외안근 감돈을 동반한 소아 안와내벽골절 1예

조승환,김수진 대한안과학회 2015 대한안과학회지 Vol.56 No.6

목적: 머리 수상 후 두통, 안구운동장애 및 복시를 주소로 내원한 소아가 내직근의 감돈을 동반한 안와내벽골절을 진단 받고 수술적 치료를 받은 1예를 경험하였기에 이를 보고하고자 한다. 증례요약: 기저질환이 없는 만 16세 남자 환자가 내원 1일 전 음주 상태로 아파트 계단에서 넘어진 후 두통 및 우측 안구의 심한 운동장애와 복시, 오심이 지속되어 수상 다음 날 내원하였다. 수상 당시 음주 상태로 기억이 없으나 후두부 부종이 만져진다고 하였다.안와 주위에 혈종이나 부종은 없었고, 세극등현미경 검사에서도 우안 비측 결막에 경도의 충혈 외에 특이소견은 관찰되지 않았다.제일안위에서 18프리즘디옵터의 외사시를 보였고, 안구운동검사에서 우안의 심한 내전 및 경도의 외전 장애가 관찰되었으며, 안구운동 시 통증을 호소하였다. 뇌자기공명영상검사에서 두개강내 이상소견은 보이지 않았고, 뇌자기공명영상검사와 부비동 전산화단층촬영에서 우안 안와내벽의 골절편에 연부 조직 및 근육이 감돈되어 있는 들창문형의 안와내벽골절 소견을 확인할 수 있었다. 내원 48시간 이내에 안와골절 정복술을 시행하였고, 수술 50일 이후에 안구운동장애와 복시는 거의 회복되었다. 결론: 안와 주변에 대한 외상의 병력이 불분명하고 안와 주위에 혈종이나 부종 등의 소견을 보이지 않는 소아 안와골절의 경우 뇌병변으로 오인할 수 있으므로, 소아에서 외상 후 안구운동제한과 복시, 오심, 구토 등의 증상이 동반된다면, 신경학적 평가 외에도 안와골절에 대한 감별 진단을 반드시 시행해야 할 것이다. Purpose: To report a case of pediatric medial wall blowout fracture with entrapment of medial rectus muscle which can be easily misdiagnosed as a cerebral lesion. Case summary: A 16-year-old male visited our clinic with headache, severe restriction of his right eye movement, and diplopia after a head injury due to falling occurring 1 day before evaluation. The patient was inebriated at the time of the accident and could not recall the event but occipital hematoma was palpable. Periorbital ecchymosis or edema was not observed with minimal soft tissue injury except mild conjunctival injection on slit-lamp examination. The patient had an 18 prism diopter exodeviation at primary position and severe medial and mild lateral gaze limitation in his right eye. Brain magnetic resonance imaging (MRI) showed no specific cerebral findings although trapdoor orbital medial wall fracture with incarceration of soft tissue and medial rectus muscle at the medial wall fracture site of his right eye was observed. Within 48 hours from the first evaluation, the blowout fracture was repaired and 50 days postoperatively, right eye gaze limitation and diplopia were nearly recovered. Conclusions: A case of pediatric blowout fracture with uncertain injury location, periocular ecchymosis, or edema absent could be misdiagnosed as a cerebral lesion. If a pediatric patient is experiencing gaze limitation, diplopia, nausea, or vomiting after trauma, neurological examination as well as evaluation for blowout fracture should be performed.

연소합성을 이용한 저온형 고체산화물 연료전지용 나노구조 세리아계 전해질 제조

조승환,김종호,김도경,Jo, Seung-Hwan,Kim, Jong-Ho,Kim, Do-Kyung 한국세라믹학회 2005 한국세라믹학회지 Vol.42 No.12

Gadolinia-doped ceria nanopowder was prepared by glycine-nitrate combustion method with different glycine/nitrate mixing ratio. The characteristics of the synthesized powder were investigated by X-ray diffraction method, transmission electron microscopy, thermal gravity, differential thermal analysis and thermo-mechanical analysis. The smallest powder was obtained with glycine/nitrate ratio 1.00 and the lowest organic and water vapor contained powder was made with glycine/nitrate ratio 1.75. According to dilatometry, fast densification was occurred around $1000^{\circ}C$ and shows full density over $1300^{\circ}C$. Finally near-fully dense ceria electrolyte was fabricated with conventional sintering technique. Glycine-nitrate process yields fine nanopowders which enable low temperature sintering and fabrication of fully dense and nanostructured oxide electrolyte.

