쇄골 중간부 골절후 불유합 및 지연 유합의 원인

윤정로,심재익,김택선,이성종,김영배,김학준,안국환,장재영,홍명표 대한골절학회 2002 대한골절학회지 Vol.15 No.4

쇄골 중간 1/3 부위의 골절은 치료 결과가 양호하여 보존적 치료가 원칙적으로 받아 들어지고 잇으며 불유합에 대한 빈도도 낮은 것으로 되어 있다. 그러나 최근 전위 및 단축의 정도가 심할 경우 높은 불유합의 결과와 불량한 임상 결과를 보고하고 있어 이런 예에 대해선 수술적 치료를 권장하고 있다. 저자들은 단축 및 전위의 정도와 불유합의 연관성을 알아보고자 하였다. 연구 대상 및 방법 : 1993년 2월부터 2002년 1월까지 본원에 내원 했던 성인 중간부 쇄골 골절 환자 194명 중 완전 전위를 보인 78례를 조사하여 이중 63례를 대상으로 분석하여 후 향적 연구를 시행하였다. 4개월 추시 후에도 방사성 사진상 유합 소견이 관찰되지 않으면 불유합의 유의성을 알아보고자 하였다. 결 과 : 63례 중 불유합 및 지연 유합을 소견을 보인 환자는 15(23%)례였다. 골유합을 보인 48례의 단축은 평균 8.6㎜(2㎜-17㎜)였고, 전위는 평균 9.7㎜(2-22㎜)였다 .불유합 및 지연 유합을 보였던 15례에서 단축은 평균 14.5㎜(3㎜-37㎜), 전위는 평균 17.3㎜(4-25㎜)였다. 18㎜이상 단축이 있었던 경우 불유합의 발생과는 통계학적으로 유의성을 나타내었고(Fisher's exact test, p<0.01), Chi-square test상 16㎜ 이상의 전위를 보였던 경우 불유합 발생과 통계학적으로 의미가 있었다(p<0.01). 결 론 : 쇄골 골절 특히 중간 1/3의 골절은 비교적 보존적 치료에 결과가 좋은 것으로 되어 있으나, 전위 및 단축이 심한 경우 불유합에 대한 가능성이 높이 때문에 보다 경과 관찰시 유합의 진행이 없으면 적극적인 치료를 고려해야한다. Purpose : Because the prognosis of the mid 1.3 clavicle fracture is good, the conservative treatment with a figure of 8 bandage is the gold standard and the nonunions are rare. However, recently surgical treatment is recommended when the shortening and displacement is severe because of the high nonunion rate and the poor clinical result. This study was undertaken to evaluate that the shortening and displacement at fracture site are associated with the development of nonunion. Materials and Methods : We analysed the 194 fractures of mid 1/3 clavicle in adults which had been treated conservatively from February 1993 to January 2002 and did the retrospective study. Of these, 78 cases were originally in the middle third of the clavicle and had been completely displaced. We reviewed 63 of these cases. The shortening and displacement at the fracture site was measured on the initial roentgenogram. And the analysis of the patients' chart was done for another predisposing nonunion factors. Nonunion and delayed union are considered to be present when there has been little or no progression of clinical or radiographic healing at a minimum of 4 months after injury. Results : 15 of the 63 cases had developed nonunion.. The average 8.6㎜(2㎜-17㎜) shortening and average 9.7㎜(2-22㎜) in the union patients. The average 14.5㎜(3㎜-37㎜) shortening and average 17.3㎜(4-25㎜) in the nonunion patients. We found that initial shortening ≥18㎜(Fisher's exact test, p<0.01) and initial displacement ≥ 16㎜(Chi-square test. p<0.01)at the fracture site were significantly associated with the development of nonunion. Conclusion : The conservative treatment with figure-80-bandage is the gold standard in the clavicle middle one third fracture. However, the nonunion is commonly occurs in the cases of more of severely shortened and displaced fractures. If there are no signs of callus formation and the patient complains of pain after several week, osteosynthesis should be considered.

공간고조파해석법을 이용한 영구자석 선형 동기전동기의 특성해석

尹相伯,洪正杓,玄東石,鄭因城 창원대학교 공작기계기술연구센터 1999 연구업적집 Vol.1 No.1

This paper presents a two dimensional analytical method of a permanent Magnet Linear Synchronous Motor(PMLSM) based on the concept of space harmonic The air gap flux densities due to permanent magnets and primary current are calculated separately, and the resultant air gap flux density is obtained by superposition of those, Maxwell's stress tensor is used to calculate thrust and normal force. The static thrutst and normal force according to exciting current and power angle are calculated, and the harmonics of the thrust are analyzed using discrete Fourier transform In order to verify the validity of the proposed analytical method, we make a test facility and compare the analysis results with the experimental ones.

혈행화된 두개골 피판을 이용한 안와저 및 안와하연의 재건술 치험례

정윤규,이훈범,김석원,봉정표,김균태,김주봉 大韓成形外科學會 1998 Archives of Plastic Surgery Vol.25 No.5

A number of methods have been introduced for support the orbital floor following a maxillectomy without orbital exenteration or severe facial trauma. These methods including skin graft and muscular sling provided the unsatisfactory results, like as diplopia, orbital ptosis, enophthalmos and severe facial deformity. Therefore the bone and soft tissue reconstructions using microvascular free flaps were performed recently by many surgeons, but long time operation, donor site morbidity, postoperative large scar, and ptosis of the flap were pointed out as disadvantages of free flap reconstruction. Vascularized calvarial bone flap, a modified method of free calvarial bone graft, was adequate for reconstruction of the orbital floor and the infraorbital rim as a horizontal buttress, especially in case of poor vascular bed and postradiated state. The authors introduced the vascularized calvarial bone flap for the orbital floor and the infraorbital rim reconstruction in 3 cases of maxillectomy, and could be obtained satisfactory results aesthetically and functionally.

