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Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?

  • Troy Li;Kenneth H. Levy;Akiro H. Duey;Akshar V. Patel;Christopher A. White;Carl M. Cirino;Alexis Williams;Kathryn Whitelaw;Dave Shukla;Bradford O. Parsons;Evan L. Flatow;Paul J. Cagle
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.245-251
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    • 2023
  • Background: For anatomic total arthroscopic repair, cementless humeral fixation has recently gained popularity. However, few studies have compared clinical, radiographic, and patient-reported outcomes between cemented and press-fit humeral fixation, and none have performed follow-up for longer than 5 years. In this study, we compared long-term postoperative outcomes in patients receiving a cemented versus press-fit humeral stem anatomic arthroscopic repair. Methods: This study retrospectively analyzed 169 shoulders that required primary anatomic total shoulder arthroplasty (aTSA). Shoulders were stratified by humeral stem fixation technique: cementation or press-fit. Data were collected pre- and postoperatively. Primary outcome measures included range of motion, patient reported outcomes, and radiographic measures. Results: One hundred thirty-eight cemented humeral stems and 31 press-fit stems were included. Significant improvements in range of motion were seen in all aTSA patients with no significant differences between final cemented and press-fit stems (forward elevation: P=0.12, external rotation: P=0.60, and internal rotation: P=0.77). Patient reported outcome metrics also exhibited sustained improvement through final follow-up. However, at final follow-up, the press-fit stem cohort had significantly better overall scores when compared to the cemented cohort (visual analog score: P=0.04, American Shoulder and Elbow Surgeon Score: P<0.01, Simple Shoulder Test score: P=0.03). Humeral radiolucency was noted in two cemented implants and one press-fit implant. No significant differences in implant survival were observed between the two cohorts (P=0.75). Conclusions: In this series, we found that irrespective of humeral fixation technique, aTSA significantly improves shoulder function. However, within this cohort, press-fit stems provided significantly better outcomes than cemented stems in terms of patient reported outcome scores. Level of evidence: III.

A Study to Decrease Exposure Dose for the Radiotechnologist in PET/CT (PET/CT 검사에서 방사선 종사자 피폭선량 저감에 대한 방안 연구)

  • Cho, Seok-Won;Park, Hoon-Hee;Kim, Jung-Yul;Ban, Yung-Kak;Lim, Han-Sang;Oh, Ki-Beak;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.159-165
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    • 2010
  • Purpose: Positron emission tomography scan has been growing diagnostic equipment in the development of medical imaging system. Compare to $^{99m}Tc$ emitting 140 keV, Positron emission radionuclide emits 511 keV gamma rays. Because of this high energy, it needs to reduce radioactive emitting from patients for radiotechnologist. We searched the external dose rates by changing distance from patients and measure the external dose rates when we used shielder investigate change external dose rates. In this study, the external dose distribution were analyzed in order to help managing radiation protection of radiotechnologists. Materials and Methods: Ten patients were searched (mean age: $47.7{\pm}6.6$, mean height: $165.5{\pm}3.8$ cm and mean weight: $65.9{\pm}1.4$ kg). Radiation were measured on the location of head, chest, abdomen, knees and toes at the distance of 10, 50, 100, 150 and 200 cm. Then, all the procedure was given with a portable radiation shielding on the location of head, chest and abdomen at the distance of 100, 150 and 200 cm and transmittance was calculated. Results: In 10 cm, head (105.40 ${\mu}Sv/h$) was the highest and foot (15.85 ${\mu}Sv/h$) was the lowest. In 200 cm, head, chest and abdomen showed similar. On head, the measured dose rates were 9.56 ${\mu}Sv/h$, 5.23 ${\mu}Sv/h$, and 3.40 ${\mu}Sv/h$ in 100, 150 and 200 cm respectively. When using shielder, it shows 2.24 ${\mu}Sv/h$, 1.67 ${\mu}Sv/h$, and 1.27 ${\mu}Sv/h$ in 100, 150 and 200 cm on head. On chest, the measured dose rates were 8.54 ${\mu}Sv/h$, 4.90 ${\mu}Sv/h$, 3.44 ${\mu}Sv/h$ in 100, 150 and 200 cm, respectively. When using shielder, it shows 2.27 ${\mu}Sv/h$, 1.34 ${\mu}Sv/h$, and 1.13 ${\mu}Sv/h$ in 100, 150 and 200 cm on chest. On abdomen, the measured dose rates were 9.83 ${\mu}Sv/h$, 5.15 ${\mu}Sv/h$ and 3.18 ${\mu}Sv/h$ in 100, 150 and 200cm respectively. When using shielder, it shows 2.60 ${\mu}Sv/h$, 1.75 ${\mu}Sv/h$ and 1.23 ${\mu}Sv/h$ in 100, 150 and 200 cm on abdomen. Transmittance was increased as the distance was expanded. Conclusion: As the distance was further, the radiation dose were reduced. When using shielder, the dose were reduced as one-forth of without shielder. The Radio technologists are exposed of radioactivity and there were limitations on reducing the distance with Therefore, the proper shielding will be able to decrease radiation dose to the radiotechnologists.

