전위된 관절내 원위 요골의 관절경을 이용한 고정술

이원용,박병문,임대의,송경섭,홍정우 대한골절학회 2003 대한골절학회지 Vol.16 No.3

목적: 전위된 관절내 원위 요골 골절에 관절경을 이용한 정복술과 경피적 K 강선 및 외고정기기를 이용한 수술법의 결과를 알아보고자 함이다. 대상 및 방법: 2001년 1월부터 8월까지 수술한 11명 12예를 대상으로 하였으며, 평균 추시 기간은 14개월 이었다. 골절의 형태는 AO 분류에 의하면 1예는 B3형, 4예는 C2형, 7예는 C3형 골절이었다. 전예에서 2.7㎜ 관절경을 이용하였으며 추가적인 관혈적 정복은 시행하지 않았다. 경피적 K 강선 고정술 후 외고정 기기를 사용하였다. 관절내 골연골 골편을 제거하였으며 추가적인 수근 골간 인대와 삼각 섬유 연골 손상의 적극적인 처치는 없었다. 고정물 제거 시기는 경피적 K 강선은 술후 4주, 외고정 기기는 7주에 시행하였다. 결과: 평균 수근 관절의 신전 및 굴곡은 정상의 72%였다. 평균 요측 길이는 12.3 ㎜, 전방경사는 5.7°, 척측 경사는 22.4°였다. 평균 관절면의 불일치는 1㎜였다. 술후 구획 증후군의 발생은 없었으며 치료 중 골절 함몰 소견은 없었다. 임상적으로 Gartland와 Werley의 평가에 의하면 8예에서 우수, 3예에서 양호, 1예에서 보통의 결과를 얻었다. 결론: 관절내 분쇄 골절의 치료에서 관절경을 이용한 관절면 정복술은 수술적 연부 조직을 최소화하면서 관절면을 비교적 정확하게 정복함으로 관절면의 불일치를 감소시켜 손상 후 좋은 결과를 얻을 수 있는 효과적인 방법으로 사료된다. Purpose: To investigate the result of arthroscopically assisted reduction of intraarticular fracture of distal radius with percutaneous K-wires and external fixation. Materials and Methods: We reviewed 12 intraarticular distal radial fractures of 11 patients treated arthroscopically assisted reduction in Orthopedic Department of Sung-Ae hospital between January, 2001 and August, 2001. The mean length of follow-up was 14 months. Analysis of them revealed that B3 was 1 case, C2 4 cases and C3 7 cases according to the AO classification. All cases were treated by 2.7 ㎜ arthroscopic devices and percutaneous K-wires pining with external fixationg, but additionally invasive reductional technique was not used. We removed the osteochondral flap but not treated. The K-wires were removed at 4 weeks, external fixation was 7 weeks, respectivley. Result: The mean active range of movement in the affected wrist was total arc of the flextion-extension 72% of the opposite side. Radiographically mean volar tilt, radial inclination and radial length compartment syndrome and fractures collapse were not occured during follow-up period. According to the Gartland and Werley demerit-point system, eleven cases were a excellent or good one was a fair result. Conclusion: Arthroscopically assisted fixation is a useful method for reducing the soft tissue injuies and preventing the articular surface incogruency by anatomically reduction un cases of intraarticular comminution.

Clinical Score System to Differentiate Severe Fever with Thrombocytopenia Syndrome Patients from Patients with Scrub Typhus or Hemorrhagic Fever with Renal Syndrome in Korea

Dae-Hyuk Heo,Yu Min Kang,송경호,Jun-Won Seo,Jeong-Han Kim,June Young Chun,전강일,강창경,Song Mi Moon,Pyoeng Gyun Choe,Wan Beom Park,Ji Hwan Bang,Eu Suk Kim,Hong Bin Kim,Sang-Won Park,Won Sup Oh,Nam Joong Kim,M 대한의학회 2020 Journal of Korean medical science Vol.35 No.11

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with high mortality in East Asia. This study aimed to develop, for primary care providers, a prediction score using initial symptoms and basic laboratory blood tests to differentiate between SFTS and other endemic zoonoses in Korea. Methods: Patients aged ≥ 18 years diagnosed with endemic zoonoses during a 3-year period (between January 2015 and December 2017) were retrospectively enrolled from 4 tertiary university hospitals. A prediction score was built based on multivariate logistic regression analyses. Results: Of 84 patients, 35 with SFTS and 49 with other endemic zoonoses were enrolled. In multivariate logistic regression analysis, independent predictors of SFTS included neurologic symptoms (odds ratio [OR], 12.915; 95% confidence interval [CI], 2.173–76.747), diarrhea (OR, 10.306; 95% CI, 1.588–66.895), leukopenia (< 4,000/mm3 ) (OR, 19.400; 95% CI, 3.290– 114.408), and normal C-reactive protein (< 0.5 mg/dL) (OR, 24.739; 95% CI, 1.812–337.742). We set up a prediction score by assigning one point to each of these four predictors. A score of ≥ 2 had 82.9% sensitivity (95% CI, 71.7%–87.5%) and 95.9% specificity (95% CI, 88.0%–99.2%). The area under the curve of the clinical prediction score was 0.950 (95% CI, 0.903–0.997). Conclusion: This study finding suggests a simple and useful scoring system to predict SFTS in patients with endemic zoonoses. We expect this strategic approach to facilitate early differentiation of SFTS from other endemic zoonoses, especially by primary care providers, and to improve the clinical outcomes.

