퇴행성 슬관절염에 대한 Vigel Cream(1% Indomethacin)의 효과에 관한 연구(抄)

석세일,성상철,구경희 임상약학사 1992 臨床藥學 Vol.12 No.9

미성숙 척추의 측만증에서 분절간 척추경 나사 고정과 후방 유합술만을 이용한 Crankshaft 현상의 예방

석세일,정의룡,김진혁,이상민,이지호,이정희,김성수,박준석 대한척추외과학회 2003 대한척추외과학회지 Vol.10 No.1

척추경 나사 고정술용 강봉의 굽힘 강도

석세일,김진혁,이상민,정의룡,진건형,조성태,이성재,김봉주,이지호,손홍문 대한척추외과학회 2001 대한척추외과학회지 Vol.8 No.2

연구목적 : 척추경 나사 고정술시 사용되고 있는 여러 가지 강봉으 굽힘 강도를 알아 보고 척추 변형의 수술적 치료시 가장 효과적인 강봉의 조건을 찾고자 하였다. 대상 및 방법 : 척추경 나사 고정술시 사용되는 4 종의 강봉(① 강봉직경 7mm,316L stainless steel ② 강봉직경 6mm,Titanium alloy ③ 강봉직경 6.35mm,Titanium ④ 강봉직경 5.5mm, Titanium)과 형상기억효과를 갖고 있는 Mi-Ti재질의 형상기억합금(Shape Memory Alloy, SMA)으로서 형상기억효과를 나타내는 matensite온도 이후의 강봉 2종(⑤ 강봉직경 6mm, SMA after martensite temperature ⑥ 강봉직경 7mm, SMA after martensite temperature) 에 대하여 굽힘 강도를 측정하였다. 각각의 강봉 8개에 대하여 MTS 858 Bionix test system을 사용하여 ASTM 규정에 맞추어 굽힘 강도와 굽힘에 대한 Young's modulus of elasticity를 구하였다. 결 과 : 굽힘 강도와 굽힘에 대한 Young's modulus of elasticity는 모두 7mm stainless steel 강봉이 가장 크고 (143.7±3.8 N/mm 및 135.1±3.0 GPa), 6mm SMA after martensite temperature 강봉이 가장 작았다(58.1±2.8 N/mm 및 68.0±2.1GPa). 7mm SMA after martensite temperature 강봉의 경우 7mm stainless steel 강봉 보다는 작지만 ,6.35mm titanium 및 6mm titanium alloy 강봉과 비슷한 굽힘 강도 및 Young's modulus of elasticity 를 보여 주었다. 결 론 : 7mm stainless steel 강봉이 가장 큰 굽힘 강도를 보여 척추 변형의 척추경 나ㅏ 기기술기 교정 정도 및 교정 소실에 가장 유리한 것으로 판단된다. 그러나, 강봉의 강도가 강할수록 다른 부작용이 증가할 수 있기에 측만증의 수술적 교정시 강봉의 선택은 만곡의 유연성을 포함한 시술 대상의 측만 변형의 특성을 충분히 이해한 후 결정하여야 할 것이다. 7mm SMA 강봉의 경우 기존의 titanium 재질의 강봉과 유사한 굽힘 강도를 보이기에, 굽힘강도가 약한 6mm 형상기억합금에 비해 척추 변형의 수술적 교정시 보다 유용할 수 있다. Purpose : To measure bending stiffness of rod in pedicle screw systems and identify the optimal rod for surgical correction of spinal deformities. Materials and Methods : Bending stiffness of six different rods-7 mm stainless steeL 6 mm titanium alloy, 6.35 mm titanium, 5.5 mm titanium, 6 mm Shape Memory Alloy after martensite temperature, 7 mm Shape Memory Alloy after martensite temperature-were measured by MTS 858 Bionix test system according to the ASTM standards. The specimen number was 8 for each rod. Young's modulus of elasticity was calculated from load-displacement data. Results : Seven-mm stainless steel rod was stiffer than any other rods with bending stiffness of 143.7 ±3.8 N/mm, and also showed largest Young's modulus of elasticity of 135.1±3.o GPa. Six-mm Shape Memory Alloy rod after martensite temperature was most flexible with bending stiffness of 58.1±2.8 N/mm, and showed smallest Young's modulus of elasticity of 68.o:t 2.1 GPa Seven-mm Shape Memory Alloy rod after martensite temperature was similar to the 6.35 mm titanium and 6 mm titanium alloy rod in bending stiffness and Young's modulus of elasticity. Conclusion : Seven-mm stainless steel rod was the stiffest rod tested, which is necessary to improve correction rate and maintain achieved correction. However, the rod selection should be individulized since stiffer rod might increase the chance of acute failure. Seven-mm Shape Memory Alloy could be more useful in deformity correction than 6 mm Shape Memory Alloy since it was not only similar to other rods in stiffness but also had shape memory function which would be necessary to establish the desired position of the spine.

