Open Posterior Approach versus Arthroscopic Suture Fixation for Displaced Posterior Cruciate Ligament Avulsion Fractures: Systematic Review

Jae­Gwang Song,Kyung Wook Nha,이세원 대한슬관절학회 2018 대한슬관절학회지 Vol.30 No.4

Purpose: To compare the clinical outcomes between the open posterior approach and arthroscopic suture fixation for displaced posterior cruciate ligament (PCL) avulsion fractures.Methods: A literature search was performed on MEDLINE, EMBASE, and the Cochrane Library databases. The inclusion criteria were as follows: papers written in English on displaced PCL avulsion fractures, clinical trial(s) with clear description of surgical technique, adult subjects, a follow­up longer than 12 months and modified Coleman methodology score (CMS) more than 60 points.Results: Twelve studies were included with a mean CMS value of 72.4 (standard deviation, 7.6). Overall, 134 patients underwent the open posterior approach with a minimum 12­month follow­up, and 174 patients underwent arthroscopic suture fixation. At final follow­up, the range of Lysholm score was 85–100 for the open approach and 80–100 for the arthroscopic approach. Patients who were rated as normal or nearly normal in the International Knee Documentation Committee subjective knee assessment were 92%–100% for the open approach and 90%–100% for the arthroscopic approach. The range of side­to­side difference was 0–5 mm for both approaches.Conclusions: Both arthroscopic and open methods for the treatment of PCL tibial­side avulsion injuries resulted in comparably good clinical outcomes, radiological healing, and stable knees.

급성 심근허혈에 의해 윤발된 승모판 폐쇄부전의 기전에 관한 실험적 연구

강덕현,송현,송재관,김현숙,이재환,임희영,이재원,박성욱,박승정,송명근 대한순환기학회 1999 Korean Circulation Journal Vol.29 No.8

두개강내로 전이된 Adenoid Cystic Carcinoma 2례 : 증례보고 Report of Two Cases

송재욱,윤상민,이창훈,장지수,이승훈,조경자,강신광 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.10

The authors describe two cases of unusual intracranial metastatic adenoid cystic carcinomas. A 42-year-old woman had a right pariental epidural metastatic mass. presumed hematogenous. spread from a primary tumor in the parotid gland. In second case, a 32-year-old man had a intracranial metastatic adenoid cystic carcinoma mimicking calcified psammomatous meningioma on CT scans. We present these unusual cases with a review of relevant literature and a discussion of possible pathogenesis.

