고관절 감염 후유증 환자에서 시행한 3세대 알루미나-알루미나 고관절 전치환술

이혁진(Hyuk-Jin Lee),유정준(Jeong Joon Yoo),구경회(Kyung-Hoi Koo),윤강섭(Kang Sup Yoon),김영민(Young-Min Kim),김희중(Hee Joong Kim) 대한정형외과학회 2008 대한정형외과학회지 Vol.43 No.3

목적: 고관절 감염 후유증 환자는 고관절의 해부학적 변형 정도가 심해 고관절 전치환술을 시행하기 어렵고 이환 연령도 낮은 관계로 치환술 후 합병증 발생률과 실패율이 높다고 알려져 있다. 본 연구에서는 마모와 골 용해 발생이 적다고 알려진 알루미나-알루미나 고관절 전치환술로 치료한 고관절 감염 후유증 환자들의 임상적, 방사선학적 추시 결과를 분석하였다. 대상 및 방법: 고관절 감염 후유증으로 무시멘트성 알루미나 알루미나 고관절 전치환술을 시행 받고 최소 5년 이상 추시(평균 6년 10개월, 5년-8년 7개월)가 가능하였던 48 고관절(48명)을 대상으로 하였다. 수술 당시 평균 연령은 36.7세(18-63세)로 41명이 50세 이하였다. 전례에서 알루미나 관절면(BIOLOX<SUP>®</SUP> forte)을 장착한 PLASMACUP<SUP>®</SUP>SC-BiCONTACT<SUP>®</SUP> system이 사용되었다. Harris 고관절 점수를 이용하여 임상적 평가를 실시하였고 방사선학적 검사로 삽입물의 고정 상태, 골 용해 발생 여부, 수술 전 후 환자의 하지 부동 정도, 수술 전 후 고관절 회전 중심 변화를 평가하였다. 결과: Harris 고관절 점수는 수술 전 평균 61.6점에서 최종 추시 시 92.2점으로 향상되었다. 전예에서 감염의 재발은 없었으며 삽입물의 안정적 고정을 확인하였다. 최종 추시 시 삽입물의 해리는 없었으며 추시 도중 골 용해가 의심되는 경우가 1예에서 관찰되었다. 하지 부동은 술 전 평균 26.2 ㎜에서 술 후 평균 9.5 ㎜로 교정되었다. 고관절 회전 중심은 수술 전과 비교하여 수술 후 평균 11.7 ㎜ 내측으로, 평균 5.2 ㎜ 하방으로 이동하였다. 대전자의 불유합이 2예 있었으나 술 후 감염 및 세라믹의 파손은 없었다. 결론: 알루미나-알루미나 고관절 전치환술로 치료한 고관절 감염 후유증 환자들의 5년 이상 추시 결과는 만족스러웠다. 감염에 의한 고관절의 해부학적 변형이 심한 젊은 환자들에게 알루미나-알루미나 관절면은 유용한 대체 관절면이라 판단된다. Purpose: THA in patients with dysplastic hips secondary to infection of the hip joint is a technically challenging procedure because of long-standing anatomic abnormalities of the bone and soft tissues. Low friction, low wear, alumina-on-alumina bearing surfaces are an attractive alternative to conventional metal-on-polyethylene articulation, and may offer a promising option for young, active patients. Here, we evaluated the results of a modern alumina-on-alumina THA performed in patients with sequelae of the hip joint infection, with a 5-year minimum follow-up. Materials and Methods: We retrospectively analyzed 48 primary cementless alumina-on-alumina THAs that had been performed in patients who had sequelae of the hip joint infection between November 1997 and December 2000. The average age of the patients at the time of the index arthroplasty was 36.7 years (range, 18-63 years) and41 patients were younger than 50 years old. They were followed-up for more than 5 years (average, 82 months range, 60-103 months). Results: All hips had no recurrence of a hip joint infection. The mean Harris hip score improved from 61.6 points preoperatively to 92.2 points at the latest follow-up. All of the implants had radiographic evidence of bone ingrowth and no radiological loosening. During the follow-up period, nocup or stem was revised. Periprosthetic osteolysis was suspected in one hip. Leg length discrepancy was corrected from 26.2 ㎜ preoperatively to 9.5 ㎜ postoperatively. Postoperatively, the hip center migrated 11.7 ㎜ medially and 5.2 ㎜ inferiorly. Nonunion of the osteotomized greater trochanter occurred in two hips, but no postoperative infection or ceramic failure was observed. Conclusion: The 5-year minimum follow-up clinical results of modern alumina-on-alumina THA in patients with sequelae of the hip joint infection were encouraging. Our results show that alumina-on-alumina articulation offers a reliable alternative solution for young patients with technically difficult arthroplasties.

