신경초종의 진단과 수술적 치료

서정탁,박병국,유총일,Suh, Jeung-Tak,Park, Byung-Guk,Yoo, Chong-Il 대한근골격종양학회 1999 대한골관절종양학회지 Vol.5 No.1

Neurilemmoma is a benign encapsulated nerve sheath tumor originated from peripheral nerve. Previously its preoperative diagnosis had mainly depended on the history, physical examination, electrodiagnostic test, ultrasonography, bone scan. But only with these diagnostic modalities, exact preoperative diagnosis was nearly impossible. Therefore operation was performed under the impression of lipoma or just simple soft tissue tumor. Recently, the advent of magnetic resonance imaging(MRI) has made it easier to diagnose neurilemoma before surgery. MRI also helps to determine the extent of lesion and operative procedures. We performed marginal excision in 24 cases, evaluated those cases with respect to the sex, age, location, chief complaint, duration of illness, preoperative diagnosis, involved nerve, imaging studies, size of mass, complication, duration of follow-up and report with review of the literature.

관절경을 이용한 슬개골 골절의 치료

서정탁,윤평주,류총일 ( Jeung Tak Suh,Pyung Joo Yun,Chong Il Yoo ) 대한슬관절학회 1997 Knee Surgery and Related Research Vol.9 No.1

Fractures of the patella are intra-articular fractures of a sesamoid bone. The goal of treatment is to restore the function of the extensor mechanism and congtvity of the articular surface of the knee. So postoperative traumatic arthritis is minimized by an accurate reduction of the articular surfaces. We analyzed nine cases of the patella fractures which were treated by the use of arthroscopy to allow visualization of and working inside of joints, and the use of the image-intensifier fluoroscope to allow real-time vi.sualization of the skeleton. The results were as follows The fixation of patelia fractures using an arthroscopy could be applied to transverse or vertical fractures without comminution and severe osteoporosis. 2. In the treatment of two types of patella fractures(simple transverse e rnarginal vertical fractures without comminution), clinically satisfactory results were obtained through the accurate reduction of articular surface using an arthroscopy and image intensifier.

급성 림프구성 백혈병 소아에서 병발한 양측 슬관절 무혈성 괴사 - 1례 예비보고 -

서정탁,남태욱 ( Jeung Tak Suh,Tae Wook Nam ) 대한슬관절학회 1997 Knee Surgery and Related Research Vol.9 No.2

Osteonecrosis (Avascular necrosis) of the bone is a known complication of systemic corticosteroid therapy and may he dose-related. It also has been associated less commonly with nonsteroida1 chemotherapy. Nonetheless, avascular necrosis of bone has heen reported infrequently in children who have received antileukemia regimens including prednisone. We report our experience with one adolescent girl with acute lymphocytic leukernia (ALL) who developed hoth femoral condylar osteonecrosis presenting bone pain after aggressive chemotherapy that including high cumulative dosage of corticosteroid as well as other antileukemia agents. We performed arthroscopic surgery with debridement, multiple drilling and screw fixation to the lesion sites. Eight months after operation, she was free of pain with full range of both knee movements. We got good resuit according to Hughston criteria.

슬관절의 관절경적 변연절제술

서정탁,박병국,송진헌,Suh, Jeung Tak,Park, Byung Guk,Song, Jin Heon 대한관절경학회 1998 대한관절경학회지 Vol.2 No.2

We reviewed the cases of 35 knees of 34 patients who had arthroscopic debridement for degenerative osteoarthritis of the knee. The patients were followed up for an average of 29 months (range: 13 months to 45 months). The mean age of the patients at operation was 54 years (range: 44 years to 75 years). At the time of follow up, the patients were evaluated using the nine-point scale by Baumgaertner et al. We divided the knee into 4 stages according to the classification system by Jackson et al. Satisfactory results were achieved in 80%(stage I), 75%(stage II), 55.6%(stage III) and 25%(stage IV) of the patients. Arthroscopic debridement is of significant value in the earlier stages of degenerative osteoarthritis (stage I and II) for the symptom relief as a simple procedure with rare complication as well as in the later stages(stage III and IV) as a time buying procedure before the total knee arthroplasty.

