소족지 중족골통을 동반한 무지 외반증에서의 변형 스카프 절골술

정진화,정현우,주인탁,Chung, Jin-Wha,Jung, Hyun-Woo,Chu, In-Tak 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.2

Purpose: The purpose of this study was to evaluate the radiological and clinical results of modified scarf osteotomy for hallux valgus with lesser metatarsalgia. Materials and Methods: Total 19 patients (24 feet) were reviewed by medical records and radiographs. All patients were female and the mean age at the time of operation was 46.4 years. The mean follow-up time was 14.8 months. We modified original scarf osteotomy by adding the procedure of closing wedge osteotomy at the medial side of distal fragment for achieving of the supination of the first metatarsal head. Additionally, Akin osteotomy of the first proximal phalanx was done in 16 patients (20 feet) and no lesser metatarsal operation was done. First-second intermetatarsal, hallux valgus and distal metatarsal articular angles were analyzed radiologically before and after the operation. And 3-dimensional CT was used to evaluate the supination of the first metatarsal head. Clinical results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) score and persistence of lesser metatarsalgia. Results: First-second intermetatarsal and hallux valgus angles were reduced from the mean pre-operative values of $14.2^{\circ}$ and $32.5^{\circ}$ to $8^{\circ}$ and $12.5^{\circ}$, respectively, 12 months after the operation. And the supination of the first metatarsal head was confirmed by 3-dimensional CT. The mean AOFAS score improved from 41.4 points pre-operatively to 87.2 points at follow-up. Lesser metatarsalgia still remained in 2 patients (2 feet). Conclusion: Modified scarf osteotomy would be an effective surgical procedure, especially, for achieving downward displacement and supination of the first metatarsal head in hallux valgus with lesser metatarsalgia.

폴리감마글루탐산 및 구연산을 혼합한 인산칼슘 시멘트의 역학 및 생물학적 분석

정진화 ( Jin Wha Chung ),김정만 ( Jung Man Kim ),김승수 ( Sung Soo Kim ),권순용 ( Soon Yong Kwon ) 한국조직공학·재생의학회 2009 조직공학과 재생의학 Vol.6 No.4

The purpose of this study was to make and evaluate the injectable alpha tricalcium phosphate(α-TCP) cement mixed with poly-gamma-glutamic acid(PGGA) and citric acid. α-TCP and PGGA component powders and citric acid solution were prepared. After mixing each 5, 10 and 15 wt% PGGA with α-TCP powder, the best match was decided by mechanical study. And then studies of initial setting time, pH, released calcium ion, mechanical strength, dynamic viscosity were done after mixing each 5, 10 and 15 wt% citric acid solution with α-TCP cement incorporated with 10 wt% PGGA. Also, cell proliferation assay using osteoblast and confocal microscope were performed. The results showed 10 wt% PGGA mixed with α-TCP cement was the best mechanical strength(compression strength; 50 MPa & diametral tensile strength; 18 MPa), but the initial setting time was about 90 minutes. After mixing various weight percents of citric acid, mixing with 10 wt% citric acid showed 80 MPa of compression strength, 22 MPa of diametral stensile strength and 5 minutes of initial setting time. As compared to control(MIIG™ 115), this match showed higher absorbance in cell proliferation assay, more individualization of actin and more activation of integrin in confocal microscope. Conclusively, α-TCP cement mixed with 10 wt% PGGA and 10 wt% citric acid showed good mechanical and biologic results. This study can be applied clinically to making injectable calcium phosphate cement bone substitute.

아킬레스건 손상 후 고정기간에 따른 기계적 수용기의 변화

유종민,정진화,윤기식,주인탁,Yoo, Jong-Min,Chung, Jin-Wha,Yoon, Ki-Syck,Chu, In-Tak 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.1

Purpose: This study was designed to determine the quantitative changes of the numbers of the mechanoreceptors in the experimentally tenotomized Achilles tendon of rabbits as compared with short-term immobilization and long-term immobilization. Materials and Methods: 14 white rabbits were used. After tenotomizing the right Achilles tendon, the subjects were divided into 2 groups according to the periods of immobilizaton. The left side of each Achilles tendon of the rabbits were used as controls. The tendons were stained with a modified gold-chloride method. Results: The number of mechanoreceptor was significantly decreased in the tenotomized Achilles tendon group than the control group (p<0.01). There was no statistical difference between the two experimental groups in the numbers of the mechanoreceptors (p>0.01). Conclusion: The injured Achilles tendons may more vulnerable to injury because of the decreased numbers of mechanoreceptors, but no difference between the periods of immobilization. It may suggest that post-operative immobilization period may not affect on the outcome of operative treatment from the viewpoint of mechanoreceptors.