수술 전 골주사 소견이 대퇴경부 골절의 치료 방법 결정에 미치는 영향

김종원(Jong Won Kim),남광우(Kwang Woo Nam),유정준(Jeong Joon Yoo),구경회(Kyung-Hoi Koo),윤강섭(Kang Sup Yoon),김영민(Young-Min Kim),김희중(Hee Joong Kim) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.2

목적: 수술 전 골주사 검사가 대퇴경부 골절의 수술적 치료 방법 결정에 미치는 영향을 알아보고자 하였다. 대상 및 방법: 2001년 1월부터 2003년 12월까지 본원에 입원한 대퇴경부 골절 환자 257예 중 수술 전 골주사 검사를 시행한 62예를 대상으로 하였다. 골절분류는 골편의 전위에 따른 Garden형을 적용하였다. Tc-99m metylenediphosphonate (<SUP>99mTc</SUP>-MDP)를 이용한 골주사의 동위원소 섭취정도는 환측 골두의 활성이 건측에 비해 전반적으로 감소되어 있을 때를 -2, 부분적 감소인 경우를 -1, 건측과 동일한 섭취일 때를 0, 활성의 전반적인 증가가 있을 때를 1로 하였다. 결과: 총 62예의 남녀비는 남자 17예, 여자 45예이었으며, 골절시 평균 연령은 67.4세(18-93세)였다. Garden 분류에 의하면 제 Ⅰ형이 19예, 재 Ⅱ형이 O예, 제 Ⅲ형이 19예, 제 Ⅳ형 24예였다. Garden 제Ⅰ형 19예에서 골주사 동위원소 섭취정도는 17예가 0, 1예가 -1,1예가 -2였다. 수술은 18예에서 다발성 핀고정술, 1예에서 양극성 반치환술을 시행하였다. 제 Ⅲ, Ⅳ형 43예에서 골주사 동위원소 섭취정도는 37예가 -2, 4예가 -1, 2예가 0이었다. 수술은 38예에서 양극성 반치환술, 4예에서 고관절 전치환술, 1예에서 다발성 핀고정술을 시행하였다. 전체 62예 중 1예에서만 골주사 소견으로 인해 수술 방법이 변경되었다. 결론: 대퇴경부 골절의 수술 전 골주사 검사상 동위원소 섭취정도는 전반적으로 골절의 전위정도와 일치하였다. 따라서 수술 전 골주사 검사가 Garden 분류와 연령에 근거한 대퇴경부 골절의 수술적 치료 방법 결정에 미치는 영향은 미미한 것으로 판단된다. Purpose: To evaluate the role of a preoperative bone scan in determining the operative treatment method of a femoral neck fracture. Materials and Methods: Between January 2001 and December 2003, 62 out of 257 patients, who underwent a preoperative bone scan after a femoral neck fracture were included. The fractures was classified according to the stage of Garden. The uptake of the Tc-99m methylenediphosphonate (99mTc-MDP) isotope was estimated visually, and categories as -2 (the femoral head activity in the fractured side is general reduction compared with the opposite side), -1 (the activity is partial reduction), 0 (the activity is normal) and 1 (the activity is general increase ). Results: 62 patients, 17 male and 45 female, with a mean age of 67.4 years (range 18 to 93) were investigated. Of the 19 patients with Garden stages Ⅰ and Ⅱ 17 were 0, and 1 each were-1 and -2. Eighteen patients were operated on with multiple pinning, and 1 with bipolar hemiarthroplasty. Of the 43 patients with Garden stages Ⅲ and Ⅳ 37 were -2, 4 were -1 and 2 were 0. Thirty-eight patients were operated on with bipolar hemiarthroplasty. Four patients were operated on with total hip arthroplasty. One patient was operated on with multiple pinning. The operative method was changed in only 1 of the 62 patients due to the bone scan finding. Conclusion: The isotope uptake of the preoperative bone scan after a femoral neck fracture generally corresponded with the degree of fracture displacement. Therefore, a preoperative bone scan seems to play no significant role in determining the operative treatment method of a femoral neck fracture.

