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      • KCI등재

        운동 도중 발생한 대흉근 파열 치험례 보고

        이병일 ( Byung Ill Lee ),김병민 ( Byoung Min Kim ),권세원 ( Sai Won Kwon ),천동일 ( Dong Ill Chun ) 대한스포츠의학회 2015 대한스포츠의학회지 Vol.33 No.1

        Rupture of the pectoralis major muscle may occur in youngers or athletes associated with extreme sports, especially during the weight training. It is uncommon, but the incidence is increased by the recent growth of athletic population. In young active individuals, ruptures of the pectoralis major muscle have the best results after surgical repair. However, if diagnosis of the pectoralis major muscle rupture is missed or delayed, the patient will be limited to return to sport activity. The object of this paper is to report our experience of pectoralis major muscle rupture in 3 cases.

      • KCI등재

        전방십자인대 재건술 후 잔류조직 보존술식과 비보존술식의 자기공명영상을 이용한 연구

        이병일(Byung-Ill Lee),김병민(Byoung-Min Kim),고덕환(Duk-Hwan Kho),권세원(Sai-Won Kwon),김환배(Hwan-Bae Kim) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.6

        목적: 전방십자인대 재건술 시 잔류조직 보존술식과 비보존술식 간 차이를 안정성 검사와 기능적 평가, 이차관절경 소견 및 자기공명영상을 이용하여 비교하고자 한다. 대상 및 방법: Outside-in 술식하에 자가 슬괵건을 이용한 재건술을 시행받고 12개월 이상 경과하여 이차관절경과 자기공명영상을 시행한 환자 23명 중 보존군 12예와 비보존군 11예로 나누어 두 군 간에 안정성 검사, 임상적 기능평가점수, 이차관절경 소견과 자기공명영상에서 signal to noise quotient (SNQ) ratio를 비교하였다. 결과: 안정성 검사와 International Knee Documentation Committee 점수, Lysholm 점수에서는 두 군 간에 차이를 보이지 않았으나 외발뛰기 검사에서 보존군에서 더 우수하였고(p<0.05), 보존군에서 유의하게 SNQ ratio가 더 낮았다(p<0.05). 이차관절경 평가는 두 군 간에 유의한 빈도 차이를 보이지 않았다. 이식건의 활액막 형성정도와 이식건의 상태는 SQN ratio와 연관성이 없었다(p>0.05). 결론: 잔류조직 보존술식은 1년 이상 추시 시 자기공명영상에서 비보존군에 비해 낮은 신호강도를 보였다. 잔류조직 보존술식이 인간대상연구에서 생물학적 차이를 보임을 자기공명영상을 이용하여 간접적으로 확인할 수 있었다. Purpose: The purpose of this study was to clarify the difference between the remnant-preserving and remnant-sacrificing techniques in anterior cruciate ligament (ACL) reconstruction using stress test, functional score, 2nd look arthroscopy and magnetic resonance imaging (MRI). Materials and Methods: Among 66 patients having anatomical ACL reconstruction with the fourstrand hamstring autograft using outside-in technique (FlipCutter®) for the femoral tunnel from April 2012 to April 2014, 23 patients who underwent 2nd look arthroscopy and MRI were included. The remnant-preserving group included 12 patients and the remnant-sacrificing group included 11 patients. The two groups were compared and analyzed with regard to stability (Stress test using GNRB<SUP>®</SUP>, pivot shift test), functional assessment (International Knee Documentation Committee [IKDC] scale, Lysholm score, one leg hoop test), and the result of second-look arthroscopy and signal to noise quotient (SNQ) ratio of the graft in MRI. Results: The two groups did not differ significantly in the stability test, IKDC scale, and Lysholm test. The remnant-preserving group showed significant improvement in one leg hoop test compared with the remnant-sacrificing group (p<0.05). The SNQ ratio of the grafted tendon in the remnant-preserving group was significantly lower than those in the remnant-sacrificing group in all regions (p<0.05). In second-look arthroscopy, no significant difference in tension, synovialization, and status of the bundle was observed between the two groups. The grade of synovialization and the status of the bundle in second-look arthroscopy did not influence the signal intensity of the graft in MRI (p>0.05). Conclusion: More than 12 months after surgery, the graft of the remnant-preserving group showed lower signal intensity compared to that of the remnant-sacrificing group by MRI evaluation. The remnant preserving technique has biological difference compared with the remnant sacrificing technique in human study.

      • KCI등재

        척추경 나사못 내고정기기를 이용한 척추질환의 치료시 발생되는 합병증

        신병준,노영복,서유성,이병일,김연일,나수균,최창욱 대한척추외과학회 1994 대한척추외과학회지 Vol.1 No.2

        The concept of pedicle screw fixation opened a new horizon of spinal surgery by providing rigid fixation of spine. But it is technically a demanding procedure which could produce lots of complications including general complications, hardware problems, technical problems and long term changes of junctional motion segments. The purpose of this paper is to analyse the complications and problems developed during and after pedicle screw fixation for various spinal disorders and tarumas. Hundred and four patients were treated by pedicle screw fixation during the 3 year period from June 1988 to June 1991, and 73 patients were followed more than 18 months. Average follow-up was 26.5 months. Threr were 44 degenerative conditions, 24 frac- tures and 5 moscellaneous disorder. Fixation segments were single in 25, two levels in 36 and more than three levels in 12. Total number of screw used were 392. Posterior fusion was done in 7, posterolateral in 36, combined A+P fusion in 11 and PLIF in 19. CDI was used in 69, Steffee plate in 3 and Diapason in 1. All the surgeries were done by one surgeon. The results were as follows: 1.94 complications were noted in 46 patients out of 73 patients(63%) studied. 2.Most complications did not show poor clinical progress except one case of dedp would infection which needed removal of hardware, one case of persistent CSF leakage and one case of thigh pain due to degeneration of upper junctional motion segment. 3.Usually more than two complications were noted in each patient. In conclusion, pedicle screw fixation itself is a nice procedure to treat many kinds of spinal problems but it also produces variable complications. So, we should always be careful to per- form precise procedure to prevent those problems. Complications could be prevented by precise diagnosis before the operation, correction of predisposing factors during the operation and care- ful postoperative care.

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