• Journal of Korean Neurosurgical Society
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• 제64권3호
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• pp.447-459
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• 2021

Objective : Oblique lateral interbody fusion (OLIF) is becoming the preferred treatment for degenerative lumbar diseases. As beginners, we performed 143 surgeries over 19 months. In these consecutive cases, we analyzed the learning curve and reviewed the complications in our experience. Methods : This was a retrospective study; however, complications that were well known in the previous literature were strictly recorded prospectively. We followed up the changes in estimated blood loss (EBL), operation time, and transient psoas paresis according to case accumulation to analyze the learning curve. Results : Complication-free patients accounted for 43.6% (12.9%, early stage 70 patients and 74.3%, late stage 70 patients). The most common complication was transient psoas paresis (n=52). Most of these complications occurred in the early stages of learning. C-reactive protein normalization was delayed in seven patients (4.89%). The operation time showed a decreasing trend with the cases; however, EBL did not show any significant change. Notable operation-induced complications were cage malposition, vertebral body fracture, injury to the ureter, and injury to the lumbar vein. Conclusion : According to the learning curve, the operation time and psoas paresis decreased. It is important to select an appropriately sized cage along with clear dissection of the anterior border of the psoas muscle to prevent OLIF-specific complications.

• 대한정형외과학회지
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• 제54권2호
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• pp.187-191
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• 2019

척추 경막외 혈종은 자연적으로 혹은 외상에 의해 발생할 수 있으며 혈관구조 이상이나 응고장애의 기저질환을 갖고 있는 환자에서 호발한다. 대부분의 척추 경막외 혈종은 명확한 이유 없이 자연적으로 발생하며 외상에 의해 발생하는 경막외 혈종은 전체 척추 손상의 1.0%-1.7% 미만으로 흔하지 않다. 저 에너지 손상에 의한 골다공증성 척추 압박골절 이후 지연성으로 발생한 척추 경막외 혈종이 마미증후군을 일으키는 사례는 드물게 보고되고 있다. 저자들은 고령에서 저 에너지 손상에 의한 척추 압박골절로 인해 지연성으로 혈종발생 후 마미증후군이 발생한 사례를 경험하였고 아직 국내에 보고된 사례가 없어 이를 문헌 고찰과 함께 보고하고자 한다.

• 한국지하수토양환경학회지:지하수토양환경
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• 제10권6호
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• pp.32-44
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• 2005

국가지하수 관측망의 314개 관정에 대한 양수시험 자료를 분석하여 국내 암반 및 충적대수층이 나타내는 수리전도도 분포, 투수량계수와 비양수량과의 관계, 양수 및 회복시험 유형에 관한 통계 자료를 제시하였다. 충적대수층의 평균 수리전도도는 1.26m/day로 암반대수층(0.076 In/day)보다 약 17배 크게 나타났다. 암반대수층 수리전도도의 평균과 분산도는 국외의 결정질 균열 암반과 거의 일치하였으며, 암종별 평균값은 퇴적암, 화성암, 변성암 순으로 뚜렷한 차이를 보였다. 투수량계수 분석 결과 국가지하수 관측망의 지하수는 암반을 통하여 $32\%$, 충적층을 통하여 $68\%$ 정도가 흐르는 것으로 나타났다. 회귀분석을 통하여 국가지하수 관측망의 대수층이 나타내는 비양수량과 투수량계수의 관계식을 제시하였다 양수 및 회복시험의 수위강하 양상에 따라 대수층의 유형을 $4\~5$개로 분류하여 각 유형이 나타내는 대수층의 특성을 분석하였다 국가지하수 관측망 대수층의 대부분$(83.7\%)$은 함양경계형을 보였으며, 관측소 인근의 하천, 암반 및 충적대수층의 수리적 연결에 의한 두 대수층간의 수직적인 지하수의 흐름, 자유면대수층에서 중력배수에 의해 발생하는 지연산출 등 다양한 공급원에 의하여 함양경계형이 나타난 것으로 분석되었다.

