일반인에서 스포츠 손상으로 인한 제2형 단독 Superior Labral Anterior and Posterior 병변의 관절경적 봉합술의 임상적 결과 및 삶의 질 평가

노성현 ( Sung Hyun No ),김정우 ( Jeong Woo Kim ),강홍제 ( Hong Je Kang ),김종윤 ( Jong Yun Kim ),김광미 ( Kwang Mee Kim ) 대한스포츠의학회 2014 대한스포츠의학회지 Vol.32 No.1

The purpose of this study was to morphologically classify the superior labral anterior and posterior (SLAP) lesion in people with athletic injuries and further research into the clinical result of arthroscopic repair of type II SLAP lesions. January 2005 to June 2012 occurred after sports activity in patients with shoulder pain diagnosed with isolated SLAP lesion by magnetic resonance imaging and arthroscopy were classified according to the tear type. Of these patients, 40 cases of type II SLAP patients were evaluated using American Shoulder and Elbow Surgeons (ASES) questionnaire and range of motion. Also satisfaction of surgery was evaluated by following up through phone calls using translated short form-36 (SF-36). At average of 35 months postoperatively, external rotation decreased slightly from 60.4 degrees to 56.2 degrees, forward elevation and internal rotation were both recovered to a range of pre-surgery but no significant changes were noticed statistically (p>0.05). Visual analogue scale, ASES scores, physical component summary, and mental component summary of SF-36 improved from 5, 1 to 1.2 (p=0.01), from 65.4 to 91.5 (p=0.017), 42.6 to 52.5 (p=0.047), and from 48.5 52.6 to (p=0.036), respectively. In comparison of a group of patients over forty years and less than forty, both groups showed good results, but group of patients less than forty years showed more improvement in pain relief, functional test, and postoperational satisfaction (p=0.004). Arthroscopic repair showed good results in patients with type II SLAP lesion due to athletic injuries especially when they were less than 40 years and it can be regarded as a good treatment with high satisfaction.

최근 10년 동안 일개 대학병원 상처 배양에서 분리된 포도알균의 항생제 내성 변화 연구

홍성노 ( Seong-no Hong ),김준 ( Joon Kim ),성현호 ( Hyun-ho Sung ) 대한임상검사과학회 2016 대한임상검사과학회지(KJCLS) Vol.48 No.4

Staphylococcus aureus, which is generally susceptible to the involvement route in community, is mostly MSSA. However, CA-MRSA is recently increased. Abuse of antibiotics and glycopeptides may increase VISA and VRSA. This study was conducted to investigate the changes on the antibiotic resistance prevalence and antibiotic susceptibility patterns of Staphylococcus aureus isolated from the wound of patients in a university hospital for the past 10 years. This study showed that antibiotic resistance was higher in males than in females; moreover, the antibiotic resistance rates increased with age. The resistance rate for penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, clindamycin, and rifampicin was, respectively, 97.7%, 60.5%, 57.4%, 48.8%, 41.1%, 44.2%, 44.2%, 14.7%, 13.2% and 3.9% in 2006. The resistance rate for penicillin, oxacillin, erythromycin, gentamicin, clindamycin, tetracycline, ciprofloxacin, fusidic acid, trimethoprim/sulfamethoxazole, fusidic acid, clindamycin, and rifampicin was, respectively 95.9%, 62.6%, 55.7%, 28.6%, 50.3%, 34.7%, 38.8%, 34.0%, 2.7% and 8.2% in 2016. Vancomycin, linezolid, quinupristin/dalfopristin, and teicoplanin exhibited 100% in antibiotic susceptibility. In particular, fusidic acid resistance was increased by 19.3% in 2016. Compared with 2006, the decreased point, 12.4% was susceptible and was statistically significant. Therefore, this study suggests that periodic review and understanding of microbial and antibiotic changes should continue to investigate appropriate antibiotic susceptibility.

Differences in the Antibiotic Resistance Pattern of Staphylococcus aureus Isolated by Clinical Specimens in a University Hospital in South Korea

홍성노,김준,성현호,Hong, Seong-No,Kim, Joon,Sung, Hyun-Ho Korean Society for Clinical Laboratory Science 2018 대한임상검사과학회지(KJCLS) Vol.50 No.2

