파쇄골 이식술을 이용한 안정된 무시멘트 비구컵 주위의 골융해에 대한 치료

서유성,임강철,권혁룡,임수재,박종석,이병일 대한고관절학회 2003 Hip and Pelvis Vol.15 No.3

슬라이딩 관측기를 갖는 가변구조제어기에 의한 도립진자의 운동제어

서용석(Yong-Seok Suh),유완식(Wan-Sik You),김영석(Young-Seok Kim) 대한전기학회 1994 대한전기학회 학술대회 논문집 Vol.1994 No.7

대퇴골 경부 골절 치료 후 발생한 합병증에서 후방피질골 분쇄 의의

서유성,정석봉,박종석,임수재,이병일 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목적 : 대퇴골 경부 골절이 발생하여 수술적 치료를 결정하고 시행하려 할 때 일차적으로 단순 내고정으로 할 것인가, 적극적 치료를 시행할 것인가는 명확한 객관적 기준보다는 다소간의 수술자의 경험과 선호도에 따라 결정되는 실정이기에 일차적 내고정을 시행하여 수술법 선택시 중요성을 부과할 수 있는 지침 일부를 마련 하고자 한다. 대상 및 방법 : 내고정 후 발생한 불유합과 무혈성 괴사, 내고정의 소실 등의 발현이 있는 환자를 대상으로 후향적으로 발생 가능한 인자를 분석하였다. 결과 : 대퇴 경부 골절을 내고정 시행하였을 경우에 합병증의 발생은 견고한 내고정의 유지에 비중을 두고 있고 다른 인자로 골절의 형태, 골다공증, 고정의 위치를 중요하게 생각하고 있지만 고정의 소실이 없어도 합병증이 발생하는 경우 골절의 형태는 후방 피질골 분쇄 골절이 동반되고 있었다. 결론 : 저자들이 시행한 환자의 분석 결과는 대퇴골 경부 골절을 일차적으로 치료시 단순 내고정과 다른 적극적 치료와의 선택의 경우에 대퇴골 후방 피질골 분쇄 유무에 비중을 두어 결정해야 할 것으로 사료된다. Purpose : When a surgeon carries out an operative treatment on a patient who has fractures of the femoral neck, he decides to do either the internal fixation for bony union of the aggressive treatment according to his experience and preparation, not according to the objective standard. The aim of this retrospective study is to prepare a guideline for the operative method. Materials and Methods : We analyse possible factors of the patient who has nonunion, avascular necrosis and loss of fixation after doing internal fixation in femoral neck fractures. Results : In this treated case of femoral neck, the appearance of complications are influenced by the maintenance of internal fixation, shape of fractures, osteoporosis, and the position of fixations; but in the complicated cases without the loss of fixation, the shape of fractures always have posterior cortical communition. Conclusion : When we choose between simple fixation and aggressive treatments in cases of fractures of the femoral neck, we must treat according to the patient’s condition, displacement of the fracture, operative technique and existence of a posterior cortical comminuted fracture.

이성분 혼합기체의 동시농축에 관한 연구

徐成燮,黃裕晳 弘益大學校 科學技術硏究所 1995 科學技術硏究論文集 Vol.6 No.-

Four cases of PSA process which includes rinse step following feed step of conventional PSA process were studied with the aim of simultaneous production of two components from gas mixture. Restrictions on PSA process and the effects of pressure, feed concentration and gas velocity on recovery have been obtained from material balances on adsorption column using uncoupled linear isotherms and local equilibrium model. Recoveries of case2 and case4 with no waste were always 1 regardless of variation of Z₂ where two shock waves meet. In other cases, recoveries were dependent on separation factor β, and were 1 for Z₂=1.

