• 대한정형외과학회지
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• 제54권3호
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• pp.281-286
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• 2019

무혈성 골괴사는 골조직 및 골수 조직의 허혈성 상태로 인한 괴사로 정의될 수 있으며, 외상성 및 비외상성으로 구분할 수 있다. 무혈성 골괴사는 대퇴골 골두, 상완골 골두와 같이 장골의 골단 부위에서 주로 발생한다. 기존의 무혈성 골괴사는 대부분 대퇴골 골두에 한정된 증례에 대한 보고 및 연구가 이루어져 왔다. 근위 대퇴골의 무혈성 괴사의 존재는 인공 고관절 전치환술 이후 생물학적 고정 실패의 원인이 된다. 본 저자들은 대퇴골 골두로부터 대퇴골 경부, 간단부 간부 및 원위부에 이르는 골수강내 부위의 대퇴골 전 영역의 무혈성 골괴사가 관찰된 56세 남자 환자에서 인공 고관절 전치환술을 시행하고 2년 추시 결과를 문헌 고찰과 함께 보고하고자 한다.

• 대한물리의학회지
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• 제9권1호
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• pp.35-44
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• 2014

PURPOSE: The aim of the study was to investigate the relationships among the hip joint passive range of motion (ROM) and femur head anterior glide (FHAG) mobility on the gait ability in patients with post-stroke hemiparesis. METHODS: The participants were 37 patients (30 male, 7 female) living in Daejeon. The ROM of the hip joint was measured by using goniometry and the FHAG mobility was measured by using the Prone Figure-4 test. The walking ability was assessed by using the 10m walk test (10MWT), and the 6-min walk test (6MWT). RESULTS: The FHAG was negatively correlated with hip extension (r=-.554, p<.05) and flexion (r=-.337) on the affected side as well as with hip extension (r=-.480), abduction (r=-.361), and adduction (r=-.426) on the non-affected side (p<.05). The gait ability was correlated with the hip joint external rotation on the non-affected side (p<.05), but showed no significant correlation with the hip ROM on the affected side (p>.05). CONCLUSION: This study provides evidence that in patients with post-stroke hemiparesis, the FHAG mobility might be correlated with hip extension. Based on these results, the FHAG mobility may be used to determine the hip extension in patients with post-stroke hemiparesis.

• 한국CDE학회논문집
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• 제13권3호
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• pp.200-208
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• 2008

Total Hip Replacement(THR) is a surgical procedure that replaces a diseased hip joint with a prosthesis. A plastic or metal cup forms the socket, and the head of the femur is replaced by a metal ball on a stem placed inside the femur. Due to the various types and shapes of human hip joint of every individual, a selected commercial implant sometimes may not be the best-fit to a patient, or it cannot be applied because of its discrepancy. Hence extracting geometry parameters of hip joint is one of the most crucial processes in designing custom-made implants. This paper describes the framework of a methodology to extract the geometric parameters of the hip joint. The parameters include anatomical axis, femoral head, head offset length, femoral neck, neck shaft angle, anteversion, acetabulum, and canal flare index. The proposed system automatically recommends the size and shape of a custom-made hip implant with respect to the patient's individual anatomy from 3D models of hip structures. The proposed procedure creating these custom-made implants with some typical examples is precisely presented and discussed in this paper.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1996년도 추계학술대회
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• pp.349-350
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• 1996

Using FEM, we analyzed the stress changes on early osteonecrosis of femoral head as the necrotic area increases. A 3D FEM model of proximal femur was made from the CT scam data of fresh frozen adult proximal femur with the material properties from literature. The model consisted of 5994 elements and 5275 nodes. FE analyses were peformed using MSC/NASTRAN. At normal states, stress transmission is mainly along the primary compression trabeculae(PCT). Until 60% involvement of PCT with necrotic lesion, stress transmission is still along the remained PCT. When the PCT involvement is from 60% to 85%, stress transmission is along the PCT and margin of the necrotic lesion. When involvement is more than 85%, stress is mostly transferred to posterior part of femoral head.

