쇄골 중간부 골절후 불유합 및 지연 유합의 원인

윤정로,심재익,김택선,이성종,김영배,김학준,안국환,장재영,홍명표 대한골절학회 2002 대한골절학회지 Vol.15 No.4

쇄골 중간 1/3 부위의 골절은 치료 결과가 양호하여 보존적 치료가 원칙적으로 받아 들어지고 잇으며 불유합에 대한 빈도도 낮은 것으로 되어 있다. 그러나 최근 전위 및 단축의 정도가 심할 경우 높은 불유합의 결과와 불량한 임상 결과를 보고하고 있어 이런 예에 대해선 수술적 치료를 권장하고 있다. 저자들은 단축 및 전위의 정도와 불유합의 연관성을 알아보고자 하였다. 연구 대상 및 방법 : 1993년 2월부터 2002년 1월까지 본원에 내원 했던 성인 중간부 쇄골 골절 환자 194명 중 완전 전위를 보인 78례를 조사하여 이중 63례를 대상으로 분석하여 후 향적 연구를 시행하였다. 4개월 추시 후에도 방사성 사진상 유합 소견이 관찰되지 않으면 불유합의 유의성을 알아보고자 하였다. 결 과 : 63례 중 불유합 및 지연 유합을 소견을 보인 환자는 15(23%)례였다. 골유합을 보인 48례의 단축은 평균 8.6㎜(2㎜-17㎜)였고, 전위는 평균 9.7㎜(2-22㎜)였다 .불유합 및 지연 유합을 보였던 15례에서 단축은 평균 14.5㎜(3㎜-37㎜), 전위는 평균 17.3㎜(4-25㎜)였다. 18㎜이상 단축이 있었던 경우 불유합의 발생과는 통계학적으로 유의성을 나타내었고(Fisher's exact test, p<0.01), Chi-square test상 16㎜ 이상의 전위를 보였던 경우 불유합 발생과 통계학적으로 의미가 있었다(p<0.01). 결 론 : 쇄골 골절 특히 중간 1/3의 골절은 비교적 보존적 치료에 결과가 좋은 것으로 되어 있으나, 전위 및 단축이 심한 경우 불유합에 대한 가능성이 높이 때문에 보다 경과 관찰시 유합의 진행이 없으면 적극적인 치료를 고려해야한다. Purpose : Because the prognosis of the mid 1.3 clavicle fracture is good, the conservative treatment with a figure of 8 bandage is the gold standard and the nonunions are rare. However, recently surgical treatment is recommended when the shortening and displacement is severe because of the high nonunion rate and the poor clinical result. This study was undertaken to evaluate that the shortening and displacement at fracture site are associated with the development of nonunion. Materials and Methods : We analysed the 194 fractures of mid 1/3 clavicle in adults which had been treated conservatively from February 1993 to January 2002 and did the retrospective study. Of these, 78 cases were originally in the middle third of the clavicle and had been completely displaced. We reviewed 63 of these cases. The shortening and displacement at the fracture site was measured on the initial roentgenogram. And the analysis of the patients' chart was done for another predisposing nonunion factors. Nonunion and delayed union are considered to be present when there has been little or no progression of clinical or radiographic healing at a minimum of 4 months after injury. Results : 15 of the 63 cases had developed nonunion.. The average 8.6㎜(2㎜-17㎜) shortening and average 9.7㎜(2-22㎜) in the union patients. The average 14.5㎜(3㎜-37㎜) shortening and average 17.3㎜(4-25㎜) in the nonunion patients. We found that initial shortening ≥18㎜(Fisher's exact test, p<0.01) and initial displacement ≥ 16㎜(Chi-square test. p<0.01)at the fracture site were significantly associated with the development of nonunion. Conclusion : The conservative treatment with figure-80-bandage is the gold standard in the clavicle middle one third fracture. However, the nonunion is commonly occurs in the cases of more of severely shortened and displaced fractures. If there are no signs of callus formation and the patient complains of pain after several week, osteosynthesis should be considered.

