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원위 요골에 발생한 거대 세포종의 일괄 절제 후 초고분자량 폴리에틸렌 삽입물을 이용한 재건술 - 증례보고 -
전대근,송원석,오정문,Jeon, Dae-Geun,Song, Won-Seok,Oh, Jung-Moon 대한근골격종양학회 2004 대한골관절종양학회지 Vol.10 No.1
A giant cell tumor (GCT) of the distal radius is not common. Curettage with bone cementation is considered as a treatment of choice but, in the case of recurrence, marked cortical disruption, or articular invasion, en bloc excision and reconstruction with proximal fibular bone graft is usual procedure. In reconstruction of en bloc resected distal radius which had recurred GCT after conservative operation, we used the ultrahigh molecular weight polyethylene (UHMWPE) liner with intramedullary rod and bone cement, because the contamination was extent in previous operation and recurrence after fibular bone graft was fearful. This article introduce our new surgical procedure.
전대근,송원석,공창배,조완형,조상현,이정동,이수용 대한정형외과학회 2013 Clinics in Orthopedic Surgery Vol.5 No.3
Background:The relationship between surgical margin and local recurrence (LR) in osteosarcoma patients with poor responses to chemotherapy is unclear. Moreover, the incidences of LR according to three different resection planes (bone, soft tissue, and perineurovascular) are not commonly known. Methods: We evaluated the incidence of LR in three areas. To assess whether there is a role of surgical margin on LR in patients resistant to preoperative chemotherapy, we designed a case (35 patients with LR) and control (70 patients without LR) study. Controls were matched for age, location, initial tumor volume, and tumor volume change during preoperative chemotherapy. Results: LR occurred at the soft tissues in 18 cases (51.4%), at the perineurovascular tissues in 11 cases (31.4%), and at the bones in six cases (17.2%). The proportion of inadequate perineurovascular margin was higher in the case group than in the control group (p = 0.01). Within case-control group (105 patients), a correlation between each margin status and LR at corresponding area was found in the bone (p < 0.001) and perineurovascular area (p = 0.001). Conclusions: LR is most common in soft tissues. In patients showing similar unfavorable responses to chemotherapy, the losses of perineurovascular fat plane on preoperative magnetic resonance imaging may be a valuable finding in predicting LR.
전대근,허태원,강봉진 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.67 No.3
The trigemino-cardiac reflex has been reported to occur during various craniofacial surgeries or procedures including manipulation of the trigeminal ganglion, tumor resection in the cerebellopontine angle, various facial reconstructions and trans-sphenoidal adenomectomy. Regarding risk factors during trans-sphenoidal adenomectomy, invasiveness closely related to the size of tumor and the degree of manipulation of cavernous sinus wall have been reported. We report the case of a 40-year-old female patient who had a relatively small-sized (< 10 mm) pituitary adenoma. Repetitive asystoles occurred during microscopic trans-sphenoidal operation of the wall of the cavernous sinus, which strongly suggests the importance of careful manipulation of the cavernous sinus wall. In addition to reporting this rare complication of trans-sphenoidal adenomectomy, we reviewed its clinical management by performing a literature search.
전대근,이종석,김석준,이수용,Jeon, Dae-Geun,Lee, Jong-Seok,Kim, Sug-Jun,Lee, Soo-Yong 대한근골격종양학회 1997 대한골관절종양학회지 Vol.3 No.2
Multicentric chondrosarcoma other than the mesenchymal subtype is rare separate entity. We experienced a case with nonmonomelic synchronous multicentric chondrosarcoma without any preexisting lesions of Oilier's disease or Maffucci's syndrome. To our knowledge, there was no report of synchronous nonmonomelic multicentric chondrosarcoma. A thirty-three year old man had right distal thigh pain of one and half year. Bone scan showed hot lesions on medial condyle of right femur and shaft of left femur. Plain X-ray showed osteolytic lesion on right femur and slight cortical thickening and calcific lesion was observed on left femoral shaft. Curettage and bone cement filling was done on both lesions. The pathology reports were grade I chondrosarcoma on both side of femur. At one month from operation, pathologic fracture of left femur occurred on bone cement-host bone junction. Conservative treatment and radiotherapy of 60Gy was done. At 8 months from operation, nonunion was evident. Segmental resection of left femur with contralateral fibula graft and second look operation on right condyle lesion were done. At 6 months from revision, fracture occurred at host-graft bone junction. We removed previous hardware and applied long DCP and massive autogenous bone graft. Afterwards, the patient looks good and union was progressing. But at 4 years from last operation, hypertrophic nonunion occurred. Another revision was done with condylar plate and bone graft and now he is well without any sign of local recurrence or metastasis.
