Purpose: Anatomically, the foot is provided with insufficient blood supply and is relatively vulnerable to venous congestion compared to other parts of the body. Soft tissue defects are more difficult to manage and palliative treatments can cause hyperkeratosis or ulcer formation, which subsequently requires repeated surgeries. For weight bearing area such as the heel, not only is it important to provide wound coverage but also to restore the protective senses. In these cases, application of flaps for hind foot reconstruction is widely recognized as an effective treatment. In this study, we report the cases of soft tissue reconstruction for which various types of flaps were used to produce good results in both functional and cosmetic aspects. Methods: Data from 37 cases of hind foot operation utilizing flaps performed between from June 2000 to June 2008 were analyzed. Results: Burn related factors were the most common cause of defects, accounting for 19 cases. In addition, chronic ulceration was responsible for 8 cases and so forth. Types of flaps used for the operations, listed in descending order are radial forearm free flap (18), medial plantar island flap (6), rotation flap (5), sural island flap (3), anterolateral thigh free flap (2), lattisimus dorsi muscular flap (2), and contra lateral medial plantar free flap (1). 37 cases were successful, but 8 cases required skin graft due to partial necrosis in small areas. Conclusion : Hind foot reconstruction surgeries that utilize flaps are advantageous in protecting the internal structure, restoring functions, and achieving proper contour aesthetically. Generally, medial plantar skin is preferred because of the anatomical characteristics of the foot (e.g. fibrous septa, soft tissue for cushion). However alternative methods must be applied for defects larger than medial plantar skin and cases in which injuries exist in the flap donor / recipient site (scars in the vicinity of the wound, combined vascular injury). We used various types of flaps including radial forearm neurosensory free flap in order to reconstruct hind foot defects, and report good results in both functional and cosmetic aspects.
Purpose : To evaluate the results and usefulness of meniscal repair using meniscal arrows with ACL reconstruction. Material and Methods : Among cases of the simultaneous meniscal arrow fixation and ACL recontruction performed between May, 1997 and September, 2000, 17 cases could be evaluated. The average follow-up were 18.5 months. Twelve cases were medial meniscus, 5 cases, lateral meniscus. All cases were longitudinal tear. Meniscal tear were seen at red-red zone in 13 cases, red-white zone in 5 cases. The results were analyzed by pain, joint line tenderness, locking, McMurray test, the Marshall knee scoring scale and complications. Results : Postoperatively two patients had mild joint line tenderness without pain on joint motion or weight bearing. No patient had locking or positive McMurray test. At last follow-up, 15 cases $(88\%)$ were 'excellent' or 'good' according to the Marshall knee score scale. There were two complications which are soft tissue irritation sign on active knee motion and a femoral chondral injury due to protruded T-shaped head of meniscus arrow. Conclusion : Meniscus arrow can be one of the options in repairing the associated meniscus tear, especially the posterior horn of medial meniscus, during ACL reconstruction. However, surgeons using meniscus arrow should be aware of its potential complications such as pain due to soft tissue irritation and chondral damage of the femoral condyle.
The purpose of this study was to investigate the effect of pelvic traction and muscle energy technique(MET) for hemiplegic patients on static standing balance. The scale for static standing balance is measured by using mean balance(%), frequence(Hz), sway area($mm^2$), sway path(mm), max sway velocity(mm/s), ant/post sway angle($^{\circ}$), lateral sway angle($^{\circ}$), sway number, change of pelvic height is measured in relation to the height of ASIS and PSIS. The subjects of this study were thirty hemiplegic patients: 15men and 15 women, with an average ages of 50.80 years. The thirty subjects were divided into 3 group of 10 at random ; ten subjects had pelvic traction after bobath therapy (the pelvic traction group), ten subjects had muscle energy technique after bobath therapy (the MET group), and ten subjects had only bobath therapy (the control group). Static standing balance was measured using BPM (balance performance monitor; data print software version 5.3), pelvic height was measured using height measuring with an adjustable horizontal arm. In order to assure the statistical significant of the result, an one-way ANOVA, the paired t-test, and a person's correlation were applied at the.05 level of significance. The results of this study were as follows: 1) The change in pelvic height were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). 2) The change in affected and non-affected on weight bearing were not statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p>.05). 3) The change in frequency were statistically significant between the MET group, the control group and the pelvic traction group on pre-treatment and post-treatment(p<.05). 4) The change in sway area were statistically significant between the MET group, the control group and the pelvic traction group on pre-treatment and post-treatment(p<.05). 5) The change in sway pa1h were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). 6) The change in max sway velocity were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). 7) The change in ant/post sway angle were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). 8) The change in lateral sway angle were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). 9) The change in sway number were statistically significant between the pelvic traction group, the MET group and the control group on pre-treatment and post-treatment(p<.05). In conclusion, there was a difference between the experimental group and the control group. In the future, we have to study continuously about pelvic traction and muscle energy technique in hemiplegic patients.
