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슬관절내 견열골절의 자기공명영상 소견과 동반된 관절내 손상: 십자인대 파열을 중심으로
홍훈표,진욱,류경남,Hong, Hun-Pyo,Jin, Uk,Ryu, Gyeong-Nam 대한영상의학회 2003 대한영상의학회지 Vol.48 No.4
목적: 슬관절의 전방 및 후방십자인대의 견열골절 손상이 있을 때 십자인대 자체의 파열 유무를 MRI소견과 수술소견을 통해서 알아보고자 하였다. 대상과 방법 : 1997년 3월부터 2002년 5월까지 전방 혹은 후방십자인대의 견열골절 손상으로진단되었던 19예의 환자 중에서 수술을 시행한 10예를 대상으로 하였다. 남녀비는 8 :2 였고, 연령분포는 10세에서 51세사이로 평균 27. 7세 였다. 십자인대의 경골 부착부위에 견열골절이 있었던 10예에서 MRI상 전방 혹은 후방십자인대의 파열 유무를 분석하였고, 수술소견과 비교 하였다. 또한 동반된 슬관절내 다른 부위의 손상 여부를 알아보았고, 환자의 수술방법 및 추적 검사상에서의 수술결과를 알아보았다. 결과: 전방십자인대의 견열골절 손상이 있었던 7예 중 인대의 부분파열이 5예, 완전파열이 1예로 진단되었고, MRI소견과 수술소견이 일치하였다. 후방십자인대의 견열골절 손상이 있었던 3예 모두가 MRI상에서 인대의 부분파열로 진단되었고, 수술소견도 일치하였다. 6예에서 슬관절내 동반된 다른 구조물의 손상이 없었고, 내측반월상연골 파열, 외측반월상연골 파열, 후방십자인대 및 내측측부인대 파열, 오금인대 파열이 각각 1예씩 동반되어 있었다. 결론: 전방 및 후방십자인대의 견열골절이 있었던 대부분의 예에서 십자인대의 부분파열 및 완전파열을 동반하였다. 수술이나 관절경 상에서 간과할 수 있는 인대자체의 손상을 MRI상에서 진단해 내는 것이 전방 및 후방십자인대의 견열골절 영상분석에 도움을 줄 것으로 생각된다. Purpose: To determine the presence of cruciate ligament tears following avulsion injuries involving the ACL and PCL, and to correlate the findings with those of surgery. Materials and Methods: Between March 1997 and May 2002, avulsion injury involving the ACL or PCL was diagnosed in 19 patients. Ten of these [8 males and 2 females aged 10-51 (avergae, 27.7) years] were included in this study. We assessed the presence of cruciate ligament tears at MR imaging, correlating the findings with those of surgery. Associated intra-articular injuries, treatment methods and follow-up results were also evaluated. Results: Among Seven patients with ACL avulsion injury, this was assessed at MR imaging as complete tear (n=1), partial tear (n=5), or intact (n=1), while all MR images of PCL avulsion injury (n=3) showed that this was partial tear. All imaging findings corresponded with the surgical findings. In four patients there was associated knee injury involving, respectively, tears of the medial meniscus, lateral meniscus, PCL and MCL, and popliteal ligament. Conclusion: Our findings showed that with one exception, patients with avulsion injury of the ACL or PCL had suffered either a partial or complete tear. MR imaging may be useful in the diagnosis of tears of the cruciate ligament which have not been noticed at surgery or arthroscopy in avulsion injuries involving the ACL and PCL
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향정신성 약물 중독에 의한 QTc 연장과 그 위험성에 대한 고찰
박관호 ( Kwan Ho Park ),홍훈표 ( Hoon Pyo Hong ),이종석 ( Jong Seok Lee ),정기영 ( Ki Young Jeong ),고석훈 ( Seok Hun Ko ),김성규 ( Sung Kyu Kim ),최한성 ( Han Sung Choi ) 대한임상독성학회 2020 대한임상독성학회지 Vol.18 No.2
Purpose: The aims of the present study were twofold. First, the research investigated the effect of an individual’s risk factors and the prevalence of psychotropic drugs on QTc prolongation, TdP (torsades de pointes), and death. Second, the study compared the risk scoring systems (the Mayo Pro-QT risk score and the Tisadale risk score) on QTc prolongation. Methods: The medical records of intoxicated patients who visited the emergency department between March 2010 and February 2019 were reviewed retrospectively. Among 733 patients, the present study included 426 psychotropic drug-intoxicated patients. The patients were categorized according to the QTc value. The known risk factors of QTc prolongation were examined, and the Mayo Pro-QT risk score and the Tisadale risk score were calculated. The analysis was performed using multiple logistic regression, Spearman correlation, and ROC (receiver operating characteristic). Results: The numbers in the mild to moderate group (male: 470≤QTc<500 ms, female: 480≤QTc<500 ms) and severe group (QTc≥500 ms or increase of QTc at least 60ms from baseline, both sex) were 68 and 95, respectively. TdP did not occur, and the only cause of death was aspiration pneumonia. The statically significant risk factors were multidrug intoxications of TCA (tricyclic antidepressant), atypical antipsychotics, an atypical antidepressant, panic disorder, and hypokalemia. The Tisadale risk score was larger than the Mayo Pro-QT risk score. Conclusion: Multiple psychotropic drugs intoxication (TCA, an atypical antidepressant, and atypical antipsychotics), panic disorder, and hypokalemia have been proven to be the main risk factors of QTc prolongation, which require enhanced attention. The present study showed that the Tisadale score had a stronger correlation and predictive accuracy for QTc prolongation than the Mayo Pro-QT score. As a result, the Tisadale risk score is a crucial assessment tool for psychotropic drug-intoxicated patients in a clinical setting.
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