관동맥연축의 비침습적 진단에 있어 Ergonovine Echocardiogrpahy의 유용성

송재관,박성욱,김재중,두영철,김원호,박승정,이종구 울산대학교 의과대학 1992 울산의대학술지 Vol.1 No.1

관동맥연축의 비침습적인 진단방법의 확립은 침습적인 관동맥조영술 및 연축유발검사에 비해 반복적용이 가능한 이론적인 장점이 있어 선별검사(screening test)로서의 기능뿐만 아니라 치료로 이용되는 약물의 효과비교 및 추적검사를 통한 관동맥연축의 임상ㄹ활동도 평가등에 손쉽게 이용될 수 있으라라 예상된다. 이에 저자들은 ergonovine 투여시 기록된 좌심실벽운동장애 유무가 갖는 관동맥연축에 의한 심근허혈의 진단적 가치를 평가하기 위해 Beside Ergonovine Echocardiography Test를 시행하였다. 관동맥조영술 및 연축유발검사에서 변이형협심증으로 증명된 30명(남자 27명, 평균연령 54세)과 비특이적인 흉통질환군 20명(여자 12명, 평균연령 55세)을 대상으로 관동맥조영술 다음날 ergonovine test를 시행하였다. 운동부하검사가 음성인 환자들을 대상으로 6시간 공복시킨 뒤 앙와위에서 상지정맥을 통하여 25-50microgram(이하 mcg)을 5뷴 간격으로 투여하여 흉통의 유무, 심전도 및 이면성심초음파를 5분마다 기록하였으며 총투여량이 350mcg에 도달하거나 양성반응을 보이는 경우 nitroglycerin 250mcg 정주 및 설하투여로 종료하였다. 좌심실벽운동의 분석은 side-by-side continuous cine-loop display가 가능한 QUAD screen 방법으로 판별하였다. 가역적인 심전도 변화나 국소적인 심실벽운동장애가 유발되는 경우를 양성으로 판정하였다. Ergonovine Echocardiography의 전체 민감도는 90%, 특이도는 100%로 동시에 기록된 심전도 변화의 민감도(73%)보다 높았으며 특히 흉통이 있으나 심전도 변화가 전혀 없었던 5례 모두에서 좌심실벽운동장애가 관찰되어 본 검사법의 우월성을 확인할 수 있었다. 양성반응을 보인 ergonovine 평균 투여량이 173±95mcg 이었으며 흉통발작의 빈도를 기준으로한 임상활동도가 높은 경우 활동도가 낮은 군에 비해 양성반응을 의한 총 ergonovine 투여량이 적었으며(123±86 vs 213±83mcg, p<0.01) 관동맥협착이 연축에 동반되어 있는 경우 정상 관동맥에 연축이 있는 경우보다 민감도가 더 높았다(100% va 60%, P=0.02). Ergonovine 투여로 혈압은 기저치 보다 약 17%정도 증가되었으나 맥박수는 큰 변화를 나타내지 않아 안전하게 시행될수 있었으며 오심, 두통, 견갑부통증, 심실기외수축, 방실차단 등이 소수례에서 관찰되었으나 검사로 인한 사망례는 없었다. Ergonovine 주입후 기록된 좌심실벽운동동장애는 심전도 변화보다 더 민감하게 관동맥연축에 의한 심근허혈을 진단할 수 있었으며 Ergonovine Echocardiography는 운동부하검사 등으로 심한 관동맥협착이 배제된 선별된 흉통환자들에서 관동맥연축의 진단에 안전하게 시행될 수 있는 민감하고 특이도가 높은 검사방법이며 변이형협심증의 임상활동도와 관동맥협착의 동반유무가 본 검사법의 결과에 영향을 미칠 수 있으리라 사료된다. The purpose of this study was to evaluate the clinical feasibility of bedside intravenous ergonovine test with echocardiography as a noninvasive diagnostic method for coronary vasospasm. Bedside ergonovine test was performed in 50 patients with chest pain one day after coronary angiography with spasm provocation test;30 patients showed positive results of provocation test while in 20 patients there was no evidence of coronary vasospasm. A bolus of ergonovine maleate(.025 or .05mg) was injected at 5 min intervals up to total cumulative dosage of 0.35mg, and 12-leads ECG and 2-D Echo were recorded every 3min after each injection. Left ventricular wall motion was analyzed with a commercially available ' QUAD' system. The positive criteria of beside ergonovine test included reversible ST segment elevation or depression, T wave changes in ECG(ECG criteria) and reversible regional wall motion abnormalities(RWMA) in Echo(Echo criteria). The overall sensitivity and specificity of ECG criteria were 73%(22/30) and 100% respectively ; The sensitivity of Echo criteria increased up to 90%(27/30) without the change of the specificity. Among 22 patients with reversible ECG changes only 73%(16/22) showed typical ST segment elevation while ST depression was recorded in 2 patients(9%) and minor T wave peaking or flattening without ST segment displacement in 4 patients(18%). Concomitant fixed coronary lesion does increase the sensitivity of the test compared to pure coronary vasospasm with ECG criteria(100% vs 60%, p<0.05). Mean does of ergonovine with positive results was 173±95 microgram(mcg) and the amount of does of ergonovine for positive result was significantly larger in patients with low disease activity (chest pain <5times/자) than those with high disease activity(213±83 vs 123±86mcg, p<0.01). There was no procedure related mortality or fatal arrhythmias. Ergonovine echocardiography is a highly sensitive and specific test for coronary vasospasm and is safe in selected patients in whom the exercise test is negative and severe fixed coronary artery disease has been excluded. Presence of concomitant fixed coronary artery disease and the degree of clinical activity of coronary vasospasm may influence the results of this test.

