglobin and that HI 1 contained approximately 20 mg/dL of serum hemoglobin. To determine the blood rejection threshold, the HI was divided into three groups: HI 0~1, HI 4~6, HI 9~15. After another batch of clinical specimens (N=40) was measured using a Hitachi-7600 (Hitachi, Japan), each specimen was moved forward and backward with the piston of the syringe to induce an artificial in vitro hemolysis, then measured again with a Hitachi-7600 (Hitachi, Japan). The percentage difference between the three groups was analyzed by ANOVA or the Kruskal-Wallis test. In the post-test, there were significant differences between the HI 0~1 and the HI 5~6: Glucose, creatinine, total protein, AST, direct bilirubin, uric acid, phosphorus, triglyceride, LDH, CPK, Magnesium, and potassium levels. Because many clinical tests differed significantly, the threshold for hemolysis could be appropriate for HI 5 (serum hemoglobin 100 mg/dL).

Correlation between the Seoul Neuropsychological Screening Battery of the Parkinson's Disease Patient with Mild Cognitive Impairment and Change of the Cerebral Ventricle Volume in the Brain MRI (경도인지장애를 동반한 파킨슨병 환자의 서울신경심리검사와 뇌 자기공명영상에서 뇌실 체적 변화에 대한 상관관계)

  • Lee, Hyunyong;Kim, Hyeonjin;Im, Inchul;Lee, Jaeseung
    • Journal of the Korean Society of Radiology
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    • v.8 no.5
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    • pp.231-240
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    • 2014
  • The purpose of this study were to analyze that the Seoul neuropsychological screening battery (SNSB) for the evaluating cognitive assessment of the Parkinson's disease patients with mild cognitive impairment (PD-MCI) and the changes of the cerebral ventricle volume in the brain magnetic resonance imaging (MRI), and we has been bring forward the guideline to determine the diagnostic criteria for the PD-MCI. To achieve this, we was diagnosed with Parkinson's disease patients (PD-MCI group: 34 patients; Parkinson's disease with normal cognition, PD-NC group: 34 patients) to perform the SNSB test for the attention, language, memory, visuospatial, and frontal/executive functions and the brain MRI. Additionally, to compared the change of the cerebral ventricle volume, we performed the brain MRI for the 32 normal control (NC) group. The volumetric analysis for a specific cerebral ventricle performed by using Freesurfer Ver. 5.1 (Massachusetts general Hospital, Boston MA, USA). As a results, compared to the PD-NC group, the PD-MCI group were statistically significant reduction in the ability to perform the memory and the visuospatial function (p<0.05). The volumetric changes for a specific cerebral ventricle were statistically significant variation in the left and right lateral ventricle, left and right inferior lateral ventricle, and 3rd ventricle. Although, in order to compared the objectification, the normalized percentage applied to the volumetric changes showed to extend the PD-MCI group than the PD-NC group. Specially, the left and right ventricle extension for the PD-MCI patients conspicuously had showed a quantitative linear relationship between the memory and the visuospatial function for the SNSB (r>0.5, p<0.05). Therefore, we were able to judge the diagnostic criteria of the PD-MCI through that can observe the volumetric variation of the specific cerebral ventricle by using Freesurfer in brain MRI, and to analyze the correlation between the SNSB.

The Changing Patterns of Demand-Supply and Role of Mineral Resources in Economic Growth during Industrialization of the Republic of Korea (한국공업화과정(韓國工業化過程)에서의 광물자원(鑛物資源)의 수급구조변화(需給構造變化)와 경제성장(經濟成長)에 있어서의 역할(役割))

