• Title/Summary/Keyword: injury benefit

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The Benefit of KT-2000 Knee Ligament Arthrometer in Diagnosis of Anterior Cruciate Ligament Injury (슬관절 전방 십자 인대 파열의 진단에 있어서 KT-2000 기기의 유용성)

  • Park, Jai-Hyung;Kim, Hyoung-Soo;Jung, Kwang-Gyu;Yoo, Jeong-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.82-88
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    • 2004
  • Purpose: In this study, we intended to ascertain the benefit of KT-2000 Knee arthrometer(KT-2000) in the diagnosis of ACL(Anterior cruciate ligament) injury by comparing the anterior displacement of normal knee with that of ACL deficient knee. Materials and Methods: We designated two examiners to measure the anterior displacement of the knee joint of 30 healthy individuals, using KT-2000, at 30$^{\circ}$ flexion setting of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation and analyzed these results according to the variables and measured the preoperative anterior displacement of the ACL injured knee in the 30 patients who have gone through an arthroscopic ACL reconstruction later. Results: The results of examiner 1 are 6.5${\pm}$1.5 mm, 2.5${\pm}$0.9 mm, 4.8${\pm}$1.2 mm, 6.4${\pm}$1.3 mm in right knee and 5.6${\pm}$1.3 mm, 2.1${\pm}$0.8 mm, 4.5${\pm}$1.2 mm, 5.2${\pm}$1.3 mm in left knee, in order of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation. The results of examiner 2 are 6.9${\pm}$1.2mm, 2.9${\pm}$1.1mm, 5.6${\pm}$1.6mm, 6.9${\pm}$1.5mm in right, 5.5${\pm}$1.7 mm,1.9${\pm}$0.9 mm, 5.1${\pm}$1.9 mm, 5.7${\pm}$1.6 mm in left knee, The side to side difference of examiner 1 in the setting of muscle relaxation is 0.9${\pm}$1.0 mm. The anterior displaement of ACL injured knee is average 11${\pm}$2.93 mm and difference of average 6.5${\pm}$2.31 mm form that of normal. In comparison between the right and left knees of healthy individuals, the both results of two examiners showed the statistical difference in the setting of muscle full relaxation but, the results showed the side to side difference below 2 mm in 25case(83%), 21case(70%) respectively and above 3 mm in just 1 case. In the comparison between the normal and ACL injured knees, the results show the statistical difference of the side to side difference in the setting of muscle relaxation(p<0.05). Conclusion: The KT-2000 result is affected by relaxation of muscles around knee, flexion angle of knee joint, rotation of tibia, the strength of displacing force, time of the test and physical factors as height and weight. However, the Accuracy of diagnosis of ACL injury by KT-2000 will increase if the examiner is skillful and the tests are made on the exact position of knee joint.

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The Clinical Summary of the Coronary Bypass Surgery (심장 관상동맥 외과)