Clinical Efficacy of Psoas Muscle Thickness for the Diagnosis of Sarcopenia in Patients with Liver Cirrhosis

( Dae Hoe Ku ),( Sang Gyune Kim ),( Moon Young Kim ),( Yeon Seok Seo ),( Han Ah Lee ),( Tae Hyung Kim ),( Sang Jun Suh ),( Young Kul Jung ),( Ji Hoon Kim ),( Hyunggin An ),( Hyung Joon Yim ),( Jong Eu 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Although most widely used method for diagnosis of sarcopenia is measurement of skeletal muscle index (SMI), several studies suggested that psoas muscle thickness per height (PMTH) is also effective for detecting sarcopenia and predicting prognosis in cirrhotic patients. This study was performed to evaluate optimal cutoffs of PMTH for detecting sarcopenia in cirrhotic patients. Methods: All cirrhotic patients who underwent abdominal CT scan including L3 and umbilical levels. Skeletal muscle area at the L3 level was measured with ImageJ software and then normalized by height squared to give the SMI. In addition, transverse psoas muscle thickness was measured at the umbilicus level and then normalized by height to give the PMTH. Three kinds of definition of sarcopenia was used as follows: (1) sex-specific cutoffs of SMI (Ł52.4 cm2/m2 in men and Ł38.5 cm2/m2 in women), SMI-sarcopenia; (2) sex-specific cutoffs of PMTH (<17.3 mm/m in men and <10.4 mm/m in women), SsPMTH- sarcopenia; and (3) sex-nonspecific cutoff of PMTH (<16 mm/m), SnPMTH-sarcopenia. Results: Six-hundred fifty-three patients were included. Age was 53.6±10.2 years and 499 patients (76.4%) were men. PMTH was well correlated with SMI (P<0.001 in both men and women). AUCs of PMTH for predicting sarcopenia by SMI was 0.779 and 0.842, and the best cutoff values of PMTH for predicting SMI-sarcopenia were 17.3 mm/m and 10.4 mm/m in men and women, respectively. Among all included patients, 230 (35.2%) and 280 (44.4%) patients were diagnosed as SsPMTH-sarcopenia and SnPMTH-sarcopenia, respectively. On multivariate Cox regression analysis, SsPMTH-sarcopenia (HR, 1.944; 95% CI, 1.144-3.304; P=0.014) were significantly associated with mortality, while SnPMTH-sarcopenia was not (HR, 1.446; 95% CI, 0.861-2.431; P=0.164). Conclusions: PMTH was well correlated with SMI in cirrhotic patients. SsPMTH-sarcopenia was independent predictor of mortality in these patients and more accurately predicted mortality compared to SnPMTH-sarcopenia.

Pyrazinamide에 의한 전격성 간부전

문대성 ( Dae Sung Moon ),장태원 ( Tae Won Jang ),옥철호 ( Chul Ho Oak ),정만홍 ( Maan Hong Jung ),유찬희 ( Chan Hui Yoo ),송준영 ( Jun Young Song ),김성은 ( Sung Eun Kim ),김자경 ( Ja Kyung Kim ),장리라 ( Lee La Jang ),이은영 ( Eu 대한결핵 및 호흡기학회 2007 Tuberculosis and Respiratory Diseases Vol.63 No.5

Standard antituberculous therapy, including isoniazid (INH), rifampin, ethambutol, and pyrazinamide (PZA), is widely used to treat active tuberculosis. The most important side effect is hepatotoxicity. In a standard four-drug regimen, PZA was the most common cause of drug-induced hepatitis and was dose-related. The incidence of drug-induced hepatitis is high at doses of 40∼70 mg/kg per day but has fallen significantly since the recommended dose was reduced. Liver toxicity induced by PZA is rare at doses of 25 mg/kg per day or less. PZA-induced fulminant hepatic failure is also rare but fatal. We report a case of fulminant hepatic failure caused by a re-challenge of PZA. (Tuberc Respir Dis 2007;63:435-439)

