원위 요골 골절의 합병증

강종우(Jong Woo Kang),박종웅(Jong Woong Park) 대한정형외과학회 2013 대한정형외과학회지 Vol.48 No.2

원위 요골 골절은 응급실에서 볼 수 있는 흔한 골절인 만큼 적절한 치료방법을 선택하는 것이 중요하고 또한 치료 과정이나 치료 후 발생하는 합병증을 조기에 인지하고 적절한 예방을 하는 것도 치료만큼 중요하다. 원위 요골 골절과 관련된 합병증은 골절 후 시기에 따라 다양한 양상으로 발생하며 그 빈도는 전체 원위 요골 골절의 약 27% 정도에 달하는 것으로 알려져 있다. 본 종설에서는 원위 요골 골절의 치료 시발생할 수 있는 합병증과 그 예방 및 적절한 치료방법에 대하여 논하고자 한다. Fracture of the distal radius is one of the most common fractures encountered in the emergency room. Although selection of a proper treatment modality is important for successful management of this fracture, early detection, prevention, and adequate treatment for its complications is also important. Complications associated with fracture of the distal radius can occur at any time during the treatment process and the prevalence rate is up to 27% of all distal radius fractures. This article provides a review of possible complications associated with distal radius fracture, along with a discussion of prevention and appropriate treatment methods.

견갑부에 발생한 양측성 배부 탄성섬유종

이우승(Woo-Seung Lee),김택선(Taik-Seon Kim),김영배(Young-Bae Kim),강종우(Jong-Woo Kang) 대한견주관절의학회 2007 대한견주관절학회지 Vol.10 No.2

악성 흑색종 치료를 위한 피판술의 임상적 결과

전우주,강종우,김일환,손길수,박종웅,Jeon, Woo-Joo,Kang, Jong-Woo,Kim, Il-Hwan,Son, Gil-Soo,Park, Jong-Woong 대한미세수술학회 2010 Archives of reconstructive microsurgery Vol.19 No.2

In surgical treatment of the malignant melanoma, radical resection and a sentinel lymph node biopsy are essential procedures to eradicate the tumor and to minimize the risk of local recurrence. For the reconstruction of skin defect after tumor resection, a skin graft has been generally performed procedure. However, if tendon or bone is exposed after tumor resection, simple skin graft is not enough for the coverage of the defect and additional procedure is mandatory. In this study, we reviewed the clinical results of 16 patients, who had been diagnosed with malignant melanoma of the limb and underwent surgical resection and reconstruction of the defect with various methods. The sentinel lymph node dissection was performed in all patients combined with radical excision of the tumor. In 11 cases of positive sentinel lymph nodes, further elective lymph node dissections were performed. The mean tumor invasion depth was 4.54 mm (2~10 mm), and AJCC stage II was most common (9 cases). The pedicled flaps were performed in 10 cases for the reconstruction of defects. All flaps were successfully survived without significant complications until the last follow up. In conclusion, a pedicled flap coverage is very useful reconstruction strategy for the soft tissue defects after radical resection of malignant melanoma.

당뇨병성 족부 질환에 의한 하지 절단 후 임상적 분석과 결과

김택선,강종우,이상준,허영재,김학준,Kim, Taik-Seon,Kang, Jong-Woo,Lee, Sang-Jun,Huh, Young-Jae,Kim, Hak-Jun 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.1

Purpose: The authors evaluated the clinical results and prognosis after amputating the lower extremity due to diabetic foot. Materials and Methods: From 1991 to 2003, the patients who had suffered amputation of his lower extremity due to diabetic foot ulcer were evaluated retrospectively. 79 patients were male and 6 patients were female. The author evaluated the patient who had the ipsilateral additional surgery, contralateral amputation, level of blood sugar, combined disease and mortality rate within 5 years from medical record. Statistical analysis was done by Chi-square test and Kaplan-Meier survival test. Results: Mean age of patients who had first experienced amputation was 63.4 years old. The mean duration of diabetes until amputation was $14.5{\pm}7.5$ years. Major amputations were 50 cases and minor amputations 35 cases. 20 patients (23.5%) were suffered ipsilateral secondary surgery including revised stump. Overall 5-year mortality rate was 18.8% (16 cases). Death rate within 1 year was 8.2% (7 cases), mortality rate within 3 years was 14.1% (12 cases). 5-year mortality rate after major amputation was 20% (10 cases) and after minor amputation was 17.1% (6 cases). It was statistically significant (p<0.05). Patient who underwent more than 2 combined vascular related disease had higher mortality rate than diabetic amputee without combined disease (p<0.05). Conclusion: Mortality rate after major amputation was significant higher than amputation after minor amputation in diabetic patients from our data.

