응급실로 내원한 자의 손상 환자의 특징

곽영수 ( Young Soo Kwak ),이강현 ( Kang Hyun Lee ),신형진 ( Hyung Jin Shin ),박경혜 ( Kyung Hye Park ),최한주 ( Han Joo Choi ),김현 ( Hyun Kim ),황성오 ( Sung Oh Hwang ) 대한외상학회 2009 大韓外傷學會誌 Vol.22 No.1

Purpose: Many studies have addressed a psychiatric analysis of self-injury patients who have self-injurious behavior and who have attempted suicide. Few studies on the injury characteristics of self-injury related trauma patients have been conducted. We analyzed the injury characteristics of self-injury patients. Methods: A retrospective review of the medical records extracted from the injury surveillance system of Wonju Christian Hospital for the period from August 2006 to February 2008 was conducted. Of the 121 cases extracted, 103 were included in this study. We analyzed the sex ratio, age group, place of injury, injury mechanism, location of injury, management results, injury severity, and relation with drinking. Results: One hundred three cases were included (sex ratio: 1.06), and the mean age was 33.9±14.2 years old. Fifty-six patients (54.4%) were discharged from the emergency department (ED) on the day of injury after primary care, and 9 patients (8.7%) were discharged, because they refused treatment. Seven patients (6.8%) died. Of these, 4 patients (3.9%) died after attempted cardio-pulmonary resuscitation in the ED, 1 patient (1%) was dead on arrival, and 2 patients (1.9%) died after admission. Sixteen patients (15.5%) were admitted to the hospital, including 2 patients (1.9%) needing emergency surgery. Sixteen patients (15.5%) were transferred to other hospitals. Sixty-one cases (59.2%) involved drinking, and 31 (30.1%) did not; for 11 cases (10.7%), the involvement of drinking was unknown. The mean revised trauma score (RTS) was 11.26±2.52, and 88 cases (85.4%) hat a RTS of 12. The mean injury severity score (ISS) was 5.80±14.56, and 9 (8.7%) severely injured patients had scores of more than 15. Conclusion: Most self-injuries were mild traumas related to drinking and occurred at a young age. Most cases were not so severe, and the patients were discharged from the ED, but some patients needed hospitalization. Other patients had injuries so severe that they died. (J Korean Soc Traumatol 2009;22:65-70)

PET위 유전적 및 기계적 특성에 관한 연구

박정후 ; 메마리 ; 곽영수 ; 조정수 釜山大學校 工科大學 1990 工科大學 硏究 報告 Vol.39 No.-

Quantitative Analysis of Tissue Injury after Minimally Invasive Total Hip Arthroplasty

곽상준,전영수,유기형,차재룡,조윤제 대한정형외과학회 2014 Clinics in Orthopedic Surgery Vol.6 No.3

Background: We intended to clarify the hypothesis that minimally invasive total hip arthroplasty (MI-THA) leads to less tissue damage and inflammatory response than does conventional total hip arthroplasty (C-THA). Methods: We performed 30 cases of THA between September 2005 and May 2006 and evaluated these cases prospectively. We chose 15 MI-THA cases for the study group and another 15 C-THA cases for the control group. We checked skeletal muscle marker enzymes, such as serum creatinine kinase and aldolase, the pro-inflammatory cytokines, interleukin (IL)-6 and 8, and the anti-inflammatory cytokines, IL-10 and IL-1 receptor antagonist (ra) the day before surgery and at postoperative days 1, 7, and 14. Results: On postoperative days 1 and 3, the study group showed significantly lower serum creatinine kinase, IL-6, IL-10, and IL-1ra values than those in the control group. Additionally, IL-8 was significantly lower on day 7 after surgery. Conclusions: These data show that MI-THA decreased the release of muscle marker enzymes due to tissue damage immediately after surgery and minimized the inflammatory response related to the surgery during the early postoperative period.

