비내시경으로 치료한 거대 전두-상안와봉소 점액낭종 1예

김기택,박장혁,김태환,박동준 대한이비인후과학회 2004 대한이비인후과학회지 두경부외과학 Vol.47 No.4

Mucoceles of the paranasal sinuses are chronic expanding lesions containing inspissated mucus, which occurs when sinus ostium is obstructed. A variety of conservative and radical surgical procedures have been introduced, with each approach having advantages as well as disadvantages. Diseased frontal sinus mucosa and bone were commonly ablated by radical frontal sinus surgery such as osteoplastic flap surgery in the past. During the last decade, endoscopic sinus surgery has become the major choice for the treatment of paranasal sinus mucoceles, and the technique of endoscopic sinus marsupialization has been considered non-invasive and successful. But the technique has limitation in cases with small frontal recess or mucocele in the lateral portion of the frontal sinus which is not accessible via the nose, and hypertrophic mucosa obstructing the entire sinus. A 52-year-old man was presented with a supraorbital cell mucocele located in the lateral side of frontal sinus mucocele, which could not be treated by endoscopic surgery alone. Endoscopic surgery with sinus marsupialization, trephination and transillumination technique was introduced. We report this case with a review of related literatures.

척추 후만증

김기택 대한척추외과학회 1999 대한척추외과학회지 Vol.6 No.2

Results of Corrective Osteotomy and Treatment Strategy for Ankylosing Spondylitis with Kyphotic Deformity

김기택,박대현,이상훈,이정희 대한정형외과학회 2015 Clinics in Orthopedic Surgery Vol.7 No.3

Background: To report the radiological and clinical results after corrective osteotomy in ankylosing spondylitis patients. Furthermore, this study intended to classify the types of deformity and to suggest appropriate surgical treatment options. Methods: We retrospectively analyzed ankylosing spondylitis patients who underwent corrective osteotomy between 1996 and 2009. The radiographic assessments included the sagittal vertical axis (SVA), spinopelvic alignment parameters, correction angle, correction loss, type of deformity related to the location of the apex, and the craniocervical range of motion (CCROM). The clinical outcomes were assessed by the Oswestry Disability Index (ODI) scores. Results: A total of 292 corrective osteotomies were performed in 248 patients with a mean follow-up of 40.1 months (range, 24 to 78 months). There were 183 cases of single pedicle subtraction osteotomy (PSO), 19 cases of multiple Smith-Petersen osteotomy (SPO), 17 cases of PSO + SPO, 14 cases of single SPO, six cases of posterior vertebral column resection (PVCR), five cases of PSO + partial pedicle subtraction osteotomy (PPSO), and four cases of PPSO. The mean correction angles were 31.9° ± 11.7° with PSO, 14.3° ± 8.4° with SPO, 38.3° ± 12.7° with PVCR, and 19.3° ± 7.1° with PPSO. The thoracolumbar type was the most common. The outcome analysis showed a significant improvement in the ODI score (p < 0.05). Statistical analysis revealed that the ODI score improvements correlated significantly with the postoperative SVA and CCROM (p < 0.05). There was no correlation between the clinical outcomes and spinopelvic parameters. There were 38 surgery-related complications in 25 patients (10.1%). Conclusions: Corrective osteotomy is an effective method for treating a fixed kyphotic deformity occurring in ankylosing spondylitis, resulting in satisfactory outcomes with acceptable complications. The CCROM and postoperative SVA were important factors in determining the outcome.