Fungicidal activities of leguminous seed extracts toward phytopathogenic fungi

Hoi-Seon Lee(이회선),Byung-Sup Kim(김병섭),Heung-Tae Kim(김흥태),Kwang-Yun Cho(조광연),Young-Joon Ahn(안용준) 한국농약과학회 1998 농약과학회지 Vol.2 No.3

Single-row Versus Double-row Capsulolabral Repair

Doo-Sup Kim,Hoi-Jeong Chung 대한견주관절의학회 2011 대한견주관절학회 학술대회논문집 Vol.2011 No.3

Prediction of thermo-poro-elastic properties of porous composites using an expanded unmixing-mixing model

Choi, Hoi Kil,Son, Myeong Jin,Shin, Eui Sup,Yu, Jaesang Elsevier 2018 COMPOSITE STRUCTURES -BARKING THEN OXFORD- Vol.188 No.-

<P><B>Abstract</B></P> <P>This study proposes an expanded unmixing–mixing model to predict the material properties of porous composites. The poroelastic strain component that results from gas pressure within the pores was added in a thermo-elastic constitutive equation. The proposed model incorporates micro-state correction factors that represent micro-array effects from kinematic compatibilities in the boundaries of fibers and matrix. Finite element models were used to calculate the material properties of the porous matrix and composites. The results indicate that the material properties predicted by the proposed model are well correlated with those obtained from the finite element models. The results suggest that the proposed model adequately captures the change in the micro-state of porous composites due to pore generation. The model also illustrates the validity of the proposed model for composite thermo-poro-elasticity.</P>

Influences of carboxyl functionalization of intercalators on exfoliation of graphite oxide: a molecular dynamics simulation

Choi, Hoi Kil,Oh, Yuna,Jung, Hana,Hong, Hyunkee,Ku, Bon-Cheol,You, Nam-Ho,Kim, Young-Kwan,Shin, Eui Sup,Yu, Jaesang The Royal Society of Chemistry 2018 Physical chemistry chemical physics Vol.20 No.45

<P>In this study, the influences of the carboxyl functionalization of intercalators on exfoliation of graphite oxide were analyzed using molecular dynamics (MD) simulations. Molecular models of four-layered graphene oxide (GO) sheets, four different solvents (ethanol, dimethylformamide, tetrahydrofuran, and <I>N</I>-methyl-2-pyrrolidone), and four different intercalators (anthracene, 2-anthracenecarboxylic acid, 2,3-anthracenedicarboxylic acid, and 2,6-anthracenedicarboxylic acid) were used in the MD simulations. A separation simulation of GO sheets was performed to determine the point at which the GO sheets begin to exfoliate. An insertion simulation was used to obtain the minimum kinetic energy required for exfoliation and to calculate GO-solvent and GO-intercalator interaction energies. As the simulation result, GO-solvent and GO-intercalator interactions affected the minimum kinetic energy required for exfoliation. Having more carboxyl functional groups on the anthracene improved both the GO-intercalator interaction and the efficiency of the intercalators during exfoliation. These results reveal that increasing the interaction energy between the GO sheets and the insertion molecules is an efficient way to improve the performance of the solvents and the intercalators for the exfoliation of GO sheets.</P>

다공성 복합재료의 삼차원 거동 예측을 위한 분리-혼합 기법의 확장

최회길(Hoi Kil Choi),신의섭(Eui Sup Shin) 한국항공우주학회 2013 韓國航空宇宙學會誌 Vol.41 No.2

고온에서 열분해 과정을 겪는 복합재료의 탄화 및 삭마 과정의 표면 침식은 주로 두께 방향으로 진행된다. 본 논문에서는 다공성 복합재료의 면내 및 두께 방향 거동을 효과적 으로 기술하기 위하여 분리-혼합 기법을 적용하였다. 섬유와 기지로 구성된 복합재료의 횡 방향 등방성 가정을 통해 분리-혼합 방정식을 삼차원으로 확장하였으며, 기공 압력, 열팽 , 열분해 과정의 수축 효과를 포함하였다. 다공성 복합재료의 대표 체적 요소를 유한요소법으로 해석하여 면내 및 두께 방향의 물성 값을 상호 비교함으로써, 확장된 분리-혼합기법의 타당성을 확인하였다. Pyrolysis and surface recession of charring composites are progressed primarily in the thickness direction. The unmixing-mixing scheme is applied to describe the in-plane and through-thickness behaviors of porous composites. The extended unmixing-mixing equations are based on transverse isotropy of unidirectionally fiber-reinforced composites. The strain components of gas pressure in pores, thermal expansion, and chemical shrinkage are included in the constitutive model. By analyzing micromechanical representative volume elements of porous composites, the validity of the derived equations are examined.

