항생제 혼합 시멘트 정을 이용한 장관골 감염성 불유합의 이단계 치료

조세현,정순택,박형빈,황선철,하용찬,황인환 대한골절학회 2004 대한골절학회지 Vol.17 No.4

목적: 장관골 감염성 불유합의 치료 시 항생제 혼합 시멘트 정을 이용한 이단계 재건술의 결과를 분석하고자 한다. 대상 및 방법: 1998년 1월부터 2002년 9월까지 장관골 감염성 불유합으로 이단계 재건 수술을 받은 41예 (대퇴골 26예, 경골 15예)를 대상으로 하였다. 일단계 수술에서는 광범위한 변연 절제술, 부골 제거 및 세척술과 기존 고정 장치의 제거 또는 외고정 장치로의 교환을 시행한 후 시공 (dead space)과 불유합 주변 연부조직 내 항생제 혼합 시멘트 정을 삽입하였다. 임상적 감염 증상이 호전된 평균 8.7주 (3주~32주) 후 이단계 재건술로서 Ⅰ군은 내고정 장치 (금속판 5예, 골수강내 금속정 8예), Ⅱ군은 외고정 장치 (Ilizarov 25예, Monofixator 3예)로 각각 고정하고 17예에서는 골내 이동술이나 골 연장술을 시행하였다. 양군 모두 필요한 경우 골 이식과 시멘트 정의 교환을 추가하였다. 추시 기간은 16개월에서 최장 71개월로 평균 45개월 이었다. 치료 결과는 골유합 기간 및 Paley 방법에 의한 방사선상 골유합 상태와 하지 기능으로 평가하였다. 결과: Ⅰ군 13예 전부와 Ⅱ군 28예 중 26예에서 감염의 치료와 골유합을 얻었다. 이단계 재건술 후 골 이식술, 골 소파술, 외고정 핀 교환과 각변형 교정술, 피부 이식 또는 근육 피판 회전술 등의 보조적 시술이 Ⅰ군은 평균 2회, Ⅱ군은 평균 6.2회 추가되었다. 평균 골유합 기간은 Ⅰ군이 19.3주이고 Ⅱ군이 23.1주로 내고정군이 더 빨랐다. 방사선상 Paley 골유합 상태는 Ⅰ군이 우수 8예, 양호 5예이었고, Ⅱ군이 우수 18예, 양호 7예, 보통 1예, 불량 2예 이었다 (p=0.492). 기능적 결과는 Ⅰ군에서 우수 6예, 양호 6예, 보통 1예 이었고, Ⅱ군에서는 우수 10예, 양호 13예, 보통 3예, 불량 2예 이었다 (p=0.267). 결론: 항생제 혼합 시멘트 정의 골수염 치료 효과가 관찰되었으며, 감염이 호전된 후 내고정 장치로 교환해 준 군이 외고정을 유지한 군에 비하여 추가 수술 횟수가 적고, 골유합 기간도 빨랐다. Purpose: To evaluate treatment results between internal na external fixation groups in two-stage reconstruction of infected nonunion of long bones using antibiotics-impregnated cement beads. Materials and Methods: In the first stage, preexisting hardwares were removed and radical debridement was done. The dead space was filled with antibiotics -impregnated cement beads and the nonunion sits was immobilized by external fixation, cast or skeletal traction. In the second stage, all cases were divided into two groups; the nonunion was fixed by internal fixation in group Ⅰ versus external fixation in group Ⅱ. The intervening period between the first and second stage was average 8.7 weeks (range, 3~23 weeks). Results: The follow-up period was average 45 months (range, 16~71 months). Infection control and bone union were achieved in all 13 cases of group Ⅰ. Infection recurred in two of 28 cases in group Ⅱ, one underwent above-knee amputation and the other case was lost in follow-up. The mean number of supportive operations including repeated curettage, augmentation and change of infected pins, angular correction, and soft tissue flap was average 2 and 6.2 times respectively in group Ⅰ and group Ⅱ. Bony union period was average 19.3 and 23.1 weeks in each group. According to Paley's classification, group Ⅰ was similar to group Ⅱ in bony and functional result (p>0.05). Conclusion: Antibiotics-impregnated cement beads provided positive effect on infection control. Internal fixation group showed less number of additional operations and earlier bony union than external fixation group.

