• Title/Summary/Keyword: 연구집중도

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Clinical Picture of Adrenal Insufficiency-associated Hypotension in Preterm Infants (조산아에서 발생하는 부신기능부전과 연관된 저혈압의 임상상)

  • Choi, Eun-Jin;Sohn, Jin-A;Lee, Eun-Hee;Lee, Ju-Young;Lee, Hyun-Ju;Chung, Hye-Rim;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
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    • v.18 no.1
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    • pp.82-88
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    • 2011
  • Purpose: This study aims to describe the clinical characteristics of adrenal insufficiency-associated hypotension in preterm infants and the effects of hydrocortisone therapy on their cardiovascular system and serum electrolytes. Methods: Twelve preterm infants less than 32 gestational weeks admitted to neonatal intensive care unit (NICU) of the Seoul National University Bundang Hospital from January 2007 to August 2009 with clinical and laboratory findings suggestive of adrenal insufficiency were analyzed retrospectively. Results: Gestational age was 27.8${\pm}$2.5 weeks and birth weight was 1,110${\pm}$307 g. Postnatal age, postmenstrual age, weight at the onset of adrenal insufficiency-associated hypotension were 19${\pm}$7 day, 30.6${\pm}$2.4 weeks, 1,285${\pm}$365 g. In preterm infants who showed vasopressor resistance, intravenous hydrocortisone was started with a stress dose of 4 mg/kg/day, maintained for 2.2${\pm}$0.7 days, and then tapered. Serum cortisol concentration before hydrocortisone administration was 11.6${\pm}$4.1 mg/dL. Mean blood pressure increased from 25.0${\pm}$5.4 mmHg to 35.0${\pm}$5.3 mmHg, 38.3${\pm}$8.0 mmHg and 41.9${\pm}$6.5 mmHg at time of hydrocortisone administration and 2, 4 and 6 hours after hydrocortisone administration. Urine output increased from 0.9${\pm}$0.6 mL/kg/hr to 4.1${\pm}$3.4 mL/kg/hr. Twelve hours after the administration of hydrocortisone, dopamine requirement decreased from 11.0${\pm}$2.9 $\mu$g/kg/min to 8.0${\pm}$2.3 $\mu$g/kg/min, and to 5.5${\pm}$3.4 ${\mu}g$/kg/min after 24 hours. Serum sodium concentration was increased from 130${\pm}$4 mEq/L to 136${\pm}$4 mEq/L, serum potassium concentration was decreased from 6.1${\pm}$1.1 mEq/L to 4.6${\pm}$0.6 mEq/L before and 12 hours after hydrocortisone administration. Conclusion: In preterm infants with adrenal insufficiency-associated hypotension, hydrocortisone administration improved blood pressure and urine output, decreased vasopressor requirement, and normalized serum electrolyte abnormalities.

Environmental Pollution in Korea and Its Control (우리나라의 환경오염 현황과 그 대책)

  • 윤명조
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1972.03a
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    • pp.5-6
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    • 1972
  • Noise and air pollution, which accompany the development of industry and the increase of population, contribute to the deterioration of urban environment. The air pollution level of Seoul has gradually increased and the city residents are suffering from a high pollution of noise. If no measures were taken against pollution, the amount of emission of pollutant into air would be 36.7 thousand tons per year per square kilometer in 1975, three times more than that of 1970, and it would be the same level as that of United States in 1968. The main sources of air pollution in Seoul are the exhaust has from vehicles and the combustion of bunker-C oil for heating purpose. Thus, it is urgent that an exhaust gas cleaner should be instaled to every car and the fuel substituted by less sulfur-contained-oil to prevent the pollution. Transportation noise (vehicular noise and train noise) is the main component of urban noise problem. The average noise level in downtown area is about 75㏈ with maximum of 85㏈ and the vehicular homing was checked 100㏈ up and down. Therefore, the reduction of the number of bus-stop the strict regulation of homing in downtown area and a better maintenance of car should be an effective measures against noise pollution in urban areas. Within the distance of 200 metres from railroad, the train noise exceeds the limit specified by the pollution control law in Korea. Especially, the level of noise and steam-whistle of train as measured by the ISO evaluation can adversely affect the community activities of residents. To prevent environmental destruction, many developed countries have taken more positive action against worsening pollution and such an action is now urgently required in this country.