Analysis of the influence of interphase characteristics on thermal conduction in surface-modified carbon nanotube-reinforced composites using an analytical model

Choi, Hoi Kil,Jung, Hana,Oh, Yuna,Hong, Hyunkee,Yu, Jaesang,Shin, Eui Sup Elsevier 2018 Composites science and technology Vol.168 No.-

<P><B>Abstract</B></P> <P>In this study, the influence of interphase characteristics on thermal conductivity of carbon nanotube (CNT)-reinforced polymer composites was investigated using a thermal resistance theory-based analytical model. Pristine, nitrogen doped, and carboxyl functionalized CNTs were used to verify the effect of surface modifications. Interfacial thermal conductivities of nanocomposites containing three different CNTs were calculated from non-equilibrium molecular dynamics (NEMD) simulations, to analyze the influence of functionalization on the interphase characteristics. Equilibrium molecular dynamics (EMD) simulations of three different CNTs and epoxy matrix were performed to estimate their effective thermal conductivities. The thermal conductivities of the nanocomposites were predicted by applying the results obtained from the MD simulations in the analytical model. The results predicted by the analytical model show that while thermal conduction in the longitudinal direction of the nanocomposites depends on thermal conductive performance of the CNTs, transverse thermal conductivity could be significantly influenced by the interphase characteristics.</P>

Clinical Results of Technique for Double Bundle Anterior Cruciate Ligament Reconstruction Using Hybrid Femoral Fixation and Retroscrew

Doo-Sup Kim,Chang-Ho Yi,Hoi-Jung Chung,Yeu-Seung Yoon 대한정형외과학회 2011 Clinics in Orthopedic Surgery Vol.3 No.4

Background: Anatomic anterior cruciate ligament (ACL) reconstruction has been presented as a means to more accurately restorethe native anatomy of this ligament. This article describes a new method that uses a double bundle to perform ACL reconstructionand to evaluate the clinical outcome. Methods: Grafts are tibialis anterior tendon allograft for anteromedial bundle (AMB) and hamstring tendon autograft withoutdetachment of the tibial insertion for posterolateral bundle (PLB). This technique creates 2 tunnels in both the femur and tibia. Femoral fi xation was done by hybrid fi xation using Endobutton and Rigidfi x for AMB and by biointerference screw for PLB. Tibialfi xations are done by Retroscrew for AMB and by native insertion of hamstring tendon for PLB. Both bundles are independentlyand differently tensioned. We performed ACL reconstruction in 63 patients using our new technique. Among them, 47 participatedin this study. The patients were followed up with clinical examination, Lysholm scales and International Knee DocumentationCommittee (IKDC) scoring system and radiological examination with a minimum 12 month follow-up duration. Results: Signifi cant improvement was seen on Lachman test and pivot-shift test between preoperative and last follow-up. Onlyone of participants had fl exion contracture about 5 degrees at last follow-up. In anterior drawer test by KT-1000, authors found improvementfrom average 8.3 mm (range, 4 to 18 mm) preoperatively to average 1.4 mm (range, 0 to 6 mm) at last follow-up. AverageLysholm score of all patients was 72.7 ± 8.8 (range, 54 to 79) preoperatively and signifi cant improvement was seen, score was92.2 ± 5.3 (range, 74 to 97; p < 0.05) at last follow-up. Also IKDC score was normal in 35 cases, near normal in 11 cases, abnormalin 1 case at last follow-up. Conclusions: Our new double bundle ACL reconstruction technique used hybrid fi xation and Retroscrew had favorable outcomes.

Estimation of interfacial properties of nanocomposites using an analytical interphase model

Choi, Hoi Kil,Yu, Jaesang,Kim, Eunho,Sup Shin, Eui Elsevier 2018 COMPOSITE STRUCTURES -BARKING THEN OXFORD- Vol.184 No.-

<P><B>Abstract</B></P> <P>In this study, an analytical interphase model is proposed to estimate the interfacial properties between a polymer matrix and carbon nanotubes (CNTs). A molecular dynamics (MD) simulation was performed to obtain the interaction energy and the geometrical parameters of the interphase. The CNTs had the different embedded surface area and functional groups. The interfacial shear strength and critical pull out force were estimated by using an analytical interphase model. The interfacial properties estimated by the proposed interphase model matched the results of the pull out test closely. The changes in the interaction energy and inter thickness introduced by the functionalization of CNTs improved the interfacial properties. These results show that the proposed assumptions were effective and the proposed interphase model using a MD simulation was useful for estimating the interfacial properties of nanocomposites.</P>