• Title/Summary/Keyword: 피부변형

Search Result 83, Processing Time 0.023 seconds

Development of a Thermoplastic Oral Compensator for Improving Dose Uniformity in Radiation Therapy for Head and Neck Cancer (두경부암 방사선치료 시 선량 균일도 향상을 위한 Thermoplastic 구강 보상체의 개발)

  • Choi, Joon-Yong;Won, Young-Jin;Park, Ji-Yeon;Kim, Jong-Won;Moon, Bong-Ki;Yoon, Hyong-Geun;Moon, Soo-Ho;Jeon, Jong-Byeong;Suh, Tae-Suk
    • Progress in Medical Physics
    • /
    • v.23 no.4
    • /
    • pp.269-278
    • /
    • 2012
  • Aquaplast Thermoplastic (AT) is a tissue-equivalent oral compensator that has been developed to improve dose uniformity at the common boundary and around the treated area during radiotherapy in patients with head and neck cancer. In order to assess the usefulness of AT, the degree of improvement in dose distribution and physical properties were compared to those of oral compensators made using paraffin, alginate, and putty, which are materials conventionally used in dental imprinting. To assess the physical properties, strength evaluations (compression and drop evaluations) and natural deformation evaluations (volume change over time) were performed; a Gafchromic EBT2 film and a glass dosimeter inserted into a developed phantom for dose verification were used to measure the common boundary dose and the beam profile to assess the dose delivery. When the natural deformation of the oral compensators was assessed over a two-month period, alginate exhibited a maximum of 80% change in volume from moisture evaporation, while the remaining tissue-equivalent properties, including those of AT, showed a change in volume that was less than 3%. In a free-fall test at a height of 1.5 m (repeated 5 times as a strength evaluation), paraffin was easily damaged by the impact, but AT exhibited no damage from the fall. In compressive strength testing, AT was not destroyed even at 8 times the force needed for paraffin. In dose verification using a glass dosimeter, the results showed that in a single test, the tissue-equivalent (about 80 Hounsfield Units [HU]) AT delivered about 4.9% lower surface dose in terms of delivery of an output coefficient (monitor unit), which was 4% lower than putty and exhibited a value of about 1,000 HU or higher during a dose delivery of the same formulation. In addition, when the incident direction of the beam was used as a reference, the uniformity of the dose, as assessed from the beam profile at the boundary after passing through the oral compensators, was 11.41, 3.98, and 4.30 for air, AT, and putty, respectively. The AT oral compensator had a higher strength and lower probability of material transformation than the oral compensators conventionally used as a tissue-equivalent material, and a uniform dose distribution was successfully formed at the boundary and surrounding area including the mouth. It was also possible to deliver a uniformly formulated dose and reduce the skin dose delivery.

Comparison and evaluation between 3D-bolus and step-bolus, the assistive radiotherapy devices for the patients who had undergone modified radical mastectomy surgery (변형 근치적 유방절제술 시행 환자의 방사선 치료 시 3D-bolus와 step-bolus의 비교 평가)

