• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.159-166
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• 2009

Purpose: We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique Materials and Methods: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated. Results: We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was $3^{\circ}$(range: $0^{\circ}\sim25^{\circ}$), the mean flexion was $137^{\circ}$(range: $130^{\circ}\sim140^{\circ}$), the mean pronation was $69^{\circ}$(range: $45^{\circ}\sim90^{\circ}$) and the mean supination was $78^{\circ}$(range: $45^{\circ}\sim90^{\circ}$). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability. Conclusion: The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.

• Journal of the Computational Structural Engineering Institute of Korea
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• v.33 no.3
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• pp.171-178
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• 2020

In this study, we develop MPI-OpenMP hybrid parallelization for multibody peridynamic simulations. Peridynamics is suitable for analyzing complicated dynamic fractures and various discontinuities. However, compared with a conventional finite element method, nonlocal interactions in peridynamics cost more time and memory. In multibody peridynamic analysis, the costs increase due to the additional interactions that occur when computing the nonlocal contact and ghost interlayer models between adjacent bodies. The costs become excessive when further refinement and smaller time steps are required in cases of high-velocity impact fracturing or similar instances. Thus, high computational efficiency and performance can be achieved by parallelization and optimization of multibody peridynamic simulations. The analytical code is developed using an Intel Fortran MPI compiler and OpenMP in NURION of the KISTI HPC center and parallelized through MPI-OpenMP hybrid parallelization. Further parallelization is conducted by hybridizing with OpenMP threads in each MPI process. We also try to minimize communication operations by model-based decomposition of MPI processes. The numerical results for the impact fracturing of multiple bodies show that the computing performance improves significantly with MPI-OpenMP hybrid parallelization.

• Journal of Trauma and Injury
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• v.29 no.4
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• pp.204-208
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• 2016

For an orthopaedic surgeon, the critical decisions to either amputate or salvage a limb with severe crushing injury with progressive ischemic change due to arterial rupture or occlusion can become a clinical dilemma at the Emergency Department (ED). And reperfusion injury is one of the fetal complications after vascular reconstruction. The authors present a case which was able to save patient's life by rapid vessel ligation at bedside to prevent severe reperfusion injury. A 43-year-old male patient with no pre-existing medical conditions was transported by helicopter to Level I trauma center from incident scene. Initial result of extended focused assessment with sonography for trauma (eFAST) was negative. The trauma series X-rays at the trauma bay of ED showed a multiple contiguous rib fractures with hemothorax and his pelvic radiograph revealed a complex pelvic trauma of an Anterior Posterior Compression (APC) Type II. Lower extremity computed tomography showed a discontinuity in common femoral artery at the fracture site and no distal run off. Surgical finding revealed a complete rupture of common femoral artery and vein around the fracture site. But due to the age aspect of the patient, the operating team decided a vascular repair rather than amputation even if the anticipated reperfusion time was 7 hours from the onset of trauma. Only two hours after the reperfusion, the patient was in a state of shock when his arterial blood gas analysis (ABGA) showed a drop of pH from 7.32 to 7.18. An imminent bedside procedure of aseptic opening the surgical site and clamping the anastomosis site was taken place rather than undergoing a surgery of amputation because of ultimately unstable vital sign. The authors would like to emphasize the importance of rapid decision making and prompt vessel ligation which supply blood flow to the ischemic limb to increase the survival rate in case of profound reperfusion injury.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.150-157
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• 2008

Purpose: We wanted to evaluate the results of surgical treatment for fracture of the scapular body. Materials and methods: The subjects of this study were seven patients with fracture of the scapular body and all these patients were managed surgically. We considered the operative indications as being 100% translation of the lateral border, or $25^{\circ}$ of angular deformity of the glenoid, or 1cm medialization or the variant of the double disruption of the superior scapular suspensory complex. There were five males and two females, and their ages ranged between 40 and 58 years (mean age: 49) with average follow up of 11 months (6~24 months). Two patients sustained multiple fractures of the ribs and spines. The surgical results were evaluated according to the subjective satisfaction, the UCLA score and the Korean shoulder score. Results: The mean UCLA score was 29 (17~33) and the mean Korean shoulder score was 86 (63~94). The self assessment for subjective satisfaction was 7.7 (4~9). There were two complications; one case of screw pull-out without the loss of the fracture fixation and the other case with screw penetration of the glenoid cavity. Conclusion: Surgical treatment may be effective for the management of severely displaced fracture of the scapular body in order to prevent the impairment of the shoulder function caused by the altered glenohumeral and scapulothoracic kinematics.

