• Journal of the Korean Orthopaedic Association
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• v.54 no.6
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• pp.574-578
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• 2019

For the treatment of a bony Bankart lesion accompanied by an acute traumatic shoulder dislocation, anatomical reduction and stable fixation of the bone fragment and glenohumeral ligament are essential to avoid chronic instability or degenerative changes. If the Bankart lesion has large bony pieces or comminuted fragments, it can be difficult to perform precise and secure fixation of the big intraarticular fragment to the fracture site because of the limited visualization of the arthroscopic procedure. In addition, in the case of the open procedure, it requires an extensive surgical dissection to access the fractured fragment, which may cause surgical approach-related morbidity, such as neurovascular complications, delayed subscapularis healing, and increased risk of stiffness. This paper describes an alternative open suture anchor technique for a large bony Bankart lesion, which was secured anatomically with squared knots after a shuttle relay through bony tunnels and adjacent soft tissue and labrum. This technique can achieve anatomical and firm fixation under direct vision, and reduce the number of surgery related morbidities.

• Clinics in Shoulder and Elbow
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• v.10 no.1
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• pp.92-98
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• 2007

Introduction: The treatment of proximal humeral fracture is traditionally determined by Neer's classification system. The severely displaced three-part or four-part fracture is an indication for primary hemiarthroplasty. The current authors report the clinical results of 10 patients who received hemiarthroplasty for proximal comminuted fractures. The minimum follow-up period was 12 months. Materials and Methods: The current authors studied 10 patients who, between July 1999 and March 2005, each received hemiarthroplasty for a proximal humeral fracture of one shoulder. According to Neer's classification system, 5 of the patients had three-part fractures, and 5 of the patients had 4-part fractures. The mean interval between trauma and hemiarthroplasty was 6.1 days. The mean age of the 6 female and 4 male patients was 67.4 years(range: 56 to 76). Shoulder function was evaluated using the Constant score, the Simple Shoulder Test, and the modified UCLA score. Results: The mean Constant score was 51.4(range: 34 to 60). The mean modified SST score was 7.8 out of 12 tasks. Excluding the one patient who had also sustained an axillary artery rupture and a brachial plexus injury after the initial trauma, the mean Constant score for the remaining 9 patients was 53.5(range: 44 to 60), and the mean SST score was 7.2 tasks. The modified UCLA score averages for pain, function, and active forward flexion and strength were, respectively, 8.2($6{\sim}10$), 6.6($2{\sim}8$), and 6.9($4{\sim}8$). The total UCLA score was an average of 21.7($12{\sim}26$). Patients' the modified UCLA ratings were as follows: Excellent: 3, Good: 6, and Poor: 1. The patient with the poor outcome was the one who had also sustained the neurovascular injury. Patient's subjective satisfaction rating were as follows: Excellent: 2, Good: 7, and Poor: 1. Conclusion: Based on short term follow-up results, this study indicates that hemiarthroplasty is the treatment of choice for proximal humeral fractures on which it would be difficult to perform open reduction and internal fixation. Hemiarthroplasty is a useful treatment modality to prevent shoulder stiffness and to allow daily living tasks in elderly patients. However, restoration of muscle power and range of joint motion were not recovered satisfactorily.

• Journal of Korean Tunnelling and Underground Space Association
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• v.20 no.3
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• pp.543-560
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• 2018

With the increased development in downtown underground space facilities that vertically cross under a railway at a shallow depth, the demand for non-open cut method is increasing. However, most construction sites still adopt the pipe roof method, where medium and large diameter steel pipes are pressed in to form a roof, enabling excavation of the inside space. Among the many factors that influence the loosening region and loads that occur while pressing in steel pipes, the size of the pipe has the largest impact, and this factor may correspond to the magnitude of load applied to the underground structure inside the steel pipe roof. The super equilibrium method (SEM) has been developed to minimize ground disturbance and loosening load, and uses small diameter pipes of approximately 114 mm instead of conventional medium and large diameter pipes. This small diameter steel pipe is called an SEM pile. After SEM piles are pressed in and the grouting reinforcement is constructed, a crossing structure is pressed in by using a hydraulic jack without ground subsidence or heaving. The SEM pile, which plays the role of timbering, is a fore-poling pile of approximately 5 m length that prevents ground collapse and supports surface load during excavation of toe part. The loosening region should be adequately calculated to estimate the spacing and construction length of the piles and stiffness of members. In this paper, we conducted a comparative analysis of calculations of loosening load that occurs during the press-in of SEM pile to obtain an optimal design of SEM. We analyzed the influence of factors in main theoretical and empirical formulas applied for calculating loosening regions, and carried out FEM analysis to see an appropriate loosening load to the SEM pile. In order to estimate the soil loosening caused by actual SEM-pile indentation and excavation, a steel pipe indentation reduction model test was conducted. Soil subsidence and soil loosening were investigated quantitatively according to soil/steel pipe (H/D).

• The Journal of the Society of Korean Medicine Diagnostics
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• v.12 no.1
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• pp.42-62
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• 2008

Objectives: It is well known that some parameters of the photoplethysmogram (PPG) acquired by time domain contour analysis can be used as markers of vascular aging. But the previous studies that have been performed for frequency domain analysis of the PPG to date have provided only restrictive and fragmentary information. The aim of the present investigation was to determine whether the harmonics extracted from the PPG using a fast Fourier transformation could be used as an index of vascular aging. Methods: The PPG was measured in 600 recruited subjects for 30 second durations, To grasp the gross age-related change of the PPG waveform, we grouped subjects according to gender and age and averaged the PPG signal of one pulse cycle. To calculate the conventional indices of vascular aging, we selected the 5-6 cycles of pulse that the baseline was relatively stable and then acquired the coordinates of the inflection points. For the frequency domain analysis we performed a power spectral analysis on the PPG signals for 30 seconds using a fast Fourier transformation and dissociated the harmonic components from the PPG signals. Results: A final number of 390 subjects (174 males and 216 females) were included in the statistical analysis. The normalized power of the harmonics decreased with age and on a logarithmic scale reduction of the normalized power in the third (r=-0.492, P<0.0001), fourth (r=-0.621, P<0.0001) and fifth harmonic (r=-0.487, P<0.0001) was prominent. From a multiple linear regression analysis, Stiffness index, reflection index and corrected up-stroke time influenced the normalized power of the harmonics on a logarithmic scale. Conclusions: The normalized harmonic power decreased with age in healthy subjects and may be less error prone due to the essential attributes of frequency domain analysis. Therefore, we expect that the normalized harmonic power density can be useful as a vascular aging marker.