Clinical and Radiologic Outcomes among Bipolar Hemiarthroplasty, Compression Hip Screw and Proximal Femur Nail Antirotation in Treating Comminuted Intertrochanteric Fractures

( You Sung Suh ),( Jae Hwi Nho ),( Seong Min Kim ),( Sijohn Hong ),( Hyung Suk Choi ),( Jong Seok Park ) 대한고관절학회 2015 Hip and Pelvis Vol.27 No.1

Purpose: In comminuted intertrochanteric fractures, various operative options have been introduced. The purpose of this study was to determine whether there were differences in clinical and radiologic outcomes among bipolar hemiarthroplasty (BH), compression hip screw (CHS) and proximal femur nail antirotation (PFNA) in treating comminuted intertrochanteric fractures (AO/OTA classification, A2 [22, 23]) Materials and Methods: We retrospectively evaluated total 150 patients (BH, 50; CHS, 50; PFNA, 50) who were operated due to intertrochanteric fractures from March 2010 to December 2012 and were older than 65 years at the time of surgery. We compared these three groups for radiologic and clinical outcomes at 12 months postoperatively, including Harris Hip Score, mobility (Koval stage), visual analogue scale and radiologic limb length discrepancy (shortening). Results: There was no statistical significance among three groups in clinical outcomes including Harris Hip Score, mobility (Koval stage), visual analogue scale. However, there was significant differences in radiologic limb discrepancy in plain radiographs at 12 months postoperatively (radiologic shortening: BH, 2.3 mm; CHS, 5.1 mm; PFNA, 3.0 mm; P=0.000). Conclusion: There were no clinical differences among BH, PFNA, and CHS in this study. However, notable limb length shortening could be originated during fracture healing in osteosynthesis, compared to arthroplasty (BH<PFNA<CHS).

Hip Fracture Surgery without Transfusion in Patients with Hemoglobin Less Than 10 g/dL

You-Sung Suh,Jae-Hwi Nho,Jonghyeon Seo,Byung-Woong Jang,Jong-Seok Park 대한정형외과학회 2021 Clinics in Orthopedic Surgery Vol.13 No.1

Background: Hip fracture surgery is associated with blood loss, which may lead to adverse patient outcomes. The hemoglobin level declines gradually in most hip fracture cases involving femoral neck fractures and intertrochanteric fractures. It decreases further after hip fracture surgery due to perioperative bleeding. We developed a protocol, which avoids transfusion in hip fracture surgery, and reviewed the hemodynamic outcomes of patients with hemoglobin less than 10 g/dL without transfusion. Methods: From 2014 to 2019, we retrospectively recruited 34 patients with hip fractures and a hemoglobin level less than 10 g/dL, who refused to undergo transfusion. There were 19 patients with femoral neck fractures and 15 patients with intertrochanteric fractures. Our patient blood management (PBM) protocol involving 4,000 U erythropoietin (3 times a week) and 100 mg iron supplement (every day) was applied to all included patients. Intraoperatively, a cell saver and tranexamic acid were used. Postoperatively, the protocol was maintained until the patients’ hemoglobin level reached 10 g/dL. We evaluated the feasibility of our protocol, perioperative complications, and hemodynamic changes. Results: Nineteen patients with femoral neck fractures underwent bipolar hemiarthroplasty and 15 patients with intertrochanteric fractures underwent internal fixation with a cephalomedullary nail. The mean hemoglobin level was 8.9 g/dL (range, 7.3–9.9 g/dL) preoperatively, 7.9 g/dL (range, 6.5–9.3 g/dL) immediately postoperatively, 7.7 g/dL (range, 4.3–9.5 g/dL) on postoperative day 1, 7.4 g/dL (range, 4.2–9.4 g/dL) on postoperative day 3, 8.1 g/dL (range, 4.4–9.7 g/dL) on postoperative day 5, 8.5 g/dL (range, 4.5–9.9 g/dL) on postoperative day 7, and 9.9 g/dL (range, 5.7–11.1 g/dL) on postoperative day 14. The average intraoperative bleeding was 206.2 ± 78.7 mL. There was no case associated with complications of anemia. Conclusions: Hip fracture surgery in patients with hemoglobin less than 10 g/dL was feasible without the need for transfusion using our PBM protocol in 34 patients. Using this protocol, the operation was conducted safely despite the anemic condition of patients with fractures whose hemoglobin was less than 10 g/dL.

