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Usefulness of Serial Ultrasonography of the Rotator Cuff Repair (회전근 개 파열의 수술적 치료시 초음파 연속 검사의 유용성)

  • Park, Jae-Hyun;Choi, Won-Ki;Choi, Chang-Hyuk
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.78-85
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    • 2008
  • Purpose: The findings of preoperative magnetic resonance imaging (MRI) and ultrasonography (US) examination in the diagnosis of rotator cuff tear were then compared with the findings of arthroscopic examination, and to evaluate the postoperative integrity of rotator cuff using serial US examination. Methods: Between February and May 2008, 29 patients with rotator cuff tear had undergone preoperative US and MRI examination and subsequent arthroscopic examination. And the results of MRI and US were compared with intra-operative results of the arthroscopic examination. We observed the postoperative integrity of rotator cuff using serial (postoperative 2 weeks, 6 weeks, 3 months) US examination. Results: The sensitivity of US and MRI for identifying rotator cuff tear were 100% and 100%. The sensitivity of US and MRI were 95% and 82% in full thickness tear, and 50%, 33% in partial thickness tear, respectively. Overall accuracy of US and MRI were 86%, 69%. Among 22 patients were operated for full thickness tear, intra-operative gap formation was identified in 11 patients (50%, small to medium 2 cases, large to massive 9 cases) which were identified at 2 weeks postoperative US. We could find 5 re-tears (23%, small to medium 1 case, large to massive 4 cases) on 6 weeks postoperative US after passive range of motion (ROM) exercise, and could also find 7 re-tears (32%, small to medium 2 cases, large to massive 5 cases)on 3 months postoperative US after active ROM exercise. Conclusion: Serial US after arthroscopic rotator cuff repair was useful to differentiate intra-operative gap formation from postoperative re-tear. We found 5 retears (23%) at 6 weeks and 7 retears (32%) at 3 months postoperative US, it was useful to make treatment plan during postoperative rehabilitation.

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The Effect of Temporary Cement Cleaning Methods on the Retentive Strength of Cementation Type Implant Prostheses (임시 시멘트 제거방법이 시멘트 유지형 임플란트 보철물의 유지력에 미치는 영향)

  • Shin, Hwang-Kyu;Song, Young-Gyun;Shin, Soo-Yeon
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.125-140
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    • 2011
  • The remnant of temporary cement on the intaglio surface of cast restoration may have a negative effect on the retentive strength of permanent cement. This study was to evaluate the effect of temporary cement cleaning methods on the retentive strength of cementation type implant prostheses. Prefabricated implant abutments - height 5.5mm, diameter 4.5mm, 6 degree axial wall taper with chamfer margins were used. Forty copings-abutment specimens were divided into four groups(each n=10) according to the cleaning methods for temporary cement(Temp-$Bond^{(R)}$) as follows : no temporary cementation(the control group), orange solvent, ultrasonic cleaning, air borne-particle abrasion. After the application of temporary cement and the separation, the cleaning procedure was performed according to the protocol of each group. The specimens were cemented with $Premier^{(R)}$ Implant $Cement^{TM}$. After the permanent cementation, the specimens were subjected to thermocycling and pulled out from the specimens with a universal testing machine at a cross-head speed of 0.5mm/min. After the retentive strength test, all the specimens were cleaned using ultrasonic cleaning, abraded with air borne-particles, and steam-cleaned. Likewise, the specimens were temporarily cemented(Temp-$Bond^{(R)}$ NE), cleaned according to the protocol of each group, cemented with $Premier^{(R)}$ Implant $Cement^{TM}$ and subjected to thermocycling and measurement of their retentive strength. The mean of group with orange solvent were significantly lower than those of other groups(p<0.05). There was no significance between group with ultrasonic cleaning and group with air borne-particle abrasion. Group with ultrasonic cleaning and group with air-particle abrasion were no significance at control group. There was no significance between group cemented with Temp-$Bond^{(R)}$ and group cemented with Temp-$Bond^{(R)}$ NE. Within the limitation of this study, it can be concluded that the temporary cement cleaning method with only orange solvent may have a negative effect on the retentive strength of permanent cement. Ultrasonic cleaning and air borne-particle abrasion methods are recommended for the temporary cement cleaning method on cementation type implant prostheses.

