http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
강호정 ( Ho Jung Kang ),김지섭 ( Ji Sup Kim ),신명호 ( Myung Ho Shin ),고일현 ( Il Hyun Koh ),최윤락 ( Yun Rak Choi ) 대한골절학회 2015 대한골절학회지 Vol.28 No.1
목 적: 주두의 불유합은 빈도가 낮으나 관절의 운동 장해나 불안정성을 야기하므로 임상적 중요성을 지닌다. 수술 후 발생한 증상이 있는 주두 불유합 환자에 대한 분석과 수술적 결과를 알아보고자 한다. 대상 및 방법: 11예를 병변의 위치와 관절면의 손상 정도에 따라 분류하였다. Mayo elbow performance score (MEPS), Oxford elbow score (OES), Disabilities of the Arm, Shoulder and Hand (DASH)를 통해 평가하였다. 결 과: 불유합 분류상 IA 2예, IIA 5예, IIIA 4예였다. 1A 중 1예는 골편 제거술을 시행하였으며, 10예는 골이식 및 금속판고정술을 시행하였다. 모든 증례에서 유합이 되었으며, 수술 후 1년 MEPS는 평균 87.7점(범위: 60-100점)로 우수 3예, 양호4예 소견을 보였다. DASH score는 평균 18.3점, OES는 평균 43.2점이었다. 2예에서 관절운동 제한, 3예에서 일시적 척골신경 증상을 보였다. 결 론: 주두골 불유합 시 골이식 및 금속판 고정술을 통해 좋은 결과를 얻을 수 있었으며, I형의 경우 골편 제거도 유용한 정상을 보였다. Purpose: Olecranon nonunion after surgical management is relatively rare, but it leads to limitation of motion of joint or instability. This retrospective study was conducted in order to analyze the cause and result of treatment.Materials and Methods: We analyzed 11 cases treated for nonunion of olecranon fractures. Nonunion was classified according to the spot of the lesion and the extent of articular surface damage. Evaluation was performed using Mayo elbow performance score (MEPS), Oxford elbow score (OES), Disabilities of the Arm, Shoulder and Hand (DASH) scores, and the range Results: According to the spot of the lesion and the extent of articular surface damage, nonunion was categorized as IA (2 cases), IIA (5 cases), and IIIA (4 cases). One case of IA underwent nonunion fragment excision and the remaining cases were treated by bone grafting. A plate was used in seven cases and the other three cases had both plate and tension band wiring fixation. All nonunions finally became union. The 11 patients with one year follow-up had average MEPS of 87.7 points (range: 60-100 points), average OES of 43.2, and average DASH score of 18.8 points. Complications included limitation of motion (2 cases) and ulnar nerve symptoms (3 cases). Conclusion: Bone grafting and fixation by plate may be beneficial. In addition, excision can be useful in type I.
수근관 감압술 후 초음파상 정중신경 단면적의 변화와 예후와의 상관관계
이승주(Seung-Joo Lee),김지섭(Ji-Sup Kim),최윤락(Yun-Rak Choi),김성준(Sung-Jun Kim),강호정(Ho-Jung Kang) 대한정형외과학회 2013 대한정형외과학회지 Vol.48 No.4
목적: 수근관 증후군 환자에서 초음파 검사를 통해 수술 전, 후의 정중신경 단면적을 수근관 내의 여러 위치에서 측정하여 수술 후 회복 정도와의 연관성에 대해 살펴보고자 한다. 대상 및 방법: 2011년 3월부터 2012년 3월까지 수근관 증후군으로 진단받고 감압술을 시행 받은 21명의 환자를 대상으로 전향적으로 분석하였다. 초음파로 월상골, 두상골, 유구골 선상의 세 위치에서 정중신경의 단면적을 측정하였다. Boston 설문지 검사를 수술전 및 후에 시행하여 호전 여부에 따라 두 군으로 나누어 각 위치에서 정중신경 단면적의 수술 전, 후 차이를 비교하였다. 결과: 양 군 간에 수술 전, 후 정중신경 단면적의 차이는 월상골 위치에서만 유의한 차이를 보였고, 두상골 및 유구골 위치에서는 유의한 차이가 관찰되지 않았다. 결론: 수근관 증후군 환자에서 정중신경 단면적의 측정은 월상골 위치에서 시행하는 것이 수술의 예후 예측에 도움이 될 것으로 생각된다. Purpose: The purpose of this study was to evaluate cross-sectional area of the median nerve using ultrasound in patients with carpal tunnel syndrome before and after endoscopic intervention, and to verify the level at which it can be used in prediction of outcome. Materials and Methods: A prospective study was conducted in 21 patients who underwent endoscopic carpal tunnel release from March 2011 to March 2012. Median nerve cross-sectional area was measured before the operation and three months after the operation at the level of lunate, pisiform and hamate. The Boston questionnaire was evaluated before the operation and three months after the operation, and then allocated as two groups (group I: symptom improvement of more than 25%, group II: symptom improvement less than 25%). Then, differences of cross-sectional area between preoperative measurement and postoperative measurement on three levels were compared between the two groups. Results: Nineteen patients were females and two were males ranging in age between 35-79 years (mean, 55.4 years). Significant differences were observed between the two groups at the lunate level. However, at the level of pisiform and hamate, no differences were observed between the two groups. Conclusion: Measurement of median nerve cross-sectional area at the lunate level showed significant correlation with outcome of carpal tunnel release.