• The Korean Journal of Pain
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• 제5권1호
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• pp.117-120
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• 1992

본 통증치료실에서 요통 및 하지 방사통을 호소하는 30세된 남자환자를 보통 시행하는 횟수 보다 많은 경막외강내 스테로이드 주입중에 발생한 양측 무혈성 골두괴사를 경험하였다. 물론 이 환자는 약국이나 한약방 등에서 약명미상의 약물을 경구투여받고 있었으므로 그것(혹시 스테로이드)으로 인한 원인인지 혹은 단순히 경막외강으로 주입된 스테로이드로 인한것인지는 분명하지 않다. 그러나 최근 피부과 질환으로 인한 스테로이드의 장기복용 및 도포로 무혈성 대퇴골두괴사가 종종 보고되고 있으므로 그 원인일수도 있다는 가정하에 통증치료실에 근무하는 종사자들의 주의를 요하는 뜻에서 이 증례를 보고하는 바이다.

• Journal of Nutrition and Health
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• 제29권9호
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• pp.943-949
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• 1996

Bone mineral density depends largely on the status of dietary minerals such as Ca, P, Mg, and F and proteins, physical activities, parathyroid hormone(PTH), calcitonin(CT), and vitamin D. The decrease of bone density often results in bone fractures and osteoporosis which is prevalent among postmenopausal women. This study was intended to examine the role of parathyroid hormone, calcitonin and cholecaliferol in bone density of mice that were fed different dual photon energy beams. We have measured three major parts of the bone : whole body, head and femur. The results are summarized as follows : 1) Bone mineral density (BMD) was more increased by feeding high Ca diet compared to that of the low Ca diet. 2) Both PTH and Vit D3 enhanced BMD in all of the different Ca levels. 3) When the dietary Ca was deequate CT showed a synergistic effect with PTH in boosting bone density, while CT+Vit D3 showed a negative effect. 4) CT tended to inhibit the effect of increasing bone density by PTH and Vit D3 in medium and low Ca groups. 5) The effect of increasing bone density by PTH in the head of mouse increased when dietary Ca was lower : The increment of bone density by PTH in high, medium, and low Ca was 3%, 8%, 19%, respectively. 6) Femur bone density was affected significantly by dietary Ca levels than hormones. The above observations indicate that bone mineral density can be improved by high dietary Ca and hormone injections including PTH, CT and cholecalciferol, and thus proper dietary and hormonal treatment may be used in preventing bone fractures and osteoporosis.

• 척추신경추나의학회지
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• 제9권1호
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• pp.115-124
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• 2014

Objectives : The aim of this study is to report the improved case of bilateral avascular necrosis(AVN) of femur head treated with Korean medicine and Fascia Chuna Therapy Methods : The patient diagnosed with bilateral AVN is hospitalized at department of korean rehabilitation medicine, Samse hospital of korean medicine. The subject is treated by herbal medicine, acupuncture, SBV and hip joint gyoung-geon chuna. This study was measured by visual analogue scale(VAS) score, walking time without pain per 6 minutes and harris hip score(HHS). Results : The patient showed decreased VAS score, HHS and improved walking time without pain per 6 minutes after treated with korean medicine and hip joint Fascia Chuna Therapy. Conclusions : The patient showed reduced pain and positive effect on activities of daily living.

• 한국임상수의학회지
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• 제39권6호
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• pp.390-394
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• 2022

A 6-year-old, 36.5 kg castrated male Golden Retriever presented for revision surgery for left total hip replacement. The patient underwent removal of the cup and head implants due to unmanageable prosthetic hip dislocation, despite revision surgery. On physical examination, the dog showed persistent weight-bearing lameness after exercise of the left hindlimb with mild muscle atrophy. Radiographic examination revealed dorsolateral displacement of the femur with a remnant stem and bony proliferation around the cranial and caudal acetabulum rims. The surgical plan was to apply the dual mobility cup to increase the range of motion and jump distance to correct soft tissue elongation and laxity caused by a prolonged period of craniodorsal dislocation of the femur. The preparation of the acetabulum for cup fixation was performed with a 29-mm reamer, and the 29.5-mm outer shell was fixed with five 2.4-mm cortical screws. The head and medium neck of the dual-mobility system were placed on the cup, and the hip joint was reduced between the neck and stem. The dog exhibited slight weight bearing on a controlled leash walk the day after surgery. The patient was discharged 2 weeks postoperatively without any complications. Six months postoperatively, osseointegration and a well-positioned cup implant were observed, and the dog showed excellent limb function without hip dislocation until 18 months of phone call follow-up.

