• 대한관절경학회지
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• 제16권1호
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• pp.17-25
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• 2012

목적: 급성 전방십자인대 손상 환자의 자기공명영상(magnetic resonance imaging, MRI)에서 나타난 골멍의 형태 및 크기와 전방십자인대의 손상 정도와의 관계를 알아보고 골멍의 발자취(footprint)를 조사해 손상기전을 알아보고자 하였다. 대상 및 방법: 급성 전방십자인대 손상 6주 이내의 급성기에 자기공명영상을 촬영하여 골멍이 나타나는 65명을 대상으로 하였다. 골멍의 형태는 Costa-Paz 분류에 따라, 골멍의 크기는 Kornaat의 방식으로 측정하였다. 자기공명영상의 전방십자인대 관상사면영상(anterior cruciate ligament [ACL] oblique coronal view)에서 손상 정도를 등급화 하였다. 결과: Costa-Paz 분류에 따른 대퇴골 외과의 골멍 형태와 전방십자인대 손상 정도의 관계를 알아본 결과, 부분 파열군(1, 2 등급)에서 제2형이 많고, 완전 파열군(3 등급)에서 제3형이 많았다(P=0.037). Kornaat 총 골멍 점수는 전방십자인대 손상 등급에 따라 차이를 보였으며(P=0.014), 손상기전은 축회전 손상(pivot shift injury)이 가장 많았고 편타 외반 손상 (clip valgus injury) 등이 뒤를 이었다. 결론: 급성 전방십자인대 손상 시 골멍의 형태와 크기는 전방십자인대의 손상 정도와 관련이 있었고, 골멍의 발자취를 통해 손상기전을 유추할 수 있어 급성 전방십자인대 손상의 진단 및 치료에 도움이 되리라 사료된다.

• 한국융합학회논문지
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• 제11권10호
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• pp.125-131
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• 2020

본 연구는 엘리트 유소년 태권도 선수들을 대상으로 골절 발생 위험을 감소시키고, 골다공증의 조기진단을 평가하는 지표로 사용되는 골밀도와 운동 수행능력을 판단하는 지표인 심폐기능, 그리고 선수들에게 최대의 적인 스포츠 손상과의 관계를 알아보고자 하였다. 골밀도와 심폐기능 그리고 스포츠 손상 간의 관계를 알아보기 위해 Pearson 상관관계 분석을 시행하였다. 또한, 골밀도가 심폐기능 및 스포츠 손상에 미치는 영향을 알아보기 위해 단순 선형회귀 분석을 시행하였다. 골밀도는 환기량(r=.388) 및 최대산소 능력(r=.478) 그리고 스포츠 손상과 상관관계가 있었다(r=-.292). 또한, 골밀도가 .002, 및 .006씩 증가하면 환기(p=.001) 및 최대 산소능력은(p=.006) 1씩 높아진다. 또한, 골밀도가 .016씩 감소하면, 스포츠 손상의 발생이 1씩 증가한다(p=.044). 선수들의 골밀도 향상으로 스포츠 손상을 예방할 수 있으며, 향후 스포츠 손상 예방 프로그램으로 활용할 수 있을 것이다.

• 대한기관식도과학회지
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• 제14권1호
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• pp.42-45
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• 2008

Tracheal injury associated with esophageal injury due to fish bone is very rare. Also, treatment of mediastinitis due to esophageal perforation when it is diagnosed late remains controversial. We report the case that we have successfully experienced treatment of mediastinitis due to tracheal and esophageal injury by fish bone.

