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ACL reconstruction with autologous hamstring tendon - Short term clinical result using new femoral suspensory fixation device 'Cross Pin' and graft tensioner for maintaining a constant tension- (자가 슬괵건을 이용한 전방 십자 인대 재건술 - 새로운 대퇴부 현수고정법인 Cross Pin과 일정한 긴장력 유지를 위한 Graft Tensioner 사용의 단기 추시 결과 -)

  • Seo, Seung-Suk;Kim, Chang-Wan;Kim, Jin-Seok;Choi, Sang-Yeong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.27-34
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    • 2011
  • Purpose: To evaluate the short term clinical result of ACL reconstruction with autologous hamstring tendon using Cross pin and Graft Tensioner and to seek way to resolve the experienced technical problems. Materials and Methods: From January 2008 to March 2009, 35 patients who had been treated arthroscopic ACL reconstruction were enrolled. The femoral side of ACL graft was fixed with Cross pin. The tibial side of graft was fixed with Intrafix and post-tie. The graft was tensioned with Graft Tensioner at 80N. We analyzed the clinical, radiographic results and complications. Results: IKDC subjective score and Lysholm score improved to 89.1 and 91.4 points. Also, Pivot shift test and One-leg hop test showed good results postoperatively. Side to side difference using KT-1000 arthrometer and Telos stress radiography improved compared with normal limb to $2.8{\pm}1.6$ mm and $2.6{\pm}1.3$ mm, respectively. The femoral tunnel enlarged to $2.3{\pm}1.1$ mm. Soft tissue irritation and femoral tunnel-graft harness length mismatch, femoral tunnel-cross pin tunnel mismatch were happened as peri-operative complications. Conclusion: Using of Cross pin and Graft Tensioner for ACL reconstruction with hamstring tendon is one of the good method for obtaining stability in short-term clinical result. But to reduce femoral tunnel-cross pin mismatch, it needs to shorten femoral bone tunnel and to create cross pin tunnel as vertical as possible. And to reduce femoral tunnel-graft harness mismatch, it needs to advance position rod further 3 mm when to create femoral tunnel.

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Comparison of Clinical Results and Second-Look Arthroscopy after Anterior Cruciate Ligament Reconstruction using Hamstring Tendon Autograft, Mixed graft and Tibialis Tendon Allograft (자가슬괵건, 혼합건 및 동종 경골건을 이용하여 실시한 전방십자인대 재건술후 임상결과 및 이차관절경 검사 비교)

  • Cho, Jin-Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.1
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    • pp.18-26
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    • 2011
  • Purpose: This study is to compare the clinical results of ACL reconstruction between three groups using hamstring tendon autograft, mixed and tibialis tendon allograft. Materials and Methods: Between August 2003 and August 2008, we analyzed 169 cases of ACL reconstruction, 66 cases used hamstring tendon autograft, 42 cases used mixed graft and 61 cases used tibialis tendon allograft, with a minimum follow-up of 12 months. For the clinical evaluation, we evaluated the Lysholm score, Telos stress test device and IKDC score. Results: The average side to side difference in Telos stress test decreased from $7.5{\pm}1.0$ mm to $1.6{\pm}1.0$ mm in autograft group, from $7.6{\pm}1.1$ mm to $1.4{\pm}1.1$ mm in mixed graft group and from $7.4{\pm}1.3$ mm to $2.5{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from 58.6 to 92.3 in autograft group, from 60.6 to 92.6 in mixed graft group and from 55.3 to 91.5 in allograft group. There was no significant difference between three groups in clinical results. At second look arthroscopy, tension of ligament and synovial coverage were good result in autograft and mixed graft than allograft group. Conclusion: All hamstring tendon autograft, mixed graft and tibialis tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. Both hamstring tendon autograft and mixed graft showed good synovial coverage in second look arthroscopy. So mixed graft will be considered as good alternative in case of shorter or thin harvested hamstring tendon.

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A Study on the Blood-Letting Therapy in Elementary Questions (("황제내경소문(黃帝內經素問)" 중(中) 사혈(瀉血)에 관한 연구(硏究))

