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미만특발골격뼈과다증 환자에서 경추부 골극에 의한 삼킴곤란 및 제한성 환기장애가 동시에 발생한 1예
이홍직 ( Hong Jik Lee ),이지현 ( Ji Hyun Lee ),김민정 ( Min Jeong Kim ),변기섭 ( Ki Sup Byun ),여현정 ( Hyun Jung Yeo ),임호준 ( Ho Joon Im ),남경식 ( Kyoung Sik Nam ) 대한내과학회 2014 대한내과학회지 Vol.87 No.1
DISH에서의 삼킴곤란은 주로 인두나 식도의 기계적 압박에 의하며 호흡곤란은 대부분 기도의 기계적 압박에 의해 발생한다. 저자들은 DISH 환자에서 경추부 골극에 의한 삼킴곤란 및 제한성 환기장애로 인한 호흡곤란이 동시에 발생한 경우를 경험하였기에 이를 문헌고찰과 함께 보고하는 바이다. Diffuse idiopathic skeletal hyperostosis (DISH) is a condition characterized by the calcification and ossification of soft tissue, and can lead to severe cervical kyphosis, presenting with a spectrum of physical complaints including dysphagia, hoarseness, stridor, aspiration pneumonia, and dyspnea due to airway compromise. Restrictive ventilatory impairment is very rare. We encountered a 73-year-old man with DISH presenting with progressive dysphagia and dyspnea over a few months. The symptoms were evaluated with a video fluoroscopy swallowing study and pulmonary function tests (PFT). The PFT revealed restrictive ventilatory impairment. A neck magnetic resonance imaging (MRI) study showed anterior cervical osteophytes causing upper airway compromise and compression of the esophagus. Osteophytes were removed surgically and the patient improved clinically. Here, we describe the case with a literature review. (Korean J Med 2014;87:120-125)
족근 중족 관절의 특발성 골관절염에 대한 수술적 치료 및 임상적 결과에 대한 분석
Jung, Hong-Geun,Byun, Woo-Sup,Myerson, Mark S.,Schon, Lew C. 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.1
Purpose: The purpose of the study was to identify the subtypes of idiopathic osteoarthritis of the tarsometatarsal joints based on accompanying hindfoot, midfoot, or foot deformities and their corresponding surgical options and also to evaluate the overall clinical results. Materials and Methods: The study included 59 patients (67 feet) with idiopathic tarsometatarsal joint osteoarthritis. Tarsometatarsal fusion was performed for tarsometatarsal joint and accompanied secondary change was divided into subtypes and various bony reconstruction was carried out. The patients were evaluated with the AOFAS midfoot score and FFI. The average patient age was 60.2 years with 40.6 months follow-up. Fifty-four feet (80.6%) had been treated with realignment fusion. Twenty-six feet had first and second tarsometatarsal joint fusion, and 20 feet had first tarsometatarsal fusion only. Six subtypes were identified based on associated foot deformities: 1) in-situ without deformities (18%), 2) pes planovalgus (45%), 3) rockerbottom (15%), 4) cavus foot (1%), 5) hallux valgus (12%), and 6) hallux valgus with pes planovalgus or rockerbottom (9%). Plantar-medial closing-wedge resection was used in 10 feet to correct rockerbottom. For pes planovalgus, a medial sliding calcaneal osteotomy was done. Lateral column lengthening with medial sliding calcaneal osteotomy was done for severe pes planovalgus, and triple arthrodesis was done for rigid pes planovalgus. Hallux valgus was corrected with the Lapidus procedure (85.7%). Results: AOFAS midfoot scores improved from preoperative 34.1 points to postoperative 83.9 points (p<0.05). The Foot Function Index postoperatively also showed significant improvement (p<0.05), with a high satisfaction rate (86.6%). There were 29 complications, most commonly sesamoid pain. Conclusion: Idiopathic tarsometatarsal OA feet can be classified into six categories. Pes planovalgus feet should be treated with medial sliding calcaneal osteotomy, lateral column lengthening, or triple arthrodesis in addition to tarsometatarsal joint realignment fusion. Rockerbottom and hallux valgus deformities should also be addressed.
