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개방형 경골 근위부 절골술 후 지연 발생한 슬와동맥 가성동맥류
임해성(Hae-Seong Lim),김상민(Sang-Min Kim),김종관(Chong-Kwan Kim) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.5
근위 경골 절골술은 비교적 젊은 나이에 내반슬 변형을 동반한 내측 골관절염 환자의 정립된 치료 방법 중 하나이다. 슬와동맥은 슬관절 주위의 수술 중 손상을 받기 쉽다. 근위 경골 절골술 후 슬와동맥의 가성동맥류가 발생하는 것은 드문 일이다. 대퇴 혈관조영술로 절골 부위 근처의 슬와동맥으로부터 발생한 가성동맥류를 발견하였다. 이러한 합병증을 예방하기 위하여 절골부위 절골 시 주위를 견인기로 조심하게 당기고 슬와동맥을 보호하기 위하여 무릎을 굽히는 것을 추천한다. 저자들은 개방형 경골 근위부 절골술 후 발생한 슬와동맥의 가성동맥류 사례에 대한 임상적 및 방사선적 치료를 보고하는 바이다. High tibial osteotomy is an established method in treatment of medial knee osteoarthritis with varus deformity in younger patients. The popliteal artery is vulnerable to injury during surgeries performed around the knee joint. Pseudoaneurysm of the popliteal artery following medial opening wedge high tibial osteotomy is rare. A femoral angiogram revealed a pseudoaneurysm arising from the popliteal artery near the osteotomy site. Careful placement of retractors around the osteotomy site during sawing and flexing the knee to displace the popliteal artery away are recommended to prevent this complication. We report on the case of a pseudoaneurysm of the popliteal artery complicating medial opening wedge high tibial osteotomy that was treated clinically and radio-graphically with literature reviews.
급성 백혈병 환자에서 fluoroquinolone 내성 대장균에 의한 양측 슬관절의 화농성 관절염 1 예
김용태,임창재,임해성,김권수,우인숙,박영이,정문현,강희정 대한감염학회 1998 감염 Vol.30 No.3
그람 음성 간균에 의한 양측 관절염의 발생은 매우 드물고 특히 과립구감소증이 동반된 경우는 보고된 예가 없다. 본 증례에서는 28세 여자 환자가 급성 백혈병을 진단받고 관해유도 치료를 시행하던 중 과립구감소증이 발생하여 예방적으로 ciprofloxacin을 사용하였다. 그러나 이 항균제에 내성을 획득한 E. coli에 의해 양측 슬관절염이 발생하여 항균제 치료와 개방성 배액술을 시행한 후 별다른 합병증없이 치료되었다. 저자들은 급성 골수성 백혈병 환자에서 관해유도 치료중 과립구감소증이 발생하여 예방적으로 사용한 quinolone계 항균제에 대해서 내성을 획득한 E. coli에 의한 양측 슬관절의 화농성 관절염 한 예를 경험하였기에 이에 문헌 고찰과 함께 보고하는 바이다. Septic arthritis is usually caused by Staphylococcus aureus. Gram-negative bacilli are implicated usually in patients with underlying illnesses, including diabetes mellitus, malignancy, coexisting arthritis, and immuno-compromised states. Their clinical course is more complicated than that by S. aureus, and so early surgical debriment is required in addition of appropriate antibiotic therapy. Gram-negative bacteremia is common in granulocytopenic patients, however, septic arthritis in these patients is rather rare. We present a case of Escherichia coli arthritis in a28-year-old woman with acute leukemia. On the 25th day following reinduction chemotherapy with vincristine, prednisolone, daunorubicin, and L-asparaginase, she suffered fever, chills, and both knee joint pain. Culture of blood and joint fluid revealed E. coli resistant to ciprofloxacin used for prevention of gram-negative infection. The patient improved with administration of imipenem and amikacin, and open drainage of both knee joints.
이진,장현주,강승식,이봉화,곽상택,임해성,정유선,정선화,계세협,주사언 대한소화기내시경학회 1999 Clinical Endoscopy Vol.19 No.3
The enterobiliary fistulas are mostly spontaneous and are caused by biliary disease associated with calculi. Review of many series shows that the most common variety of enterobiliary fistulas is a cholecystoduodenal fistula followed by cholecystocolic, cholecystogastric and choledochoduodenal fistula in that order. But very few cases of choledochocolonic fistulae have been reported. We report a case of choledocholithiasis combined with the absence of gallbladder leading to a choledochocolonic fistula, which was confirmed by endoscopic retrograde cholangiography and abdominal exploration in a 63-year-old male patient with complaint of right upper abdominal pain.
김현규,김용태,박성우,유형준,유재명,최문기,임성희,김두만,박철희,임해성 대한내분비학회 1998 Endocrinology and metabolism Vol.13 No.2
Cushings syndrome in pregnancy is rare. This is explained by the syndromes association with amencerhea, infertility and abortions. Matemal and fetal risks increase markedly when pregnancy does occur in woman with hypercortisolism. Since pregnant women without Cushings syndrome develop some features of Cushings syndrome, such as hypertension, hyperglycemia and striae, a high index of clinical suspician must be maintained to prevent delay in diagnosis. The physiologic changes in adrenocorticostemid metabolism during pregnancy further complieate the diagnosis. We describe a case of Cushings syndmme in pregnancy secondary to an adrenal cortical adenoma which was diagnosed immediately after a preterm delivery in 24-year-old woman with preeclampsia (J Kor Soc Endocrinol 13:264-270, 1998).