• Journal of Trauma and Injury
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• 제20권2호
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• pp.130-137
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• 2007

Purpose: Ultrasound is of proven accuracy in abdominal and thoracic trauma and may be useful for diagnosing extremity injury in situations where radiography is not available, such as disasters and military and space applications. However, the diagnosis of fractures is suggested by history and physical examination and is typically confirmed with radiography. As a alternative to radiography, we prospectively evaluated the utility of extremity ultrasound performed by trained residents of emergency medicine (EM) one patient with wrist and ankle extremity injuries. Methods: Initially, residents of EM performed physical examinations for fractures. The emergency ultrasound (EM US) was performed by trained residents, who used a portable ultrasound device with a 10- to 5-MHz linear transducer, on suspected patients before radiography examination. The results of emergency ultrasound and radiography and the final diagnosis were recorded, and correlation among them were determined by using Kappa s test Results: Thirty-nine patients were enrolled in our study. The average age was $36.6\;{\pm}\;19.3$ years. There were radius Fx. (n=21), radius-ulna Fx. (n=1), ulna Fx. (n=1), and contusion (n=2) injuries among the wrist injury and lat.-med. malleolar Fx. (n=13), lat. malleolar Fx. (n=6), and med. malleolar Fx. (n=3) injuries among the ankle injury. Comparing EM US with radiography, we found the sensitivity, specificity, positive predictive value, and negative predictive value of EM US for Fx. diagnosis to be 100%, 66.7%, 97.3%, 100% and those of radiography to be 97.2%, 100%, 100%, and 75%, respectively. Kappa s test for a correlation between the Fx. diagnosis of EM US and the final diagnosis of Fx was performed, and Kappa's value was 0.787 (P = 0.004).Conclusion: EM US for Fx. can be performed quickly and accurately by EM residents with excellent accuracy in remote locations such as disaster areas and in military and aerospace applications. EM US was as useful as radiography in our study and had a high correlation to the final diagnosis of Fx. Therefore, ultrasound should performed on patients with extremity injury to determine whether extremity evaluation should be added to the FAST (focused abdominal sonography trauma) examination.

• 한국임상수의학회지
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• 제29권5호
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• pp.412-415
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• 2012

1년령의 중성화된 수컷 요크셔테리어와 7년령의 암컷 푸들이 골절의 지연유합으로 내원하였다. 요크셔테리어의 경우 오른쪽 요골과 척골의 원위부가 골절되었고, 푸들의 경우 왼쪽 경골과 비골의 원위부가 골절되었다. 두 환자에서 신체검사 및 방사선검사를 통해 골절의 유합이 지연되고 있음을 확인하였다. 골절부는 금속판 및 나사못으로 고정시키고 자가해면질골을 골절 틈새에 이식하였다. 또한 빠른 골유합을 위해 $20{\mu}g$의 rh-BMP 2 가 포함된 matrigel을 골절부에 주입하였다. 수술 후 방사선검사를 통해 골절부의 치유 상태를 확인하였다. 장기간의 방사선검사에서 두 마리 모두 빠른 골유합을 보였다. 첫 증례에서는 방사선사진상에서 2주째에 요골과 척골 골절 틈새에 골밀도가 증가하였다. 20주째에는 골절선이 더 이상 관찰되지 않았으며, 정상 외관을 회복하였다. 두 번째 증례에서는 방사선사진상에서 11주째에 골절 치유가 진행되고 있음이 확인되었다. 이 두 증례 모두 예상한 것보다 골절의 치유가 빠르게 일어났다. 따라서 rh-BMP 2와 matrigel은 지연유합된 골절의 치유를 촉진하는데 효과가 있다고 생각된다.

