• 대한골관절종양학회지
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• 제16권2호
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• pp.80-86
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• 2010

목적: 골격계는 전이성 암에 의해 흔히 영향을 받는 부위이다. 본 연구를 통해 하지에서 발생한 전이성 병적 골절에 대한 치료로서 잠김 금속판을 이용한 치료 결과에 대해 알아보고자 한다. 대상 및 방법: 2004년부터 2010년까지 하지에 발생한 전이성 암에 의한 병적 골절에 대하여 잠김 금속판을 이용하여 치료받은 12명(13예)의 환자를 대상으로 평가를 시행하였다. 평균 환자 나이는 62.2세(50-81세)였으며, 골절은 각각 근위 대퇴골 2예, 대퇴골 간부 3예, 원위 대퇴골 3예, 근위 경골 4예, 원위 대퇴골 1예에서 발생하였다. 치료 결과로서 휠체어 보행 가능 시기, 통증 완화 정도 및 합병증을 평가하였으며, 또한 수술 시간 및 술 후 실혈량에 대하여 평가하였다. 결과: 수술 후부터 휠체어 보행까지는 평균 3.2일(1-6일)이 소요되었다. 평균 시각 통증 척도는 수술 전 8.1점(7-9점)에서 술 후 1주일째 2.7점(2-4점)으로 호전되었으며, 수술과 연관된 조기 합병증은 발생하지 않았다. 평균 수술 시간은 88.4분(70-105분)이었으며, 술후 평균 실혈량은 246.5 ml (130-320 ml)이었다. 결론: 하지의 전이성 병적 골절에 대한 치료로서, 잠김 금속판을 이용한 내고정술은 심한 골 파괴나 골 결손을 보이는 장골의 골간단부 혹은 골간부 병변에 효과적인 치료 방법이며, 또한 조기 보행을 가능하게 하고, 통증 및 술후 합병증 감소에 도움을 줄 수 있을 것이다.

• 대한소아치과학회지
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• 제26권2호
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• pp.310-316
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• 1999

외상받은 치아에서 치수강폐쇄, 치수괴사, 치근흡수, 인접치조골소실, 치근단염증성변화 및 치아상실 등의 부작용이 나타날 수 있으며, 이는 치근형성정도, 탈구의 종류, 고정의 기간에 따라 예후가 달라진다. 외상후 부작용의 빈도를 줄이기 위해서는 조기에 치수생활력 유무를 판단하는 것이 중요하다. 그러나 미성숙치근을 가진 치아는 치수내 신경발달분포가 불완전하고, 환자의 연령이 어려 술식에 대한 이해력이 부족하고 치과에 대한 공포감 때문에 전기치수검사등의 전통적인 치수생활력 방법의 신뢰도가 떨어진다. 반면 laser Doppler flowmetry는 치수혈류량을 측정하여 치수생활력을 검사하는 방법으로서 보존적이며 객관적이고, 외상후 비교적 조기에 치수생활력을 측정할 수 있는 신뢰도가 높은 치수생활력 검사방법이다. 이에 저자는 외상받은 미성숙치아를 대상으로 냉검사, 전기치수검사, laser Doppler flowmetry를 이용하여 치수생활력을 검사하여 다음과 같은 결과를 얻었다. 1. 외상받은 치아의 치수생활력은 초기에는 음성으로 나타날 수 있으나 시간의 경과에 따라 양성으로 회복될 수 있어 장기간의 관찰이 필요하다. 2. 치수생활력은 냉검사, 전기치수검사 보다 laser Doppler flowmetry 에서 더 빨리 나타났다. 3. 냉검사와 전기치수검사의 두가지 치수생활력 검사방법중 전기치수검사 보다 냉검사가 신뢰도가 더 높았다.

• 조형예술학연구
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• 제3권
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• pp.87-144
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• 2001

