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최종혁,정재봉,최우진,김형식,Choi, Chong-Hyuk,Chung, Jae-Bong,Choi, Woo-Jin,Kim, Hyoung-Sik 대한관절경학회 2005 대한관절경학회지 Vol.9 No.2
목적: 통증을 동반한 비골하 부골과 경골하 부골의 관절경을 이용한 절제술 후 그 결과를 알아보았다. 대상 및 방법: 비골하 부골과 경골 부골에 대하여 관절경적 절제술을 시행한 환자 중 16명의 환자를 대상으로 하였으며, 경골 부골이 4예, 비골하 부골이 12예 였다. 평균 추시 기간은 9개월(범위:$6\{sim}42$개월)이었다. 모든 환자는 임상적으로 미학적 검사와 방사선학적으로 단순 방사선 촬영을 시행하였고, 8예에서 골 주사 검사, 3예에서 단층촬영 및 12예에서 MRI 검사를 시행하였다. 절제술의 결과는 Ogilvie-Harris의 방법으로 평가하였다. 결과: 술 후 통증, 관절 강직 등의 주관적 평가와 파행, 활동성의 기능적 평가에서 모두 술 전보다 통계적으로 유의하게 호전되었다(p<0.05) 술 후, 8예에서 경미한 통증과 간헐적인 부종이 남아있었으며, 이중 3예에서 활액막염이, 3예에서 MRI상 전염이 동반된 경우였고, 2예에서 불충분한 절제를 했던 경우였다. 결론: 통증을 동반한 경골하 부골 및 비골하 부골의 관절경을 이용한 절제술은 최소 침습적 이고 동반 병변도 함께 치료할 수 있는 효과적인 수술방법이다. 또한 완전 절제를 위해 술 전에 방사선학적 평가가 필수적이며, 동반 병변을 알아내는데는 MRI등의 특수검사가 유용하다. Purpose: The purpose of this study is to evaluate the result of arthroscopic excision of painful Os subtibiale and Os subfibulare. Materials and Methods: Sixteen patients who had accessory bone in the ankle joint were treated by arthroscopy. Os subtibiale was four cases and os subfibulare twelve. The average follow-up period was 9 months$(range:6{\sim}42months)$. All patients were evaluated clinically with physical examination and radiologically with simple X-ray and for further evaluation, eight with bone scan, three with computed tomography and twelve with magnetic resonance image. We estimated the result of resection with Ogilvie-Harris's criteria. Results: All parameters of subjective and functional evaluation were improved with statistical significance(p<0.05). At final evaluation, eight patients still complained of mild pain and among them, three patients for synovitis, three for tendinitis on MRI and two for incomplete resection. Conclusion: The arthroscopic resection is a very effective method for painful os subtibiale and subfibulare using small incisions and for treatment of associated lesion. The preoperative radiological evaluation is essential and magnetic resornance image is useful for detecting of associated lesion.
