진구성 아킬레스 건 파열에 대한 단일 절개 술식을 통한 건이전술 및 재건술

박광환,김범수,이진우,Park, Kwang-Hwan,Kim, Bom-Soo,Lee, Jin-Woo 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.1

Purpose: The purpose of this study was to evaluate the clinical outcome of neglected Achilles tendon rupture treated with reconstruction and augmentation with flexor hallucis longus (FHL) tendon using one incision technique. Materials and Methods: Between July 2006 and March 2008, eleven patients with neglected Achilles tendon rupture received surgical treatment. Through one incision technique, augmentation with auto FHL tendon transfer was performed using a Bio-Interference screw (Arthrex, Naples, FL) and followed by V-Y advancement (5 cases) or gastronemius fascial turn-down flap procedure (6 cases). After mean follow up of 20.7 months (range, 11.8-33.3 weeks), clinical outcomes were evaluated with Visual Analogue Scale (VAS), American Orthopedic Foot and Ankle Society (AOFAS) score, 10 repetitive double heel raise test, 10 repetitive single heel raise test and subjective satisfaction. Results: The length of the gap after debridement was $5.4{\pm}2.0$ cm. The VAS improved from $4.1{\pm}0.9$ to $1.5{\pm}0.8$ at last follow up (p<0.05). The AOFAS score increased from $38.9{\pm}12.2$ to $91.5{\pm}8.9$ at last follow up (p<0.05). Eight patients were satisfied with excellent results and three were satisfied with good results. All patients were able to perform 10 repetitive double heel raise and nine out of eleven patients were able to perform 10 repetitive single heel raise at last follow up. There were no complications including deep infection or re-rupture. Conclusion: Augmentation with FHL tendon transfer and reconstruction with V-Y advancement or turn-down flap through one incision technique appeared to be effective and safe. This technique is recommendable for the treatment of neglected Achilles tendon rupture.

S.E.R.I. 수술법을 이용한 소건막류의 치료

김선용,박광환,이진우,Kim, Sun-Yong,Park, Kwang-Hwan,Lee, Jin-Woo 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.1

Purpose: The purpose of this study was to evaluate the clinical and radiological outcomes of the S.E.R.I. (simple, effective, rapid, inexpensive) operation for the bunionette deformity. Materials and Methods: Between March 2005 and February 2009, 22 patients (26 feet) who had been treated for the bunionette deformity with minimally invasive osteotomy were reviewed retrospectively. Clinically, Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, shoes selectivity, disappearance of callus and patient's satisfaction level by Coughlin scoring system were evaluated. Radiologically, the bunionette was classified as four types according to the Fallat classification. The 4-5$^{th}$ intermetatarsal angle (4-5$^{th}$ IMA), the 5$^{th}$ metatarsophalangeal angle (5$^{th}$ MPA) and the length of 5th metatarsal bone (5$^{th}$ MTL) were analyzed at preoperatively and at final follow up visit. Results: VAS improved from $6.8{\pm}1.8$ points to $2.2{\pm}1.8$ points (p<0.05). AOFAS score improved from $54.0{\pm}14.2$ points to $90.0{\pm}4.8$ points (p<0.05). There was no change in shoes selectivity. 9 feet (34.6%) were satisfied with excellent results, 16 feet (61.5%) with good results and 1 foot (3.9%) with fair results. The average 4-5$^{th}$ IMA was corrected from $10.1{\pm}2.3^{\circ}$ to $4.4{\pm}1.7^{\circ}$ (p<0.05). The average 5$^{th}$ MPA was corrected from $11.5{\pm}8.6^{\circ}$ to $-0.1{\pm}4.1^{\circ}$ (p<0.05). The average 5$^{th}$ MTL was changed from $66.1{\pm}4.3$ millimeters to $64.1{\pm}4.4$ millimeters (p=0.069). There was no malunion, nonunion or delayed union and other perioperative complications. Conclusion: S.E.R.I. operation is less invasive and easy technique. This procedure is recommendable for the treatment of the bunionette deformity.

