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패혈증 비브리오균에 의한 위장관염에 이은 급성 화농성 척추염
옥혜성 ( Hea Sung Ok ),김병기 ( Byeong Ki Kim ),김기훈 ( Ki Hoon Kim ),박만제 ( Man Je Park ),이현수 ( Hyoun Soo Lee ),위유미 ( Yu Mi Wi ),강철인 ( Cheol In Kang ) 대한내과학회 2014 대한내과학회지 Vol.86 No.4
Vibrio vulnificus is a halophilic gram-negative bacillus capable of causing severe to life-threatening infections in high-risk populations. Osteomyelitis caused by V. vulnificus is extremely rare, and a previously reported case had been associated with an adjacent soft-tissue infection. Herein we report the first case of vertebral osteomyelitis resulting from hematogenous spread of V. vulnificus gastroenteritis. The patient was successfully treated with a combination of cefotaxime and ciprofloxacin. (Korean J Med2014;86:519-522)
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비 확공성 골수강내 교합정을 이용한 경골 간부 골절의 치료
윤형구(Hyung Goo Yoon),전광표(Kwang Pyo Jeun),정대은(Dae Eun Jung),전호승(Ho Seung Jeon),박만제(Man Je Park) 대한골절학회 1996 대한골절학회지 Vol.9 No.2
Recently intramedullary nailing has become the most common method treating tibial fractures. Reamed intramedullary nailing technique leaves the problem of destroying thc endosteal blood supply, which associated with delayed union and postoperative infection. Recent reports have shown excellent rate of union and low rate of infection with unreamed interlocking intramedullary nail. Author reviewed 58 cases of tibia shall fractures that were treated with unreamed interlocking nail from Feb. 1992 to Feb. 1994. I. Forty nine fractures were closed and 9 were open (Gustilo-Andersonl;3,II;5, IIIa;1). Thirty one fractures involved the distal portion, 19 fractures the middle portion, 6 fractures the proximal portion and 2 fractures were segmental. 2. Thirty six cases were male and 22 were female. The most common age was 3rd decade (25.8%). 3. The most common cause was traffic accident. 4. Average interval from injury to operation were 5.7 days in closed fracture and 11.3 days in open fracture. 5. The mean duration of hone union were 15.7 weeks in closed fracture and 19.5 weeks in open fracture. 6. Complications include I case of delayed union, I case of joint stifmess and 1 case of screw failure. 7. According to the functional results by Klemm and Borner, 42 cases were excellent, 15 cases were good and 1 was fair.
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요추 질환에 대한 경추간공 후방 추체간 유합술의 치료 결과
박만제 白中央醫療院 2004 仁濟醫學 Vol.25 No.1
Purpose : To evalute the clinical and radiological result treated by transforaminal lumbar interbody fusion(TLIF) and transpedicular instrumentarion for lumbar disease. Materials and Methods : Twenty-seven cases with follow-up over 12 months were analyzed retrospectively. Etiologic conditions were lumbar stenosis in 15 cases, failed back surgery syndrom in 7 cases, spondylolithesis in 3 cases, lumbar disc with instability in 2 cases. Data regarding blood loss, operative time were recorded. Clinical result was analyzed by Kim's criteria. Radiologic evaluation containing the bone union and intervertebral space height was assessed by simple X-ray. Result : The satisfactory clinical result rate was 86%. Postoperative fusion states were bone union in situ 28 level, delayed union in 3 level, Disc height was changed from 10.6mm preoperatively to 13.1mm postoperatively and remained 12.2mm at the latest follow-up. The average blood loss was 480ml. The average operation time was 185 min. Postoperative complications were dural laceration and wound infection. There were no nonunion, instrument breakage and nerve palsy. Conclusion : Transforaminal lumbar interbody fusion(TLIF) and transpedicular instrumentarion for lumbar disease showed excellent clinical and radiological result. TLIF also provide elimination of the need for prolonged retraction of the dura and conus medullaris and maintenance of the normal muscular attachments, but long-term clinical outcomes studies are necessary to address issues concerning the clinical effectiveness of these procedures.
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Modified Extended Iliofemoral 도달법에 의한 복합비구 골절의 치료
박만제 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Purpose: To assess the results of reduction and complication of modified extended iliofemoral approach recommended by Reinert in complex acetabular fracture. Materials and Methods: Ten cases with follow-up over 12 months had open reduction and internal fixation of a complex aetabular fracture using this surgical approach and evaluated the anatomic reconstruction as well approach-related mobidity and complications. Treatment result was analyzed by Harris's hip scoring system and Matta's reontgenographic grading system. Result: Eight cases produced a satisfactory reduction of fracture(3㎜ or less displacement ). Clinical result were satisfactory in 9 cases according to Harris's hip scoring system. The complications were superficial wound infection in 1 case, marginal skin necrosis 1 case, heterotopic ossification 1 case. There were no deep infection and funtionally significant heterotopic ossification. Conclusion: Anatomical reduction and firm fixation is essential for good result and modified extended iliofemoral approach is one of the good methods for surgical exposure of complex acetabular fracture.
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