충청북도편 - 청주시 시장 이준영

이준영 대한지방행정공제회 1965 地方行政 Vol.14 No.136

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골수이형성증후군과 동반된 랑게르한스세포조직구증

이준영,박영민,김형옥,이준영 대한피부과학회 2013 대한피부과학회지 Vol.51 No.10

랑게르한스세포조직구증은 미성숙한 랑게르한스 세포의 비정상적인 증식이 피부, 림프절, 간, 신장, 뼈, 신경 등의 장기를 침범하는 드문 질환이다. 랑게르한스세포조직구증은 주로 일차 또는 특발성으로 발생하나 드물게 백혈병이나 림프종, 다른 고형암 등과 동반되어 발생한다1. 랑게르한스세포조직구증이 골수이형성 증후군과 동반되는 경우는 해외에 드물게 보고된바 있으나 국내에는 보고가 없다2-5. 68세 여자 환자가 두피에 발생한 홍반성 결절을 주소로 내원하였다. 1개월 전 무증상의 병변이 두피에 발생하였고, 점차 크기가 커지면서 출혈 동반하였다고 하였다. 과거 력에서는 특이소견 없었다. 환자의 후두부 두피에 2개의각 5 mm, 1 cm 크기의 홍반성 결절이 관찰되었으며, 표면 부위에 출혈과 가피가 관찰되었다(Fig. 1). 검사실 소견에서는 일반 혈액 검사에서 백혈구 수치가 13,680×106/L으로 증가되어 있으며, 혈색소 9.8 g/dl, 혈소판 수 56,000×106/L로 감소한 소견 보였다. 백혈구 분획에서 후골수세포 (metamyelocytes) 2%, 골수세포(myelocytes) 2%가 관찰되었다. 골수천자 검사에서는 10% 이상의 골수 세포에서 이형성을 보이는 골수이형성증후군의 소견이 관찰되었으며, 전자검사에서 46,XX,del(20) (q11.2)의 이상소견이 관찰되었다. 병리조직학적 검사에서는 균일한 단핵세포들이 미만성으로 침윤되어 있었고, 침윤한 세포들은 크기가 약간 커져 있으면서 신장 모양의 세포들이 다수 관찰되었다(Fig. 2A, B). 종양세포들은 면역화학검사인 CD1a, S-100 염색에 양성 소견을 보였으며, Ki-67에서는 33%정도의 세포에서 양성소견이 관찰되었다(Fig. 2C, D, E). 골수 이형성 증후군에서 골수 세포의 이상 무리(abnormal clone)의 진화로 백혈병 등 다른 악성 질환의 발생 위험도가 높아지는 것은 이미 잘 알려진 사실이다. 또 랑게르한스세포조직구증도 백혈병, 림프종, 고형암 등 여러 가지 악성 질환과 동반될 수 있다1. Edelbroek 등4은 18명의 랑게르한스세포조직구증 환자 중 2명에서 골수이형성 증후군을 동반하였다고 보고하였다. 흥미롭게도 랑게르한스 세포조직구증이 소아에서 많이 발생하지만, 골수이형성 증후군이 동반된 경우는 소아2보다 성인3-5에서 더 많이 보고 되었다. 랑게르한스세포조직구증은 골수이형성 증후군이나 백혈병 등의 다른 악성종양과 동반될 수 있기 때문에 이에 대한 철저한 검사가 필요하다. 저자들은 성인에서 골수 이형성 증후군과 랑게르한스세포조직구증이 동반된 증례를 경험하고 드문 증례로 생각되어 보고한다.