Information on the prevalence of S. aureus and the current antimicrobial resistance profile is necessary in selecting the appropriate treatment of S. aureus infections in any part of the world. This study examined the frequency and antibiotic resistance list of S. aureus isolates obtained from clinical specimens at one hospital in Korea. A total of 1,746 gram positive cocci collected were identified as S. aureus. S. aureus isolates were obtained from different samples including sputum (N=565; 32.4%), endotracheal aspirate (358; 20.5%), wounds (329; 18.8%), blood (137; 7.8%), urine (67; 3.8%), and pus (59; 3.4%). All 1,545 S. aureus (100%) strains screened from sputum (565; 36.6%), endotracheal aspirate (388; 25.1%), wounds (329; 21.3%), blood (137; 8.9%), urine (67; 4.3%), and pus (59; 3.8%) were sensitive to glycopeptide (vancomycin, teicoplanin), oxazolidinone (linezolid) and stretogramin (quinupristin/dalfopristin). The prevalence of resistant S. aureus was significantly (P<0.01) lower in urine, blood, pus, wounds, and sputum than in endotracheal aspirates. As a result, there was a significant difference in the antibiotic resistance of S. aureus according to the clinical specimens. 황색포도상구균의 유병률에 대한 정보와 항생제 내성 리스트는 전 세계 어느 곳에서나 황색포도상구균 감염의 적절한 치료 방법을 선택하는 데 필요하다. 이 연구는 한국의 어느 병원 임상 검체에서 얻은 황색포도상구균 균주의 빈도와 항생제 저항성을 조사하기 위하여 수행하였다. 그람 양성구균 1,746 개의 균은 S. aureus으로 확인되었다. S. aureus은 객담(N=565, 32.4%), 기관내 흡인(358, 20.5%), 상처(329, 18.8%), 혈액(137명, 7.8 %), 고름(59 %, 3.4 %)이었다. 객담, 기관 내 흡인, 상처, 혈액, 소변 및 고름에서 스크리닝 된 1,282개의 S. aureus 균주 모두 글리코 펩타이드 옥시 졸리 디논(리네 졸리드) 및 스트렙토그라민(퀴뉴프리스틴/달포프리스틴)에서 모두 민감성이 나타났다. 황색 포도상 구균은 기관 내 흡인과 비교하면 소변, 혈액, 고름, 상처 및 객담에서 내성이 유의하게 낮았으며(P<0.01), 기관내 흡인 검체에서 분리 된 황색포도상 구균의 경우 특히 내성의 빈도가 높았다. 결과적으로, 임상 표본에 따라 황색 포도상 구균의 항생제 저항성에는 상당한 차이가 있었다.

척골 신경 내에 발생한 혈관종

김태균(Tae Kyun Kim),최병산(Byong San Choi),강홍제(Hong Jae Kang),노성현(Sung Hyun No) 대한정형외과학회 2011 대한정형외과학회지 Vol.46 No.4

신경 내에 혈관종은 매우 드물게 보고된다. 이에 척골 신경내에 발생한 혈관종을 현미경적 탐색술 및 절제술 후, 합병증 없이 치료됨을 경험 하였기에 보고하고자 한다. An intraneural hemangioma is an extremely rare condition. We report here on an intraneural hemangioma of the ulnar nerve. Microscopic exploration and excision of the lesion resulted in complete relief of the patient’s symptoms.

고도 굴곡형 슬관절 전치환술의 중기 결과

김광미(Kwang Mee Kim),전철홍(Churl Hong Chun),강홍제(Hong Je Kang),노성현(Sung Hyun No) 대한정형외과학회 2012 대한정형외과학회지 Vol.47 No.4

목적: 고도 굴곡형 인공관절을 사용하여 슬관절 전치환술을 시행한 환자의 중기 추시 결과를 보고한다. 대상 및 방법: 2004년 11월부터 2006년 6월까지 고도 굴곡형 치환물을 사용하여 슬관절 전치환술을 시행한 77명, 119예를 대상으로 하였다. 평균 연령은 67.3세, 평균 추시 기간은 71.1개월이었다. 평가는 관절운동범위, Hospital for Special Surgery (HSS) score를 조사하였으며 기능적 평가를 시행하였고, 방사선학적으로 평가를 하였다. 결과: 평균 관절운동범위는 104.7o에서 129.8o로, 평균 HSS score는 42.7점에서 93.5점으로 호전되었다. 쪼그려 앉기 33명(42.8%), 양반다리 앉기 75명(97.4%), 무릎 꿇기 27명(35.0%), 바닥 및 의자에서 일어나기는 각각 45명(58.4%), 73명(94.8%)에서 가능하였다. 6예에서 슬관절 강직으로 도수 조작술을 시행하였고, 1 mm 정도의 방사선 투과성 선을 보이는 경우는 5예였으나 진행하지 않았으며 의미 있는 해리는 없었다. 결론: 대퇴 치환물의 조기해리는 치환물 자체의 문제가 아닌 것으로 생각되나 조기해리의 원인에 대한 연구 및 장기 추시가 필요할 것으로 생각한다. Purpose: The purpose of this study was to evaluate the mid-term results of high-flexion total knee arthroplasty. Materials and Methods: We retrospectively reviewed 77 patients who underwent 119 total knee arthroplastys using high-flexion implants (LPS-flex<SUP>®</SUP>, Zimmer, Warsaw, IN, USA) from November 2004 to June 2006. The mean age was 67.3 years (range, 54-83 years), and the average follow-up duration was 71.1 months. We assessed preoperative and last follow-up functional outcomes with ranges of motion (ROM) and the Hospital for Special Surgery (HSS) score and investigated their ability to squat, sit cross-legged knee, kneel, or stand up from the floor or a chair at the final follow-up. The Knee Society Radiographic evaluation and scoring system was used for radiologic evaluation. Results: The mean ROM increased from 104.7o preoperatively to 129.8o postoperatively at the final follow-up. The average HSS score improved from 42.7 points preoperatively to 93.5 points postoperatively. At the final follow-up, 33 patients (42.8%) were able to squat; 75 patients (97.4%) were able to sit cross-legged; 27 patients (35.0%) were able to kneel; 45 patients (58.4%) were able to stand up from the floor and 73 patients (94.8%) were able to stand up from a chair. Six cases encountered stiff knees as a complications, and were treated with manipulation procedures. 1 mm radiolucent lines were detected in 5 cases, but none of them were progressive. Conclusion: We believe that the hyperflexion implant itself is not a cause of early loosening. Research on reasons regarding early loosening and long-term follow-ups will be needed.

