• Proceedings of the KSMRM Conference
• /
• 대한자기공명의과학회 2003년도 제8차 학술대회 초록집
• /
• pp.21-21
• /
• 2003

목적： 악성뇌종양 주변부위의 역동자기공명영상에서의 시간신호강도곡선 양상으로 종양의 성장 양상이나 예후를 판단할 수 있는지를 알고자 한다. 대상 및 방법： Anaplastic oligodendroglioma 3예, Anaplastic astrocytoma 1예, Glioblastoma multiforme 1예, Malignant ependymoma 2예, Medulloblastorna 1예로서, 총 8예의 종양절제전, 혹은 후의 잔류 종양을 대상으로 하였다. Routine MRI에 추가하여 종양부위에서 Turbo spin echo T1 강조 역동자기공명영상을 하였으며, Gd-DTPA 0.1 mmol/kg를 급속 주사 한 후, TR/TE, 350/15, slice thickness 6 mm, slice number 3, NEX 2회, scan time은 15 초로 하여 5 분 동안 20회 영상을 얻었다. 가시적으로 조영증강이 없는 종양의 주변부위나 수술경계부위에 관심영역을 그려서 시간신호강도곡선을 얻었으며, 첫 회 조영제 통과시의 peak 이후에 신호가 감소하는 경우를 Normal pattern으로, peak 이후에 신호가 계속 유지되거나 증가하는 경우를 Tumor pattern으로 하였으며, Normal pattern과 Tumor pattern을 보인 예들을 구분하여 종양의 재성장 상태와 환자의 생존 기간을 비교 관찰하였다.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
• /
• 제25권1호
• /
• pp.7-16
• /
• 1995

하악에 발생한 45예, 상악에 발생한 1예로 총 46예의 법랑모세포종이 연구되었다 환자의 평균연령은 34세였으며 성별에 따른 차이는 없었다. 가장 흔한 징후는 악골 또는 안면의 종창이었다. 소구치-대구치-하악지 부위를 침범한 예가 20예(43.5％)였다. 다방성 병소가 26예(56.5％)에서 발견되었다. 방사선학적 형태는 환자의 연령이나 조직학적 형태와는 상관관계가 없었다. 단방형 형태는 주로 젊은 환자에서 발견되었으며 10대에 호발하는 상관관계를 나타내었다(P<0.05). 근치 또는 보존적 수술로 치료를 받은 분석 가능한 18명의 환자에서 재발율은 33.3％를 나타내었다. 다방성 형태(36.4％)학적 행태를 명확하게 예측하기 위해서는 좀 더 상세한 임상 및 방사선학적 변수가 첨가되어야 할 것으로 사료되었다.

• Proceedings of the Korea Contents Association Conference
• /
• 한국콘텐츠학회 2013년도 춘계 종합학술대회 논문집
• /
• pp.441-442
• /
• 2013

통합적인 홍수 예경보시스템의 구현을 위해서는 작은 단위지역별, 재해특성별 수요자의 요구상황에 맞는 시스템 개발이 요구된다. 그런데 도시하천 유역의 경우 주로 본류하천에 의한 배수위 영향을 받고 있으며 제내지로부터는 배수펌프에 의한 인위적인 유입 유량이 하천 수위에 영향을 미치고 있다. 이러한 도시하천의 경우 강우-유출 관계 및 유량-수위 관계가 특수한 형태를 나타내어 이에 대한 면밀한 해석을 통해서만이 적용성 높은 홍수 예경보가 가능할 것이다. 따라서 본 연구에서는 이러한 배수위 영향을 받는 도시하천에 대한 홍수 예경보 측면에서의 분석 기법을 수립하고, 특정 하천 지점에서의 예경보 발령 기준 수위에 대한 지속시간별 경보발령 예상 강우량 데이터를 구축하여 실제 호우상황 발생 시 직접적으로 이용 가능한 중소하천 홍수예경보 분석 체계를 마련하였다.

• Proceedings of the Korean Institute of Navigation and Port Research Conference
• /
• 한국항해항만학회 2011년도 춘계학술대회
• /
• pp.22-24
• /
• 2011

본 연구는 예부선 선원이 해상작업 시 발생할 수 있는 근골격계 부담 작업의 위험성을 평가 하기위해 실행되었다. 근골격계 부담 작업은 예부선 선원들의 인터뷰, 작업 분석, 자세 평가를 통해 분석을 통해 분석이 되었으며, 도출된 근골격계 부담 작업은 인간공학 분야에서 작업자세 평가 도구인 OWAS, REBA를 활용하여 분석을 실시하였다. 분석을 위해 오일 탱커 부선에서 작업을 하는 예부선 선원들의 송유관 체결 작업과 모선과 접안을 위한 줄 잡기 작업을 분석하였으며 해당 작업들은 OWAS 점수 3점과 REBA 점수 9점 이상으로 해당 작업이 근골격계에 부담되는 작업이며 작업자세 교정이 필요한 것으로 나타났다. 따라서 예부선 작업환경의 위험성이 외부환경에 대한 위협뿐만 아니라 작업자의 작업자세가 장기적인 위협을 보이고 있음을 보여주었다.

