• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.185-188
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• 2008

견봉-쇄골 관절 손상은 흔히 견관절 상외측에서의 직접적인 외상으로 발생한다. Rockwood 제4형 손상은 상대적으로 드물게 생기며, 다발성 외상 환자의 경우 타 손상으로 쉽게 잘못 진단되어지거나 간과되어지는 경우가 있다. 제 4형 손상 환자의 잘못된 치료를 피하기 위해서는 견봉-쇄골 관절의 세심한 이학적 검사와 적절한 방사선학적 검사가 필요하다. 이에 저자들은 다발성 늑골 골절이 동반된 제 4형 견봉-쇄골 관절 손상을 초기에 진단하지 못하고 간과한 2예를 변형 Weaver-Dunn 재건술로 치료하였기에 문헌 고찰과 함께 보고하고자 한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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• pp.392-399
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• 2019

Wilson disease a rare autosomal recessive inherited disorder of copper metabolism, is characterized by excessive deposition of copper in the liver, brain, and other tissues. Wilson disease is often fatal if it is not recognized early and treated when it is symptomatic. Gitelman syndrome is also an autosomal recessive kidney disorder characterized by low blood levels of potassium and magnesium, decreased excretion of calcium in the urine, and elevated blood pH. Hereditary sensory autonomic neuropathy type IV (HSAN-IV), a very rare condition that presents in infancy, is characterized by anhidrosis, absence of pain sensation, and self-mutilation. It is usually accompanied by developmental delay and mental retardation. We report a case of Wilson disease manifested as fulminant hepatitis, acute pancreatitis, and acute kidney injury in a 15-year-old boy comorbid with HSAN-IV and Gitelman syndrome. Such concurrence of three genetic diseases is an extremely rare case.

• 대한간호학회지
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• 제48권3호
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• pp.335-348
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• 2018

Purpose: The purpose of this study was to identify parental coping strategies in the face of early infant and toddler injury, and to provide basic data for a parental education program and the most desirable directions it should take. Methods: A Q-methodology to analyze the subjectivity of each item was used. Thirty-four Q-statements were derived from a literature review and interviews. Forty-seven parents were classified into a shape of normal distribution using a 9-point scale. Collected data were analyzed by the pc-QUANL program. Results: Five types of parental coping in early infant and toddler injury were identified. Type I was "hospital treatment focused", type II was "Improving the safety of the child's environment", type III was "expression of negative emotion", type IV was "taking the lead in problem solving", and type V was "Interrogating the person in charge of the situation in which the injury occurred". Conclusion: The results of this study indicate that different approaches to educational programs can be used for parents in early childhood injury.

• 대한족부족관절학회지
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• 제7권1호
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• pp.119-125
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• 2003

Purpose: The purpose of this study fracture. Materials and Methods: The clinical and radiological analysis were performed on 19 cases of the talus neck fractures who had been treated with conservative treatment or variable methods of operative treatment. Each cases followed up more than 1 year and 6 months from May 1989 to June 2001. The clinical results were analyzed according to the age, cause of injury, fracture type of Hawkins classification, associated soft tissue injury, method of treatments, complications, and Hawkins scoring system. Results: According to Hawkins classification, type I was 6 cases(32%), type II was 5 cases(26%), typeIII was 7 cases(37%), and typeIV was 1 case(5%). In all cases, complete bony union was obtained. According to the Hawkins scoring system, 8 cases(42%) were excellent and good. Avascular necrosis was 4 cases(25%). Traumatic arthritis was 10 cases which were occurred in type II, III and IV. An ankle fusion was 1 case. Conclusion: In talar neck fractures, non-displaced fracture treated by the cast immobilization and displaced fracture treated by early open reduction and internal fixation were expected good results. The complications were 77% of traumatic arthritis and 31% of avascular necrosis in type II, III and IV. We should preoperatively explain to the patient for high complication rates of traumatic osteoarthritis and avascular necrosis in the talus neck fractures.

