• Journal of Korean Foot and Ankle Society
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• v.26 no.2
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• pp.95-102
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• 2022

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the management of syndesmotic injuries over the last few decades. Materials and Methods: A web-based questionnaire containing 36 questions was sent to all KFAS members in September 2021. The questions were mainly related to the preferred techniques and clinical experiences in the treatment of patients with syndesmotic injuries. Answers with a prevalence ≥50% of respondents were considered a tendency. Results: Seventy-six (13.8%) of the 550 members responded to the survey. The results showed that the most preferred method to diagnose a syndesmotic injury was magnetic resonance imaging (MRI). Intraoperatively, the external rotation stress test and the Cotton test were most frequently used to confirm syndesmotic diastasis. The reduction was usually done by a reduction clamp. One 3.5-mm screw was used most frequently over three cortices at 2~4 cm above the ankle joint. The preferred ankle position during fixation was 0° dorsiflexion. Removal of the syndesmotic screw was routinely done by most surgeons, mainly because of the limitation of movement and risk of screw breakage. Factors that affect suture button selection included non-rigid fixation which enables adequate fixation, early weight-bearing, and an infrequent need to remove the hardware. Inadequate reduction was considered the main factor that affects poor prognosis. Conclusion: This study proposes updated information about the current trends in the management of syndesmotic injuries in Korea. Consensuses in both the diagnostic and therapeutic approach to patients with syndesmotic injury were identified in this survey study. This study may raise the awareness of the various possible approaches toward the injury and should be used to further establish a standard protocol for the management of syndesmotic injuries.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.196-205
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• 2023

Purpose: Surgical stabilization of rib fractures (SSRF) is widely used in patients with flail chests, and several studies have reported the efficacy of SSRF even in multiple rib fractures. However, few reports have discussed the hardware failure (HF) of implanted plates. We aimed to evaluate the clinical characteristics of patients with HF after SSRF and further investigate the related factors. Methods: We retrospectively reviewed the electronic medical records of patients who underwent SSRF for multiple rib fractures at a level I trauma center in Korea between January 2014 and January 2021. We defined HF as the unintentional loosening of screws, dislocation, or breakage of the implanted plates. The baseline characteristics, surgical outcomes, and types of HF were assessed. Results: During the study period, 728 patients underwent SSRF, of whom 80 (10.9%) were diagnosed with HF. The mean age of HF patients was 56.5±13.6 years, and 66 (82.5%) were men. There were 59 cases (73.8%) of screw loosening, 21 (26.3%) of plate breakage, 17 (21.3%) of screw migration, and seven (8.8%) of plate dislocation. Nine patients (11.3%) experienced wound infection, and 35 patients (43.8%) experienced chronic pain. A total of 21 patients (26.3%) underwent reoperation for plate removal. The patients in the reoperation group were significantly younger, had fewer fractures and plates, underwent costal fixation, and had a longer follow-up. There were no significant differences in subjective chest symptoms or lung capacity. Conclusions: HF after SSRF occurred in 10.9% of the cases, and screw loosening was the most common. Further longitudinal studies are needed to identify risk factors for SSRF failure.

• Journal of Korean Society of Environmental Engineers
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• v.33 no.7
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• pp.516-522
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• 2011

The largest problem of domestic anaerobic digestion is low digestion efficiency. Reasons of the problem would be low organic matters input, low mixing efficiency in digestion tank, refractory excess sludge etc.. In this study, screw attached disk-type concentration system and a mechanical mixing system, solubilization facility improvements were performed to solve problems. Through these improvements, the sludge conc. of the concentrator increased 2.6-fold and the volume reduction efficiency was increased 3.0-fold. In addition, the dead-space is reduced by mechanical agitation. Anaerobic digester gas production in the digestion tank is increased from $193.8m^3$ to $386.0m^3$ per day. Digestion efficiency is improved to 54.6% from 47.6%. Digestion gas production is increased from $0.30Nm^3/kg$ VS to $0.42Nm^3/kg$ VS.