  • Jang, Wonseok;Park, Kwangwoo;Shin, Dongbong;Kim, Jongdae;Kim, Seijoon;Ha, Jinsook;Jeon, Mijin;Cho, Yoonjin;Jung, Inho
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.28 no.1
    • /
    • pp.7-16
    • /
    • 2016
  • Purpose : This study aimed to compare and evaluate between the efficiency of two respective devices, 3D-bolus and step-bolus when the devices were used for the treatment of patients whose chest walls were required to undergo the electron beam therapy after the surgical procedure of modified radical mastectomy, MRM. Materials and Methods : The treatment plan of reverse hockey stick method, using the photon beam and electron beam, had been set for six breast cancer patients and these 6 breast cancer patients were selected to be the subjects for this study. The prescribed dose of electron beam for anterior chest wall was set to be 180 cGy per treatment and both the 3D-bolus, produced using 3D printer(CubeX, 3D systems, USA) and the self-made conventional step-bolus were used respectively. The surface dose under 3D-bolus and step-bolus was measured at 5 measurement spots of iso-center, lateral, medial, superior and inferior point, using GAFCHROMIC EBT3 film (International specialty products, USA) and the measured value of dose at 5 spots was compared and analyzed. Also the respective treatment plan was devised, considering the adoption of 3D-bolus and stepbolus and the separate treatment results were compared to each other. Results : The average surface dose was 179.17 cGy when the device of 3D-bolus was adopted and 172.02 cGy when step-bolus was adopted. The average error rate against the prescribed dose of 180 cGy was -(minus) 0.47% when the device of 3D-bolus was adopted and it was -(minus) 4.43% when step-bolus was adopted. It was turned out that the maximum error rate at the point of iso-center was 2.69%, in case of 3D-bolus adoption and it was 5,54% in case of step-bolus adoption. The maximum discrepancy in terms of treatment accuracy was revealed to be about 6% when step-bolus was adopted and to be about 3% when 3D-bolus was adopted. The difference in average target dose on chest wall between 3D-bolus treatment plan and step-bolus treatment plan was shown to be insignificant as the difference was only 0.3%. However, to mention the average prescribed dose for the part of lung and heart, that of 3D-bolus was decreased by 11% for lung and by 8% for heart, compared to that of step-bolus. Conclusion : It was confirmed through this research that the dose uniformity could be improved better through the device of 3D-bolus than through the device of step-bolus, as the device of 3D-bolus, produced in consideration of the contact condition of skin surface of chest wall, could be attached to patients' skin more nicely and the thickness of chest wall can be guaranteed more accurately by the device of 3D-bolus. It is considered that 3D-bolus device can be highly appreciated clinically because 3D-bolus reduces the dose on the adjacent organs and make the normal tissues protected, while that gives no reduction of dose on chest wall.

  • PDF

The Effect of Celosia cristata L. ethanol Extract on Anti-oxidant & Anti-aging Activity (맨드라미 (Celosia cristata L.) 에탄올 추출물이 항산화 및 항노화 작용에 미치는 효과)

  • Pyo, Young-Hee;Yoon, Mi-Yun;Son, Ju-Hyun;Choe, Tae-Boo
    • KSBB Journal
    • /
    • v.23 no.5
    • /
    • pp.431-438
    • /
    • 2008
  • For the experiment, to develop new materials for cosmetics, the Celosia cristata L. plant ethanol extract were used for physiological effect and cosmetics application research. The Celosia cristata L. is a Korean traditional variety grown. To investigate the effect of Ethanol extract of Celosia cristata L. on skin care, we measured anti-oxidant activity and anti-aging activity. Celosia cristata L. ethanol extract itself had anti-oxidant activity in a dose-dependent manner in 1-diphenyl-2-picryl-hydrazyl(DPPH) radical scavenging. Ethanol extract had anti-oxidant activity in a dose-dependent manner. Silica dose-dependently increased the intracellular ROS generation in RAW 264.7 cells. Celosia cristata L. ethanol extract inhibited silica-induced intracellular superoxide anion generation and $H_2O_2$ generation and hydro-peroxide generation in RAW 264.7 cells. For anti-aging effects, the hyaluronidase inhibition effects, were relatively strong and they also showed elastase activity inhibition effects, which suggesting the Celosia cristata L. ethanol extract might be used as hydration and anti-wrinkle agents. From the above results, it is referred that Celosia cristata L. ethanol extract appears to have potent anti-oxidant activity and anti-aging activity.