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The Storage Stability of Semi-Salted and Dried Mackerel by Free-Oxygen Absorber (탈산소제에 의한 반염건고등어 저장중의 품질안정성)

  • LEE Eung-Ho;CHUNG Young-Hoon;JOO Dong-Sik;KIM Jeong-Hee;OH Kwang-Soo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.18 no.2
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    • pp.131-138
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    • 1985
  • The preservative effect of modified-atmosphere storage on the shelf-life of packed semi-salted and dried mackerel, Scomber japonicus, was examined. The semi-salted and dried mackerel fillets were packed in laminated plastic film bags (polyester/nylon/casted polypropylene: $12{\mu}m/15{\mu}m/60{\mu}m,\;15{\times}16cm$) filled with air (control, C), nitrogen gas (N), deoxygenized air (O) prepared by using free-oxygen absorber enclosed in the bag, in vacuum(V), and stored at $5^{\circ}C$. The quality of packed sample during the storage were examined in terms of viable cell counts of bacteria, thiobarbituric acid(TBA) value, perozide value(POV), volatile basic nitrogen(VBN), trimethylamine(TMA), adenosine triphosphate(ATP) and its related compounds and sensory evaluation. The results obtained are as follows: The pH of all the samples was in the range of $6.1{\pm}0.2$, and the contents of VBN and amino nitrogen of them increased during storage. In color values, L value(lightness) decreased while a and b values (red and yellow) revealed a tendency to increase during storage. The viable cell counts of the control sample(C) increased to $3.0{\times}10^6/g$ after 15 days storage but those of the other samples(V, N and O)were in the range of $2{\sim}6{\times}10^5/g$ after 20 days storage. The content of TMA increased during storage, but the histamine content showed a little change during storage and its content of all samples were less than 16 mg/100g. The inosinic acid(IMP) was rapidly degraded while inosine and hypoxanthine increased during storage. The TBA value of the control(C) reached a peak in 9 days and then decreased gradually while that of the sample(O) showed a little change during storage. The changes in POV of all the samples during storage showed a similar tendency to the TBA value. Fatty acid composition of raw mackerel consists of $35.6\%$ of saturated acid, $30.3\%$ of monoenoic acid and $34.2\%$ of polyenoic acid. The major fatty acid of the sample products were oleic acid($C_{18:1}$), palmitic acid($C_{16:0}$), docosahexaenoic acid($C_{22:6}$). The contents of polyenoic acid such as $C_{22:6},\;C_{20:5}$ decreased during storage while the other fatty acids showed a little change. From the results of sensory evaluation, the shelf-life of the control sample(C) was about 7 days and that of sample(V), (N) and (O) was about 15 days. It was concluded that deoxygenized atmosphere(free-oxygen absorber enclosed in the bag) was a good condition for preserving the quality of semi-salted and dried mackerel.

