Effect of Total Hip Arthroplasty on Ipsilateral Lower Limb Alignment and Knee Joint Space Width: Minimum 5-Year Follow-up

Choi Yun Seong,Park Jung-Wee,Kim Tae Woo,Kang Kee Soo,Lee Young-Kyun,Koo Kyung-Hoi,Chang Chong Bum 대한의학회 2023 Journal of Korean medical science Vol.38 No.20

Background: This study aimed to 1) assess the effect of total hip arthroplasty (THA) on coronal limb alignment, namely, the hip–knee–ankle angle (HKA), 2) identify factors that determine changes in the HKA, and 3) determine whether alignment changes influence the knee joint space width. Methods: We retrospectively evaluated 266 limbs of patients who underwent THA. Three types of prostheses with neck shaft angles (NSAs) of 132°, 135°, and 138° were used. Several radiographic parameters were measured in the preoperative and final radiographs (at least 5 years after THA). A paired t-test was used to confirm the effect of THA on HKA change. Multiple regression analysis was performed to identify radiographic parameters related to HKA changes following THA and changes in knee joint space width. Subgroup analyses were performed to reveal the effect of NSA change on the HKA change, and the proportion of total knee arthroplasty usage and changes in radiographic parameters between maintained joint space and narrowed joint space groups were compared. Results: The preoperative mean HKA was 1.4° varus and increased to 2.7° varus after THA. This change was related to changes in the NSA, lateral distal femoral angle, and femoral bowing angle. In particular, in the group with a decrease in NSA of > 5°, the preoperative mean HKA was largely changed from 1.4° varus to 4.6° varus after THA. The prostheses with NSA of 132° and 135° also led to greater varus HKA changes than those with an NSA of 138°. Narrowing of the medial knee joint space was related to changes in the varus direction of the HKA, decrease in NSA, increase in femoral offset. Conclusion: A large reduction in NSA can lead to considerable varus limb alignment after THA, which can have adverse effects on the medial compartment of the ipsilateral knee.

Rat의 복강내에 투여한 5-fluorouracil-polyglycolic acid 제형이 장기에 미치는 영향에 관한 연구

강대영,송규상,최정목,노승무,정경수,오정연,김진향,양준묵,최선웅,이진호,조준식,민병무,김용백,김창식,박근성,김승영,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

For more effective intraperitoneal chemotherapy, the authers made 5-fluorouracil-polyglycolic acid composite disks(FU-PGA disks) with 5-fluorouracil and polyglycolic acid, a biodegradable polymer. We inserted the FU-PGA disk into the peritoneal cavites of Sprague-Dawley male rats, the control and three experimental groups; one FU-PGA disk insert group(300mg/kg), two FU-PGA disk insert group(600mg/kg), and three FU-PGA disk insert group(900mg/kg). The control group received a similar number of PGA disk inserts. A pharmacokinetic study was performed to measure the 5-fluorouracil concentration in the peritoneal fluid, blood, and tissues(liver, kidney and heart) at 24 hours, 72hours and 168 hours after insertion of the FU-PGA disk. Light and electron microscopic studies were done. The results were as follows: 1) The number of white blood cells and platelets decreased after FU-PGA insertion. The degree was proportional to the duration and amounts inserted. The change in the number of red blood cells varied slightly. 2) Light microscopically, slight changes were noted at 168 hours in the 3 disk insert group (900mg/kg). Mild fatty change and hepatocyte degeneration around the central veins of the liver were noted, with vacuolar degeneration in the proximal convoluted tubules of the kidney. 3) Electron microscopically,the liver showed focal increases of lipid droplets in the hepatocytes, and irregular nuclear membrane with focal nucleolar segregation of the fibrillar and granular elements. Also the double membranous structure of the hepatocytes and Kupffer cells was widened with bleb formation. The kidney showed wide separation of the nuclear double membrane in the proximal convoluted tubular cells and mesangial cells, with vacuolation and myelin figure formation in the mitochondria of the proximal convoluted tubular cells, at 72 hours and 168 hours in the 2 to 3 FU-PGA insert groups. The heart showed focal loss of cristae,vacuolation and myelin figure formation in the mitochondria of the 2 to 3 FU-PGA insert groups. In conclusion, despite the large amont of FU-PGA inserted, the histopathological changes in the liver, kidney and heart were slight, and consonant with the very low amount of 5-fluorouracil concentrations detected in the liver, kidney and heart. The above results suggest that the FU-PGA composite can serve as a new device for releasing drugs in a controlled manner and easily targeted to intraperitoneal organs. This device can improve the efficacy of intraperitoneal chemotherapy for gastric cancer.