• 대한한방내과학회지
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• 제35권4호
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• pp.519-531
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• 2014

Objectives: Diabetic nephropathy is the most common cause of end stage renal disease. Transforming growth factor (TGF)-${\beta}1$, type IV collagen, advanced glycation end-products (AGEs), and angiotensin II type 1 receptor (AT1) are the main factors of diabetic nephropathy. We investigated the effects of Prunus on renal function and histopathological changes of diabetic nephropathy rat model induced by unilateral nephrectomy and streptozotocin. Methods: Diabetes was induced in male Sprague-Dawley rats ($290{\pm}10g$) by injecting streptozotocin (55 mg/kg) into the tail vein after unilateral nephrectomy. Rats were divided into 3 groups (n=6): normal, control, and Prunus. After 8 weeks of oral administration of Prunus extract on the Prunus group from 3 days after streptozotocin injection, we checked weight, 24 hrs urine, blood biochemistry and renal tissue to evaluate renal function and histopathological changes by examining parameters including albuminuria, BUN, creatinine, cholesterol, low density lipoprotein (LDL), triglyceride, TGF-${\beta}1$, type IV collagen, AGEs, and AT1. We also measured mRNA expression of TGF-${\beta}1$, type IV collagen, AGEs, and AT1 by Real Time polymerase chain reaction (RT-PCR). Results: Prunus decreased the amount of 24 hrs proteinuria, and inhibited histopathological changes of diabetic nephropathy including the expression and accumulation of TGF-${\beta}1$, type IV collagen and AGEs which could promote development of diabetic nephropathy. Prunus also inhibited mRNA expression of TGF-${\beta}1$, type IV collagen. Conclusions: These findings suggest that Prunus might protect the renal function and inhibit the development of renal injury by regulating factors including TGF-${\beta}1$, type IV collagen, AGEs, except AT1, so Prunus can be used for diabetic patients to prevent the progression of diabetic nephropathy.

• Archives of Reconstructive Microsurgery
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• 제7권1호
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• pp.35-40
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• 1998

The incidence of brachial plexus injury is increasing because of the development of motor vehicle but the the results of treatment was reported poor due to its complex anatomical structure and changes of function and sensory during the recovery after trauma. But the results of treatment has been improved by the recently introduced high sensitive diagnostic method that can evaluate accurately the site and extent of the injury and treatment method. Restoration of the elbow flexion is the most important goal of treatment after brachial plexus injury and nerve graft, neurotization and muscle transfer were used for methods of treatment. From December 1992 to May 1994, the author performed 6 cases of latissimus dorsi transfer at the same side for the improvement of elbow flexion in the patients of brachial plexus injury. There were 5 cases of male, one case of female and average age was 22 years old. The causes of injury were traffic accident in 3 cases, gun shot injury, falldown and birth injury in each one case and in all cases, the type of injury were upper arm type. The average follow up period were 1 year 5 months ranging from 12 months to 4 years 5 months. In all cases, active elbow flexion was impossible before operation and average muscle power was grade I. We analysed the active range of motion, muscle power and the functional results. At the last follow up, range of active elbow flexion was average $124^{\circ}$ and flexion contracture was average 11 degrees and the average of muscle power was grade IV. In the functional analysis, there were two cases of excellent, three cases of good and 1 case of fair. There was no complications including wound infection, vascular compromise and donor site problem. The results of latissimus dorsi transfer for improvement elbow flexion in the patients of brachial plexus injury is one of the useful mettled for the restoration of elbow flexion.

• 대한임상전기생리학회지
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• 제1권2호
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• pp.21-30
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• 2003

The purpose of this study was to know the effect of aquatic-exercise on muscle atrophy which induced by steroid injection. The forty-eight Sparague-Dawley adult male rats were assigned to the 4 groups; GroupI(distilled water injection), GroupII(steroid injection), GroupIII(distilled water injection and aquatic exercise), GroupIV(steroid injection and aquatic exercise). We observed their body weight, histological change by PAS stein. The results of this study were as follows; 1. After 2 weeks, the change of weights appeared that non-steroid injection groups increase weight and steroid injection groups decreased weight hasty. after 4 weeks, weights recovered from weight before test. It was possible to explain the change of weight by type II muscle fiber increase. 2. In histological change of muscle fibers, atrophy didn't observed in test group I, because type II muscle fibers were developed well. we observed not only injury of muscle fiber and muscle atrophy but specifically grouping type I muscle fiber in test group II. normal arrangement of muscle fibers were visible in test group and type II muscle fibers increased. we could observe muscle recovery because of type II muscle fibers increase in test group IV. therefore, it was seem that type II cell was recovering through aquatic exercise.

