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증례 보고 : 외전 감입에 의한 상완골 근위부 사분 골절의 보존적 치료
김동준 ( Dong Jun Kim ),김문찬 ( Moon Chan Kim ),조재림 ( Jae Lim Cho ),정흥태 ( Hung Tae Chung ),김인보 ( In Bo Kim ) 대한골절학회 2011 대한골절학회지 Vol.24 No.1
상완골 근위부 골절 중 특히, 외전 감입에 의한 사분 골절은 수술적 치료 후 조기 재활로 견관절의 운동범위를 회복시켜야 좋은 임상결과를 얻을 수 있다. 하지만 저자들은 보존적인 치료를 시행하여 우수한 임상결과를 얻은 환자의 증례를 경험하였다. 이에 문헌 고찰과 함께 증례를 보고하는 바이다. For valgus impacted four part fracture of the proximal humerus, surgical stabilization and early mobilization of the joint can produce the best clinical outcomes. But, we have experienced a case of conservative treatment and gained good clinical results. We have reported this case and included a review of the relevant literatures.
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鄭興泰,吳貞姬 고려대학교 의과대학 1988 고려대 의대 잡지 Vol.25 No.1
The association of muscle weakness with glucocorticoids treatment has been reported clinically and experimentally. Light microscopic study of biopsy specimens from patients and animals given such steroids has revealed pathologic changes with a variety of myofilament alteration or histochemical features. However, the lesions have not been described in detail. The purpose of this paper is to correlate the morphologic changes in cross sectioned muscles of rats receiving prednisolone acetate parentally with the size of diameter and glycogen content from those muscles known as white muscle in the medial head of gastrocnemius and red muscle in the soleus. The experimental rats were divided into 5 groups with those of control, 5, 10, 15 days of prednisolone acetate treated and 30 days after completion of 15 days prednisolone treated groups. Prednisolone acetate were given intra muscular injection with 8 mg/kg daily according to the each experimental group. The cross section of the medial head of the gastrocnemius and soleus muscles were observed by light microscope numberring them on the H & E preparation and glycogen content by PAS technique. The results obtained were as follows: 1. Significant alterations were observed in the size of the diameter and glycogen content with the cross sectioned muscle fibers in both muscles. 2. The average size of the muscle fibers of the medial head of gastrocnemius gradually reduced from 28.85㎛ to 16.18㎛, the smallest in it's average size at 15 days prednisolone treatment and the average size of the soleus gradually reduced from 28.71㎛ to 19.68㎛, the smallest size in it's diameter at 10 days treatment. 3. The regeneration action was observed in soleus muscle with 15 days prednisolone treatment with replacement of hypertrophic fibers and the average diameter was increased by 115% (33.3 ㎛). 4, Cross sections stained with PAS for glycogen showed a marked generalized increment in color from 1.9% to 85.8% dark reaction at 10 days prenisolone treatment in medial head of the gastrocnemius, and 20.8% to 92.0% dark reaction at 5 days treatment which were remained until 10 days treatment in soleus muscle but the variations were recovered relatively at 15 days treatment. 5. The alteration of muscle fibers induced by prednisolone treatment were greatly fast but the replacement action with hypertrophic fibers were dominant in soleus (red) muscle than medial head of the gastrocnemius (white) muscle. 6. At 30 days after completion of prednisolone treatment, the muscle fibers were recovered relatively to normal in both muscles.
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