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요추부 후방 추체간 유합술에서 케이지 충전형 실리콘 함유 다공성 하이드록시 아파타이트의 방사선학적 결과
최승명(Seung-Myung Choi),김용민(Yong-Min Kim),이형준(Hyeong-Jun Lee),이종혁(Jong-Hyuk Lee) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.5
목적: 실리콘 함유 다공성 하이드록시 아파타이트(silicon-containing porous hydroxyapatite, Si-HA)를 케이지 내에 삽입하여 자가 골편과 함께 요추부 후방 추체간 유합술(posterior lumbar interbody fusion, PLIF)에 사용한 후 방사선적 결과를 통해 유합 능력을 분석해 보고자 하였다 대상 및 방법: PLIF를 시행받은 환자들 중 Si-HA를 케이지에 충전하여 수술한 12명을 대상으로 하였다. 요추부 추체간 공간에 블록 형태의 Si-HA를 cage에 충전하여 방사선 검사 및 3차원 컴퓨터 단층촬영 검사 추시를 통해 유합능력을 분석하였다. 결과: 술 후 12개월 단순 방사선 추시상 12명 중 11명이 grade Ⅳ(완전 유합)를 보였고 1명은 grade Ⅲ를 보였다. 술 후 24개월의 추시에서는 모두 grade Ⅳ를 보였다. 술 후 12개월 3차원 컴퓨터 단층촬영 검사상 전체 예에서 agdre I (완전 유합)을 기록하였다. 결론: Si-HA는 PLIF에서 자가골, 동종골과 함께 효과적인 유합 매개체 중 하나라고 생각되었다. Purpose: The objective of this study is to analyze the radiologic fusion rate in posterior lumbar interbody fusion (PLIF) using silicon-containing porous hydroxyapatite (Si-HA) chips packed within a cage. Materials and Methods: Twelve patients who underwent PLIF using Si-HA (BoneMedik-S™; Meta-Biomed, Cheongju, Korea) blocks packed within a cage were enrolled. PLIF was performed in the same manner in all patients. A cage filled with Si-HA was inserted into disc space. Serial Ⅹ-rays and 3-dimensional computed tomography (3D-CT) were performed for evaluation of the fusion status. Results: At postoperative 12 months, 11 cases showed grade Ⅳ and one case showed grade Ⅲ on X-rays. At postoperative 24 months, all cases showed grade Ⅳ (complete fusion). Assessment of fusion by 3D-CT also showed grade I in all cases at postoperative 12 months. Conclusion: Considering the above results, Si-HA packed in a cage appears to be an effective bone graft material for use in PLIF.
협부형 척추전방전위증에 대한 후방가동관절 이용한 골유합술 및 척추경나사못 고정술의 수술적 결과
김찬,이승명,신호,Kim, Chan,Lee, Seung Myung,Shin, Ho 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1
Objective : Posterior lumbar interbody fusion(PLIF) provides the favorable outcome to degenerative lumbar disease, especially isthmic spondylolisthesis. To determine the long-term effect of PLIF using psterior movable segment, we analysed the results of follow-up radiologic changes and surgical outcome retrospectively Patients and Method : During the past 11 years(1989. 1.-1999. 9.), 148 patients with symptomatic lumbar spondylolisthesis were managed at our department and the clinical wants were throughly recieved and final outcome is determined at last follow up. PLIF using antogenous bone(posterior movable segment, iliac bone and rib) were performed in 106 case. Results : After an average follow-up period of 33 months(range ; 15-58 months), the results were excellent in 66 cases, good in 37 cases, fair in 2 cases and poor in 1 cases. And the satisfactory results were 103 cases(98.2%) in PLIF,. Conclusion : In conclusion, patients who underwent PLIF with autologous bone graft had good clinical and radiological outcomes without significant neurological complications.
흉·요추 불안정성 척추 손상 환자에서 전방 감압술과 전방기기 및 Surgical Titanium Mesh를 이용한 내고정술 (장기적 추적 검사 결과)
박환민,이승명,조하영,신호,정성헌,송진규,장석정,Park, Hwan Min,Lee, Seung Myung,Cho, Ha Young,Shin, Ho,Jeong, Seong Heon,Song, Jin Kyu,Jang, Seok Jeong 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.1
Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.