질식 자궁근종절제술의 임상적 고찰

장유진 ( Eu Gene Chang ),이소명 ( So Myung Lee ),조혜연 ( Hye Yeon Cho ),박서연 ( Seo Yeon Park ),김은경 ( Eun Kyoung Kim ),강우대 ( Woo Dae Kang ),김종운 ( Jong Woon Kim ),김석모 ( Seok Mo Kim ),최호선 ( Ho Sun Choi ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.9

목적: 질식 자궁근종절제술을 시행한 환자를 대상으로 임상 경과 및 수술 후 합병증 여부를 분석하여 질식 근종절제술의 유용성 및 안정성에 대해 알아보고자 하였다. 방법: 1997년 11월부터 2006년 7월까지 전남대학교 병원에서 질식 자궁근종절제술을 시행한 59명의 환자를 대상으로 수술시간, 혈색소 변이, 수술 후 통증, 수술 후 합병증, 수술 후 입원기간에 대해 후향적 고찰을 하였다. 결과: 59명 환자의 평균 연령은 41.54±5.8세였고, 근종의 평균 크기는 6.79±1.75 cm였다. 평균 수술시간은 66.69±34.49분이었고 수술 후 평균 혈색소 감소량은 2.67±1.26 g/dL. 술후 24시간 이후에 38℃ 이상의 발열을 보인 경우는 1명이었으며, 술후 후복막내 출혈로 재수술을 했던 경우가 1명이었다. 평균 입원기간은 4.91±1.25일이었다. 결론: 질식 근종절제술은 유용하고 안전한 수술방법이다. 개복을 통한 근종절제술과 복강경하 근종절제술을 본 연구 결과와 비교하여 질식 근종절제술의 임상적 유용성을 더 연구할 필요가 있으며 질식 근종절제술이 보다 대중화되고 효과적인 수술방법이 될 것을 기대한다. Objective: The aim of this study was to evaluate the clinical effectiveness and safety of vaginal myomectomy via colpotomy with analyzing clinical course and postoperative complication. Methods: A retrospective study was performed in 59 patients, who underwent vaginal myomectomy between November 1997 and July 2006 in department of gynecology, Chonnam National University Hospital. Operating time, hemoglobin change, postoperative pain, perioperative complication, and days of hospital stay were recorded. Results: Fifty-nine patients were evaluated, mean age of patients was 41.54±5.8 years. Mean diameter of the uterine myoma was 6.79±1.75 cm. Mean operating time was 66.69±34.49 minute. Mean hemoglobin loss was 2.67±1.26 g/dL, and mean days of hospital stay was 4.91±1.25 days. One patient had febrile morbidity. Only one patient had suffered from retroperitoneal bleeding enough to get on operation. Conclusion: Vaginal myomectomy seems to be a feasible and safe surgical procedure. Further randomised studies are needed to compare this procedure with laparotomy and laparoscopy, and vaginal myomectomy is expected to be more effective and generalized surgical procedure.

국내 논문에 있어 대상자별 원예치료 프로그램 내의 원예활동 조사연구

오대민(Dae-Min Oh),장유진(Eu-Jean Jang),소인섭(In-Sup So),이영현(Young-Hyun Lee),허무룡(Moo-Ryong Huh),최영애(Young-Ae Choi),허북구(Buk-Gu Heo) 한국원예학회 2006 원예과학기술지 Vol.24 No.1

다양한 상황 및 대상에게 적용될 수 있는 효과적인 원예치료 프로그램 개발과 원예활동을 위한 새로운 원예용품 및 작물 개발을 위한 기초적 자료를 마련하고자 원예치료와 관련한 69편의 연구논문을 분석한 결과, 원예치료 프로그램에서 사용된 원예활동은 대부분 실내에서 식물 기르기(Ⅰ형), 실외 정원에서 식물 기르기(Ⅱ형), 아트와 크래프트(Ⅲ형)이었으며 그 종류가 다양하게 활용되어진 것으로 조사되었다. 반면 그룹 활동(Ⅳ형), 소풍(Ⅴ형), 요리(Ⅵ형), 식물과 관련한 공부(Ⅶ형)로 분류되는 원예활동은 그 종류가 한정적으로 조사되었다. 이는 대상자 특성을 고려한 치료사의 의도에 따른 활동 선정과 원예와 관련된 활용 가능한 각종 인프라의 여건이 상당부분 작용했을 것으로 여겨진다. 앞으로 활용 가능한 원예 관련 시설, 대상자 특성이 고려된 원예 활동 용구 및 식물과 원예활동을 바탕으로 통합된 커리큘럼 등의 요소를 포함하여 원예활동을 분석한다면 보다 발전된 학문과 산업에 기여할 수 있을 것으로 보인다. Sixty nine research papers related with horticultural therapy were studied to develop a therapy program which could be applied to various kinds of participants under various circumstances and provide a basic data for development of new horticultural products. According to the papers, the most frequent forms of horticultural activities applied to therapy programs were found out to be plant culture indoor (type Ⅰ), plant culture in outdoor garden (type Ⅱ) and art and craft (type Ⅲ). However, variations activities related with group activity (type Ⅳ), picnic (type Ⅴ), cooking (type Ⅵ) and botanical study (type Ⅶ) were limited. These findings would be explained by the choice of therapists taking characteristics of individual participants available horticultural infrastructure into account.

