원판형 내측 연골판 파열 - 1 예 보고 -

김동휘,김배균,김정만,Kim, Dong-Hui,Kim, Bae-Gyun,Kim, Jung-Man 대한관절경학회 2004 대한관절경학회지 Vol.8 No.1

슬관절에서 외측 원판형 연골판은 흔히 발견되고 있으나, 내측 원판형 연골판의 빈도 및 보고가 드물다. 본 증례에서는 수평 파열과 더불어 상순에 국한된 변연부 파열이 관찰되었으며 이는 정상의 반월상 연골뿐만 아니라 원판형 외측 반월상 연골에서도 보기 드문 형태이다. 다른 정상 연골판이나 원판형 외측 반월상 연골 파열의 형태와 비교하여 본 증례의 파열 기전을 논하였다. Although the lateral discoid meniscus of the knee has been observed frequently, the discoid medial meniscus has rarely been reported in the literature. A discoid medial meniscus with the horizontal tear and the peripheral tear of upper lip were observed. This tear pattern is not usual in the lateral discoid meniscus as well as in the normal meniscus. A plausible mechanism of the tear pattern compared with the normal shape and the discoid lateral meniscus was discussed in the following.

論文(론문) : 小字本系統 『金櫃要略』 吳遷本의 特徵에 대한 考察-鄧珍本과의 比較를 中心으로-

김동휘 ( Dong Hui Kim ),정창현 ( Chang Hyun Jeong ),백유상 ( You Sang Baik ),금상현 ( Sang Hyun Kim ),안진희 ( Jin Hee Ahn ),박성진 ( Seong Jin Park ),장우창 ( Woo Chang Jang ) 대한한의학원전학회(구 대한원전의사학회) 2013 대한한의학원전학회지 Vol.26 No.4

Objective: The recently reported Wuqian edition(吳遷本) Jinguiyaolue(金櫃要略) is known to be written in small letters unlike other large lettered versions of the book. The Wuqian edition(吳遷本) takes after the name of Wuqian who copied an ancient version that was found at the time(Ming dyanasty, 1395). It is known to differ in organization and contents to other versions. In this study, I would like to examine how the small-lettered version of the Jinguiyaolue had been created, through a thorough examination of the Wuqian edition, and evaluate its value as a new version of the Jinguiyaolue. Method: First, the systems of both large-lettered and small-lettered versions of the 『Jinguiyaolue』 were briefly examined, followed by comparison from chapter 1 to 22, of organization, contents, and formulas between the oldest version of the large-lettered versions, the Deng-zhen edition, and the newly discovered Wuqian edition of which examples of each item are listed. The original source was identified for parts that were different. Result & Conclusion : 1. The Deng-zhen edition and Wuqian edition show vast differences in the organization, table of contents, name of chapter, location of each verse or line, existence of certain verses or lines, name of formula, quantity of medicinal ingredients, processing methods and other aspects. 2. The small-lettered edition was published based on the large-lettered edition of the Jinguiyaolue published by the Jiaozheng-yishuju(校正醫書局) after a general cross-examination process followed by selection, modification and supplementation of the large-lettered edition. Reference texts used in cross-examination were Qianjinyaofang(千金要方), Waitaimiyao(外臺秘要), Maijing(脈經), and Shanghanlun(傷寒論). 3. Considering Wuqian`s own annotations and preface, it is clear that he wanted to create the best version of the 『Jinguiyaolue』. Wuqian himself seems to have had professional knowledge of bibliography and medicine.

