내시경을 이용한 수근관 증후군의 치료

노권재,유재두 梨花女子大學校 醫科大學 醫科學硏究所 1996 EMJ (Ewha medical journal) Vol.19 No.4

The cause of carpal tunnel syndrome is the compression of median nerve at the carpal tunnel. Surgical release of transverse carpal ligament is indicated if symptom persists in spite of conservative treatment. Release of transverse carpal ligament without neurolysis is sufficient to relieve the symptom. Several methods of endoscopic treatment have developed and the good results were reported. We reported the results of 13 cases treated with endoscopic carpal tunnel release in 12 patients from March 1995 to July 1996. Eleven cases treated with one portal technique(Agee) and 2 cases treated with two incision technique(Chow). Average follow-up period is 11months(4-19 months). Average age was 48.5(35-56)years old. There were 11 women and 1 male. Average duration of symptoms before the operation was 9 months. According to Cseuz's creiteria, excellent results was obtained in 77% of patients. Tingling sensation dimnished within 24 hours after operation in six patients. Two thenar atrophy didn't recovered at 8 months after operation. Three scar tenderness occured. Relief of symptom was achieved quickly when endoscopic method was used but several technical pitfall must be avoided.

골수강내 금속정을 사용한 경골 골절의 치료 : Rigid Nail과 Flexible Nail의 비교 Comparison between Rigid and Flexible Nails

윤여헌,노권재 梨花女子大學校 醫科大學 醫科學硏究所 1994 EMJ (Ewha medical journal) Vol.17 No.1

1987년 1월부터 1993년 6월까지 이화여자대학교의과대학 정형외과학교실에서 골수강내 금속정 삽입술로 치료한 108예의 경골 골절을 flexible nail로치료한 군(제 1군)과 rigid nail로 치료한 군(제 2군)으로 나누고 각각의 성적을 비교 분석한 결과는다음과 같다. 1) 골유합에 소요된 기간은 평균 17.5주였으며,rigid nail이 flexible nail에 비하여 현저히 단축되었다. 2) 합병증의 발생은 17예(15%)였으며, flexiblenail은 각형성이나 골길이의 단축 등 부정유합이많았고, rigid nail은 골감염이 많았다. To dilrectly coimpare the rigid and flexible jlltrarnedullary nails for the treatment of tibialfractiires, we restrospectively reviewed the clinical result of 108 tibial fractures treated at theEwha Womans University Hospital between January 1987 to June 1993. Twenty-one cases werebelonged to the flexible nail(FN) group, while 87 fractures were included to the rigid(nonlocking or interlocking) nail(RN) group. Average period between the injury and fracture union was overall 17.5 weeks(range, 11-67)and it was much shorter in the RN group(15.2 weeks) than the FN group(29.0). Complicationsduring and after treatment in terms of malunion as well as delayed or non-union, were alsomore common in the FN group. However. deep wound infecctions were only found after rigidnailing. In conclusion, in view of the fracture union time and comptication rate, rigid nailing showedbetter results than the flexible one. But the flexible nails had several inherent advantages especially ill the technical aspects of their use.