코골이 및 폐쇄성 수면무호흡증에서 Laser-assisted Uvulopalatoplasty와 LaserUvulopalatopharyngoplasty의 치료 성적 : 장기추적관찰후 환자 만족도 조사

김재호,이윤식,박형욱,송용진,남순열,김용재,이봉재 대한이비인후과학회 2000 대한이비인후과학회지 두경부외과학 Vol.43 No.2

관동맥연축의 진단을 위한 Ergonovine Echocardiography의 안전성 및 임상적 유용성

송재관,박성욱,강덕현,조구영,나득영,이내희,이철환,홍명기,김재중,박승정 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

여성생식계 상피세포에서 Glutathione S-Transferase 출현도에 관한 면역조직화학적 관찰

송계용,김석중,김미경,박용욱,유재형,박상철 중앙대학교 의과대학 의과학연구소 1991 中央醫大誌 Vol.16 No.2

Both placental form (GST-Pi) and basic form (GST-L) of glutathione S-transferase were studied in the epithelium of normal, tumor and tumor like lesions of female genital system. The results obtained were as follows : 1. Staining reaction of GST-Pi were moderate in normal cytotrophoblasts, mild in syncytiotrophoblasts, strong in corpus luteum, moderate to strong in salpingeal mucosa and in proliferative glands, moderate in secretory glands of indometrium and moderate in superficial squamous epithelium of cervix 2. Staining reaction of GST-L were mild in cytotrophoblasts and in syncytiotrophoblasts, of chorionic villi in corpus luteum, negative in salpingeal mucosa, very weak in proliferative glands, mild in secretory, glands of endometrium and in superficial squamous epithelium of cervix. 3. Staining reaction of GST-L were mild in cytotrophoblast and syncytiotrophoblast of choriocarcinoma, moderate in cytotrophoblasts, mild in syncytiotrophoblasts of hydatidiform mole, negative in mucinous epithelium of cust adenoma, in hyperplastia and adenocarcinoma, and mild in adenocarcinoma of cervix. 4. Staining reaction of GST-L were very weak in cytotrophoblasts and syncytiotrophoblasts of choriocarcinoma and in hydatidiform mole, negative in mucinous epithelium of cust adenoma, very weak in serous eptiethlium, negative to mild in hyperplastic and adenocarcinoma, mild in squamous cell carcinoma and adenocarcinoma of cervix. Therefore, staining reaction and distribution of GST-Pi and L isoengumes were different in normal and neoplastic cell of trophoblasts, salpinx, endometrin and cervix

신뢰성 이론에 의한 PSC박스거더교의 시공중 안전성 평가

여성욱,장일영,송재호 금오공과대학교 산업기술개발연구원 2000 産業技術開發硏究 Vol.16 No.-

Recently, the bridge structures are becoming longer and larger mainly due to the development in materials, the improvement in construction and the advance in structural analysis and design technique. So, construction of this type of bridges such as cable stayed bridge, suspension bridge and segmental PSC box girder bridge are increasing nowadays. Especially, the segmental PSC box girder bridges are widely constructed for medium and long span bridges. But it has been well known that structural failure probability during the construction, in general is higher than that during the service life due to lack of the empirical judgement, field data and standard process for the construction as well as due to high uncertainty involved in the evaluation of loads and strength of structures during construction. So in this study for the reliability based safety assessment of segmental PSC box girder bridges during construction, which are erected by Free Cantilever Methods, a set of linear strength limit state models are suggested for the box girder. The reliability of the structures using the proposed practical limit state model is evaluated by using Advanced First Order Second Moment method. Also the proposed models are applied to the safety assessment of a real bridge during construction stage in order to check their applicability in practice for the bridge assessment engineering. Finally, the important factors of construction stages are identified through the sensitivity analysis of the main random variables.

