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Analysis of Predictors of Results after Surgical Treatment of Acetabular Fractures
신종기,안성진,고태식,이정섭 대한고관절학회 2015 Hip and Pelvis Vol.27 No.2
Purpose: The aim of this study was to analyze the factors affecting the outcomes after surgical treatment of acetabular fractures. Materials and Methods: Between January 2000 and December 2012, 106 patients with acetabular fractures were treated with open reduction and internal fixation. We performed a retrospective cohort study to analyze the factors which may influence a patient’s prognosis after surgical treatment of an acetabular fracture. The factors examined included age, femoral head injury, fracture type, dislocation, initial displacement, delay to injuryrelated surgery (in days), and quality of reduction. Additionally, we investigated clinical and radiological outcomes, as well as the development of osteoarthritis. Results: Patients included 85 males (80.2%) and 21 females (18.8%) with a mean age of 50.4 (17-78) years. The mean follow-up period was 2.6 (1-10) years. In a univariable regression analysis, quality of reduction, age, and initial displacement were significantly associated with radiological and clinical outcomes. In a multivariable regression analysis, quality of reduction (P<0.001) and initial displacement (P=0.001) were found to be factors predictive of clinical and radiological outcomes. Additionally, the quality of reduction (P=0.005) was found to be predictive of osteoarthritis development. Conclusion: Study results indicated that the quality of reduction was the most important factor influencing the prognosis of patients with acetabular fractures.
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신종기,손승민,김태우,신원철,이정섭,서근택 대한고관절학회 2016 Hip and Pelvis Vol.28 No.4
Purpose: Preoperative on-screen templating is a method of using acetate templates on digital images. The aim of the present study was to evaluate the accuracy, intra- and interobserver reliabilities of preoperative on-screen templating using digital radiographs for total hip arthroplasty (THA). Materials and Methods: Two hundred patients with hip disease who were treated with primary cementless THA were retrospectively evaluated. The accuracy of on-screen templating was assessed by comparing the predicted prosthesis sizes with the actual sizes used operatively. The inter- and intraobserver reliabilities of the templating results were also evaluated. Results: The prosthesis prediction accuracy within ±one size was 96.6% for the cup size and 97.8% for the stem size. The inter- and intraobserver reliabilities for the implant size were substantial (kappa>0.70). The intraand interobserver reliabilities for the leg length discrepancy and femoral offset difference using the intraclass correlation coefficient ranged from 0.89 to 0.97. Conclusion: Preoperative on-screen templating using digital radiographs showed substantial accuracy and reliability for implant prediction. It is an effective method for predicting the size of implant, correcting the leg length discrepancy and restoring the femoral offset.
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고태식,신종기,윤명수,이정섭 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.1
Study Design: A prospective study. Purpose: To identify associations between psychiatric factors and patient-reported outcomes after corrective surgery in patients with lumbar degenerative kyphosis (LDK). Overview of Literature: Thus far, to the best of our knowledge, patient factors that may help predict patient-reported outcomes after corrective surgery for LDK have not been studied. Methods: We prospectively investigated 46 patients with LDK who underwent surgical correction with a minimum follow-up of 2 years. Demographic data were collected. Short form-36, mental component scores (MCS), physical component scores (PCS), Scoliosis Research Society-22 (SRS-22) scores, and Roland–Morris Disability Questionnaire (RMDQ) scores were determined before the surgery and after 2 years of follow-up. Psychiatric conditions were preoperatively evaluated using the Zung depression scale (ZDS) and Zung anxiety scale (ZAS). Patients were divided into two groups (with or without psychiatric issues), according to baseline ZDS and ZAS scores. Results: Patients included 43 women and 3 men. Twelve patients were deemed to have psychiatric problems (P group) and 34 patients had no psychiatric problems (NP group). No significant intergroup differences were found in MCS, PCS, SRS-22, and RMDQ scores preoperatively. However, at the 2-year follow-up, a significant intergroup difference was observed between PCS and RMDQ scores. Multiple regression analysis revealed that only the presence of a preoperative psychiatric problem can predict PCS and RMDQ scores. Other factors, such as, gender, age, body mass index, bone mineral density, osteotomy site, number of fusion segments, and instrumented levels did not affect PCS or RMDQ scores. Conclusions: The presence of a psychiatric factor may be an important risk factor underlying poor physical and pain scores after corrective surgery in patients with LDK. The findings presented here suggest that psychiatric factors should be evaluated prior to surgery for determining the risk of a poor outcome.