• 대한핵의학회지
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• 제24권1호
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• pp.124-132
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• 1990

It has been reported that hematoma is one of the most crucial factors in fracture healing since callus formation is disturbed by washing out the hematoma near a fracture site. However, it is not clear why the hamatoma is important and how it plays a role during the fracture healing. In order to investigate the role of hematoma in the process of fracture healing, the osteogenic potential by subperiosteal transplantation have been studied. Experimental fractures by operation were made at the mid-shaft of the tibia in New Zealand white rabbits. Removal of hematoma at the fracture site was done after 2 and 3 days from experimental fracture, and the removed hematoma was transplanted into the subperiosteal area at the mid-shaft of the ulna of each rabbit. As control groups, we have performed 3 different procedures 1) the hematoma was transplanted into the muscular layers at the thigh and forearm; 2) autologous blood clots were transplanted into the subperiosteal area of the ulna; and 3) sham operation without a transplantation into the subperiosteal area. After transplantation, serial bone scintigraphy and simple radiography were performed at 4 days, 1 week, and 2 weeks to detect an abnormality. The results of bone scintigraphy were positive in 5 of 6 experimental group. However, all in three control groups were negative. Histological observation of the positive bone revealed new bone formation with trabeculation. These results suggest the hematoma in fracture site has osteogenic potential in the subperiosteal area which can be demonstrable by bone scintigraphy and histologic findings. Therefore, it is considered that hematoma of the fracture site plays an important role in the process of fracture healing. Further biochemical investigation using various experimental models is mandatory to apply this preliminary result to the treatment of clinical delayed union or nonunion.

• 생태와환경
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• 제42권1호
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• pp.115-123
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• 2009

서로 다른 두 시기의 부영양호(일감호) 현장수에 대한 한국산 말조개(U. douglasiae)의 섭식특성을 비교 조사하였다. 두 실험수 모두 패류밀도가 클수록 엽록소 a 감소가 뚜렷하였으며, 동일한 패류밀도에서는 저온기 현장수에서 엽록소 a 감소가 더 뚜렷하였다. 저온기 현장수에서는 패류 밀도에 따른 여과율 및 식물플랑크톤 현존량 변화가 뚜렷하였으나, 고온기 현장수에서는 두 패류 밀도의 여과율 및 식물플랑크톤 현존량 변화가 유사한 경향을 보였다. 각 출현종에 대한 말조개의 조류제어능은 저온기 현장수의 S. ulna와 S. hantzschii, 고온기 현장수의 S. ecornis, T. regulare, P. simplex는 빠른 시간 내에 감소하는 경향을 보였으나, 저온기 현장수의 S. ecornis는 서서히 감소하는 경향을 보였으며, 고온기 현장수의 M. aeruginosa는 제어효율이 가장 좋지 않았다. 따라서 한국산 말조개는 저온기 규조류 대발생 수역의 생태친화적 제어에 효과적인 생물제재로서 활용이 가능할 것으로 판단되었다.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.118-122
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• 1998

This study evaluated the development of osteolysis of Kudo total elbow arthroplasties according to the fixation with or without cement. Twenty-four elbows of nineteen patients of rheumatoid arthritis underwent total elbow arthroplasty from 1986 to 1993. The patients were followed for an average of 42 months ranging from 36 months to 59 months. In cemented humeri, 1 of 13 (7.7%) showed osteolysis. In the humeri of cementless fixation, 5 of II (45.5%) revealed osteolysis, representing higher rate compared to cement fixation (P<0.05). In the ulna, osteolysis was identified in none of 16 (0%) of cement fixation, which was significantly less than the incidence of osteolysis in cement less fixation (3 of 8,37.5%) (P<0.01). It was concluded that the cement fixation result in less osteolysis than the cementless fixation in Kudo type total elbow arthroplasty.

• 대한골관절종양학회지
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• 제1권1호
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• pp.60-67
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• 1995

It is difficult to manage the growing deformity of forearm bone caused by hereditary osteochondromatosis in children, because deformity and discrepancy of limb length is progressive. The are many treatment methods of these problems including excisio of osteochondroma, lengthening of ulna, shortening of radius, corrective osteotomy with or without lengthening apparatus. Among many treatment methods, we tried free vascularized epiphyseal transplantation with the proximal fibular epiphysis in 3 patients of hereditary osteochondromatosis for inducement of continuous bone growth and deformity correction. The average duration of follow up was 7 years and 1 month, the shortest duration being to 4 years and 5 months and the longest 10 years and 8 months. Serial radiologic and clinical evaluation were carried out during follow up and there were satisfactory length gain, deformity correction and improvement of adjacent joint motion in 2 cases. According to our follow up evaluation, free vascularized epiphyseal transplantation is valuable procedure in forearm deformity of hereditary osteochondromatosis although it needs skillful and experienced operative technique.

