주관절의 초음파 검사

김철홍,이명진,강민수,Kim, Chul Hong,Lee, Myung Jin,Kang, Min Soo 대한정형외과초음파학회 2012 대한정형외과 초음파학회지 Vol.5 No.2

이 종설은 주관절에서의 초음파 검사 방법을 서술하였으며 주관절의 구조물들은 표층에 위치하기 때문에 초음파 사용이 용이하고 동적인 검사와 건 측과의 비교를 쉽게 할 수 있다는 장점으로 인하여 환자의 병변에 대한 많은 정보를 제공해 준다. 주관절에서 초음파 검사는 주관절 주변의 건, 근육, 인대 와 점액낭의 비정상적 형태뿐만 아니라 미세 골절(occult fracture), 주관(cubital tunnel) 내의 척골 신경의 압박 유무도 평가할 수 있다. 향후 주관절의 연부조직 이상을 진단하는 수단으로서의 초음파의 가치는 점점 증가할 것이다. The purpose of this article is review about the use of ultrasonography in the evaluation of the elbow joint. Ultrasonography has several key advantages in elbow joint, including easy assessment of target structure in elbow joint and ability to perform real time dynamic examination and to compare with opposite site. Ultrasonography is easy available to visualize abnormalities affecting tendons, muscles, ligaments, bursae, and occult fractures around the elbow joint and also allows accurate assessment of ulnar nerve in cubital tunnel. The role of ultrasonography will increase further with regards to evaluation of soft-tissue abnormalities of the elbow joint.

요추추간판탈출증군과 단순요통군간의 Current Perception Threshold상의 차이에 관한 연구

김철홍,이병훈,권혜연,임춘우,서정철,윤현민,송춘호,장경전,안창범,Kim Cheol-Hong,Lee Byung-Hoon,Kwon Hye-Yeon,Lim Chun-Woo,Seo Jung-Chul,Youn Hyoun-Min,Song Choon-Ho,Jang Kyung-Jeon,Ahn Chang-Beohm 대한침구의학회 2001 대한침구의학회지 Vol.18 No.6

Objective : The aim of this study is to assess the ability of the CPT test to dignosis radiculopathy in Korean with NeuvalTM CPT database. Method : Electrical stimulation(at 2000, 250, and 5Hz) using Neurometer was applied to the 19 patients who felt back and sciatic pain with herniated intervertevral disc(HIVD) of L-spine, dignosisd by lumbar CT or MRI, and the 33 patients who felt only back or hip or leg pain without HIVD, stenosis, spondylolisthesis which causing radiculopathy. The test sites were toe1, toe3 and toe5 related to L4, L5 and S1 nerve roots. Results : The mean values of the CPT of HIVD group was stiatically lower than LBP group at toe1-250Hz, toe3-2000Hz, 250Hz and toe5-250Hz, 5Hz. The grading CPT score of HIVD group was stastically higher than LBP group at the toe3(L5). The VAS of HIVD group was stastically higher than LBP group. Conclusion : These results suggest that the CPT test can be a valuable testing for diagnosing radiculopathy in Korean. In using CPT test further study is needed for the diagnosis and evaluation of sensory nerve dysfunction in the musculoskeletal disease.