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Actual Results on the Control of Illegal Fishing in Adjacent Sea Area of Korea (한국 연근해 불법어업의 지도 단속 실태)

  • Lee, Sang-Jo;Kim, Jin-Kun
    • Journal of Fisheries and Marine Sciences Education
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    • v.10 no.2
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    • pp.139-161
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    • 1998
  • This thesis includes a study on the legal regulation, the system and formalities on the control of illegal fishing. And the author analyzed the details of the lists of illegal fishing controlled by fishing patrol vessels of Ministry of Maritime Affairs and Fisheries from 1994 to 1996 in adjacent sea area of Korea. The results are summarized as follows ; 1. The fishing patrol vessels controlled total 826 cases in 2,726 days of 292 voyages by 17 vessels in 1994, total 1,086 cases in 3,060 days of 333 voyages by 18 vessels in 1995 and total 933 cases in 3,126 days of 330 voyages by 19 vessels in 1996. 2. The fishing period of illegal fishing was generally concentrated from April to September. But year after year, illegal fishing was scattered throughout the year. 3. The most controlled sea area of illegal fishing was the south central sea area in the sea near Port of Tongyeong. The sea area occupied about 36~51% of totality and the controlled cases were gradually increased every year. The second was the south western sea area in the sea near Port of Yosu. The sea area occupied about 18-27% and the controlled cases were a little bit increased every year. The third was the south eastern sea area in the sea near Pusan. The sea area occupied about 13~23% and the controlled cases were gradually decreased year by year. 4. The most controlled kind of illegal fishing was the small size bottom trawl. This occupied about 81-95% of totality and the controlled cases were gradually increased year by year. The second was the medium size bottom trawl. This occupied about 4-7% and the controlled cases were gradually decreased year by year. The third was the trawl of the coastal sea, this occupied about 2~4% and the controlled cases were a little bit decreased every year. 5. The most controlled address of illegal fishing manager was Pusan city which occupied about 33-51% of totality. The second was Cheonnam which occupied about 24-29%. The third was Kyungnam which occupied about 16~35%. 6. The most controlled violation of regulations was Article 57 of the Fisheries Act which occupied about 56-64% of totality. The second was Article 23 of Protectorate for Fisheries Resources which occupied about 21-36%. And the controlled cases by it were gradually increased every year.

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A Study on the View on Nature in Ch'o-Jung's Three-Verse Poems(Sijo) (초정(艸丁) 김상옥(金相沃) 시조(時調)에 나타난 자연관(自然觀))

  • Choi, Heung-Yeol
    • Sijohaknonchong
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    • v.30
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    • pp.263-300
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    • 2009
  • Adoration for nature constitutes one of the primary subjects that literature has tackled since the origin of human history. Nature expressed through a poet's subjective imagination is the internalized and reorganized nature. This study examines the view on nature enacted in Ch'o-Jung's three-verse poems (sijo) in light of the traditional views on nature implicated in the ancient three-verse poems (koshijo), which is in line with the long-established Oriental view on nature. To dignitaris(sadaebu) in the Chosun Dynasty, nature appeared as the idealistic subject for moral culture ($shims{\breve{o}}ngsuyang$), which also becomes the literary space where the purity and justice of the world view of Neo-Confucianism(Sungrihak) is contained in the form of the three-verse poem, the lyrical poetic space where the "I" is united with nature by way of "enjoying of wind and moon"($umpungnongw{\breve{o}}i$) and "living in quiet retiremen"($yuyuchaj{\breve{o}}k$), and the object for the poetical perception of the surrounding world. Ch'o-Jung' s three-verse odes are found in Reed pipe ($Ch'oj{\breve{o}}k$), Sixty Five Pieces of Three-Verse Odes (Samhaengshi-$yukshipopy{\breve{o}}n$), Autumn Fragrance ($Hyangginam{\check{u}}n-ga{\check{u}}l$), and The Words of Zelko va Tree ($N{\check{u}}tinamu{\check{u}}i-mal$). This study analyzes 212 pieces of Ch'o-Jung' s three-verse poems chosen from theses books. In Ch'o-Jung's poems, the traditional view on nature expressed in the ancient three-verse poems is rendered in such a way that metaphysical understanding of nature is indirectly transmitted through the objective correlatives found nature. Nature is no longer the object of straightforward utterance, but transformed, displaced, and removed: that way, nature gets objectified to form a complicated and multi-layered structure. In conclusion, the view on nature manifested in Ch'o-Jung's three-verse poems is based on traditional metaphysics. Second, nature is the object of lyrical nostalgia and adoration. Third, nature is imbued with the fundamental affection for parents. Fourth, nature is associated with organic life. Fifth, the nature in Ch'o-Jung's poems reveals the beauty of stillness endorsed in Lao-tse's and Chung-tze's philosophy. And last, nature is the agent for self-realization and meditation.