복합운동프로그램에 참여한 뇌성마비 청소년의 신체구성, 등속성 근력 및 운동기능의 변화

조승환,이운용,이대택 대한운동사협회 2009 아시아 운동학 학술지 Vol.11 No.3

[INTRODUCTION] The purpose of this study was to investigate the changes of body composition, isokinetic muscular strength, and motor function in cerebral palsy participating combined exercise program. [METHOD] Eight men volunteered for this study (15.4±1.6 yrs, 154.9±6.7 cm, 46.6±9.4 kg, 19.2±9.4 %Fat) and they were more than 13 year old who could communicate and exercise by themselves. They performed walking and weight bearing exercise 3 times a week for 8 weeks. Then after 4 weeks, they participated the exercise program again. Body composition for BIA and isokinetic muscular strength for Biodex were measured. Motor function for Gross Motor Function Measures(GMFM) were also measured. [RESULT] Body composition did not significantly differed between before and after exercise (p>.05). Isokinetic muscular strength; Knee extensor and flexor muscular strength and GMFM were significantly different between before and after exercise (p<.05). [CONCLUSION] Combined exercise program affected isokinetic muscular strength and motor function but did not seem to affect the body composition. In other words, walking and muscular strength combined exercise affected to cerebral palsy youth in isokinetic muscular strength and motor function only. [서론] 본 연구의 목적은 뇌성마비 청소년의 복합 운동프로그램 참여에 따른 신체구성, 등속성 근력 및 운동기능에 미치는 영향을 살펴보는 데 있다. [방법] 피험자(n=8명, 나이: 15.4±1.6세, 키: 154.9±6.7cm, 몸무게: 46.6±9.4kg, %Fat: 19.2±9.4%)는 뇌성마비 진단을 받은 13세 이상 중등학교 특수 학급 학생이었다. 이들에게는 8주간 주3회 60분씩 개인별 체력 수준에 맞추어 유산소 운동과 근력강화 운동을 병행하였고 운동 4주후 개인 체력 수준에 맞추어 강도가 재설정 되었다. 피험자의 신체구성은 생체전기저항 방법을 이용하여 측정했고, 등속성 근력은 등속성 운동장비(Biodex Pro4)를 이용하여 측정했다. 운동기능은 대동작기능평가(Gross Motor Function Measures)방법 중 걷기와 관련된 4·5영역을 평가하였다. [결과] 걷기와 근력 복합운동이 뇌성마비 청소년의 신체구성에는 영향을 미치지 못했다(p>.05). 반면 등속성 근력 분석 결과 좌우측 슬관절 신전과 굴곡 최대 근력과 운동기능 변화에서는 효과가 있는 것으로 나타났다(p<.05). [결론] 뇌성마비 청소년에게 걷기와 근력 복합운동이 등속성 근력과 운동기능에 제한적으로 효과가 있는 것을 알 수 있었다.

Clinical Outcomes of Total Hip Arthroplasty for Displaced Femoral Neck Fractures in Patients 80 Years of Age and Older Selected by Clinical Frailty Score

조승환,Se Hwan Lee,윤선중 대한고관절학회 2020 Hip and Pelvis Vol.32 No.3

Purpose: The utility of total hip arthroplasty (THA) for the treatment of displaced femoral neck fractures in elderly patients (≥80 years of age) remains controversial as a patient’s general condition is an essential factor impacting recovery. This study aims to determine if THA is a valuable option for appropriately selected elderly patients. Materials and Methods: All patients underwent cementless THA using a direct lateral approach with a rectangular stem. Eighty-two patients ≥80 years of age underwent THA due to a displaced femoral neck. Clinical frailty scale (CFS) scores <5 were indicated for THA. The modified Harris hip score (mHHS), visual analogue scale (VAS), and patient satisfaction were used to assess outcomes. Results: Nine of 82 patients died in the study period with another underlying disease. One, a 90-year-old male with pneumonia expired in the intensive care unit at 7-day postoperatively, while the other eight died due to causes unrelated to THA. Of the remaining 73 patients: (i) mean mHHS score increased to 80.57±21.36 at 1- year postoperatively; (ii) VAS was 2.3±0.9 points six-months postoperatively; and (iii) 78.7% of patients reported that they were very satisfied or satisfied 1-year postoperatively. The number of perioperative complications was 10.8% (9 hips) without the need for revision surgery. Conclusion: The use of THA in patients ≥80 years of age with low CFS scores (<5) described here yielded favorable results and a relatively low rate of complications. However, a well-controlled comparative study or randomized trial is required to further refine selection criteria for THA in this patient population.

