척골 신경 피하 전방 이동술을 이용한 주 관 증후군의 수술적 치료

손홍문,하상호,이준영,오선종,유재원 대한정형외과학회 2003 대한정형외과학회지 Vol.38 No.3

Cloning and Expression of Recombinant Macrophage-colony Stimulating Factor - A Progressive Strategy for Economical Production

손홍문,고영종,Mineon Park,김보라,김옥준,김동휘,문영래,임원봉 한국생물공학회 2016 Biotechnology and Bioprocess Engineering Vol.21 No.3

Macrophage-colony stimulating factor (M-CSF) has been reported to be required for the proliferation and differentiation of macrophages from hematopoietic progenitor cells. Recently, recombinant M-CSF (rM-CSF) became widely used as a biological research reagent in bone marrow stimulations, vaccine development, gene therapy approaches, and stem cell mobilization. rM-CSF is a glycoprotein that activates and enhances the differentiation and survival of macrophages, which play a key role in the osteoclastogenetic response. Here, we describe the construction of the gene encoding rM-CSF, its cloning, and expression in Escherichia coli, as well as the purification of rM-CSF protein, and its activity in a biological assay in mouse bone marrow cells. Our results show that the combination of experimental strategies employed to obtain recombinant rM-CSF can yield a biologically active protein, and may be useful when scaling-up production of other biologically similar proteins.

송아지와 사람의 요추 모델의 생역학적 비교

손홍문,유재원,임만택 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1

Background and Objectives: Calf spines are commonly used in biomechanical research as a substitute for human cadaveric spines. Despite widespread use, the validity of this model has not been thoroughly investigated. The purpose of this study was to perform biomechanical flexibility tests using identical methods and instrumentation on calf and cadaveric lumbar spines to determine whether significant differences exist between the results from the two models. Materials and Methods: Five fresh calf spines and five cadaver lumbar spines (L2-L5) were used for flexibility testing. The L2 and L5 vertebrae were used to attach the loading and base frames, respectively. Three reflective markers were attached to L3 and L4. Specimens underwent nondestructive biomechanical testing using the VICON 3-D motion analysis system. Maximum moments of 6.4 Nm were achieved in five increments of 1.6 Nm. The rotations of L3 with respect to L4 were measured to determine the stability of the specimens in five cases : 1) intact ; 2) partial discectomy, including partial laminectomy and partial facetomy ; 3) partial discectomy with ISOLA pedicle screw instrumentation ; 4) total discectorny with instrumentation and 5) instrumentation with inter body graft. Rotational angles were normalized to the intact case to determine the overall stabilizing effects. Data were analyzed using ANoVA to determine if significant differences existed. Results: In both models an increase in motion was observed after the partial discectorny, instrumentation reduced motion beyond the intact, and the total discectomy increased motion in all cases. Placement of the inter body graft decreased motion in axial rotation, flexion, and extension, but increased motion in lateral bending. A two-way ANoVA showed no significant differences between the two models during flexion and extension (p)O. 05) however, differences were noted during axial rotation and lateral bending (p<0.05). In all loading cases there were differences between the various testing cases (p<.05). Conclusion: This study demonstrated that calf lumbar spines can serve as a substitute for human cadaveric spines in biomechanical testing. Motion trends were similar for the two models in flexion and extension ; however, significant differences were found in axial rotation and lateral bending. These results suggest that the calf lumber spine can be a good model for in vitro biomechanical evalution of spinal instrumentation. The extrapolation of calf spine data to the in vivo case, especially during axial ratation and lateral bending, should carefully consider the variations between the two models.

전위된 관절내 종골 골절의 수술적 치료 후 방사선학적 계측치와 임상 결과와의 관계

손홍문,임만택,문현식 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.3

Objectives: The purpose of our study was to evaluate the relationship between radiographic parameters and clinical results after operative treatment of the displaced intra-articular calcaneal fractures. Materials and Methods: We analyzed 35 patients of unilateral displaced intraarticular calcaneal fractures who had been treated by operative treatment. At the last follow up, we measured the radiographic parameters including Bohler angle, Gissane angle, heel height, calcaneal length, talocalcaneal angle, talar declination angle, and subtalar incongruity between normal and affected site. Clinical results were measured by Creighton-Nebraska Health Foundation Assessment Score (CNH). And then the correlation between the radiographic parameters and the clinical results were analysed by Pearson correlation method. Results: The average difference between normal and affected site were Bohler angle 15˚ (0-35), Gissan angle 6.5˚(0-20), heel height 4.7mm (1-12), calcaneal length 2.0mm (0-7), talocalcaneal angle 5.5˚(1-19), talar declination angle 2.2˚(0-8), calcaneal width 4.0mm (1-9), subtalar incongruity 0.54mm (0-2.5). The correlation coefficients between radiographic parameters and CNH score were Bohler angle 0.066 (p=0.75), Gissane angle 0.038 (p=0.829), heel height 0.019 (p=0.916), calcaneal length 0.091 (p=0.386), talocalcaneal angle 0.059 (p=0.737), talar declination angle 0.118 (p=0.501) , calcaneal width 0.250 (p=0.291), and subtalar incongruity 0.784 (p=0.002) respectively. Among the all radiographic parameters, The subtalar incongruity shows strong linear correlation with clinical results. Conclusion: We suggested that the subtalar incongruity was significantly correlated with the' clinical results after operative treatment of the displaced intraarticular calcaneal fractures.