• The Journal of Engineering Geology
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• v.27 no.3
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• pp.233-244
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• 2017

We conducted hydraulic fracturing experiments on cement samples to investigate the dependency of fracture propagation on the viscosity of injection fluid and the in situ stress state. Ten cubic samples (20 cm side length) were produced using cement that was cured in water for more than one month. Samples were placed in a tri-axial compression apparatus with three independent principal stresses. An injection hole was drilled and the sample was hydraulically fractured under a constant injection rate. We measured injection pressures and acoustic emissions (AE) during the experiments, and investigated the fracture patterns produced by hydraulic fracturing. Breakdown pressures increased exponentially with increasing viscosity of the injection fluid. Fracture patterns were dependent on differential stress (i.e., the difference between the major and minor principal stresses). At low differential stress, multiple fractures oriented sub-parallel to the major principal stress axis propagated from the injection hole, and in some samples the fracture orientation changed during propagation. However, at high differential stress, a single fracture propagated parallel to the major principal stress axis. AE results show similar patterns. At low differential stress, AE source locations were more widespread than at high differential stress, consistent with the fracture pattern results. Our study suggests that hydraulic fracturing during shale gas extraction should be performed parallel to the orientation of minimum differential stress.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.4
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• pp.296-303
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• 2016

This study was performed to evaluate the effect of hemoglobin (Hb) on bone mineral density (BMD) in university students by performing a quantitative analysis. The subjects included healthy university students aged 20 to 30 years. Although osteoporosis has traditionally been considered as a disease of aging women, it is becoming an increasingly concerning male health problem. Diagnosis of osteoporosis is calculated with a quantitative assessment of BMD. Laboratory blood and urine tests are mainly used with low BMD or fragility fractures to identify any possible causes of bone metabolism disorders. In this study, there was no difference in BMD according to gender. The average red blood cell (RBC), Hb, and Hematocrit (HCT) were significantly higher in males (p<0.01). The correlation between lumbar spine, skeletal muscle mass (SMM), and basal metabolic rate (BMR) was statistically significant (p<0.01). Hb showed a 51.7% statistical influence on BMD by multiple regression analysis. These findings are useful to understand the relationship between BMD and Hb; lower Hb level is associated with lower BMD. The Hb level was the strongest predictor of abnormal BMD. In conclusion, this study showed that a low Hb value was significantly correlated with low bone mass, suggesting that a low Hb value is a risk factor for changes in bone turnover that leads to a decrease bone density.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.1
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• pp.42-48
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• 2006

Open reduction and rigid internal fixation is the most popular treatment method for maxillofacial fracture patients, and it is unevitable that postoperative pain can be developed. Many surgeons including oral & maxillofacial surgeons have made constant efforts to decrease postoperative pain. This study is a comparison of postoperative analgesia and intramuscular analgesia in patients with mandibular fractures. In this study, twenty-one patients (Experimental group) were randomly selected and they were injected with IV patient-controlled analgesia (PCA; Walkmed$^{(R)}$, USA). For control group another twenty-one patients were injected with intramusclar non-steroid anti-inflammatory drugs (Rheoma$^{(R)}$, Samsung Pharm. Co.). And then, we measured visual analogue scale (VAS) scores from first postoperative day to second day at regular time interval. The following results were uptained; 1. In patient group who with open reduction and rigid internal fixation, there was significant difference of postoperative analgesic effect during the first postoperative day(p<0.05). 2. In patient group with over 90 minutes surgery time, there was significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p<0.05). 3. In patient group with less than 90 minutes surgery time, there was no significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p>0.05). 4. In patient group with surgery of open reduction using rigid internal fixation at single fractured site, there was no significant difference of postoperative analgesic effect during the first and second postoperative day when compared between experimental group and control group(p>0.05). 5. In patient group with surgery at two fractured sites, there was significant difference of postoperative analgesic effect during the first postoperative day when compared between experimental group and control group(p<0.05). As mentioned above, it suggest that patient-controlled analgesia is more effective for postoperative pain relief than intramuscular injection in patients with rigid internal fixation by open reduction after mandibular fracture occurred. Especially, it is considered that in patient with more than 90 minutes surgery time or in cases with multiple fractured sites had more effective results with PCA therapy than conventional intramuscular analgesics.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.4
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• pp.438-452
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• 2005

Statement of problem: The use of Ceromer is increasing in dentistry. But, the research of Ceromer has not been conducted much. Purpose : This study was to evaluate the marginal fidelity and internal adaptation according to marginal position. Materials and Methods: In this study 60 resin crowns were fabricated. The measurements of the marginal fidelity were carried out using stereomicroscope $SZ-40^{(R)}$ (Olympus, Japan) and the measurements of fracture strength were done using Instron $8871^{(R)}$ (Instron Co., U.S.A.) at a cross head speed of 1mm/min. All of the measurements were statistically analyzed by ANOVA test, multiple range test and Weibull analysis. Statistical significance was set in advance at the probability level of less than 0.05. All of the measurements were analyzed with Window $SPSS^{(R)}$ Version 10.0 soft ware for the personal computer. Results : 1. There were no statistical differences of the marginal fidelity between $Targis^{(R)}$ and $Tescera^{(R)}$, but difference between these two and $BelleGlass^{(R)}$ according to materials. 2. There were no statistical differences of the marginal fidelity between no fiber group and fiber group. There were no interactions between each maerial and with/without fiber group in the marginal fidelity 3. There were statistical differences of the fracture strength between $Tescera^{(R)}$ and $BelleGlass^{(R)}$ but no statistical differences of the fracture strength between $Targis^{(R)}$ and $Tescera^{(R)}$, $Targis^{(R)}$ and $BelleGlass^{(R)}$ according to materials. 4 There were statistical differences of the fracture strength between no fiber group and fiber group. There were no interactions between each material and with/without fiber group in the fracture strength. 5. When comparing the fracture surface, no fiber group showed the resin which were fractured at the labial surface and separated from the adhesion surface. In fiber group, the fractures took a place in resin compartments. Conclusion. The marginal fidelity and the fracture strength were clinically acceptable. From these results, $Targis^{(R)}$ and $Tescera^{(R)}$ were superior than $BelleGlass^{(R)}$ in the marginal fidelity But, when applying these resin crowns in clinic, more careful consideration is needed and further study is recommended.

