http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
활액막 절제 및 십자인대 절단후 관절연골 변화에 관한 실험적 연구
강응식,장준섭 최신의학사 1975 最新醫學 Vol.18 No.9
Mature articular cartilage is an aneural, avascular, and alymphatic specialized form of tissue 1, 2. 6, 9, 12, 14, 15, 16, 20, 25, :0). The initial degeneration of articular cartilage may occur spontaneously with normal wear and tear in aging cartilage, or it may occur in articular cartilage that has been damaged by the local conditions, such as injury or synovectomy. It is the purpose of this report to study the ultrastructural and light microscopical appearance of the articular cartilage after synovectomy and cutting the cruciate ligaments of rabbits. Thirty young rabbits each weighing about 2.0kg were used for the experimental study and the animals were sacrificed at time intervals of 3, 7,14.28, and 42 days respectively after the synovectomy or cutting the cruciate ligaments. The tissue were decalcified and prepared by standard paraffin embedding procedure and stained with hematoxylin and eosin for histologic observation. For electron microscopy, the specimen fixed in 4% glutaraldehyde for 4 hours and postfixed for 2 hours at 4°C with 1% osmium tetraoxide in 0. 1 M phosphate buffer with pH 7.426). All tissues were dehydrated in graded alcohol and embedded in Epon 812 according to standard procedures. They were cut into section of 500 ? with a glass knife. The sections were mounted on copper grids, stained with uranyl acetate and lead hydroxide and observed with the Hitachi 11-E Electron Microscope. The results of the light and electron microscopic findings are as follows; 1. The degeneratve changes of the articular cartilage were appeared after 7 days and became increasingly severe in later samples in the groups of synovectomy. But the degenerative changes of the articular cartilage obtained 6 weeks after synovectomy in light microscope were not severe. 2. The degenerative changes of the articular cartilage were appeared after 7 days and became increasingly severe in later samples in the group of the cutting the cruciate ligaments. 3. By the electron microscopic findings, the degenerative changes of the articular cartilage were appeared after 1 week and continued steadily up to 6 weeks in the group of synovectomy. And the degenerative changes of the articular cartilage in the group of the cutting the cruciate ligaments were severe in degree comparing to the group of synovectomy.
상완골 과 상부 골절에서의 이중 긴장 대 기법을 이용한 수술적 치료
강호정,김홍희,심동준,한수봉,강응식 대한골절학회 2002 대한골절학회지 Vol.15 No.4
목 적 : 이중 긴장 대 기법을 이용한 상완골 과 상부 골절의 임상적 결과를 분석하여 그 유용성을 보고하고자 한다. 대상 및 방법 : 1992년 10월부터 2001년 9월까지 상완골 원 위부 골절로 치료한 환자 중 이중 긴장 대 기법을 시행한 14예를 대상으로 하였다. 골절의 원인으로서는 실족에 의한 단순 손상이 11예, 교통사고에 의한 손상이 2예, 직접 타격에 의한 손상이 1예가 있었다. AO/ASIF 분류 방법에 따라 분류하면 A2가 2예, A3이 1예,. C1이 6예, C2가 3예, C3이 2예였으며, 성별로는 남자가 5예, 여자가 9예였고, 평균 나이는 51.6 세 (최소 15세, 최대 88세)였다. 분쇄 골절이 심한 4예에서 주두 절골 술을 시행하였다. 술 후 고정기간은 평균 20.6일 이었고, 경화를 보인 시기는 술 후 평균 10.1주 였다. 65세 이상의 5예에 있어서는 술 전에 골 밀도 검사를 시행하였으며, 대퇴경부의 평균 T-score가 -3.65였고 요추부의 평균 T-score가 -2.97이였다. 평균 추 시 기간은 평균 16.4개월(최소 12개월, 최대 29개월) 이였다. 평가는 최종 외래 내원시 주관절의 운동 범위, 통증 유무, 환자의 만족도를 조사하였다. 결 과 : 최종 추후 결과를 분석하였으며, 운동범위는 Excellent군이 8예, Good군이 4예, Fair군이 2예 였으며, Poor군은 없었다. 10예에서는 술 후 통증이 전혀 없었으며, 4예에서는 가끔씩 통증을 호소하였다. 합병증으로는 1예에서 주두에 K-강선 삽입부위의 피부자극에 의한 통증으로 술 후 6개월째 조기 제거를 시행하였다. 척골신경 전방 전위 술을 8예에서 시행 하였으며, 시행하지 않은 6예 중에 2예에서 척골신경 자극증상이 있었다. 그 중 1예에서는 술 후 8개월째 척골신경 전방 전위 술을 시행 받았으나, 다른 1예에서는 대중적 치료로 증세가 호전되었다. 1예에서 K-강선 삽입부위에 부분적 피부괴사 소견이 보였으나 핀 제거 술 및 창상 치료 후 치유되었다. 결 론 : 이중 긴장 대 기법을 이용한 상완골 과 상부 골절의 치료가 수술이 간단하고 수술 시간을 단축시킬 수 있으며, 정복 시 골막의 박리 손상을 줄일 수 있어 골편의 탈활(devitalization)이 적으며, 골절부의 압축력을 얻을 수 있다. 특히 젊은 환자의 단순 과 상부 골절에서 과도한 술기를 피하고 조기 관절 운동을 하기위한 경우나, 술 전 골 밀도 검사상 골 다공 증을 동반한 분쇄가 심한 노령 환자의 과상부 및 과간 골절의 치료에 있어 이중 긴장 대 기법은 상완골 상부 골절의 치료에 유용한 방법이 될 수 있으리라 사료된다. PURPOSE : This study evaluated the clinical result of supracondylar fractures of the humans treated with double tension band osteosynthesis. MATERIALS AND METHODS : From October 1992 to September 2001, 14 patients with supracondylar fractures of the humerus were treated by method of double tension band osteosynthesis. eleven fractures were the results of slipped down injury and two traffic accidents and one direct trauma. All fractures were classified according to the AO fracture classification (A2; 2. A3; 1. C1; 6, C2; 3. C3; 2). There were 6 males and 9 females with average age of 51.6 age of 51.6 years (range 15 to 88). Olecranon osteotomy was performed in 4 patients with severe comminuted fractures. Postoperative immobiliza-tions were required for an average of 20.6 days and consolidations were noted after an average of 10.1 weeks. Before operation, bone marrow density studies were performed in five fractures above 65 years. Average T-score of the patients were -3.65 on femur neck and -2.97 on lumbar spine. All patients were re-examined after an average of 16.4 months. RESULTS : Union and consolidation was achieved in all 14 patients judged their results as excellent and four as good. Ten patients had no pain and four had only occasional discomfort. Early removal of K-wires was performed in one patient because irritation of one side K-wires were develop. Sensory change of the ulnar nerve was noted in two patients. Anterior transposition of ulnar nerve was performed in one patient and the other was improved spontaneously. Skin necrosis was developed in one patient but was healed after pin removal and conservative care. CONCLUSION : The advantages of double tension band wiring are an easier and faster procedure, less periosteal and muscle damage, and more symmetrical compression than double plating. Therefore, in the commiuted osteoporotic fracture with poor tolerance for internal fixation with the plate or the simple supracondylar fractures in young age, double tension band osteosynthesis can provide sufficient and secure stability to allow early functional exercise.