• 대한족부족관절학회지
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• 제1권1호
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• pp.43-50
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• 1997

The tarsometatarsal joint complex is formed by articulation of the five metatarsal bases with the three cuneiform bones and the cuboid bone. Fracture-dislocation of tarsometatarsal area are difficult to recognize on standard radiographs. The exact diagnosis is occasionally delayed. As a result, improper treatment and late sequelae remains. We decided to make a study of patients with normal foot radiographs on 200 cases. Standard radiographic evaluation was used to study the normal variants of the foot and to evaluate the coincided alignment of the lisfranc joint. Accurate accessment on AP & lateral & $30^{\circ}$ oblique projection of radiographs are very adventageous & important, and next final outcome was detected. : 1. Coincided alignment below 1mm and unfolded lisfranc joint on AP projection was well visalized on 1st cuneiform-metatarsal lateral border and 2nd cuneiform-metatarsal medial border. 2. Coincided alignment below 1mm and unfolded lisfranc joint on oblique projection was well visualized on 2nd cuneiform-metatarsal lateral border and 3rd cuneiform-metatarsal medial border and 3rd cuneform-metatarsal lateral border. 3. More proximal location of 2nd lisfranc joint compared to another joint was 196 cases (98%). It is due to inceleration of 2nd metatarsal base between 3rd & 1st cuneiform. 4. 3rd lisfranc joint was volarward position compared to 2nd listranc on lateral projection at 191 cases (95.5%). It's due to anterior covexity of lisfranc joint. 5. Wide dorsal sided 2nd lisfranc is investigated at 189 cases (94.5%). Because of it. 2nd & 3rd lisfrances are mainly volar dislocated usually. 6. Notching on 5th metatarsal base is visible on 171 cases (85.5%). 7. 4th lisfranc joint had offset normally within $2\sim3mm$ at 98 cases (49%). 8. 5th Lisfranc joint had normally offset within $2\sim3mm$ at 99 cases (49.5%). 9. On lateral projection, slight dorsal location of cuneiform to metatarsal base is investigated at 82 cases (41%).

• Clinics in Shoulder and Elbow
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• 제2권1호
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• pp.14-20
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• 1999

Purpose: Despite of the popular use of the reconstruction plate for the fixation of clavicular shaft fractures, some disadventages have been raised such as long period of immobilization, long skin incision, loosening of plate and screws, and increased chance of nonunion due to severe periosteal injury. Thus, the authors have performed intramedullary multiple Steinmann pins fixation that could reduce the disadvantages of plate fixation in order to compare the treatment results between the two groups. Materials & Methods: From 1994. Jan. to 1997. Dec. the department of orthopaedic surgery of the Kwak's hospital treated operatively for 56 cases of the clavicular shaft fractures in adult. 39 cases of them were treated with the plate fixation and 17 cases with the intramedullary multiple Steinmann pins fixation(SP group). Reconstruction plates(Plate group) were used for 26 out of 39 patients treated with plate fixation. Among the Plate group and SP group, each 15 cases were selected by age and sex and compared each other according to the bone union time, union rate, complication, and functional results. The follow-up period was 12 months at the shortest and 48 months at the longest and the average was 16 months. Results: The Plate group showed that the bone union time was 7 weeks and the bone union rate was 93%. The SP group showed 6.5 weeks and 100% respectively. In complication, the Plate group had 1 case of loosening of plate and screws and delayed union; SP group had 1 case of pin migration. The functional results according to Kang's criteria, 87% of the Plate group and 93% of the SP group showed good or excellent. Conclusion : The SP group showed very comparable results in terms of the bone union time, bone union rate, complication, and functional results comparing to the Plate group. The intramedullary multiple Steinmann pins fixation showed several advantages over the reconstruction plate fixation, which were simple operative technique, easy removal of pins, being able to perform immediate postoperative full range of motion exercise. Therefore, the intramedullary multiple Steinmann pins fixation is thought to be one of the useful operative techniques in treatment of the clavicular shaft fractures in adult.