강호정(Ho Jung Kang),김지섭(Ji Sup Kim) 대한정형외과학회 2020 대한정형외과학회지 Vol.55 No.6
수지는 복잡한 구조와 필수적인 기능을 가진 신체 부위로, 외상에 노출되기 가장 쉬운 부위이다. 수지 골절의 치료 원칙은 적절한 고정으로 골절부의 안정성을 획득하는 것과 안정성을 담보로 한 조기 관절 운동 간의 균형을 신중하게 결정하는 것이다. 치료에도 불구하고 합병증으로 강직이나 변형 등으로 인해 기능적, 미용적 문제가 되는 경우가 많다. 본 종설은 수지 골절 치료의 최신 지견을 소개하고, 치료가 어렵고 결과가 좋지 않은 것으로 알려진 관절면의 손상을 포함한 지절 관절 주위의 골절 및 탈구 위주로 정리하였으며, 치료 증례 소개와 합병증에 대한 접근 및 치료 순서로 기술하였다. Fingers are body parts with a complex structure and essential functions that are the most prone to trauma. The principle of treatment for finger fractures is to determine the balance between obtaining stable fracture fixation and early joint movement. Despite proper treatment, there are many cases of functional and cosmetic problems caused by stiffness or deformation as complications. This review article introduces the latest knowledge in the treatment of finger fractures focusing on fractures and dislocations around the interphalangeal joints, including joint surface damage, which is difficult to treat and leads to poor results. This article consists of fracture cases and describes the methods and solutions to address these complications.
과신전 손상 후 발생한 제5 수지 신전형 중수지 관절 잠김
윤홍기(Hong-Kee Yoon),최윤락(Yun-Rak Choi),김지섭(Ji-Sup Kim),박재한(Jae-Han Park),강호정(Ho-Jung Kang) 대한정형외과학회 2014 대한정형외과학회지 Vol.49 No.5
신전형 중수지 관절 잠김은 매우 드문 질환으로 신전제한 없이 굴곡제한을 보이는 상태를 말한다. 현재까지 밝혀진 원인으로는 중수지 관절의 과신전 수상 이후 수장판의 파열 및 관절 내 감입으로 알려져 있다. 본 증례는 과신전 손상으로 파열된 수장판과 부 요측측부 인대가 배측 탈구 후, 요측과에 상부로 감입되면서 발생한 신전형 중수지 관절 잠김에 대해 배측 접근법을 이용한 관혈적 정복술 후 양호한 임상 결과를 얻었기에 문헌고찰과 함께 보고하고자 한다. The extension type locked metacarpophalangeal joint of the little finger is an extremely rare condition characterized by loss of flexion with little or no loss of extension. The most common cause for locking is entrapment of a strap of the ruptured palmar plate. We treated a locked metacarpophalangeal joint of the little finger due to a hyperextension injury. The mechanism of locking was a torn part of the palmar ligament that forcefully rides across the prominence of the radial condyle of the metacarpal bone together with the accessory collateral ligament. These dislocated parts of the ligament formed a constricting bundle that prevented closed reduction. Locking was released successfully by an open reduction using the dorsal approach of the metacarpophalangeal joint without complication.
A.Giddens의 구조화이론 구축에 있어서의 베버적 요소
金至燮 慶一大學校 1996 論文集 Vol.13 No.1
Structuration theory which attempts to transcend the dichotomies of the voluntarism and determinism, the subject and object, and the synchronic and diachronic through the conception of the duality of structure, is a new perspective, recently spelt-out by Anthony Giddens. The perspective, which unified and amalgamated the existing social theories selectively, regards the relation of agency-structure as that of interdependence, and tries to explain the principle of operation in agency-structure as a whole. But it is evident that in constructing the basic components of structuration theory, A. Giddens owed too much to M. Weber's sociology. Particularly it has often been pointed out that Weber had effects on Giddens' constructing of conceptions of agency or agent. It is well-known that Weber's sociology is founded on the interpretation of diverse motivations of actors. Because of this fundamental standpoint, the concept of Weber's interpretation(Verstehen) has been discussed exclusively in terms of epistemological status, and his methodological individualism has been stressed distinctively, and the conception of his subjective meaning has been regarded only as standing in opposition to all structural considerations. According to this tendency, Weber's analysis of agency-structure relation has been treated lightly. Patterning of action-orientations is the central conception of his analysis of agency-structure relation. Through the operating principle of patterning of action-orientations, Weber made a structural explanation plainly. After all, his structural explanation is about the influence of agency on structure and on the contrary, the structural constraint on agency. This paper concerns on the extent to which Weber influenced on the conceptions of agency or agent, and the duality of structure in structuration theory. On the one hand, it argues that Weber's causal interpretation is the approach to the interrelation of agency-structure.