• Experimental and Molecular Medicine
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• 제50권12호
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• pp.3.1-3.14
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• 2018

Type 1 diabetes mellitus (T1DM) is a pathological condition associated with osteopenia. $WNT/{\beta}$-catenin signaling is implicated in this process. Trabecular and cortical bone respond differently to $WNT/{\beta}$-catenin signaling in healthy mice. We investigated whether this signaling has different effects on trabecular and cortical bone in T1DM. We first established a streptozotocin-induced T1DM mouse model and then constitutively activated ${\beta}$-catenin in osteoblasts in the setting of T1DM (T1-CA). The extent of bone loss was greater in trabecular bone than that in cortical bone in T1DM mice, and this difference was consistent with the reduction in the expression of ${\beta}$-catenin signaling in the two bone compartments. Further experiments demonstrated that in T1DM mice, trabecular bone showed lower levels of insulin-like growth factor-1 receptor (IGF-1R) than the levels in cortical bone, leading to lower $WNT/{\beta}$-catenin signaling activity through the inhibition of the IGF-1R/Akt/glycogen synthase kinase $3{\beta}$ ($GSK3{\beta}$) pathway. After ${\beta}$-catenin was activated in T1-CA mice, the bone mass and bone strength increased to substantially greater extents in trabecular bone than those in cortical bone. In addition, the cortical bone of the T1-CA mice displayed an unexpected increase in bone porosity, with increased bone resorption. The downregulated expression of WNT16 might be responsible for these cortical bone changes. In conclusion, we found that although the activation of $WNT/{\beta}$-catenin signaling increased the trabecular bone mass and bone strength in T1DM mice, it also increased the cortical bone porosity, impairing the bone strength. These findings should be considered in the future treatment of T1DM-related osteopenia.

• Journal of Trauma and Injury
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• 제20권2호
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• pp.90-95
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• 2007

Purpose: This research was conducted to study whether the specific location of pelvic-bone fractures could increase the risk for injury to the urinary bladder, urethra, or lower gastrointestinal tract. Methods: We retrospectively reviewed the data of 234 patients with pelvic-bone fractures who visited the emergency department of Kyungpook National University Hospital from January 2004 to December 2006. The location of the pelvic-bone fracture was divided into 8 parts. The association of fracture location with injury to the urinary bladder, urethra, or lower gastrointestinal tract was analyzed with Fisher' s-exact test and multiple logistic regression. Results: Nineteen(19) patients had urinary bladder injury, 8 had urethral injury, and 9 had lower gastrointestinal tract injury. The following fracture locations were found to be significant; urinary bladder: sacroiliac (SI) joint (p<0.001), symphysis pubis (p=0.011), and sacrum (p=0.005); urethra: SI joint (p=0.020); lower gastrointestinal tract: symphysis pubis (p=0.028). After the multiple logistic regression analysis, the primary and the independent predictors for each of the injuries were as follows; urinary bladder: sacroiliac joint (p=0.000, odds ratio [OR]=10.469); lower gastrointestinal tract: symphysis pubis (p=0.037, OR=7.009). Conclusion: Consideration of further workup for injuries to the lower gastrointestinal and urinary tract is needed for some locations of pelvic-bone fractures because certain pelvic-bone fracture locations, especially the sacroiliac joint and the symphysis pubis, are associated with increased risk for injury to the lower gastrointestinal and urinary tracts.

• Clinics in Shoulder and Elbow
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• 제26권2호
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• pp.131-139
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• 2023

Background: Massive rotator cuff tears (RCTs) are complicated by muscle atrophy, fibrosis, and intramuscular fatty degeneration, which are associated with postoperative tendon-to-bone healing failure and poor clinical outcomes. We evaluated muscle and enthesis changes in large tears with or without suprascapular nerve (SN) injury in a rat model. Methods: Sixty-two adult Sprague-Dawley rats were divided into SN injury (+) and SN injury (-) groups (n=31 each), comprising tendon (supraspinatus [SSP]/infraspinatus [ISP]) and nerve resection and tendon resection only cases, respectively. Muscle weight measurement, histological evaluation, and biomechanical testing were performed 4, 8, and 12 weeks postoperatively. Ultrastructural analysis with block face imaging was performed 8 weeks postoperatively. Results: SSP/ISP muscles in the SN injury (+) group appeared atrophic, with increased fatty tissue and decreased muscle weight, compared to those in the control and SN injury (-) groups. Immunoreactivity was only positive in the SN injury (+) group. Myofibril arrangement irregularity and mitochondrial swelling severity, along with number of fatty cells, were higher in the SN injury (+) group than in the SN injury (-) group. The bone-tendon junction enthesis was firm in the SN injury (-) group; this was atrophic and thinner in the SN injury (+) group, with decreased cell density and immature fibrocartilage. Mechanically, the tendon-bone insertion was significantly weaker in the SN injury (+) group than in the control and SN injury (+) groups. Conclusions: In clinical settings, SN injury may cause severe fatty changes and inhibition of postoperative tendon healing in large RCTs. Level of evidence: Level Basic research, controlled laboratory study.