중족골통에서의 소족지 중족 절골술

이승열,정진화,Lee, Seung-Yeol,Chung, Jin-Wha 대한족부족관절학회 2017 대한족부족관절학회지 Vol.21 No.3

Metatarsalgia means the pain under the lesser metatarsal heads. The many causes of metatarsalgia can be categorized into three groups: local disease in the region, altered forefoot biomechanics, and systemic disease affecting the region. Surgical options need to be considered if nonsurgical treatment fails. The metatarsal osteotomies are designed primarily to reduce the weightbearing forces on the metatarsal head by elevating or shortening the metatarsal. Many lesser metatarsal osteotomies have been described, and their success depends on many factors. Regardless of the method employed, it is important to maintain or restore the metatarsal cascade to maintain an even pressure under the lesser metatarsal heads and prevent transfer lesions. The surgeon must understand the effects of the metatarsal osteotomy on the forefoot patho-biomechanics and decide, using a combination of clinical examinations and imaging, whether the desired effect of the osteotomy is to shorten or elevate the metatarsal head or both.

족관절 급성 염좌의 진단과 치료

변주환,정진화,Byun, Chu-Hwan,Chung, Jin-Wha 대한족부족관절학회 2015 대한족부족관절학회지 Vol.1 No.2

Acute sprain of the ankle requires comprehensive history taking and physical examination in diagnosing the type of severity and deciding on the plan of treatment. Literature supports functional treatment as the treatment of choice for grade I and II injuries. During the acute phase, the goal of treatment focuses on controlling pain and swelling. PRICE (protection, rest, ice, compression, and elevation) is a well-established protocol at this phase. There is some evidence that application of ice and use of nonsteroidal anti-inflammatory drugs improves healing and speeds recovery. Then the functional treatment (motion restoration and strengthening exercises) is administered to progress the rehabilitation appropriately in order to facilitate healing and restore the mechanical strength and proprioception. Early mobilization has been shown to result in more rapid return to work and daily activities than immobilization. Grade III injuries still generate controversy in terms of the best management available, and more studies on early mobilization, cast immobilization, or surgery are needed. Even the Cochrane reviews published to date are not conclusive.

만성 족저 근막염 환자에게 전향적으로 시행한 스테로이드 주사와 주사침 천공술

이지원,정진화,Lee, Jiwon,Chung, Jin-Wha 대한족부족관절학회 2021 대한족부족관절학회지 Vol.25 No.4

Purpose: This study sought to compare needle fenestration with a corticosteroid injection for the treatment of chronic plantar fasciitis. We hypothesized that needle fenestration would be as effective as a corticosteroid injection while avoiding the potential adverse effects of the corticosteroid. Materials and Methods: Forty female patients with unilateral chronic plantar fasciitis who did not respond to a minimum of 6 months of various conservative treatments were prospectively randomized to receive either a corticosteroid injection or needle fenestration. Visual analogue scale and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used for all patients before treatment and at 3-, 6-, and 12-month following treatment. Results: The corticosteroid injection group had a before-treatment average AOFAS Ankle-Hindfoot score of 56.4, which increased to 87.3 at 3 months and 78.2 at 6 months after treatment but decreased to 62.4 at 12 months. The needle fenestration group had a before treatment average AOFAS ankle-hindfoot score of 49.5, which increased to 77.8 at 3 months and 92.1 at 6 months after treatment and remained at a high score of 89.4 at 12 months. There were no complications in either group. Conclusion: In the treatment of chronic plantar fasciitis, needle fenestration is as effective at 3- and 6-month post-treatment as a corticosteroid injection. Also, unlike a corticosteroid, its effect remains until 12 months post-treatment.

