In vivo 3D Kinematics of Axis of Rotation in Malunited Monteggia Fracture Dislocation

Eugene Kim,Se-Jin Park,Haw-Jae Jeong,Jin Whan Ahn,Hun-Kyu Shin,Jai Hyung Park,Mi Yeon Lee,Murase Tsuyoshi,Ikemototo Sumika,Sugamoto Kazuomi,Young-Min Choi 대한견주관절의학회 2014 대한견주관절학회지 Vol.17 No.1

Background: Normal elbow joint kinematics has been widely studied in cadaver, whilst in vivo study, especially of the forearm, is rare. Our study analyses, in vivo, the kinematics of normal forearm and of malunited forearm using a three-dimensional computerized simulation system. Methods: We examined 8 patients with malunited Monteggia fracture and 4 controls with normal elbow joint. The ulna and radius were reconstructed from CT data placing the forearm in three different positions; full pronation, neutral, and full supination using computer bone models. We analyzed the axis of rotation 3-dimentionally based on the axes during forearm rotation from full pronation to full supination. Results: Axis of rotation of normal forearm was pitch line, with a mean range of 2 mm, from full pronation to full supination, connecting the radial head center proximally and ulnar fovea distally. In normal forearm, the mean range was 1.32 mm at the proximal radioulnar joint and 1.51 mm at the distal radioulnar joint. However in Monteggia fracture patients, this range changed to 7.65 mm at proximal and 4.99 mm at distal radoulnar joint. Conclusions: During forearm rotation, the axis of rotation was constant in normal elbow joint but unstable in malunited Monteggia fracture patients as seen with radial head instability. Therefore, consideration should be given not only to correcting deformity but also to restoring AOR by 3D kinematics analysis before surgical treatment of such fractures.

사용자 움직임 인식이 가능한 휴대형 센서 디바이스 구현

안진호(Jin-Ho Ahn),박세준(Sejun Park),홍유진(Eugene Hong),김익재(Ig-Jae Kim),김형곤(Hyoung-Gon Kim) 大韓電子工學會 2009 電子工學會論文誌-SD (Semiconductor and devices) Vol.46 No.10

후측방 유합술 시 탈무기질화 골기질을 적용한 경우의 유효성과 안정성

안재성(Jae-Sung Ahn),이호진(Ho-Jin Lee),박유진재진(Eugene Park),노창균(Chang-Kyun Noh),이기영(Ki Young Lee) 대한정형외과학회 2016 대한정형외과학회지 Vol.51 No.3

목적: 요추 후측방 유합술 시 탈무기질화 골기질의 효과를 분석하고자 한다. 대상 및 방법: 2009년부터 2012년까지 탈무기질화 골기질을 사용한 30예(I군)와 자가 후방 장골을 사용한 30예(II군)를 조사하였다. 수술 후 2년 동안 주기적 단순 방사선 사진을 촬영하여 Lenke’s scale에 따라 분류 후 굴곡-신연 측면 방사선 사진을 통해 골유합 여부를 확인하였다. 또한 수술 후 2년째 척추경 나사못 주위 방사선 투과대 여부를 조사하였으며, 환자의 임상 증상 평가를 위해 visual analogue scale과 Oswestry disability index (ODI) 점수를 각각 조사하여 분석하였다. 결과: I군 중 19예는 유합, 11예는 불유합되었으며, II군 중 22예는 유합, 8예는 불유합되어 두 군에서 통계적으로 유의한 차이는 보이지 않았다(p=0.57). 유합이 일어난 주수에 있어서도 두 군 간의 통계적 차이는 없었다(p=0.097). 수술 후 2년째에 평가한 척추경 나사못 주위 방사선 투과대 여부, 요통과 ODI 점수에 있어서도 각각 양 군 간의 통계적인 유의성은 없었다. 결론: 요추 후측방 유합술 시 탈무기질화 골기질의 사용은 자가골과 유사한 골유합률을 보이며, 자가골 이식에 따른 합병증을 피할 수 있어 효과적인 골대체재로 생각된다. Purpose: The purpose of this study is to analyze the effects of demineralized bone matrix on posterolateral lumbar fusion. Materials and Methods: From 2009 to 2012, 30 patients who had undergone posterolateral fusions using demineralized bone matrix (group I) and 30 who had received autogenous posterior iliac bone grafts (group II) were investigated. Bone union was determined by evaluating serial simple lumbar radiographs taken during the 24 months after surgery. Bone status was classified according to Lenke’s scale and the bone fusion was finally determined by flexion/extension lateral radiographs. We also examined halo signs around the pedicular screws evident on the radiographs, scored back pain using a visual analogue scale (VAS), and Oswestry disability index (ODI) score 2 years after surgery to evaluate clinical status of patients. Results: In group I, 19 patients showed union and 11 patients did not; the values for group II were 22 and 8. These proportions did not differ significantly (p=0.57). Time to union was somewhat shorter in group II (25.3±7.9 weeks), but did not differ significantly from that of group I (p=0.097). No statistical significance in the periscrew Halo count, VAS for back pain, and ODI score was observed between the two groups. Conclusion: The union rate after using demineralized bone matrix for lumbar posterolateral fusion is similar to that attained when autogenous bone grafts are employed, and lacks the morbidity associated with such grafts. Thus, demineralized bone matrix is an effective bone graft substitute when posterolateral fusion surgery of the lumbar spine is required.