무지 외반증의 근위 갈매기형 절골술 후 고정 방법에 따른 결과 차이

김택선,강규복,강종우,김학준,Kim, Taik-Seon,Kang, Kyu-Bok,Kang, Jong-Woo,Kim, Hak-Jun 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.1

Purpose: The authors evaluated the differences between K-wires and Bold screw for fixing the proximal metatarsal chevron osteotomy of moderate and severe hallux valgus. Materials and Methods: There were 59 patients (81 feet) who were moderate and severe degree hallux valgus according to the classification of Mann. They all got the proximal chevron osteotomy when correcting the deformity. All patients were followed up at least 6 months. We divided the patients into 2 groups, K-wires fixed group as A, Bold screw fixed group as B. Group A were 42 patients (63 feet) and Group B were 18 patients (19 feet). Among the Group B, 2 feet who were failed to fix the oetotomy site with Bold screw, were fixed with K-wires during operation. We measured the AOFAS score preoperatively, postoperatively and at final follow-up, VAS score at 2 weeks after the operation. Also preoperative, postoperative and follow-up hallux valgus angle (HVA) and intermetatarsal angle (IMA) were measured for each patients. Results: Mean follow up period was 1.34 year (range: 6 months-6.16 years). Mean VAS score of group A was $3.21{\pm}1.7$ and group B $1.76{\pm}1.0$. Preoperative mean AOFAS score of group A was $45.61{\pm}8.3$, group B $44.41{\pm}8.9$, the final mean score of group A was $88.87{\pm}8.3$ and group B $92.47{\pm}4.4$. Preoperative mean HVA was $30.82{\pm}6.6$ degrees in group A and $32.88{\pm}14.5$ degrees in group B, the final mean angle of group A was $14.89{\pm}8.3$ degrees and group B $17{\pm}4.4$ degrees. The preoperative mean IMA of group A was $13.69{\pm}3.6 $degrees and group B $12.35{\pm}5.2$, the final mean angle of group A was $9.26{\pm}3.6$ degrees and group B $12.35{\pm}5.8$ degrees. Conclusion: There were no statistical differences in radiologic and clinical results (p>0.05) but, group B exceeded group A in VAS score (p=0.0007) and had no statistical significance in terms of reduction angle loss (p=0.06). Early returning to normal life activity may be possible for patients using Bold screws.

큰느타리버섯 균사체로 제조한 발효두부 추출물의 면역 활성

이상원(Sang-Won Lee),강종우(Jong-Woo Kang),김재용(Jae-Yong Kim),박경욱(Kyung-Wuk Park),박석규(Seok-Kyu Park),주옥수(Ok-Soo Joo),이성태(Sung-Tae Yee),서권일(Kwon-Il Seo) 한국식품영양과학회 2010 한국식품영양과학회지 Vol.39 No.1

두부의 기능성 및 저장성을 향상시킬 목적으로 큰느타리버섯 균사체를 이용한 발효두부를 제조하여 물과 메탄올로 추출하여 면역세포 활성에 미치는 효과를 조사하였다. 큰느타리버섯 균사체를 배양하기 위한 최적 배지는 PD broth 배지인 것을 확인하였으며, 큰타리버섯 균사체를 이용한 두부의 최적 발효기간은 7일 정도가 적당하였다. 큰느타리버섯 균사체를 이용하여 발효한 두부의 물 및 메탄올추출물은 0.01 ㎍/mL 농도 이상에서 비장세포의 증식을 유도하였으며, 이들 추출물은 IL-6, IFN-γ 분비를 유도하는 것으로 나타났다. 발효두부 물 추출물은 대조군에 비해 대식세포의 일산화질소 생산을 1 ㎍/mL 농도 이상에서 유의적으로 증가시키는 것을 알 수 있었으며, 메탄올 추출물은 10 ㎍/mL 농도 이상에서 그 생산을 증가시켰다. 발효두부 추출물들은 대식세포가 분비하는 IL-6, TNF-α, IL-1β 및 GM-CSF 분비량을 유의하게 증가시켰다. 따라서 큰느타리버섯 균사체로 발효한 두부는 기능성 두부로 개발이 가능하리라 생각된다. In order to improve the functional benefits and storage properties of soybean tofu, fermented tofu was developed using Pleurotus eryngii mycelia. The immune activities of water and methanol extracts of the tofu were investigated. The optimal medium for the growth of Pleurotus eryngii mycelia was PD broth medium and the optimal fermentation period for the tofu was 7 days. The water and methanol extracts of the fermented tofu induced the proliferation of spleen cells at above 0.01 ㎍/mL. The water extract increased IL-2, IFN-γ production, while the methanol extract increased IFN-γ synthesis. The water and methanol extracts of the fermented tofu induced the NO production in RAW264.7 macrophage cells at above 1 ㎍/mL and above 10 ㎍/mL concentration, respectively. The extracts also significantly increased the production of IL-6, TNF-α, IL-1β and GM-CSF in the cells. These results suggest that the tofu fermented with Pleurotus eryngii mycelia could be developed as a functional tofu.

