• Journal of Korean Neurosurgical Society
• /
• v.64 no.4
• /
• pp.575-584
• /
• 2021

Objective : Cervical expansive laminoplasty is an effective surgical method to address multilevel cervical spinal stenosis. During surgery, the spinous processes of C2 and C7 are usually preserved to keep the insertion points of the cervical musculature and nuchal ligament intact. In this regard, dome-like laminectomy (undercutting of C7 lamina) instead of laminoplasty is performed on C7 in selected cases. However, resection of the lamina can weaken the C7 lamina, and stress fractures may occur, but this complication has not been characterized in the literature. The objective of the present study was to investigate the incidence and risk factors for C7 laminar fracture after C7 dome-like laminectomy and its impact on clinical and radiological outcomes. Methods : Patients who underwent cervical open-door laminoplasty combined with C7 dome-like laminectomy (n=123) were classified according to the presence of C7 laminar fracture. Clinical parameters (neck/arm pain score and neck disability index) and radiologic parameters (C2-7 angle, C2-7 sagittal vertical axis, and C7-T1 angle) were compared between the groups preoperatively and at postoperatively at 3, 6, 12, and 24 months. Risk factors for complications were evaluated, and a formula estimating C7 fracture risk was suggested. Results : C7 lamina fracture occurred in 32/123 (26%) patients and occurred at the bilateral isthmus in 29 patients and at the spinolaminar junction in three patients. All fractures appeared on X-ray within 3 months postoperatively, but patients did not present any neurological deterioration. The fracture spontaneously healed in 27/32 (84%) patients at 1 year and in 29/32 (91%) at 2 years. During follow-up, clinical outcomes were not significantly different between the groups. However, patients with C7 fractures showed a more lordotic C2-7 angle and kyphotic C7-T1 angle than patients without C7 fractures. C7 fracture was significantly associated with the extent of bone removal. By incorporating significant factors, the probability of C7 laminar fracture could be assessed with the formula 'Risk score = 1.08 × depth (%) + 1.03 × length (%, of the posterior height of C7 vertebral body)', and a cut-off value of 167.9% demonstrated a sensitivity of 90.3% and a specificity of 65.1% (area under the curve, 0.81). Conclusion : C7 laminar fracture can occur after C7 dome-like laminectomy when a substantial amount of lamina is resected. Although C7 fractures may not cause deleterious clinical outcomes, they can lead to an unharmonized cervical curvature. The chance of C7 fracture should be discussed in the shared decision-making process.

• Journal of Korean Orthopaedic Sports Medicine
• /
• v.11 no.2
• /
• pp.87-91
• /
• 2012

Nonunion of the hallucal sesamoid usually occurs after stress fracture. In case of persistent disabling symptoms after non-operative treatment, surgery can be an option. We report a rare case of combined stress fractures of the medial bipartite sesamoid and the lateral sesamoid after overuse. Nonunion of the medial sesamoid developed in spite of cast immobilization, and it was eventually healed with curettage and bone grafting.

• Journal of the Korean Society of Propulsion Engineers
• /
• v.15 no.5
• /
• pp.82-88
• /
• 2011

In the present work, FEM analyses are carried out to investigate the fractures occurred within the structural part in the course of combustion experiment. The loss of structural integrity stems from the localized deformation and the damage induced due to a severe change in the thermal load. Moreover, the two-back stress evolution model is proposed using the Armstrong-Frederick and the Phillips' rules to depict the plastic deformation, and the continuum damage mechanics is also incorporated into the present model. It is noted that the present model is able to formulate a wide range of constitutive description with ease. The numerical results depicts that a severe strain localization and damage evolution can be obtained depending on the dominant back stress.

