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A Comparison of Outcomes after Early and Delayed Reconstruction in the Acute Posterior Cruciate Ligament Injuries (급성 후방십자인대 손상 환자에서 조기 재건군과 지연 재건군의 결과 비교)

  • Lee, Yong Sik;Lee, Soo Won;Seo, Byung Ho;Kim, Yoon Gi
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.31-37
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    • 2013
  • Purpose: This study performed to compare degree of joint stiffness and clinical results between early and delayed reconstruction of acute posterior cruciate ligament (PCL) injuries. Materials and Methods: Thirty-two Patients who underwent PCL reconstruction between March 2008 and October 2011 enrolled this study. We performed transtibial single bundle reconstruction using the allo-achilles tendon in all cases. We divided the patient into two groups, early reconstruction group underwent surgery before a week, delayed reconstruction group underwent surgery after 3 weeks, before 6 weeks. All the patients underwent aggressive joint motion exercise till surgery and enrolled post operative rehabilitation program. We checked posterior drawer stress radiography, range of motion, the Lysholm score, the International Knee Documentation Committee (IKDC) score and the Tegner score to evaluate the results. Results: At the final follow up the Lysholm score was 92.1 in the early group and 93.8 in the delayed group. All the cases were rated above B (near normal) on IKDC score (p=0.808, p=0.722). The Tegner score was 6.6 in the early reconstruction group and 6.2 in the delayed group (p=0.480), The average of maximum flexion and extension angle was $133.9^{\circ}$, $1.4^{\circ}$ in the early group and $133.6^{\circ}$, $1.1^{\circ}$ in the delayed group (p=0.560, p=0.581), no complication such as deep vein thrombosis or infection, no difference in posterior drawer stress radiography (p=0.750). Conclusion: We could obtain satisfactory clinical results in both the early and delayed reconstruction groups of acute PCL injuries. Therefore, the early reconstruction of PCL performed before a week could be one of the treatment options for acute PCL injury.

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Ultrasound Measurement of Coracohumeral Distance in Patients with or without Subcoracoid Impingement (오구돌기하 충돌 증후군 유무에 따른 초음파를 이용한 상완오구돌기 계측)

  • Jang, Suk Hwan;Kim, Sang Bum
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.20-27
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    • 2014
  • Purpose: The purpose of this study was to evaluate coracohumeral distance (CHD) in patients with or without subcoracoid impingement with hypothesis that patients with subcoracoid impingement would have narrower CHD. Materials and Methods: One hundred twenty-four patients with subacromial impingement were evaluated. The subjects with subcoracoid impingement which was affirmed clinically and confirmed by ultrasound guided subcoracoid injection (n=28) was compared with patients with subacromial impingement only (n=96). Patients with stiffness and rotator cuff tear were excluded. Absolute CHD was measured on magnetic resonance imaging (MRI) axial images and on ultrasound with the humerus in neutral position and internal rotation. Also relative ratio of distance difference (RRDD) defined as the difference of CHD in neutral position and internal rotation compared with absolute CHD in neutral on ultrasound was also measured. Results: The distance measured in neutral position was similar between US imaging and MRI (p>0.05) and both measurements did not have significant difference between the two groups (p>0.05). On ultrasound, the difference in CHD in internal rotation between the two groups nearly met the level of significance (p=0.07). No significant difference of CHD difference in two humeral positions was seen between the two groups. However, RRDD value was significantly greater in subcoracoid impingement group (p<0.05). Conclusion: No significant difference of CHD was seen between the subcoracoid impingement group and the control group. RRDD value was greater in subcoracoid impingement group suggesting that individualized coracohumeral distance in internal rotation should be taken into account when assessing patients with subcoracoid impingement.

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Influence of Column Aspect Ratio on the Hysteretic Behavior of Slab-Column Connection (슬래브-기둥 접합부의 이력거동에 대한 기둥 형상비의 영향)