경골 골수정 고정술후 교합나사의 파단

박형빈,강번중,송해룡,구경회,정순택,조세현 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 경골 골절에서 골수정 고정술후 발생하는 교합나사 파단의 빈도와 발생 원인을 밝히고자한다. 대상 및 방법 : 1995년 3월부터 2000년 10월까지 골수정으로 치료하였던 경골 간부골절 82예중 내고정물 파단이 발생하거나 골유합이 이루질 때까지 추시 가능하였던 75예를 대상으로 하였다. 내고정물 파단 빈도와 위치, 골절의 양상, 술후 골절부 신연 및 골유합 이상 여부를 조사하였다. 결 과 : 교합나사 파단은 7예였고 (9.3%), 근위부 두 번째 나사의 파단이 가장 흔하였다. 교합나사으 ㅣ파단은 AO분류 B형과 C형 골절, 술후 골절부가 신연된 경우, 개발성골절, 자연유합 및 불유합의 경우 발생하였다. 결 론 : 교합나사 파단의 주된 요인은 골절부의 골과 골 접촉이 불안정하기 때문이며, 개방성 골절, 지연유합 및 불유합도 교합나사 파단의 위험인자라고 생각한다. 교합나사 파단을 예방하기 위해서는 수술시 골절부 신연을 피해야하며 골절부 골접촉이 불안정한 경우 완전 체중부하를 골유합시까지 제한하여야할 것으로 생각한다. Purpose : The aims of this study were to investigate the prevalence and the causes of crew breakage in tibia nailing. Materials and Methods : Between 1995 and 2000, eighty-two tibial diaphyseal fracture were treated with interlocking nails. The loss of follow-up was 7 cases. We retrospectively reviewed seventy-five cases. We investigated the rate and location of metal failure and evaluated the fracture pattern, the presence of distraction after nailing and union abnormality. Results : Screw breakage was identified in seven cases (9.3%) and most frequently occurred on the second proximal locking screw. Screw breakage occurred in AO type B or C type fractures, fracture site distraction after nailing, open fracture, delayed union and nonunion. Conclusion : The main cause of screw breakage is unstable bone to bone contact on the fracture site caused by comminution of distraction. The open fracture, delayed union, and nonunion also contributing factors for screw breakage. For preventing screw breakage, it is necessary to avoid fracture site distraction and delay full weight bearing in cases having unstable fracture site contact.

응급센터에서 기관내 삽관을 시행하지 않은 호흡곤란 환자의 동맥혈 이산화탄소분압과 호기말 이산화탄소분압의 연관성분석

김형국,박승현,오동렬,박규남,이원재,황두영,최승필,이운정,정시경,김세경 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Background: The end-tidal carbon dioxide tension(ETCO₂) is defined as a partial pressure of carbon dioxide at the end of an exhaled breath. The purpose of this study is to determine the correlation between ETCO₂and arterial carbon dioxide tension(PaO₂) in nonintubated patients with respiratory distress in emergency department(ED). Methods: A prospective non-blind study was performed in ED of our university hospitals. Participants included all nonintubated adult patients with respiratory distress requiring arterial blood gas analysis. ETCO₂was measured with a capnography monitor during tidal volume breathing. ETCO₂were recoreded at the time of arterial blood gas sampling. The correlation between ETCO₂and PaCO₂was analyzed in all patients and in subgroups by simple linear regression. Results: Sixty patients were enrolled. In all patients, ETCO₂was 5.72mmHg lower than PaCO₂and correlated well with PaCO₂(r²=0.716). ETCO₂correlated best with PaCO₂in patients who were either acidotic or non-smoking. Conclusion: ETCO₂correlate well with PaCO₂in nonintubated patients with respiratory distress in ED. ETCO₂may be sufficient to reflect PaCO₂in selected patients and obviate the need for repeat arterial blood gas determination.

고온에서 충동제트의 냉각특성에 대한 실험적 연구

서정세,김형수 慶尙大學校生産技術硏究所 1997 生産技術硏究所論文集 Vol.13 No.-

The experiments were performed in a high temperature furnace to examine the effects of the temperature difference between the single round jet and the surrounding fluid on the characteristics of impinging heat transfer. It was found that the average heat transfer coefficient increased in proportion to 1.5th power of the jet velocity, which was higher than that of previous measurements in which the jet temperature was the same as the ambient temperature. since the jet is thermally mixed with its surroundings, the heat transfer increases as the nozzle-to-surface distance decreases. The maximum average heat transfer occurred at the nozzle-to-surface distance normalized by the nozzle diameter.

이성분 양이온성 계면활성제 혼합용액의 임계미셀농도에 대한 연구 1. CTAB와 다른 양이온성 계면활성제 CTB 및 DTAB 혼합용액

김진형,오세웅,고정수 木浦大學校基礎科學硏究所 1999 基礎科學硏究誌 Vol.17 No.-

The critical micelle concentration (??) in a micellar state of the mixed surfactant systems of cetyltrimethylammonium bromide (CTAB) with cetylpyridinium bromide(CPB) and dodecyltrimethylammonium bromide (DTAB) were determined at 25℃ as a function of the overall mole fraction of CTAB by the use of surface tension method. CMC values of pure CTAB, CPB, and DTAB were 9.95×10-4 M, ?? M, and ?? M, respectively. Interaction parameterβ value of CPB-CTAB mixture was evaluated as -1.3. In case of DTAB-CTAB mixture, constancy in β value was not obtained over all composition of the mixture.