반복 작업 근로자들에서의 경견완장애에 관한 연구

최재욱,염용태,송동빈,박종태,장성훈,최정애 大韓産業醫學會 1996 대한직업환경의학회지 Vol.8 No.2

본 연구는 근골격계 질환중에서 대표적인 질환인 경견완장애를 대상으로 일부 제조업 및 전화교환수 근로자에서의 경견완장애의 유병실태 파악, 경견완장애의 정확한 분류 및 향후 진단기준의 개발에 필요한 기초적인 자료 수집에 목적을 두었다. 조사대상은 반복동작에 폭로되는 생산직 근로자 98명, 모전화국의 전화교환수 115명을 대상으로 근골격계 증상호소, 이학적 검사 및 신경학적검사와 기타 혈중 효소등의 임상검사 및 악력의 차이 등을 조사하였다. 조사대상 사업장 중 B사업장은 전자부품을 생산하는 사업장으로, 제품 조립라인의 작업형태는 주야 2교대 근무이며, 앉아서 하는 작업과 서서하는 작업이 혼재 되어있다. A사업장은 전화교환작업, 즉 컴퓨터단말기를 취급하는 작업으로 전원 앉아서 하는 작업이며, 주야 2교대 작업이다. 조사대상 집단의 일반적 특성은 다음과 같다. A사업장 근로자의 평균 연령은 37.9세, 평균 근속년수는 17년이며, B사업장은 평균 연령 37.7세, 평균 근속년수 10.4년이었다. A 사업장은 대상 근로자 115명이 전원 여자였으며, B사업장은 대상근로자 98명 중 남자 68(69.4%)명, 여자 30(30.6%)명이었다. 조사 결과는 다음과 같다. 사업장별 자각 증상 호소율은 A 사업장의 경우 경부 85.2%, 견관절 81.7%, 주관절 34.8%, 완관절 73.0%의 순으로 특히 경부 및 견관절, 완관절의 증상 호소율이 높았으며, 반면 B 사업장은 경부 51.2%, 견관절 56.1% 주관절 23.5%, 완관절 31.3%의 순이었다. 근속년수별 자각증상 호소율은 경부와 견관절의 자각증상 호소율이 40%이상으로 주관절 및 완관절의 지각 증상 호소율에 비해서 상대적으로 높았으며, 경부와 완관절은 근속년수가 증가함에 따라 자각증상에 호소율이 통계적으로 유의하게 증가하였다. A 사업장, B 사업장 모두 최소 22.8% 이상의 근로자(증상 경험자중)가 병원이나 약국을 방문하여 치료를 받았다고 응답하였으며, 사업장 간의 차이는 보이지 않았다. 조사 대상자 전원에게 신경학적 검사와 근전도 검사를 포함한 정밀건강진단을 실시하였다. 정밀건강진단 결과 A 사업장은 질병자가 10명(8.6%), 요주의자가 31명(26.9%), 재검자가 2(1.7%)이었으며, B 사업장은 질병자가 16(16.3%), 요주의자가 12명(12.2%), 재검자 2명(2.0%)이었다. 이러한 이상자의 질병별 유형은 긴장성 경부증후군에 해당하는 사람이 46명으로 이 중 질병자는 13명, 요주의자 30명 재검자 3명이었으며, 수근관증후군은 16명으로 질병자 3명, 요주의자 8명, 재검자 5명이었다. 기타 드퀘르뱅씨병은 5명으로 질병자 4명, 요주의자 1명이었으며, 외측상과염 3명, 이두근개건염 3명, 회전근개건염 3명, 내측상과염 2명, 경추디스트증후군이 5명 등이었다. 사업장별로는 A 사업장의 경우 긴장성경부증후군이 11명, 수근관증후군이 8명, 드퀘르뱅씨병 3명, 경추디스크증후군이 1명이었으며, B 사업장은 긴장성경부증후군이 35명, 수근관증후군이 8명, 드퀘르뱅씨병 2명등의 순이었다. 이러한 결과는 A 사업장의 경우 작업 조건이 의자에 앉아서 실시하는 컴퓨터 작업인데 반하여 B 작업장은 대부분 기립작업, 반복 조립으로 이러한 작업조건에 차이에 기인하는 것으로 판단된다. 경견완장애의 이상소견과 관련이 있는 성별, 연령, 빈도 위험도 점수 및 힘 위험도를 독립변수로 설정하여 다단계 로지스틱 회귀분석을 실시하였다. 경견완장애 이상소견에 통계적으로 유의한 영향을 미친 변수는 성별(p=0.0005), 연령(p=0.0093)이었으며, 힘위험도는 p값이 0.0567, 빈도위험도는 0.0983으로 유의하지 않았다. The purpose of this study is to investigate the current status of and to collect the basic informations of musculoskeletal diseases of upper extremities in manufacturing and telecommunication companies. The subjects were 213 workers, consisted of 98 manufacturing workers and 115 telephone operators. The musculoskeletal symptom survey, job safety analysis(JSA), and medical examinations including neurologic and nerve conduction velocity(NCV) test were conducted. All workers were women in company A, while the other composed of 68(69.4%) men and 30(30.6%) women. The results were as follows: 1. The rates of self-reporting symptoms in each company were 85.2% at the neck, 81.7% at the shoulder joint, 73.0% at the wrist joint and 34.8% at the elbow joint in company A, while 56.1% at the shoulder joint, 51.2% at the neck and 23.5% at the elbow joint in company B in order. 2. No relationship was observed between the work duration and symptom rate in company A, but the highest symptom rate was observed at the neck in 10-19 year work duration group, at the shoulder, elbow and wrist joint in 5-9 year work duration group in company B. 3. Over the 22.8% of total workers in this study having symptoms got medical treatment at the medical clinics or drug stores, but there was no statistical difference between both companies. 4. In company A, 16(13.9%) workers were classified as D category, 12(10.4%) workers as C category and 2(1.7%) workers as R category among 115 workers. And D category was 10(10.2%), C category 31(31.6%) and R category 4(4.0%) among 98 workers in company B. D category means disease category needed futher treatment, C category means disease category needed no treatment and R category means recheck category needed futher evaluation. 5. The types of musculoskeletal disorders including D, C, and R category were 46 cases(D 13, C 30, R 3)of tension neck syndrome (TNS), 16 cases(D 3, C 8, R 5) of carpal tunnel syndrome (CTS), 5 cases of De Quervain's disease, 3 cases of lateral epicondylitis, 3 cases of bicipital tendinitis, 3 cases of rotator cuff tendinitis, 2 cases of medical epicondylitis, and 5 cases of cervical disc syndrome. 6. In company A, the total cases of 11 TNS, 8 CTS, 3 De Quervain's disease, 3 lateral epicondylitis, 3 rotator cuff tendinitis and 1 cervical disc syndrome were diagnosed and so were total cases of 35 TNS, 8 CTS and 4 cervical disc syndrome in company B. 7. By stepwise multiple regression analysis with dichotomization of musculoskeletal disease, the following odds ratios were significantly high(p<0.05)-sex(2.707) and age (1.926).