mtDNA l1778위치의 돌연변이를 가진 Leber씨 유전성 시신경병증과 Leber's plus: 임상적 양상과 유전학적 연구

권순억,황정민,박혜원,강동화,구자성,이광우,노재규 대한신경과학회 1997 대한신경과학회지 Vol.15 No.2

노령의 대퇴 전자간 골절 치료에서 압박고 나사못의 안정성 및 유용성

김종오,노권재,윤여헌,고영도,유재두,정준모,방한천,정재학 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 노령의 대퇴 전자간 골절에서 압박고 나사못의 안정성에 영향을 주는 인자들간의 상관 관계와 골절 양상에 따른 술후 고관절 기능을 평가 및 분석하였다. 대상 및 방법: 압박고 나사를 이용하여 수술적 치료를 시행한 231명의 환자 중 6개월 이상 추시가 가능하였던 60세 이상 84명의 환자들을 대상으로 했다. 방사선적 계측은 압박고 나사못의 활강 길이 및 내반각, 가압 나사 위치, 정복 상태, 원위 골편의 내측 전위를 측정하였으며 술후 기능은 Clawson의 기능 평가표로 하였고 골절 양상에 따라 방사선 계측과 기능 회복과의 상관 관계를 평가하였다. 결 과: 임상 결과는 불안정 골절에서 양호가 10례, 불량이 23례, 안정 골절에서는 양호 40례, 불량이 11례로 안정 골절에서 임상 결과가 좋았고(p<0.001), 압박고 나사 활강은 10 ㎜ 이상일 때 양호가 4례, 불량이 21례, 10 ㎜ 이하에서 양호가 46례, 불량이 13례로 10 ㎜ 이상 활강시에 술후 결과가 불량했다(p<0.001). 다르 방사선적 계측 요인은 결과에 의미있는 차이를 보이지 않았다. 또한, 불안정 골절 중에서 전위 양상 골절의 경우 10㎜ 이상 활강이 12례, 10㎜ 이하 활강이 8례, 분쇄 양상 골절의 경우는 10㎜ 이상이 11례, 10㎜ 이하가 2례로 분쇄 양상의 불안정 골절에서 10㎜ 이상 활강이 의미있게 많았다 (p<0.001). 결 론: 10㎜ 이상의 지연 나사 활강은 고관절 기능 회복 약화를 유발시킬 수 있으며 불안정 골절 분쇄 양상 골절은 이런 지연 나사의 활강이 과도하게 유발될 수 있으므로 불안정 분쇄 양상 골절에서 압박고 나사의 단독 사용은 재고해 보아야 할 것이다. Purpose: To evaluate the relationship between fracture stability and functional results, and analyze the correlation between stability factors and the outcome in intertrochanteric fracture of the elderly. Materials and Methods: Of the 231 patients, 84 patients with age above 60 were able to follow up for minimum 6 months. We measured the sliding length of the lag screw, varus degree, position of lag screw, reduction status and medialization of distal fragment radiologically. The functional outcome of the treatment was evaluated with the Clawson's result classification and we evaluated the correlation between the radiological results of measurement and the functional recovery depending on the Evans fracture classification. Results: There were good results in 40 cases out of 51 stable fractures, and in 10 cases out of 33 unstable fractures (p<0.001). In case of sliding of lag screw more than 10㎜, good results were obtained in 4 cases, and poor in 21. And in case of sliding less than 10㎜, good results were obtained in 46, and poor in 13. (p<0.001).But there was no relationship between other radiologic factors and clinical results. In unstable type, there were 12 cases with lag screw sliding more than 10㎜ and 10 cases with less than 10㎜. In comminuted type, there were 11 cases with lag screw sliding more than 10㎜ and 2 cases with less than 10㎜(p<0.001). Conclusion: The sliding of lag screw more than 10㎜ may result in poor outcome. As in comminuted unstable pattern, sliding of lag screw might be excessive, the use of compression hip screw alone is not good treatment option.

