다발성 골수종으로 이행한 단일형질세포종 1예

정재용,모성환,기장도,문철호,김창욱,전용준,박유환,정춘해,오윤경 조선의대 1995 The Medical Journal of Chosun University Vol.20 No.2

K 강선 및 긴장대 강선을 이용한 원위 쇄골 제 2형 골절의 치료

정환용,이우석,전택수,김대환,김광균,임재우 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 쇄골 윈위부 제 Ⅱ형 골절의 치료에 있어 견봉 쇄골 관절을 통과하지 않고 직접 골편을 고정시키는 K 강선 및 긴장대 강선을 이용한 고정술로 치료한 환자에서 임상 결과를 후향적으로 분석하여 보고하고자 한다. 대상 및 방법: 2000년 5월부터 2001년 5월까지 쇄골 원위부 제 Ⅱ형 골절로 관혈적 정복술 및 K 강선 및 긴장대 강선을 이용한 고정술을 실시한 12례 중 최소 1년 이상 추시가 가능한 11례를 대상으로 하였다. 임상적 평가를 위해 최종 추시에서 변형된 견관절 기능 평가법을 사용하여 결과를 분석하였고 골유합 상태, 합병증, 견관절 운동범위를 측정하였다. 결 과: 전례에서 골유합을 얻었으며, 수술 후 골 유합까지의 기간은 평균 10주 (8~12주)였다. 최종 추시 상 견관절의 운동범위는 모두 정상 소견이었고, 변형된 견관절 기능 평가상 우수 9례, 양호 2례였다. 결 론: 쇄골 원위부 제 Ⅱ형 골절에서 K 강선 및 긴장대 강선을 이용한 고정술은 좋은 치료 방법 중 하나로 사료된다. Purpose: This is retrospective study to analyze the clinical results of the usefulness of K-wires and tension band wiring that fix the fracture fragment directly without passing the acromioclavicular joint in distal clacivle type Ⅱ fractures. Materials and Methods: From May 2000 to May 2001, eleven patients with distal clavicle type Ⅱ fracture were treated by open reduction and internal fixation with K-wires and tension band wiring. The clinical results were analyzed according to modified shoulder rating scale for distal clavicle freacture. Radiological union, complication, and range of motion of the shoulder were assessed. Results: All fractures were united at 10 weeks (8~12 weeks) in average. Finally, full range of motion of the shoulder joint was achieved in all patients. No complication was found and the modified shoulder rating scale for distal clavicle fracture were as follows: excellent 9 and good 2. Conclusion: K-wires and tension band wiring can be a good treatment method for distal clavicle type Ⅱ fractures.

굽은 경골 교합성 골수강내 금속정 : 1예 보고 A Case Report

정환용,이우석,김대환 대한골절학회 2003 대한골절학회지 Vol.16 No.1

경골 골절에서 골수강내 금속정 치료 후 이차적인 수상으로 발생한 파손된 골수강내 금속정에 관한 보고는 간간히 있었으나, 굽은 골수강내 금속정에 대한 보고는 극히 드물었다. 저자들은 이전에 경골 골절로 골수강내 금속정으로 수술한 후 교통사고로 발생한 굽은 골수강내 금속정 환자 1예를 치험하였기에 보고하는 바이다. Broken tibial intramedullary nails caused by secondary trauma have been infrequently reported, but bent intramedullary tibial nail was extremely rare. We describe a rare case of a bent intramedullary tibial nail due to a traffic accident who had previously operated with intramedullary tibial nail

전위주의의 이론에서 미적 현대의 이론으로 : 페터 뷔르거의 미학과 문학이론에 관한 연구 Peter Burgers Kunst- und Literaturtheorie