쾌속조형공정 지원 정형외과 골절 수술 - 증례 보고 -

손홍문,이준영,하상호,유재원,이상홍,안동규 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.7

New surgical techniques utilizing computer-aided engineering have been recently developed to improve the quality of surgery and reduce the risk to patients. This paper reports the surgical cases using rapid prototyping assisted orthopeadic fracture surgery (RPAOFS). RPAOFS utilizes the symmetric characteristics of the human body, and the potential for RE and RP in which the physical shape is manufactured repidly from the CT data. The physical shape before the injury was manufactured from the RP using the mirror transformed CAD data of the uninjured extents. Subsequently, pre-operative planning, such as the selection of the proper implant, preforming of the implant, selection of the fixation positions, and surgery are performed utilizing the physical shape. RPAOFS was applied to two cases such as a distal tibia communited fracture and a proximal tibia plateau fracture. The surgical results showed that RPAOFS is an effective surgical tools. 최근 수술 결과의 개선과 환자에 대한 위험 감소를 위하여 컴퓨터 응용기술을 이용한 새로운 수술 기법들이 개발되고 있다. 본 연구에서는 쾌속조형공정 지원 정형외과 골절수술기법(RPAOFS)의 적용 증례에 대한 결과보고이다. RPAOFS 은 인체의 대칭 특성과 역공학 및 쾌속조형공정의 기술적조합의 장점인 골의 손상없이 CT 데이터로부터 3차원 실물형상 의 쾌속제작 특성을 이용한다. 환측의 골절전 원형골 실물형상은 건측의 CT 데이터를 역공학으로 3차원 복원하고, 이 데 이터를 거울 대칭 변환하여 환측의 골절전 원형골 CAD 데이터를 생성하여 Objet 쾌속조형공정을 이용하여 제작하였다. 제작된 환측 골절전 원형골 실물형상을 이용하여 인체 형상에 적합한 내고정물 선정 및 내고정물 사전 성형, 내고정물 위 치 및 고정위치 선정, 수술 경로 결정 등 사전 수술 계획 수립과 시술을 수행하였다. RPAOFS을 경골 원위부 분쇄골절과 경골 근위부 함몰 골절에 대하여 적용하였다. 수술 결과, 수술 시간, 방사선 투사횟수, 절개 크기 등을 최소화할 수 있었으 며 환자의 재활 속도가 현저히 빨라짐을 알 수 있었다. 이 결과로부터 RPAOFS가 효과적인 정형외과 골절 수술 방법임을 알 수 있었다.

척골 경상 돌기 골절을 동반한 원위 요골 골절과 원위 요척 관절 불안정성과의 관계

손홍문 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.2

Objectives: The purpose of this study was to evaluate the patterns (size, displacement) of ulnar styloid process fractures accompanying distal radius fracture and determine their relative contribution to distal radioulnar joint (DRUJ) instability. Materials and Methods: We evaluated 62 cases of distal radius fracture with ulnar styloid fractures who were treated by operation and were followed up for more than six months. Distal radius fractures were classified according to the AO system, and accompanying ulnar styloid fractures were evaluated for both size (0-49%, 50-99%, >100%) and displacement (undisplaced, <2㎜, ≥2㎜). Each distal radius fracture was also evaluated for radiographic and clinical evidence of DRUJ instability at last follow-up. Results: DRUJ instability was revealed in 12 cases. Both the large size of the ulnar styloid fracture (50-99%; 10 cases, ≥100%; 2 cases) and its severe displacement (<2㎜; 3cases, ≥2㎜; 9 cases) at the time of injury have more instability than minimal size and displacement. The communition of the distal radius fracture was significantly related DRUJ instability, C3 type 7 cases on 6 cases(85.7%). but, involvement of the radiocarpal articular surface did not generate significant difference in the incidence of DRUJ instability, Conclusion: The fracture at the base of ulnar styloid and significant displacement of an ulnar styloid fracture were found to increase the risk of DRUJ instability.

최소 절개 방법과 내시경적 방법에 의한 수근관 감압술의 결과 비교

손홍문,이준영,박성용,문영래 대한정형외과학회 2003 대한정형외과학회지 Vol.38 No.3

급성 척수 손상 후 신경보호 및 재생을 위한 약물 치료

손홍문,양경호 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

This is a retrospective review of current literature regarding neuroprotection and regeneration after acute spinal cord injury. Our objective was to provide an update for clinicians of the pathophysioloy of secondary injury, which is the main target for the treatment of spinal cord injury and the emerging therapeutic strategies for promoting neural regeneration. We particularly focused on currently used medications that may have neuroprotictive potential in spinal cord injury. While laboratory research in animal models reportedly resulted in some degrees of promising result, prospective randomized clinical results are anxiously awaited.

