백서에서 난소 제거와 고정이 뼈에 미치는 영향에 대한 연구

차응남,이석현 고려대학교 의과대학 1994 고려대 의대 잡지 Vol.31 No.1

Previous studies implied association of osteoporosis with estrogen deficiency, immobilization and low calcium absorption only through epidemiological studies. There have been only a few experimental studies verifing the etiologic factors of osteoporosis in vivo condition. The author conducted an experimental study using white rats in order to find out what the endocrinological and biochemical changes of experimentally induced oseteoporosis are and how they behave with or against each other. White rats, eighty five in number of 3 to 6 month old females and weighing 220±12.7gm were divided into four groups. They consisted of Group Ⅰ (n=10) for control, Group Ⅱ (n=25) for bilateral oophrorectomy, Group Ⅲ (n=25) for bilateral division of sciatic nerve and hip spica cast immobilization, and Group Ⅳ (n=25) for bilateral oophphorectomy and bilateral division of sciatic nerve plus hip spica cast immobilization. Blood samples were taken preoperatively and postoperatively at six weeks to check Estradiol and Oteocalcin levels there of. And then, rats were sacrified immediately after the second sampling to retrieve femora for bone mineral density measurement and torsional stress test. Estradiol levels before operation were 21.4±13.3 pg/ml for Group Ⅰ, 31.6±3.1 pg/ml for Group Ⅱ, 25.6±4.5pg/ml for Group Ⅲ and 33.7±4.5 pg/ml for Group Ⅳ, respectively. There were no significant differences observable among the groups. Estradiol levels at six weeks postoperatively were 42.3±18.8 pg/ml for Group Ⅰ, 5.4±2.7 pg/ml for Group Ⅱ, 40.8±5 pg/ml for Group Ⅲ and 6.2±2.3 pg/ml for Group Ⅳ, respectively. Apparent reductions in Group Ⅱ and Ⅳ were proved of statistical significance. Osteocalcin levels preoperatively were 1.2±0.6 ng/ml for Group Ⅰ, 1.7±0.4ng/ml for Group Ⅱ, 1.5±0.1 ng/m for Group Ⅲ and 1.5±0.1 ng/ml for Group Ⅳ, respoectively. At six weeks postoperatively they were 1.6±0.1 ng/ml for Group Ⅰ, 1.7±0.3 ng/ml for Group Ⅱ, 1.8±0.3ng/ml for Group Ⅲ and 1.2±0.1ng/ml for Group Ⅳ, respectively. The differences and changes among the groups and measurements were not of statistical signifcance. Bone mineral contents at six weeks postoperatively were 0.248±0.03g for Group Ⅰ, 0.177±0.03g for Group Ⅱ, 0.226±0.04g for Group Ⅲ and 0.092±0.01g in Group Ⅳ, respectively. Low values of Group Ⅱ and Ⅳ compared to those of Group Ⅰ and Ⅲ were of statistical significance. Torsional strength of bones at six weeks postoperatively were 4.0±0.2 N/m for Group Ⅰ, 1.5±0.1 N/m for Group Ⅱ, 1.5±0.1 N/m for Group Ⅲ and 1.4±0.1 N/m for Group Ⅳ, respectively. Decreases of experimental groups(Ⅱ, Ⅲ, Ⅳ) compared to that of control group(Ⅰ) were of statistical significance, but differences among the experimental groups were not of significance. From above observations, it was possible to conclude that osteoporosis measurable by bone mineral content and torsional stress test was caused by oophorectomy and immobilization in vivo, the former of which was more rapid and profound than the latter during early phase. When both factors, i.e., oophorectomy and immobilization are exerted simultaneously, the resultant osteoporosis was found in higher degree than either factor only, but not at incremental degree as one may expect.

슬관절 내측 측부인대 파열의 치료에 대한 임상적 고찰

車應南,邊永壽 최신의학사 1989 最新醫學 Vol.32 No.7

우측 경골 근위부 골간단에 발생한 골육종의 항암요법 및 사지구제술

차응남,김용민,정필현,안영언,강석,유문집 東國大學校醫學硏究所 1993 東國醫學 Vol.1 No.-

과거에는 사지에 발생한 골육종에 대한 치료로 절단방법이 많이 이용되어 왔으나 최근에는 항암요법 및 자기공명 영상술의 발달과 더불어 사지구제술이 보편화 되어가고 있는 추세이다. 본 동국대학교 정형외과학 교실에서는 우측 경골 근위부 골간단에 발생한 골육종에 대한 치료로 항암요법 및 사지구제술을 실시한 례가 있어서 문헌고찰과 함께 보고하는 바이다. In the past, amputation has been the most common surgical treatment for osteogenic sarcoma of a bone of an extremity. Due to the advances, in the diagnostic imaging, in adjuvant and neoadjuvant treatment and in the surgical technique for reconstruction of limb salvage who have osteogenic sarcoma, the limb salvage surgery becomes the treatment of preferred modality. We experienced a case of osteogenic sarcoma who underwent limb salvage procedure after neoadjuvant chemotherapy. We report this case with clinical details

Slipped Capital Femoral Epiphysis in a Pituitaty Adenoma Compromised Adult : 1례 보고

