중추성 요붕증을 동반한 원발성 폐 조직구증 X

김영민 ( Young Min Kim ),박융인 ( Yung In Park ),최영근 ( Young Kuen Choi ),이재승 ( Jae Seung Lee ),이우철 ( Woo Chul Lee ),홍진희 ( Jin Hee Hong ),이수봉 ( Soo Bong Lee ),류기찬 ( Ki Chan Reu ),이민기 ( Min Ki Lee ),이창훈 ( Cha 대한결핵 및 호흡기학회 1999 Tuberculosis and Respiratory Diseases Vol.46 No.1

고혈압 환자에서 좌심실비대가 심실성 부정맥 발생에 미치는 영향

배우형(Woo Hyung Bae),이현국(Hyeon Gook Lee),박융인(Yoong In Park),박용현(Yong Hyun Park),오현명(Hyun Myung Oah),임종훈(Jong Hoon Lim),안병재(Byung Jae An),김성호(Seong Ho Kim),전국진(Kook Jin Chun),홍택종(Taek Jong Hong),신영우(Yung 대한내과학회 1999 대한내과학회지 Vol.56 No.4

N/A Objectives:Left ventricular hypertrophy(LVH) increases the risk of sudden death in hypertensive patients and this is known due to ventricular arrhythmias. Thus, author studied the relationship between LVH as a hypertensive target organ damage and ventricular arrhythmias. Methods:24-hour ambulatory electrocardiographic monitoring, measurement of microalbumin in 24-hour urine and fundoscopic examination were performed on 100 hypertensives (50 patients without LVH and 50 patients with LVH on EKG) who admitted Pusan National University Hospital. Results:In patients with LVH, ventricular extrasystoles occurred more frequently than without LVH(p<0.05) and ventricular couplet and ventricular tachycardia were more common but statistically not different. Microalbuminuria and hypertensive retinopathy were more severe in patients with LVH than without LVH(p<0.05 and p<0.01, respectively). Conclusion:Of the ventricular arrhythmias, ventricular extrasystole but not ventricular couplet and ventricular tachycardia occurred more frequently in patients with LVH than without LVH. Thus, prospective study with long-term follow up should be done to establish the relationship between hypertensive LVH and cardiovascular mortality, especially sudden death. And, further study should be done to make the relationship between reduction in LVH with antihypertensive therapy and reduction in LVH-associated ventricular arrhythmias.

울혈성 심부전 환자의 치료 경과중 혈청 마그네슘의 동태에 관한 고찰

임종훈(Jong Hoon Lim),전국진(Kook Jin Chun),정준훈(Joon Hoon Jeong),김병진(Byung Jin Kim),오현명(Hyun Myung Oah),박용현(Yong Hyun Park),박융인(Yong Hyun Park),홍택종(Taek Jong Hong),신영우(Yung Woo Shin) 대한내과학회 1997 대한내과학회지 Vol.53 No.6

N/A Objectives: There are many interesting reports suggesting that magnesium(Mg) deficiency is deleterious in patients with congestive heart failure (CHF). It is paradoxical that the most important cause of Mg deficiency in these persons is maybe use of therapeutics including diuretics. Authors investigated the trend of serum and 24 hour urine Mg with other relating electrolytes in Mg homeostasis prospectively, in the management of CHF. And we assessd the effects of medications and many variables in .CHF on serum Mg, and the usefulness of serum Mg representing the body content. Methods: Fifty three patients who were diagnosed as CHF by clinical finding and echocardiogaphy were prescribed conventional doses of diuretics as furosemide 40mg and spironolactone 50mg daily, with or without angiotensin converting enzyme(ACE) inhibitor and digitalis. And then, serial serum and 24 hour urine Mg, sodium, potassium and calcium were obtained at admission, 2nd day, 5th day, and discharge. Results: The patients group with chronic CHF, which was defined as long-term use of diuretics over 6 months, showed higher prevalence of low level of serum Mg concentration than the group with acute one(11 of 28, 39% vs. 2 of 25. 8%, P< 0.01). Of those two groups, the latter showed upward trend of serum Mg from admission to discharge, but the former showed no change. In 24 hour urine Mg excretion, the amount of the patients with CHF was larger than that of control group. In the chronic CHF group, the effect of digitalis on decreasing serum Mg was evident. Serum Mg of acute CHF group correlated with serum BUN(r=0.5609). Whereas, that of chronic group with ejection fraction(r= ?0.4742) and plasma renin activity(r= ? 0.3791), with serum potassium(r=0.4673) and creatinine(0.5846). Serum Mg may be useful indicator of Mg homeostasis, especially in chronic CHF patients. Conclusion: Because patients with chronic CHF were prone to deficiency of Mg in the management, maintaining the adequate serum Mg through long- term replacement seems very important in decreasing the morbidity and mortality of these persons.

