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종골 골절 시 골절편에 의해 발생한 비복 신경의 포착(1예 보고)
이윤태,이태진,김성환,윤한국,Lee, Yun-Tae,Lee, Tae-Jin,Kim, Sung-Hwan,Yoon, Han-Kook 대한족부족관절학회 2011 대한족부족관절학회지 Vol.15 No.1
Sural nerve is a sensory nerve that innervates the lateral side of ankle and foot, and the injury of this nerve can be usually caused by surgical approch of calaneal fracture or achilles tendon injury. Entrapment neuropahty of sural nerve caused by bony fragment after calcaneal fracture is not reported, yet. Authors experienced one case that sural nerve injury due to bony fragment after calcaneal fracture and we regard that it is a rare case, so we report this case after reviewing literatures.
중등도 이상의 무지 외반증에서 근위 초승달형 절골술의 효과
이윤태,김형복,윤한국,Lee, Yoon-Tae,Kim, Hyoung-Bok,Yoon, Han-Kook 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.1
Purpose: The purpose of this study was to retrospectively analyze the clinical and radiologic results of the proximal crescentic osteotomy for moderate to severe hallux valgus deformity. Materials and Methods: Between March 2001 and March 2008, 55 patients (71 feet) who had undergone crescentic osteotomy and distal soft tissue procedure for hallux valgus were followed up for more than one year. The average follow-up period was 15.8 months (12~28 months) and the average age at the time of surgery was 49.8 years (20~69 years). We analyzed the hallux valgus angle (HVA), the first-second intermetatarsal angle (IMA), the length of 1st metatarsal bone and the position of medial sesamoid in preoperative and the last follow-up radiographs. The American Othopeaedic Foot and Ankle Society (AOFAS) score and patient satisfaction were measured by modifying Johnson's method which were used for clinical outcome assessments. Results: The HVA and the IMA were 36.2 and 15.8 degrees preoperatively, and 10.8 and 3.9 degrees at the last follow-up, respectively. The amount of shortening of 1st metatarsal bone averaged $2.3{\pm}1.1$ rum postoperatively. The medial sesamoid position improved from a preoperative average of grade 6.6 to the last follow-up average of grade 1.9. The AOFAS score improved from a preoperative average of 45.3 points to an average 90.6 points at the last follow-up. The patient's satisfaction was completely satisfied in 61 cases (85.9%), satisfied with minor reservations in 6 cases (8.5%), satisfied with major reservations in 2 cases (2.8%), and dissatisfied in 2 cases (2.8%). Conclusion: Proximal crescentic osteotomy produced satisfactory results for moderate to severe hallux valgus deformity.
종골의 관절 내 골절에서 외측 광범위 도달법을 이용한 F형 금속판 고정술과 잠김 금속판 고정술의 비교
이윤태,오현철,윤한국,장재원,장기준,Lee, Yun-Tae,Oh, Hyun-Cheol,Yoon, Han-Kook,Jang, Jae-Won,Jang, Ki-Jun 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.3
Purpose: To evaluate the radiological and clinical results after open reduction and internal fixation with calcaneal F plate and locking calcaneal plate using lateral extensile approach in the treatment of intra-articular calcaneal fracture Materials and Methods: This study included 34 cases of 33 patients followed up for at least 6 months postoperatively. F plate was applied in 18 cases (Group 1), locking plate was used in 16 cases (Group 2) and compared radiological and clinical results between two groups. Results: Radiollogically, the mean Bohler angle was improved from $5.5^{\circ}$ preoperatively to $20.1^{\circ}$ postoperatively and $18.8^{\circ}$ at the last follow up in group 1 and $8.6^{\circ}$ preoperatively, $21.4^{\circ}$ postoperatively and $20.3^{\circ}$ at last follow up in group 2. Bone union was observed in all cases and 4 cases of screw loosening were noted in Group 1 with extended fracture to anterior process. At the last follow up, both groups showed clinical results in American orthopedic foot and ankle society ankle hindfoot score, 76(77 in Sanders type II and 75 in type III) in group 1 and 72(73 in type II and 70 in type III) in group 2. Conclusion: F plate and locking plate showed firm fixation and satisfactory clinical results in the treatment of intra-articular calcaneal fracture. We suggest applying locking plate in cases with extended fracture to anterior process, considering screw loosenings in those who were treated with F plate fixation.