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Acute Respiratory Distress Syndrome in Respiratory Intensive Care Unit (호흡기계 중환자실에서 치료 관리된 급성호흡곤란증후군의 임상특성)

  • Moon, Seung-Hyug;Song, Sang-Hoon;Jung, Ho-Seuk;Yeun, Dong-Jin;Uh, Su-Tack;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.6
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    • pp.1252-1264
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    • 1998
  • Background : Patients with established ARDS have a mortality rate that exceeds 50 percent despite of intensive care including artificial ventilation modality, Mortality has been associated with sepsis and organ failure preceding or following ARDS ; APACHE II score ; old age and predisposing factors. Revised ventilator strategy over last 10 years especially at ARDS appeared to improve the mortality of it. We retrospectively investigated 40 ARDS patients of respiratory-care unit to examine how these factors influence outcome. Methods : A retrospective investigation of 40 ARDS patients in respiratory-care unit with ventilator management over 46 months was performed. We investigated the clinical characteristics such as a risk factor, cause of death and mortality, and also parameters such as APACHE II score, number of organ dysfunction, and hypoxia score (HS, $PaO_2/FIO_2$) at day 1, 3, 7 of severe acute lung injury, and simultaneously the PEEP level and tidal volume. Results : Clinical conditions associated with ARDS were sepsis 50%, pneumonia 30%, aspiration pneumonia 20%, and mortality rate based on the etiology of ARDS was sepsis 50%, pneumonia 67%(p<0.01 vs sepsis), aspiration pneumonia 38%. Overall mortality rate was 60%. In 28 day-nonsurvivors, leading cause of death was severe sepsis(42.9%) followed by MOF(28.6%), respiratory failure(19.1 %), and others(9.5%). There were no differences in variables of age, sex, APACHE II score, HS, and numbers of organ dysfunction at day 1 of ARDS between 28-days survivor and nonsurvivors. In view of categorized variables of age(>70), APACHE II score(>26), HS(<150) at day 1 of ARDS, there were significant differences between 28-days survivor and nonsurvivors(p<0.05). After day 1 of ARDS, the survivors have improved their APACHE II score, HS, numbers of organ dysfunction over the first 3d to 7d, but nonsurvivors did not improve over a seven-day course. There were significant differences in APACHE II score and numbers of organ dysfunction of day 3, 7 of ARDS, and HS of day 7 of ARDS between survivors and nonsurvivors(p<0.05). Fatality rate of ARDS has been declined from 68% to less than 40% between 1995 and 1998. There were no differences in APACHE II score, HS, numbers of organ dysfunction, old age at presentation of ARDS. In last years, mean PEEP level was significantly higher and mean tidal volume was significantly lower than previous years during seven days of ARDS(p<0.01). Conclusions : Improvement of HS, APACHE II score, organ dysfunction over the first 3d to 7d is associated with increased survival Decline in ARDS fatality rates between 1995 and 1998 seems that this trend must be attributed to improved supportive therapy including at least high PEEP instead of conventional-least PEEP approach in ventilator management of acute respiratory distress syndrome.

