• 대한관절경학회지
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• 제11권2호
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• pp.117-121
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• 2007

목적: 후방 십자 인대의 골편을 포함하지 않은 대퇴 부착 부 견열 손상에 대한 관절경적 일차 봉합술의 추시 결과를 보고한다. 대상 및 방법: 1993년 1월부터 2002년 12월까지 본원에서 관절경적 후방 십자 인대 봉합술을 시행한 13례 중 2년 이상 추시가 가능했던 10례를 대상으로 하였으며 평균 추시 기간은 $38.7{\pm}11$개월이었다. 평균 나이는 $28.2{\pm}6$세로 남자 8례, 여자 2례였다. 모든 예에서 최종 추시 시 Lysholm and Gillquist 점수 및 International Knee Documentation Committee(IKDC) criteria를 이용하여 평가 하였으며, 후방 전위 검사로 후방 불안정성을 평가하였으며, 후방 부하 측면 방사선 사진으로 경골의 후방 전위를 측정하였다. 결과: Lysholm and Gillquist 점수는 평균 $94.5{\pm}2.6$, International Knee Documentation Committee criteria에 따른 결과는 4례에서 A(normal), 6례에서 B(nearly normal)이었다. 후방 전위 검사 상 5례에서 grade I의 후방 불안정성을 보였으며, 5례에서 grade II의 후방 불안정성을 보였다. 후방 부하 측면 방사선 사진에서 경골의 후방 전위는 평균 $3{\pm}2.3mm$ 이었다. 결론: 후방 십자 인대의 골편을 포함하지 않은 대퇴 부착 부 견열 손상에 대한 관절경적 일차 봉합술은 후방 불안정성을 줄이고 기능적 회복을 향상시키기 위해 유용한 방법으로 사료된다.

• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.181-187
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• 2010

목적: 회전근 개 전층 중파열, 대파열 환자에 대하여 관절경적 교량형 봉합 술식을 시행한 후 임상 결과를 분석 보고하고자 하였다. 대상 및 방법: 2007년 11월부터 2008년 10월까지 회전근 개 전층 중파열, 대파열을 관절경적 교량형 봉합 술식으로 치료받은 90예를 대상으로 하였고, 평균 추시 기간은 15개월 (12~23개월)이었다. 파열의 크기는 중파열이 43예, 대파열이 47예였다. 술 전 및 최종 추시 시 KSS, ASES, UCLA, Visual Analogue Scale (VAS)를 이용한 기능평가를 시행하였다. 결과: 휴식 및 운동 시 평균 VAS 점수는 각각 수술 전 2.56, 6.94에서 최종 추시 시 0.96, 1.70으로 현저한 감소를 보였다. UCLA 점수는 수술 전 평균 17.08점에서 최종 추시 시 31.17점으로 향상되었으며, 최우수가 31예 (34%), 양호가 49예 (54%), 불량이 10예 (12%)였다. 최종 추시 시 60세 이하인 경우 31.47점, 61세 이상인 경우 30.69점이었으며 (p=0.344), 중파열인 경우 31.23점, 대파열인 경우 31.11점이었고 (p=0.924), 비외상군이 31.10점, 외상군이 31.23점이었다 (p=0.929). 결론: 회전근 개 전층 중파열, 대파열 환자에서 관절경적 교량형 봉합 술식을 시행하여 동통의 감소 및 견관절 기능 향상의 우수한 결과를 얻을 수 있어 믿을만한 수술적 방법 중 하나라고 생각한다. 수술 당시 연령, 외상력 유무는 치료 결과에 큰 영향을 주지 않았다.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.77-86
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• 2009

Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.

• 대한족부족관절학회지
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• 제17권3호
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• pp.196-202
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• 2013

Purpose: To report the clinical results from using absorbable suture materials instead of nonabsorbable materials which have been used more commonly to repair Achilles tendon. Materials and Methods: We retrospectively reviewed 21 cases of acute Achilles tendon rupture, treated surgically from 2004 to 2011. Mean follow-up period is 6 months. We repaired Achilles tendon using size 1 Vicryl (Polyglactin 910, Ethicon) for core suture and size 3-0 Vicryl for epitendinous suture. At three months after surgery, we evaluated clinical results with single heel raise height by centimeters, differences of calf circumference and passive range of motion of ankle joint, compared to contralateral side. Also we recorded clinical results with subjective satisfaction grades. Results: At three months after surgery, 20 of 21 patients were able to perform single heel raise over 5 cm in height. Calf circumference differences were less than 1 cm in 12 cases, between 1 cm to 3 cm in 5 cases, more than 3 cm in 4 cases. There was no difference in range of passive motion in 19 cases. All patients satisfied with daily activity except 2 cases with mild discomfort. There was no complication such as rerupture, elongation or infection. Conclusion: We experienced excellent clinical results from repairing Achilles tendon with using absorbable suture materials in terms of functional outcomes and patient's satisfaction without any complication. So we may consider using absorbable suture materials instead of nonabsorbable materials to repair Achilles tendon.