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전효택,유인걸,이진수,신종기,송영현 한국자원공학회 2005 한국자원공학회지 Vol.42 No.6
The purposes of this study are to investigate the contamination level of heavy metals and to suggest an environmental restoration plan for contaminated regions in the abandoned mine area. Environmental geochemical survey was conducted in the vicinity of Dong-A Au-Ag-Cu mine located on Geojae-si of Kyungsangnamdo Province in Korea. Samples collected from waste rock pile, soil, stream sediment, stream water and groundwater in the area were analyzed for As, Cd, CN, Cu, Pb and Zn. The concentrations of Cd, Cu and Zn in soil and stream sediment samples ranged from 0.01 to 15.2 mg/kg, 0.9 to 1200 mg/kg and 1.2 to 653 mg/kg, respectively, which exceed the guideline value of heavy metals in a Soil Conservation Act in Korea. The concentrations of As, Cd, CN, Cu, Pb and Zn in stream water samples are relatively low than those of the Korean stream water standard, but especially two samples taken from the southern valley near the mine shaft contained high concentrations of 0.4 mg/ Cd, 0.1 mg/ CN, 15.4 mg/ Cu and 73.9 mg/ Zn. The concentrations of As, Cd, CN, Cu, Pb and Zn in groundwater samples are lower than those of the Korean drinking water standard. It is suggested that various treatments for contaminated soil and groundwater such as containment, isolation, capping and constructed wetland were needed for environmental restoration plans. 본 연구는 경남 거제시 하청면에 소재하는 동아 금-은-구리광산 지역에 대해 토양, 하상퇴적물 및 자연수를 채취하여 오염 실태를 파악, 오염지역에 대한 적절한 복원방법을 제시하고자 하였다. 시료채취는 2001년 8월 및 2002년 5월 두 번에 걸쳐 수행되었으며 채취된 토양 및 하상퇴적물은 전처리과정을 거쳐 토양오염공정시험법에 따라 유도결합플라스마(ICP-AES)를 이용하여 As, Cd, Cu Pb 및 Zn에 대한 분석을 실시하였다. 물시료는 여과 및 산처리후(양이온) ICP-AES로 중금속을 분석하였으며 특히 CN성분은 흡광광도법(UV)을 이용하여 분석하였다. 토양내 중금속의 최고 함량은 As가 4.0 mg/kg, Cd가 9.7 mg/kg, Cu가 386 mg/kg, Pb가 108 mg/kg 및 Zn이 533 mg/kg로 나타났는데, 이중에서 Cd, Cu, Pb 및 Zn 등 4성분이 토양환경보전법의 토양오염 우려기준을 초과하였다. 하상퇴적물내 중금속의 최고 함량은 As가 1.0 mg/kg, Cd가 15.2 mg/kg, Cu가 1200 mg/kg, Pb가 27 mg/kg 및 Zn이 653 mg/kg으로 Cd, Cu, Zn의 함량이 토양오염 우려기준보다 높게 나타났다. 자연수의 경우 갱도 주변 일부지점의 중금속함량 즉, Cd가 0.4 mg/ , CN이 0.1 mg/ , Cu가 15.4 mg/ 및 Zn이 73.9 mg/ 으로 하천수 수질기준 중 사람의 건강보호기준을 초과하고 있는 것으로 나타났다. 따라서 이들 지역에 대한 오염지수를 산출하였으며, 그 결과 오염지수 1.0을 초과하는 오염지역들에 대해 복구방안으로써 자연정화처리시스템 적용, 연직차수시설 설치 및 복토, 폐석 제거 또는 고립화 등을 제시할 수 있다.
