고령의 대퇴골 불안정형 전자간 골절의 수술적 치료 -압박 고나사 단독 사용과 전자부 안정화 금속판 병용 사용군의 비교-

김갑중 ( Kap Jung Kim ),양대석 ( Dae Suk Yang ),이상기 ( Sang Ki Lee ),최원식 ( Won Sik Choy ),배경완 ( Kyoung Wan Bae ) 대한골절학회 2011 대한골절학회지 Vol.24 No.4

목적: 65세 이상 대퇴골 불안정형 전자부 골절에서 압박 고나사 단독 사용군과 압박 고나사와 전자부 안정화 금속판 병용 사용 군의 방사선학적 결과를 비교 분석하고자 하였다. 대상 및 방법: 2006년부터 2009년 5월까지 대퇴골 불안정형 전자부 골절로 압박 고나사 단독 사용 또는 압박 고나사와 전자부 안정화 금속판을 병용 사용해서 수술을 시행한 121예를 대상으로 하였다. 압박 고나사 사용군 (제1군)은 54예, 압박 고나사와 전자부 안정화 금속판 병용 사용군 (제2군)은 67예였다. 주기적 방사선 촬영을 통해 지연 나사의 활강, 대전자의 외측 전이, 대퇴 경-간각 변화 및 합병증을 비교 분석하였다. 결과: 평균 지연 나사의 활강은 1군 7.6 mm, 2군 3.9 mm로 2군이 지연 나사 활강이 적었다 (p=0.001). 평균 대전자 외측 전이는 1군 3.86 mm, 2군 0.59 mm로 2군이 적었다 (p=0.01). 평균 대퇴 경-간각 변화는 1군 3.57°, 2군 3.66°로 유사하였다. 1군에서 15예, 2군에서 10예의 합병증이 있었다. 결론: 65세 이상 고령의 대퇴골 불안정형 전자부 골절에서 압박 고나사와 전자부 안정화 금속판의 병용 사용은 지연 나사의 활강과 대전자 외측 전이를 감소 및 낮은 수술 후 합병증으로 유용한 술식으로 생각된다. Purpose: To evaluate the radiologic results between compressive hip screw and compressive hip screw with additional trochanteric stabilizing plate in patients with femoral unstable intertrochanteric fractures in patients with more 65 years old. Materials and Methods: From 2006 to May 2009, 121 cases were included. Group I (compressive hip screw only) was 54 cases and group II (compressive hip screw with trochanteric stabilizing plate) was 67 cases. We checked the lag screw sliding, lateral translation of greater trochanter, changes of neck-shaft angle and complications through periodic follow up of radiographs. Results: Mean lag screw sliding was 7.6 mm in group I and 3.9 mm in group II (p=0.001). Mean lateral translation of greater trochanter was 3.86 mm in group I and 0.59 mm in group II (p=0.01). Mean changes of neck-shaft angle was nearly the same, 3.57° in group I and 3.66° in group II. Complications were 15 cases in group I and 10 cases in group II. Conclusion: Compressive hip screw with additional trochanteric stabilizing plate was effective surgical option in patients with femoral unstable intertrochanteric fractures in patients with more than 65 years old. It decreased lag screw sliding, lateral translation of greater trochanter and complication rates.

족근관 증후군의 수술적 치료

안재훈,김갑중,김하용,최원식,양대석,Ahn, Jae-Hoon,Kim, Kap-Jung,Kim, Ha-Yong,Choy, Won-Sik,Yang, Dae-Suk 대한족부족관절학회 2007 대한족부족관절학회지 Vol.11 No.2

