성인 쇄골 간부 골절에서 두 가지 수술적 치료군 간의 결과 비교: 금속판을 이용한 관혈적 정복 및 내고정술과 Steinmann Pin을 이용한 경피적 겸자 정복 및 골수강내 고정술의 결과 비교

허성식 ( Sung Sik Ha ),심재천 ( Jae Chun Sim ),홍기도 ( Ki Do Hong ),김재영 ( Jae Young Kim ),강정호 ( Jung Ho Kang ),박광희 ( Kwang Hee Park ) 대한골절학회 2007 대한골절학회지 Vol.20 No.3

목적: 성인 쇄골 간부 골절에서 금속판을 이용한 관혈적 정복 및 내고정술과 Steinmann pin을 이용한 경피적 겸자 정복 및 골수강내 고정술의 결과를 분석하여 비교하였다. 대상 및 방법: 2002년 3월부터 2006년 1월까지 본원에서 치료한 총 68예의 쇄골 간부 골절을 대상으로 하였으며, 금속판을 이용한 33예, Steinmann pin을 이용한 35예의 치료 결과를 분석하였다. 최종 결과 판정은 강 등의 기준에 의한 임상적 결과와 방사선학적 골유합 기간으로 하였고, 수술 시간을 비교하였다. 결과: 임상적 결과는 우수 이상의 예가 금속판을 이용한 군의 경우 총 33예 중 29예로 88%, Steinmann pin을 이용한 군의 경우 총 35예 중 32예로 91%의 결과를 보였다. 방사선학적 골유합 시기는 각각 평균 8.9주와 9.1주였고, 수술 시간은 금속판 군에서 평균 72분, Steinmann pin 군에서 평균 18분이었다. 결론: 성인 쇄골 간부 골절의 치료에 있어 금속판을 이용한 수술 군과 Steinmann pin을 이용한 수술 군은 임상적, 방사선학적 결과 면에서 통계학적으로 큰 차이를 보이지 않았으나, Steinmann pin을 이용한 수술 군에서 수술 시간 및 회복기간의 감소로 인하여 경제적인 면과 수술반흔의 감소에 따른 미용적인 면에서 더 만족스런 결과를 보였다. Purpose: To evaluate the results between open reduction and internal fixation with the plate and percutaneous reduction by towel clip and intramedullary fixation with Steinmann pin for clavicle shaft fractures in adult. Materials and Methods: We have studied the results in 33 cases with the plate. 35 cases with the Steinmann pin among total 68 cases of clavicle shaft fracture. The patients were followed up over a period of at least 12 months. The final postoperative outcome was analyzed with the clinical outcomes using Kang`s criteria. radiological union time and operation time. Results: The clinical outcome that was good or excellent according to the Kang`s criteria showed a distribution of 88% in the group using the plate with 29 cases out of total 33 cases. 91% in the group using the Steinmann pin with 32 cases out of total 35 cases. The mean radiological union time was 8.9 weeks in the group using the plate. 9.1 weeks in the group using Steinmann pin. The mean operation time was 72 minutes in the group using the plate, whereas was 18 minutes in the group using Steinmann pin. Conclusion: In the treatment of adult clavicle shaft fracture. two groups did not show a significant statistical difference in clinical and radiological outcomes. However, the operation time and postoperative functional recovery was significantly shorter and faster in the group using Steinmann pin. Additionally economic and cosmetic aspect was more satisfactory in the group using Steinmann pin.