만성 요통환자에서 펠루비서방정 투여군과 펠루비정 투여군간 유효성 및 안전성 비교평가 - 무작위배정, 이중눈가림, 다기관 제 3상 임상시험

김기택,김태균,최지웅,안재성,고영도,김영우,이정희 대한척추외과학회 2016 대한척추외과학회지 Vol.23 No.2

Study Design: A randomized, double-blind, multi-institution, phase III study. Objectives: To evaluate the efficacy and safety of the Pelubi Sustained Release (SR) Tab in patients with chronic back pain, in comparison with the Pelubi Tab, whose efficacy has already been approved, a phase 3 clinical trial was conducted. Summary of Literature Review: The Pelubi Tab Has shown clinical efficacy in patients with back pain. Materials and Methods: From April 11, 2014 to July 24, 2014, 166 chronic back pain patients were recruited as subjects through a multi-institution, double-blind, random sample. We compared the experimental and control groups’ clinical efficacy, which was estimated by the 100-mm Pain Visual Analog Scale (VAS) after 28 days of medication. We also compared the treatment efficacy of both drugs by using a variation of the Oswestry Disability Index (ODI) and Physician Global Assessment (PGA), with the total usage of relief medicine. The side effects and clinical pathology were also noted. Results: Neither group showed a significant difference in 100-mm Pain VAS or ODI variation (p=0.1702, p=0.9041). There was no statistically significant difference between the experimental group and the control group in PGA or total usage of relief medicine. The ODI and PGA variation were not worse in the experimental group than the control group. The two groups showed no significant differences in side effects (p=0.9708). Conclusions: This study found that the Pelubi SR Tab applied to back pain patients was not inferior to the Pelubi Tab and did not show any significant difference in terms of safety. The Pelubi SR Tab can be used with the same expectation of safety as the Pelubi Tab. Materials and Methods: From April 11, 2014 to July 24, 2014, 166 chronic back pain patients were recruited as subjects through a multi-institution, double-blind, random sample. We compared the experimental and control groups’ clinical efficacy, which was estimated by the 100-mm Pain Visual Analog Scale (VAS) after 28 days of medication. We also compared the treatment efficacy of both drugs by using a variation of the Oswestry Disability Index (ODI) and Physician Global Assessment (PGA), with the total usage of relief medicine. The side effects and clinical pathology were also noted. Results: Neither group showed a significant difference in 100-mm Pain VAS or ODI variation (p=0.1702, p=0.9041). There was no statistically significant difference between the experimental group and the control group in PGA or total usage of relief medicine. The ODI and PGA variation were not worse in the experimental group than the control group. The two groups showed no significant differences in side effects (p=0.9708). Conclusions: This study found that the Pelubi SR Tab applied to back pain patients was not inferior to the Pelubi Tab and did not show any significant difference in terms of safety. The Pelubi SR Tab can be used with the same expectation of safety as the Pelubi Tab. 연구계획: 무작위배정, 이중눈가림, 다기관 제 3상 임상시험. 목적: 펠루비서방정의 만성 요통환자에서 유효성 및 안정성을 평가하기 위해 임상 3상 시험을 통해 효과가 입증되었던 펠루비정과의 비교 연구를 시행하였다. 선행문헌의 요약: 요통환자에게 사용되는 펠루비정은 임상적 유효성이 입증되었다. 대상 및 방법: 2014년 4월 11일부터 2014년 7월 24일 까지 105일 동안 비교연구에서 통계학적 유효성을 갖는 실험군 산출을 하였고, 이를 기준으로 선별된 만성 요통환자 166명을 대상으로 하였다. 연구는 다기관, 이중눈가림, 무작위배정을 통하여 시행하였다. 약물 투여전 대비 28일째 100 mm Pain Visual Analog Scale(VAS)의 변화로 평가되는 통증 완화 효과에 대한 시험약과 대조약의 치료적 유효성을 비교 하였다. 또한 Oswestry Disability Index (ODI) 및 Physician’s Global Assessment (PGA)의 변화, 구제약의 사용횟수 및 총 사용량으로 평가되는 시험약과 대조약의 치료적 유효성 비교와 이상반응, 임상병리결과에 대하여 검사하였다. 결과: 시험약 투여 후 100 mm pain VAS 및 ODI의 변화량의 차이를 군간 비교한 결과 각각 두 군의 차이는 없었다(p=0.1702, p=0.9041). 또한 PGA, 구제약의 사용횟수 및 사용량에서 시험군과 대조군 간의 통계적 유의성이 없었다. ODI 및 PGA의 변화에서도 시험군은 대조군에 비하여 열등성을 보이지않았다. 시험군과 대조군의 이상반응 발현율은 통계학적으로 유의한 차이를 보이지 않았다(p=0.9708). 결론: 본 임상시험결과 요통환자에게 사용되는 펠루비서방정은 대조약인 펠루비정과 비교하여 유효성 면에서 열등하지 않으며, 안전성 면에서도 유의한차이를 보이지 않으므로 유효하고, 안전하게 사용할 수 있는 약제라고 사료된다.