전치의 후방견인에 따른 입술과 주위 연조직의 수직적 변화

강창수,김경호,최광철 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.2

입술의 돌출을 해소하고자 하는 환자들은 자신의 안모 개선을 안모의 측면보다는 거울로 볼 수 있는 정면을 통하여 느끼는 것이 보편적이다. 안모의 정면에서 평가가 이루어질 때에는 입술이 후방으로 들어간 정도와 함께 입술과 그 주위 조직의 수직적 변화에 의해서도 큰 영향을 받을 수 있으므로 교정치료 진단이나 치료 후 평가를 위한 측모두부방사선 사진 분석 시 전통적으로 중요시되고 있는 입술의 시상적 이동뿐만 아니라 흔히 간과하기 쉬운 수직적인 변화에 관해서도 평가가 이루어져야 한다. 따라서 본 연구에서는 입술 돌출을 주소로 내원한, 성장이 완료된 성인 여성 61명을 대상으로 측모두부 방사선 사진을 촬영하여 전치의 후방견인시 나타나는 입술과 주위 연조직의 수직적 변화를 계단식 다중 회귀 분석법을 이용하여 조사한 결과 다음과 같은 결론을 얻었다. 1.상, 하순의 philtrum길이 (SnLs, LiB') 는 전치의 후방견인 후 증가하였고, 상, 하순의 vermilion height (LsStms, StmiLi) 와 vermilion length (LsLi) 는 감소하였다. 2.상, 하순의 길이 (SnStms, StmiB')와 연조직의 하안면 고경 (SnMe')은 치료 후 유의성 있는 변화를 보이지 않았다. 3.상순의 philtrum길이 증가에 상악 전치의 정출 △UIV 이 가장 큰 영향을 주었으며 하순의 philtnlm길이 증가에는 치료 전 overjet이 가장 큰 영향을 주었다. 4.상, 하순의 vermilion height감소에 상순의 두께 감소가 가장 큰 영향을 주었다. Patients who want to reduce their lip protrusion usually estimate the severity of the lip protrusion on the frontal aspect. Most orthodontists have a perplexed experience of a reduced thin line of vermilion border on the frontal aspect as incisors are retracted, even though the lip protrusion is thought to be reduced favorably on the sagittal aspect. Some patients also look older after orthodontic treatment because of severe lip thinning. This unaesthetic reduction of vermilion border urges us to study the vertical lip change during orthodontic procedure. The purpose of this study was to evaluate the vertical lip and perioral soft tissue changes in respect to incisor retraction in an effort to analyze which factors might be responsible for their vertical changes, using the multiple regression analysis. The results were as follows. 1.Upper and lower lip philtrum length(SnLs, LiB') were increased after retraction of anterior teeth, where as upper and lower vermilion height(LsStms, StmiLi), and vermilion length(LsLi) were decreased. 2.Upper and lower lip length(SnStms, StmiB'), and soft tissue lower anterior facial height(SnMe') did not show any significant difference after treatment. 3.The increase of the upper lip philtrum length was mainly influenced by the extrusion of upper anterior teeth(△UIV), and the increase of the lower lip philtrum length was mainly influenced by the initial overjet before treatment. 4.The decrease of the upper and lower lip vermilion height was mainly influenced by the decrease of upper lip thickness.

