• Title/Summary/Keyword: proximal method

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Internal Fixation with a Locking T-Plate for Proximal Humeral Fractures in Patients Aged 65 Years and Older

  • Yum, Jae-Kwang;Seong, Min-Kyu;Hong, Chi-Woon
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.217-221
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    • 2017
  • Background: The purpose of this study was to evaluate the clinical and radiographic outcomes of internal fixation with locking T-plates for osteoporotic fractures of the proximal humerus in patients aged 65 years and older. Methods: From January 2007 through to December 2015, we recruited 47 patients aged 65 years and older with osteoporotic fractures of the proximal humerus. All fractures had been treated using open reduction and internal fixation with a locking T-plate. We classified the fractures in accordance to the Neer classification system; At the final follow-up, the indicators of clinical outcome-the range of motion of the shoulder (flexion, internal rotation, and external rotation) and the presence of postoperative complications-and the indicators of radiographic outcome-the time-to-union and the neck-shaft angle of the proximal humerus-were evaluated. The Paavolainen method was used to grade the level of radiological outcome in the patients. Results: The mean flexion was $155.0^{\circ}$ (range, $90^{\circ}-180^{\circ}$), the mean internal rotation was T8 (range, T6-L2), and the mean external rotation was $66.8^{\circ}$ (range, $30^{\circ}-80^{\circ}$). Postoperative complications, such as plate impingement, screw loosening, and varus malunion were observed in five patient. We found that all patients achieved bone union, and the mean time-to-union was 13.5 weeks of the treatment. The mean neck-shaft angle was $131.4^{\circ}$ at the 6-month follow-up. According to the Paavolainen method, "good" and "fair" radiographic results each accounted for 38 and 9 of the total patients, respectively. Conclusions: We concluded that locking T-plate fixation leads to satisfactory clinical and radiological outcomes in elderly patients with proximal humeral fractures by providing a larger surface area of contact with the fracture and a more rigid fixation.

Detection method of proximal caries using line profile in digital intra-oral radiography (디지털 구내방사선사진에서 라인 프로파일을 이용한 인접면우증식의 인지 방법)

  • Park, Jeong-Hoon;Choi, Yong-Suk;Kim, Gyu-Tae;Hwang, Eui-Hwan;Lee, Gi-Ja;Choi, Sam-Jin;Park, Hun-Kuk
    • Imaging Science in Dentistry
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    • v.39 no.4
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    • pp.185-189
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    • 2009
  • Purpose : The purpose of this study was to investigate how to detect proximal caries using line profile and validate linear measurements of proximal caries lesions by basic digital manipulation of radiographic images. Materials and Methods : The X-ray images of control group (15) and caries teeth (15) from patients were used. For each image, the line profile at the proximal caries-susceptible zone was calculated. To evaluate the contrast as a function of line profile to detect proximal caries, a difference coefficient (D) that indicates the relative difference between caries and sound dentin or intact enamel was measured. Results : Mean values of D were $0.0354{\pm}0.0155$ in non-caries and $0.2632{\pm}0.0982$ in caries (p<0.001). Conclusion : The mean values of caries group were higher than non-caries group and there was correlation between proximal dental caries and D. It is demonstrated that the mean value of D from caries group was higher than that of control group. From the result, values of D possess great potentiality as a new detection parameter for proximal dental caries.

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Pylorus-preserving Proximal Gastrectomy vs. Total Gastrectomy with Jejunal Interposition for Proximal Gastric Adenocarcinomas (상부 위암에서 유문보존 근위부 위아전절제술과 공장간치술을 시행한 위전절제술의 비교)

  • Noh Seung-Moo;Jeong Hyun-Yong;Lee Byong-Seok;Cho June-Sik;Shin Kyung-Sook;Song Kyu-Sang;Lee Tae-yong
    • Journal of Gastric Cancer
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    • v.2 no.3
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    • pp.145-150
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    • 2002
  • Purpose: The aim of this study was to evaluate the shortterm outcome of a pylorus-preserving proximal gastrectomy by comparing it with a jejunal interposition after a total gastrectomy in proximal gastric adenocarcinoma. Materials and Methods: For 22 patients (12 men and 10 women) who underwent a pylorus-preserving proximal gastrectomy, several clinical parameters were obtained from the medical records retrospectively. In this study, the data were collected between September 1993 and December 1999 at Chungnam National University Hospital, and the results were compared with those of 25 patients (17 men and 8 women) who underwent an isoperistaltic simple jejunal interposition. Results: The average operative time in the pylorus-preserving proximal gastrectomy group (220 minutes) was shorter than that in the jejunal interposition group (243 minutes) (P<0.05). The hemoglobin and hematocrit levels were significantly higher in the pylorus-preserving proximal gastrectomy group at 2 years after the operation. The body weight ratio (postoperative body weight/preoparative body weight) in patients who had a pylorus-preserving proximal gastrectomy was significantly higher than that in patients with a jejunal interposition at 2 years after the operation. The jejunal interposition procedure had better outcomes in anastomotic site stricture, duration of hospital stay, and number of removed lymph nodes (P<0.05). Conclusions: We think that from the viewpoint of quality of life, a pylorus-preserving proximal gastrectomy, as well as a jejunal interposition, is a useful reconstruction method for early adenocarcinomas of the proximal stomach. However, stricture of the esophagogastrostomy site in the pyloruspreserving proximal gastrectomy is a common problem to be solved in the future.