알루미나 세라믹-세라믹 관절면을 이용한 무시멘트 인공 고관절 전치환술

김동휘 ( Dong Hui Kim ),이상홍 ( Sang Hong Lee ),유재원 ( Jae Won You ),조성원 ( Sung Won Cho ) 대한고관절학회 2010 Hip and Pelvis Vol.22 No.3

목적: 대퇴 골두 무혈성 괴사의 환자에서 세라믹-세라믹 관절면을 이용한 인공 고관절 전 치환술 후 임상적, 방사선학적 결과를 평가하고자 하였다. 대상 및 방법: 2004년 3월부터 2006년 2월까지 고관절 전 치환술을 시행 받은 21명 31예를 대상으로 하였고 평균 추시 기간은 56개월(48~72개월)이었다. 무혈성 괴사증의 원인은 알코올 12예, 특발성 10예, 스테로이드 6예, 후 외상성 3예였다. 임상적 결과는 Harris 고관절 점수와 서혜부 및 대퇴부 동통 유무를, 방사선학적 결과는 비구컵과 대퇴 스템 주변의 골 용해, 불안정성, 대퇴스템의 고정위치, 관절 면 마모등을 평가 하였다. 결과: 최종 추시 결과 Harris 고관절 점수는 평균 93점 이었고, 서혜부 및 대퇴부 통증은 없었다. 합병증으로는 비골 신경마비 1예, 세라믹 골두 골절 1예, 관절내 소리가 2예, 후방탈구 2예가 관찰되었고, 최종 추시 결과 2명이 간경화 후유증으로 사망하였다. 방사선 최종 추시시 전례에서 골내 성장을 얻었고, 비구 컵과 대퇴 스템의 이동, 위치 변형, 골 용해 소견은 관찰되지 않았다. 결론: 평균 56개월 추시 결과 전례에서 골내 성장 고정을 얻었고, 세라믹 골두 골절 1예를 제외하고 양호한 결과를 얻을 수 있었으나 좀 더 장기 추시가 필요할 것으로 사료된다. Purpose: We wanted to evaluate the clinical and radiological results of total hip arthroplasty using a ceramic-on-ceramic articulation Materials and methods: From March 2004 to February 2006, total hip arthroplasty was performed in 21 patients and 31 hips. The mean follow up period was 56 months (range: 48~72 months). The causes for the AVN were alcohol in 12 cases, idiopathic in 10 cases, steroid in 6 cases and post-traumatic in 3 cases. The clinical results were evaluated using the Harris hip score and according to the pain on the inguinal area or thigh. The radiographic evaluation was performed to determine the level of osteolysis and instability around the acetabular cup and femoral stem, the position of the femoral stem and the wear of the articular surface. Results: At the most recent follow-up, the mean Harris hip score was 93 points with no inguinal or thigh pain. The complications included one case of peroneal nerve palsy, one case of ceramic head fracture, two cases of noise in the joint, two cases of posterior dislocation and two patients died because of complication related to liver cirrhosis. Radiologically, bone ingrowth was noted in all the cases with no migration of the acetabular component and femoral stem, changing of the position or osteolysis. Conculsion: Total hip arthroplasty with ceramic on ceramic articulation shows satisfactory results at an average of 56 months follow up. There was bone ingrowth in all cases except for one ceramic head fracture. Further follow-up study should be performed to evaluate the long-term results.

대퇴 전자부 골절에서 환자 경향 및 수술적 치료의 변화

김동휘(Dong-Hui Kim),이상홍(Sang-Hong Lee),하상호(Sang-Ho Ha),유재원(Jae-Won You) 대한정형외과학회 2011 대한정형외과학회지 Vol.46 No.1

