공기단축형 복합시공기술 개발

임홍철,Im, Hong-Cheol 한국건설관리학회 2011 건설관리 : 한국건설관리학회 학회지 Vol.12 No.1

슬관절 내측부 인대 손상의 보존적 치료

임홍철,심재학,남혁우,왕준호,노영진 대한스포츠의학회 2000 대한스포츠의학회지 Vol.18 No.2

Purpose : The medial collateral ligament injury is the most common injury of the knee. Recently Non-operative treatment has been preferred than operative treatment and most of patients have satisfactory clinical results after non-operative treatment. But a few patients have continuous instability after non-operative treatment, so the purpose of this study is to fine out the cause of persistent symptom. Methods and Materlals : We performed a retrospective study of one hundred thirty seven patients with medial collateral ligament injury treated non-operative from January 1990 to December 1997. W divided patients into two groups: isolated medial collateral ligament injury (groupⅠ): medial collateral ligament injury with concomitant anterior cruciate ligament injury (groupⅡ) and we analysed MRI finding, valgus instability, and Lysholm knee score. Result : At the follow up, three of group Ⅰ, five of group Ⅱ had persistent grade Ⅲ valgus instability. In group Ⅰ, we could find two case of rupture of the proper of medial collateral ligament with inward inversion and one case of concomitant posteromedial compartment injury. We could find the proper rupture of medial collateral ligament with inversion inward in two patients, the injury of posteromedial compartment in one patient. Two patients of group Ⅱ with grade Ⅲ valgus instability had anterior instability with laxity of grafted tendon after anterior cruciate ligament reconstruction. Conclusion : Most of isolated injury of the medial collateral ligament heals wthout operative intervention. But in case of rupture of the proper portion of medial collateral ligament with inversion inward or concomitant injury of posteromedial compartment, we should consider the operative treatment of medial collateral ligament. In case of medial collateral ligament injury with anterior cruciate ligament, it would better to consider the delicate reconstruction of anterior cruciate ligament.

결출성 절단사지에 대한 재접합 후 추시결과

임홍철,서승우,홍준석,장욱성,Lim, H.C.,Suh, S.W.,Hong, J.S.,Jang, W.S. 대한미세수술학회 1993 Archives of reconstructive microsurgery Vol.2 No.1

High level, major limb amputation above the wrist and ankle joint has some characteristic problems because of the large muscle mass and poor potential for nerve regeneration. As an adjunct method to reduce warm ischemic time prior to bony stabilization, temporary vascular shunting by simple catheterization has been performed, which has not been associated with any significant complication and has improved on success rate in replantation surgery. The authors have experienced 198 cases replantation of amputated limbs and digits from September, 1983 at the Korea medical center, Guro hospital, of which, 13 cases of successful replantation of amputated limbs by avulsion injury above the wrist and ankle joint level, which is generally considered as contraindication, were followed up for average 4.5 years(minimum 1.5 to maximum 8.4 years) on terms of survival rate, function and appearance. The clinical analysis upon these cases is to be presented with review of references.