사염화탄소 투여 흰쥐에서 간섬유화 진행에 따른 Propranolol 의 약동학적 지표들의 변화

이민호,강주섭,강문수,윤병철,이오영,함준수,변재원,윤창옥 대한간학회 2001 Clinical and Molecular Hepatology(대한간학회지) Vol.7 No.2

Background/Aims : This study was designed to determine the effect of hepatic fibrotic severity on pharmacokinetics of propranolol in CC1q - treated rats. Methods - 1 mL/kg of 10% CC14 in olive oil was injected intramuscularly to rats twice weekly for 4, 6, 8 and 10 weeks, respectively (n=6). Control (n=6) was a sham - injected equal dose of olive oil for 10 weeks. After intravenous bolus injection of 2 mg/kg propranolol to rats, the serum propranolol concentrations were analyzed for 4 hours at various time points by a HPLC - fluorimetric system, and pharmacokinetic parameters such as Co, MRT, AUC, Vdss, tl/2(p) and CLp were determined. Then, a small amount of hepatic tissue was obtained and subjected to determination of the hepatic 4 - hydroxyproline content, which confirmed the hepatic fibrotic severity. Results : The serum concentrations of propranolol at 0.5, 1, 2 and 4 hours were significantly increased in CC1q-treated rats (p$lt;0.01). In proportion to the duration of CC4 treatment, Co and AUC were significantly increased, and Vdss and CLp were significantly decreased (p$lt;0.001). But MRT and t1/2(β) were not significantly changed. The hepatic 4 -hydroxyproline content was gradually increased in CC4-treated rats (p$lt;0.001). Conclusion - Gradual changes in pharmacokinetic parameters of propranolol were seen to be dependent on the hepatic fibrotic severity. We suggest that gradual dosage modification, according to their hepatic fibrotic severity, is necessary for many drugs administered to patients with chronic liver disease.(Korean J Hepatol 2001;7:181-188)

한국인 직무 스트레스 측정도구의 개발 및 표준화

장세진,고상백,강동묵,김성아,강명근,이철갑,정진주,조정진,손미아,채창호,김정원,김정일,김형수,노상철,박재범,우종민,김수영,김정연,하미나,박정선,이경용,김형렬,공정옥,김인아,김정수,박준호,현숙정,손동국 大韓産業醫學會 2005 대한직업환경의학회지 Vol.17 No.4

Background and Purposes: Over the past three decades, numerous studies performed in Korea have reported that job stress is a determinant risk factor for chronic diseases and work disability. Every society has its own culture and occupational climate particular to their organizations, and hence experiences different occupational stress. An occupational stress measurement tool therefore needs to be developed to estimate it objectively. The purpose of this study is to develop and standardize the Korean Occupational Stress Scale (KOSS) which is considered to be unique and specific occupational stressors in Korean employees. Subjects and Methods: Data were obtained from the National Study for Development and Standardization of Occupational Stress (NSDSOS Project: 2002-2004). A total of 12,631 employees from a nationwide sample proportional to the Korean Standard Industrial Classification and the Korean Standard Occupational Classification were administered. The KOSS was developed for 2 years (2002-2004). In the first year, we collected 255 items from the most popular job stress measurement tools such as JCQ, ERI, NIOSH and OSI, and 44 items derived from the a qualitative study (depth interview). Forty-three items of KOSS, in the second year, were retained for use in the final version of the KOSS by using Delphi and factor analysis. Items were scored using conventional 1-2-3-4 Likert scores for the response categories. Results: We developed eight subscales by using factor analysis and validation process: physical environment (3 items), job demand (8 items), insufficient job control (5 items), interpersonal conflict (4 items), job insecurity (6 items), organizational system (7 items), lack of reward (6 items), and occupational climate (4 items). Together they explained 50.0% of total variance. Internal consistency alpha scores were ranged from 0.51 to 0.82. Twenty-four items of the short form of the KOSS (KOSS-SF) were also developed to estimate job stress in the work setting. Because the levels of the subscales of occupational stress were gender dependent, gender-specific standard norms for both the 43-item full version and the 24-item short form using a quartile for the subscales of KOSS were presented. Conclusion: The results of this study suggest that KOSS might be an appropriate measurement scale to estimate occupational stress of Korean employees. Further and more detailed study needs to be conducted to improve the validity of this scale.