갑상선 기능항진증 환자의 골밀도에 관한 연구 : 예보

노흥규,성기양,윤상임 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.2

A preliminary study to evaluate the effect of thyroid function on the bone mineral density(BMD) was done. BMD was measured at lumbar spine 2, 3, 4 (A-P view) in 10 euthyroid nodular goiter, 8 primary hypothyroidism and 20 hyperthyroidism patients, perimenopausal or postmenopausal periods. Serum calcium, phosphorus, thyroid hormone concentrations and other parameters were measured to analysis. The results were as follows. 1. The BMDs of euthyroidism, hypothyroidism, and hyperthyroidism were 0.85± 0.16gm/㎠ (M±SD), 0.83±0.29 and 0.79±0.16 respectively, without any significant difference, but the BMD of hyperthyroidism was lowest. 2. The BMD of postmenopause of all thyroid disease patients was significantly lower than that of perimenopause patients. 3. There was no significant relationship between BMD and serum calcium, phosphorus, T_3, T_4 or duration of treatment for thyroid disease. In conclusion, the BMD is affected mainly by the age and thyroid function, so attention to osteoporosis must be considered for the patients of thyroid disease in menopause.

당뇨병환자에서 게이트심장혈액풀신티그라피를 이용한 심기능 평가

윤상임,송치운,이진홍,안미애,성기양,송민호,이강욱,신영태,김영건,노흥규 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

Major cardiovascular complications of diabetes are coronary atherosclerosis, diabetic dilated cardiomyopathy, autonomic neuropathy and those are major causes of morbidity and mortality in diabetic patients. Gated blood pool heart scan is noninvasive and useful method for evaluation of functional status of heart in diabetics. We evaluated 52 patients with diabetes and divided 3 groups. Group 1 were 11 patients without proteinuria or with proteinuria less than 550mng during 24 hours. Group 2 were 9 patients with proteinuria more than 550mg during 24 hours and group 3 were 32 patients with endstage renal diasese due to diabetes. We performed 99mTc-HSA cardiac gated blood pool scan and used left ventricular ejection fraction(LVEF), peak ejection rate(PEF) to indices of LV systolic function and peak filling rate(PER) to index of LV diastolic function. The results were follows : 1) LVEF, PER were significantly lower in diabetics with ESRD than diabetics without ESRD, but there were no significant difference between normal controls and diabetics without ESRD 2) PFR was significantly lower in diabetics than normal controls, but there were no significant differences in diabetics with or without nephropathy. 3) There were negative correlation between PER, PFR and duration of diabetes. On the basis of results, PFR is a LV functional index of GBPS which can disclose early change of LV dysfunction in patients with diabetes.

폐경기 여성에서의 Cyclofenil의 효능에 관한 연구 : 갱년기 장애 및 Ca 장흡수에 관하여

노흥규,윤상임,성기양,이경숙,이강욱 충남대학교 의과대학 지역사회의학연구소 1991 충남의대잡지 Vol.18 No.1

In postmenopausal syndrome, most common symptoms are those of vasomotor irritability such as hot flush and palpitation, irritable bladder symptoms and dyspareunia according to atrophy of urogenital epithelium, anxiety, nervousness, depression and insomnia. Approximately 40 percent of women in postmenopausal period develop symptoms serious enough to seek medical assistance. Among non-steroid agents, cyclofenil(4, 4' cyclohexidene methlyene diphenoacetate) is known to be a quite interesting substance according to the action at the level of the hypophyseal and hypothalamic centers by reducing the incretion of FSH and restoring normal endorphin, dopamine and norepinephrine activities, thus favorably affecting the whole postmenpausal neurovegutative symptomatology. In order to evaluate effect of cyclofenil on postmenopausal symptomatology and calcium metabolism, we examined 32 patients with postmenopausal syndrome before and after 200mg/day of oral cyclofenil treatment for 30-60 days. The results were as follows: 1. With 30 days of cyclofenil administration, subjective symptoms such as facial flush, palpitation, anxiety, nervousness and dyspareunia were improved significantly (p<0.001, p<0.001, p<0.01, p<0.005, respectively). But insomnia and depression were improved significantly after 60 days of cyclofenil administration (p<0.05, p<0.001, respectively). 2. Intestinal calcium absorption rate disclosed tendency of improvement without statistical significance 30 days after cyclofenil treatment. 3. Serum calcium and phosphorus level were not changed significantly before and after cyclofenil. 4. There was no definite evidence of side effects such as uterine bleeding due to cyclofenil. In conclusion, we thought that cycofenil is effective in management of postmenopausal syndrome but for the effect on calcium metabolism, further evaluation should be needed.

