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Two Cases of Rhinocerebral Mucormycosis in Diabetic Patients
김명구,조우령 대한비과학회 2000 Journal of rhinology Vol.7 No.1
Rhinocerebral mucormycosis is a rare fungal infection that involves the paranasal sinus and orbits and usually presents asacute invasive fungal sinusitis. It progresses rapidly, is often fatal, and occurs most commonly in patients with uncontrolleddiabetes. If the condition is not treated, the fungal infection may disseminate into the brain and cause death within a week. Weencountered two cases of rhinocerebral mucormycosis confirmed with histophathological examination. The cases were treatedsuccessfully with surgical debridement, a systematic application of amphotericin B, and irrigation and soakage with amphotericinB.
김명구,나석인,이종민,박주용 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.3
Purpose: The use of graft tissue fixation using bioabsorbable interference screws (BISs) in anterior cruciate ligament (ACL) reconstruction offers various advantages, but limited pullout strength. Therefore, additional tibial fixation is essential for aggressiverehabilitation. We hypothesized that additional graft tissue fixation using bioabsorbable suture anchors (BSA) would provide sufficient pull-out strength. Materialsand Methods: Twenty four fresh frozen porcine distal femur and patellar tendon preparations were used. All specimens were divided into three groups based on additional fixation methods: A, isolated BIS; B, BIS and BSA; and C, BIS and post cortical screw. Tensile testing was carried out under an axial load. Ultimate failureload and ultimate failure load after cyclic loading were recorded. Results: The ultimate failure loads after load to failure testing were 166.8 N in group A, 536.4 N in group B, and 438 N in group C; meanwhile, the ultimate failure loads after load to failure testing with cyclic loading were 140 N in group A, 466.5 N in group B, and 400 N in group C. Stiffness after load to failure testing was 16.5 N/mm in group A, 33.5 N/mm in group B, and 40 N/mm in group C. An additional BSA fixation resultedin a significantly higher ultimate failure load and stiffness than isolated BIS fixation, similar to post screw fixation. Conclusion: Additional fixation using a BSA provided sufficient pullout strength for ACL reconstruction. The ultimate failureload of the BSA technique was similar to that of post cortical screws.
김명구,배주한,전윤상,Kim, Myung-Ku,Bae, Joo-Han,Jeon, Yoon-Sang 대한관절경학회 2009 대한관절경학회지 Vol.13 No.2
목적: 석회화 건염에 대하여 보존적 치료 및 조기 관절경을 이용한 수술적 치료 후 통증과 임상경과를 비교 관찰하였다. 대상 및 방법: 2002년 2월부터 2008년 5월까지 석회화 건염으로 진단받은 30예 중 6개월 이상 추시관찰이 가능하였던 스테로이드 주사치료 15예 및 수술 치료 15예를 대상으로 하여 석회질의 통증과 운동 범위의 호전을 2주, 12주, 24주째 각각 비교 관찰하여, Constant-Murley score를 이용하여 평가하였다. 결과: 통증 정도는 Constant-Murley score상 보존적 치료군의 경우 수술 전 평균 3.2에서 치료 이후 2주, 12주, 24주째 각각 13.6점, 14.5점, 14.7점이었으며, 수술적 치료군은 수술 전 평균 3.3에서 수술후 2주, 12주, 24주째 각각 10.2점, 13.0점, 14.3점이었다. 운동 범위는 보존적 치료군의 경우 수술 전 평균 14.3에서 치료 이후 2주, 12주, 24주째 각각 21.7점, 31.3점, 35.7점이었으며, 수술적 치료군은 수술 전 평균 14.4에서 수술후 2주, 12주, 24주째 각각 33.1점, 35.8점, 36.4점이었다. 치료 2주째 및 12주째 두 간의 비교에서는 수술적 치료 군이 유의하게 우수하였으나, 최종 추시시는 통계학적인 차이가 없었다. 결론: 석회화 건염의 조기 관절경적 치료는 환자의 만족도를 높이고 조기에 일상 생활로 복귀할 수 있는 효과적인 치료법으로 사료된다. Purpose: We evaluated the level of pain and clinical presentation of calcific tendinitis after treatment with conservative and early arthroscopic operation. Materials and Methods: We reviewed 30 patients with calcific tendinitis with the minimum of 6 months of follow up period, treated from February 2002 to May 2008. We implemented Constant-Murley score to evaluate the pain of calcification and improvement of range of motion at the 2nd week, 12th week and 24th week with the patients who had treatment with steroid injection in 15 cases and operation in the other 15 cases. Results: Evaluating the level of pain using Constant-Murley score, we found that conservative treatment group had the scale of 3.2 before treatment and 13.6, 14.5 and 14.7 at 2nd, 12th, and 24th week, respectively since started treatment. The operation group, on the other hand, had the scale of 3.3 preoperatively and 10.2, 13.0, and 14.3 at 2nd, 12th and 24th week postoperatively. The range of motion in the conservative treatment group showed 14.3 on average before the treatment and 21.7, 31.3 and 35.7 at 2nd, 12th and 24th week after treatment. The operation group had 14.4 on average preoperatively, and 33.1, 35.8 and 36.4 at 2nd, 12th and 24th week postoperatively. The operation group had statistically significant improvement compared to the conservative group at the 2nd and 24th week, but showed no difference between the two groups at the final follow up. Conclusion: Early arthroscopic treatment of calcific tendinitis seems to be an excellent option that can increase the level of satisfaction of the patients and an efficient way of putting the patients back to their normal life promptly.