• Investigative Magnetic Resonance Imaging
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• 제25권2호
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• pp.93-100
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• 2021

Purpose: (1) To evaluate the trabecular pattern at the femoral attachment of the posterior cruciate ligament (PCL) in patients with a PCL injury; (2) to analyze bone microarchitecture by applying gray level co-occurrence matrix (GLCM)-based texture analysis; and (3) to determine if there is a significant relationship between bone microarchitecture and posterior instability. Materials and Methods: The study included 96 patients with PCL tears. Trabecular patterns were evaluated on T2-weighted MRI qualitatively, and were evaluated by GLCM texture analysis quantitatively. The grades of posterior drawer test (PDT) and the degrees of posterior displacement on stress radiographs were recorded. The 96 patients were classified into two groups: acute and chronic injury. And 27 patients with no PCL injury were enrolled for control. Pearson's correlation coefficient and one-way ANOVA with Bonferroni test were conducted for statistical analyses. This protocol was approved by the Institutional Review Board. Results: A thick and anisotropic trabecular bone pattern was apparent in normal or acute injury (n = 57/61;93.4%), but was not prominent in chronic injury and posterior instability (n = 31/35;88.6%). Grades of PDT and degrees of posterior displacement on stress radiograph were not correlated with texture parameters. However, the texture analysis parameters of chronic injury were significantly different from those of acute injury and control groups (P < 0.05). Conclusion: The trabecular pattern and texture analysis parameters are useful in predicting posterior instability in patients with PCL injury. Evaluation of the bone microarchitecture resulting from altered biomechanics could advance the understanding of PCL function and improve the detection of PCL injury.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권2호
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• pp.155-162
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• 2001

This is a clinical study on patients who had visitied the Emergency Room of Pusan National University Hospital and then been treated in the Department of Oral and Maxillofacial Surgery during recent 5 years, from 1992 to 1996. The results were as follow ; 1. The total number of patients was 2,680 and the ratio of male to female was 1.96:1, The highest monthly incidence was shown in September(12.1%) and October(10.5%) and the age distribution peaks was the third decade(24.3%), followed by the first(23.1%) and the fourth decade(17.2%). 2. Soft tissue injury group(29.1%) was the most prevalent, followed by tooth injury group(16.1%), facial bone injury group (16.0%), toothache group(11.2%), socket bleeding group(11.1%), infection group(9.8%) and TMJ dislocation group(5.9%). 3. The percentage of in-patients and out-patient were 21.6% and 78.4%, respectively. The frequent causes of admission were facial bone fracture(73.8%), infection(20.8%) and soft tissue injury(4.8%) in order. However, soft tissue injury was the most frequent cause in out-patient, followed by tooth injury(20.5%), toothache(14.3%), socket bleeding(14.2%) and TMJ dislocation(7.6%). 4. In the facial bone injury group, the mandibular fractures(70.6%) showed the highest incidence, followed by zygomatic bone and arch fractures(7.5%), maxillary bone fractures(4.0%) and nasal bone fractures(4.0%). 5. In the mandibular bone fracture, the most common location was symphysis(36.7%), followed by the mandibular angles(33.1%) and the condyles(21.8%). 6. The common causes of facial bone fractures were violence, fall and traffic accident in order. 7. The common causes of soft tissue injury were fall down, fight and traffic accident in order and the highest incidence was observed in infants before the age of 10 years(44.0%). 8. In the group of tooth injury, tooth luxation(38.5%) showed the highest incidence followed by tooth fracture(33.2%) and tooth loss(17.1%). The common causes of tooth injury were fall, fight and traffic accident in order. 9. In infected patients group, the ratio of in-patients to out-patients was 1 : 1.28, Buccal(24,7%) and infraorbital space abscess(23.3%) showed the highest incidence. 10. The pain caused by dental caries(39.0%) and pericoronitis(26.6%) showed high incidence in the toothache group. 11. The high incidence was observed during third(34.0%) and fourth (24.5%) decades in TMJ dislocation group. 12. In the group of socket bleeding patients, 92% was post-operative hemorrhage and 8% was accompanied with other systemic hemorrhagic diseases.

