등속성 운동검사를 이용한 정상 한국인 성인에서의 발목관절 근력 측정

최승명,박지강,하윤원,조병기,Choi, Seung-Myung,Park, Ji-Kang,Ha, Yoon-Won,Cho, Byung-Ki 대한족부족관절학회 2015 대한족부족관절학회지 Vol.19 No.4

Purpose: Restoration of ankle stability through the strengthening exercise of peroneus muscles is considered an important factor for achievement of successful outcomes, in the rehabilitation program following ankle ligament injuries. However, there were few definitive data on normal muscle strength, including eversion power by peroneus muscles. This study was conducted to evaluate the muscle strength of ankle joint measured using an isokinetic dynamometer in normal Koreans. Materials and Methods: Sixty adults (120 ankles) were recruited and divided into three groups (20 in their twenties, 20 in thirties, and 20 in forties). Each group consisted of 10 males and 10 females. The selection criteria were no history of ankle injury and no evidence of instability. The peak torque, total work, and deficit ratio were measured using the Biodex$^{TM}$ (Biodex Medical Systems). Differences in muscle strength by age, gender and dominant versus non-dominant side were analyzed. Results: The peak torque of dorsiflexion was average 31.5 Nm at $30^{\circ}/s$ of angular velocity and 18.8 Nm at $90^{\circ}/s$; average 69.3 Nm ($30^{\circ}/s$) and 42.4 Nm ($90^{\circ}/s$) on plantarflexion; average 19.6 Nm ($30^{\circ}/s$) and 10.8 Nm ($90^{\circ}/s$) on inversion; average 12.9 Nm ($30^{\circ}/s$) and 8.0 Nm ($90^{\circ}/s$) on eversion. The deficit ratio of strength in women was average 61.1% of men on dorsiflexion; average 66.2% on plantarflexion; average 48.5% on inversion; average 55.4% on eversion. The deficit ratio in non-dominant foot was average 88.6% of dominant foot on dorsiflexion; average 90.1% on plantarflexion; average 85.1% on inversion; average 85.6% on eversion. Conclusion: The muscle strength of the ankle joint showed a tendency to weaken with age. There were significant differences in muscle strength by gender and dominancy. Further studies for comparison of patients with ankle instability, a comparison between before and after surgery for instability, the correlation between clinical outcomes and the recovery in muscle strength will be needed.

요추부 후방 추체간 유합술에서 케이지 충전형 실리콘 함유 다공성 하이드록시 아파타이트의 방사선학적 결과

최승명(Seung-Myung Choi),김용민(Yong-Min Kim),이형준(Hyeong-Jun Lee),이종혁(Jong-Hyuk Lee) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.5

목적: 실리콘 함유 다공성 하이드록시 아파타이트(silicon-containing porous hydroxyapatite, Si-HA)를 케이지 내에 삽입하여 자가 골편과 함께 요추부 후방 추체간 유합술(posterior lumbar interbody fusion, PLIF)에 사용한 후 방사선적 결과를 통해 유합 능력을 분석해 보고자 하였다 대상 및 방법: PLIF를 시행받은 환자들 중 Si-HA를 케이지에 충전하여 수술한 12명을 대상으로 하였다. 요추부 추체간 공간에 블록 형태의 Si-HA를 cage에 충전하여 방사선 검사 및 3차원 컴퓨터 단층촬영 검사 추시를 통해 유합능력을 분석하였다. 결과: 술 후 12개월 단순 방사선 추시상 12명 중 11명이 grade Ⅳ(완전 유합)를 보였고 1명은 grade Ⅲ를 보였다. 술 후 24개월의 추시에서는 모두 grade Ⅳ를 보였다. 술 후 12개월 3차원 컴퓨터 단층촬영 검사상 전체 예에서 agdre I (완전 유합)을 기록하였다. 결론: Si-HA는 PLIF에서 자가골, 동종골과 함께 효과적인 유합 매개체 중 하나라고 생각되었다. Purpose: The objective of this study is to analyze the radiologic fusion rate in posterior lumbar interbody fusion (PLIF) using silicon-containing porous hydroxyapatite (Si-HA) chips packed within a cage. Materials and Methods: Twelve patients who underwent PLIF using Si-HA (BoneMedik-S™; Meta-Biomed, Cheongju, Korea) blocks packed within a cage were enrolled. PLIF was performed in the same manner in all patients. A cage filled with Si-HA was inserted into disc space. Serial Ⅹ-rays and 3-dimensional computed tomography (3D-CT) were performed for evaluation of the fusion status. Results: At postoperative 12 months, 11 cases showed grade Ⅳ and one case showed grade Ⅲ on X-rays. At postoperative 24 months, all cases showed grade Ⅳ (complete fusion). Assessment of fusion by 3D-CT also showed grade I in all cases at postoperative 12 months. Conclusion: Considering the above results, Si-HA packed in a cage appears to be an effective bone graft material for use in PLIF.