  • 정황규
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.174-185
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    • 1980
  • It was my great nohour that I can be exposed to such plenty materials of the coronary bypass surgery. Here, I am summarizing the xoronary bypass surgery, clinically. The material is serial 101 patients who underwent coronary bypass surgery between July 17, 1979 to November 30, 1979 in Shadyside Hospital, University of Pittsburgh. 1. Incidence of the Atherosclerosis is frequent in white, male, fiftieth who are living in industrialized country. It has been told the etiologic factor of the atherosclerosis is hereditary, hyperlipidemia, hypertension, smoking, drinking, diabetes, obesity, stress, etc. 2. The main and most frequent complication of the coronary atherosclerosis is angina pectoris. Angina pectoris is the chief cause of coronary bypass surgery and the other causes of coronary bypass surgery are obstruction of the left main coronary artery, unstable angina, papillary muscle disruption or malfunction and ventricular aneurysm complicated by coronary artery disease. 3. The preoperative clinical laboratory examination shows abnormal elevation of plasma lipid in 82 patint, plasma glucose in 40 patient, total CPK-MB in 24 patient stotal LDH in 22 patient out of 101 patient. 4. Abnormal ECG findings in preoperative examine were 29.1% myocardial infarction, 25.8% ischemia and injury, 14.6T conduction defect. 5. Also we had done Echocardiography, Tread Mill Test, Myocardial Scanning, Vectorcardiography and Lung function test to get adjunctive benefit in prediction of prognosis and accurate diagnosis. 6. The frequency of coronary atherosclerosis in main coronary arteries were LAD, RCA and Circumflex in that order. 7. The patients' main complaints which were became as etiologic factor undergoing coronary bypass surgery were angina, dyspnea, diaphoresis, dizziness, nausea and etc. 8. For the coronary bypass surgery, we used cardiopulmonary bypass machine, non-blood, diluting prime, cold cardioplegic solution and moderate cooling for the myocardial protection. 9. We got the grafted veins from Saphenous and Cephalic vein. Reversed and anastomosed between aorta and distal coronary A. using 5-0 and 7-0 prolene continuous suture. Occasionally we used internal mammary A. as an arterial blood source and anastomosed to the distal coronary A. and to side fashion. 10. The average cardiopulmonary bypass time for every graft was 43.9 min. and aortic clamp time was 23 minute. We could Rt. coronary A. bypass surgery only by stand by the cardiopulmonary machine and in the state of pumping heart. 11. Rates by the noumbers of graft were as follow : 21.8% single, 33.7% double, 26.7% triple, 13.9% quadruple, 3% quintuple and 1% was sixtuple graft. 12. combined procedures with coronary bypass surgery were 6% aneurysmectomy, 3% AVR, 1% MVR, 13% pacer implantation and 1% intraaortic ballon setting. 13. We could see the complete abolition of anginal pain after operation in 68% of patient, improvement 25.8%, no change in 3.1%, and there was unknown in 3%. 14. There were 4% immediate postoperative deaths, 13.5% some kinds of heart complication, 51.3% lung complications 33.3% pleural complications as prognosis.

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Comparative study on patterns and symptoms of disharmony(病機病症) between the internal organs(藏府) and external bodily form(身形) (藏府와 身形의 病機 및 病症에 대한 比較考察)

  • Baek, Sang-Ryong
    • Journal of Korean Medical classics
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    • v.13 no.2 s.17
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    • pp.21-21
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    • 2000
  • All living things including human being consist of soul(spirit) and body. Soul is the root of a life and body frames it. I wrote this paper to tell how internal injury due to endogenous etiological factors and affection due to exegenous pathogenic factors, affect the internal organs and the external bodily from. This paper begins with description of the patterns of disharmony of the internal organs. General disorders of each Five-Jang(五藏) an be classified into two types of soul and body. The Liver and the Heart which lead changing to Yang(陽) of vital energy, have close relationship with spiritual symptoms because spirit is related to Yang. The Lung, Kidneys, the Spleen which lead changing to m(陰) of vital energy, mainly connected with physical disorders because body is relatively close to m. The Five-Jang are ruled by the Five-Phases(五行) system and cause troubles with Oche(五體) and the nine body orifice. Otherwise the main function of the Six-Bu(六府) is to receive food, absorb the usuable portions, and transmit and excrete waste. Therefore they can cause such problems as abdominal pain, distention, difficulty in urination, and constipation. The spleen is responsible for sending Grain-Ki)穀氣) 내 that is closely connected with the six-Bu. The Gall bladder takes care of control of giving out spirit. That's why it presents many symptoms related to the spirit that is ruled by the Five-Jang. Patterns of disharmony of external bodily form is influenced by the state of Maridians. Bodily forms get divided into many parts by the function of six-meridians(六經) to which they belong. Six-meridians have their own function related to excretion, related to excretion, retention, and balance(開闔樞). If local bodily froms get affected by pernicious influences, the Meridians to which they are attached will lose harmony and connot fulfil their own functions. Because the meridian symtem unifies all parts of the body, the whole body will be under the influence of the affection although local parts of the bodily forms get affected. Therefore the symptoms of disharmony should be considered in a synthetic view. There are however, also cases which should be focused on the very meridian channels affected. Disorder within a Meridian generates derangement in the pathway make it not to benefit the muscles and skin belong to it. Because the meridians connect the interior organs with the exterior bodily form, they are influenced by each other.

