http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
최장석,곽희철,김정한,정훈재,Choi, Jang-Seok,Gwak,, Heui-Chul,Kim, Jung-Han,Chung, Hoon-Jae 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.2
Purpose: To emphasize the importance of considering tuberculosis in atypical cases of foot and ankle by reporting clinical results of those cases. Materials and Methods: Seven cases which were diagnosed as tuberculosis around foot and ankle from March 1996 to June 2007 were included. We reviewed initial impressions, the time to be diagnosed, clinical symptoms, laboratory findings, radiological findings and the clinical results and complications. Results: We followed up at least 6 months ($6{\sim}24$ months) after surgery in all cases. Initially 2 cases had been diagnosed as cellulitis, 4 cases as chronic osteomyelitis, and 1 case as an ankle instability. Tuberculosis was diagnosed after biopsy in all cases. Mean duration of symptom was 15 months ($6{\sim}36$ months) except in infants. There were various radiologic manifestations such as osteopenia, bony erosion or destruction and cystic changes. Symptoms were relieved in all cases within 4 months with chemotherapy followed by surgical biopsy, except one ankle which had been misdiagnosed as ankle instability and joint destruction was developed after modified Brostrom surgery. Conclusion: It is important to perform a surgical biopsy for diagnosis and proper management even with a faint suspicion on tuberculosis in foot and ankle. And in case of need, when surgical biopsy is performed, curettage procedure may help to improve clinical result.
동결 동종골의 구조적 삽입을 이용한 거골하 신연 유합술
최장석,곽지훈,전성수,박홍기,Choi, Jang-Seok,Kwak, Ji-Hoon,Jun, Sung-Soo,Park, Hong-Gi 대한족부족관절학회 2011 대한족부족관절학회지 Vol.15 No.4
Purpose: Subtalar distraction arthrodesis is useful treatment option for restore hindfoot alignment. but, using structural autograft have high risk of donor site morbidity. Recently, by replacing the structural allograft has been reported satisfactory clinical results. Therefore, the authors reviewed the results of subtalar distraction arthrodesis using a structural allograft, retrospectively. Materials and Methods: From January 2008 to May 2010, 12 patients (12 feets; 9 male, 3 female) underwent subtalar distraction arthrodesis using frozen structural allograft. 9 cases were calcaneal malunion, 2 were nonunion or malunion after subtalar arthrodesis, 1 was other cause. Mean age was 38.9 (12~66) years old and follow up period was 16.5 (12~36) months. Surgical was performed with posterolateral approach and tricortical allobone block of frozen femoral neck was used. Analysis was done with retorspective manner to evaluate preoperative, postoperative, and final follow up radiologic measurement and AOFAS ankle-hindfoot scale. Results: There was statistically significant increase (p<0.05) of ankle-hindfoot scale from preoperative 27.5 points to postoperative 72.5 points, talocalcaneal height by 6.62 mm, calcaneal pitch angle by 5.73 degrees, lateral talocalcaneal angle by 6.38 degrees and significant decrease (p<0.05) of tali-1st metatarsal angle by 5.23 degrees. 11 feet (91.7%) acquired bony union and it takes average 5.1 months. Final post-operative result revealed talocalcaneal height changed by 2.57 mm, calcaneal pitch anble, lateral talocalcaneal angle, talar-1st metatarsal angle were changed by 2.63 degrees, 1.62 degrees, 1.18 degrees, respectively (p<0.05). 3 cases of partial osteonecrosis of posterior facet of calcaneus were observed in operation field, 4 cases of complication were developed (1 case of nonunion, 1 collapse of allobone graft, 1 screw loosening, 1 superficial skin necrosis). Conclusion: Subtalar distraction arthrodesis using frozen structural allobone graft is useful alternative treatment method of arthrodesis with structural autobone graft.
최장석,김광희,곽지훈,박홍기,이신우,Choi, Jang-Seok,Kim, Kwang-Hee,Kwak, Ji-Hoon,Park, Hong-Gi,Lee, Shin-Woo 대한족부족관절학회 2011 대한족부족관절학회지 Vol.15 No.4
Purpose: Pathogenesis of intraneural ganglion is controversial, however, the synovial theory that the intraarticular region is the origination of disease has come into the spotlight nowadays. But there are a few researches about intraneural ganglion in foot and ankle. We studied 7cases of intraneural ganglion. We are going to prove the synovial theory by indentifying articular branch of intraneural ganglion. Materials and Methods: From August 2003 to May 2011, we evaluated 7 ouf of 8 patients diagnosed as a intraneural ganglion in foot and ankle. The gender ratio were 4 male and 3 female, and the mean age at the time of surgery was 52.9 years. Clinically, we checked pre and post operative symptom, muscle tone and whether loss of muscle tone and sensation exists. We analyzed surgical records and preoperative MRI and compared those with intra-operative finding. Results: In MRI analysis of 7cases, the connection around the joints were confirmed, and 1 case was confirmed in the retrospective analysis of MRI. Intraneural ganglions occurred in medial plantar nerve 3 cases, lateral plantar nerve 1 case, superficial peroneal nerve 1 case and sural nerve 1 case. We could not found recurrence during the follow up periods. Most patients relieved pain after operation, but recovery of sensation was unsatisfactory. We could find some cases pathological finding of the nerve intraoperatively, and clinical result of that cases was poor. Conclusion: Intraneural ganglion can occur in various parts in foot and ankle. We concluded that the intranneural ganglion originated from joint by identifying the artichlar branch of ganglion. Due to its small size, it is difficult to find articular branch in operation field. But we do our best to find and remove articular branch. Currently, considering the small amount of research in foot and ankle, more research about articular brach is needed.
