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슬관절 동통과 관련된 활막 추벽(Synovial Plica)의 임상적 특성
이동철,송대흡 대한슬관절학회 1996 대한슬관절학회지 Vol.8 No.2
The synovial plicae of knee are a remnants of synovial folds during the coalescence of three compartments of knee at the third months of fetal status. The plicae is present in 20-55% of the knee joints and could be changed into the pathologic plica which had been converted into fibrotic status by trauma and exercise. The pathologic synovial plicae result in the chondromalacia of patella and femoral condyle as well as disability of knee function. We have analysed the 24 cases of plica syndrome of knee using arthroscope between 1993. April and 1935. Jan. The results were as follows: 1. The most of patients were young, active males (2nd and 3rd decade) whose average age was 23.6 years. They had the history of trauma (60%) such as direct blunt hitting, twisting and strenous exercise. 2, The physical examination revealed snapping, swelling, positive McMurray test, instability and pseudolocking, The patients complained joint line pain, infra and parapatellar pain and pain around medial femoral condyle. 3. The composition of pathologic plicae showed 7 cases of medial patellar plica (MP), 7 cases of perforated or obliterated suprapatellar plica (SP) and 10 cases of combined plica (MP+SP). 4. The chondromalacia of articular cartilage of the patella and femoral condyle was visible in 83 percent. The chondromalacia of patella(65%) was more visible(2 times) than femoral side(35%). 5. Thc clinical results after arthroscopic plica excision was mostly improved than before operation about 75 percent of the patients(18 cases), but in the remaining 25 percent (6 cases), the pain was not improved.
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대퇴 사두건을 이용한 관절경적 이중 다발 전방 십자 인대 재건술
김성재,정광암,송대흡,Kim, Sung-Jae,Jung, Kwang-Am,Song, Dae-Heup Korean Arthroscopy Society 2005 대한관절경학회지 Vol.9 No.2
Recently, the interest on anatomical ACL reconstruction with double bundle technique is increased to reproduce the original load distribution, and kinematics of the knee. We developed an arthroscopic double bundle ACL reconstruction technique using autogenous quadriceps tendon with 2 splitted graft and patellar bone plug. The anteromedial bundle and posteolateral bundle of the ACL is replicated with each splitted graft of quadriceps tendon and fixed with biodegradable interference screw on the 2 femoral tunnels. The patellar bone plug of quadriceps tendon is fixed with biodegradable interference screw within the 1 tibial tunnel. We suggest that our technique using quadriceps tendon may be an alternative in arthroscopic double bundle ACL reconstruction.
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전춘배,안종철,송대흡,이석강 영남대학교 의과대학 1997 Yeungnam University Journal of Medicine Vol.14 No.1
골격근의 과축적 당원의 운동 중 이용 양상과 골격근의 구성 섬유 특성에 따른 당원의 이용 양상을 규명한 본 연구 결과를 요약하면 다음과 같다. 정상 군의 당원 농도는 가자미근에서 4.57±0.34 mg/gm wet wt.(이하 동일 단위)였으며 적색 비복근은 5.11±0.24, 족척근은 6.55±0.20으로서 족척근이 가장 높았다. 가자미근의 당원 농도는 운동 부하 후 당투여 1시간 군에서 정상 군에 비해서 약 1.9배 높았으며 적색 비복근은 1.8배 높았다. 족척근의 당원 농도는 운동 후 당 투여 군에서 정상 군과 통계적으로 유의한 차이가 없었다. 간 당원 농도는 정상군에서 41.0±1.47이였으며 대조 군에서는 정상 군의 2.9%에 불과했으나 당투여 1시간, 2시간 및 운동 부하 후 당투여 1시간 군등 모든 군의 당원 농도는 정상 군의 19-32%의 범위 내에 있었다. 혈당 및 인슐린은 운동 부하 후 당 투여 군에서 가장 높았으며 유리 지방산은 대조군 및 당투여 2시간군에서 높았다. 운동 부하 중 가자미근 및 적색 비복근의 당원 감소는 초 과축적 당원군, 과축적군 및 정상 군에서 다같이 운동 부하 첫 30분에 급격하였으나 초 과축적군에서 더 급격하였다. 운동 부하 30분엣 60분 사이에는 초 과축적군 및 정상 군에서 다같이 당원 감소는 거의 없었으나 과축적군에서는 지속적인 감소 상을 보였다. 간 당원은 정상 군에서 가장 급격한 감소를 보였으며 골격근과는 달리 운동부하 60분간 지속적으로 감소하였다. 초 과축적당원군의 간 당원 농도는 변화가 없거나 증가하는 경향이었다. 운동 부하 중 혈당은 모든 실험군에서 감소하였으며 인슐린은 운동 부하 후 당투여 군에서 감소하였다. 혈중 유리 지방산 농도는 모든 군에서 증가하였으며 운동 부하 후 당투여 군에서 가장 낮았다. The aim of the present investigation has been to evaluate depletion pattern of the supercompensated stores is based in the fact that a glycogen-depleted muscle by exercise with have an increased avidity for glycogen when exposed to a high carbothdrate diet. The glycongen concentration of soleus, red gastrocenemius and plantaris muscle, and liver was measured at 0,30 and 60 minutes during treadmill exercise. The experimental animals were divided into 5 group - Normal(N), Control(C), 1Hour(1HR:after 1hour of glucose ingestion), 2Hour(2HR:after 2hour of glucose ingestion )and Exercies- 1Hour(EX-1HR:glucose ingestion after 1 hour of preloading treadmill exercise)group - for glycogen storage study. The glycogen concentration of soleus, red gastrocnemius and plantaris muscles in N group was 4.57±0.34,5.11±0.24 and 6.55±0.20 mg/gm wet wt., respectively. The glycogen concentration of soleus and red gastrocnemius on EX-1HR group were about 1.9 and 1.8 times than that of N group, respectively, but the concentration of plantaris was not higher than that of N group. The glycogen concentration of liver in N group was 41.0±1.47mg/gm wet wt. and the concentration of the overnight fasted C group was only 2.9% of the value of N group. The level of glycogen concentration of liver in the other glucose ingested groups(1HR,2HR, including EX-1HR) was within 19-32% of that of N group. The blood glucose concentration of EX-1HR group was higher than that of N group, the plasma free fatty acid concentration of C and 2HR group was higher than that of N group and the plasma insulin concentration of EX-1HR group was higher than that of N group. The concentrations os supercompensated glycogen of soleus and red gastrocnemius were rapidly decreased during 30 minutes of exercise but there was almost no changes of the concentration during the other 30 minutes of continuing exercise. The concentration of N group during 30 minutes of exercise was decreased but more slowly than those of EX-1HR group. The remaining level of glycogen after 60 minutes of exercise in EX-1HR group was higher than that of N group. Taken together, the mobilization of endogenous muscle glycogen at the first stage of exercise was proportioned to the initial level of glycogen concnetration, and later on, when exercise continued, the muscle glycogen level was stabilized. And the remaining level of supercompensated muscle glycogen after 60 minutes of exercise was higher than that of normally stored glycogen level. The mobilization of the glycogen stroed in show and fast oxidative muscle fibers in faster than in the fast glycolytic muscle fibers during strenous exercise.
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