분쇄가 심한 Ruedi-Allgower II, III형의 개방성 경골 천정 골절에서 단계적 수술의 결과

이준영,최귀연,장현웅,김영욱 대한족부족관절학회 2019 대한족부족관절학회지 Vol.23 No.3

Purpose: This study analyzed the clinical and radiological results of Reudi-Allgower type II and III open tibia pilon fracture patients who underwent plate fixation after the recovery of a soft tissue injury after external fixation. Materials and Methods: From 2010 to 2015, this study analyzed 14 patients who were treated for open tibial pilon fractures and could be followed up at least one year. The mean age was 49 years and the average follow-up period was 19 months. An emergency operation was performed for external fixation and open wounds, and secondary surgery was performed for definitive fixation using a plate. The radiological and clinical evaluations were analyzed retrospectively. Complications, such as post-traumatic osteoarthritis and wound infections were also analyzed. Results: The mean duration between two-staged surgery was 21 days and the mean bone union time was 9.2 months. Three cases of delayed union and one case of nonunion were reported. The malunion did not occur in all cases. The average American Orthopaedic Foot and Ankle Society (AOFAS) score was 68 points. A limitation of the ankle motion occurred in all cases. In four cases, wound infections due to initial open wounds occurred; one patient underwent a below the knee amputation due to chronic osteomyelitis. Post-traumatic arthritis occurred in 10 cases. Conclusion: Severe comminuted tibial plateau open fractures of Reudi-Allgower type II and III, which are high-energy injuries that result in extensive soft tissue damage, have a higher incidence of complications, such as ulcer problems and osteomyelitis, than closed tibia plateau fractures. Post-traumatic arthritis is the most common complication of tibia plateau open fractures, and staged surgery is recommended because of the relatively satisfactory clinical results.

원위 비골 골절의 수술 후 발생한 불유합의 관련 인자

이준영,최귀연,강신욱,고강열 대한족부족관절학회 2018 대한족부족관절학회지 Vol.22 No.3

Purpose: The purpose of this study was to evaluate the radiologic outcomes of distal fibular fractures and to analyze the risk factors associated with nonunion. Materials and Methods: Between January 2009 and March 2016, 13 patients who had final nonunion with ankle fracture were included. In the control group, 370 patients who had undergone bony union and removed metal implants were included. All patients underwent the same surgical procedure and had the same treatment method, ultimately achieving satisfactory open reduction results with less than 2 mm fracture gap. Surgical treatment of fracture was considered to have the same effect on nonunion, and factors that might be associated with nonunion were evaluated. SPSS ver. 13.0 (SPSS Inc., USA) was used for all statistical analyses. Pearson’s chi-square test and multi-variate regression analysis were performed to determine the factors affecting nonunion of distal fibular fracture. A p-value less than 0.05 was considered statistically significant, and relative risk was assessed. Results: The mean age of 13 patients was 46.9 years (range, 16∼57 years); there were 8 men and 5 women. Among the 13 patients with nonunion, atrophic was the most common (12 cases). The association between the injury mechanism and the Lauge-Hansen classification and diabetes mellitus was not statistically significant. Distal fibular fractures with tibia shaft fracture (p=0.015) and Danis-Weber type C fracture (p=0.023), open fracture (p=0.011), and smoking (p=0.023) were significantly associated with nonunion. Conclusion: In this study, the combined injury of the ipsilateral tibia shaft fracture, open fracture, and Danis-Weber type C fracture may increase the possibility of nonunion. Therefore, caution is advised to prevent nonunion.

족관절 개방성 삼과골절의 즉각적인 수술의 결과

이준영,조용진,강신욱,조영민,최현배,Lee, Jun-Young,Cho, Yong-Jin,Kang, Sin-Wook,Cho, Yung-Min,Choi, Hyun-Bai 대한족부족관절학회 2020 대한족부족관절학회지 Vol.24 No.1

Purpose: Generally, the treatment of ankle trimalleolar open fractures is divided into two stages: external fixation and debridement; and secondary internal fixation. On the other hand, this two-stage operation takes considerable treatment time and is challenging in procedures requiring reduction. The purpose of this study was to evaluate the radiologic and clinical results of an immediate one-stage internal fixation operation considering the wound conditions to overcome two stage operation disadvantages. Materials and Methods: From September 2009 to January 2018, 24 cases of ankle trimalleolar open fractures, who underwent immediate internal fixation and were followed up for at least one year, were studied retrospectively. The open wound was divided into the Gustilo-Anderson classification. Open reduction and internal fixation were performed on every medial and lateral malleolar fracture. On the other hand, with posterior malleolar fractures, surgical or conservative treatment was performed depending on the fragment size. The radiologic outcome was evaluated using the Burwell and Charnley criteria and American Orthopaedic Foot and Ankle Society (AOFAS) scores, and complications, such as infection and posttraumatic arthritis, were used for the clinical evaluation. Results: The wound was classified into eight cases (33.3%) of type I, 11 cases (45.8%) of type II, and five cases (20.8%) of type IIIa. The degree of reduction was anatomical, fair, and poor in 16 cases (66.7%), six cases (25.0%), and two cases (8.3%), respectively. The mean AOFAS score was 79 points, and there were complications, such as infection in three cases (12.5%) and post-traumatic arthritis in two cases (8.3%). Conclusion: Satisfactory results were obtained through immediate surgical treatment in ankle trimalleolar open fractures of types I, II, and IIIa.