• New & Renewable Energy
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• v.6 no.4
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• pp.6-14
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• 2010

Pretreatment of cellulosic biomass is necessary before enzymatic saccharification and fermentation. Extrusion is a well established process in food industries and it can be used as a physicochemical treatment method for cellulosic biomass. Aqueous ammonia soaking treatment at mild temperatures ranging from 60 to $80^{\circ}C$ for longer reaction times has been used to preserve most of the cellulose and hemicellulose in the biomass. The objective of this study was to evaluate the effect of extrusion treatment on aqueous ammonia soaking method. Extrusion was performed with miscanthus sample conditioned to 2mm of particle size and 20% of moisture content at $200^{\circ}C$ of barrel temperature and 175rpm of screw speed. And then aqueous ammonia soaking was performed with 15%(w/w) ammonia solution at $60^{\circ}C$ for 1, 2, 4, 8, 12 hours on the extruded and raw miscanthus samples respectively. In the combined extrusion-soaking treatment, most compositions removal occurred within 1~2 hours and on a basis of 1 hour soaking treatment values, cellulose was recovered about 85% and other compositions, including hemicellulose, are removed about 50% from extruded miscanthus sample. The combined extrusion-soaking treated and soaking only treated samples were subjected to enzymatic hydrolysis using cellulase and ${\beta}$-glucosidase. The enzymatic digestibility value of combined extrusion-2 hours soaking treated sample was comparable to 12 hours soaking only treated sample. It means that extrusion treatment can shorten the conventional long reaction time of aqueous ammonia soaking. The findings suggest that the combination of extrusion and soaking is a promising pretreatment method to solve both problems for no lignin removal of extrusion and long reaction time of aqueous ammonia soaking.

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.3
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• pp.557-565
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• 1997

Screw-shaped implants of commercially pure (c.p.) titanium, c.p. niobium, c.p. zirconium, and stainless steel(Sus 304) were inserted in the rabbit tibial bone over 12 weeks of follow-up. New developed torque gauge instrument was used to evaluate the implant holding power and a image analysis program coupled to a microscope was used for histomorphometry. The three best consecutive threads of each implant were measured. Quantitative analyses at 12 weeks revealed a partial bone contact to the four kinds investigated metals. There were no obvious adverse tissue reactions to any of the biomaterials. At 12 weeks the average removal torques for titanium, niobium and zirconium were better than that needed for Sus 304 screws, on the other hand high score of bony contact ratio of titanium and niobium were showed in comparison to those of zirconium and Sus 304. There was no significant differences in the amount of interfacial bone of zirconium and Sus 304 whereas there was significant difference in the torque forces of niobium and Sus 304. Three months after implant insertion, the average removal torque was 6.64 Ncm for the titanium, 6.57 Ncm for the niobium, 6.38 Ncm for the zirconium, and 4.25 Ncm for the Sus 304. On average bone contacts there were 51.24% in the titanium, 48.19% in the niobium, 31.79% in the zirconium, 23.54% in the Sus 304. Biocompatibility of the titanium, niobium and zirconium was acceptable level in comparison to the Sus 304.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.2
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• pp.95-103
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• 2020

Purpose: The purpose of this study was to compare the axial displacement of the hexagonal and conical abutment in internal conical connection implant after screw tightening and cyclic loading. Materials and Methods: Internal conical connection implants were divided into two groups (n = 10): group HEX, hexagonal abutment; and group CON, conical 2-piece abutments. The axial displacement and removal torque values were measured after 30 Ncm torque tightening and 250N loading test of 100,000 cycles. The Student t test with 5% significance level was used to evaluate the data. Results: HEX group demonstrated significantly higher axial displacement values after 30 Ncm tightening in comparison to the CON group (P < 0.05). No significant difference was found in axial displacement after cyclic loading (P = 0.052). Removal torque loss before and after the cyclic loading both revealed no significant difference between groups (P = 0.057 and P = 0.138). Removal torque value decreased after cyclic loading in both groups (P < 0.05). Conclusion: Overall, both abutment with or without hexagon index presented similar biomechanical performance except HEX group demonstrated significantly more axial displacement after applying tightening torque.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.3
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• pp.206-214
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• 2014

This study is to evaluate how different bearing surface angles of abutment screw affect the mechanical stability of the joint in the conical seal design implant system. Materials and Methods: Internal connection type regular implants, two-piece cemented type abutments and tungsten carbide/carbon-coated titanium alloy abutment screws were selected. Titanium alloy screws with conical ($45^{\circ}$) and flat ($90^{\circ}$) head designs which fit on to abutment were fabricated. The abutments were tightened to implants with 30 Ncm by digital torque gauge. The loading was applied once to the central axis of abutment. The mean axial displacement was measured using micrometer before and after the tightening and loading (n = 5). The abutment was tightened to implants with 30 Ncm and T-shape stainless steel crown was cemented. Then the change in the amount of reverse-torque was measured after the repeated loading to the central axis, and the place 5 mm away from the central axis. Compressive bending and fatigue strength were measured at the place 5 mm away from the central axis (n = 5). Results: Both groups showed the largest axial displacement when abutment screw tightening and total displacement was greater in the flat head group compared to conical head group (P < 0.05). However, there were no significant differences in reverse torque value, compressive bending and fatigue strength (P > 0.05). Conclusion: Within the limitations of this study, the abutment screw head design had no effect on two groups regarding the joint stability, however the conical head design affected the settlement of abutment resulting in the reduced total displacement.