The Effect of Constraint-Induced Movement Therapy(CIMT) With Cognitive-Perceptual Training on Upper Extremity Function of Stroke Patients With Mild Cognitive Impairment (경도 인지손상을 가진 뇌졸중 환자의 상지 기능에 미치는 강제유도운동치료(CIMT)와 인지-지각 훈련의 병행 효과)

  • Kim, Hun-Ju;Shin, Joong-Il;Kam, Kyung-Yoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.12
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    • pp.5684-5691
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    • 2011
  • The purpose of this study is to examine effects of constraint-induced movement therapy(CIMT) and/or cognitive-perceptual training(CPT) on the change of hand function in cerebrovascular accident(CVA) patients and to evaluate the change in the amount and quality of use of the affected upper extremity in performing daily living tasks. The subjects of study were 10 patients who had been under rehabilitation for more than three months after CVA onset. They were all determined as mild cognition impairment according to NCSE or MVPT test. For CIMT group, to restrict the movement of the unaffected hand the subjects had been worn modified resting arm-splint in daytime for 4 weeks. For CIMT+CPT group, the subjects were performed CPT with CIMT and control group had been under conventional occupational therapy for the same period. CIMT+CPT group showed significant improvement in simulated feeding, lifting large light objects, and lifting large heavy objects of Jebsen-Taylor Hand Function Test. CIMT group also showed significant improvement compared with control group. The mean changes of the amount of use(AOU) of the affected arm had a statistically significant difference among groups (p<.05). While CIMT+CPT group had the biggest change in the quality of movement(QOM) of upper extremity of the affected side, CTL group showed the smallest change. Both CIMT and CIMT+CPT groups had statistically significant difference in the change in the quality of movement in upper extremity of affected side with CTL group(p<.05), but there was not significant difference between CIMT group and CIMT+CPT group. CIMT performed to the patients of stroke, with mild impairment in cognitive perceptual abilities showed the improvement in hand movement and AOU and QOM of upper extremity in the affected side and the combination of CIMT with CPT showed synergic effects.

The Effectiveness of Sympathetic Skin Response Studies for Patients with Primary Palmar Hyperhidrosis and Who Undergo Thoracic Sympathicotomy (일차성 수부 다한증에서 교감신경절제술 후 교감신경 피부반응 검사의 효용성)

  • Yoon, Jeong-Seob;Sim, Sung-Bo;Rhee, Won-Ihl
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.738-743
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    • 2009
  • Background: There is no standardized tool and parameter that can accurately assess the sympathetic function before and after performing sympathectomy in patients with primary palmar hyperhidrosis. We examined the effective-ness of the sympathetic skin response (SSR) study for documenting the change of sympathetic denervation before and after performing selective thoracic sympathicotomy. Material and Method: We prospectively investigated the SSR from 12 healthy subjects who were diagnosed with primary hyperhidrosis. Each SSR was recorded on the right palm or sole with electrical stimuli applied to the skin at the left wrist and foot and vice versa for the controlateral side. This test was performed before, 2 weeks and 1 year after selective thoracic sympathicotomy. The data was corrected for the onset latency and the amplitude of the SSR (n=24). Result: The mean age of the 12 patients was $24.6{\pm}0.4$ years (range: 19~36) and the gender ratio was 1 : 0.7. The mean values of the preoperative, postoperative 2 weeks and postoperative 1 year onset latency and amplitude of the palmar side (n=24) were $1.46{\pm}0.24$ msec and $6,043{\pm}2,339{\mu}V$, $1.63{\pm}0.42$ msec and $823{\pm}638{\mu}V$, and $1.44{\pm}0.39$ msec and $2,412{\pm}1,546{\mu}V$, respectively. The mean values of the plantar side (n=38) were $1.83{\pm}0.42$ msec and $2,816{\pm}1,694{\mu}V$, $2.16{\pm}0.39$ msec and $1,445{\pm}1,281{\mu}V$ and $1.95{\pm}0.25$ msec and $1,622{\pm}865{\mu}V$, respectively. Among the documented parameters, only the palmar amplitude (p=0.002) showed statistical significance in recording the change of the sympathetic system within the same individual for the pre and postoperative period. Conclusion: The SSR amplitude ratio may be a useful parameter for documenting the efficacy of sympathetic denervation after selective sympathicotomy.