• 대한한방내과학회지
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• 제29권3호
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• pp.787-799
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• 2008

Objective : Diabetic nephropathy is the most common cause of end stage renal disease. AGE, $TGF-{\beta}1$ type IV collagen, and macrophage/monocyte infiltration are the main factors of diabetic nephropathy. We investigated the effects of Salvia miltiorrhiza on renal function and histopathological changes in streptozotocin(STZ)-induced diabetic nephropathy rat model. Methods : Diabetes was induced in male Sprague-Dawley rats(290${\pm}$10g) by injecting STZ(45mg/kg) into the tail vein. Rats were divided into 3 groups(n = 6): normal, control, and salvia. After 8 weeks of administration of Salvia miltiorrhiza extract on the Salvia group, we checked 24 hrs urine, blood biochemistry and renal tissue to evaluate renal function and histopathological changes by examining parameters including albuminuria, BUN, creatinine, cholesterol, LDL, TG, macrophage/monocyte antigen(ED-1), $TGF-{\beta}1$, AGE, and type IV collagen. Results : Salvia miltiorrhiza decreased the amount of 24hrs proteinuria, and inhibited histopathological changes of diabetic nephropathy including the expression and accumulation of various factors which could promote development of diabetic nephropathy. Conclusion : These findings suggest that Salvia miltiorrhiza might protect the renal function and inhibit the development of renal injury by regulating factors including AGE, $TGF-{\beta}1$ Type IV collagen, macrophage and monocyte infiltration. So Salvia miltiorrhiza can be used for diabetic patients to prevent the progression of diabetic nephropathy.

• Journal of Yeungnam Medical Science
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• 제18권2호
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• pp.187-198
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• 2001

저자들은 1991년 1월부터 1997년 12월까지 7년간, 수술적으로 치료한 경골과 골절 환자 중 최단 1년에서 최장 8년까지 장시 추시 관찰이 가능했던 29예를 대상으로 치료 예후에 관여하는 인자를 조사하여 다음과 같은 결과를 얻었다. 1. 20대부터 40대까지가 15명(51.7%)을 차지해 활동기 연령층에서 발생 빈도가 높았고, Schatzker의 분류에 의해 2형 골절이 11예(37.9%)로 가장 많았다. 동반 연부 조직 손상은 18예(62.1%)에서 발생되었으며, 외측 반월상 연골 손상이 6예(33.3%), 내측 측부 인대손상이 4예(22.2%)로 많았다. Blokker 평가 기준에 의해 29예 중 23예(79.3%)가 양호하였다. 2. 불량한 결과와 관련 있는 요인으로는 30대 이전의 연령층, 고 에너지 손상의 Schatzker 분류 IV형 이상의 골절, 전방 십자 인대 손상과 반월상 연골 손상 등의 동반 손상이었다. 또한 각 골절의 양상과 손상의 정도에 따라 골절면의 정확한 해부학적 정복과 견고한 내고정을 시행하여, 조기에 슬관절 운동을 시행하여야 슬관절의 기능을 향상시킬 수 있을 것으로 사료되었다.

• 대한관절경학회지
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• 제12권1호
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• pp.24-31
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• 2008

목적: 전방십자인대 파열 시 손상 시기와 원인에 따른 동반 손상의 빈도 및 양상을 비교하여 평가하고자 하였다. 대상 및 방법: 전방십자인대 재건술을 시행하였던 547례의 슬관절을 대상으로 손상 시기(급성과 만성), 손상 원인(운동과 비운동) 및 운동 종목에 따라 동반 손상의 빈도와 양상을 후향적으로 비교 분석하였다. 결과: 손상 시기에 따라 수상 후 3개월 이내는 급성으로, 3개월 이후는 만성으로 분류하였으며 급성 손상군에서 내측 측부 인대 손상 및 골 좌상이 많았고 만성 손상군에서는 내측 및 외측 반월상 연골 손상의 빈도가 유의하게 높았다(p=0.014, 0.029). 연골 손상은 급성 손상군의 경우 대퇴 활차부에(p=0.027), 만성 손상군의 경우 대퇴 내과에 많았고(p=0.011), Grade I, II의 연골 손상은 급성 손상군에(p=0.016), Grade III, IV의 손상은 만성 손상군에(p=0.017) 많았다. 손상 원인에 따른 차이로는 운동 손상군에서 외측 반월상 연골 손상의 빈도가 높았으며(p=0.035) 비운동 손상군에서 대퇴 내과의 연골 손상이(p=0.010) 유의하게 많았다. 운동 종목 별로는 스키에서 내측 측부 인대 손상이(p=0.005), 체조에서 연골 손상이(p=0.017) 다른 종목에 비해 많았다. 결론: 내측 및 외측 반월상 연골 손상, 심한 연골 손상의 빈도는 만성 손상군에서 높았고 손상 원인과 운동 종목에 따른 동반 손상의 빈도 및 양상에 차이가 있었다.