• 대한소아치과학회지
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• 제41권4호
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• pp.314-321
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• 2014

본 연구는 치아 외상의 양상과 외상 후 초진 시기의 지연이 치료에 미치는 영향에 대해 알아보고자, 2009년 1월부터 2013년 12월까지 전남대학교 치과병원 소아치과에 치아 외상을 주소로 내원한 환자 378명(외상 치아 940개)을 대상으로 기록을 조사하여 다음과 같은 결과를 얻었다. 외상의 빈도는 남자가 여자보다 2배 더 높았다. 전체 외상의 원인은 넘어짐(36.5%)이 가장 많았고, 상악 중절치(66.9%)가 가장 많이 영향을 받았다. 유치에서 가장 흔한 외상 유형은 아탈구(43.9%)였고, 영구치에서는 단순 치관파절(30.9%)이었다. 전체 환자의 10%만이 외상 후 1시간 이내에 치과에 내원하였다. 유치에서 가장 흔한 초진 시 처치는 경과관찰(53.2%)이었고, 영구치는 근관치료(27.3%)였다. 영구치에서 초진 시기의 경과에 따라 근관치료 비율은 증가하였다. 이는 외상 후 초진 시기가 늦어질수록 치수가 생활력을 잃을 가능성이 높아진다는 것을 알려준다.

• Clinical and Experimental Pediatrics
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• 제57권3호
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• pp.140-148
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• 2014

Purpose: Lowe syndrome is a rare, X-linked recessive disorder caused by mutations in the OCRL gene. It involves multiple anatomic systems, particularly the eyes, central nervous system, and kidneys, and leads to profound growth failure and global developmental delay. This study evaluated the clinical and genetic characteristics of Korean patients with Lowe syndrome. Methods: The clinical findings and results of genetic studies were reviewed for 12 male patients diagnosed with Lowe syndrome at a single medical institution. Results: The mean age of the patients at presentation was 2.2 months (range, 0-4 months), although the diagnosis was delayed by a mean of 2.8 years (range, 0-9.7 years). The mean follow-up period was 9.0 years (range, 0.6-16.7 years). Nine mutations in OCRL were identified in 11 patients (92%), with three novel mutations. The main presentation was congenital cataract in both eyes necessitating early cataract removal in the 11 patients with impaired visual acuity. Profound short stature and developmental delay were observed in all patients, and seizures occurred in 50% of the patients. All patients suffered from proximal renal tubular dysfunction, and one patient developed chronic renal failure. Other manifestations included pathologic fracture (50%), cutaneous cysts (42%), and cryptorchidism (42%). However, there was no bleeding tendency, and none of the patients died during the study period. Conclusion: This study describes the clinical and genetic characteristics of Korean patients with Lowe syndrome. The observations are helpful for understanding the natural courses of Lowe syndrome and for appropriate genetic counseling.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.111-124
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• 2013

Purpose: We should prepare proper medical service for disaster control as South Korea is not free from terrorism and war, as we experienced through the two naval battles of the Yeonpyeong, one in 1999 and the other in 2002, the sinking of Cheonan in 2010, and the attack against the border island of Yeonpyeong in 2010. Moreover, North Korea's increasingly bellicose rhetoric and mounting military threats against the world demand instant action to address the issue. The aim of this article is to describe our experience with three patients with combat-related gunshot and explosive injuries to their extremities and to establish useful methods for the management of patients with combat-related injuries. Methods: Three personnel who had been injured by gunshot or explosion during either the second naval battle of the Yeonpyeong in 2002 or the attack against the border island of Yeonpyeong in 2010 were included in our retrospective analysis. There were one case of gunshot injury and two cases of explosive injuries to the extremities, and the injured regions were the left hand, the right foot, and the right humerus. In one case, the patient had accompanying abdominal injuries, and his vital signs were unstable. He recovered after early initial management and appropriate emergency surgery. Results: All patients underwent emergent surgical debridement and temporary fixation surgery in the same military hospital immediately after their evacuations from the combat area. After that, continuous administration of antibiotics and wound care were performed, and definite reconstructions were carried out in a delayed manner. In the two cases in which flap operations for soft tissue coverage were required, one operation was performed 5 weeks after the injury, and the other operation was performed 7 weeks after the injury. Definite procedures for osteosynthesis were performed at 3 months in all cases. Complete union and adequate functional recovery were achieved in all cases. Conclusion: The patient should be stabilized and any life-threatening injuries must first be evaluated and treated with damage control surgery. Staged treatment and strict adherence to traditional principles for open fractures are recommended for combat-related gunshot and explosive injuries to the extremities.

