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- 저자 : 장준동(Jun dong Chang) (검색결과 67 건)
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장준동,이원익,최수중,김석우,강신택,Chang, Jun-Dong,Lee, Weon-Ik,Choi, Soo-Joong,Kim, Seok-Woo,Kang, Shin-Taeg 대한근골격종양학회 2000 대한골관절종양학회지 Vol.6 No.2
종양성 석회증은 칼슘과 인산의 대사장애 없이 관절주위의 연부조직에 석회성분의 침착을 일으키는 질환으로 그 원인은 정확히 알려져 있지 않으며, 발생빈도는 매우 드물며 주로 흑인에서 발생한 예들이 보고되어 있으나 황인종에서 수 차례 재발되어 보고된 예는 아직 없다. 이에 저자들은 우측 슬관절과 대퇴부에 발생하여 수 차례 재발된 종양성 석회증 1예를 경험하였기에 문헌고찰과 함께 보고하고자 한다. 21세 여자 환자로서 우측 슬관절과 대퇴부 후방의 종괴를 주소로 내원하였으며 과거력상 14년 전부터 타 병원에서 4차례에 걸쳐 생검 및 제거술을 실시하였으나 재발을 반복하였다. 치료로서 제거 가능한 종괴의 철저한 변연 절제술을 시행하였으며 조직학적 소견상 종양성 석회증으로 진단되었던 예이었다. 술 후 24개월 이상 추시 관찰하여 현재까지 재발의 소견이 없었다. 저자들은 황인종에서 발생빈도가 드문 재발된 종양성 석회증 1예를 보고하는 바이다. Tumoral calcinosis is a disease of unclear etiology which presents with periarticular and intramuscular calcification without the disorder of calcium and phosphorus metabolism. The incidence is very rare but the rate is higher among the blacks than whites. There has been no report on the recurrent occurrence on the asian race. We report a case that recurred several times with tumoral calcinosis of both knee and thigh. A 21-year-old woman visited to our department with masses in both right thigh and knee. She had a history of local excisions and biopsies(4 times at other hospital) and showed prompt recurrences. The complete marginal excision was performed for the treatment. The histological examination showed the findings that are compatible with tumoral calcinosis. There has been a free of recurrence over the past two years.
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대퇴골두 무혈성괴사에서 대퇴골두의 침범정도 및 병기가 대퇴경부에 미치는 영향에 관한 연구
장준동 ( Jun Dong Chang ),이영호 ( Young Ho Lee ),박혜림 ( Hye Rim Park ),최수종 ( Soo Joong Choi ),장호근 ( Ho Guen Chang ),조원호 ( Won Ho Cho ),이창주 ( Chang Ju Lee ) 대한고관절학회 1996 Hip and Pelvis Vol.8 No.2
The purpose of this study is to evaluate the MR signal abnormality and the histologic changes in the femoral neck in the patient of AVN of the femoral head, to evaluate the factors that affect the changes in the the femoral neck, to correlate the head involvement according to radiographic staging and MR imaging with the MR signal and histologic changes in the femoral neck. Forty-five hips in 37 patients who had AVN of the femoral head (> stage III) were studied with radiography and MRI. Twenty femoral head and neck specimens for histologic study were obtained i ntraoperati vely. Patient data such as age, sex, site, bilateraity, weight, activity, the history of alcohol or steroid showed no statistically significant difference according to femoral neck involvement. Abnormal MR imaging in the femoral neck was observed in 19 hips (42.2%). The pattern was classified as Type A (diffuse, Mitchell class C, 10 cases), Type B (localized, Mitchell class D, 4 cases), Type C (localized with central lesion, Mitchell class A, 5 cases). This study demonstrated that changes on MR imaging and histologic findings in the femoral neck were increased when the extent of involvement of the femoral head on the radiograph and MR imaging is extensive. Further study such as a clinical study combined with MRI and histologic study is required to know the influence of the histologically changed area on the result of cementless THA.