Purpose: The authors intended to analyze the operative results of tarsal tunnel syndrome. Materials and Methods: Twenty-one patients with tarsal tunnel syndrome were followed for more than 1 year after operation. The mean age was 44 years, and the mean follow up period was 2 years and 9 months. Clinically preoperative and postoperative AOFAS ankle-hindfoot score and visual analogue scale for pain were analyzed. Radiologically the cause of disease was investigated, and the size of mass was measured, if possible. The duration of symptom, the presence of space occupying lesion (SOL), the effect of epineurolysis were statistically analyzed to see the relation with the operative results. Results: Operative release of tarsal tunnel was done in all cases, and epineurolysis was done in 11 cases. The causes of the disease were 10 soft tissue masses, 7 talocalcaneal coalitions, 1 nonunion of medial talar process fracture, and 1 pes planovalgus, and 3 idiopathic cases. The masses were subdivided into 7 ganglions, 2 neurilemmomas, and 1 lipoma. There was 1 case of combined talocalcaneal coalition and ganglion. Clinically AOFAS ankle-hindfoot score was increased from 62.7 points preoperatively to 84.3 points postoperatively. Visual analogue scale was improved from 6.5 preoperatively to 2.2 postoperatively. Two cases were graded as unsatisfactory. One was severe pes planovalgus, and the other was idiopathic case. The duration of symptom and the epineurolysis were not related with the results. However the presence of space occupying lesion was significantly related with the good results. Conclusion: Early operative release of tarsal tunnel appears to be important for the improvement of symptom. However the prognosis is limited in case that there is no SOL.

수부에 발생한 기괴 방골성 골연골성 증식증(Nora 병변)의 염색체 변이

김갑중(Kap-Jung Kim),김하용(Ha Yong Kim),양대석(Dae Suk Yang),최원식(Won-Sik Choy),임춘화(Chun Wha Ihm) 대한정형외과학회 2008 대한정형외과학회지 Vol.43 No.2

기괴 방골성 골연골성 증식증은 중족골, 중수골, 근위지와 중위지에 호발하는 골연골종과 유사한 질환이다. 주로 골종괴로 인한 증상을 나타내며 재발이 흔하나 양성인 경과를 취한다. 최근에는 병변의 염색체 검사를 통해 1번 염색체와 17번 염색체간에 전이를 보고한 저자들도 있다. 저자들은 수부 중위골에 발생한 1예의 기괴 방골성 골연골성 증식증을 치료하고 염색체 분석에서 전위와 중복을 확인하였기에 문헌 고찰과 함께 보고하는 바이다. Bizarre parosteal osteochondromatous proliferation is a disease similar to an osteochondroma that usually involves the metatarsal, metacarpal, proximal and middle phalanx. The symptoms are normally caused by the bone mass, the condition has a benign clinical course but recurrence is common. Recently, it was reported that there is a translocation between chromosome 1 and 17. We report a case of BPOP in the middle phalanx of hand with translocations and duplication in cytogenetic karyotyping with a review of relevant literature.

큰 대퇴골두를 사용한 무시멘트 세라믹 고관절 전치환술

최원식(Won Sik Choy),안재훈(Jae Hoon Ahn),감병섭(Byoung Sup Kam),양대석(Dae-Suk Yang),차용한(Yong-Han Cha),이능기(Neung-Ki Lee) 대한정형외과학회 2010 대한정형외과학회지 Vol.45 No.5

