• 대한임상검사과학회지
• /
• 제47권3호
• /
• pp.117-124
• /
• 2015

중간엽줄기세포는 손상된 관절연골 치유능력을 가지고 있어 줄기세포 치료 분야에서 대표적인 성체줄기세포로 알려져 있다. 자외선이 조사된 생체 친화성 필름 조성물인 DTOPV (S-triazine bridged p-phenylenevinylene)는 친수성 특성의 표면을 가진 형광 화합물이다. 이전의연구에서 물질표면의 습윤성과 친수성이 세포부착 및 증식에 중요한 역할을 하는 것이 확인 되었으며, 이번 연구에서는 DTOPV를 이용하여 중간엽줄기세포의 연골분화능을 향상시키고자 하였다. 일반 배양용기로 사용하고 있는 TCPS (tissue culture polystyrene)와 자외선이 조사된 패턴된 DTOPV 필름을 이 실험에 사용하였고 TGF (transforming growth factor)-${\beta}3$가 포함된연골분화배지로 중간엽줄기세포를 2주동안 분화유도를 하였다. TCPS에서 배양된 중간엽줄기세포는 단층으로 자라면서 분화가 유도된 반면, 자외선이 조사된 DTOPV 필름 위에서 배양된 세포는덩어리진 구형으로 형태가 변하였으며, 연골세포에 특이적으로 염색되는 Safranine O 염색으로 DTOPV 조건에서 더 붉게 염색됨을 관찰하였다. 또한 연골세포 특이적인 유전자인 Type II collage이 DTOPV 조건에서 더 강하게 발현되는 것을 확인함으로써 TCPS보다 DTOPV에서 연골세포로 분화가 향상된 것을 알 수 있었다. 따라서 자외선이 조사된 생체 친화성 필름 조성물인 DTOPV을 이용한 경우에 일반 배양용기보다 빠르게 연골분화가 이루어짐을 알 수 있었다. 결론적으로 향후 조직공학 분야에서 DTOPV가 중간엽줄기세포의 효과적인 연골분화 물질로서 활용될 수 있는 가능성을 확인 하였으며, 더 나아가 약물 스크리닝과 같은 진단분야에 활용될 수 있음을 알 수 있었다.

• 대한의용생체공학회:의공학회지
• /
• 제19권1호
• /
• pp.53-58
• /
• 1998

본 연구에서는 슬개골의 골밀도와 Von Mises 응력의 분포를 조사하였다. 18개 슬개골의 골밀도는 컴퓨터 단층촬영과 영상분석 소프트웨어를 사용하여 결정하였다. 슬개골의 골밀도는 위치에 따라 변화됨을 발견하였다. 골밀도값은 상외측부에서 가장 크고 아래쪽 혹은 내쪽으로 갈수록 감소하였다. 이 분포는 슬개골 안에서 소주의 조직과 일치됨을 보였다. 각 슬개골에서 2차원 유한요소법을 실행한 결과 슬개골의 최대 Von Mises응력은 비관절 표면 위에 있는 피질외피에 따라 발생하였다. 소주의 최대 Von Mises응력은 슬개골의 후방부에 존재했다. 이 발견들은 생체내의 유한요소 연구에 대한 잠재적 가능성을 증명하였다. 따라서 이러한 연구들은 주문형, 환자특성에 맞는 슬개골 인공보철물들의 개발을 유도할 수 있게 한다.

• 대한족부족관절학회지
• /
• 제1권1호
• /
• pp.30-37
• /
• 1997

Pilon fracture is an intraarticular fracture of distal tibia. It is high energy injury with significantly associated soft tissue damage, bone comminution, and articular surface disruption. Until recently, this treatment has followed the AO principles, Because the risk of complications outweighs potential benefits, the principle of a Pilon fracture treatment are changing. Newer techniques using articulated external fixation minimize disturbance of the soft tissue envelope and have decreased these complications. Series of 5 patients with Pilon fracture were treated by articulated external fixator and followed up more than 12 monthes at the Department of orthopaedic surgery, Kang Dong Sacred Heart Hospital, College of medicine, Hallym University. The results were as follows: 1. The type of fracture were type C2(3 cases),type C3(2 cases) according to AO-$M{\ddot{u}}ller$ classification. 2. The clinical results according to functional criteria by Mast and Teipner were good in 4 cases and poor in 1 case, which is an old fracture. 3. Techniques utilizing articulated external fixator were associated with satisfactory results and appeared to significantly decrease the incidence of soft tissue complication, post-traumatic arthritis, osteoporosis, and fibrosis of ankle joint.