목적: 대퇴 전자부 골절에서 환자의 연령 및 골절 양상 그리고 치료 방법에 대하여 후향적으로 조사하여 변화양상을 알아보고자 하였다. 대상 및 방법: 1999년 6월부터 2007년 6월까지 대퇴 전자부 골절에 대해 본원에서 수술적 치료를 시행하고 1년 이상 추시가 가능하였던 65세 이상의 환자 240명을 대상으로 수술 시기에 따라 4년 단위로 나누어 A, B 군으로 구분하였다. 각 군간의 연령, 골밀도, 골절 원인, 골절 양상, 수술적 치료방법의 변화를 비교 분석하였다. 결과: A군은 108명, B군은 132명이었으며 평균 연령은 A군은 75.4세, B군은 77.6세로 B군에서 2.2세 높았다. 골절 원인에 따른 차이는 없었으며, AO 분류상 A군은 A2-2 이상의 분쇄골절이 44예(40%), Evans 분류상 불안정 골절 77예(71%)이었고 B군에서는 각각 65예(49%)와 100예(76%)로 분쇄 골절과 불안정성 골절이 증가하였다. 골밀도 검사에서 B군이 평균 -0.29 이상 감소하였으며, 수술적 방법은 A군은 압박 고 나사 61예(56%), 근위 대퇴정 41예(38%), 인공 고관절 반치환술 6예(6%), B군은 각각 48예(36%), 73예(55%), 11예(9%)로 근위 대퇴정 및 인공 고관절 반치환술을 이용한 치료가 증가하였다. 결론: 평균 연령의 증가, 골밀도의 감소, 분쇄골절이나 불안정성 골절이 증가하였으며 수술적 치료에서 근위 대퇴정이나 일차적인 인공관절 치환술의 시용이 점차 많이 시행되었다. Purpose: The purpose of this study was to analyze characteristics of femur intertrochanteric fractures concerning age, fracture pattern, and change in operation method, retrospectively. Materials and Methods: Of the patients over 65 years of age that had been treated between June 1999 and June 2007, two hundred forty patients, who were available for follow-up for at least 1 year were selected. Patients were divided into 2 groups, A or B, based on their time of operation during a 4-year period. Age, bone marrow density (BMD), causes of fracture, fracture patterns, and treatment trends were analyzed. Results: The number of patients in group A was 108 and in group B was 132; the mean age was 75.38 years and 77.58 years, retrospectively with the mean age increased by 2.2 years. In group A, 44 cases (40%) were comminuted fractures over AO type A2-2, 77 cases (71%) were unstable fracture using Evans classification; in group B, there were 65 cases (49%) and 100 cases (76%), respectively. Based on the BMD analysis, an average -0.29 decreased in group B. In group A. 61 cases (56%) were treated with compressive hip screw, 41 cases (38%) with proximal femoral nail, 6 cases (6%) with bipolar hemiarthroplasty. In group B, 48 cases (36%) were treated with compressive hip screw, 73cases (55%) with proximal femoral nail, and 11 cases (9%) with bipolar hemiarthroplasty. Conclusion: There were increases in patient age, percentages of unstable fractures, fracture comminution and decrease in bone marrow density. The use of proximal femoral nail or primary arthroplasty increased.

골자공증이 있는 고령의 대퇴부 전자간 골절에서 근위 골수강내 고정술을 이용한 치료

김동휘 ( Dong Hui Kim ),이상홍 ( Sang Hong Lee ),문영래 ( Young Lae Moon ),이준영 ( Jun Young Lee ),송근상 ( Kun Sang Song ) 대한골절학회 2007 대한골절학회지 Vol.20 No.3

