상악측절치 수복을 위한 Cantilever bridge

김형수,양홍서,Kim Hyoung-Soo,Yang Hong-So 대한치과보철학회 1993 대한치과보철학회지 Vol.31 No.3

The purpose of this study was to analysis the stress distribution induced by three unit PFM bridges and various cantilever bridges replacing maxillary latersal incisor. The simplified two-dimensional photoelastic models used for this study was contructed in the folio- wing way. CR/R ratio was designed to be 1 : 1, 1 : 1.25 and 1 : 1.5. The pontics of cantilever bridge supported by maxillary canines consisted of wrap-around type, rest-extension type, and simple type. 3-unit PFM bridge was constructed with traditional method. 1kg vertical static load was applied on the center of the incisal edge of the pontic. The stress pattern was examined and recorded by photography. The results obtained were as follows ; 1. The magnitude of stress on the abutment root apex area of a traditional 3-unit bridge was the lowest. 2. The model of cantilevered pontic with a rest showed the relatively well distributed stress around the abutment tooth. The model with simple pontic generated the greatest stress concentration in the supporting structure of the abutment tooth. 3. As the height of bone level reduced, the rotational and vertical force increased around the abutment tooth. 4. The stress concentration of the 3-unit bridges occured on the root apex and stress concentration of the cantilever briage occured on the root apex and cervix area, 5. In the case of the cantilever bridge, stress concentrated distally on the root apex area of the abutment tooth and additional stress was observed mesially on the upper part of the root. Especially in the case of the simple pontic, was phenomenon was more apparent than the others. 6. Force applied to cantilevered pontic was transmitted to the adjacent central incisor through the contact surface. Stress was markedly observed on the mesial cervix area in the case of simple pontic and on the root apex area in the case of wrap-around type and rest-extension type.

슬개대퇴 관절의 기능적 해부학 및 생체역학

김형수,박상준,Kim, Hyoung-Soo,Park, Sang-Joon 대한정형외과스포츠의학회 2005 대한정형외과스포츠의학회지 Vol.4 No.2

흔히 접하게되는 슬관절 전방 통증에 대해, 원인과 질환별 기준에 따른 수술적(recipe type)치료가 시도되고 있다. 유발요인은 다양하여, 대퇴의 내회전, 외반슬, 신전 기전의 외회전, 상위 슬개골. 편평한 활차 오목, 적합성이 부족한 슬개골, 인대 이완 등을 예로 들 수 있다. 그러나 다수의 의사들은 치료를 위한 접근에 있어 한정되어 있다. 이에 슬개대퇴 관절의 기능적 해부학과 생체 역학에 대한 이해가 필요하겠으며, 과학적 원칙에 맞는 치료를 통해 효과를 향상시킬 수 있을 것이다. 본 저자들은 슬개대퇴 관절의 기능적인 해부학과 생체역학에 대한 정보를 요약하였으며, 이는 슬개대퇴 관절 질환에 의한 슬관절 전방 통증의 기본적인 개념의 이해와 당면하는 임상적 사용에 도움을 줄 것이다. Even though, anterior knee pains are most frequently encountered in knee clinics, many physicians use a 'recipe'-type of approach to their treatment. But many predisposing factors have been included internal rotation of the femur, valgus knee alignment, external rotation of the extensor mechanism, patellar alta, a flat trochlear groove, patella with poor congruence and ligatmentous laxity. Many scientific principles on which these commonly used treatment are based, can lead to refinements and improvement in treatment. We reviewed and summarized the recent functional anatomical and biomechanical data that are most relevant to the contemporary treatment of patellofemoral joint disorders.

