• 한국임상수의학회지
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• 제25권5호
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• pp.415-419
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• 2008

The purpose of this study was to determine clinical features of canine episcleritis and outcomes of therapy in Korea. The medical records of dogs with episcleritis presented at the Veterinary Medical Teaching Hospital of Seoul National University from January 2006 to December 2007 were reviewed. Episcleritis was diagnosed in 17 eyes of 12 dogs. The most frequently affected breed was Shih Tzu (n = 6). The median affected age was 5 years with a range from 3 years to 12 years. Simple episcleritis was identified in 8 dogs, nodular granulomatous episcleritis (NGE) in 3 dogs, and secondary episcleritis caused by panophthalmitis in a dog. The combination immunosuppressive therapy of topical corticosteroids, topical cyclosporine A, and intralesional injection of triamcinolone (4 mg) and gentamicin (4 mg) was performed. Most of the patients with episcleritis were resolved within 30 days following the therapy. Surgical excision was performed in 1 NGE case which was not responded to the medical therapy. Recurrence was observed in 4 dogs between 5 and 8 months after the first visit. It is considered that strong immunosuppressive therapy and periodic ocular examination are needed to control episcleritis.

• 대한족부족관절학회지
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• 제16권4호
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• pp.247-256
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• 2012

Purpose: This study was performed to evaluate the clinical outcomes of operative treatment using mini-open sinus tarsi approach for displaced intraarticular calcaneal fractures. Materials and Methods: We studied 18 cases (16 patients) of intraarticular calcaneal fractures who were treated with sinus tarsi approach by same surgeon. The mean age of patients was 44.8 years, and mean follow-up period was 17.2 months. The measurement of B$\ddot{o}$hler angle, Gissane angle, the degree of articular surface depression, and the period to union were performed through preoperative and postoperative radiographs. The clinical evaluation was performed according to hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and scale of the Creighton-Nebraska health foundation (CNHF). Results: B$\ddot{o}$hler angle and Gissane angle had improved significantly from preoperative average $9.8^{\circ}$, $117.6^{\circ}$to average $22.4^{\circ}$, $113.4^{\circ}$ immediate postoperatively, and had maintained to average $21.8^{\circ}$and $114.2^{\circ}$ at the last follow-up. The degree of articular surface depression had improved significantly from preoperative average 5.2 mm to 1.2 mm at the last follow-up. All cases achieved bone union, and the period to union was average 10.5 weeks. AOFAS score was average 86.2 points at the last follow-up. There were 7 excellent, 9 good, and 2 fair results according to the CNHF scale. Therefore, 16 cases (88.8%) achieved satisfactory results. Conclusion: The minimally invasive sinus tarsi approach using headless compression screw seems to be an effective surgical method for displaced intraarticular calcaneal fractures, because of the possibility of accurate restoration of articular surface and the low risk of postoperative soft tissue complications.

• 대한족부족관절학회지
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• 제16권4호
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• pp.229-234
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• 2012

Purpose: The purpose of this study is to find out clinical and radiological outcomes in 70 patients of both calcaneal fracture. Materials and Methods: From March 1993 to March 2011, 70 patients underwent non-operative management or operative management at our hospital. Conservative management was performed in 15 cases of undisplaced fracture (Group A). Operative management was performed in 125 cases including 32 cases of undisplaced fracture (Group B), 60 cases of joint depression type fracture (Group C), 33 cases of tongue type fracture (Group D). Results were evaluated by VAS score, AOFAS score, circle draw test, Bohler angle (BA), Gissane angle, width & height of calcaneus. Results: VAS scores were 2.0 in group A, 2.0 in group B, 2.2 in group C, 2.7 in group D. AOFAS scores were 90.4 in group A, 91.9 in group B, 72.2 in group C, 79.2 in group D. Circle draw tests were 8.4 cm in group A, 10.1 cm in group B, 7.6 cm in group C, 7.9 cm in group D. Bohler angles (BA) and Gissane angles were $19.1^{\circ}$, $96.7^{\circ}$ in group A, $21.8^{\circ}$, $119.1^{\circ}$ in group B, $26.3^{\circ}$, $121.2^{\circ}$ in group C, $19.7^{\circ}$, $119.7^{\circ}$ in group D. Calcaneal widths and heights were 39.5 mm, 31.6 mm in group A, 32.7 mm, 37.0 mm in group B, 34.4 mm, 39.2 mm in group C, 35.2 mm, 38.7 mm in group D. Conclusion: The main cause of bilateral calcaneal fracture is an injury from a fall, and the cases were more frequently occurred in men than women. Also the fracture in the right side tend to occur more severely compared to the left side. The surgical treatment shows better results than conservative treatment in bilateral calcaneal fracture.