• Clinics in Shoulder and Elbow
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• 제5권2호
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• pp.110-117
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• 2002

Purpose: We compared the results of open and arthroscopic Bankart repair in traumatic recurrent anterior dislocation ,3f the shoulder. Materials and methods: We analysed 7 cases underwent open Bankart repair (group I) and 13 cases underwent arthroscopic Bankart repair (group Ⅱ). The average follow-up period was 68.1 months (51-113 months) in group I and 41.1 months (16~57 months) in group Ⅱ. All patients in group I and Ⅱ were non-athletes. We analyzed statistically objective evaluation, such as the stability of shoulder joint, the range of motion, pain, impaired throwing, Bankart rating system by Rowe and subjective evaluation, visual analog scale (VAS) between two groups. Results: In terms of dominant and non-dominant shoulders, the age at initial episode of dislocation, the elapsed time from injury to surgery, the number of preoperative dislocations associated with susceptibility to apprehension. respectively, there was no statistically significant differences between two groups. In group I the average Rowe's scortls was 84.3 and 3 cases (43%) had excellent results,4 cases (S7cfo), good ones. In group H the average Rowe's scores was 87.3 and 7 cases (54%) had excellent results,6 cases, good ones. There was tendency to show more excellent results in group ll, but there was no statistically significant differences. The average VAS were 90.3 points in group I and 88 points in group Ⅱ, which showed also no statistically significant differences. Conclusion: Open and arthroscopic Bankart repairs had no significant difference and showed also good results in travinatic recurrent anterior dislocation of shoulder.

• Archives of Plastic Surgery
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• 제33권6호
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• pp.780-783
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• 2006

Purpose: Rupture of a collateral ligament of the metacarpophalangeal joint is rare except in the thumb. The injured digit became flexed and deviated toward ulna side by the hypothenar intrinsic musculature. Incomplete rupture of a collateral ligament of the metacarpophalangeal joint can be often managed by splinting the affected digit in flexion position, however, in the case of complete tears that distraction of the ends of the ruptured collateral ligament is too great to allow repositioning by splinting. Primary repair of the ruptured collateral ligament or reattachment to bone by a pull-out wire, or tendon graft technique appears to be adequate. Methods: We report a case of instability of fifth metacarpophalangeal joint due to complete rupture of radial collateral ligament. This 18-year-old male presented pain in his right outstretched hand after trauma. The diagnosis was obtained by physical examination and simple radiography. Because of persistent instability after the initial conservative treatment, open reduction and repair surgical treatment was required. Results: The fifth metacarpophalangeal joint became free of pain and stable under forced lateral deviation. Postoperative results showed good metacarpophalangeal joint function and stability during 8 months follow-up period. Conclusion: Because of the interposition of the sagittal band between the ruptured ends of radial collateral ligament such as Stener-like lesion of the thumb, surgical repair of metacarpophalangeal joint collateral ligament of the finger was justified in case of complete laxity in full flexion.

• Journal of Chest Surgery
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• 제29권7호
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• pp.759-762
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• 1996

충남대학교 병원 흉부외과에서 1985년 6월부터 1995년 10월까지 식도 천공 15례를 경험하였다. 남녀 비는 9 대 6 이 었으며, 연령 분포는 19세 에서 71세 (평균 49세)까지 였다. 식도 천공 원인은 다양하여, 특 발성 및 식도이물 섭취로, 천공된 례가 각각 4례, 기구 조작에 의한 경우 3례, 흉부 둔상 1례, 약물(클로 르칸키) 섭 취 1례, 기관 절개술시 식도 손상 1례, 원인 불명의 천공 1례가 있었다. 천공 부위는 흉부 식도 9례, 경부 식도 6례 였다. 증상은 동통 11례, 발열 9례, 연하 곤란 Bfl, 호흡 곤란 5례 등이었다. 수술은 경 부 식도 천공의 경우 절개 및 배액술, 단순 봉합, 위루술등, 흉부 식도 천공의 경우 단순 봉합, 단순 봉합 및 흥막 보강술, 위루술 등을 시행하였다 1례가 사망하였으며, 사인은 패혈증이 었다.

