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급성하벽심근경색 환자에서 흉부유도 ST 절하강의 임상적 의의
이성구(Sung Ku Lee),백효종(Hyo Jong Baek),서상문(Sang Moon Suh),천병도(Byung Do Chun),이중기(Choong Ki Lee),김신우(Shin Woo Kim),우언조(Eon Jo Woo),강승완(Seung Wan Kang),채성철(Shung Chull Chae),전재은(Jae Eun Jun),박의현(Wee Hyun P 대한내과학회 1992 대한내과학회지 Vol.43 No.4
N/A The prognostic significance of precordial ST segment depression during early stages of acute inferior myocardial infarction is controversial. To examine this problem, electrocardiographic findings on admission were compared with the clinical variables in 50 patients with a first transmural inferior infarction. Patients were classified according to the admission ECG obtained an average of 7.0hours after the onset of chest pain. Twenty-five patients (group I) had≥1.0mm ST depression in at least one of leads V1 to V6 and 25 (group II) did not. There were no significant differences between the two groups in peak creatinine kinase activity, prevalence of in-hospital complications (i, e., congestive heart failure, hypotension, arrhythmias requiring treatment and death), and maximal ST elevation in inferior lead. A weak correlation existed between the quantities (mV) of inferior ST segment elevation and precordial ST depression (r=0.43, p<0.05). Thus, precordial ST depression during acute inferior infarction is not a reliable marker of the extent of myocardial damage or an adverse hospital course. Precordial ST segment depression might represent a benign electrical phenomenon.
Streptozotocin - 당뇨병 백서에서 당뇨병 이환기간에 따른 대동맥의 이완능 저하 및 Oxygen - Free Radical 에 의한 이완능의 손상정도
김정국(Jung Guk Kim),강승완(Sung Wan Kang),권삼(Sam Kwon),백운이(Woon Yi Back),김보완(Bo Wan Kim),하승우(Sung Woo Ha),서예경(Ye Kyung Seo),김수동(Su Dong Kim),김신우(Shin Woo Kim) 대한내과학회 1996 대한내과학회지 Vol.50 No.1
N/A Objectives: Diabetes mellitus produces histological evidence of endothelial alterations as well as changes in vascular function in experimental animal. Oxygen free radicals interfere with or destroy endothelium-dependent relaxation in normal and diabetic blood vessels. The present study was investigated whether the duration of diabetic state can affect the severity of impairment in endothelium-dependent and/or independent relaxation and the sensitivity to oxygen free fadical (OFR)-induced damage in diabetic rat vasculature. Methods: The relaxative responses of aortic rings precontracted with norepinephrine in vitro to cumulative concentrations of acetylcholine (ACh) and nitroglycerine (NTG) were conducted in 3- and 10- week streptozotocin (STZ)-diabetic rats and agematched controls. After exposure to H2O2 generated by mixing xanthine and xanthine oxidase, the degree of impairment in relaxative responses to ACh and NTG were also compared between 3- and 10-week diabetic rats. Results: The relaxative responses of aortic rings produced by cumulative concentrations of ACh were significantly lower in both 3- and 10-week diabetic rats than in the age-matched controls. The impairments of relaxative responses to ACh in 10-week diabetic rats were significantly greater than those in 3-week ones. After H2O2 exposure, the impairments of relaxative responses to