망간 노출 근로자의 정신 ·신경행동 양상에 영향을 주는 요인

문영한,권기련,김은아,김규상,김양호,김재우,노재훈,양정선,진영우 大韓産業醫學會 1999 대한직업환경의학회지 Vol.11 No.2

The risk posed to human health by environmental manganese (Mn) exposure is unknown. The purpose of this study is to establish if subclinical effects related to Mn exposure and examine the factors influencing psychoneurobehaviral outcomes of Mn exposed workers. This study involved 121 male workers of welding, alloy furnace, and manufacturing of welding stick. Study investigations include: a questionnaire covering demographic characteristics, job and exposure history and medical symptoms and conditions, monitoring workplace air for personal exposure to respirable and inhalable manganese, analysis of blood and urine samples, psychoneurobehaviral test(neurobehaviral core test battery(NCTB), signal change on magnetic resonance imaging (MRI) scans, minimental state and neurological examination). The main results of this study were as follows; 1. Preliminary results showed that, with increasing manganese exposure, neurobehaviral performance was poorer and signal change on MRI scans increased. 2. The results of examination revealed significant relations on psychoneurobehaviral outcomes (neurobehaviral performance, signal change on MRI scans, and neurological features). 3. In multiple regression, age and educational status as demographic variables and exposure level were significantly related to neurobehaviral test. Also exposure level and serum Mn concentrations were positively related to signal change on MRI scans and neurological features affected by Mn on the brain (signal change). 4. Psychoneurobehaviral outcomes from Mn exposure were related to neurobehaviral performance, signal change on MRI scans, neurological features and profile of mood states (POMS), and influenced positively with age, alcohol and smoking history, and duration of Mn exposure, negatively with educational status. Serum Mn concentrations in combination with brain MRI scans, and perhaps a battery of neurobehaviral tests, appear to be the best way to monitor excessive exposure to Mn. These results are consistent with our knowledge on Mn action on the brain and are similar to the type of neurobehaviral dysfunction. They suggest that there may be age, educational status, and life style (alcohol and drinking history) differences with chronic environmental exposure. These findings suggest further evaluation, particularly on relationships between Mn exposure, aging, and susceptibility factors.