소성온도에 따른 ZnO계 적층형 칩 바리스터의 미세구조와 전기적 특성의 변화

김철홍,김진호,Kim, Chul-Hong,Kim, Jin-Ho 한국세라믹학회 2002 한국세라믹학회지 Vol.39 No.3

소성온도에 따른 ZnO계 적층형 세라믹 칩 바리스터(약칭 MLV)의 미세구조와 전기적 특성의 변화를 조사하였다. 소성온도 1100$^{\circ}$C에서 Ag/Pd(7:3) 내부전극층의 두께가 불균일하게 변화하면서 부분적인 공극이 발생하기 시작하고, 1150$^{\circ}$C에서는 상당한 전극 패턴의 소멸과 박리가 관찰되었다. 950$^{\circ}$C로 소성한 MLV의 경우 누설전류의 열화가 특히 컸는데 이는 미반응의 pyrochlore상이 잔류하여 액상과 천이원소의 균일한 분포가 일어나지 않았기 때문이라 사료된다. 1100$^{\circ}$C 이상의 온도로 소성한 경우에는 바리스터 특성 및 그 재현성의 저하가 관찰되었는데, 이는 내부전극의 소멸, 전극물질과 소체의 반응, 그리고 $Bi_2O_3$의 휘발에 기인한 것으로 보인다. 한편, 950∼1100$^{\circ}$C의 전 소성온도 범위에 걸쳐 온도가 증가할수록 정전용량과 누설전류는 증가하고 항복전압과 피크전류는 감소하였으나, 비선형계수와 클램핑 비는 각각 ∼30 및 1.4로 거의 일정한 값을 유지하였다. 특히 1000∼1050$^{\circ}$C 소성체의 경우 칩 바리스터에 적합한 바리스터 특성이 재현성 있게 나타났다. 결과적으로 Ag/Pd(7:3) 합금은 1050$^{\circ}$C의 동시 소성 온도이하에서는 $Bi_2O_3$를 함유한 대부분의 ZnO계 MLV의 내부전극으로 충분히 사용가능한 것으로 판단된다. Microstructure and the electrical porperties of a ZnO-based multilayered chip-type varistor(abbreviated as MLV) with Ag/Pd(7:3) inner electrode have been studied as a function of firing of temperature. At 1100$^{\circ}$C, inner electrode layers began to show nonuniform thickness and small voids, which resulted in significant disappearance of the electrode pattern and delamination at 1100$^{\circ}$C. MLVs fired at 950$^{\circ}$C showed large degradation in leakage current, probably due to incomplete redistribution of liquid and transition metal elements in pyrochlore phase decomposition. Those fired at 1100$^{\circ}$C and above, on the other hand, revealed poor varistor characteristics and their reproductibility, which are though to stem from the deformation of inner electrode pattern, the reaction between electrode materials and ZnO-based ceramics, and the volatilization of $Bi_2O_3$. Throughout the firing temperature range of 950∼1100$^{\circ}$C, capacitance and leakage current increased while breakdown voltage and peak current decreased with the increase of firing temperature, but nonlinear coefficient and clamping ratio kept almost constant at ∼30 and 1.4, respectively. In particular, those fired between 1000$^{\circ}$C and 1050$^{\circ}$C showed stable varistor characteristics with high reproducibility. It seems that Ag/Pd(7:3) alloy is one of the electrode materials applicable to most ZnO-based MLVs incorporating with $Bi_2O_3$ when cofired up to 1050$^{\circ}$C.

압전소자를 이용한 생체지질 단분자막의 누적특성평가

김철홍,박옥순,장상목,최용성,권영수 ( Chul Hong Kim,Ok Soon Park,Sang Mok Chang,Yong Sung Choi,Young Soo Kwon ) 한국화학공학회 1992 추계학술발표논문집 Vol.- No.-

도플러 초음파 감시하 알렌 검사로 진단한 상지 볼크만 구축 환자의 척골 동맥 협착 - 1례 보고 -

김철홍,하동호,김보건,유성곤,Kim, Chul Hong,Ha, Dong Ho,Kim, Bo Kun,You, Sung Gon 대한정형외과초음파학회 2011 대한정형외과 초음파학회지 Vol.4 No.2

볼크만 구축 환자의 술 전 준비 단계에서 척골 및 요골 동맥에 대한 도플러 초음파 유도 알렌 검사를 시행하여 청각 도플러와 CT-혈관조영술에서는 확인되지 않았던 척골 동맥의 혈류 감소를 인지할 수 있었다. 저자들은 척골 및 요골 동맥에 대한 도플러 초음파 유도 알렌 검사의 유용성에 대한 인식을 높이고자, 그 증례를 문헌고찰과 함께 보고하고자 한다. We had applied Doppler ultrasound guided modified Allen's test for a Volkmann's ischemic contracture patient who had ulnar artery constriction which was not detected with acoustic Doppler and CT-angiogram preoperatively. We report this case of Volkmann's ischemic contracture with brief review of literatures for awareness of the Doppler-ultrasound guided modified Allen's test.