THE DENIAL MANAGEMENT OF SELF-INFLICTED ORAL MUTILATION (자해로 인한 구강내 손상의 치과적 조절 : 증례 보고)

  • Lee, Sang-Ik;Kim, Young-Jae;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Jang, Ki-Taeg
    • Journal of the korean academy of Pediatric Dentistry
    • /
    • v.32 no.2
    • /
    • pp.244-250
    • /
    • 2005
  • Self-injurious behavior is defined as deliberated harm to one's own body without suicidal intent. It usually occurs as head banging or hitting, body hitting, skin cutting, or finger biting and includes ocular, genital, and self-inflicted oral mutilation. Self-injurious behavior can occur with mental retardation, coma, psychotic problem, poisoning, or character disorders. In pediatric patients, self-injurious behavior usually is reported to lip, cheek and tongue biting, and many kinds of dental management methods have been introduced to prevent self-injurious behavior patients from self biting. This report presents two self-inflicted oral mutilation patients who were all treated successfully with appliances such as modified activator without wire for retention, modified tongue-rake appliance and mouth guard.

  • PDF

Black Hair Follicular Dysplasia in a Shih Tzu (Shih Tzu 견에서 발생한 Black Hair follicular Dysplasia 일례)

  • Kim Sung-ryong;Kim Young-in;Seo Jeong-a;Park Ji-won;Jeong A-young;Lee Keun-woo;Oh Tae-ho
    • Journal of Veterinary Clinics
    • /
    • v.22 no.2
    • /
    • pp.157-159
    • /
    • 2005
  • Two-month old male Shih Tzu weighing 2.1 kg was presented with alopecia in black-haired areas of the skin. The hair loss had been present since five weeks of age. There was no history of pruritus on any part of the body. No other symptoms had been recognized. Physical examination found no abnormalities other than hair loss. Skin examination showed marked alopecia of black-haired area of the body. The white areas appeared to have hair growth of normal density and texture. Affected pigmented areas showed no evidence of skin lesions. Skin scraping and fungal culture were negative. Microscopic examination of plucked black hairs showed marked pigment clumping in the remnants of the follicles and were mainly in telogen phase. But white hairs were normal in various stages of hair growth. The diagnosis of black hair follicular dysplasia was made based on the history, alopecia of the pigmented areas, the confinement of abnormalities to dark areas, and the normal unpigmented areas.

Surface properties on ion beam irradiated polycarbonate (이온주입에 의한 폴리카보네이트의 표면특성 조사)

