경골 근위부 종양에서 인공 삽입물 사용시 슬개골 전적출술이 관절기능 회복에 미치는 영향

박일형,김재도,인주철,전인호,Park, Il-Hyung,Kim, Jae-Do,Ihn, Joo-Chul,Chun, In-Ho 대한근골격종양학회 1996 대한골관절종양학회지 Vol.2 No.1

The purpose of this study is a comparative evaluation of range motion, especially extension deficit between the group of total patellectomy and that of intact patella, after reconstruction of the patellar tendon in the prosthetic replacement of a proximal tibia. Between 1990 and 1994, 15 patients who had a primary malignancy on proximal tibia were operated on. All patients were evaluated clinically and radiographically. Two patients were excluded because one had a deep infection treated with arthrodesis of the knee and the other was a composite allograft. The mean follow-up of the 13 patients was 27 months(15-47), including 10 osteosarcomas, 1 chondrosarcoma, 1 malignant fibrous histiocytoma and 1 malignant giant cell tumor. Eleven patients had a resection of the proximal tibia and 2 had an extracapsular total knee resection with distal femur. Reconstruction of the defect was done in 8 cases with a custom-made Link Endo-Model Total Rotation Knee Joint Prosthesis, and in 5 with How Medica Modular Resection System (HMRS). We used two methods to reconstruct the ligamentum patellae. Fixation of the patellar tendon to the prosthesis only with suturing and/or stapling(group SS) was done in 7. Transposition of gastrocnemius muscle to enhance fixation and to cover the prosthesis(group TG) was done in 6. Regardless of fixation methods, total patellectomy was done in 5 either to lengthen the patellar tendon or to make primary skin closure easier or for both. In 8 cases, patella was left intact or resurfaced with polyethylene prosthesis. Active extension was measured while the patient was in a sitting position. There is no statistically meaningful difference in terms of extension deficit (Wilcoxon rank test, p=0.8800) between patellectomy group and intact patella group, and between group of fixation only with suturing and that of gastrocnemius transposition. Two cases of extension deficit over 30 degree were seen in group SS and in the group of intact patella. Conclusively, total patellectomy could be an option without increasing the risk of extension deficit when primary skin closure is difficult or patellar tendon is a little bit short to be fixed. There is no rating in the Enneking system of functional evaluation that this finding into consideration.

대퇴골 원위부 골간단의 피질골 결손에 대한 방사선학적 분류 및 그에 따른 임상적 경과관찰

박일형,오창욱,민우기,Park, Il-Hyung,Oh, Chang-Wug,Min, Woo-Kie 대한근골격종양학회 1999 대한골관절종양학회지 Vol.5 No.1

Over 60 cases were enlisted, but only 31 cases among 24 patients were eligible with a minimum follow-up of 1 year and complete medical documents with imaging data. There were 18 boys and 6 girls, and 7 patients had bilateral lesions. The age of the patients ranged from 2 to 20 years(mean:10.5 years). At their first visit, most lesions had a highly characteristic location and radiographic appearance of radiolucent lesion(s) ranging from 1 to 3cm, except for one case of 5.5 cm in the posteromedial comer of distal femoral metaphysis. The margins were generally well-defined, although some were ill-defined. After reviewing our cases from the viewpoint of clinical course and radiographic patterns, we divided these lesions into two types. Type I is the osteolytic lesion excavated into the posteromedial aspect of the distal femur without cortical defect; and type II is the buldged out lesion of the femur with cortical irregularity into the surrounding soft tissues. Both types have distinctive clinical courses. Type I lesions were easy to make a definite diagnosis with plain radiographs alone, but in type II, it was sometimes very difficult to differentiate it from malignant tumors or chronic localized osteomyelitis. For this lesion, Gd-enhanced MRI was the most effective method for differential diagnosis. In this study, biopsy was not necessary to confirm the diagnosis. Clinical symptoms of type I were very minor or even absent. Many of them were accidentally found after minor trauma around the knee joint. Clinical symptoms disappeared far earlier than radiographical lesions. No treatment such as restriction of activity or drugs was necessary. For type II, the clinical symptoms were more accentuated and lasted longer, and it was necessary to restrict the activity for a certain period in many cases. However, all were self-limited.