ACh in 3- and 10- week diabetic aortas was also significantly greater than those in the control ones. However, the severity of H -induced damage in 10-week diabetic aortas was not significantly different than that in 3-week ones. In contrast, aortic rings of 3- and 10-week diabetic rats could still be fully relaxed by NTG, even after exposure to H2O2. Conclusion: These findings suggest that in STZ-diabetic rat aortas selective impairment of endothelium-dependent relaxation to ACh can be found early even over a 3-week period after the induction of diabetes and the impairment may be greater in those with the longer duration of the diabetic state and that the impairment of the vascular relaxation by OFR is also selective to endothelium-dependent response but the sensitivity of OFR-induced damage may not be related to the duration of the diabetic state
오구견봉인대만을 이용한 술식과 견봉골편을 포함한 오구견봉인대를 이용한 변형 Weaver and Dunn 술식에서의 만성 견봉쇄골관절 손상 치료결과 추시
박진영(Jin-Young Park),강승완(Seung-Wan Kang),이상훈(Sang-Hoon Lhee),서중배(Jung-Bae Seo),이승준(Seung Jun Lee) 대한견주관절의학회 2010 대한견주관절학회지 Vol.13 No.2
목적: 저자들은 만성 견봉쇄골 관절 손상 환자에 대한 치료방법중, 오구견봉인대만을 이용한 변형 Weaver-Dunn 술식과 Shoji 등에 의해 소개된 골편이 부착된 오구견봉인대 전위술식간의 방사선학적 및 기능적인 평가를 통해 양군간의 치료결과를 비교하고자 하였다. 대상 및 방법: 본 연구는 1997년 1월부터 2009년 6월까지 만성 견봉쇄골관절 손상으로 진단받은 50명의 환자를 대상으로 하였다. 이중 20명은 오구견봉인대만을 이용한 변형 Weaver-Dunn 술식을 이용하여 수술하였고, 나머지 30명은 골편을 이용한 술식을 통하여 수술하였다. 두 군의 평균 추시 기간은 각각 13.1 개월과 14.9 개월이었다. 결과: 술 후 1년째의 변형 Weaver-Dunn 군과 골편 이용군의 평균 오구쇄골간격, VAS 점수 및 ASES 점수는 3.8 mm (-3 to 6 mm); 3 mm (-2 to 6 mm), 3.5 (1.0 to 7.0); 4.2 (1.0 to 7.5) and 91.1 (81.66 to 95); 79.6 (31.66 to 95)였다. 두 군간의 방사선학적, 기능적 평가에서 통계학적으로 유의한 차이를 발견할 수는 없었다. 두 군의 실패환자는 각각 2명, 1명이었다. 결론: Shoji 술식군에서 상대적으로 재전위정도가 낮은 양상임을 알 수 있었고, 변형 Weaver-Dunn 술식에 비견할 만한 치료방법으로 생각된다. Purpose: The purpose of our study was to compare treatment results of two different surgical techniques for chronic acromioclavicular joint dislocations. Materials and Methods: Fifty consecutive patients diagnosed as chronic acromioclavicular joint dislocations between January 1997 and June 2009 were included in the study. Patients were randomized into two different groups. Patients in the first group (n=20) were treated using a modified Weaver and Dunn method using a simple coracoacromial ligament transfer method. Patients in the other group (n=30) were treated with acromial bone-block transfer containing coracoacromial ligament. Mean follow-up times for the two groups were 13.1 and 14.9 months, respectively. Results: At 1 year postoperatively, mean coracoclavicular distance, the VAS score and the ASES score for the Weaver-Dunn method group; for the bone block transfer method group were 3.8 mm (-3 to 6 mm), 3.5 (1.0 to 7.0) and 91.1 (81.66 to 95); 3 mm (-2 to 6 mm), 4.2 (1.0 to 7.5) and 79.6 (31.66 to 95). There were no significant differences in radiologic (p=0.377) and functional (p=0.093) results between the two groups. Failures in the former and latter group were, respectively, two and one. Conclusion: The bone block transfer method shows a tendency to maintain coracoclavicular distance and appeared to yield similar results as the modified Weaver Dunn method.