정용환 한국독어독문학회 2002 獨逸文學 Vol.84 No.1

In der vorliegenden Arbeit handelt es sich um eine kritische Rekonstruktion der Kunst- und Literaturtheorie Peter Bu¨rgers. Der Schwerpunkt der Arbeit liegt in seiner Beziehung zur kritischen Theorie und seiner (Re-)Konstruktion der a¨sthetischen Moderne. Die a¨sthetischen Theorien der Frankfurter Schule kennzeichnen sich nicht nur durch die Kritik des a¨sthetischen Scheins, sondem auch durch eine spezifische Vorstellung dessen Rettung : der a¨sthetische Schein werde durch dessen 'glu¨ckliches' Ende gerette. Diese Vorstellung ist als Anwendung des 'Marxschen Topos der Aufhebung durch die Verwirklichung' auf die Kunst aufzufassen. Im großen und ganzen stehen auch die a¨sthetischen U¨berlegungen Bu¨rgers in dieser Tradition. Der Unterschied liegt darin, dass fu¨r Bu¨rger die Aufhebung der Kunst durch die Verwirklichung am Anfang des 20. Jahrhunderts von den Dadaisten und den Surrealisten schon versucht worden ist, wa¨hrend z. B. Adorno sie auf die utopische Zukunft projeziert. Bu¨rger sieht in diesem - gescheiterten - Versuch den entscheidendsten Schritt in der Kunstgeschichte der bu¨rgerlichen Gesellschaft: die Avantgardebewegung habe nicht die vorhergegangenen Stilen oder Tendenzen der Kunst, sondern die bu¨rgerliche Institution Kunst selbst in Frage gestellt und deren affirmativen Charakter untblo¨ßt; der freie und ungehemmte Gebrauch aller bisherigen ku¨nstlerischen 'Materialien' durch die Avantgardebewegung habe die Idee eines epochalen Stils oder einer lineraren Kunstentwicklung zunichtegemacht. Aus dieser Interpretation der Avantgardebewegung zieht Bu¨rger drei theoreische Konsequenzen: die institutionstheoretische Rekonstruktion der Literaturgeschichte, die Kritik der idealistischen A¨sthetik als 'Zentrum der Institution Kunst' und die U¨berwindung der einstra¨ngigen Konstruktion der a¨sthetischen Moderne Adornos. Seit den 70er Jahre hat Bu¨rger immer wieder versucht, Adornos A¨sthetik zu 'historisieren' und zu u¨berbieten, vor allem mit seiner institutionstheoretischen Deutung der Avantgardebewegung. Jetzt, wo deren Bedeutung bei Bu¨rger deutlich verblaßt ist, kommt die Kontinuita¨t zwischen den beiden Theoretikern deutlicher ins Gesicht, obwohl der 'utopische Glanz des a¨stheitschen Scheins' (Wellmer) in der A¨sthetik Adornos von Bu¨rger zugunsten dessen Erkenntnisfunktion aufgegeben ist. In diesem Sinne sind Bu¨rgers kunst- und literaturtheoretische Arbeiten wohl als begrenzte Profanisierung und Erga¨nzung der A¨sthetik Adornos aufzufassen: auch im Beharren auf die wenigen "authentischen ku¨nstlerischen Realisationen unserer Gegenwart" angesichts der 'allgemeinen A¨sthetisierung der Lebenswelt'.

혈청 neuron specific enolase를 이용한 심정지후 신경학적 예후의 예측

강용선,정성필,박기일,김승환,김태승,이한식 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.2

Background: The purpose of this study was to determine that the assessment of serum neuron specific enolase(NSE) could provide a reliable early predictor of neurologic outcome after cardiac arrest. Methods: Prospective, observational study was performed from April 1996 to March 1998 at a university teaching hospital ED. Serum NSE concentrations were analysed twice at 24 and 48 hours after return of spontaneous circulation(ROSC). Neurologic outcome was categorized using cerebral performance category(CPC). Results: Twenty-nine patients(16 were men) were enrolled during the study period. The mean age was 50.8 years. Nine(31%) of them showed good outcome defined as CPC 1-3, and 20(69%) patients showed bad outcome defined as CPC 4-5. In the good outcome group, the serum NSE was revealed 33.8±9.3 ng/ml at 24 hours, 34.0±4.73 ng/ml at 48 hours. While in the bad outcome group, it was 99.5±11.7 ng/ml and 114.6±15.8 ng/ml. The NSE at 48hr after ROSC was more prescise than that of 24hr. When the cutoff value of 50 ng/ml at 48hr, the sensitivity was 82%, and specificity was 93%. Conclusion: This study suggest that the serum NSE may represent a valuable, noninvasive, and useful clinical tool for prediction of neurologic outcome after cardiac arrest.

심장수술이 심전도에 미치는 영향 : Ⅰ. 개방성동맥관 수술 52례 Report of 52 Cases

이영균,정경원,유세영,손광현,김종환,서경필 최신의학사 1970 最新醫學 Vol.13 No.3

Fifty-two cases of patent ductus arteriosus were operated on, consisting of 32 females and 20 males. The youngest was 10 month old girl and the oldest 38 years old woman. Severe pulmonary hypertension of 110mmHg was found in two cases, both of which succumbed, one during surgery due to cardiac arrest and the other died one week after operation. In the later case severe tracho-bronchial tree obstruction was found by autopsy. One and a half years old girl expired 3 days after operation. By autopsy bronchopneumonia was found. A fourteen years old girl died of bacterial endocarditis one month after discharge from the hospital. Two cases associated with pulmonary hypertension and an adult were operated on under general hypothermia. All the survival cases showed satisfactory results.