Precontoured Locking Compression Plate를 이용한 전위성 쇄골 간부 골절의 수술적 치료

김정우(Jeong Woo Kim),강홍제(Hong Je Kang),노성현(Sung Hyun No) 대한견주관절의학회 2012 대한견주관절의학회지 Vol.15 No.2

목적: 전위성 쇄골 간부 골절에서 관혈적 정복술 후 윤곽 성형된 잠김 압박 금속판(precontoured locking compression plate)을 이용하여 내고정을 시행한 환자를 대상으로 방사선학적 결과 및 임상적 결과를 분석하여 윤곽 성형된 잠김 압박 금속판의 유용성을 알아보고자 하였다. 대상 및 방법: 2009년 3월부터 2010년 2월까지 본원에서 쇄골 간부 골절에 대해 윤곽 성형된 잠김 압박 금속판을 이용하여 관혈적 정복 및 금속 고정술을 시행하고 1년 이상의 추시가 가능했던 34예를 대상으로 하였다. 수술 후 방사선학적 결과는 골유합 여부와 성별 및 나이에 따른 골유합시기의 차이를 평가 하였으며 임상적 결과는 최종 추시 시 quick DASH Score 및 반대측과 관절 운동 범위의 차이를 평가 하여 분석하였다. 결과: 방사선학적 평가에서 모든 예에서 골유합을 얻을 수 있었으며 평균 골유합 기간은 12.3주였으며 성별 및 나이에 따른 골유합 기간은 통계학적으로 유의한 차이를 보이지 않았다(p=0.87). 임상적 평가에서 최종 quick DASH Score는 평균 23.5점 (12~42)이었으며, 최종 추시시 견관절의 운동은 건측과 비교 시 통계학적으로 유의한 차이를 보이지 않았다 (p=0.69). 결론: 전위성 쇄골 간부 골절에 대해 윤곽 성형된 잠김 압박 금속판을 이용한 내고정술은 정확한 해부학적 정복과 견고한 내고정을 유지 할 수 있어 조기 운동이 가능하여 견관절 운동의 회복과 함께 전례에서 골유합을 얻을 수 있어 쇄골 간부 골절 치료에서 유용하게 사용될 수 있다고 사료된다. Purpose: To assess the effectiveness of internal fixation using a precontoured locking compression plate for the treatment of the displaced clavicle fracture by analyzing both radiological and clinical outcomes. Materials and Methods: We reviewed 34 cases of displaced clavicle shaft fracture treated by internal fixation using precontoured locking compression plates between May 2009 and February 2010. Radiological outcomes were analized on the basis of bone union and the differences between the time for bone union depending on sex and age. Clinical outcomes were analyzed on the basis of quick DASH Scores and the differences in the range of motion of the affected shoulder compared to the contralateral shoulder. Results: In the radiological evaluation, all fractures showed bone union, and the average time for bone union was 12.3 weeks, without delayed unions. Time for bone union did not differ significantly with respect to sex and age (p=0.87). In the clinical evaluation, the average final quick DASH Score was 23.5(range, 12~42). At final follow up, the range of motion after bone union in the affected shoulder was not significantly different from that of the contralateral shoulder (p=0.69). Conclusion: The internal fixation achieved using precontoured locking compression plate in displaced clavicle shaft fracture showed effective bone union and can be considered as a reliable method with fine clinical results showing early range of motion at the shoulder joint.