중등도 이상의 무지 외반증에서 최소 절개를 이용한 원위 중족골 절골술의 결과

허정욱,은일수,고영철,박만준,박숙현,Huh, Jung-Wook,Eun, Il-Soo,Ko, Young-Chul,Park, Man-Jun,Park, Sook-Hyun 대한족부족관절학회 2015 대한족부족관절학회지 Vol.19 No.2

Purpose: Minimal incision distal metatarsal osteotomy (MIDMO) is known to be an effective surgical procedure for mild to moderate hallux valgus. However, the result of MIDMO on moderate to severe hallux valgus is controversial; therefore, we investigated the radiological and clinical results of MIDMO on moderate to severe hallux valgus. Materials and Methods: We reviewed 51 feet (48 patients) with moderate to severe hallux valgus. The mean age was 67.0 years and the mean follow-up period was 32.2 months. Radiological data of hallux valgus angle, first intermetatarsal angle, and distal metatarsal articular angle on plain radiographs were analyzed. Recurrence, union, lateral translation of distal fragment and angulation were also analyzed. The clinical data were obtained using American Orthopaedic Foot and Ankle Society (AOFAS) score of preoperation and last follow-up. Receiver operating characteristic (ROC) curve was used to determine a cut-off value. Results: The mean hallux valgus angle measured at preoperation was $37.7^{\circ}$ and $15.9^{\circ}$ at last follow-up. The mean first intermetatarsal angle of preoperation and last follow-up were $15.2^{\circ}$ and $8.3^{\circ}$. The mean distal metatarsal articular angle changed from $12.6^{\circ}$ at preoperation to $7.8^{\circ}$ at last follow-up. Preoperative hallux valgus angle (p=0.0051) and distal metatarsal articular angle (p=0.0078) were statistically significant factors affecting postoperative AOFAS score. Cut-off value of each was $37^{\circ}$ and 13o, respectively. Lateral translation of distal fragment in 5 recurrent cases was 23.0% compared to 45.3% of 46 non-recurrent cases. The result was statistically significant and the cut-off value was 38%. Conclusion: Sufficient lateral translation over 38% in MIDMO on moderate to severe hallux valgus patients with preoperative hallux valgus angle under $37^{\circ}$ and distal metatarsal articular angle under $13^{\circ}$ can lead to good clinical results without recurrence.

선천성 기관-윤상연골 협착에서 성공적으로 시행한 활주 기관-윤상연골 성형술

허정욱,한석주,김영호,김명준,이기영,김재억,한애리,황의호,Huh, Jung-Wook,Han, Seok-Joo,Kim, Young-Ho,Kim, Myung-Joon,Lee, Gee-Young,Kim, Jae-Eok,Han, Ai-Ri,Hwang, Eui-Ho 대한소아외과학회 2001 소아외과 Vol.7 No.1

Slide tracheoplasty. as a treatment for congenital tracheal stenosis, has been recently reported to have good results and quite a number of advantages as compared with conventional tracheoplasties. The aim of this study is to report a new surgical technique modified from the slide tracheoplasty. "the slide cricotracheoplasty" for the congenital cricotracheal stenosis. A girl was born by Cesarean section and the diagnosis of esophageal atresia (Gross type C) and cricotracheal stenosis (30 % of total length of trachea) was established. Esophageal atresia was successfully corrected at the 8th day of life. At the 31st day of life, corrective surgery for congenital cricotracheal stenosis. the slide cricotracheoplasty. was performed with success. Slide cricotracheoplasty is almost the same procedure as slide tracheoplasty except for two technical features. First the cricoid cartilage was split on its anterior surface. Second the split cricoid cartilage was fixed to pre vertebral fascia to maintain enough space to accommodate the sliding caudal segment of trachea because of the stiffness of the cricoid cartilage. We believe that the sliding cricotracheoplasty is a new surgical technique for congenital cricotracheal stenosis that has similar results and advantages as the sliding tracheoplasty.

