관절성형술 및 측두근막 이식술을 이용한 악관절 강직증의 치험례

진택현,오승환,류동목,김여갑,이상철 大韓顎顔面成形再建外科學會 1996 Maxillofacial Plastic Reconstructive Surgery Vol.18 No.1

This is a case of bony ankylosis of right temporomandibular joint with mild facial asymmetry resulted from trauma, which bring about the right condylar fracture, and corrected by interpositional arthroplasty with temporal fascia flap and coronoidectomy. The postoperative results were functionally and esthetically good, but continued osbervation is necessary to evaluation of abnormal bony growth and reankylosis.

소아의 상완골 원위부 과간 골절

이우석,정환용,김우식,김용찬,전택수,김남현,김규태 대한골절학회 2004 대한골절학회지 Vol.17 No.4

상완골 원위부 과간 골절은 소아에서는 매우 드물게 발생되는 골절로 대부분 주관절의 굴곡상태로 주관절 후방부에 직접적인 충격에 의해 발생하는 것으로 보고되고 있다. 전위가 없거나 경미한 경우 도수적 정복술 혹은 도수적 정복술 후 경피적 핀고정술을 시행하며, 전위가 심한 골절이거나 도수적 정복술이 불가능한 경우 관혈적 정복술 후 핀고정술을 시행하는 것으로 알려져 있다. 저자들은 전위된 상완골 원위부 과간 골절 환아 2예에서 각각 도수적 정복술과 관혈적 정복술 후 K 강선 고정술을 시행하여 만족한 결과를 얻었기에 보고하는 바이다. Intercondylar fractures of the distal humerus are very rare in children. The pattern of the fracture would suggest that the mechanism of injury involves a fall directly on the flexed elbow. Most agree that the undisplaced fracture can be managed conservatively. With increasing displacement and comminution, the opinions tend to differ. We suggest that closed reduction with percutaneous K wire pinning and open reduction with percutaneous K wire pinning offer a satisfactory methods by which to treat displaced intercondylar fracture in children.

쇄골 골절에서 지연성 상완 신경총 마비 : 1예 보고 A Case Report

이우석,정환용,전택수,김용상,김남현 대한골절학회 2003 대한골절학회지 Vol.16 No.2

상완 신경총 마비는 쇄골 골절 후에 매우 드물게 발생하며, 대부분 많은 가골 형성을 동반한 쇄골의 중간1/3 부위 골절 불유합에서 발생한다. 골절의 치유 과정에서 과형성된 가골이 상완 신경총을 압박할 수 있으며, 감압술고 불유합에 대한 수술적 치료를 필요로 한다. 이에 저자들은 쇄골 골절 후 불유합과 과도한 가골 형성에 의해 발생된 지연성 상완 신경총 마비 환자를 치험 하였기에 보고하는 바이다. The brachial plexus palsies secondary to nonunion of the clavicle fracture are extremely rare. The nonunions are hypertrophic and usually in the middle third of the clavicle. Hypertrophic callus produced healing process will cause a compression of the neurovascular bundle. This lesion requires operative treatment for decompression of the brachial plexus and internal fixation of nonunion. We present a case of delayed brachial plexus palsy due to nonunion and excessive callus formation of a clavicular fracture.

쇄골 중간부 골절후 불유합 및 지연 유합의 원인

윤정로,심재익,김택선,이성종,김영배,김학준,안국환,장재영,홍명표 대한골절학회 2002 대한골절학회지 Vol.15 No.4

쇄골 중간 1/3 부위의 골절은 치료 결과가 양호하여 보존적 치료가 원칙적으로 받아 들어지고 잇으며 불유합에 대한 빈도도 낮은 것으로 되어 있다. 그러나 최근 전위 및 단축의 정도가 심할 경우 높은 불유합의 결과와 불량한 임상 결과를 보고하고 있어 이런 예에 대해선 수술적 치료를 권장하고 있다. 저자들은 단축 및 전위의 정도와 불유합의 연관성을 알아보고자 하였다. 연구 대상 및 방법 : 1993년 2월부터 2002년 1월까지 본원에 내원 했던 성인 중간부 쇄골 골절 환자 194명 중 완전 전위를 보인 78례를 조사하여 이중 63례를 대상으로 분석하여 후 향적 연구를 시행하였다. 4개월 추시 후에도 방사성 사진상 유합 소견이 관찰되지 않으면 불유합의 유의성을 알아보고자 하였다. 결 과 : 63례 중 불유합 및 지연 유합을 소견을 보인 환자는 15(23%)례였다. 골유합을 보인 48례의 단축은 평균 8.6㎜(2㎜-17㎜)였고, 전위는 평균 9.7㎜(2-22㎜)였다 .불유합 및 지연 유합을 보였던 15례에서 단축은 평균 14.5㎜(3㎜-37㎜), 전위는 평균 17.3㎜(4-25㎜)였다. 18㎜이상 단축이 있었던 경우 불유합의 발생과는 통계학적으로 유의성을 나타내었고(Fisher's exact test, p<0.01), Chi-square test상 16㎜ 이상의 전위를 보였던 경우 불유합 발생과 통계학적으로 의미가 있었다(p<0.01). 결 론 : 쇄골 골절 특히 중간 1/3의 골절은 비교적 보존적 치료에 결과가 좋은 것으로 되어 있으나, 전위 및 단축이 심한 경우 불유합에 대한 가능성이 높이 때문에 보다 경과 관찰시 유합의 진행이 없으면 적극적인 치료를 고려해야한다. Purpose : Because the prognosis of the mid 1.3 clavicle fracture is good, the conservative treatment with a figure of 8 bandage is the gold standard and the nonunions are rare. However, recently surgical treatment is recommended when the shortening and displacement is severe because of the high nonunion rate and the poor clinical result. This study was undertaken to evaluate that the shortening and displacement at fracture site are associated with the development of nonunion. Materials and Methods : We analysed the 194 fractures of mid 1/3 clavicle in adults which had been treated conservatively from February 1993 to January 2002 and did the retrospective study. Of these, 78 cases were originally in the middle third of the clavicle and had been completely displaced. We reviewed 63 of these cases. The shortening and displacement at the fracture site was measured on the initial roentgenogram. And the analysis of the patients' chart was done for another predisposing nonunion factors. Nonunion and delayed union are considered to be present when there has been little or no progression of clinical or radiographic healing at a minimum of 4 months after injury. Results : 15 of the 63 cases had developed nonunion.. The average 8.6㎜(2㎜-17㎜) shortening and average 9.7㎜(2-22㎜) in the union patients. The average 14.5㎜(3㎜-37㎜) shortening and average 17.3㎜(4-25㎜) in the nonunion patients. We found that initial shortening ≥18㎜(Fisher's exact test, p<0.01) and initial displacement ≥ 16㎜(Chi-square test. p<0.01)at the fracture site were significantly associated with the development of nonunion. Conclusion : The conservative treatment with figure-80-bandage is the gold standard in the clavicle middle one third fracture. However, the nonunion is commonly occurs in the cases of more of severely shortened and displaced fractures. If there are no signs of callus formation and the patient complains of pain after several week, osteosynthesis should be considered.