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Release of Renal Dipeptidase from Rabbit Renal Proximal Tubules and Its Inhibition by Gentamicin

  • Kang, Bok-Yun;We, Jeoung-Soon;Choi, Kyong;Lee, Hwanghee-Blaise;Han, Ho-Jae;Park, Haeng-Soon
    • Archives of Pharmacal Research
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    • v.22 no.4
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    • pp.367-371
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    • 1999
  • Effects of several durgs on rabbit renal proximal tubules were examined for the applicability of renal dipeptidase (RDPase, EC 3. 4. 13. 11) release as a model system to study nephrotoxicity. The proximal tubule prepared by the method of Taub (1990) released RDPase spontaneously in the control experiment which was confirmed by Western blotting. RDPase was also released form cisplatin, lipopolysaccardie (LPS), and indomethacin-treated tubules. Gentamicin inhibited RDPase release in a concentration-dependent manner. This RDPase release system may not be a general model to screen nephrotoxicity but could be a useful source of RDPase purification in a simple and inexpensive way.

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Open Intramedullary Nail with Tension Band Sutures on Proximal Humeral Fracture (상완골 근위부 골절에 시행한 긴장 대 봉합을 동반한 관혈적 골수강내 고정술)

  • Park, Jin-Young;An, Jin-Woo;Lee, Sung-Churl
    • Clinics in Shoulder and Elbow
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    • v.6 no.2
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    • pp.149-160
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    • 2003
  • Purpose: to determine the results after open intramedullary nailing and tension band suture technique in proximal humerus fracture for improving the stability and decreasing the complications. Materials and Method: Authors reviewed 27 patients treated by open intramedullary nailing and tension band suture technique. Mean follow-up period was 39 months (24-59months). Surgical neck fracture were 6 cases, surgical neck fracture with shaft fracture were 3 cases, three part fracture with greater tuberosity fracture were 17 cases, four part fracture was 1 case and fracture and dislocation were 2 cases Results: We got the bony union in 26 cases. Average pain scale was 1 point (0-6), Neer score was 86 point(45-99) and ASES score was 85 point(40-100). We separate all cases in two groups based on age (65 years), L-spine t-score (-2.5) and Neer classification (2 and 3 part). There is no significance in pain scale, Neer score and ASES score between each group. Conclusion: As a method of surgical treatment on severe proximal humeral fractures, we recommend intramedullary nailing and tension band suture technique and it may have particular advantages in early exercise and satisfactory functional outcome.

An Efficient Load Balancing Scheme for Gaming Server Using Proximal Policy Optimization Algorithm

  • Kim, Hye-Young
    • Journal of Information Processing Systems
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    • v.17 no.2
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    • pp.297-305
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    • 2021
  • Large amount of data is being generated in gaming servers due to the increase in the number of users and the variety of game services being provided. In particular, load balancing schemes for gaming servers are crucial consideration. The existing literature proposes algorithms that distribute loads in servers by mostly concentrating on load balancing and cooperative offloading. However, many proposed schemes impose heavy restrictions and assumptions, and such a limited service classification method is not enough to satisfy the wide range of service requirements. We propose a load balancing agent that combines the dynamic allocation programming method, a type of greedy algorithm, and proximal policy optimization, a reinforcement learning. Also, we compare performances of our proposed scheme and those of a scheme from previous literature, ProGreGA, by running a simulation.

Partial Knee Joint Defect Reconstruction with Vascularized Proximal Fibular Articular Surface (슬관절 부분결손에 대한 혈관부착 비골근위 관절면을 이용한 재건술)

  • Chung, Duke-Whan
    • Archives of Reconstructive Microsurgery
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    • v.7 no.2
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    • pp.157-164
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    • 1998
  • It has been very difficult to managing partial joint defect in any etiologies, especially in children. Unicondylar defect of the tibial condyle in children reconstructed with proximal fibular head with articular cartilage from 1995. Two kinds of transfering methods were used, peroneal artery pedicled ipsilateral fibula head transposition to defective lateral tibial condyle defect that revealed poor prognosis with gradual absorption of transposed fibular epiphysis. Free vascularized fibular head transplantation with microvascular anastomosis underwent in the case with medial condyle defect of tibia which revealed very satisfactory results. Author can conclude with these clinical experiences: 1. Tranposition without epiphyseal vesssels intact is not sufficient in fibular head osteochondral transplantation in reconstruction of tibial condyle defect. That means peroneal arterial vascular pedicle is not enough for transplanted proximal epiphysis maintains its function on articular surface and growth activity in children. 2. The anterior recurrent tibial artery is one of the most important and easy to utilizing vessel in proximal fibular epiphyseal transplantation. 3. Free vascularized fibular head transplantation is hopeful method in reconstruction of the knee joint in the patient with partial joint defect which has no effective solution in conventional methods.