관절경적 미세골절술이 실패한 거골의 골연골 병변에 대한 치료로서의 재차 미세골절술

최우진,박광환,이모세,정광호,이진우,Choi, Woo Jin,Park, Kwang Hwan,Lee, Moses,Chung, Kwangho,Lee, Jin Woo 대한족부족관절학회 2015 대한족부족관절학회지 Vol.19 No.2

Arthroscopic treatment has been reported to provide effective improvement of ankle function when used in treatment of small osteochondral lesion of talus; however, favorable long-term results have been less predictable for large osteochondral lesion of talus. In cases in which primary arthroscopic treatment fails, the decision regarding which subsequent technique to choose has become increasingly difficult, as good clinical outcomes may be unlikely for such patients irrespective of the surgical technique used. Redomicrofracture should be used judiciously for treatment of osteochondral lesion of talus in which arthroscopic treatment has failed.

중년층의 구강건강지식, 실천 및 보철치료 만족실태 조사

고은정,이용환,박광환,Go, Eun-Jeong,Lee, Yong-Hwan,Park, Kwang-Hwan 한국치위생학회 2011 한국치위생학회지 Vol.10 No.2

Objectives : The purpose of this study was to examine the oral health knowledge and actual oral health care of the selected subjects, their decision making about prosthetic treatment, the state and characteristics of their prosthetic treatment and their satisfaction with prosthetic treatment in an attempt to provide some information on the improvement of the quality of life related to oral health and the promotion of oral health. Methods : The subjects in this study were 250 people who received education in two different lifelong education institutions in the city of Busan. After a survey was conducted from May 23 to June 15, 2011, the answer sheets from 217 respondents were analyzed. Results : 1. As for the general characteristics of the respondents, the men(52.1%) outnumbered the women. Those who were in their 60 and up(47.5%) made up the largest age group, and the married people(65.4%) outnumbered the unmarried ones. By occupation, the company employees(20.3%) made up the biggest group. By education, the greatest group was high-school graduates(36.1%). By monthly mean income, the biggest group gained an income of 2.01 million won or more(36.9%). As to medical security, community-based insurance was most prevailing (36.9%). In terms of health promotion, the largest group worked out to stay fit(52.4%). 2. Regarding oral health knowledge, they had a good knowledge about the cause of dental caries(56.7%), but they weren't well aware of the right time for regular dental checkup(47.9%). In relation to oral health care, regular scaling wasn't prevailing(16.9%). 3. Regarding connections between the general characteristics and satisfaction with prosthesis, the less-educated respondents expressed significantly more dissatisfaction(p=0.015). By monthly mean income, those who had a smaller income were dissatisfied in general(p=0.028). Conclusions : The findings of the study illustrated that it's required to spread awareness of the importance of oral health among people in general, and that differentiated incremental oral health care should be provided for different age groups. In order to raise the satisfaction of patients with prosthesis, how to relieve their pain and anxiety and how to adjust prosthetic treatment cost properly should carefully be considered. In addition, the government should take measures to offer assistance for the low-income classes in preparation for an increase in the elderly population.

1회용 RF교통카드 발매기 운영체제 개발방법에 관한 연구 (A single use RF Transit Card Study on development of operating systems, vending machines)

유신철(Sin-Cheol Yu),박광환(Kwang-Hwan Park) 한국철도학회 2011 한국철도학회 학술발표대회논문집 Vol.2011 No.5

Vending machines to release single-use RF(Radio Frequency) transport cards at Seoul Metro stations are operated under unmanned facility and have release & charge function. This Paper introduces function, configuration of vending machine to release single-use RF transport cards, the basic concepts & overview about vending machine’s operating system. And suggests programming procedure to develop OS image of Windows Embedded operating system which is onboard the main board’s electronic circuitry.