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이정섭(Jung Sub Lee),신종기(Jong Ki Shin),최경운(Kyung Un Choi),서근택(Kuen Tak Suh) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.3
목적: 퇴행성 요추 질환에 있어 황색 인대의 병리 조직학적 소견과 임상 증상 및 방사선학적인 소견과의 연관성에 대해 알아보고자 한다. 대상 및 방법: 단분절 퇴행성 요추 질환으로 수술적 치료를 시행했던 척추관 협착증 15예와 퇴행성 척추 전방 전위증 11예를 대상으로 황색인대를 전절제하여 조직 병리학적으로 황색 인대 내의 탄성 섬유의 양과 주행방향, 교원 섬유의 양 그리고 국소 병변을 측정하였다. 임상적 및 방사선학적으로 나이, 성별, 술 전 Japanese Orthopaedic Association (JOA) 점수, 신경학적 파행의 양상, 척추 전방 전위의 정도, 추간판의 높이, 추체간의 각도, 추체간 운동범위를 측정하였다. 결과: 황색 인대 내 탄성 섬유의 양, 탄성 섬유의 주행방향, 그리고 교원 섬유의 양은 술 전 JOA 점수와 통계학적 의의가 없었다. 황색 인대 내의 국소병변으로 혈관 형성이 15예, 석회화가 10예, 연골세포가 9예, 골화가 8예, 결절종성 낭종이 5예, 육아종성 조직이 4예가 있었다. 석회화가 있었던 군(10예)에서의 환자의 나이는 평균 70.3세였으며 없었던 군(16예)은 평균 63.8세로 나이가 많은 환자에서 석회화의 발생이 높았다. 석회화가 있었던 군과 없었던 군의 술 전 평균 JOA 점수는 13.5점, 15.6점로 석회화가 없었던 군에서 접수는 높았다. 골화는 퇴행성 척추 전위증(7예)에서 척추관 협착증(1예)에서 보다 발생 빈도가 높았다. 결론: 퇴행성 요추 질환의 황색 인대의 조직소견에서 다양한 국소병변이 관찰되었다. 황색 인대 내 석회화의 발생은 연령이 높은 환자에서 빈도가 높았으며 술 전 JOA 점수는 석회화가 발생한 군에서 낮았다. 골화는 퇴행성 척추 전방 전위증 환자에서 척추관 협착증 환자에서보다 발생 빈도가 높아 국소 동적 요소가 영향을 미치는 것으로 판단된다. Purpose: To determine the association between the histological findings of ligamentum flavum (LF) and the clinical symptoms or radiological findings of patients with degenerative lumbar disease. Materials and Methods: Twenty-six patients with mono-segmental degenerative lumbar diseases (15 patients with spinal stenosis and 11 patients with degenerative spondylolisthesis) underwent a surgical decompression with en bloc resection of the LF. Tissue specimens of the LF were pre-pared, and the changes in the elastic and collagen fibers were evaluated. The focal lesions were observed in the LF. The following clinical and radiological parameters were investigated in order to determine the possible association with the histological findings: age, gender, preoperative Japanese Orthopaedic Association (JOA) score, the type of neurogenic intermittent claudication, % slip, height of the intervertebral disc, intervertebral angle, intervertebral angle of motion. Results: There were no significant relationships between the changes in the elastic or collagen fibers and the JOA score. In regard to the focal lesions in the LF, vascularization was observed in 15 cases, calcification in 10, chondrocyte in 9, ossification in 8, ganglion-like cystic lesions in 5 and granulation in 4. The average age of the patients with and without calcification were 70.3 and 63.8 years, respectively. The average preoperative JOA scores of the patients with and without calcification were 13.5 and 15.6 points, respectively. Ossification was more commonly observed in those with degenerative spondylolisthesis (7 cases) than in those with spinal stenosis (1 case). Conclusion: Various focal lesions in the LF were observed. Calcification was observed more frequently in elderly patients, and the average preoperative JOA scores of the patients with calcification were lower. Ossification was observed more frequently in patients with degenerative spondylolisthesis (7 cases) than in those with spinal stenosis (1 case), suggesting involvement of a mechanical load in the ossification of ligaments.