  • Choi, Myung-Shin;Cho, In-Jung;Ahn, Jong-Mun;Shin, Sung-Woo
    • Journal of the Korea Concrete Institute
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    • v.19 no.4
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    • pp.515-525
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    • 2007
  • In this investigation, results of laboratory tests on four reinforced concrete flat plate interior connections with elongated rectangular column support which has been used widely in tall residential buildings are presented. The purpose of this study is to evaluate an effect of column aspect ratio (${\beta}_c={c_1}/{c_2}$=side length ratio of column section in the direction of lateral loading $(c_1)$ to the direction of perpendicular to $c_1$) on the hysteretic behavior under earthquake type loading. The aspect ratio of column section was taken as $0.5{\sim}3\;(c_1/c_2=1/2,\;1/1,\;2/1,\;3/1)$ and the column perimeter was held constant at 1200mm in order to achieve nominal vertical shear strength $(V_c)$ uniformly. Other design parameters such as flexural reinforcement ratio $(\rho)$ of the slab and concrete strength$(f_{ck})$ was kept constant as ${\rho}=1.0%$ and $f_{ck}=40MPa$, respectively. Gravity shear load $(V_g)$ was applied by 30 percent of nominal vertical shear strength $(0.3V_o)$ of the specimen. Experimental observations on punching failure pattern, peak lateral-load and story drift ratio at punching failure, stiffness degradation and energy dissipation in the hysteresis loop, and steel and concrete strain distributions near the column support were examined and discussed in accordance with different column aspect ratio. Eccentric shear stress model of ACI 318-05 was evaluated with experimental results. A fraction of transferring moment by shear and flexure in the design code was analyzed based on the test results.

Experiment of Flexural Behavior of Composite Beam with Steel Fiber Reinforced Ultra High Performance Concrete Deck and Inverted-T Steel Girder (강섬유로 보강된 초고성능 콘크리트 바닥판과 역T형 강거더 합성보의 휨거동 실험)

  • Yoo, Sung-Won;Ahn, Young-Sun;Cha, Yeong-Dal;Joh, Chang-Bin
    • Journal of the Korea Concrete Institute
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    • v.26 no.6
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    • pp.761-769
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    • 2014
  • Ultra high performance concrete (UHPC) has been developed to overcome the low strengths and brittleness of conventional concrete. Considering that UHPC, owing to its composition and the use of steel fibers, develops a compressive strength of 180 MPa as well as high stiffness, the top flange of the steel girder may be superfluous in the composite beam combining a slab made of UHPC and the steel girder. In such composite beam, the steel girder takes the form of an inverted-T shaped structure without top flange in which the studs needed for the composition of the steel girder with the UHPC slab are disposed in the web of the steel girder. This study investigates experimentally and analytically the flexural behavior of this new type of composite beam to propose details like stud spacing and slab thickness for further design recommendations. To that goal, eight composite beams with varying stud spacing and slab thickness were fabricated and tested. The test results indicated that stud spacing running from 100 mm to 2 to 3 times the slab thickness can be recommended. In view of the relative characteristic slip limit of Eurocode-4, the results showed that the composite beam developed ductile behavior. Moreover, except for the members with thin slab and large stud spacing, most of the specimens exhibited results different to those predicted by AASHTO LRFD and Eurocode-4 because of the high performance developed by UHPC.

Cyclic Behavior of Wall-Slab Joints with Lap Splices of Coldly Straightened Re-bars and with Mechanical Splices (굽힌 후 편 철근의 겹침 이음 및 기계적 이음을 갖는 벽-슬래브 접합부의 반복하중에 대한 거동)

  • Chun, Sung-Chul;Lee, Jin-Gon;Ha, Tae-Hun
    • Journal of the Korea Concrete Institute
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    • v.24 no.3
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    • pp.275-283
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    • 2012
  • Steel Plate for Rebar Connection was recently developed to splice rebars in delayed slab-wall joints in high-rise building, slurry wall-slab joints, temporary openings, etc. It consists of several couplers and a thin steel plate with shear key. Cyclic loading tests on slab-wall joints were conducted to verify structural behavior of the joints having Steel Plate for Rebar Connection. For comparison, joints with Rebend Connection and without splices were also tested. The joints with Steel Plate for Rebar Connection showed typical flexural behavior in the sequence of tension re-bar yielding, sufficient flexural deformation, crushing of compression concrete, and compression rebar buckling. However, the joints with Rebend Connection had more bond cracks in slabs faces and spalling in side cover-concrete, even though elastic behavior of the joints was similar to that of the joints with Steel Plate for Re-bar Connection. Consequently, the joints with Rebend Connection had less strengths and deformation capacities than the joints with Steel Plate for Re-bar Connection. In addition, stiffness of the joints with Rebend Connection degraded more rapidly than the other joints as cyclic loads were applied. This may be caused by low elastic modulus of re-straightened rebars and restraightening of kinked bar. For two types of diameters (13mm and 16mm) and two types of grades (SD300 and SD400) of rebars, the joints with Steel Plate for Rebar Connection had higher strength than nominal strength calculated from actual material properties. On the contrary, strengths of the joints with Rebend Connection decreased as bar diameter increased and as grade becames higher. Therefore, Rebend Connection should be used with caution in design and construction.