견봉 쇄골 관절 탈구의 관혈적 정복술시 오구 쇄골 인대 봉합의 필요성

김유진(Eugene Kim),신헌규(Hun-Kyu Shin),정화재(Haw-Jae Jeong),최재열(Jae-Yeol Choi),박세진(Se-Jin Park),최규보(Kyubo Choi),임종준(Jong-Jun Lim) 대한견주관절의학회 2010 대한견주관절의학회지 Vol.13 No.2

목적: 오구 쇄골 인대를 봉합하지 않고 견봉 쇄골 관절의 관혈적 정복만 시행한 환자군에서의 임상적, 방사선학적 추시 결과를 확인하고자 하였다. 대상 및 방법: 1998년부터 2007년까지 변형 Phemister 술식과 갈고리 금속판 (AO hook 금속판, Wolter 금속판)을 사용하여 견봉 쇄골 관절 탈구로 수술 받은 환자 중 삽입물 제거한 53예를 대상으로 하였다. 변형 Phemister 술식을 사용한 군이 21명, 갈고리 금속판을 사용한 군이 32명 이였다. 임상적 평가는 Constant score를 이용하였으며, 양측 쇄골과 오구돌기 사이의 수직거리를 비교하여 방사선적 평가를 하였다. 결과: Constant score는 변형 Phemister 술식을 사용한 군에서는 87.59±7.8, 갈고리 금속판을 사용한 군에서는 89.35±5.3로 통계학적 차이는 없었다. 두 군에서 수술 전 손상 부위의 쇄골 오구돌기의 평균 거리는 15.9 mm 이였으며, 건측 견관절은 평균 8.0 mm 이였다. 갈고리 금속판 환자군에서 건측과 비교하여 평균 1.0 mm, 변형 Phemister 환자군에서는 평균 1.2 mm 의 수직 전위가 관찰되었으며 통계학적 차이는 없었다. 결론: 오구쇄골 인대를 복원 하지 않은 견봉 쇄골 관절 탈구의 관혈적 정복술 및 내고정술은 양호한 임상적, 방사선학적 결과를 보였다. Purpose: We evaluated clinical and radiological results for open reduction and internal fixation of acromioclavicular dislocation without coracoclavicular ligament repair after removal of implants. Materials and methods: Clinical and radiological results were obtained for 53 patients who underwent open reduction and internal fixation of an acromioclavicular joint dislocation between 1998 and 2007. A total of 21 patients were treated with a modified-Phemister method and 32 patients were treated with a Hook plate method. All subjects were surveyed after removal of their implants. The Constant scoring system was administered postoperatively to evaluate clinical results. Radiologic outcomes were evaluated by both coracoclavicular intervals on plain films. Results: Constant scores were 87.59±7.8 in the Phemister group and 89.35±5.3 in the Hook plate group. For both groups, the mean coracoclavicular interval at preoperative radiography was 15.9 mm at the injured site and 8.0 mm at the opposite site. After metal removal, the mean difference between coracoclavicular distances between normal and injured sites were 1.0 mm for the Hook plate group and 1.2 mm for the modified Phemister method group (p>0.05). Conclusion: Open reduction and internal fixation of an acromioclavicular joint without coracoclavicular ligament repair shows good long-term clinical and radiological results.