  • Lee, Jun-Geun
    • Journal of the Korean Institute of Oriental Medical Informatics
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    • v.14 no.1
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    • pp.19-42
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    • 2008
  • Blood-Letting Therapy is a rational and ecological medical treatment by which we can heal most of the diseases by removing the static blood which precipitates in the blood vessel and blocks the flowing of blood. And the static blood is the generic term for the injurious, bad, dead and precipitated blood which is blocked the capillary vessel. The Yellow Emperor's Canon of Internal Medicine says that "the patient is treated with drugs internally and stone acupuncture externally. "In the old texts, the blood-letting therapy is mentioned as blood-letting, network vessel pricking, bloodletting, pricking, and arousing pulses etc and it is noted down as the method of network vessel pricking in 'On the Application of Needles' of Spiritual Pivot. Nine-pricking therapy, twelve-pricking therapy and five-pricking therapy are recorded in the methods of network vessel pricking and among them, the method of squeezing blood after pricking the affected part is explained as the network vessel pricking. There are four methods of network vessel pricking, pricking, picking, cluster needling and scatter-pricking and they are fluidly applied to the various symptoms of diseases. In 'On Discriminative Treating for Patients of Different Regions' in Elementary Questions, Ki-baek emphasizes "most of the local people, there are black in skin and loose in striate, and their diseases are mostly of carbuncle kind. It is suitable to treat the disease with stone therapy to prick with stone, so the stone therapy is transmitted from the east. "And in 'On the Corresponding Relation Between the Eum and Yang of Man and All Things' in Elementary Questions, when the Emperor asked Ki-Back, he answered "sthenia means the sthenia of evil, and deficiency means the deficiency of healthy energy. When the blood is sthenic, the evil should be discharged by pricking when out letting the blood; deficiency of vital energy is the asthenia of channels and network vessels, so the energy should drain from the channel which is not deficient, to replenish. "And in this case we can use the methods of 'Breaking out the static bloods', 'driving out the static bloods', blood-letting'. With this we can infer that the blood-letting therapy is made use of the important medical treatments from the ancient times. Especially in referring to the principles of treatment in The Yellow Emperor's Canon of Internal Medicine, it mostly alluded to acupuncture therapies and only eleven times to medicinal treatments. This is to verify that the blood-letting therapy formed the foundation of the medical art. In Dong's Therapy of Acupuncture-Moxibustion and Bloodletting, Dong Kyeong-Chang gave emphasis on the points that there must be extravasated bloods without exception in the serious illnesses which is old, unnatural, accompanying acute pains and so we can revive our body‘s sprit by circulating 'gi' and static blood piled up in the network vessel, regulating the weakness and strength, and controling the disharmony of the internal organs. The blood-letting therapy has effect on the orifice in emergency, such as fore draining, freeing network vessels, harmonizing gi and blood, relieving pain, dispersing swelling and concretion, sedation, resolving toxin as well as strengthening the heart, relieving itching. So it has distinguished effect on all kinds of medical treatment to the modern people. But by the change of social customs and the confucianism of confucius - it is widely spread on the period of North and South Dynasties, 'Wi' and 'Jin' in china and the period of the Three States in korea - The blood-letting therapy which was regarded as the most important medicinal treatment withered rapidly. And Confucius accentuated the importance of our body and all its members, loyalty and filial piety and banned any damage of our body under no circumstances. As a result of it, the therapy of blood-letting had a rapid decrease and barely kept itself in existence in both countries. What is worse, at the period of Japanese colonial rule of korea and our nation's founding of early stage, it has been withered by the high-handed policy to change Oriental Medicine into modern medical science. So the therapy of blood-letting barely kept itself in existence in some Buddhist temples. Another case, it has handed down as a old-fashioned quick fix in folk remedies. But all kinds of the contamination of heavy metals and the misuses of antibiotics are widely spread nowadays, which increased diseases of adult people and incurable diseases as modern society unavoidably made its way into a highly industrial society. To make us more miserable, the western medical science - the antibiotics and surgical operation medical science - already reveals itself into a limit. The necessity of a new medical science which can give a security to the patients who are suffering from the diseases of adult people and the incurable diseases is especially come into the force nowadays. In view of the results after bibliographically studying on the blood-letting Therapy in Elementary Questions of the Yellow Emperor's Canon of Internal Medicine, the blood-letting therapy has acted for the important Oriental medicinal science and has been clarified the prominent effects on the diseases of adult people and the incurable diseases. So it is regarded as an appropriate thing that we lay out a determined theory of the blood-letting therapy and of course prevent the unwanted side effects from inappropriate medicinal treatments, and make full use of clinic by elevating the curative value and that we win back our self-respect of medical treatment which is dominated from the western medical science and ultimately contribute to national medical welfare.

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Return of Self-identity and Story of the Other which disappeared in Advaita Vedanta (아드와이따 베단따의 자아정체성 귀환과 사라진 타자의 이야기)