가골 신연술을 이용한 다발성 단중수증의 치료

배인탁,박지강,최승명,김국종 대한수부외과학회 2017 대한수부외과학회지 Vol.22 No.2

The treatment of a brachymetacarpia using a distraction osteogenesis was mostly single, unilateral pattern. In case of multiple brachymetacarpia, singlestage lengthening or rapid distraction lengthening with a bone graft were usually used. Multiple brachymetacarpia treated by distraction osteogenesis is rarely reported. We report a case of a 15-year-old female presented with bilateral multiple brachymetacarpia treated by distraction osteogenesis simultaneously without complications. Also, we have evaluated the clinical results and factors which influence the clinical results. 가골 신연술을 이용한 단중수증의 치료는 대부분 단발성에 대한 것으로 다발성의 경우 대개 골이식을 통한 일단계 신연술이나 급속 신연 이후 골이식을 추가하는 술식을 사용한다. 가골 신연술을 이용한 다발성 단중수증의 동시 치료는 드물다. 저자들은 양측 다발성 단중수증으로 내원한 15세 여성 환자를 가골 신연술을 통해 동시에 치료하여 합병증 없이좋은 결과를 얻었기에 치료 시 주의 사항 등에 대하여 문헌 고찰과 함께 보고한다.

골이식 없이 국소마취하에 경피적 나사못 고정으로 치료한 주상골 요부 골절 불유합의 결과

차정권,박지강,최승명,양재영 대한수부외과학회 2017 대한수부외과학회지 Vol.22 No.2

Purpose: The purpose of this study was to analyze the results of patients with scaphoid waist nonunion treated with percutaneous screw fixation without bone grafting under local anesthesia. Methods: We enrolled scaphoid waist nonunion of 15 patients which had no deformity, displacement, evidence of avascular necrosis and bone cyst under 5 mm on its radiological study. All patients were male with an average age of 28.9±6.2 years (range, 17–38 years). The mean time to surgery from initial injury was 10.8±2.2 months (range, 6–14 months). All patients were treated with percutaneous screw fixation without bone grafting via volar approaching under local anesthesia and postoperative radiographs were reviewed and documented the flexion and extension arcs of the injured wrist and uninjured wrist, disability of the arm, shoulder and hand (DASH) score at final follow-up. Results: All 15 patients showed radiological union at an average 5.5±1.0 months. At 12 months follow-up, the flexion and extension arcs of the injured wrist were 95% and 98.5% of the uninjured wrist. The average DASH score at final follow-up was 7±3.9 (range, 0–15). None of these patients showed any complications associated with surgery. Conclusion: Percutaneous screw fixation without bone grafting under local anesthesia was reliable primary treatment method for scaphoid waist nonunion without displacement or deformation in the fracture site. 목적: 주상골 요부 골절 후 발생한 불유합에 대하여 국소마취하에 골이식 없이 시행한 경피적 나사못 내고정술의 결과를 평가하였다. 방법: 주상골 요부 골절 불유합 환자 중 골절부에 전위나 변형이 없고 5 mm 이하의 골낭종, 무혈성 괴사와 관절증의 증거가 없는 15예의 환자를 대상으로 하였다. 모두 남성이었고 평균 나이는 28.9±6.2세(범위, 17-38세), 수상 후 수술까지 기간은 평균 10.8±2.2개월(범위, 6-14개월)이었다. 국소마취하에 수장측으로 접근하여 골이식 없이 경피적 나사못고정술을 시행하였고 골유합 및 변형 여부를 방사선학적으로 평가하였다. 최종 추시에서 DASH score와 건측 대비 환측의 수근관절 운동 범위를 측정하였다. 결과: 모든 환자에서 술 후 평균 5.5±1.0개월에 방사선학적 골유합을 얻었다. 최종 추시 12개월에 건측 대비 환측의 수근관절 굴곡과 신전은 각각 95%와 98.5%로 회복되었고 평균 DASH score는 7±3.9점(범위, 0-15점)이었다. 모든 환자에서 수술과 관련된 합병증은 없었다. 결론: 골이식 없이 국소마취하에 시행하는 경피적 나사못 고정 방법은 골절부에 전위나 변형이 없는 주상골 요부 불유합의 치료에 일차적으로 시도해볼 수 있는 적절한 치료방법이라 생각한다.

