외상 없는 젊은 환자에서 반월상 연골의 돌출

심재천(Jae-Cheon Sim),전종현(Jong-Hyun Jeon),서이락(Yi-Rak Seo),박대원(Dae-Won Park),남태석(Tae-Seok Nam) 대한정형외과학회 2018 대한정형외과학회지 Vol.53 No.5

목적: 외상력이 없는 젊은 남자의 무릎 자기공명영상을 통하여 정상적인 반월상 연골의 크기, 돌출의 정도, 동반 변형에 대해 알아보고자 하였다. 대상 및 방법: 슬관절을 제외한 타 부위의 동통을 주소로 정형외과 외래를 방문한 환자 중 연구 당시 슬관절 부위의 동통을 호소하지 않고, 슬관절 외상력이 없는 젊은 77명(91 슬관절)을 대상으로 하였다. 평균 나이는 21.6±1.1세(19-24세)였으며, 1.5Tesla magnetic resonance unit (Magneton Symphony; Siemens, Erlangen, Germany)을 이용하여 검사를 시행하였다. 이를 통하여 반월상 연골의 크기, 돌출, 돌출률, 동반 변형에 대해 알아보았다. 결과: 관상면에서 내측 반월상 연골의 평균 크기는 9.0±1.1 mm (7.1-11.9 mm), 돌출의 정도는 2.0±1.0 mm (0-4.4 mm), 반월상 연골 돌출률(돌출 크기/전체 크기×100)은 22.7%±11.5% (0%-53.7%)였다. 내측 반월상 연골의 돌출은 관상면과 시상면에서 각각 92.3%, 80.2%에서 관찰되었다. 관상면에서 외측 반월상 연골의 평균 크기는 11.1±3.4 mm (7.3-22.9 mm), 돌출의 정도는 0.5±0.7 mm (0-2.5 mm), 반월상 연골 돌출률은 4.0%±6.7% (0%-26.3%)였다. 외측 반월상 연골의 돌출은 관상면에서 34.1%에서 관찰되며, 시상면에서는 관찰되지 않았다. 결론: 외상 없는 젊은 환자의 자기공명영상 검사에서 반월상 연골의 돌출은 흔히 관찰되며, 외측보다 내측에서 더 흔하게 관찰된다. Purpose: The aim of this study was to assess the size and extrusion of the meniscus in young and non-traumatic knees, especially in Korean males. Materials and Methods: The participants (n=91 knees, 77 patients) were consecutive patients observed at an orthopedic outpatient clinic who had another problem unrelated to the knee joint. The patients were excluded from the study if they had a history of trauma and pain on the knee joint. The patients received a magnetic resonance imaging (MRI) scan on the knee joint. The size, extrusion, and extrusion ratio of the meniscus on an MRI scan were evaluated. Results: The mean age of the participants was 21.6±1.1 years (range, 19-24 years). The mean size of the medial meniscus on the coronal plane was 9.0±1.1 mm (range, 7.1-11.9 mm). The extent of extrusion on the coronal plane was 2.0±1.0 mm (range, 0-4.4 mm). The extrusion ratio (extruded size/total size×100) of the medial meniscus on the coronal plane was 22.7%±11.5% (range, 0%-53.7%). The extent of extrusion on the sagittal plane was 1.6±1.1 mm (range, 0-4.0 mm). The extrusion ratio (extruded size/total×100) of the medial meniscus on the sagittal plane was 18.0%±11.9% (range, 0%-40.7%). The incidence of medial meniscal extrusion on the coronal and sagittal plane are 92.3% and 80.2%, respectively. The mean size of lateral meniscus on the coronal plane was 11.1±3.4 mm (range, 7.3- 22.9 mm). The extent of extrusion on the sagittal plane was 0.5±0.7 mm (range, 0-2.5 mm). The extrusion ratio of the lateral meniscus on the sagittal plane was 4.0%±6.7% (range, 0%-26.3%). The incidence of lateral meniscal extrusion on the coronal plane was 34.1%. No extrusion of the lateral meniscus was observed on the sagittal plane. Conclusion: In young and non-traumatic knees, the extrusion of meniscus was common, especially medial meniscus than lateral meniscus.

가변각 수장측 잠김 금속판을 이용한 원위 요골 골절 치료

심재천 ( Jae Cheon Sim ),하성식 ( Sung Sik Ha ),홍기도 ( Ki Do Hong ),김태호 ( Tae Ho Kim ),성민철 ( Min Chul Sung ) 대한골절학회 2015 대한골절학회지 Vol.28 No.1

Purpose: The purpose of this study is to evaluate outcome of variable-angle volar locking plate for treatment of distal radius fractures. Materials and Methods: We retrospectively analyzed the results in 45 cases treated by variable-angle volar locking plate. We evaluated the clinical results according to the Mayo wrist performance scoring system and radiographic results. Results: All cases had bony union. The mean Mayo wrist performance scoring system was 84.8. Between preoperative and immediate postoperative radiographic measurement, the mean radial length improved from 8.4 to 11.8 mm, radial inclination from 14.2o to 22.4o, volar tilt from ?4.5o to 9.6o, and intraarticular step-off from 1.8 to 0.3 mm (p<0.05). Between immediate postoperative and latest follow-up radiographic measurements, the mean loss of radial length measured 0.8 mm, radial inclination 0.4o, and volar tilt 0.9o (p>0.05). All cases showed bone union with no evidence of malunion, nonunion, or metal failure. Conclusion: Treatment of distal radius fractures using variable angle volar locking plate showed satisfactory outcomes. It is a good option to obtain stable fixation without significant loss of reduction.

