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RISS 인기검색어
- 검색키워드
- 저자 : 장형원 ( Hyoung Won Jang ) (검색결과 3 건)
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Clinical Article : 소아 청소년기 운동선수에서 발생한 슬관절 박리성 골연골염의 수술적 치료 결과
국우종 ( Woo Jong Kuk ),장형원 ( Hyoung Won Jang ),김재영 ( Jae Young Kim ),하정구 ( Jeong Ku Ha ),김진구 ( Jin Goo Kim ) 대한스포츠의학회 2013 대한스포츠의학회지 Vol.31 No.2
The purpose of this study was to investigate clinical and radiological outcomes of multiple drilling in case of failed conservative treatment of juvenile osteochondritis dissecans in athletes. We treated 37 lesions from 30 athletic patients who failed conservative treatment for juvenile osteochondritis dissecans. Multiple drillings were done for 32 lesions and multiple drilling and bioabsorbable pin fixations were done for 5 lesions. Lysholm score, Hughston clinical scale were used for clinical evaluation before and last follow up of treatment. For radiologic evaluation we used magnetic resonance imaging at 3 months and 12 months after operation. Of all 37 lesions, 11 lesions were located on medial femoral condyle, 2 lesions on lateral femoral condyle and 24 lesions on trochlear groove. There were clinical and radiological improvement from Hughston scale after operative treatment. Twenty-five patients among 30 returned to the sports activity. There were no specific complications after operation. Multiple drilling and bio-absorbable pin fixation of juvenile athletic osteochondritis dissecans patients after failure of conservative treatment showed good clinical and radiologic results. So it would be helpful for juvenile athletic patients to return to sports activities.
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반월상 연골 동종 이식술 후 발생한 화농성 관절염의 관절경적 치료 - 증례 보고 -
김엽,윤정로,서동훈,장형원,Kim, Yeub,Yoon, Jung-Ro,Suh, Dong-Hoon,Jang, Hyoung-Won 대한관절경학회 2009 대한관절경학회지 Vol.13 No.1
21세 남자 환자로 반월상 연골 이식술 후 발생한 급성 화농성 관절염에 대해 반복적 관절경하 변연 절제술 및 세척술을 이용 성공적으로 치료 하였던 증례에 대해 보고 하고자 한다. 저자들의 치료 과정은 관절경을 이용한 변연 전제술과 10L 식염수 세척술, 5회의 반복적 관절경 시술, 항생제 정맥 주사로 진행하였다. 반복적 관절경 시술은 임상적 소견과 검사실 결과을 기준으로 결정하였다. 본 증례는 반월상 연골 이식술 후 발생한 급성 화농성 관절염의 치료로 조기에 시행한 관절경 변연 절제술 및 세척술, 이후의 반복적 관절경하 세척술이 효과적 치료 방법의 하나로 고려 될 수 있다고 사료된다. We report the case of a 21-year-old man with acute septic arthritis of the knee after meniscal allograft transplantation, which was successfully treated with repeated arthroscopic debridement and irrigations. Our procedures included arthroscopic debridement and irrigation with 10L normal saline, repeated arthroscopic irrigations (5 times), and intravenous antibiotics. Our decision to repeat the debridement was based on clinical and laboratory results. The significance of this case is that early aggressive arthroscopic debridement and repeated irrigations as part of a treatment protocol of acute septic arthritis after meniscal allograft transplantation can be an effective treatment option in selected cases.
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급성 신부전에서의 필수 아미노산으로 구성된 TPN의 효과
서영희,윤정이,장형원,이명덕 한국병원약사회 2002 병원약사회지 Vol.19 No.3
Morbidity and mortality in acute renal failure(ARF) remain high despite the early and aggressive therapy of dialysis and other medical advances. ARF is characterized by consistently protein catabolic body wasting which may have adverse effects on the outcome of their illness in the presence of excessive nitrogen retention. The patients with ARF frequently are uremic symptoms and suffer from malnutrition by therapy including dialysis, so require nutritional support. But among the nutrients, unselected protein cannot be administrated to patients with ARF because of aggravation of uremic symptoms. Recently, several studies have suggested that patients with ARF may benefit from treatment with infusions of small quantities of essential amino acids(EAA). The metabolic effect of intravenous EAA based Total Parenteral Nutirition(TPN) (NETNA ; Total Nutrient Admixture Formula) in the treatment of ARF retrospectively was evaluated. From June 1998 through July 2002, of all patients(n=38) at Kangnam St. Mary's hospital with ARF received NETNA, 8 patients met most of the following criteria in this study ; without dialysis and the administration time over 5 days. The time interval between the renal injury leading to renal failure and the beginning of therapy with NETNA was 17.2days. The time of NETNA administration was 16.4days. The mean total calories before treatment was 676.5㎉/d and after was 1682.5㎉/d(1378 ㎉ - 80% as NETNA). The mean blood urea nitrogen level decreased before treatment from 67.9±43.2㎎/㎗ to 35.9±38.2㎎/㎗ and the mean serum creatinine level dropped markedly from 5.59±4.3㎎/㎗ to 2.3±1.7㎎/㎗. The mean plasma potassium and magnesium concentration were unchanged by the treatment and remained within the normal range. The mean phosphate level statistically significantly dropped from 5.13±0.25㎎/㎗ to 2.93±1.40㎎/㎗(p<0.05). The mean cholesterol and triglyceride concentration remained within the normal range. Of 8 patients, 5 was carried out hemodialysis before NETNA administration, they all were stopped after administraion of NETNA. Intravenous administration of EAA based on TPN resulted in a stabilization of blood urea nitrogen levels and improved nutritional state with perhaps more rapid recovery of renal function. Adequate nutrition support could be performed in ARF without the need for additional therapy for the metabolic consequence of uremia(ex. dialysis).
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