Marginal and internal fit of interim crowns fabricated with 3D printing and milling method (3D 프린팅 및 밀링 방법으로 제작된 임시 보철물 적합도 비교 분석)

  • Son, Young-Tak;Son, KeunBaDa;Lee, Kyu-Bok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.4
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    • pp.254-261
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    • 2020
  • Purpose: The purpose of this study was to assess the marginal and internal fit of interim crowns fabricated by two different manufacturing method (subtractive manufacturing technology and additive manufacturing technology). Materials and Methods: Forty study models were fabricated with plasters by making an impression of a master model of the maxillary right first molar for ceramic crown. On each study model, interim crowns (n = 40) were fabricated using three types of 3D printers (Meg-printer 2; Megagen, Zenith U; Dentis, and Zenith D; Dentis) and one type milling machine (imes-icore 450i; imes-icore GmbH). The internal of the interim crowns were filled with silicon and fitted to the study model. Internal scan data was obtained using an intraoral scanner. The fit of interim crowns were evaluated in the margin, absolute margin, axial, cusp, and occlusal area by using the superimposition of 3D scan data (Geomagic control X; 3D Systems). The Kruskal-wallis test, Mann-Whitney U test and Bonferroni correction method were used to compare the results among groups (α = 0.05). Results: There was no significant difference in the absolute marginal discrepancy of the temporary crown manufactured by three 3D printers and one milling machine (P = 0.812). There was a significant difference between the milling machine and the 3D printer in the axial and occlusal area (P < 0.001). The temporary crown with the milling machine showed smaller axial gap and higher occlusal gap than 3D printer. Conclusion: Since the marginal fit of the temporary crown produced by three types of 3D printers were all with in clinically acceptable range (< 120 ㎛), it can be sufficiently used for the fabrication of the temporary crown.

The Alterations of Geochemical Behavior of Arsenic in Stabilized Soil by the Addition of Phosphate Fertilizer (인산질 비료에 의한 안정화 적용 토양 내 비소의 지구화학적 거동 변화)

  • Jeon, Yong-Jung;Kim, Bun-Jun;Ko, Ju-In;Ko, Myoung-Soo
    • Economic and Environmental Geology
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    • v.55 no.2
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    • pp.209-217
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    • 2022
  • The purpose of this study was to confirm the dissolution of arsenic from the stabilized soil around abandoned coal mines by cultivation activities. Experimental soils were collected from the agricultural field around Okdong and Buguk coal mines, and the concentration of arsenic in the soil and the geochemical mobility were confirmed. The average arsenic concentration was 20 mg/kg. The soil with relatively high geochemical mobility of arsenic in the soil was used in the batch and column experiment. The limestone was mixed with soil for soil stabilization, and the mixing ratio was 3% of limestone, based on the soil weight. The phosphoric acid fertilizer (NH4H2PO4) was added to the soil to simulate a cultivation condition according to the Rural Development Administration's rules. Comparative soil without mixing limestone was prepared and used as a control group. The arsenic extraction from soil was increased following the fertilizer mixing amount and it shows a positive relationship. The concentration of phosphate in the supernatant was relatively low under the condition of mixing limestone, which is determined to be result of binding precipitation of phosphate ions and calcium ions dissolved in limestone. Columns were set to mix phosphoric acid fertilizers and limestone corresponding to cultivation and stabilization conditions, and then the column test was conducted. The variations of arsenic extraction from the soil indicated that the stabilization was effectible until 10 P.V.; however, the stabilization effect of limestone decreased with time. Moreover, the geochemical mobility of arsenic has transformed by increasing the mobile fractions in soil compared to initial soil. Therefore, based on the arsenic extraction results, the cultivation activities using phosphoric fertilizer could induce a decrease in the stabilization effect.