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The Characteristics and Significance of 'Wanpan Changgeuk' Written by Heogyu (허규 연출 '완판 창극'의 특징과 의의)

  • Kim, Kee-hyung
    • (The) Research of the performance art and culture
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    • no.20
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    • pp.5-30
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    • 2010
  • It has been diversified and serious attempt to establish the identity of Changgeuk, but it is still independent dramaturgy or the current unformed progressive art. In this situation, exploring works of the identity of changgeuk that is base on the performed individual and specific works in the title of Changgeuk is needed. The 80s and 90s Heo, Gyu was leading an active life as a director who was responsible for directing of Changgeuk. He dramatized Siljeon Pansori -which is a group of Pansori missing text- as well as 5-remained Songs in Pansori and he presented a number of creative Changgeuk works on stage. Especially, the completion of dramatizing 5-remained Songs in Pansori under the name of 'Wanpan Changgeuk -which means full version performance without omit-' is the one of his big achievement by performing "Heungbojeon" on the stage 1982 and "Jeokbyeokga" 1985. The purposes of this research are confirmation of Heo's direction of the formulation and considering its characteristics & significance through 'Wanpan Changgeuk' which written by Heo. Heo was a practical play who was interested in the subjective formulation of national culture and creative transmission for Korean traditional performance. He tried to formulate Changgeuk to a representative performance of Korea. In the process he pointed out those problems, (1) interpretation of a work problem, (2) actor's creative problems, (3) structure problem of theater for Changgeuk. He indicated that the other challenges are to use of the stage & device, to overcome sentimentalism, to stylize acting, to improve own quality, to control the speed and length of the song, to choose the suitable musical accompaniment, to create new repertories problems, and etc. Changgeuk is classified in 3 group by origin, (1)dramatizing of 5-remained Songs, (2)dramatizing of 7-missing Songs, (3)creative dramatizing. It contains all of 3 types that Heo's work. The dramatizing of remained 5 Songs are the great importance among those works. Heo hoped that Chaggeuk has become the most representative art work of Korea by performing 'Wanpan Changgeuk' compiled heritage of Korea's outstanding artistic achievement. The characteristics of 'Wanpan Changgeuk' can be summarized following four. (1) Directing attitudes that emphasizes tradition, (2) Accepting the elements of traditional performance actively, (3) Valuing the classy and ethic, (4) Emphasizing humor and active utilizing of the secondary characters. Heo's 'Wanpan Changgeuk' shows a peak of the artistic level which Changgeuk can be reached. He want to make Changgeuk a Korean representative artistic performance by compiling Pansori heritage and accommodating Korean traditional performance. Heo continued his effort to present Pansori's authenticity and to dramatize from beginning to end without missing. It shows very well that 'Wanpan Changgeuk' takes 4~5 hours for playing. It looks Heo's achievement in the 'Wanpan Changgeuk' influenced Changgeuk significantly since then. Heo's 'Wanpan Changgeuk' is matrix of 'Wanpan JangMak Changgeuk' attempted in the 1990s. Especially, their intent is consistent to synthesize texts and to show all the virtue of Pansori. But 90's 'Wanpan JangMak Changgeuk' aim for large stage, fancy device & costume and variety contents compared with 'Wanpan Changgeuk'. Recently, producers have tried not to make a impressive Changgeuk but to make a interesting one. They usually organize performance within 2 hours and prefer orchestral music to its unique sound. In those point of view, it seems that Heo's idle in 'Wanpan Changgeuk' has become one of target to conquer in these days.