  • Yun, Suckew
    • Economic and Environmental Geology
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    • v.18 no.1
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    • pp.65-92
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    • 1985
  • A total of 12 mineral commodities significant in domestic output, economy and/or strategy of the Republic of Korea are chosen to examine the structural changes in production and demand-supply of these minerals during the last two decades of her industrialization. These include iron and manganese ores as the raw materials for iron and steel making, copper, zinc and tungsten ores among other non-ferrous metallic minerals, limestone (cement), kaolin, talc, pyrophyllite and graphite among other non-metallic minerals, and anthracite coal as the only domestic source of fossil energy. These are reviewed historically in time-series based on the statistical data which are tabulated and graphed in terms of domestic output, export, import, apparent demand-supply, its increasing rate, and self-sufficiency rate of each commodity. The increasing rates of demand-supply (IRDS) of some more important commodities are compared with those of Gross Domestic Production (GDP) and Economic Growth Rate (EGR) to evaluate how the IRDS contributed to the GDP and EGR. The major results revealed are as follows: Among the 12 commodities, the domestic output of 8 commodities appeared to have grown with steady upward trends: they are ores of lead, zinc and tungsten, limestone (cement), kaolin, talc, pyrophyllite and anthracite coal. Two commodities, ores of iron and copper, continued with unchanging or slightly declining trends and varied fluctuations, in spite of their cardinal importance to the heavy industry and strategy of Korea. The remaining two, graphite and manganese ore, have gradualy declined in domestic output in which the former has still enough resource potential but the latter has not and virtually ceased its domestic output. Trade patterns for mineral commodities in the Republic of Korea during the last two decades have changed greatly, being marked by a shift from mineral-exporting to mineral importing, mainly because of increasing consumption of mineral raw materials for industrialization rather than beceuse of decreasing output of domestic mineral commodities in quantity. In terms of trade patterns, the 12 commodities concerned in this study can be classified into the following four groups. The 1st group - ores of lead and tungsten have only been exported without imports. The 2nd group - amorphous graphite, and pyrophyllite have mainly been exported but partly been imported. The 3rd group - kaolin, talc and crystalline graphite have equally been exported and imported, but quantity of imports have rapidly been increased with time. The 4th group - ores of iron, manganese and zinc have shifted from exports to imports during the industrialization, particularly owing to the initiation of iron and steel making by the Pohang Iron and Steel Company in the middle 1970' s and the new establishment of the Onsan Zinc Refinery in the late 1970' s. All of the 12 commodities under considerations were far above 100% in self-sufficiency rate before or in the early 1960' s. Recently, however, most of them have been declined to below 100% except for those of limestone (cement) and pyrophyllite. It is particularly serious to identify that the self-sufficiency rates of the three important metallic minerals, iron, copper and manganese ores in 1982 appeared to be 5.1%, 0.5%, and 0.01%, respectively. The average self-sufficiency rate of the total domestic minerals produced in 1982 was 14.4% (in value) for that year. Mining industry appeared to be extremely high in its intermediate demand rate whereas its intermediate input rate to be quite low indicating that mineral raw materials have been exerted strong forward linkage effects upon the other industries rather than backward linkage effects. In comparing the curves of increasing rates of demand-supply of several major minerals - iron ore, manganese ore, copper ore, limestone (cement), kaolin, and anthracite coal - with those of Gross Domestic Production and Economic Growth Rate drawn on every graph, it is clearly shown that the curves of increasing rates of demand-supply comprise around 6 to 7 periods of cycles which roughly harmonious with those of the curves of GDP and EGR, except for the curve of anthracite coal of which the configuration seems to have resulted from the (artificial) government's mineral policy rather than from economic free market mechanism. The harmonic feature of these curves well suggests that the increasing rates of demand-supply of major minerals have been significantly contributed to the GDP and EGR. In addition, the wider amplitudes of the iron, manganese and copper curves than those of the limestone (cement) and kaolin curves indicate that the contribution of the former, metallic commodities, has been greater than that of the latter, non-metallic commodities.

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Suggestion for Technology Development and Commercialization Strategy of CO2 Capture and Storage in Korea (한국 이산화탄소 포집 및 저장 기술개발 및 상용화 추진 전략 제안)

  • Kwon, Yi Kyun;Shinn, Young Jae
    • Economic and Environmental Geology
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    • v.51 no.4
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    • pp.381-392
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    • 2018
  • This study examines strategies and implementation plans for commercializing $CO_2$ capture and storage, which is an effective method to achieve the national goal of reducing greenhouse gas. In order to secure cost-efficient business model of $CO_2$ capture and storage, we propose four key strategies, including 1) urgent need to select a large-scale storage site and to estimate realistic storage capacity, 2) minimization of source-to-sink distance, 3) cost-effectiveness through technology innovation, and 4) policy implementation to secure public interest and to encourage private sector participation. Based on these strategies, the implementation plans must be designed for enabling $CO_2$ capture and storage to be commercialized until 2030. It is desirable to make those plans in which large-scale demonstration and subsequent commercial projects share a single storage site. In addition, the plans must be able to deliver step-wised targets and assessment processes to decide if the project will move to the next stage or not. The main target of stage 1 (2019 ~ 2021) is that the large-scale storage site will be selected and post-combustion capture technology will be upgraded and commercialized. The site selection, which is prerequisite to forward to the next stage, will be made through exploratory drilling and investigation for candidate sites. The commercial-scale applicability of the capture technology must be ensured at this stage. Stage 2 (2022 ~ 2025) aims design and construction of facility and infrastructure for successful large-scale demonstration (million tons of $CO_2$ per year), i.e., large-scale $CO_2$ capture, transportation, and storage. Based on the achievement of the demonstration project and the maturity of carbon market at the end of stage 2, it is necessary to decide whether to enter commercialization of $CO_2$ capture and storage. If the commercialization project is decided, it will be possible to capture and storage 4 million tons of $CO_2$ per year by the private sector in stage 3 (2026 ~ 2030). The existing facility, infrastructure, and capture plant will be upgraded and supplemented, which allows the commercialization project to be cost-effective.