  • Park, Hyo-yeop
    • Journal of Korean Philosophical Society
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    • v.126
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    • pp.109-132
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    • 2013
  • The most important vocabulary in Advaita $Ved{\bar{a}}nta$, which is anthropology and soteriology on the self, is of course '${\bar{a}}tman$' or 'the self', to which '$an{\bar{a}}tman$' or 'the other' is in opposition. As $Ved{\bar{a}}ntic$ system revolves around the concept ${\bar{a}}tman$, it can be compared favorably with 'final vocabulary' of Richard Rorty. Moreover, $Ved{\bar{a}}ntic$ system can be termed as 'a return of self-identity', in which a process of returning is from a deceived self to the true and original self. After all, story of '$an{\bar{a}}tman$' or 'the other' in $Ved{\bar{a}}nta$ seems to have no significance at all. However, discourse about the other can also lead a something fruitful. There are such doctrines in $Ved{\bar{a}}nta$ that support a procedure of self-realization not according to the Hegelian dialectic but to the transposition and continuous antagonism between the self and the other, as a special meaning of viveka (discrimination) that fixes a boundary between the self and the other, a destruction of falsehood that is more important than establishment of truthfulness, a transposition of the true and the false before and after self-realization. Thus the other is not disappeared but only hidden, even after accomplishing its own methodological role, and the same is with discourse about the other. To revive forgotten vocabulary in $Ved{\bar{a}}nta$ is an attempt to reconstruct devaluated story by means of shifting the pivot of discourse from the self to the other. The essential thing in this attempt may be to revive the conceptions of 'effort' that is intently concealed and of 'self-inquiry' that has lost its true meaning. Out of these, a systematic and continuous self-inquiry, consists in having a scenario on the question 'Who am I?' and utilizing that scenario by experience without interruption. A work of reconstructing the lost narratives in $Ved{\bar{a}}nta$ can be feasible only when the history of self-inquiry is redescribed in the system itself, provided that object of inquiry is not 'a self as the self' but 'a self as the other'.

Anterolateral Ligament of the Knee: Anatomy, Biomechanics, Techniques, and Clinical Outcome (슬관절 전외측인대의 해부학, 생역학, 수술법 및 임상적 결과)

  • Kim, Seong Hwan;Lee, Tae-Hyub;Park, Yong-Beom
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.4
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    • pp.281-293
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    • 2020
  • An anterior cruciate ligament (ACL) reconstruction is one of the most frequent surgical procedures in the knee joint, but despite the better understanding of anatomy and biomechanics, surgical reconstruction procedures still fail to restore rotational stability in 7%-16% of patients. Hence, many studies have attempted to identify the factors for rotational laxity, including the anterolateral ligament (ALL), but still showed controversies. Descriptions of the ALL anatomy are also confused by overlapping nomenclature, but it is usually known as a distinctive fiber running in an anteroinferior and oblique direction from the lateral epicondyle of the femur to the proximal anterolateral tibia, between the fibular head and Gerdy's tubercle. The importance of the ALL as a secondary restraint in the knee has been emphasized for successful ACL reconstructions that can restore rotational stability, but there is still some controversy. Some studies reported that the ALL could be a restraint to the tibial rotation, but not to anterior tibial translation. On the other hand, some studies reported that the role of ALL in rotational stability would be limited as a secondary structure because it bears loads only beyond normal biomechanical motion. The diagnosis of an ALL injury can be performed by a physical examination, radiology examination, and magnetic resonance imaging, but it should be assessed using a multimodal approach. Recently, ALL was considered one of the anterolateral complex structures, as well as the Kaplan fiber in the iliotibial band. Many studies have introduced many indications and treatment options, but there is still some debate. The treatment methods are introduced mainly as ALL reconstructions or lateral extra-articular tenodesis, which can achieve additional benefit to the knee stability. Further studies will be needed on the indications and proper surgical methods of ALL treatment.

Policy Direction for The Farmland Sizing Suitable to Regional Trait (지역특성을 반영한 영농규모화사업의 발전방향-충남지역을 중심으로-)

  • Shim, Jae-Sung
    • The Journal of Natural Sciences
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    • v.14 no.1
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    • pp.83-121
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    • 2004
  • This study was carried out to examine how solid the production foundation of rice in Chung-Nam Province is, and, if not, to probe alternative measures through the size of farms specializing in rice, of which direction would be a pivot of rice industry-oriented policy. The results obtained can be summarized as follows : 1. The amount of rice production in Chung-Nam Province is highest in Korea and the size of paddy field area is the second largest : This implying that the probability that rice production in Chung-Nam Province would be severely influenced by a global trend of market conditions. The number of farms specializing in rice becoming the core group of rice farming account for 7.7 percent of the total number of farm household in Korea. Average field area financial support which had been input to farm household by Government had a noticeable effect on the improvement of the policy of farm-size program. 2. Farm-size program in Chung-Nam Province established from 1980 to 2002 in creased the cultivation size of paddy field to 19,484 hectares, and this program enhanced the buying and selling of farmland and the number of farmland bargain reached 6,431 household and 16,517 hectares, respectively, in 1995-2002. Meanwhile, long-term letting and hiring of farmland appeared so active that the bargain acreage reached 6,970 hectares, and farm involved was 7,059 households, however, the farm-exchange-and-unity program did not satisfy our expectation, because the retirement farm operators reluctantly participated to sell their farms. Another reason that had delayed the bargain of farms rested on the general category of social complication attendant upon the exchange and unity operation for scattered farm. Such difficulties would work negative effects out to carry on the target of farm-size work in general. 3. The following measures were presented to propel the farm-size promotion program : a. Occupation shift project, followed by the social security program for retirement and elderly farm operators, should be promptly established and also a number of types of incentives for promoting the letting and hiring work and farm-exchange-and-unity program would also be set up. b. To establish the effective key system of rice production, all the farm operators should increase the unit area yield of rice and lower the production cost. To do so, a great deal of production teams of rice equipped with managerial techniques and capabilities need to be organized. And, also, there should be appropriate arrays of facilities including information system. This plan is desirable to be in line with a diversity of the structural implement of regional integration based on farm system building. c. To extend the size of farm and to improve farm management, we have to devise the enlargement of individual size of farm for maximized management and the utilization of farm-size grouping method. In conclusion, it can be said that the farm-size project in Chung-Nam Province which has continued since the 1980s was satisfactorily achieved. However, we still have a lot of problems to be solved to break down the barrier for attainment of the desirable farm-size operation work.. Farm-size project has fairly close relation with farm specialization in rice and, thus, the positive support for farm household including the integrated program for both retirement farmers and off-farm operators should be considered to pursue the progressive development of the farm-size program, which is key means to successful achievement of rice farming enforcement in Chung-Nam Province.