목적: 골다공증이 있는 고령의 대퇴부 전자간 골절에 대하여 근위 골수강내 고정술로 치료받은 환자들을 대상으로 임상적 및 방사선적 결과를 분석하여 술식의 유용함과 합병증 등을 알아보고자 하였다. 대상 및 방법: 대퇴 전자간 골절에 대해 근위 골수강내 고정술로 치료받은 환자 중 1년 이상 추시 가능하였던 32예의 환자를 대상으로 하였다. Evans 분류상 안정성 골절은 11예였으며 불안정성 골절은 21예였다. 임상적으로 보행 능력을 비교하였고, 방사선학적으로 건측 대퇴 경부의 골밀도 검사 및 술 후 골유합 및 합병증 등을 분석하였다. 결과: 술 전과 술 후 보행능력의 비교평가에서는 술 후 양호가 9예 (28%), 보통이 17예 (53%), 불량이 6예 (19%)였으며 술 후 활동 상태를 기준으로 정상 보행을 보인 경우 7예, 한 개의 목발로 통증 없이 보행 가능한 경우 9예, 두 개의 목발로 보행 가능한 경우 5예, 타인의 도움이 있어야만 보행이 가능한 경우 11예였다. 방사선 평가상 건측 대퇴 경부의 골밀도 검사상 T-score는 -3.12였고 3개월 이내 골 유합을 보였던 경우는 20예였다. 합병증으로는 술 중 근위부 골절이 2예, 3예의 불유합 및 술 후 1년 내 사망이 4예가 있었다. 결론: 고령의 대퇴부 전자간 골절에서 근위 골수강내 고정술 비교적 유용한 치료방법이나 T-score가 -3.0 이하로 심한 골다공증이 있거나 불안정성 골절인 경우 합병증의 빈도가 비교적 높아 이에 대해서는 인공관절 치환술 등의 치료방법이 유용할 것으로 사료된다. Purpose: Clinical and radiologic results of femur intertrochanteric fractures treated with ITST nail in elderly patients with osteoporosis were analysized to evaluate the efficacy and complication of ITST nailing. Materials and Methods: 32 patients who were treated with ITST nail due to femur intertrochanteric fracture and were followed up for more than 1 year were analysed. According to Evans classification, 11 cases were stable fractures and 21 cases were unstable fractures. Clinically, ambulatory function was compared and radiologically, BMD of healthy leg was checked with analysis of postoperative bone union and complication. Results: In ambulatory function comparison before and after the operation, there were 9 cases of good, 17 cases of moderate and 6 cases of poor. Considering social activity after the operation, 7 cases showed normal ambulation, 9 cases showed ambulatory with one cane, 5 cases showed two cane ambulation and 11 cases showed dependent ambulation. In radiologic evaluation, T-score of ward triangle in healthy femoral neck showed BMD of-3.12. In 20 cases, bone union was observed within 3 months. The patients with low BMD result had poor outcome. There were 2 cases of intraoperative proximal femur fracture, 3 cases of nonunion and 4 cases of death within 1 year. Conclusion: In elderly patients with intertrochanteric fracture, ITST nailing is relatively efficient treatment. However, in pateint with severe osteoporosis (T-score<-3.0) and unstable fracture pattern, arthroplasty should be considered due to relatively high complicaton rate.

학질(학疾)의 자락사혈(刺絡瀉血) 치료법(治療法)에 대한 고찰(考察) -『소문(素問),자학(刺학)』을 중심으로-

김동휘 ( Dong Hui Kim ),정창현 ( Chang Hyun Jeong ),장우창 ( Woo Chang Jang ),유정아 ( Jeong Ah Lyu ),백유상 ( You Sang Baik ) 대한한의학원전학회(구 대한원전의사학회) 2011 대한한의학원전학회지 Vol.24 No.4

The texts of 『Hwangjenaegyeong(黃帝內經)』 explains Hakjil(학疾) in detail, especially in the 「Jahak(刺학」chapter, where bloodletting treatment is applied in many cases. The following paper categorized and organized Hakjil(학疾) cases treated by bloodletting methods, then analyzed applicable subjects and appropriate time for the procedure based on the texts. Afterwards, the mechanism for the cessation of Hakjil(학疾) seizures was examined. The findings of this research are as follows. 1. In the contents of 『Hwangjenaegyeong(黃帝內經)』, the appropriate time for acupuncture and bloodletting procedure is when Hakjil(학疾) seizures start to present themselves. 2. When a seizure takes place as a symptom of the body getting rid of the Hak(학) pathogen, Yanggi(陽氣) rushes to the locus of the pathogen, causing congestion of Gi(氣) and Blood(血) resulting in static blood[瘀血]. Therefore, bloodletting at the time of seizure initiation helps the flow of Gi(氣) and Blood(血), preventing the rush of Yanggi(陽氣). This is a restoration of the balancing function of Eum(陰) and Yang(陽), which indicates that bloodletting not only promotes smooth flow of Gi(氣) and Blood(血), but extends its effects to mental functions that balances Eum(陰) and Yang(陽). 3. Although Hakjil(학疾) seizures are presented in terms of Gi(氣) and Blood(血) in symptoms such as chill and fever[寒熱], static blood[瘀血], pain, etc., a fundamental disturbance in mental functions that control cold and heat seems to be present.