슬관절 인공관절 치환술 중 발생한 내측 측부 인대 견열 골절에 대해 생흡수성 봉합 나사못을 이용한 고정 후 발생한 골용해

허정욱(Jung-Wook Huh),박만준(Man-Jun Park),홍성확(Seong-Hwak Hong),박준형(Joon-Hyung Park) 대한정형외과학회 2020 대한정형외과학회지 Vol.55 No.6

슬관절 인공관절 치환술 중 드물게 발생하는 내측 측부 인대 견열 골절의 치료는 보조기나 캐스트 등의 보존적 치료, 금속 나사못을 이용한 고정 등의 다양한 치료법이 소개되고 있다. 생흡수성 봉합 나사못은 생체 적합성, 방사선 투과성, 제거를 위한 2차 수술이 불필요하다는 장점 등으로 여러 부위에서 금속 고정물을 대체해 사용되고 있으나 골용해 등의 합병증이 보고되고 있다. 저자들은 슬관절 인공관절 치환술 중 발생한 내측 측부 인대 견열 골절에 대해 생흡수성 봉합 나사못을 이용한 고정 후 심각한 골용해 소견을 경험하여 사용에 신중을 기해야 한다는 판단하에 이에 대한 문헌 고찰과 함께 보고하고자 한다. Although rare, the treatment options for a medial collateral avulsion fracture during total knee arthroplasty (TKA) range from conservative management using a cast and orthosis to internal fixation using metal screws. Bioabsorbable suture anchors have been used to replace metal fixators with distinct advantages, such as biocompatibility, radiolucency, and unnecessary second removal surgery, but complications, such as osteolysis, have been reported. This paper reports a potential risk of an extensive osteolysis-related suture anchor fixation of a medial collateral ligament (MCL) avulsion fracture during TKA in conjunction with a literature review.

슬관절 인공관절 치환술 후 대퇴신경 차단술의 Ropivacaine 농도 변화에 따른 결과 비교

허정욱(Jung-Wook Huh),박만준(Man-Jun Park),고영철(Young-Chul Ko),하동준(Dong-Jun Ha),박숙현(Sook-Hyun Park),박태홍(Tae-Hong Park),박준형(Joon-Hyung Park) 대한정형외과학회 2018 대한정형외과학회지 Vol.53 No.3

목적: 슬관절 전치환술 후 통증을 줄이는 여러 가지 방법이 있으며 그 중 말초신경 차단술이 유용하게 사용되고 있다. Ropivacaine을 사용한 대퇴신경 차단술(femoral nerve block, FNB)은 효과적으로 통증을 감소시키나 대퇴사두근력을 약화시켜 낙상 등의 위험성을 높인다. 본 연구는 FNB 시 ropivacaine 농도의 변화에 따라 통증 및 대퇴사두근력에 미치는 영향에 대해 비교하여 보고하고자 한다. 대상 및 방법: 2016년 1월부터 2016년 12월까지 퇴행성 관절염으로 슬관절 전치환술을 시행한 120명의 환자를 대상으로 하였다. FNB의 ropivacaine 농도에 따라 환자들을 세 군으로 나누었다(1군: 0.125% ropivacaine 6 ml FNB, 2군: 0.2% ropivacaine 6 ml FNB, 3군: normal saline 6 ml FNB). 모든 환자는 술 후 3시간째 1% lidocaine 10 ml와 0.75% ropivacaine 10 ml로 FNB를 시행받고 수술 다음날 6시간 간격으로 총 4회에 걸쳐 0.2% ropivacaine, 0.125% ropivacaine, normal saline 6 ml를 도관을 통해 각각 주입하였다. 시각통증척도(visual analogue scale, VAS) 점수로 통증 정도를 측정하였고, medical research council (MRC) grade와 슬관절의 신전 가능 정도를 측정하여 대퇴사두근력을 평가하였다. 결과: 술 후 1일 18시와 술 후 2일 6시에 측정한 VAS 점수는 3군이 나머지 군과 비교하여 유의하게 통증 점수가 높았고, MRC grade는 2군이 나머지 군과 비교하여 유의하게 점수가 낮았으며 슬관절 신전 운동 정도는 2군이 나머지 군과 비교하여 유의하게 각도가 작았다. 결론: 슬관절 전치환술 후 0.125% ropivacaine으로 FNB를 시행하여 대퇴사두근력의 약화 없이 통증 조절의 효과를 얻을 수 있을 것으로 생각된다. Purpose: Peripheral nerve block is one of the many options available to reduce pain after total knee arthroplasty. Among the various kinds of peripheral nerve block procedure, femoral nerve block (FNB) using ropivacaine is a very effective method for reducing pain. However, it has been known to cause weakness in the quadriceps femoris, resulting in an increased risk of fall during ambulation after surgery. The purpose of this study was to compare the effectiveness of FNB on pain and muscle strength with different concentrations of ropivacaine. Materials and Methods: Our study was performed on 120 patients with knee osteoarthritis who had undergone total knee arthroplasty between January 2016 and December 2016. Patients were divided to 3 groups depending on the concentration of ropivacaine: Group 1 received 0.125% ropivacaine 6 ml FNB; group 2 received 0.2% ropivacaine 6 ml FNB; group 3 received normal saline 6 ml FNB. FNB with 1% lidocaine 10 ml and 0.75% ropivacaine 10 ml was performed to all groups at 3 hours after surgery. From the day after surgery, each group of patients were injected 4 times with FNB on their own designated concentration of ropivacaine with an interval of 6 hours. The severity of pain was estimated by visual analogue scale (VAS) and the strength of quadriceps femoris was measured using medical research council (MRC) grade and knee extension angle. Results: VAS score in group 3 was significantly higher compared to other groups; MRC grade in group 2 was significantly lower than in other grades, and knee extension angle in group 2 was significantly lower than in other groups at 6 pm on the day of and at 6 am on the day after surgery. VAS score, MRC grade, and extension angle of all groups showed no significantly difference at other times. Conclusion: FNB with 0.125% ropivacaine after total knee arthroplasty shows effective reduction of pain without inducing quadriceps femoris weakness.