당뇨 신경병증

심정인,정진화,Shim, Jung-In,Chung, Jin-Wha 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.4

Neuropathy is a common complication of diabetes. It is characterized by a progressive loss of peripheral nerve fibers. The development of the neuropathy is linked to poor glycemic control, age, and the duration of diabetes. Peripheral sensory polyneuropathy is the most common type in neuropathy. Diabetic neuropathy is the most significant etiologic factor of the foot ulcer that may leads to amputation. Current treatments in diabetic neuropathy have no definitive effects on repair or reverse the damaged nerve but only to relieve of symptoms, especially on pain. When the focal compressive neuropathy is combined with diabetic neuropathy, the nerve would be more vulnerable and symptoms might get worse. Surgery is indicated for decompression of an entrapped nerve, like posterior tibial nerve in tarsal tunnel, after failure of the initial conservative treatments.

헤스페리딘/PLGA 필름에서 망막색소상피세포의 부착과 증식거동

이소진(So Jin Lee),강수지(Su Ji Kang),김혜윤(Hye Yun Kim),이정환(Jung Hwan Lee),김은영(Eun Young Kim),권순용(Soon Yong Kwon),정진화(Jin Wha Chung),주천기(Choun Ki Joo),강길선(Gil Son Khang) 한국고분자학회 2014 폴리머 Vol.38 No.1

망막색소상피(retinal pigment epithelium, RPE)는 시기능을 유지하는데 중요한 역할을 하여 RPE의 퇴화는 여러 망막변성질병을 유발한다. 현재 이에 대한 효과적인 치료법이 부족하여 세포 이식에 적합한 지지체를 제작하기 위해, 생분해성 고분자인 PLGA와 항염증, 항산화 작용 등의 기능이 있는 헤스페리딘을 이용하여 하이브리드 필름을 제조하였다. ARPE-19를 파종한 후, MTT 분석법을 이용하여 세포 증식률을 확인하고, 세포의 부착 및 세포 형태를 SEM을 통하여 확인하였다. 또한 RPE 세포의 특이적 유전자 발현정도를 확인하기 위하여 RT-PCR을 수행하였고, RPE65의 발현을 확인하기 위해 AEC 면역화학적 염색을 실시하였다. 그 결과, 헤스페리딘/PLGA 필름은PLGA보다 RPE 세포의 부착, 증식 및 표현형 유지가 우수함을 확인하였고, 이를 통해 헤스페리딘/PLGA 필름의 망막재생을 위한 조직공학적 담체로써 응용 가능성을 확인할 수 있었다. Retinal pigment epithelium (RPE) plays an important role in maintaining the visual function and the degenerationof the RPE causes several retinal degeneration disease. In order to fabricate the suitable carrier for RPE transplantation,the hybrid poly(lactide-co-glycolide) (PLGA) film with hesperidin was prepared. Hesperidin has an antiinflammatoryand antioxidant characteristics. ARPE-19 was seeded on hesperidin/PLGA film and then, cell proliferationwas determined by the MTT assay, and cell adhesion and cell morphology were confirmed by SEM. Also, RT-PCR wasperformed to confirm the expression of the specific genes, and AEC immunohistochemical staining was performed todetermine the expression of RPE65. As a result, we confirmed that attachment, proliferation and phenotype maintenanceof RPE cells were more excellent on hesperidin/PLGA film than PLGA film, thereby we were able to confirm the potentialapplications of hesperidin/PLGA film as tissue engineering carrier for regeneration of retina.