생체골의 열전도성 및 열처리된 골의 염전력 변화에 대한 실험적 연구

박일형,김신근,신동규,인주철,Park, Il-Hyung,Kim, Sin-Gun,Shin, Dong-Kyu,Ihn, Joo-Chul 대한근골격종양학회 1995 대한골관절종양학회지 Vol.1 No.1

인체골 4 시편(specimen)과 돼지 경골 25쌍을 이용하여, 생체골의 열전도성 측정과 열처리후 열처리온도와 시간에 따른 골의 염전력을 실험한 결과를 요약하면 다음과 같다. 인체골에 있어서 골수강을 제거하지 않고 $60^{\circ}C$의 항온식염수에서 열처리하면, 골심부의 온도가 $20^{\circ}C$에서 $58^{\circ}C$에 도달하는데 소요된 시간은 경골근위부가 32분 50초, 대퇴골 원위부가 30.분, $80^{\circ}C$ 항온조에서는 경골근위부가 12분 50초, 대퇴골 원위부가 11분 10초 소요되었다. 돼지 경골간부의 피질골내부(endosteum)에 열전대를 부착하고 뼈 양끝을 밀봉하여 같은 실험을 행한 결과 $50^{\circ}C$까지는 시간에 비례해서 일정한 비율로 온도상승이 이루어 졌으며, $20^{\circ}C$에서 $58^{\circ}C$에 이르는 시간이 $60^{\circ}C$ 항온조에서는 7분, $70^{\circ}C$에서는 3분 30초, $80^{\circ}C$에서는 2분이었다. 따라서 임상에서 골수강을 제거 후 장골의 간부(shaft) 만을 항온조에 달굴때는 골구강내에도 데워진 심염수로 가득차게 되므로 상기 시간의 절반이 못되는 짧은 시간내에 피질골의 내부가 $58^{\circ}C$에 이르리라고 판단되었다. 골수강을 소파하지 않은 돼지 경골을 각각 4쌍씩 우측만을 $60^{\circ}C$ 35분, $80^{\circ}C$ 15분 열처리한 후 실험군의 최대염전력은 대조군과 비교할 때 +7.0%, -5.1%, -3.2%, -4.2%의 변화가 있었고, $80^{\circ}C$ 15분 열처리후는 -4.3%, -3.8%, -1.4%(1예는 실험 오류로 제외됨)의 변화가 있었다. 골수강을 완전 제거한 되재 경골을 각각 4쌍씩 우측만을 $60^{\circ}C$, $70^{\circ}C$, $80^{\circ}C$에서 15분 열처리 후 실험군의 최대염전력은 대조군과 비교할 때 -3.4%, -4.2%, -0.7%, +2.7%의 변화가 있었고, $70^{\circ}C$ 15분 열처리후는 -2.8%, -3.9%, -2.1%(1예는 실험 오류로 제외됨)의 변화가 있었으며, $80^{\circ}C$ 15분 열처리후는 +5.2%, -4.4%, -2.9%, -0.3%의 염전력 변화가 있었다. 그러므로 골수강을 제거하지 않고 $80^{\circ}C$ 35분, $60^{\circ}C$ 15분 열처리 하거나, 골수강을 완전소파 후 $60^{\circ}C$ 15분, $70^{\circ}C$ 15분, $80^{\circ}C$ 15분 열처리해서는 각군사이에 염전력의 유의한 차이는없었다. 이상의 결과로 돼지 경골의 경우 $60^{\circ}C$ 항온에서는 35분까지, $80^{\circ}C$이하의 항온에서는 15분까지 열처리하여도 골강도에는 거의 영향이 없는 것으로 나타났다. In countries where confucianism is popular, it is extremely hard to get fresh cadaver bone for allograft. Therefore in Korea, the reimplantation of resected autoclaved autogenous bone segments has been increasingly performed for limb reconstruction of extremities with malignancies. To preserve the bone morphogenetic protein and mechanical strength of heated bone, many studies have reported that pasteurization of bone is far better than autoclaving over $100^{\circ}C$. Based on this assumption, replacement with a pasteurized autogenous bone graft after resection of a malignant bone tumor was deemed feasible for reconstruction. However, little is known about how high a temperature and how much time for pasteurization is needed to make tumors completely necrotic and to maintain the mechanical strength of bone. Consequantly, experimental studies were carried out to test heat conductivity of human bone and torsional strength of porcine tibia after pasteurization. First, two pairs of human proximal tibia and distal femur were used. We used T-type thermocoples to check core temperature of the bone and a computerized data acquisition system to record results. Without reaming of the medullary cavity, in a $60^{\circ}C$-thermostatic saline tub, it took 32 minutes and 50 seconds to raise the core temperature of human proximal tibia from $20^{\circ}C$ to $58^{\circ}C$, and 30 minutes for distal femur. In a $80^{\circ}C$ saline tub, it took 12 minutes and 50 seconds for proximal tibia, and 11 minutes and 10 seconds for distal femur. In contrast, using porcine tibia whose cortical thickness is similar to that of human tibia, after reaming of the medullary canal, it took less than 3 minutes and 30 seconds in a $60^{\circ}C$ saline tub, less than 1 minute and 45 seconds in a $70^{\circ}C$ tub, and less than 1 minute in a $80^{\circ}C$ tub to elevate core temperature from $20^{\circ}C$ to $58^{\circ}C$. Second, based on data of the heat conductivity test, we compared the torsional strength before and after pasteurization. Twenty matched pairs of porcine tibia were used, The left one was used as a non-heated control group and the right one as a pasteurized experimental group. Wighout reaming of the medullary cavity, there was no statistical difference in torsional strength between the pasteurization of the $60^{\circ}C$-35minute and of $80^{\circ}C$-15minute. With reaming, we also found no statistical difference among pasteurization of $60^{\circ}C$-15 minute, of $70^{\circ}C$-15 minute, and of $80^{\circ}C$-15 minute groups. In conclusion, reaming of the medullary canal is very helpful in saving pasteurization time. And, in a $60^{\circ}C$ saline tub, no significant weakness in torsional strength occurs with pasteurization of the bone for up to 35 minutes. Also no significant weakness in torsional strength occurs with an exposure of 15 minutes to the $80^{\circ}C$ saline tub.