Polymerase chain reaction 양성 소아 마이코플라스마 폐렴에서 혈청 IgM enzyme-linked immunosorbent assays의 진단적 가치
이혜진 ( Hye Jin Lee ),이윤태 ( Yoon Tae Lee ),김경훈 ( Kyung Hoon Kim ),양은애 ( Eun Ae Yang ),김환수 ( Hwan Soo Kim ),전윤홍 ( Yoon Hong Chun ),윤종서 ( Jong-seo Yoon ),김현희 ( Hyun Hee Kim ),김진택 ( Jin Tack Kim ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.5
Purpose: Mycoplasma pneumoniae (MP) is a common cause of community-acquired pneumonia (CAP) in children. MP serum IgM and polymerase chain reaction (PCR) are the methods that enable early diagnosis in patients with MP pneumonia. The objective of this study was to investigate the clinical value of serum MP-specific IgM antibodies in PCR-positive MP pneumonia for the early diagnosis of MP pneumonia in children with CAP. Methods: Out of 129 patients with lower respiratory tract infection aged over 3 years, 90 CAP children were enrolled in the study. Throat swab MP real-time PCR and serum enzyme-linked immunosorbent assays (ELISA) IgM antibodies were performed. A positive rate of MP PCR and serum IgM, the level of IgM index, clinical features, and laboratory findings were analyzed. Results: MP PCR was positive in 57 cases. Longer fever duration before admission (P<0.001), higher rates of lobar or segmental pneumonia (P=0.048), unilateral infiltration (P=0.038), and extrapulmonary symptoms (P=0.049) were associated with MP PCR-positive pneumonia. Serum IgM index was significantly higher in MP PCR-positive pneumonia them in MP PCR-negative pneumonia (3.9±3.0 vs. 0.8±1.3, P<0.001). Using MP PCR as a gold standard, the sensitivity, specificity, positive predictive value and negative predictive value of serum IgM were 85.5%, 82.1%, 91.4%, and 71.9%, respectively. The area under the curves for serum IgM index was 0.892, and the ROC analysis indicated that an optimal cutoff value of 1.05 for serum IgM provided the highest sensitivity and specificity interestingly (83.9% vs. 85.7%, P<0.001). Conclusion: Serum IgM ELISA has useful diagnostic value in PCR-positive MP pneumonia. Applying an IgM index cutoff of 1.05 improves diagnostic accuracy. (Allergy Asthma Respir Dis 2018;6:248-254)
말초 혈관 폐쇄성 질환이 있는 당뇨족에서 절단술시 시행한 풍선 혈관 성형술
이윤태(Yun Tae Lee),김성민(Seong Min Kim),유주형(Ju Hyung Yoo),오현철(Hyun Cheol Oh),하중원(Joong-Won Ha),성승용(Seung Yong Sung),장지훈(Jee-Hoon Chang),윤한국(Han Kook Yoon) 대한정형외과학회 2009 대한정형외과학회지 Vol.44 No.5
하지의 주요 혈관의 폐쇄에 따른 괴저나 화농성 감염 발생 시에는 절단술을 고려해야 한다. 특히 말초 혈관 폐쇄성 질환은 당뇨가 동반된 경우에 절단술 시행 확률이 더 높으며, 수술 후에도 절단단의 괴사나 혈종, 감염 등의 합병증으로 인한 재수술의 가능성 역시 당뇨가 없는 경우보다 높다. 본 증례에서는 당뇨족이 동반된 말초 혈관 폐쇄성 질환에서 절단술을 시행할 경우 절단단의 상처 치유를 향상시키기 위해 수술 중 절단 부위에 풍선혈관 성형술을 시행하였고, 절단단의 조기 상처 치유를 경험하였기에, 문헌 고찰과 함께 보고하는 바이다. Amputation should be considered for the patients with limb necrosis or infection due to major vessel obstruction combined with diabetes. Patients with peripheral artery occlusive disease combined with diabetes have a higher risk of amputation and a higher possibility of reoperation than those patients without diabetes because of complications that include hematoma, infection and necrosis of the stump. We report here on 2 cases for which balloon angioplasty was used to promote wound healing on the stump site during amputation, and the patients had peripheral artery occlusive disease with a diabetic foot. The wounds healed early without complication in both cases.