A Study on the 1889 'Nanjukseok' (Orchid, Bamboo and Rock) Paintings of Seo Byeong-o (석재 서병오(1862-1936)의 1889년작 난죽석도 연구)

  • Choi, Kyoung Hyun
    • Korean Journal of Heritage: History & Science
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    • v.51 no.4
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    • pp.4-23
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    • 2018
  • Seo Byeong-o (徐丙五, 1862-1936) played a central role in the formation of the Daegu artistic community-which advocated artistic styles combining poetry, calligraphy and painting-during the Japanese colonial period, when the introduction of the Western concept of 'art' led to the adoption of Japanese and Western styles of painting in Korea. Seo first entered the world of calligraphy and painting after meeting Lee Ha-eung (李昰應, 1820-1898) in 1879, but his career as a scholar-artist only began in earnest after Korea was annexed by Japan in 1910. Seo's oeuvre can be broadly divided into three periods. In his initial period of learning, from 1879 to 1897, his artistic activity was largely confined to copying works from Chinese painting albums and painting works in the "Four Gentlemen" genre, influenced by the work of Lee Ha-eung, in his spare time. This may have been because Seo's principal aim at this time was to further his career as a government official. His subsequent period of development, which lasted from 1898 until 1920, saw him play a leading social role in such areas as the patriotic enlightenment movement until 1910, after which he reoriented his life to become a scholar-artist. During this period, Seo explored new styles based on the orchid paintings of Min Yeong-ik (閔泳翊, 1860-1914), whom he met during his second trip to Shanghai, and on the bamboo paintings of Chinese artist Pu Hua (蒲華, 1830-1911). At the same time, he painted in various genres including landscapes, flowers, and gimyeong jeolji (器皿折枝; still life with vessels and flowers). In his final mature period, from 1921 to 1936, Seo divided his time between Daegu and Seoul, becoming a highly active calligrapher and painter in Korea's modern art community. By this time his unique personal style, characterized by broad brush strokes and the use of abundant ink in orchid and bamboo paintings, was fully formed. Records on, and extant works from, Seo's early period are particularly rare, thus confining knowledge of his artistic activities and painting style largely to the realm of speculation. In this respect, eleven recently revealed nanjukseok (蘭竹石圖; orchid, bamboo and rock) paintings, produced by Seo in 1889, provide important clues about the origins and standards of his early-period painting style. This study uses a comparative analysis to confirm that Seo's orchid paintings show the influence of the early gunran (群蘭圖; orchid) and seongnan (石蘭圖; rock and orchid) paintings produced by Lee Ha-eung before his arrest by Qing troops in July 1882. Seo's bamboo paintings appear to show both that he adopted the style of Zheng Xie (鄭燮, 1693-1765) of the Yangzhou School (揚州畵派), a style widely known in Seoul from the late eighteenth century onward, and of Heo Ryeon (許鍊, 1809-1892), a student of Joseon artist Kim Jeong-hui (金正喜,1786-1856), and that he attempted to apply a modified version of Lee Ha-eung's seongnan painting technique. It was not possible to find other works by Seo evincing a direct relationship with the curious rocks depicted in his 1889 paintings, but I contend that they show the influence of both the late-nineteenth-century-Qing rock painter Zhou Tang (周棠, 1806-1876) and the curious rock paintings of the middle-class Joseon artist Jeong Hak-gyo (丁學敎, 1832-1914). In conclusion, this study asserts that, for his 1889 nanjukseok paintings, Seo Byeong-o adopted the styles of contemporary painters such as Heo Ryeon and Jeong Hak-gyo, whom he met during his early period at the Unhyeongung through his connection with its occupant, Lee Ha-eung, and those of artists such as Zheng Xie and Zhou Tang, whose works he was able to directly observe in Korea.

The Modern Understanding and Misunderstanding about the Thirteen-story Stone Pagoda of Wongaksa Temple (원각사(圓覺寺)13층탑(層塔)에 대한 근대적 인식과 오해)

