• Journal of Chest Surgery
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• v.46 no.2
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• pp.130-134
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• 2013

Background: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. Materials and Methods: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. Results: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). Conclusion: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly.

• Geomechanics and Engineering
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• v.11 no.3
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• pp.345-359
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• 2016

In order to investigate the influence of the interfacial angel on failure characteristics and mechanism of combined coal-rock mass, 35 uniaxial/biaxial compressive simulation tests with 5 different interfacial angels of combined coal-rock samples were conducted by PFC2D software. The following conclusions are drawn: (1) The compressive strength and cohesion decrease with the increase of interfacial angle, which is defined as the angle between structure plane and the exterior normal of maximum principal plane, while the changes of elastic modulus and internal friction angle are not obvious; (2) The impact energy index $K_E$ decreases with the increase of interfacial angle, and the slip failure of the interface can be predicted based on whether the number of acoustic emission (AE) hits has multiple peaks or not; (3) There are four typical failure patterns for combined coal-rock samples including I (V-shaped shear failure of coal), II (single-fracture shear failure of coal), III (shear failure of rock and coal), and IV (slip rupture of interface); and (4) A positive correlation between interfacial angle and interface effect is shown obviously, and the interfacial angle can be divided into weak-influencing scope ($0-15^{\circ}$), moderate-influencing scope ($15-45^{\circ}$), and strong-influencing scope (> $45^{\circ}$), respectively. However, the confining pressure has a certain constraint effect on the interface effect.

• Journal of Korean Neurosurgical Society
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• v.42 no.4
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• pp.271-275
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• 2007

Objective : Although a significant correction of local kyphosis has been reported previously, only a few studies have investigated whether this correction leads to an improved overall sagittal alignment. The study objective was to determine whether an improvement in the local kyphotic angle improves the overall sagittal alignment. We examined and compared the effects of thoracic and lumbar level kyphoplasty procedures on local versus overall sagittal alignment of the spine. Methods : Thirty-eight patients with osteoporotic vertebral compression fractures who showed poor response to conventional, palliative medical therapy underwent single-level kyphoplasty. The pertinent clinical data of these patients, from June 2006 to November 2006, were reviewed retrospectively. We measured preoperative and postoperative vertebral body heights, which were classified as anterior, middle, or posterior fractured vertebral body heights. Furthermore, the local and overall sagittal angles after polymethylmethacrylate deposition were measured. Results : More height was gained at the thoracic level, and the middle vertebral height regained the most. A significant local kyphosis correction was observed at the fractured level, and the correction at larger spanning segments decreased with the distance from the fractured level. Conclusion : The inflatable balloon kyphoplasty procedure was the most effective in regaining the height of the thoracic fractured vertebra in the middle vertebral body. The kyphosis correction by kyphoplasty was mainly achieved in the fractured vertebral body. Sagittal angular correction decreased with an increase in the distance from the fractured vertebra. No significant improvement was observed in the overall sagittal alignment after kyphoplasty. Further studies in a larger population are required to clarify this issue.

• Journal of Korean Neurosurgical Society
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• v.53 no.3
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• pp.145-149
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• 2013

Objective : We analyzed the clinical and radiologic features of posterior apophyseal ring separation (PARS) with lumbar disc herniation and suggest the proper management options according to the PARS characteristics. Methods : We reviewed case series of patients with PARS who underwent surgery of lumbar disc herniation. Preoperative symptoms, neurologic status, Body Mass Index, preoperative and postoperative Visual Analogue Scale (VAS) and Korean-Oswestry Disability Index (K-ODI) scores, operation types were obtained. PARS size, locations, the degree of resection were assessed. Results : PARS was diagnosed in 109 (7.5%) patients among 1448 patients given surgical treatment for single level lumbar disc herniation. There were 55 (50.5%) small PARS and 54 (49.5%) large PARS. Among the large PARS group, 15 (27.8%) had lower endplate PARS of upper vertebra at the level of disc herniation. Thirty-nine (72.2%) were upper endplate PARS of lower vertebra. Among the group with upper endplate PARS of lower vertebra, unresected PARS was diagnosed in 12 (30.8%) cases and resected PARS was diagnosed in 27 (69.2%) cases. VAS and K-ODI scores changes were $3.6{\pm}2.9$ and $5.4{\pm}6.4$ in the unresected PARS group, $5.8{\pm}2.1$ and $11.3{\pm}7.1$ in the resected PARS group. The group with upper endplate PARS of lower vertebra showed significant difference of VAS (p=0.01) and K-ODI (p=0.013) score changes between unresected and resected PARS groups. Conclusion : The large PARS of upper endplate in lower vertebra should be removed during the surgery of lumbar disc herniation. High level or bilateral side of PARS should be widely decompressed and arthrodesis procedures are necessary if there is a possibility of secondary instability.