Effect of epidural corticosteroid injection on magnetic resonance imaging findings

( Min Soo Kim ),( Tae Yoon Jeong ),( Yu Seon Cheong ),( Young Wook Jeon ),( So Young Lim ),( Seong Sik Kang ),( In Nam Kim ),( Tsong Bin Chang ),( Hyun Ho Seong ),( Byeong Mun Hwang ) 대한통증학회 2017 The Korean Journal of Pain Vol.30 No.4

Background: Magnetic resonance imaging (MRI) of the spine is the preferred diagnostic tool for pathologic conditions affecting the spine. However, in patients receiving epidural corticosteroid injection (ESI) for treatment of spinal diseases, there is a possibility of misreading of MR images because of air or fluid in the epidural space after the injection. Therefore, we defined the characteristics of abnormal changes in MRI findings following an ESI in patients with low back pain. Methods: We reviewed the medical records of 133 patients who underwent MRI of the lumbar spine within 7 days after ESI between 2006 and 2015.All patients were administered an ESI using a 22-gauge Tuohy needle at the lumbar spine through the interlaminar approach. The epidural space was identified by the loss of resistance technique with air. Results: The incidences of abnormal changes in MRI findings because of ESI were 54%, 31%, and 25% in patients who underwent MRI at approximately 24 h, and 2 and 3 days after ESI, respectively. Abnormal MRI findings included epidural air or fluid, needle tracks, and soft tissue changes. Epidural air, the most frequent abnormal finding (82%), was observed in 41% of patients who underwent MRI within 3 days after injection. Abnormal findings due to an ESI were not observed in MR images acquired 4 days after ESI or later. Conclusions: Pain physicians should consider the possibility of abnormal findings in MR images acquired after epidural injection using the interlaminar approach and the loss of resistance technique with air at the lumbar spine. (Korean J Pain 2017; 30: 281-6)

Cronkhite-Canada 증후군 1예

이수걸,문창형,김무영,최성호,여동승,강필중,송철수,조몽,양웅석,허윤,문한규 대한내과학회 1992 대한내과학회지 Vol.42 No.2

저자들은 Cronkhite-Canada 증후군 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Cronkhite-Canada syndrome is a disease entity, including such characteristics as gastrointestinal polyposis associated with ectodermal changes-alopecia, hyperpigmentation of the skin and atrophy of the nails. But it has no familial tendency. In 1955, a report of 2 patients by Cronkhite and Canada established this entity as clinically distinct from any of the other known forms of gastrointestinal polyposis. Since that time, at least 53 similar casas has been described in the world literature, but no case has been reported in Korea.

AR 모델 및 LSQ 기반 변류기 2차 전류 복원 기법

張洙榮(Soo-Young Chang),李東圭(Dong-Gyu Lee),姜相熙(Sang-Hee Kang) 대한전기학회 2006 전기학회논문지A Vol.55 No.6

The current flowing though a power line is measured by a current transformer (CT). Since a CT is a kind of transformer, saturation of magnetic flux in the core may occur when a large primary current flows. This saturation makes the secondary current of a CT distorted and causes problems in the protection point of view. Because of the current distortion, a protection relay cannot collect the correct information showing how the primary power system changed. Consequently, the current distortion may cause the mal-operation or operation time delay of protective relay. In this paper, an algorithm based on AR model and LSQ is proposed to compensate the saturated CT secondary currents. Various test results indicate that the proposed algorithm can accurately compensate a severely distorted secondary current and is not affected by remanence.