비전형적인 진행양상을 보인 매독성 척수염

허정욱(Jung-Wook Huh),김민우(Min-Woo Kim),정윤성(Yun-Sung Jung) 대한정형외과학회 2023 대한정형외과학회지 Vol.58 No.4

05 포스터 발표 : 자연생태 환경 분야(PN) ; 식물공장 시스템내 광환경 제어가 적축면 상추 생장에 미치는 영향

허정욱 ( Jeong Wook Heo ),김동억 ( Dong Euk Kim ),이광재 ( Kwang Jae Lee ),강동현 ( Dong Hyeon Kang ),이시영 ( Si Young Lee ),신현만 ( Hyun Man Shin ),허윤선 ( Yoon Sun Huh ),이기열 ( Ki Yeol Lee ),김태중 ( Tae Jung Kim ),김숙종 ( 한국환경농학회 2014 한국환경농학회 학술대회집 Vol.2014 No.-

Plant factory, which considered as a novel plant production system preparing for the climate changes such as a global warming or raining, is an attractive year-round production technique of leafy plants regardless of place or season. The environmental factors of air temperature, relative humidity, nutrient, CO2 concentration, light intensity or quality inside the factory system influencing on growth have been reported. In this study, effects of light-environmental control of quality or intensity were investigated on growth of red curly lettuce ( Brassica rapa) seedlings with different four growth ages (0, 10, 20, and 30 days-old after transplanting) inside the factory system. ‘Tukksum’ red-curly lettuce which developed two true leaves was used as a plant material, and the seedlings were cultured under nutrient solution of 1.5 ds m-1 EC and 5.8 pH for 10 days after light exposure of 50, 100 or 230 μmol m-2 s-1. Light-emitting diodes of Red, blue plus red, and blue plus white were used, and fluorescent light was considered as a control. In 0 day-old seedlings after transplanting, dry weight and number of leaves under blue plus red light of 50 μmol m-2 s-1 light intensity for 10 days increased 28 and 19% comparing with the control, respectively. Increasing of fresh and dry weights in 30 days-old seedlings was significantly stimulated by blue plus red and red light. However, leaf pigmentation was inhibited by the red light regardless of the different growth ages and promoted by the mixture lights. Under 230 μmol m-2 s-1 light intensity, number of leaves, fresh and dry weights were greater by mixture-light exposure on 20 days-old seedlings. On 30 days-old seedlings, increment of dry and fresh weights was also affected by the mixture light. Leaf pigmentation was significantly inhibited by the red light regardless of the different light intensities in all the growth ages. Higher growth and pigmentation could be achieved at 20 and 30 days-old seedlings cultured under the mixture lights of blue, red, or white. It is concluded that light intensity should be controlled according to growth ages for growth and pigmentation, but rather stable control during culture period, and monochromic red is not suitable for leaf pigmentation of red curly lettuce in plant factory system.