서동현,박용욱,김도영,이상수,윤태경,박현철,강승완,Suh, Dong-Hyun,Park, Yong-Wook,Kim, Do-Young,Lee, Sang-Soo,Yoon, Tae-Kyung,Park, Hyun-Chul,Kang, Seung-Wan 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.1
Purpose: Problematic late sequelae are common following a calcaneal fracture regardless of the initial treatment. We retrospectively evaluated the painful conditions and reviewed the results of the operative treatment in patients with previously treated calcaneal fractures. Materials and Methods: Between October 1996 and September 2001, forty-three patients who underwent subsequent surgical treatment for late sequelae of calcaneal fracture were reviewed. The initial treatment consisted of only immobilization in a cast in 7 patients, closed reduction with pin fixation (Essex-Lopresti technique) in 22 and open reduction and internal fixation in 14. Painful conditions in the hind foot included subtalar arthritis in 31 patients, calcaneofibular impingement in 13, peroneal tendinitis in 6, displaced posterior bony fragment in 3, sural neuritis in 2, subtalar and midtarsal arthritis in 1 and displaced plantar bony fragment in 1. The surgical procedures for the late complications were performed at a mean of 19 months (range, 6 to 35 months) after the injury and consisted of lateral wall ostectomy and in situ subtalar fusion in 28 patients, only lateral wall ostectomy in 5 patients, lateral wall ostectomy and subtalar distraction arthrodesis in 3, removal of displaced posterior bony fragment in 3, sural nerve transposition in the peroneus brevis in 2, triple arthrodesis in 1 and removal of displaced plantar bony fragment in 1. Mean postoperative follow up period was 57 months (range, 33 to 82 months). The results of treatment were evaluated on the basis of pain, improvement in the ability to perform activities of daily living, to return to work or to a pre-injury level of activity. Results: Pain was partially relieved in 38 patients (88%), but not relieved in 5. Function improved in 34 patients (79%), and 32 (74%) returned to work or to a pre-injury level of activity. There was a trend that the longer the interval between the injury and the operation, the longer the subsequent interval until the patient returned to full activities or work. Conclusion: Meticulous physical examination and intensive prompt treatment for remaining pain after initial treatment of calcaneal fractures are recommended for patient's satisfaction and returning to work.
무지 외반증 치료로 사용된 제1 중족골 근위 반월형 절골술 후 발생한 제1 중족골 족배측 각형성 정도
서동현,박용욱,김도영,이상수,서영진,박현철,강승완,Suh, Dong-Hyun,Park, Yong-Wook,Kim, Do-Young,Lee, Sang-Soo,Seo, Young-Jin,Park, Hyun-Chul,Kang, Seung-Wan 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.2
Purpose: We try to retrospectively evaluated the amount of dorsal angulation angle of the first metatarsal commonly occurring as the complication of proximal dome osteotomy for hallux valgus. Materials and Methods: Between January 2004 and March 2004, 34 patients who underwent proximal dome osteotomy for moderate to severe hallux valgus. Two of 34 patients were male, and thirty-two were female. The average age was 57.6 years. We measured and compared hallux valgus angle, 1st-2nd intermetatarsal angle, dorsal angulation angle of 1st metatarsal on preoperative, postoperative, postoperative 3 weeks', postoperative 3 months' X-ray. Results: Osteotomy sites were completely united on plane X-ray in all cases. The hallux valgus angle averaged $41.2^{\circ}$ ($30{\sim}60^{\circ}$) at preoperative, $4.3^{\circ}$ ($-10{\sim}20^{\circ}$) at postoperative, $5.5^{\circ}$ ($-1{\sim}20^{\circ}$) at 3 weeks after operation, $7.8^{\circ}$ ($-2{\sim}20^{\circ}$) at 3 months after operation. The 1st-2nd intermetatarsal angle averaged $17.1^{\circ}$ ($12{\sim}24^{\circ}$) at preoperative, $6.3^{\circ}$ ($0{\sim}13^{\circ}$) at postoperative, $7.2^{\circ}$ ($0{\sim}15^{\circ}$) at 3 weeks after operation, $8.7^{\circ}$ ($0{\sim}18^{\circ}$) at 3 months after operation. The dorsal angulation angle averaged $0.4^{\circ}$ ($0{\sim}3^{\circ}$) at postoperative, $1.6^{\circ}$ ($0{\sim}7^{\circ}$) at 3 weeks after operation, $2.1^{\circ}$ ($0{\sim}8^{\circ}$) at 3 months after operation. There were no statistically correlation between increase of dorsal angulation angle of the distal segment of the first metatarsal and increase of hallux valgus angle or 1st-2nd intermetatarsal angle. Conclusion: Our results shows that the dorsal angulation of distal fragment occurring after the proximal dome osteotomy in the treatment of hallux valgus may be minimized with meticulous surgery and patient's education.