  • Lee, Jae-Hyung;Yang, Dae-Jeong;Kil, Jae-Kyun;Kim, Bo-Young
    • Proceedings of the Korean Institute of Electrical and Electronic Material Engineers Conference
    • /
    • 2003.11a
    • /
    • pp.31-35
    • /
    • 2003
  • 폴리카보네이트는 내열성과 투명성이 우수한데 비해 내후성이 좋지 않아 황변 및 물성이 저하되고, 내찰상성이 약하여 긁히기 쉬운데다 이물질에 의해 오염되기 쉬워 투명성이 저하되는 문제점이 있다. 이러한 단점을 극복하고, 사용하는 용도에 따라 요구되는 다양한 기능성을 부여하기 위하여 폴리카보네이트 표면에 기능성층을 형성시킴으로써 그 목적을 달성하고자 한다. 본 논문에서는 이온 주입기술을 이용하여, 폴리카보네이트 표면의 전기전도도 특성을 향상시키고, 피부암 및 백내장 등을 유발하는 유해한 자외선 (UV-A, UV-B)을 차단하려 한다. 표면전기전도도의 향상은 이물질로부터 오염되는 정도를 낮추며, 정전기를 방지할 수 있다. PC(Polycarbonate) 표면에 $N^+,\;Ar^+,\;Kr^+,\;Xe^+$ 이온을 에너지 20keV에서 50keV을 사용하여, 주입량 $5{\times}10^{15}\;{\sim}\7{\times}10^{16}\cm^2$ 로 조사하였다. 이온 주입된 PC의 표면을 두 접점 방법의 표면 저항 측정으로 표면전기전도도 특성을 알아보았고, 자외선차단 특성은 UV-Vis 로 분석하였다. 이들 전기적 광학적 특성간의 상관관계를 관찰하고, 이러한 특성을 나타내는 화학적 기능그룹들의 변화를 보기 위해 FTIR 분석법으로 관찰하였다. 이온조사량의 증가에 따라 표면저항은 $10^7{\Omega}/sq$까지 감소하여 표면전기특성을 증가시키며, 자외선 차단 특성은 UV-A를 95%까지 차단하여 인체에 유해한 자외선 차단에 유용함을 확인하였다. 이러한 특성은 PC 표면에 카본 네트워크 형성과 $\pi$전자들의 운동량을 증가시키는 구조로 고분자 사슬들의 결합구조 변형에 의한 것으로 생각된다.블을 가지고 파서를 설계하였다. 파서의 출력으로 AST가 생성되면 번역기는 AST를 탐색하면서 의미적으로 동등한 MSIL 코드를 생성하도록 시스템을 컴파일러 기법을 이용하여 모듈별로 구성하였다.적용하였다.n rate compared with conventional face recognition algorithms. 아니라 실내에서도 발생하고 있었다. 정량한 8개 화합물 각각과 총 휘발성 유기화합물의 스피어만 상관계수는 벤젠을 제외하고는 모두 유의하였다. 이중 톨루엔과 크실렌은 총 휘발성 유기화합물과 좋은 상관성 (톨루엔 0.76, 크실렌, 0.87)을 나타내었다. 이 연구는 톨루엔과 크실렌이 총 휘발성 유기화합물의 좋은 지표를 사용될 있고, 톨루엔, 에틸벤젠, 크실렌 등 많은 휘발성 유기화합물의 발생원은 실외뿐 아니라 실내에도 있음을 나타내고 있다.>10)의 $[^{18}F]F_2$를 얻었다. 결론: $^{18}O(p,n)^{18}F$ 핵반응을 이용하여 친전자성 방사성동위원소 $[^{18}F]F_2$를 생산하였다. 표적 챔버는 알루미늄으로 제작하였으며 본 연구에서 연구된 $[^{18}F]F_2$가스는 친핵성 치환반응으로 방사성동위원소를 도입하기 어려운 다양한 방사성의 약품개발에 유용하게 이용될 수 있을 것이다.었으나 움직임 보정 후 영상을 이용하여 비교한 경우, 결합능 변화가 선조체 영역에서 국한되어 나타나며 그 유의성이 움직임 보정 전에 비하여 낮음을 알 수 있었다. 결론: 뇌활성화 과제 수행시에 동반되는 피험자의 머리 움직임에 의하여 도파민 유리가 과대평가되었으며 이는 이 연구에서 제안한 영상정합을 이용한 움직임 보정기법에 의해서 개선되었다. 답이 없는 문제, 문제 만들기, 일반화가 가능한 문제 등으

  • PDF

THE CERVICAL ISLAND FLAP FOR INTRAORAL RECONSTRUCTION FOLLOWING EXCISION OF ORAL CANCER -REPORT OF 3 CASES- (구강암 적출후 경부 도상 피판을 이용한 구강내 결손부의 재건 -3 치험례-)

  • LEE, Seong-Geun;LIM, Jong-Soo;KIM, Kyung-Hyun;JEON, So-Yeun;CHO, Young-Sung;SHIN, Sang-Hun;CHO, Young-Cheol;SUNG, Iel-Yong;KIM, Uk-Kyu;KIM, Jong-Ryoul;CHUNG, In-Kyo;YANG, Dong-Kyu
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • v.20 no.3
    • /
    • pp.263-268
    • /
    • 1998
  • Many myocutaneous flaps have been used for the reconstruction of intraoral defects caused by the excision of oral cancer. Among these myocutaneous flaps, cervical island flap has been introduced by Farr et al. Although different in detail, this flap was designed as the platysma myocutaneous flap by Futrell et al in the supraclavicular site. Since many authors applied this flap to cover intraoral defect, they discussed deeply the blood supply of this flap. To improve further flap survival, it was modified by Tashiro et al. This flap makes its vascularity highly reliable. The amount of tissue needed for reconstruction can be accurately planned. The surgical and reconstruction procedure can be performed simply, rapidly, and effectively. Oral functions including deglutition, speech, and denture fitting are not compromised. With it's minimal deformity, new donor fields is not necessory. Of course, we keep in mind that this flap has limitations in patients where much bulk of tissue defects is needed and more than 3000 rad radiation due to the metastasis of neck lymph node is exposed. In three patients with intraoral squamous cell carcinoma($T_{1-3}N_0M_0$), we performed induction chemotherapy with FP regimen including pepleomycin. Thereafter, we ablated oral cancer and peformed reconstruction of intraoral defects with cervical island flap designed by Tashiro et al. Due to these significant benefits and minimal limitations, we have found that this flap is adequate for reconstruction of most intraoral defects following cancer ablation.