우리나라 지하수 이용 형태 고찰과 합리적 활용 방안에 대한 연구

김형수,Kim, Hyoung-Soo 한국지하수토양환경학회 2017 지하수토양환경 Vol.22 No.5

Groundwater accounts for more than 10% of the total water supply in Korea. However, the contribution of groundwater to public water supply systems has been poorly played role throughout the country except for Jeju Island. Compared with the groundwater uses in foreign countries, the pattern of groundwater use in Korea seems to be very deformed and unreasonable. Currently, the development and use of groundwater in Korea are mostly carried out by the individuals, and public sectors such as central and local governments are not actively involved in such activities. Private groundwater use and management will continue to cause groundwater depletion and pollution problems. It is necessary to actively enhance the role of public authorities in groundwater managements by engaging precise hydrogeological surveys and proper economic evaluation in the development and operation of groundwater sources. Also, in order to solve the problems that public water supply systems overly rely on the surface water sources, it is necessary to take policies that require the water supply companies to secure a variety of water sources.

슬괵건을 이용한 전방 십자 인대 재건술

김형수,김주학,지정민,Kim, Hyoung-Soo,Kim, Joo-Hak,Ji, Jeong-Min 대한관절경학회 2005 대한관절경학회지 Vol.9 No.2

슬개건과 슬괵건은 전방 십자 인대의 관절 내 재건에 가장 빈번하게 사용되는 조직이다. 일반적으로 중앙 1/3 슬개건 이식을 전방 십자 인대 재건에 있어서 gold standard로 생각하고 있다. 그러나 Harder와 Aglietti 등의 저자들에 의한 최근의 연구들은 슬관절 안정성과 기능적인 결과에 있어서 중앙 1/3 슬개건 이식과 슬괵건 이식 사이에 통계학적으로 의미 있는 차이점을 발견하지 못했다. 이 연구의 목적은 문헌 고찰을 통하여 (1) 전방 십자 인대 재건술에 있어서 슬괵건 이식의 역사를 고찰하고 (2) 전방 십자 인대 재건술에 있어서 슬괵건 이식의 사용에 대한 적응증을 논의하고 (3) 연합 이중 고리의 반건양건과 박건 이식을 사용하여 $RIGIDFIX^{circledR}$와 $INTRAFIX^{circledR}$로 고정하는 전방 십자 인대 재건술의 술기를 묘사하고 (4) 슬괵건 전방 십자 인대 재건술의 결과를 재검토하는 것이다. The central third of the patellar tendon and hamstring tendons(semitendinosus and gracilis) are the most frequently used tissues for intra-articular replacement of the anterior cruciate ligament(ACL). At present, many surgeons consider the central third patellar ten don graft to be the gold standard for replacement of the ACL. Recent prospective studies by Marder et at and Aglietti et al, however, have failed to show any statistically significant differences in knee stability and functional outcome between central third patellar tendon grafts and hamstring tendon grafts. The review of this article is to (1) review the historical use of hamstring tendon grafts for ACL reconstruction; (2) discuss indications for use of hamstring tendon grafts for ACL reconstruction; (3) describe our present operative technique using a combined double-looped semitendinosus and gracilis graft with $RIGIDFIX^{circledR}$ and $INTRAFIX^{circledR}$ and (4) review the results of hamstring ACL reconstructions.

체포 과정에서 발생한 견갑 - 흉곽 해리 - 증례보고 -

김형수,유정현,염주상,배원하,Kim, Hyoung-Soo,Yoo, Jeong-Hyun,Yeom, Ju-Sang,Bae, Won-Ha 대한정형외과스포츠의학회 2008 대한정형외과스포츠의학회지 Vol.7 No.2