국내 원예치료 관련 연구논문 추이와 제언

오대민(Dae-Min Oh),장유진(Eu-Jean Jang),소인섭(In-Sup So),이영현(Young-Hyun Lee),허무룡(Moo-Ryong Huh),최영애(Young-Ae Choi),허북구(Buk-Gu Heo) 한국원예학회 2006 원예과학기술지 Vol.24 No.1

국내 실정에 맞는 한국형 원예치료의 개발과 정착에 방향성을 설정해 주는 계기 마련을 위해 1998년부터 2003년까지 6년간 발표된 원예치료 관련 연구논문의 학회지별 추이를 살펴보면 한국식물ㆍ인간ㆍ환경학회와 한국원예치료연구회에 게재된 논문이 대부분을 차지하며 원예치료 관련 기초논문과 응용연구논문은 6년간의 전체 비율에서 큰 차이를 보이고 있지 않으나, 2000년 이후부터 기초연구논문이 감소하고 응용연구 논문이 많은 비율을 차지하였다. 응용연구의 대부분이 치료공간을 대상으로 하고 있으며, 그 대상자는 치매, 정신분열, 우울증 등으로 시도되어 왔으며 예방공간에서도 아동, 청소년, 성인과 노인을 대상으로 적용되었다. 그러나 치료 및 재활공간에 편중된 경향을 나타내며, 그 중에서 정신지체와 정신분열, 치매에 중점적으로 적용된 것으로 나타났다. 본 연구는 원예치료와 관련된 연구의 종합적인 분석을 시도함으로써 원예치료의 앞으로의 발전 방향 모색에 기여할 것으로 생각된다. The published papers on horticultural therapy for 6 years from 1998 to 2003 was analysed to suggest a direction in which Korean-style horticultural therapies would be developed and applied. Most of the articles were published by the Korean Society for Plants, People and Environment and the Korean Horticultural Therapy Association. The proportion of theoretical papers was similar to that of applied ones for the six year period, but the proportion of the former has decreased while that of the latter has increased since 2000. A majority of applied studies dealt with space of treatment; the participants were those who suffered from senile dementia, schizophrenia or melancholia; and the therapy was applied to children, teenagers, adults or the aged for preventive purpose. However, it tends to emphasize too much on place of treatment and rehabilitation and deal mainly with participants of mental retardation, schizophrenia or senile dementia.

정수장 배출수 처리효율 향상을 위한 상등수 자동집수장치개발에 관한 연구

권대영 ( Dae Young Kwon ),최민규 ( Min Kyu Choi ),이의재 ( Eu Jae Lee ) 한국수처리학회 2015 한국수처리학회지 Vol.23 No.3

Recently, a novel system with high efficiency has been developed to drain only supernatant of residuals effectively from water treatment plant, which results in high removal efficiency in water treatment by enhancing the quality of residuals and recycling water. The system could positively cope with the variation of water quality by a monitoring device. It was also operated automatically by an auto-control program. The purpose of the present investigation is to evaluate the treatment efficiency of an auto supernatant drain system (ASDS) in treating the residuals from water treatment plant by operating pilot tests as well as column tests. The ASDS improved BOD of the water flowing into the residuals basin by 40.6% and that of the water flowing into the thickener by 90.8%. The improvement effect of COD by the system were 26.7% and 83.9% for the recycled water and the effluent, respectively. The system also improved 1.62 mgL-1 and 0.17 mgL-1 in terms of the mean TN and TP, respectively. The ASDS improved 4.56 % of the mean moisture content and 87.3 % of the mean recovery rate.

폴리머/질화붕소 복합재료의 마찰 특성에 관한 연구

민유진(Eu-Gene Min),김창래(Chang-Lae Kim),김대은(Dae-Eun Kim) 대한기계학회 2016 대한기계학회 춘추학술대회 Vol.2016 No.4

폴리머기반 필름의 기계적 특성에 관한 연구

민유진(Eu-gene Min),강경희(Kyung-hee Kang),김대은(Dae-Eun Kim) 대한기계학회 2017 대한기계학회 춘추학술대회 Vol.2017 No.2