• The Journal of Korean Academy of Prosthodontics
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• v.40 no.6
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• pp.545-559
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• 2002

There has been increasing use of IPS Empress $2^{(R)}$ owing to easy fabrication method, high esthetics similar to natural teeth, good marginal accuracy, and sufficient fracture strength. However, in clinical application, although a luting agent and the tooth cementation bonding procedure influence the marginal accuracy and fracture strength restoration, there has been a controversy in the selection of proper luting agent. This study was to measure the marginal fidelites and fracture strength of IPS Empress crowns according to three cement types, Protec $cem^{(R)}$, Variolink $II^{(R)}$ and Panavia $21^{(R)}$. After construction of 12 experimental dies for each group, IPS Empress $2^{(R)}$ crowns were fabricated and luted the metal master die prepartion of the maxillary right premolar. Marginal gaps before cementation and after cementation were measured. Buccal incline on the functional cusp of specimens were loaded until the catastrophic failure and fracture strength was measured. The results of this study were as follows: 1. The range of gap was $34.04{\pm}4.84{\mu}m$ before cementation and $37.88{\pm}5.00{\mu}m$ after cementation, which showed significant difference by paired t-test (p<0.05). The difference in the results from marginal accuracy according to measuring point proved to be not statistically significant by two-way ANOVA test (p>0.05). 2. The difference in the results from marginal accuracy according to three cement types Proved that The Variolink $II^{(R)}$ cement group had the least gap, $35.43{\pm}5.03{\mu}m$, and showed superior marginal accuracy while there existed statistic significance in Protec $cem^{(R)}$ cement group, $39.06{\pm}4.41{\mu}m$ or Panavia $21^{(R)}$ cement group, $39.16{\pm}4.39{\mu}m$ by two-way ANOVA test & multiple range test (p<0.05). 3. The difference in the results from fractures strength testing according to three cement type groups proved to be statistically significant (p<0.05). The Variolink $II^{(R)}$ cement group shows highest fracture strength of $1257.33{\pm}226.77N$, Panavia $21^{(R)}$ cement group has $1098.08{\pm}138.45N$, and Protec $cem^{(R)}$ cement group represents the lowest fracture strength of $926.75{\pm}115.75N$. 4. Three different cement groups of different components showed acceptable marginal fidelity and fracture strength. It is concluded that IPS Empress $2^{(R)}$ crowns luted using Variolink $II^{(R)}$ cement group had stronger fracture strength and smaller marginal gap than the other cement groups. Although Variolink $II^{(R)}$ resin cement seemed acceptable to clinical applications in IPS Empress $2^{(R)}$ system, the IPS Empress $2^{(R)}$ system still requires long-term research due to the lack of data in clinical applications.

• Geomechanics and Engineering
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• v.9 no.5
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• pp.619-629
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• 2015

Influenced by various mining activities, fractures in rock masses have different densities, set numbers and lengths, which induce different mechanical properties and failure modes of rock masses. Therefore, precisely expressing the failure criterion of the fractured rock influenced by coal mining is significant for the support design, safety assessment and disaster prevention of underground mining engineering subjected to multiple mining activities. By adopting PFC2D particle flow simulation software, this study investigated the propagation and fractal evolution laws of the micro cracks occurring in two typical kinds of rocks under uniaxial compressive condition. Furthermore, it calculated compressive strengths of the rocks with different confining pressures and box-counting dimensions. Moreover, the quantitative relation between the box-counting dimension of the rocks and the empirical parameters m and s in Hoek-Brown strength criterion was established. Results showed that with the increase of the strain, the box-counting dimension of the rocks first increased slowly at the beginning and then exhibited an exponential increase approximately. In the case of small strains of same value, the box-counting dimensions of hard rocks were smaller than those of weak rocks, while the former increased rapidly and were larger than the latter under large strain. The results also presented that there was a negative correlation between the parameters m and s in Hoek-Brown strength criterion and the box-counting dimension of the rocks suffering from variable mining activities. In other words, as the box-counting dimensions increased, the parameters m and s decreased linearly, and their relationship could be described using first order polynomial function.