주파수 영역 필터링을 통한 콘크리트 시편 내부 레이더 탐사

임홍철,이윤식 한국지진공학회 2002 한국지진공학회논문집 Vol.6 No.4

지진 발생시 건축물의 내부상태를 탐사하는데 있어 콘크리트 구조물의 두께, 철근의 피복깊이, 공동의 유무를 탐사하게 되고, 이것을 통해 건축물의 손상을 추정할 수 있다. 이때 콘크리트 내부를 탐사하는 방법으로 지중 탐사 레이더(ground penetrating radar)가 효과적으로 이용될 수 있다. 기존의 레이더 측정 방법에서는 콘크리트 내부를 탐사하기 위해 시간영역에 있는 데이터로 콘크리트의 유전상수를 구하고 시간을 거리로 환산하여 육안 식별에 의해서 결과를 분석하였다. 본 연구에서는 콘크리트 시편을 측정한 후 측정된 데이터를 주파수 영역으로 변환하여 스펙트럼 분석과 필터링을 통한 방법으로 신호 처리하여 시간영역에서의 데이터 분석능력을 향상 시켰다. 데이터 획득을 위해 주로 사용되는 900MHz, 1GHz, 그리고 1.5㎓ 중심 주파수를 갖는 세 개의 안테나를 사용하여 철근시편을 탐사하였다. 주파수 영역에서 차단 주파수(cutoff frequency)를 1/3 옥타브에 의하여 변화시키면서 저역 통과, 고역 통과, 그리고, 대역 통과 등의 필터링을 하였고, 각각의 중심 주파수에 대한 가장 효과적인 차단 주파수를 찾으려고 했다. 차단 주파수의 범위는 최대 하위 2옥타브에서 상위 1옥타브와 최소 하위 2옥타브에서 하위 1옥타브가 적합하였고, 주파수 영역에서 필터링을 통해 콘크리트 내부 정보 분석력 향상을 위한 토대를 마련하였다. Radar method can be effective in probing concrete structures damaged by earthquake. Data analysis is usually performed in time domain, by considering time delay of the wave due to the dielectric constant of concrete. In this study, improved data analysis has been performed using signal processing scheme of spectra analysis and filtering. Three antenna with 900MHz, 1㎓, and 1.5㎓ center frequency were used to detect a steel bar or delamination in specimens for obtaining data, Frequency spectrum was filtered in low pass, high pass, and band pass varying cutoff frequency with 1/3 octave in frequency domain. The most effective cutoff frequency for each frequency has been determined as the range for 2 octave lower to 1 octave higher and 2 octave lower to 1 octave lower. This result provided a basis in improving data analysis capability using frequency domain filtering.

40세 이상에서 발견된 외측 원판형 연골의 임상분석

임홍철,노경선,정효섭,Lim, Hong-Chul,Noh, Kyoung-Sun,Jung, Hyo-Sub 대한관절경학회 2006 대한관절경학회지 Vol.10 No.1

목적: 40세 이상의 성인에서 발견된 외측 원판형 연골의 임상적 특징에 대해서 분석하고자 한다. 재료 및 방법: 1994년 3월부터 2004년 3월까지 40세 이상에서 원판형 연골이 발견되어 관절경적 치료후 1년 이상 추시가 가능한 48명의 환자 53예를 대상으로 하였고 환자의 평균 연령은 48.4세($40{\sim}62$세)였다. 환자군을 대상으로 이학적 검사 소견, 단순 방사선 및 MRI 소견, 관절경 소견을 분석하였다. 결과: 전체 53예중 증상 이환 기간은 1년이내가 42예(79.2%)로 대부분을 차지하였고 26예(49.1%)에서 외상의 기왕력이 있었으며, 방사선학적 검사상 대퇴골 외과의 편평화, 외측 구획의 퇴행성 변화가 37예(69.8%)에서 관찰되었다. 또한 내측 구획의 퇴행성 변화는 16예(30.2%)에서 관찰되었다. 슬관절경 검사상 45예(84.9%)에서 원판형 연골의 파열이 관찰되었고 파열이 없었던 경우는 8예(15.1%)였다. 파열형태는 복합형(18예, 40.0%)의 파열 형태가 가장 흔하게 나타났으며 그외 종파열(longitudinal) 12예(26.7%), 수평파열(horizontal) 11예(24.4%), 횡파열(transverse) 4예(8.9%)가 관찰되었고, 내측 연골판 파열을 동반하는 경우는 7예(13.2%)였다. 치료 방법으로는 관절경하 연골판 성형술이 46예(86.8%), 이중 6예에서 연골판 성형술 후 부분적 봉합술을 함께 시행하였으며 연골판 아절제술이 5예(9.4%), 연골판 전절제술이 1예(1.9%), 1예(1.9%)에서 관절경 검사후 슬관절 전치환술을 시행하였다. 결론: 성인의 원판형 연골은 소아의 경우와는 달리 외상의 기왕력을 가지고 있는 빈도가 높으며 가벼운 외상에 의해 증상이 발현된다. 또한 슬관절 내 외측 구획의 퇴행성 변화 등 방사선학적인 변화를 관찰할 수 있어 가능한 보존적인 수술적 치료가 필요할 것으로 사료된다. Purpose: The purpose of this study was to analyze the clinical results of symptomatic lateral discoid meniscus found in adults over 40 years old. Materials & Methods: From March 1994 to March 2004, 53 cases treated for lateral discoid meniscus in 48 patients aged over 40 years with the mean age $48.4(40{\sim}62)$ who were followed up more than 1 year, were analyzed by physical findings, simple X-ray, MRI and arthroscopic exam. Results: Most of the cases (42 cases, 79.2%) had symptoms for less than 1 year duration. 26 cases(49.1 %) out of 53 had trauma history. Simple radiologic evaluation showed that lateral condylar abnormality such as the flattening of lateral femoral condyle, marginal osteophytes, and subchondral sclerosis was seen in 37cases(69.8%). Also medial condyle showed degenerative changes in 16 cases (30.2%). Tear of discoid meniscus in 45 cases(84.9%) were examined by arthroscope and tear was not detected in 8 cases(15.1%). Type of tear was complex(18 cases), longitudinal(12 cases), horizontal(11 cases) and transverse(4 cases). Concomitant medial meniscal rupture was found in 7 cases(13.2%). The simple procedure done was reshaping(46 cases), subtotal resection(5 cases), total resection(1 case) and meniscal repair after reshaping in 6 cases, and arthroplasty was performed after arthroscopic examination in 1 case. Conclusion: Onset of symptom in adult lateral discoid meniscus is usually traumatic in origin. Most cases showed radiologic abnormality such as degenerative change in lateral condyles as well as medial condyles and the results of preservative surgical treatment was the most preferred option in most patients.