신전 제한법을 이용한 골성 추지 골절 치료의 예후 인자

한수봉(Soo-Bong Hahn),박광환(Kwang-Hwan Park),최윤락(Yun-Rak Choi),강호정(Ho-Jung Kang),이정길(Jung-Kil Lee) 대한정형외과학회 2010 대한정형외과학회지 Vol.45 No.2

목적: K-강선을 이용한 신전 제한법으로 수지 골성 추지 골절을 치료하였을 때의 임상적 결과와 예후 인지에 대해 알아보고자 하였다. 대상 및 방법: 2002년 7월부더 2009년 1월까지 수지 골성 추지로 내원한 환자들 중 K-강선을 이용한 신전제한법을 시행한 환자 중 6개월 이상 추시 관찰이 가능했던 49명의 환자를 대상으로 하였으며, Wehbe and Schneider 분류를 이용하여 골절양상을 분류하였고, Crawford 분류를 이용하여 임상적 결과에 대한 평가를 하며, 나이, 성별, 수상부터 수술까지의 기간, 수술 전 골절면과 관절면이 이루는 각도, 수술 후 전위 정도를 조사하여 예후 인자를 분석하였다. 결과: Crawford 분류에 의한 임상적 결과 평가로 우수 22예, 양호 20예, 보통 6예, 불량 1예이었다. 고령일수록, 이탈구가 있을수록, 수술 전 추지 골절편각이 30도 이하일수록, 수술 후 전위가 클수록 결과가 좋지 않은 것으로 조사되었다.(p<0.05). 결론: 수지 골성 추지 골절 치료에서 K-강선을 이용한 신전 제한법은 나아가 젊고, 아탈구가 없고. 정복이 정확한 경우, 특히, 추지 골절편각이 30도 이상인 경우에 예후가 좋은 것으로 나타났다. Purpose: The purpose of this study was to evaluate the clinical results and prognostic factors of the extension block technique for treating a bony mallet finger. Materials and Methods: Between July 2002 and January 2009, forty-nine patients who underwent the extension block technique for a bony mallet finger were evaluated. The minimum period of follow up was 6 months. The type of fracture was classified by the Wehbe and Schneider method. The results were evaluated by the Crawford classification. The prognostic factors were analyzed according to age, gender, the timing of the surgery, the mallet fragment angle and the residual displacement. Results: According the Crawford classification, there were 22 excellent, 20 good, 6 fair and 1 poor results. The poor prognostic factors were an older patient age, subluxation, a smaller mallet fragment angle and smaller postoperative displacement (p<0.05). Conclusion: The prognostic factors of the extension block technique for bony mallet finger were the patient age, subluxation, the mallet fragment angle (more than 30 degrees) and the postoperative displacement.

마이크로프로세서를 적용한 직류모터 제어방법 연구

유신철(Yu Sin-Cheol),박광환(Park Kwang-Hwan),조동안(Cho Dong-An) 한국철도학회 2010 한국철도학회 학술발표대회논문집 Vol.2010 No.7

본 원고는 직류전원에서 사용하는 직류용 소형전동기(motor)로 전력용 반도체 제어소자인 Power Transistor, MOSFET를 이용하여 전동기(motor) 구동의 드라이브 회로를 구성하고 전동기 동작원리와 정 · 역회전의 회전방향 제어에 대하여 다루고자 한다. 그리고, 제동운전 및 펄스폭 변조(PWM)에 의해 가변되는 회전속도제어 방법에 대해 기술하여 직류용 전동기(motor)의 기본적인 원리를 이해함과 더불어 마이크로프로세서를 이용한 다양한 전동기(motor) 제어방법을 제시하였다. This paper treats the method to build up Motor drive-circuit using semi-conduct control part like power transistor, MOSEFT and refers to the operation theory, forward, reverse rotation control and speed control method which is changed by PWM. And also, this paper mention to the basic principle of DC Motor and various Motor control method using micro-processor.