Kim, Il-Sup,Hong, Jae-Taek,Sung, Jae-Hoon,Byun, Jae-Hoon The Korean Neurosurgical Society 2011 Journal of Korean neurosurgical society Vol.50 No.6
Although posterior segmental fixation technique is becoming increasingly popular, surgical treatment of craniovertebral junctional disorders is still challenging because of its complex anatomy and surrounding critical neurovascular structures. Basilar invagination is major pathology of craniovertebral junction that has been a subject of clinical interest because of its various clinical presentations and difficulty of treatment. Most authors recommend a posterior occipitocervical fixation following transoral decompression or posterior decompression and occipitocervical fixation. However, both surgical modalities inadvertently sacrifice C0-1 and C1-2 joint motion. We report two cases of basilar invagination reduced by the vertical distraction between C1-2 facet joint. We reduced the C1-2 joint in an anatomical position and fused the joint with iliac bone graft and C1-2 segmental fixation using the polyaxial screws and rods C-1 lateral mass and the C-2 pedicle.
설혜영,변홍식,최인섭 고려대학교 의과대학 1995 고려대 의대 잡지 Vol.32 No.2
A new method of the endovascular occlusion of the cerebral aneurysm using detachable coil called by GDC(Guglielmi detachable coil) has been developed by Guglielmi in 1991. The mechanisms of GDC treatment are the electrolysis and electrothrombosis. To evaluate the clinical results of GDC treatment, 45 cerebral aneurysms(9 small, 28 large, 8 giant aneurysms) in 42 patients(l0 males, 32 females) were analized. 1 Among total 45 cerebral aneurysms, anterior circulation aneurysms were 28 cases (62.2%) and posterior circulation aneurysms were 17 cases(37.8%). Most common site of cerebral aneurysms was the supraclinoid portion of internal carotid artery (15 cases, 33.3%). The second common site was the tip of basilar artery (6 cases, 13.3%) and the third, the cavernous portion of internal carotid artery(5 cases, 11.1%). 2. Among total 45 cerebral aneurysms, more than 90% occlusions of cerebral aneurysms with GDC were seen in 41 cases(91.1%). 3. Among total 42 patients, 3 patients(7.1%) had major complications by GDC treatment : death due to thrombosis, embolism. arterial dissection. And 3 patients(7.1%) showed temporary arterial occlusions. 4. Among 21 patients who had 6 months follow up study, 17 patients(81.0%) were successful for the treatment and 4 patients(l9.0%) were unsuccessful with coil packing or migration. Endovascular occlusion of cerebral aneurysm with GDC is the promising new technique. It had more advantages compared with the detachable ballon occlusion ; less stress to the wall of the aneurysm, more complete occlusion of the aneurysm lumen. It can be also an alternative or adjunct method to surgical clipping of the aneurysm.
내측 활주 종골 절골술과 거골하 관절 제동술로 치료한 성인의 특발성 유연성 편평족 -1예 보고-
정홍근,변우섭,유문집,Jung, Hong-Geun,Byun, Woo-Sup,Yoo, Moon-Jib 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.2
There have been many reports about surgical treatments of flexible flatfoot in children and acquired adult flatfoot deformity due to posterior tibial tendon dysfunction common in the 5th and 6th decades. However there has been a controversy for surgical treatment guideline for painful idiopathic flexible flatfoot deformities in young adults. Therefore, we present a 27-year-old female with severe painful idiopathic flexible flatfoot who was treated with medial sliding calcaneal osteotomy and subtalar arthroereisis using $Kalix^{(R)}$ (Newdeal SA, Vienne, France) endoprosthesis and had good clinical outcome with high patient satisfaction at 10 months follow-up postoperatively.