• 대한정형외과스포츠의학회지
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• 제8권1호
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• pp.13-18
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• 2009

목적: 원위부 이두박근 파열의 치료 결과를 보고하고자 한다. 대상 및 방법: 1987년 2월부터 2004년 3월까지 이두박근 원위부 파열로 치료를 받은 16명의 환자를 대상으로 하였다. 전례 남자였으며, 평균 연령은 33.9세였다. 9례(56%)에서는 수술적 치료를 시행하였다. 수술 시기는 수상 후 평균 4.7일이었다. 수술은 모두 파열된 원위부 이두박근을 해부학적으로 복원해주었다. 평가는 술 후 1년째에, 보존적인 치료를 시행 받았던 환자는 전화 인터뷰를 통하여 이두박근 근력, 환자의 만족도, 직업의 복귀 등에 대하여 조사하였다. 결과: 수술적인 치료를 시행 받았던 9례에서는 주관절의 굴곡-신전 운동범위와 회외-회내전 운동 범위는 각각 건측의 85.8%, 86.3%를 보였고, 이두박근 근력은 건측의 75%로 측정되었다. 주관적인 만족도는 8례에서 매우 만족, 1례에서 매우 불만족의 결과를 보였으며, 9례 중 8례는 예전의 직업으로 복귀하였다. 보존적 치료를 시행 받았던 예에서는 이두박근 근력은 수상 전 근력의 65%를 보였고, 환자의 주관적인 만족도는 4례에서 만족, 2례에서 불만족, 1례에서 매우 불만족의 결과를 보였다. 7례 중 3례에서만 기존의 직업으로 복귀할 수 있었다. 결론: 조기 해부학적 복원술은 이두박근의 근력과 주관절의 굴곡, 회외전 범위를 최대한 회복 시 킬 수 있는 효과적인 방법이다. 젊고 활동력이 높은 환자에서는 가급적 보존적 치료 보다는 수술적 치료를 시행해야만 한다.

• Clinical and Experimental Reproductive Medicine
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• 제31권4호
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• pp.273-277
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• 2004

Intramural pregnancy is an unusual ectopic gestation located within the uterine wall, completely surrounded by myometrium and separate from the uterine cavity, fallopian tube, or round ligament. It is known to be difficult to diagnose, and associated with a high rate of uterine rupture. We report a case of intramural pregnancy in which early diagnosis was made and successful treatment was done by dilatation and curettage. Diagnostic laparoscopy confirmed the absence of uterine rupture during the procedure. Therefore, conservation of fertility can be possible with early diagnosis of intramural pregnancy. To our knowledge, this is the first case report of intramural pregnancy following IVF-ET in Korea.

• 대한족부족관절학회지
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• 제10권1호
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• pp.37-41
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• 2006

Purpose: To investigate the early results of limited open repair technique of Achilles tendon ruptures, and to describe the surgical technique. Materials and Methods: From October 2004 to February 2005, a total of 10 patients with Achilles tendon rupture underwent limited open repair. The average age of the patients was 39.3 years, and the average follow-up period was 9 months. The causes of injury were sports injuries in 8 cases, and slip down in 2. The mean interval between the injury and the operation was 9 days. The clinical results were assessed by patient's satisfaction, incision length, hospitalization, the ankle-hindfoot scale of American Foot and Ankle Society (AOFAS), and complications. Results: Of 10 patients, 8 were very satisfied, and the remaining 2 were satisfied. The mean incision length was 2.0 cm, and the mean hospitalization was 2 days. The mean AOFAS score was 97 points, and there was no complications such as infection, rerupture, or nerve injury. All patients returned to work at approximately 2 months, and resumed light exercise such as jogging at approximately 3 months. Conclusion: Limited open repair technique of Achilles tendon ruptures is provided for better cosmetic results, high patient's satisfaction, and functionally successful results without postoperative complications.

• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1113-1120
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• 2000

Objectives : Despite advance in the surgical treatment of the intracranial aneurysm, we have to be surgical complication. The aim of this report is to evaluate the complication and its management in intracranial aneurysm operation. Methods : We reviewed our exprience with interesting cases of surgical complication of intracranial aneurysm : 1) rebleeding, 2) intra-operative premature rupture, 3) missed aneurysm in angiography, 4) vasospasm. Results : The risk of rebleeding was not related to the patients' initial comdition, but all other intracranial complications occurred significantly more often in patients graded poor compared with patients in good clinical condition. Rebleeding before early surgery remains as major cause of unfavorable outcome. The causes of intraoperative premature ruptures were as follows : 1) dural opening and arachnoid opening(8.3%), 2) hematoma removal(12.5%), 3) brain retraction(16.7%) 4) aneurysm dissection(62.5%). The double suction technique and primary hemostasis using a small piece of cotton or temporary clip resulted in good outcome even in cases with premature rupture. The incidence of missed aneurysm in angiography occurred in 10%. The causes were as thrombosed aneurysm, vasospasm on feeder artery. The most common missed aneurysm is also the most common aneurysm(anterior communicating artery aneurysm). The repeated angiography were documented in missed aneurysm. Balloon angioplasty is superior topapaverine for treatment of proximal vessel vasospasm by viture of a more sustained effect on the vessel. Papaverine can be useful as an adjunct to ballon angioplasty and also for the treatment of distal vessels that are not accessible for ballon angioplasty. Conclusion : The minimization of the complications and active treatment can reduced the mortality and morbidity of ruptured aneurysm patients.