Scapulothoracic dissociation is a rare injury caused by blunt force or massive traction to the anterolateral shoulder girdle with disruption of scapulothoracic articulation. This injury is characterized by massive soft-tissue swelling of the shoulder with intact skin, lateralization of damaged scapular. It frequently is accompanied by various musculoskeletal injuries and neurovascular injuries. 33-year-old man sustained a scapulothoracic dissociation without fracture and Vascular injuries during arresting. We report diagnostic method, clinical finding and non-operative management with literatures. 견갑-흉곽 해리는 둔상이나, 견갑부 전외측 방향으로 가해진 강한 견인력에 의해 견갑-흉곽 관절의 붕괴를 야기하는 드문 손상이다. 이 손상은 견갑부에 피부 손상은 없으나 심한 부종, 손상받은 견갑부의 외측이동으로 특징 지어지며, 많은 경우에 다양한 근골격계 손상과 신경혈관 손상이 동반된다. 본원에서는 체포과정에서 발생된 33세 남자환자에서 골절과 혈관 손상이 관찰되지 않은 견갑-흉곽 해리를 경험하였기에, 진단 방법과 임상 양상, 치료 방침을 문헌 고찰과 함께 보고하는 바이다.

경추의 전신조정술 관절치료가 관절가동범위에 미치는 영향

김형수,김은영,구봉오,배성수,Kim Hyoung-Su,Kim Eun-Young,Koo Bong-Oh,Bae Sung-Soo 대한물리치료학회 2003 대한물리치료학회지 Vol.15 No.4

Purpose: The purpose of this study is to search effect that GCM joint treatment gets to range of motion of cervical, lumbar, trunk and anke. And cervical gets in ankle joint. Methods: Estimated body deformity using GCM body type assesment chart then measured range of motion of each region. After control group did as act freely after do experiment pre measurement control group did post measurement. After control group did as act freely after do experiment premeasurement, control group did postmeasurement. Each region was measured by measurer who each subject person differs. Experimental group did GCM joint treatment and all measurements each region by measurer who each subject person differs three times measure postmeasurement after premeasurement. When measure with each measurement, measured after leave and walk time interval for 10 minutes. Result: For the analysis of the result of experiment, the results is change amount comparison increased to keep in mind except cervical flexion and both ankle joint's dorsiflexion after experiment of experimental group. In experimental group, cervical, lumber and ankle joint of range of motion was significantly increased(p<.05).

Trevor 병; 편측성 골단 이형성증 - 증례 보고 -

김형수,장준희,Kim, Hyoung-Soo,Chang, Jun-Hee 대한정형외과스포츠의학회 2009 대한정형외과스포츠의학회지 Vol.8 No.1

Trevor 병이라고도 불리는 편측성 골단 이형성증(dysplasia epiphysealis hemimelica)은 2세에서 14세 연령에서 한측 사지의 내측 또는 외측의 편측 골단부의 연골 이상 발육을 특징으로 하는 소아기의 드문 희귀 질환이다. 국내에서는 술 후 재발한 1례를 포함하여 6례가 보고 되었다. 본 교실에서 경험한 7세 남아는 좌측 슬관절의 통증을 호소하나 슬관절의 변형은 없었다. 단순 방사선 소견상 우슬부 대퇴골 원위부 내과의 골단 내측에 여러 개의 편심성 화골점이 관찰되었고, 자기 공명 영상 소견상 골단부 내측에 불규칙한 화골점 및 비정상적인 연골 비대가 확인되었다. 본 교실에서는 대퇴 내과 골단에 발생한 임상적으로 매우 드문 희귀 질환을 경험하여 자기 공명 영상 소견을 포함하여 문헌 고찰과 함께 보고하는 바이다. Trevor's disease, also known as dysplasia epiphysealis hemimelica, is rare abnormality characterized by aberrant cartilaginous overgrowth forming one half of epiphysis. Typically the patient is 2 to 14 years of age. Until now only six cases, including a case recurred after surgery, have been reported in Korea. A seven year-old boy complained pain of the left knee. However, any deformity of the knee was not seen. The plain radiographic findings showed multiple ossifications asymmetrically on the medial epiphysis of distal femur. The magnetic resonance imaging (MRI) clearly demonstrated the epiphyseal mass which contained low signal spots corresponding to calcified foci and abnormal cartilaginous overgrowth. We report one additional case with a brief review of literature with the MRI findings.