시판농후 발효유에서 Bifidus균의 경시변화

윤광로,박상주 中央大學校 食糧資源硏究所 1992 食糧資源硏究所 論文集 Vol.4 No.1

시판 농후 발효유의 저장 중에 유산균수, Bifidus균수의 경시적 변화를 조사하였다. Bifidus균의 검출에서 혐기적으로 BL배지에서 NNL용액에 5ml을 첨가하여 배양하는 방법이 간편 방법으로 적합하였으나, 시료별 유산균수에 비하여 Bifidus균의 검출이 감소되었으며 5℃에서 유효기간 동안 Bifidus균의 변화는 거의 없었다. 총 유산균수(혐기적 배양)는 ?? ∼?? 정도였으며 Bifidusr균은 시료별 많은 편차를 보였다. B,N,Y,S회사제품은 유효기간 동안 ??을 유지하여 큰 차이를 보이지 않았으나 M 회사 제품만이 유산균수, Bifidus균수도 적게 검출되었다. Bifidus균의 증식촉진 여부를 알아보기 위하여 SMP배지에서 oligo당을 첨가한 결과, 산도나 pH, Bifidus균수의 차이를 발견하지 못하였으며, 이는 SMP배지 자체가 생장 영양원으로 충분하였던 것으로 판단되었다. The counts of Bifidobacterium in commercial products of stirred yogurt were detected in order to investigate the consecutive changes of this bacteria. An anaerobic culture method was chosen to isolate the lactic acid bifidobacteria. This method using BL agar media containing NNl solution was found to be the most convenience and suitable for detect the total counts of Bifidobacterium. With this method, it were found that total counts of Bifidobaterium in samples were ranged over ?? ∼?? whereas that of total lactic acid bacteria cultured in anaerobic condition were ?? ∼?? /g. Among sample products made by B, N, S and M company, only a sample of M company was found to have lower level of total counts of lactic acid bacteria than other samples, B, N, Y and S. Commercial samples from B, N, Y and S company indicated consistently the average total counts of Bifidobacterium to ?? /g.

韓國人에서 HumFIBRA/FGA와 D21S11 遺傳座의 對立遺傳子 頻度와 遺傳的 變異의 分析

김윤신,황적준,이혜린,구태완,한길로,김성민,이혜승 大韓法醫學會 1998 대한법의학회지 Vol.22 No.1

Allele-and genotype frequencies of the two short tandem repeat (STR) loci, HumFGA and D21S11, were determined in Korean population(n=196). DNA typing was accomplished by applying fluorescence-labeled PCR products and a differently labeled sequenced allelic ladders, followed by automated analysis using ABI 377 automatic sequencer and GeneScan 2.02 software. Prior to typing, allelic ladder of each locus was constructed with a combination of all alleles occuring from the population sample. A total of 15 alleles and 48 genotypes with the heterozygosity of 0.854 for HumFGA, and 12 alleles and 33 genotypes with the heterozygosity of 0.787 for D21S11 are observed in a population of 196 genetically unrelated individuals. No deviations from Hardy-Weinberg equilibrium were observed(p=0.753 for HumFGA, p=0.262 for D21S11). The data presented here (power of discrimination and average power of exclusion) show that both STR Loci, HumFGA and D21S11, are very informative for individualization from criminal evidences, and are also useful for parentage testing.

농부가 아닌 환자에서 발생한 긴털가루진드기(Tyrophagus Putrescentiae)에 의한 기관지천식 1례

최대로,김형수,고창옥,김희선,윤호성,박용범,김상훈,이재영 대한천식 및 알레르기학회 2004 천식 및 알레르기 Vol.24 No.1

Storage mites are believed one of the most important allergens in farmers and rural regions. Tyrophagus putrescenitiae, belonging to storage mites, is found not only within storehouses but also in the house dust, and the third most common mites following Dematophagoides farinae and Dermatophagoides pteronyssnus in house dust in Korea. The sensitization rate to Trophagus putrescentiae was reported as high as that of house dust mite in patients visiting the allergy clinic in large cities in Korea. We experienced a 69-year-old man who had suffered from dyspnea, wheezing, and coughing for 10 years. He retired from the teaching profession, and had lived in a large city. Deajeon. The skin prick test showed a positive reaction to Tyrophagus putrescentiae and negative reactions to house dust mites. The bronchial challenge test with Tyrophagus putrescentiae showed late asthmatic reaction. We confirmed a Tyrophagus putrescentiae induced asthma in non occupational setting. (J Asthma Allergy Clin Immunol 24 : 141-5, 2004)

