척추강 협착증 환자의 척추의 미란이 동반된 부골화된 요추 추간판 탈출증 : 증례 보고 Case Report

송경진,송경진 의과학연구소 1990 全北醫大論文集 Vol.14 No.3

We experienced 47 years old female patient with 4 years low back pain with sciatica and abnormal slow shuffling gait. On myelograghy we diagnosed as spinal stenosis induced by degenerative spondylosis and disc hemiation. But on C-T we could find vertebral erosion with abnormal shifting of theral sac by soft tissue mass. With fenestration, adhesiolysis and mass removal partent became pain free and normal gait.

퇴행성 경추 질환에서 단분절 전방추간판 제거술 및 유합술의 결과 - 3가지 유합 방법의 비교 -

송경진*,최병렬,양근호,이광복 대한정형외과학회 2003 대한정형외과학회지 Vol.38 No.3

3T3-L1 세포와 KS483 세포의 Transdifferentiation에 대한 Dexamethasone, Retinoid Acid, Vitamin D의 효과

송경진,양정례,박진우,서규범,최문기 대한정형외과학회 2002 대한정형외과학회지 Vol.37 No.4

흉추 및 요추부 유합술 후 심부 감염의 위험 인자

송경진,송광훈,박용근,이광복,김상림 대한척추외과학회 2008 대한척추외과학회지 Vol.15 No.3

Study Design: This is a retrospective analysis Objectives: We wanted to analyze the risk factors related to deep infection and removing an implant after thoracic and lumbar spinal arthrodesis. Summary of literature reviews: The relationship between deep infection and implant removal is controversial. Materials and Methods: We retrospectively compared the infection group with the non-infection group for the rates of deep infection, the preoperative diagnosis, the number of fused segments, the operative methods, the graft materials, the operating time and the blood loss. Moreover, we classified the deep infection patients into two groups: those who underwent implant removal and those who did not, and we compared the microorganisms that were cultured out of the patients. We also compared the relationship of deep infection with the risk factors, the mean hospital stay and the mean number of operations. Results: There were 18 cases (2.46%) of deep infection. The factors that did not show a significant difference were the preoperative diagnosis, the graft material, the increased number of fused segments, age, gender and BMI. The factors that were significant were the operating time (p=0.001), the amount of blood loss (p<0.000), DM (p=0.021), and PLF (p=0.054). The incidence of implant removal was higher for the cases with deep infection caused by MRSA. We were able to see a significant difference of between the group that had undergone implant removal and the group that had not undergone implant removal. Conclusions: The incidence of deep infection after thoracic and lumbar spinal athrodesis increased as the operating time and blood loss increased, and it was also higher when either PLF or DM were present. Implant removal causes bad clinical results, so physicians should be very cautious when operating on a case of implant removal.

하경추부 신전손상의 진단

송경진,배현경,고대하 대한정형외과학회 2003 대한정형외과학회지 Vol.38 No.2

개에서 척골의 원위 성장판 조기 폐쇄증에 대한 방사선학적 평가

송경진,이희천,이기창,권정국,최민철 한국임상수의학회 2003 한국임상수의학회지 Vol.20 No.3

A 11 month-old Shihtzu was referred to the Veterinary Medical Teaching Hospital, Seoul National University. Clinical signs of this patient were lameness, shortening limb, angular deformity, rotation of foot, subluxaion of elbow joint and restricted range of movement of left forelimb. For the evaluation of the abnormalities of left forelimb, radiographic examination was carried out. Radiographic findings were characteristics of premature closure of distal ulna such as closure of distal ulna growth plate and cranial bowing of radius. With radiographic signs and physical examination, it was diagnosed as premature closure of growth plate of the left forelimb. After osteotomy of the radius and ostectomy of the ulna, radiographic evaluation of limb about angulation of elbow joint was performed every 2-3 weeks for 3 months. In case of premature closure of distal growth plate of ulna, radiography was very useful for diagnositic method of premature closure of distal ulna and monitoring of healing process.

