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RISS 인기검색어
- 검색키워드
- 저자 : 고한석(Han Suk Ko) (검색결과 89 건)
- 무료
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고한석,한창수,채정호,Ko, Han-Suk,Han, Chang-Su,Chae, Jeong-Ho 대한불안의학회 2014 대한불안의학회지 Vol.10 No.1
Reactive disorder is a group of diagnosis with a definitely known etiology and whose etiological factor is essential to the diagnosis. In DSM system, such reactive disorders are listed as adjustment disorder, acute stress disorder, brief psychotic disorder with marked stressor and posttraumatic stress disorder (PTSD). However, a growing number of individuals is suffering from a prolonged feeling of embitterment after exceptional negative life events and this condition could be diagnosed neither PTSD nor adjustment disorder nor depressive disorder in the context of DSM-IV diagnostic system. This clinical condition can be described as 'posttraumatic embitterment disorder' (PTED). PTED is a reactive disorder triggered by exceptional, though normal negative life events such as conflict in the workplace, unemployment, death of a relative, divorce, severe illness, or experience of loss or separation. The common feature of such events is that they are experienced as unjust, as a personal insult, accompanied by psychological violation of basic beliefs and values. The central psychopathological response pattern in PTED is a prolonged feeling of embitterment. In particular, the core emotion of embitterment can lead to the rejection of treatment. Therefore, "wisdom therapy" as a new treatment approach specifically designed for PTED has been developed. It is assumed that many patients suffering from PTED are often misunderstood and misdiagnosed. This review would help to introduce PTED into the clinical field in psychiatry.
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고한석 ( Han Suk Ko ),전태환 ( Tae Hwan Jeon ),김병직 ( Byung Jik Kim ),임영 ( Young Lim ),서정국 ( Jung Guk Seo ),주석규 ( Suk Kyu Zoo ),김진환 ( Jin Hwan Kim ) 대한고관절학회 1993 Hip and Pelvis Vol.5 No.1
Acetabulum consisting of the hip joint is the most important weight bearing joint in the lower extremity. The principle of treatment for this fracture must be restored the hip function which require accurate anatomical reduction and firm internal fixation followed by early joint moton. But because of the difficulties in the evaluation <@k classification of the fracture and in the exposure & reduction, treatment of displaced acetabular fracture have been controvirsal. Recently many authors stressed that surgical operation is often required to achieve the accurate anatomical reduction of fractured acetabulum and reported its good results. Authors reviewed and analysed 24 patients with displaced acetabular fractures by surgical treatment who had displacement of minimum 3mm after skeletal traction, which were treated at Department of Orthopedic Surgery, Inje University, Seoul Paik Hospital from Jan. 1987 to Jan. 1992. The results were as follows: l. According to Letournels classification, the most common type was posterior wall fracture, the second was transverse with posterior wall fracture, and pelvic bone fracture was the most common associated injuries. 2. Surgical approaches were Kocher-Langenbeck in 14 cases, Ilioinguinal in 5 cases, Obsorne and Moore in each 2 cases, triradiate trochanteric 1 case. 3. The satisfactory result was achieved in each 17 cases of patients with congruent reduction clinically & radiologically and in 14 cases clinically and in 15 cases radiologically of the patients who underwent surgical treatment.
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고관절 치환술 후의 합병증 : 감염된 인공 고관절의 치료
고한석 ( Han Suk Ko ) 대한고관절학회 2006 Hip and Pelvis Vol.18 No.4
인공 관절의 감염은 수술 전에 주위 깊은 검사와 수술계획을 요하는 주요한 합병증이다. 즉각적인 진단과 조기에 수술을 하도록 하며, 특히 급성 감염과 혈행성 감염의 경우 이는 더욱 중요하다 하겠다. 완벽한 진단 방법은 없지만 임상적 검사와 혈청학적 검사, 방사선 검사 및 세균학적 분석을 포괄적으로 이용하여 진단을 할 경우 신뢰도를 높일 수 있다. 철저한 병력 청취와 임상 검사, 위험 인자의 파악과 더불어 환자의 증상, 감염의 증후 및 ESR, CRP 검사가 이루어져야 한다. 방사선 검사의 경우 주기적인 간격으로 촬영한 일련의 필름을 비교하여 다른 진단을 배제시키고, 이를 기초로 필요한 추가 검사가 이루어지는 동시에 치료도 시작되어야 한다. 여러 가지 새로운 영상기법이 있지만 아직까지 인공관절 감염의 진단에 단독적으로 신뢰할 수는 없다. 수술 전에 세침 흡입 검사를 시행해야 하고 만약 음성이라고 하더라고 감염의 가능성이 높다면 반복 시술을 고려하여야 한다. 수술적 처치의 역할은 분명하며 최근에는 2단계 재치환술이 지지를 받고 있고, articulating spacer를 사용하여 높은 감염 치유율을 보이고 있다.
