• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.71-72
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• 2009

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.2
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• pp.126-129
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• 2007

An irreducible dislocation of the knee joint is quite rare. Most irreducible knee dislocations are posterolateral dislocations and result from the soft tissue interposition. To the best of our knowledge, there is no report of an irreducible knee dislocation result from interposition of the detached cartilage from the medial femoral condyle. We present a case of 51 years old female with irreducible knee dislocation which was treated with an arthroscopic debridement of the detached cartilage, result in reduction of the joint, which is failed in closed reduction. And then we perform the delayed arthroscopic reconstructions for the ruptured anterior and posterior cruciate ligaments. Debridement of the interposed structure using the arthroscope allows for reduction of the joint and good result without the need for an open procedure.

• Journal of Oral Medicine and Pain
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• v.25 no.3
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• pp.305-313
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• 2000

이 연구의 목적은 악관절 내장증 환자에서 관절원판의 형태를 자기공명영상사진으로 평가하고 임상적 증상과의 관계를 알아보고자 하는 것이다. 악관절 내장증의 증상을 가진 90명의 환자에서 169개의 관절을 자기공명영상사진으로 관절원판과 하악과두의 관계를 기준으로 정상군, 정복성 관절원판 변위군, 비정복성 관절원판 변위군으로 분류하고 관절원판의 형태를 5가지로 나누었다. 임상검사는 측두하악관절통과 관절음의 유무를 확인하여 그 상관관계를 알아보았다. 실험 결과에서 측두하악관절통은 각 군에서 관절원판의 형태와는 정상군을 제외하고는 통계적인 유의성이 없었으며, 염증성 삼출액과 유의한 관계를 보였다. 관절음은 정복성 관절원판 변위환자에서 관절원판형태와 통계적으로 유의성을 보였으며, 비정복성 관절원판 변위환자에서도 상당수 관절음이 발생하였음을 알 수 있었다. 이 결과는 측두하악관절의 통증은 관절원판의 형태가 많이 변형될수록 통증이 심해지는 경우가 많았지만, 다른 여러 가지 원인들이 존재할 수 있으며, 관절음은 정복성 관절원판 변위환자에서 관절원판의 변형이 심할수록 관절원판이 정복할 때 발생될 수 있다는 것을 의미한다. 따라서, 임상적인 검사와 더불어 자기공명영상사진으로 정확한 진단을 함으로써 관절원판 변위의 적절한 치료가 행해질수 있으리라 생각된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.110-115
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• 2008

Purpose: Intussusceptions are one of the most common causes of intestinal obstruction in infants and young children. Although it is easily treated by non-operative reduction using barium, water or air, this treatment is very stressful for young patients and may cause bowel perforation, peritonitis and shock. In this study, we identified the risk factors associated with the failure of non-operative reduction, to identify a group of children that would benefit from the procedure and those who would not. Methods: We reviewed the medical records of patients with intussusception who were treated at the Korea University Medical Center Ansan hospital from March 1998 to July 2006. Three hundred fourteen children with intussusception were identified. Among them, non-operative reductions were performed in three hundred. Clinical and radiological variables were compared according to the failure or success of the non-operative reduction. Results: Non-operative reductions were successful in 243 (81%) and failed in 57 (19%). The group that had failed procedures had a younger age (12.3${\pm}$17.2 months vs. 18.0${\pm}$15.8 months, p=0.03), longer symptom duration before reduction (33.6${\pm}$29.0 hr vs. 21.5${\pm}$20.3 hr, p<0.01), more vomiting and lethargy (p<0.01), but less abdominal pain and irritability (p<0.01), compared with the group that had a successful procedure. Logistic regression analysis showed that the factors associated with the failure of non-operative reductions were a younger age, less than 6 months of age (odds ratio: 2.5, 95% confidence interval: 1.2~5.2, p=0.01), duration of symptoms, longer than 24 hrs before reduction (odds ratio: 2.1, 95% confidence interval: 1.2~4.2, p=0.03), bloody stool (odds ratio: 4.8, 95% confidence interval: 1.9~12.2, p<0.01), lethargy (odds ratio: 3.4, 95% confidence interval: 1.1~10.4, p=0.04), and abdominal pain or irritability (odds ratio: 0.2, 95% confidence interval: 0.1~0.4, p<0.01). Conclusion: For children with intussusception, an age younger than 6 months, and duration of symptoms more than 24 hrs before reduction, as well as the presence of bloody stools, lethargy and abdominal pain or irritability were variables associated with failure of a non-operative reduction. Knowledge of these variables should be considered in making clinical decisions for therapeutic interventions.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.239-247
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• 2018

Purpose: We investigated occurrence of reduction loss after extension block (EB) Kirschner wire fixation or additional interfragmentary fixation (AIF) and clinical results including extension lag of the distal interphalangeal joint for treating bony mallet finger. Methods: Forty-six patients were included with a mean follow-up of 28 months (range, 12-54 months). Twenty-seven patients were treated with EB K-wire fixation (Group A) while 19 patients were treated with AIF (Group B). We checked radiologic factors, such as amount of articular involvement, volar subluxation, mallet fragment angle, reduction loss, range of motion including extension lag, and functional outcomes using Crawford's criteria. Results: Reduction loss occurred in eight patients (17%). Differences in mean extension lag, age, preoperative volar subluxation and mallet fragment angle between patients with reduction loss and those with reduction maintaining were significant. However, there were no significant differences in gender, hand dominance, amount of articular involvement, AIF, or further flexion between reduction loss and reduction maintaining. As for patterns of displacement, there was a significant relationship between gap or step-off and extension lag. Using Crawford's evaluation criteria, functional outcomes were excellent in 31, good in 10, fair in 3, and poor in 2 patients. Conclusion: Reduction loss should be careful in older age, smaller mallet fragment angle and preoperative volar subluxation.