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Incase of Same Region Treatment by using a Tomotherapy and a Linear Accelerator Absorbed Dose Evaluation of Normal Tissues and a Tumor (토모테라피와 선형가속기를 이용한 동일 부위의 치료 시 종양 및 정상조직의 흡수선량 평가)

  • Cheon, Geum-Seong;Kim, Chang-Uk;Kim, Hoi-Nam;Heo, Gyeong-Hun;Song, Jin-Ho;Hong, Joo-Yeong;Jeong, Jae-Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.2
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    • pp.97-103
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    • 2010
  • Purpose: Treating same region with different modalities there is a limit to evaluate the total absorbed dose of normal tissues. The reason is that it does not support to communication each modalities yet. In this article, it evaluates absorbed dose of the patients who had been treated same region by a tomotherapy and a linear accelerator. Materials and Methods: After reconstructing anatomic structure with a anthropomorphic phantom, administrate 45 Gy to a tumor in linac plan system as well as prescribe 15 Gy in tomotherapy plan system for make an ideal treatment plan. After the plan which made by tomoplan system transfers to the oncentra plan system for reproduce plan under the same condition and realize total treatment plan with summation 45 Gy linac treatment plan. To evaluate the absorbed dose of two different modalities, do a comparative study both a simple summation dose values and integration dose values. Then compare and analyze absorbed dose of normal tissues and a tumor with the patients who had been exposured radiation by above two differents modalities. Results: The result of compared data, in case of minimum dose, there are big different dose values in spleen (12.4%). On the other hand, in case of the maximum dose, it reports big different in a small bowel (10.2%) and a cord (5.8%) in head & neck cancer patients, there presents that oral (20.3%), right lens (7.7%) in minimum dose value. About maximum dose, it represents that spinal (22.5), brain stem (12%), optic chiasm (8.9%), Rt lens (11.5%), mandible (8.1%), pituitary gland (6.2%). In case of Rt abdominal cancer patients, there represents big different minimum dose as Lt kidney (20.3%), stomach (8.1%) about pelvic cancer patients, it reports there are big different in minimum dose as a bladder (15.2%) as well as big different value in maximum dose as a small bowel (5.6%), a bladder (5.5%) in addition, making treatment plan it is able us to get. Conclusion: In case of comparing both simple summation absorbed dose and integration absorbed dose, the minimum dose are represented higher as well as the maximum dose come out lower and the average dose are revealed similar with our expected values data. It is able to evaluate tumor & normal tissue absorbed dose which could had been not realized by treatment plan system. The DVH of interesting region are prescribed lower dose than expected. From now on, it needs to develop the new modality which are able to realize exact dose distribution as well as integration absorbed dose evaluation in same treatment region with different modalities.

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Mass Production Process for Flour Noodles Containing Perilla Leaves and Their Antioxidant Effects (깻잎 첨가 국수 대량 생산 공정 개발 및 이의 항산화 효과)

  • Hyun, Hyo-Eun;Lee, Eun-Hwa;Noh, Jeong-Sook;Song, Yeong-Ok
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.12
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    • pp.1688-1693
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    • 2011
  • This study was evaluated mass production processes for flour noodles containing perilla leaf (FNPL) and to examine the antioxidant properties of FNPL. The processes for perilla leaf preparation before dough making were the main focus. The sensory evaluation was used as a tool to determine the optimal conditions for each step in the process. The appearance, taste, flavor, texture and overall acceptability were evaluated using a 9 point scale sensory evaluation. Eight minutes blanching of perilla leaf in boiling water (1:30, w/v) was found to be a suitable time to remove the unpleasant leaf flavor remaining in the final noodle product when fresh perilla leaf was used. The appearance, taste, texture and overall acceptability of FNPL were significantly different from FNPLs prepared with other blanching times. The appearance of FNPL containing 40% (w/v) perilla leaf homogenates was the best. In the dough making process, additional water was not required when 6 portions of 40% perilla leaf homogenate were added to 10 portions of flour, suggesting that the water adding step in the dough preparation process can be skipped. The antioxidant activity of FNPL was expressed as the radical scavenging activity. The DPPH ($IC_{50}$; 0.56 mg/mL), super oxide radical ($IC_{50}$; 9.53 mg/mL) and hydroxy radical scavenging activities ($IC_{50}$; 169.2 ${\mu}g$/mL) of FNPL were increased 19.6 (p<0.001), 1.4 (p<0.01) and 17.8 fold, respectively, compared to those for flour noodle (p<0.001). In conclusion, perilla leaf added to noodles at a final concentration of 19% (w/w) can increase the sensory and antioxidant properties of flour noodles.