Diagnosis of fibroadenoma using radiolabeled bladder cancer specific peptide

하영수,곽원정,이화영,이병헌,홍일화,정규식,안광일,유정수 대한방사성의약품학회 2015 Journal of radiopharmaceuticals and molecular prob Vol.1 No.1

Most tumors are believed to overexpress several receptors, and small peptides targeting these receptors were developed for diagnosis and tumor therapy during past decade. Here we report that fibroadenoma can be visualized by bladder cancer specific peptide. A 9-mer bladder cancer specific peptide, which was discovered from the phage display method, was synthesized by peptide synthesizer, and additional tyrosine was conjugated at the N-terminal for radioiodination (Y-BP). Y-BP was radiolabeled with 131/124I using Iodogen tube. The rat treated with N-butyl-N-(4-hydroxybutyl)nitrosamine for 8 weeks was allowed to grow until large size tumor was developed under axilla. The tumor model was microPET imaged sequentially using [18F]FDG and radioiodinated 124I-Y-BP. The tumor was excised and examined by immunostaining studies. Radioiodinated 124I-Y-BP was purified using fast protein liquid chromatography (FPLC) in > 90% radiochemical purity. The whole tumor was well visualized by [18F]FDG with several intense focal uptake within tumor. The tumor was also clearly seen with 124I-Y-BP at 4 h post-injection, and to our surprise the tumor uptake of 124I-Y-BP lasted up to three days. The tumor was diagnosed histologically as a fibroadenoma derived from mammary gland. In conclusion, the bladder cancer specific peptide showed the good potential as a new radiotracer for the detection of breast fibroadenoma. J Radiopharm Mol Probes 1(1):38-45, 2015

2013년 베트남 구순구개열 봉사 보고

곽은정,정승원,이규태,정휘동,정영수 대한구순구개열학회 2013 대한구순구개열학회지 Vol.16 No.2

Our department has been participated on annual volunteer medical service for the cleft lip and palate patients in the provincial hospital of Quang Nam Province, Tamky, Vietnam, since 2011, in collaboration with Japanese team. This year, the medical service was schedule from the 1st to the 6th of June. On the first day, 55 patients were examined and 27 patients were selected for the surgery. Later, additional 3 patients were examined and 2 were decided to have the surgery. Surgery was performed from the 2nd to the 6th day and our department took charge of 10 patients. Among the 10 patients, two flap palatoplasty was performed on 4 patients who had been diagnosed as incomplete cleft palate, Mulliken’s modification of rotation advancement was performed on 2 patients who had been diagnosed as unilateral incomplete cleft lip and palate, and secondary lip and nasal deformity each. Unilimb Z-plasty was performed on 3 patients who had been diagnosed as secondary lip and nasal deformity, and intravelar veloplasty was performed on 1 patient who had been diagnosed as breakdown uvula. We report the cases and surgical techniques used for the treatment of cleft lip and palate patients in Tamky during the medical service, 2013. Furthermore, we represent our results and plan to improve the medical service program.

Acetabular Insufficiency Fracture Following Prolonged Alendronate Use and the Failure of Total Hip Arthroplasty in “Frozen” Bone: Two Cases Report

곽상준,조윤제,정광영,이주현,전영수,유기형 대한고관절학회 2017 Hip and Pelvis Vol.29 No.4

Atypical insufficiency fracture of the femur following prolonged bisphosphonate use is well described. Regardless of the cause, insufficiency fracture of the acetabulum is extremely rare, and no reports have described insufficiency fractures of the acetabulum that are associated with prolonged bisphosphonate use. This report demonstrates the possibility of insufficiency fracture at the acetabulum following long-term alendronate use and the necessity of particular care in managing insufficiency fractures in “frozen” bone. We describe two cases of insufficiency fracture of the acetabulum following 6 years of alendronate use. Given the patients’ medical histories and bone biopsy findings, these insufficiency fractures were thought to be attributable to alendronate use. One case involved the left hip and the presence of pelvic fractures on the opposite side. The patient was treated using cementless total hip arthroplasty (THA), which failed 1 year after surgery. The hip was revised with a massive bone graft and a supportive wire mesh. The other case was managed via THA with a Ganz reinforcement ring due to concerns regarding the use of a cementless implant.