구두 상부용 가죽의 인장 회복량 측정실험

이정민,배민철,김영우,최승명,백성관,이형욱,Lee, Jeongmin,Bae, Mincheol,Kim, Yungwoo,Choi, Seongmyung,Baek, Sungkwan,Lee, Hyoungwook 한국교통대학교 융복합기술연구소 2017 융ㆍ복합기술연구소 논문집 Vol.7 No.1

In general, the shoe stretcher is utilized to stretching the leather of shoe upper in the longitudinal direction. In the capstone design class, we tried to make a shoe leather stretcher for the ball of foot. Since a natural cow leather was recovered in length according to relaxation time after stretched, it was difficult to predict the initial amount of set up of stretching. In this paper, tensile and relaxation experiments were conducted in order to predict the amount of initial stretching for appropriate tensile length. Apparatus of leather stretching was designed and strains of leather were measured according to relaxation times of 12, 18, 24 hours after stretching of 24 hours. It was revealed that the ratio of the final relaxed strain and the initial applied strain was about 0.404 with R-square of 0.990 for a shoe cow leather.

충수돌기염 천공에 의해 발생한 요근 및 대퇴부 농양 - 증례 보고 -

김동수,김용민,최의성,손현철,정수리,최승명,박상준 대한척추외과학회 2015 대한척추외과학회지 Vol.22 No.1

연구 계획: 증례 보고목적: 충수돌기염 천공에 의해 발생한 요근 및 대퇴부 농양의 증례를 경험하여 문헌 고찰과 함께 보고하고자 한다. 선행문헌의 요약: 요근 농양의 증상은 발열 및 하부 요통, 요근 경련이 알려져 있다. 대상 및 방법: 53세 남자환자가 고열 및 하부 요통, 하퇴부 통증을 주소로 내원하였다. 요근 농양 및 대퇴부 농양이 발견되었고, 충수돌기염 천공이 동반되어 수술적 치료 및 경피적 배농술을 시행하였다. 결과: 수술적 치료와 함께 광범위 항생제를 8주간 사용 후 환자는 특별한 합병증 없이 회복되었다. 결론: 패혈증을 동반한 요근 및 대퇴부 농양이 있을 경우는 정확한 이학적 검사 및 복부와 골반의 전산화 단층 촬영 등을 통해 농양의 원인을 찾아야 하며, 증상이 비특이적일 지라도 소화-비뇨기 계통 등 여러 가지 요인이 요근 농양의 원인이 될 수 있음을 고려하고 의심하는 것이 중요하다. Study Design: A case report. Summary of Literature Review: The symptoms of psoas abscess are fever, low back pain, and spasm of the psoas muscle. Objectives: To report a case of psoas and thigh abscess caused by ruptured appendicitis. Materials and Methods: A 53- year old male patient visited the complaining of fever, low back pain and thigh pain. Imaging studiesrevealed psoas abscess and thigh abscess, accompanied by ruptured appendicitis. Therefore, surgical treatment with percutaneousdrainage was performed. Results: The patient recovered and returned to his normal life after 2 months. Conclusion: It is necessary to identify the cause of the infection using physical examination as well as abdominal and pelvis computedtomography when a patient has fever, psoas abscess and thigh abscess. It is also important to be aware that the cause of psoas abscessmay also be gastrointestinal tract disease with non specific symptoms.

진행된 무지 강직증에서 생체흡수성 압박나사를 이용한 원위 중족골의 배측 쐐기 절골술

김용민,조병기,김동수,최의성,손현철,박경진,박지강,최승명,Kim, Yong-Min,Cho, Byung-Ki,Kim, Dong-Soo,Choi, Eui-Sung,Shon, Hyun-Chul,Park, Kyoung-Jin,Park, Ji-Kang,Choi, Seung-Myung 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.1

Purpose: This study was performed retrospectively to evaluate clinical outcomes of distal metatarsal osteotomy using bio-compression screw as the joint preservation method for advanced hallux rigidus. Materials and Methods: Eleven cases were followed up for more than 1 year after distal metatarsal dorsal wedge osteotomy for advanced hallux rigidus. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) score and patient's satisfaction score. The range of motion, and the period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were evaluated. As the radiographic evaluation, the interval of $1^{st}$ MTP (metatarsophalangeal) joint space and the period to union were measured. Results: The AOFAS hallux score had improved significantly from preoperative average 50.7 points to 87.6 points at the last follow-up (p=0.005). The subjective satisfaction score was average 90.6 points. There were no case of subsequent fusion or additional operation, and no complication associated with bio-compression screw. The period to return to running exercise, tip-toeing gait, squatting, walking down the stairs were average of 24.8 weeks, 20.4 weeks, 16.8 weeks, 18.5 weeks respectively. Dorsiflexion of $1^{st}$ MTP joint had improved significantly from preoperative average $17.5^{\circ}$ to $44^{\circ}$ (p<0.001). All cases achieved union of osteotomy site, and the period to union was average 10.4 weeks. The interval of $1^{st}$ MTP joint space had improved significantly from preoperative average 1.2 mm to 3.5 mm (p=0.014). Conclusion: Distal metatarsal osteotomy using bio-compression screw seems to be one of effective treatment methods for advanced hallux rigidus, because of restoration of the first MTP joint motion, and reliable pain relief, and needlessness of hardware removal.