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시멘트를 사용한 인공 고관절의 재치환술시 방사선 소견과 수술소견의 비교관찰
고한석 ( Han Suk Ko ),정우석 ( Woo Suk Jeong ),김병직 ( Byung Jik Kim ),김영롱 ( Young Yong Kim ) 대한고관절학회 1995 Hip and Pelvis Vol.7 No.1
Since the use of the Charnley hip prosthesis, the component loosening has been the most cause of failure. The roentgenographic appearance of the bone cement junction in total hip arthroplasties has recevied frequent attention. The incidence of loosening as a mode of clinical failure is consistently much lower than the incidence of radiolucent lines. One study shows aseptic loosening of the acetabulum component necessitating revision occurred in 6 percent of all 322 acetabular component, while 2 percent of all 322 femoral component. The present investigation was an attempt to compare observations on plain radiographs with those made during the exchange operation in a series of total hip arthroplasties revised for various reasons. In a series of 29 patients, 30 cases who have admitted for revision at Seoul Paik Hospital from March 1992 to March 1994 by late loosening after being performed cemented total hip athropasty were studies about the radiographic analysis, correlation of the real and radiographic measurement of cement and bone contact. The Result as follows; 1. The mean age at revision was 56 years old and the average time to revision was 12.3 years.
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Charnley Low-Friction 인공고관절술후 비구컵의 후기해리(late loosening)와 마모
고한석 ( Han Suk Ko ),전태환 ( Tae Hwan Jeon ),김영룡 ( Young Yong Kim ),김병직 ( Byung Jik Kim ) 대한고관절학회 1993 Hip and Pelvis Vol.5 No.1
Since the use of the Charnley hip prothesis, the component loosening has been the most common causes of failure. Although the detailed mechanism of loosening is as yet unclear, mehanical factors including quality of fixation, stress transfer and micromotion and biologic factors such as tissue necrosis, healing and response to particulate debris have been under close scrutiny. The 18 patients who have admitted for revision at Seoul Paik Hospital from Sep. 1992 to Apr. 1993 by late loosening (more than ten years after postoperatively) of acetabular cup after being performed Charnley Low-Friction arthroplasty were studied about the radiographic analysis, correlation of the real and radiographic measurement of wear and microscopic examination of granuloma tissue. The results were as follows: 1. The mean age at revision was 57 years old and the average time to revision was 13 years. 2. Acetabular radiolucent line (more than 2mm) was found in all cases and 12 cases (67%) of them was involved all three zones and the most common site was a zone III(16 cases: 8996). Femoral radiolucent line was found in 16 cases (89%), 11 cases of them was definite loosening (more than 2mm) and the most common site was a zone 7 (9 cases: 60%). 3. The average wear of polyethylene cup measured from radiographs by Charnley and Cupic (1973) was 2.98mm and average wear rate was 0.23mm / year, the real wear by Wrobleski (1985) was 3.47mm and average wear rate was 0.27mm / year.
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금속판과 나사못 고정술을 이용한 장관골의 감염성 불유합의 치료
고한석 ( Han Suk Ko ),강영훈 ( Yeong Hun Kang ),김덕원 ( Deok Weon Kim ),하정구 ( Jeong Ku Ha ) 대한골절학회 2006 대한골절학회지 Vol.19 No.1
목적: 장관골의 감염성 불유합을 치료하는 데 있어서 금속판을 이용한 내고정술을 시행하였던 경우를 고찰하여 그 유용성을 평가하고자 하였다. 대상 및 방법: 1993년 3월부터 2004년 2월 까지 본원에서 장관골의 감염성 불유합으로 진단되어 금속판 내고정술과 동종 해면골 이식술을 시행 받았던 10예에 대하여 후향적 고찰을 하였다. 치료는 먼저 괴사조직의 철저한 변연 절제술과 세척후에 금속판을 이용한 고정술로 이루어졌고, 2례에서는 가교 금속판 고정법을 이용하기도 하였다. 동종 해면골 이식이 6예에 이루어졌으나, 창상의 상태에 따라 내고정 후 4주 뒤에 시행되기도 하였다. 결과: 10예 중 9예에서 방사선적 유합을 평균 6.8개월에 확인할 수 있었고, 그 이전에 감염증의 치료를 얻을 수 있었다. 결론: 금속판 내고정술은 감염성 불유합의 치료에 이용되는 견고한 고정 방법으로 유용한 방법이며, 삽입물이 감염증을 악화시킬 수 있다는 일반적 우려는 가교 금속판 고정술이나, 사전 철저한 변연 절제술, 해면골 이식등의 동반 술기로 극복할 수 있다고 생각된다. Purpose: To evaluate the usefulness of internal fixation with plate in treating infected nonunion of long bone. Materials and Methods: From March 1993 to February 2004, ten patients who underwent internal fixation with plate and cancellous bone graft on account of infected nonunion of long bone were retrospectively examined. The medical treatment were composed of thorough and adequate debridement of necrotic tissue, irrigation and plate fixation. Two patients were operated on with bridging plate method. Autologous cancellous bone graft was performed in 6 patients. In 2 cases, it was performed 4 weeks after internal fixation. Results: In 9 patients, radiographic union appeared on the average of 6.8 months and infections were cured before union occurred. Conclusion: Internal fixation with plate is a useful method for the solid fixation in the treatment of infected nonunion. The general concern was that the inserted hardware worsened the infection, which was overcomed with the operative techniques as bridging plate, debridement and cancellous bone graft.
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