단순 혹은 주관절 주위 손상을 동반한 소두 골절의 수술적 치료

강호정(Ho-Jung Kang),박광환(Kwang-Hwan Park),이정길(Jung-Kil Lee),최윤락(Yun-Rak Choi),한수봉(Soo-Bong Hahn),김성재(Sung-Jae Kim) 대한견주관절의학회 2009 대한견주관절학회지 Vol.12 No.2

목적: 단순 소두 골절 및 주관절 주위 손상을 동반한 소두 골절의 수술적 치료에 대한 결과를 분석하고 예후 인자를 알아보고자 하였다. 대상 및 방법: 관혈적 정복 및 내고정술을 시행한 25명의 환자 (평균나이, 49세)를 대상으로 하였고, 소두 골절은 1형 골절이 19예, 3형 골절이 6예 있었다. 평균 추시 기간은 14.8개월이었고 최종 추시시 방사선학적 및 기능적 결과를 분석하여 소두 골절의 형태, 동반 골절 유무가 예후에 영향을 미치는가를 평가하였다. 결과: 25예 중 24예에서 평균 1년에 방사선학적 유합을 얻었으며, 기능적 결과는 Broberg와 Morrey의 점수에 의해 우수 18예, 양호 4예, 보통 2예, 불량 1예였다. 소두 골절은 1형의 빈도가 가장 높았고, 동반 주위 골절은 외과 골절이 가장 많았다. 1형 골절이 3형 골절인 경우보다, 주위골절이 있는 경우 비관절면 골절인 경우가 관절면 골절인 경우보다 임상적 결과가 좋았다. 나이, 동반골절의 종류, 소두 골절에 대한 내고정물의 종류, 수술적 접근법, 수술 후 고정 기간에 따른 임상적 결과의 차이는 없었다. 결론: 전체의 88%에서 만족할 만한 결과를 얻었다. 그리고 소두 골절의 형태와 추가적인 관절면 골절 동반 유무가 중요한 예후 인자로 조사되었다. Purpose: We wanted to assess the radiological and clinical results and the prognostic factors after an operation for capitellar fractures associated with/without other injury around the elbow. Materials and Methods: Among the 25 patients (mean age: 49 years-old) who underwent open reduction and internal fixation for capitellar fractures, there were nineteen type 1 fractures and six type 3 fractures. The mean follow up period was 14.8 months. We assessed the factors affecting the radiological and functional results, such as the fracture pattern, the patient age and the surgical approaches. Results: In 24 of 25 patients, bony union was achieved at postoperative 1 year. There were eighteen excellent, four good, two fair and one poor functional results according to the Broberg and Morrey elbow score. The most common type was type 1 and the most common associated injury was lateral condylar fracture. The patients with type 1 fracture rather than the patients with type 3 fracture and the patients who had an extraarticular associated fracture rather than an intraarticular associated fracture had better clinical outcomes. Conclusion: 22 (88%) of the patients were satisfied at the result. The type of capitellar fracture and an associated intraarticular elbow fracture were shown to be important prognostic factors in this study.

중년층의 구강건강지식, 실천 및 보철치료 만족실태 조사

고은정 ( Eun Jeong Go ),이용환 ( Yong Hwan Lee ),박광환 ( Kwang Hwan Park ) 한국치위생학회 2011 한국치위생학회지 Vol.11 No.5

Objectives: The purpose of this study was to examine the oral health knowledge and actual oral health care of the selected subjects, their decision making about prosthetic treatment, the state and characteristics of their prosthetic treatment and their satisfaction with prosthetic treatment in an attempt to provide some information on the improvement of the quality of life related to oral health and the promotion of oral health. Methods: The subjects in this study were 250 people who received education in two different lifelong education institutions in the city of Busan. After a survey was conducted from May 23 to June 15, 2011, the answer sheets from 217 respondents were analyzed. Results: 1. As for the general characteristics of the respondents, the men(52.1%) outnumbered the women. Those who were in their 60 and up(47.5%) made up the largest age group, and the married people(65.4%) outnumbered the unmarried ones. By occupation, the company employees(20.3%) made up the biggest group. By education, the greatest group was high-school graduates(36.1%). By monthly mean income, the biggest group gained an income of 2.01 million won or more(36.9%). As to medical security, community-based insurance was most prevailing (36.9%). In terms of health promotion, the largest group worked out to stay fit(52.4%). 2. Regarding oral health knowledge, they had a good knowledge about the cause of dental caries(56.7%), but they weren`t well aware of the right time for regular dental checkup(47.9%). In relation to oral health care, regular scaling wasn`t prevailing( 16.9%). 3. Regarding connections between the general characteristics and satisfaction with prosthesis, the less-educated respondents expressed significantly more dissatisfaction(p=0.015). By monthly mean income, those who had a smaller income were dissatisfied in general(p=0.028). Conclusions: The findings of the study illustrated that it`s required to spread awareness of the importance of oral health among people in general, and that differentiated incremental oral health care should be provided for different age groups. In order to raise the satisfaction of patients with prosthesis, how to relieve their pain and anxiety and how to adjust prosthetic treatment cost properly should carefully be considered. In addition, the government should take measures to offer assistance for the low-income classes in preparation for an increase in the elderly population. (J Korean Soc Dent Hygiene 2011;11(5):671-683)