  • PDF

식품과 알레르기: 유전자 재조합 식품의 알레르기 위험성

  • 손대열
    • Proceedings of the Korean Journal of Food and Nutrition Conference
    • /
    • 2000.12a
    • /
    • pp.29-34
    • /
    • 2000
  • 산업 발달에 따라 날로 많은 식품들이 새롭게 개발되어지고 있다. 또한 이와 병행해서 식품으로 인한 알레르기 발생 빈도도 날로 증가하고 있으며 그 증상 또한 점차 심화되고 있는 것이 세계적인 추세이다. 우리나라도 예외는 아니어서 일반 알레르기 환자뿐 아니라 식품으로 인한 알레르기 환자들이 점차 증가됨이 보고되어지고 있다. 농산물 시장의 수입개방이후 우리나라에는 많은 해외 농산물이 수입되어지고 있으며 그 중 작년 한해의 경우 총 수입 농산물의 10%를 넘는 유전자 재조합 농산물이 우리나라에 수입되어진 것으로 통계 보고되어졌다. 이러한 관점에서 알레르기 환자의 증가와 새로운 식품 (특히 유전자 재조합 식품)의 증가에는 서로 관련성이 있을 것으로 추측되어지고 있어 (새로운) 식품에 대한 알레르기성의 예측과 관리가 필요한 실정이다. 이에 몇몇 발표된 유전자 재조합 식품에 관련된 알레르기성 검사 논문들과 실험실에서 이루어진 연구 결과들을 중심으로 유전자 재조합 식품의 알레르기 위험성에 대해 알아보고자 한다. 일반적으로 식품의 단백질이 알레르겐(allergen)으로 작용하기 위해서는 먼저 소화효소에 의해 분해되어지고 장에서 흡수되어져서 immunopotent cell에 의해 process 되어 immune system에 present 되어져야 한다. 따라서 단백질로 인한 알레르기 반응은 그 단백질의 자연적 형태 뿐만이 아니라 소화 효소에 분해된 단편들의 구조 또는 다른 알레르겐 단백질과의 유사 구조로 인한 교차 반응에 의해 발생함을 기억해야 한다. 식품 단백질 중 어떤 단백질이 알레르겐으로 작용하는가에 대한 특이성 조사에 많은 관심이 집중되어지고 있지만 아직까지는 대략 다섯 개 정도의 일반적인 특성으로서 요약되어질 수 있다. 그러나 이러한 대략의 특성에 적용되지 않는 식품 알레르겐도 많음을 잊어서는 안 될 것이다. 알레르겐으로 작용하는 식품 단백질의 일반적 특성 1. 좋은 수용성 2. 식품내에 많은 부분을 차지하는 주 단백질이 주 알레르겐으로 작용 3. 단백질내에 하나 이상의 IgE-binding site 존재 4. 위장액에 대한 저항성 5. 10~70 kDa 크기 유전자 재조합 기술이란 말 그대로 유전자를 인위적으로 새롭게 조합하는 기술로 이전의 기술로는 불가능했던 유전적 변형을 농작물과 동물에 가능하게 했으며 이로 인해 유전적으로 변형된 식용 동식물의 개발이 가능하게 되었다. 새로운 유전인자를 개체에 삽입함으로 새로운 단백질이 발현 될수 있고 그로 인해 1) 해충과 질병에 대한 저항성 증가, 2) 화학 제초제에 대한 새로운 저항성 부여, 3) 식품의 저장성 향상, 4) 식품의 영향적 보충/향상 등의 이점을 얻을 수 있다 (표 1). 