Locking Compression Plate를 이용한 원위 요골 골절의 치료

심재천 ( Jae Cheon Sim ),정남식 ( Nam Sik Chung ),홍기도 ( Ki Do Hong ),하성식 ( Sung Sik Ha ),강지훈 ( Ji Hoon Kang ) 대한골절학회 2005 대한골절학회지 Vol.18 No.2

지간 신경종의 자기 공명 영상을 이용한 진단

홍기도,하성식,심재천,김재영,Hong, Ki-Do,Ha, Sung-Sik,Sim, Jae-Cheon,Kim, Jae-Young 대한족부족관절학회 2003 대한족부족관절학회지 Vol.7 No.1

Most interdigital neuroma can be diagnosed clinically. But, diagnostic local injection method, sonography and magnetic resonance image(MRI) have been used as secondary tests for clinical confirmation or surgery. Recently, there have been active discussions on the method of interdigital neuroma diagnosis for which sonography or MRI is used. For finding out the location or the number of interdigital neuroma particularly in non-typical clinical manifestation or surgery, MRIs, which are exellent in tissue contrast, may be quite helpful. This case had an interdigital neuroma showing non-typical manifestation. MRIs were used for clinical diagnostic confirmation and finding out the location and the number of interdigital neuroma. Thus, the validity along with literary consideration is being reported.

슬관절 관절내 발생한 양성 섬유성 조직구종: 증례 보고

홍기도,하성식,심재천,김태호,이종성,성민철,Hong, Ki-Do,Ha, Sung-Sik,Sim, Jae-Cheon,Kim, Tae-Ho,Lee, Jong-Seong,Sung, Min-Chul 대한근골격종양학회 2012 대한골관절종양학회지 Vol.18 No.2

슬관절에서의 양성 섬유성 조직구증은 매우 드문 질환으로 대부분의 경우 통증 등의 특별한 증상을 유발하지 않고 심부에 위치하고 있어 진단을 놓치기 쉬우며 우연히 발견되는 경우가 많다. 저자들은 슬관절의 운동제한과 동통을 주소로 내원한 53세 여자 환자에 대해서 외관상 촉지 되지 않았다가 MRI 검사에서 슬개건 하부의 종물을 발견하였고, 진단적 관절경 검사 후 절제 및 조직 생검 결과 양성 섬유성 조직구종으로 밝혀진 1예를 경험하게 되었다. 심부 양성 섬유성 조직구증은 모든 양성 섬유성 조직구증의 5% 이하로 흔하지 않은 것으로 알려져 있는 가운데 슬관절에서 발생한 1예에 대해서 문헌고찰과 함께 보고하고자 한다. Benign fibrous hitiocytoma of the infrapatella fat pad is very rare. It has usually do not induced a pain or a symptom because it was located deep tissue. So it was very difficult to be diagnosed. We experienced a case of deep benign fibrous histiocytoma in a 53-year-old woman. It was diagnosed by MRI. Diagnostic arthroscopic procedure was performed and the lesion was completely resected by open excision. We report a rare case of benign fibrous hitiocytoma presenting as an intra-articular tumor in the joint causing pain and limitation of movement.

Locking Compression Plate를 이용한 족근 관절 외과 골절의 치료

하성식,홍기도,정남식,심재천,안상천,Ha, Sung-Sik,Hong, Ki-Do,Chung, Nam-Sik,Sim, Jae-Cheon,Ahn, Sang-Cheon 대한족부족관절학회 2005 대한족부족관절학회지 Vol.9 No.1

Purpose: The purpose of this study was to investigate usefulness of locking compression plate (LCP) as an open reduction technique by evaluating clinical results obtained from the patients with lateral malleolar fracture treated by internal fixation using LCP after open reduction. Materials and Methods: Among the patients with lateral malleolar fracture, the 28 patients who were treated by internal fixation using Locking compression plate after an open reduction and were able to be followed up for more than 6 months were included in this study. Final postoperative evaluation was done based on the Meyer's clinical and radiologic evaluation system. Results: All cases achieved anatomical reduction and fixation of the reduction postoperatively. 28 minutes were taken meaningly from the incision to the fixation of LCP plate after the anatomical reduction. Everage bony union time was 8.2 weaks, and the result was excellent in 23 cases (82%), good in 5 cases (17%) and poor result was abscent according to the criteria of Meyer et al. One case of post traumatic arthritis and one case of superficial infection on the operation site were found, but non-union, delayed union and malunion were not occurred. Conclusion: The internal fixation after open reduction using LCP is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including easy application and a greater stability due to its capability of maintaining exact anatomical reduction even though the screw does not penetrate the medial cortex of fibular to add the stability and rigidity of the fixation.

