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항생제 혼합 시멘트정 및 외고정기구를 이용한 경골 감염성 불유합의 이단계적 치료
정연천 대한골절학회 2000 대한골절학회지 Vol.13 No.4
PURPOSE: To evaluate the results of two-stage treatment for infected nonunion of the tibia using antibiotics impregnated cement beads(AICB) and external skeletal fixation. MATERIALS AND METHODS: We analyzed 25 infected tibial nonuinon that were treated with AICB and external skeletal fixation from July 1995 to April 1998. The average follow-up was 25 months. In the first stage, sequestrectomy and radical debridement was performed. and then the soft tissue and bony defects were filled with AICB and was stabilized with external skeletal fixation. In the second stage, after removal of AICB and the nonunion site was either grafted with autogenous cancellous bone graft(17 patients) or internal bone transport(8 patients) was performed according to the bone defect size. RESULTS: The average bony union time was 36.8 weeks. The intervening time between the first and second stages of treatment was 4 to 6 weeks (average 5.4 weeks). There were 8 pin tract infections, 1 Postoperative infection after the second-stage bone grafting. According to Paley's functional assessment system, excellent or good results were obtained in 20 cases. There was no poor result. CONCLUSION: In our opinion, the above advocated two-stage treatment is an acceptable treatment modality for the management of infected tibial nonunion.
양대천,정연도 한국경영교육학회 2010 경영교육연구 Vol.63 No.-
M&A is actively taking place worldwide among all industry fields. As more and more firms choose M&A as their growth strategy, the M&A market is rapidly growing. Traditionally, firms pursued internal growth strategy by making use of internal resources such as facility extension and new construction. However, as the recent business environments rapidly change, firms are seeking external growth strategy to promptly acquire facilities and business resources through M&As. In this study, we compare internal with external growth firms by their characteristics and performances. Through the comparisons, the internal growth firm might find out what competencies it needs to obtain in order to grow efficiently by M&A and which department's efficiencies it needs to improve. The contents of this paper are as follows. First, it compares the characteristics of the two types of firms in four aspects: strategy, organization, process, and corporate culture. Second, it compares the performances of the two types of firms using HOB model, which divides each activity of business value chain. The results are as follows. Internal growth firm is optimized for production and shows superiority in improvement of product efficiency. Comparatively, external growth firm is optimized for holding market, executing M&A and integrating organizations leaded by its proficient management in finance, and shows superiority in improvement of marketing efficiency, administration efficiency and financial effects multiplier. This study suggests with caution that if an internal growth firm wants to alter its strategy to external growth to correspond to the recent M&A trend, it might choose to gradually supplement necessary competencies for external growth along with maintaining its strength rather than immediately abandoning the efficient internal growth system.
항생제 혼합 시멘트정 및 외고정기구를 병용한 대퇴골 감염성 불유합의 이단계적 치료
송해룡,박형빈,정연천 대한골절학회 2000 대한골절학회지 Vol.13 No.4
PURPOSE: The purpose of this study was to find out the treatment efficiency of two stage osteosynthesis with antibiotic cement beads and external skeletal fixation for infected nonunion of femur. MATERIALS AND METHODS: In the first stage, radical debridement was performed. The soft tissue and bony defects were filled with antibiotics impregnated cement beads and the nonunion site was stabilized with external skeletal fixation. In the second stage, the debrided nonunion site was repaired with bone grafting. The intervening time between the first and second stages of treatment was 4 to 6 weeks (average 5.4 weeks). The bone defects ranged from 0.5 to l4cm, Autogeneous iliac cancellous bone grafting was performed in 17 patients and microvascularized fibular graft was performed in 5 patients. RESULTS: The follow-up period was average 45 months (range, 27-62 months). Infection control and bone union were achieved in all 22 cases. Postoperative infection after the second-staged bone grafting occurred in one patient. This recurred case was treated with repeated two staged operation. Even though aggressive physical theraphy was done, all patients had relevant knee flexion deficits. 14 patients were achieved more than 100 degrees of knee flexion, but 8 patients had less than 80 degrees of range of motion. CONCLUSION: We have found that two-stage treatment with antibiotic beads local therapy, external skeletal fixation, and staged bone grafting is an acceptable treatment modality for the management of infected femoral nonunion. It results in rapid recovery from osteomyelitis and a predictable recovery from nonunion.