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김희선(Hee Seon Kim),민학진(Hak Jin Min),윤의성(Ui Seoung Yoon),서재성(Jae Sung Seo),김윤종(Yoon Jong Kim),임병호(Byung Ho Lim) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.3
목적: 슬관절 전치환술 후 5년 이내의 조기 실패 원인 및 평균기간을 분석하였다. 대상 및 방법: 1994년 8월부터 2003년 5월까지 시행한 786예의 일차 슬관절 전치환술 중에서 5년 이내에 조기 실패로 재치환술을 시행한 38예를 대상으로 하였다. 여자가 36예, 남자가 2예였고 재치환술시 연령은 평균 66세였다. 원인 질환은 퇴행성 관절염이 36예로 대부분을 차지하였다. 결과 분석을 위해서 후향적으로 조기 실패의 원인과 기간 등을 조사하였다. 결과: 조기 실패를 보인 환자의 재치환술까지의 기간은 평균 2년이었고 조기 실패의 원인으로는 폴리에틸렌의 마모가 18예(47.4%)로 가장 많았으며 수술 후 치환물의 부정렬, 특히 경골의 절골각이 평균 5.1˚ 내반이었고 3˚ 이상의 내반을 보인 경우가 14예(82.4%)였으며 좌식생활, 재래식 화장설의 사용 등 슬관절을 과도하게 굴곡하는 일상생활을 하고 었었다. 그 외 감염이 16예(42.1%), 슬관절 불안정성이 2예(5.3%)였으며 무균성 해리 및 슬개골 삽입물의 해리가 각 1예(2.6%)였다. 결론: 슬관절 전치환술후 조기 실패로 재치환술을 시행한 경우는 38예 4.8%였고 실패의 가장 큰 원인은 폴리에틸렌의 마모와 감염이었다. 수술 후 치환물의 부정렬과 슬관절을 과도하게 굴곡하는 환경이 삽입물의 조기 마모와 관련되어 있을 것이라 사료되며, 당뇨병이나 장기간 스테로이드 복용 등이 감염과 연관되어 있을 것으로 생각된다. Purpose: To analyze the cause of failure and average period in patients who had revision surgery with￢in 5 years of their primary total knee arthroplasty (TKA). Materials and Methods: 786 total knee arthroplasties were performed between August 1994 and May 2003. During the period, there were 38 cases, 36 females and 2 males, of revision surgery within 5 years. The mean age was 66 years. The most common causes of disease in revision were degenerative arthritis. We analyzed the reasons for early failure retrospectively. Results: Revision TKA were performed at average 2 years after primary TKA. The causes of revision were polyethylene wear in 18 cases (47.4%), deep infection in 16 (42.1%), instability in 2, and aseptic loosening in 1, dissociation of patella component in 1. The degree of varus in tibial cutting was 5.1˚ in average in polyethylene wear group. The obliquity of the tibial joint line was more than 3˚ varus in 14 cases (82.4%). Most patients had their knee in hyperflexion and squatting position during activities of daily living. Conclusion: Thirty eight cases (4.8%) were performed revision surgery within 5 years of primary TKA. Polyethylene wear and deep infection were the common causes of early failure of primary TKA. The component malalignment, hyperflexion and squatting position during activities of daily living may be related to polyethylene wear. Diabetes mellitus and long term steroid application, may be related to infection.
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김희선(Hee Seon Kim),민학진(Hak Jin Min),윤의성(Ui-Seoung Yoon),서재성(Jae Seong Seo),김윤종(Yoon Jong Kim),김진수(Jin Soo Kim) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.7
슬관절 전 치환술 후 발생하는 자발성 혈관절증은 매우 드문 합병증으로 알려져 있고 국내에는 아직 보고된 바 없다. 저자들은 퇴행성 관절염으로 슬관절 전 치환술을 시행 받은 60세 여자 환자에서 수술 후 10개월에 발생한 자발성 혈관절증에 대해서 관혈적 활액막 제거술로 치유된 1예를 경험하였기에 보고하고자 한다. Spontaneous hemarthrosis of the knee after a total knee arthroplasty is a rare complication, and there is no report is available in Korea. We report a case that was cured with an open synovectomy in the spontaneous hemarthrosis, which developed 10 months after the total knee arthroplasty for degenerative osteoarthritis in a 60-year-old woman.