딥러닝을 활용한 다발성 골절 분류

이상현(Sang Hyun Lee),한찬식(Chan Sik Han),최승명(Seung Myung Choi),이건명(Keon Myung Lee) 한국지능시스템학회 2019 한국지능시스템학회논문지 Vol.29 No.4

정형외과 의사는 컴퓨터 단층 촬영(CT)을 활용해 골절 환자의 골절 범주를 식별하고 치료 방법을 결정한다. 골절이 발생하게 되면 다발성 골절인 경우가 많고 골절 범주가 많기 때문에, 의사가 골절을 정확히 분류하기 위해서는 높은 전문성과 많은 노력이 필요하다. 이 논문에서는 골절 범주 식별을 다중 부류 분류 문제로 정의하고, 골절의 범주를 식별하기 위해 딥러닝을 사용하는 방법을 제안한다. 제안하는 딥러닝 모델은 GoogleNet과 유사한 형태로 골절의 특징을 추출하고, 다층퍼셉트론으로 각 골절 범주의 점수를 계산해 분류를 한다. 그리고 출력 노드의 점수가 특정 임계값 내에 있는 최대 4개의 골절 부류를 선택한다. 하반신 골절 CT 데이터에 대한 제안 방법의 정밀도는 73.3%, 재현율은 86.9%였다. The orthopedists use computed tomography(CT) to identify fracture categories of fractured patients and determine their treatment. Fractures often result in multiple fractures which have various categories. Here it is required for orthopedists to have a high level of expertise and stressful examination. This paper casts the fracture category identifier task as a multi-label classification problem, and proposes a deep learning based method to it. The proposed deep learning model extracts the features of fractures with GoogleNet-like front-end and determines the fracture categories from the categorieswise score computed with back-end fully connected layer. The proposed method showed 73.3% precision and 86.9%recall for a CT dataset for lower body fracture in the experiments.

±250kV HVDC XLPE 케이블시스템 개발

정의환(Eui-Hwan Jung),이수봉(Soo-Bong Lee),김성윤(Sung-Yoon Kim),이태호(Tae-Ho Lee),김윤형(Yoon-Hyoung Kim),최승명(Seung-Myung Choi),이수길(Su-Kil Lee),전승익(Seung-Ik Jeon),박완기(Wan-Ki Park) 대한전기학회 2014 대한전기학회 학술대회 논문집 Vol.2014 No.7

슬관절 관절경술 후 하지에 발생한 피하기종

박경진(Kyoung-Jin Park),최의성(Eui-Sung Choi),김용민(Yong-Min Kim),김동수(Dong-Soo Kim),손현철(Hyun-Chul Shon),조병기(Byung-Ki Cho),박지강(Ji-Kang Park),최승명(Seung-Myung Choi),은현준(Hyeon-Jun Eun) 대한정형외과학회 2013 대한정형외과학회지 Vol.48 No.6

하지의 피하기종은 드문 질환으로서 신체적 검사상 이환 부위의 염발음과 영상검사상 공기음영을 특징으로 하며, 가스 형성 박테리아에 의한 가스 괴저 혹은 괴사성 근막염의 징후로 신속한 감별진단 및 적절한 치료가 이루어지지 않았을 경우 생명에 치명적인 결과를 야기할 수 있다. 저자들은 슬관절 관절경술 후 우측 하지에 발생한 피하기종이 발생한 드문 증례를 경험하였고 신체적, 혈액적 검사상 감염징후는 보이지 않아 가스 괴저 혹은 괴사성 근막염을 배제하고 수술적 치료 없이 집중관찰 및 보존적 치료 후에 호전되어 문헌 고찰과 함께 보고하고자 한다. Subcutaneous emphysema of lower extremity is a rare disease entity. Crepitation and swelling on physical examination and gas on radiographs raise the concern of infection due to the presence of gas gangrene forming organisms. Therefore, delay of diagnosis and appropriate management can be a major predisposing factor for sepsis and further associated high mortality. We experienced a rare case of subcutaneous emphysema of the right lower extremity after knee arthroscopy; life-threatening infection was ruled out by physical examination and laboratory testing. The patient recovered uneventfully with conservative management. Therefore, we report on this case with a review of current literature.