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Long Term Clinical and Radiological Follow-up Study in Spondylolisthesis, Grade I : Decompression with or without Instrument (GradeⅠ요추부 척추 전방 전위증의 치료 : 감압성 후궁절제술과 고정기구 삽입술의 비교)

  • Chung, Seung Young;Kim, Gook Ki;Lim, Young Jin;Kim, Tae Sung;Leem, Won;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.30 no.sup2
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    • pp.235-241
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    • 2001
  • Objective : Controversy exists which surgical treatment better in lumbar grade I spondylolisthesis, decompressive laminectomy with or without lumbar instrumentation. Methods : Out of Sixty-four patients with lumbar spondylolisthesis underwent surgery, 18 patients operated with decompressive laminectomy alone and 44 patients with decompession and lumbar instrument, during recent 5-years between January, 1994 and December, 1998. The author studied a long term follow-up in the above two groups to analyzing the overall clinical outcomes in each group and to determining the incidence of pos-toperative radiologic instability. Results : 1) Overall postoperative symptoms improvement were not so different in both groups. 2) Postoperative progressive subluxation is more common after decompressive laminectomy without instrumentation than with instrumentation group. 3) Overall clinical outcomes were slightly better in decompressive laminectomy without instrumentation than with instrumentation group but there was no significant difference. 4) Postoperative radiologic changes did not seem to influence the patient-reported clinical outcomes. 5) Postoperative complications is more common in decompressive laminectomy with instrumentation group than without instrumentation group. Conclusion : In the surgical management of grade I spondylolisthesis, the efficiency and superiority of surgical treatments requires the cost effectiveness and risk/benefit analysis of decompressive laminectomy with or without instrumentation. Therefore, Further detailed studies of long term follow up in a large number of patients in each group are needed for choice of best treatment.

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The Clinical Analysis of Patients with Carpal Tunnel Syndrome Underwent Surgery - Comparison Between Conventional and Endoscopic Surgery - (수술적 치료를 받은 수근관 증후군 환자에서 고식적인 방법과 내시경적 방법의 비교 연구)

  • Kwon, Yung-Jun;Kim, Tae-Sung;Lim, Young-Jin;Rhee, Bong-Arm;Leem, Won;Kim, Gook-Ki
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.372-378
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    • 2000
  • The carpal tunnel syndrome is one of the most common entrapment neuropathy. Surgical treatments consist of conventional open technique, alternative technique using retinaculatome, and endoscopic surgery. This study compares the outcomes of surgical treatment of carpal tunnel syndrome following conventional versus endoscopic release. The authors reviewed 56 cases of 33 patients with carpal tunnel syndrome treated surgically in our institute from January 1991 to May 1998. The follow-up evaluation was possible in 36 cases of 20 patients who had conventional release and in 11 cases of 7 patients with endoscopic release. The following parameters were evaluated for comparison : improvement of symptom, return to normal work, recovery of strength of grip and pinch, rate of complication, follow-up electrophysiologic finding. Compared with open decompression, the group of endoscopic decompression needed significantly less time to go back to work(p<0.001). Also strength of grip and pinch improved faster in the group of endoscopic decompression as well, compared with open decompression(p<0.05). These results indicate that endoscopic procedure is an excellent, minimally invasive method to treat carpal tunnel syndrome, performed by surgeons who are fully aware of the anatomy.

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A Comparative Study on the Rules of Origin of Fishery Products in South Korea's Major FTAs : Focused on the Korea-US FTA and European Agreements (우리나라 주요 FTA협정의 수산물 원산지 규정에 관한 비교 연구 - 한·미 및 유럽권 협정을 중심으로 -)

  • Park, Jin-Woo;Pak, Myong-Sop;Choi, Doo-Won
    • Korea Trade Review
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    • v.41 no.5
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    • pp.213-233
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    • 2016
  • In an FTA, rules of origin are decided by an agreement between countries directly involved and provided through a written agreement, considering the characteristics of each industry and the situations of the countries, for the characteristics of each item. The PSR on fishery products by item are broadly divided into an agreement that applies the wholly-obtained criterion and an agreement that applies the Change of Chapter (CC). Fishery products belong to HS Code Chapter 3, which are generally produced through obtaining by raising or fishing. This study compared each agreement from this point of view. For the fishery products caught, an error in the job-related judgment may occur in a situation in which the persons in charge do not have any background knowledge involved with high sea fisheries. Since ships may sail, hoisting the flag of the country of registration according to an international agreement, involved with requirements for the recognition of ships for the judgment of the country of origin, the principle of the exclusivity of the flag state should be taken into consideration.

