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이용범,양철중,Cheng Zhen Li,Zhong Zhuan,권승철,노규철 대한정형외과학회 2018 Clinics in Orthopedic Surgery Vol.10 No.1
Background: This study aimed to investigate whether fatty infiltration (FI) measured on a single sagittal magnetic resonance imaging (MRI) slice can represent FI of the whole supraspinatus muscle. Methods: This study retrospectively reviewed the MRIs of 106 patients (age 50–79 years) divided into three rotator cuff tearsize groups: medium, large, and massive. Fat mass and muscle mass on all T1-weighted sagittal MRI scans (FA and MA) were measured. Of the total MRI scans, the Y-view was defined as the most lateral image of the junction of the scapular spine with the scapular body on the oblique sagittal T1-weighted image. Fat mass and muscle mass seen on this Y-view single slice were recorded as F1 and M1, respectively. Fat mass and muscle mass were also assessed on MRI scans lateral and medial to the Y-view. The means of fat mass and muscle mass on these three slices were recorded as F3 and M3, respectively. Average FI ratios (fat mass/ muscle mass) of the three assessment methods (F1/M1, FA/MA, and F3/M3) were compared. Intraclass correlation coefficients (ICCs) were calculated for inter- and intraobserver reliability. Results: ICCs showed higher reliability (> 0.8) for all measurements. F1/M1 values were not statistically different from FA/MA and F3/M3 values (p > 0.05), except in males with medium and large tears. F3/M3 and FA/MA were not statistically different. The difference between F1/M1 and FA/MA did not exceed 2%. Conclusions: A single sagittal MRI slice can represent the whole FI in chronic rotator cuff tears, except in some patient groups. We recommend measurement of FI using a single sagittal MRI slice, given the effort required for repeated measurements.
서영진,최영희,신재혁,양철중,송시영,Seo, Young-Jin,Choi, Young-Hee,Shin, Jae-Hyuk,Yang, Cheol-Jung,Song, Si Young 대한족부족관절학회 2015 대한족부족관절학회지 Vol.1 No.2
We experienced a rare case of parosteal lipoma, which located on the periosteum of the foot 4th metatarsus. A 22-year-old woman visited the hospital with painful mass in her foot. Based on the assessment of plain radiographs, computed tomography scan, and magnetic resonance image, it was suspected as lipoma. Marginal excision was performed and parosteal lipoma was confirmed histologically. Any local recurrence and complications were not observed in 2 years after surgery.
Xiao Ning Liu,양철중,김지의,Zhen Wu Du,Ming Ren,Wei Zhang,Hong Yu Zhao,김경옥,노규철 대한정형외과학회 2018 Clinics in Orthopedic Surgery Vol.10 No.1
Background: To evaluate the influence of bone marrow aspirate concentrate (BMAC) on tendon-to-bone healing in a rabbit rotator cuff model and to characterize the composition of growth factors in BMAC. Methods: In this in vivo study, 40 rabbits were allocated into five groups: control (C), repair + saline (RS), repair + platelet-rich plasma (PRP; RP), repair + BMAC (RB) and repair + PRP + BMAC (RPB). A tear model was created by supraspinatus tendon transection at the footprint. Six weeks after transection, the torn tendon was repaired along with BMAC or PRP administration. Six weeks after repair, shoulder samples were harvested for biomechanical and histological testing. Ten rabbits were used for processing PRP and BMAC, followed by analysis of blood cell composition and the levels of growth factors in vitro . Results: The ultimate load-to-failure was significantly higher in RPB group compared to RS group (p = 0.025). BMAC-treated groups showed higher values of biomechanical properties than RS group. The histology of BMAC-treated samples showed better collagen fiber continuity and orientation than RS group. BMAC contained significantly higher levels of the several growth factors than PRP. Conclusions: Locally administered BMAC enhanced tendon-to-bone healing and has potential for clinical applications.