관절경적 반월상 연골판절제술

임홍철 中央醫學社 1993 中央醫學 Vol.58 No.10

제 18 차 정기학술대회 초록집 : 39. 만성 신부전증 환자에 있어서 대퇴 사투근의 자연적 파열 - 증례 보고 -

임홍철,심재학,최병섭,남혁우,홍명표 대한슬관절학회 2000 정기학술대회 Vol.- No.-

정형외과 영역의 응급처치

林弘喆 대한의사협회 1999 대한의사협회지 Vol.42 No.5

신전제한을 유발하는 슬내장증

임홍철,홍준석,김태형,민경구 대한슬관절학회 1998 대한슬관절학회지 Vol.10 No.2

The authors have performed arthroscopic management in 126 knees of 121 patients with internal derangement of knee(IDK) from March, 1995 to June, 1997 at Guro hospital. Among them, there were 41 knees of 39 patients who had complained the extension block of knee joint which must be differentiated from flexion contracture and extension lag. As a result of arthroscopy, the associated diseases with extension block were lateral discoid meniscus tear in 13 knees, bucket handle tear in 9 knees, hypertrophic infrapatellar plica in 7 knees, Hoffa's disease in 5 knees, ACL rupture in 3 knees, intra-articular loose bodies in 2 knees, and cyclops lesion in 2 knees. In conclusion, detailed historical taking and physical examination followed by arthroscopic management are very useful methods to confirm the pathology and making complete treatment of IDK causing extension block.

골유합술식을 이용한 대퇴경부 골절의 치료

임홍철,전승주,손원용,김기성 대한골절학회 1999 대한골절학회지 Vol.12 No.1

We reviewed respectively the results of treatment of femoral neck fracture using osteosynthetic methods, in 29 patients who were treated at the Department of Orthopedic Surgery, Guro Hospital, Korea university, from January 1991 to December 1995. 20 cases were stabilized by cannulated hip screw, 6 cases by compression hip screw and 3 cases by Knowles pin. With the average follow up of 26 months (12 - 45 months ), we analyzed the cause of injury with age, fracture types by Garden' s method, the accuracy of reduction by Garden' s alignment index and the functional results of the hip by Harris hip score and walking capacity. The adequacy of reduction by Garden' s alignment index were as follows: anatomical in 14, acceptable in 12 and poor in 3 cases. The functional results by Harris hip score and walking capacity were as follows: excellent in 21, good in 3, fair in 2 and poor in 3 cases. Complications after treatment of femoral neck fracture were one case of AVN, one case of non-union and two cases of combination of AVN and non-union. All these complications were developed in displaced femoral neck fracture with poor quality of reduction and directly correlated with initial displacement of fracture and reversely correlated with adequacy of reduction Our conclusions are that treatment of femoral neck fracture using osteosynthesis is favorable in young age regardless 'of initial displacement and in old age without osteoporosis and displacement and satisfactory results are produced from acceptable to anatomical reduction of fracture.