최장석(Jang Seok Choi),안기찬(Ki Chan An),장재호(Jae Ho Jang),신정욱(Jung Wook Shin),김윤준(Yoon Jun Kim) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.4
목적: 나노섬유 지지체를 이용한 수핵 재생술의 가능성을 조직배양 및 동물실험을 통해 검증해 보고자 하였다. 대상 및 방법: 지지체는 75:25 PLGA 생분해성 고분자를 전기방사법을 이용하여 제작하였다. 생체 외 실험으로 6마리의 생후 6개월 된 3 kg 전후의 뉴질랜드산 흰색 수토끼로부터 18개의 척추체를 분리 후 배양하였다. 실험군은 한 쪽의 종판에 구멍을 내고 일부 수핵을 제거한 군(defect)과 종판 천공 후 수핵 일부을 제거하고 나노섬유 지지체를 삽입한 군(nanofiber), 그리고 정상군으로 나누었으며 10일간 배양하였다. 자기 공명 영상 검사(MRI)와 조직검사를 통해 퇴행정도를 판별하였다. 동물실험 6마리의 뉴질랜드산 흰색 수토끼를 이용하였다. 척추 측방 절개를 이용한 후복막 도달법을 이용하였으며 각 토끼의 제2-3, 3-4 요추간 추간판을 11번 수술칼로 섬유륜을 절개 후 일부 수핵을 제거하였으며 제3-4 요추간 추간판에 나노섬유 지지체를 삽입하였다. 실험군은 defect 군, nanofiber군, normal군으로 구분하였으며 시술 후 1, 2, 3개월째 단순 방사선 검사 및 MRI 검사와 조직검사를 실시하여 퇴행 정도를 판단하였다. 결과: 생체 외 실험 nanofiber 군에서 defect군보다 높은 T2 강조영상 신호세기와 수핵세포의 증식을 보여주었다. 동물실험군에 비해 nanofiber 군과 defect군 모두 현격한 추간판 퇴행을 보여주었으나 nanofiber군과 defect군 사이에는 유의한 차를 보이지 않았다. 결론: 생체 외 실험을 통해 나노섬유 지지체가 수핵 세포의 증식과 세포 외 기질 형성에 긍정적인 영향을 끼친 것을 확인할 수 있었다. 그러나 동물실험에서는 생체외 실험과는 상반된 결과를 나타내었으며 이는 시술시 발생한 섬유륜의 손상에 의한 결과라 추정된다. 따라서 퇴행성 추간판 질환의 수핵 재생을 위해서는 섬유륜의 재생에 관한 연구도 병행되어야 할 것으로 생각한다. Purpose : To investigate the potential of nucleus pulposus (NP) regeneration with a nanofiber-based scaffold inserted in the degenerative disc. Materials and Methods : A nanofiber scaffold was fabricated using an electrospinning technique. In the in-vitro study, a total 18 discs with endplates on both sides were obtained from six New Zealand White (NZW) rabbits. A small volume of NP was removed through the hole from the endplate. The specimens were classified into three groups, intact (normal), inserting nanofiber scaffold (nanofiber), and defect (defect) group. The discs were analyzed by MRI scan and histological analysis. Six NZW rabbits were used in the in-vivo study. An annulotomy was performed through the dorsal approach L2-3 and L3-4 disc. A nanofibrous sheet type scaffold was inserted at L3-4. X-ray, MRI and histology analysis were carried out at 4, 8, 12 weeks after surgery. Results : In the in-vitro study, the Nanofiber groups showed higher signal intensity and cell proliferation than the defect groups. In the in-vivo study, the Nanofiber and defect groups showed significant degeneration but there was no significant difference between these groups. Conclusion : Nanofiber scaffold might provide a favorable environment for regenerating disc cells. However, a defect in the annulus fibrosus (AF) might delay the regeneration of the disc cell at the nanofiber group. Therefore, NP regeneration using any scaffold should be examined along with AF regeneration for effective clinical applications.
최장석(Jang-Seok Choi),김정한(Jung-Han Kim),곽희철(Heui-Chul Gwak),김상우(Sang-Woo Kim) 대한정형외과학회 2009 대한정형외과학회지 Vol.44 No.2
견갑골의 견봉 또는 오구 돌기 골절은 드물며, 그 중 두 개가 동시에 골절되는 경우는 매우 드물며, 대개 견갑부의 직접 외상에 의해 발생한다. 이러한 골절은 간과하기 쉬우며 주의깊은 검사를 통해 발견되어 질 수 있다. 저자들은 수상 당시 단순 방사선 사진에서 미리 발견하기 어려운 견봉 골절을 동반한 견갑골의 오구 돌기 골절을 가진 흔치 않은 증례를 문헌과 함께 보고하는 바이다. Fractures of the acromial process or the coracoid process of scapula are rare, and this is usually the result of direct trauma to the shoulder. This type of fracture is often neglected, but it can be detected by performing careful evaluation. We report here on an unusual case involving a fracture of the coracoid process along with concomitant acromial fracture.