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김희선(Hee Seon Kim),신동현(Dong Hyun Shin),이승현(Seunghyeong Lee),송순호(Soonho Song),전광민(Kwang Min Chun) 대한기계학회 2013 대한기계학회 춘추학술대회 Vol.2013 No.12
The goal of this study is to experimentally evaluate the effects of different types of catalysts, GHSV (Gas Hourly Space Velocity) and O<SUB>2</SUB>/C ratio of reactants on the performance of a methane reformer, which was designed and built to produce syngas in the laboratory. Two different types of catalysts were employed ?a precious metal catalyst (monolith type) consisting of 1wt% Rh/CeO<SUB>2</SUB>-ZrO<SUB>2</SUB> and a mixed catalyst consisting of 1wt% Rh/CeO<SUB>2</SUB>-ZrO<SUB>2</SUB> (monolith type) and 18wt% Ni on calcium aluminate catalyst (pellet type). The O<SUB>2</SUB>/C ratio of reactants was varied from 0.25 to 1.0 and GHSV was ranged from 5,000h<SUP>-1</SUP> to 10,000h<SUP>-1</SUP>. For each experimental condition, the catalyst temperature (the temperature of the reaction mixture) and concentrations of product gases (H<SUB>2</SUB>, CO, CO<SUB>2</SUB>) were measured. The results showed that both catalyst temperature and syngas concentration were increased as GHSV increased up to 10,000h<SUP>-1</SUP>, and the precious metal catalyst showed the better performance than the mixed catalyst. However, performance of the reformer was deteriorated when the O<SUB>2</SUB>/C ratio was increased above 0.75.
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당뇨환자의 영양지식수준에 따른 자가관리 현황 및 웹베이스 영양관리 프로그램 개발에 관한 요구도 조사
김희선(Hee Seon Kim),안윤(Yun Ahn),배제헌(Jea Hurn Bae),윤정은(Jung Eun Youn) 대한지역사회영양학회 2011 대한지역사회영양학회지 Vol.16 No.1
This study was conducted to assess needs of self-management nutrition program for diabetic patients. The survey was conducted among 100 diabetic patients, and the mean age of the subjects was 54.2 years old. Thirty three percent of the subjects were diagnosed diabetes less than 2 years ago. The average nutrition knowledge score about diabetes was 10.2 point, and percentages of correct answers were very high in ``foods rich in fiber`` (97.0%), ``relevance of exercise and insulin`` (97.0%), ``quantity of insulin injection`` (91.0%), and ``diabetes menu`` (91.0%). The sources of nutrition information were hospitals/healthcare centers (56.1%), TV/radio (19.2%), and internet (13.1%). Sixty nine percent of the subjects have experienced nutrition education on subjects as ``menu planning skills``(22.4%), ``selecting foods`` (22.4%), ``relevance of blood glucose and eating foods`` (21.5%) by personal counseling (54.4%). The total score of eating behavior was higher after diagnosed diabetes (35.3) than before (30.0) (p < 0.001). The preferred topics in developing diabetes nutrition information websites were ``diabetes mellitus``, ``relevance of blood glucose and foods``, and ``selecting foods for diabetes``. The subjects wanted the websites developed by ``using mainly illustrations, pictures, tables`` (22.8%) and ``using simple design`` (19.6%). The preferred contents in developing diabetes self-management nutrition program were ``dietary life diagnosis``, ``chronic disease risk diagnosis``, ``calorie control by selecting foods and cooking skills``, and ``dietary assessment``. In designing the program, the subjects` most wanted designs were ``be handy and simple in using`` (29.3%), ``using simple design`` (17.9%), and ``using mainly illustrations, pictures, tables`` (15.7%). (Korean J Community Nutr 16(1) : 155~168, 2011)
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