• 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 Biomedical Engineering Research
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• v.27 no.5
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• pp.210-217
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• 2006

Many types of interspinous distraction devices (IDDs) have been recently developed as an alternative surgical treatment to laminectomy and fusion with pedicle screws for the treatment of the lumbar spinal stenosis (LSS). They are intended to keep the lumbar spine in a slightly flexed posture to relieve pain caused by narrowing of the spinal canal and vertebral foramen. However, their biomechanical efficacies are not well known. In this study, we evaluated the kinematic behaviors and changes in intradiscal pressure (IDP) of the porcine lumbar spine implanted with IDD. For kinematics analysis, five porcine lumbar spines (L2-L6) were used and the IDD was inserted at L4-L5. Three markers (${\phi}{\le}0.8mm$) were attached on each vertebra to define a rigid body motion for stereophotogrammetric assessment of the spinal motion in 3-D. A moment of 7.5Nm in flexion-extension, lateral bending, and axial rotation were imparted with a compressive force of 700N. Then, IDD was implanted at L3-L4. IDPs were measured using pressure transducer under compression (700N) and additional extension moment (700N+7.5Nm). In kinematic behaviors, insertion of IDD resulted in statistically significant decrease 42.8% at the implanted level in extension. There were considerable changes in ROM at the adjacent levels, but statistically insignificant. In other motions, there were no significant changes in ROM as well regardless of levels. IDPs at the surgical level (L3-L4) under compression and extension moment decreased by 12.9% and 18.8% respectively after surgery (p<0.05). At the superiorly adjacent levels, IDPs increased by 19.4% and 12.9% under compression and extension, respectively (p<0.05). Corresponding changes at the inferiorly adjacent levels were 29.4% and 6.9%, but they were statistically insignificant (p>0.05). The magnitude of pressure changes due to IDD, both at the operated and adjacent levels, were far less than the previously reported values with conventional fusion techniques. Our experimental results demonstrated the IDDs can be very effective in limiting the extension motion that may cause narrowing of the spinal canal and vertebral foramens while maintaining kinematic behaviors and disc pressures at the adjacent levels.

• Journal of Korea Water Resources Association
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• v.57 no.5
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• pp.359-369
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• 2024

Korea prepares for potential floods by designating June 21st to September 20th as the flood season. However, many dams in Korea have suffered from extreme floods caused by different climate patterns, as in the case of the longest consecutive rain of 54 days in the 2020's flood season. In this context, various studies have tried to develop novel methodologies to reduce flood damage, but no study has ever dealt with the validity of the current statutory flood season thus far. This study first checked the validity of the current flood season through the observation data in the 21st century and proved that the current flood season does not consider the effects of increasing precipitation trends and the changing regional rainfall characteristics. In order to deal with these limitations, this study suggested seven new alternative flood seasons in the research area. The rigid reservoir operation method (ROM) was used for reservoir simulation, and the long short-term memory (LSTM) model was used to derive predicted inflow. Finally, all alternatives were evaluated based on whether if they exceeded the design discharge of the dam and the design flood of the river. As a result, the floods in the shifted period were reduced by 0.068% and 0.33% in terms of frequency and duration, and the magnitude also decreased by 24.6%, respectively. During this period, the second evaluation method also demonstrated that flood decreased from four to two occurrences. As the result of this study, the authors expect a formal reassessment of the flood season to take place, which will ultimately lead to the preemptive flood response to changing precipitation patterns.

• Proceedings of the Korea Water Resources Association Conference
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• 2006.05a
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• pp.312-317
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• 2006

지역규모의 기후변화 모의결과를 이용하여 금강유역 용담댐의 홍수기 치수안전도에 대한 민감도분석을 수행하였다. 기후변화 모의에 사용된 SNURCM(Seoul National University Regional Climate Model)은 미국 National Center for Atmospheric Research의 Community Climate System Model의 전지구모형을 기반으로 spectral nudging 기법을 사용한 공간해상도 30 km, 연직 21층의 지역기후모형이다. 기후변화 시나리오로는 SRES 'B1'이 사용되었으며 과거 control run에 대한 기후모의 정확도 분석을 통하여 SNURCM 기상자료를 관측치와 비교한 결과 면적강우량을 다소 과소추정하였고 이점을 감안하여 SNURCM의 일 모의결과에 보정 계수를 적용하였다. 하천유출량은 SSARR 모형을 이용하여 SNURCM 모의가 수행된 전체기간을 $1980{\sim}1999$년과 $2000{\sim}2019$년으로 20년씩 나누어 용담댐 일 유입량을 산정하여 통계분석을 실시하였고 과거와 미래 20년 동안을 비교하여 본 결과 (1) 유량의 평균보다는 분산이 미래 20년 동안 증가하여 가뭄과 홍수에 대한 위험도가 증가함을 알 수 있었고, (2) 특히 연최대유량 또한 미래 20년 동안 상당히 증가하여 홍수기 치수대책이 더욱 중요해질 것으로 판단되었다. 마지막으로 용담댐 운영은 범용 시스템분석 도구인 STELLA(System Thinking Experimental Learning Laboratory with Animation) 상에서 GUI로 구현하여 유입량 변화에 따른 용담댐 치수안전도 변화를 모의해 보았다. 용담댐의 홍수기 운영은 저수지 수위가 제한수위를 초과하기 시작하면 Rigid ROM 발효하여 방류량을 결정하도록 구성하였고, 무효방류(spill)가 일어나는 현상을 실패로 가정하여 이에 대한 신뢰도(reliability), 회복도(resiliency), 그리고 심도(vulnerability)를 치수안전도 지표로 계산하였다. 전체기간을 1980년${\sim}$1999년, 2000년${\sim}$2019년, 2000년${\sim}$2009년, 그리고 2010년${\sim}$2019년까지 총 4구간으로 나누어 결과를 도출하였으며 예상한 바와 같이 후반기 20년 동안에 세 가지 지표가 취약해 지는 것을 확인할 수 있었고, 특히 2000년부터 2009년까지 10년 동안에는 더욱 취약해짐을 확인할 수 있었다.

• Journal of Biomedical Engineering Research
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• v.38 no.1
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• pp.9-15
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• 2017

Recently, flexible cages have been introduced in an attempt to absorb and reduce the abnormal load transfer along the anterior parts of the spine. They are designed to be used with the pedicle screw systems to allow some mobility at the index level while containing ROM at the adjacent level. In this study, a finite element (FE) study was performed to assess biomechanical efficacies of the flexible cage when combined with pedicle screws with flexible rods. The post-operated models were constructed by modifying the L4-5 of a previously-validated 3-D FE model of the intact lumbar spine (L2-S1): (1) Type 1, flexible cage only; (2) Type 2, pedicle screws with flexible rods; (3) Type 3, interbody fusion cage plus pedicle screws with rigid rods; (4) Type 4, interbody fusion cage plus Type 2; (5) Type 5, Type 1 plus Type 2. Flexion/extension of 10 Nm with a compressive follower load of 400N was applied. As compared to the Type 3 (62~65%) and Type 4 (59~62%), Type 5 (53~55%) was able to limit the motion at the operated level effectively, despite moderate reduction at the adjacent level. It was also able to shift the load back to the anterior portions of the spine thus relieving excessively high posterior load transfer and to reduce stress on the endplate by absorbing the load with its flexible shape design features. The likelihood of component failure of flexble cage remained less than 30% regardless of loading conditions when combined with pedicle screws with flexible rods. Our study demonstrated that flexible cages when combined with posterior dynamic system may help reduce subsidence of cage and degeneration process at the adjacent levels while effectively providing stability at the operated level.