Cha, Eung-Nam,Kang, Suk 최신의학사 1993 最新醫學 Vol.36 No.4

신생아에서 발생한 급성화농성 고혈관절염에 대한 고찰

강석,차응남,김용민 최신의학사 1993 最新醫學 Vol.36 No.5

동측 대퇴골 및 경골 간부 골절의 치료

유문집,차응남,김용민 동국대학교 경주대학 1993 東國論集 Vol.12 No.-

Multiple fractures are becoming increasing due to traffic and industrial developments. Ipsilateral femur and tibia fractures are caused by high energy trauma and associated with many problems such as hemorrhagic shock, longer morbidity, delayed union of nonunion, knee stiffness etc. Recently the principles of treatment are directed to rigid internal fixation and early mobilization for more satisfactory functional recovery. Since July 1990, we managed 6 patients who had ipsilateral femur and tibia shaft fractures mainly with intramedullary nailing. The results are as follows ; 1. All the 6 cases were accompanied by multiple fractures and/or dislocations. Ipsilateral knee injuries were combined in 2 cases. 2. As for the femur, intramedullary nails were used in all cases. Intramedullary nailing was used for the tibia in 5 cases, and external skeletal fixator in the other one. 3. All the fractures united. Union time of the femoral fractures ranged from 6 to 8 months(mean : 29 weeks ; 6.7 months). Tibia shaft fractures united at from 14 to 32 weeks(mean : 22 weeks ; 5.2 months) postoperatively. 4. 3 Knees recovered full range of motion. But in the other 3 knees, limitations of further flexion to average 100 degrees were noted.

슬관절 손상환자에 있어서 자기공명영상의 진단적 의의

강석,김종필,차응남,김경철,조창성,김용민,황정수,정필현 東國大學校醫學硏究所 1994 東國醫學 Vol.2 No.-

슬관절 손상환자의 진단방법에는 여러 가지가 있으나 자기공명영상은 최근에 발전된, 정형외과영역에서 매우 유용한 진단방법이다. 자기공명영상은 골 및 연부조직의 미세구조를 잘 보여줄뿐 아니라 고도의 정확도를 가진 비 침습적 검사법이다. 본 동국대학교 정형외과학 교실에서는 1994년 1월부터 9월까지 본교실에서 치료받은 슬관절 손상환자에 있어서 이학적 검사, 단순 방사선검사 및 자기공명영상검사후 수술적 방법으로 확진된 30례를 분석하여 비교함으로서 자기공명영상의 진단적 유용성에 대해 알아보고 문헌고찰과 함께 보고하는 바이다. There have been several diagnostic methods to evaluate the knee injury patient with guarded accuracy. Magnetic Resonance Imaging(MRI) is recently developed diagnostic tool of highly improved benefits especially in orthopaedic field. MRI not only shows fine osseus and soft tissue structure, but is not invasive with upgraded accuracy. Authors analysed 30 cases of knee injury of which were diagnosed by simple X-ray including stress view, MRI, and physical examination under anesthesia. All the cases were confirmed at final operative intervention from Jan.1994 to Aug.1994 at our hospital. The purpose of this paper is to appreciate the diagnostic value of MRI in knee injured patient compair with simple X-ray including stress view and physical examination. The sensitivity and specificity of MRI were 78%,100% for ligament injury, and 100%,100% for meniscus injury, respectively. We believe that MRI, when combined with physical examination and X-ray finding gives the most accurate non-invasive method of information to delineate pathologic findings in the knee injury patient.

Cis-A2B3형에 의한 ABO 불일치 1예

하경임,전창호,김우택,차응남,강석,오영철 大韓輸血學會 1993 大韓輸血學會誌 Vol.4 No.1

백서에서 난소 제거와 고정이 뼈에 미치는 영향에 대한 연구

이석현(Seok Hyun Lee),차응남(Eung Nam Cha),조창성(Chang-Sung Cho) 대한정형외과학회 1995 대한정형외과학회지 Vol.30 No.3

Delta 맞물림 금속정을 사용한 폐쇄성 골수강내 고정술시 발생한 대퇴골 근위부 골절

김용민,김종원,유문집,정필현,차응남,강석 대한골절학회 1992 대한골절학회지 Vol.5 No.2

Closed intramedullary nailing is a complex technique which usually requires fracture table and image intensifier, so that the patient and surgeon are exposed to the radiation. But this technique affords considerable advantages such as high rate of union, less infection rate and early weight bearing, etc. The main causes of failure or complication of this procedure are inapproprisate entry point and inadequate nail size. These are especially important problems in the patient who's femoral canal diameter is very small (8 or 9mm). The Delta femoral interlocking nails(diameter 10mm and 11mm)were devised for the femurs with narrow canal diameter. However, proximal portion of the Delta nail (about 7cm from the proximal end)is thick(diameter 13mm)to gain strength enough for holding the insertion device and fixation o( the interlocking screws. If the insertion point is not correct or proximal reaming is inadequate, iatrogenic proximal femoral fracture may occur during final insertion of the nail. We experienced 2 cases of this complication during fixation of femoral shaft fractures using the Delta nails. We managed this problem with hip spica cast immobilization in one case, and multiple pinning of femur neck in the other.