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나기태 ( Ki Tae Na ),이주엽 ( Joo Yup Lee ) 대한골절학회 2016 대한골절학회지 Vol.29 No.2
The wrist joint is formed by the distal end of the radius and ulna proximally, and eight carpal bones distally. It has many ligaments to maintain stability of the complex bony structures. The incidence of ligament injuries of the wrist has increased due to sports activities. However, diagnosis and management of these injuries are sometimes difficult because of the anatomic complexity and variable injury patterns. Among them, scapholunate ligament injury and triangular fibrocartilage tears are the two most common injuries resulting in chronic disabling wrist pain. Thorough understanding of the wrist anatomy and physical and radiologic examination is mandatory for proper diagnosis and management of these conditions. This article will briefly discuss the wrist joint anatomy and biomechanics, and review the diagnosis and management of the scapholunate ligament injury and triangular fibrocartilage injury.
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이상명(Sang-Myung Lee),송석환(Seok-Whan Song),이승구(Seung-Koo Rhee),박재철(Jae-Chul Park),나기태(Ki-Tae Na) 대한정형외과학회 2010 대한정형외과학회지 Vol.45 No.4
목적: 진행된 Kienbock 질환의 치료 시 삼주상 유합술(STT fusion), 주상-유두골 유합술(SC fusion), 그리고 주상-유두-유구-삼각골 유합술 (SCHT fusion)의 임상적 치료 결과를 평가하고자 한다. 대상 및 방법: Lichtman 분류 제 Ⅲ기 또는 Ⅳ기인 40명의 환자를 대상으로 제한적 수근관절 유합술을 실시하였다. 술 전 방사선 결과와 수술 시 관절 면에 대한 평가를 통해 삼주상 및 주상-유두골 유합술은 제 Ⅲa와 Ⅲb기에서 시행하였으며 주상-유두-유구-삼각골 유합술은 Ⅲb기와 Ⅳ기에서 시행하였다. 평균 추시 기간은 31.6개월(범위 13-108)이었으며 수술 시 평균 나이는 44.7세(범위 22-71)였다. 삼주상 유합술은 13예, 주상-유두골 유합술은 19예, 그리고 주상-유두-유구-삼각골 유합술은 8예에서 시행하였다. 치료 결과를 평가하기 위하여 수근관절의 운동 범위, 파악력(grip strength) 통증(VAS, visual analog pain score)을 측정하였으며 최종추시 방사선학적 변화도 측정하였다. 결과: VAS 점수는 삼주상 유합술에서 4.7점, 주상-유두골 유합술에서 3.0점. 주상-유두-유구-삼각골 유합술에서 4.5점이었다. 파악력은 반대편과 비교하여 삼주상 유합술에서 72%, 주상-유두골 유합술에서 78%, 주상-유두-유구-삼각골 유합술에서 54%이었다. 통증의 감소는 주상-유두골 유합술 군이 디른 두 군에 비해 우수하였으며(p=0.007), 주상-유두-유구-삼각골 유합술 군에서 파악력 감소가 관찰되었다(p=0.009). 세 군 간에 운동 범위는 유의한 차이가 없었다. 주상-유두골 유합술을 시행한 1예를 제외하고 모든 예에서 골유합을 얻을 수 있었다. 결론: 진행된 Kienbock 질환의 치료로써 제한적 수근관절 유합술은 유용한 방법이며 통증의 경감에 있어서 주상-유두골 유합술이 삼주상 유합술에 비하여 우월한 결과를 보였다. 주상-유두-유구-삼각골 유합술은 제 Ⅳ기 Kienbock 질환에 있어서 고려해볼 만한 구제 수술이라 생각 된다. Purpose: To evaluate clinical outcomes of triscaphe (STT), scapho-capitate (SC) and scapho-capito-hamato-triquetral (SCHT) fusion in advanced Kienbock's disease. Materials and Methods: Forty patients with Lichtman stage Ⅲ and Ⅳ disease were treated with limited wrist fusion. sn & SC fusion for stage Ⅲb and Ⅲb, and SCHT fusion for Ⅲb and Ⅳ were done according to preoperative radiologic and intraoperative articular surface findings. The mean follow-up period was 31.6 months (range 13-108) and the mean age at the time of their surgery was 44.7 years (range 22-71) There were 13 cases of sn fusion, 19 cases of SC fusion and 8 cases of SCHT fusion. For assessment of treatment results, wrist range of motion, grip strength, VAS (visual analog pain score) and any radiologic changes of the wrist were checked at last follow-up. Results: VAS score was 4.7 for STT, 3.0 for SC, 4.5 for SCHT. Grip strength, compared with the contralateral side, was 72% for STT, 78% for SC, and 54% for SCHT. Pain was more improved for the SC fusion group than for the other two groups (p=0.007). Grip strength was decreased more in the SCHT fusion group than in the other two groups (p=0.009). There were no statistically significant differences in range of motion between any of the three groups. The bone achieved union in all cases except one SC fusion. Conclusion: Limited wrist fusion in advanced Kienbock's disease has been regarded as a valuable method. However, SC fusion has been thought of as a more favorable technique than sn fusion with respect to pain relief. SCHT fusion is thought to be a possible salvage procedure with a limited indication for Stage Ⅳ Kienbock's disease.
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태양열 온수급탕 시스템에 관한 연구 : 아파트를 중심으로 With relevance to Apartment
송인춘,김기세,구현덕,김병수,나기태 忠南大學校 産業技術硏究所 1999 산업기술연구논문집 Vol.14 No.1
This work was carried out to propose a model of the most effective layout and installation for applying the Solar Hot Water system to apartment and to offer the basic data for promoting the destribution of this Solar Hot Water system in the country. For this purpose, the performed experiments are as followings: 1)Measurement and analysis of the amount of hot water adn the cost of water used in apartment of which the area is 30 to 40 pyung. 2)to esimate the efficiency of Solar Hot Water System in accordance with an angle of inclination. 3) Analysis of economical efficiency the annual expected saving cost produced by replacing the existing hot water system with the Solar Hot Water System. 4)Proposal of the best model for installing the Solar Hot Water System in apartment by considering the place and sunshine,and compaison of merit and demerit of this system.
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개별환경제어(PEM)시스템의 운용에 따른 건물의 에너지절약성에 관한 연구
송인춘,구현덕,김기세,나기태,김병수 忠南大學校 産業技術硏究所 1999 산업기술연구논문집 Vol.14 No.1
The building energy conservation possibility by introducing personal environment module(PEM)system was analyzed by DOE-2.1E building energy analysis program on the 6 stories office building. The results showed energy consumption of the building with PEM system could be increased more than the conventional VAV system when the occupant was not decreased. But the energy consumption rate in the building with PEM could be equal to VAV system when approximately 20% of the occupant is decreased. As a result, basically PEM system can consume more about 9.2%energy than the VAV system, but it can also have the possibility to save energy about 11.4% if it is operating with energy conservative way.
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