소병술후 동시에 시행한 동종 해면골 이식술로 치료한 만성 국소형 골수염

박일형(Il Hyung Park),인주철(Joo Chul In),김도헌(Do Heon Kim) 대한정형외과학회 1998 대한정형외과학회지 Vol.33 No.3

논문 : 재현의 폭력과 체험으로서의 연극: 사라 케인의 『폭파』

박일형 ( Il Hyung Park ) 한국영미문학페미니즘학회 2004 영미문학페미니즘 Vol.12 No.1

보안 인지 및 실천 현황 분석을 통한 대학 연구정보보안 수준 제고 방안

박일형(Il-hyung Park),김성우(Seong-woo Kim),서승우(Seung-woo Seo) 한국정보보호학회 2010 정보보호학회논문지 Vol.20 No.2

대학은 국가적으로 연구개발비 및 연구인력 측면에서 큰 비중을 차지하고 있는 핵심연구기관임에도 블구하고 연구정보보안에 대한 투자가 소홀하여 연구정보 유출이 우려되고 있는 것이 현실이다. 이와 관련, 본 논문에서는 연구정보 유출을 예방하기 위한 노력의 일환으로 대학 구성윈의 보안 인지수준과 실천수준을 분석하고 대학내 연구정보보안 수준 제고를 위한 구체적 방안을 제시한다. 이를 위해 먼저 대학 구성원을 대상으로 실시한 설문조사 결과를 분석하여 연구정보보안 및 보안의식에 관련된 현황을 파악한다. 이를 바탕으로 상관관계분석, 일원배치 분산분석, 다중회귀분석 등 통계분석을 실시하여 정보보안의식 및 보안실천수준, 전임교원 보안수준, 연구실 정보보안 관리절차와 같은 문제점들이 존재함을 보인다. 마지막으로 분석결과를 기반으로 교육·홍보를 통한 보안지식 및 의식 개선, 연구책임자 의무사항을 포함하는 연구실 보안관리 규정 제정, 정보유출방지·출입자 통제 솔루션 등의 보안수준 향상을 위한 대책들을 제시한다. Universities are one of leading R&D institutes, however, their scarce security investment allows research information to leak outside. This paper proposes methods for improving security level of academic institutes to protect research information by analyzing security awareness and activities. To do that, we verified the current status of information security and awareness level by analyzing the survey which was conducted for a member of Seoul National University. As a result of statistical analysis using correlation, analysis of variance, multi regression and so on, we concluded that it is essential to improve security awareness, activities, professor's security level and management process for research labs. Thus, we suggest the following methods, security awareness and knowledge development through education, security management for research labs through provision, introduction of data protection softwares and physical control of visitors which are to be adopted to improve security level.