비 류마치스성 동통 치료에 대한 Rengasil의 효과 : A Double-Blind, Cross-Over Between-Patient Clinical Trial

석세일,신병준,이재원,이관희 최신의학사 1987 最新醫學 Vol.30 No.11

골다공증 - 관리 및 대책

석세일 한국만성질환관리협회 1993 월간성인병 Vol.144 No.-

후방 도달 척추 절제술을 이용한 강직성 요천추 변형의 치료

석세일,정의룡,이정희,김진혁,김성수,이지호,최원기,박용원 대한척추외과학회 2004 대한척추외과학회지 Vol.11 No.2

흉부 청소년기 특발성 척추 측만증에서 상부만곡 유합의 적응증 : 분절 기기를 이용한 청소년기 특발성 척추측만증에서 이중 흉부만곡의 인지와 치료 Recognition and Treatment of Double Thoracic Curve Pattern in Adolescent Idiopathic Scoliosis Treated with Segmental Instrumentation

석세일,김진혁,김원중,이상민,이지호,김우일,황훈,진건형 대한척추외과학회 1999 대한척추외과학회지 Vol.6 No.3

서론 : 이중 흉추 만곡을 갖는 특발성 척추측만증에서 상부 흉추 만곡에 대한 유합술의 적응증은 아직까지 명백하지 않으며, 상부 흉추 만곡을 간과할 경우 술후 대상 부전 또는 어깨 높이의 차이가 악화되는 결과를 초래할 수 있다. 연구목적 : 본 논문은 후향적 연구로, 특발성 척추측만증에서 상부 흉추 만곡의 유합술에 대한 적응증을 알아보고자 하였다. 대상 및 방법 : 분절 척추경 나사 고정술 및 반회전술(derotation)로 치료한 특발성 척추측만증 환자 중 하부 흉추 만곡 40도이상, 상부 흉추 25도 이상인 환자 40명을 대상으로 하였다. 환자중 18명은 상,하부 흉추 만곡 모두 유합하였으며(제 1군), 22명은 하부 흉추 만곡의 각도 및 교정도와 양측 어깨높이의 차이를 측정하였다. 결과 : 제 1군에서는 상부 흉추 만곡은 술전 45±9도에서 술후 21±11도로 55.2±17.7%교정되었으며, 하부 흉추 만곡은 술전 55±10도에서 술후 20±10도로 교정되었다. 어깨높이 차이는 술전 -6±12㎜에서 술후 1±9㎜로 개선되었다. 제 2군에서는 상부 흉추 만곡은 술전 32.5도에서 술후 도로 18±6%교정되었으며, 하부 흉추 만곡은 술전 58±10도에서 술후 18±6도로 교정되었다. 어깨 높이의 차이는 제 1군에서는 술전 어깨높이 차이x0.6+12㎜이었다. 결론 : 상부 흉추 만곡이 25도 이상인 특발성 흉추 척추만증에서 술전 좌측 어깨높이가 우측보다 비슷하거나 높을 경우 상하부 만곡 모두 유합하여야 술후 어깨높이의 악화를 방지할 수 있을 것으로 사료된다. Study design : A retrospective study. Objectives : To determine the indications of fusing the proximal thoracic curve when treating an idiopathic thoracic scoliosis with segmental instrumentation. Summary of background data : Failure to recognize a significant proximal thoracic curve often results in postoperative shoulder asymmetry due to relative overcorrection of the lower thoracic curve. With segmental instrumentation that enhances the correction of the instrumented curve, the double thoracic curve pattern that needs fusion of both the proximal and the distal thoracic curves needs to be redefined. Materials and methods : Forty thoracic AIS patients with a right lower thoracic curve >40 and a left proximal thoracic curve >25 treated by segmental pedicle screw instrumentation were analyzed after a minimum follow up of 2 years. Results : Of the 40 patients. 18 were treated by fusion of both the proximal and the distal curves while 22 were treated by fusion of the distal curve only. The postoperative shoulder height difference(SHD.㎜) was 0.9 x preoperative SHD(㎜) + 5.3 for the both curve fusion and 0.6 x preoperative SHD(㎜) + 12 for the distal curve fusion(linear regression), showing that proximal thoracic curve fusion improved the SHD when the left shoulder was level with or higher than the right. Conclusions : An idiopathic thoracic scoliosis with a proximal thoracic curve>25 and level or elevated left shoulder should be considered a double thoracic curve pattern and treated by both the proximal and the distal curve fusion when using a segmental instrumentation.