Observation of Volume Change and Subsidence at a Coal Waste Dump in Jangseong-dong, Taebaek-si, Gangwon-do by Using Digital Elevation Models and PSInSAR Technique (수치표고모델 및 PSInSAR 기법을 이용한 강원도 태백시 장성동 폐석적치장의 적치량과 침하관측)

  • Choi, Euncheol;Moon, Jihyun;Kang, Taemin;Lee, Hoonyol
    • Korean Journal of Remote Sensing
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    • v.38 no.6_1
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    • pp.1371-1383
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    • 2022
  • In this study, the amount of coal waste dump was calculated using six Digital Elevation Models (DEMs) produced between 2006 and 2018 in Jangseong-dong, Taebaek-si, Gangwon-do, and the subsidence was observed by applying the Persistent Scatterer Interferometric SAR (PSInSAR) technique on the Sentinel-1 SAR images. As a result of depositing activities using DEMs, a total of 1,668,980 m3 of coal waste was deposited over a period of about 12 years from 2006 to 2018. The observed subsidence rate from PSInSAR was -32.3 mm/yr and -40.2 mm/yr from the ascending and descending orbits, respectively. As the thickness of the waste pile increased, the rate of subsidence increased, and the more recent the completion of the deposit, the faster the subsidence tended to occur. The subsidence rates from the ascending and descending orbits were converted to vertical and horizontal east-west components, and 22 random reference points were set to compare the subsidence rate, the waste rock thickness, and the time of depositing completion. As a result, the subsidence rate of the reference point tended to increase as the thickness of the waste became thicker, similar to the PSInSAR results in relation to the waste thickness. On the other hand, there was no clear correlation between the completion time of the deposits and the rate Of subsidence at the reference points. This is because the time of completion of the deposits at all but 5 of the 22 reference points was too biased in 2010 and the correlation analysis was meaningless. As in this study, the use of DEM and PSInSAR is expected to be an effective alternative to compensate for the lack of field data in the safety management of coal waste deposits.

Dual Plate Fixation for Periprosthetic Femur Fracture after Total Knee Arthroplasty (슬관절 전치환술 후 발생한 대퇴골 삽입물 주위 골절의 이중 금속판 고정술)

  • Kim, Dong Hwi;Cha, Dong Hyuk;Ko, Kang Yeol
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.26-33
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    • 2021
  • Purpose: This study evaluated the results of dual plate fixation for periprosthetic femur fracture after total knee arthroplasty (TKA). Materials and Methods: From October 2007 to February 2013, 23 cases of periprosthetic femur fracture after TKA were treated at the author's hospital. There were 13 cases of fixation using a medial and lateral dual plate when the stability of the fracture site could not be achieved by one side fixation with a follow-up of more than one year. The cases included no loosening of the femoral component in fractures that were categorized as Lewis-Rorabeck classification II and supracondylar comminuted fractures and elongation of the fracture line to the lateral epicondyle of the femur or stem in the medullary canal. The mean age was 72 years (65-82 years), and 11 cases were female. Three cases had a stem due to revision. The mean bone marrow density was -3.2 (-1.7 to -4.4), and the mean period from primary TKA to periprosthetic fractures was 28 months (1-108 months). The mean follow-up period was 23 months (12-65 months). The medial fracture site was first exposed via the subvastus approach. Second, the supplementary plate was fixed on the lateral side of the fracture using a minimally invasive plate osteosynthesis technique. The average union time, complications, and Hospital for Special Surgery Knee Score (HSS) at the last follow-up were evaluated. Results: The mean union time was 17.4 weeks (7-40 weeks). Two cases showed delayed bone union and nonunion occurred in one case, in whom bone union was achieved three months later after re-fixation using a dual plate with an autogenous bone graft. The mean varusvalgus angulation was 1.67 degrees (-1.2-4.9 degrees), and the mean anterior-posterior angulation was 2.86 degrees (0-4.9 degrees) at the last follow-up. The mean knee range of motion was 90 degrees, and the HSS score was 85 points (70-95 points) at the last follow-up. Conclusion: Dual plate fixation for periprosthetic femur fractures that had not achieved stability by one side plate fixation after TKA showed a good clinical result that allowed early rehabilitation.