부산지역 소아 및 성인의 A형 간염 바이러스 항체 양성률에 대한 역학적 조사

권영옥,최임정,정진화,박지현,Kwon, Young Ok,Choi, Im Jeong,Jung, Jin Wha,Park, Ji Hyun 대한소아청소년과학회 2007 Clinical and Experimental Pediatrics (CEP) Vol.50 No.3

목 적 : A형 간염 유병률은 그 지역의 생활환경과 위생상태와 밀접한 관계가 있으며 시간 및 지역에 따라 다양한 양상을 보인다. 최근에 들어와 A형 간염 유병률의 변화에 대하며 많은 이들이 보고하여 왔다. 이에 본 연구는 부산 지역에 거주하는 소아과 성인을 대상으로 A형 간염 항체 유병률을 측정하였다. 방 법 : 부산시에 거주하고 2004년 10월부터 2005년 3월까지 메리놀병원에 입원한 472명을 대상으로 하였으며 전 연령층의 혈청으로부터 면역방사계수 측정법을 이용하여 항 A형 바이러스 IgG 항체 유무를 측정하였다. 결 과 : 1) A형 간염 IgG 항체 양성률은 총 472명 중 108명에서 항체가 검출되어 22.8%이었고, 2-5세가 1.7%, 6-10세가 1.7%, 11-20세가 0%, 21-30세가 40.5%, 31-40세가 82.1%, 41-50세가 94.7%, 51세 이상이 100%로 조사되었다. 2) 각 연령군 모두에서 남녀간의 항체 양성률(P=0.2)간에 유의한 차이는 없는 것으로 나타났다. 결 론 : 우리 나라에서는 최근 경제발전과 더불어 생활환경이 향상되어 A형 간염 항체 양성률이 지난 20년 전보다 현저하게 감소되었다. 현재 소아 연령에서 A형 간염 항체 보유율이 매우 낮아 이들이 성인이 되는 경우 현증 A형 간염의 유행이 초래될 가능성이 높아지고 있다. 따라서 개인위생 및 생활환경을 개선하고, 고위험군을 대상으로 수동면역 및 능동면역을 시행하여 바이러스의 전파를 막아 A형 간염의 발생을 적극적으로 예방하여야 하겠다. Purpose : The prevalence of hepatitis A virus (HAV) in a certain community reflects that community's living standards and hygienic conditions. And the pattern of HAV infection differs over time and geography. Recently, a shift in prevalence has been observed in cases from chilhood to adulthood. We studied the HAV antibody prevalence in the general population in Busan. Methods : From October 2004 to March 2005, total 472 subjects were tested for HAV antibodies. All samples were collected from patients in Maryknol Hospital. Results : The overall seropositive rate was 22.8% (108/472). The seropositive rates were 1.7% in subjects aged 2-5 years, 1.7% in 6-10 years, 0% in 11-20 years, 40.5% in 21-30 years, 82.1% in 31-40 years, 94.7% in 41-50 years, and 100% in subjects aged over 50 years. There was no significant gap between gender groups. Conclusion : As the socioeconomic conditions in Korea have improved, the HAV seropositive rate in school-aged children has dramatically decreased in the last 20 years. But, the seropositive rate of HAV didn't differ according to gender. The seropositive rate of HAV in the pediatric group was very low, which suggests the increasing possibility of clinical HAV infection in adults in the near future. Therefore, we should actively prevent the spread of hepatits A virus. In order to do that, we need to reorganize our lifestyle and personel hygiene and carry out active and passive immunization to high risk groups.

관절경적 족관절 유합술 후 조기 체중부하 보행

김윤정,조성욱,정진화,Kim, Yoon-Chung,Cho, Sung-Wook,Chung, Jin-Wha 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.4

Purpose: The accepted general management principle after ankle arthrodesis is to maintain non-weight bearing for 6 to 8 weeks. The aim of this study was to report clinical outcome of patients allowed early weight bearing after arthroscopic arthrodesis. Materials and Methods: We analyzed medical records and radiographs to determine fusion rate and complication risk of 22 sequential patients allowed to walk under short leg cast within 3 days after arthroscopic ankle arthrodesis using 2 screws from January 2008 to June 2012. The minimum follow-up period was 18 months, and the mean age of the patients was 67 years. Results: The mean visual analog scale was decreased from 8.9 points preoperatively to 2.3 points after 12 months. Complete ankle fusion was achieved in 19 patients (86.4%) at 3-month follow-up. There were 2 cases of delayed union and one case of nonunion at 12-month follow-up. There was no other complication such as wound problem, persistent swelling of the ankle. Conclusion: Bony union may not be interfered even though patients were allowed to walk under cast within a few days after arthroscopic ankle arthrodesis.