• 대한정형외과학회지
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• 제54권6호
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• pp.574-578
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• 2019

급성 견관절 탈구에 동반된 골성 반카르트 병변은 골편과 상완인대의 정확한 해부학적 정복과 안정된 고정이 치료에 필수적이며, 이의 실패는 견관절 재발성 불안정성과 외상 후 관절염을 유발할 수 있다. 반카르트 병변에 큰 뼈 조각 또는 분쇄된 골절 파편이 있는 경우, 관절경 수술 시 제한된 시야와 조작의 어려움으로 큰 골편을 골절 부위에 정확하고 견고하게 고정하는 것이 어렵다. 개방형 시술 시는 골편에 도달하고 고정하기 위하여 광범위한 연부 조직 유리 및 절제가 필요하여 이는 신경과 혈관 합병증, 견갑하건의 약화 및 견관절 강직 등, 외과적 접근법과 관련된 병적 상태를 유발할 수 있다. 저자들은 관절경적 수술이 용이하지 않은 크기의 관절와 골절이 동반한 견관절 전방 탈구 환자에서 골절면에 봉합나사 고정 후 골 터널을 만든 골편에 봉합사를 통과한 후 골편 및 상완인대를 함께 매듭 하여, 해부학적 위치로 안정된 정복을 얻는 수술방법을 보고하고자 한다.

• Clinics in Shoulder and Elbow
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• 제16권2호
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• pp.73-83
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• 2013

목적: 심한 회전근 개 부전을 동반한 관절와 상완 관절염 환자나 가성 마비 환자들에 대한 치료로 역형 견관절 전치환술 시행한 후 최소 3년 추시 결과를 알아보고자 하였다. 대상 및 방법: 2007년 7월부터 2010년 7월까지 본원에서 역형 견관절 전치환술을 시행 받은 13명(남자: 3명, 여자: 10명)의 환자를 대상으로 하였다. 추시 기간은 평균 54.2개월(37~74개월)이었으며, 임상적 결과는 동통에 대한 VAS 점수, 능동적 관절 운동 범위, ASES 평가 방법, Korean 견관절 평가 방법을 이용하였으며, 수술 중 및 수술 후 합병증에 대해서 분석하였다. 결과: 총 13예 중 지연성 심부 감염을 제외한 11예의 동통에 대한 VAS 점수는 술 전 평균 7.5(6~10)점에서 술 후 1.5(0~4)점으로, 능동적 전방 거상은 $42.7(10{\sim}100)^{\circ}$ 에서 $129.1(110{\sim}180)^{\circ}$ 로, ASES 점수는 32.9(11.7~46.7)점에서 80.2(58.3~95.0)점으로, KSS 점수는 36.8(24~47)점에서 78.4(61~92)점으로 호전되었다. 합병증으로는 다양한 정도의 관절와 절흔이 총 13예 중 12예, 수술 중 관절와 골절 1예, 일시적인 신경 손상이 2예 발생하였고, 지연성 심부 감염이 2예 발생하여 재수술이 필요하였다. 결론: 역형 견관절 전치환술은 최소 3년의 추시 결과, 심한 회전근 개 부전을 동반한 관절와 상완 관절염 환자나 가성 마비 환자들에 대해 효과적인 치료 방법의 하나로 생각된다. 그러나, 술 후 재수술이 필요한 지연성 심부 감염 등의 심각한 합병증과 수술 술기와 관련한 합병증의 발생 가능성을 고려해 볼 때 숙련된 의사에 의해 매우 신중하게 시행 되어져야 할 것으로 사료된다.