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불응성 주관절 외상과염에 대한 혈소판 풍부 혈장 주입 치료의 임상적 결과
고상훈(Sang-Hoon Ko),이채칠(Chae-Chil Lee),강병성(Byeong Seong Kang),이기재(Ki-Jae Lee),이선호(Seon Ho Lee) 대한견주관절의학회 2010 대한견주관절의학회지 Vol.13 No.1
목적: 주관절 외상과염은 주관절 동통을 유발하는 대표적인 질환 중 하나로 이에 대한 치료 방법은 여러 문헌에서 보고 된 바 있다. 본원에서는 외상과염에 대한 혈소판 풍부 혈장 (Platelet-Rich-Plsma) 주입 치료를 시행한 후 그 임상적 결과를 평가해 보고자 하였다. 대상 및 방법: 2009년 1월부터 2009년 12월까지 본원에서 외상과염으로 진단받은 환자 15명 (남자 5명, 여자 10명)을 대상으로 하였으며, 평균 연령은 43.5세 였다. 모든 환자는 타 병원에서 1년 이상의 물리치료, 약물치료 등의 보존적 치료를 시행 받았으나, 증상호전을 보이지 않아 수술적 치료를 고려하는 환자였다. 대상 환자는 주관절 외상과에 경피적 혈소판 풍부 혈장 농축액 3cc를 1회 주입하였으며, 치료효과의 판정은 휴식 시와 작업 시의 visual analogue scale (VAS), The Patient-Rated Tennis Elbow Evaluation (PRTEE)를 시술 후 4, 12주 후 측정하고 치료 전후를 비교평가 하였다. 결과: 치료 4주, 12주 단기 추시에서 휴식시 통증의 VAS 평균 값은 치료 전 4.6에서 치료 4주째 2.5 12주째 1.8로 개선 되었고, 작업시 통증의 경우 치료 전 7.8에서 치료 4주째 6.2 치료 12주째 4.25로 개선 되었다. PRTEE score 평균 값은 치료 전 60.13에서 치료 4주째 46.12, 12주째 24.6으로 개선 되었다. 결론: 보존적 치료에 반응을 보이지 않는 불응성 주관절 외상과염의 치료에 있어 혈소판 풍부 혈장 주입을 이용한 치료는 효과적인 치료법이며, 수술적 치료를 시행 전 고려 되어야 한다고 사료된다. Purpose: To evaluate clinical results of a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis. Materials and Methods: Between Jan and Dec 2009, fifteen patients (5 male, 10 female) received a diagnosis of lateral epicondylitis of the elbow and were evaluated in this study. Their average age was 43.5 years. All patients were initially given a variety of non-surgical treatments for more than 1year. All patients were considering surgery. These patients were given a single percutaneous injection of 3cc of platelet-rich plasma. To assess pain, we used a visual analogue scale (VAS) at rest and during work & the Patient-Rated Tennis Elbow Evaluation (PRTEE) score. We compared the score before treatment with scores 4 and 12 weeks after treatment. Results: Average VAS scores at rest improved from 4.6 before treatment to 2.5 at week 4, and 1.8 at week 12. The average VAS score while working also improved from 7.8 before treatment to 6.2 at week 4, and 4.25 at week 12. The average PRTEE score improved from 60.13 before treatment to 46.12 at week 4 and 24.6 at week 12. Conclusion: Treatment using a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis appears to be an effective treatment modality. Platelet-rich plasma should be considered before surgical intervention.
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임재욱 ( Jae Uk Im ),김은혜 ( Eun Hye Kim ),전홍길 ( Hong Gil Jun ),오지선 ( Ji Seon Oh ),최승원 ( Seung Won Choi ),강병성 ( Byeong Seong Kang ) 대한내과학회 2013 대한내과학회지 Vol.84 No.6
The gastrointestinal tract is commonly involved in patients with systemic sclerosis. The manifestations include motility disorder, pseudo-obstruction, malabsorption, bacterial overgrowth, diverticuli, and, less commonly, pneumatosis cystoides intestinalis (PCI). PCI is characterized by the presence of air in the submucosal or subserosal layer of the bowel wall and is often accompanied by pneumoperitoneum. Although PCI is a benign condition that often responds to conservative management, it is a poor prognostic factor of systemic sclerosis. We report a case of PCI in a patient with systemic sclerosis. The chest and abdominal radiographic findings comprised pneumoperitoneum, marked dilation of the bowels, and intramural air, compatible with PCI. The patient`s symptoms improved spontaneously. It is important to recognize PCI as a gastrointestinal manifestation of systemic sclerosis, and physicians should differentiate it from serious complications-such as intestinal perforation-based on clinical manifestations. (Korean J Med 2013;84:868-872)
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한국산 잡견에서 Sevoflurane 또는 Halothane 마취중 부정맥을 유발시키는 Epinephrine 용량에 대한 비교연구
김태성,김현수,김광민,강병성,윤석훈 대한마취과학회 1997 Korean Journal of Anesthesiology Vol.33 No.1
Background : Epinephrine used in surgery to provide hemostasis may elicit ventricular arrhythmias. A desirable anesthetic would not sensitize the myocardium to exogenously administered epinephrine. So the effect of sevoflurane, which was introduced to clinical anesthesia recently, on cardiac arrhythmias induced by the infusion of epinephrine was compared with those of halothane which was already known to epinephrine-induced arrhythmia in the 14 mongrel dogs. Methods : The authors compared the arrhythmogenicity(three or more premature ventricular contractions, PVCs)of intravenously administered epinephrine in 14 mongrel dogs who were randomly assigned to receive sevoflurane(1.7 vol%) or halothane(0.75 vol%) anesthesia equipotently. The arrhythmogenic doses of epinephrine determined in this comparative study were expressed by both infusion rates of epinephrine during sevoflurane and halothane anesthesia. Results : The mean values of the arrythmogenic infusion rates of epinephrine were 27.1 7.6 g/kg for sevoflurane and 2.7 0.8 g/kg for halothane. Conclusions : We concluded that the arrythmogenic doses of epinephrine during sevoflurane were significantly higher than those during halothane anesthesia. (Korean J Anesthesiol 1997; 33: 1∼5)
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