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A Study on the Basic Planning of the Nam-Hae Sin-Sa Architecture (남해신사 기본계획에 따른 신당건축 고찰)

  • Kim, Sang Tae;Jang, Hun Duc
    • Korean Journal of Heritage: History & Science
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    • v.42 no.2
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    • pp.62-85
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    • 2009
  • The Nam-Hae Sin-sa, the South Sea shrine in Yeong-Am, Korea was a national institution for public peace and bliss, was excavated in 2000, and the shrine and the 3-way-gate were reconstructed in 2001. Hae Sin-sa, the Sea shrine is a place for religious service separated into the Nam-Hae Sin-sa, the Dong-Hae Myo, and the Seo-Hae Dan. The Dong-Hae Myo was reconstructed, but restored shrine and 3-way-gate of the Nam-Hae Sin-sa is not perfect in comparison with excavation plan in 2000, therefore new reconstruction was researched through the related literature, the analysis of historical maps and excavation results, the interview with the concerned people and the case study. This research defines the analysis of the Plan of the Nam-Hae Sin-sa Reconstruction as follows. 1. The Nam-Hae Sin-sa was the institution for religious service operated by national direct management, represents the shrine for public peace and bliss on the Mountain, the Sea, and the River. Especially the Nam-Hae Sin-sa had an important position on the pivot of international trade with China and Japan, and had a role of main shrine with another one in the Mt. Ji-ri San. 2. The name of the Sea shrine was called as Nam-Hae Sin-sa(the South Sea shrine), Dong-Hae Myo(the East Sea shrine), Seo-Hae Dan(the West Sea shrine). But the name of the South Sea shrine had changed in the early period of Chosun as Nam-Hae Sin-sa to the later Chosun as Nam-Hae Dang through the research of related literature and historical map. Such as the Seo-Hae Dan, it was constructed for the Dan, the flat raised-floor without buildings, and changed to the type of Sa-Dang with addition of buildings. 3. The historical map of Hae Sin-sa informs the types of the roof, the Mat-bae roof was used in the Dong-Hae Myo, but the Pal-jak roof was showed in the Seo-Hae Dan and the Nam-Hae Sin-sa. 4. According to the analysis of Yong-Ch'uck the unit length, Nam-Hae Sin-sa was reconstructed in the period of Koryo on large scale, but it was restored in the Chosun on middle scale. And the Unit of Yong Ch'uck was changed into Yeong-jo Ch'uck in the period of Chosun. 5. As the results, The Plan of the Nam-Hae Sin-sa Reconstruction designed the new shrine into the 3 Kan front and the 2 Kan side with 3:2 scale. An-ch'o-gong with Yong-du and Yong Mi the ornaments represents head and tail of dragon, the Un-gong and the ornament of Pa-ryun-dae-gong in the building, and the Ch'ung-ryang of the Yong-du show the image of the institution for religious service for the god of the sea who look like dragon. The inner gate building and the main entrance were designed as same plan and scale as Hyang-gyo, the Korean Traditional School and Shrine of Confucianism, on the basis of results of excavation. Raise the 3-tall gate of the main entrance with harmony of the scale and the shape, because the side of gate building has the Mat-bae roof. 6. This research shows that Plan of the Nam-Hae Sin-sa Reconstruction is composed into shrine space and reservation space from the main entrance to inner gate and shrine like Jung-ak Dan in the Mt. Gye-ryong San, and it also informs the well in the west side of Sin-sa is an important factor of the plan of shrine architecture.