• 폴리머
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• 제27권3호
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• pp.226-234
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• 2003

이프리플라본은 이소플라본의 파생물로서 골의 재흡수를 방지하여 골의 재형성을 방해함으로써 골 형성에 도움을 준다. 이프리플라본은 칼슘의 양을 안정적으로 증가시킴과 함께 골수 줄기 세포의 작용으로 세포층에 칼슘을 침착시킨다. 조직공학적 골을 형성시키기 위해 락타이드-글리를라이드 공중합체 (PLGA)에 이프리플라본을 함유시킨 지치체를 용매 캐스팅/염 추출법으로 제조하였다. 수은 다공도계, 주사 전자 현미경, 시차 주사 열량계, X선 회절기를 이용하여 특성결정을 수행하였고, 이프리플라본이 함유된 지지체와 이프리플라본이 함유되지 않은 지지체를 면역이 결핍된 쥐의 피하에 삽입하여 이들의 골 형성을 비교하였다. 조직을 hematoxylin & eosin, 본쿠사 염색과 면역화학적 염색법인 콜라겐 I 형과 오스테오칼신 염색을 하였다. 이프리플라본이 함유된 담체의 다공도는 91.7% 이상이었고, 평균 다공 크기도 101 $\mu\textrm{m}$였다. PLGA로만 제조된 지지체와 이프리플라본을 50% 함유시킨 지지체를 동물 실험을 수행한 결과 이프리플라본은 피하 층과 다른 연조직에서 미분화 줄기 세포가 칼슘 침착, 골아 세포, 골상으로의 유도에 더 많은 영향을 주는 것을 관찰하였다. 결론적으로 이프리플라본을 함유한 지지체에서 이프리플라본이 골형성에 중요한 요인으로 작용한다고 사료된다.

• 한국산학기술학회논문지
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• 제13권9호
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• pp.4073-4081
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• 2012

우리나라 성인의 관절염 유병률 수준을 제시하고, 높은 유병율을 보이는 하위집단을 파악하고자 국민건강영양조사 제4기(2007년-2009년) 자료를 이용하여 고유병률 관련 요인을 분석하였다. 통계분석은 국민건강영양조사의 복합표본설계를 반영한 가중치를 적용하기 위해 SAS 9.2 survey procedure로 실시하였다. 19세 이상 성인 18,406명을 대상으로 '연간 본인 인지 관절염'(이하 관절염) 유병률과 사회인구학적 또는 건강행태 요인별 유병교차비를 분석한 결과는 다음과 같다. 관절염 조유병률은 11.7%였고, 이것의 세부 분류인 골관절염은 10.2%, 류마티스관절염은 1.7%의 유병률을 보였다. 19-44세 연령층에서 2.4%, 45-64세 층이 16.4%, 65세 이상에서 38.3%로 연령층 증가에 따라 급격히 증가하였다. 사회인구학적 측면에서 연령보정 관절염 유병률이 상대적으로 높은 집단은 여성, 비아파트 거주자, 이혼 사별 별거 상태인 경우, 낮은 교육년수, 특정직업군(농림어업 종사자, 단순노무종사자, 무직), 낮은 가구총소득, 의료보호 대상자 집단 등이었다. 건강행태 측면에서 연령보정 관절염 유병률이 상대적으로 높은 집단은 체질량지수(BMI)가 높은 집단이었고, 연령, 성, BMI를 보정한 경우 매일 음주군의 유병률이 상대적으로 높았다. 본 연구에서 파악된 고유병률 집단들은 지역사회 관절염 관리사업의 목표집단으로 고려되어야 할 것이다.