개에서 회장내 단백이 췌효소 및 담즙분비와 위배출 및 소장주행 시간에 미치는 영향

강진경(Jin Kyung Kang),최흥재(Heung Jai Choi),박인서(In Suh Park),정재복(Jae Bock Chung),이상인(Sang In Lee),송시영(Si Young Song),정준표(Jun Pyo Chung),(Hiroshi Tohno),(eugene P . DiMagno) 대한소화기학회 1993 대한소화기학회지 Vol.25 No.6

N/A The aim of this study is to determine if protein in the ileum of dogs affects postprandial pancreaticobiliary secretion, gastric emptying, small bowel transit time, and circulating levels of gastrointestinal regulatory peptides such as peptide YY (PYY), neurotensin (NT), and pancreatic polypeptide (PP). Five dogs were prepared with permanent infusion and aspiration catheters in the duodenum and ileum. Ileal infusion (2 ml/rnin) was begun coincidentally with feeding a 300 Cal mixed nutrient meal containing both a iiquid marker (PEG 4000) and a solid marker (99mTc-sulfur colloid) in a conscious state of dogs. Ileal infusates were isosmolar solutions containing either 0.9% NaCl (control study) or 20 mg/rnl of protein solution (protein infusion study) in the 3:1 ratio of casein to essential amino acids. The secretory pattern of amylase and lipase was parallel, but. the secretion of trypsin was non-parallel to secretion of amylase and lipase. The pattern of exocrine pancreatic enzyme secretion was similar both in control and intraileal protein infusion studies. The secretion of exocrine pancreatic enzymes including amylase, lipase and trypsin, were increased by intraileal protein infusion compared with their secretion in control studies, and the secretion of amylase was significantly decreased (p<0.02) by intraileal protein infusion compared with their results in control studies. Although gastric emptying of both liquid and solid meals was delayed by the intraileal infusion compared with the control studies, there was no significant delay in gastric emptying (Tl/ 2) of liquid, whereas significant difference was noticed in gastric emptying (Tl/4) ol solid (p<0.02) between the control and intraileal protein infusion studies. The small bowel transit time was significantly prolonged (p<0.01) by intraileal protein infusion compared with time measured in control studies. The mean serum levels of PYY and NT were increased by intraileal protein infusion compared with those of control studies, but the mean serum level of PP was not changed. ln conclusion, it is suggested that intraileal protein riiay promote digestion and absorption of nutrients by increasing the enzyme secretion of the pancreas, delaying gastric emptying and prolonging small bowel transit time which may be influenced by hormones such as PYY and NT.

정상과 몬테지아 부정유합의 주관절 근위요척관절(PRUJ)의 생체학적 3차원적 회전축의 분석

김유진(Eugene Kim),정화재(Haw-Jae Jeong),안진환(Jin Whan Ahn),최재열(Jea-Yeol Choi),신헌규(Hun-Kyu Shin),박세진(Se-Jin Park),이승희(Seong-Hee Lee),이준희(Junhee Lee),Tsuyoshi Murase,Kazuomi Sugamoto 대한견주관절의학회 2013 대한견주관절학회 학술대회논문집 Vol.2013 No.3

Clinical and Radiological Outcomes of Foraminal Decompression Using Unilateral Biportal Endoscopic Spine Surgery for Lumbar Foraminal Stenosis

김주은,최대정,PARK EUGENE JAE JIN 대한정형외과학회 2018 Clinics in Orthopedic Surgery Vol.10 No.4