요배부 수술 실패 증후군에서 자기공명영상의 이용

이준규,안재성,권순태,김환정,정제택 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

This study was compared pre-operative MRI finding with operative finding on 36 cases with the failed back surgery syndrome (FBSS) retrospectively. The purpose of this study was to determine the accuracy of the MRI on the FBSS including early complications such as hematoma of infection. Of the 51 patients with FBSS, we analyzed pre-operative MRI finding compared with operative finding on 36 cases excluding nonunion, instability, metal failure and pseudoarthrosis who underwent an operation for the FBSS from December 1994 to June 1997. There were 25 men (69.4%) and 11 women (30.6%), aged from 16 to 68 years (average 43.6 years). These were divided into 5 sub-groups and calculated sensitivity, specificity and positive predictability. MRI accuracy in recurred disc was 84%, scar adhesion, recurred or developed stenosis, infection and hematoma 100% each and all, overall accuracy of the MRI 93%, respectively. Average interval of re-operation in FBSS WAS 4.3 years. In the 18 cases (50%), symptoms persist without pain-free interval after first operation. Early complications including hematoma and infection are easily detected with MRI. Especially if patient complains of severe leg pain or neurologic deficit, it is a good diagnostic procedure to check the MRI. The MRI is a useful method for evaluation of most cases of the FBSS, but it has limitations to evaluate recurred disc or scar adhesion only in T1, T2 weighted image. Therefore Gd-DTPA enhancement is necessary for the accurate diagnosis.

Factors Affecting the Optimal Charge Rate for Waste Disposal within Vertically Linked Two Stage Waste Treatment Service Markets

Taek-Whan Han(한택환) 한국환경정책학회 2024 한국환경정책학회 학술대회논문집 Vol.2024 No.2

National Emission Trading Schemes : Designing the Market

Taek-Whan Han(한택환),Wonzoe-Shin,Kangil Lee 한국환경정책학회 2008 한국환경정책학회 학술대회논문집 Vol.2008 No.10

Discussions on the Specialized Refrigerant Recovery Agents System in Korea

Taek-Whan, Han(한택환) 한국환경정책학회 2019 한국환경정책학회 학술대회논문집 Vol.2019 No.2

Feasibility of Introducing Economic Incentive System in F-Gas Recovery in Korea

Taek-Whan Han(한택환),Dongsoon Lim(임동순) 한국환경정책학회 2016 한국환경정책학회 학술대회논문집 Vol.2016 No.10

The Effect of Pulsed Radiofrequency Treatment into Sciatic Nerve in Both Normal and Neuropathic Pain Induced Rats

Whan Taek Byeon,Young Bae Kwon 한국실험동물학회 2006 Laboratory Animal Research Vol.22 No.1

Pulsed radiofrequency (PRF) stimulation into dorsal root ganglion (DRG) has been recently introduced as an alternative method of pain intervention in patients with neuropathic pain. Animal studies further reveal that PRF stimulation into DRG increases Fos expression (neuronal activity marker) in the spinal cord. Thus, it is assumed that PRF induced neuronal activation may be closely related with long-term analgesic effect in the neuropathic conditions. Presently, it is not clear PRF application into peripheral nerve fiber including sciatic nerve also produces analgesic effect in neuropathic pain condition. We firstly evaluated whether PRF application for two minutes into right sciatic nerve of rat in mid thigh increased spinal Fos expression. And then we further investigated whether this PRF application produced analgesic effect on the neuropathy using rat chronic constriction injury (CCI) model. PRF application did not significantly increase Fos expression in the spinal cord as compared with control animals. Furthermore, PRF application failed to reduce the mechanical allodynia and non-noxious stimulation induced spinal Fos expression in CCI model. Therefore, this data suggest that PRF treatment into sciatic nerve do not produce the spinal neuronal activity as well as pain relief in neuropathic animal model.