백서에서 Gabapentin 전신투여가 Facial Formalin Test에 미치는 영향

김철홍,백승완,김해규,권재영,김경훈,최성환,Kim, Chul-Hong,Baik, Seong-Wan,Kim, Hae-Kyu,Kwon, Jae-Young,Kim, Kyoung-Hun,Choi, Sung-Hwan 대한치과마취과학회 2003 Journal of Dental Anesthesia and Pain Medicine Vol.3 No.2

Background: Gabapentin is a novel anti-epileptic drug, which is used in clinical practice to treat epilepsy. This drug is also used as an analgesic in pain patients. The antinociceptive effect of this drug was assessed using the formalin test in the rat. Methods: In order to investigate the effects of gabapentin on the trigeminal nerve territory, we injected 0.5% formalin into the upper lip. Adult, male, Sprague-Dawley rats received a $50{\mu}l$ subcutaneous injection of 5% formalin into one vibrissal pad and the consequent, facial grooming behavior was monitored. Consistent with previous investigations using tile formalin model, animals exhibited biphasic nocifensive grooming (phase 1, 0-12 min; phase 2, 12-60 min). Results: The intraperitoneal administration gabapentin 5 minutes prior to the formalin injection led to a significant, dose-dependent reduction in grooming time during phase 2. In high doses, gabapentin also reduced the time of grooming during phase 1. Conclusions: The Intraperitoneal injection of gabapentin has an analgesic effect in the facial formalin rat model and this analgesic effect increases dose-dependently.

근막 통증 증후군의 통증 유발점 주사

김철홍,박진우,Kim, Chul-Hong,Park, Jin-Woo 대한정형외과초음파학회 2014 대한정형외과 초음파학회지 Vol.7 No.2

인체에서 가장 큰 기관인 골격근은 통증과 기능장애를 초래할 수 있는데, 통증 유발점이라는 특징적인 병변을 가지는 근막 통증 증후군이 골격근의 가장 흔한 병적 상황 중의 하나이다. 통증 유발점은 골격근 내의 taut band라고 불리는 띠안에 존재하는 과민한 통증성 국소 병변으로 국소 통증 뿐만 아니라 연관통 및 만성적인 관절운동 제한과도 동반된다. 다양한 치료법들이 시도되었으나 통증 유발점 주사법이 가장 효율적인 치료법으로 사용되고 있으며 이 종설에서는 근막 통증 증후군의 일반적 병인과 통증 유발 주사의 방법에 대하여 소개하고자 한다. Skeletal muscles which are the largest part of human body may develop pain and dysfunction. The myofascial pain syndrome that has trigger points as a unique characteristic is a major cause of morbidity. Trigger points are focal, hyperirritable painful areas located in a taut band of skeletal muscle. They produce local area pain and a referred pattern pain and often accompany chronic joint dysfunction. Various modalities are used to inactivate trigger points in myofascial pain syndrome. Trigger-point injection has been shown to be one of the most effective treatment modality to provide prompt relief of symptoms. This review article presents general concept of myofascial pain syndrome and technique of trigger point injection.

65세 이상의 대퇴 전자간부 골절 환자의 위험인자 및 임상적 결과에 대한 분석

김철홍 ( Chul Hong Kim ),이규열 ( Kyu Yeol Lee ),김성수 ( Sung Soo Kim ),이명진 ( Myung Jin Lee ),왕립 ( Lih Wang ),김현준 ( Hyeon Jun Kim ),강정모 ( Jung Mo Kang ) 대한고관절학회 2013 Hip and Pelvis Vol.25 No.2