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Proximal Interphalangeal Joint (PIPJ) Arthrodesis for Treating PIPJ Osteoarthritis in a Horse

  • Seo, Jeeyoon;Park, Joon-Young;Lee, Minhyun;Cho, Young-Jae;Kim, Byung Hyun;Seo, Jong-Pil
    • Journal of Veterinary Clinics
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    • v.36 no.5
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    • pp.292-295
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    • 2019
  • A 2-year-old, 440 kg, thoroughbred gelding showed a lameness grade of 3 out of 5, as well as swelling and heating on the proximal interphalangeal joint (PIPJ). Periarticular new bones due to the arthritis were observed on performing radiography and ultrasonography. PIPJ arthrodesis was performed under general anesthesia. With the PIPJ open, the articular cartilage was removed by using curette, chisel, and mallet. Arthrodesis was performed with a PIP plate and two additional transarticular cortex screws inserted in lag fashion. A cast was placed over the limb distal from the proximal metatarsal bone. At 6 months after surgery, complete union of the PIPJ was confirmed by radiography, and the incision site was well closed. Based on the outcome, a PIP plate with two additional transarticular cortex screws inserted in lag fashion is recommended as a method for treating osteoarthritis of the PIPJ in horses.

Proximal Gastrectomy for Gastric Cancer

  • Jung, Do Hyun;Ahn, Sang-Hoon;Park, Do Joong;Kim, Hyung-Ho
    • Journal of Gastric Cancer
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    • v.15 no.2
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    • pp.77-86
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    • 2015
  • Laparoscopic proximal gastrectomy (LPG) is theoretically a superior choice of minimally-invasive surgery and function-preserving surgery for the treatment of proximal early gastric cancer (EGC) over procedures such as laparoscopic total gastrectomy (LTG), open total gastrectomy (OTG) and open proximal gastrectomy (OPG). However, LPG and OPG are not popular surgical options due to three main concerns: the first, oncological safety; the second, functional benefits; and the third, anastomosis-related late complications (reflux symptoms and anastomotic stricture). Numerous recent studies have concluded that OPG and LPG present similar oncological safety profiles and improved functional benefits when compared with OTG and LTG. While OPG with modified esophagogastrostomy does not provide satisfactory results, OPG with modified esophagojejunostomy showed similar rates of anastomosis-related late complications when compared to OTG. At this stage, no standard reconstruction method post-LPG exists in the clinical setting. We recently showed that LPG with double tract reconstruction (DTR) is a superior choice over LTG for proximal EGC in terms of maintaining body weight and preventing anemia. However, as there is no definitive evidence in favor of LPG with DTR, a randomized clinical trial comparing LPG with DTR to LTG was recommended. This trial, the Korean Laparoscopic Gastrointestinal Surgery Study-05 (NCT01433861), is expected to assist surgeons in choice of surgical approach and strategy for patients with proximal EGC.

EVALUATION AND DEVELOPMENT OF DIGITAL DEVICE FOR MEASURING PROXIMAL TOOTH CONTACT TIGHTNESS (디지털 방식의 인접면 접촉강도 측정장치의 개발 및 평가)

  • Choi, Woo-Jin;Kim, Kyung-Hwa;Kim, Jin-A;Kang, Dong-Wan;Oh, Sang-Ho
    • The Journal of Korean Academy of Prosthodontics
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    • v.45 no.5
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    • pp.687-695
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    • 2007
  • Statement of problem: The proper contact relation between adjacent teeth in each arch plays an important role in the stability and maintenance of the integrity of the dental arches. Proximal contact has been defined as the area of a tooth that is in close association, connection, or touch with an adjacent tooth in the same arch. Purpose: The aim of this study was to develop a digital device for measuring the proximal tooth contact tightness by pulling a thin stainless steel strip (2mm wide, 0.03mm thick) inserted between proximal tooth contact. Material and method: This device consists of measuring part, sensor part, motor part and body part. The stainless steel strip was connected to a stain gauge. The strain gauge was designed to convert the frictional force into a compressive force. This compressive force was detected as a electrical signal and the electrical signal was digitalized by a A/D converter. The digital signals were displayed by a micro-processor. The pulling speed was 8mm/s. Results: For testing reliability of the device in vivo, two healthy young adults (A, B) participated in this experiment. The tightness of proximal tooth contact between the second premolar and the first molar of mandible (subject A) and maxilla (subject B) was measured fifteen times for three days at rest. We double-checked the accuracy of the device with a Universal Testing Machine. Output signals from the Universal Testing Machine and the measuring device were compared. Regression analysis showed high linearity between these two signals. In vivo test, no significant differences were found between measurements. Conclusion: This device has shown to he capable of producing reliable and reproducible results in measuring proximal tooth contact. Therefore, it was considered that this device was appropriate to apply clinically.