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- 저자 : Min Hong Zoo(주민홍) (검색결과 4 건)
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Clinical Study of Rhabdomyolysis After Exercise
안영준,이승림,유재호,주민홍,김성완,박지만,양보규,Ahn, Young-Joon,Yi, Seung-Rim,Yoo, Jae-Ho,Zoo, Min-Hong,Kim, Seong-Wan,Park, Ji-Man,Yang, Bo-Kyu Korean Orthopaedic Society for Sports Medicine 2007 대한정형외과스포츠의학회지 Vol.6 No.2
목적: 전투 경찰에게서 과도한 신체 활동 후 발생한 횡문근 융해증의 임상 양상 및 치료에 대해 알아 보고자 하였다. 대상 및 방법: 2004년 6월 1 일부터 2005년 5월 23일까지 운동이나 훈련 후 발생한 근육통 및 근육종창을 주소로 본원을 방문한 전투 경찰 중에서 횡문근 융해증이 의심되어 입원한 13명의 환자를 대상으로 혈액검사(CPK, CK-MB, AST BUN/Cr, Electrolyte) 및 임상 경과를 관찰하였다. 이 들은 모두 남자였고, 평균 연령은 20세 ($19\sim21$세) 였다. 발병 원인으로는 팔굽혀펴기 후 발생한 것이 7례, 축구 경기 후 발생한 것이 5례, 시위 진압 후 발생한 것이 1례였다. 이 학적 소견상 다양한 신체 부위에 종창 및 압통을 호소하였는데 전완부에 발생한 경우가 4례, 상완부가 3례, 견갑부가 1례, 하지가 5례였다. 횡문근 융해증의 진단기준은 내원 당시 임상증상과 함께 혈중 CPK가 1,000 IU/L이상인 경우로 하였고 약물 복용력이나 내과적 질환이 있는 경우는 대상에서 제외하였다. 모든 환자에서 99mTc-MDP 20mCi를 정맥주사 후 4시간에 bone scan을 시행하였다. 치료는 침상 안정가료 및 수액요법을 시행하였고 동통을 심하게 호소하는 환자에게는 부목고정을 실시 하였다. 결과: 전체 입원환자 13명의 평균 재원 기간은 20일 (14일$\sim$42일)이었고 내원 당시 급성신부전을 보인 1례를 제외하고는 수액 요법 및 휴식을 시행한지 평균 8일 (2일$\sim$11일) 후 혈액학적으로 CPK가 1000이 하로 감소되었으며 임상적으로도 뚜렷한 회복을 보였다. 급성신부전을 보인 1례에서는 혈액투석 및 수액요법을 시행 한 후 회복되었다. 결론: 심한 운동이나 훈련 후 부종 및 근육통을 호소하는 환자에서 운동 유발 횡문근 융해증을 의심하여 조기에 혈액검사 및 수액 치료를 시행하는 것이 중요하다. Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.
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안영준,한성호,양보규,이승림,유재호,정선욱,빈성우,주민홍,김성완,Ahn, Young-Joon,Hahn, Sung-Ho,Yang, Bo-Kyu,Yi, Seung-Rim,Yoo, Jae-Ho,Chung, Shun-Wook,Bin, Sung-Woo,Zoo, Min-Hong,Kim, Seong-Wan 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.1
Purpose: The purpose of this study is to assess the results of the autologous osteochondral grafting for the osteochondral lesion of the talus. Materials and Methods: This study included 21 patient who had been treated with the open autologous osteochondral grafting between December, 1999 and December 2003. We treated the patients with autologous osteochondral grafting method who had the lesion of stage II or medial lesion of stage III without improvement for at least 6 months, the medial lesion of stage IV, the lateral lesion of stage III, IV by Berndt and Harty's classification or who had not improved with previous operation. The average duration of follow up was 26 (12-56) months. 6 patients had been treated with the previous operation that 3 patients with drilling, 3 patients excision, curettage and drilling. Results: The average AOFAS Ankle/Hindfoot score was 92.7 points and no patient had a limitation of the daily activities due to pain or abnormal function. Postoperative radiography showed good joint congruency and postoperative MRI good incorporation of the graft. The average Lysholm knee score was 96 points and only two patients had mild knee pain during severe exertion. Conclusion: The autologous osteochondral grafting is the useful operative method when the lesion is advanced stage or when previous operative treatment has failed.
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Synovial Osteochondroid Metaplasia of the Elbow Joint Mimicking a Fracture
Jae Ho Yoo(유재호),Bo Kyu Yang(양보규),Seong Wan Kim(김성완),Min Hong Zoo(주민홍) 대한정형외과학회 2008 대한정형외과학회지 Vol.43 No.1
저자들은 골절로 오인되기 쉬운 주관절 활액막 골연골 화생의 증례를 보고하고자 한다. 군복무 중인 21세 남자가 경미한 직접 가격 후 주관절의 통증을 호소하였다. 단순 방사선 사진 및 전산화 단층 촬영 상 작은 골편이 보여, 주관절의 골절을 의심하고 수술을 시행하였다. 급성 손상에 합당한 출혈이나 부종 등의 소견은 없었으며, 절제 생검을 시행하였다. 골편은 섬유 조직 및 활액막에 피복되어 있었으며, 병리 조직 검사 상 최종 진단은 활액막 골연골 화생이었다. 임상적으로 주관절 급성 손상 환자의 영상 검사 상 보이는 골편의 감별 진단에 활액막 골연골화생을 포함시켜야 할 것으로 사료된다. We present here a case of synovial osteochondroid metaplasia of the elbow joint that was almost mistaken for a fracture. A 21-year-old military recruit complained of pain at the elbow after a minor direct injury. Since the imaging studies, including simple radiographs and CT scans, showed a small bony fragment, an operation was performed under the impression of fracture of the elbow joint. There was no evidence of acute injury such as bleeding or swelling, and excisional biopsy was done. The histopathological findings of osteochondroid metaplasia surrounded by fibrous tissue and synovium led to the pathologic diagnosis of synovial osteochondroid metaplasia. Clinicians should include this tumorous entity in differential diagnosis when a bony fragment is seen on the radiographs of an acutely injured subject.
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