• 대한족부족관절학회지
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• 제23권4호
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• pp.166-172
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• 2019

Purpose: This study evaluated the clinical and radiological results after reinforcement of the weakened medial joint capsule using Internal Brace (Arthrex) for treating severe hallux valgus. Materials and Methods: This study reviewed 56 cases of 50 patients that were followed-up postoperatively for at least 12 months, from September 2017 until August 2018. An extended distal chevron osteotomy combined with a distal soft-tissue release was performed by a single surgeon to treat severe hallux valgus. Internal Brace was applied in 12 cases (group A) who had weakened medial joint capsules, and capsulorrhaphy was performed in 44 cases (group B), and these two groups were compared postoperatively for the clinical and radiological results. The postoperative complications were also investigated. Results: No significant differences at 1-year follow-up on the Manchester-Oxford Foot Questionnaire and the patients' satisfaction scores were found between the two groups (p=0.905 and p=0.668, respectively). For the radiology, the changes of the values between before surgery and at 1-year follow-up according to the group showed no significant differences in the hallux valgus angle, intermetatarsal angle, and the hallux interphalangeal angle (p=0.986, p=0.516, p=0.754, respectively). Recurrence of hallux valgus was reported in two cases in group A, and in three cases in group B. Transfer metatarsalgia occurred in 4 cases in group B. Conclusion: Based on these results, we recommend the capsule reinforcing technique using Internal Brace as a successful operative option for treating a weakened medial capsule in patients with severe hallux valgus.

• 대한족부족관절학회지
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• 제23권4호
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• pp.159-165
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• 2019

Purpose: This study investigated the recurrence rate after performing hallux valgus correction using scarf and Akin osteotomy, and also identified the correlation and cut-off values of both the preoperative and postoperative radiographic parameters as risk factors for the recurrence of hallux valgus. Materials and Methods: We reviewed 87 hallux valgus patients (122 feet) who received scarf and Akin osteotomy from January 2007 to August 2015. The clinical outcomes were evaluated using the visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) scores. The radiological outcome measures included the hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) as determined on the serial weight bearing radiographs. Recurrence was defined as more than 20 degrees of HVA noted on the final follow-up radiograph. Those radiological factors associated with recurrence were evaluated and analyzed. Results: The mean follow-up duration was 20.6 months (12.0~46.5 months) and the mean age was 44 years (13~80 years). The VAS and AOFAS scores were significantly improved at the time of the final follow-up (7.0 to 2.0, p<0.001; 78.0 to 92.0, p<0.001; respectively). Significant corrections in the HVA, IMA, and DMAA were obtained (p<0.001). Eleven (9.0%: 11/122) cases experienced recurrent hallux valgus deformity. The postoperative IMA, DMAA and HVA showed significant moderate to strong correlation with HVA at the final follow-up (Pearson correlation coefficient: 0.44, 0.70, and 0.88, respectively; p<0.001). Postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees showed statistically significant correlation with radiological recurrence at the last follow-up, and the odds ratio of each variable was high in order. Conclusion: Our radiographic results indicated that postoperative HVA>16.7 degrees, postoperative DMAA>13.9 degrees, and postoperative IMA>8.2 degrees can be risk factors for hallux valgus recurrence. These risk factors may be helpful for modifying surgical procedures and preventing the recurrence of hallux valgus.