고려인삼의 미래 안전성에 달렸다

이준영 한국인삼전략화협의회 2005 인삼·약초 Vol.2 No.2

뇌경색 환자에서 항응고제 투여로 성공적인 치료를 보인 대동맥의 유동성 혈전

이준영,김대현,이영훈,문정수,김현정,박재형 대한뇌졸중학회 2008 Journal of stroke Vol.10 No.2

The atherosclerotic plaque of thoracic aorta is an important embolic source of stroke. However, the relationship between the plaque location in the thoracic aorta and the development of embolic stroke and adequate treatment for mobile thrombi were still incompletely elucidated. We recently encountered four patients with unexplained cerebral infarction, in whom trans-esophageal echocardiography (TEE) showed evidence of freely mobile thrombi attached to atherosclerotic plaques in the descending thoracic aorta. TEE showed retrograde and rotational blood flow in thoracic aorta in all patients. In follow-up TEE, mobile thrombi disappeared after anticoagulant therapy. We suggest that retrograde emboli from atheromas distal to the origins of cervical arteries can be an important cause of the ischemic stroke. Anticoagulation therapy could be beneficial in patients with mobile thrombi in the thoracic aorta. (Korean J Stroke 2008;10:134-138)

택지개발사업지구의 쓰레기 자동집하시설 최적규모(안)

이준영 한국유체기계학회 2008 유체기계 연구개발 발표회 논문집 Vol.2008 No.-

영미소설의 영화적 수용과 질 들뢰즈의 “시간-이미지”: 오만과 편견, 위대한 개츠비, 남아있는 나날들의 영화화를 중심으로

이준영 영상영어교육학회 2018 영상영어교육 (STEM journal) Vol.19 No.1

This essay attempts to analyze such cases of the screen adaptations of English novels as Pride and Prejudice, The Great Gatsby, and The Remains of the Day in terms of Gilles Delueze’s film theory and Georg Lukács’s discussion of time in his theory of the novel. Delueze controversially proposes that, by the very break-up of the sensorymotor schema, the constitutive images of the cinema have been changed from the movement-images into the time-images in which time as duration is represented directly in pure optical and sound situations. Lukács also points out that, unlike any other literary genres, such as the drama and the epic, the novel as a form of transcendental homelessness includes real time as duration among one of its constitute principles. Therefore, in order to adapt the narrative of the novel into the cinema, this essay claims, its concept and role of time should be transferred successfully into the screen by means of the cinematography of “the time-images” Whereas the 2013 and 1993 film versions of The Great Gatsby and The Remains of the Day demonstrate certain levels of success in transforming the time of the original novels into their cinematography, the 2005 film adaptation of Pride and Prejudice does not.

10세 남자 운동선수에서 발생한 아킬레스건 파열을 동반한 종골 골단의 견열 골절: 증례 보고

이준영,박이규,임재환,Lee, Jun Young,Bak, Yi Gyu,Lim, Jae Hwan 대한족부족관절학회 2018 대한족부족관절학회지 Vol.22 No.2

Calcaneal apophysitis is a relatively common disease in young athletes. On the other hand, if not treated properly, it can lead to apophyseal avulsion fracture in rare cases. In the case of apophyseal avulsion fractures, it is often necessary to remove or preserve the bone fragment, which often requires a suture of the Achilles tendon. A 10-year-old badminton athlete visited the outpatients' clinic with pain in both heels from 10 months ago without any trauma history. After conservative therapy, the pain in the left heel was relived but the right heel pain persisted. After 10 months of conservative therapy, the patient visited the outpatients' clinic showing a calcaneal apophyseal avulsion fracture with a total rupture of the Achilles tendon. In the operation room, a bone fragment needed to be removed because of its poor viability and the fragment was too thin for fixation. After removing the bone fragment, the ruptured Achilles tendon was fixed with an anchor system.