언어의 한계: 베케트와 비트겐슈타인

박일형 ( Il Hyung Park ) 한국현대영어영문학회 2016 현대영어영문학 Vol.60 No.2

This thesis is a conjecture on some of the common themes of interest that Beckett must have found in Wittgenstein. Rather than raise Wittgenstein’s philosophy as yet another ‘theory’ to read Beckett’s work, it is more of an attempt at materializing some of the common themes of understanding between the two writers. The problem lies in the resistance against the metalanguage in Beckett’s work, but more seriously with the resistance of Wittgenstein’s philosophy against any attempt at theorizing. For Wittgenstein, philosophy was not a body of doctrine but an “activity”. The most common theme that unites the two writers can be summarized as the ‘limits of language’. This is the theme of the early work of Wittgenstein, and for Beckett, the theme runs through his entire oeuvre. The limits of language discussed in Wittgenstein’s Tractatus is the disparity between what can be said and what cannot be said. For Wittgenstein, the limits of language is tantamount to the limits of the world, thinking and meaning and the process of delineating the limits inherently involves the paradoxical process of thinking about the unthinkable. Such an examination of the limits is also one of the key themes in Beckett’s work. The space in Beckett’s plays calls for not simply a choice between either the inside or the outside of the limits but an annotation upon the contradictory relationship between the inside and the outside. The thesis will concentrate on the shared interest of the two writers on the issue of ‘contradiction’ or ‘contradictory forms’ within the context of the limits of language. (Hongik University)

기식(寄食)의 연쇄 : 쥐와 모더니즘 문학 Rats and Modernism

박일형 ( Il Hyung Park ) 한국영어영문학회 2007 영어 영문학 Vol.53 No.1

소모로서의 궁핍: 베케트의 빈궁문학

박일형 ( Il Hyung Park ) 한국영미문화학회 2010 영미문화 Vol.10 No.2

Representation of destitution may be considered as an expression of a social desire toward forging a bond or solidarity with the impoverished. However, political and ethical demands of the solidarity force the formulaic framework structuring the form of representation to its limits. The thesis aims to examine the responses to such demands within the tradition of modernist literature that can be traced from Charles Baudelaire, Knut Hamsun to Franz Kafka and that somehow culminates with Samuel Beckett, and to analyze how the issue of destitution that weaves through Beckett`s works criticizes and inherits such a heritage. Whereas destitution in 19th century Realism is structurally fixed and its potential for change is inherently excluded, for these writers, destitution is no longer the state of rigid reality in which any possibility is limited. It is destitution as an imperative that calls for exploitation of possibilities that can be recuperated from the impoverished condition of destitution. What these writers consistently resist against is destitution that leads to compensation and reward. Since occupying a superior position toward the other as the subject of description or sympathy can be seen as one form of profit or reward, they have persistently pursued absolute solitariness and austere conditions rather than prematurely simulating a sense of solidarity and community. The ultimate goal of destitution as an imperative is to pursue destitution in order to worsen it by identifying and then excluding and expending possessions and assets to a state of penury. This is a paradoxical process that opens up the realm of possibilities of destitution and redefines it as abundance and wealth. Destitution for Beckett as seen in the writers above is the objective of literature. But, what he focuses on is to amplify the shreds of economic world that still remain in a state of poverty and to reveal extreme poverty as a state of odd affluence and to transform it into a pursuit of accumulation and profit. One of his famous axioms, “less is more", contains the essence of such a paradoxical strategy. In a sense, such approach is a twist on the strategy that identifies and uses any remaining potential hidden in destitution as was pursued by other writers. It also expands on the imagination of the destitute described by Hamsun. But Hamsun and Beckett are diametrical opposites. Unlike Hamsun, Beckett does not link imagination with a sense of guilt. Imagination is not intended to overcome the destitute reality nor to culminate in artistic martyrdom as in the case of Kafka`s hunger artist. The imagination of the impoverished in Beckett is simply a hilarious game and not an escape that ends in a sense of guilt. This game formulates a “rhetorical question" or derision at the ironical situation where the pursuit of hunger and art as the disinterestedness has been turned into symbolic capital. It is inherently a fundamental critique at the aestheticization of destitution that has been pursued by Modernism. Beckett`s efforts at divulging falsehood inherent in non-profit acts such as charity, donation and hospitality are dissections of social fictions in which aestheticization of destitution remains a part of the whole.

미성숙 돼지 장골에서의 페놀 소작술과 냉동수술의 골괴사 범위에 대한 비교

박일형(Il Hyung Park),인주철(Joo Chul Ihn),이상욱(Sang Wook Lee),손경락(Kyung Rak Sohn),전인호(In Ho Chun) 대한정형외과학회 1997 대한정형외과학회지 Vol.32 No.1