목적: 65세 이상의 대퇴 전자간부 골절 환자에서 환자 위험 인자와 임상적 치료 결과와의 관계에 대하여 결과를 분석하였다. 대상 및 방법: 2000년 1월부터 2012년 3월까지 대퇴 전자간부 골절로 내원하여 본원에서 수술을 시행하였던 65세 이상 환자, 321명을 대상으로 하였다. 연령, 성별, 음주 및 흡연 유무, 심혈관계 질환, 뇌혈관계 질환, 술전 혈액 검사 수치 등의 환자 위험 요인을 분석하였으며, 입원 후 수술까지 지연된 기간, 주말 입원 여부, 마취 방법, 수술 시간 등의 수술 전 후 처치에 따른 수술 후 합병증 발생률 및 사망률과의 관계에 대하여 비교 분석하였다. 결과: 환자 위험 요인의 분석에서는 여성의 경우 사망률이 13.0%로 더 높은 것으로 나타났다(P=0.043). 수술 시간이 3시간 이상이었을 경우 사망률 및 합병증 발생률이 각각 29.1%, 20.8%로 더 높은 것으로 나타났으며(P<0.001, P=0.027), 수상 후 수술까지 지연된 시간이 4일 이상 지연된 경우 사망률 및 수술 후 합병증 발생률이 각각 20.1%, 18.8%로 더 높은 것으로 나타났다(P<0.001, P<0.001). 음주 및 흡연 유무, 수술 전 기저질환, 마취 방법, 수술 시간 등의 사망률 및 합병증 발생률은 통계적으로 유의한 차이를 보이지 않았다. 결론: 대퇴 전자간부 골절 환자의 치료에서 환자 위험요인의 중요성에 대해 인지하고, 수술 전후 처치 시에 수술까지의 기간과 마취 방법 등의 조절 가능한 인자들을 조절한다면 수술 후 사망률 및 합병증 발생률을 줄일 수 있을 것이다. Purpose: This study examined therelationship between the clinical outcome and risk factors of intertrochanteric femoral fractures in patients over 65 years old. Materials and Methods: From January 2000 to March 2012, three hundred and twenty one patients older than 65 years, who underwent surgeryfor intertrochanteric femoral fractures, were evaluated. The following parameters wereanalyzed: the patient risk factors, such as age, sex, smoking, drinking history, cardiovascular disease, cerebrovascular disease and delayed days to surgery; admission day of the week; anesthetic method; operation time by perioperative care related to clinical outcome including postoperative mortality; and complications. Results: An analysis of the risk factors revealedfemale patients to have a 13% higher mortality (P=0.043). Aduration of surgerylonger than 3 hours was associated with a 29.1% and 20.8% higher mortality and complication rate, respectively (P<0.001, P=0.027). Asurgical delay of four days or more after admission wasassociated with a 20.1% and 18.8% higher mortality risk and complication rate, respectively (P<0.001, P<0.001). Smoking, drinking history, underlying disease, anesthetic method, and operation time had no significant effect on the outcome. Conclusion: In addition to recognizing the importance of patient-related risk factors, modifying the operative factors, such as reducing surgical delays and method of anesthesia, can reduce the mortality and postoperative complications of intertrochanteric femoral fractures.

관절경적 전방십자인대 복원술

김철홍 ( Chul Hong Kim ),김경택 ( Kyung Taek Kim ),이재원 ( Jae Won Lee ),김현준 ( Hyeon Jun Kim ) 대한슬관절학회 2007 대한슬관절학회지 Vol.19 No.1

Purpose: To evaluate the efficacy of arthrorscopic ACL repair on femoral side using suture technique. Materials and Methods: We performed arthroscopic ACL repair suture technique on femoral side and evaluate the results using the functional grading system of Lysholm and physical examination in 15 cases between July, 1997 and June, 2004 that were able to be followed up for more than 24 months. The mean age was 32.1 years old, the follow up period were 58.7 month. Results: The postoperative Lysholm knee score increased from preoperative mean 17 to postoperative mean 93 by an average of 76 points. Postoperative Excellent group over 90 points were 6 cases (40%), Good group over 75 points were 8 cases (53%), Fair group over 51 points was 1 case (7%). On anterior drawer test, 3 cases showed anterior instability between 0 and 2 mm and 2 cases between 3 and 5 mm. But other 10 cases did not show anterior instability on anterior drawer test. On stress lateral radiographic evaluation, the mean anterior translation of tibia was 2 (0~5) mm. Conclusion: We concluded that arthroscopic ACL repair with suture technique is one of the most reliable and effective method to recover the instability and full ROM enabling early rehabilitation.

바울의 소명의식과 복음 선포에 나타난 그의 전도, 개종, 교회 개척의 특징

김철홍(Chul hong Kim) 한국복음주의신약학회 2015 신약연구 Vol.14 No.2

Paul was a church-planting pastor. When he preached the gospel to plant churches, in what way did he convert his audience, and how did he plant them? This study raises not just 'what' questions but also 'how' questions. To bear out his understanding of evangelism, conversion, and church-planting, it delves into some texts in which Paul's apostolic self-understanding is expressed. It is an inter-disciplinary research, employing sociological studies of religious conversion to properly explain his understanding of evangelistic activities and conversion. It will produce some practical implications that can be implemented by local church pastors for evangelism. Paul understands conversion as death of old self and birth of new self. He attempts to produce a strong rather than weak conversion. Taking the prophetic commission given to Jeremiah as his own calling, Paul sees himself as a constructor and sower as well as a demolishing man. He tries to destroy pagan world-view to create a new value system on the basis of the gospel. Using various separation languages, he helps his converts to build a strong self-identity as Christians. Through personal and affectionate relationships with each of them, and through preaching imminent persecution, parousia of the Lord, and judgment, Paul reinforce their conversion resolutions. The deeper understanding of Paul's evangelism we have, the more effective strategies nowadays Christian churches may put into practice.