• Archives of Plastic Surgery
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• v.36 no.3
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• pp.318-321
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• 2009

Purpose: The bony mallet finger injury is generally managed by conservative treatments, but operative treatments are needed especially when the fractures involve above 30% of articular surface or distal phalanx is accompanied by subluxation in the volar side. This is the reason they often result in chronic instability, articular subluxation and unsatisfactory cosmetic. In this report, We describe new method using the hook plate as an operative treatment of Mallet finger deformity. Methods: Among 13 patients with Mallet finger deformity who came from February 2006 to February 2008, six patient were included in surgical indication. Under local anesthesia, H or Y type incision was made at the DIP joint area. After the DIP joint extension, the hook plate was put on the fracture line, and one self tapping screw was used for fixation. 2 hole plate which was one of the holes in 1.5 mm diameter was cut in almost half and bended through approximately $100^{\circ}$. Results: In all six cases which applied the hook plate, complications such as loss of reduction or nail deformity were not seen. In only one patient, hook pate was removed due to inflammatory reaction after surgery. At 2 weeks after operation, active motion of DIP joint was performed. The result was satisfactory not only cosmetically but also functionally. At 6 weeks after operation, the range of motion of DIP joint was average $64^{\circ}$. Conclusion: The purpose of the operative treatment for mallet finger deformity using the hook plate is to provide anatomical reduction with rigid fixation and to prevent contracture at the DIP joint. While other operations take 6 weeks, the operation using the hook plate begins an active motion at 2 weeks after operation. Complication rate was low and the method is rather simple. Thus, the operation using the hook plate is recommended as a good alternative method of the mallet finger deformity treatment.

• Tunnel and Underground Space
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• v.14 no.3
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• pp.167-174
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• 2004

This paper is to introduce an article published in Rock Mechanics and Rock Engineering, 2003. In this research, a fracture mechanics model is developed to illustrate the importance of time-dependence far brittle fractured rock. In particular a model is developed fer the time-dependent degradation of rock joint cohesion. Degradation of joint cohesion is modeled as the time-dependent breaking of intact patches or rock bridges along the joint surface. A fracture mechanics model is developed utilizing subcritical crack growth, which results in a closed-form solution for joint cohesion as a function of time. As an example, a rock block containing rock bridges subjected to plane sliding is analyzed. The cohesion is found to continually decrease, at first slowly and then more rapidly. At a particular value of time the cohesion reduces to value that results in slope instability. A second example is given where variations in some of the material parameters are assumed. A probabilistic slope analysis is conducted, and the probability of failure as a function of time is predicted. The probability of failure is found to increase with time, from an initial value of 5% to a value at 100 years of over 40%. These examples show the importance of being able to predict the time-dependent behavior of a rock mass containing discontinuities, even for relatively short-term rock structures.

• Journal of Veterinary Clinics
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• v.24 no.3
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• pp.325-330
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• 2007

This study was to determine whether canine model which produce acute permanent joint instability in short period without postoperative exercise have a degenerative changes and also evaluated its suitability as an appropriate animal OA models. Ten skeletally mature beagle dogs underwent a unilateral surgical transection of the cranial cruciate ligament and, the medial collateral ligament as well as a medial meniscectomy. The contra-lateral joint was used as control. After 12 weeks, After 12 weeks, the amount of joint damage, inflammation and biochemical change of synovial fluid was evaluated. Histological analysis showed chondrocyte clone formation, hypertrophy of the cartilage and moderate loss of proteoglycans in the experimental joints compared to control joints. In addition, the synovial inflammation in the experimental joints was observed. Biochemical analysis of SF showed significantly increased MMP (matrix metalloproteinase) -2 and -9 in experimental joints compared to control joints. This canine OA model shows the characteristics of degenerative joint disease, and may have a advantages of reducing the time and cost because postoperative exercise is not needed in this OA model.

• Annals of Clinical Neurophysiology
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• v.12 no.1
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• pp.3-6
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• 2010

The British guideline for early management of persistent low back pain, published in 2009, indicated that physicians should offer exercise or medication, rather than radiological interventions or injections, as first choice of treatment in the patients with chronic low back pain (CLBP). However, there had been great controversies regarding the effectiveness of interventional treatment of patients with CLBP. Both somatic (discogenic, instability, etc) and psychosocial factors contribute to the pathophysiology of chronic low back pain (CLBP). Although it can be difficult in many occasions, thorough interview with the patients and specific diagnostic approaches can help us to identify which is the main etiology in individual patient. With the recent progress in medical radiology and development of new therapeutic modalities, some subgroups of patients of CLBP caused by somatic factors appear to be good candidates of interventional therapy. Interventional therapy can be considered in patients with CLBP caused by annulus rupture, facet joint degeneration, disc degeneration, and vertebral column instability. Among other subgroups of CLBP, carefully selected patients with disc degeneration show the most favorable result by interventional therapy. In this regard, discogenic pain, either as a form of CLBP or acute discogenic radiculopathy, seems to be a good indication of interventional therapy. Because many spine specialists generally consider those with radiculopathy are easier to be treated, patients with CLBP tend to be subjects of conventional conservative therapy. For these reasons, clinicians should make their best effort to identify every possible somatic cause in patients with CLBP before regarding them as hypochondriacs. In this review, some of the recent evidence on the role of interventional treatment in patients with CLBP will be discussed, and some of our cases who showed favorable results by interventional therapy will be presented.

• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.162-166
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• 2005

Purpose: To analyze the clinical and radiological feature of Os subfibulare and to evaluate the results after anatomical reduction and internal fixation with bone graft for Os subfibulare. Materials and Methods: Forty-two cases, which underwent anatomic reduction and bone graft for Os subfibulare from October 1998 to September 2004 were reviewed. We analysed preopertive symptoms and onset of symptoms and radiologically measured the size and amounts of displacement of Os subfibulare under the inversion stress. Postoperatively we evaluated the clinical results measured by Hasegawa method and evidence of union. Results: Preoperatively there were only pain around the lateral malleolus in 16 cases, only instability of ankle joint in 3 cases, and pain and instability in 23 cases. The age of symptom onset averaged 23 years(range, 13-38 years). Radiographically Os sufibulare anteriorly located from lateral malleolus were in 40 cases, posteriorly situated in 2 cases. The size of Os subfibulare ranged from $1{\times}4\;mm$ to $8{\times}17\;mm$. In 22 cases of inversion stress view, displacement of the Os sbufibulare averaged $1.5{\pm}1.1\;mm$ (0 to 5 mm). The postoperative clinical results were excellent in 41 cases, poor in 1 case. There were complications of 1 case of irritation of sural nerve, 1 case of nonunion. Conclusion: Anatomic reduction and bone graft is effective treatment method for symptomatic Os subfibulare.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.111-117
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• 2001

Introduction : The Functional muscle transfer is used to reconstruct the injuried muscle and paralysis of the shoulder. Especially transfer of the trapezius has been the treatment of choice but it has disadvantages of inadequate function and deformed contour, and instability of humeral head in case of acromion resection. We report an operation for shoulder reconstruction after wide resection of malignant fibrous histiocytoma, using rotational latissimus dorsi flap and review the operation method and clinical outcome. Materials and Methods : A patient, 53 year old, with malignant fibrous histiocytoma in the acromioclavicular joint area had been underwent wide excision, including the deltoid, clavicular head of pectoralis major, part of trapezius, lateral 1/3 of clavicle and acromion including scapular spine. The rotational latissimus dorsi flap with its neurovascular pedicle was dissected and then placed over the resected area and transfer of muscle attached at coracoid process was done to achieve stability of the humeral head. The range of motion of the shoulder and test of muscle power were evaluated for functional outcome. Total follow-up period is 2 years 11 months. Results : At last follow-up, the range of motion of the shoulder is abduction $90^{\circ}$, flexion $90^{\circ}$, internal rotation $40^{\circ}$, external rotation $50^{\circ}$ and the muscle power is 4 grade in all direction and then we obtained good functional results. There are no complications such as instability or subluxation of the humeral head and deformed contour and he is a disease-free survival state. Conclusions : The transfered latissimus dorsi flap provides adequate lever arm and stabilization and covering of the humeral head by sufficient muscle volume and width. This procedure can be useful not only for the paralysed deltoid reconstruction but also for use in reconstructive surgery after wide resection of the shoulder for malignant tumor.

• Journal of Korean Foot and Ankle Society
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• v.12 no.1
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• pp.66-73
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• 2008

Purpose: To report the clinical results of tibio-talo-calcaneal arthrodesis fixed with multiple cannulated screws for the cases of painful ankle and hindfoot arthropathy regardless of any deformity or instability. Materials and Methods: A retrospective analysis was performed upon 10 patients that underwent tibio-talo-calcaneal arthrodesis from October 1999 to May 2006. There were 4 males and 6 females, with an average age of 63 years (43-70). The etioloty of arthrodesis included 5 osteoarthritis, 2 Charcot joints, 1 rheumatoid arthritis, 1 Tbc arthritis and 1 residual poliomyelitis. Chief complaints were pain in 9 cases and instability in 1 case. Three patients had combined severe varus deformity. Tibio-talo-calcaneal arthrodesis using multiple cannulated screws was performed by transfibular approach for all cases and short leg cast was applied for 12 weeks postoperatively. Results: The average follow-up period was 16.5 months (12-26 months). VAS pain score was average 8.2 (7-10) and modified AOFAS score was average 25 (8-40, total 86) preoperatively. At final follow-up, VAS score was average 1.0 (0-3) and AOFAS score improved to average 66 (58-75). There were 4 complications: 2 nonunion, 1 tibia stress fracture and 1 malunion. Seven of 8 patients were satisfied with the results at final follow-up. Conclusion: Fixation with multiple cannulated screws for tibio-talo-calcaneal arthrodesis through transfibular approach is a recommendable surgical option.