노랑초파리 발생과정에서 sta 유전자의 발현 양상에 관한 연구

박지권,정형복,김세재 제주대학교 생명과학연구소 2000 제주생명과학연구 Vol.3 No.-

Drosophila stuvarista(sta) gene encodes the ribosomal protein D-p40, consisting of 270 amino acids. The D-p40 is highly conserved between such evolutionarily distinct organisms as human(63% identity) and hydra(58% identity) and has the effect of Minute phenotype such as other ribosomal proteins. We identified the sta gene in the process of Drosophila cDNA library screening and analyzed the developmental expression pattern of sta gene in the transcription level using in situ hybridization. Each animal stage and tissues of 3rd instar larva and adults were showed ubiquitously expression pattern. These results were similar to other ribosomal proteins that represented Minute phenotype. Also, we expressed the 31kDa recombinant proteins of D-p40 using his-tag expression system in E. coli and purified by affinity chromatography. Immunoblot result of the developmental stages was showedthat strongly detection only the stage of embryo and pupa. This result suggested that the expression of sta gene were regulated in the level of post-translation modification ailed considered that sta gene had to other function during development as well as to function as a core ribosomal component.

복강내에 발생한 다발성 혈관종 : 증례 보고

정갑중,김형호,최홍조,김영훈,조세헌,정진숙,남경진,김상순 동아대학교의과대학 1992 동아의대학술지 Vol.4 No.1

Effects of Alkali Post-treatments on Heterointerface and Device Performances of Cd-free Flexible Cu(In,Ga)Se₂ Solar Cells

Awet Mana Amare,Inchan Hwang(황인찬),Inyoung Jeong(정인영),Joo Hyung Park(박주형),Soomin Song(송수민),Ara Cho(조아라),Jun-Sik Cho(조준식),Seung Kyu Ahn(안승규),Jinsu Yoo(유진수),Se Jin Ahn(안세진),Jihye Gwak(곽지혜),Donghyeop Shin 한국신재생에너지학회 2023 한국신재생에너지학회 학술대회논문집 Vol.2023 No.6

급성신부전을 동반한 알콜성 횡문근융해증 2례

김영민,오동렬,이원재,김형국,황두영,이환,최경호,정시경,김세경,김영옥 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

Rhabdomyolysis is a biochemical and clinical syndrome caused by lysis of skeletal muscle cell and release of muscle cell contents into the circulation. In addition to traumatic cause, various nontraumatic causes have been reported. Rhabdomyolysis has frequently been associated with seamy aspects of life and society: alcoholic abuse, drug addiction, sadistic drill exercise, war events and attempted suicide. The abuse of alcohol causes many hazards in many organs. One of these is acute alcoholic myopathy that may present as a fulminent syndrome of muscle pain and tenderness associated with rhabdomyolysis and acute renal failure. Because the prognosis of adequately treated rhabdomyolysis is excellent, early recognition and prompt management are essential in emergency situation. We experienced two typical cases of alcohol-induced rhabdomyolysis with acute renal failure and report these cases with literature review.

응급의료센터에서 신경색의 조기진단

최경호,오동렬,이원재,박규남,박승현,황두영,김형국,정시경,김영민,김세경 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

To evaluate appropriate diagnostic studies for renal infartion in emergency medical center, we analysed 33 patients of renal infarction treated in this hospital for last 8 years. Eleven patients, 4 trauma associated and 7 aortic disease associated patients were excluded. They are 11 males and 11 females with a mean age of 51 years. Fourteen came to the emergency medical center and seven came to the outpatient department, in the other one patient renal infarction was developed during hospitalization with other disease. On their past history they had hypertension in 9, valvular heart disease in 5, and diabetic mellitus in 4 patients. Abdominal or flank pain was noted in 17 of 22(77%). The other symptoms were vomiting, nausea, fever and so on. On microscopic examination of initial urine in hospital, 5 patients showed more than 10 red blood cells by high power field examination. The mean lactic dehydrogenase level was 1,239 I.U/L(normal range 218-472 I.U/L), while the mean aspartate aminotransferase and mean alanine aminotransferase were 51 I.U/L(normal range 13-36 I.U/L) and 44 I.U/L(normal range 5-33 I.U/L). Abdominal ultrasonography showed positive findings in 5 of 16(31%), of which 3 were confirmed by Doppler ultrasonography. In 18, computed tomography was done and all those showed positive findings of renal infarction(100%). In conclusion, it is important that identify the elevated lactic dehdrogenase level in case of any suspicion about renal infarction and confirm by computed tomography.