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      • 줄넘기 運動의 有ㆍ無酸素的 運動强度 역치수준 設定을 위한 硏究

        盧成圭,윤재원,김두경,하명수,장세원,윤중현 江原大學校附設體育科學硏究所 1987 江原大學校附設體育科學硏究所論文集 Vol.- No.12

        The purpose of this study was the level of Aerobic-Anaerobic exercise intensity according to Rope skipping frequency by the skipping type at different age group(Middle, Junior high school and collegean). Types of Rope skipping(Jump, Leap and Double jump) with 100 rounds per min(5min), 120 rounds per min (5min) and max round frequency were tested by 120 volunteer untrained men and women students (forty middle school, forty high school and forty collegean) form Oct. 10. 1987 to No V.5. 1987. The results are showed at the skip intensity of 120 rounds per min. was higher than that of 100 rounds per min. at all skipping types, and men students showed less HR than women students. From the testing result, Double Jump was Considered as Anaerobic Exercise, Tean Jump was determined the strongest Aerobic exercise, and Jump or Leap were moderate Aerobic exercise. Recommending round frequency per min from multiple regression were follows. ----------------------------------------------------------------------------- Type Age 15 18 21 duration Sex ----------------------------------------------------------------------------- Jump man 127☆ 147 167 5min woman 113 126 140 5min ----------------------------------------------------------------------------- D.Jump man 137 169 211 2min woman 126 155 183 2min _____________________________________________________________________________ ☆ Round numbers per min

      • KCI등재

        슬관절 관절염에 대한 외측 폐쇄 경골 절골술

        노두현(Du Hyun Ro),이상훈(Sahnghoon Lee),성상철(Sang Cheol Seong),이명철(Myung Chul Lee) 대한정형외과학회 2014 대한정형외과학회지 Vol.49 No.2

        경골 근위부 절골술은 내반 혹은 외반 변형을 동반한 슬관절 골관절염에서 널리 사용되는 수술적 치료 방법 중 하나로 외측 폐쇄형 절골술, 내측 개방형 절골술, 돔형 절골술, medial opening hemicallotasis가 있으며 이 중 외측 폐쇄형 절골술과 내측 개방형 절골술 이 가장 널리 쓰인다. 수술의 목적은 슬관절의 내반 변형을 외반으로 바꾸어 내측 구획에 가해지는 과도한 압력을 줄여주는 데 있다. 환자 본인의 관절을 살리며 통증의 경감을 얻을 수 있는 효과적인 치료 방법으로 신중한 환자 선택과 철저한 수술 전 계획이 필수적 이다. 본 종설에서는 환자 선택에서부터 수술 전 검사 및 계획, 외측 폐쇄형 절골술의 방법 및 주의할 점, 수술의 합병증, 절골술 이후 발생하는 경골 경사각의 변화, 슬개 인대의 변화, 보행의 변화를 살펴보고 그간 보고된 장기 추시 결과를 고찰해 본다. 수술의 장점과 한계점을 파악하여 적절한 환자에게 시행한다면 관절염 환자의 통증 경감에 많은 도움이 될 것이다. Proximal tibial osteotomy is an effective, well-established treatment for unicompartmental arthritic knee with varus or valgus deformity. Four basic types are commonly described: lateral closing wedge osteotomy, medial open wedge osteotomy, dome osteotomy, and medial opening hemicallotasis. The objective of this procedure is to realign the weight-bearing axis through the knee by redistributing the forces of weight to the less involved compartment of the knee. With thorough preoperative planning and careful selection of patients, optimal outcome can be expected with preservation of the patient’s joint. In this article, we reviewed selection of patients, surgical planning, surgical technique, complications, pre- and post-operative change in mechanics, and long term surgical outcome of closing wedge osteotomy. Optimal outcome is expected in patients with young age (younger than 60), stable knee, medially confined osteoarthritis, and good range of motion. According to the literature, average 10-year survival rate is expected to be 60% to 90%. Closing wedge osteotomy allows for rapid bone healing, early weight bearing, rehabilitation, and low rates of correction loss. Surgeons should keep in mind that optimal indication, preoperative planning, and use of safe operative technique are essential to achievement of best results.