최소 내측 광근 절개 도달법[Mini-Midvastus Approach]을 이용한 최소 침습 슬관절 전치환술의 단기 추시 결과
유주형(Ju Hyung Yoo),윤한국(Han Kook Yoon),한창동(Chang Dong Han),윤항섭(Hang Seob Yoon),이윤태(Yun Tae Lee),오현철(Hyun Cheol Oh),성승용(Seung Yong Sung),정현수(Hyun Soo Chung) 대한정형외과학회 2009 대한정형외과학회지 Vol.44 No.2
목적: 최소 내측 광근 절개 도달법에 의한 최소 침습 슬관절 전치환술의 단기적인 임상적 결과를 분석하고자 한다. 대상 및 방법: 2005년 8월부터 2006년 2월까지 최소 내측 광근 절개법을 이용한 최소 침습 슬관절 전치환술을 시행하여 1년 이상 추시가 가능하였던 77예(61명)를 대상으로 하였다. 모든 예에서 대퇴사두근-보존형 최소 침습 기구와 Nexgen LPS-flex total knee system (Zimmer, Warsaw, IN)을 이용하였고, 수술 전 후 임상자료, 수술 결과, 방사선학적 결과를 분석하였다. 결과: 수술에 의한 합병증은 발생하지 않았으며, 피부 절개 길이는 평균 8.4±0.6 ㎝, 수술 시간은 평균 95.5±5.7분, 수술 후 출혈량은 평균 727.5±315.5 cc였다. 수술 후 경골 삽입물의 정렬 각도는 평균 0.2±1.3° 내반, 대퇴 경골간 각도는 평균 5.8±1.8° 외반이었다. 수술 후 8주와 1년째 관절 운동 범위와 HSS 슬관절 점수는 각각 평균 117±10°, 120±11°와 평균 88.9±7.1, 96.2±4.5였다. 결론: 최소 내측 광근 절개에 의한 최소 침습 슬관절 전치환술은 적절한 수술 수기와 기구를 사용한다면 수술 중에 합병증 발생 없이 양호한 삽입물의 정렬과 임상적 결과를 얻을 수 있는 최소 침습 방법의 하나로 생각된다. Purpose: To investigate the effectiveness of minimally invasive total knee arthroplasty using the mini-midvastus approach through analyzing the short-term clinical outcomes. Materials and Methods: Seventy-seven consecutive total knee arthroplasties were performed with the mini-midvastus surgical technique from August 2005 to February 2006 and were followed for more than 1 year after the procedure. All operations were performed with the Nexgen LPS-flex total knee system using a MIS quad-sparing instrument. The evaluation included preoperative and postoperative clinical data, surgical and radiological outcomes. Results: The length of skin incision was average 8.4±0.6 ㎝ and the operation time was average 95.5±15.7 minutes. The blood loss was average 727.5±315.5 cc. The tibial component alignment angles averaged 0.2±1.3° varus and the tibiofemoral angles averaged 5.8±1.8°. The mean ROM and the mean HSS score was 117±10° and 120±11°, 88.9±7.1 and 96.2±4.5 at eight weeks and one year after surgery respectively. Conclusion: If proper surgical procedures are performed using the appropriate surgical instruments, minimally invasive total knee arthroplasty with the assistance of the mini-midvastus approach, can result in good clinical outcomes and alignment of the implants.
Partial Sequence Analysis of Puumala Virus M Segment from Bats in Korea
윤복영(Bok Young Yun),윤정종(Jeong Joong Yoon),이윤태(Yun Tae Lee) 대한바이러스학회 1999 Journal of Bacteriology and Virology Vol.29 No.1
Hantavirus is a genus of the Bunyaviridae family causing two serious diseases, hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). Puumala virus is a member of hantavirus originally found in Europe, and its natural reservoir is Clethrionomys glareolus. It is also associated with the hurnan disease nephropathia epidemica, a milder form of HFRS. To identify the hantaviruses in bats, bats were collected from Jeong-Sun, Won-Joo, Chung-Ju and Hwa-Cheon area in Korea, and nested RT-PCR was performed with serotype specific primer from M segment. Interestingly, Puumala virus was detected in bats (Rhinolophus ferrum-equinum) only from Won-Joo. The 327 bp nested RT-PCR product, was sequenced. The sequence database search indicates that the sequence is homologous to the published sequence of Puumala viruses. The sequence similarities were ranged from 71% to 97%. The highest sequence similarity was 97% with Puumala virus Vranicam strain, and the lowest was 71% with Puumala virus K27 isolate. Puumala virus Vranicam strain was isolated from a bank vole (Clethrionomys glareolus) in Bosnia-Hercegovina. Puumala virus K27 was isolated from human in Russia. This analysis confirms that bats (Rhinolophus ferrum-equinum) in Korea are natural reservoir of Puumala virus.
Thoracic Epidural Cavernous Hemangioma
Joong Won Ha(하중원),Soo Bin Lee(이수빈),Yun Tae Lee(이윤태),Ju Hyung Yoo(유주형),Hyun Cheol Oh(오현철),Han Kook Yoon(윤한국),Sang Hoon Park(박상훈),Seong Hoon Kim(김성훈),Yung Park(박융) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.2
31세 남자 환자가 극심한 흉추부 통증 및 하반신 마비로 내원하였다. 영상 검사상 제11, 12 흉추부 경막 배측으로 골외 경막 외 종양이 발견되었다. 척수는 복측으로 압박되어 있었다. 병변은 제11, 12 흉추 후궁 절제술 후 완전 절제되었으며 병리 조직 검사상 해면상 혈관종 소견을 보였다. 환자는 절제술 후 완전한 증상의 호전을 보였다. A 31-year-old male presented with severe back pain and paraparesis. Imaging studies demonstrated an extraosseous, extradural mass without bone invasion at the T11-T12 vertebral level, located dorsal to the thecal sac. The spinal cord was compressed ventrally. The lesion was completely excised after a T11-T12 laminectomy. Histopathological examination revealed a cavernous hemangioma. The patient’s symptoms improved after excision of the lesion.