• Atmosphere
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• v.21 no.4
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• pp.391-404
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• 2011

This study investigates the impact of cumulus parameterization scheme (CPS) with different horizontal grid sizes on the simulation of the local heavy rainfall case over the Korean Peninsula. The Weather Research and Forecasting (WRF)-based real-time forecast system of the Joint Center for High-impact Weather and Climate Research (JHWC) is used. Three CPSs are used for sensitivity experiments: the BMJ (Betts-Miller-Janjic), GD (Grell-Devenyi ensemble), and KF (Kain-Fritsch) CPSs. The heavy rainfall case selected in this study is characterized by low-level jet and low-level transport of warm and moist air. In 27-km simulations (DM1), simulated precipitation is overestimated in the experiment with BMJ scheme, and it is underestimated with GD scheme. The experiment with KF scheme shows well-developed precipitation cells in the southern and the central region of the Korean Peninsula, which are similar to the observations. All schemes show wet bias and cold bias in the lower troposphere. The simulated rainfall in 27-km horizontal resolution has influence on rainfall forecast in 9-km horizontal resolution, so the statements on 27-km horizontal resolution can be applied to 9-km horizontal resolution. In the sensitivity experiments of CPS for DM3 (3-km resolution), the experiment with BMJ scheme shows better heavy rainfall forecast than the other experiments. The experiments with CPS in 3-km horizontal resolution improve rainfall forecasts compared to the experiments without CPS, especially in rainfall distribution. The experiments with CPS show lower LCL(Lifted Condensation Level) than those without CPS at the maximum rainfall point, and weaker vertical velocity is simulated in the experiments with CPS compared to the experiments without CPS. It means that CPS suppresses convective instability and influences mainly convective rainfall. Consequently, heavy rainfall simulation with BMJ CPS is better than the other CPSs, and even in 3-km horizontal resolution, CPS should be applied to control convective instability. This conclusion can be generalized by conducting more experiments for a variety of cases over the Korean Peninsula.

• Journal of Korean Neurosurgical Society
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• v.55 no.5
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• pp.255-260
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• 2014

Objective : The purpose of this study was to compare the radiological and neurological outcomes between two atlantoaxial fusion method for atlantoaxial stabilization; C1 lateral mass-C2 pedicle screws (screw-rod constructs, SRC) versus C1-2 transarticular screws (TAS). Methods : Forty-one patients in whom atlantoaxial instability was treated with atlantoaxial fixation by SRC group (27 patients, from March 2005 to May 2011) or TAS group (14 patients, from May 2000 to December 2005) were retrospectively reviewed. Numeric rating scale (NRS) for pain assessment, Oswestry disability index (ODI), and Frankel grade were also checked for neurological outcome. In radiologic outcome assessment, proper screw position and fusion rate were checked. Perioperative parameters such as blood loss during operation, operation time, and radiation exposure time were also reviewed. Results : The improvement of NRS and ODI were not different between both groups significantly. Good to excellent response in Frankel grade is shown similarly in both groups. Proper screw position and fusion rate were also observed similarly between two groups. Total bleeding amount during operation is lesser in SRC group than TAS group, but not significantly (p=0.06). Operation time and X-ray exposure time were shorter in SRC group than in TAS group (all p<0.001). Conclusion : Both TAS and SRC could be selected as safe and effective treatment options for C1-2 instability. But the perioperative result, which is technical demanding and X-ray exposure might be expected better in SRC group compared to TAS group.

• Journal of Korean Academy of Nursing
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• v.18 no.1
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• pp.34-43
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• 1988

The present study has been undertaken to assess the electrical activity of right tibialis anterior, right gastrocnemius, right rectus femoris, right biceps femoris and right paralumbarvertebral muscles quantitatively by EMC while standing erect on the height of 0cm, 3cm, 5cm and 7cm heels. The inclinations of the heels were 0, 6, 11, 17 degrees, respectively. Foully young women ranging from 18 to 24 of age were examined. Electrical activity of various muscles while standing erect on the height of various heels were compared with that of 0cm heel. The results obtained were as follows : 1. Electrical activity of the tibialis anterior increased significantly as the height of heels became higher ; which was thought to be due to the effort to counteract the instability standing with high heels. 2. There was a significant increase in electrical activity of the gastrocnemius as the height of heels increased. It might be due to compensatory activity against shifting of the center of gravity forward. 3. There was a significant increase .in electrical activity of the rectus femoris and biceps femoris at the height of 3cm, 5cm and 7cm heels ; which seemed to be due to the effort to stabilize the knee joint. 4. Electrical activity of the paralumbarvertebral muscles increased significantly at the height of 5cm and 7cm heels ; which was considered to be due to the effort to prevent forward imbalance. From These results, it may be concluded that electrical activities of various postural muscles increase significantly while standing erect on the height of 3cm, 5cm and 7cm heels to counteract an instability of their posture and compensate the forward shifting tendency of the center of gravity.