• 한국지구물리탐사학회:학술대회논문집
• /
• 2003.11a
• /
• pp.272-280
• /
• 2003

A definite shut-in pressure in hydraulic fracturing techniques is needed for obtaining the correct information on the in-situ stress regimes in rock masses. The relation between the behaviour of hydraulically induced fractures and the condition of remote stress is considered to be major reasons of an ambiguous shut-in pressure in hydraulic fracturing pressure-time history curves. This paper describes the results of a series of numerical analyses carried out using UDEC(Universal Distinct Element Code, Itasca), which is based on the discrete element method, to compare several methods for determining the shut-in pressure during hydraulic fracturing. The fully coupling of hydraulic and mechanical analysis was applied, and the effects of four different discontinuity geometries in numerical modelling have been investigated for this purpose. The effects of different remote stress regimes and different physical properties on hydraulic fracture propagation have been also analyzed. Several methods for obtaining shut-in pressure from the ambiguous shut-in curves have been applied to all the numerical models. The graphical intersection methods, such as (P vs. t) method, (P vs. log(t)) method, (log(P) vs. log(t)) method, give smaller values of the shut-in pressure than the statistical method, (dP/dt vs. P). Care should be taken in selecting a method for shut-in pressure, because there can be existed a stress anomaly around the wellbore and fracturing from the wellbore by a constant flow rate may have a more complicate mechanism.

• Steel and Composite Structures
• /
• v.2 no.1
• /
• pp.35-50
• /
• 2002

A series of tests on simple-welded plate specimens (SWPS) and T-stub tension specimens simulating some of the joint details in moment frame connections were conducted in this investigation. The effects of weld strength mismatch and weld metal toughness on structural behavior of these specimens were considered under both static and dynamic loading conditions. Finite element analyses were performed by taking into account typical weld residual stress distributions and weld metal strength mismatch conditions to facilitate the interpretation of the test results. The major findings are as follows: (a) Sufficient specimen size requirements are essential in simulating both load transfer and constraint conditions that are relevant to moment frame connections, (b) Weld residual stresses can significantly elevate stress triaxiality in addition to structural constraint effects, both of which can significantly reduce the plastic deformation capacity in moment frame connections, (c) Based on the test results, dynamic loading within a loading rate of 0.02 in/in/sec, as used in this study, premature brittle fractures were not seen, although a significant elevation of the yield strength can be clearly observed. However, brittle fracture features can be clearly identified in T-stub specimens in which severe constraint effects (stress triaxiality) are considered as the primary cause, (d) Based on both the test and FEA results, T-stub specimens provide a reasonable representation of the joint conditions in moment frame connections in simulating both complex load transfer mode and constraint conditions.

• Nuclear Engineering and Technology
• /
• v.48 no.1
• /
• pp.259-267
• /
• 2016

Most manufacturing processes, including welding, create residual stresses. Residual stresses can reduce material strength and cause fractures. For estimating the reliability and aging of a welded structure, residual stresses should be evaluated as precisely as possible. Optical techniques such as holographic interferometry, electronic speckle pattern interferometry (ESPI), Moire interferometry, and shearography are noncontact means of measuring residual stresses. Among optical techniques, ESPI is typically used as a nondestructive measurement technique of in-plane displacement, such as stress and strain, and out-of-plane displacement, such as vibration and bending. In this study, ESPI was used to measure the residual stress on the welded part of butt-welded American Society for Testing and Materials (ASTM) A36 specimens with $CO_2$ welding. Four types of specimens, base metal specimen (BSP), tensile specimen including welded part (TSP), compression specimen including welded part (CSP), and annealed tensile specimen including welded part (ATSP), were tested. BSP was used to obtain the elastic modulus of a base metal. TSP and CSP were used to compare residual stresses under tensile and compressive loading conditions. ATSP was used to confirm the effect of heat treatment. Residual stresses on the welded parts of specimens were obtained from the phase map images obtained by ESPI. The results confirmed that residual stresses of welded parts can be measured by ESPI.

• Proceedings of the Korean Society of Propulsion Engineers Conference
• /
• 2011.04a
• /
• pp.272-278
• /
• 2011

In the present work, FEM analyses are carried out to investigate the fractures occurred within the structural part in the course of combustion experiment. The loss of structural integrity stems from the localized deformation and the damage induced due to a severe change in the thermal load. Moreover, the two-back stress evolution model is proposed using the Armstrong-Frederick and the Phillips' rules to depict the plastic deformation, and the continuum damage mechanics is also incorporated into the present model. It is noted that the present model is able to formulate a wide range of constitutive description with ease. The numerical results depicts that a severe strain localization and damage evolution can be obtained depending on the dominant back stress.