연부조직육종 환자에서 $O^6$-MGMT 와 촉진자 과메틸화의 예후적 중요성

서정탁,김정일,오종석,최경운,Suh, Jeung-Tak,Kim, Jeung-Il,Oh, Jong-Seok,Choi, Kyung-Un 대한근골격종양학회 2009 대한골관절종양학회지 Vol.15 No.1

Purpose: The DNA repair protein, $O^6$-methylguanine-DNA methyltransferase (MGMT), removes alkyl adducts from the $O^6$ position of guanine. Epigenetic inactivation of MGMT has been found in human neoplasia and considered one of the implicated factors in chemoresistance. Materials and Methods: Sixty-two patiensts with soft tissue sarcomas (STS) were analyzed for the status of MGMT protein expression by immunohistochemistry and the promoter hypermethylation of the MGMT gene using methylation-specific PCR. Result: The loss of MGMT expression was found in 20 cases (32.3%) of total 62 STS. MGMT promoter hypermethylation rate was 25.0% (11/44 cases). The loss of MGMT expression showed significant association with high AJCC stage, high FNCLCC grade, and aggressive behavior. However,when the group who received chemotherapy was analyzed (n=27), loss of MGMT expression was correlated with worse survival in multivariate analysis (p=0.024). MGMT promoter hypermethylation is associated with high FNCLCC grade. MGMT promoter hypermethylation status had a strong correlation with loss of MGMT expression (p=0.000). Conclusion: Our results suggest that MGMT promoter hypermethylation and loss of MGMT expression had a tendency to be associated with poor prognosis and that loss of MGMT protein expression is frequently occurs via MGMT promoter hypermethylation.

침윤성 근육내 지방종

서정탁,김정일,천상진,이춘기,구자경,김영균,Suh, Jeung-Tak,Kim, Jeung-Il,Cheon, Sang-Jin,Lee, Choon-Key,Ku, Ja-Gyung,Kim, Young-Goun 대한근골격종양학회 2005 대한골관절종양학회지 Vol.11 No.1

Purpose: To suggest an accurate diagnosis and treatment of infiltrating intramuscular lipoma by analysis of the clinical, biological, radiological and pathological features. Materials & Methods: 20 patients who treated at our hospital for infiltrating intramuscular lipoma from 1998. to 2001 were selected for this study. Mean age was 45.8 years old. Four were male and eight female. All cases were checked preoperative radiographs, MRI and diagnosed by biopsy. The methods of surgical treatment included excision of tumor and peripheral tissue. We assessed the recurrence by follow up. Results: Tumors located in upper limbs 5 cases, lower limbs 3 cases, abdomen 3 cases, gluteal region 1 case. In preoperative radiographs, infiltrating intramuscular type were 7 cases. In 11 cases, tumors were completely excied with peripheral tissue. 1 cases was incompletely excised because it was very huge mass and infiltrated lung. Encapsulated tumors were 3cases and uncapsulated tumors 9 cases. There were no recurrence excepts 1 case that was infiltrated lung. Conclusion: Infiltrating intramuscular lipoma was wrongly diagnosed as well differentiated liposarcoma. To increase the rate of correct diagnosis, preoperative radiographs, MRI and pathologic diagnosis were performed. Careful wide excision is necessary to prevent the recurrence.

전 절제술로 치료한 근위 비골의 거대 세포종

서정탁,최성종,김영균,김정일,김휘택,유총일,Suh, Jeung-Tak,Choi, Sung-Jong,Kim, Young-Goun,Kim, Jeung-Il,Kim, Hui-Taek,Yoo, Chong-Il 대한근골격종양학회 2003 대한골관절종양학회지 Vol.9 No.2

Purpose: To report our experiences of clinical features, treatment method and results of giant cell tumor of 5 patients in proximal fibula. Materials and Methods: Five patients managed with an en bloc resection preserving common peroneal nerve and lateral collateral ligament reconstruction with biceps femoris tendon followed up between January 1997 and July 2001. Preoperative plain radiograph and MRI and bone scan were checked. The recurrence of the tumor was judged by plain radiograph and clinical signs. Lateral instability of knee joint was checked during the outpatient follow-up. Results: The mean age of the patients at the time of operation was twenty- three (21-29). There were one male and four female patients. Dull pain was main symptom and palpable mass was seen in two patients. Peroneal nerve palsy and local recurrence were not observed except one case of temporary peroneal nerve palsy. During the outpatient follow up, one among 5 patients showed slight lateral instability and the other 4 patients showed no instabililty. Conclusion: Giant cell tumor in proximal fibula managed with an en bloc resection preserving common peroneal nerve and lateral collateral ligament reconstruction with biceps femoris tendon showed favorable results.

