A claw pole motor with two field winding is designed. Since the north and south poles of rotor are separately excited, the leakage field in the air gap is minimized and the flux linking with the armature winding is maximized. 3D FEM analysis showed the feasibility of the motor.
Purpose: This study investigated the epidemiology and treatment outcomes of patients with traumatic limb amputation who visited a regional trauma center.Methods: From November 2015 to December 2021, patients with traumatic limb amputation who visited the Regional Trauma Center at Pusan University Hospital were retrospectively studied. The injury mechanism, number of operations for accompanying injuries, hospitalization period, injury severity score, insurance classification, and medical costs were investigated using medical records. We analyzed medical costs according to the injury site and treatment method. Results: We enrolled 57 patients who visited the hospital for traumatic limb amputation. The median patient age was 55 years, and there were 48 males and nine females. Seventeen patients underwent replantation, and 40 patients underwent amputation. Replantations were performed in 43.7% of cases of upper extremity injuries and in 12.0% of cases of lower extremity injuries. Six operations were performed per patient for replantation and three for amputation (p=0.027). In an analysis of the total medical costs submitted to the national health insurance system, replantation surgery was over twice as expensive as amputation surgery for the upper extremities (p=0.029). However, no significant cost difference was observed for lower limb amputations. Conclusion: As a treatment for limb amputation patients, replantation requires a higher number of operations and a longer hospital stay than amputation. There was no difference in patients’ contributions to medical costs between replantation and amputation, but from the standpoint of national health insurance coverage, upper extremity injuries cost more when treated by replantation than by amputation.
Purpose: Bony mallet finger is commonly seen in the young sports population, and surgical intervention is often necessary in cases where the joint surface is compromised.After surgical treatment, compliance with wound management tends to be poor and return to sports activities is delayed, resulting in decreased patient satisfaction.Therefore, the authors suggest that early return to sports can be facilitated through the modified Kirschner wire (K-wire) extension block technique and wound management.Methods: From March 2022 to February 2023, surgical treatment was performed on 24 patients with bony mallet fingers who had closed fractures with more than one-third involvement of the joint surface or subluxation of the distal interphalangeal joint.Surgeries were conducted within 2 weeks of the injury, employing the K-wire extension block technique.At the first outpatient department follow-up after 1 week, suture knots were removed, medical skin adhesive bonds were applied and an opencast was utilized to fix only distal interphalangeal joint allowing for immediate showering and engagement in physical activities.Results: All patients expressed satisfaction from both functional and cosmetic perspectives and were able to return to sports activities early.According to Crawford evaluation criteria, the results were as follows: excellent in 68.8%, good in 25.0%, and fair in 6.2%.There were no cases of poor outcomes. Conclusion:In cases where early return to sports activities is desired, the K-wire extension block technique with burying the K-wires beneath the skin and employing opencast can be an alternative method that can facilitate early return to sports.
Segmental fractures often result from high-energy or indirect trauma that causes bending or torsional forces with axial loading. We evaluated surgical outcomes of patients with forearm segmental diaphyseal fractures.We retrospectively analyzed data from patients with forearm segmental fractures for which they underwent surgery at the Pusan National University Trauma Center from March 2013 to March 2022. We also analyzed accompanying injuries, injury severity score (ISS), injury mechanism, occurrence of open fracture, surgical technique, and treatment results.Fifteen patients were identified, one with bilateral segmental diaphyseal forearm bone fracture, for a total of 16 cases. Nine of the patients were male. The overall mean age was 50 years, and the mean follow-up period was 16.2 months. Six cases who underwent surgery using plate osteosynthesis achieved bone union without length deformity at final follow-up. Three of seven patients who underwent intramedullary nailing alone underwent reoperation due to nonunion. Six cases achieved bone union at final follow-up, three of which showed length deformity. Three patients underwent surgery using a hybrid method of IM nailing, plates, and mini cables. One patient who underwent surgery with a plate and one patient who underwent surgery with IM nailing alone showed nonunion and were lost to follow-up.Plate osteosynthesis is considered the gold standard for treatment of adult forearm diaphyseal segmental fractures. In this study, IM nailing was associated with high rates of non-union and length deformity. However, the combination of IM nailing and a plate-cable system may be an acceptable alternative in segmental diaphyseal forearm fracture, achieving a union rate similar to that provided by plate fixation.
A 27-year-old man was admitted for evaluation of a 20-year history of chronic epigastric pain and weight loss of 3 kg over the preceding month. Despite several upper endoscopy examinations, no specific cause could be found. Physical examination showed mild epigastric tenderness. Laboratory findings were unremarkable apart from elevated creatinine level (3.17 mg/dL) due to focal segmental glomerulosclerosis. To investigate the cause of the abdominal pain, which became aggravated after a meal and improved with fasting, abdominal sonography was performed and showed a benign-looking 2-cm cystic lesion on the body of the pancreas ([Fig. 1 a]). Although the cyst was devoid of intraluminal Doppler signal ([Fig. 1 b]), it proved on abdominal magnetic resonance imaging (MRI) to be one of two focal venous aneurysms ([Fig. 2 a, b]). Twisting of mesenteric vessels along the mesentery was also visualized on abdominal MRI ([Fig. 2 c, d]). Thus, both the focal venous aneurysms and the persistent abdominal pain could be attributable to intestinal malrotation. The findings of a small-bowel series were also compatible with intestinal malrotation: the distal duodenum and jejunum were arranged in a corkscrew appearance on the right side of the ligament of Treitz ([Fig. 3 a]), and the cecum was also located in the right upper quadrant ([Fig. 3 b]) [1]. Surgical management was planned, and on laparotomy the small intestine was found to be arranged in a coiled fashion ([Fig. 4 a]). Ladd's band could clearly be demonstrated and was excised to resolve the intestinal malrotation ([Fig. 4 b]) [2].
