하악골 우각부 골절시 교합력에 대한 소형금속판 내고정의 삼차원적 응력 해석

박기덕(Ki Deog Park),류선열(Sun Youl Ryu) 대한구강악안면외과학회 1993 대한구강악안면외과학회지 Vol.19 No.4

The purpose of this study was to investigate the stress distribution and the displacement to the occlusal force in the intact mandible and in the angle fractured mandible fixed with miniplate at the upper and lower border. X, Y, Z-directions of force(10kg) were applied on the right and left mandibular first molar unilaterally. Material property, geometry, and load conditions of each model were inputed to the three dimensional finite element program and the stress distribution and the displacements finite element program and the stress distribution and the displacements were analyzed. The results obtained were as follows: 1. In the intact model, stresses were evenly distributed along the external oblique ridge of mandible. On the opposite side. Low level stresses were distributed along the external oblique ridge and coronoid process and maximam principal stress was observed at the load applied teeth. 2. In the cases of fractured model, higher level stresses were observed than those of intact model and maximam principal stress was observed on the miniplate when the load was applied at the left first molar. In cases of load applied at the left first molar maximam principal stress was observed on the load applied tooth in model of internal fixation on external oblique ridge and in cases of load applied at the right first molar maximam principal stress was observed on miniplate model of internal fixation on inferior border 3. In the cases of internal fixation with miniplate on the external oblique ridge, stress distribution was similar to those of intact model and displacement was smaller than that of internal fixation on the mandibular inferior border. 4. In the cases of internal fixation with miniplate on the inferior border, stress was distributed along the inferior border, being different form those in intact model. 5. In three type models, highest stress-concentration was observed under the vertical(Z) directional load and relatively stable results under inner(X) directional load on the fracture side first molar. Under load applied on opposite first molar, results were similar in three type models. These results suggest that stress distribution of internal fixation with miniplate on the external oblique ridge is more similar to intact model than internal fixation with miniplate on the inferior border with less displacement and internal fixation with miniplate on the external oblique ridge is more stable fixation method.

두경부 영역의 종양 절세후 광배근피판을 이용한 재건술

이종호,박광,서구종,박기덕,Lee, Jong-Ho,Park, Kwang,Seo, Ku-Jong,Park, Ki-Deog 대한악안면성형재건외과학회 1992 Maxillofacial Plastic Reconstructive Surgery Vol.14 No.1

저자들은 악안면부에 발생한 종양 절제 후 광배근피판(유정 피판, 5례 : 유리 피판, 1례)으로 재건하여 5례에서 성공하였다. 큰 피판 형성의 잠재성은 두경부에서 충분한 종물제거와 재건을 가능하게 하였으며, 피판 형성이 빠르고 용이하며 긴 혈판경(약 45cm)을 채득할 수 있었다. 공여부 합병증과 기능 상실이 적어 두경부의 커다란 결손부 재건에 매우 유용한 피판으로 판단되었으며, 경부곽청술 후 노출되는 심부 조직에 대해 심미적이며 기능적인 보호를 제공할 수 있었다. Latissimus dorsi myocutaneous flap is useful for the breast reconstruction, chest wall coverage, free flap transfer, and head and neck area reconstruction, especially in large defect. We have had some experience of 5-pedicled and 1-free latissimus dorsi myocutaneous flap in head and neck area and found many advantages and some problems. The conclusions were as follows : 1. Potentially large flap size enabled us agressive tumor resection and reconstruction. 2. Speedy and easy flap elevation and long vascular pedicles reduced operation time and flap failure. 3. Due to fewer complication and functional loss of doner site, pedicled latissimus dorsi flap was a good choice for large head and neck reconstruction. 4. Because of flap bulkness, thin and small defect was not appropriate for reconstruction.