Tubular Retractor와 현미경을 이용한 최소 침습적 요추간판 제거술

박융(Yung Park),하중원(Joong Won Ha),오현철(Hyun Cheol Oh),유주형(Ju Hyung Yoo),이윤태(Yun Tae Lee),이두형(Doo Hyung Lee),최철준(Chul Jun Choi) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.6

목적: Tubular retractor와 현미경을 이용한 최소 침습적 요추간판 제거술의 소개와 함께 이 수술법의 단기적 임상 결과와 장점을 알아보고자 하였다. 대상 및 방법: 2003년 4월부터 2004년 4월까지, 45명의 요추간판 탈출중 환자를 대상으로 tubular retractor (METRx-MD System, Medtronic Sofamor Danek, Memphis, TN)와 현미경을 사용하여 요추간판 제거술을 실시하였다. 모든 환자에서 1인치 크기의 정중방(para-median) 피부 절개를 통해 tubular retractor를 삽입하고 이를 통하여 후방 감압술을 시행하였다. 수술 후 임상 결과, 수술 시간, 실혈량, 수혈 유무, 보행 시기, 입원 기간 및 합병증에 관한 결과를 수집, 분석하였고, 수술 후 임상 결과는 MacNab 분류를 사용하여 평가하였다. 결과: Tubular retractor를 이용하여 최소 침습적 요추 후방 감압술을 시행 받은 45명의 환자 중, MacNab 분류에 따른 임상 결과는 최우수 33명(73%), 우수 10명(22%)이었다. 평균 수술 시간이 63분(35-95분) 소요되었고, 평균 실혈량은 62 ㎖ (50-110 ㎖)로 측정되었고, 수혈이 필요한 경우는 없었다. 또한 2명을 제외한 43명의 환자가 수술 당일 자발적인 보행을 할 수 있었으며, 평균 입원 기간은 2.3일이었다. 경막 손상, 수술 후 감염, 수술 후 재발 및 다른 합병증은 관찰되지 않았다. 결론: Tubular retractor와 현미경을 이용한 요추간판 제거술은 요추간판 탈출증 치료의 유용한 술기이며, 기존 고식적인 수술의 장점을 그대로 유지시키면서도, 최소 침습적 접근법을 통하여 만족할 만한 임상 결과를 가져올 것으로 사료된다. Purpose: To evaluate the early clinical results of lumbar microdiscectomy using minimally invasive tubular retractor (METRx-MD system, Medtronic Sofamor Danek, Memphis, TN), and to validate the merits of minimally invasive spinal surgery. Materials and Methods: From April, 2003 to April 2004 we retrospectively studied a consecutive series of 45 patients who underwent lumbar microdiscectomy using minimally invasive tubular retractor. In all cases, minimally invasive approach using the tubular retractor were performed with a 2 ㎝ sized paramedian incision. The following data were collected: clinical outcomes, operative time, intraoperative blood loss, need for blood replacement, time needed before ambulation, length of hospital stay, and complications. The clinical outcomes were assessed by the modified MacNab criteria. Results: Minimally invasive tubular microdiscectomy was performed in 45 patients over a 12-month period with an average follow-up of approximately 8 months. The clinical outcomes assessed by MacNab criteria were excellent in 33 patients (73%), good in 10 patients (22%). The average operative time was 63 minutes (range, 35 to 95 minutes). The average blood loss was 62 ㎖ (range, 50 to 110 ㎖). None of the patients needed blood replacement. With the exception of 2 patients, all patients could walk at the day of surgery. The average hospital stay was 2.3 days. None of the patients had dural tear, wound problem, or other complications. Conclusion: Lumbar microdiscectomy using tubular retractor can offer a useful modality for the treatment of lumbar herniated disc with the merits of minimally invasive spinal surgery. Further long-term, randomized, prospective investigations are needed to fully evaluate the impact of this technique.

최소 침습적 후방 요추체간 유합술

박융(Yung Park),하중원(Joong-Won Ha),성승용(Seung-Yong Sung),오현철(Hyun-Cheol Oh),유주형(Ju-Hyung Yoo),이윤태(Yun-Tae Lee) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.2