• 대한족부족관절학회지
• /
• 제17권3호
• /
• pp.220-224
• /
• 2013

Purpose: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, it could lead to skin irritation and medial pain after the surgery. The purpose of this paper was to report our clinical and radiographic results with transarticular fixation of Akin osteotomy for the treatment of patients with hallux valgus after resection of the medial protrusion of base of the proximal phalanx. Materials and Methods: Our study is subject to 34 cases of 30 patients who went through proximal phalanx medial corticectomy among patients undergone both hallux valgus surgery and Akin osteotomy at our institution from March 2006 to March 2012. In all cases, we used absorbable suture material through the articular surface for Akin osteotomy after resection of the medial protrusion in proximal phalanx. Radiographs were reviewed to assess the union and displacement of osteotomy site at the time of postoperative 6 months. The clinical results were assessed by using AOFAS score and complication such as skin irritation and pain. Results: AOFAS score was improved from average 44 points(36-58), before operation and average 87 points(74-96), 12 months after operation. In two cases, partial union was suspected in radiological perspective, however, complete union on the osteotomy site was observed in all cases, 12 months after the operation. No patients was dissatisfied with pain, joint discomfort, skin irritation and inflammation from the knot. Conclusion: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, We have good results by transarticular fixation of Akin osteotomy using absorbable suture material.

• 대한족부족관절학회지
• /
• 제8권2호
• /
• pp.138-141
• /
• 2004

Purpose: The purpose of this study was to document the results of fixation with ethibond suture in akin osteotomy and its advantages. Materials and Methods: From May 2001 to January 2004, Akin osteotomy was performed in 218 patients. We reviewed 110 patients (114 feet) who were possible radiographic evaluation more than 6 months after operation. 110 feet had hallux valgus and 4 feet had hallux valgus interphalangeus. 105 patients were female and 5 were male. The average age was 43.8 years old (18 to 68 years old). The average follow up was 9 months (6 to 23 months). After performing the Akin osteotomy at 7 mm from the proximal articular surface of the proximal phalanx, one hole is made on either side of the osteotomy site with a K-wire. The passer was passed through the both holes and the ethibond was passed. And then, the ethibond was tied tightly. 2 sutures in 66 feet and 1 suture in 48 feet were made. Radiographic bone union at 6 months follow up was regarded as success and loss of the reduction, nonunion was regarded as failed. Results: In the radiographic evaluation, bony union were made at 6 months follow up in all feet. There was no difference between 2 sutures and 1 suture, and the knots were removed in 3 feet because of skin irritation. Conclusion: The fixation of the osteotomy site using suture material was an effective method in Akin osteotomy. The advantage of this procedure was unnecessity of the material removal.

• 대한의용생체공학회:의공학회지
• /
• 제36권2호
• /
• pp.43-47
• /
• 2015

Osteoarthritis is the most common chronic joint disease in the world. With its progression, cartilage thickness tends to diminish, which causes severe pain to human being. One way to examine the stage of osteoarthritis is to measure the cartilage thickness. When it comes to inter-subject study, however, it is not easy task to compare cartilage thickness since every human being has different cartilage structure. In this paper, we propose a method to assess cartilage defect using MRI inter-subject thickness comparison. First, we used manual segmentation method to build accurate atlas images and each segmented image was labeled as articular surface and bone-cartilage interface in order to measure the thickness. Secondly, each point in the bone-cartilage interface was assigned the measured thickness so that the thickness does not change after registration. We used affine transformation and SyGN to get deformation fields which were then applied to thickness images to have cartilage thickness atlas. In this way, it is possible to investigate pixel-by-pixel thickness comparison. Lastly, the atlas images were made according to their osteoarthritis grade which indicates the degree of its progression. The result atlas images were compared using the analysis of variance in order to verify the validity of our method. The result shows that a significant difference is existed among them with p < 0.001.