후방 십자 인대의 해부학과 생역학

김형수,Kim, Hyoung-Soo 대한관절경학회 1998 대한관절경학회지 Vol.2 No.1

As with anterior cruciate ligament reconstruction, posterior cruciate ligament(PCL) reconstruction requires a good understanding of the anatomy and biomechanical properties of the PCL to place the graft correctly as well as to choose the appropriate structure and material for the graft. The anatomy and function of the PCL can be somewhat confusing and continuing to evolve so far. Recent studies have focused on the insertion site anatomy and the identification of the functional components of the ligament. The issue of the ligament isometry and the role of PCL in knee kinematics are still totally resolved. This article can be provided an update on current concepts of the anatomy and biomechanics of the PCL through literature reviews. A clear understanding of these knowledges enables the clinicians to diagnose injuries to the PCL accurately and to reconstruct these structures successfully.

관절경적 전방 십자 인대 재건술 - 골-슬개건-골과 4중 슬괵건 자가이식의 전향적 비교 연구 -

김형수,박승림,강준순,이우형,김영훈,박주식,Kim, Hyoung-Soo,Park, Seung-Rim,Kang, Joon-Soon,Lee, Woo-Hyoeng,Kim, Young-Hoon,Park, Ju-Sik 대한관절경학회 1998 대한관절경학회지 Vol.2 No.1

Purpose : The purpose of this study was to compare the postoperative success and stability of arthroscopically assisted anterior cruciate ligament(ACL) reconstructions using the central one third bone patellar tendon bone(BPB) autograft versus a quadrupled semitendinosus/gracilis(ST) autograft in patients with "isolated" ACL tears. Materials & Methods : A strict criteria to identify isolated ACL tears was used which included : no previous surgery, no other ligamentous injury, no history of patellofemoral symptoms, no patellofemoral malalignment, no meniscal pathology, no chondromalacia or chondral injury and no limitation of motion of the injured knee. 30 patients (15 BPB, 15 ST) with a mean age of 27.4 years were available for a mean follow up of 18 months (between 12 months and 26 months). Preoperatively, there was no significant difference between the two groups with respect to age, sex and degree of laxity. Results : Postoperatively, we couldn't find significant differences between the two groups with respect to subjective Lysholm score, objective laxity including Lachman test, pivot shift test and KT-2000 measurements. Mean side to side difference of KT-2000 scores at 20lbs were 1.5mm for the BPB group and 1.4mm for the ST group. Positive Lachman test was found in 26.7% and 33.3% and positive pivot shift was found in 20% and 33.3% of the patients in the BPB and ST groups, respectively. Anterior knee pain (33.3%) was more common in the BPB group. There were 80% of the patients in both groups above nearly normal grade according to the IKDC grade. Conclusions : In patients with "isolated" ACL tears, the overall results, ligamentous stability for the patellar tendon and the quadrupled semitendinosus/gracilis were comparable. We consider that the quadrupled autogenous hamstring tendon is a good alternative substitute in ACL reconstruction together with the bone patellar tendon bone.

전방십자인대 손상 슬관절의 자연적 병의 경과

김형수,Kim, Hyoung-Soo 대한관절경학회 1997 대한관절경학회지 Vol.1 No.1

The natural history of the anterior cruciate ligament(ACL)-deficient knee remains controversial. although numerous investigation have tried to ascertain the course that the knee would follow once the ACL has lost functional integrity. An extensive review of the literature performed according to symptoms. physical examinations, associated surrounding tissue injuries. returns to activity level and radiological changes in the knee joint. An active individual with a non-functioning ACL was susceptible to injury to the menisci and deteriorate the articular cartilage, followed radiographic changes. An activity levels in general also changed after injury. The most common symptom was pain. But instability varied in these individuals. Conclusively we believe that all these factors will eventually, if not initially, result in a symptomatic knee. which will result in significant limitations to the individual's desired level. So we recommend an aggressive approach in person who desired to return to a relatively active life style in young person as well as in middle aged individuals who have significant symptomatic ACL deficient knee.