Compressive Behavior of Precast Concrete Column with Hollow Corresponding to Hollow Ratio (중공비율에 따른 중공 프리캐스트 철근콘크리트 기둥의 압축거동)

  • Lee, Seung-Jun;Seo, Soo-Yeon;Pei, Wenlong;Kim, Kang-Su
    • Journal of the Korea Concrete Institute
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    • v.26 no.4
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    • pp.441-448
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    • 2014
  • From several researches, recently, it was found that using hollowed precast concrete (HPC) column made more compact concrete casting in joint region possible than using normal solid PC (Precast concrete) column. Therefore, the rigidity of joints can be improved like those of monolithic reinforced concrete (RC). After filling the hollow with grout concrete, however, it is expected that the HPC column behaviors like composite structure since PC element and grout concrete have different materials as well as there is a contact surface between two elements. These may affect the structural behavior and strength of the composite column. A compressive strength test was performed for the HPC column with parameter of hollow ratio for the case with and without grout in the hollow and the result is presented in this paper. The hollow ratios in the test are 35, 50 and 59% of whole section of column. Concentrated axial force was applied to top of the specimens supported as pin connection for both ends. In addition, finite element (FE) analysis was performed to simulate the failure behavior of HPC column for axial compression. As a result, it was found that the hollow ratio did not affect the initial stiffness of HPC filled with grout regardless of the strength difference of HPC and grout. However the strength was increased inversely corresponding to the hollow ratio. The structural capacity of HPC without grout closely related to the hollow size. Especially, the local collapse governs the overall failure when the thickness of HPC is too thin. Based on these effect, a suitable equation was suggested for calculation of the compressive strength of HPC column with or without grout. FE analysis considering the contact surface between HPC and grout produced a good result matched to the test result.

Analysis of Flexural Behavior of Composite Beam with Steel Fiber Reinforced Ultra High Performance Concrete Deck and Inverted-T Shaped Steel with Tension Softening Behavior (인장연화거동을 고려한 강섬유 보강 초고성능 콘크리트 바닥판과 역T형 강재 합성보의 휨거동 해석)

  • Yoo, Sung-Won;Yang, In-Hwan;Jung, Sang-Hwa
    • Journal of the Korea Concrete Institute
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    • v.27 no.2
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    • pp.185-193
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    • 2015
  • Ultra high performance concrete (UHPC) has been developed to overcome the low tensile strengths and brittleness of conventional concrete. Considering that UHPC, owing to its composition and the use of steel fibers, develops a compressive strength of 180 MPa as well as high stiffness, the top flange of the steel girder may be superfluous in the composite beam combining a slab made of UHPC and the steel girder. In such composite beam, the steel girder takes the form of an inverted-T shaped structure without top flange in which the studs needed for the composition of the steel girder with the UHPC slab are disposed in the web of the steel girder. This study investigates experimentally and analytically the flexural behavior of this new type of composite beam to propose details like stud spacing and slab thickness for further design recommendations. To that goal, eight composite beams with varying stud spacing and slab thickness were fabricated and tested. The test results indicated that stud spacing running from 100 mm to 2 to 3 times the slab thickness can be recommended. In view of the relative characteristic slip limit of Eurocode-4, the results showed that the composite beam developed ductile behavior. Moreover, except for the members with thin slab and large stud spacing, most of the specimens exhibited results different to those predicted by AASHTO LRFD and Eurocode-4 because of the high performance developed by UHPC.

Rheological properties of dental resin cements during polymerization (치과용 레진 시멘트의 유변학적 성질)

  • Lee, Jae-Rim;Lee, Jai-Bong;Han, Jung-Suk;Kim, Sung-Hun;Yeo, In-Sung;Ha, Seung-Ryong;Kim, Hee-Kyung
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.2
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    • pp.82-89
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    • 2014
  • Purpose: The purpose of this study was to observe the change of viscoelastic properties of dental resin cements during polymerization. Materials and methods: Six commercially available resin cement materials (Clearfil SA luting, Panavia F 2.0, Zirconite, Variolink N, RelyX Unicem clicker, RelyX U200) were investigated in this study. A dynamic oscillation-time sweep test was performed with AR1500 stress controlled rheometer at $32^{\circ}C$. The changes in shear storage modulus (G'), shear loss modulus (G"), loss tangent (tan ${\delta}$) and displacement were measured for twenty minutes and repeated three times for each material. The data were analyzed using one-way ANOVA and Tukey's post hoc test (${\alpha}$=0.05). Results: After mixing, all materials demonstrated an increase in G' with time, reaching the plateau in the end. RelyX U200 demonstrated the highest G' value, while RelyX Unicem (clicker type) and Variolink N demonstrated the lowest G' value at the end of experimental time. Tan ${\delta}$was maintained at some level and reached the zero at the starting point where G' began to increase. The tan ${\delta}$and displacement of the tested materials showed similar pattern in the graph within change of time. The displacement of all 6 materials approached to zero within 6 minutes. Conclusion: Compared to other resin cements used in this study, RelyX U200 maintained plastic property for a longer period of time. When it completed the curing process, RelyX U200 had the highest stiffness. It is convenient for clinicians to cement multiple units of dental prostheses simultaneously.

