• Journal of Trauma and Injury
• /
• v.37 no.1
• /
• pp.89-96
• /
• 2024

The indications for total hip replacement are increasing and not limited to osteoarthritis. Total hip replacement may also be done for trauma and pathological fractures in patients otherwise physiologically fit and active. This trend has led to an inevitable rise in complications such as periprosthetic femoral fracture. Periprosthetic femoral fracture can be challenging due to poor bone quality, osteoporosis, and stress fractures. We present a case of periprosthetic femoral fracture in a 71-year-old woman with some components of an atypical femoral fracture. The fracture was internally fixed but was subsequently complicated by infection, implant failure needing revision, and later stress fracture. She was on a bisphosphonate after her index total hip replacement surgery for an impending pathological left proximal femur fracture, and this may have caused the later stress fracture. Unfortunately, she then experienced implant breakage (nonunion), which was treated with a biplanar locking plate and bone grafting. The patient finally regained her premorbid mobility 13 months after the last surgery and progressed satisfactorily towards bony union.

• Journal of the Korea institute for structural maintenance and inspection
• /
• v.13 no.5 s.57
• /
• pp.142-148
• /
• 2009

This paper is to investigate the fracture behavior characteristics of box culvert and incremental crack width of upper slab for the incremental loading by the 3-axis loading system. In the 3-axes loading system, loading directions are upper side, left and right side which simulate earth pressure and static traffic load. With the incremental load, crack patterns is investigated on the upper slab, left and right wall. Especially, on the upper slab, crack width is measured by crack gage. Based on the experimental results, structural internal force indices of box culvert are estimated quantitatively.

• Korean Journal of Acupuncture
• /
• v.41 no.3
• /
• pp.110-117
• /
• 2024

Objectives : The objective of this study is to report a case of a patient with a fracture of the 1st metatarsal bone, whose symptoms improved after receiving Complex Korean Medical treatment mainly focused on acupuncture. Methods : During admission treatment, the patient received 2 sessions of acupuncture treatment, 1 session of pharmacopuncture treatment, and electromoxibustion daily. To assess the patient's condition regarding the 1st metatarsal bone fracture, X-rays were performed on the affected area of the patient on a weekly basis, along with a daily follow up on the Numerical Rating Scale (NRS), degree of swelling (measured in cm via measuring tape), and the temperature of the affected area. The Foot Function Index (FFI) and Health Assessment Questionnaire (HAQ) were also used to add credibility in assessing the patient's current condition. Results : After 4 weeks of hospital admission treatment, the NRS of the pain in the affected area decreased from 4 to 1, with the night pain NRS of the affected area also being reduced from 8 to 0. There was a general improvement in the swelling and temperature of the affected area, as well as the FFI and HAQ of the patient. Conclusions : The study shows that complex Korean medical treatment can be effective in treating patients with bone fractures even without interventions involving traditional Korean herbal medicine.

• Clinical and Experimental Pediatrics
• /
• v.61 no.11
• /
• pp.366-370
• /
• 2018

Purpose: Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals. Methods: A 4-year-old child without Bacille Calmette-$Gu{\acute{e}}rin$ vaccination was diagnosed as having culture-proven disseminated TB. The child initially presented with symptoms of inflammatory bowel disease, and nosocomial and kindergarten exposures were reported. The exposed individuals to the index case were divided into 3 groups, namely household, nosocomial, or kindergarten contacts. Evaluation was performed following the Korean guidelines for TB. Kindergarten contacts were further divided into close or casual contacts. Chest radiography and tuberculin skin test or interferon-gamma-releasing assay were performed for the contacts. Results: We examined 327 individuals (3 household, 10 nosocomial, and 314 kindergarten contacts), of whom 18 (5.5%), the brother of the index patient, and 17 kindergarten children were diagnosed as having latent TB infection (LTBI). LTBI diagnosis was more frequent in the children who had close kindergarten contact with the index case (17.1% vs. 4.4%, P=0.007). None of the cases had active TB. Conclusion: This is the first reported case of TB transmission among young children from a pediatric patient with disseminated TB in Korea. TB should be emphasized as a possible cause of chronic diarrhea and failure to thrive in children. A national TB control policy has been actively applied to identify Korean children with LTBI.