      • KCI등재

        전방십자인대 재건수술은 지난 20년간 어떻게 발전하였나

        노두현(Du Hyun Ro),한혁수(Hyuk-Soo Han),이명철(Myung Chul Lee) 대한정형외과학회 2021 대한정형외과학회지 Vol.56 No.1

        전방십자인대 재건수술 술기는 최근 20년간 많은 발전을 이뤘으며 결과가 과거에 비해 크게 향상되었다. 전방십자인대의 해부학적 이해 또한 20년 전과 현재가 다르며 이에 맞추어 수술 방법 또한 변화하고 있다. 이중다발 개념은 여전히 유효하나 리본 형태의 전방십자인대 모양, 직접 섬유, 간접 섬유가 그 개념을 서서히 대체하고 있다. 등장점 개념은 더 이상 존재하지 않으며 단일다발 해부학적 재건, 이중다발 해부학적 재건, 잔류조직 보존술식, 직각터널 술식 등 다양한 수술 방법들이 행해지고 있으며 논문을 통해 검증되고 있다. 이식건의 종류에 있어서도 자가건인 골-슬개건-골, 슬건, 대퇴사두근건, 동종건에 대한 관심이 시간에 따라 변화하고 있으며 이런 변화는 현재 진행형이다. Considerable progress on anterior cruciate ligament reconstruction surgery has been made over the past 20 years, and the results have improved significantly. An anatomical understanding of the anterior cruciate ligament has also changed, and the surgical technique has also changed accordingly. The double-bundle concept is still valid, but the ribbon-shaped anterior cruciate ligament concept, including direct fiber and indirect fiber, is gradually replacing it. The isometry point theory no longer exists, and various surgical methods, such as single-bundle anatomical reconstruction, double-bundle reconstruction, remnant preservation, and rectangular tunnel technique, are being performed. Regarding the graft, interest in the bone-patellar tendon-bone, patellar tendon, quadriceps tendon, and allogeneic tendon change over time, and this change is ongoing.

      • KCI등재
      • HBeAg 음성 만성 B형 간질환에서 Lamivudine의 치료 효과

        정인두,박능화,김병철,박지현,서광원,김대현,주광로,김도하 대한간학회 2003 Clinical and Molecular Hepatology(대한간학회지) Vol.9 No.2

