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문영래,박준광,오서진,Moon, Young Lae,Park, Joon Kwang,Oh, Seo Jin 대한관절경학회 1999 대한관절경학회지 Vol.3 No.2
목 적 : 화농성 주관절염의 치료 방식 중의 하나인 관절경적 처치를 제시하고, 경과를 평가하고자 하였다. 대상 및 방법 : 급성 화농성 주관절염 환자 7례를 대상으로 하였으며, 연령 분포는 6세에서 32세로 다양한 양상을 보였다. 관절 천자와 임상 검사에 의해 확진되면 즉시 응급으로 관절경적 변연 절제술 및 세척술을 시행하였고, 환자의 경과 관찰을 시행하였다. 결 과 : 혈액 검사상 백혈구 수치 및 적혈구 침강 속도와 c-반응성 단백의 정상화는 소아에서 8.4일, 성인에서 12.3일 소요되었다. 1년 추시 결과 전례에서 주관절 운동 제한은 없었고, 혈액 검사상 정상 소견을 보였으며, 그 외 후유증이나 합병증은 관찰되지 않았다. 결 론 : 화농성 관절염의 치료는 적절한 배농과 항생제 처치가 원칙이며, 이러한 관점에서 본다면 관절경적 변연 절제술 및 세척술은 다른 방식에 비해 관절 연골을 보호하고 전체적인 병리 상태를 관찰하면서 시행할 수 있는 유용한 방식 중의 하나로 사료된다. Purpose : This study was to evaluate the effectiveness of arthroscopic management for septic elbows. Materials and Methods : The subjects were 7 patients ranged in age from 6 to 32 years. All patients were diagnosed as having septic arthritis of the elbow after arthrocentesis. Emergency arthroscopic lavage, debridement, and selective synovectomy for infective and necrotic tissue were performed. All patients had a follow-up period of more than 12 months by checking leukocyte count, ESR, CRP and range of motion. Results : For children, we found a return to normal of laboratory tests for infection after an average of 8.4 days while for adults, it required 12.3 days. After 12 months all patients showed normal elbow function as well as normal blood tests. Conclusion : We found arthroscopic management for septic arthritis of the elbows made it possible to visualize the pathologic findings directly and protect further articular damage. In conclusion, arthroscopic management is one of the efficient methods for controlling the joint infection.
신동민,하상호,박준광 대한슬관절학회 1994 대한슬관절학회지 Vol.6 No.1
The intra-articular osteochondroma of the knee is very rare and is the result of extrasynovial metaplasia if the fibrous capsule or of the adjacent connective tissue of a joint. The authors experienced a case of intra-articular osteochondroma of the left knee in a 15 year old girl, which was embedden in ACL and arised from the intercondylar notch. Histology and gross findings are consistent with the osteochondroma. The mass was excised and the symptom was relieved completely.
소아 상완골 과상부 골절의 강선 고정치료에 대한 임상적 고찰
김광,문영래,박준광,윤태현 대한골절학회 2000 대한골절학회지 Vol.13 No.2
Purpose: The supracondylar fracture of the humerus is the most common elbow injury in children. They are commonly treated with closed reduction and percutaneous pin fixation. We measured the stability of supracondylar fractures, fixed with different configuration of pins, according to the each type of supracondylar fractures. Material and method: We reviewed 42 supracondylar fractures of the humerus in children that were treated with percutaneous pin fixation from 1988 to 1997. The follow up period ranged from 1.5 to 41 months. The patient s average age was 9.2 years. The most common cause of injury was fall down injury in thirty three. The extension type is the most common, accounting for 95% of cases. We compared the initial post-op films with the follow up films which was checked at 2-3weeks later to estabilish the stability by assessing the anterior beak prominence of the proximal fragment on lateral radiograph. Result: There were 8 cases of Type II-A (hyperextension post cortext intact AP, lateral appearance), 10 cases of Type II-B (displaced/angulated with osseous contact AP, lateral appearance) and 24 cases of Type III (completely displaced AP, lateral appearance). The greatest stability was achieved with two crossed pins placed from the medial and lateral condyles. Final failure of the fixation occurred in two cases of the group II-B, fixed with only two lateral pins. Conclusion: The two crossed pins which were placed from the medial and lateral condyles provided the greatest stability of the fracture fragment. When we treat the type II-B pattern fracture (displaced/angulated with osseous contact AP, lateral appearance), we must check the rotational stability after lateral pin fixation. If the fracture is unstable, we must fix the fracture with additional medial crossed pin fixation.
문영래,유재원,심형준,박준광 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1
Purpose : The purpose of this study is to evaluate the usefulness of arthroscopic drainage in the management of septic arthritis of the shoulder. Materials and methods : The cases of nine septic glenohumeral joints were evaluated. Each patient was treated by arthroscopic irrigation and necrotic synovectomy, combined with parenteral antibiotics. Result In five of nine shoulders in which treatment was begun four weeks or less after symptoms appeared, a satisfactory functional outcome was obtained, while four patients who were treated after a delay of more than four weeks had poor results. Conclusion : The most significant factors leading to poor results of treatment were delay in instituting treatment, virulence of the infecting organism, and a serious process of underlying disease. Arthroscopic drainage is a valuable procedure for the treatment of the septic arthritis of shoulder. Arthroscopic drainage is a method that has proved effective, with minimal morbidity, in attempts to cure septic arthritis of the shoulder.