세계적으로 유전자 재조합 된 새로운 농산물의 재배는 날로 증가추세에 있으며 그 중에서 가장 많은 부분을 차지하는 농산물로 soybean을 들 수 있으며 (표 2) soybean을 중심으로 그 알레르기성의 변화가 연구 조사된 몇 가지 예를 살펴보고자 한다. (표 3)에 요약된 soybean중 첫 번째 경우는 재초제에 대한 저항성을 높여주기 위해 Agrobacterium에 존재하는 EPSPS라는 단백질을 콩에서 발현하도록 찬 유전자 재조합 된 콩의 경우이다. 이 콩의 경우에는 첫째. 이전된 새로운 단백질 EPSPS가 다른 여러 식물에 이미 존재하고 있는 단백질로서 우리가 이미 이러한 식품을 섭취할 때 이 단백질도 같이 섭취해오고 있었다는 점, 둘째. 이 단백질이 소화액 분해 실험에서 짧은 시간내에 분해가 되었다는 점, 셋째. 재조합 된 콩과 자연 콩이 성분 분석에서 차이를 나타내지 않았다는 점, 네 번째. 쥐를 통한 다양섭취 실험에서 아무런 이상 반응이 없었다는 점등의 결과를 기준으로 알레르기에 대한 개별 검사 없이 안전한 콩으로 결론짓고 있다. 영양성을 높이기 위해 Brazil nut에서 methionine 함량이 풍부한 2s albumine을 콩에서 발현하도록 한 두 번째 유전자 재조합 콩의 경우 이전된 단백질 때문에 Brazil nut에 알레르기 반응을 일으키는 알레르기 환자들을 조사한 결과 역시 재조합 된 콩에도 알레르기 반응을 일으켰다는 보고이다. Brazil nut에서 콩으로 이전된 단백질이 Brazil nut에서의 알레르기성을 그대로 유지한 점을 볼 때 새로운 단백질이 어디에서 유래하는가가 중요함을 잘 보여준 연구이다 세 번째 콩의 경우 역시 영양성을 높여주기 위해 corn에서 10 kDa과 HSZ 단백질을 콩에서 발현하도록 유전자 재조합했는데 이 콩의 경우는 알레르기 환자들이 유전자 재조합 된 콩과 자연 콩에 반응의 차이를 나타내지 않았다는 결과 보고이다. 위의 세 실험 결과들을 종합해 볼 때 무엇보다도 새롭게 발현된 단백질이 원래 어떤 성질을 갖고 있으며 어디에서 유래했는지가 알레르기성 조사에 중요한 역할을 한다 할 수 있겠다. 또한 유전자 재조합된 식품들은 알레르기 환자들을 위해 표기되어져야 할 것인데 이를 위한 알레르기성 검사 실험은 공공단체를 통해 이루어져야 할 것이며 환자들마다 알레르겐으로 작용하는 단백질의 인식부위(epitope)가 다를 수 있기 때문에 적어도 10명 이상의 알레르기 환자들이 조사되어져서 검사가 이루어져야 할 것이다. 환자들의 혈청을 통한 in vitro 실험에서는 ELISA, RAST, immunoblotting과 같은 검사 방법들이 적용될 수 있고, 그 결과가 음성인 경우에 그 다음 단계로 in vivo 실험에서는 직접 환자의 피부반응검사 (skin prick test)나 DBPCFC (double-blind placebo-controlled food challenge) 검사 방법을 통해 확인되어져서 이 모든 경우가 음성인 경우와 하나라도 양성인 경우를 구별하여 식품에 표기함으로 알레르기 환자들의 유전자 재조합 식품에 대한 안전성이 보장되어져야 할 것이다.