목적: 큰 대퇴골두를 사용한 세라믹-세라믹 관절면 무시멘트 고관절 전치환술의 임상적 및 방사선학적 결과를 분석하고자 하였다. 대상 및 농법: 36㎜의 대퇴골두를 사용한 세라믹-세라믹 관절면 무시멘트 고관절 전치환술을 시행하였던 환자 중 2년 이상 추시 가능하였던 환자 72예를 대상으로 하였다. 평균 연령은 62세(50-85), 평균 추시기간은 35.3개월 (25-53개월)이었다. 임상적 평가로는 Harris hip score와 서혜부 및 대퇴부 통증을 조시하였다. 방사선학적으로 각종 지표를 이용하여 분석하였다. 결과: 평균 Harris hip score는 술전 57.5점에서 최종 추시 시 94.8점으로 상승하였다. 고관절의 평균 운동범위는 굴곡 109° (100°-125°), 외회전 42° (35°-49°), 외전 35°(30°-45°)였다. 최종 추시 시 임상적으로 유의한 서혜부 통증이 1예 있었다. 추시 방사선 사진상 대퇴 삽입물의 진행성 수직침강이나 비구컵 정사도의 유의한 변화는 없었으며, 전례에서 안정성을 유지하였다. 방사선 투과 선은 대퇴측에서 4예 (5.6%), 비구측에서 2예(2.8%)에서 보였으며, 골내막 신생골 형성은 대퇴측에서 28예(38.9%), 비구측에서 26에(36.1%)에서 각각 관찰되었다. 골용해는 대퇴측과 비구측에서 모두 관찰되지 않았다. 결론: 큰 대퇴골두를 사용한 세라믹-세라믹 관절면 무시멘트 고관절 전치환술의 최소 2년 이상 추시 결과 임상적으로 만족스러운 결과를 얻었다. Purpose: The authors evaluated the clinical and radiological results of ceramic on ceramic articulation cementless total hip arthroplasty using a large diameter head. Materials and Methods: Seventy-two hips were followed for more than 2 years after ceramic on ceramic articulation cementless total hip arthroplasty using a 36 ㎜ diameter head. The mean patient age was 62 years (range 50-85), and the mean followup period was 35.3 months (range 25-53). The Harris hip score, the postoperative inguinal pain and the thigh pain were analyzed clinically. The radiological results were assessed using various radiological indices. Results: The mean Harris hip score improved from preoperative 57.5 points to postoperative 94.8 points The postoperative mean flexion of hip was 109° (range 100°-125°), external rotation was 42° (range: 35°-49°) and abduction was 35° (range: 30°-45°). There was one case of inguinal pain. Radiologically, all the stems demonstrated stable fixation without progressive subsidence of the stem or significant change in the cup obliquity. A radiolucent line was observed around the stem in 4 cases (56%) and around the cup in 2 cases (28%). Endosteal new bone formation was observed around the stem in 28 cases (38.9%) and around the cup in 26 cases (361 %) There was no osteolysis around the stem or the cup. Conclusion: The short-term results of ceramic on ceramic cementless total hip arthroplasty using a large diameter head demonstrated satisfactory results.

만성 퇴축된 회전근개 파열에서 건부착부 내측화를 이용한 관절경적 봉합술의 임상적 결과

이광원(Lee Kwang won),문경호(Moon Kyung ho),양대석(Yang Dae suk),김용호(Kim Yong ho),천영섭(Cheon Young sup) 대한견주관절의학회 2017 대한견주관절학회 학술대회논문집 Vol.2017 No.3

골반골의 수직 불안정성 골절과 동반된 고관절의 전방 탈구 - 보고-

김갑중 ( Kap Jung Kim ),김하용 ( Ha Yong Kim ),양대석 ( Dae Suk Yang ),최원식 ( Won Sik Choy ) 대한골절학회 2007 대한골절학회지 Vol.20 No.3

Pelvic fractures result from high energy trauma and often associated with concomitant injuries. But, vertically unstable pelvic fractures combined with anterior dislocation of the hip is far less common. The traumatic dislocation of the hip is a true orthopedic emergency and it should be considered that a femoral head can be exposed to deteriorized vascularity. We report a case of vertically unstable pelvic fractures combined with traumatic anterior dislocation of the hip joint with the review of the literature.

해부학적 복원이 불가능한 대파열 혹은 광범위 회전근개 파열에서 관절경하 부분 봉합술이 유용한 치료 방법인가?: 회전근개 치유를 위한 예후 인자로서 견봉 상완 간격

이광원(Kwang won Lee),천영섭(Young sub Chun),이규상(Gyu sang Lee),마창현(Chang hyun Ma),양대석(Dae suk Yang) 대한견주관절의학회 2018 대한견주관절학회 학술대회논문집 Vol.2018 No.3

Methotrexate에 의해 유발된 방사선 회상 피부염

김대석 ( Dae Suk Kim ),이희정 ( Hee Jung Lee ),최윤진 ( Yoon Jin Choi ),정혜진 ( Hye Jin Chung ),정기양 ( Kee Yang Chung ) 대한피부과학회 2007 大韓皮膚科學會誌 Vol.45 No.7