• Archives of Reconstructive Microsurgery
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• 제3권1호
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• pp.81-89
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• 1994

Firstly the wrap-around free flap from the great toe was transferred successfully by Morrison and O'Brien in 1980 for reconstruction in chronic case of amputated thumb distal to the MP joint. Since then, significant bone peg resorption and grafted bone fracture have been reported in most of cases after operation. We have performed thumb reconstructions within 2 weeks after injury in 11 cases which included acute crushing injuries or failed replantation of thumb at Guro Hospital from September, 1983 to October, 1993. The results obtained from this study are as follows: 1. There were 8 males and 3 females and the mean age was 28.8 years old ranged from 3 years old to 50 years old. 2. The most common injury mechanism was machinary injury in 10 of 11 cases. 3. We have performed thumb reconstructions by using wrap-around free flap from the great toe without bone graft in 6 cases and with bone graft in 5 cases within 2 weeks after injury. 4. During 6 years and 1 month mean follow-up period, there were bone resorptions in 3, grafted bone fracture in 1, infections in 2 and soft tissue necrosis in 3 cases. 5. We obtained satisfactable results in respect of function and cosmesis and urged to use this flap for reconstruction in acute thumb injury.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.57-62
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• 2010

Purpose: This study analyzed the characteristics of stable pelvic bone fractures with intra-abdominal solid organ injury. Methods: Medical records were retrospectively reviewed from January 2000 to December 2009 of patients with stable pelvic bone fractures. A stable pelvic bone fracture according to Young's classification is defined as a lateral compression type I and antero-posterior compression type I. Subjects were divided into two groups, one with (injured group) and one without (non-injured group) intra-abdominal solid organ injury, to evaluate the dependences of the characteristics on the presence of an intra-abdominal solid organ injury. Data including demographics, mechanism of injury, initial hemodynamic status, laboratory results, Revised Trauma Score (RTS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), amount of transfusion, admission to intensive care unit (ICU), and mortality were analyzed. Results: The subjects were 128 patients with a mean age of 42 years old, of whom were 67 male patients (52.3%). The injured group had 21 patients(16.4%), and the most frequent injured solid organ was the liver. Traffic accident was the most common mechanism of injury and lateral compression was the most common type of fracture in all groups. Initial systolic blood pressure was lower in the injured group, and the ISS was greater in the injured group. Arterial pH was lower in the injured group, and shock within 24 hours after arrival at the emergency department was more frequent in the injured group. Transfused packed red blood cells within 24 hours were 8 patients(38.1%) in the injured group and 11 patients(10.3%) in the non-injured group. Conservative treatment was the most common therapeutic modality in all groups. Stay in the ICU was longer in the injured group, and three mortalities occurred. Conclusion: There is a need to decide on a diagnostic and therapeutic plan regarding the possibility of intra-abdominal solid organ injury for hemodynamically unstable patients with stable pelvic bone fractures and for patients with stable pelvic bone fractures along with multiple associated injuries.