후크형 강섬유 혼입율 및 형상비에 따른 콘크리트의 휨 및 압축 특성

김동휘 ( Dong-hui Kim ),장석준 ( Seok-joon Jang ),김선우 ( Sun-woo Kim ),박완신 ( Wan-shin Park ),윤현도 ( Hyun-do Yun ) 한국구조물진단유지관리공학회 2021 한국구조물진단유지관리공학회 논문집 Vol.25 No.3

이 연구는 후크형 강섬유의 체적비 및 형상비에 따른 콘크리트 설계기준강도 30MPa를 갖는 콘크리트의 역학적 특성, 휨 및 압축거동에 미치는 영향에 대하여 분석한다. 실험에서 형상비가 상이한 3종류의 섬유가 사용되었다. 섬유의 형상비는 64, 67, 80이며 섬유의 보강량은 체적비 0.25%, 0.50% 및 0.75%가 선정되었다. 강섬유 보강 콘크리트의 휨거동은 하중-균열폭 곡선, 휨강도 및 휨인성이 평가되었다, 압축거동은 압축응력-변형률 관계 곡선, 압축강도 및 인성 등이 평가되었다. 실험결과로부터 강섬유 보강 콘크리트의 휨강도, 휨인성 및 파괴에너지는 강섬유 혼입량이 증가됨에 따라 향상되는 것으로 나타났다. 그러나 형상 64와 67인 강섬유로 보강된 콘크리트의 역학적 특성은 큰 차이를 보이지 않았다. 이 연구에서 검토된 강섬유 보강 콘크리트의각 배합에 대한 유럽기준(MC2010)에 의한 산정된 휨 잔여강도는 기준에서 인장 철근 또는 보강 매쉬를 대체할 수 있는 한계기준을 모두 충족하는 것으로 나타났다. This study investigates the influence of hooked-end steel fiber volume fraction and aspect ratio on the mechanical properties, such as compressive and flexural performance, of concrete with specified compressive strength of 30MPa. Three types of hooked-end steel fibers with aspect ratios of 64, 67 and 80 were selected. The flexural tests of steel fiber reinforced concrete (SFRC) prismatic specimens were conducted according to EN 14651. The compressive performance of SFRC with different volume fractions (0.25, 0.50 and 0.75%) were evaluated through standard compressive strength test method (KS F 2405). Experimental results indicated that the flexural strength, flexural toughness, fracture energy of concrete were improved as steel fiber volume fraction increases but there is no unique relationship between steel fiber volume fraction and compressive performance. The flexural and compressive properties of concrete incorporating hooked-end steel fiber with aspect ratio of 64 and 80 are a little better than those of SFRC with aspect ratio of 67. For each SFRC mixture used in the study, the residual flexural tensile strength ratio defined in Model Code 2010 was more than the limit value to be able to substitute rebar or welded mesh in structural members with the fiber reinforcement.

대퇴골 전자부 역사상 골절의 압박고 나사를 이용한 치료

김동휘 ( Dong Hui Kim ),이상홍 ( Sang Hong Lee ),하상호 ( Sang Ho Ha ),유재원 ( Jae Won You ) 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.1