• Journal of Korean Society of Environmental Engineers
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• v.33 no.1
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• pp.39-46
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• 2011

NO oxidation is an important prerequisite step to assist the selective catalytic reduction (SCR) at low temperatures ($<200^{\circ}C$). Therefore, we conducted the lab- and bench-scales experiments appling the sodium chlorite powder ($NaClO_2(s)$) for the oxidation of NO to $NO_2$ and the carbon-based catalyst for the reduction of $NO_x$ and $SO_2$; the lab- and bench-scales experiments were conducted in laboratory and iron-ore sintering plant, respectively. In the lab-scale experiment, known concentrations of $NO_x$ (200 ppm), $SO_2$ (75 ppm), $H_2O$ (10%) and $NH_3$ (400 ppm) in 2.6 L/min were introduced into a packed-bed reactor containing $NaClO_2(s)$, then gases produced by the reaction with $NaClO_2(s)$ were fed into the carbon-based catalyst (space velocity = $2,000hr^{-1}$) at $130^{\circ}C$. In the bench-scale experiment, flue gases of $50Nm^3/hr$ containing 120 ppm NO and 150 ppm $SO_2$ were taken out from the duct of iron-ore sintering plant, then introduced into the flow reactor; $NaClO_2(s)$ were injected into the flow reactor using a screw feeder. Gases produced by the reaction with $NaClO_2(s)$ were introduced into the carbon-based catalyst (space velocity = $1,000hr^{-1}$). Results have shown that, in both lab- and bench-scales experiments, NO was oxidized to $NO_2$ by $NaClO_2(s)$. In addition, above 90% of $NO_x$ and $SO_2$ removal were obtained at the carbon-based catalyst. These results lead us to suggest that the combination of $NaClO_2(s)$ with the carbon-based catalyst has the potential to achieve the simultaneous removal of $NO_x$ and $SO_2$ at low temperature ($<200^{\circ}C$).

• The Journal of the Korean dental association
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• v.54 no.7
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• pp.501-512
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• 2016

We evaluated a self-inflatable osmotic tissue expander for its utility in creating sufficient soft tissue elongation for primary closure after bone grafting. Six patients with alveolar defects who required vertical augmentation of >6 mm before implant placement were enrolled. All had more than three prior surgeries, and flap advancement for primary coverage was restricted by severely fibrosed scars. Expanders were inserted beneath the flap and fixed with a screw. After 4 weeks, expander removal and bone grafting were performed simultaneously. A vertical block autograft and guided bone regeneration and distraction osteogenesis were performed. Expansion was sufficient to cover the grafted area without additional periosteal incision. Complications included mucosal perforation and displacement of the expander. All augmentation procedures healed uneventfully and the osseous implants were successfully placed. The tissue expander may facilitate primary closure by increasing soft tissue volume. In our experience, this device is effective, rapid, and minimally invasive, especially in fibrous scar tissue.

• Journal of Korean Foot and Ankle Society
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• v.15 no.4
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• pp.187-194
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• 2011

Ankle injuries may involve the distal tibiofibular syndesmosis and can be associated with a variable degree of trauma to the soft tissue and osseous structures that play an important role in ankle joint stability. Ankle syndesmotic injury may occur solely as a soft tissue injury or in association with variable ankle fractures. Ankle syndesmotic injury does not necessarily lead to ankle instability; however, the coexistence of deltoid ligament injury critically destabilizes the ankle joint. The prevalence of these injuries may be higher than previously reported. The diagnosis of syndesmotic injury as not always easy because isolated ankle sprains may be missed in the absence of a frank diastasis and syndesmotic instability may be unnoticed in the presence of bimalleolar ankle fractures. Controversies arise at almost every phase of treatment includings : type of fixation(screw size, type of implant), number of cortices required for fixation and of need for hardware removal. Regardless of controversies, the most important goal should be restore and maintain the normal tibiofibular relationship to allow for healing of the ligamentous structures of the syndesmosis.