• 대한의용생체공학회:의공학회지
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• 제31권3호
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• pp.199-209
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• 2010

The locking compression plates-distal femur(LCP-DF) are being widely used for surgical management of the extra-articular complex fractures of the distal femur. They feature locking mechanism between the screws and the screw holes of the plate to provide stronger fixation force with less number of screws than conventional compression bone plate. However, their biomechanical efficacies are not fully understood, especially regarding the number of the screws inserted and their optimal configurations. In this study, we investigated effects of various screw configurations in the shaft and the condylar regions of the femur in relation to structural stability of LCP-DF system. For this purpose, a baseline 3-D finite element (FE) model of the femur was constructed from CT-scan images of a normal healthy male and was validated. The extra-articular complex fracture of the distal femur was made with a 4-cm defect. Surgical reduction with LCP-DF and bone screws were added laterally. To simulate various cases of post-op screw configurations, screws were inserted in the shaft (3~5 screws) and the condylar (4~6 screws) regions. Particular attention was paid at the shaft region where screws were inserted either in clustered or evenly-spaced fashion. Tied-contact conditions were assigned at the bone screws-plate whereas general contact condition was assumed at the interfaces between LCP-DF and bone screws. Axial compressive load of 1,610N(2.3 BW) was applied on the femoral head to reflect joint reaction force. An average of 5% increase in stiffness was found with increase in screw numbers (from 4 to 6) in the condylar region, as compared to negligible increase (less than 1%) at the shaft regardless of the number of screws inserted or its distribution, whether clustered or evenly-spaced. At the condylar region, screw insertion at the holes near the fracture interface and posterior locations contributed greater increase in stiffness (9~13%) than any other locations. Our results suggested that the screw insertion at the condylar region can be more effective than at the shaft during surgical treatment of fracture of the distal femur with LCP-DF. In addition, screw insertion at the holes close to the fracture interface should be accompanied to ensure better fracture healing.

• 한국의학물리학회지:의학물리
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• 제21권3호
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• pp.298-303
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• 2010

전립선암에서 세기조절방사선치료와 입체조형방사선치료의 선량분포 특성을 비교하였다. 세기조절방사선치료에서는 치료계획표적용적에 200 cGy를 33회 조사하여 6,600 cGy가 조사되도록 하였다. 세기조절방사선치료에서는 PTV의 최대선량이 104.4%이었으며, 최소선량이 89.5%였으며, 삼차원입체조형치료에서는 PTV의 최대선량이 105.3%이었으며, 최소선량이 85.5%을 나타내었다. 100%에 대한 CI는 세기조절방사선치료에서 1.02였으며, 삼차원입체조형치료에서는 0.97을 나타내었다. 중요장기 직장에 대해서 세기조절방사선치료에서는 5,000 cGy 이상이 34.0%였으며, 삼차원입체조형치료에서는 63.3%였고, 방광에 대해서 세기조절방사선치료에서는 4,000 cGy 이상이 30.1%였으며, 삼차원입체조형치료에서는 30.6%였고, 오른쪽 대퇴골두부에 대해서 세기조절방사선치료에서는 2,000 cGy 이상이 9.5%였으며, 삼차원입체조형치료에서는 17.5%였고, 왼쪽 대퇴골두부에 대해서 세기조절방사선치료에서는 2,000 cGy 이상이 10.6%였으며, 삼차원입체조형치료에서는 18.3%을 나타내었다. 삼차원입체조형치료와 세기조절방사선치료의 비교에서 세기조절방사선치료가 삼차원입체조형치료에 비해 PTV의 선량분포에서는 5%의 정도 선량분포의 이득이 있었으며, 직장 선량에 대해서는 5,000 cGy 이상 선량에서 29.3%의 감소가 있었고, 방광 선량에 대해서는 거의 비슷한 분포를 나타내었고, 오른쪽 대퇴골두부의 선량에서는 8.0%, 왼쪽 대퇴골두부의 선량에서는 7.7%의 선량 이득을 나타내었다.