누두흉 환자에서 Nuss 금속막대 제거 전 · 후 폐 역학 변화

강규식,백남순,김천숙,안기량,권진형,김지은,유시현 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Nuss operation is one of the surgical procedure for pectus excavatum and it's method is the insertion of convex steel bar under the sternum through small bilateral thoracic incision. As the patients is growing, the thorax can be compressed gradually by steel bar. So Nuss bar needs to be removed two years after Nuss operation. This study was undertaken to assess the effect on the repiratory mechanics before and after the removal of the Nuss bar. Twenty patients with previous Nuss operation were allocated for the removal of Nuss bar. Lung mechanics (dynamic lung compliance, static lung compliance, and airway resistance), hemodynamic change (heart rate, systolic pressure, and diastolic pressure), and pulmonary gas exchange (arterial oxygen tension, arterial carbon dioxide tension, pulse oximeter saturation, and end tidal carbon dioxide tension) were measured before and after removal of Nuss bar. Respiratory mechanics (dynamic and static lung compliance, inspiratory airway resistance), pulmonary gas exchange and hemodynamic parameter were unchanged before and after the removal of Nuss bar. We concluded that lung mechanics were not changed before and after the removal of Nuss bar in the patients with pectus excavatum and the 95% patients were satisfied with operation.

후복막강 부신경절종 적출시 Nicardipine과 Esmolol을 사용한 마취관리 : 증례보고 A case report

강규식,김덕,김천숙 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Paragangliomas are tumors arising from the neuroendocrine elements (Chief cells) of the paraganglia. Paragangliomas are uncommon tumors and are infrequently found in the extraadrenal retroperitoneum. We investigated and treated a patient with retroperitoneal paraganglioma, which was found incidentally at abdominal computer tomograhy. It was confirmed by pathological study. We report a case of retroperitoneal paraganglioma successfully managed intraoperatively with an infusion of nicardipine and an intermittent esmolol injection.

대전시 3 대 하천의 수질 및 식물플랑크톤상에 관한 연구

강창민,이상명,엄준식,이정희,이호원,홍춘표 한국환경과학회 2000 한국환경과학회지 Vol.9 No.4

The studies on physico-chemical factors and phytoplankton at the 3 rivers in the Taejon city were conducted from November 1997 to May 1998. The Results were as follows; In the water quality, the down streams were generally worse than the upper streams. Water temperature was varied from 2.4℃ to 23.0℃; DO from 1.80㎎/ℓ to 17.6㎎/ℓ ; pH from 4.7 to 10.4 ; BOD from 0.78㎎/ℓ to 8.80㎎/ℓ; COD from 0.32㎎/ℓ to 8.26㎎/ℓ ; SS from 2.0㎎/ℓ to 43.0㎎/ℓ ; total phosphate was from 0.001㎎/ℓ to 0.709㎎/ℓ ; total nitrogen 0.01㎎/ℓto 11.69㎎/ℓ . In phytoplankton species, they were identified as total 191 taxa composed of 8 classes, 18 orders, 35 families, 74 genera, 152 species, 35 varieties and 4 forms. The dominant species were Synedra ulna in Taejon-chon, Diatoma vulgare in Yudong-chon, Oscillatoria princeps, Scenedesmus gadricauda, Synedra ulna, and Diatom vulgare in Gap-chon. Standing crops of phytoplankton were from 2,076 cells/㎖ to 97,356 cells/㎖.

요하지통 환자에서 두 개의 캐눌라를 이용한 박동성 고주파 신경근 응고술의 임상 연구

김천숙,배재영,배덕구,강규식,안기량,권진형,김지은,유시현 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Dorsal root ganglion(DRG) block by the local anesthetics and steroids which has done classically in low back pain(LBP) patients with radiculopathy has high incidence of recurrence rate and side effects of steroids. Recently a new technique of pulsed radiofrequency thermocoagulation(P-RFTC) was introduced and substituted for it because of the benefits such as relatively low recurrence rate, low risk of nerve injury and comfort during the procedure. We experienced 15 patients who had LBP with radiculopathy and no or little response to epidural steroid injection. When we performed DR ganglionotomy by P- RFTC under the C-arm guide in these patients, we tried to approach the exact DR ganglion using tow cannulas - the one for obtaining patient's subjective symptoms and injection of contrast dye, the other for making a RF lesioning after identifying the impedance of sensory and motor stimulation. In conclusion, DR ganglionotomy by P- RFTC using two cannulas in LBP patients is an easy and safe procedure with satisfactory results.