        목적: HBeAg 음성 만성 B형 간질환 환자에서 라미부딘 치료 효과, 내성 발생률, 치료 종료 후 재발률 및 각각의 예측 인자를 알아보고자 하였다. 대상과방법: HBeAg 음성, anti-HBe 양성이나 HBV DNA가 양성인 HBeAg 음성 만성 B형 간질환으로 진단 받은 환자 중에서 혈청 ALT치가 상승되어 있는 59명을 대상으로 라미부딘을 1일 100mg씩 6개월(평균 14개월)이상 투여하였다. 평균 연령은 42.1세였고 남녀 비는 52:7이였다. 치료 전 혈청 ALT평균치는 368 IU/L, HBV DNA평균치는 494 pg/mL였다. 치료 전, 치료 개시 후 및 종료후 1-2개월 간격으로 간기능 검사, HBeAg, anti-HBe, HBV DNA를 측정하였다. 치료 반응군은 반응이 일어난 시점을 기준으로 1-2개월 간격으로 2번 이상 반응이 유지되는 것을 확인한 후 투약을 중지하고 재발 유무를 추적 관찰하였다. 결과: 라미부딘 투여 후 50명 중 56명(94.9%)에서 혈청 HBV DNA가 음전되었으며 누적 음전율은 1개월후 27%, 2개월 후 71%, 3개월 후 90%, 5개월 후 95%였다. 혈청 ALT치는 52명(88.2%)에서 정상으로 회복되었으며 대부분 6개월 내에 이루어졌다. 혈청 ALT치의 누적 정상화율은 2개월 후 30%, 3개월 후 47%, 6개월 후 78%, 10개월 후 86%였다. 혈청 HBV DNA가 음전되고 혈청 ALT치가 정상으로 유지된 치료 반응은 52예(88.1%)에서 일어났으며, 누적 치료반응률은 2개월 후 10%, 4개월 후 49%, 6개월 후 66%, 10개월 후 80%, 18개월 후 88%였다. 라미부딘 총 투여 기간이 유일한 치료 반응 예측 인자였다(p=0.000). 변이형의 출현은 5예(8.5%)에서 일어났고 누적 발생률은 10개월 후 8%, 16개월 후 13%였다. Breakthrough발생 예측인자와 관련된 유의한 인자는 없었다. 치료 반응군중 투여 중지한 34명 중 17명(50%)에서 재발하였으며(평균추적기간: 6개월, 범위: 1-22개월) 대부분 투여중지 6개월 내에 재발하였다. 누적 재발률은 3개월 후 24%, 6개월 후 47%, 10개월 후 66%였다. 재발과 관련된 예측 인자는 치료 반응후 추가적인 라미부딘 누여만이 유의한 인자였다(p=0.019). 특히 12개월 이상 유지한 7명 모두에서 재발하지 않았다. 결론: 라미부딘은 HBeAg 음성 만성 B형 간질환에서 높은 치료효과와 낮은 breakthrough를 보였으며 라미부딘 투여 기간만이 유일한 치료 반응 예측 인자이었다. 그러나 치료 종료 후 많은 예에서 재발하였으며 치료 반응 후 추가적인 라미부딘 투여 기간만이 유일한 재발 예측 인자였으며 재발을 막기 위해서는 장기간의 추가적인 라미부딘 투여가 필요할 것으로 사료된다. Background/Aims: Lamivudine therapy is effective in inhibiting HBV replications in patients with HBeAg-negative chronic liver disease. However, the sustained response rate appears to be particularly poor, because the vast majority of patients relapse soon after cessation of therapy. The aim of this study was to evaluate the efficacy of lamivudine, the breakthrough rate, and the relapse rate of discontinuing therapy after response in patients with HBeAg-negative chronic liver disease. Methods: Fifty-nine patients with HBeAg-negative chronic liver disease who have received lamivudine for at least 6 months, were studied. The mean duration of treatment was 14 months. Complete response was defined as undetectable serum HBV DNA by bDNA and normalization of ALT levels. Once HBV DNA disappearance and ALT normalization were observed, lamivudine therapy was continued for at least two additional months. The mean follow-up after cessation of treatment was 6 (1-22) months. Results: Fifty-six patients were undetectable HBV DNA. The cumulative HBV DNA loss rates at 3 months and 5 months were 90% and 95%, respectively. The ALT normalization was observed in 52 patients. The cumulative ALT normalization rates at 6 months and 10 months were 78% and 86%, respectively. The complete response was observed in 52 patients. The cumulative rates of complete response at 10 months and 18 months were 80% and 88%, respectively. A predictive factor for complete response was only the duration of lamivudine treatment. Virological breakthrough was observed in 5 (8.5%). Thirty-four patients stopped taking lamivudine after 7.7 (2-15) months of the additional therapy. Seventeen of those patients (50%) experienced relapse. The cumulative relapse rates at 3 months, 6 months and 10 months were 24%, 47% and 66%, respectively. The only predictive factor for relapse was the duration of additional lamivudine treatment after response. Conclusions: Lamivudine was an effective treatment of HBeAg negative chronic liver disease. Relapse, however, was usually observed after cessation of lamivudine. Our results showed that long-term lamivudine therapy is required in order to decrease the high relapse rates in patients with HBeAg-negative chronic liver disease.