외측 도달법을 이용한 종골 관절내 골절의 관혈적 정복

송경진,양근호,이주홍 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목적 : 관절내 종골 골절에 대해 외측 도달법을 이용한 내고정을 시행 후 치료결과를 분석하여 그 유용성을 확인해보고자 하였다. 대상 및 방법 : 관절내 골절을 가지고 종골 골절의 경우 중 외측 도달법으로 내고정술을 시행하고 1년이상 추시 관찰이 가능했던 20명(21예)를 대상으로 하였다. 성별은 남자 17명, 여자 3명이었고 평균 33세(16~62세)이었으며, 원인별로는 추락사고가 14예이었고 나머지는 교통사고로 인한 골절이었다. 골절의 분류는 단순 방사선 사진상 Essex-Lopresti 분류를 이용하였고, 모든 예는 관절내 골절을 가지는 경우만 포함하였으며 이 중 관절 함몰형이 17예로 대부분이었고, 4례의 설상형은 심한 분쇄골절 양삼이었다. 술 전과 술 후 Bo¨hler 각의 변화를 비교하였고, 임상적 평가는 Paley와 Hall에 의한 평가 기준을 따랐다. 결과 : 수술 전 Bo¨hler 각은 평균 2.8에서 술 후 평균 25.1로 회복 되었고, 임상적 평가 상 우수 3예, 양호 13예, 보통 4예, 불량 1예이었다. 술 후 합병증으로 3예의 창상 열개, 1예의 감염, 1예의 비복신경 손상이 있었으먀, 추 후 합병증으로 일상 생활에 지장을 초래하는 정도의 족관절 운동범위 제한이 3예, 지속되는 동통이 3예, 외상성 관절염이 2예에서 확인되었다. 이 중 1 예에서 운동범위 제한과 동통이, 1예에서 운동제한과 외상성 관절염이 동시에 존재하였다. 1예는 창상 조직의 감염과 이에 따른 괴사로 자유 피판술을 시행하였다. 결론 : 분쇄가 심한 종골의 관절내 골절에서 외측 도달법은 거골하 관절을 직접 노출시켜 정확한 해부학적 복원과 견고한 내고정을 시행할 수 있고 신경 혈관 손상이 적어 유용한 방법으로 사료된다. Purpose : This study was designed to investigate the usefulness of lateral approach for accurate reduction and rigid internal fixation comminuted intra-articular fracture of calcaneus. Meterial and Method : Twenty patients(21 cases) who had inter-articular fracture of calcaneus and underwent an open reduction and internal fixation using lateral approach were enrolled. Using Essex-Lopresti classification, all cases were intra articular fracture, which joint depression type was 17 case and 4 of severe comminuted tongue type. We compared the preoperative and postoperative change of Bo¨hler’s angle and clinical results were analyzed using Paley and Halls evaluation protocol and scoring system. Results : The average Bo¨hler’s angle was restored from 2.8 to 25.1 after operations and clinical results classified 4 well, 12 good, 4 fair, 1 poor cases. Postoperative complications were 2 cases of wound dehiscence, 1 of infection and one had sural nerve injury. Late complocations included 3 cases of limitation of motion of ankle that disturb usual activity, 3 of sustained pain and 2 of traumatic arthritis and 2 cases had 2 complications at the same patients. Conclusion : The lateral approach is valuable for the comminuted intra-articular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint, and also with little morbidity of neurovascular injury.

보험심사 근무직의 직무스트레스와 정신건강

송경진,이정원 서비스사이언스학회 2021 서비스연구 Vol.11 No.1

국내의 의료보험 제도의 순기능은 높이 평가받지만 불완전한 보장성의 문제로 인해 국민들은 민영의료보험 가입을통해 보장성을 확보하고자 한다. 이로 인해 최근 민영의료보험의 가입률이 높아지게 되었고, 청구율 또한 높아지게되었다. 이처럼 민영의료보험을 찾는 사람이 늘어남에 따라 민영의료보험사의 근로자는 직무 부담이 가중되었으며,특히 보험금 지급을 담당하는 보험심사 근무직의 경우 보험금을 고객과의 소통, 회사의 수익 상출에 기여 등 다양한이유로 직무스트레스가 나날이 증가하고 있으며 그로 인한 부작용을 경험하고 있다. 이에 본 연구는 보험심사 근무직의 직무스트레스가 정신건강에 미치는 영향에 대해 분석하여 보험심사 근무직의 직무스트레스를 감소시키고 정신건강을 증진하고자 서술적 조사 연구를 실시하였다. 분석 결과, 보험심사 근무직의 직무스트레스는 정신건강에 유의한 정(+)의 영향을 미치는 것으로 나타났다. 세부적으로는 직무스트레스가 역할수행능력·자기신뢰도, 우울, 수면장애·불안, 일반건강·생명력의 정신건강 4가지 요인모두에 유의한 영향을 미치는 것으로 나타났다. 본 연구를 통해 보험심사 근무직의 직무스트레스가 정신건강에 유의한 정(+)의 영향을 미친다는 사실을 알 수 있었다. 직무스트레스는 근로자로 하여금 직무수행에 대한 열의를 감소시키고 이직률, 퇴사율을 높이는 등 조직적인 측면에서의 부작용을 초래하기도 하지만 개인의 신체 건강을 악화시키고 우울, 불안 등과 같은 질환을 유발하여 정신건강을 피폐하게 만들기도 한다. 따라서 이를 예방하기 위하여 대상자의 특성에 맞는 적절한 직무스트레스 예방법과 대처법을 제공하여 직무스트레스를 감소시키고 정신건강을 증진할 수 있도록 지원하여야 할 것이다.