갑상선암에서 MAGE 1-6 mRNA를 검출하는MAGE common primer의 의의

남철우,최영식,박요한,이강대 고신대학교의과대학 2006 고신대학교 의과대학 학술지 Vol.21 No.2

Background: MAGE (melanoma antigen gene) was named as cancer/testis specific antigens since their expression is only detected in the testis or cancer cells. Because of their relatively specific expression in the cancer cells, they have been considered as the early diagnosis of several cancers, or the appropriate targets for the specific immunotherapy mediated by cytotoxic T lymphocytes. Therefore, there were many reports about the expression of MAGE genes in various types of malignant tumors, but only a few reports in human thyroid neoplasms. The purpose of this study was to determine whether the MAGE common primers expressed in different histological types of thyroid tumors and to see the clinical usefulness of MAGE common primers on the thyroid tumors. Methods: Fifty-nine patients who underwent thyroidectomy at Kosin Medical Center from January, 2001 to April, 2002 were included in the study. Of the 59 patients 40 were papillary carcinoma, 4 follicular carcinoma, 3 medullary carcinoma, 1 anaplastic carcinoma, 4 nodular hyperplasia, 3 adenomatous goiter, and 4 follicular adenoma. Total cellular mRNA was extracted from those 48 cancer tissues, 11 benign tissues and additional eleven normal control thyroid tissues. Nested reverse transcriptase-polymerase chain reactions (nested RT-PCR) with the MAGE common primers designed to detect MAGE 1-6 genes were employed in this study. With probes confirmed by DNA sequencing. Results: Of those 48 cases of thyroid carcinomas 10 cases (20.8%) were expressed MAGE common primers. In the 40 papillary carcinoma, MAGE common primers were expressed in 17.5%. In the four follicular carcinoma, they were expressed in two cases, and in one case of one anaplatic carcinoma. However, in the three cases of medullary carcinoma, MAGE gene was not expressed. None of 11 benign tumors and 11 normal tissues expressed any of these MAGE common primers. The sensitivity of MAGE common primers in thyroid tumors was 20.8% and the specificity was 100%. Conclusion: These results suggested that MAGE common primers were expressed low in the malignant thyroid tumors but it was not expressed in benign tumors and normal tissues. It is suggested that MAGE common primers can be used for preoperative differential diagnosis of follicular carcinoma from benign follicular adenoma which cannot be made by fine needle aspiration cytology of thyroid tissue. However, further study is needed for clinical application of MAGE common primers expression as tumor markers in the thyroid tumors.

수술실 오염도감소를 위한 수술실공조시스템에 대한 연구

김천숙,박은정,강규식,김지은,안기량,권진형,유시현,주영철,권순정 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.1

Background: The OR(operating room) should provide an optimum environment that is safe for the patient and the working personnel. The air ventilation system of OR has been studied to decrease the contamination of air. We investigated the flow and contamination of the air in OR at our hospital. Method: Cultures in OR were made and the number of bacteria and fungi were calculated. A two-dimensional model for the cross-section of an operation room is developed for the CFD (computational fluid dynamics) analysis. The characteristics of air flow in the empty operation room and in the occupied operation room are calculated by using a CFD program. Results: The current air ventilation system of our hospital does not deliver the clean air to the operating site efficiently in occupied OR. Conclusions: We suggested a new location of air ventilation system which improves air venting with little increase of the cost of equipment.

