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우영균(Young Kyun Woo),이화성(Hwa Sung Lee),김주영(Ju Young Kim) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.4
목적: 슬관절 전치환술 시 슬개골 치환 유무에 따른 임상적, 방사선학적 결과를 비교하여 효용성 여부를 알고자하였다. 대상 및 방법: 2002년 1월부터 2003년 6월까지 양측 슬관절 치환술을 동시에 시행한 환자들 중 무작위로 한측만 슬개골 치환술을 시행한 환자 20명을 대상으로 전방 슬관절 통증의 유무와 knee society clinical rating system, patellar score, patient-satisfaction score, 슬개-대퇴 관절 일치성(patellofemoral congruency)을 조사하였다. 결과: 전체적인 knee society knee score나 patellar score에서 슬개골 치환술을 시행한 군과 하지 않은 군 사이에 통계적으로 의미 있는 차이는 없었으며, patient-satisfaction score에서도 술 후 전방 슬관절 통증이 있던 4예 중 2예서만이 불만족스러운 결과를 보였고, 슬개-대퇴 관절 일치성에서는 슬개골 비치환군과 치환군에서 각각 98.8%, 98%의 일치성을 보였다. 결론: 슬관절 전치환술 시 슬개골 치환 여부가 임상적, 방사선학적으로 결과에 영향을 미치지 않았으며, 수술전 관찰되는 전방 슬관절 통증이나 슬개골 병적 상태, 슬개골 정렬 상황, 수술 기법 등을 고려하여 판단해야 할 것으로 생각된다. Purpose : This study evaluated the clinical and radiological results of a randomized clinical trial of patella resurfacing. Materials and Methods : A blinded, prospective study was carried out for 20 patients who underwent bilateral TKA with one patellar side being resurfaced from Jan. 2002 to Jun. 2003. The clinical results were assessed using the knee society clinical rating system, patellar score and patient-satisfaction score. Radiologically, patellofemoral congruency was assessed by measuring the patellar displacement in the skyline view. Results : There were no significant differences between the resurfaced and non-resurfaced knees with respect to the overall knee society knee scores or the patellar scores. In the patient-satisfaction scale, 2 out of 4 knees with anterior pain postoperatively were unsatisfactory to the patients. The average patellar congruency in the non-resurfacing/resurfacing group was 98.8%/98%. Conclusion : The clinical and radiological results after TKA were not associated with patellar resurfacing. It appears that a variety of factors such as preoperative anterior knee pain, pathological lesion and alignment of patella, and the surgical technique are related to the postoperative results.
슬관절 전방십자인대 신연 손상에 따른 기질 금속 단백 분해 효소(MMP)-2의 발현
우영균(Young Kyun Woo),송석환(Seok Whan Song),권순용(Soon Yong Kwon),이화성(Hwa Sung Lee),김영훈(Young Hoon Kim) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.4
목적: 조직 재형성 과정은 손상된 조직의 자연 치유에 필수적이다. 세포외 기질 분해에 관여하는 기질 금속단백 분해효소(matrix metalloproteinase, MMP)가 이 과정에서 중요한 역할을 하는데, 본 연구는 전방십자인대의 손상에 따른 MMP-2의 발현을 알아보고자 하였다. 재료 및 방법: MMP-2의 지속적인 발현 여부를 파악하기 위해 쥐에서 대퇴골-전방십자인대-경골 복합체를 얻어 신연 손상을 가한 후 1주일간 관찰하였다. 그 후 인대 복합체를 세 군으로 나누어, 제1군은 5 N 및 12 N으로 10, 30, 60분 동안, 제2군은 5와 15 N의 힘으로 5, 10, 30, 60 및 120분 동안, 제3군에서는 5, 8, 10, 12 및 15 N 하에 각각 30 및 60분 동안 손상을 주었다. MMP-2의 발현은 0.05% gelatine zymography를 이용하여 검사하였다. 결과: 인대 손상 후 MMP-2의 지속적인 분비를 관찰할 수 있었으며, 발현 강도는 손상 받은 시간이나 가해진 힘의 크기에 비례하여 증가하였다. 인대 조직 자체의 검사에서는 배양액의 결과보다 전구형의 발현 강도는 미약했으나, 활성형은 더욱 뚜렷이 나타났으며, 손상 시간 및 크기에 따라 발현 정도는 역시 증가하였다. 결론: MMP-2는 인대 손상 후에 즉각적으로 발현되었으며, 강도는 손상 시간이나 가해진 힘에 비례하여 증가하였다. MMP-2의 발현이 인대 손상 후 진행되는 조직 재형성기 과정에서 중요한 역할을 할 것으로 생각된다. Purpose : Tissue remodeling is essential for the natural healing of damaged tissue. The matrix metalloproteinases (MMPs) that degrade the extracellular matrix to play a central role in this process. This study was designed to examine the basic relationship between MMP-2 and anterior cruciate ligament (ACL) injury. Materials and Methods : After the femur-ACL-tibia complex was harvested from rats, the continuous release of MMP-2 in the stretch group was evaluated. The complexes were divided into three groups. To stretch the complexes, in group I, 5 and 12 N weights were used for 10, 30, and 60 minutes. In group Ⅱ, 5 and 15 N weights were used for 5, 10, 30, 60, and 120 minutes. And in group Ⅲ, 5, 8, 10, 12, and 15 N weights were used for 30 and 60 minutes. MMP-2 activity was evaluated using 0.05% gelatin zymography. Results : MMP-2 was expressed and the signal intensity was increased according to the stretch duration and magnitude. In the tissue analysis, active MMP-2 was markedly present and the expression was increased in response to the stretch in the supernatant samples. Conclusion : MMP-2 was released immediately after ligament injury and its activity was increased in proportion to the stretch duration and magnitude. It is believed that MMP-2 expression plays an important role in the remodeling process after an ACL injury.