탈구를 동반한 족관절 골절에서 수술적 치료 후 최소 2년 추시 결과

조승환,이준영,조성원,박치형,Jo, Sueng-Hwan,Lee, Jun-Young,Cho, Sung-Won,Pak, Chi-Hyoung 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.1

Purpose: In previous study, the frequency of osteoarthritis and discomfort were high in ankle fracture-dislocation but detail results about ankle fracture-dislocation has rarely been investigated. In this study, we retrospectively analyze the outcome of the operative treatment of ankle fracture with dislocation for over-2 years follow up. Materials and Methods: There were 47 cases of ankle fracture-dislocation in our hospital from March 2007 to May 2010. We investigated 20 patients who underwent operation and were possible for over-2 years follow up. The result was estimated with the direction of dislocation, fracture type, the time of bone union and post-traumatic osteoarthritis with plain radiologic images. In clinical assessment, we statistically evaluated the function and pain through AOFAS score and Olerud & Molander scoring system. Results: By Lauge-Hansen classification, there were 13 cases(65%) of pronation-external rotation and 6 cases(30%) of supination-external rotation, 1 case(5%) of supination-adduction. AOFAS score was 85.5, and Olerud & Molander score was "excellent" in 8 cases, "good" in 5 cases, "fair" in 3 cases and "poor" in 4 cases. Postoperative complications in 4 cases revealed post-traumatic arthritis. All kinds of lateral dislocation of ankle fracture was 15 cases and the most common. Of these, all 3 cases, anterolateral dislocation showed post-traumatic osteoarthritis. Conclusion: In ankle fracture-dislocation, post-traumatic osteoarthritis occurred in 4 of 20 patient(20%). Especially, the possibility of post-traumatic osteoarthritis was more in cases of anterolateral or lateral dislocation. So, it must be needed that deliberate examination, for example, preoperative MRI and sufficient explanation to patient. Also, we have to follow up the patients carefully.