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Policy Suggestions to Korea from a Comparison Study of the United States, the United Kingdom, Germany, the Netherlands, and Denmark's Polices on Risk Assessment of Contaminated Soils (토양오염 지역의 위해성 평가에 관한 외국 정책의 비교분석 및 우리나라의 정책 개선에 관한 고찰)

  • Park Yong-Ha;Yang Jay-E.;Ok Yong-Sik
    • Journal of Soil and Groundwater Environment
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    • v.10 no.5
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    • pp.1-10
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    • 2005
  • Policies of the United States, the United Kingdom, the Netherlands, Germany and Denmark were compared and analyzed on risk assessment of contaminated sites. These countries were chosen from a feasible preliminary analysis of 18 countries of the European Union and the U. S. All the countries selected met two major criteria : I) implementation of risk assessment to determine the soil contamination and remediation targets of contaminated sites, ii) use of soil guidance values and risk assessment as complementary measures to determine soil contamination. Suggested policy improvements to Korea regarding these issues include i) legislation of a rational risk assessment methodology of contaminated sites, and ii) enactment of collaboration of risk assessment with the soil guidance values. To establish effective risk assessment legislation, additional in-depth research on social, economic and long-term effects of the proposed risk assessment methodologies, as well as the mutual consent of all parties including academia, industry, and administration will be necessary. Linking risk assessment with soil guidance values would be applicable to a site contaminated where the contaminant concentration exceeds a certain soil guidance value. In parallel, application of risk assessment to a site where a contaminant concentration is naturally different such as mining sites would be plausible. The policy suggestions above are not yet conclusive due to a lack of policy implementation, and simulation. Thus, additional research on developing risk assessment methodology is needed. Nevertheless, initiation of the suggested policy would increase the efficacy of Korean policy regarding the survey and remediation of contaminated sites.

Evaluation of Three Species of Diatoms for Rearing Larvae of Sea Urchin, Strongylocentrotus intermedius (북쪽말똥성게, Strongylocentrotus intermedius 유생에 대한 3종 규조류의 먹이효과)

  • Lee Chae Sung;Baik Kook Ki
    • Journal of Aquaculture
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    • v.8 no.4
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    • pp.317-326
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    • 1995
  • In order to evaluate three species of diatoms as the live food sources for rearing larvae of sea urchin, Strongylocentrotus intermedius, six different feed experiments were conducted for 35 days. We measured sizes, survival rates on elapsed day after hatching and required days of each larval stages of sea urchin in the different feeding experiments. Sizes of the larvae of sea urchin cultured with Isochrysis + Chaetoceros, Isochrysis, Chaetoceros and Pavlova were $735{\mu}m$, $718{\mu}m$, $701{\mu}m$ and $642{\mu}m$, respectively. The highest daily growth rates of the larvae of sea urchin showed Isochrysis within 6 armed and Chaetoceros after 6 armed. Survival rates of the larvae of sea urchin cultured with Chaetoceros, Isochrysis + Chaetoceros, Isochrysis and Pavlova were $37.2\%,\;35.0\%,\;32.4\%,\;and\;18.4\%$, respectively. The required days from fertilization to the 8 armed (Senior) stage in the larvae of sea urchin, fed Chaetoceros, Isochrysis, Paviova, chaetocerost+pavlova, pavloua + Isochrysis and Isochrvsis + chaetoceros were 24, 27, 33, 28, 30 and 25 days, respectively.

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Treatment Outcome of Gamma Knife Radiosurgery for GH-Secreting Pituitary Tumors (성장호르몬 분비 뇌하수체선종에 대한 감마나이프 방사선수술의 치료결과)