Trehalose의 노화 억제 효과

박정욱,정한모,송재철 울산대학교 2000 생활과학논문집 Vol.2 No.1

시차주사열량기와 색도계를 이용하여 Trehalose의 가래떡 노화에 미치는 영향을 검토하였다. 가래떡의 노화정도는 저장온도와 무관하게 경시적으로 증가하였는데 Trehalose가 노화를 억제하는 것으로 나타났다. 특히 저온에서 노화가 실온보다 심하게 일어났으며 저장초기에 저장온도에 대한 영향이 큰 것으로 나타났다. 그리고 L*값은 실온저장(25℃)시 냉장저장(4℃)의 경우보다 시간에 따른 변화가 컸으며, 냉동보관시 a*값은 저장 1일째 까지는 변화가 없다가 5%를 첨가한 가래떡을 실온에서 저장한 경우에는 가장 낮은 a*값을 나타내었다. b*값의 경우에는 Trehalose 첨가량과 저장온도에 따라 크게 변하지 않았다. 색깔안정화의 효과는 Trehalose 첨가농도가 증가할수록 큰 것으로 나타났으며, 특히 냉장보관시에 효과가 두드러지는 것으로 관찰되었다. This studies were investigated to provide the influence of trehalose on retrogradation of Korean rice cake by differential scanning calorimeter and tristimulus values of CIE color Croma Meter. Having no connection with storage temperature, degree of retrogradation of Korean rice cake was increased with storage time. Degree of retrogradation of Korean rice cake was decreased in case of addition of trehalose to the Korean rice cake paste. Degree of retrogradation of Korean rice cake stored at low temperature(4℃) was higher than that of Korean rice cake stored at room temperature(25℃). In particular, degree of retrogradation of Korean rice cake was shown to be clearly influenced by storage temperature at the beginning of storage. The value of L of Korean rice cake at room temperature was indicated to be significantly changed compared with that of Korean rice cake at low temperature. The value of a of Korean rice cake was not changed until one day of storage, and shown to be minimized in storage at room temperature(25℃) in case of addition of 5% trehalose to the paste of Korean rice cake. The change of b value in general was not significantly observed even if storage temperature and amount of trehalose have been variable. However effects of trehalose in color stability of Korean rice cake was remarkably exhibited in storage at low temperature(4℃).