젊은 연령층에서의 에너지 음료 섭취와 안압과의 상관관계

조승환,이창규 대한안과학회 2015 대한안과학회지 Vol.56 No.7

Purpose: Several energy drinks containing a high content of caffeine are widely consumed among young adults. We examined the effects of caffeinated energy drinks on intraocular pressure (IOP) and blood pressure (BP) in healthy young subjects. Methods: In this prospective randomized, case-controlled cross over study conducted, from August to September of 2014, 40healthy young volunteers (80 eyes) in their 20's and 30's drank 2 types of beverage each consumed after a 3-month washout period. The study participants were randomly given the caffeinated energy drink (group I, n = 20) or caffeine-free drink (group II,n = 20), IOP and BP were measured at 0, 30, 60, 90, and 120 minutes and 12 and 24 hours after beverage consumption. Results: In group I, the mean ± standard deviation (SD) of IOP at baseline was 13.2 ± 1.56 mm Hg and the IOP increased until 24 hours after drink consumption. IOPs at 30, 60, 90, and 120 minutes and 12 and 24 hours after drinking caffeinated energy drink were 14.45 ± 2.12, 14.93 ± 2.02, 14.85 ± 1.55, 14.2 ± 1.34, 14.25 ± 1.74, and 13.35 ± 1.61, respectively and statistically significant at 30, 60, 90, 120 minutes and 12 hours (p < 0.05). A corresponding increase in BP after drinking the caffeinated energy drink was observed but without statistical significance. Drinking the caffeine-free beverage did not affect IOP or BP significantly. Conclusions: IOP increases after consuming the caffeinated energy drink were statistically significant at 30, 60, 90, and 120 minutes and 12 hours. Therefore, caffeinated energy drinks may not be recommended for glaucoma patients or glaucoma suspects. 목적: 최근 젊은 연령층에서 수요가 증가하고 있는 에너지 음료 섭취와 안압 및 혈압의 변화와 연관성에 대해 알아보고자 한다. 대상과 방법: 2013년 8, 9월 기저질환이 없는 20, 30대의 젊은 연령층 40명, 80안을 대상으로 무작위로 두 군을 분류하여 연구를 시행하였다. 그룹1(40안)은 카페인이 없는 비타민 음료를 마시게 하고, 그룹2(40안)는 카페인이 들어있는 에너지 음료를 마시게 하였으며, 음료 섭취 직전, 섭취 이후 30, 60, 90, 120분, 12, 24시간의 안압과 혈압을 측정하였다. 세 달 뒤, 음료를 맞바꾸어 동일한 연구를 시행한 후 그 결과를 비교하였다. 결과: 카페인이 포함된 에너지 음료를 섭취하기 전의 안압은 13.2 ± 1.56 (mmHg)이었고, 음료 섭취 후 30분에 14.45 ± 2.12, 60분 14.93 ± 2.02, 90분 14.85 ± 1.55, 120분 14.2 ± 1.34, 12시간 14.25 ± 1.74, 24시간에 13.35 ± 1.61로 증가하였으며, 음료 섭취30, 60, 90, 120분, 12시간 후의 안압은 통계적으로 유의한(p<0.05) 차이를 보였다. 혈압은 에너지 음료 섭취 후 상승하였으나 유의한차이는 보이지 않았고, 카페인이 없는 음료를 마신 경우 안압, 혈압은 모두 의미 있는 변화를 보이지 않았다. 결론: 카페인이 포함된 에너지 음료 섭취 30, 60, 90, 120분, 12시간 후에 측정한 안압이 음료 섭취 전에 비해 유의하게 증가하였으므로 녹내장과 녹내장 의증 환자에서는 최근 많이 소비되고 있는 카페인이 포함된 에너지 음료의 섭취 시 주의를 기울여야 할 것이다.

The Correlation between the Fracture Types and the Complications after Internal Fixation of the Femoral Neck Fractures

조승환,이상홍,이현준 대한고관절학회 2016 Hip and Pelvis Vol.28 No.1

Purpose: This study aims to determine the correlation between the fracture patterns and the complications in patients with femoral neck fracture treated with internal fixation. Materials and Methods: The study comprises 45 patients with femoral neck fracture treated with multiple screws or compression hip screw between May 2008 and April 2012. The mean age was 48 years at the time of the surgery and the mean duration from initial injury to surgery was 20 hours. The fracture patterns were identified according to the anatomical location, the Garden classification and the Pauwels classification. The occurrence of nonunion and avascular necrosis were reviewed with clinical results including Harris hip score and Lunceford hip function test. The correlation between the fracture pattern and occurrence of complications were analyzed. Results: Fracture site union was achieved in 40 hips with the average union time of 17 weeks. Five nonunions occurred which showed high likelihood to occur in subcapital type, displaced (Garden stage III or IV) and Pauwels type III fractures (P<0.05). Avascular necrosis was developed in 10 hips which was mostly in subcapital type and Pauwels type III fracture but no statistical significance was found (P>0.05). The mean Harris hip score was 91 points, and Lunceford functional results were excellent in 15 hips, good in 24, fair in 4 and poor in 2. Conclusion: There was high risk of nonunion in subcapital type fracture, displaced fracture (Garden stage III and IV) and vertically oriented fracture (Pauwels type III). Careful attention is needed in these fracture types.

뇌성마비 환자의 CT소견-뇌반구 용적과 뇌측실 용적을 중심으로-

조승환 대한영상의학회 1989 대한영상의학회지 Vol.25 No.2

Authors analysed the CT findings of 28 cerebral palsy patients at Pusan National University Hospital from January 1984 to December 1987 Volumes of hemisheres lateral ventricles and parenchywas were measured in patients who showed no remarkable abnormality on CT film and compared with those of normal control group. 1. Among the 28 cerebral palsy patients there were 6 cases of diffuse atrophy in CT findings and unilateral atrophy in 2 cases and encephalomalacia and diffuse white matter low density in 1 cases had no specific abnormal finding on CT. 2. Difference in volumes of brain parenchyme and lateral ventricles of each hemisphere was greater than that of control group. 3. The were more enlared lateral ventricles and prominent unilateral brain atrophy in 18 cases of cerebral palsy who showed abnormality on CT as compared with normal control group.