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양규현 ( Kyu Hyun Yang ),정재봉 ( Jae Bong Chung ),윤한국 ( Han Kook Yoon ),박시영 ( Si Young Park ),윤항섭 ( Hang Seob Yoon ) 대한골절학회 2007 대한골절학회지 Vol.20 No.1
목 적: 전위성 관절내 종골 골절의 관혈적 정복 및 내고정술에 있어 F형 금속판의 임상적 유용성에 대해 알아보았다. 대상 및 방법: F형 금속판을 이용한 내고정술 후 6개월 이상 추시 가능하였던 43예를 대상으로 하였다. 방사선적으로 B?hler 각을 측정하였고 Sanders 분류를 사용하였다. 그 외에 국소 감염, 외상성 관절염, 불유합, 금속판 및 나사의 파절 등을 조사하였다. 임상적 평가는 Maryland foot score를 사용하였고 임상결과에 미치는 인자에 대하여 알아보았다. 결 과: B?hler 각은 술 전 평균 0.5˚ (범위: -24.7∼35.5˚)에서 술 후 평균25.8˚ (범위: 14.2∼38.6˚)로 향상되었고 최종 추시에는 평균 23.5˚ (범위: 10.2∼37.5˚)로 수술 직후에 비해 평균 2.3˚ 감소하였다. 금속판의 파절이 2예, 나사의 파절이 2예 발생하였지만 B?hler 각의 변화에는 영향을 미치지 않았다. 외상성 관절염은 5예, 내반 부정유합은 1예, 심부 감염이 1예에서 발생하였다. 임상적 평가에서는 우수 10예, 양호 22예, 보통10예, 불량 1예의 결과를 나타내었다. 환자의 나이, 술 전 B?hler 각, 보상이 가능한 보험 가입 여부 등이 술 후 임상적 결과에 의미 있게 영향을 미치는 것으로 나타났다. 결 론: 전위성 관절내 종골 골절에서 F형 금속판을 이용하여 만족스러운 고정 및 지지를 얻을 수 있었다. Purpose: To evaluate the clinical efficacy of F-plate in displaced intra-articular fractures of calcaneus. Materials and Methods: Total 43 cases treated with F-plate and followed up at least six months postoperatively were reviewed. Radiographically, B hler angle was measured and all cases were subdivided by Sanders classification. Each case was reviewed for the presence of local infection, traumatic arthritis, nonunion, and any breakage of plate or screw. Maryland foot score was used for clinical assessment and factors influencing on clinical results were determined. Results: The mean B hler angle was improved from 0.5˚ (range: -24.7.35.5˚) preoperatively to 25.8˚ (range: 14.2.38.6˚) postoperatively and the angle at last follow-up was 23.5˚ (range: 10.2.37.5˚), showing about 2.3 degree decline compared to postoperative B hler angle. There were two cases of F-plate breakage and two cases of screw breakage but the metal breakage did not affect any change in B hler angle. Other complications were; five cases of traumatic arthritis, one case of varus malunion and one case of deep wound infection. According to Maryland foot score, there were 10 excellent, 22 good, 10 fair and 1 poor result. Furthermore, Age, pre-operative B hler angle and the patient`s expectation on financial compensation had significant influences upon the clinical result. Conclusion: F-plate fixation seems to yield firm fixation and satisfactory clinical results in the treatment of displaced intra-articular fractures of calcaneus.
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최기훈,안희철,안무업,정재봉,김성은,배지훈,서정열,조준휘,박찬우,옥택근,Choi Gi Hoon,Ahn Hee Cheol,Ahn Moo Eob,Chung Jae Bong,Kim Sung Eun,Bae Ji Hoon,Seo Jeong Yeol,Cho Jun Hwi,Park Chan Woo,Ok Taek Gun 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.1
In emergency department, the clinicians occasionally meet some patients with toxicity caused by ingestion of unknown wild edible greens or herbal agents. Due to there was few quantitative or qualitative studies about the mechanism or clinical features of these materials, it' s hard to approach to the patients and start the initial management in emergency department. Authors experienced the case of poisoning by Scopolia Japonica ingestion. We report this case with review of Scopolia Japonica.
