• 한국재료학회:학술대회논문집
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• 한국재료학회 2012년도 춘계학술발표대회
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• pp.56.2-56.2
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• 2012

Clinically-favored materials for bone regeneration are mainly based on bioceramics due to their chemical similarity to the mineral phase of bone. A successful scaffold in bone regeneration should have a 3D interconnected pore structure with the proper biodegradability, biocompatibility, bioactivity, and mechanical property. The pore architecture and mechanical properties mainly dependent on the fabrication process. Bioceramics scaffolds are fabricated by polymer sponge method, freeze drying, and melt molding process in general. However, these typical processes have some shortcomings in both the structure and interconnectivity of pores and in controlling the mechanical stability. To overcome this limitation, the rapid prototyping (RP) technique have newly proposed. Researchers have suggested RP system in fabricating bioceramics scaffolds for bone tissue regeneration using selective laser sintering, powder printing with an organic binder to form green bodies prior to sintering. Meanwhile, sintering process in high temperature leads to bad cost performance, unexpected crystallization, unstable mechanical property, and low bio-functional performance. The development of RP process without high thermal treatment is especially important to enhance biofunctional performance of scaffold. The purpose of this study is development of new process to fabricate ceramic scaffold at room temperature. The structural properties of the scaffolds were analyzed by XRD, FE-SEM and TEM studies. The biological performance of the scaffolds was also evaluated by monitoring the cellular activity.

• Journal of Korean Neurosurgical Society
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• 제44권1호
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• pp.8-14
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• 2008

Objective : The purpose of this study was to determine the efficacy of short segment fixation following postural reduction for the re-expansion and stabilization of unstable burst fractures in patients with osteoporosis. Methods : Twenty patients underwent short segment fixation following postural reduction using a soft roll at the involved vertebra in cases of severely collapsed vertebrae of more than half their original height. All patients had unstable burst fracture with canal compromise, but their motor power was intact. The surgical procedure included postural reduction for 2 days and bone cement-augmented pedicle screw fixations at one level above, one level below and the fractured level itself. Imaging and clinical findings, including the level of the vertebra involved, vertebral height restoration, injected cement volume, local kyphosis, clinical outcome and complications were analyzed. Results : The mean follow-up period was 15 months. The mean pain score (visual analogue scale) prior to surgery was 8.1, which decreased to 2.8 at 7 days after surgery. The kyphotic angle improved significantly from $21.6{\pm}5.8^{\circ}$ before surgery to $5.2{\pm}3.7^{\circ}$ after surgery. The fraction of the height of the vertebra increased from 35% and 40% to 70% in the anterior and middle portion. There were no signs of hardware pull-out, cement leakage into the spinal canal or aggravation of kyphotic deformities. Conclusion : In the management of unstable burst fracture in patients with severe osteoporosis, short segment pedicle screw fixation with bone cement augmentation following postural reduction can be used to reduce the total levels of pedicle screw fixation and to correct kyphotic deformities.

• Hip & pelvis
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• 제30권4호
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• pp.269-275
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• 2018

Purpose: The purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients. Materials and Methods: In this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun. A Richard screw was inserted and the plate was fixed over the femoral shaft. Patients were mobilized and clinical outcomes were rated using the Salvati and Wilson's scoring system. Results: More patients included in this study were between 66 and 70 years old than any other age group. The most common fracture according to the Orthopaedic Trauma Association classification was type 31A2.2 (46.7%). The T-score was found to be $-2.506{\pm}0.22$ (mean${\pm}$standard deviation); all patients were within the range of -2.0 to -2.8. The duration of radiological union was $13.67{\pm}1.77$ weeks. Salvati and Wilson's scoring at 12 months of follow up was $30.96{\pm}4.97$. The majority of patients were able to perform their normal routine activities; none experienced implant failure or screw cut out. Conclusion: Bone cement augmentation may effectively prevent osteoporosis-related hardware complications like screw cut out in elderly patients experiencing intertrochanteric fractures.

• 한국분말재료학회지
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• 제27권6호
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• pp.468-476
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• 2020

The bone cement used for vertebroplasty must be sufficiently injectable. The introduction of granules reduces the amount of liquid required for liquefaction, implying that higher fluidity is achieved with the same amount of liquid. By employing β-tricalcium phosphate granules with an average diameter of 50 ㎛, changes in injectability are observed based on the paste preparation route and granular fraction. To obtain acceptable injectability, phase separation must be suppressed during injection, and sufficient capillary pressure to combine powder and liquid must work evenly throughout the paste. To achieve this, the granules should be evenly distributed. Reduced injection rates are observed for dry mixing and excessive granular content, owing to phase separation. All these correspond to conditions under which the clustered granules weakened the capillary pressure. The injected ratio of the paste formed by wet mixing displayed an inverted U-type shift with the granular fraction. The mixture of granules and powder resulted in an increase in the solid volume fraction, and a decrease in the liquid limit. This resulted in the enhancement of the liquidity, owing to the added liquid. It is inferred that the addition of granules improves the injectability, provided that the capillary pressure in the paste is maintained.