• 대한족부족관절학회지
• /
• 제3권1호
• /
• pp.26-32
• /
• 1999

Fractures of the tibial pilon are the severe injuries to the ankle joint resulted from axial compression, shear and/or rotational forces. The pilon fractures have been difficult in management due to the severe comminution of articular surface and frequent soft tissue problem. Among many treatment options, limited internal fixation of the tibia with long screws and multiple pins augmented with external fixation or casting provide adequate stabilization without soft tissue compromise. Among the patients of pilon fracture admitted to our hospital from March 1993 to March 1997 who treated by limited internal fixation and external fixation or casting, 25cases are included who could be follow up for more than 10months. According to Ruedi and Allgower, typeI 3cases, typeII 14cases, typeIII 8cases. The authors analyzed the clinical and radiological results of the tibial pilon fractures according to Magnusson. The results were as follow. 1. 10cases at Ruedi-Allgower typeII were obtained above fair and 5cases at Ruedi-Allgower typeIII were obtained above fair. 2. The postoperative complications were skin problem(3cases) and infection(2cases), which were treated by antibiotics and flap surgery.

• 대한족부족관절학회지
• /
• 제3권1호
• /
• pp.40-48
• /
• 1999

The neck of the talus is its most vulnerable and fragile segment, because of narrow diameter, devoid of hyaline padding and honeycombed internally by vascular channels etc. Talar neck fractures comprise 50% of all major to the talus. The majority occurs as a result of high-energy injuries, such as motor vehicle accidents or fall from a height. Anatomically, talar surface is covered mainly with articular cartilage and blood supply to the talus is very poor. So, complications, such as non-union, avascular necrosis and post traumatic arthritis, are frequent. The authors reviewed fourteen cases of talar neck fractures treated in our clinics from Jan. 1992 to Mar. 1997, and average follow-up period was over 15 months. The results obtained were as follows; 1. Patients' average age was 31.2 years. 2. The most common cause was traffic accident(9/14, 64%), and hyperdorsiflexion injury of the ankle was common mechanism of the fractures. 3. According to the modified Hawkins classification, type I was four cases, type II was nine cases, type III was one case and type IV was no case. 4. Hawkins sign of subcortical radiolucency was found in 64% (9/14) of the fractures. 5. Avascular necrosis was occurred in 21% (3/14) of the fractures(in two cases of type II fractures, and in one of type III). 6. According to the Hawkins criteria, four cases in type I, five in type II were an excellent result. Two cases, one in type II and one in type III were good result, and two in type II were fair. One in type II was poor result.

• 대한관절경학회지
• /
• 제2권2호
• /
• pp.168-172
• /
• 1998

저자들은 관절운동의 장애 없이 양측 슬관절의 탄발음과 동통 및 파행을 주소로 한 6세 소아에서 관절경을 통해, 일반적인 탄발음의 원인이 아닌 외측 원판형 연골의 비후된 근위부착형의 리스버그 인대와 전방십자인대의 확장된 기시부의 충돌에 의해 탄발음이 유발된 1례를 발견하고 이를 관절경적으로 절제함으로서 치료하여 좋은 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다.

• 대한정형외과스포츠의학회지
• /
• 제4권2호
• /
• pp.79-85
• /
• 2005

슬개-대퇴 관절의 증상은 다양한 원인에 의해 발생될 수 있다. 대부분의 환자는 만성적인 불편감을 호소하며, 특징적인 급성통증의 양상을 보이는 경우도 매우 드물다. 따라서 우선적으로 보존적 치료가 시행되어야 하며, 이에 대한 반응이 없을 경우 수술적 치료를 시행해야 한다. 수술 방법의 결정은 환자의 연령, 활동도, 술 후 재활 능력 등을 고려하여 선택되어야 한다. 수술적 치료시 정확한 진단이 선행되어야 하며, 수술 시 그 원인적 요소를 제거 혹은 교정해야 한다. 관절경적 치료는 수술에 따른 이환율을 줄이고, 조기 재활의 장점이 있어 유용한 방법이다. 슬개골 관절면의 평가 및 치료를 위해서는 상내방 혹은 상외방 도달법도 효과적이다. 수술 시 정상적인 조직의 제거는 술 후 슬관절의 문제를 야기할 수 있으므로 병적인 변화가 없을 경우 보존해 주어야 한다. 관절경적 치료가 힘들거나 혹은 치료 효과가 없다고 판단될 경우 개방성 방법에 의한 수술도 반드시 고려해야 한다.