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금성 몰리브데늄광상의 잠두 반암형 광체에 대한 부존가능성과 성인적 환경
최선규,박정우,서지은,김창성,신종기,김남혁,유인걸,이지윤,안용환,Choi, Seon-Gyu,Park, Jung-Woo,Seo, Ji-Eun,Kim, Chang-Seong,Shin, Jong-Ki,Kim, Nam-Hyuck,Yoo, In-Kol,Lee, Ji-Yun,Ahn, Yong-Hwan 대한자원환경지질학회 2007 자원환경지질 Vol.40 No.1
The Guemseong mine is located near the southern margin of the Jurassic Jecheon granitoids collectively with the Cambro-Ordovician mixed dolostone-limestone series of the Yeongweol Group, Choseon Supergroup. Here, two spatially distinct types of skarn formation have been observed. The upper transitional skarn is the calcic Mo skarn which has the mineral assemblage of $garnet+hedenbergite+epidote{\pm}wollastonite{\pm}magnetite{\pm}hematite{\pm}amphibole{\pm}chlorite{\pm}vesuvianite$ within the calcite marble. On the other hand, the lower proximal skarn occurs as a discordant magnesian Fe skarn at the contact of Mo-bearing aplitic cupolas with unidirectional solidification texture(UST) within the dolomitic marble. The magnesian Fe skarn has the mineral assemlage $olivine+diopside+magnetite+tremolite+serpentine+talc+chlorite{\pm}phlogopite$. The formation of two different types of skarn and ore mineralization in Geumseong mine have been attributed to multistage and complex metasomatic replacements that ultimately resulted in silicate-oxide-sulfide sequence of metasomatism. An early prograde stage with anhydrous skarn minerals such as olivine, clinopyroxene and/or garnet with magnetite, formed from high temperature (about $500^{\circ}\;to\;400^{\circ}C$) at an environmental condition of low $CO_2$ fugacity ($XCO_2<0.1$) and 0.5 kbar. The later retrograde stage with hydrous silicates such as amphibole, serpentine, phlogopite, epidote and chlorite with molybdenite or hematite, termed from relatively lower temperature (about $400^{\circ}\;to\;300^{\circ}C$). 금성광상은 캠브리아기-오르도비스기 조선누층군 중 영월층군의 탄산염암과 쥐라기 제천화강암체와의 남측 경계부를 따라 백운석질 석회암과 석회암의 조성차이를 반영하여 서로 다른 유형의 스카른대가 배태되고 있다. 금성광상에서 스카른화작용은 전반적으로 규산염광물-산화광물-황화광물이 순차적으로 교대-정출되는 특징을 보이고 있으며, 공간적으로 상부 스카른에 배태된 점이성 스카른형 Mo광상과 하부 스카른에 배태된 근지성 스카른과 함께 수반되는 단방향 결정성장조직의 큐폴라형 Mo광상으로 양분된다. 금성광상의 상부 스카른대는 휘수연석${\pm}$자철석${\pm}$적철석과 함께 석회암이 교대된 Ca계열 스카른광물인 석류석+단사휘석+녹렴석+양기석+녹니석${\pm}$규회석${\pm}$사장석${\pm}$베스비아나이트의 광물조합을 보이고 있는 반면, 하부 스카른대는 자철석과 함께 백운석질 석회암이 교대된 Mg계열 스카른광물인 감람석+투휘석+투각섬석+금운모+사문석${\pm}$고니석${\pm}$활석으로 구성되어 있다. Ca계열 및 Mg계열 스카른광물의 공생관계 및 열역학적 자료를 종합적으로 검토한 결과, 전진 스카른 단계 스카른화 작용은 약 0.5kbar, $XCO_2<0.1$의 조건의 약 $500^{\circ}{\sim}400^{\circ}C$ 온도범위에서 진행되었으며, 후퇴 스카른 단계 함수규산염광물의 안정영역은 약 $500^{\circ}{\sim}400^{\circ}C$ 온도범위로 추정된다.