응급실을 통한 정신과 입원환자에 대한 임상적 고찰

소용섭,정영조,오석환 大韓神經精神醫學會 1988 신경정신의학 Vol.27 No.2

Hospital records of 127 neuropsychiatric patients admitted to Seoul Paik Hospital via the E.R. from January 1, 1984 to December 31, 1986 were reviewed, and the following results were obtained. 1) Patients admitted via the E.R. comprised 22.8% of total neuropsychiatric admissions. 2) The readmission rate of patients via E.R. was 36.2%, that of the patients admitted via the O.P.D. was 22.7% 3) The average duration of hospitalization of neuropsychiatric pateints admitted via the E.R. was 36 days that of the patients admitted via the O.P.D. was 48.3 days. 4) 32.3% of the E.R. admission patients were in their twenties ; 55.9% of them were in their twenties or thirties. Male for female ratio was 1.15 : 1 5) 22.8% of the E.R. patients were diagnosed as schizophrenic disorder ; which was the most frequent diagnosis in all patients. 6) 34.6% of the E.R. patients were discharged within 2 weeks, and 60.6%, within 1 month. 7) Presenting problems, in the order of frequency, were paralysis of numbness of extremities, somatic sysmptoms, hallucination of paranoid delusion, and anxiety or panic state. More than half of the patients presented one or more of these symptoms. 8) 36.2% of the E.R. patients were discharged against medical advice. This was higher than A.M.A. discharge rate of 26.7% of the patients admitted via the O.P.D.

늑막삼출액을 동반한 다발성골수종 1예

김용화,주기산,서영환,조경상,김상도,정춘해 朝鮮大學校 附設 醫學硏究所 1992 The Medical Journal of Chosun University Vol.17 No.2

Pleural effusion in a patient with multiple myeloma due to plasma cell involvement of the pleura has been reported infrequently. We report a case of multiple myeloma with pleural involvement presenting bone pain and dyspnea in a 69-year-o1d woman. On the physical examination, the patient looked chronically ill with bedridden state. There was a palpable mass on the left posterior lower chest, firm but not tender and decreased breathing sound in the left lower lung. Laboratory finding revealed amemia, elevation of ESR, globulin, and calcium. X-ray of the chest showed pleural effusion in the left lower lung, and multiple pathologic fractures in the both ribs. X-ray of the skull, and pelvis revealed multiple punched-out osteolytic fractures in the both ribs. X-ray of the skull, and pelvis revealed multiple punched-out osteolytic lesion, and compression fracture in the lumber spine. Serum and urine electrophoresis revealed a M-spike. Serum and urine immunoelectrophoresis demonstrated an IgA-kappa monoclonal protein. Thoracentesis revealed serosanguinous fluid but not containing atypical plasma cells. Bone marrow examination showed 16.7% of immature plasma cells. With first cycle of melphalan, prednisone chemotherapy, improvement of pain and disappearance of pleural effusion was observed.

소아의 상완골 원위부 과간 골절

이우석,정환용,김우식,김용찬,전택수,김남현,김규태 대한골절학회 2004 대한골절학회지 Vol.17 No.4

상완골 원위부 과간 골절은 소아에서는 매우 드물게 발생되는 골절로 대부분 주관절의 굴곡상태로 주관절 후방부에 직접적인 충격에 의해 발생하는 것으로 보고되고 있다. 전위가 없거나 경미한 경우 도수적 정복술 혹은 도수적 정복술 후 경피적 핀고정술을 시행하며, 전위가 심한 골절이거나 도수적 정복술이 불가능한 경우 관혈적 정복술 후 핀고정술을 시행하는 것으로 알려져 있다. 저자들은 전위된 상완골 원위부 과간 골절 환아 2예에서 각각 도수적 정복술과 관혈적 정복술 후 K 강선 고정술을 시행하여 만족한 결과를 얻었기에 보고하는 바이다. Intercondylar fractures of the distal humerus are very rare in children. The pattern of the fracture would suggest that the mechanism of injury involves a fall directly on the flexed elbow. Most agree that the undisplaced fracture can be managed conservatively. With increasing displacement and comminution, the opinions tend to differ. We suggest that closed reduction with percutaneous K wire pinning and open reduction with percutaneous K wire pinning offer a satisfactory methods by which to treat displaced intercondylar fracture in children.

쇄골 골절에서 지연성 상완 신경총 마비 : 1예 보고 A Case Report

이우석,정환용,전택수,김용상,김남현 대한골절학회 2003 대한골절학회지 Vol.16 No.2

상완 신경총 마비는 쇄골 골절 후에 매우 드물게 발생하며, 대부분 많은 가골 형성을 동반한 쇄골의 중간1/3 부위 골절 불유합에서 발생한다. 골절의 치유 과정에서 과형성된 가골이 상완 신경총을 압박할 수 있으며, 감압술고 불유합에 대한 수술적 치료를 필요로 한다. 이에 저자들은 쇄골 골절 후 불유합과 과도한 가골 형성에 의해 발생된 지연성 상완 신경총 마비 환자를 치험 하였기에 보고하는 바이다. The brachial plexus palsies secondary to nonunion of the clavicle fracture are extremely rare. The nonunions are hypertrophic and usually in the middle third of the clavicle. Hypertrophic callus produced healing process will cause a compression of the neurovascular bundle. This lesion requires operative treatment for decompression of the brachial plexus and internal fixation of nonunion. We present a case of delayed brachial plexus palsy due to nonunion and excessive callus formation of a clavicular fracture.