서영진,유연식,송시영,양철중,하종문,김윤상 연세대학교의과대학 2016 Yonsei medical journal Vol.57 No.5
Purpose: The purpose of this study was to compare the clinical outcomes of arthroscopic anatomical double bundle (DB) anteriorcruciate ligament (ACL) reconstruction with either selective anteromedial (AM) or posterolateral (PL) bundle reconstruction while preserving a relatively healthy ACL bundle. Materials and Methods: The authors evaluated 98 patients with a mean follow-up of 30.8±4.0 months who had undergone DB or selective bundle ACL reconstructions. Of these, 34 cases underwent DB ACL reconstruction (group A), 34 underwent selective AM bundle reconstruction (group B), and 30 underwent selective PL bundle reconstructions (group C). These groups were comparedwith respect to Lysholm and International Knee Documentation Committee (IKDC) score, side-to-side differences of anterior laxity measured by KT-2000 arthrometer at 30 lbs, and stress radiography and Lachman and pivot shift test results. Pre- and post-operative data were objectively evaluated using a statistical approach. Results: The preoperative anterior instability measured by manual stress radiography at 90° of knee flexion in group A was significantlygreater than that in groups B and C (all p<0.001). At last follow-up, mean side-to-side instrumented laxities measured by the KT-2000 and manual stress radiography were significantly improved from preoperative data in all groups (all p<0.001). There were no significant differences between the three groups in anterior instability measured by KT-2000 arthrometer, pivot shift, or functional scores. Conclusion: Selective bundle reconstruction in partial ACL tears offers comparable clinical results to DB reconstruction in completeACL tears.
서영진,최영희,신재혁,양철중,송시영 대한족부족관절학회 2015 대한족부족관절학회지 Vol.19 No.3
We experienced a rare case of parosteal lipoma, which located on the periosteum of the foot 4th metatarsus. A 22-year-old woman visited the hospital with painful mass in her foot. Based on the assessment of plain radiographs, computed tomography scan, and magnetic resonance image, it was suspected as lipoma. Marginal excision was performed and parosteal lipoma was confirmed histologically. Any local recurrence and complications were not observed in 2 years after surgery
노규철,Xiao Ning Liu,Zhong Zhuan,양철중,김용태,이근우,최경호,김경옥 대한정형외과학회 2018 Clinics in Orthopedic Surgery Vol.10 No.2
Background: Leukocyte-poor platelet-rich plasma (LP-PRP) from peripheral blood is currently used as a concentrated source of growth factors to stimulate repair at sites of soft tissue injury. Fibroblasts are primary mediators of wound healing. Thus, we aimed to assess the positive effect of LP-PRP on human fibroblast proliferation in vitro . Methods: LP-PRP was prepared from 49 donors. The fibroblasts were seeded, and at 24 hours after seeding, 1 × 107/10 μL LP-PRP was added once to each well. The cells were harvested 10 times during study period at our planned points, and we examined cell proliferation using the water-soluble tetrazolium salt-1 assay. We collected the supernatants and measured the amount of growth factors such as platelet-derived growth factor (PDGF)-AB/BB, insulin-like growth factor-1 (IGF-1), transforming growth factor-β1 (TGF-β1), and vascular endothelial growth factor (VEGF), which are known to be involved in wound healing processes, by multiplex assay. Results: Human fibroblasts treated with LP-PRP showed a significant increase in proliferation when compared to untreated controls (p < 0.001 at days 4, 6, and 8). Multiplex cytokine assays revealed various secretion patterns. PDGF-AB/BB appeared at early time points and peaked before fibroblast proliferation. IGF-1 and TGF-β1 secretion gradually increased and peaked on days 4 and 6 post-treatment. The early VEGF concentration was lower than the concentration of other growth factors but increased along with cell proliferation. Conclusions: Platelets in LP-PRP release growth factors such as PDGF, IGF-1, TGF-β1 and VEGF, and these growth factors have a promoting effect for human fibroblast proliferation, one of the important mediators of wound healing. These results suggest that growth factors derived from LP-PRP enhance the proliferation of human fibroblast.
외상성 수지 허혈 괴사에 대한 Prostaglandin E1 보존 치료에 의한 구제치료 - 증례 보고 -
신재혁 ( Jae Hyuk Shin ),장호근 ( Ho Guen Chang ),양철중 ( Cheol Jung Yang ),안정태 ( Jungtae Ahn ) 대한골절학회 2015 대한골절학회지 Vol.28 No.4
Prostaglandin E1 (PGE-1) is a potent vasodilator, which also inhibits platelet aggregation, affects the blood flow viscosity, and fibrinolysis. The compound also excerts anti-inflammatory effects by inhibiting the monocyte and neutrophil function. PGE-1 has been widely administered following microvascular flap surgery, along with perioperative antithrombotic agents such as low molecular weight heparin or aspirin, showing excellent results. We report a case showing successful salvage recovery from post-traumatic ischemic necrosis of the finger via PGE-1 assisted conservative treatment.