Vegetation Structure and Population Dynamics of Berchemia racemosa Habitats (청사조(Berchemia racemosa) 자생지의 식생구조 및 개체군 동태 분석)

  • Beon, Mu-Sup;Kim, Young-Ha
    • Korean Journal of Environment and Ecology
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    • v.22 no.6
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    • pp.679-690
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    • 2008
  • The objectives of this study are to investigate and analyze the vegetation structure and population dynamics of Berchemia racemosa habitats in the Weolmyung park in Gunsan city, and base on that to seek the ecological habitat conservation plan for the Berchemia racemosa. In results, the Berchemia racemosa habitats are located at $81{\sim}93$ meters above the sea level, in steep seaside slope of a mountain. The soil texture are silt loam mainly and soil pH were $4.1{\sim}5$. The vascular plants in the Berchemia racemosa habitats has been analyzed as 61 taxa; 33 families, 51 genera, 54 species, 6 varieties, and 1 forms. Berchemia racemosa as a Specific plant species by floral region was the class V. Berchemia racemosa habitats were classified into 7 vegetation communities of Quercus serrata community(A1), Alnus firm a community(A2), Platycarya strobilacea community(A3), Robinia pseudoacacia community(A4) and 3 Pinus densiflora communities(B1, B2, B3). The importance value of Berchemia racemosa were 30%(A1), 15%(A2), 27%(A3), 65%(A4), 18%(B1), 45%(B2) and 35%(B3) on shrubs layer and 12, 27, 20, 18, 11, 18, 21 % on herb layer. The constant companion species with Berchemia racemosa were Stephanandra incisa and Ligustrum obtusifolium. Total 103 populations appear in the 7 Berchemia racemosa habitats. Their spatial distribution pattern were clumped for the most part. The average height was 133cm, the root color diameter was 4.4cm and the ramification branch number was 9.4. From the results of this study, it is suggested the continued monitoring and the active protection measures for the Berchemia racemosa habitats.

Properties of stretch-activated $K^+$ channels in an G292 osteoblast-like cell (G292 세포에서 세포막 신장으로 활성화되는 $K^+$통로의 특성)

  • Lee, Sang-Gook;Jung, Dong-Keun;Suh, Duk-Joon;Park, Soo-Byung
    • The korean journal of orthodontics
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    • v.30 no.2 s.79
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    • pp.197-204
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    • 2000
  • [$K^+$]-selective ion channels were studied in excised inside-out membrane patches from human osteoblast-like cells (G292). Three classes of $K^+$channels were present and could be distinguished on the basis of conductance. Conductances were $270\pm27\;pS,\;113\pm12\;pS,\;48\pm8\;pS$ according to their approximate conductances in symmetrical 140 mM KCl saline at holding potential of -80 mV It was found that the small conductance (48 pS) $K^+$channel activation was dependent on membrane voltage. In current-voltage relationship, small conductance $K^+$channel showed outward rectification, and it was activated by the positive potential inside the membrane. In recordings, single channel currents were activayed by a negative pressure outside the membrane. The membrane pressure increased $P_{open}$ of the $K^+$ channel in a pressure-dependent manner. In the excised-patch clamp recordings, G292 osteoblast-like cells have been shown to contain three types of $K^+$ channels. Only the small conductance (48 pS) $K^+$channel is sensitive to the membrane stretch. These findings suggest that a hyperpolarizing current, mediated in part by this channel, may be associated with early events during the mechanical loading of the osteoblast. In G292 osteoblast-like cells, $K^+$channel is sensitive to membrane tension, and may represent a unique adaptation of the bone cell membrane to mechanical stress.