Radiation recall dermatitis is the development of an inflammatory reaction in the previously irradiated area, precipitated by the administration of certain drugs. A 54-year-old man was diagnosed with follicular lymphoma, grade 3 and stage 3. Cancer recurred two years after complete remission obtained by chemotherapy and radiotherapy. Therefore, he was again treated with fludarabine and mitoxantrone for five cycles, then underwent an allogeneic peripheral blood stem cell transplantation (PBSCT). The patient started to receive methotrexate the day after PBSCT. On the day of the first methotrexate administration, the patient developed erythematous erosions with pruritus and severe pain in the previously irradiated area. The skin lesion resolved almost completely after dressing with topical antibiotics and wet dressing with 0.3% aluminium solution for 2 weeks. We report a case of radiation recall dermatitis in a patient with follicular lymphoma that occurred after receiving methotrexate. (Korean J Dermatol 2007;45(7):742∼744)

완전 절제술로 치료한 조갑하 외골증 4예

김도영 ( Do Young Kim ),김대석 ( Dae Suk Kim ),정우길 ( Woo Gil Chung ),정기양 ( Kee Yang Chung ) 대한피부과학회 2006 대한피부과학회지 Vol.44 No.10

Subungual exostosis is a benign, acquired tumor of cartilaginous bone which occurs beneath the nail of the distal phalanx, and can often lead to displacement and deformity of the overlying nail. Complete surgical excision is a curative treatment for subungual exostosis. Since there have been no case reports of complete surgical removal of subungual exostosis in the Korean dermatologic literature, we report four cases of subungual exostosis that were successfully treated through complete excision or excision in combination with additional curettage. (Korean J Dermatol 2006;44(10):1220~1224)

卵巢畸形腫의 病理組織學的 檢索

梁大石,金春元 한양대학교 의과대학 1982 한양의대 학술지 Vol.2 No.1

To many the term ovarian dermoid cyst denotes merely a ball of hair invested by amantle of ectodermal tissue occasionally supporting one or more teeth. Careful examination, however, frequently reveals a variety of tissues including bone, cartilage, smooth muscle, fat, and so forth. Benign custic teratomas are believed to be associated with a high includence of complications; it appears, however, that this concept is based on clinical impressions handed down to us. The laterality, ago incidence, size and microscopic description of these tumors are discussed in considerable detail. Brief mention also is made regarding the incidence of struma ovarili, pregnancy, torsion and coincidental lesions found in association with ovarian teratomas. A histopathologic study was made on 137 teratomas of ovary that were obtained during a period of 8 years and 10 months, from May 1972 to Feb, 1981. at the department of Clinical Pathology, College of Medicine, Han Yang University. The following results are obtained 1. Begin cystic teratomas are 96.5%, maligant teratomas are 2.1% of which shows 1.4% squamous carcinoma and 0.7% of adenocarcinoma and struma ovaril are 1.4%. 2. Age distribution is 71.9% in 2nd to 3rd decades and mean ageis 32 years. The youngest one is 4 years and the oldest is 68 years. 3. No site predilection was identified with bilaterality in 11.3% of cases. 4. The overage size of the tumor is 9.84cm in diameter and 80.5% of cases are between 5cm to 14cm in cross diameter. 5. Clinical symptom is developed within 1 year in 60% of case. 6. The main symptoms are abdomnal pain, addominal mass and menstrual distrubance, in order of frequency any they are 50%, 41.7% and 10.6%, respectively. 7. Associated lesions are pregancy, cervicitis, squamous metaplasia and uterine myoma, serous cystadenoma and proteinuria and they are 20%, 10.6%, 5.3% and 24.2%, respectively. 8. The complications are tortion(15.9%), rupture(2.3%) and infection(0.8%). 9. The componets are skin and its appendage are 97% and 87.9% respectively. The majority is ectodermal origin tissue.