• Journal of Periodontal and Implant Science
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• 제38권2호
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• pp.153-162
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• 2008

Purpose: Recombining bone morphogenetic protein (BMP) is usually acquiredfrom high level animals. Though this method is effective, its high cost limits its use. The purpose of this study was to evaluate the effect of bone morphogenetic protein-2 with protein transduction domain (BMP-2/PTD;TATBMP-2) on bone regeneration. Rat calvarial defect model and osteoblastic differentiation model using MC3T3 cell were used for the purpose of the study. Materials and Methods: MC3T3 cells were cultured until they reached a confluence stage. The cells were treated with 0, 0.1, 1, 10, 100, 500 ng/ml of BMP-2/PTD for 21 days and at the end of the treatment, osteoblastic differentiation was evaluated usingvon Kossa staining. An 8mm, calvarial, critical-size osteotomy defect was created in each of 48 male Spraque-Dawley rats (weight $250{\sim}300\;g$). Three groups of 16 animals each received either BMP-2/PTD (0.05mg/ml) in a collagen carrier, collagen only, or negative surgical control. And each group was divided into 2 and 8 weeks healing intervals. The groups were evaluated by histologic analysis(8 animals/group/healing intervals) Result: In osteoblastic differentiation evaluation test, a stimulatory effect of BMP-2/PTD was observed in 10ng/ml of BMP-2/PTD with no observation of dose-dependent manner. The BMP-2/PTD group showed enhanced local bone formation in the rat calvarial defect at 2 weeks. New bone was observed at the defect margin and central area of the defect. However, new bone formation was observed only in 50% of animals used for 2weeks. In addition, there was no new bone formation observed at 8 weeks. Conclusion: The results of the present study indicated that BMP-2/PTD(TATBMP-2) have an positive effect on the bone formation in vitro and in vivo. However, further study should be conducted for the reproducibility of the outcomes.

• 대한골관절종양학회지
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• 제12권2호
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• pp.112-117
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• 2006

목적: 본 연구에서는 골 종양의 발생 부위 중 비교적 드문 부위인 비골에서 원발하는 골 종양의 종류와 그 치료 후 경과에 대하여 연구하고자 하였다. 대상 및 방법: 1993년 1월 1일부터 2005년 12월 31일까지 하지의 골종양을 진단 받고 수술적 치료를 받은 환자 중 비골의 원발성 골종양 환자에 대하여 조사하여 그 임상적 결과를 조사하였다. 결과: 상기 기간에 비골의 원발성 골종양을 진단 받고 수술적 치료를 받은 환자는 총 17명(남자 10명, 여자 7명)이었으며 평균 연령은 22세, 평균 추시는 18개월이었다. 병리조직 검사 결과 골연골종이 8예로 가장 흔한 진단이었으며 그 외에 골육종, 섬유성 골이형성증이 2예씩 진단되었다. 악성 골 종양의 빈도는 10.5%였다. 그 부위별로는 근위부, 간부, 원위부가 각각 12예, 4예, 1예였다. 최종 추시 시의 임상적인 만족도는 우수 혹은 양호의 결과가 14명으로 나타났다. 결론: 비골은 골 이식 시에 가장 흔한 공여부 중의 하나로 병변이 경골까지 침범되거나 원위부에 위치하지 지 않는 이상 절제 후에 재건술이 특별히 필요하지 않기 때문에 적극적인 수술적인 치료가 가능하며 특히 간부의 경우에는 충분한 절제 경계를 확보하기 용이하다. 그러나 전체적으로 그 빈도가 낮은 편이며 증상이 명확하지 않고 병변이 진행될 경우에 절단술이 필요할 수 있어 진단에 주의를 요한다.

• Journal of Gastric Cancer
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• 제9권1호
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• pp.1-5
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• 2009