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Comparison of Antioxidant and Physiological Properties of Jerusalem Artichoke Leaves with Different Extraction Processes (추출방법에 따른 돼지감자 잎의 항산화 및 생리활성 비교)

  • Kim, Jae-Won;Kim, Jong-Kyoun;Song, In-Seong;Kwon, Eun-Sung;Youn, Kwang-Sup
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.1
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    • pp.68-75
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    • 2013
  • The physiological properties of water extracts from Jerusalem artichoke (Helianthus tuberosus L.) leaves (JAL) with different extraction processes (stirrer extraction, SE; reflux extraction, RE; autoclave extraction, AE; low temperature high pressure extraction, LTPE) were investigated. The freeze-dried powder yields of SE, RE, AE, and LTPE were 22.33%, 29.88%, 31.65, and 15.74%, respectively. AE showed the highest value of extract yield. The $a^*$ and $b^*$ values were higher in AE compared to other extracts. Total polyphenolics and flavonoids contents in AE was significantly higher than in other extracts. The amount of proanthocyanidin related substances were highest in LTPE (29.36 mg/g), followed by RE (21.57 mg/g), SE (20.35 mg/g), and AE (13.02 mg/g). The electron donating abilities of SE, RE, AE, and LTPE at a concentration of $500{\mu}g/mL$ (w/v) were 76.16%, 39.55%, 25.50%, and 12.59%, respectively. Reducing power for the four different processes was 1.79, 1.60, 1.51, and 1.17, respectively. Additionally the same tendency was observed with electron donating ability and reducing power for ABTS radical and nitrite scavenging abilities. AE and LTPE showed relatively high antioxidant activities. Alpha-glucosidase, xanthine oxidase, and angiotensin I-converting enzyme inhibitory activities of LTPE at a concentration of $500{\mu}g/mL$ (w/v) were somewhat higher than other extracts. Additionally, there was significantly higher or little lower inhibitory activity compared to the control group. In conclusion, we provided experimental evidence that extracts of JAL have potential as functional materials, and component analysis of JAL could be used as new cosmeceuticals. Also, LTPE is the superior method for the enhancement of biological activity.

Effect of Irrigation Water Depth on Greenhouse Gas Emission in Paddy Field (논물 담수심이 온난화 가스 배출에 미치는 영향)

  • Lee, Kyeong-Bo;Kim, Jong-Gu;Park, Chan-Won;Shin, Yong-Kwang;Lee, Deog-Bae;Kim, Jae-Duk
    • Korean Journal of Soil Science and Fertilizer
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    • v.38 no.3
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    • pp.150-156
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    • 2005
  • The increasing emission of greenhouse gases may change agricultural environment. The agronomic productivity will depend upon change of temperature, precipitation, solar radiation and fertilization. This study was conducted to investigate greenhouse gas emission with irrigation water depth in paddy field. Area of each experiment plot is $70m^2$, Three treatments with three replications were carried out in this experiment, which was laid out as randomized complete block design. The treatments of irrigation water were maximum field water capacity and 4 and 8 cm depth. The application rate of fresh rice straw was $8,000kg\;ha^{-1}$ in combination with chemical fertilizers ($110kg\;N\;ha^{-1}$, $45kg\;P_2O_5\;ha^{-1}$ and $57kg\;K_2O\;ha^{-1}$). The $CH_4$ emission was highest at 32 days after rice transplanting with rice straw treatment. The $CH_4$ emission in the plot of maximum field water capacity was lower compared with 4 and 8 cm of irrigation depth. $CH_4$ and $N_2O$ emission under different water depth in the paddy field were 30 and $1.52kg\;ha^{-1}$ at 8 cm depth, 281 and $1.71kg\;ha^{-1}$ at 4 cm depth, and 219 and $2.01kg\;ha^{-1}$ at water saturated condition. The total emission of greenhouse gases equivalent to $CO_2$ emission with rice straw application were $6,939kg\;CO_2\;ha^{-1}$ at 8 cm depth plot, $6,431kg\;CO_2\;ha^{-1}$ at 4 cm depth plot and $5,222kg\;CO_2\;ha^{-1}$ at water saturated condition. The GWPs without rice straw application were $4,449kg\;CO_2\;ha^{-1}$ at 8 cm depth plot, $3,702kg\;CO_2\;ha^{-1}$ at 4 cm depth plot and $4,579kg\;CO_2\;ha^{-1}$ at water saturated condition.