전대근,김석곤,송재격,강봉진,권민아,Soo Mi Jeon 대한마취통증의학회 2013 Korean Journal of Anesthesiology Vol.64 No.6
Background: The ultrasound guidance in regional nerve blocks has recently been introduced and gaining popularity. Ultrasound-guided supraclavicular block has many advantages including the higher success rate, faster onset time, and fewer complications. The aim of this study was to examine the clinical data according to the varied volume of local anesthetics in the ultrasound-guided supraclavicular block. Methods: One hundred twenty patients were randomized into four groups, according to the local anesthetic volume used: Group 35 (n = 30), Group 30 (n = 30), Group 25 (n = 30), and Group 20 (n = 30). Supraclavicular blocks were performed with 1% mepivacaine 35 ml, 30 ml, 25 ml, and 20 ml, respectively. The success rate, onset time, and complications were checked and evaluated. Results: The success rate (66.7%) was lower in Group 20 than that of Group 35 (96.7%) (P < 0.05). The average onset times of Group 35, Group 30, Group 25, and Group 20 were 14.3 ± 6.9 min, 13.6 ± 4.5 min, 16.7 ± 4.6 min, and 16.5 ± 3.7 min, respectively. There were no significant differences. Horner's syndrome was higher in Group 35 (P < 0.05). Conclusions: In conclusion, we achieved 90% success rate with 30 ml of 1% mepivacaine. Therefore, we suggest 30 ml of local anesthetic volume for ultrasound-guided supraclavicular block.
Hemiarthroplasty for Osteosarcoma of Proximal Tibia
전대근,조완형,김진욱,고한상,Jeon, Dae-Geun,Cho, Wan-Hyeong,Kim, Jin-Wook-,Koh, Han-Sang The Korean Musculoskeletal Tumor Society 2006 대한골관절종양학회지 Vol.12 No.1
목적: 근위 경골 육종의 절제 후 재건은, 특히 골성장이 완료되지 않은 환자의 경우 많은 문제점이 있다. 본 연구에서는 근위 경골 육종의 절제 후 재건에 따르는 문제점을 보완하기 위한 새로운 술식을 시도해 보고자 하였다. 대상 및 방법: 근위 경골에 발생한 골육종의 절제 후 반관절성형술을 시행한 4례를 대상으로 하였다. 평균 연령은 13세였으며 술후 평균 추시 기간은 64개월이었다. 전례에서 초고분자량 폴리에틸렌 삽입물(ultra-high molecular weight polyethylene liner)을 이용하여 관절면을 재건한 후 엔더정(Ender-nail)과 골시멘트를 이용하여 남아있는 경골에 고정하였다. 결과: 최종 추시상 MSTS 기준에 의한 기능적 점수는 23.5점(78.3%)이었다. 전례에서 술후 슬관절 동통, 불안정성은 관찰되지 않았다. 결론: 골성장이 완료되지 않은 소아 환자의 근위 경골 육종 절제 후 재건 방법으로서 반관절 성형술은 효과적인 술기로 판단된다.
전대근,은연주,오은미,김현경 한국항공우주학회 2014 한국항공우주학회 학술발표회 논문집 Vol.2014 No.11
도착관리시스템은 항공기의 안전하고 효율적인 도착을 위한 관제지원도구로서 도착 항공기의 순서화 및 접근관제구역으로의 미터링 기능을 가진다. 본 연구에서는 제주공항으로 도착하는 항공기를 대상으로한 도착관리 시스템의 운용개념 및 요구사항을 정의하였으며, 이를 토대로 도착관리 주기능 처리 소프트웨어 설계를 수행하였다. 설계를 통해, 외부 자료 디코딩 및 인코딩, 비행계획 및 항적 연관, 4 차원 정밀 궤적 생성, 조언 정보 생성 등 총 4 개 소프트웨어 구성요소를 식별하였으며, 구성요소 별처리 절차 및 인터페이스를 정의하였다. 본 연구 결과는 향후 소프트웨어 구현 과정에 활용될 예정이다. AMAN(Arrival Manager) is a decision supporting tool for safe and efficient arrivals through sequencing and metering arrival streams of traffic. In this study, operational concepts and requirements of AMAN for arrivals to Jeju airport are defined. Based on them, the main processing software for AMAN is designed. Through the design, four software components are identified, which include decoder and encoder of inputs and outputs, correlator of flight plans with system tracks, 4-dimensional trajectory predictor, and advisory generator. In addition, processes and interfaces for each component are also defined. The results of this study will be used for the implementation of software.