무시된 대퇴경부 골절로 오인된 방사선 유발 속발성 골육종의 병적 골절

전영수(Young Soo Chun),한정수(Chung Soo Han),곽상준(Sang Joon Kwak),허동범(Dong Bum Huh) 대한정형외과학회 2011 대한정형외과학회지 Vol.46 No.3

소발성 골육종은 소아에서는 드물며, 이들 중 절반 이상이 50세 이상의 환자에서 발생하는 것으로 알려져 있다. 방사선 치료 후 발생하는 이차성 골육종은 2,500 cGy 이상의 방사선 치료를 받은 환자의 약 1%에서, 노출 후 약 10-15년 후에 발생하며, 방사선 치료 후에 발생하는 가장 흔한 형태의 육종이다. 우측 대퇴경부골절로 본 병원을 방문한 51세 여자 환자는 9년 전 혈관점액종(angiomyxoma)으로 방사선 치료를 받은 병력을 가지고 있으며, 2주 전에 동일 부위의 낙상으로 인해 충격 받은 병력이 있었다. 방사선 사진상 골절부위의 경화소견이 관찰되어 지연 진단된 대퇴경부골절로 진단하였다. 비관혈적 정복 및 나사못 고정술로 치료한 후 통증의 지속 및 과다한 가골 형성의 소견을 보여 정밀 검사를 시행하였고, 방사선 조사 후 발생한 속발성 골육종에 의한 병적 골절로 진단하였다. 본 증례를 통하여 오진된 골육종에 대한 경각심을 주고자 한다. Secondary osteosarcoma has a relatively higher incidence in middle aged persons than in children. Radiation-induced osteosarcoma occurs in approximately 1% of patients who have been treated with more than 2,500 cGy. The time interval from radiation to onset of secondary osteosarcoma is approximately 10 to 15 years. A 51-year-old female who have been treated with radiation for angiomyxoma was hospitalized due to right hip pain. She had a minor trauma 2 weeks prior to hospitalization. A day before hospitalization, she experienced a second trauma by fall, and then, severe hip pain developed. A radiograph of the patient showed femoral neck fracture with sclerotic change of fractured margin. We diagnosed the patient as having a neglected femoral neck fracture and treated it with closed reduction using cannulated screw fixation. At 6 months post-surgery, the patient had residual pain of the right hip and we could find overproduced callus at the fracture site. Through further evaluation, we diagnosed this as secondary osteosarcoma with pulmonary metastasis. We report this case to make a warning about a misdiagnosed osteosarcoma as a simple femoral neck fracture.

비구 강화 환을 이용한 고관절 비구컵 재치환술의 중기 추시 결과

곽상준 ( Sang Joon Kwak ),전영수 ( Young Soo Chun ),유기형 ( Kee Hyung Rhyu ),허동범 ( Dong Bum Huh ),유명철 ( Myung Chul Yoo ),조윤제 ( Yoon Je Cho ) 대한고관절학회 2011 Hip and Pelvis Vol.23 No.3

목적: 비구 강화 환(reinforcement ring)을 사용하여 인공 고관절 재치환술을 시행한 후 임상적 및 방사선학적 결과를 분석하고자 하였다. 대상 및 방법: 1997년부터 2005년까지 36명의 환자 36예를 대상으로 비구 강화환과 동종 골이식을 이용하여 비구 재 치환술이 시행되었다. AAOS III형 골 결손이 34예, IV형이 2예였다. 수술 후 평균 추시 기간은 7.2년이었다. 결과: 술전에 비하여 Harris 고관절 점수는 92.3점으로 의미 있게 향상되었다(p<0.001). 1예에서 이식 골과 골반 골 사이의 유합이 되지 않아 비구 컵의 해리가 발생하였고, 감염이 2예(5.4%), 고관절 탈구 2예(5.4%) 발생하였다. 수술 중 비구 강화 환의 부적절한 고정이 이루어진 1예를 제외한 모든 예에서 골 이식은 잘 유합 되었다. 재 치환술이 필요했던 경우와 비구 컵의 해리가 발생한 경우를 재 치환술의 실패로 정의하였을 때 성공률은 91.7%였다. 결론: 비구 강화환을 이용하여 비구 재치환술을 시행받은 환자에서 비구 주위 골재건과, 훌륭한 임상적 및 방사선학적 결과를 보여주었다. 좋은 결과를 얻기 위해서는 수술 시 정확한 삽입물의 삽입이 필요하며, 각각의 비구 강화환의 종류에 따른 특성을 잘 이해하고 시행해야겠다. Purpose: To evaluate the clinical and radiographic outcomes of the revision total hip arthroplasty using the acetabular reinforcement ring. Materials and Methods: Thirty-six acetabular revisions were performed in 36 patients with use of the reinforcement ring and structural or morselized allograft, between 1997 and 2005, in thirty-six patients. According to the AAOS classification, thirty-four cases of acetabular defects were Ttype III, and two were Ttype IV. Mean follow-up period after surgery was 7.2 years. Results: The mean Harris hip score was 92.3, which was significantly increased compared with the preoperative score. (p<0.001). There were five failures: a case of aseptic loosening of Muller ring, two cases of infection (5.4%) and two cases of hip dislocation (5.4%). Graft incorporation and bone remodeling occurred successfully in all hips, but in the case of aseptic loosening in which the ring fixation had been inadequate at the time of surgery. The success rate was 91.7% with a mean follow-up of 7.2 years, if the cases of revision or loosening of the component were classified into failure cases. Conclusion: Patients treated with acetabular revision with three kinds of reinforcement ring had reconstitution of periacetabular bone stock as well as good clinical and radiographic results. For the good results, the secure implant fixation during the surgery should be confirmed and we should completely understand the characters of the each kinds of reinforcement rings.