불안정성 대퇴 전자간 골절에서 양극성 고관절 반치환술 시 대전자부 골편 고정 방법의 비교

서유성 ( You Sung Suh ),최상욱 ( Sang Wook Choi ),박종석 ( Jong Seok Park ),임수재 ( Soo Jae Yim ),신병준 ( Byung Joon Shin ) 대한고관절학회 2008 Hip and Pelvis Vol.20 No.2

목적: 양극성 고관절 반치환술로 대퇴 전자간 골절을 치료하는 경우, 대전자 골편을 고정하는 3가지 방법의 임상적 및 방사선학적 결과를 평가하고자 하였다. 대상 및 방법: 46예를 대상으로 하여, 고정 방법은 1군) 8자형 강선 결박술(18예), 2군) 원형 강선 결박술(23예), 3군) 인장 대 강선 결박술(11예)이였다. 강선의 파손과 골편의 전위 여부로 방사선학적 평가를 하였고, Merle d’Aubigne 기준에 따라 기능적 평가를 하였다. 결과: 골편 전위 발생율은 1 군 22.2%, 2 군 52.2%, 3군 9.1%로, 군 간 유의한 차이가 있었다(p=0.022). 강선 파손 발생율은 27.8%, 13.0%, 9.1%로 유의한 차이가 없었다. 1군 78.6%, 2군 82.4%, 3군 88.9%이 Merle d`Aubigne 기준의 양호 이상의 기능적 결과를 보였다. 결론: 대전자 골편을 고정하는데 인장 대 강선 결박술이 더 유용한 방법으로 사료된다. Purpose: To evaluate clinical and roentgenographic outcomes after bipolar hemiarthroplasty utilizing three different greater trochanteric fragment fixation methods for intertrochanteric fracture repair. Materials and Methods: Forty-six hips (Boyd-Griffin type II: 44, type IV: 2) that had undergone greater trochanteric fragment fixation through bipolar hemiarthroplasty were evaluated at a minimum of 1 year following surgery. The fixation groups were: 1) figure of 8 wiring (18 cases), 2) cerclage wiring (23 cases), and 3) tension band wiring (11 cases). The roentgenographic results were evaluated in terms of fragment migration and wire breakage. The functional results were evaluated according to the hip rating scale of Merle d`Aubigne. Results: The rate of fragment migration was 22.2% in group 1, 52.2% in group 2, and 9.1% in group 3, and there was a statistically significant difference among the groups (p=0.022). The rate of wire breakage was 27.8% in group 1, 13.0% in group 2, and 9.1% in group 3, but there was no statistically significant difference among the groups. According to the Merle d`Aubigne scale, 78.6% of the repairs in group 1, 82.4% of the repairs in group 2, and 88.9% of the repairs in group 3 were rated as excellent, very good, or good. Conclusion: The tension band wiring method is more useful than the figure of 8 and cerclage wiring methods for fixing the greater trochanteric fragment during bipolar hemiarthroplasty.

인공관절 치환술 후 CRP 수치를 이용한 급성 감염의 예측

서유성(You-Sung Suh),최형석(Hyung-Suk Choi),노재휘(Jae-Hwi Nho),원성훈(Sung-Hun Won),최종원(Jong-Won Choi),이재철(Jae-Chul Lee),박종석(Jong-Seok Park) 대한정형외과학회 2012 대한정형외과학회지 Vol.47 No.2