  • Lim, Young Jin;Choi, Yeong Ho;Leem, Won;Lee, Ki Taek;Koh, Jun Seok;Kim, Tae Sung;Kim, Gook Ki;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.30 no.5
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    • pp.567-574
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    • 2001
  • Objective : As for growth hormone(GH) secreting pituitary adenoma, it's remission should be declared on the basis of satisfactory controlling of the tumor, normalization of hormonal level, and symptomatic improvement of the patient. Several modalities of treatment have been applied and administered, and yet, this disease still remains as inveterate one to be fully treated. The purpose of this study is to evaluate the outcome of gamma knife radiosurgery(GKRS) for GH secreting pituitary adenoma, and to identify various factors affecting the outcome of the treatment. Method : A group of 24 out of 35 patients, treated by Leksell gamma knife unit during the period of March of 1992 through October of 1997, had been observed for more than two years. The mean target volume of microadenoma was $449.3mm^3(range 216-880mm^3)$, and that of macroadenoma was $3183.1mm^3(range 1456-13125mm^3)$. The tumor margin was covered with 50% isodose profile, and mean marginal dose was 25.2Gy(range 15-32.4Gy). The mean number of isocenter was 4.3(range 1-6). The exposed dose to the optic apparatus was less than 8Gy. The mean follow-up period was 37.8months(range 24-102months). Result : No patients showed any increase in the tumor volume during the follow-up period. And definite shrinkage of tumor volume(tumor volume reduction rate, TVRR : more than 50%) was obtained in 10 patients(41.7%). Twenty one patients(87.5%) had reduced hormonal level compared than pre-treatment level. Among them, normalization of the hormonal level was achieved in 12 patients(50%). Clinicoendocrinological remission was seen in 3 patients (12.5%). According to the results of statistical analysis, tumor volume(p=0.016),duration of symptoms(p=0.046), initial GH level(p=0.017), and the invasion of cavernous sinus(p=0.036) were significantly favorable to post-radiosurgical outcome. The TVRR was significantly related to post-radiosurgical reduction of serum GH level. Permanent complication was not seen. Conclusion : The authors concluded that GKRS is a safe and effective treatment modality for acromegaly. To otain the better outcome of GKRS in GH secreting pituitary adenoma, more careful and sophisticated treatment-planning is recommended.

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The Role of Gamma Knife Radiosurgery for Essential and Secondary Trigeminal Neuralgia - vs Microsurgery - (특발성 및 이차성 삼차 신경통에 대한 감마나이프 방사선수술의 역할 - 수술적 치료와의 비교 -)

  • Keem, Sang Hyun;Lim, Young Jin;Leem, Won;Rhee, Bong Arm;Koh, Jun Seok;Kim, Tae Sung;Kim, Gook Ki
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.650-658
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    • 2000
  • Objective : To evaluate the role of Gamma Knife radiosurgery in essential and tumor-related(secondary) trigeminal neuralgia, outcomes of radiosurgery and microsurgery were compared each other. Methods : Five patients with essential trigeminal neuralgia underwent stereotactic radiosurgical treatment with Leksell Gamma Knife and twenty five patients were treated with microsurgery during the same period(1994. 1-1997. 6). A 4-mm collimator was used and REZ or proximal portion of trigeminal nerve was targeted with maximal dose of 60-72Gy. The mean follow-up after radiosurgery was 39.4 months and that after microsurgery was 47.9 months. Results : At the last follow-up, four patients(80%) had excellent(pain free) or good(50-90% pain relief) outcomes, one(20%) had poor control after radiosurgical treatment. Twenty-three patients(92%) had excellent or good outcomes and two(8%) had poor results after microsurgery. Postoperative complications occurred in ten(40%) with microsurgery, but there were no complications in patients with Gamma Knife radiosurgery. Six patients with secondary trigeminal neuralgia received radiosurgical treatment directed at their tumors, and three patients were surgically treated. Three of six(50%) patients treated with Gamma Knife had pain relief while two of three patients with surgical treatment showed immediate pain relief. Post-treatment complications were developed in two of six radiosurgical patients and in one of three surgical patients. Conclusion : Gamma Knife stereotactic radiosurgery may be considered as a useful and alternative option for the treatment of essential and secondary trigeminal neuralgia owing to of its safety and less complications. The preliminary results obtained in our series appear encouraging, although the outcome is not so good as that of surgery.

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A Clinical Analysis of Chronic Subdural Hematoma according to Age Factor (연령에 따른 만성 뇌경막하 혈종의 임상적 분석)

  • Jeong, Jae Eun;Kim, Gook Ki;Park, Jong Tae;Lim, Young Jin;Kim, Tae Sung;Rhee, Bong Arm;Leem, Won
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.748-753
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    • 2000
  • Objectives : A 10-year retrospective clinical study was undertaken to determine the differences between two groups according to age at presentation(group A, under 50 ; B, over 50). Methods : We analyzed 468 cases with chronic subdural hematoma admitted to the department of neurosurgery in our hospital from January 1987 to December 1996. The patients were divided into two groups according to age at presentation(group A, under 50 ; B, over 50). Results : 1) The number of group A was 126 cases(26.9%) and that of group B was 342 cases(73.1%), respectively. Males were more frequently involved than females in each group. 2) There noted a history of head trauma in 88.9% of group A and 92.4% of group B. Forty-nine patients(38.9%) of group A and 103 cases(30.1%) of group B revealed a history of alcoholism. 3) Group A patients presented with symptoms of increased intracranial pressure such as headache(75.% ), nausea and vomiting(68.0%). However, Group B patients had more frequent mental changes(84.0%) and focal neurological deficits such as hemiparesis(76.5%). 4) Onset of symptom and its duration was shorter in group A than group B. 5) Six patients among 441 cases(1.4%) treated with burr hole drainage and two patients of 27 cases(5.4%) with craniotomy died, and all of these were group B patients. The two cases among six patients with burr hole drainage developed huge intracerebral hemorrhage and brain stem hemorrhage, respectively. Conclusion : In treating patients with chronic subdural hematoma, distinguishing between two age groups is quite helpful to determine treatment strategies.

