단 외회전근을 보존하는 술식의 대퇴 인공관절 전치환술의 pitfall -증례 보고-

문창윤 ( Chang Yun Moon ),김영율 ( Young Yul Kim ),박상은 ( Sang Eun Park ),지종훈 ( Jong Hun Ji ),김원유 ( Weon Yoo Kim ) 대한고관절학회 2009 Hip and Pelvis Vol.21 No.1

短縮語形成に影響する音韻的要因について -重子音における有標性を中心に-

문창윤 ( Moon Chang-yun ),구마가이가쿠지 ( Kumagai Gakuji ) 한국일어일문학회 2021 日語日文學硏究 Vol.116 No.-

이 논문에서는, 형태소 경계에 위치하는 중자음(촉음)의 유표성이 일본어 단축어 형성에 미치는 영향에 대해 고찰하였다. 단일어의 경우, 무성저해음 뿐만 아니라 유성저해음도 중자음을 구성할 수 있지만(예:/kjappu/, /heddo/), 접근음은 중자음화되기 어렵다. 한편 복합 단축어의 경우에는, 무성저해음이 가장 많이 중자음화하는 것으로 나타났다(예:/nikkado/). 그러나 촉음을 포함하는 복합 단축어의 예가 매우 적고, 복합어를 구성하는 요소에 따라서는 특정한 패턴으로 단축되는 경향이 있었다. 이 문제를 해결하기 위해, 어형성 실험을 시행하였다. 실험에서는, 촉음이 단축어에 유지되는 패턴(예:/niQkeru/+/kadomiumu/→/niQkado/, /Q/는 중자음의 첫 번째 요소)과, 촉음 대신 촉음 바로 뒤에 위치한 자립박이 단축어에 포함되는 패턴(예:/neQto/+/geemu/→/netoge/)을 사용하였다. 일본어 모국어 화자에게 가상 복합어와 두 단축 패턴을 제시하고, 단축 시 더욱더 자연스럽게 느껴지는 패턴을 한 가지만 고르게 하였다. 실험 결과, 무성저해음으로 구성되는 중자음의 허용도는 가장 높은 반면, 접근음은 가장 회피되는 것으로 나타났다. 이 결과는, 본래 일본어의 고유어에만 적용되는 음운 제약이, 화자의 어휘부에 존재하지 않는 외래어에도 적용될 수 있다는 가능성을 시사한다. 또한 자음의 공명도가 높을수록 중자음을 형성하기 어렵다는 유표성 계층(Podesva 2002; Kawahara 2007)이 일본어 단축어 형성 과정에 영향을 미치는 중요한 요인 중 하나라는 사실이 검증되었다. The current study focuses on consonant gemination in truncated compounds of Japanese loanwords. In this language, voiced and voiceless obstruent geminates can be observed in lexical simple loanwords (e.g., /kjappu/ ‘cap’, /heddo/ ‘head’), while approximants can hardly be geminated, on the one hand, and truncated compounds allow only voiceless obstruent geminates (e.g., /nikkado/ ‘nickel cádmium’; /wetti/ ‘wet wipes’), on the other hand. The aim of the current study is to experimentally examine whether voiced obstruent and approximant geminates are less likely to appear than voiceless geminates. There are two main types of truncated patterns of compounds whose first element contains the first part of a geminate in the second-initial mora. The first type contains the first part of the geminate (e.g., /niQkeru/ ‘nickel’ + /kadomiumu/ ‘cádmium’ → /niQkado/ ‘nickel cá dmium’) (‘Q’ represents the first part of the geminates). The second type avoids gemination and instead contains the third mora (e.g., /neQto/ ‘Internet’ + /geemu/ ‘game’ → /netoge/ ‘computer game’). Our experiment prepared twenty-seven new compounds with a nonce word in the first element and a real word in the second one (e.g., /seQtarisu/ + /panorama/ ‘panorama’) and asked thirty-two native speakers of Japanese which of the two patterns (/seQpano/ vs. /setapano/) would be preferred. The results showed that voiceless geminates were the most acceptable, while approximant geminates were the least acceptable, and voiced geminates came in the middle. A possible reason for the difference between voiceless and voiced obstruents is that the truncation process of loanwords can be affected by the constraint working in native words of Japanese that voiceless obstruents are much more likely to occur than voiced ones. Furthermore, the difference between voiced obstruents and approximants can be accounted for by the markedness hierarchy of sonority in gemination that the higher the sonority is, the more difficult it is to become a geminate (Podesva 2002; Kawahara 2007). This is why more sonorous consonants (i.e., approximants) were less acceptable than less sonorous ones (i.e., voiced obstruents).