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옥택근,조준휘,박찬우,김성은,최기훈,배지훈,서정열,정재봉,안희철,안무업,유기철,Ok, Taek-Gun,Cho, Jun-Hwi,Park, Chan-Woo,Kim, Sung-Eun,Choi, Ki-Hoon,Bae, Ji-Hoon,Seo, Jeong-Yeul,Chung, Jae-Bong,Ahn, Hee-Cheol,Ahn, Moo-Eob,You, Ki-Cheol 대한임상독성학회 2004 대한임상독성학회지 Vol.2 No.2
Acute poisoning is one of the diseases which need the most fastest emergency measures at the very beginning. However, at present, The Korea doesn't manage the toxication all over the country, and in particular, there is no guide to medical cure paying due regard to the traits of each area. This paper focused on the issue that the necessary data in preparing the facilities for the treatment of the poisoned patients and materials for medical treatment including antidote would have to be collected, after finding the special features of the symptoms by searching the present conditions of the poisoning in small towns next to farm villages in the North area of Youngseo, Kangwon province. This study was based on the questionnaires from 111 patients who were carried into the emergency room by the poisoning in two university hospitals of the North area of Youngseo, Kangwon, for one year, 2002. Upon investigation, the patients(111) visiting emergency room by the acute poisoning during the research period was found to be 0.37 percent of all patients(30,085) visiting emergency room. Among them, the most high percentage was given in their twenties and thirties at the rate of $39.6\%$, and the ratio($40.5\%$) of the poisoned patients after their fifties was much higher than a research($10\%$) of other areas. Many poisoned patients came to their rescue in an emergency room generally in spring and in winter, from 7 a.m. to 3 p.m. Agricultural chemical of the toxic materials had a majority at a ratio of $57.7\%$, and paraquat of the agricultural chemicals was found to have a lot of toxicity by $31.7\%$. As the trace of the toxication, the oral poisoning was common by $89.2\%$, and $55.9\%$ in the case of operating gastric lavage and nasogastric irrigation, but only $14.4\%$ for prescribing antidote. The mortality of the acute poisoned patients was $17.2\%$, and the toxication by paraquat held a majority. As a result, the acute poisoning of the North area in Youngseo, Kangwon had both of the characteristics of the rural and the city, and the patients over their fifties by the population aging had more attack of the disease than other regions. Also, with the high ratio of the toxication by the agricultural chemicals, especially, the lethal agricultural chemical was used frequently. Therefore, these dangerous situations need to find the ways to cope with.
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최정태,안무업,안희철,최영미,정재봉,서정열,유기철,이삼우,박석현,조준휘,김성환,김아진,송근정 대한응급의학회 2001 대한응급의학회지 Vol.12 No.4
Purpose : This study was conducted to develop field triage, transportation, distribution, and prehospital care at a fire disaster by analyzing the victims of the fore that broke out at a bar in Incheon. Method : We analyzed the cases of the victims of a fire in Incheon in Oct. 1999. We determined the primary care hospital, the arrival time, the burn size, the outcome, and the injury type from the medical records, the concerned organ records, and interviews with concerned persons. Result : The total number of victims was 137: 56 prehospital deaths, 1 hospital death, and 80 survivals. The Pearson correlation coefficient between the burn size and the severity was -0.175. There were 121(89.6%) cases of inhalation injury, 59 (43.7%) cases of flame burns, 66 (48.9%) cases of hypoxic brain damage, and 16 (11.9%) cases involving other types of injury. Conclusion : The causes of death of the fire victims were inhalation injury and hypoxic brain damage due to CO poisoning and other toxic inhalants. We propose the use of a simple triage and rapid treatment(START) system and a reassessment the delayed category in fire disasters.
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안희철,서정열,정재봉,최영미,최정태,유기철,안무업,최광민,김홍기,김성환,조준휘 대한응급의학회 2002 대한응급의학회지 Vol.13 No.1
Purpose: This study was conducted to examine various clinical factors for their ablity to predict mortality in geriatric patients following trauma. Methods: In this retrospective study, medical records from Chun Cheon Sacred Heart hospital were reviewed for patients 65 years and older who sustained trauma. The following variables were extracted and examined, independently and in combination, for their ablity to predict death: age, gender, mechanism of injury, blood pressure, and respiration, pulse rate, as well as Glasgow Coma Score, Revised Trauma Score, and Injury Severity Score. These patients had entered the hospital following trauma during a 2-year period (1999-2000). Results: The Injury Severity Score (more than 28), the Glasgow Coma Score (less than 9), and the Revised Trauma Score (less than 9), were variables that correlated with mortality. Mortality rates were higher for men than for women. Admission variables associated with the highest risks of death included hypotension (mean blood pressure <78 mmHg); pedestrian and motorcycle traffic accident; skull fracture, subdural hemorrhage, and diffuse axonal injury; and hemothorax and lung contusion. Conclusion: Admission variables in geriatric trauma patients can be used to predict the outcome and may also be useful in making decisions about triage, and treatment of the patient.
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