공구경 보정을 이용한 2차원 자유곡선의 가공

신하용,정회민,곽영수 대한산업공학회 1995 산업공학 Vol.8 No.3

주철근 겹침이음 및 형상비에 따른 철근콘크리트 교각의 내진거동 분석

조창백,신호진,곽임종,정영수 한국지진공학회 2012 한국지진공학회논문집 Vol.16 No.5

국내외 교량의 내진성능 평가관련 연구들을 조사, 분석한 결과 국내에서 휨 거동 교각의 내진성능에 대한 연구는 상당히 이루어졌으나, 국내에 상당수 분포하는 것으로 분석된 휨-전단 교각에 대해서는 연구실적이 부족한 것으로 파악되었다. 따라서, 이 연구에서는 휨-전단 복합거동이 예측되는 형상비 2.67과 전단거동이 예측되는 형상비 2.25의 실물크기 실험체 및 형상비 2.67의 축소모형 실험체를 제작하여 준정적 내진성능 실험을 실시하였으 며, 주철근의 겹침이음과, 형상비 변화에 따른 파괴거동을 조사 및 분석하였다. 실험결과 휨-전단거동이 예상되는 형상비 부근의 교각은 형상비와 철근상세 변화에 따라 파괴거동 특성이 휨-전단 파괴에서 전단 파괴 또는휨 파괴, 그리고 주철근 부착파괴로 변하는 것을 확인할 수 있었다. 이와 같은 실험결과들로부터 비내진 원형 철근콘크리트 교각에 대한항복변위 및 극한변위 산정식을 제안하여 실험을 실시하지 않고도 실제 비내진 교각의 내진성능을 파악할 수 있도록 하였으며, 이는 추후비내진으로 분류되는 실제 교량의 내진성능 조사 및 보수보강에 큰 도움이 될 것으로 판단된다. The objective of this study is to evaluate the seismic capacity of RC piers with small aspect ratios. Test specimens were selected from the prototype piers among existing national roadway bridges which are expected to fail in shear and/or complex shear-flexural mode. Two groups of full scale RC pier models were constructed with aspect ratios of 2.25 and 2.67. Quasi-static tests have been implemented to investigate the failure behavior of the RC piers in terms of the lap-spliced longitudinal reinforcing steel and the aspect ratio. It is confirmed that regarding its shear-flexural behavior, the pier is very sensitive to the aspect ratio or details. In the case of a test pier with highly lap-spliced longitudinal bars, the bond failure of lap-splice steels was the dominant cause of failure before the occurrence of flexure or shear-flexural failure, despite a slight change in the aspect ratio. Finally, based on the test results and analysis, this paper proposes formulas for the yielding and ultimate displacements of circular reinforced concrete bridge piers without seismic details. These formulas will be useful for the investigation and upgrade of the seismic capacity of bridge piers without seismic details.