Comparative study on patterns and symptoms of disharmony(病機病症) between the internal organs(藏府) and external bodily form(身形) (장부(藏府)와 신형(身形)의 병기(病機) 및 병증(病症)에 대한 비교고찰(比較考察))

  • Baek, Sang-Ryong
    • Journal of Korean Medical classics
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    • v.13 no.2 s.17
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    • pp.22-42
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    • 2000
  • All living things including human being consist of soul(spirit) and body. Soul is the root of a life and body frames it. I wrote this paper to tell how internal injury due to endogenous etiological factors and affection due to exogenous pathogenic factors, affect the internal organs and the external bodily from. This paper begins with description of the patterns of disharmony of the internal organs. General disorders of each Five-Jang(五藏) an be classified into two types of soul and body. The Liver and the Heart which lead changing to Yang(陽) of vital energy, have close relationship with spiritual symptoms because spirit is related to Yang. The Lung, Kidneys, the Spleen which lead changing to m(陰) of vital energy, mainly connected with physical disorders because body is relatively close to m. The Five-Jang are ruled by the Five-Phases(五行) system and cause troubles with Oche(五體) and the nine body orifice. Otherwise the main function of the Six-Bu(六府) is to receive food, absorb the usable portions, and transmit and excrete waste. Therefore they can cause such problems as abdominal pain, distention, difficulty in urination, and constipation. The spleen is responsible for sending Grain-Ki(穀氣) so that is closely connected with the six-Bu. The Gall bladder takes care of control of giving out spirit. That's why it presents many symptoms related to the spirit that is ruled by the Five-Jang. Patterns of disharmony of external bodily form is influenced by the state of Meridians. Bodily forms get divided into many parts by the function of six-meridians(六經) to which they belong. Six-meridians have their own function related to excretion, related to excretion, retention, and balance(開闔樞). If local bodily forms get affected by pernicious influences, the Meridians to which they are attached will lose harmony and cannot fulfil their own functions. Because the meridian system unifies all parts of the body, the whole body will be under the influence of the affection although local parts of the bodily forms get affected. Therefore the symptoms of disharmony should be considered in a synthetic view. There are however, also cases which should be focused on the very meridian channels affected. Disorder within a Meridian generates derangement in the pathway make it not to benefit the muscles and skin belong to it. Because the meridians connect the interior organs with the exterior bodily form, they are influenced by each other.

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The Study on Wound Healing in Rabbit Skins by Low-intensity Laser Irradiation (저강도 레이저 조사에 의한 가토 피부의 상처 치유에 관한 연구)

  • 김식현;전진석
    • Biomedical Science Letters
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    • v.6 no.2
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    • pp.119-129
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    • 2000
  • The skin is an organ that has many important roles, including protection against infection, regulation of temperature and fluid loss, and sensory function. Injury to the skin, wound repair normally involves: (1) balanced activity of inflammation, (2) the re-epithelial phase and (3) the matrix formation of remodeling phase. Thus, skin wound healing is a finely controlled biological process involving a series of complex cellular interactions. Laser therapy is being implemented with increasing frequency in medicine. Low intensity laser is one that is capable of producing an energy density so low that any biologic alterations are the result of direct irradiation effect, not thermal events. This study was designed to evaluate the efficacy of low intensity laser therapy on skin wound healing in rabbits. A total of 10 male rabbits (New Zealand White Rabbit), age 8 weeks were used. Skin wound were surgically created dorso-lateral on the flank of 10 rabbits (2$\times$2 cm/damage areas). The experimental animals were treated with 5Hz (830 nm wave length) low-intensity laser (MILTA-01 Model) daily for 10 min (1.6 J/$cm^2$) for 12 days. Control animals were sham treated with the laser head. Laser irradiation animals showed a complete remodeling of the epithelial layer, a positive repair of connective tissues, and enhanced the wound closure rate over time as compared to the control animals. Especially, laser irradiation groups improved fibroblast activity, cellular content, granulation tissue formation, and collagen deposition which is resulted in improving the tensile strength of the wound. These findings suggest that laser photostimulation could accelerate healing of open wound in rabbits, and may be benefit in the treatment of open wound, including decubitis ulcers.

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Who Should Live? Autonomous Vehicles and Moral Decision-Making (자율주행차와 윤리적 의사결정: 누가 사는 것이 더 합당한가?)