      • KCI등재

        Total Knee Arthroplasty: Is It Safe? A Single-Center Study of 4,124 Patients in South Korea

        Kyunga Ko,Kee Hyun Kim,Sunho Ko,Changwung Jo,Hyuk-Soo Han,Myung Chul Lee,Du Hyun Ro 대한정형외과학회 2023 Clinics in Orthopedic Surgery Vol.15 No.6

        Background: Although total knee arthroplasty (TKA) is considered an effective treatment for knee osteoarthritis, it carries risks of complications. With a growing number of TKAs performed on older patients, understanding the cause of mortality is crucial to enhance the safety of TKA. This study aimed to identify the major causes of short- and long-term mortality after TKA and report mortality trends for major causes of death. Methods: A total of 4,124 patients who underwent TKA were analyzed. The average age at surgery was 70.7 years. The average follow-up time was 73.5 months. The causes of death were retrospectively collected through Korean Statistical Information Service and classified into 13 subgroups based on the International Classification of Diseases-10 code. The short- and long-term causes of death were identified within the time-to-death intervals of 30, 60, 90, 180, 180 days, and > 180 days. Standard mortality ratios (SMRs) and cumulative incidence of deaths were computed to examine mortality trends after TKA. Results: The short-term mortality rate was 0.07% for 30 days, 0.1% for 60 days, 0.2% for 90 days, and 0.2% for 180 days. Malignant neoplasm and cardiovascular disease were the main short-term causes of death. The long-term (> 180 days) mortality rate was 6.2%. Malignant neoplasm (35%), others (11.7%), and respiratory disease (10.1%) were the major long-term causes of death. Men had a higher cumulative risk of death for respiratory, metabolic, and cardiovascular diseases. Age-adjusted mortality was significantly higher in TKA patients aged 70 years (SMR, 4.3; 95% confidence interval [CI], 3.3–5.4) and between 70 and 79 years (SMR 2.9; 95% CI, 2.5–3.5) than that in the general population. Conclusions: The short-term mortality rate after TKA was low, and most of the causes were unrelated to TKA. The major causes of long-term death were consistent with previous findings. Our findings can be used as counseling data to understand the survival and mortality of TKA patients.

      • KCI등재

        Rectangular-Tunnel Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon-Patellar Bone Autograft Can Reduce Early Donor Site Morbidity While Maintaining Comparable Short-term Clinical Outcomes

        Do Weon Lee,Du Hyun Ro,Myung Chul Lee,Hyuk-Soo Han 대한정형외과학회 2024 Clinics in Orthopedic Surgery Vol.16 No.1

        Background: Rectangular tunnel and graft have been recently designed to closely resemble the native anatomy in anterior cruciate ligament reconstruction (ACLR). This study was performed to compare the short-term clinical outcomes between rectangular and round femoral tunnels in ACLR using quadriceps tendon-patellar bone (QTPB) autografts. Methods: A total of 78 patients who underwent primary ACLR with QTPB autografts performed by three senior surgeons and had at least 1 year of postoperative follow-up were retrospectively reviewed. Patients who underwent rectangular tunnel ACLR (n = 40) were compared to those treated with the conventional round tunnel ACLR (n = 38). Outcomes including knee stability, clinical scores, quadriceps strength, associated complications, postoperative knee range of motion, and cross-sectional area of the graft were assessed. Results: Significant improvements in knee stability and clinical scores were observed after surgery in both groups (all p < 0.001). The postoperative measurements of knee stability and clinical scores were not significantly different between the two groups. Knee extension strength deficit at 60°/sec was significantly less in the rectangular tunnel group than in the round tunnel group at postoperative 6 months (41.7% vs. 48.9%, p = 0.032). The cross-sectional area of the partial-thickness QTPB graft was approximately 60% of the full-thickness QTPB graft. Conclusions: In the short-term, rectangular tunnel ACLR was comparable to round tunnel ACLR with QTPB autograft despite the smaller cross-sectional area. Additionally, the rectangular tunnel ACLR allowed partial-thickness grafting technique, which could subsequently reduce early donor site morbidity.