  • PDF

Forest Structure in Relation to Slope Aspect and Altitude in valley Forests at Hambaeksan Area (함백산지역 계곡부의 사면방향과 해발고에 따른 산림구조)

  • 박인협;최윤호;이석면;최영철;유석봉
    • Korean Journal of Environment and Ecology
    • /
    • v.15 no.4
    • /
    • pp.361-368
    • /
    • 2002
  • The valley forests located at the east-facing slope and the west facing slope in Hambaeksan area were studied to investigate forest structure in relation to aspect and altitude of the slope. There was little difference in density. mean DBH and basal area of the tree layer between east-facing slope and west-facing slope. The importance percentages of Tilia amurensis and Betula costata in west-facing slope were higher than those in east-facing slope. However, the importance percentages of Quercus mongilica and Fraxinus rhynchophylla in the west facing slope were lower than those in east-facing slope. Species diversity of the west-facing slope was 1.415 and that of the east-facing slope was 1.328. Elevation trends were also found for forest structure. As elevation Increased basal area and mean height of the tree layer decreased in both of east-facing slope and west-facing slope. There was a tendency that number of species, species diversity and evenness decreased with increasing elevation. The importance percentage of Quercus mongolica increased with increasing elevation while those of Betula costata and Maackia amurensis decreased. The result of cluster analysis for the tree and subtree layer indicated that the studied forests were classified into the mixed forest community of broad-leaved tree species at west-facing slope and the low and middle elevation belts of east-facing slope and Quercus mongolica community at the high elevation belt of east-facing slope. Quercus mongolica was significantly and positively correlated with Symplocos chinensis for. pilosa, Acer tschonoskii var. rubripes and deutzia glabrata. Betula costata was significantly and negatively correlated with Quercus mongolica and Acer pseudo-sieboldianum.

Double-bundle Anterior Cruciate Ligament Reconstruction using Autogenous Hamstring Grafts (이중 다발 자가 슬괵건을 이용한 전방십자인대 재건술)

  • Choi, Nam-Yong;Nam, Won-Sik;Yang, Young-Jun;Han, Chang-Hwan;Moon, Chan-Woong;Kwon, Jae-Young;Song, Hyun-Seok
    • Journal of the Korean Arthroscopy Society
    • /
    • v.12 no.2
    • /
    • pp.112-117
    • /
    • 2008
  • Purpose: Double-bundle reconstruction of anterior cruciate ligament(ACL) has the advantage of restoring the isometry and original function of ACL. The purpose of this study is to evaluate the clinical results following double-bundle reconstruction of ACL using autogenous hamstring grafts through an accessory anteromedial portal. Materials and Methods: From January 2005 to July 2006, sixty patients(52 males, 8 females) underwent double-bundle ACL reconstruction using autogenous hamstring tendons..The mean age was 31.7 years($20{\sim}51$ years). The mean follow up period was 13.4 months($12{\sim}16$ months). We made a horizontal-oblique skin incision just medial to tibial tuberosity and harvested semitendinosus and gracilis tendon. Tibial tunnel for posterolateral bundle was made near its anatomical position. By modifying an anatomic reconstruction of ACL by Yasuda et al., we made a femoral tunnel for posterolateral bundle through accessory anteromedial portal. Tunnels for anteromedial bundle were made with conventional method. We reconstructed anteromedial bundle with semitendinosus tendon and posterolateral bundle with gracilis tendon. Clinical results at last follow up were evaluated by range of motion, extent of anterior displacement(KT-1000 arthrometer), pivot-shift test. Functional evaluation of clinical outcomes were evaluated by Lysholm score and modified Feagin Scoring System. Results: There was no limitation of motion of knee joint at last follow up. Mean side to side difference of anterior displacement of tibia by KT-1000 arthrometer was improved from 8.4 mm preoperatively to 1.7 mm postoperatively(p<0.05). Average Lysholm score was improved from 64.1 preoperatively to 92.2 postoperatively(p<0.05). In modified Feagin Scoring System, 90% of cases were rated as good or excellent. Conclusion: Double-bundle reconstruction of ACL using autogenous hamstring grafts through accessory anteromedial portal results in good clinical outcomes.

  • PDF