• Korean Journal of Legislative Studies
• /
• 제16권1호
• /
• pp.101-144
• /
• 2010

이 연구는 국회 원내 생산성의 평가 범주를 법안심사, 예 결산심사, 국정감사의 3개 범주로 나누고, 법안심사, 예 결산심사, 국정감사의 산출물을 국회의원에게 투입된 비용으로 나눈 결과를 역대 국회별 정부유형별로 비교하여 민주화 이후 국회생산성의 추이를 종합적으로 평가했다. 국회 원내 생산성을 측정해본 결과, 정부유형이 법안심사, 예 결산 심사, 국정감사 생산성에 영향을 미치고 있음을 확인할 수 있었다. 단점정부는 법안심사에서 대통령과 집권당에 우호적인 환경을 제공해 줌으로써 전체 법안 가결의 생산성이 높아진다. 그러나 예 결산 심사의 생산성은 정부예산의 수정률이 낮아짐으로써 생산성이 낮아지고, 국정감사 역시 행정부의 정책집행에 대한 지적사항을 반대당 지배 국회보다 적게 산출함으로써 생산성이 낮아진다. 반면 분점정부는 대통령과 집권당에게 비우호적인 입법 환경을 제공함으로서 법안심사의 생산성은 낮은 반면, 정부 예산안의 삭감비율이 높아지면서 예 결산 심사의 생산성은 높아지고, 국정감사에서 행정부에 대한 다수의 시정요구를 함으로써 국정감사의 생산성 역시 높아진다. 결국 생산성의 높고 낮음이 문제가 아니라 생산성의 내용이 중요하다. 생산성의 '절대값'보다 생산성의 내용과 성격에 대한 이해가 선행되어야 하는 이유가 여기에 있다.

• Clinical and Experimental Pediatrics
• /
• 제52권4호
• /
• pp.458-463
• /
• 2009

Purpose : Schizencephaly is a uncommon congenital brain anomaly characterized by congenital clefts spanning the cerebral hemispheres from pial surface to lateral ventricles and lined by gray matter. In this study, we investigated the clinical manifestation and radiologic findings of pediatric schizencephaly. Methods : The data of 13 patients who were diagnosed with schizencephaly in Severance Childrens Hospital and Yongdong Severance Hospital from January 2005 to December 2007 were analyzed retrospectively. Results : The mean age at diagnosis was $9.08{\pm}2.67$ months old and ranged from 1 to 30 months. The ratio of male to female patients was 3.33:1. Five (38.5%) patients had bilateral clefts, while 8 (61.5%) had unilateral clefts. Five (38.5%) patients had closed lip clefts, and 4 (30.8%) had opened lip clefts. Four (30.8%) patients had multiple clefts. Associated anomalies showed in all cases. The clinical features consisted of mild unilateral weakness in 7 (53.8%) cases and a hemiparesis was present in 3 (23.1%) patients. A tetraparesis was in 3 (23.1%) patients. There was no difference in motor deficit between unilateral and bilateral clefts. Delayed development was observed in all cases. Epilepsy was present in 7 (53.8%) patients, 5 patients with unilateral clefts and 2 patients with bilateral clefts. Three (42.8%) patients showed intractable seizures. Conclusion : Schizencephaly showed variable clinical manifestations and radiologic findings in association with the types and locations of the clefts. It is necessary to diagnose schizencephaly early and to detect the development of epilepsy. Intensive and large studies of the correlation of clinical outcomes and radiologic findings should be continued for more effective treatment.