This study looks into historical genealogy of autonomy in art criticism on modernism and presents the view of the judgment and correction about that. A matter of autonomy in art appeared in the attempt to totally reconsider and upset the theory of 'Mimesis' or 'Representation' which was the basis of traditional aesthetic theory. In the traditional theory of representation, they assumed primary image exists first and then tried to obtain visual similarity to it through art works. However, in the theory of autonomy in modernism, they maintained the reduction to pure form' or medium', regarding what art works represents and how similar to primary image are not the true essence of art. In the early 20th century, C. Bell laid the foundation stone of the theory of Formalism', providing that a matter of autonomy is significant form', which is the combination of lines and colors Aesthetic autonomy theory came to a climax by C. Greenberg, who systemized art criticism on modernism in the middle 20th century. According to his theory, the pursuit of the essence of form resulted in the specificity of medium' and flatness. They thought that the autonomy of art would be achieved by eliminating outward social factors from art works. This theory ended by Minimalism preventing the instructive function of art work and only emphasizing its material property. Since the middle 20th century, the autonomy theory was confronted with the limit and intense attack because it resulted in this fixed canon and materialism, so they began laying emphasis on those extrinsic factors around art works such as human life, society, history, and so on. This study focuses on arguing and complementing the limit of autonomy such as the adhesive and fixed canon, and then defining the more dynamic area of it. For this, first, I introduced the view of T. J. Clark and T. Crow who criticized the aesthetic autonomy theory. They denied the transcendental structure of form, and found form only in the association with substantial life and society. And they insisted the dynamism of form by emphasizing form as a result of negation insisted by avant-garde. Second, I researched the view of A. C, Danto and M. Fried, who complemented the traditional autonomy theory. They made autonomy emerge from the fixation of form like flatness through connecting essentialism with historical view. In conclusion, I insist that autonomic position of art make it possible to connect or mediate between material form and human or social elements. Therefore, autonomy should not be reduced to the axis of form or that of society but make interaction between two heterogeneous axes.

• Journal of Chest Surgery
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• 제32권11호
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• pp.998-1003
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• 1999

Background: Bovine pericardium treated with glutaraldehyde(GA) is one of the most popular prosthetic materials. However, its late calcific degeneration after implantation results in early failure of the prosthesis. Therefore, we investigated the effects of combined treatment with sodium dodecyl sulfate(SDS) and glutamate on calcific degeneration of GA treated bovine pericardium. Material and Method: Sixty square-shaped pieces of bovine pericardia were fixed in 0.625% GA solution with 4g/L MgCl2.6H2O as a control group (group 1). Sixty pieces pretreated with 1% SDS (group 2) and sixty pieces posttreated with 8% glutamate (group 3) were also fixed in the same GA solution. Sixty pieces pretreated with 1% SDS and posttrated with 8% glutamate were also fixed in the same GA solution (group 4). After 1 month of fixation, the pieces were implanted into the belly of sixty Sprague-Dawley rat subdermally and were extracted 1 month, 2 months and 3 months after the implantation. With an atomic absorption spectrophotometry, we measured the calcium amount deposited. Result: The calcium deposition in 1 month was 2.01$\pm$0.13 mg/g in group 1, 1.45$\pm$0.31 mg/g in group 2, 2.49$\pm$0.15 mg/g in group 3 and 0.75$\pm$0.27 mg/g in group 4. In 2 months, it was 3.57$\pm$0.15 mg/g in group 1, 0.98$\pm$0.30 mg/g in group 2, 3.46$\pm$0.12 mg/g in group 3, and 1.48$\pm$0.39 mg/g in group 4, and 5.45$\pm$0.42 mg/g in group 1, 2.43$\pm$0.53 mg/g in group 2, 4.20$\pm$0.55 mg/g in group 3, and 1.02$\pm$0.27 mg/g in group 4 in 3 months. The calcium depositions in group 2 and 4 were less than those of group 1 and 3 in 1 month 2, months, and 3 months(p<0.01). The calcium depositions in group 1, 2 and 3 increased with time. However, they remained unchanged in group 4, which was statistically significant(p<0.01). Conclusion: Pretreatment with SDS is effective in reducing calcification of GA treated bovine pericardium, and the combined method of pretreatment with SDS and posttreatment with glutamate was more effective than the other methods.

• 대한족부족관절학회지
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• 제12권1호
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• pp.26-30
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• 2008

Purpose: The authors evaluated the differences between K-wires and Bold screw for fixing the proximal metatarsal chevron osteotomy of moderate and severe hallux valgus. Materials and Methods: There were 59 patients (81 feet) who were moderate and severe degree hallux valgus according to the classification of Mann. They all got the proximal chevron osteotomy when correcting the deformity. All patients were followed up at least 6 months. We divided the patients into 2 groups, K-wires fixed group as A, Bold screw fixed group as B. Group A were 42 patients (63 feet) and Group B were 18 patients (19 feet). Among the Group B, 2 feet who were failed to fix the oetotomy site with Bold screw, were fixed with K-wires during operation. We measured the AOFAS score preoperatively, postoperatively and at final follow-up, VAS score at 2 weeks after the operation. Also preoperative, postoperative and follow-up hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured for each patients. Results: Mean follow up period was 1.34 year (range: 6 months-6.16 years). Mean VAS score of group A was $3.21{\pm}1.7$ and group B $1.76{\pm}1.0$. Preoperative mean AOFAS score of group A was $45.61{\pm}8.3$, group B $44.41{\pm}8.9$, the final mean score of group A was $88.87{\pm}8.3$ and group B $92.47{\pm}4.4$. Preoperative mean HVA was $30.82{\pm}6.6$ degrees in group A and $32.88{\pm}14.5$ degrees in group B, the final mean angle of group A was $14.89{\pm}8.3$ degrees and group B $17{\pm}4.4$ degrees. The preoperative mean IMA of group A was $13.69{\pm}3.6 $degrees and group B $12.35{\pm}5.2$, the final mean angle of group A was $9.26{\pm}3.6$ degrees and group B $12.35{\pm}5.8$ degrees. Conclusion: There were no statistical differences in radiologic and clinical results (p>0.05) but, group B exceeded group A in VAS score (p=0.0007) and had no statistical significance in terms of reduction angle loss (p=0.06). Early returning to normal life activity may be possible for patients using Bold screws.