• Journal of the Korean GEO-environmental Society
• /
• v.18 no.4
• /
• pp.31-40
• /
• 2017

In this study, a simple method to evaluate the seismic vulnerability of river levees was examined considering the structural characteristic of river levee, that is long, and the functional characteristic of river levee that performs temporary function against flood but is a permanent structure in the ordinary way. Considering the fact that one of the main failure modes of the levee during the earthquake are the settlement due to the strength reduction of the ground caused by the increase of the excess pore pressure in the levee body and foundation and the settlement due to liquefaction, the 2-dimensional section of the levee was regarded as the 1-dimensional section and the liquefaction potential index (LPI) for the regarded section was estimated. The estimated LPI was correlated with the seismic vulnerability of river levees. The relationship between the displacement of the levee crest caused by the earthquake and the seismic vulnerability of the levees was obtained from the results of previous researches and the correlation between the displacements of the levee crest computed by 2-dimensional dynamic coupled analyses and LPIs based on the results of 1-dimensional seismic response analyses was investigated. In connection with this correlation, as a result of examination of the correlation between LPI and the seismic vulnerability of the levee, it was concluded that the method for evaluation of the seismic vulnerability of the Korean river levee using LPI is applicable.

• Tuberculosis and Respiratory Diseases
• /
• v.81 no.4
• /
• pp.311-318
• /
• 2018

Background: The aim of this study was to examine the influence of body mass index (BMI) on the development of acute kidney injury (AKI) in critically ill patients in intensive care unit (ICU). Methods: Data of patients admitted to medical ICU from December 2011 to May 2014 were retrospectively analyzed. Patients were classified into three groups according to their BMI: underweight (< $18.5kg/m^2$), normal ($18.5-24.9kg/m^2$), and overweight (${\geq}25kg/m^2$). The incidence of AKI was compared among these groups and factors associated with the development of AKI were analyzed. AKI was defined according to the Risk, Injury, Failure, Loss of kidney function, and End-stage (RIFLE) kidney disease criteria. Results: A total of 468 patients were analyzed. Their mean BMI was $21.5{\pm}3.9kg/m^2$, including 102 (21.8%) underweight, 286 (61.1%) normal-weight, and 80 (17.1%) overweight patients. Overall, AKI occurred in 82 (17.5%) patients. The overweight group had significantly (p<0.001) higher incidence of AKI (36.3%) than the underweight (9.8%) or normal group (15.0%). In addition, BMI was significantly higher in patients with AKI than that in those without AKI ($23.4{\pm}4.2$ vs. $21.1{\pm}3.7$, p<0.001). Multivariate analysis showed that BMI was significantly associated with the development of AKI (odds ratio, 1.893; 95% confidence interval, 1.224-2.927). Conclusion: BMI may be associated with the development of AKI in critically ill patients.

• Journal of the Computational Structural Engineering Institute of Korea
• /
• v.17 no.3
• /
• pp.319-332
• /
• 2004

Due to their high strength to weight ratios and excellent durability, fiber reinforced polymer(FRP) is widely used in construction industries. In this paper, a shape optimum design of FRP bridge decks haying pultruded cellular cross-section is presented. In the problem formulation, an objective function is selected to minimize the volumes. The cross-sectional dimensions and material properties of the deck of FRP bridges are used as the design variables. On the other hand, deflection limits in the design code, material failure criteria, buckling load, minimum height, and stress are selected as the design constraints to enhance the structural performance of FRP decks. In order to efficiently treat the optimization process, the cross-sectional shape of bridge decks is assumed to be a tube shape. The optimization process utilizes an improved Genetic Algorithms incorporating indexing technique. For the structural analysis using a three-dimensional finite element, a commercial package(ABAQUS) is used. Using a computer program coded for this study, an example problem is solved and the results are presented with sensitivity analysis. The bridge consists of a deck width of 12.14m and is supported by five 40m long steel girders spaced at 2.5m. The bridge is designed to carry a standard DB-24 truck loading according to the Standard Specifications for Highway Bridges in Korea. Based on the optimum design, viable cross-sectional dimensions for FRP decks, suitable for pultrusion process are proposed.