Background: Since open Wiltse approach allows limited visualization for foraminal stenosis leading to an incomplete decompression, we report the short-term clinical and radiological results of unilateral biportal endoscopic foraminal decompression using 0° or 30° endoscopy with better visualization. Methods: We examined 31 patients that underwent surgery for neurological symptoms due to lumbar foraminal stenosis which was refractory to 6 weeks of conservative treatment. All 31 patients underwent unilateral biportal endoscopic far-lateral decompression (UBEFLD). One portal was used for viewing purpose, and the other was for surgical instruments. Unilateral foraminotomy was performed under guidance of 0° or 30° endoscopy. Clinical outcomes were analyzed using the modified Macnab criteria, Oswestry disability index, and visual analogue scale. Plain radiographs obtained preoperatively and 1 year postoperatively were compared to analyze the intervertebral angle (IVA), dynamic IVA, percentage of slip, dynamic percentage of slip (gap between the percentage of slip on flexion and extension views), slip angle, disc height index (DHI), and foraminal height index (FHI). Results: The IVA significantly increased from 6.24° ± 4.27° to 6.96° ± 3.58° at 1 year postoperatively (p = 0.306). The dynamic IVA slightly decreased from 6.27° ± 3.12° to 6.04° ± 2.41°, but the difference was not statistically significant (p = 0.375). The percentage of slip was 3.41% ± 5.24% preoperatively and 6.01% ± 1.43% at 1-year follow-up (p = 0.227), showing no significant difference. The preoperative dynamic percentage of slip was 2.90% ± 3.37%; at 1 year postoperatively, it was 3.13% ± 4.11% (p = 0.720), showing no significant difference. The DHI changed from 34.78% ± 9.54% preoperatively to 35.05% ± 8.83% postoperatively, which was not statistically significant (p = 0.837). In addition, the FHI slightly decreased from 55.15% ± 9.45% preoperatively to 54.56% ± 9.86% postoperatively, but the results were not statistically significant (p = 0.705). Conclusions: UBEFLD using endoscopy showed a satisfactory clinical outcome after 1-year follow-up and did not induce postoperative segmental spinal instability. It could be a feasible alternative to conventional open decompression or fusion surgery for lumbar foraminal stenosi

Suction Drain Tip Culture after Spine Surgery: Can It Predict a Surgical Site Infection?

안재성,이호진,PARK EUGENE JAE JIN,박일영,이재원 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.6

Study Design: Retrospective clinical study. Purpose: To assess the diagnostic value of suction drain tip culture in patients undergoing primary posterior spine surgery. Overview of Literature: To date, the diagnostic value of suction drain tip culture for predicting surgical site infection (SSI) has not been firmly established in orthopedic or spinal surgery. Methods: In total, 133 patients who underwent primary posterior spine surgery from January 2013 to April 2015 were included in this retrospective study. Patients diagnosed with infective disease or condition was excluded. The suction drain tip was cut off approximately 5 cm from its far end. The sample was sent to the microbiological laboratory of the hospital for culture analysis. Any signs of infection, such as wound discharge or dehiscence, fever, chills, or chronic pain, were recorded. The culture outcome, identification of bacteria, and postoperative transition of the serum C-reactive protein level were also recorded in all patients. The wounds were followed up for a minimum of 3 months. Results: A positive drain tip culture was found in 48 patients (36.1%), of whom, 6 developed SSI. The sensitivity of drain tip culture for SSI after primary posterior spine surgery was 60.0%, and the specificity was 65.9%. The association between the incidence of positive suction tip culture and SSI was not statistically significant. Among the 48 positive drain tip cultures, there was no significant association between the occurrence of SSI and virulence of isolated bacteria. There was no significant association between drain tip culture positivity and the duration of drainage, or between the rate of SSI and duration of drainage. Conclusions: Suction drain tip culture analysis is a poor predictor of SSI after primary posterior spine surgery. Routine use of a drain tip culture is not supported by the results of this study.

당뇨병성 족부 궤양에 의한 절단술후 상처 치유와 발목-상완 지수, 족지-상완 지수, 족지압의 관계

박세진,정화재,김유진,이재욱,Park, Se-Jin,Jeong, Hwa-Jae,Kim, Eugene,Lee, Jae-Wook 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.4

Purpose: The purpose of this study is to establish guidelines for ankle-brachial index (ABI), toe-brachial index (TBI) and toe pressure with regard to healing of diabetic foot amputation wound. Material and Methods: We designed a retrospective study that included patients with diabetic foot ulcer. From 2008 to 2011, 46 patients who had suffered from amputation of a foot due to diabetic foot ulcer were included in this study. We divided them into amputation-success group and amputation-revision group, and compared their ankle-brachial index (ABI), toe-brachial index (TBI) and toe pressure between two groups. Amputation-revision group is that first forefoot amputation is failed to heal successfully and need to have another proximal amputation. Results: Toe pressure was 78 mmHg (54~107) in the amputation success group, 0 mmHg (0~43) in the amputation revision group (p=0.000). Ankle-brachial index was 1.1650(1.0475~1.1975) in the amputation success group, 0.92(0.5275~1.0750) in the amputation revision group (p=0.05), and toe-brachial index was 0.6100(0.4050~0.7575) in the amputation success group, 0.00(0.00~0.4150) in the amputation revision group (p=0.04), respectively. Conclusion: ABI, TBI, toe pressure of amputation success group were significantly higher than those of amputation revision group.