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Studies on Seed Production of Rainbow Trout, Oncorhynchus mykiss - Hatching rate and early stage performance of USA strain rainbow trout, Oncorhynchus mykiss - (무지개송어, Oncorhynchus mykiss의 종묘생산에 관한 연구 - 미국산 무지개송어의 부화 및 자치어 성장 -)

  • Baik, Kook-Ki;Choi, Young-Hee;Lee, Joong-Chul;Park, In-Sik;Kim, Young-Kil;Kim, Doo-Youn;Lee, Chae-Sung
    • Journal of Aquaculture
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    • v.20 no.2
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    • pp.85-89
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    • 2007
  • This study examined the hatching rate of eyed-eggs and growth of fingerlings of USA strain rainbow trout, Oncorhynchus mykiss, which were transplanted on Nov. 17, 2005 from the USA for improvement of breeding. The diameter and weight of eyed-eggs were $4.95{\pm}0.34\;mm$ and $0.07{\pm}0.003\;g$, respectively. The eyed-eggs were hatched in 8 days later and hatching rates were $77.3{\sim}98.6%$. After 56 days from hatching, the fingerlings grew to $4.0{\pm}0.7$ cm and 0.62 g in total length and body weight, respectively. The relationships between total length (TL) and elapsed days (ED) were expressed as TL=0.0366ED+1.8645 ($r^2=0.928$, n=350). The relationships between body weight (BW) and elapsed days (ED) were expressed as following; $BW=0.0638e^{0.0408ED}\;(r^2=0.9917,\;n=350)$. And survival of rainbow trout was $64.5{\pm}1.3%$ in 56 days after hatching.

Management Outcome and Clinical Manifestation of Posterior Circulation Aneurysms VS. Anterior Circulation Aneurysm (후순환계 뇌동맥류의 임상양상과 치료예후 - 전순환계 동맥류와의 비교분석을 중심으로 -)

  • Jeong, Je Hoon;Kim, Gook Ki;Koh, Jun Seok;Lim, Young Jin;Kim, Tae Sung;Leem, Won;Rhee, Bong Arm
    • Journal of Korean Neurosurgical Society
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    • v.30 no.9
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    • pp.1086-1093
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    • 2001
  • Object : With the recent variable treatment modalities and the development of microsurgical techniques, outcomes of surgical and medical management of aneurysm have shown much progress in the last 10 years. However, the management of posterior circulation aneurysm is still a debatable due to its difficulty in limited surgical approach, complicated anatomical structure and many small perforators to vital structure. The purpose of this study is to compare the results of clinical manifestation and outcome of surgery with respect to anterior and posterior circulation aneurysms. Material and Methods : We evaluated the 33 patients with PCAs(posterior circulation aneurysm) and 359 patients with ACAs(anterior circulation aneurysm) treated between 1994 and 1999, retrospectively. Results : Posterior circulation aneurysms showed higher tendency(5 cases, 14.7%) to have unusual shapes, such as dissecting or fusiform compared with anterior circulation aneurysm(15 cases, 4.2%). There were more multiple aneurysms in posterior circulation aneurysm(8 cases, 26.5%) than anterior circulation aneurysm(59 cases, 16.2%). The number of patients with Hunt-Hess grade III or IV on admission were 91(25.3%) in anterior circulation aneurysms, and 14(42.4%) in posterior circulation aneurysms. There were higher incidences of vasospasm and acute hydrocephalus in patients with posterior circulation aneurysm. In cases of anterior circulation aneurysm, neck clipping was possible in 97%. But, in posterior circulation aneurysm, neck clipping was possible only in 67.7% of each. Two hundred forty four cases(85.0%) of all anterior circulation aneurysms and 22 cases(78.6%) of all posterior circulation aneurysms showed good recovery(GR) or moderate disability(MD). The postoperative mortality rates of anterior and posterior circulation aneurysms were 4.9% and 10.7%, respectively. Conclusion : These results indicate that there exist substantial differences with respect to that there were few difference in the aspect of surgery and management outcome between posterior circulation aneurysms and anterior circulation aneurysms.

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