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.

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.

4겹의 반건양건과 골-슬개건-골을 이용한 관절경적 전방 십자 인대 재건술의 중기적 치료 결과 비교

김형수,박승림,강준순,이우형,김기욱,Kim, Hyoung-Soo,Park, Seung-Rim,Kang, Joon-Soon,Lee, Woo-Hyeong,Kim, Ki-Wook 대한관절경학회 2001 대한관절경학회지 Vol.5 No.1

목적 : 본 논문의 목적은 전방 십자 인대 손상에 있어서 반건양건과 골-슬개건-골 자가이식을 이용한 관절경적 전방 십자 인대 재건술후의 술 후 중기적 성공여부와 안정성을 비교하기 위함이다. 대상 및 방법 : 순수한 전방 십자 인대 파열만을 가진 80명의 환자를 대상으로 하였다. 평균 추시 기간은 골-슬개건-골군은 49.4개월이었고 반건양건군은 48.8개월이었다. 술후 주관적인 Lysholm score와 anterior drawer test, Lachman test, pivot shift test, KT-2000 measurement에 따른 객관적인 이완정도 및 IKDC 평가법을 이용하여 최종결과를 비교하였다. 결과 : 전방 전위 검사상 반건양건군에선 양성이 $22.5\%$, 골-슬개건-골군에 $27.5\%$ Lachman 검사상 반건양건군에선 양성이 $30.0\%$, 골-슬개건-골군에선 $25.0\%$, pivot shift 검사상 반건양건군에선 양성이 $15\%$, 골-슬개건-골군에선 $20\%$를 보였으며 통계학적으로 의미있는 차이를 보이지는 않았다(p>0.05). 20lbs에 따른 KT-2000 검사의 차이는 반건양건군에서는 2.2mm, 골-슬개건-골군에서는 2.1mm의 차이를 보였다(p>0.05). 주관적인 Lysholm 점수 평가 상 두군에서 의미있는 차이를 발견하지 못하였다(>0.05). 전방 슬관절의 통증은 골-슬개건-골군에서 더 흔히 나타났으며 양쪽군 모두가 IKDC 등급 상 $82.5\%$에서 유사 정상 등급 이상의 결과를 나타내었다. 결론 : 전방 십자 인대 재건술에 있어서 골-슬개건-골이식건을 이용하는 방법과 비교하여 반건양건도 관절의 안정성에 있어서 유용한 방법으로 생각된다. Purpose : The purpose of this study was to compare the postoperative success and stability of arthroscopically assisted anterior cruciate ligament(ACL) reconstructions using central one third bone-patellar-tendon bone(BPB) autograft versus quadrupled semitendinos-us(ST) autograft as the medium term review. Materials and Methods : Eighty patients(40 BPBs,40 STs) with isolated ACL injury were available for a mean follow up of 49.4 months(BPB) and 48.8 months(ST). There was no significant difference between the two groups with respect to age and sex. We compare the final results between two groups with respect to subjective Lysholm score, objective laxity including anterior drawer test, Lachman test, pivot shift test, KT-2000 measurements and International Knee Documentation Committee(IKDC) evaluation system. Results : Postoperatively, positive anterior drawer test was found in $22.5\%\;and\;27.5\%$, positive Lachman test was found in $30.0\%$ and $25.0\%$ and positive pivot shift test was found in $15\%\;and\;20\%$ of the ST and BPB group, respectively(p>0.05). Mean side to side difference of KT-2000 at 20 lbs was 2.2 mm for the ST group and 2.1 mm for the BPB group. There was no significant difference between the two groups about Lysholm score(>0.05). Anterior knee pain was knee common in the BPB group. Eighty-three percent of the patients were nearly normal according to the IKDC grade in both groups. Conclusion : We consider that autogenous semitendinosus tendon is a good alternative subsititute in ACL reconstruction together with the bone-patellar tendon-bone autograft.

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.