Annual Change and C:N:P ratio in Particulate Organic Matter in Chinhae Bay, Korea

이필용,강창근,박종수,박주석,LEE, PIL-YONG,KANG, CHANG-KEUN,PARK, JONG-SOO,PARK, JOO-SUCK The Korean Society of Oceanography 1994 韓國海洋學會誌 Vol.29 No.2

An investigation of the annual change and C:N:P ratio in particulate organic matter (POM) in Chinhae Bay, a semi-enclosed bay of the southern coast of Korean Peninsula, was carried out for a period of 12 months between January and December, 1993. The concentrations of POM have a broad range: 198∼4,416 ugC/l, 24∼792 ugN/l and 4.5∼69.0 ugP/l, Marked seasonal changes of POM, particularly particulate organic carbon (POC) and nitrogen (PON), were observed in the surface water. Generally, the concentration of POM peaks in summer. The C:N:P composition ratio of particulate organic matter, which is high in summer, also shows a seasonal change. The C:N assimilation ratio is constant at 6.53, which is consistent with the Redfield ratio. The significant linear relationship between POM and chlorophyll-a in the surface water during the survey period (except for January and February) and the C:N ratio suggest that the concentration of POM is controlled by phytoplankton biomass. POM peaks in summer, a period characterized by high freshwater input and the strong stratification, as a result of the intense proliferation of phytoplankton by a large amount of nutrient loading from the tributaries. On the other hand, the high C:P and N:P ratios in summer indicate that P is limited for phytoplankton growth owing to N-enrichment from a high input of freshwater with a high dissolved inorganic N:P ratio.

Ohlson 모형에서의 보수주의 재고찰

강창수 ( Chang-soo Kang ) 공주대학교 KNU 기업경영연구소 2010 기업경영리뷰 Vol.1 No.1

본 연구는 최근 연구에서 초과이익가치평가모형(residual income valuation model, 이하 RIM)에 기초한 내재가치추정의 하향편이(downward bias)문제를 초래한 것으로 지적받아온 Ohlson 모형의 보수주의 측정치의 이상현상을 재고찰해 봄으로써 동 측정치의 기업가치측정상의 중요성을 재확인하는 것을 목적으로 한다. 본 연구는 이러한 연구목적을 위하여 다음과 같은 연구절차를 진행하였다. 첫째, Ohlson(1995), FO(1995, 1996)의 연구에서 다룬 RIM 모형을 순차적으로 그 가정을 중심으로 자세히 해석하였다. 둘째, 이를 토대로 RIM의 내재가치추정의 하향편이문제를 초래한 Ohlson 모형상의 보수측정치의 이상현상을 선행연구에서 어떻게 해소했는지를 살펴보고 그 문제점을 지적하였다. 셋째, 지적된 문제점을 해소하는 대안을 제시하였다. 이러한 과정을 통해 본 연구는 제기된 연구문제에 다음과 같은 잠정적인 결론을 제시한다. 첫째, Ohlson 모형에서의 보수주의 측정치에서 나타나는 이상현상은 모형의 설정오류문제가 아닐 수 있다. 둘째, FO(1996)연구모형에 기초할 때 Ohlson 모형에서의 보수주의 측정치의 이상현상은 영업현금흐름의 지속성이 영업자산의 지속성을 초과하지 못해 발생한 것으로 해석될 수 있다. 따라서 보수주의 계수값의 이상현상은 보수주의가 작동하는 Ohlson 모형의 가정의 범위를 벗어나는 상황에서 발생된 것으로 Ohson 모형 자체의 수정을 반드시 필요로 하지 않음을 시사한다. The purpose of this study is to revisit the negative conservatism coefficient issue as a reason to cause downward bias to intrinsic value estimation based on Ohlson model. and to confirm the value of the coefficient in firm valuation. For the purpose, I followed the procedures as follow; First, I revisited Ohlson(1995) and FO(1995, 1996) model and explained the meaning of the assumptions the models are based on. Then, I reviewed a research to detour the negative conservatism coefficient issue by changing the Ohlson model partly and pointed out a limit of the research. Third, I suggest a alternative for solving the issue while using Ohlson model without any model change. Based on the procedures, I provide some preliminary conclusions to the research problem. First. the negative conservatism coefficient issue might not be caused by the misspecification error of the model. Second, Based on FO(1996) model, the negative conservatism coefficient issue can happen when the persistence of operating cash flow of firms is less than the persistence of operating assets. Therefore, this result implies that Ohlson models are still effective for coping with the research subjects related to conservatism without any model correction.