  • Shin, Hong Im
    • Science of Emotion and Sensibility
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    • v.22 no.4
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    • pp.15-30
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    • 2019
  • The reduction of traffic accidents is a primary potential benefit of autonomous vehicles (AVs). However, the prevalence of AVs also arouses a key question: to what extent should a human wrest control back from AVs? Specifically, in an unavoidable situation of emergency, should an AV be able to decide between the safety of its own passengers and endangered pedestrians? Should AV programming include well-accepted decision rules about actionsto take in hypothetical situations? The current study (N = 103) examined individual/situational variables that could perform critical decision-making roles in AV related traffic accidents. The individual variable of attitudes toward AVs was assessed using the Self-driving Car Acceptance Scale. To investigate situational influences on decisional processes, the study's participants were assigned to one of two groups: the achievement value was activated in one group and the benevolence value was triggered in the other through the use of a sentence completion task. Thereafter, participants were required to indicate who should be protected from injury: the passengers of the concerned AV, or endangered pedestrians. Participants were also asked to record the extent to which they intended to buy an AV programmed to decide in favor of the greater good according to Utilitarian principles. The results suggested that participants in the "achievement value: driver perspective" groupexpressed the lowest willingness to sacrifice themselves to save several pedestrians in an unavoidable traffic accident. This group of participants was also the most reluctant to buy an AV programmed with utilitarian rules, even though there were significant positive relationships between members' acceptance of AVs and their expressed intention to purchase one. These findings highlight the role of the decisional processes involved in the "achievement value" pertaining to AVs. The paper finally records the limitations of the present study and suggests directions for future research.

Staged Reconstruction of the Mangled Hand with the Combined Use of Pedicled Groin Flap and Free Wrap Around Flap (광범위 수부 손상에서 서혜부 유경피판과 유리 포장주위피판을 이용한 단계적 무지 재건술)

  • Roh, Young-Hak;Chung, Moon-Sang;Baek, Goo-Hyun;Lee, Young-Ho;Gong, Hyun-Sik;Rhee, Seung-Hwan;Lee, Ye-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.18 no.2
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    • pp.62-66
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    • 2009
  • Purpose: Despite the free tissue transfer using microsurgical technique being the current trend of soft tissue reconstruction of the hand, the pedicled groin flap has the advantage to provide coverage for the mangled hand without necessitating the use of a damaged arterial system and also providing the benefit of saving the arterial system for later free tissue transfer. This report presents the author's experience using pedicled groin flap in four cases of mangled hands with massive bone and soft tissue defects requiring later thumb reconstruction with the free wrap around flap. Materials and methods: The patients' age ranged from 30 to 51 years; three patients were male and one was female. The causes of mangled hand included two machinery crush injuries, one laboratory explosion and one motor vehicle accident. While evaluating the post-operative results, factors like flap survival, complications, stability in opposition, pinch power and 2 point discrimination were taken into account. Results: All massive soft tissue defects of the hands were completely covered with pedicled groin flap successfully. The reconstructed thumb using free wrap around flap did not have any limitation in opposition. There was no occurrence of post-operative infection and all the flaps survived completely. The average pinch power was 70% of the contralateral intact thumb and average 2 point discrimination was 10 mm. Conclusion: The pedicled groin flap for the reconstruction of the massive soft tissue defects of the hand with subsequent reconstruction of the thumb with a wrap around flap is a very useful procedure. The combined use of pedicled groin flap and wrap around flap allows adequate coverage of sizable soft tissue defects and functional thumb opposition in cases of reconstruction of the mangled hands.

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Pyloric Obstruction with Advanced Gastric Cancer: Stent vs. Bypass (악성 위출구 폐쇄 치료의 선택: 스텐트 삽입술 혹은 수술적 우회술?)

  • Lee, Beom-Jae;Park, Jong-Jae
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.1-5
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    • 2009
  • In the past, conservative bypass surgery was usually performed for palliation of malignant obstruction of the gastrointestinal tract. However, endoscopic stenting was developed recently, and technical advances and clinical experience have made it possible to establish stent implantation as one of the main treatment options. There are several advantages in stent implantation over bypass surgery, such as high feasibility and technical success rate, non-invasiveness, rapid symptomatic response, short hospitalization, and cost-effect benefits. Complications, such as stent ingrowth, stent injury by bile or acid, and migration, may occur and early re-insertion is frequently needed. Recently, diverse novel stents which are powered to predict stent migration or ingrowth have been developed and are being used in the clinical setting. In general, stent implantation is known to be beneficial in patients who are expected to survive <6 months, and surgical bypass may be more effective in patients who can survive >6 months. In this review, we have compared the technical feasibility, clinical outcomes, complications, and cost-benefit between stent implantation and bypass surgery, and determined the optimal treatment strategy in malignant upper gastrointestinal obstruction.