Study on the Characteristics of EEG in Resting State on Visuo-Spatial Working Memory Performance (시공간 작업기억 수행능력에 따른 안정상태에서의 뇌파 특성 연구)

  • Jung, Chul-Woo;Lee, Hyeob-Eui;Wi, Hyun-Wook;Choi, Nam-Sook;Park, Pyong-Woon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.4
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    • pp.351-360
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    • 2016
  • The purpose of this study is to predict visual-spatial working memory performance through the characteristics of an electroencephalogram (EEG) in the resting state. The 31 study participants, middle school students with various to academic performance, were underwent visual-spatial working memory test in the Comprehensive Attention Test (CAT) on December in 2014. Each 7 and 6 participants were divided into an Excellent Working Memory (EWM) group and Poor Working Memory (PWM) group depending on the forward/backward working memory scores. The EEG measurements and analysis of the data from a Brain Function Tester were performed by the two groups. A Mann-Whitney Test was used to examine the statistical differences between them. The activation of high beta (${\beta}H$) at the Fp1 and Fp2 sites in the left and right hemisphere, and that of the low beta (${\beta}L$) in the right hemisphere in the EWM group was significantly higher than that in the PWM group. In conclusion, there is a correlation between the visual-spatial working memory performance and the activation of ${\beta}H$ and ${\beta}L$ in the resting state and a close correlation that of ${\beta}L$ in the right hemisphere in terms of mental activity and faculty. Therefore, the visual-spatial working memory performance can be predicted by the activation of ${\beta}H$ and ${\beta}L$ in the resting state. The activation of EEG can be applied as an assessment tool and provide basis data for visual-spatial working memory performance.

A Study on the Screening of the Novel Genes Associated with Lysosomal Trafficking and Mutation Detection in Fibroblasts of the Patients with Mucolipidosis type II and III (리소좀 교통 이상을 초래하는 뮤코지방증 2형과 3형 환자의 섬유아세포를 이용한 신규 유전자 탐색 및 돌연변이에 대한 연구)

  • Song, Seng Mi;Chang, Soo Hee;Paik, Kyung Hoon;Jin, Dong-Kyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.5 no.1
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    • pp.65-75
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    • 2005
  • Purpose: To understand genetic differences and similarities between mucolipidosis and control. Methods: Using the fibroblast of the mucolipidosis II and control, forward and reverse subtracted libraries were constructed. Among these clones, we investigated mutations in the GNPTA (MGC4170) gene, which codes for the ${\alpha}/{\beta}$ subunits of phosphotransferase, and in the GNPTAG gene, which codes for the ${\gamma}$ subunits in 5 Korean patients with mucolipidosis type II or IIIA. Result: Several differentially expressed cDNAs were cloned and their sequences were determined. Mutation analysis of the interested gene, GNPTA was performed and we identified 7 mutations in the GNPTA gene, but none in the GNPTAG gene. The mutations in type II patients included p.Q104X(c.310C>T), p.R1189X(c.3565C>T), p.S1058X(c.3173C>G), p.W894X(c.2681G>A) and p.H1158fsX15(c.3474_3475delTA), all of which are non-sense or frame shift mutations. However, a splicing site mutation, IVS13+1G>A (c.2715+1G>A) was detected along with a non-sense or a frame shift mutation (p.R1189X or p.E858fsX3(c.2574_2575delGA)) in two mucolipidosis type IIIA patients. Conclusion: This report shows that mutations in the GNPTA gene coding for the ${\alpha}{\beta}$subunits of phosphotransferase, and not mutations in the GNPTAG gene, account for most of mutations found in Korean patients with mucolipidosis type II or IIIA.

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