대퇴골 전자간부 골절의 내고정 실패에 대한 원인분석 및 치료

서동훈 ( Dong Hun Suh ),한승범 ( Seung Bum Han ),강종우 ( Jong Woo Kang ) 대한고관절학회 2007 Hip and Pelvis Vol.19 No.2

목적: 압박 고 나사를 이용하여 수술한 대퇴골 전자간부 골절 중 고정에 실패한 15예에 대하여 내고정 실패의 양상과 원인, 치료방법의 결과를 분석하고자 하였다. 대상 및 방법: 1999년 1월부터 2005년 8월까지 활강 압박 고 나사를 이용한 내고정술 시행 후 내고정 실패가 발생하여 치료받은 환자들 중 1년 이상 추시가 가능하였던 15예에 대해 골절의 형태, 정복의 정확도 및 실패의 양상, 추정되는 원인, 그리고 술 후 임상적 결과와 방사선학적 결과에 대하여 분석하였다. 결과: 실패 양상은 골두 내 천공 7예, 압박 고 나사의 파손 1예, 압박 고 나사의 금속판으로부터의 이탈 1예, 압박 고 나사의 과도한 활강 2예, 금속판의 파손 2예, 금속판을 고정한 나사못 파손에 의한 고정소실 2예였다. 추정되는 원인은 부적절한 내고정물의 선택이 6예, 기술적인 실패가 9예였다. 인공관절 치환술을 시행한 10예에서 술 후 Harris Hip score는 평균 67.8점(46~97점)으로 3예에서만 만족스러운 결과를 보였고, 95도 칼날 금속판을 이용하여 내고정술을 시행한 4예에서는 술 후 Harris Hip score는 평균 88.4점(80~95점)이었으며 전예에서 5개월 이내에 골 유합 소견을 보였다. 결론: 대퇴골 전자간 골절의 성공적인 내고정을 위해서는 적절한 내고정물의 선택과 정확한 술기가 필요하며, 내고정 실패시 대퇴골두와 비구부가 건전할 때에는 환자의 연령과 전신상태를 파악하여 인공관절 치환술과 함께 95도 칼날 금속판등을 이용한 재내고정술도 고려하여야 할 것으로 판단된다. Purpose: We wanted to analyze the causes of fixation failure after performing compression hip screw fixation for intertrochanteric fracture and we wanted to evaluate the methods to mange this type of failure. Materials and Methods: From January 1999 to August 2005, 15 patients who underwent operation due to fixation failure after compression hip screw ixation for intertrochanteric fracture were evaluated, with at least 1 year follow up, for the fracture type, the status of the reduction, the aspects of failure, the causes of the failure and the clinical and radiologic results after operation. Results: There were 7 cases of cut out by the hip screw, 1 case of hip screw breakage, 1 case of dislodging the hip screw, 2 cases of excessive sliding of the hip screw, 2 cases of plate breakage and 2 cases of fixation loss of the plate. The failure of cases was due to incorrect choice of the implants, and that of 9 cases was due to technical error. The Harris Hip score was an average of 67.8 for 10 cases of failed arthroplasty at the last follow up and 88.4 for 4 cases of re-fixation with a 95 degree angled blade plate, and bone union was achieved at a minimum of 5 months. Conclusion: It is important to choose an adequate implant and a precise technique to achieve a successful result for fixation of unstable intertrochanteric fracture, and refixation with a 95 degree angled blade plate could be considered for the management of failed intertrochanteric fracture with arthroplasty.

Team Building 훈련프로그램

강종우 漢陽大學校 學生生活硏究所 1992 大學生活硏究 Vol.10 No.-