악성 위장관 협착에 의한 폐쇄 증상의 개선을 위하여 과거에는 고식적인 수술적 우회술을 주로 시행하였으나, 최근 내시경적 스텐트 삽입술이 개발되고 기술적 진보와 임상 경험이 축적됨에 따라 새로운 치료 방침의 하나로 확립되었다. 스텐트 삽입술은 고식적 우회술에 비해 시술이 간편하여 성공률이 높고 비침습적이며 단기간에 증상을 개선시키고 시술과 관련된 이환률이 적다는 장점이 있으며 시술에 필요한 입원기간이 짧고 비용면에서 더욱 효과적일 수 있다. 반면 종양의 스텐트 내발육 혹은 위산이나 담즙에 의한 스텐트 손상, 스텐트 일탈 등의 합병증이 발생하여 폐쇄 증상이 조기에 재발하고 재시술이 필요할 수 있다는 문제점이 있어 최근에는 스텐트 일탈을 예방하고 종양의 내발육을 극복할 수 있는 다양한 종류의 스텐트가 개발되어 임상에 응용되고 있다. 일반적으로 악성 위장관 폐쇄에 의한 폐쇄 증상의 완화를 목적으로 하는 스텐트 삽입술은 기대 여명이 6개월 이하인 환자에서 효과적이고 그 이상의 생존이 기대되는 환자에서는 고식적 우회술을 시행하는 것이 적합한 치료 방침으로 생각된다. 본 종설에서는 악성 위출구 폐쇄 환자의 치료에서 쟁점이 되고 있는 스텐트 삽입술과 수술적 우회술 중 어떤 치료가 보다 적절한가를 판단하기 위해서 기술적 측면, 임상 증상의 개선, 합병증, 비용 대비 효과 등을 문헌 고찰을 통해 비교함으로써 적절한 치료 방법의 선택에 대한 해답을 찾고자 한다.

• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.142-149
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• 2009

목적: 단순 소두 골절 및 주관절 주위 손상을 동반한 소두 골절의 수술적 치료에 대한 결과를 분석하고 예후 인자를 알아보고자 하였다. 대상 및 방법: 관혈적 정복 및 내고정술을 시행한 25명의 환자 (평균나이, 49세)를 대상으로 하였고, 소두 골절은 1형 골절이 19예, 3형 골절이 6예 있었다. 평균 추시 기간은 14.8개월이었고 최종 추시시 방사선학적 및 기능적 결과를 분석하여 소두 골절의 형태, 동반 골절 유무가 예후에 영향을 미치는가를 평가하였다. 결과: 25예 중 24예에서 평균 1년에 방사선학적 유합을 얻었으며, 기능적 결과는 Broberg와 Morrey의 점수에 의해 우수 18예, 양호 4예, 보통 2예, 불량 1예였다. 소두 골절은 1형의 빈도가 가장 높았고, 동반 주위 골절은 외과 골절이 가장 많았다. 1형 골절이 3형 골절인 경우보다, 주위골절이 있는 경우 비관절면 골절인 경우가 관절면 골절인 경우보다 임상적 결과가 좋았다. 나이, 동반골절의 종류, 소두 골절에 대한 내고정물의 종류, 수술적 접근법, 수술 후 고정 기간에 따른 임상적 결과의 차이는 없었다. 결론: 전체의 88%에서 만족할 만한 결과를 얻었다. 그리고 소두 골절의 형태와 추가적인 관절면 골절 동반 유무가 중요한 예후 인자로 조사되었다.

• Clinics in Shoulder and Elbow
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• 제12권1호
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• pp.1-6
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• 2009

목적: 불안정성 쇄골 원위부 골절에 대하여 mini-T 금속판을 이용한 수술적 치료를 시행 후 임상적 및 방사선학적 결과를 알아보고자 하였다. 대상 및 방법: 2004년 12월부터 2007년 7월까지 쇄골 원위부 골절 중 Neer 분류 제 2형인 불안정성 골절에 대하여 mini-T 금속판을 이용한 수술을 시행한 환자 중 1년 이상 추시 관찰이 가능하였던 15예를 대상으로 임상적 및 방사선학적 결과를 분석하였다. 결과: 방사선학적 골유합은 평균 3.1개월(3~4개월)에 이루어졌으며 심부 감염이나 고정 실패 등의 합병증은 없었다. 최종 추시 시 미국 견주관절학회 평가 점수(ASES score)는 평균 97점(85~100점)으로 양호한 결과를 보였으며, 견관절의 운동 범위도 1예를 제외하고 모든 예에서 정상으로 회복된 소견을 보였다. 결론: 불안정성 쇄골 원위부 골절에 대하여 mini-T 금속판을 이용한 수술 방법은 양호한 임상적 및 방사선학적 결과를 보여 좋은 수술 방법으로 사료되나 더 많은 증례를 통한 장기적인 결과 분석이 필요하리라 생각된다.