• 대한족부족관절학회지
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• 제7권2호
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• pp.223-231
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• 2003

Purpose: Achilles tendon rupture has become more common in the recent years. As suture with foreign material has been blamed for impaired healing, better results should be expected from the use of autogenous material such as plantaris tendon. We have evaluated the surgical results of end-to-end anastomosis using the plantaris tendon as suture material. Materials and Methods: Between Jan 1997 and Jan 2002, the 60 patients were included this study during one year follow-up. We performed the operations with end-to-end suture technique using modified Lynn's method. The plantaris tendon has been used as a autogenous suture material and can be utilized in the end-to-end anastomosis of ruptured Achilles tendon with modifed Bunnel suture technique. We used a clinical scoring system reported by Leppilahti to evaluate the results. Results: The overall results were excellent in thirty eight(63.3%), good in sixteen(26.6%), fair in five(8.3%) cases, and poor in only one (1.6%) case. Fifty four cases(90%) had the score more than good. We had no deep infection, rerupture, deep vein thrombosis, and skin necrosis as major complication. In just 2 cases, although there were superficial skin infection, the wounds did not proceed necrosis due to using antibiotics. Conclusion: End-to-end anastomosis using the plantaris tendon as suture material was good treatment option that had low infection rate and no foreign body reaction because of using autogenous material, and therefore we can get rapid healing of ruptured tendon due to early ragne of motion and accerlerated rehabilitation.

• Archives of Plastic Surgery
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• 제36권5호
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• pp.667-669
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• 2009

Purpose: Radial and ulnar arteries are two major arteries responsible for the blood supply of the hand. We experienced early recurrent thrombosis of ulnar artery after arteriorrhaphy in a patient with rupture of ulnar and radial arteries due to glass injury. Thus, we thought this would require reviews. Method: 41 - year - old female patient was presented for the laceration of right wrist due to glass injury. Operative findings revealed the rupture of radial artery, ulnar artery, ulnar nerve and most of the flexor tendons. We performed three consecutive operations because of the recurrent arterial thrombosis in ulnar artery. Arteriorrhaphy was performed in each operation and the interpositional vein graft was performed in the final operation. Result: Consequently, doppler ultrasonography was performed on twentieth postoperative day and fair flow in the ulnar artery was visualized. Pathologic examination of the artery revealed no histopathologic abnormalities. Conclusion: It is not a matter of ease to follow up the patients with rupture of radial or ulnar arteries. Obstruction of the repaired artery is also not easy to detect because it usually presents no definite symptoms. We could detect the obstruction of the artery following arteriorrhaphy with the doppler ultrasonography in less than a week postoperatively, and repeated operations were followed. We reviewed the causes and factors affecting the thrombosis and hereby report with literature review.

• Journal of Chest Surgery
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• 제40권5호
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• pp.351-355
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• 2007