      • KCI등재

        Development of Prediction Model Using Machine-Learning Algorithms for Nonsteroidal Anti-inflammatory Drug-Induced Gastric Ulcer in Osteoarthritis Patients: Retrospective Cohort Study of a Nationwide South Korean Cohort

        Jaehan Jeong,Hyein Han,Du Hyun Ro,Hyuk-Soo Han,Sungho Won 대한정형외과학회 2023 Clinics in Orthopedic Surgery Vol.15 No.4

        Background: Nonsteroidal anti-inflammatory drugs (NSAID) are currently among the most prescribed medications worldwide to relieve pain and reduce inflammation, especially in patients suffering osteoarthritis (OA). However, NSAIDs are known to have adverse effects on the gastrointestinal system. If a gastric ulcer occurs, planned OA treatment needs to be changed, incurring additional treatment costs and causing discomfort for both patients and clinicians. Therefore, it is necessary to create a gastric ulcer prediction model that can reflect the detailed health status of each individual and to use it when making treatment plans. Methods: Using sample cohort data from 2008 to 2013 from the National Health Insurance Service in South Korea, we developed a prediction model for NSAID-induced gastric ulcers using machine-learning algorithms and investigated new risk factors associated with medication and comorbidities. Results: The population of the study consisted of 30,808 patients with OA who were treated with NSAIDs between 2008 and 2013. After a 2-year follow-up, these patients were divided into two groups: without gastric ulcer (n=29,579) and with gastric ulcer (n=1,229). Five machine-learning algorithms were used to develop the prediction model, and a gradient boosting machine (GBM) was selected as the model with the best performance (area under the curve, 0.896; 95% confidence interval, 0.883–0.909). The GBM identified 5 medications (loxoprofen, aceclofenac, talniflumate, meloxicam, and dexibuprofen) and 2 comorbidities (acute upper respiratory tract infection [AURI] and gastroesophageal reflux disease) as important features. AURI did not have a dose-response relationship, so it could not be interpreted as a significant risk factor even though it was initially detected as an important feature and improved the prediction performance. Conclusions: We obtained a prediction model for NSAID-induced gastric ulcers using the GBM method. Since personal prescription period and the severity of comorbidities were considered numerically, individual patients’ risk could be well reflected. The prediction model showed high performance and interpretability, so it is meaningful to both clinicians and NSAID users.

      • KCI등재

        Titanium Alloy Knee Implant Is Associated with Higher Bone Density over Cobalt Chromium: A Prospective Matched-Pair Case-Control Study

        Do Weon Lee,Du Hyun Ro,Hyuk-Soo Han,Myung Chul Lee 대한정형외과학회 2023 Clinics in Orthopedic Surgery Vol.15 No.4

        Background: Little is known about the relationship between implant material and periprosthetic bone mineral density (pBMD) in total knee arthroplasty (TKA). The purpose of this study was to investigate the change in pBMD after TKA and to compare pBMD changes between two different implant materials. Methods: A prospective matched-pair case-control study was conducted on 29 patients who underwent bilateral TKAs. The participants were randomly allocated to undergo cemented TKAs with a titanium nitride (TiN)-coated implant on one knee (TiN group) and a cobalt-chromium (CoCr) implant on the other knee (CoCr group). The pBMD was measured using dual-energy X-ray absorptiometry scans before surgery and at 1 and 2 years after surgery. The results were then compared between the two groups. The pBMDs at longer follow-ups (> 2 years) were estimated using simple radiographs (pBMDe). Results: At 2 years after surgery, the pBMD significantly decreased in both groups at medial metaphysis of the tibia and anterior portion of the distal femur (all p < 0.001). The CoCr group showed a larger decrease in pBMD than did the TiN group in the medial and anterior metaphysis of the proximal tibia (p = 0.003 and p = 0.046, respectively). The pBMDe was significantly higher in the TiN group at the anterior portion of the distal femur 7 years after surgery (p = 0.019). Conclusions: The pBMD significantly decreased 2 years after TKA in certain regions regardless of the implant material used. However, the decrease was significantly less in the TiN group in specific regions of the tibia and femur. The TiN implant was beneficial in preserving the periprosthetic bone stock after TKA.

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