  • Nam, Dongsin
    • MISULJARYO - National Museum of Korea Art Journal
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    • v.100
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    • pp.50-80
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    • 2021
  • This paper critically examines the history of the theories connected to the Wongaksa Temple Pagoda that have developed over the last 100 years focusing on the original number of stories the pagoda would have reached. Part II of this paper retraces the dynamic process of the rediscovery of the Wongaksa Temple Pagoda by Westerners who traveled to Korea during the port-opening period. Koreans at the time viewed the Wongaksa Temple Pagoda as an object of no particular appeal or even as an eyesore. However, Westerners appreciated it as a wonder or magnificent sight. Since these Westerners had almost no prior knowledge of Buddhist pagodas, they were able to write objective travelogues. At the time, these visitors generally accepted the theory common among Joseon intellectuals that Wongaksa Temple Pagoda once had thirteen stories. Part III focuses on Japanese government-affiliated scholars' academic research on the Wongaksa Temple Pagoda after the proclamation of the Korean Empire and the Japanese Government-General of Korea's subsequent management of the pagoda as a cultural property during the colonial era. It also discusses issues with Japanese academic research and management. In particular, this portion sheds light on the shift in theories about the original number of stories of the Wongaksa Temple Pagoda from the ten-story theory supported by Sekino Tadashi (關野 貞), whose ideas have held a great influence on this issue over the last 100 years, to the thirteen-story theory and then to the idea that it had more than thirteen. Finally, Part IV addresses the change from the multi-story theory to the ten-story theory in the years after Korea's liberation from Japan until 1962. Moreover, it highlights how Korean intellectuals of the Japanese colonial era predominantly accepted the thirteen-story theory. Since 1962, a considerable quantity of significant research on the Wongaksa Temple Pagoda has been published. However, since most of these studies have applied the ten-story theory suggested in 1962, they are not individually discussed in this paper. This retracing of the history of theories about the Wongaksa Temple Pagoda has verified that although there are reasonable grounds for supporting the thirteen-story theory, it has not been proved in the last 100 years. Moreover, the number of pagoda stories has not been fully discussed in academia. The common theory that both Wongaksa Temple Pagoda and Gyeongcheonsa Temple Pagoda were ten-story pagodas was first formulated by Sekino Tadashi 100 years ago. Since the abrasion of the Wongaksa Temple Stele was so severe the inscriptions on the stele were almost illegible, Sekino argued that the Wongaksa Temple Pagoda was a ten-story pagoda based on an architectural analysis of the then-current condition of the pagoda. Immediately after Sekino presented his argument, a woodblock-printed version of the inscriptions on the Wongaksa Temple Stele was found. This version included a phrase that a thirteen-story pagoda had been erected. In a similar vein, the Dongguk yeoji seungnam (Geographic Encyclopedia of Korea) published by the orders of King Seongjong in the late fifteenth century documented that Gyeongcheonsa Temple Pagoda, the model for the Wongaksa Temple Pagoda, was also a thirteen-story pagoda. The Wongaksa Temple Stele erected on the orders of King Sejo after the establishment of the Wongaksa Temple Pagoda evidently shows that Sekino's ten-story premise is flawed. Sekino himself wrote that "as [the pagoda] consists of a three-story stereobate and a ten-story body, people call it a thirteen-story pagoda," although he viewed the number of stories of the pagoda body as that of the entire pagoda. The inscriptions on the Wongaksa Temple Stele also clearly indicate that the king ordered the construction of the Wongaksa Temple Pagoda as a thirteen-story pagoda. Although unprecedented, this thirteen-story pagoda comprised a ten-story pagoda body over a three-story stereobate. Why would King Sejo have built a thirteen-story pagoda in an unusual form consisting of a ten-story body on top of a three-story stereobate? In order to fully understand King Sejo's intention in building a thirteen-story pagoda, analyzing the Wongaksa Temple Pagoda is necessary. This begins with the restoration of its original name. I disprove Sekino's ten-story theory built upon flawed premises and an eclectic over-thirteen-story theory and urge applying the thirteen-story theory, as the inscriptions on the Wongaksa Temple Stele stated that the pagoda was originally built as a thirteen-story pagoda.

Comparisons of Unicortical and Bicortical Lateral Mass Screws in the Cervical Spine : Safety vs Strength (경추부의 후관절 나사못 고정술에서 단피질삽입법과 양피질 삽입법 간의 특성에 관한 비교)

  • Park, Choon-Keun;Hwang, Jang-Hoe;Ji, Chul;Lee, Jae Un;Sung, Jae Hoon;Choi, Seung-Jin;Lee, Sang-Won;Seybold, Eric;Park, Sung-Chan;Cho, Kyung-Suok;Park, Chun-Kun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1210-1219
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    • 2001
  • Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.