하악골 우각부 골절시 소형금속판 내고정에 따른 3차원적 응력해석

박기덕,류선열 전남대학교 치과대학 1992 전남치대논문집 Vol.4 No.1

The purpose of this study was to investigate the stress distribution and the displacement in the intact mandible and in the angle fractured mandible fixed with miniplate at the upper and lower border. X, Y, Z-directions of force(10Kgf) were applied on the right and left mandibular first molar unilaterally. Material property, geometry, and load conditions of each model were inputed to the three dimensional finite element program and the stress distribution and the displacement were analyzed. The results obtained were as follows: 1. In the intact model, stresses were evenly distributed along the external oblique ridge of mandible. On the opposite side, low level stresses were distributed along the external oblique ridge and coronoid process and Maximal principal stress was observed at the load applied teeth. 2. In the cases of fractured model, higher level stresses were observed than those of intact model and maximal principal stress was observed on the miniplate when the load was applied at the left first molar. In cases of load applied at left first molar maximal principal stress was observed on load applied tooth in model of internal fixation on external oblique ridge and in cases of load applied at right first molar maximal principal stress was observed on miniplate model of internal fixation on inferior border. 3. In the cases of internal fixation with miniplate on the external oblique ridge, stress distribution was similar to those of intact model and displacement was smaller than that of internal fixation on the mandibular inferior border 4. In the cases of internal fixation with miniplate on the inferior border, stress was distributed along the inferior border, being different from those in intact model. 5. In three type models, highest stress-concentration was observed under the vertical-(Z)-directional load and relatively stable results under inner-(X)-directional load on the fracture side first molar. Under load applied on opposite first molar, results were similar in three type models. These results suggest that stress distribution of internal fixation with miniplate on the external oblique ridge is more similar to intact model than internal fixation with miniplate on the inferior border with less displacement and internal fixation with miniplate on the external oblique ridge is more stable fixation method.

국소맛사지 특수운동요법 및 신체교정요법이 만성요통환자에게 미치는 효과

이원재,박기덕 한국운동과학회 1999 운동과학 Vol.8 No.2

국소맛사지, 특수운동요법 및 신체교정요법이 만성요통환자에게 미치는 효과. 운동과학, 제8권 제2호, 231-244, 1998, 비만형인 40∼50대 여성중 6개월 이상 통증을 호소하는 16명을 대상으로 맛사지요법, 운동요법 및 신체교정요법 등 3가지 상이한 치료법을 적용했을 때 골밀도분석(골밀도, 골무기질함유량), 기초체력분석(유연성, 근력, 평형성, 근지구력, 민첩성), 요천추전만 각도와 요천추측만 각도 분석을 함으로써 가장 안전하면서도 효율적인 요통치료법을 관련환자 및 정형외과적인 의료인 등에게 중요한 기초자료를 제공하기 위한 연구결과는 다음과 같다. 1. 골밀도 및 골무기질 함량은 정상군과 요통환자군과의 비교에서 유의한 차이가 없었다. 2. Sit & reach, Trunk extension, Back strength는 시술기간별에서는 유의한 차이가 나타났다. 3. Balance (Left)는 시술방법과 기간간의 상호작용에서 유의한 차이가 나타났으며, 시술기간별에서도 유의한 차이가 나타났다. 4. Balance (Right)는 시술기간별, 방법, 기간과 방법간의 상호작용에서 유의한 차이가 나타나지 않았다. 5. Sit-up에서는 시술기간별에서는 유의한 차이가 나타났다. 6. Side step은 시술방법과 기간간의 상호작용에서 유의한 차이가 나타났으며, 시술기간별에서도 유의한 차이가 나타났다. 7. 요천추전만 및 요천추측만에 있어서는 시술기간별에서만 유의한 차이가 나타났다. 이상의 연구 결과를 비추어 볼 때 비만인 만성요통환자들에게 국소맛사지, 특수운동요법, 신체교정요법이 유용한 치료요법으로 사용될 수 있는 것으로 나타났으며, 물리치료사나 정형외과적 의료인, 기타 환자들에게 매우 활용가치가 높다고 할 수 있다. The effect to chronic low back pain patients for massage, special exercise program and chiropractic. Exercise Science, 8(2): 231-244, 1999. The purpose of this study was to analyze bone mineral density (B.M.D, B.M.C), physical fitness (flexibility, strength, balance, endurance, agility), lumbosacral lordosis angle and scoliosis angle, when the chronic low back pain patients for obese women of ages 40-50 olds adapted three different remedy of the massage, special exercise program. Thus, the important basic data for the efficient remedy method of the chronic low back pain presents to the orthopedic doctor, physical therapist, and et al.. Subjects were 16 women to feel the chronic low back pain over 6 months. The results obtained were as follows 1. Bone mineral density 1) There was no significant difference for B.M.D and B.M.C between control and low back pain group. 2 Physical fitness: 1) There was a significant difference for sit & reach, trunk extension, back strength among the three different treatment periods. 2) There were significant differences on main effect of treatment period and the interaction of method±treatment period for balance(lett). 3) There was no significant differences on main effect of treatment period and method, and the interaction of method±treatment period for balance(right). 4) There was a significant difference for sit-ups among the three different treatment periods. 5) There were significant differences on main effect of treatment period and the interaction of method±treatment period for side step. 3. X-ray 1) There was a significant difference for lumbosacral lordosis and lumbosacral scoliosis angle among the three different treatment periods. As Use above results, the massage, special exercise program, and chiropractic for chronic low back pain patients of obesity person can use one of the remedy method. Thus, the important basic data for the efficient remedy method of the chronic low back pain can be considered to present the orthopedic doctor, Physical therapist, and et al.