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Esophageal Rupture Due to Diving in Shallow Waters
( Sung Ho Han ),( Soon-ho Chon ),( Jong Hyun Lee ),( Min Koo Lee ),( Oh Sang Kwon ),( Kyoung Hwan Kim ),( Jung Suk Kim ),( Ho Hyoung Lee ),( June Raphael Chon ) 대한외상학회 2018 大韓外傷學會誌 Vol.31 No.1
Delayed esophageal rupture due to blunt injury is not new. However, rupture due to suspected barotrauma is very rare. We describe a case of esophageal rupture in a male 24-year-old patient after diving in shallow waters. The patient was quadriplegic and could not experience the typical chest pain related to rupture and resulting mediastinitis. The rupture was discovered 4 days after emergency decompressive laminectomy and fusion for his cervical spine. The rupture was evidently caused by barotrauma and was discovered four days after admission. He underwent primary closure and pericardial flap as a life-saving procedure.
둔기손상에 대한 쇄골골절에 생긴 외상성 쇄골하동맥 박리: 폐쇄가 길면 수술하느냐 또는 스텐트를 삽입하느냐?
전순호 ( Soon Ho Chon ),이길수 ( Kil Soo Yie ),강재걸 ( Jae Gul Kang ) 대한외상학회 2015 大韓外傷學會誌 Vol.28 No.3
Subclavian injuries in blunt trauma are reported in less than 1% of all arterial injuries or chest related injuries. We report a female 68 yr-old patient whom has visited our emergency center due to a motorcycle traffic accident with complaints of right chest wall and shoulder pain. Her injury severity score was 22 and she was found with a comminuted clavicle fracture and subclavian artery injury. She developed delayed symptoms of pallor, pain and motor weakness with loss of pulse in her right arm. Attempts at intervention failed and thus, she underwent emergency artificial graft bypass from her subclavian artery to her brachial artery. Her postoperative course was uneventful and she is happy with the results. Although rare, a high index of suspicion for the injury must be noted and the inevitable surgical option must always be considered. [ J Trauma Inj 2015; 28: 219-221 ]
Rib Fixation for a Patient with Severely Displaced and Overlapped Costal Cartilage Fractures
( Sung Ho Han ),( Soon-ho Chon ),( Jong Hyun Lee ),( Min Koo Lee ),( Oh Sang Kwon ),( Kyoung Hwan Kim ),( Jung Suk Kim ),( Ho Hyoung Lee ) 대한외상학회 2018 大韓外傷學會誌 Vol.31 No.1
Rib fixations for flail chest or displaced rib fractures are not a new technique. However, reports on rib fixations involving costal cartilage fractures are very few and surprisingly there are no reports of internal fixations involving only the costal cartilage in the English literature. The diagnosis is difficult and the necessity of the procedure may be quite controversial. Placing plates in screws into the costal cartilage alone may seem unstable and easily dislodged or stripped through the cartilage. We report a 31-year-old male scuba diver instructor who underwent rib fixations over his 7th and 8th costal cartilage ribs for severe pain. The procedure was done with conventional plates and screws. He had the plates and screws removed 2 months later due to lingering pain, but with them removed he is now quite happy with the results without pain. The procedure for fixation of painful overlapped costal cartilage is quite simple and can be done with the usual conventional methods, fixating plate and screws directly over the cartilage alone without fixation over the bony rib.