목적: 인공관절 치환술 후 4주 이내의 급성 감염에서 측정된 C-반응성 단백(C-reactive protein, CRP)의 변화 양상을, 감염이 없었던 인공관절 환자군과 비교하여 차이점을 분석하고자 하였다. 대상 및 방법: 하지 인공관절 치환술 후 4주 이내에 발생한 급성 술 후 감염 환자 33예(고관절: 26예, 슬관절: 7예)를 대상으로 하여, CRP를 측정하여 같은 기간 감염이 없었던 환자군 50예(고관절 25예, 슬관절 25예)의 CRP 변화 양상과 비교하고 분석하였다. 결과: 비감염군에서는 술 후 2-3일째 CRP의 급격한 상승 후 수술 3주째까지 지속적인 감소 추세를 나타내지만, 심부 감염군에서는 술 후 13일경, 천부 감염군에서는 술 후 10일경에 CRP의 상승이 나타나는 bimodal curve를 나타내었다. 결론: 인공관절 치환술 후 CRP가 재상승하는 양상(bimodal pattern)인 경우 급성 술 후 감염을 의심하여 적극적인 조기 검사 및 치료를 통해 효과적인 치료를 할 수 있었다. Purpose: C-reactive protein (CRP) has been shown to be useful in the diagnosis of periprosthetic infection. This study analyzed the serial CRP measurements in patients with acute postoperative infection by comparing with the serial CRP measurements in patients without postoperative infection. Materials and Methods: From 2004 to 2009, 33 patients with acute postoperative infection developed within 4 weeks of surgery were enrolled including 26 cases of hip arthroplasty and 7 cases of total knee arthroplasty. We measured the serial CRP levels in the groups with both deep infection and superficial infection. The CRP measurements in the group without postoperative infection were also analyzed based on the changing pattern of CRP. Results: In the non-infected group, CRP level sharply increased in 2-3 days postoperatively and it showed a continuing downward pattern till the third postoperative week. However, a bimodal curve pattern was obtained in the groups with both deep and superficial infection. The group with deep infection showed a second increase in CRP level around the 13th postoperative day and the group with superficial infection showed a second increase in CRP level around the 10th postoperative day. Conclusion: If there are bimodal patterns of CRP after arthroplasty, acute postoperative infections can be suspected. We can treat them effectively without delay by detection of bimodal increase in CRP.

Prevalence of Human Papilloma Virus Infections and Cervical Cytological Abnormalities among Korean Women with Systemic Lupus Erythematosus

Lee, You-Hyun,Choe, Jung-Yoon,Park, Sung-Hoon,Park, Yong-Wook,Lee, Shin-Seok,Kang, Young-Mo,Nam, Eon-Jeong,Park, Won,Kwon, Seong-Ryul,Bae, Sang-Cheol,Kim, Yun-Jung,Suh, Chang-Hee,Kim, Hyoun-Ah,Hur, Na The Korean Academy of Medical Sciences 2010 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.25 No.10

<P>We performed a multicenter cross-sectional study of 134 sexually active systemic lupus erythematosus (SLE) patients to investigate the prevalence of and risk factors for high risk human papilloma virus (HPV) infection and cervical cytological abnormalities among Korean women with SLE. In this multicenter cross-sectional study, HPV testing and routine cervical cytologic examination was performed. HPV was typed using a hybrid method or the polymerase chain reaction. Data on 4,595 healthy women were used for comparison. SLE patients had greater prevalence of high-risk HPV infection (24.6% vs. 7.9%, <I>P</I><0.001, odds ratio 3.8, 95% confidence interval 2.5-5.7) and of abnormal cervical cytology (16.4 vs. 2.8%, <I>P</I><0.001, OR 4.4, 95% CI 2.5-7.8) compared with controls. SLE itself was identified as independent risk factors for high risk HPV infection among Korean women (OR 3.8, 95% CI 2.5-5.7) along with ≥2 sexual partners (OR 8.5, 95% CI 1.2-61.6), and Pap smear abnormalities (OR 97.3, 95% CI 6.5-1,456.7). High-risk HPV infection and cervical cytological abnormalities were more common among Korean women with SLE than controls. SLE itself may be a risk factor for HPV infection among Korean women, suggesting the importance of close monitoring of HPV infections and abnormal Pap smears in SLE patients.</P>