평택시 미군기지 주변 주민의 비행기 소음과 청각학적 평가결과의 관련성

정종도,김현주,정재윤,노상철,권호장 大韓産業醫學會 2009 대한직업환경의학회지 Vol.21 No.2

목적: 비행기소음이 청각에 대한 포괄적인 영향을 파악하기 위하여 이명 및 난청과의 관련성을 규명하고자 한다. 또한 변조이음향방사 검사를 통해 비행기소음의 난청에 대한 영향을 객관적으로 파악하고자 하였다. 방법: 연구 대상지역은 평택시에 위치한 두 개의 미군기지(K-55, K-6) 주면 8개 마을로 선정하였고 대조지역은 비행장에서 10 km 이상 떨어진 5개 마을이었다. 연구대상은 전도성 난청자와 순음청력검사에 협조가 불가능한 경우를 제외하고 노출군 492명 , 대조군 200명이었다. 환경소음은 2005년 12월 9일, 노출지역 8개, 대조지역 2개 마을을 동시에 주간 8시간 측정하였다. 구조화된 설문지를 통해 이명 여부와 그 불편감을 조사하였고, 이명 불편감은 구조화된 '이명 불편감 설문지'를 통해 파악한 뒤감정적, 기능적, 재앙화적 측면에서의 점수를 합산하여 산출하였다. 청력평가를 위해 0.5, 1, 2, 3, 4, 6, 8 kHz에 대하여 순음청력검사와 1582, 2003, 3175,4007 Hz에 대하여 번조이음향방사 검사를 시행하였다. 비행기소음의 노출특성 및 혼란변수의 성차를 고려하여 성별층화분석을 했고, 연속변수는 일반선형모델(general linear model)을 사용하여, 범주형 변수는 로지스택 회귀분석을 사용하여 분석하였으며, 보정한 혼란변수는 연령, 교육정도, 스트레스 반응척도, 군대소음, 농업소음, 직업소음이었다. 결과: 이명 증상 호소율은 남성에서 노출군 47.3%, 대조군 27.6%이었고, 여성에서 노출군 50.8%, 대조군 28.5%이었으며, 그 대응비는 남성에서 2.06(95% CI:1.09~3.88), 여성에서 1.97(95% CI: 1.17~3.30)이었다. 이명 불편감 영역별 점수는 남녀 모두에서 감정적, 기능적, 재앙화적 측면에서 노출군이 비노출군보다 유의하게 높았다(p<0.001). 순음청력검사결과 남성에서는 우측 귀 0.5, 1 kHz에서, 여성에서는 좌측 귀 0.5, 1 kHz와 우측 귀 0.5, 1, 2, 3, 4, 6 kHz 주파수 영역에서 노출군의 청력역치가 대조군보다 유의하게 높았다(p<0.05). 변조이음향방사 검사결과, 남성에서는 두 군간에 비정상률의 차이가 없었으나, 여성의 비정상률은 좌측 귀 3175, 4007 kHz 영역에서 각각 1.92(95% CI:1.10~3.36), 2.71 (95% CI: 1.49~4.91), 우측 귀 각각 1.73(95% CI: 1.01~2.99), 1.78(95% CI:1.01~3.15)의 대응비를 보였다. 결론: 연구결과 수십 년간 군 기지의 비행기소음에 노출된 집단에서 이명과 이명 불편감이 대조군보다 유의하게 높았다. 순음청력검사는 노출군이 대조군보다 통계적으로 유의한 청력저하를 보였다. 변조이음향방사 검사는 여성 노출군에서만 대조군보다 통계적으로 유의한 비정상률을 보였다. 이로부터 비행기소음이 이명과 난청 등 삶의 질에 영향을 미치는 건강문제를 유발할 가능성을 확인할 수 있었다. Objective: To investigate the relationship between aircraft noise and the results of audiological evaluation on tinnitus and hearing loss among residents near United States military air-bases in Pyeongtaek city. Methods: Residents (n=492) exposed to aircraft noise were selected from eight villages near U.S. military air-bases (K-55 and K-6) in Pyeongtaek city. Residents (n=200) from five villages located at least 10km away from the air-base were selected for the control group. All participants completed a questionnaire on tinnitus and audiological evaluations included pure tone audiometry (PTA) and distortion Product otoacoustic emissions (DPOAE). Statistical analyses involved a general linear model and multiple logistic regression stratified by gender and data was a쏜usted by age, educational level, stress response index and noise type (i.e. military, agricultural and occupational). Results: The equivalent noise levels (Leq) in the vicinity of the air-field were 73.4~81.5 dB (A). Tinnitus prevalence was 47.3% and odds ratio (OR) was 2.06 (95% confidence interval (CI): 1.09-3.88) among noise-exposed males. Tinnitus prevalence was 50.8% and OR was 1.97(95% CI: 1.17~3.30) among noise-exposed females. Tinnitus handicap scores among exposed group were significantly higher in functional, emotional, and catastrophic subclasses (P<0.001). PTA revealed hearing thresholds among the exposed group of 0.5 and 1 kHz (male right ear), 0.5 and 1 kHz (female left ear) and 0.5, 1, 2, 3, 4 and 6 kHz on female right ear that were significantly higher than those of the unexposed group. No Significant difference in DPOAE was observed among noise-exposed mes. However, significant differences were evident for noise-exposed females at 3175 and 4007 Hz. ORs of right female ears 3175 and 4007 Hz were 1.73(95% CI: 1.01-2.99) and 1.78(95% CI: 1.01-3.15). ORs of left female ears at 3175 Hz and 4007 Hz were 1.92(95% CI: 1.10-3.36) and 2.71(95% CI: 1.49-4.91) Conclusions: Aircraft noise may adversely affect hearing function and tinnitus.

The role of postoperative neutrophil-to-lymphocyte ratio as a predictor of postoperative major complications following total gastrectomy for gastric cancer

Jae Seung Kwak,Sung Gon Kim,Sang Eok Lee,Won Jun Choi,Dae Sung Yoon,In Seok Choi,Ju Ik Moon,Nak Song Sung,Seong Uk Kwon,In Eui Bae,Seung Jae Lee,Seung Jae Roh 대한외과학회 2022 Annals of Surgical Treatment and Research(ASRT) Vol.103 No.3

