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김기수,최용수,염경성,손경선,이재혁,Kim, Ki-Soo,Choi, Yong-Soo,Yeom, Kyung-Sung,Shon, Kyung-Sun,Lee, Jae-Hyuk 대한근골격종양학회 1999 대한골관절종양학회지 Vol.5 No.4
The purpose of this study was to verify the importance of apoptosis in genesis of osteosarcoma and whether apoptosis may play an important role as a predictive factor for the response to chemotherapy. Of the patients who were diagnosed osteosarcoma between January 1995 and June 1999, ten patients were selected. All specimens were obtained before and after preoperative chemotherapy and examined for the occurrence of apoptosis. Apoptosis was investigated by in situ end-labeling technique on paraffin-embedded sections and apoptotic indices were calculated before and after chemotherapy. The ages of ten patients ranged from 15 to 59 with equal sex ratio. All patients completed the planned pre-operative chemotherapy. Apoptosis occurs in osteosarcoma and apoptotic indices are increased after chemotherapy. Mean apoptotic index (AI) before and after chemotherapy were 17.2 (range 6-28.9) and 26.3 (9.6-46.2), respectively. Apoptotic cells were usually present around the necrotic area. The AI was increased as the progression of stage and in responder group more than in non-responder. Apoptosis is induced by pre-operative chemotherapy and the response is variable. Changes in AI levels before and after chemotherapy may possibly predict an individual patient's overall response.
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흉요추 이행부 (T12-L2) 골절의 전방유합술이 요추운동 분절에 미치는 영향
김기수,최용수,정현균,염경성 대한척추외과학회 1997 대한척추외과학회지 Vol.4 No.2
Study design : We analyzed the segmental mobility of the lumbar spine after anterior stabilization in the thoracolumbar spinal fractures, and the data were compared with those obtained from an asymptomatic control group. Objective : To determine the effects of anterior stabilization on the unfused segments of the lumbar spine. Summary of Literature review : Spinal fusions are commonly used to stabilize unstable motion segments and to help the maintenance of correction afforded by the instrumentation applied in surgery for spinal deformity or injuries. How the presence of the fusion effects upon the remaining unfused spine is not well understood. Materials and Methods : We measured the segmental deformations of the lumbar spine radiologically, from maximum flexion to maximum extension, right and left maximum lateral bending, in 20 asymptomatic volunteers( the control group ) and 30 patients who had the anterior stabilization of the thoracolumbar spinal fractures(the study group). We assessed the percentage of segmental deformations which were obtained by multipling one hundred after the segmental deformation value was divided by the total lumbar deformation value. We made the comparison between the White and Panjabi's results and the control group, between the control group and the study group, between the segmental deformations and the percentage of segmental deformations. Results : In the control group , the segmental deformations were smaller than those of the corresponding segments in the White and Panjabi's results. In the flexion-extension rotation of the lumbar spine, the segmental deformations had a tendency to increase from cephalad to caudal in the control and study group. In the residual lumbar spinal mobility, the segmental deformations of the study group had decreased rather than those of the control group. Especially the segmental deformation below the juxtafused segment had increased more than those of the corresponding segment of the control group in the right lateral bending rotation. The residual lumbar spinal mobility tended to decrease from T12 vertebral stabilization to L2 vertebral stabilization. Conclusion : The unfused segments had accommodated a greater percentage of segmental deformations in spite of diminishing the segmental deformations in comparison with those of the corresponding control subjects. It suggests that the greater percentage of segmental deformations predisposes to early degeneration of unfused segments.
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Hydroxyapatite 피복 인공 삽입물을 이용한 전위 대퇴골 경부 골절의 치료
김기수(Ki Soo Kim),정영율(Young Yool Chung),염경성(Kyung Sung Yeom),조경진(Kyung Jin Cho),안용철(Yong Chul Ahn) 대한고관절학회 1999 Hip and Pelvis Vol.11 No.1
Although still a matter of debate, heimarthroplasty is accepted as an optimum treatment for displaced femoral neck fractures in the elderly. 126 patients with displaced femoral neck fracture were treated with the HA-coated ABG hip system in Kwangju christian hospital from February 1992 to February 1997, 44 patients were died and 34 were lost to follow up. This study included 42 patients (43 hips) who followed up more than two years. The average age of the patients was 71.6years. Sixteen patients were men and 26 were women. The average follow up period was 40.4 months. The average Harris hip scores were 88.6 points and 40 patients had more than fair functional results at the last follow up. More than 86% of the femoral stem implanted patients achieved initial good surgical fit and fixation by osteointegration was seen in 40 cases. In five cases of 6 patients undersized stems were fixed by osteointegration during the last follow-up. We performed revision in 3 patients because of cup migration in 2 cases and periprosthetic fracture in one case. We concluded that HA-coated bipolar hemiarthroplasty in elderly patients with displaced femoral neck fracture showed satisfactory functional and radiological results without high perioperative mortality and major complications
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