• Journal of Chest Surgery
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• 제29권1호
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• pp.32-37
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• 1996

본 서울중앙병원에서는 1991년 5월에서 1995년 9월까지 심근경색후 합병된 심실중격결손증 7례 환자의 수술을 시행 하였다. 남자환자가 2명, 여자환자가 5명 이었으며, 평균연령은 65세 (범위 : 54~76)였다. 심실중격결손의 위치는 전중격 결손이 6명이 었으며, 전후중격 경계부 심실중격결손이 1명 있었다. 모든 환자에서 술전 심초음파와 심혈관조영술을 시행하여 심실기능과 관상동맥 병변의 위치를 파악하였다. 수술은 심근괴사후 평균 24 $\pm$ 12일 후에 시행하였다. 좌심실 심근괴사 조직을 통하여 Teflon patch로 봉합하였고, 추가적인 수술로 3명 환자에서는 관상동맥 우회 술을 시행하였고, 5명 환자에서 심실류 제거술을 시행하였으며, 1명 환자에서 좌심실혈전 제거술을 시행하였다. 심실중격결손의 봉합시 중격근육전층을 통하여 interuptted pledget 봉합함으로써 심실중격 결손 재발을 막으려고 노력하였으며, 수술후 합병증으로는 폐렴 1명, 좌측대퇴부 피부괴사 1명이 있었다. 조기 사망률은 없었고 외국으로 이민간 1명을 제외하고 6명 모두 수술후 3개월에서 63개월 사이(평균28개월)에 추적 조사상 합병증이나 사망 없이 NYHA I-II상태로 생활하고 있다.

• Journal of Korean Neurosurgical Society
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• 제29권5호
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• pp.604-608
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• 2000

Objective : The purpose of this non randomized prospective study was to verify the effect of pain control in small doses of epidural morphine and bupivacaine through continuous infusion for 48 hours. Patients and Methods : Thirty-five patients who underwent spine surgery including laminectomy, fusion with fixation were assigned into two groups ; pain control group(n＝20) and control group(n＝15). Pain score was measured on a visual analogue scale(VAS). A continuous infusor was used to give morphine and bupivacaine continuously via indwelling epidural catheter which was placed before closure of muscles in pain control group. Results : Mean scores(VAS) of pain control group were between 1.3 and 2.1 from the 30 min to the 72 hour, but the lowest mean score in the control group was about 2.6 at the 72 hour. Although a number of extra-analgesics were used in control group, differences of mean scores were statistically significant till 24 hour in pain control group. The patients in pain control group was less painful than the patients in control group from 24 hour till 72 hour, but it was statistically insignificant. There were some side effects such as nausea/vomiting, pruritus, urinary retention which existed transiently, but there was no respiratory depression. Conclusion : It was concluded that the early postoperative pain can be easily and safely controlled with continuous infusion of epidural morphine and bupivacaine in small doses.

• Journal of Yeungnam Medical Science
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• 제11권2호
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• pp.284-292
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• 1994

1992년 12월부터 1994년 6월까지 영남대학교 의과대학 부속병원 정형외과에 내원한 대퇴골두무혈성 괴사 환자 28명, 31 고관절에 대해 시행한 경전자간 회전 절골술의 결과는 다음과 같다. 1. 대상 환자는 한명을 제외하고는 모두 남자였으며, 평균 연령은 44.3세로 삼, 사십대가 대부분이었다. 2. 무혈성 괴사의 원인은 과다한 음주에 의한 것이 18례로 가장 많았고, 괴사의 정도는 Ficat와 Arlet의 분류에 의하면 II a가 16례로 가장 많았다. 3. 절골술 후 고정 방법으로는 screw가 15례, DHS가 16례였고, 고정 방법에 따른 대퇴경간각의 변화로는, screw를 사용한 경우는 술전에 비해 내반고 되는 경향을 보였고, DHS를 사용한 경우는 외반고 되는 경향을 보였다. 4. 술전 대퇴골두 측면 방사선 사진에서 측정한 대퇴골두 전체 관절면에 대한 건전한 관절면의 비는 1/3이하가 8례, 1/3 이상이 23례(74%)이었다. 5. 술후 고관절의 전후면 방사선 사진에서 측정한 비구의 체중 부하면에 대한 전위된 건전한 대퇴골두의 관절면 비는 36% 이상이 24례(78%), 21-35%가 6례, 20% 이하가 1례였다.