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장준동(Jun-Dong Chang),유제현(Je-Hyun Yoo),이상수(Sang-Soo Lee),심정원(Jung-Weon Shim),김창영(Chang-Young Kim),권순억(Soon-Eok Kwon) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.2
목적: 고관절 주위 골절이 있었던 노인 환자에서 대퇴골두의 관절 연골의 변성 정도를 육안적, 조직학적, 면역 조직 화학적 소견을 통해 평가해 보고자 하였다. 대상 및 방법: 고관절 주위 골절로 양극성 반치환술을 시행 받은 65세 이상 환자 중 수상 전에 고관절부 동통없이 보행이 가능하고 술 전 단순 방사선 사진상 퇴행성 변화가 없었던 30예를 대상으로 하였고, 평균 나이는 79.7세 (65-94)였다. 육안적 소견은 술 중 적출된 대퇴골두의 체중 부하부위 3구역(전상, 중상, 후상방) 및 비체중 부하 부위 1구역(하방)에서 시행한 후, 총 4구역에서 연골하골을 포함한 관절 연골을 채취하여 Hematoxylin & Eosin 염색 및 Safranin O 염색을 시행하여 조직학적 변성정도를 분류하였고, Ⅱ형 collagen 항체를 이용하여 면역 조직 화학염색을 시행하였다. 결과: Outerbridge 분류에 의한 육안적 소견은 grade Ⅰ 이하가 82.5%였고, Mankin 등급에 의한 조직학적 소견과는 유의한 상관 관계를 보였다. Mankin 등급에 의한 조직학적 소견은 24예(80%)에서 경도의 변성을, 나머지 6예에서 중등도의 변성을 보였으며, 각 구역별 변성 정도는 모두 평균 5점 이하로 경도의 변성을 보였다. 체중 부하부위와 비체중 부하부위 간의 변성 정도에는 유의한 차이가 없었다. Hollander 등의 분류에 의한 면역 조직 화학염색상 결괴는 grade Ⅰ 이하가 28예(93.3%)로 대부분 정상 또는 경미한 변성을 보였다. 결론: 고관절 주위 골절이 있었던 노인 환자에서 방사선적으로 고관절부의 퇴행성 변화 소견이 없는 경우 대퇴 골두 연골의 변성 정도는 대부분 경도의 변성을 보였으며, 부위와 상관없이 전반적인 변화를 보였다. Purpose: To evaluate the incidence, grade and extent of the degenerative changes in the femoral head articular cartilage in the elderly with hip fracture through gross, histological and immuno-histochemical studies. Materials and Methods: The study examined 30 femoral heads obtained from patients over 65 years with no arthrosis by radiograph, who had undertaken bipolar hemiarthroplasty due to hip fracture. The mean age of patients was 79.7 years and the study examined three weight bearing zones (anterior, middle and posterior) and one non-weight bearing zone (inferior) of each femoral head. Results: The gross findings showed significant correlation with the Mankin grade for each zone (p<0.05). Twenty four cases (80%) showed mild degeneration according to the Mankin grade and the others moderate. The mean Mankin score at each zone of all femoral heads was 5 points, which indicated mild degeneration. No significant difference was found between the weight bearing zone and the non-weight bearing zone (p=0.75). The distribution of type Ⅱ collagen antibody stainabilities mainly showed normal or mild degeneration (93.3%). Conclusion: Degeneration of the articular cartilage of the femoral heads in the elderly with hip fracture and no arthrosis by radiograph was mostly mild, and showed generalized changes regardless of the zone.