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태백산 광화대 북부에서 칼린형 금광화작용 부존 잠재력 평가를 위한 지구화학 탐사
성규열,박맹언,윤성택,문영환,유인걸,김량희,신종기,김의준,Sung, Kyu-Youl,Park, Maeng-Eon,Yun, Seong-Taek,Moon, Young-Hwan,Yoo, In-Kol,Kim, Ryang-Hee,Shin, Jong-Ki,Kim, Eui-Jun 대한자원환경지질학회 2007 자원환경지질 Vol.40 No.5
태백산 광화대 북부의 지질환경과 광화작용 양상을 살펴보면, 다양한 금속 광상의 형성이 시 공간적으로 반복되어 있다는 점에서 미국 네바다 지역의 칼린형 금광상 분포지역과 매우 유사하다. 영월지역에서는 두 곳의 뚜렷한 비소 이상대와 다수의 안티모니 이상대가 형성되지만, 금속광산의 분포와는 뚜렷한 상관성을 보이지 않았다. 반면, 정선 지역에는 영월지역과 달리 두 곳의 뚜렷한 비소 이상대가 금속광산(주로 금 은 광산)의 분포와 상당히 일치하며, 안티모니 이상대는 비소 이상대와 비교적 일치하고 있다. 연구지역 변질석회암의 금, 은, 비소, 안티모니, 구리, 납, 아연, 몰리브데늄 등은 칼린형 금광상과 유사한 이동도를 보이고, 정선지역에서 상대적으로 부화되어 있는 특징을 보인다. 금 은 및 칼린형 금 광화작용의 효과적인 지시원소인 비소와 안티모니는 특징적으로 부화된 양상을 보여주고 있으나, 천금속류인 납과 아연은 시료에 따라서 다소 불규칙한 양상을 보였다. 특히, 금 은을 비롯한 비소와 안티모니의 부화도의 분포양상은 네바다 지역, 중국, 인도네시아의 칼린형 금광상들과 상당히 유사하다. 따라서, 영월 및 정선 지역에서의 광화작용을 야기한 광화유체는 칼린형 금광상을 형성한 유체와 매우 흡사하였음을 시사해 준다. 그러나, 천금속 및 몰리브데늄의 부화도 양상은 네바다의 칼린형 금광상들과는 차이가 나는데, 이는 열수용액과 반응한 모암의 광물 및 화학성 차이에 기인하는 것으로 추정된다. The characteristics of the mineralization and geology in the northern Mt. Taebaek mining district are found to be similar with those reported from Nevada district where the Carlin-type gold deposit occurs characteristically as repeated metallic ore deposits in space and time. Though two spots of hs and several spots of Sb anomalies were recognized in the Yeongweol area, they have no relationship with any metalliferous mineralization. On the other hand, two spots of As anomaly in the Jeongseon area have shown to be related with metalliferous ore deposits (mainly Ag-Au), and they are closely associated with Sb anomaly. Some elements of altered limestones in the study such as Au, Ag, As, Sb, Cu, Pb, Zn, and Mo area are closely associated together, and are more enriched in the Jeongseon area than in the Yeongweol area. In particular, Sb and As which may reflect the occurrence of the Carlin-type gold deposit are highly enriched. However, the base metals such af Zn and Pb are highly variable according to samples. The patterns of the enrichment factor for Sb and As, as well as those for Ag and Au, are very similar with those reported from the Carlin-type gold deposits in Nevada. These similarities in elemental distribution may imply that hydrothermal ore mineralization in the study areas was possibly originated from a fluid with the characteristics of the Carlin-type gold mineralization found in Nevada, China, and Indonesia. However, the pattern of base metals and Mo are different. This may result from different chemistry and/or mineralogy of host rock in the study areas.
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