Gadolinium-doped Ceria/Magnesia (CGO/MgO) 복합체 전해질의 전기적 특성 분석

조승환,김도경,Jo, Seung-Hwan,Muralidharan, P.,Kim, Do-Kyung 한국재료학회 2008 한국재료학회지 Vol.18 No.9

Composites of gadolinium-doped ceria/magnesia(CGO/MgO) were synthesized and characterized for the electrolytes of intermediate temperature solid oxide fuel cells. XRD and SEM results revealed that composite electrolytes consisted of their own phases after sintering at $1400^{\circ}C$ without noticeable solid solution of Mg into CGO. As the MgO content increased, the total electrical conductivity decreased, which might be attributed to the decrease of grain boundary conductivity, possibly due to the lowering of the continuity of the CGO grains and blocking effects of the insulating MgO phase. The space charge effect may not be a significant factor to affect the electrical conductivity of the CGO/MgO composites.

대퇴골 간부 골절에 대한 골수강내 금속정 치료 후 발생한비후성 불유합에서 금속정 교환술의 결과

조승환,이광철,이상홍,이준영,김동휘,박성해,조영민 대한골절학회 2019 대한골절학회지 Vol.32 No.2

Purpose: This study examined the outcomes of exchange nailing for the hypertrophic nonunion of femoral shaft fractures treated with intramedullary nailing as well as the factors affecting the treatment outcomes. Materials and Methods: From January 1999 to March 2015, 35 patients, who had undergone intramedullary nailing with a femoral shaft fracture and underwent exchange nailing due to hypertrophic nonunion, were reviewed. This study investigated the time of union and complications, such as nonunion after exchange nailing, and analyzed the factors affecting the results. Results: Bone union was achieved in 31 cases (88.6%) after exchange nailing and the average bone union period was 22 weeks (14-44 weeks). Complications included persistent nonunion in four cases, delayed union in one case, and superficial wound infection in one case. All four cases with nonunion were related to smoking, three of them were distal shaft fractures, and one was a midshaft fracture with underlying disease. Conclusion: Exchange nailing produced satisfactory results as the treatment of hypertrophic nonunion after intramedullary nailing. Smoking is considered a factor for continuing nonunion even after exchange nailing. In the case of a distal shaft, where the intramedullary fixation is relatively weak, additional efforts are needed for stability. 목적: 골수강내 금속정 고정술로 치료한 대퇴골 간부 골절에서 발생한 비후성 불유합에 대해 금속정 교환술의 결과를 알아보고 결과에 영향을 미치는 인자에 대해 알아보고자 하였다. 대상 및 방법: 1999년 1월부터 2015년 3월까지 대퇴골 간부골절로 골수강내 금속정 고정술을 시행한 환자 중 비후성 불유합이 발생하여 조선대학교병원에서 금속정 교환술을 시행한 35예를 대상으로 하였다. 금속정 교환술을 시행한 후 골유합 시기와 불유합 등의 합병증에 대해 조사하였고, 금속정교환술 이후에도 발생한 불유합에 영향을 미치는 요인에 대해 분석하였다. 결과: 금속정 교환술 시행 후 31예(88.6%)에서 골유합이 이루어졌으며 평균 골유합 기간은 22주(14-44주)였다. 합병증으로는 불유합 4예, 지연유합 1예, 표재성 창상 감염이 1예 발생하였다. 불유합이 발생한 4예 모두 흡연과 관련이 있었으며이 중 3예는 원위 간부 골절이었고 1예는 중간부 골절로 기저질환이 있었다. 결론: 대퇴골 간부 골절의 골수강내 금속정 고정술 후 발생한비후성 불유합의 치료로 금속정 교환술은 만족할 만한 결과를 보였다. 흡연은 금속정 교환술 후에도 불유합을 지속시킬수 있는 요인으로 생각되며 원위 간부의 경우 골수강내 금속정의 교환술만으로는 충분한 고정력이 부족하므로 추가적인안정성을 위한 노력이 필요할 것으로 생각된다.