• 대한치과보철학회지
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• 제42권3호
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• pp.307-326
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• 2004

Statement of problem. The long-term success of implants is the development of a stable direct connection between bone and implant surface, which must be structural and functional. To improve a direct implant fixation to the bone, various strategies have been developed focusing on the surface of materials. Among them, altering the surface properties can modify cellular responses such as cell adhesion, cell motility and bone deposition. Purpose. This study was to evaluate the cellular behaviors on the surface-modified titanium by morphological observation, cellular proliferation and differentiation. Material and methods. Specimens were divided into five groups, depending on their surface treatment: electropolishing(EP) anoclizing(AN), machining(MA), blasting with hydroxyapatite particle(RBM) and electrical discharge machining(EDM). Physicochemical properties and microstructures of the specimens were examined and the responses of osteoblast-like cells were investigated. The microtopography of specimens was observed by scanning electron microscopy(SEM). Surface roughness was measured by a three-dimensional roughness measuring system. The microstructure was analyzed by X-ray diffractometer(XRD) and scanning auger electron microscopy(AES). To evaluate cellular responses to modified titanium surfaces, osteoblasts isolated from neonatal rat were cultured. The cellular morphology and total protein amounts of osteoblast-like cell were taken as the marker for cellular proliferation, while the expression of alkaline phosphatase was used as the early differentiation marker for osteoblast. In addition, the type I collagen production was determined to be a reliable indicator of bone matrix synthesis. Results. 1. Each prepared specimen showed specific microtopography at SEM examination. The RBM group had a rough and irregular pattern with reticulated appearance. The EDM-treated surface had evident cracks and was heterogeneous consisting of broad sheet or plate with smooth edges and clusters of small grains, deep pores or craters. 2. Surface roughness values were, from the lowest to the highest, electropolished group, anodized group, machined group, RBM group and EDM group. 3. All groups showed amorphous structures. Especially anodized group was found to have increased surface oxide thickness and EDM group had titaniumcarbide(TiC) structure. 4. Cells on electropolished, anodized and machined surfaces developed flattened cell shape and cells on RBM appeared spherical and EDM showed both. After 14 days, the cells cultured from all groups were formed to be confluent and exhibited multilayer proliferation, often overlapped or stratified. 5. Total protein amounts were formed to be quite similar among all the group at 48 hours. At 14 days, the electropolished group and the anodized group induced more total protein amount than the RBM group(P<.05). 6. There was no significant difference among five groups for alkaline phosphatase(ALP) activity at 48 hours. The AN group showed significantly higher ALP activity than any other groups at 14 days(P<.05). 7. All the groups showed similar collagen synthesis except the EDM group. The amount of collagen on the electropolished and anodized surfaces were higher than that on the EDM surface(P<.05).

• Journal of Yeungnam Medical Science
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• 제10권2호
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• pp.388-399
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• 1993

1983년 2월부터 1993년 5월까지 저자들이 interlocking IM nail정을 이용하여 치료한 경골 골절을 평균 14개월 추시하여 다음과 같은 결론을 얻었다. 1. 총 38례 중 37례에서 골유합을 이루어 97.3%의 골유합율은 보였으며 평균골유합기간은 18.7주였다. 2. 금속정의 사용 범위는 경골 간부 및 근위부나 원위부 골절에서 만족할 만한 결과를 얻었다. 3. interlocking nail은 심한 분쇄성 골절, 개방성 골절, 골소실이 있는 개방성 골절 동에서 견고한 고정을 얻을 수 있었다. 4. 불유합 및 지연유합된 경우 모두 골유합을 이루어 나사못 맞물림을 이용한 금속정 고정법은 경골 간부 골절에서 훌륭한 치료법으로 생각된다. 5. 가장 중요한 합병증은 Valgus 각형성 2례 및 varus 1례와 심부감염 1례 등이었다. 6. 금속정은 고정력이 견고하여 조기 관절운동 및 보행이 가능하여 관절 강직이나 근위축을 방지할 수 있었다.