• 대한물리치료과학회지
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• 제9권3호
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• pp.129-140
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• 2002

This study intended to find out how the handicapped use medical aid, their satisfaction at using it and so on. First a preliminary survey(Apr. 20$\sim$24, 2002) was made for the handicapped who had been cured for rehabilitation by wearing medical aid at hospitals and welfare center in Jeonbuk region. Then total 120 subjects were asked to fill out a standardized questionnaire from May 15$\sim$22, 2002. Out of total 95 questionnaires collected, 84 questionnaires were analyzed except for 11 cases unsuitable for the intention of this study. The results can be outlined as follows: 1. In general characteristic, it was found that the causes of disability included disease(35 respondents; 41.7%), traffic accident(23 respondents, 27.4%) and so on. In addition, 1st handicap comprised the majority(32 respondents; 58.2%) in handicap grade and ankle foot orthosis(or b-k orthosis) was most often used as medical aid(28 respondents: 33.3%) 2. In particular, it was also shown that the 1st handicap mainly resulted from traffic accident(15 respondents, 27.3%) and post-disease disability (11 respondents, 20.0%). They wore medical aid for 1 year or less on the average, because they were hospitalized for cure, which showed statistically significant level(P<0.05). 3. It was found that total 69 respondents(82.1%) were more or less satisfied with their medical aids depending on the causes of disability, and total 46 respondents(83.6%) were satisfied with their aids according to their handicap grade, but there were no statistical significance. 4. Total 56(66.7%) respondents answered that they would purchase medical aid on their own expenses, when they became handicapped. And the price of medical aid ranged from $\300,000{\sim}400,000$(25 respondents: 29.8%) to \ 500,000 or more(24 respondents: 28.6%). It means that they purchased more or less expensive medical aid on their own expenses, which showed statistical significance(P<0.05). 5. If there was any failure of medical aid, 9 respondents(37.5%) answered that they would be serviced from medical companies, and 7 respondents(29.2%) would be serviced from medical aid manufacturers. Most respondents were serviced for their medical aids from related companies. For the question about the causes of dissatisfaction upon repair service, 11 respondents(45.8%) answered that existing service company provided unskilled repair services and other respondents answered that there was no spare part or higher service expenses than they thought. These answers had the statistical significance(P<0.05). However, 20 respondents(79.2%) answered that they were satisfied with the repair service, which means that most respondents are satisfied with the service. In view of the results as described above, it can be concluded that their handicap or disability results from disease or sequelae after traffic accident and most of the affected wear their own medical aid. In the future, it is required that the medical insurance should cover those medical aids, and the service for failed medical aids should be commissioned by technical serviceman to realize customized manufacture and repair service according to different causes so that the handicapped can enjoy more or less comfort and convenience in their daily lives without any extreme difficulty.

• 대한의용생체공학회:의공학회지
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• 제31권3호
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• pp.199-209
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• 2010

The locking compression plates-distal femur(LCP-DF) are being widely used for surgical management of the extra-articular complex fractures of the distal femur. They feature locking mechanism between the screws and the screw holes of the plate to provide stronger fixation force with less number of screws than conventional compression bone plate. However, their biomechanical efficacies are not fully understood, especially regarding the number of the screws inserted and their optimal configurations. In this study, we investigated effects of various screw configurations in the shaft and the condylar regions of the femur in relation to structural stability of LCP-DF system. For this purpose, a baseline 3-D finite element (FE) model of the femur was constructed from CT-scan images of a normal healthy male and was validated. The extra-articular complex fracture of the distal femur was made with a 4-cm defect. Surgical reduction with LCP-DF and bone screws were added laterally. To simulate various cases of post-op screw configurations, screws were inserted in the shaft (3~5 screws) and the condylar (4~6 screws) regions. Particular attention was paid at the shaft region where screws were inserted either in clustered or evenly-spaced fashion. Tied-contact conditions were assigned at the bone screws-plate whereas general contact condition was assumed at the interfaces between LCP-DF and bone screws. Axial compressive load of 1,610N(2.3 BW) was applied on the femoral head to reflect joint reaction force. An average of 5% increase in stiffness was found with increase in screw numbers (from 4 to 6) in the condylar region, as compared to negligible increase (less than 1%) at the shaft regardless of the number of screws inserted or its distribution, whether clustered or evenly-spaced. At the condylar region, screw insertion at the holes near the fracture interface and posterior locations contributed greater increase in stiffness (9~13%) than any other locations. Our results suggested that the screw insertion at the condylar region can be more effective than at the shaft during surgical treatment of fracture of the distal femur with LCP-DF. In addition, screw insertion at the holes close to the fracture interface should be accompanied to ensure better fracture healing.