이상현(Sang Hyun Lee),한찬식(Chan Sik Han),최승명(Seung Myung Choi),이건명(Keon Myung Lee) 한국지능시스템학회 2019 한국지능시스템학회논문지 Vol.29 No.4
정형외과 의사는 컴퓨터 단층 촬영(CT)을 활용해 골절 환자의 골절 범주를 식별하고 치료 방법을 결정한다. 골절이 발생하게 되면 다발성 골절인 경우가 많고 골절 범주가 많기 때문에, 의사가 골절을 정확히 분류하기 위해서는 높은 전문성과 많은 노력이 필요하다. 이 논문에서는 골절 범주 식별을 다중 부류 분류 문제로 정의하고, 골절의 범주를 식별하기 위해 딥러닝을 사용하는 방법을 제안한다. 제안하는 딥러닝 모델은 GoogleNet과 유사한 형태로 골절의 특징을 추출하고, 다층퍼셉트론으로 각 골절 범주의 점수를 계산해 분류를 한다. 그리고 출력 노드의 점수가 특정 임계값 내에 있는 최대 4개의 골절 부류를 선택한다. 하반신 골절 CT 데이터에 대한 제안 방법의 정밀도는 73.3%, 재현율은 86.9%였다. The orthopedists use computed tomography(CT) to identify fracture categories of fractured patients and determine their treatment. Fractures often result in multiple fractures which have various categories. Here it is required for orthopedists to have a high level of expertise and stressful examination. This paper casts the fracture category identifier task as a multi-label classification problem, and proposes a deep learning based method to it. The proposed deep learning model extracts the features of fractures with GoogleNet-like front-end and determines the fracture categories from the categorieswise score computed with back-end fully connected layer. The proposed method showed 73.3% precision and 86.9%recall for a CT dataset for lower body fracture in the experiments.
서울 대기 중 PM<sub>2.5</sub> 내 OC와 EC로부터 SOC 추정방법의 비교 평가
유하영,김기애,김용표,정창훈,신혜정,문광주,박승명,이지이,Yoo, Ha Young,Kim, Ki Ae,Kim, Yong Pyo,Jung, Chang Hoon,Shin, Hye Jung,Moon, Kwang Ju,Park, Seung Myung,Lee, Ji Yi 한국입자에어로졸학회 2020 Particle and Aerosol Research Vol.16 No.1
The organic carbon in the ambient particulate matter (PM) is divided into primary organic carbon (POC) and secondary organic carbon (SOC) by their formation way. To regulate PM effectively, the estimation of the amount of POC and SOC separately is one of important consideration. Since SOC cannot be measured directly, previous studies have evaluated determination of SOC by the EC tracer method. The EC tracer method is a method of estimating the SOC value from calculating the POC by determining (OC/EC)pri which is the ratio of the measured values of OC and EC from the primary combustion source. In this study, three different ways were applied to OC and EC concentrations in PM<sub>2.5</sub> measured at Seoul for determining (OC/EC)pri: 1) the minimum value of OC/EC ratio during the measurement period; 2) regression analysis of OC vs. EC to select the lower 5-20% OC/EC ratio; 3) determining the OC/EC ratio which has lowest correlation coefficient value (R<sup>2</sup>) between EC and SOC which is reported as minimum R squared method (MRS). Each (OC/EC)pri ratio of three ways are 0.35, 1.22, and 1.77, respectively from the 1 hourly data. We compared the (OC/EC)pri ratio from 1hourly data with 24 hourly data and revealed that (OC/EC)pri estimated from 24 hourly data had twice larger than 1hourly data due to the low time resolution of sampling. We finally confirmed that the most appropriate value of (OC/EC)pri is that calculated by a regression analysis of 1 hourly data and estimated SOC amounts at PM<sub>2.5</sub> of the Seoul atmosphere.