고령의 대퇴전자간 분쇄골절 치료 시 내고정술과 인공관절 반치환술간의 임상결과 비교

문창윤 ( Chang Yun Moon ),지종훈 ( Jong Hun Ji ),박상은 ( Sang Eun Park ),김영율 ( Young Yul Kim ),이세원 ( Se Weon Lee ),김원유 ( Weon Yoo Kim ) 대한고관절학회 2008 Hip and Pelvis Vol.20 No.4

목적: 고령 환자의 불안정성 대퇴전자간 골절에서 무작위로 전향적으로 시행한 내고정술과 고관절 부분 치환술간의 연령별 임상 결과를 비교 분석하고자 하였다. 대상 및 방법: 2004년 1월부터 2007년 2월까지 70세 이상 고령에서 대퇴 전자간 불안정성 골절로 내고정이나 고관절 부분 치환술을 시행한 62예에 대해 최소 12개월(12개월~36개월) 추시 관찰하여 SF-36을 통해 임상적 평가를 시행하였다. 내고정을 시행한 군은30명, 부분 치환술을 시행한 군은 32명이다. 임상 결과 분석은 SF-36을 이용하였으며 SPSS를 통해 통계 분석하였다. 결과: 70대에서는 동통, 파행, 보조기 사용 여부 항목에서 부분 치환술 군이 유의하게 좋은 결과를 보였고, 80대에서는 파행 항목에서만 부분 치환술 군이 좋은 결과를 보였으나(P<0.05), 나머지 항목에서는 각 군간에 유의한 차이가 없었다. 내고정군에서 고정물 실패가 4예 있었고, 부분 치환술 군에서 감염에 의한 실패가 2예, 탈구로 인한 재치환술이 2예 있었다. 결론: 고령의 불안정성 대퇴 전자간 골절 시 내고정술보다 초기 안정성으로 동통이 적고 조기 기동이 가능한 고관절 부분 치환술이 더 유용할 것으로 사료되었다. Purpose: We wanted to analyze the clinical outcomes of prospectively randomized surgeries between internal fixation and hemiarthroplasty for treating unstable intertrochanteric hip fracture in elderly patients. Materials and Methods: From January, 2004 to December, 2007, 62 cases of unstable intertrochanteric fracture that underwent internal fixation or hemiarthroplasty were analyzed retrospectively for the clinical outcomes with using the SF-36. Thirty cases were treated with internal fixation and 32 cases were treated with hemiarthroplasty. The clinical outcomes, as assessed by using the SF-36, were statistically analyzed with using SPSS for Windows. Results: Hemiarthroplasty show a better result than internal fixation for pain, limping and the support scales in the 70~79 years old group, and the limping scale was also better in the over 80 years old group (P<0.05). There were no differences between the two groups according to age. Four cases of internal fixation failed due to loss of fixation (3) and nonunion (1), and 4 cases of hemiarthroplasty failed due to infection (2) and revision for dislocation (2). Conclusion: Primary hemiarthroplasty should be more beneficial than osteosynthesis, such as performing internal fixation, for treating unstable intertrochanteric fracture in elderly patients because of the reduced pain and early ambulation that are due to the early stabilization.