요통환자의 진단과 치료

김기택 大韓家庭醫學會 1997 Korean Journal of Family Medicine Vol.18 No.2

Estrogen Receptor 2 유전자 다형성과 척추 후종인대 골화증의 관계

김기택,곽윤호,이상훈,손은석,박경준,김덕현 대한척추외과학회 2012 대한척추외과학회지 Vol.19 No.1

Study Design: Genetic screening of the estrogen receptor 2 (ESR2) genes in patients with ossification of the posterior longitudinal ligament (OPLL). Objective: We studied the relationships between ESR2 gene polymorphisms and OPLL to understand the pathophysiology of OPLL. Summary of Literature Review: The OPLL has a strong genetic component. Several familial surveys and human leukocyte antigen (HLA) haplotype studies reveal that genetic background is an important component in the occurrence of OPLL and a large number of gene analysis studies were utilized to clarify the susceptible gene for OPLL, including COL11A2, BMP-2, TNF-α, NPPS, leptin receptor,transforming growth factor (TGF)-β, Retinoic X receptor, ER, IL-1, PTH, and VDR have been performed. Materials and Method: Genomic deoxyribonucleic acid (DNA) samples obtained from 164 patients (93 men and 71 women) with OPLL and 219 control subjects, without the disease (105 men and 114 women) were amplified by polymerase chain reaction, and polymorphism genotypes were determined by the restriction endonuclease digestion. The distribution of genotypes was compared between the patients with the disease and the control subjects. Results: The polymorphism of ESR2 [rs1256049, exon6, Val328Val, p=0.018, odd ratio (OR)=2.41, 95 confidence interval (CI)=1.15-5.02 in the recessive model] only showed statistically significant association between the control and the OPLL groups. The rest SNPs of ESR2did not show any significant differences between the control and the OPLL groups. Conclusions: Estrogen receptor 2 (ESR2) gene polymorphisms (rs 1256049) was associated with OPLL. In future studies, we will perform target SNP chip between OPLL and candidate gene. 연구계획: 척추 후종인대 골화증(ossification of the posterior longitudinal ligament, OPLL) 환자의 estrogen 수용체 2(estrogen receptor 2, ESR2) 유전자에 대한 분석목적: 후종인대 골화증의 병태생리를 이해하기 위하여 ESR유전자 이형성과의 관계를 연구 하였다. 선행문헌의 요약: 후종인대 골화증은 사람 백혈구 항원(human leukocyte antigen, HLA) 및 가계도 조사등에 의해 강한 유전적 경향을 보이는 것으로 밝혀 졌고 많은 연구를 통하여 COL11A2, BMP-2, TNF-α, NPPS, leptin receptor, transforming growth factor(TGF)-β, Retinoic X receptor, ER, IL-1, PTH,VDR등의 유전적 관련성이 보고 되었다. 대상 및 방법: 164명의 후종인대 골화증군과 219명의 대조군에서 DNA를 채취한 후 ESR2의 rs1256049, rs928554, rs1255998 3개의 각각 유전자형을후종인대 골화증과 상관관계를 분석하였다. 결과: ESR2의 여러 이형성 중에 rs1256049 [exon6, Val328Val, p=0.018, odd비 (OR)=2.41, 95 신뢰구간(confidence interval, CI)=1.15-5.02 in the recessive model]중 A/A genotype만이 양군에서 통계적으로 유의한 차이를 보이며 연구대상군에서 많은 발현을 보였다. 다른 이형성은 유의한 차이를보이지 않았다. 결론: ESR 2 gene의 다형성 중 rs1256049의 A/A genotype이 후종인대 골화증의 발생 위험과 관련성을 나타내었다.

보육원에서

김기택 대한기독교서회 2010 基督敎 思想 Vol.620 No.-

압박골절에서 경피적 척추 성형술 후 발생한 신경근 손상 : 증례 보고 A Case Report

김기택,석경수,김진문,박경찬 대한척추외과학회 2001 대한척추외과학회지 Vol.8 No.2

경피적 척추 성형술은 1984년 프랑스에서 처음 소개되었다. 경피적 척추 성형술은 동통을 동반한 압박골절에서 치료의 한 방법으로 최근 소개되고 있다. 유럽의 몇몇 보고에 의하면 척추체 압박골절에서 우수한 임상 결과를 얻을 수 있었고 합병증은 경미하고 빈도가 매우 적은 것으로 되어 있다. 본 저자들은 압박골절에서 경피적 척추 성형술 후 신경근 손상 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. The first image-guided percutaneous vertebroplasty was performed in France in 1984. Percutaneous vertebroplasty recently has been introduced as a therapeutic alternative for the treatment of pain associated with compression fracture. Several European reports have described excellent results for treatment of compression fracture, and complications were minor and infrequent. We experienced a case of root injury after percutaneous vertebroplasty in compression fracture, which was treated by posterior decompression and removal of the cement

저압가스질화에 의한 강의 질화층 성장거동

김기택,김윤기,김상권,문경일,김영국 한국표면공학회 2010 한국표면공학회 학술발표회 초록집 Vol.2010 No.5

저압 가스질화법에 의한 탄소강(S45C)과 합금강(SKD61)의 질화과정에서 표면에 형성되는 질소화합물의 성장거동을 주사전자현미경, 에너지분산형 x-선 분석, x-선 회절을 이용하여 관찰하였다. 540℃에서 1분 질화처리에 의해서 표면에 다수의 입자가 연결된 형태의 질화물이 형성되며, 질화시간이 증가됨에 따라 입자 사이에 존재하는 pore의 양이 감소하고, 화합물층의 두께는 증가하였다. S45C 강보다 SKD61강의 경우 같은 시간에 더 많은 양의 pore가 존재하며 질화물층의 두께가 얇았다.

[시인의 산문] 시 못 쓰는 날의 일기

김기택 천년의시작 2019 (계간)시작 Vol.18 No.3