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Occurrences of Pyogenic Arthritis of the Knee in Korea
Sung Il Shin(신성일),Kyung Won Song(송경원),Jin Young Lee(이진영),Seung Yong Lee(이승용),Gab Lae Kim(김갑래),Young Seok Ko(고영석),Hyung Seok Oh(오형석),Kun Ho Shin(신건호) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.8
목적: 한국에서 슬관절 화농성 관절염의 원인을 분석한다. 대상 및 방법: 1994년 1월 1일부터 2005년 3월 31일까지 슬관절의 화농성 관절염으로 치료하였던 149예 가운데 균 검사에서 양성을 보였던 72예에 대하여 발생 빈도와 원인을 분석하였고. 환자의 평균 연령은 63세(46세부터 82세까지)였으며 70세 이상의 환자가 약 47% (34예)를 차지하였다. 결과: 정형외과에서 입원 치료 받은 총 환자 수에 대한 발생 비율은 입원 환자 1,000명당 7.4명(p<0.05)이었으며, 균 검사에서 양성으로 판명되는 비율이 약 48%를 보였다. 총 72예의 분석에서 슬관절에 선행 질환은 61예에서 확인할 수 있었는데 그 중 퇴행성관절염 41예, 류마티스관절염 20예로 대부분관절 질환을 갖고 있었다. 과거에 스테로이드나 HA의 관절 내 주사 요법의 경험이 있거나 혹은 침구 치료 등의 전통 요법을 받은 경우가 48예로서 약 67%의 환자가 슬관절에 대한 직접 치료를 받은 경험이 있었다. 주사를 시행한 횟수는 37예를 분석하였을 때 주사 약제와 관계없이 1회 내지 5회가 9예, 6회 내지 10회가 17예, 10회 내지 15회가 9예, 그밖에 16회에서 20회가 2예이었다. 결론: 슬관절의 화농성 관절염은 주로 관절강내 또는 관절주위 치료나 침술과 같은 의원성 원인 때문인 경우가 많다. Purpose: To analyze recent causes of the pyogenic arthritis of knee in patients in Korea. Materials and Methods: Among 149 cases of pyogenic arthritis of the knee treated in the Orthopedic Department of the University Hospital from 1 January 1994 to 31 March 2005, we identified the causative bacteria in 72 cases. The mean patient age was 63 years old (range, 46 to 82 years) and 47% (34 cases) were greater than 70 years of age. Results: The incidence of pyogenic arthritis of the knee in patients who had been discharged from the Orthopaedic Department was 7.4 per 1,000 patients (p<0.05), and 48% of them had positive bacteriological studies. We noted 61 patients who had preexisting conditions of the knee: 41 with degenerative arthritis, and 20 with rheumatoid arthritis. Forty-eight (67%) patients had received previous intra-articular or periarticular steroid or hyaluronic acid (HA) injections, or acupuncture treatments. The medications that were injected were: steroids (12 cases), HA (10 cases), steroids plus HA (9 cases), and 6 cases were unidentified. The frequency of the injections, regardless of the medication used, was 1 to 5 times in 9 cases, 6 to 10 times in 17 cases, 10 to 15 times in 9 cases, and 16 to 20 times in 2 cases. We identified the medical specialties that were involved in the performance of the intra-articular injections in 29 cases: Orthopaedics (14 cases), Pain Management (5 cases), Rheumatology (3 cases), Rehabilitation Medicine (2 cases), Family Medicine (2 cases), Internal Medicine (1 cases), and others (2 cases). Conclusion: Pyogenic arthritis of the knee may be due frequently to iatrogenic causes, such as intra-articular or peri-articular injections and acupuncture treatments. This has been influenced mainly by changes in the types of injection materials, increased of frequency of injections, frequency and the expansion of injection clinics.
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현윤석,송경원,신성일,이진영,이승용,김갑래,신건호,서은호,반태서,Hyun, Yun-Seok,Song, Kyung-Won,Shin, Sung-Il,Lee, Jin-Young,Lee, Seung-Young,Kim, Gab-Lae,Shin, Kun-Ho,Seo, Eun-Ho,Ban, Tae-Seo 대한족부족관절학회 2007 대한족부족관절학회지 Vol.11 No.1
Purpose: To evaluate the clinical efficacy of the limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus. Materials and Methods: From March 2000 to February 2006, we studied retrospectively 186 patients, 203 cases who were treated with open reduction and internal fixation through limited posterior approach and were followed up for more than 1 year. The clinical results were evaluated with Creighton-Nebraska score and circle draw test after 1 year. We checked simple AP, lateral, axial and Broden's view preoperatively and 1 year after surgery, and compared $B{\ddot{o}}hler$ angle and Gissane angle. Results: By Creighton-Nebraska score, Sanders type 2 was 86.4, type 3 was 74.3, type 4 was 62.4. And by circle draw test, type 2 was 8.9 cm, type 3 was 7.2 cm, type 4 was 5.9 cm. $B{\ddot{o}}hler$ angle and Gissane angle were $7.6^{\circ}$, $102.4^{\circ}$, and it increased to $23.5^{\circ}$, $128.6^{\circ}$ after postoperative 1 year. Conclusion: Limited posterior approach for the surgical treatment of intraarticular fracture of calcaneus was considered to an effective treatment modality.