고령의 대퇴 전자간 골절에서 인공관절 치환술시 변형된 이중 긴장강선 고정술을 이용한 대전자 고정술

김원유 ( Weon Yoo Kim ),신은수 ( Eun Soo Shin ),문창윤 ( Chang Yun Moon ) 대한고관절학회 2009 Hip and Pelvis Vol.21 No.3

Purpose: We wanted to evaluate the clinical and radiological results after performing arthroplasty for an intertrochanteric fracture in patients 70 years of age or older, and we used a new fixation technique of the greater trochanter. Material and Methods: From January, 2004 to August 2007, we treated 21 cases (M/F: 3/18) of intertrochanteric fracture with hemiarthroplasty with modified double tension band wiring. All the cases were above type 2 (AO/OTA A1.3) according to the Jensen modification of the Evans classification, and all the patients were elderly. The fractures were evaluated for the fracture pattern by using simple radiography and 3D computed tomography. We analyzed the clinical and radiological results at a minimum of 12 months (range: 12~36 months). Results: We performed hemiarthroplasty with modified double tension band wiring. Two cases (9.5%) among the 21 cases developed loss of reduction due to an additional injury and one of them underwent reoperation using a greater trochanter reattachment device (GTRD). The greater trochanters were well maintained without displacement and excellent union was seen at the fracture site of 19 cases. Conclusion: The modified double tension band wiring technique, along with several other fixation methods, should be considered to easily obtain rigid fixation in an unstable intertrochanteric fracture.

견봉 골의 수술적 치료

지종훈(Jong-Hun Ji),김원유(Weon-Yoo Kim),박상은(Sang-Eun Park),김영율(Young-Yul Kim),문창윤(Chang-Yun Moon) 대한견주관절의학회 2008 대한견주관절의학회지 Vol.11 No.2

비구 골절의 내고정 수술 후 발견된 관절면 사이에 낀 골절편의 관절경적 제거

김원유 ( Weon Yoo Kim ),지종훈 ( Jong Hun Ji ),박상은 ( Sang Eun Park ),이세원 ( Se Won Lee ),문창윤 ( Chang Yun Moon ) 대한고관절학회 2008 Hip and Pelvis Vol.20 No.3

Osteochondral fragements incarcerated in the hip joint during fracture-dislocation have been reported to be the cause of posttraumatic arthritis, and open reduction of the fracture or removal of the fragments during surgery is recommended. Locking symptoms developed during hip joint movement in a patient with a history of hip joint fracture-dislocation (Thompson and Epstein (T-E) type III) after undergoing internal fixation of the acetabular fracture. Computer tomographic (CT) scan revealed a bony fragment impinging on the acetabular weight-bearing portion. This bony fragment was removed using hip arthroscopy. We recommend that CT evaluation be performed after surgery for acetabular fractures. We also recommend arthroscopic removal as a treatment option for posttraumatic loose bodies in the hip joint.

횡 중격 도달을 이용한 슬와 낭종의 관절경적 치료와 추시 결과

지종훈 ( Jong Hun Ji ),김원유 ( Weon Yoo Kim ),박상은 ( Sang En Park ),신은수 ( Eun Su Shin ),문창윤 ( Chang Yun Moon ) 대한슬관절학회 2009 대한슬관절학회지 Vol.21 No.3

Purpose: The purpose of this study is to evaluate the usefulness of the trans-septal approach for treating popliteal cyst, to determine the frequency and types of the associated pathologies and to assess the follow up ultrasound evaluation. Materials and Methods: From February, 2002 to February, 2007, 44 patients with popliteal cyst were treated by arthroscopy only. Fourteen patients were male and 30 patients were female. Their average age was 50 years (range: 20∼77 years). We used the trans-septal portal approach. We evaluated the satisfaction of the patients and the recurrence of the popliteal cyst by performing ultrasound exams at an average follow up of 36 months after surgery. At the final follow up, we evaluated the clinical results by the criteria of Rauschning and Lindgren. Results: We found no communication between the knee joint and the popliteal cyst by CT or MRI in 4 cases (8%), but we found a communication by arthroscopy in all the cases. Thirty-four cases had intra-articular pathologies and 9 cases didn`t. The total intra-articular pathologies included 17 articular cartilage defects or chondral lesion (38%) and 15 meniscus tears (34%). In 1 case, open excision was performed for the revision surgery because the patient had recurrence of the popliteal cyst, which caused compressive neuropathy of the common peroneal and tibial nerve. At the last follow up, the clinical outcome of surgery according to the criteria of Rauschning and Lindgren was grade 0 (28 cases), grade1 (12 cases), grade 2 (3 cases) and grade 3 (1 case). Conclusion: We can approach the orifice of a popliteal cyst directly with using the trans-septal portal and easily decompress the orifice of the cyst. We propose that the arthroscopic decompression using the trans-septal portal is an excellent treatment modality for popliteal cysts.