• Archives of Craniofacial Surgery
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• v.17 no.3
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• pp.119-127
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• 2016

Background: Conventional correction of malunioned zygoma requires complete regional exposure through a bicoronal flap combined with a lower eyelid incision and an upper buccal sulcus incision. However, there are many potential complications following bicoronal incisions, such as infection, hematoma, alopecia, scarring and nerve injury. We have adopted a zygomaticofrontal suture osteotomy technique using transconjunctival incision with lateral paracanthal extension. We performed a retrospective review of clinical cases underwent correction of malunioned zygoma with the approach to evaluate outcomes following this method. Methods: Between June 2009 and September 2015, corrective osteotomies were performed in 14 patients with malunioned zygoma by a single surgeon. All 14 patients received both upper gingivobuccal and transconjunctival incisions with lateral paracanthal extension. The mean interval from injury to operation was 16 months (range, 12 months to 4 years), and the mean follow-up was 1 year (range, 4 months to 3 years). Results: Our surgical approach technique allowed excellent access to the infraorbital rim, orbital floor, zygomaticofrontal suture and anterior surface of the maxilla. Of the 14 patients, only 1 patient suffered a complication-oral wound dehiscence. Among the 6 patients who received infraorbital nerve decompression, numbness was gradually relieved in 4 patients. Two patients continued to experience persistent numbness. Conclusion: Transconjunctival incision with lateral paracanthal extension combined with upper gingivobuccal sulcus incision offers excellent exposure of the zygoma-orbit complex, and could be a valid alternative to the bicoronal approach for osteotomy of malunioned zygoma.

• Journal of Periodontal and Implant Science
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• v.50 no.2
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• pp.97-105
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• 2020

Purpose: The present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw. Methods: Patients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications. Results: Seventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale. Conclusions: NDIs in the anterior and posterior jaws functioned equally well in terms of periimplant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.13 no.5
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• pp.19-27
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• 1993

Recent work in the mechanics of fracture points out the desirability of a knowledge of the elastic energy release rate, the crack extension force, and the character of the stress field surrounding a crack tip in analyzing the strength of cracked bodies. The objective of this work is to provide a discussion of the energy rates, stress fields and the like of various cases for anisotropic elastic bodies which might be of interest. Reinforced concrete, wood, laminates, and some special types of elastic bodies with controlled grain orientation are often orthotropic. In this paper, determination of the stress intensity factors(SIFs) of orthotropic plane elastic body using crack tip singular element and fine mesh in near the crack tip is performed. A numerical method in this paper was used by displacement correlation method. A numerical example problem of an orthotropic cantilevered single edge cracked elastic body subjected to shear loading was analyzed, and the results of this paper are in good agreement with those of the others.

• Transactions of the Korean Society of Mechanical Engineers
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• v.9 no.2
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• pp.150-157
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• 1985

In terms of behavior of fatigue cracks propagated after build-up around the artificial drilled miro-hole, this study has been made of the build-up process of slips and micro cracks, behavior of micro-crack propagation and the definition of fatigue limit under the rotating bending stress with low carbon steel. The results of this study are as follows: (1) The fatigue limit is the repropagating critical stress for the nonpropagating cracks which have grown to some limit around the micro-hole in regard of the magnitude of micro-hole. (2) Behavior of the slips and micro-cracks initiation are occurring simultaneously in front and in rear of micro-hole tips in the view of the rotational direction, regardless of the magnitude of micro-hole. (3) Behavior of fatigue crack propagation is different from magnitude of micro-hole, its behavior is propagation of single crack about respectively large hole, but about respectively small hole, fatigue crack propagated joining phenomena of micro-cracks. (4) The behavior of fatigue fracture is affected by the factor of its defects in the view of magnitude of micro-hole when the diameter of the micro-holes are smaller than 50.mu.m, and this is also affected with the size effect of micro-hole diameter.

• Journal of Power System Engineering
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• v.13 no.5
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• pp.52-58
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• 2009

A gas turbine consists of an upstream compressor and a downstream turbine with a combustion chamber, and also the compressor and the turbine are generally coupled using a single shaft. Many casing bolts are used to assemble two horizontally separated casings, the gas turbine casing and the compressor casing, in both of axial and vertical directions. Because drilled holes for casing bolts in vertical direction are often too close to drilled holes for casing bolts in axial direction, one can observe cracks in the area frequently during operations of a gas turbine. In this study of the root cause analysis for the cracking initiating from the drilled holes of the casings of a gas turbine, the finite element analysis(FEA) was applied to evaluate the thermal and mechanical characteristics of the casings. By applying the field operation data recorded from combined cycle power plants for FEA, thermal and thermo-mechanical characteristics of a gas turbine are analyzed. The crack is initiated at the geometrical weak point, but it is found that the maximum stress is relieved when the same type of cracks is introduced on purpose during FEA. So, it is verified that the local fracture could be delayed by machining the same type of defects near the hole for casing flange bolts of the gas turbine, where the crack is initiated.

• Journal of the Korean Ceramic Society
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• v.40 no.7
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• pp.690-695
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• 2003

Soft-solution route employing PVA(Polyvinyl Alcohol) as a polymeric carrier in a mixed metal cation solution was used for synthesis of single-phase nickel aluminate (NiA1$_2$O$_4$) powders. The PVA ensured the homogeneous distribution of metal ions in the solution and it resulted in the decrease of crystallization temperature. The synthesized powders prepared by PVA addition were soft and ball-milled easily. The ball-milled powders of about 300 nm in size were fully densified to density of 4.35 g/㎤ at 1600$^{\circ}C$ for 1 h. The Vickers hardness, flexural strength, fracture toughness and thermal expansion coefficient of the sintered nickel aluminate were 14.2 ㎬, 304 ㎫, 4.8 ㎫$.$m$\^$1/2/ and 9.8${\times}$10$\^$-6//$^{\circ}C$, respectively.