The Journal of the Korean bone and joint tumor society
/
v.1
no.2
/
pp.133-144
/
1995
After resection of intraarticular, periacetabulum(P2) and pubic rami(P23) and extraarticular, proximal femur(P2-H12) by Enneking classification, reconstruction is very difficult. We experienced three cases of saddle prostheses for reconstruction after P2, P23, and P2-H12 resection in pelvic malignancies. Case 1 was a high grade chondrosarcoma in 36 year-old-man and P2 resection was done. But he died of disease 19 months after operation. Case 2 was a malignant giant cell tumor in 32 year-old-woman. P23 resection was given and she is disease-free 32 months after operation. Case 3 was an osteosarcoma of 27-year-old-man and P2-H12 resection was performed and he is disease-free postoperative 12 months now. According to MSTS functional evaluatin system, all three patients showed no pain(5), intermediate function(2), emotinally satisfied(3), one cane or crutch supported(1), limited walking(3), and minor cosmetic gait(3). There was no significant complication and no dislocation except intermittent inguinal hernia in case 2. All patients started crutch walking 3 weeks after operation. Around 6 months postoperatively, the preserved iliac wing(P1 component) was hypertrophied enough to endure the full weight bearing. All could have squating and kneeling positions. In conclusion, saddle prosthesis would be a very useful method of reconstruction after P2, P23, and/or H1-2 resection to shorten the operation time and to reduce the infection rate without significant loss of function.
Ha, Tae Hyu;Cho, Bong-Ho;Kim, Tae Hyeong;Lee, Doo Yong;Eom, Tae Sung
Journal of Korean Society of Steel Construction
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v.25
no.5
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pp.519-530
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2013
Cyclic tests on modular building units for low-rise buildings composed of stud panels and a light-weight steel perimeter frame, were performed to evaluate the earthquake resistance such as stiffness, load-carrying capacity, ductility, and energy dissipation per load cycle. The strap-braced and sheeted stud panels were used as the primary lateral load-resistant element of the modular building units. Test results showed that the modular building units using the strap-braced and sheeted stud panels exhibited excellent post-yield ductile behaviors. The maximum drift ratios were greater than 5.37% and the displacement ductility ratios were greater than 5.76. However, the energy dissipation per load cycle was poor due to severe pinching during cyclic loading. Nominal strength, stiffness, and yield displacement of the modular building units were predicted based on plastic mechanisms. The predictions reasonably and conservatively correlated with the test results. However, the elastic stiffness of the strap-braced stud panel was significantly overestimated. For conservative design, the elastic stiffness of the strap-braced stud panel needs be decreased to 50% of the nominal value.
Sikdar, Sourav;Mukherjee, Avinaba;Bishayee, Kausik;Paul, Avijit;Saha, Santu Kumar;Ghosh, Samrat;Khuda-Bukhsh, Anisur Rahman
Journal of Pharmacopuncture
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v.16
no.3
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pp.11-22
/
2013
Objectives: The present investigation aimed at examining if post-cancer treatment with a potentized homeopathic drug, Condurango 30C, which is generally used to treat oesophageal cancer, could also show an ameliorating effect through apoptosis induction on lung cancer induced by benzo[a]pyrene (BaP) in white rats (Rattus norvegicus). Methods: Lung cancer was induced after four months by chronic feeding of BaP to rats through gavage at a dose of 50 mg/kg body weight for one month. After four months, the lung-cancer-bearing rats were treated with Condurango 30C for the next one ($5^{th}$), two ($5^{th}-6^{th}$) and three ($5^{th}-7^{th}$) months, respectively, and were sacrificed at the corresponding time-points. The ameliorating effect, if any, after Condurango 30C treatment for the various periods was evaluated by using protocols such as histology, scanning electron microscopy (SEM), annexinV-FITC/PI assay, flow cytometry of the apoptosis marker, DNA fragmentation, reverse transcriptase-polymerase chain reaction (RT-PCR), immunohistochemistry, and western blot analyses of lung tissue samples. Results: Striking recovery of lung tissue to a near normal status was noticed after post-cancerous drug treatment, as evidenced by SEM and histology, especially after one and two months of drug treatment. Data from the annexinV-FITC/PI and DNA fragmentation assays revealed that Condurango 30C could induce apoptosis in cancer cells after post-cancer treatment. A critical analysis of signalling cascade, evidenced through a RT-PCR study, demonstrated up-regulation and down-regulation of different pro- and anti-apoptotic genes, respectively, related to a caspase-3-mediated apoptotic pathway, which was especially discernible after one-month and two-month drug treatments. Correspondingly, Western blot and immunohistochemistry studies confirmed the ameliorative potential of Condurango 30C by its ability to down-regulate the elevated epidermal growth factor receptor (EGFR) expression, a hallmark of lung cancer. Conclusion: The overall result validated a positive effect of Condurango 30C in ameliorating lung cancer through caspase-3-mediated apoptosis induction and EGFR down-regulation.