송석환,우영균,이승구,이화성,이상훈,Song, Seok-Whan,Woo, Young-Kyun,Rhee, Seung-Koo,Lee, Hwa-Sung,Lee, Sang-Hoon 대한근골격종양학회 1997 대한골관절종양학회지 Vol.3 No.2
본 대학 부속 성모병원에서 경험한 사구종양 11례를 후향적으로 분석하였다. 전례가 여자로, 특징적인 동통 및 압통, 그리고 냉각 과민성의 3 주증상을 보였다. 손톱밑 사구종양이 8례, 발톱밑 사구종양이 1례, 그리고 원위 수지 수질(pulp)내 사구종양이 2례이었다. 10례에서 합병증없이 만족스러운 결과를 얻었으며, 손톱바닥을 종괴와 함께 절제한 1례는 손톱기형으로 경과추시중이다. 사구종양은 완전한 절제시 국소재발이나 전이를 하지 않는 양성종양이나, 손톱 바닥의 손상 시 손톱의 변형을 초래할 수 있으므로 완벽한 절제 및 손톱바닥의 세심한 재 봉합이 이루어져야하겠다. From 1988 to 1997, we experienced 11 cases of glomus tumor in fingers(10 cases) and toe(1 case). All patients were female, and showed typical pain, tenderness, and cold sensitivity of the lesions. The locations were subungal in nine cases and in pulp from distal phalangeal bone in two cases. Three patients had histories of one or two failed previous operations, and two patients had another glomus tumor in their bodies. All except one had satisfactory results subjectively and without complications. One patient was operated by the excision of the tumor including germinal matrix and surrounding tissues of nail bed, and had a nail deformity in follow-up. The glomus tumor is not malignant to recur or metastasize in the case of complete excision. However, the surgeon should be alert not to injure or repair the nail bed meticulously after the excision of the tumor to prevent a late deformity of nail.
비심멘트 반구형 비구부품의 고정방법에 따른 부품의 안착성에 대한 연구 -반구형 부품의 선상고정, 압박고정 및 이중반경 부품의 고정에 대한 비교-
김용식 ( Yong Sik Kim ),우영균 ( Young Kyun Woo ),권순용 ( Soon Yong Kwon ),김기원 ( Ki Won Kim ),이화성 ( Hwa Sung Lee ),이성재 ( Sung Jae Lee ),박수안 ( Soo An Park ) 대한고관절학회 1996 Hip and Pelvis Vol.8 No.2
Thirty-eight paired, size-matched, fresh-frozen cadaver acetabular were used to study reamed surface topography and the seating of on-line versus oversized noncemented components. Four commonly used constructs were considered: on-line reamed and 2-mm oversized hemispherical cups, and on-line reamed and 1-mm oversized dual-radius cups. Reamed surface topography was indexed by three-dimensional surfaces mathematically fitted to digitized castings. Component seating was indexed by the distribution of bone-cup contact and the thickness of the gap between the component backing and the bone. The reamed surfaces were better approximately by slightly blunt ellipsoids than by spheres, especially for the smaller acetabulae. Seating of the on-line hemispherical cups was best near the pole and poorest near the equator, whereas the converse was true for the 1-mm oversized dual-radius cups. The on-line dual-radius cups offered better overall compromise between polar and equatorial contact than did the 2-mm oversized hemispherical components.
김용식 ( Yong Sik Kim ),우영균 ( Young Kyun Woo ),송석환 ( Seok Whan Song ),권순용 ( Soon Yong Kwon ),김기원 ( Ki Won Kim ),이화성 ( Hwa Sung Lee ),김정호 ( Jeong Ho Kim ),이승구 ( Seoung Koo Rhee ) 대한고관절학회 1997 Hip and Pelvis Vol.9 No.1
Twenty-six primary hip prostheses were implanted in nineteen patients with a diagnosis of aplastic anemia between January 1990 and December 1992. The preoperative diagnosis were osteonecrosis of the femoral head in twenty-five hips and femoral neck fracture in one. The duration of follow-up was minimum of fours years. Preoperatively, the average Harris hip score was 56. At four years postoper- atively, the average score reached 87. At this time, twelve hips were rated excellent, eleven good, two fair, and one poor. One patient who received a bipolar arthroplasty showed an intrapelvic protrusion of the acetabular component. Another bipolar fixed with Boneloc cement was performed due to femoral neck fracture. There was no migration of component, subsidence, radiolucency or osteolysis in three hips with hybrid fixation. No sign of migration of acetabular component was seen with unce- mented prosthesis. Two hips with HA coated acetabular componentss showed a progressive radiodense line. Progressive retroacetabular osteolysis was found in one hip at zone I and II. There were neither cases of infection nor hemorrhagic complications. Two patients died of pneumonia and sepsis, respectively, at fifty-three and fifty-seven months postoperatively. It appears that fatty marrow conversion of proximal femur and pelvis does not affect the survival of cemented and uncemented fixation, but long-term follow-up is needed to validate our view. We have demonstrated that the hip arthroplasty in most patients with aplastic anemia can be successful despite the fact that hematologic characterics of aplastic anemia seem to indicated a high risk for hemorrhagic complication and infection. In conclusion, we strongy recommend hip arthroplasty if the patients has a painful hip joint, regardless of severity of aplastic anemia whose prognosis may be disappointing.