• The Korean Journal of Pain
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• 제24권2호
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• pp.119-122
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• 2011

A rotator cuff tear causes shoulder pain and limits movement of the shoulder joint. A chronic degenerative change or impingement is the reason for a rotator cuff tear. Diagnosis is made based on medical history and, physical and radiological examinations. Other causes of shoulder pain include calcific tendinitis, degenerative arthropathy, joint dislocation, fracture, and primary or metastatic neoplasm. However, metastatic cancer in the shoulder joint is difficult to diagnosis. We experienced a case in which a 46-year-old female patient complained of left shoulder pain and limited joint mobility, and these symptoms were due to metastatic breast cancer in the shoulder.

• 대한기관식도과학회지
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• 제7권1호
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• pp.76-79
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• 2001

A 60-year-old male was admitted due to cervical spine injury (C7-T1 fracture dislocation) and quadriparesis after slip down. During conservative management in department of neurologic surgery, he complainted of fever, dyspnea, neck swelling. Follow up cervicothoracic CT revealed abscess pocket in paraglottic, retropharyngeal, anterior cervical spaces and mediastinum. Also noted bilateral pleural effusions. Under impression of descending necrotizing mediastinitis (DNM). cervical drainage and bilateral chest tube insertion was performed immediately. On next day. mediastinal drainage through mediastinotomy was performed with careful handling of cervical spine. Escherichia coli was identified in bacteriologic culture. Wire fixation of dislocated C7-T1 spine through Posterior approach was performed on 30th days after mediastinotomy. Right chest tube was removed on 40th days. At now, the patient is on rehabilitation and physical training program. DNM is relatively rare, but lethal disease with high mortality. Immedate and sufficient mediastinal drainage is essential in treatment.

• 한국소성가공학회:학술대회논문집
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• 한국소성가공학회 2008년도 춘계학술대회 논문집
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• pp.431-434
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• 2008

Effects of microstructure on the toughness of low carbon HSLA steels were investigated. Nickel decreased the ferrite-austenite transformation temperature, resulted in increase of the fraction of bainitic ferrite. However, it was decreased with increasing deformation amount at austenite region. Since fine austenite grains formed by dynamic recrystallization under large strain transformed to acicular ferrite or granular bainite rather than bainitic ferrite. The effective grain size, thus, was decreased by deformation and it resulted in lower ductile-brittle transition temperature (DBTT). The bainitic ferrite was thought to inhibit the fracture crack initiation and to delay the crack propagation by its high dislocation density and hard interlath $2^{nd}$ phase constituents, respectively. Thus, DBTT was also decreased by Ni addition in low carbon HSLA steels.

• Clinics in Shoulder and Elbow
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• 제3권2호
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• pp.61-67
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• 2000

Purpose: Most proximal humeral fractures are minimally displaced and can be treated satisfactorily with a conservative method. But in many comminuted fractures, hemiarthroplasty is usually done as a primary treatment. The authors evaluated how much functional improvement was achieved after hemiarthroplasty and which factors influence on the final functional results. Materials and Methods: Eleven hemiarthroplasties were performed for three- and four-part fractures(including fracture-dislocation) between April 1992 and June 1999. There were eight women and three men, and the mean age was 65 years. According to Neer classification, six was three-part fracture and five was four-part fracture. Six patients were injured on their right shoulder and five on the left shoulder. Among the five four-part fractures, three had axillary nerve injury and among the six three-part fractures, only one patient had axillary nerve injury. The average follow-up period was 2.4 years(1 year-7 years) after operation. The functional results were evaluated with the UCLA scoring system(Modification for hemiarthroplasty). In addition to the overall results, we compared the results according to the classification of the fracture, the cause of injury, and whether the axillary nerve was injured. Results: At the last follow-up, average total UCLA score was 18.2. The mean score for pain was 7.0, mean muscle power and motion score was 5.5 and 5.7 respectively. The pain relief was more satisfactory than any other functional results. The average score for three-part fractures was 22, and the average for four-part fractures was 13.6. The average score for the patients fractured by vehicle accidents was 15.3, and 19.3 for the patients fractured by slip-down injury. In patients without axillary nerve injury, the average score was 20, and with axillary nerve injury, the score was 15. Conclusion: Shoulder hemiarthroplasty, for the treatment of proximal humeral fractures, cannot restore the shoulder function to normal, but can achieve the functional result to some degree, especially for the activity of daily living. And as for pain, we think that it is relatively effective measure. And we think that the severer the comminution, the more the chance of axillary nerve injury, and the poorer the functional results. In conclusion, the severity of initial injury seems to be the major prognostic factor.

• 대한소아치과학회지
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• 제30권4호
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• pp.576-580
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• 2003

7세 남아가 맹출 중인 상악 영구 중절치의 외상을 주소로 내원하였다. 환아의 우측 중절치는 아탈구와 치근 파절을 보였고, 좌측 중절치는 함입성 탈구와 치근 파절을 보였다. 두 치아는 정복 후 선부자에 의해 고정하였다. 이후 주기적인 검진을 시행하였다. 4년이 지난 현재, 우측 중절치는 방사선 사진에서 파절편 사이에 방사선 투과성이 보이지 않고 정상적인 치조백선을 보여 경조직으로 치유되는 양상을 보였다. 좌측 중절치는 파절편이 분리되어있고 근관이 점차 폐쇄되는 소견을 보이고 있어 골과 결합조직의 개입에 의한 치유 양상을 보이고 있다. 임상 검사에서 정상적인 동요도와 타진 반응을 보였고, 전기치수검사에 양성 반응을 보였다. 외상을 받은 치아의 예후는 외상의 유형, 환자의 연령, 치근의 발육단계, 변위의 정도 등에 의해 영향을 받는다. 본 증례는 개방근관을 가진 치아가 외상 후 우측 중절치는 석회화 조직으로 치유, 좌측 중절치는 골과 결합조직의 개입으로 치유되고 있는 양상을 보이고 있어 이를 보고하는 바이다.