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Development of Traffic Accident Rate to Improve the Reliability of the Valuation of Accident Costs Savings on National Highways (국도 사고비용 산정의 신뢰도 향상을 위한 사고원단위 개선)

  • Wanhyoung Cho;Kijung Kum
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.22 no.5
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    • pp.19-29
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    • 2023
  • The accident rate in South Korea is simply classified according to the road type and the number of lanes, but other countries apply various factors affect accidents. In this study, national highways where accidents occurred were divided into urban, rural, older, and modern roads using TAAS(Traffic Accident Analysis System) data, and a model of accident costs savings is suggested. As a result of analyzing 1,416.2 km, the fatality rate(person/100mil-vehicle·km) was 4.21 for urban-older, 1.37 for urban-modern, 2.18 for rural-older, and 0.99 for rural-modern roads. The rates of urban roads had a higher result than rural. The injury rate(person/100mil-vehicle·km) for urban-older was 182.63, that for urban-modern was 103.42, that for rural-older was 67.44, and that for rural-modern road was 42.96, which showed a similar pattern to fatality rates. Accident rates of a modern road were much lower than the KDI Guideline. The benefit of applying the result of this study was calculated and the valuation of accident costs savings is increased from 0.6% to 14.1%, while B/C is improved from 0.626 to 0.724.

Comparison of the Neurologic Outcome according to the Method of Proximal Graft Anastomosis at the Aortic Side during Off-pump Coronary Artery Bypass Grafting: The Heartstring Sealing System versus Conventional Manual Anastomosis (무심폐기 관상동맥 우회술에 있어서 이식편의 대동맥부 근위부 문합 방법에 따른 수술 후 신경학적 합병증 발생의 비교: 하트스트링을 이용한 방법 대 고식적인 수기 문합술)

  • Cho, Won-Chul;Kim, Joon-Bum;Kim, Hee-Jung;Kim, Hwan-Wook;Kim, Yun-Seok;Jung, Jae-Seung;Choo, Suk-Jung
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.441-446
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    • 2009
  • Background: Side clamping of ascending aorta during proximal graft anastomosis in coronary bypassing surgery in-creases the risk of direct aortic injury as well as embolization of intimal atheroma. Heartstring proximal sealing system (Guidant Corporation, Santa Clara, Calif), developed to avoid aortic side clamping, may minimize risks of such complications. The aim of the current study is to compare the surgical outcomes of the two proximal anastomosis techniquesi.e., Heartstring system versus aortic side clamping in off pump coronary bypassing' surgery (OPCAB). Material and Method: From January 2003 to August 2008, 499 patients underwent OPCAB. Of them, proximal graft anastomosis was performed using Heartstring system in 182 patients (Group I) and conventional manual anastomosis in 317 patients (Group II). The two groups were compared for postoperative major complications and mortality. Result: Two groups showed similar characteristics in terms of preoperative demographic data, left ventricular ejection fraction, renal function and history of diabetes, hypertension and smoking. Although there was no inter-group difference in the history of cerebral ischemia (p=0.48), preoperative brain magnetic resonance angiography revealed greater incidence of severe carotid artery stenosis (>75% of lumen) in the Group I than in the. Group II (44.5% in the Group I and 30.0% in the Group II, p=0.003). There were no inter-group differences in postoperative mortality (p=0.40) and complications (p=0.47) including neurologic events (3 in the Group land 2 in the Group II, p=0.258). Whereas neurologic events all comprised transient ischemic attacks in the Group I, they comprised multiple embolic strokes in the Group II. One patient in the Group II experienced aortic dissection during proximal anastomosis which resulted in ascending aortic replacement. Conclusion: Although proximal anastomosis using Heartstring system did not show statistically significant benefit over aortic side clamping, the. absence of embolic stroke maybe a definite benefit which may be better defined through further studies over a larger cohort.