장경대 마찰 증후군의 치료에서 스트레칭 운동의 유용성

서정탁,홍성확,이춘기,Suh, Jeung-Tak,Hong, Seong-Hwak,Lee, Choon-Key 대한정형외과스포츠의학회 2006 대한정형외과스포츠의학회지 Vol.5 No.2

Purpose: To analyze the effectiveness of the treatment with the stretching exercise in the patients with iliotibial band (ITB) friction syndrome. Materials and Methods: 22 patients with ITB friction syndrome were treated with the stretching exercise of the ITB. The criterion for determining the good result is more than 75% recovery according to the classification of success of treatment. We analyzed the differences of the duration of treatment at which the good result it achieved according to sincerity of the stretching exercise. The sincerity of the exercise is defined at performing more than 50% of the exercise that we prescribed. Results: Of 22 patients, there were good results in 19 cases (87%) within 8 weeks after the treatment. Except for 3 cases who did not achieved good results, the average duration of the treatment is 28.1 days. In patients with good results there was no statistical significance for the relationship between the duration of symptoms before diagnosis (average 25.6 days) and the duration of the treatment (average 28.1 days). In comparison with the group who performed the exercise sincerely and the group who did not, the average duration of the treatment if 23 days and 32.7 days respectively and there was significant difference between the two groups. Conclusion: The stretching exercise in ITB friction syndrome was helpful in reducing the duration of treatment.

전방슬관절 동통환자의 골주사 및 전산화단층촬영 비교

서정탁,박원욱,유총일 ( Jeung Tak Suh,Weon Wook Park,Chong Il Yoo ) 대한슬관절학회 1993 Knee Surgery and Related Research Vol.5 No.2

20 patients with clinical diagnosis of patellofemoral pain were examined with cornputed tiosoography and lateral image of bone scan. The mean age of the patients was 28 year and mean duration of pain was 15 months. The results were as follows: 1, Mean patellar bone scan activity was 70.4 % in pain side contrast to 56.1% in control side. 2. The sensitivit of computed tomography was 0.95 and bone scan, 0.70. 3. Correlation coeffitient of computed tomography and bone scan was 0.60 (sulcus angle), 0.70 (congruence angle), 0.65 (patellar tilt angle). According to abave results, we consider that perfarmances of both computed to- mography and bone scan are helpful diagnostic procedures to find out causes of pa- tients with anterior knee pain.

동종 이식건을 이용한 전방 십자 인대 재건술

서정탁,천상진,이정섭,Suh Jeung-Tak,Cheon Sang-Jin,Lee Jung-Sub 대한관절경학회 2000 대한관절경학회지 Vol.4 No.1

목적 : 동종 이식건을 이용하여 전방 십자 인대 재건술을 시행한 후 추시하여 임상 결과 및 방사선학적 변화를 관찰하고자 하였다. 대상 및 방법 : 1995년 1월부터 1998년 12월까지 동종 이식건을 이용하여 관절경적 전방 십자 인대 재건술을 시행한 환자 중에서 1년이상 추시가 가능한 22례를 대상으로 전방 전위 검사, Lachman 검사, Pivot shift 검사, 방사선 촬영, 건측과 환측의 슬관절 운동 범위의 차이 및 CA-4000 knee motion analyzer를 이용하여 양측 슬관절의 전위 정도를 측정하였고, Lysholm knee score 를 이용하여 평가하였다. 결과 : Lysholm knee score는 술전 평균 54점에서 술후 평균 81점으로 평균 27점 증가하였고, CA-4000 knee motion analyzer를 이용하여 전방 전위력을 가하여 정상측과 비교한 양측 차이가 3 mm 미만인 경우가 16례$(73\%)$, 3 - 5 mm인 경우가 4례$(18\%)$, 6 mm 이상인 경우가 2례 $(9\%)$였다. 12례에서 평균 1.5 mm의 경골 터널 크기의 증가를 보였지만, 골융해나 낭종 형성의 소견은 없었고 터널 크기의 증가와 임상 결과와는 무관하였다. 결론 : 제한적 증례이지만 동종 이식건을 이용한 전방 십자 인대 재건술의 임상적 결과는 문헌에서 보고된 자가 이식건을 이용한 경우에서의 임상적 결과와 비슷한 양상을 보였고, 이 같은 결과로 미루어보아 전방 십자 인대 재건술시 동종 이식건은 훌륭한 자가 이식건의 대체물이 될 수 있다고 사료된다.