정복 불가능한 슬관절 탈구의 드문 예: 내측광근의 단추구멍손상 - 증례 보고 -

김형수,박승림,강준순,이우형,김기욱,Kim, Hyoung-Soo,Park, Seung-Rim,Kang, Joon-Soon,Lee, Woo-Hyeong,Kim, Ki-Wook 대한관절경학회 2001 대한관절경학회지 Vol.5 No.1

정복되지 않는 슬관절 탈구 중 내측 광근에 의한 단추구멍 손상에 의한 경우는 매우 드문 경우로 이에 대한 신속한 정복이 지연된 슬관절 탈구로 발생할 수 있는 합병증을 줄일 수 있다. 저자들은 슬부의 후외방 전위와 대퇴골 내과의 돌출을 보이는 환자를 자기 공명 영상으로 진단하고 이에 대해 관절 절개술을 이용하여 정복술 및 양측 십자인대 복원술로 치료한 환자를 경험하였다. 술후 10개월에 환자는 경도의 후방 불안정이 있었으나 관절의 운동 범위는 정상으로 회복되었다. The muscular button holing of vastus medialis is a very rare case of irreducible knee dislocations, and rapid reduction of this can diminish the complications which delayed reduction accompanies. We diagnosed a patient who appeared posterolateral dislocation of the knee and protrusion of the medial femoral condyle with MRI grossly. That was reduced by open arthrotomy, followed the reconstruction of both cruciate ligaments and repair of medial collateral ligament. Patient didn't show joint instability except minor posterior sagging and had full range of motion postoperatively after 10 months.

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).

초등학교 병설유치원의 건축계획요소 및 공간위계에 관한 연구 - 경기도 화성지역사례를 중심으로 -

김형수,박재승,Kim, Hyoung-Soo,Park, Jae-Seung 한국교육시설학회 2015 敎育施設 Vol.22 No.4

This study analyzes the domestic kindergarten attached to elementary school, and that is to present the basic data to be established in the future on the basis of the problems seen in kindergarten attached to elementary school analysis of construction planning. For this study, selecting 10 kindergartens in Hwaseong, Gyeonggi-do, and the selected spatial configuration of kindergarten. And then, analyzes Space Organization, Circulation Plan, Area Distribution, Spatial Hierarchy of them. The results were as follows. 1) The current kindergarten attached to elementary school is associated with the most elementary building planes are independent. 2) Most of them don't have space for secondary activities such as playroom or hallway space between the classrooms and the entrance. 3) Interior space is composed of educational space, service space, administrative space. 4) Kindergarten attached to elementary school should plan increase the area because it is small scale there are a lot of dead space. 5) The main users of kindergarten children should be planned simultaneously in a space that is used along with the teacher. Such a kindergarten attached to elementary school in order to be implemented in construction and environmental characteristics of the kindergarten curriculum developers and juxtaposition of kindergarten teachers and architects such exchanges should be made a doctor of the tripartite briskly.

수치 모사를 활용한 수평 혹은 경사형 특수 정호 지하수 흐름 특성 평가

김형수,Kim, Hyoung-Soo 한국지하수토양환경학회 2008 지하수토양환경 Vol.13 No.2

수평 혹은 경사 형태 특수 정호 양수량에 대한 시공간적 수위 강하를 지하수 수치 모델링을 활용하여, 평가하였다. 지하수 수치 모델링은 상용 프로그램인 FEFLOW(version 5.1)의 1차원 선형 불연속 특징 요소를 활용하여 수행되었으며, 수치해의 검증을 위해 Zhan과 Zlotnik(2002)이 제안한 연속된 점 형태 배출원 배열 방식 준 해석해와 비교하였다. 비교 검증 결과, 수치해와 준해석해는 최대 수위 강하가 나타나는 양수 최인접부를 제외하고는 거의 일치한 형태를 보여주었다. 검증된 수치적 방법을 이용하여, 강변여과 방식 취수가 검토되는 현장에 대한 수위강하를 정량적으로 평가할 수 있었다. The drawdown distribution due to pumping by horizontal or slanted wells is analyzed by numerical modelling. In the numerical modelling uses 1-D discrete element feature included in commercial groundwater modeling program FEFLOW (version 5.1) and the results are compared with the semi analytic solution which uses superposition of successive point sources proposed by Zhan and Zlotnik (2002). Results of the numerical modeling agree well with the semi analytic solution except for very near field region of sink sources. The drawdown distribution due to pumping in riverbank filtration(RBF) plan site can be evaluated quantitatively by the numerical modeling in this study.

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.

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.