Purpose: To investigate the results of treatment of reverse oblique trochanteric fractures with compression hip screw. Methods: We reviewed the results of 12 cases of reverse oblique trochanteric fracture treated with compression hip screw from January 2000 to December 2006 which could be followed up for more than 1 year. The mean follow up period was 26 months (15~40). The mean age was 48 years old. Injury mechanism was composed of 6 cases of traffic accident and 6 cases of fall down. 8 persons were man. We investigated the union time, degree of neck-shaft angle change, amount of sliding of compression hip screw, complications, functional and clinical results. Results: 10 cases were united and the mean union time were 5 months (3~8). The mean neck-shaft angle change was 3.5 degrees (0~12). The amount of sliding of compression hip screw was 8.9 mm (2~24). There were six coxa vara, six leg due to coxa vara shortening, two nonunion, and one superficial infection. Unsatisfactory results of Jensen`s social function score and Parker and Palmer`s mobility score were studied. Conclusion: The results of treatment of reverse oblique trochanteric fractures with compression hip screw were relatively unsatisfied. (J Korean Soc Traumatol 2010;23:1-5)

이산치 신호를 이용한 PV시스템의 제어특성

김동휘(Dong-Hui Kim),백형래(Hyung-Lae Baek) 전력전자학회 1999 전력전자학술대회 논문집 Vol.1999 No.7

Solar cell generate DC power from sunlight whose power is different at any instance according to condition of variables insolation and temperature, In order to Improve the system utility factor and efficiency of energy conversion. it is desirable to operate the PV system at maximum power point of solar cell under different condition, In this paper, Boost chopper is controlled It output voltage with a new discrete control algorithm for MPPT. PWM signal of DC-DC converter are generated with a 89C51 microcontroller. switching frequency of DC-DC converter is set at 10kHz, Simulation and experimental results show that the PV system studied m this paper is always operated at maximum power point under different maximum power point of solar cells having stabilized output voltage waveform with relatively small ripple component.

온병(溫病) 혈증(血證)의 락맥병기(絡脈病機)에 대한 고찰 -주객교(主客交)와 건혈(乾血)을 중심으로-

김동휘 ( Dong Hui Kim ),정창현 ( Chang Hhyun Jeong ),장우창 ( Woo Chang Jang ),류정아 ( Jeong Ah Lyu ),백유상 ( You Sang Baik ) 대한한의학원전학회 ( 구 대한원전의사학회 ) 2012 대한한의학원전학회지 Vol.25 No.1

Objective : Blood disease is common these days due to modern man`s excessiveness in Yang heat (陽熱) and vulnerability of the Eum blood(陰血). This exposes them to warm- heat/dampness-heat diseases, where pathogenic heat easily penetrates the blood dimension(血分) creating stagnated blood(瘀血). Consequently, pathogenic symptoms in the collateral vessels increase, making it crucial to understand the pathogenic mechanism of the disease. Method : This paper examines the condition and region of the collateral vessel diseases(CVD) according to the blood diseases of Onbyeong, by analyzing each prescription`s matching symptom. The disease in question in this paper is ``stagnated blood fixated in the collateral vessels``. Therefore diseases with stagnated blood in the Yang collaterals and Viscera collaterals or viscera themselves from the 〈Ju-Gaek-Gyo〉chapter of On-Yeok-Ron(溫疫論) , and 〈Dry Blood-DaeWhangJaChungWhan(大黃蔗蟲丸)〉chapter of Geum-Gue-Yo-Rak(金櫃要略) , were examined respectively. Result & Conclusion : The process of CVD according to the blood diseases of Onbyeong can be summarized as follows. First, bleeding in the Yang and Bowel collaterals, then stagnation in the Yang and Bowel collaterals, and finally stagnation in the viscera collaterals or Liver itself. The refractory nature of blood stagnation symptoms of the collateral vessels is mainly due to the characteristics of the collateral vessel itself. In structure, they are very narrow and small, situated at the most terminal part of the body where it is difficult for the Jeong Gi(精氣) to reach. Also, as they are symptomatic of degeneration of Jeong Gi, the root of the disease is very deep. Therefore to resolve blood stagnation in the cases of Ju-Gaek-Gyo and Dry Blood, general approaches using ``Gi communication(行氣)`` or ``Blood vitalizing(活血)`` medicinals will not suffice. Special medicinals such as crustacean and insects need to be appropriately applied.