양수호,전양빈,전순호,김혁,정원상,최요원,전석철,전석훈,박문향,지행옥,Yang, Soo-Ho,Chon, Yang-Bin,Chon, Soon-Ho,Kim, Hyuk,Chung, Won-Sang,Choi, Yo-Won,Chon, Suk-Chul,Chon, Suk-Hoon,Park, Moon-Hyang,Jee, Heng-Ok 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery (J Chest Surg) Vol.31 No.2
악성 간엽종은 유아와 태생기에서 매우 드문 종양이다. 악성간엽종은 성인에서 극히 드물고 섬유조직이외의 둘 또는 그 이상의 간엽성분으로 구성된 종양으로 결체조직의 어떤 형태로도 분화할 가능성이 있는 태생기 간엽에서 기원한다고 생각된다. 환자는 61세 남자로 2개월 전 가래를 동반한 기침을 주소로 검사를 받던 중 우폐상부에 매우 큰 종괴를 보이는 암종으로 입원하였다. 환자는 우폐상부 미세침윤조직검사상 편평상피세포암 의심하에 우전폐절제술을 받았다. 수술장 소견상 종괴는 흉벽과 심하게 유착되었으며 우폐하부까지 침습된 소견을 보이는 악성간엽종으로 진단되었다. 환자는 수술후 5,000rad의 방사선 조사를 받고 수술후 6개월째인 현재까지 재발징후없이 경과 관찰중이다. Malignant mesenchymoma is a very rare tumor presented during the embryonic and infant period and malignant mesenchymoma in the adult is extremely rare. Tumor is composed of two or more unrelated mesenchymal derivatives apart from fibrous tissue. These tumors are thought to be originated from embryonic mesenchyme capable of differentiating into any type of connective tissue. A 61 years old man with complaints of cough and copious sputum of onset of two months was admitted after initial examinations, showing a very huge mass over the right upper lobe. Right pneumonectomy with partial rib resection of 3rd, 4th, and 5th ribs was performed due to the initial diagnostic impression of squamous cell carcinoma by the fine needle aspiration biopsy. The operative field presented a mass locating across the interlobal fissure with severe adhesions to the chest wall. Postoperatively, the patient received 5,000 rads of radiotherapy and presently, 6 months later, has shown no signs of recurrence.
신성호,전양빈,전순호,강정호,김혁,정원상,김영학,지행옥,Shin, Sung-Ho,Chon, Yang-Bin,Chon, Soon-Ho,Kang, Jung-Ho,Kim, Hyuk,Chung, Won-Sang,Kim, Young-Hak,Jee, Heng-Ok 대한흉부심장혈관외과학회 1998 Journal of Chest Surgery (J Chest Surg) Vol.31 No.9
Poland씨 증후군과 관련된 흉벽기형은 매우 드문 질환으로 선천적으로 대흉근의 흉골부 결손과 한쪽 상지의 다양한 기형을 동반한다. 또한 Poland씨 증후군의 다른 임상적 특징은 유방과 유두의 결손 및 저형성, 피하 지방과 액모의 결손, 늑연골 및 늑골전면부의 이상을 포함한다. 그 기원은 확실하지 않으나 유전과는 관계 가 없는 것으로 알려져 있다. Poland씨 증후군은 심한 정신적인 그리고 신체적인 문제를 일으킬 수 있으며 초기 발견 및 수술적 교정이 이득이 될 것으로 생각된다. 본원은 Poland씨 증후군으로 진단된 37세 남자환자를 성공적으로 수술치험하였기에 이를 보고하는 바이다. The chest wall deformity associated with Poland's syndrome is a very rare anomaly which consists of congenital unilateral absence of the sternal head of the pectoralis major muscle and various abnormalities of the upper extremity. Other clinical features associated with Poland's syndrome include deficiency or absence of the breast and nipple, deficiency of subcutaneous fat and axillary hair, and abnormalities of costal cartilages and anterior ends of ribs. The origin remains uncertain, but is considered not to be hereditary. Poland's syndrome may pose a serious psychologic and cosmetic problem, early recognition and surgical correction may prove beneficial. A 37 year old patient with Poland's syndrome was encountered and underwent satisfactory surgical correction.