목적: 전통적 또는 최소 침습적 접근법 중 한 방법을 이용한 단 분절 후방 요추체간 유합술 후 얻은 임상 및 방사선학적 결과를 비교 분석하여, 실제로 최소 침습적 접근법을 통한 요추 유합술이 전통적인 접근 방법을 이용한 유합술보다 최소 침습적 수술로서의 장점들을 가지고 있는지 알아보고자 하였다. 대상 및 방법: 2003년 10월부터 2004년 10월까지 단 분절 후방 요추체간 유합술을 시행 받은 환자 중 최소 1년 이상 추시가 가능했던 46명을 대상으로 하였다. 이 중 27명은 최소 침습적 접근법을, 19명은 전통적 접근법을 이용한 후방 요추체간 유합술을 시행 받은 환자였다. 두 군 간의 임상 및 방사선학적 결과, 수술 시간, 설혈량, 수혈량, 술 후 요통, 술 후 첫 보행 시기, 입원 기간 및 합병증 등을 비교하여 통계 분석하였다. 결과: 수술 후 최소 1년 추시한 임상 및 방사선학적 결과는 두 비교 군에서 통계적 유의한 차이가 없었다. 최소 침습적 유합술 군에서 실혈량, 수혈량, 술 후 요통이 통계적으로 의미 있게 적었으며, 술 후 첫 보행 시기와 퇴원 시기도 최소 침습적 유합술 군에서 의미 있게 빨랐다. 그러나 수술 시간은 최소 침습적 유합술이 전통적 유합술보다 더 길게 소요되었으며, 최소 침습적 유합술 군에서 수술 술기의 기술적인 합병증이 2예가 있었다. 결론: 단 분절 후방 요추체간 유합술을 위한 두 수술 접근법 중 최소 침습적 방법이 실혈량, 술 후 요통, 보행 시기 및 입원 기간 면에서 전통적인 방식보다 우수하였고, 최소 침습적 접근법이 기존 전통적 수술 접근법의 장점을 유지하면서도 수술 직후 환자의 빠른 회복과 재활에 유리한 장점을 가지고 있다고 생각된다. 그러나 최소 침습적 요추 후방 유합술은 전통적 접근법에 비해 수술 시간이 더 걸리고 수술 술기의 기술적 어려움으로 인한 합병증이 발생될 수 있어, 이에 대한 보다 여러 기관의 장기적이고 전향적인 연구 보고가 필요할 것으로 생각된다. Purpose: To compare the clinical and radiographic results of the two approaches for posterior lumbar fusion, one-level posterior lumbar interbody fusion (PLIF) performed with a minimally invasive approach or the traditional open approach. Materials and Methods: This study examined a consecutive series of 46 patients who underwent one-level PLIF procedure (27 cases performed with minimally invasive approach and 19 cases with traditional open approach) by one surgeon at one hospital. The following data were compared with a minimum 1-year follow-up: the clinical and radiographic results, surgical time, estimated blood loss, transfusion requirements, postoperative back pain, time needed before ambulation, length of hospital stay, and complications. Results: There was no statistical difference between the two groups in terms of the clinical and radiographic results at the last follow-up. The minimally invasive group was found to have a less blood loss, fewer transfusion requirements, less postoperative back pain, a shorter recovery time, and a shorter hospital stay. However, minimally invasive group required a longer surgical time and there were 2 cases with technical complications. Conclusion: This study confirmed the favorable results reported by previous uncontrolled cohort studies. It also showed that the minimally invasive approach had a similar surgical efficacy to that of traditional open approach. However, minimally invasive technique requires a steep learning curve and attention in order to lower the risk of complications.

X-ray and dielectric study of the phase transition in PbFe ½ Nb ½ O3 - PbCo ½ W ½ O3 ceramics

Yung Park(박융),Hong Min Lee(이홍민),Ho-Gi Kim(김호기) 대한전기학회 1997 대한전기학회 학술대회 논문집 Vol.1997 No.7

급성 요통을 일으킨 결핵과 통풍이 혼재된 척추관절병증

박융(Yung Park),하중원(Joong Won Ha),권지원(Ji-Won Kwon),엄광식(Kwangsik Eum) 대한정형외과학회 2021 대한정형외과학회지 Vol.56 No.4

부고환 결핵으로 부고환 절제술 및 항결핵제제를 복용중인 67세 남자 환자가 급성 요통 및 방사통을 주소로 내원하였다. 환자는 통풍의 과거력은 없었으나 혈액 검사상 고요산혈증 소견을 보였으며, 요추 후관절 및 후궁 부위의 골 파괴 병변이 관찰되었다. 요추 후관절 부위의 컴퓨터 단층촬영 유도하 바늘 생검을 실시하여 조직학적 검사를 시행한 결과 통풍성 척추관절병증 및 결핵성 척추염이 진단되었다. 환자는 통풍성 관절염에 대한 보존적 치료를 통해 증상은 호전되었다. 항결핵제제 복용 등 고요산혈증 위험을 가진 환자가 급성 요통을 호소하는 경우 통풍성 척추관절병증을 감별진단해야 하겠다. A 67-year-old male patient with a history of epididymectomy and anti-tuberculosis treatment for epididymis tuberculosis was admitted for acute low back pain and radiating pain. The patient had no history of gout but showed hyperuricemia and a bone destruction lesion in the facet joint and lamina of the lumbar spine. A histology examination was performed after a computed tomography-guided needle biopsy, and the findings were compatible with gout spondyloarthropathy and tuberculous spondylitis. The acute symptoms improved after conservative treatment for gouty arthritis. When patients with hyperuricemia risk factors, such as taking anti-tuberculosis drugs, complain of acute low back pain, gout spondyloarthropathy should be considered in a differential diagnosis.