Controlled bending of proximal femoral nails used in fractures of bowed femurs: biomechanical study with clinical application

손홍문,조승환 조선대학교 의학연구원 2022 Medical Bilogical Science and Engineering Vol.5 No.2

We aim to investigate whether the controlled bending of the commercially available nail could affect the nail’s biomechanical properties. We also report the clinical application using such method. A commercially available titanium proximal femoral nails were used for the current study. Using the custom made bending Jig, the portion distal to the bending point of the original nail was bent to varus curvature so that the alignment of the nail is equivalent to medial bowing of 1,000 mm radius. The biomechanical test was performed using the static four point bending test according to American Society for Testing and Materials (ASTM) standards. The measured biomechanical properties were compared between the original nail and the pre-bended nail. There was no significance difference between the original nail and the pre-bended nail in terms of mechanical properties we measured (p<0.05). Only 0.32% difference in bending strength was noticed between the two group which is considered to be negligible. The patient utilizing controlled bending nail showed early bone healing without complication. The result of the current study indicates that the additional bending of the commercially available intramedullary nail has only minimal effect on the biomechanical property of the nail. Therefore, we think controlled bending can be done on a commercially available intramedullary nail and can be used safely in the patient with severe anterolateral bowing.

다발성 흉요추 및 요추 골절의 치료: 골다공증이 없는 환자에서의 연속성 골절과 비연속성 골절의 비교

손홍문,박이규,강신욱 대한척추외과학회 2018 대한척추외과학회지 Vol.25 No.1

Study Design: Retrospective study. Objectives: To evaluate the outcomes of multiple thoracolumbar and lumbar fractures depending on whether the fractures were contiguous. Summary of the Literature Review: The treatment of multiple spine fractures in patients without osteoporosis has rarely been reported. Materials and Methods: From February 2004 to January 2016, 81 patients without osteoporosis who had acute thoracolumbar and lumbar fractures and underwent posterior fusion surgery were evaluated. Patients were divided into 2 groups (group A: contiguous, group B: non-contiguous). We investigated the causes of the injuries, the locations of the injuries within the spine, the range of fusion levels, and functional outcomes based on the patients’ general characteristics. Results: Group A comprised 37 patients and group B comprised 44 patients. In most patients, the fusion included 3 segments (group A: 12, group B: 14) or 4 segments (group A: 9, group B: 10). Group A scored 21.2 and group B scored 19.0 on the Korean Oswestry Disability Index. In both groups, longer fusion was associated with poorer clinical results. In the clinical evaluation of the fusion rate, there was no statistically significant difference between the 2 groups (p=0.446). Conclusions: In this study, patients with multiple vertebral fractures showed more fusion segments and poor clinical outcomes in contiguous fractures. In the patients with non-contiguous fractures, the clinical results were better when a minimal number of segments was fused. Therefore, the authors recommend conservative treatment to minimize the number of segments that are fused in noncontiguous multiple thoracolumbar and lumbar fractures when decompression is not necessary. 연구 계획: 후향적 연구목적: 다발성 흉요추 및 요추 골절에서 골절의 연속성 유무에 따라 분류하고, 두 군 간의 치료 결과를 비교하고자 하였다. 선행 문헌의 요약: 골다공증이 없는 다발성 흉요추 및 요추 골절의 수술적 치료 결과에 대한 보고는 드물다. 대상 및 방법: 2004년 2월부터 2016년 1월까지 다발성 흉요추 및 요추 골절로 후방유합술을 받은 환자 중 골다공증성 골절환자를 제외한 81명을 대상으로 하였다. 골절이 연속적으로 발생한 경우와 비연속적으로 발생한 경우를 각각 A, B군으로 나누고 각 군간의 나이, 성별 등 일반적인 특성과 함께 수상원인, 손상 받은 척추위치, 유합술의 범위, 합병증, 통증 및 임상적 기능평가를 시행하였다. 결과: A군은 37명, B군은 44명이었다. 유합 분절의 수는 3개의 분절을 유합한 경우가 A군 12예, B군 14예였다. 4개의 분절을 유합한 경우는 A군이 9예, B군이 10예였다. Korean Oswestry disability index (KODI)에서 A군은 평균 21.2점이었고 B군은 19.0점으로 B군에서 양호한 결과를 보였다(p=0.018). 유합 범위에 따른 임상적 평가에서 두 군 모두 유합 범위가 많을수록 결과가 좋지 않았지만 통계학적 차이는 없었다(p=0.446). 결론: 연속성골절에서 유합 분절이 더 많고 임상결과도 좋지 않았으며, 비연속성 골절일 경우에는 신경학적 감압이 필요하지 않거나 불안정성이 적어 최소한의 분절을 유합하는 경우 임상결과가 더 나은 것으로 나타났다. 그러므로 비연속성 다발성 흉요추 및 요추골절에서 감압이 필요치 않은 골절부위는보존적 치료를 하여 유합분절을 최소화 하는 것이 좋을 것으로 사료된다. 약칭 제목: 다발성 흉요추 및 요추 골절의 치료