Serum homocysteine and tumor necrosis factor-alpha levels after intravenous gammaglobulin treatment in patients with Kawasaki disease (가와사키병 환자에서 면역글로불린 투여 전 후 호모시스테인, tumor necrosis factor-alpha 혈중 농도에 대한 연구 - 가와사키병 환아에서 호모시스테인, TNF-α 혈중 농도 비교 분석 -)

  • Cha, Jung Hwa;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1093-1099
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    • 2006
  • Purpose : Homocysteine is a strong and independent risk factor for cardiovascular disease. The deleterious effects of homocysteine included endothelial dysfunction, arterial intimal-medial thickening, wall stiffness and procoagulant activity. However, the precise mechanism responsible for homocysteine release in children with coronary artery disease is still unknown. The purpose of this study was to investigate serum homocysteine and tumor necrosis $factor(TNF)-{\alpha}$ levels and identify whether these levels had any association with the development of coronary artery lesions in Kawasaki disease(KD). Methods : Serum homocysteine and $TNF-{\alpha}$ levels were measured in 24 KD patients(group 1, eight patients with normal coronary artery; group 2, 16 patients with coronary artery lesions) and 21 controls(group 3, 10 afebrile controls; group 4, 11 febrile controls). Blood samples were drawn from each study group before and after intravenous immunoglobulin(IVIG) therapy and in the convalescent stage. Results : The homocysteine levels before IVIG therapy were significantly higher in group 1 than in group 3, and in group 2 than in group 3 and 4. The $TNF-{\alpha}$ levels before IVIG therapy were significantly higher in group 2 than group 3 and 4. Serum homocysteine and $TNF-{\alpha}$ levels were highest in group 2 before IVIG therapy. In the acute KD patients, serum homocysteine levels correlated significantly with $TNF-{\alpha}$ levels. Conclusion : The increased serum homocysteine levels in the acute stage increase the susceptibility to coronary arterial lesions in KD. $TNF-{\alpha}$ may also play an important role in the formation of coronary arterial lesions in KD.

Pulse wave velocity and ankle brachial index in adolescents with essential hypertension (본태성 고혈압 청소년에서 pulse wave velocity와 ankle brachial index에 대한 연구)

  • Joo, Sun Young;Cho, Ki Young;Cho, Su Jin;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.769-776
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    • 2006
  • Purpose : Pulse wave velocity(PWV) and ankle brachial index(ABI) are not only noninvasive methods used to assess arterial stiffness in adults, but also useful, simple ways to estimate the severity of hypertension, end stage renal disease and atherosclerosis in adults. But there are few studies on PWV and ABI in adolescents and children. In this study, hypertensive adolescents were compared to normal individuals to find out the usefulness of PWV as the index of progress in the disease. Methods : 413 teenagers were divided into three groups. The first group consisted of adolescents that only had hypertension(Group 1 : 23 teenagers). The second group consisted of the adolescents who had hypertension with obesity(Group 2 : 17 teenagers), and the last group was the normal subjects(Group 3 : 328 teenagers). Weight, height and body mass index were measured. Simultaneous measurements of systolic, diastolic and average blood pressure were obtained from the four extremities. PWV, ABI, ejection time and preejection period were also measured. Results : Right brachial-ankle PWV was significantly higher in both group 1 and group 2 compared with group 3, and significantly higher in group 2 compared with group 1. Likewise, left brachial-ankle PWV also showed significantly higher values in both group 1 and group 2 compared with group 3, and also higher values in group 2 compared with group 1. Positive correlations were found between the systolic, diastolic, average blood pressure and PWV. There were also positive correlations between the blood pressure and weight, body mass index. Conclusion : Higher PWV was demonstrated in adolescents with essential hypertension compared to normal subjects. Follow-up study is needed to evaluate the progress.