Chon, Hyangah,Wang, Rui,Lee, Sangyeop,Bang, So-Young,Lee, Hye-Soon,Bae, Sang-Cheol,Hong, Sung Hyun,Yoon, Young Ho,Lim, Dong Woo,deMello, Andrew J,Choo, Jaebum Springer-Verlag 2015 Analytical and Bioanalytical Chemistry Vol.407 No.27
<P>We assessed the clinical feasibility of conducting immunoassays based on surface-enhanced Raman scattering (SERS) in the early diagnosis of rheumatoid arthritis (RA). An autoantibody against citrullinated peptide (anti-CCP) was used as a biomarker, magnetic beads conjugated with CCP were used as substrates, and the SERS nanotags were comprised of anti-human IgG-conjugated hollow gold nanospheres (HGNs). We were able to determine the anti-CCP serum levels successfully by observing the distinctive Raman intensities corresponding to the SERS nanotags. At high concentrations of anti-CCP (>25??U/mL), the results obtained from the SERS assay confirmed those obtained via an ELISA-based assay. Nevertheless, quantitation via our SERS-based assay is significantly more accurate at low concentrations (<25??U/mL). In this study, we compared the results of an anti-CCP assay of 74 clinical blood samples obtained from the SERS-based assay to that of a commercial ELISA kit. The results of the anti-CCP-positive group (n???=???31, >25??U/mL) revealed a good correlation between the ELISA and SERS-based assays. However, in the anti-CCP-negative group (n???=???43, <25??U/mL), the SERS-based assay was shown to be more reproducible. Accordingly, we suggest that SERS-based assays are novel and potentially useful tools in the early diagnosis of RA.</P>
이식물에 따른 전방 십자 인대 재건술의 결과 비교 : 자가 골-슬개건-골, 동종 골-슬개건-골 그리고 동종 아킬레스건의 비교
최호림,최원태,이정웅,전재균,김의순,이장근,고염규 대한슬관절학회 2001 대한슬관절학회지 Vol.13 No.2
목적 : 전방 십자 인대 손상 환자를 대상으로 자가 및 동종 골-슬개건-골, 그리고 동종 아키레스 건을 이용해 관절경적 재건술을 시행하고 이들의 임상 경과를 분석하여 보고하고자 한다. 대상 및 방법 : 1995년 7월부터 2001년 4월까지 본원에서 전방 십자 인대 손상 환자를 대상으로 관절경적 재건술을 시행한 147례 중 2년 이상 추시가 가능했던 32명의 환자를 대상으로 하였다. 제 Ⅰ군(13 례)은 자가 골-슬개건-골 이식물을 이용하고, 제 Ⅱ군(11례)은 동종 아킬레스 건 이식술을, 그리고 제 Ⅲ군(8 례)에서는 동종 골-슬개건-골 이식술을 이용하겨 재건술을 시행하였다. 수술시 평균 환자의 나이는 34세였고, 평균 추시 기간은 35개월(25개월~54개월)이었다. 환자의 주관적 평가로 IKDV knee ligament standard evaluation form과 Lysholm knee scoring scale을 사용하였고 객관적 전·후방 안정도의 측정을 위해서 KT-2000TM arthrometer(MED metic, USA)를 사용하였다. Kruskal-Wallis test와 Mann-Whit-ney U(Wilcoxon Rank Sum) 검정법을 이용하여 세 집단을 비교 통계 분석하였다. 결과 : IKDC 최종 평가상 모든 군에서 B(거의 정상) 이상으로 양호하였고, 이식건 공여부 동통은 자가 골-슬개건-골을 이용한 군에서 2례 발생하였으나 통계학적인 유효성은 없었다. KT-2000^TM arthrometer에서는 30lb 부하시 정상측과 비교하여 슬 후 제 1군 1.96mm, 제 2군 2.32mm, 제 3군 2.6mm의 차이를 보여 만족스러운 결과를 보였다. Lysholm knee scoring scale을 이용한 평가는 제 Ⅰ군이 평균 88점(good), 제 Ⅱ군이 85점(goood), 제 Ⅲ군이 89점(good)이었다. 결론 : 전방 십자 인대 재건술시 이식건의 선택은 환자 개개인의 특성에 따라 달라져야 할것으로 생각되며, 동종 이식물도 임상적으로 좋은 결과를 보여 자가 이식건의 대체물로 사용될 수 있으리라 사료된다. Purpose : To compare the long-term results of reconstruction for the anterior cruciate ligament used by BPTB autograft, BPTB allograft and Achilles tendon allograft. Materials and Methods : We reviewed the results of 147 patients who had been managed with arthroscopic ACL reconstruction using different graft such as BPTB autograft, Achilles tendon allograft and allograft BPTB. Thirty two patients(average age, 34 years) were retrospectively evaluated. The follow-up period was more than two years(average, 35 months). Results were evaluated with IKDC knee ligament standard evaluation form, KT-2000^TM arthrometer, and Lysholm knee scoring scale. Kruskal-Wallis test and Mann-Whitney U test(Wilcoxon Rank Sun) were used for statistical analysis. Results : On IKDC scale, the final evaluation was nearly normal in all patients. We could not find statistical difference among the three groups by KT-2000TM arthrometer. Conclusion : The use of allografts may be an acceptable choice for ACL reconstruction.