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Evaluation for Rock Cleavage Using Distributional Characteristics of Microcracks and Brazilian Tensile Strengths (미세균열과 압열인장강도의 분포 특성을 이용한 결의 평가)

  • Park, Deok-Won
    • Korean Journal of Mineralogy and Petrology
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    • v.33 no.2
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    • pp.99-114
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    • 2020
  • The characteristics of the Brazilian tensile strengths(σt) parallel to the rock cleavages in Jurassic granite from Geochang were analysed. The evaluation for the six directions of rock cleavages was performed using the parameter values on microcrack length and the above strength. The strength values of the five test specimens belonging to each direction were classified into five groups. The strength values of these five groups increase in order of group A < B < C < D < E. The close dependence between the above microcrack and strength was derived. The analysis results of this study are summarized as follows. First, the chart showing the variation and characteristics of strength among the three rock cleavages were made. In the above chart, the strength values of six directions belonging to each group were arranged in order of rift(R1 and R2), grain(G1 and G2) and hardway(H1 and H2). The strength distribution lines of the five groups concentrate in the direction of R1. And the widths among the above five lines indicating strength difference(Δσt) are the most narrowest in R1 direction. From the related chart, the variation characteristics among the two directions forming each rock cleavage were derived. G2(2)-test specimen shows higher value and lower value of the difference in strength compared to the case of G1(1)-test specimen. These kinds of phenomena are the same as the case between the test specimen H2(2) and H1(1). The strength characteristics of the above test specimens (2) suggest lower microcrack density value and higher degree of uniformity in the distribution of microcracks arrayed parallel to the loading direction compared to those of test specimens (1). The six strength values belonging to each group were arranged in increasing order in the above chart. The strength values of the test specimens belonging to both group D and E appear in order of R1 < R2 < G1 < H1 < G2 < H2. Therefore, the strength values of group D and E can be indicator values for evaluating the six directions of rock cleavages. Second, the correlation chart between slope angle(θ) and strength difference(Δσt) were made. The values of the above two parameters were obtained from the five strength distribution lines connecting between the two directions. From the chart related to rift plane(G1-H1, R'), grain plane(R1-H2, G') and hardway plane(R2-G2, H'), the slope values of linear functions increase in order of R'(0.391) < G'(0.470) < H'(0.485). Among three planes, the charts related to hardway plane show the highest distribution density among the five groups. From the related chart for rift(R1-R2, R), grain(G1-G2, G) and hardway(H1-H2, H), the slope values of linear functions increase in order of rift(0.407) < hardway(0.453) < grain(0.460). Among three rock cleavages, the charts related to rift show the highest frequency of groups belonging to the lower region. Taken together, the width of distribution of the slope angle among the three planes and three rock cleavages increase in order of H' < G < R' < R < G' < H. Third, the correlation analysis among the parameters related to microcrack length and the tensile strengths was performed. These parameters may include frequency(N), total length(Lt), mean length(Lm), median length(Lmed) and density(ρ). The correlation charts among individual parameters on the above microcrack(X) and corresponding five levels of tensile strengths for the five groups(Y) were made. From the five kinds of correlation charts, the values of correlation coefficients(R2) increase along with the five levels of strengths. The mean values of the five correlation coefficients from each chart increase in order of 0.22(N) < 0.34(Lt) < 0.38(ρ) < 0.57(Lmed) < 0.58(Lm). Fourth, the correlation chart among the corresponding maximum strength for group E(X) and the above five parameters(Y) were made. From the related chart, the values of correlation coefficient increase in order of 0.61(N) < 0.81(Lt) < 0.87(ρ) < 0.93(Lm) < 0.96(Lmed). The two parameters that have the highest correlations are median length with maximum strength. Through the above correlation analysis between microcrack and strength, the credibility for the results from this study can be enhanced.