온실재배 케일의 생장에 미치는 보광 효과

허정욱 ( Jeong Wook Heo ),김현환 ( Hyeon Hwan Kim ),이광재 ( Kwang Jae Lee ),윤정범 ( Jung Boem Yoon ),이정관 ( Joung Kwan Lee ),허윤선 ( Yoon Sun Huh ),이기열 ( Ki Yeol Lee ) 한국환경농학회 2015 한국환경농학회지 Vol.34 No.1

BACKGROUND: For commercial production of greenhouse crops under shorter day length condition, supplementary radiation has been usually achieved by the artificial light source with higher electric consumption such as high-pressure sodium, metal halide, or incandescent lamps. Light-Emitting Diodes (LEDs) with several characteristics, however, have been considered as a novel light source for plant production. Effects of supplementary lighting provided by the artificial light sources on growth of Kale seedlings during shorter day length were discussed in this experiment. METHODS AND RESULTS: Kale seedlings were grown under greenhouse under the three wave lamps (3 W), sodium lamps (Na), and red LEDs (peak at 630 nm) during six months, and leaf growth was observed at intervals of about 30 days after light exposure for 6 hours per day at sunrise and sunset. Photosynthetic photon flux (PPF) of supplementary red LEDs on the plant canopy was maintained at 0.1 (RL), 0.6 (RM), and 1.2 (RH) μmol/m2/s PPF. PPF in 3 W and Na treatments was measured at 12 μ mol/m2/s. Natural light (NL) was considered as a control. Leaf fresh weight of the seedlings was more than 100% increased under the 3 W, Na and RH treatment compared to natural light considering as a conventional condition. Sugar synthesis in Kale leaves was significantly promoted by the RM or RH treatment. Leaf yield per 3.3 m2 exposed by red LEDs of 1.2 μmol/m2/s PPF was 9% and 16% greater than in 3W or Na with a higher PPF, respectively. CONCLUSION: Growth of the leafy Kale seedlings were significantly affected by the supplementary radiation provided by three wave lamp, sodium lamp, and red LEDs with different light intensities during the shorter day length under greenhouse conditions. From this study, it was suggested that the leaf growth and secondary metabolism of Kale seedlings can be controlled by supplementary radiation using red LEDs of 1.2 μmol/m2/s PPF as well as three wave or sodium lamps in the experiment.

The impact of obesity on the outcomes of laparoscopic colectomy : An observational study

Seoung Wook Choi(최승욱),Jung Wook Huh(허정욱),Bo Young Oh(오보영),Yoon Ah Park(박윤아),Yong Beom Cho(조용범),Seong Hyeon Yun(윤성현),Hee Cheol Kim(김희철),Woo Yong Lee(이우용),Ho-Kyung Chun(전호경) 대한종양외과학회 2016 Korean Journal of Clinical Oncology Vol.12 No.2

Purpose: The impact of obesity on the surgical outcomes of Asian patients undergoing laparoscopic colon surgery is not clear. The purpose was to evaluate the outcome of laparoscopic surgery in obese Asian patients with colon cancer. Methods: We retrospectively reviewed the prospectively collected data of 1,740 consecutive patients who underwent laparoscopic surgery for colon cancer between January 2008 and December 2010. Patients were classified according to the categories proposed by the International Obesity Task Force, Non-obese (body mass index [BMI]<25.0 kg/m2), Obese-I (BMI, 25.0–29.9 kg/m2), and Obese-II (BMI≥30 kg/m2). Surgical outcomes, including open conversion, operative time, and postoperative hospital stay, were compared in the Non-obese, Obese-I, and Obese-II patients. Results: Of the 1,192 patients in the study, 812 (68.1%), 360 (30.2%), and 20 (1.7%), were classified as Non-obese, Obese-I, and Obese-II, respectively. The Obese-II group had higher conversion rates (10.0% vs. 3.6% and 1.6%, P=0.008) and, longer operative times (180.35 vs. 162.54 and 147.84 minutes, P<0.001) than the Obese-I and Non-obese group. However, the other postoperative outcomes were not significantly different. The overall survival and disease-free survival were not significantly different between groups (P=0.952). Multivariate analysis showed that the independent risk factor for conversion were BMI, total operative time, previous operative history, and cancer perforation. Conclusion: The outcomes of laparoscopic colon surgery in obese patients are similar to those of non-obese patients, offering all the benefits of a minimally invasive approach. However, the conversion rate was higher in obese patients. It is therefore very important for surgeons to be aware of these risks during laparoscopic colon surgery in obese patients.