관절염에 대한 Diphenpyramide의 임상적 연구

석세일,정필현,이춘성 최신의학사 1984 最新醫學 Vol.27 No.3

비스테로이드성 소염진통제 β -Cyclodextrin-Piroxicam의 유효성 및 안전성에 관한 비교연구 : Double Blind Study

석세일,이상훈,김상수,장상범 中央醫學社 1995 中央醫學 Vol.60 No.2

The authors have conducted a clinical study on the safety and efficacy with newly developed β-Cyclodextrin-Piroxicam(Brexine®) in 60 cases of the patients of osteoarthritis and rheumatoid arthritis during six months from June 1994 to November 1994. The study was a randomized controlled study of 19 β-Cyclodextrin-Piroxicam versus Piroxicam(Dispersible tablet) assessing the clinical efficacy and side effects in 30 patients receiving daily 20 mg of β -Cyclodextrin-Piroxicam and in 30 patients receiving daily 20 mg of Piroxicam(Dispersible tablet). Total period of administration was eight weeks. Therapeutic efficacy and tolerability after 4, 8 weeks were evaluated by themselves and doctors. The average age of patients was 55.8 years and 13 cases were men and 47 cases were women. The sites of pain were knee in 28 cases, low back in 27 cases, neck in 5 cases, hand and wrist in 5 cases and others in 4 cases. The results were as follows ; 1. Most patients showed significant improvements in pain scale, morning stiffness and tenderness in both the β-Cyclodextrin-Piroxicam and the Piroxicam group. 2. There were four cases of gastrointestinal intolerance in the Piroxicam group and two in the β-Cyclodextrin-Piroxicam group. 3. The efficacy of Piroxicam at 8 weeks was 70.0 % and tolerance was 86.7 % and the efficacy of β-Cyclodextrin-Piroxicam was 83.3 % and tolerance was 93.3 %. In conclusion, β-Cvclodextrin-Piroxicam, used in the treatment of osteoarthritis and rheumatoid arthritis, appears to be a effective and well tolerated drug compared to Piroxicam.

킹 제1형 청소년기형 특발성 척추 측만증에서 분절 척추경 나사못 기기술이 원위 요추 유합 범위에 미치는 영향

석세일,김진혁,김원중,김동수,이상민,김진해 대한척추외과학회 1997 대한척추외과학회지 Vol.4 No.2

Study Design : This study analyzes the influence of segmental pedicle screw fixation on distal fusion extent of King type I adolescent idiopathic scoliosis(AIS). Objectives : To verify the efficacy of segmental pedicle screw fixation in preservation of distal lumbar motion segments. Summary of Background Data : King type I AIS has usually been treated by fusion to L4. However, segmental pedicle screw fixation may shorten the distal fusion extent by reducing the horizontal tilt of the lower end vertebra. Materials and Methods : Eighteen King type I AIS subjected to segmental pedicle screw fixation of both curves were analyzed after a minimum follow-up of 2 years. Fourteen were fused to L3(short fusion group, SF) and 4 were fused to L4(long fusion group, LF). They were compared for correction of deformity, spinal balance and L4 tilt. Results : In SF group, the thoracic curve showed 71.6% correction. Lumbar curve and L4 tilt corrections were 76.8% and 75.2% respectively. In LF group, the thoracic curve showed 65.2% correction. Lumbar curve and L4 tilt corrections were 76.8% and 78.4% respectively. There was no significant difference between two groups. Spinal balance was maintained in all patients(SF 14/14; LF 4/4). Conclusions : Segmental pedicle screw fixation may shorten the distal fusion extent of King type IAIS to L3, preserving a distal motion segment with a correction of deformity and spinal balance comparable to fusion down to L4. It is attributed to enhanced segmental control of the system enabling horizontalization of L4.