유리피판을 이용한 하인두-식도 재건 치험례

봉정표,정윤규,이훈범,김주봉,이재화,나동균,김석원 大韓成形外科學會 1997 Archives of Plastic Surgery Vol.24 No.6

Hypopharyngo-esophageal cancer is usually found at late stage. Its main treatment is surgical intervention and it often requires radical resection. Reconstruction of the hypopharyngo-esophageal defect after the resection of carcinomas of the hypopharynx and the cervical esophagus has traditionally been carried out with deltopectoral or musculocutaneous flap. Another approach is to reconstruct the defect with the colon or stomach. Recent advances in microvascular surgical techniques have resulted in one stage reconstruction with free flap. Both jejunal free flap and radial forearm free flap is a good alternative for the reconstruction of hypopharyngo-esophageal defect. Six cases of the radial forearm flap and nine cases of the jejunal flap were used to reconstructed the hypopharyngo-esophageal defect in 15 patients. In jejunal free flap, upper margin was reconstructed with end to side anastomosis and lower margin with end to end anastomosis. In radial forearm free flap, we used trapezoid shaped flap and tubed by complete or partial tubing according to the condition of the defects. Stricture and fistula are troublesome complications. The complications were peritonitis(n=1) and fistula(n=1). We concluded that both forearm and jejunal free flap is a useful alternative in reconstruction of hypopharynx and cervical esophagus.

인접한 고층건물의 豊荷重 상호간섭에 관한 연구

조강표,정진택,정명채,김윤석 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.2(구조계)

Wind load is evaluated based on Standard Design Loads for Building of AIK(Architectural Institute of Korea), which was obtained from wind-tunnel experiment for an isolated building in open country, actual wind load can be different from the code because of terrain, building geometry, wind direction, separation distance between the buildings. Among them. separation distance is the most important factor. This paper presents the interference factor for sqaue section high-rise building structure, focusing on the separation distance. Interference factor was obtain from the force balance test in a wind tunnel.

카드뮴폭로에 대한 생물학적 지표 : Competitive ELISA에 의한 Metallothionein 정량 Assay of Metallothionein by Competitive ELiSA

박정덕,이우석,공윤,홍연표,장임원 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

Metallothionein (MT) is a cadmium binding protein that played major roles in protective mechanism for cadmium toxicity. In the present study, competitive ELISA was established to assay the MT expression utilizing monospecific antibody which was generated against MT-I. A total of 10 Sprague-Dawley rats was injected with CdCl₂ for two weeks to induce MT. The cytosolic fraction of rat liver was obtained by differential centrifugation. Two major MT isozymes (MT-I & MT-II) at ca. 10 kDa were purified by Sephadex G-75 gel filtration followed by DEAE-Trisacryl-M anion exchange column chromatography, respectively. Two rabbits were immunized 4 times consecutively with the conjugate of purified MT-I. The sera were collected by heart puncture. When immunoblot was carried out, the immunized rabbit sera (anti-MT-I) exhibited specific immunoreactive band at MT-I while showed any cross reactions neither with MT-II nor with other cytosolic proteins. By chequerboard titration using the monospecific antibody, the competitive ELISA was established. The dose-dependent relationship was observed between anti-MT-I anti-body and the amount of MT in biological samples (r²=0.9980). These results suggested strongly that competitive ELISA is a simple, rapid and reproducible method for screening cadmium exposure.

다발성 동맥류와 혈전증을 동반한 베체트병 1예

신표진,김장영,이승환,윤정한 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.8

Clostridium difficile 장염에 의한 속발성 유전분증에서 발현된 독성 장염

조형원,정혜경,강현주,이윤표,강혜원,심기남,정성애 Ewha Womans University School of Medicine 2014 EMJ (Ewha medical journal) Vol.37 No.1

Amyloidosis is characterized by extracellular deposition of protein fibrils in one or multiple organs. AA amyloidosis is secondarily occurred to be related with chronic infections or inflammatory diseases. We report a 67-year-old man suffered from secondary AA amyloidosis related with chronic Clostridium difficile colitis after repeated total hip replacement surgery. Infection control is the most important treatment of AA amyloidosis secondary to chronic infection. However, the patient’s C. difficile colitis was not controlled well, eventually toxic megacolon with sepsis was developed. Consequently, he had to take total colectomy, but he expired with multi-organ failures. We suggested that early surgical procedure might be one option for intractable C. difficile colitis complicated with secondary amyloidosis.

주행속도에 따른 부상마그네트의 특성을 고려한 상전도 자기부상시스템의 부상제어에 관한 연구

玄東石,洪正杓,鄭因城,許眞,尹相伯 창원대학교 공작기계기술연구센터 1999 연구업적집 Vol.1 No.1

A collective controller for electromagnetic suspension (EMS) system considering the speed characteristics of electromagnets is presented. The speed characteristics of the electromagnet are analyzed by finite element method (FEM) and Neural Network algorithm is used for the controller considering speed. The proposed controller is examined and the dynamic characteristics are compared with those of other controllers. The simulation results show that proposed controller has a better performance at high speed.

외경동맥 분지에 발생한 외상성 동맥류 4예 : 증례보고 Report of 4 Cases

황금,허철,홍순기,김헌주,한용표,최윤정 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.4

We report four cases of traumatic aneurysm in the branches of external carotid artery and reviewed other cases from the literature in view of their clinical feature and management.