Acoustic characteristics of speech-language pathologists related to their subjective vocal fatigue (언어재활사의 주관적 음성피로도와 관련된 음향적 특성)

  • Jeon, Hyewon;Kim, Jiyoun;Seong, Cheoljae
    • Phonetics and Speech Sciences
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    • v.14 no.3
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    • pp.87-101
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    • 2022
  • In addition to administering a questionnaire (J-survey), which questions individuals on subjective vocal fatigue, voice samples were collected before and after speech-language pathology sessions from 50 female speech-language pathologists in their 20s and 30s in the Daejeon and Chungnam areas. We identified significant differences in Korean Vocal Fatigue Index scores between the fatigue and non-fatigue groups, with the most prominent differences in sections one and two. Regarding acoustic phonetic characteristics, both groups showed a pattern in which low-frequency band energy was relatively low, and high-frequency band energy was increased after the treatment sessions. This trend was well reflected in the low-to-high ratio of vowels, slope LTAS, energy in the third formant, and energy in the 4,000-8,000 Hz range. A difference between the groups was observed only in the vowel energy of the low-frequency band (0-4,000 Hz) before treatment, with the non-fatigue group having a higher value than the fatigue group. This characteristic could be interpreted as a result of voice abuse and higher muscle tonus caused by long-term voice work. The perturbation parameter and shimmer local was lowered in the non-fatigue group after treatment, and the noise-to-harmonics ratio (NHR) was lowered in both groups following treatment. The decrease in NHR and the fall of shimmer local could be attributed to vocal cord hypertension, but it could be concluded that the effective voice use of speech-language pathologists also contributed to this effect, especially in the non-fatigue group. In the case of the non-fatigue group, the rhamonics-to-noise ratio increased significantly after treatment, indicating that the harmonic structure was more stable after treatment.

Marginal bone loss between internal- and external- abutment connection type implants placed in the first molar area (제1대구치 위치에 식립된 단일 임플란트의 지대주 연결 유형에 따른 임플란트 주위골 흡수)

  • Seok-Hyun Lee;Eun-Woo Lee;Ha-Na Jung;Ok-Su Kim
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.1
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    • pp.32-44
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    • 2023
  • Purpose: The purpose of this study was to investigate the effect of implant connection type on marginal bone loss (MBL) and to analyze the factors that affect MBL. This study focuses on single implants planted in the upper and lower first molar area. Materials and Methods: A total of 87 implants from 68 patients were tracked for a period over 5 years. There were 57 external connection type (EC) implants and 30 internal connection type (IC) implants in 38 males and 30 females. The MBL and EA were measured from intraoral radiograph images taken after 5 years at most. Results: Significant difference in MBL between EC and IC type was observed in patients without GBR or diabetes. Patients without GBR exhibited an MBL of -0.065 ± 0.859 mm in EC type and -0.627 ± 0.639 mm in IC type (P = 0.025). Using multiple regression analysis, a statistically significant negative correlation was observed between MBL and conditions including implant-abutment connection type (β = -0.303), diabetes (β = -0.113), emergence angle > 30° (β = -0.234), and age (β = -0.776). Conclusion: Within this results, IC type implants had less MBL than EC type, and implant prosthesis with emergence angle over 30° showed greater MBL. To minimize the MBL of the implant and ensure implant stability, careful consideration should be given to the EA of implant prosthesis and its connection type.