배경: 급성 심근경색증에 합병된 심실중격 결손은 내과적 치료만으로는 $85\sim90%$의 높은 사망률을 보이는 질환으로서, 본 병원에서의 외과적 치료 경험을 분석하였다. 대상 및 방법: 1996년 8월부터 2006년 8월 사이에 급성 심근경색증 후 합병된 심실중격 결손으로 수술적 치료를 시행한 11예를 대상으로 후향적으로 의무기록을 검토하였다. 남자가 4명, 여자가 7명이었으며 평균연령은 $70{\pm}11$ (범위, $50\sim84$)세였다. 심실중격 결손의 위치는 전중격 결손이 7예, 후중격 결손이 4예 있었다. 심실중격 결손은 급성 심근경색 후 $2.0{\pm}1.3$ (범위, $1\sim5$)일째에 발견되었으며 심실중격 결손의 진단 후 $2.4{\pm}2.7$ (범위, $0\sim8$)일째에 수술을 시행하였다. 모든 환자에서 수술전 심초음파와 관상동맥조영술을 시행하여 심실중격 결손의 위치, 심실 기능, 그리고 관상동맥 병변을 파악하였으며, 수술 전에 대동맥내 풍선 펌프를 삽입한 경우가 10예 있었다. 결과: 11예 모두에서 infarct exclusion 술식을 시행하였고, 8예에서는 관상동맥우회술을 함께 시행하였으며 평균 문합수는 $1.0{\pm}0.8$개였다. 수술 사망은 1예였으며 수술 후 초음파 소견에서 잔여 단락이 발견되었던 2예에서는 첩포의 누출에 대해 재수술을 시행하였다. 그 밖의 합병증으로는 일시적인 심방세동(7예), 발작성 심실상성빈맥(1예), 저심박출증(3예), 재수술이 필요했던 출혈(2예), 흉골 지연봉합(2예), 급성 신부전(2예), 폐렴(1예), 대동맥내 풍선펌프로 인한 혈전색전증(1예),수술 후 섬망(2예) 등이 있었다. 생존한 10명의 환자들 중 1명을 제외한 나머지 9명의 환자에서 $38{\pm}40$개월간의 추적관찰이 되었는데, 추적 관찰 기간 중에 3명이 사망하였고 생존한 6명의 환자는 모두 양호한 상태(NYHA 기능등급, $I{\sim}II$)를 보였으며, 그 중 3명에서는 혈역학적으로 큰 의미가 없는 잔여단락이 있었다. 결론: 급성 심근경색증 후 심실중격 결손은 수술위험도가 높은 질환이지만, 수술 전 대동맥내 풍선펌프를 삽입하고 조기에 심실중격 결손부의 infarct exclusion 술식과 함께 관상동맥우회술을 시행함으로써 만족할 만한 수술 및 중기 결과를 얻을 수 있었다.

• 대한수학교육학회지:수학교육학연구
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• 제18권4호
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• pp.469-482
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• 2008

본 연구에서는 무한 개념을 실무한적으로 파악하는 경우와 가무한적으로 파악하는 경우에 각각 부딪히게 되는 문제점들을 분석하였다. 또, 우리나라의 초등학교와 중학교 수학 교육과정에서 신중하지 못하게 실무한적 개념을 사용하고 있는 사례도 고찰하였다. 현대 수학에서 요구하는 실무한적 무한 개념의 학습을 위해서는 가무한적인 직관은 결국 단절해야 하는 인식론적 장애라고 할 수 있지만, 초기의 학교수학에서부터 그러한 단절을 요구하기에는 실무한 개념이 너무 비직관적이고 많은 패러독스를 유도하며 적절한 은유를 제공하지 못한다는 점이 문제가 된다.

• 한국원자력학회:학술대회논문집
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• 한국원자력학회 1997년도 추계학술발표회논문집(1)
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• pp.713-718
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• 1997

In the TMI-2 accident, approximately twenty(20) tons of molten core material drained into the lower plenum. Early advanced light water reactor (LWR) designs assumed a lower head failure and incorporated various measures for ex-vessel accident mitigation. However, one of the major findings from the TMI-2 Vessel Investigation Project was that one part of the reactor lower head wall estimated to have attained a temperature of 1100$^{\circ}C$ for about 30 minutes has seemingly experienced a comparatively rapid cooldown with no major threat to the vessel integrity. In this regard, recent empirical and analytical studies have shifted interests to such in-vessel retention designs or strategies as reactor cavity flooding, in-vessel flooding and engineered gap cooling of the vessel Accurate thermohydrodynamic and creep deformation modeling and rupture prediction are the key to the success in developing practically useful in-vessel accident/risk management strategies. As an advanced in-vessel design concept, this work presents the COrium Attack Syndrome Immunization Structures (COASIS) that are being developed as prospective in-vessel retention devices for a next-generation LWR in concert with existing ex-vessel management measures. Both the engineered gap structures in-vessel (COASISI) and ex-vessel (COASISO) are demonstrated to maintain effective heat transfer geometry during molten core debris attack when applied to the Korean Standard Nuclear Power Plant(KSNPP) reactor. The likelihood of lower head creep rupture during a severe accident is found to be significantly suppressed by the COASIS options.

• Journal of Gastric Cancer
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• 제13권1호
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• pp.65-68
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• 2013

Gastric carcinoma rarely presents as a perforation, but when it does, is perceived as advanced disease. The majority of such perforations are Stage III/IV disease. A T1 gastric carcinoma has never been reported to perforate spontaneously in English literature. We present a 56 year-old Chinese male who presented with a perforated gastric ulcer. Intra-operatively, there was no suspicion of malignancy. At operation, an open omental patch repair was performed. Post-operative endoscopy revealed a macroscopic Type 0~III tumour and from the ulcer edge biopsy was reported as adenocarcinoma. Subsequently, the patient underwent open subtotal gastrectomy and formal D2 lymphadenectomy. The final histopathology report confirms T1b N0 disease. The occurrence of a perforated early gastric cancer reemphasises the need for vigilance, including intra-operative frozen section and/or biopsy, as well as routine post-operative endoscopy for all patients.