• Tunnel and Underground Space
• /
• v.18 no.1
• /
• pp.1-9
• /
• 2008

Acoustic emission (AE) and Microseimsic (MS) activities are law-energy seismic events associated with a sudden inelastic deformation such as the sudden movement of existing fractures, the generation of new fractures or the propagation of fractures. These events rapidly increase before major failure and happen within a given rock volume and radiate detectable seismic waves. The main difference between AE and MS signals is that the seismic motion frequencies of AE signals are higher than those of MS signals. As the failure of geotechnical structures usually happens as a high velocity and small displacement, it is nat easy ta determine the precursor and initiation stress level of failure in displacement detection method. To overcame this problem, AE/MS techniques far detection of structure failure and damage have recently adapt in civil engineering. This study deal with the basic theory of AE/MS and state of arts in monitoring technique using AE/MS.

• Tunnel and Underground Space
• /
• v.26 no.1
• /
• pp.12-23
• /
• 2016

For a successful accomplishment of Carbon Capture Sequestration (CCS) projects, appropriate injection conditions should be designed and optimized for site specific geological conditions. In this study, we evaluated the effect of injection conditions such as injection temperature and injection rate on the geomechanical stability of CCS system in terms of TOUGH-FLAC simulator, which is one of the well-known T-H-M coupled analysis methods. The stability of the storage system was assessed by a shear slip potential of the pre-existing fractures both in a reservoir and caprock, expressed by mobilized friction angle and Mohr stress circle. We demonstrated that no tensile fracturing was induced even in the cold CO2 injection, where the injected CO2 temperature is much lower than that of the reservoir and tensile thermal stress is generated, but shear slip of the fractures in the reservoir may occur. We also conducted a scenario analysis by varying injected CO2 volume per unit time, and found out that it was when the injection rate was decreasing in a step-wise that showed the least potential of a shear slip.

• Clinics in Orthopedic Surgery
• /
• v.10 no.4
• /
• pp.455-461
• /
• 2018

Background: Surgical-site, multimodal drug injection has recently evolved to be a safe and useful method for multimodal pain management even in patients with musculoskeletal trauma. Methods: Fifty consecutive patients who underwent plating for mid-shaft and distal clavicular fractures were included in the study. To evaluate whether surgical-site injections (SIs) have pain management benefits, the patients were divided into two groups (SI and no-SI groups). The injection was administered between the deep and superficial tissues prior to wound closure. The mixture of anesthetics consisted of epinephrine hydrochloride (HCL), morphine sulfate, ropivacaine HCL, and normal saline. The visual analogue scale (VAS) pain scores were measured at 6-hour intervals until postoperative hour (POH) 72; stress biomarkers (dehydroepiandrosterone sulfate [DHEA-S], insulin, and fibrinogen) were measured preoperatively and at POH 24, 48, and 72. In patients who wanted further pain control or had a VAS pain score of 7 points until POH 72, 75 mg of intravenous tramadol was administered, and the intravenous tramadol requirements were also recorded. Other medications were not used for pain management. Results: The SI group showed significantly lower VAS pain scores until POH 24, except for POH 18. Tramadol requirement was significantly lower in the SI group until POH 24, except for POH 12 and 18. The mean DHEA-S level significantly decreased in the no-SI group ($74.2{\pm}47.0{\mu}g/dL$) at POH 72 compared to that in the SI group ($110.1{\pm}87.1{\mu}g/dL$; p = 0.046). There was no significant difference in the insulin and fibrinogen levels between the groups. The correlation values between all the biomarkers and VAS pain scores were not significantly different between the two groups (p > 0.05). Conclusions: After internal fixation of the clavicular fracture, the surgical-site, multimodal drug injection effectively relieved pain on the day of the surgery without any complications. Therefore, we believe that SI is a safe and effective method for pain management after internal fixation of a clavicular fracture.