Clinical observation for the Geriatric C.V.A. (노인(老人) 뇌졸중(腦卒中)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Seo, Un-Kyo;Jeong, Ji-Cheon;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.14 no.2
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    • pp.50-70
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    • 1993
  • Clinical observation was done on 92 cases of Occlusive CVD, Cerebral hemorrhage (Subarachnoid hemorrhage) which were confirmed by Brain CT scan and observed for over 4 weeks, among the 121 cases which were more than 65 years of age. they admitted to the Dept. of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from July 1992 to June 1993. The result were as follows; 1. In this study, Occlusive CVD was 74 cases, Cerebral hemorrhage (Subarachnoid hemorrhage was 2 cases) was 18 cases. 2. The ratio of male to female was 1.09:1. The age distribution showed the large number in the 65-69 year group(52.2%), 7th decade was 44.5% over 8th decade was 3.3% in ratio. 3. The site of Occlusive CVD was most common at MCA. the site of Cb-hemorrhage was most common at Basal ganglia. 4. The most common preceding disease was hypertension(47.8%) and the next were diabetes mellitus(14.1%), heart desease(14.1%). 5. Recurrence rate was 33.7% and 2nd attack was 20.7%, 3rd attack was 8.7%, 4th attack was 4.3% 6. Predisposing factors in Occlusive CVD were initiated usually during resting and sleeping, and that in Cb-hemorrhage were represented chiefly exercising(66.6%). 7. The smoker was 52.2%, the drinker was 32.6% in whole group. the drinker was 61.1% by the Cb-hemorrhage. 8. The ratio of the season distribution was as follow, fall 35.8%, winter 29.3%, spring 19.6%, summer 15.3%, that of the month distribution was november 15.2%. 9. Duration from on set in Occlusive CVD, 60.8% was within 5 days, that in Cb-hemorrhage, 77.8% was within 5 days. 10. Level of consciousness on attack was clear 42.2%, lethargy and mental change(dull, stupid etc.) 41.3%. The common symptoms were motor disturbance(90.2%), verbal disturbance(65.2%), headache(43.5%). 11. The physical theraphy of Occlusive CVD has been performed 75.7% in whole group and the average beginning time was 6.4 days, and that of Cb-hemorrhage has been performed 61.1% in whole group and the average beginning time was 13 days. 12. Duration of hospitalization was noted 11-20 days was 31.5%, over 21 days was 46.8%, and the average admission was 22.7 day(Occlusive CVD), 32days (Cb-hemorrhage). 13. The main complication were observed in the studies; urinary tract infection and pneumonia were noted in 6.5%, bed sore in 5.4%. 14. The ratio of systolic blood pressures in admission and discharge decreased from 58.7% to 28.3% in over 160 mmHg, that of diastolic blood pressures in admission and discharge decreased from 72.8% to 51.1% in over 90 mmHg. In 31(33.7%) of the 92 cases it showed the glucose levels of more than normal. 15. The patients have done family history of hypertension and C.V.A were 32.6% of all 16. Occlusive CVD In 83.8% and Cb-hernorrhage in 72.2% were improved 17. The herb medications were various Sunghyanggeonggisan, Sopungtang, CHunmagudeungeum were used most frequently and Gamidaebotang, Boyangwhanotang, Gagamyunjotang, Mangeumtang etc. were used as discharge.

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