장기간 비스포스포네이트 복용중인 환자에서의 경골에 발생한 비전형 골절 양상의 부전골절 - 증례 보고 -

박민정 ( Min Jung Park ),이수진 ( Su Jin Lee ),감진화 ( Jin Hwa Kam ),이윤태 ( Yun Tae Lee ),유주형 ( Ju Hyung Yoo ),오현철 ( Hyun Cheol Oh ),하중원 ( Joong Won Ha ),박융 ( Yung Park ),박상훈 ( Sang Hoon Park ),김성훈 ( Seong Hoo 대한골절학회 2017 대한골절학회지 Vol.30 No.3

장기간 비스포스포네이트를 복용한 환자에게서 다양한 증례의 비전형적 대퇴골 골절의 발생이 보고되어 왔으나 대퇴골 이외의 부위에서 비전형적 골절은 보고된 증례가 많지 않았다. 저자들은 장기간 비스포스포네이트를 복용한 환자에게서 외상 없이 경골 간부의 전외측 부위에서 발생한 비전형적 골절 양상의 부전골절을 경험하여 국내에서 처음으로 이의 치료 결과를 문헌 고찰과 함께 보고하고자 한다. Atypical femoral fracture related to a long-term bisphosphonate therapy has commonly been reported; however, a fracture at the site other than the femur has rarely been reported to date. Herein, we report a case of a patient on long-term bisphosphonate therapy who presented atypical tibial insufficiency fracture at the anterolateral aspect of diaphysis, without trauma. We, for the first time in Korea, present this case with a literature review.

고관절 전치환술시 시행된 마취방법에 따른 결과 비교

황성관 ( Sung Kwan Hwang ),박융 ( Yung Park ) 대한고관절학회 1997 Hip and Pelvis Vol.9 No.1

One hundred twenty eight patients underwent 128 primary unilateral total hip arthroplasties from January 1992 to December 1995. Patients were divided into two groups based on the type of anesthesia utilized for their procedure. Group I consisted of 56 patients (35 women and 21 men; average age 56 years) who had general endotracheal anesthesia. Group II consisted of 72 patients (40 women and 32 men; average age 58 years) who had spinal anesthesia. Data were analyzed by anesthesia group to compare a variety of clinically relevant factors. No statistically significant differences in each groups were noted regarding average age at the time of surgery, the underlying diseases, the number of preexisting medical conditions, surgical time, length of hospitalization, deep venous thrombosis, deep infections, death and intraoperative blood transfusion. Significant differences were observed for two factors: 1) estimated intraoperative blood loss was higher in Group I (p <0.05), and 2) postoperative hemovac output was also greater in Group I (p <0.05). In conclusion, spinal anesthesia appears to be a safer modality for patients, especially with pulmonary problems undergoing primary unilareral total hip replacement.

Hydroxyapatite Coating 과 Porous Coating 된 비구컵의 방사선학적 변화 비교

황성관 ( Sung Kwan Hwang ),박융 ( Yung Park ) 대한고관절학회 1996 Hip and Pelvis Vol.8 No.2

The purpose of this study was to compare the radiological changes of Hydroxyapatite-coated cups with those of porous-coated cups. From January 1992 to December 1994, we carried out 125 total hip arthroplasties in 101 patients; 61 hips in 49 patients had H-A coated acetabular implants of Omnifit' system and 64 hips in 52 patients with porous coated acetabular implants of Mallory-Head' Hip system. And the average follow up period was 32 months (1S to 56 months). Radiologic evaluation of both acetabular components reveals that bone condensation begins to occur in over 40% of cases by one year with both H-A and porous-coated cups, but by five years, condensation with HA cups was seen in 93% of cases in zone 1 and 5796 in zone 3, compared with 89% in zone 1 and 44% in zone 3 with porous cups. Reactive line formation was found in only 2% of the HA-coated cups, whereas with porous-coated cups it was seen in 3% of cases. Prosthetic migra- tion was noted with two HA- and four porous-coated cups. Comparing the use of HA-and porous-coated acetabular cups, the radiological results over threeto-five years appear similiar. Continued follow-up of this patient population is desirable to establish the durability of these three-to-five year results.