회전근 개 대파열 및 거대 파열에서 상완 이두 근 장두를 포합한 회전근 개 봉합술의 중기 추시 결과

지종훈(Jong-Hu Ji),박상은(Sang-Eun Park),김영율(Young-Yul Kim),김원유(Weon-Yoo Kim),권오수(Oh-Su Kewon),문창윤(Chang-Yun Moon) 대한견주관절의학회 2008 대한견주관절학회지 Vol.11 No.2

불안정성 골반골절의 치료시 경피적 천장골 나사못의 수와 위치에 대한 비교

김원유(Weon-Yoo Kim),지종훈(Jong-Hun Ji),권오수(O-Su Kwon),박상은(Sang-Eun Park),김영율(Young-Yul Kim),문창윤(Chang-Yun Moon) 대한정형외과학회 2009 대한정형외과학회지 Vol.44 No.1

목적: 불안정성 골반골절에서 천장관절의 해부학적 정복 후 S1 혹은 S2에 천장골 나사못을 이용한 고정술을 시행한 뒤 나사못의 위치와 수에 따른 방사선학적 및 임상적 결과를 분석하였다. 대상 및 방법: 천장관절 골절 및 탈구를 포함한 Tile 분류 C (AO/OTA)의 불안정성 골반골절 31예 중 16예에서는 S1에 한 개의 나사못을, 15예에서는 S1와 S2에 두 개의 나사못을 이용한 경피적 고정술을 시행하고, 평균 40.2개월의 추시 관찰을 하여 방사선학적 결과와 Majeed score와 SF-36을 이용한 임상적 결과를 분석하였다. 결과: 수술 후 평균 40.2개월(12-76개월) 관찰상 S1에 단 한 개의 나사못으로 고정한 군 중 5예에서 나사못의 변위가 있었으나 두 개의 나사못으로 고정한 군에서는 변위가 관찰되지 않았다. 경피적 나사못 고정술시 좁은 안전영역을 보이는 경우 S1에 두 개의 나사못으로 고정하기 어려운 경우가 있다. 본 저자는 좁은 안전영역을 가진 불안정성 골반환 손상 환자에게 S1과 S2에 나사못을 고정하여 임상적으로 좋은 결과를 보였다. 결론: 불안정성 골반환의 정복과 고정을 위한 두 개의 나사못을 이용한 경피적 고정술은 효과적이고 믿을만한 방법이며, 특히 좁은 안전영역을 가진 환자에게는 S1에 삽입 후 S2에 추가로 나사못의 삽입이 권장된다. Purpose: A closed reduction of the posterior arch and percutaneous fixation with S1 and S2 iliosacral (IS) screw was performed on an unstable pelvis fracture with a disruption of the sacroiliac complex. The radiological and clinical results were analyzed according the number of screws and their position. Materials and Methods: Of 31 cases with an unstable pelvis fracture involving the sacral complex, classified as Tile type C (AO/OTA), 16 and 15 cases were treated with one 81 screw fixation and two screws fixation into S1 and S2, respectively, using a percutaneous fixation technique. The patients were followed up for a minimum of 12 months and the radiological and clinical outcomes were analyzed statistically using the Majeed score and SF-36. Results: Five cases of screw displacement occurred in the one screw fixation group. On the other hand, there was no screw displacement in the two screws fixation group after a mean follow-up of 40.2 months. In the case of a narrow safe zone (iliac cortical density, ICD), it is impossible to fix with two 81 screws. However, in these patients, good clinical results were achieved with 81 and S2 were achieved with 81 and 82 screw without complications. Conclusion: The technique of two screws fixation is an efficient and reliable method for reducing and fixing the unstable pelvic ring disruptions. Additional S2 screw fixation is recommended for patients with a narrow ICD.