• Tuberculosis and Respiratory Diseases
• /
• v.62 no.6
• /
• pp.516-522
• /
• 2007

Background: Postoperative pulmonary complications are important problems that prolong the length of the hospital stay and increase patient mortality. However, our knowledge of the postoperative factors that increase the risk of these complications is less than complete. Methods: We conducted a prospective study to determine the risk factors for postoperative pulmonary complications. A total of 199 patients were referred to the Pulmonology Department for preoperative pulmonary evaluation. We reviewed the perioperative variables according to the National Surgical Quality Improvement Program (NSQIP). Postoperatively, we collected data on the occurrence of postoperative pulmonary complications and we evaluated the relationship between the perioperative variables and outcomes. Results: Twenty two patients (11%) had pulmonary complications; 6 had respiratory failure, 4 had pneumonia, 13 had pleural effusion and, 2 had atelectasis. Five variables were statistically significantly associated with pulmonary complications on the bivariate analyses. Multiple logistic regression analyses revealed that three of these variables were independently associated with an increased risk of pulmonary complications; a high cardiac risk index (OR 16.5, p=0.002), emergency surgery (OR 10.3, p=0.017), and thoracic/abdominal surgery (OR 3.8, p=0.047). Conclusion: The risk factors for postoperative pulmonary complications are a high cardiac risk index, emergency surgery and thoracic/abdominal surgery.

• Journal of Korean Tunnelling and Underground Space Association
• /
• v.19 no.4
• /
• pp.567-576
• /
• 2017

In a performance-based design, the structural safety is estimated from pre- defined damage states and corresponding damage indices. Both damage states and damage indices are well defined for above-ground structures, but very limited studies have been performed on underground structures. In this study, we define the damage states and damage indices of a cut-and-cover box tunnel which is one of typical structures used in metro systems, under a seismic excitation from a series of inelastic frame analyses. Three damage states are defined in terms of the number of plastic hinges that develop within the structure. The damage index is defined as the ratio of the elastic moment to the yield moment. Through use of the proposed index, the inelastic behavior and failure mechanism of box tunnels can be simulated and predicted through elastic analysis. In addition, the damage indices are linked to free-field shear strains. Because the free-field shear strain can be easily calculated from a 1D site response analysis, the proposed method can be readily used in practice. Further studies are needed to determine the range of shear strains and associated uncertainties for various types of tunnels and site profiles. However, the inter-linked platform of damage state - damage index - shear wave velocity - shear strain provides a novel approach for estimating the inelastic response of tunnels, and can be widely used in practice for seismic designs.

• Journal of Korea Water Resources Association
• /
• v.51 no.11
• /
• pp.989-998
• /
• 2018

Connectivity between water source and demand node can be served as a critical system performance indicator of the degree of water distribution network (WDN)' failure severity under abnormal conditions. Graph theory-based approaches have been widely applied to quantify the connectivity due to WDN's graph-like topological feature. However, most previous studies used undirected-unweighted graph theory which is not proper to WDN. In this study, the directed-weighted graph theory was applied for WDN connectivity analyses. We also proposed novel connectivity indicators, Source-to-Node Shortest Pathway (SNSP) and SNSP-Degree (SNSP-D) which is an inverse of the SNSP value, that does not require complicate hydraulic simulation of a WDN of interest. The proposed SNSP-D index was demonstrated in total 42 networks in J City, South Korea in which Pearson Correlation Coefficient (PCC) between the proposed SNSP-D and four other system performance indicators was computed: three resilience indexes and an energy efficiency metric. It was confirmed that a system representative value of the SNSP-D has strong correlation with all resilience and energy efficiency indexes (PCC = 0.87 on average). Especially, PCC was higher than 0.93 with modified resilience index (MRI) and energy efficiency indicator. In addition, a multiple linear regression analysis was performed to identify the system hydraulic characteristic factors that affect the correlation between SNSP-D and other system performance indicators. The proposed SNSP is expected to be served as a useful surrogate measure of resilience and/or energy efficiency indexes in practice.