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주상골 불휴합에서 Matti-Russe 골이식과 Herbert 나사를 이용한 골유합술의 결과
조덕연,함영길,이명형 대한골절학회 1996 대한골절학회지 Vol.9 No.1
Fracture of scaphoid are second most common fractures of wrist, and about 1/6 of these fractures proceed to nonunion. The most widely used surgical procedure of scaphoid nonunion has been Matti-Russe procedures, and Hebert screw is a recently introduced fixation device as a means of rigid internal fixation promoting union and decreasing immobilization time. Authors have managed 15 cases of scaphoid nonunion with Matti-Russe bone grafting technique and Herbert screw, and accomplished satisfactory results: The union rate was 96.6%, the average time to union was 17.1 weeks, and according to Maudsley's assessment criteria, we obtained 7 cases of excellent, 6 good, and 2 fair results. Despite of it's technical demand and lack of the number of study material, Matti-Russe bone grafting technique with Herbert screw fixation seems efficient and reliable method of treatment.
조덕연 대한골절학회 1996 대한골절학회지 Vol.9 No.4
Patellar fractures constitute approximately 1 percent of skcletal injuries in the literature and 3.4 percent in the author's institution. The goals of treatment me restoration of the extensor mechanism and perfect restoration of the articulating surface. In contrast to moat other intraarticular fractures, the selection of treatment must take into consideration tensile stress of the bone, as well as compressive stress. The basic schema for treatment of patellar fracture is as follows: 1. To determine therapy. patellar fractures must be classified in 3 models;The mechanism of injury, amount of displacement. and configuration of fracture. 2. Nonoperative treatment is indicated if the extensor retinaculum is intact and if dispiacement of fragment is minimal. 3. The success of operative treatment depends on 0a exact reduction of fracture, secure fixation, and the amount of articular cartilage damage. 4. Recent biomechanical studies on the efficiency of various forms of fixation for patellar fractures showed that fixation with modified tension band wiring with or without circumferential wiring was superior to tension band wiring or circumferential wiring. 5. Partial patellectomy should be selected in preference to total patellectomy if at all possible because partial patellectomy offers better function.
악성종양에서 혈청 Intercellular Adhesion Molecule-1의 혈청
조덕연,김현수,박상준,김종숙,최지영,윤환중,김삼용 충남대학교 의과대학 지역사회의학연구소 1995 충남의대잡지 Vol.22 No.1
Intercellular adhesion molecule-1 (ICAM-1) is a glycoprotein serving as ligands for leukocyte intergrin receptors, i.e. LFA-1, MAC-l. It has been suggested that the expression of ICAM-1 and the levels of circulating ICAM-1 were increased in several malignancies. We measured serum ICAM-1 by ELISA in patients with stomach cancer (n=25), acute lymphoblastic leukemia (n=7), non-Hodgkin's lymphoma (n=14), and metastasis of unknown origin (n=5). Serum levels of circulating ICAM-1 in all malignancies were significantly higer than in normal controls. And serum level of ICAM-1 in stomach cancer ptients having metastatic disease was higher than in patients with localized disease (p=0.027). These results suggest that elevated serum ICAM-1 is a rather common feature for malignancies, not unique for certain types of cancer such as malignant melanoma. It remains to be clalified whether marked increase of serum ICAM-1 in metastatic stomach cancers simply reflect tumor burden or this molecule plays a role in progression in stomach cancer.
조덕연,서재곤,노재영 대한슬관절학회 1992 대한슬관절학회지 Vol.4 No.2
The objective of this clinical study is to present a new method of preloading a reconstruction at the time of fixation. Traditional concepts of isometry and graft tension on a relatively short graft caused overtensioning of ACL grafts and resulted in erratic healing and ACL loosening. In order to prevent the problem of stretching out of the ACL grafts, 1/3 bone-Achilles tedon autograft, 11 cm in length was used for the ACL graft. Bone block of bone-Achilles tendon autograft was fixed in the tibial tunnel with a self-locking method and femoral fixation was done with 100 Newtons of graft force using modified Bunnel wire suture technique over the two femoral screws. The total strain did not exceed 7 %. Of the 100 cases of bone-Achilles tendan reconstruction 40 cases (group II) were done with 100 Newtons of graft force setting. KT- 1000 measurements have been used to document graft tensioning. The immediate postoperative right-left difference was -3 millimeters which remained -1 millimeter after one year of remodelling. The graft foce-setting group (group Il) resulted in more consistent results. Graft tension could be maintained in full range of knee motion and pivot shifting was not noted. Lachman test was negative in all force setting group and only 3 cases of mild anterior drawer signs were noted with concomittant mild pivot gliding. Early knee motion exercise after third day of operation was possible and full extension was obtained in a week. Maintenance of graft tension was important to prevent residual laxity. Both the graft length and thickness was essential to survive the strain of preload and knee motion.
정형외과영역에서 Nimesulide^(�)의 임상적 관찰
조덕연,유병용,이종범 中央醫學社 1991 中央醫學 Vol.56 No.11
Nimesulide is known to be highly effective on various painful conditions and low incidence oK gastrointestinal disturbance after medication and would logically be applied in orthopaedic field. A clinical study was carried out in 30 patients who were in painful conditions. The patients received daily dose of 200 mg Nimesulide for ten days. Nimesulide was proved to have alleviation and/or elimination of pain in 87 % of them all. Side effects were not noted in all patients. The result of this study has shown that Nimesulide is an effective and safe analgesic and worthy of clinical utility.