• 한국세라믹학회지
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• 제42권11호
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• pp.770-776
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• 2005

Hardening and hydroxyapatite(HAp) formation behavior of the bioactive cements in the system of $CaO-SiO_{2}-P_{2}O_{5}$ glasses and the corresponding glass-ceramics were studied. DCPD (Dicalcium Phosphate Dihydrate: $CaHPO_4{\cdot}2H_2O$) and DCPA (Dicalcium Phosphate Anhydrous: $CaHPO_4$) were developed when the prepared glass and glass-ceramic powders were mixed with three different solutions. The DCPD and DCPA transformed to HAp when the cement was soaked in Simulated Body Fluid (SBF), and this HAp formation strongly depended on the releasing capacity of $Ca^{2+}$ ions from the cements. The glass-ceramic containing apatite showed fast setting, but no HAp formation was observed because no $Ca^{2+}$ ions were released from this glass-ceramics. The compressive strength of the cements increased with reaction time in SBF until all DCPD and DCPA transformed to HAp.

• 한국세라믹학회지
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• 제50권4호
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• pp.275-279
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• 2013

The purpose of this study was to prepare calcium phosphate cement [CPC] for use in artificial bone. Nano-crystalline calcium phosphate [CaP] was precipitated at $37^{\circ}C$ using highly active $Ca(OH)_2$ in DI water and an aqueous solution of $H_3PO_4$. From the XRD measurements, the nano-CaP powder was close to apatitic TCP phase and the powders fired at $800^{\circ}C$ showed a critical ${\beta}$-TCP phase. A mixture of one mole $CaCO_3$ and two moles di-calcium phosphate was calcined at $1100^{\circ}C$ to make a reference ${\beta}$-TCP material. The nano-CaP powders were added to the normal ${\beta}$-TCP matrix and fired at $900^{\circ}C$ to make a ${\beta}$-TCP block. The sintered block showed improved mechanical strength, which was caused by the solid state interaction between nano-CaP and normal ${\beta}$-TCP.

• Journal of Mechanical Science and Technology
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• 제15권7호
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• pp.1041-1050
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• 2001

Control of bone cement volume (PMMA) may be critical for preventing complications in vertebroplasty, the percutaneous injection of PMMA into vertebra. The purpose of this study was to predict the optimal volume of PMMA injection based on CT images. For this, correlation between PMMA volume and textural features of CT images was examined before and after surgery to evaluate the appropriate PMMA amount. The gray level run length analysis was used to determine the textural features of the trabecular bone. Extimation of PMMA volume was done using 3D visualization with semi-automatic segmentation on postoperative CT images. Then, finite element (FE) models were constructed based on the CT image data of patients and PMMA volume. Appropriate material properties for the trabecular bone were assigned by converting BMD to elastic modulus. Structural reinforcement due to the changes in PMMA volume and BMD was assessed in terms of axial displacement of the superior endplate. A strong correlation was found between the injected PMMA volume and the area of the intertrabecular space and that of trabecular bone calculated from the CT images (r=0.90 and -0.90, respectively). FE results suggested that vertebroplasty could effectively reinforce the osteoporotic vertebra regardless of BMD or PMMA volume. Effectiveness of additional PMMA injection tended to decrease. For patients with BMD well lower than 50mg/ml, injection of up to 30% volume of the vertebral body is recommended. However, less than 30% is recommended otherwise to avoid any complications from excessive PMMA because the strength has already reached the normal level.

• 접착 및 계면
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• 제7권3호
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• pp.1-9
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• 2006

본 연구에서는, PMMA 뼈시멘트의 약한 기계적, 열적 특성을 향상시키기 위해서, 분자량이 상이한 3종류의 폴리에틸렌(PE, 200, 3,800 및 8,000 kg/mol) 분말을 뼈 시멘트에 첨가하였다. PE 분말의 표면 불활성으로 인한 다른 생체 재료와의 약한 결합력으로 인해 MMA/자일렌의 혼합 용액으로 표면 개질시켰다. 3 wt%의 표면 개질한 3 종류의 PE 분말을 각각 기존의 PMMA 뼈 시멘트에 첨가하여 새로운 뼈 시멘트를 제조하였다. 복합 PMMA 뼈 시멘트의 인장 강도를 측정한 결과, PE의 분자량이 증가할수록, 인장강도가 증가하는 경향성을 살펴볼 수 있었다. 또한, 제조한 복합 PMMA 뼈 시멘트의 경화온도가 $100^{\circ}C$ 이상의 고온에서 $40^{\circ}C{\sim}80^{\circ}C$까지 확연히 감소함을 확인할 수 있어 본 방법에 의한 PE 복합 뼈시멘트의 응용가능성을 확인하였다.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2006년도 춘계학술대회 논문집
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• pp.651-652
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• 2006

The choice of suitable hip implant is one of important factors in total hip replacement (THR). In clinical view points, improper adaptation of hip implant might cause abnormal stress distribution to the bone, which can shorten the lifespan of replaced hip implant. Currently, interest in custom-designed hip implants has increased as studies reveals the importance of geometric shape of patient's femur in modeling and designing custom hip implants. In this study, we have developed the custom-designed hip implant models with various sizes in hip implant, and the stress distribution in the bone was analyzed using Finite Elements methods. It was found that minimizing the gap between implant stem and femoral cavity is crucial to minimize stress concentration in the bone.

• Clinics in Shoulder and Elbow
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• 제23권3호
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• pp.152-155
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• 2020

Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.