Einleitung: Infolge der im August 2007 in Kraft getretenen Gesetze stehen deutsche Knochenbanken vor der Entscheidung, ihren Betrieb angepasst an die neuen Behördenvorgaben fortzusetzen oder auf die eigene Knochenbank zu verzichten und auf alternative Knochenersatzstoffe zurückzugreifen. Die Fortsetzung der Tätigkeit erfordert die Beantragung der Erlaubnis nach § 20 b und c Arzneimittelgesetz (AMG) und die Einführung einer Thermodesinfektion für humane Femurköpfe. Es stellt sich die Frage, ob nach Anschaffung entsprechender Geräte und zusätzlicher Kosten für den Zulassungsprozess die Inbetriebnahme einer klinikeigenen Knochenbank noch kostengünstig sein kann. Methode: Zunächst wurde der durchschnittliche Bruttoarbeitslohn pro Minute für alle in den Spendeprozess involvierten Mitarbeiter ermittelt. Berücksichtigt wurden alle Tätigkeiten der OP-Pflege und der Ärzte, die direkt an der Aufnahme einer Spongiosaspende in die Knochenbank beteiligt sind. Als zusätzliche Kosten wurden der Stromverbrauch zweier Tiefkühlschränke pro Jahr bei einer Kühlleistung von − 80 °C, der Stromverbrauch pro Thermodesinfektionprozess, die Materialkosten für Desinfektionsset und Dokumentationsbögen, die Laborkosten, die Zulassungskosten und Gerätekosten für die Thermodesinfektion berücksichtigt. Einmalige Anschaffungskosten wurden auf einen Femurkopfumsatz von 5 Jahren, dies entspricht in diesem Falle 610 Spongiosaspenden, umgelegt. Ergebnisse: Folgende Kosten wurden pro Femurkopf ermittelt: Personalkosten Arzt 14,13 €, Personalkosten Pflege 3,71 €, Energiekosten pro Femurkopf von 15,2 €. Ein Desinfektionsset kostet 102,77 €, ein Dokumentationsbogen 2,38 €, die Laborkosten pro Femurkopf betragen 107,25 €. Für die Bearbeitung der Anträge, Begehung und Erlaubnisurkunde berechnet das Regierungspräsidium einmalig 2650 €, für den Lobator müssen 12 495 € veranschlagt werden. Von Februar 2010 bis Februar 2011 wurden 411 potenzielle Spender aufgeklärt, 122 Femurköpfe wurden in ein Aufbereitungsverfahren gegeben. Dies ergibt Gesamtkosten pro Femurkopf von 274,82 €. Die Aufbereitung eines Femurkopfs in einem Gewebeservice liegt bei Berücksichtigung der entsprechenden Arbeitsschritte und Laborkosten bei 535,23 €. Diskussion: Auch unter neuen gesetzlichen Gesichtspunkten ist das Führen einer lokalen Knochenbank trotz höheren logistischen Aufwands für größere Abteilungen wirtschaftlich attraktiv.
CVD-Ru represents a critically important class of materials for BEOL interconnects that provides Cu reflow capability. The results reported here include superior gap-fill performance, a solution for plausible integration issues, and robust EM / TDDB properties of CVD-Ru / Cu reflow scheme, by iterative optimization of process parameters, understanding of associated Cu void generation mechanism, and reliability failure analysis, thereby demonstrating SRAM operation at 10 nm node logic device and suggesting its use for future BEOL interconnect scheme.
Purpose: A diaphyseal simple transverse fracture (DSTF) of the upper extremity (UE) requires direct anatomical reduction and absolute stability. No standard efficient method exists for reducing and maintaining a DSTF, despite its importance. Here, we introduce our transosseous wiring (TOW) method for UE-DSTFs.Methods: To maintain reduction, the UE-DSTF was first fixed with TOW before definitive fixation with a locking plate across the fracture. We retrospectively reviewed 15 patients with at least 1 year of postoperative follow-up treatment from 2019 to 2021.Results: All patients had achieved anatomical reduction and bone union at the final follow-up. Three patients had hardware removed because of irritation caused by the plate and screws. However, none of those three patients complained of irritation from the wire. One patient experienced refracture at the same site after hardware removal after a fall. The same technique was used in this case, and the bone union was observed 6 months after surgery.Conclusion: TOW is a simple straightforward method that can be applied without special instruments. It could be an efficient method for interfragmentary compression and attachment of a locking plate without the burden of maintaining the reduction of UE-DSTFs.
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