Purpose: This study was performed to investigate the role of the perioperative neutrophil-to-lymphocyte ratio (NLR) as an early predictor of major postoperative complications after total gastrectomy for gastric cancer. Methods: This single-center, retrospective study reviewed consecutive patients with gastric cancer who underwent total gastrectomy at a single institution from March 2009 to March 2021. The postoperative complications were graded according to the Clavien-Dindo classification. We analyzed the patient demographics and surgical outcomes according to the grade of postoperative complications in the major complications group (≥grade III) and the no major complications group (<grade III and no complication). Laboratory tests were performed preoperatively and on postoperative days (POD) 2 and 5 to determine the NLR. Results: Out of 212 patients (mean age, 64.1 years; 152 male [71.7%]), 63 (29.7%) underwent minimally invasive surgery. Twenty-five (11.8%) were in the major complications group and 187 (88.2%) were in the no major complications group. There was a significant difference in the NLR on POD 2 (16.54 . 8.83, P = 0.033) between the 2 groups. According to the receiver operating characteristic curve for the NLR on POD 2, the cutoff was calculated to be 9.6. In multivariate analysis, an NLR on POD 2 of ≥9.6 and an American Society of Anesthesiologists physical status classification of ≥III were statistically significant predictors of major postoperative complications. Conclusion: Determination of the NLR on POD 2 is a simple and useful method for the early prediction of major complications after total gastrectomy for gastric cancer.

A Stress Fracture of the Ulna in a Female Non-Professional Golfer

Kwon-Jae Roh(노권재),Dong-Wook Kim(김동욱) 대한정형외과학회 1994 대한정형외과학회지 Vol.29 No.6

Seroepidemiology of Hepatitis Viruses and Hepatitis B Genotypes of Female Marriage Immigrants in Korea

Kwon, Jae-Cheol,Chang, Hye Young,Kwon, Oh Young,Park, Ji Hoon,Oh, In Soo,Kim, Hyung Joon,Lee, Jun Hyung,Roh, Ha-Jung,Lee, Hyun Woong Yonsei University, College of Medicine 2018 Yonsei medical journal Vol.59 No.9

<P><B>Purpose</B></P><P>The Korean society has moved rapidly toward becoming a multicultural society. This study aimed to estimate the seroprevalence of hepatitis viruses and investigate hepatitis B virus (HBV) genotypic diversity in female marriage immigrants.</P><P><B>Materials and Methods</B></P><P>Screening program was conducted at support centers for multicultural families in 21 administrative districts in Korea between July 2011 and January 2017. A total of 963 female marriage immigrants were included in this study. Blood samples were tested for hepatitis viral markers and HBV genotype.</P><P><B>Results</B></P><P>Subjects' median age was 33 years (20–40 years), and they originated from nine countries including Vietnam (n=422, 43.8%), China (n=311, 32.3%), the Philippines (n=85, 8.8%), Cambodia (n=58, 6.0%), and Japan (n=39, 4.0%). About 30% (n=288) of subjects required hepatitis A vaccination. HBsAg positive rate was 5.4% (n=52). Positive HBsAg results were the highest in subjects from Southeast Asia (6.6%, n=38). Anti-HBs positive rate was 60.4% (n=582). About 34% (n=329) of subjects who were negative for anti-HBs and HBsAg required HBV vaccinations. Genotypes B and C were found in 54.6% (n=12) and 45.4% (n=10) of the 22 subjects with HBV, in whom genotypes were tested. Eight (0.8%) subjects were positive for anti-HCV. Positive anti-HCV results were the highest in subjects from Central Asia (7.9%, n=3).</P><P><B>Conclusion</B></P><P>Testing for hepatitis viral marker (hepatitis A virus IgG and HBsAg/anti-HBs) is needed for female marriage immigrants. Especially, HBV genotype B is different from genotype C of Koreans. Therefore, interest and attention to vaccination programs for female marriage immigrants are necessary for both clinicians and public health institutes.</P>

American Football Injuries in Korea

Kwon Jae Roh,Dong Wook Kim 대한견주관절의학회 1995 대한견주관절학회 학술대회논문집 Vol.1995 No.5