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관절경하 제한적 내고정술과 Ilizarov 기기를 이용한 경골 천정 골절의 치료
이진영 ( Jin Young Lee ),김갑래 ( Gab Lae Kim ),오형석 ( Hyung Seok Oh ),신건호 ( Kun Ho Shin ),박덕용 ( Deok Yong Park ) 대한골절학회 2006 대한골절학회지 Vol.19 No.2
목적: 관절경하 제한적 내고정술과 Ilizarov 외고정기를 이용하여 경골 천정 골절을 치료하여 만족할 만한 결과를 얻었기에 그 유용성을 보고하는 바이다. 대상 및 방법: 1999년 1월부터 2004년 3월까지 본원에서 제한적 내고정술과 Ilizarov 외고정기를 이용하여 치료한 22예의 경골 천정 골절 환자를 대상으로 임상적 평가, 골유합 시기, 관절 운동 범위, 합병증을 후향적 분석하였다. 결과: 평균 주시 기간은 16개월이었고 평균 연령은 39.2세였다. Ovadia와 Beals의 방법에 따른 평가상 1, 2형 골절에서 모두 양호이상의 만족스런 결과를 보였다. 술 후 평균 골유합 기간은 폐쇄성 굴절이 13주, 개방성 굴절은 평균 16주에 이루어 졌다. 평균 관절 운동 범위는 족배 굴곡은 12도 (0~20도), 족저 굴곡은 25도 (15~35도)였다. 결론: 경골 천정 골절의 수술적 치료 후 발생할 수 있는 연부조직 합병증과 관절면의 부조화는 예후에 매우 중요한 요소이며 이를 최소화하기 위해 수술 시 연부조직 및 골조직에 대한 거친 조작을 피하고 관절면을 정확히 정복해야 한다. 따라서 관절겸하 제한적 정복술과 Ilizarov 기기를 이용한 수술법은 매우 효과적인 치료법이라 생각한다. Purpose: To evaluate the clinical results of the pilon fractures treated with arthroscopically assisted limited open reduction and Ilizarov external fixation. Materials and Methods: This is a retrospective study of the clinical result, bone union, complication and postoperative ankle function of 22 pilon fractures treated with arthroscopically assisted limited open reduction and lIizarov external fixation between January 1999 to March 2004. Results: Clinical follow up averaged 16 months, with an average age of 39.2. All patients with type 1 and 2 fracture had excellent or good score by Ovadia and Beals criteria. Closed fractures healed within 13 weeks and open fractures within 16 weeks after surgery in average. Average range of motion of the ankle was 12° dorsiflexion (0~20 degree) and 25° plantar flexion (15~35 degree). Conclusion: Minimal soft tissue dissection and anatomical reduction are very important factor for minimizing complication and satisfactory ankle function. So, arthroscopically assisted limited open reduction and lIizarov external fixation is an effective treatment option for tibial pilon fractures.
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신건호,김길생 단국대학교 경영경제연구소 1997 經營, 經濟硏究 Vol.1 No.-
There are rapid changes in corporative environment home and abroad. Korea enterprises might face with either advantageous or difficult condition for there management. To survive, grow and keep developing, therefore, they must adapt themselves to the environment. They should maximize the need of consumer, and cope quickly with the changed environment. And to raise the competitiveness in domestic and international market, they are introducing new management techniques, such as reengineering, benchmarking or restructuring, for increasing quality, cutting cost and reducing working process. To examine the effectiveness of reengineering, this article selected the determinants which may effect if by investigation of document, studied the characteristics and developing procedures of reengineering in the organizations of U.S.A., Japan and Korea by case analysis, analysed whether reengineering is fit to korean enterprises using practical analysis by questionaire, and especially, considered what kind of organizations it will be useful. For the goal of our study, we made use of the examples of the organizations of U.S.A., Japan and Korea, and surveyed 250 employees who participated or is participating in reengineering project team from 50 organizations that had applied or are using reengineering. According to the result of our study, we found that Korean enterprises were successful in general, and as their progressive corporate-culture, professional management system, innovative strategy, the sense of competitive risk and the level of information technology were higher, their reengineering result was greater. Consequently, it seemed that reengineering is fit as a technique of management innovation for an organization whose progressive corporate-culture, professional management system, innovative strategy, the sense of competitive risk and the level of information technology are higher. The effectiveness of the article lies in offering some informations about corporate culture, management system or management strategy to apply effective reengineering, to the enterprises that perform now or will perform in the future management innovation by reengineering. Indeed, for the academic world, it extended to a new field of study on management innovation by using management system and the degree of the sense of competitive risk as variables of corporative characteristic.
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