유구골 고리 골절 불유합에 대한 골편 절제술

강호정(Ho-Jung Kang),정성훈(Sung-Hoon Jung),정준영(Joon-Young Jung),박광환(Kwang-Hwan Park),한수봉(Soo-Bong Hahn) 대한정형외과학회 2008 대한정형외과학회지 Vol.43 No.4

목적: 유구골 고리 골절 불유합에 대한 골편 절제술의 치료 결과에 대해 알아 보고자 하였다. 대상 및 방법: 유구골 고리 골절 후 불유합으로 수술적 치료를 받은 9명의 환자, 9예에 대하여 후향적으로 연구하였으며, 수술 후 동통, 운동범위, 저린 증상 및 파악력에 대해 임상적으로 평가하였다. 결과: 초기 증상으로는 단순 통증이 3예, 저린 감각이 3예, 수지 굴곡의 제한이 2예, 통증 및 수지 굴곡의 제한이 동반된 경우가 1예였다. 손상의 추정 원인은 주로 스포츠 활동이었다. 증상 발현 후 진단까지의 기간은 평균 15개월(2개월-5년)이었으며, 진단은 단순 방사선 촬영이 1예, 수근관 촬영 6예에서 가능하였으며, 컴퓨터 단층촬영으로 전례에서 확인되었다. 치료는 모두 골편 절제술을 시행하였으며, 수근관 증후군이 동반된 3예에서는 횡수근 인대 절제술을 시행하였고, 제 5심수지 굴건의 파열이 있었던 경우에서는 2예에서는 건 봉합술을, 나머지 한 예에서는 제 4심수지 굴건으로의 건전이술을 시행하였다. 수술 후 감염 등의 합병증은 없었으며, 8예에서는 우수한 결과를, 1예에서는 한시적인 제 4, 5 수지의 저린 증상을 호소하였다. 결론: 유구골 고리 골절 불유합의 골편 절제술은 1년 추시에서 우수한 결과를 보였다. Purpose: To evaluate the treatment results of fragment excision of the hamate hook nonunion. Materials and Methods: Nine patients operated for hamate hook nonunion were reviewed retrospectively, and were clinically assessed for pain, range of motion, tingling sensation, and grip strength postoperatively. Results: The initial symptoms were pain (3 cases), tingling sensation (3 cases), 5<SUP>th</SUP> DIP joint flexion LOM (2 cases), and pain and accompanying LOM in 5<SUP>th</SUP> DIP joint flexion (1 case). The causes of injuries seemed to be mainly associated with sports activities. Time from initial symptom to diagnosis was averaged 15 months (2 months-5 years), and confirmative image was plain x-ray (one case), carpal tunnel view (six cases), and CT scan (two cases). All patients underwent fragment excision, and in three patients with accompanying carpal tunnel syndrome, transverse carpal ligament release was performed accordingly. In three other patients complicated with 5<SUP>th</SUP> FDP rupture, tenorrhaphy was performed in two cases, and tendon transfer was performed in the other case. Eight patients showed excellent clinical results one year postoperatively, but one patient complained of transient tingling sensation on the 4<SUP>th</SUP> and 5<SUP>th</SUP> fingers. Conclusion: Hamate hook excision after nonunion showed excellent clinical results in one year postoperative follow-up.