• Journal of Korean Neurosurgical Society
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• 제61권5호
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• pp.574-581
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• 2018

Objective : The zero-profile implant (Zero-P) is accepted for use in anterior cervical fusion for the treatment of degenerative cervical disease. However, evidence pertaining to its efficiency and safety in traumatic cervical injury is largely insufficient. This study aimed to compare the overall outcomes of patients who underwent Zero-P for traumatic cervical disc injury. Methods : Data from a total of 53 consecutive patients who underwent surgery for traumatic or degenerative cervical disc disease using the Zero-P were reviewed. Seventeen patients (group A) had traumatic cervical disc injury and the remaining 36 (group B) had degenerative cervical disc herniation. The fusion and subsidence rates and Cobb angle were measured retrospectively from plain radiographs. The patients' clinical outcomes were evaluated using the Japanese Orthopedic Association (JOA) score and Odom's criteria. Results : The C2-7 Cobb and operative segmental angles increased by $3.45{\pm}7.61$ and $2.94{\pm}4.59$ in group A; and $2.46{\pm}7.31$ and $2.88{\pm}5.49$ in group B over 12 postoperative months, respectively. The subsidence and fusion rate was 35.0% and 95.0% in group A; and 36.6% and 95.1% in group B, respectively. None of the parameters differed significantly between groups. The clinical outcomes were similar in both groups in terms of increasing the JOA score and producing a grade higher than "good" using Odom's criteria. Conclusion : The application of Zero-P in patients with traumatic cervical disc injury was found to be acceptable when compared with the clinical and radiological outcomes of degenerative cervical spondylosis.

• 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.

• 대한치과교정학회지
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• 제16권1호
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• pp.85-106
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• 1986

The purpose of this investigation was to know the means of the T.M.J. space and to compare spational differences in centric relation and centric occlusion by the T.M.J. Tomogram and to study the correlation between the articular eminence slope and the lingual surface slope of the maxillary central incisor by the Cephalogram in near normal occlusion subjects. These results could give contribution for the diagnosis of orthodontic treatment and T.M.J. dysfunction and the assessment of orthopedic treatment and orthognathic surgery. 44 young adults (28 men and 16 women, 21 to 27 years of age) were selected from the Dental students in Yonsei Univ. Criteria for selection was normal occlusion, no clinical signs and T.M.J. dysfunction, no history of orthodontic treatment, and no missing tooth. After submental vertex view analysis. each subject was given the T.M.J. Tomogram in centric relation and centric occlusion and the Cephalogram was given with Quint Sectograph. All data was recorded and statistically processed with the CYBER computer system. Results were analyzed: the following findings and conclusions were derived. 1. The mean value for the combined right and left anterior joint space was 2.549mm, the posterior space was 2.260mm, and superior space was 3.31mm in centric relation. The anterior space was 2.316mm, posterior space was 2.474mm, and superior space was 3.435mm in centric occlusion. 2. In the centric relation position, both condyles were placed more posterioly and superioly in their fossae than in the centric occlusion position by the spatial difference. 3. In the centric occlusion position, both condyles were more symmetrically placed in their fossae with equal anterior-posterioly rather than in the centric relation position. 4. The mean articular eminence angle was $48.19^{\circ}$ and the mean fossa height was 7.911mm. A strong positive correlation between the articular eminence angle and fossa height in T.M.J. Tomogram was found. 5. In Cephalometric analysis, there was a strong positive correlation between the articular eminence slope and the lingual surface slope of the upper central incisor to the FH plane, occlusal plane, and S-N plane. 6. There was moderate positive correlation between the S-E measurements and the fossa height, articular eminence angle, and DcGn < F-H.