개의 실험적 췌외분비부전에서 단백과 탄수화물의 흡수가 지방 흡수에 미치는 영향

정준표,정재복,박승우,이세준,문병수,송시영,이관식,이상인,문영명,강진경,Eugene, P. Dimagno 대한소화기학회 2002 대한소화기학회지 Vol.40 No.2

목적: 췌외분비부전에 의한 지방변의 치료는 아직 난제로서 이를 해결하기 위해서는 지방 흡수에 영향을 미치는 요인을 밝히는 것이 필요하다. 식이가 지방 흡수에 영향을 미치는 것으로 알려져 있으나, 아직 지방, 단백 및 탄수화물 등의 흡수에 있어서 상호 관련성 여부에 대해서는 잘 알려져 있지 않다. 본 연구에서는 개의 실험적 췌외분비부전에서 지방, 단백 및 탄수화물 등의 흡수가 효소 제제(세균성 리파제, 돼지 췌효소제) 및 용량 의존적인지, 지방 흡수가 단백 및 탄수화물의 흡수와 연관되는지 등을 알아보고자 하였다. 대상 및 방법: 20 ㎏ 내외의 암컷 mongrel 개 5마리를 사용하였고, 주-부췌관을 결찰-분리하여 췌외분비 부전을 유발하였다. 효소제의 제형은 모두 분말을 사용하였으며, 용량은 세균성 리파제와 돼지 췌효소제 각각 7.500, 15,000, 30,000 IU을 사용하여 무순서로 실험하였고, 무치료 대조실험도 시행하였다. 실험식이로는 고지방식이{850 Cal, 지방 43% (80.2 g), 단백질 36% (151.6 g), 탄수화물 21% (98.2 g)}를 사용하였다. 72시간 동안 대변을 수집하여 대변내 지방, 단백 및 탄수화물의 양을 측정하였고, g/24 hr로 환산하였다. 지방, 단백 및 탄수화물의 coefficient of fat absorption (CFA), coefficient of protein absorption (CPA) 및 coefficient of carbohydrate absorption (CCA)을 계산하였으며, 다중회귀분석을 이용하여 통계 처리하였다. 결과: CFA, CPA 및 CCA 모두 췌효소제의 용량 의존적으로 증가하였으며(각각 p<0.001), CFA와 CPA는 돼지 췌효소제가 세균성 리파제보다 더 컸으나(각각 p=0.002 및 p<0.001), CCA는 효소제의 종류와는 무관하였다. CPA가 증가할수록 CFA는 증가하였으며(p<0.001), CCA가 증가하여도 CFA는 증가하였다(p<0.001). 결론: 개의 실험적 췌외분비부전에서 지방, 단백 및 탄수화물의 흡수는 췌효소의 용량 의존적으로 증가하고, 돼지 췌효소제가 세균성 리파제보다 지방 및 단백의 흡수에 유리하며, 단백과 탄수화물의 증가는 지방의 흡수를 증가시킨다. 따라서 단백과 탄수화물의 흡수를 극대화하도록 식이를 조절하면 지방 흡수를 증가시킬 수 있을 것으로 생각된다. Background/Aims: Interactions among fat, protein, and carbohydrate absorption may play a role in the treatment of steatorrhea. We determined in canine exocrine pancreatic insufficiency (EPI) whether fat, protein, and carbohydrate absorptions are dependent on the pancreatic enzyme preparation (bacterial lipase, BL; porcine lipase, PL) and whether absorption of fat is related to absorptions of protein and carbohydrate. Methods: Five dogs underwent ligation of pancreatic ducts. Then, seventy two-hour fecal balance studies were performed while a high fat meal (fat 43%) was given. Powdered BL or PL was given at doses of 0, 7,500, 15,000, and 30,000 IU. Stool fat, protein, and carbohydrate were measured and coefficients of fat (CFA), protein (CPA), and carbohydrate (CCA) absorptions were calculated. Multiple regression analysis was used for statistical analysis. Results: CFA and CPA increased preparation (PL is better than BL) and dose dependently. However, CCA increased dose-dependently but not preparation-dependently. Fat absorption increased as protein and carbohydrate absorption increased (p<0.001). Conclusions: In dogs with EPI fed a high fat diet, porcine pancreatic enzyme increases fat and protein absorption greater than bacterial lipase, and the increase of fat absorption is related to the increase of protein and carbohydrate absorptions.