• Archives of Hand and Microsurgery
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• v.23 no.4
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• pp.230-238
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• 2018

Purpose: Metacarpal fractures are common injuries of the hand. They are treated using closed reduction (CR) or open reduction (OR) techniques. The management strategy depends on fracture site characteristic and fixation methods. In this study, we evaluated pre- and postoperative fracture angulation, when metacarpal fractures bad been treated using two different techniques: CR with parallel transverse pinning and OR with plate fixation. Methods: Forty-six patients undergoing anatomic reduction to treat extra-articular metacarpal fractures were recruited. They were included in one of two therapeutic groups: Group 1, CR with parallel transverse pinning (n=21); Group 2, OR with plate fixation (n=25). Fracture angulation values have been measured on pre- and postoperative radiologic images. Values were compared between pre- and postoperative states, and between corresponding measurements of each group. Results: All extra-articular metacarpal fractures were successfully treated without wound related complications or the limit of joint motion. Both groups demonstrated adequate reduction at immediate postoperative period (postoperative angulation of group 1, $20^{\circ}{\pm}7^{\circ}$; group 2, $19^{\circ}{\pm}5^{\circ}$). During the observation at follow-up period, Group 1 exhibited slight recurrence (follow-up angulation of group 1, $24^{\circ}{\pm}10^{\circ}$). Nonetheless, Group 2 showed adequate reduction state in both immediate postoperative and long-term follow-up periods (follow-up angulation of group 2, $18^{\circ}{\pm}6^{\circ}$). Conclusion: Extra-articular metacarpal fractures were successfully restored without functional complications. CR with parallel transverse pinning method exhibited recurrence after pin removal, which necessitates cautious postoperative exercise and monitoring.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.199-199
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• 2009

• Defense and Technology
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• no.2 s.264
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• pp.54-63
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• 2001

샤를마뉴가 발전시킨 군사 제도 중 핵심 요소는 국경의 요새화된 기지와 도시의 이용에 있었다. 이러한 것은 모든 정복된 지역들의 국경을 따라 구축되어, 국경을 따라 이어진 도로망에 의해 서로 연결되어 있었다. 여기에 추가하여 각각의 소도시들과 연결되는 이전의 국경에 직접적으로 연결되는 도로망이 있었다. 보급품을 저장한 이 요새들은 훈련된 프랑크 기병부대의 기동 기지가 되었고, 정복된 지역들에 질서를 유지하게 하였고, 차후의 작전을 구사하는 프랑크 군의 힘이 되었다.

• The Journal of the Korea Contents Association
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• v.9 no.12
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• pp.385-390
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• 2009

The Pneumatic Reduction and VCUG (Voiding Cystourethrography) are commonly used in the paediatric age group. The procedures had a particularly long fluroscopic screening time, despite a successful outcome for paediatric patients. Pneumatic Reduction and VCUG almost invariably requires fluoroscopic guidance which does confer a radiation dose. This article contains suggestions on how the radiation dose to paediatric patients from Pneumatic Reduction and VCUG can be made "as low as reasonably achievable" (ALARA). The aim of our study was eliminated in spot image applying the FluoroGrab, which has function of capturing an image of interest area from the picturing while fluoroscopic procedures. FluoroGrab has clinical value equivalent to the spot image, and is applied to the most recent fluoroscopic procedures. The radiologist and the radiographers should consider new option for decreasing the radiation exposure delivered to paediatric patients by making equipment modifications to the fluoroscopy to optimize radiation exposure reduction techniques. Thus, we propose the FluoroGrab instead of spot exposure for the reduction of patient exposure dose in paediatric, and try to confirm the effect of the mitigating amount of radiation exposure to paediatric patients when pneumatic reduction and VCUG. Fluorograb is the safe and useful method that shows the equivalent level of accuracy to spot exposure, and to minimize the radiation load to paediatric patients are to be the substitute for the spot exposure for Pneumatic Reduction and VCUG.

• Proceedings of the Korea Contents Association Conference
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• 2009.05a
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• pp.1167-1172
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• 2009

The Pneumatic Reduction and VCUG (Voiding Cystourethrography) are commonly used in the paediatric age group. The procedures had a particularly long fluroscopic screening time, despite a successful outcome for paediatric patients. Pneumatic Reduction and VCUG almost invariably requires fluoroscopic guidance which does confer a radiation dose. This article contains suggestions on how the radiation dose to paediatric patients from Pneumatic Reduction and VCUG can be made "as low as reasonably achievable" (ALARA). The aim of our study was eliminated in spot image applying the FluoroGrab, which has function of capturing an image of interest area from the picturing while fluoroscopic procedures. FluoroGrab has clinical value equivalent to the spot image, and is applied to the most recent fluoroscopic procedures. The radiologist and the radiographers should consider new option for decreasing the radiation exposure delivered to paediatric patients by making equipment modifications to the fluoroscopy to optimize radiation exposure reduction techniques. Thus, we propose the FluoroGrab instead of spot exposure for the reduction of patient exposure dose in paediatric, and try to confirm the effect of the mitigating amount of radiation exposure to paediatric patients when pneumatic reduction and VCUG. Fluorograb is the safe and useful method that shows the equivalent level of accuracy to spot exposure, and to minimize the radiation load to paediatric patients are to be the substitute for the spot exposure for Pneumatic Reduction and VCUG.