Iohexol을 이용한 척수강 조영술 후 발생한 간대성 전신 발작 -증례보고-

송경진,이광복 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.6

We encountered a patient who had a rare occurrence of a seizure after lumbar myelography from the beginning of this untoward side effect. Clinical trials with iohexol in myelography have demonstrated a good tolerability of this water-soluble contrast medium. However, there have been a few reports that have shown acute adverse reactions such as headaches, vomiting, psychosis, confusion and generalized tonic-clonic seizures. Despite the reports on the safety of iohexol use, it may cause a generalized seizure attack without an epileptogenic history. Therefore, thorough attention and the preparation for emergency treatments for the seizure are essential in every myelography using iohexol as a contrast medium. Moreover, in order to avoid unwanted legal problems, the patients and their family need to be informed of the necessity and possible side effects associated with myelography. Iohexol (Omnipaque)은 합병증이 거의 발생하지 않는 안전한 조영제로 알려져 있어, 임상의 여러 분야에서 다양하게 사용되고 있으며, 정형외과에서는 척수강 조영술에 흔히 사용되고 있다. 저자는 안전하다고 보고된 이 조영제로 척수강 조영술 후에 발생한 간대성 전신 발작을 일으킨 환자를 경험하였기에 보고하고자 하며, 이를 통해 조영제가 일으킬 수 있 는 부작용에 대해 환자 및 보호자에게 충분한 설명의 필요성과 면밀한 관찰 및 응급처치에 대한 대비의 필요성에 대해 강 조하고자 한다.

Efficacy of PEEK Cages and Plate Augmentation in Three-Level Anterior Cervical Fusion of Elderly Patients

송경진,Gyu Hyung Kim,Byeong Yeol Choi 대한정형외과학회 2011 Clinics in Orthopedic Surgery Vol.3 No.1

Background: To evaluate the clinical effi cacy of three-level anterior cervical arthrodesis with polyethyletherketone (PEEK) cagesand plate fi xation for aged and osteoporotic patients with degenerative cervical spinal disorders. Methods: Twenty one patients, who had undergone three-level anterior cervical arthrodesis with a cage and plate construct fordegenerative cervical spinal disorder from November 2001 to April 2007 and were followed up for at least two years, were enrolledin this study. The mean age was 71.7 years and the mean T-score using the bone mineral density was -2.8 SD. The fusionrate, change in cervical lordosis, adjacent segment degeneration were analyzed by plain radiographs and computed tomography,and the complications were assessed by the medical records. The clinical outcomes were analyzed using the SF-36 physical compositescore (PCS) and neck disability index (NDI). Results: Radiological fusion was observed at a mean of 12.3 weeks (range, 10 to 15 weeks) after surgery. The average angle ofcervical lordosis was 5° preoperatively, 17.6° postoperatively and 16.5° at the last follow-up. Degenerative changes in the adjacentsegments occurred in 3 patients (14.3%), but revision surgery was unnecessary. In terms of instrument-related complications,there was cage subsidence in 5 patients (23.8%) with an average of 2.8 mm, and loosening of the plate and screw occurred in 3patients (14.3%) but there were no clinical problems. The SF-36 PCS before surgery, second postoperative week and at the lastfollow-up was 29.5, 43.1, and 66.2, respectively. The respective NDI was 55.3, 24.6, and 15.9. Conclusions: For aged and osteoporotic patients with degenerative cervical spinal disorders, three-level anterior cervical arthrodesiswith PEEK cages and plate fi xation reduced the pseudarthrosis and adjacent segment degeneration and improved the clinicaloutcomes. This method is considered to be a relatively safe and effective treatment modality.