• 대한간호학회지
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• 제15권3호
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• pp.74-80
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• 1985

This study was attempted to identify the difference between body image of the patients with lower limb fracture and that of normal persons, and to examine if supportive group care could offer an apportunity for positive change in body image of the patient with lower limb fracture under the Quasi-experimental design. The subjects for this study were obtained by ta-king convenient sample of soldiers; the experimental group were 44 lower limb fractured patients hospitalized on the orthopedic Surgery unit in S Army General Hospital, while the control group were 44 normal enlisted men serving in the B Army regiment. Supportive group nursing care was given to the lower limb fractured patients who belong to the experimental group. Pre-and post-tests were administered to the experimental and the control group. The instruments to measure body image of the subjects were body Cathexis Scale developed by Scord and Jourard (1953) and Body Meaning Scale dove-loped by the reseacher. The reliability coefficients by Cronhach's u-test were .95 in body Cathexis Scale and .89 in Body Meaning Scale in this study. Data for this study were collected over a period 12 days from the 12th to the 24th of October, 1984 by the questionnaire. Data were analyzed by computer. Frequency, Percentage and x²-test were used to examine general chacteristics of the subjects. t-test was used to analyze the hypotheses. Analysis of variance was used to test difference in body image between groups classified by the general characteristics. Pearson Correlation Coefficient was used to identify the correlation between Body Cathexis Scale and Body Cathexis Scale and Body Meaning Scale. The results of this study were as follows: 1. No significant difference was found between the experimental and the control group on general characteristics of the subjects (p> .05). 2. Hypothesis I:“There will be a difference in body image between patiens with lower limb fracture and normal persons,”was supported(Body Cathexis t=6.91, p<.001, Body Meaning t=5.66, p< .001). 3. Hypothesis Ⅱ;“The will be a difference in body image of patients with lower limb fracture bet-ween after and before, supportive group nursing care was provided,”was supported (Body Cathexis t=5.90, p<.001, Body Meaning t=4.45, p <.001). 4. There was no significant difference in body image between groups classified by the general characteristics (p> .05). 5. The correlation between Body Cathexis Scale and Body Meaning Scale: It was reported that Body Cathexis Scale correlated with Body Meaning Scale in total subjects of the experimental and control group (r=.744, p<.001). That is, there was relatively high correlation between two scales. body Cathexis Scale correlated with Body Meaning Scale in the experimental group(r=.738, p <.001) and in the control group (r=.352, p <.001). That is, there was more than moderate correlation between two scales. In conclusion, it was found that there was a difference in body image between patients with lower limb fracture and normal persons, and supportive group nursing care offered an opportunity for positive change in body image of the patient with lower limb fracture.

• 대한족부족관절학회지
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• 제17권2호
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• pp.130-135
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• 2013

Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

• Tuberculosis and Respiratory Diseases
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• 제40권1호
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• pp.72-78
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• 1993

연구배경 : 원발성 폐암의 전이 병소 발견은 병변 자체와 위험한 합병증을 예방하기 위한 치료 계획의 수립에 중요하다. 원발성 폐암은 임파절, 부신, 뇌, 간장, 뼈로 잘 전이되며 뼈중에서는 주로 두개골, 척추, 늑골 그리고 장골 등을 침범한다. 편평상피암에서의 골전이는 다른 폐암에 비하여 비교적 낮은 빈도로 알려져 있으며 특히 원위부 족지골에의 전이는 매우 드물다. 방법 : 저자등은 연세대학교 의과대학 세브란스병원에서 우측 제 5 원위부 족지골에만 전이 병소가 발견된 폐암 1 예를 경험하였다. 결과 : 처음 편평상피암의 진단시에 T4N3MO의 상태였으며 세 번째 항암제 투여시 처음으로 원격 전이가 제 5 원위부 족지골에 국한되어 발견되었다. 단순 골사진과 전신 골 주사검사상 우측 제 5 원위부 족지골의 국소적 이상 소견이 관찰되었으며 제 5 족지의 절단 조직검사에서 폐의 편평상피암이 전이된 병변임을 병리조직학적으로 확인할 수 있었다. 결론 : 본 증례의 특징은 뼈중에서도 통상적으로 전이가 잘되는 두개골, 철추, 늑골이나 장골이외에 제 5 원위부 족지골에 처음 전이가 된 것이다. 따라서 원발성 폐암 환자에서 이학적 검사상 국소적인 염증같은 이상 소견이 발견되면 가능성은 비록 적더라도 전이성 병변을 의심해 보는 것이 필요하리라고 생각된다.