비구부 재치환술후 발생하는 탈구의 위험 요인

서유성 ( You Sung Suh ),소재완 ( Jae Wan Soh ),박종석 ( Jong Seok Park ),임수재 ( Soo Jae Yim ),이병일 ( Byung Ill Lee ) 대한고관절학회 2006 Hip and Pelvis Vol.18 No.3

목적: 일차성 인공 고관절 전치환술후 여러 가지 원인에 의해 재치환술을 시행 받은 환자중 비구컵의 교체 없이 폴리에틸렌 삽입물 교환만 시행 받은 환자에서 탈구가 발생하는 경향이 있어 그 원인과 예방 방법에 대해 고찰해 보고자 한다. 대상 및 방법: 일차성 인공 고관절 전치환술후, 비구부만 재치환술을 받은 28예를 대상으로 하였다. 28예중 남자가 20예, 여자가 8예였고, 재치환술시 평균 연령은 55세였으며, 28예 모두 후외방 도달법으로 수술하였다. 17예에서 비구컵, 폴리에틸렌 삽입물과 인공 대퇴 골두 모두를 교환하였고, 10예에서 폴리에틸렌 삽입물과 인공 대퇴 골두만 교환하였으며, 1예에서 폴리에틸렌 삽입물 교환만 하였다. 결과: 재치환술을 시행한 28예 중에서 총 7예에서 탈구가 발생하였다. 7예 모두 비구컵 교체 없이 폴리에틸렌 삽입물과 인공 대퇴 골두만 교체한 경우였다. 또한 탈구가 발생한 7예 모두에서 재치환술후 올바른 자세 유지가 안되면서 조기 체중 부하를 시행하는 등 환자의 협조가 안되었다. 결론: 고관절 재치환술의 방법중 저자들은 비구컵 교체 없이 폴리에틸렌 삽입물과 인공 대퇴 골두만 교체한 경우 새롭게 탈구가 발생하는 경향이 있음을 발견하였는데, 그 주원인으로는 부적절한 연부 조직 장력과 고관절부의 이완 등으로 생각하고, 따라서 재치환술시 대퇴 경부 길이를 증가시키거나, 가장자리가 상승된 폴리에틸렌 삽입물을 사용하거나, 비구컵을 적절한 위치로 재조정하는 것이 필요하고, 또한 재치환술후 조기에 고관절 외전 보조기를 착용하는 것도 탈구의 위험성을 낮추는 방법이라 사료된다. Purpose: To analyze the causes and to prevent dislocations of the hip joint that occur in patients who underwent revisions of total hip arthroplasties by changing only the polyethylene liners and femoral heads, subsequent to primary total hip arthroplasties. Materials and Methods: We evaluated 28 patients who underwent acetabular component revisions of total hip arthroplasties subsequent to primary total hip arthroplasties. The average age of the patients was 55 years old and all 28 patients had operations through the posterolateral approach. In 17 of the cases, the acetabular cups, polyethylene liners, and femoral heads were changed; in 10 cases, just the polyethylene liners and femoral heads were changed; and in 1 case, only the polyethylene liner was changed. Results: We observed 7 cases of hip dislocations that occurred among a total of 28 cases after revisions of total hip arthroplasties. In all 7 cases, the polyethylene liners and femoral heads were changed, but not the acetabular cups. In additional, in all 7 cases of dislocation, the patients were non-compliant and started weight-bearing prematurely after revisions of the total hip arthroplasties Conclusion: We observed new dislocations in the 7 cases in which the polyethylene liners and femoral heads were changed. The main reasons were inadequate soft tissue tension and hip joint laxity. Therefore, it is necessary to increase the neck length, use elevated rim polyethylene liners, readjust the acetabular cups to their optimal positions, and apply hip abduction braces to patients early after revision of total hip arthroplasties in order to lessen the danger of dislocations.