• 대한골관절종양학회지
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• 제14권2호
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• pp.178-181
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• 2008

골막하에 발생하는 결절종은 매우 드물며, 골막 연골종, 지방종, 건초 거대 세포종, 혈종, 기타 염증 그리고 방골성 골육종 등과 감별이 필요하다. 현재까지 보고된 골막하 결절종의 발생 부위는 경골이 가장 흔하며, 요골, 척골, 대퇴골에서도 발생이 보고되었지만, 비골에 발생한 경우는 1예만 보고되어 있다. 이에 저자들은 30세 여자 환자의 우측 원위 비골 부위에 발생한 골막하 결절종을 경험하였기에 이를 문헌 고찰과 함께 보고하는 바이다.

• Advances in biomechanics and applications
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• 제1권3호
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• pp.143-158
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• 2014

Forearm fractures in children are very common among all pediatric fractures. However, biomechanical investigations on the pediatric forearm are rather scarce, partially due to the complex anatomy, closely situated, interrelated structures, highly dynamic movement patterns, and lack of appropriate tools. The purpose of this study is to develop a computational tool for child forearm investigation and characterize the mechanical responses of a backward fall using the computational model. A three-dimensional 10-year-old child forearm finite element (FE) model, which includes the ulna, radius, carpal bones, metacarpals, phalanges, cartilages and ligaments, was developed. The high-quality hexahedral FE meshes were created using a multi-block approach to ensure computational accuracy. The material properties of the FE model were obtained by scaling reported adult experimental data. The design of computational experiments was performed to investigate material sensitivity and the effects of relevant parameters in backward fall. Numerical results provided a spectrum of child forearm responses with various effective masses and forearm angles. In addition, a conceptual L-shape wrist guard design was simulated and found to be able to reduce child distal radius fracture.

• Archives of Reconstructive Microsurgery
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• 제12권2호
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• pp.93-98
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• 2003

Purpose : The purpose of this study is to investigate an occurrence of valgus deformity of ankle joint after vascularized fibular graft in children. Materials and Methods : Four children under 15 years who were surgically treated with vascularized fibular graft were studied. The age of the patients was from 4 years to 13 years, the follow-up period was from 24 months to 108 months. The causes of vascularized fibular graft were open fracture (1 case), congenital psuedarthrosis (2 cases), hypoplastic ulna (1 case). The tibiofibular synostosis was done in 3 cases and not in 1 case. We measured the tibiotalar angle and bimalleolar angle at immediately postoperative and final radiography, and checked ankle motion, pain, and instability of ankle joint. Results : The A-P mortise angle was not different between initial and final radiography in all cases. The intermalleolar angle increased in all cases at the final radiography. There were no pain, instability and limitation of ankle motion. Conclusion: We consider the tibiofibular synostosis can prevent from ankle valgus deformity after vascularized fibular graft in children.

• 한국임상수의학회지
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• 제21권4호
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• pp.406-408
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• 2004

A nine-month-old male Jindo with non weight-bearing on the right forelimb in flexed position, pain and edema of the elbow, and resist elbow extension was brought to the Veterinary Teaching Hospital, Chungbuk National University. Elbow radiographs showed loss of humeroradial joint space and lateral displacement of the radius and ulna. Closed reduction was reported the best therapy in most cases of luxation of the elbow but conservative reduction was impossible. Open reduction of the luxated elbow was performed and ruptured collateral ligaments were identified. Displaced elbow was required bloody surgical operation and gentle reduction to restore elbow joint. Internal reduction of choice for elbow luxation with rupture of collateral ligament in the dog was a double locking-loop suture pattern. To ensure secure grasping of parallel bundles of ligament fibers to transverse bites of each suture were placed superficial to the longitudinal bites. All ligaments were repaired with 3-metric (size 2 USP) monofilament polypropylene suture. No complications have been noted during a five-month follow up.