Human Mitochondrial DNA Sequencing에 의한 개인식별에 관한 연구

김종진,윤송노,최동호,이영보,최상규 內務部 國立科學搜査硏究所 1996 國立 科學 搜査 硏究所 年報 Vol.28 No.-

펄스폭제어방식을 이용한 Switching Regulator에 관한 연구

박규태,윤형로,최승국 연세대학교 산업기술연구소 1981 논문집 Vol.13 No.2

본 논문에서는 Switching Regulator 내의 PWM 시스템에서의 위상지연과 스위칭소자의 지연에 의한 위상지연을 고찰하였고 출력필터의 연속전류모드와 불연속전류모드의 궤환에 의한 시스템의 특성을 분석하였다. 또한 Surge에 의한 Normal mode 잡음과 Ground 잡음전류에 의한 Common mode spike 잡음의 원인을 분석하고 그 대책을 강구하였으며 실제 스위칭 레귤레이터의 제작에 필요한 회로구성과 소자의 선정요건을 고찰하여 효율 82.6%, spike 잡음 10mvp-p 이내의 안정되고 특성이 우수한 레귤레이터를 설계하였다. The phase shift in PWM System due to the time delay in the switching elements has been studied. Employing the normal model, various performance characteristics of the converter for both continuous current operation and discontinuous current operation are compared. The normal mode noise generated by surge and common mode noise generated by ground noise current have been studied. To decrease the noise, several methods are introduced. Hardware circuits are built and in experimental measurements, it shows a high efficiency of 82.6% and low spike noise of 10mv p-p max.

축구선수의 Detraining과 Retraining이 혈청지질 및 호르몬농도에 미치는 영향

정정화,박재현,채종훈,성혜련,황지인,윤미숙,노금선,윤종관,윤영학,노순덕,정경숙,박일규,김은희,박현태,박상갑 대한스포츠의학회 1999 대한스포츠의학회지 Vol.17 No.1

The purpose of this study was to investigate the effects of detraining and retraining on serum lipid and hormones in soccer players. Subjects were seven male high-school soccer players. V˙O_2max was determined for each subjects by administering a treadmill test(initial speed: 90m/min, grade: 5%, increasing speed per 3 min: 30m/min). Serum lipid(T-C, TG, HDL-C LDL-C) and hormones(epinephrine, norepinephrine, growth hormones, cortisol) were assayed pre and post detraining in 10, 20, 30 days after retraining. The repeated ANOVA was used to determine significant differences. The 0.05 level of significance was as critical level for the study. The results of the study were as follows: 1. V˙O_2max(ml/min) were 3576.3±204.2ml/min pre detraining, 3234.1±198.9 ml/min post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/min) were 3601.4±170.9 ml/min. There were significantly(p<.05) increased in retraining periods. 2. V˙O_2max(ml/kg/min) were significantly(p<.05) decreased from 62.3±2.9 ml/kg/min to 55.9±4.7 ml/kg/min in detraining. In 10, 20, 30 days after retraining, V˙O_2max(ml/kg/min) were 62.4±3.4ml/kg/min, 62.7±2.3ml.kg/min, 67.3±7.2ml/kg/min respectively. There were significantly(p<.05) increased in retraining periods. 3. T-C were significantly (p<.05) increased from 166.6±8.5mg/dl to 175.3±10.3 mg/dl in detraining. In 10, 20, 30 days after retraining, T-C were 160.1± 3.2mg/dl, 156.7±3.7mg/dl, 140.3±9.0mg/dl. There were significantly(p<.05) decreased in retraining periods. 4. HDL-C were 61.4±6.6mg/di pre detraining, 5.3±6.6mg/dl post detraining. There are significant(p<.05) difference between pre and post detraining. In 10, 20, 30 days after retraining, HDL-C were 56.9±7.1mg/dl, 56.4±9.2mg/dl, 57.7±9.1mg/dl respectively. There were no significant difference in retraining periods. 5. The hormones(epinephrine. norepinephrine, growth hormone, cortisol) were changed as same patterns. Epinephrine were 26.0±7.0[g/ml pre detraining, 24.6±3.2pg/ml post detraining. In 10, 20, 30 days after retraining, epinephrine were 26.9±5.6pg/ml, 30.6±6.2pg/ml, 29.4±5.6pg/ml respectively. There were no significant difference in retraining periods. In conclusion, HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were decreased, T-C, LDL-C and TG were increased in detraining. But HDL-C, epinephrine, norepinephrine, growth hormone and cortisol were increased, T-C, LDL-C and TG were decreased in retraining.