• Journal of Trauma and Injury
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• 제25권1호
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• pp.7-16
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• 2012

Purpose: Cervical dislocations with locked facets account for more than 50% of all cervical injuries. Thus, investigating a suitable management of cervical locked facets is important. This study examined factors of close reduction failure in traumatically locked facets of the subaxial cervical spine patients to determine suitable surgical management. Methods: We retrospectively analyzed of the case histories of 28 patients with unilateral/bilateral cervical locked facets from Nov. 2004 to Dec. 2010. Based on MRI evaluation of disc status at the injury level, we found unilateral dislocations in 9 cases, and bilateral dislocations in 19 cases, The patients were investigated for neurologic recovery, closed reduction rate, factors of the close reduction barrier, fusion rate and period, spinal alignment, and complications. Results: The closed reduction failed in 23(82%) patients. Disc herniation was an obstacle to closed reduction (p=0.015) and was more frequent in cases involving a unilateral dislocation (p=0.041). The pedicle or facet fracture was another factor, although some patients showed aggravation of neurologic symptoms, most patients had improved by the last follow up. The kyphotic angle were statistically significant (p=0.043). Sixs patient underwent anterior decompression/fusion, and 15 patients underwent circumferential fusion, and 7 patients underwent posterior fusion. All patients were fused at 3 months after surgery. The complications were 1 case of CSF leakage and 1 case of esphageal fistula, 1 case of infection. Conclusion: We recommend closed reduction be performed as soon as possible after injury to maximize the potential for neurological recovery. Patients fot whom closed reduction of the cervical locked facets have a higher incidence of anatomic obstacles to reduction, including facet fractures and disc herniation. Immediate direct open anterior reduction or circumferential fixation/fusion of locked cervical facets is recommended as a treatment of choice for traumatic locked cervical facet patients after closed reduction failure.

• Clinics in Shoulder and Elbow
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• 제5권1호
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• pp.37-41
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• 2002

Purpose : To evaluate the effect of radial head resection on longevity in nonconstrained total elbow arthroplasty, Materials and Methods : The results of 20 cases of radial head replaced Pritchard ERS and 18 cases of radial head excised Kudo elbow was followed for 6 to 16 years, 10.6 years in average. The rate of loosening, osteolysis, radial head subluxation, joint dislocation and valgus deformity were compared between the two groups. Results'There was no exaggerated cubitus valgus in Pritchard ERS group. However there developed one case of delayed subluxation of radial head occurred in 6 years postoperatively, one case of loosening, and one case of sponta- neous fracture of humeral shaft due to osteolysis. In Kudo elbow group,5 cases (27.8%) showed exaggerated valgus deformity with instability. There were one case of loosening and one case of delayed dislocation occurred in a year postoperatively. Conclusion : The most clear feature of Kudo elbow was exaggerated cubitus valgus. However, the ostolysis was developed in both groups and there was no difference in rate of the other complications between the two groups.

• Clinics in Shoulder and Elbow
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• 제20권2호
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• pp.59-67
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• 2017

Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were $75.8^{\circ}$ (range, $50^{\circ}-90^{\circ}$), $170^{\circ}$ (range, $150^{\circ}-180^{\circ}$), and $163.8^{\circ}$ (range, $140^{\circ}-180^{\circ}$), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

• 척추신경추나의학회지
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• 제14권1호
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• pp.49-59
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• 2019

본 증례에서는 넘어진 후 상완골 골절 진단 하에 수술하였으나 뒤늦게 원위 요척관절 탈구로 진단되어 1차 수술 후 정복 소실되어 Sauve-Kapandji 수술받은 환자를 대상으로 한방재활치료를 약 3주간 시행하였다. 관절가동추나, 침 치료, 한약물 치료 등 한방재활치료 결과 우측 팔꿈치, 손목, 손가락 관절 가동범위, 수술부위 통증, 근력, 상지 기능 등에서 의미 있는 호전을 보였다. 본 연구는 단일 증례 보고라는 한계가 있으나, 한방재활치료가 수술 후 환자의 전반적인 경과에 효과적으로 작용하였기에 보고하는 바이다.

• 한국방사선학회논문지
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• 제13권3호
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• pp.425-431
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• 2019

본 연구자는 척주 측만증 및 허리뼈 분쇄 골절된 환자의 수술 후 단순 엑스선 척주 측방향 촬영에서 두개의 철심이 겹친 영상을 얻어내기 위해 엑스선관 및 인체팬톰의 각도를 변화시켜 영상을 얻었다. 영상 평가를 위해 대학병원 영상의학과에서 10년 이상 근무한 방사선사 5명에게 주관적 평가를 하였다. 측정 결과 척주 측만증 측방향 촬영은 정중 이마면을 IR면 중심에 일치되게 하고 일곱 번째 등뼈가 중앙이 되도록 자세를 조정한 후 엑스선관과 척주팬톰 자세를 각각 수직으로 촬영하면 척주 측방향 촬영에서 두 개의 겹쳐진 영상을 얻을 수 있었고 주관적 평가에서도 높은 점수를 얻었다. 또한 허리뼈 탈구 골절된 허리뼈 측방향 촬영은 이마면을 IR면 중심에 일치시키고 네번째 허리뼈가 중앙이 되도록 자세를 조정하여 엑스선관 각도를 수직되게 하고 척주 팬톰을 네번째 허리뼈를 수직하여 촬영 하게 되면 척주 측방향 촬영에서 두개의 철심이 겹치는 영상을 얻을 수 있었고 주관적 평가에서도 높은 점수를 얻었다.