• Journal of Chest Surgery
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• 제49권2호
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• pp.73-79
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• 2016

Background: The aim of this study was to report our early experiences with the endovascular repair of ruptured descending thoracic aortic aneurysms (rDTAAs), which are a rare and life-threatening condition. Methods: Among 42 patients who underwent thoracic endovascular aortic repair (TEVAR) between October 2010 and September 2015, five patients (11.9%) suffered an rDTAA. Results: The mean age was $72.4{\pm}5.1years$, and all patients were male. Hemoptysis and hemothorax were present in three (60%) and two (40%) patients, respectively. Hypovolemic shock was noted in three patients who underwent emergency operations. A hybrid operation was performed in three patients. The mean operative time was $269.8{\pm}72.3minutes$. The mean total length of aortic coverage was $186.0{\pm}49.2mm$. No 30-day mortality occurred. Stroke, delirium, and atrial fibrillation were observed in one patient each. Paraplegia did not occur. Endoleak was found in two patients (40%), one of whom underwent an early and successful reintervention. During the mean follow-up period of $16.8{\pm}14.8months$, two patients died; one cause of death was a persistent type 1 endoleak and the other cause was unknown. Conclusion: TEVAR for rDTAA was associated with favorable early mortality and morbidity outcomes. However, early reintervention should be considered if persistent endoleak occurs.

• Advances in pediatric surgery
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• 제20권1호
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• pp.7-11
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• 2014

The present study compared the postoperative analgesic effects of ilioinguinal and iliohypogastric nerve block with infiltration of local anesthetics (bupivacaine) into the wound in children after inguinal hernia repair. Ninety children below 7 years old who were scheduled elective inguinal hernia repair were randomly allocated into one of three groups. The patients in nerve block (NB) group, ilioinguinal and iliohypogastric nerve block was done with 0.5 mL/kg of 0.25% bupivacaine. The patients in infiltration of local anesthetics (LI) group, 0.5 mL/kg of 0.25% bupivacaine was infiltrated into the wound after surgery. The patients in control group were allocated as a Control group. Postoperative pain was assessed at 1, 3, 5, and 24 hours after operation with FLACC scale and additional analgesic consumption were counted. The three groups were not significantly different in age, sex, body weight, and duration of operation. Pain scores at 1 hour and 3 hours after operation were significantly higher in Control group than in NB group and LI group (p<0.01), whereas there were no difference between NB group and LI group. The rescue analgesics administration was significantly higher in Control group (n=11) than in NB group (n=6) and LI group (n=7) (p<0.05). There were 2 cases of transient femoral nerve palsy in NB group. Both of ilioinguinal and iliohypogastric nerve block and infiltration of local anesthetics into the wound provided effective postoperative analgesia in early postoperative period following inguinal hernia repair in children. But no difference between the two methods. Technically, infiltration of local anesthetics into the wound was easier and safer than ilioinguinal and iliohypogastric nerve block.

• 한국건축시공학회지
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• 제16권5호
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• pp.455-461
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• 2016

대형구조물이나 고층 건물에 승강기는 필요적임에도 불구하고 승강기 사고가 꾸준히 보고되고 있다. 이러한 승강기 사고가 사소하면 재난안전본부에서 처리되고 있으나 중대한 사고가 아닐 경우 안전공단에 보고되지 않아 누적되지 않고 있다. 또한 승강기의 부품교체나 수리시에는 이용자가 비용을 부담하는 유지관리항목에 포함되는 것인지 아니면 소유자가 비용을 부담하는 장기수선대상항목에 포함되는 것인지와 관련하여 갈등요인이 되고 있다. 그러나 승강기 사고 수는 줄어들지 않고 있고, 승강기 보수비용과 관련한 갈등은 점점 심각해지고 있다. 그러므로 승강기의 사고나 고장을 감소시키고 승강기의 운행중단을 줄이며 승강기 소유자와 사용자간의 갈등을 줄일 필요가 있다.따라서 본 연구에서는 승강기 하자보수책임기간중에 하자보수처리절차, 승강기의 고장이나 사고가 발생시 통지절차, 승강기 유지관리계약서 작성방향, 승강기검사의 공정성 담보방향을 제시하였다.