This study was performed to offer the data for design of the seedling bed transfer equipment to make the automation of working process in a plant factory. The seedling bed transfer equipment pushing the seedling bed with bearing wheels on the rail for interconnecting each working process by a pneumatic cylinder was made and examined. The examined transfer force to push the seedling bed with a weight of 178.9 N by the pneumatic cylinder with length of 60 cm and section area of 5 $cm^2$ was measured by experiments. The examined transfer forces was compared with theoretical ones calculated by the theoretical formula derived from dynamic system analysis according to the number of the seedling bed and pushing speed of the pneumatic cylinder head at no load. The transfer function of the equipment with the input variable as the pushing speed $V_{h0}$(m/s) and the output variable as the transfer force f(t)(N) was represented as $F(s)=(V_{h0}/k)(s+B/M)/(s(s^2+Bs/M+1/(kM))$ where M(kg), k(m/N) and B(Ns/m) are the mass of the bed, the compression coefficient of the pneumatic cylinder and the dynamic friction coefficient between the seedling bed and the rail, respectively. The examined transfer force curves and the theoretical ones were represented similar wave forms as to use the theoretical formular to design the device for the seedling bed transfer. The condition of no vibration of the transfer force curve was $kB^2>4M$. The condition of transferring the bed by the repeatable impact and vibration force according to difference of transfer distance of the pneumatic cylinder head from that of the bed was as $Ce^{-\frac{3{\pi}D}{2\omega}}<-1$, where ${\omega}=\sqrt{\frac{1}{kM}-\frac{B^2}{4M^2}}$, $C=\{\frac{\frac{B}{2M}-\frac{1}{kB}}{\omega}\}$, $D=\frac{B}{2M}$. The examined mean peak transfer force represented 4 times of the stead state transfer force. Therefore it seemed that the transfer force of the pneumatic cylinder required for design of the push device was 4Bv where v is the pushing speed.
Purpose: To analyze results of treating acromioclavicular injuries using clavicle hook plates. Materials and Methods: Between February 2008 and April 2010, 18 patients with acromioclavicular joint injury treated by clavicle hook plates were reviewed. Using the Rockwood classification, 7 dislocations were classified as type III injuries and 11 as type V injuries. Implant removal was done at least 3 months from initial fixation. Simple X-rays were taken for comparing the state of reduction, and clinical outcomes were evaluated by the Korean Shoulder Scoring System and the American Shoulder Elbow Society score. The average follow-up period was 9 months. Results: On weight bearing X-rays, the average coracoclavicular distance showed a 114% increase compared to the contralateral side at the time of injury. It decreased to 23% by the last follow-up. The mean Korean Shoulder Scoring System and the American Shoulder Elbow Society score were 80 and 74 at the last follow-up. Conclusion: The immediate stability these plates provide allows rapid rehabilitation. Clavicle hook plate fixation for acromioclavicular joint dislocation is considered an effective method for ensuring satisfactory results both radiologically and clinically.
Talus is a important structure of the ankle joint and its function is critical for ambulation and weight bearing. The talus fracture is rare, but the complications of fracture and dislocation are serious and resulting in avascular necrosis, osteoarthritis. So its treatment is carefully considered at initial status. Authors reviewed 11 cases of fracture and dislocation of the talus treated at Yeungnam university hospital from 1984 to 1991. The longest follow up was 8 years and shortest, 1 year. The results were as follows. 1. There were all males, the average age was 30 years old. 2. The most common cause was fall down(8 cases), and next traffic accident(2cases), sports injury(1 case). 3. According to Marti-Weber classification, 1 cases was type I, 1 in type II, 4 in type III and 5 in type IV. 4. The method of treatment were open reduction and internal fixation in 6 cases, the others were closed reduction in 5 cases. 5. Final results(by Hawkins grading system) were as follows, 3 cases were excellent, 4 cases were good, 1 case was fair and 3 cases were poor. 6. Complications were AVN in 2 cases, degenerative arthritis in 8 cases, malunion in 1 case. 7. The range of motion of the ankle joint was relatively preserved(74%), but in the subtalar joint it was decreased(43%).
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.5
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pp.54-63
/
2018
In this study, the stability and economic feasibility of a MSE (Mechanically stability earth) wall with a pre-cast concrete pacing panel was investigated for a standard section of highway. Based on the design criteria, the MSE walls of the panel type were designed considering the load conditions of the highway, such as the dead load of the concrete pavement, traffic load, and impact load of the barrier. The length of the ribbed metal strip was arranged at 0.9H according to the height of the MSE walls. Because the length of the reinforcement was set to 0.9H according to the height of the MSE wall, the external stability governed by the shape of the reinforced soil was not affected by the height increase. The factor of safety (FOS) for the bearing capacity was decreased drastically due to the increase in self-weight according to the height of the MSE wall. As a result of examining the internal stability according to the cohesive gravity method, the FOS of pullout was increased and the FOS of fracture was decreased. As the height of the MSEW wall increases, the horizontal earth pressure acting as an active force and the vertical earth pressure acting as a resistance force are increased together, so that the FOS of the pullout is increased. Because the long-term allowable tensile force of the ribbed metal strip is constant, the FOS of the fracture is decreased by only an increase in the horizontal earth pressure according to the height. The panel type MSE wall was more economical than the block type at all heights. Compared to the concrete retaining wall, it has excellent economic efficiency at a height of 5.0 m or more.
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