대퇴골 간부 골절 수술 후 지연성으로 발생한 대퇴 동맥의 폐색

소재완(Jaewan Soh),심재천(Jae-Cheon Sim) 대한정형외과학회 2022 대한정형외과학회지 Vol.57 No.2

외상 후 손상 부위 이하 조직에 허혈성 괴사가 발생하면, 우선적으로 혈관 손상을 의심하게 된다. 하지만, 수상한 지 며칠이 지나 지연성으로 혈관이 폐색되는 경우는 흔하지 않다. 저자들은 대퇴골 골절 수상 당시와 수술 직후 혈류 순환은 유지되었으나, 대퇴동맥의 폐색이 진행되어 수술 후 5일째에 하지의 허혈성 괴사의 발생이 확인되어 치료했던 증례를 경험하였기에, 문헌 고찰과 함께 보고하고자 한다. Once ischemic necrosis occurs in the tissue below an injury site after trauma, a vascular injury is suspected first. On the other hand, it is not common for a blood vessel to become obstructed after a delay of a few days after the initial trauma. The authors experienced a case where the blood flow was maintained at the time of a femoral fracture injury and immediately after surgery, but the femoral artery was occluded later. On the 5th day after surgery, ischemic necrosis of the lower limb was confirmed and treated. This case is reported with a review of the relevant literature.

농산물 법정도매시장과 유사도매시장의 효율성 비교분석

이관수(Lee, Kwan-Soo),심재천(Sim, Jae-Cheon) 대한경영학회 2002 大韓經營學會誌 Vol.15 No.3

압박 고나사로 치료한 대퇴골 전자간부 골절의 고정 실패 인자에 대한 분석

정남식 ( Nam Sik Chung ),심재천 ( Jae Cheon Sim ),홍기도 ( Ki Do Hong ),하성식 ( Sung Sik Ha ),박성준 ( Sung Joon Park ) 대한고관절학회 2005 Hip and Pelvis Vol.17 No.4

목적: 대퇴골 전자간부 골절에서 압박고 나사를 이용한 수술적 치료후 발생할 수 있는 고정 실패에 영향을 미치는 인자에 대하여 분석하고자 하였다. 대상 및 방법: 1999년 1월부터 2003년 12월까지 대퇴골 전자간부 골절을 압박 고나사를 이용하여 치료하고 1년이상 추시가 가능하였던 73례를 대상으로 하였다. 이중 고정 실패는 11례였으며 성별 및 연령, 골절 양상, 골다공증, 나사의 골두 내 위치, 정복 양상 등 고정 실패에 관여할 것으로 기대되는 인자들을 통계학적으로 분석하였다. 결과: 성별 및 연령은 통계적인 차이를 보여주지 못했다(P>0.05). 골절 양상은 불안정성 여부가 고정 실패에 기여하는 유의한 인자로 나타났으며 Singh25) 지수를 이용한 골다공증을 기준으로 나눈 두 군에서도 의미있는 빈도 차이를 보여주었다(P<0.05). 대퇴골두 내 나사못이 상방에 위치한 경우와 골절의 수술적 정복후 전후면 방사선 사진상 5 mm 이상 전위된 경우에도 통계적인 차이를 보여주었다(P<0.05). 결론: 압박고 나사를 이용한 대퇴골 전자간부 골절의 치료에서 불안정성 골절, 심한 골다공증이 있는 경우 각별한 주의를 요하며 고정 실패를 방지하기 위해서는 정확한 정복이 필요하고 대퇴골두 내 압박 고나사의 상방 위치를 피하는 것이 좋을 것으로 사료된다. Purpose: To analyze the significant factors that may affect failure of fixation after surgical treatment of intertrochanteric fracture with compression hip screw. Materials and Methods: From January 1999 to December 2003, the authors analyzed 73 cases of trochanteric fracture of the femur treated with compression hip screw and followed for more than one year. There were eleven cases of failure of fixation. The relationship between the following factors was statistically analyzed: sex and age, fracture type, the degree of osteoporosis, placement of screw in femoral head, quality of reduction and failure of fixation. Results: Difference between age and sex were not statistically meaningful factor (P>0.05). The relationship between failure of fixation and unstable fracture was significant (P<0.05). There was a difference of prevalence between the two groups divided by the degree of osteoporosis using the Singh index (P<0.05). In the case of superior placement in the femoral head and displacement of the cortex of the proximal femur on radiologic AP view, there were more failures of fixation (P<0.05). Conclusion: More attention needs to be devoted to treatment in severe osteoporotic unstable intertrochanteric fracture. Accurate reduction and avoidance of the placement of the lag screw in the superior part of the femoral head were important factors to prevent failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.

우리나라 농산물 도매시장의 발전방안에 관한 연구

이관수(Lee, Kwan-Soo),심재천(Sim, Jae-Cheon) 대한경영학회 2001 大韓經營學會誌 Vol.28 No.-