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무시멘트 인공 고관절 전치환술 후 대퇴골 주위에 발생한 골용해 -형태와 크기에 영향을 주는 요인들에 관한 연구-
장준동 ( Jun Dong Chang ),위영훈 ( Young Hoon We ),최수중 ( Soo Joong Choi ),장호근 ( Ho Guen Chang ),이창주 ( Chang Ju Lee ) 대한고관절학회 1998 Hip and Pelvis Vol.10 No.1
There are many investigations about the femoral osteolysis including the patterns and size of the lesion. However, the factors, which influence the patterns and size of the femoral osteolysis, are not well known. Purposes of the study were to evaluate the patterns of the femoral osteolysis, to analyze the planimetric and approximate volumetric values of the lesion after cementless total hip arthroplasty and to evaluate the factors, which influence the patterns and size of the femoral osteolysis. We analyzed 120 hips who had undergone cementless THA using Harris Galante pomus prosthesis (Zimmer, Warsaw, Indiana) in 49 hips and Anatomic components (Zimmer, Warsaw, Indiana) in 71 hips. After an average of 4.9 years (range 4-10 years), 45 cases (37.5%) showed femoral osteolysis on the radiograph. The mean rate of linear wear was 0.24+-0.14mm in the cases of the femoral osteolysis. The size of the femoral osteolysis was correlated with duration, stem type, linear wear amount and linear wear rate. The linear wear amount showed higher correlation than the linear wear rate. In this study, the factors which influence the patterns of the femoral osteolysis were not found. Among eight cases of the revision, five cases required the revision due to severe femoral osteolysis lesion and polyethylene liner wear without the loosening of the prosthesis. We could confum that the size of osteolysis is important factor for the result of THA. Therefore, it is necessary to carefully follow-up the patients which show the osteolytic lesion and include the size of osteolysis in the item of the evaluation for the result of THA.
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인공 고관절 전치환술후 마모편에 의해 발생한 배액관(Sinus Drainage)
장준동 ( Jun Dong Chang ),정영기 ( Young Ki Chung ),이창주 ( Chang Ju Lee ) 대한고관절학회 1997 Hip and Pelvis Vol.9 No.1
Retrieval and autopsy studies on failed total hip replacement have shown that wear debris induces thickening or blackening, by the metallic debris, of capsular and interfacial tissues. Most of the case, wear debris is stored in the capsular tissue. In cases of large amount of particulate debris, debris are transported away via joint fluid channel or via the perivascular lymph space and stored in the interfacial membrane. In result, the size of the inflammatory tissue becomes enlarged. We are reporting sinus drainage of the wear debris from the failed Acetabular Cup System (ACS) total hip arthroplasty which has not been reported on the literature and discussing the mechanism of development of sinus drainage after catastrophic failure of the polyethylene liner.
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Harris-Galante 비구컵의 polyethylene liner 마모
장준동 ( Jun Dong Chang ),정수원 ( Soo Won Jeong ),최수중 ( Soo Joong Choi ),장호근 ( Ho Guen Chang ),이창주 ( Chang Ju Lee ) 대한고관절학회 1997 Hip and Pelvis Vol.9 No.2
There were many investigations about the polyethyiene wear rate and the factors which influence the wear. However, wear rate was different among studies and the factors that predispose to rapid wear are not definitely determined as well. Purposes of the study were to measure the amount and rate per year of linear wear of the polyethylene(PE) of the Harris-Galante porous(HGP) cups using the computer base technique and to evaluate the factors which influence the linear wear rate and the influence of the linear wear rate to the resu)t of the THA. Wear amount, wear direction, and cup position were measured. From the standard AP radiograph, two center points are selected at the head and the margin of the cup using a digitizer. Linear wear was defined as distance from the center of the head to the center of the outer shell. The computer system and software convert the data points after correction for magnification into two circles. The measurement of wear using the computer base technique was effective and the mean rate of linear wear was 0.15+0.18mm. Linear wear rate correlated with age, size of cup, thickness of liner, inclination of cup, and osteolysis, but not with the weight, diagnosis, sex, and site. The incidence of osteolysis of the femur was significantly higher in the cups which had 0.15mm/year of wear or more. It is necessary to observe more carefully the patients who had 0.15mm/year of wear or more. Our study aiso suggested that the alternatives of the bearing surface should be considered in younger patients.
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