Effects of dietary supplementation with probiotic CS-A on performance in broiler chickens

Seong Soo Kang1*, Se Eun Kim, Ara Go, Kyung Mi Shim, Chun Sik Bae, Chang Jong Moon, Sung-Ho Kim, Jong-Choon Kim, Jin-Cheol Yoo, Seung Sik Cho 충북대학교 동물의학연구소 2012 Journal of Biomedical and Translational Research Vol.13 No.3

Probiotics, enzymes, organic acids, oligosaccharides, antioxidants, and other functional materials are actively being explored as alternatives to antibiotics. Probiotics include live beneficial microorganisms that colonize the intestinal tract and competitively inhibit attachment and growth of harmful microbes. Probiotics also increase feed efficiency by assisting in nutrient absorption and digestion. The current study was conducted in order to evaluate the effect of a new probiotic, CS-A, as a dietary supplement of a fermented product on growth performance, feed intake, and feed conversion efficiency in broiler chickens, and to evaluate its value as an alternative for antibiotics used as a feed additive. Antibacterial and anti-inflammatory effects of CS-A were investigated in vitro and the in vivo effects of a constant concentration of supplemented CS-A on growth rate and feed efficiency were evaluated. In addition, the safety of CS-A was assessed by examination of common symptoms and mortality. Determination of minimal inhibitory concentration revealed an excellent antibacterial effect of CS-A. Cytotoxicity was low and anti-inflammatory effects were achieved at the effective concentration of CS-A. Supplementation with 0.1% CS-A resulted in a feed efficiency score of 1.84 in broilers, compared to 2.00 in the control group. There were no adverse clinical findings, necropsy findings, hematology, and altered serum biochemistry parameters, and no mortality. Thus, it is concluded that CS-A is safe and effective as a feed additive.

원주지역에서 발생한 비외상성 심정지의 일주변화

박금수,김영식,이진응,임종천,이강현,임경수,황성오,최경훈 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

To estimate the quality of the emergency medical services system of Wonju City, we studied the diurnal variations of 179 non-traumatic cardiac arrest victims who received cardiopulmonary reuscitation at the emergency center of Wonju Christian Hospital. Diurnal variations of non-traumatic cardiac arrest patients were as follows ; The occurence of cardiac arrest at day-time was higher than night-time; 18 cases (11%) from midnight to AM 4, 25 cases (14%) from AM 4 to AM 8, 42 cases (24%) from AM 8 to AM 12, 46 cases (25%) from AM 12 to PM 4, 35 cases (19%) from PM 4 to PM 8, 13 cases (7%) from PM 8 to midnight. Witness cardiac arrest was increased more during the day than night ; 40% from midnight to AM 4, 48% from AM 4 to AM 8, 57% from AM 8 to AM 12.52% from AM 12 to PM 4, 60% from PM 4 to PM 8, 38% from PM 8 to midnight. The transportation time at night-time cardiac arrest was more longer than day-time cardiac arrest ; 30±12mins from midnight to AM 4, 26±9mins from AM 4 to AM 8, 27±12mins AM 8 to Am 12, 25±11mins from AM 12 to PM 4, 25±9mins from PM 4 to PM 8, 35±15mins from PM 8 to midnight. The rate of restoration of spontaneous circulation(ROSC) in day-time cardiac arrest was higher than the night-time cardiac arrest ; 30% from midnight to AM 4, 36% from AM 4 to AM 8, 32% AM 8 to AM 12, 44% from AM 12 to PM 4, 41% from PM 4 to PM 8, 15% from PM 8 to midnight. The survival rate of cardiac arrest has been correlated with collapse time, early bystander CPR, early advanced care. To improve outcome for prehospital cardiac arrest, we concluded that early bystander CPR, and early advanced life support should be performed at the scene and during the transportation especially at night.

Nuss 방법에 의한 소아 오목가슴 수술 후 정맥 통증자가조절법을 사용한 Fentanyl 과 Fentanyl-Ketorolac의 진통효과 비교

안기량,서은정,김천숙,강규식,유시현,정진헌,정지원 순천향의학연구소 2006 Journal of Soonchunhyang Medical Science Vol.12 No.2

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