30세 이하 산발성 대장암 환자의 임상 병리학적 특징

오종욱(Jong Wook Oh),허정욱(Jung Wook Huh),박윤아(Yoon Ah Park),조용범(Yong Beom Cho),윤성현(Seong Hyeon Yun),이우용(Woo Yong Lee),김희철(Hee Cheol Kim) 대한종양외과학회 2016 Korean Journal of Clinical Oncology Vol.12 No.2

Purpose: The purpose of this study was to investigate the distinctive clinicopathologic features and oncological survival outcomes of sporadic colorectal cancer in patients under the age of 30 years old. Methods: From 1994 to 2013, total 15,206 patients underwent curative or palliative surgery for sporadic colorectal cancer in our institution. 235 patients (1.5%) were under 30 years of age. Patients who presented with metachronous cancers, recurrent cancers, hereditary nonpolyposis colorectal cancer, familial adenomatous polyposis and patients without a microsatellite instability (MSI) analysis were excluded. A total 79 pateints who were ≤30 years old with sporadic colorectal cancer were enrolled. Results: Seven patients (8.9%) had family history of colorectal cancer. Location of the tumor was 23 (29.1%) in right colon, 29 (36.7%) in left colon, 27 (34.2%) in rectum. Young patients tend to present with a higher incidence of mucinous and signet ring cell tumors (15.2%), poorly differentiated tumors (11.4%) and advanced stage such as Stage III (31.6%), Stage IV (30.4%). microsatellite instability-high (MSI-H) was observed in 10 (12.7%), microsatellite stable (MSS)/ microsatellite instability-low (MSI-L) in 69 (87.3%). 66.7% (n=6) of the MSI-H tumors showed loss of hMLH1 expression; no MSS/MSI-L tumors showed hMLH1 loss. 5 years ovarall survival was 72.8%. Stage specific overall survival was 100% for stage I, 100% for stage II, 75.9% for stage III, 31.4% for stage IV. Conclusion: Patients with sporadic colorectal cancer under the age of 30 seem to have poor outcome than older patients, because of characteristic clinical and biological behaviors. Early detection of colorectal cancer (CRC) confers survival benefit to young patients.

한국인 대장암 환자의 종양조직에서 APC 유전자변이

조상혁(Sang Hyuk Cho),허정욱(Jung Wook Huh),김영진(Young Jin Kim),신명근(Myung Geun Shin),김형록(Hyeong Rok Kim) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.76 No.3

Purpose: APC (adenomatous polyposis coli) gene is one of the tumor-suppressor genes that acts in the early stages of cancer. Among general colon cancer patients, normal APC gene expression is deficient in 80%. It seems that APC is the most important gene in the development of colon cancer. This study was performed to analyze the mutation spectra of APC gene in sporadic colon cancer tissue from Korean patients with colon cancer. Methods: A total of 38 patients with sporadic colon cancer were enrolled. Colon cancer tissues were analyzed for the determination of APC gene mutation spectra by multiplex ligation-dependent probe amplification (MLPA) method using SALSA MLPA P403 APC kit (MRC-Holland, Amsterdam, NL). Results: APC gene mutations showing deletion/duplication in one or more exons were detected in 23 (60.5%) patients. Duplication in 13 patients (56.5%), duplication and deletion in 7 patients (30.4%), and deletion in 3 patients (13.1%) was detected. The incidence of APC gene mutation found in this study was highest in exon 3. From this study, no significant differences were observed with respect to clinicopathologic findings and the presence or absence of APC mutations. Conclusion: The frequency of APC gene mutation was about 61% in Korean patients with colon cancer, it showed concordance with the previous reports on the frequency of APC gene mutation from Caucasian patients with sporadic colon cancer. However, in contrast to these reports, the frequency of duplication disclosed much higher than those of western countries.