• Journal of Chest Surgery
• /
• 제37권3호
• /
• pp.267-271
• /
• 2004

Compensatory sweating is the main cause of patient dissatisfaction after sympathetic surgery for craniofacial hyperhidrosis. Surgery that sympathetic nerve trunk preserved and extent of resection limited was introduced to decrease compensatory sweating. From Jan 2000 to July 2002, the vidio-assisted thoracoscopic T2 sympathetic clipping and rami comunicantes selective division were performed in 36 patients suffering from craniofacial hyperhidrosis. Twenty two patients underwent a T2 sympathetic nerve clipping (Group 1), and fourteen patients underwent division of the T2 ramicommunicates (Group 2). We retrospectively analysed the rate of satisfaction, dryness of face, the rate of compensatory sweating, grade of compensatory sweating. The dryness of face was that no statistical difference between group 1 and group 2 (p=0.387); group1: dry 22.7% (5/22), humid 77.3% (17/22) group 2: dry 14.3% (2/14), humid 78.5% (11/14), persist 7.2% (1/14). The rate of satisfaction was 77.3% in T2 clipping and 64.2% in T2 sympathicotomy with no significant in the statistic analysis (p=0.396). The rate of compensatory sweating on group 2 was lower than group 1 (p=0.042); 95.4% (21/22) in T1 sympathetic clipping and 71.4% in T2 ramicotomy. The rate of embarrassing and disabling compensatory sweating was 70.5% (embarassing 8 patients, disabling 9 patients) in T2 clipping and 42.9% (embarassing 8 patients, disabling 9 patients)in T2 ramicotomy with statistically significant difference (p=0.036). The sympathetic trunk preservation surgery for craniofacial hyperhidrosis (T2 ramicotomy) redueced the rate of compensatory sweating when compared to the blocking surgery of sypathetic trunk (T2 clipping).

• Tuberculosis and Respiratory Diseases
• /
• 제44권4호
• /
• pp.889-898
• /
• 1997

Pulmonary Embolism can develop in variable conditions, and presents with nonspecific symptoms and signs. If diagnosis is delayed, it can be resulted in catastrophic results. Therefore, early diagnosis and adequate treatment is crucial in Pulmonary Embolism. Lung Perfusion Scan is useful screening test. Negative result can exclude pulmonary embolism. But, perfusion defects don't always mean pulmonary embolism. To find the better methods of interpretation of lung perfusion scan and To evaluate the clinical course and outcomes of the patients, in whom pulmonary embolism was suspected by lung perfusion scan, we reviewed the clinical records of 49 cases suspected by lung perfusion scan at Seoul National University Hospital during the period of January, 1995 to July, 1996. The results are as follows. First impression of cases in which PE was present at time of admission were pulmonary embolism (63%), heart diseases (26%), and pneumonia (11%) in orders. Underlying diseases of cases in which PE developed during admission were malignancy (36.5%), ICH (22.7%), sepsis (13.7%), and SLE (9.1%) in orders. The predisposing factors were operation (20%), cancer (16%), immobility (16%), connective tissue disease (16%), heart dis. (10%), old age (10%), and preg/pelvic dis. (8%) The results, of lung perfusion scan were HPPE 40 cases(26.8 %), IPPE 21 cases(14.1%), LPPE 88 cases (59.1%), and cases(%) of treatment in these cases were HPPE 34 cases(85%), IPPE 9 cases(42.9%), LPPE 0 case(0.0%). Treatments were heparin and warfarin (69.5%), heparin alone (8.2%), warfarin alone (2.0%), embolectomy (4.1%), thrombolytics (2.0%), IVC filter (2.0%), and no treatment (12.2%) In 34 cases (69.4%), follow up could be done, and 5 cases were recurred (10.2%). The causes of recurrence was incomplete anticoagulant therapy (3 cases) and recurrence of predisposing factor (2 cases). Expired case due to pulmonary embolism was one who was expired just before trial of thrombolytic therapy. Conclusion : Efforts should be made to shorten the interval from onset of Sx to Dx, ie, high index of suspision.

• The Journal of the Korean bone and joint tumor society
• /
• 제20권1호
• /
• pp.7-13
• /
• 2014

Purpose: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. Materials and Methods: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's$^{(R)}$ Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS$^{(R)}$ proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. Results: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. Conclusion: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.

• Journal of Chest Surgery
• /
• 제37권9호
• /
• pp.768-773
• /
• 2004

Failure of mitral valve repair sometimes may be ascribed to severe or progressive alteration of the subvalvar apparatus. The aim of this study was to evaluate the effects of new chordae formation on mitral repair. Material and Method: From March 1997 to february 1999, 26 patients underwent mitral valve repairs with new chordae formation, we compared the symptoms and echocardiographic findings checked at preoperative state, and intraoperative period, discharge, and their last OPD visit. There were 45 male, and 11 female patients, and their mean age was 51.2$\pm$43.4 years. Etiology of the lesions was degenerative (18), rheumatic (6), infective (1) and ischemic (1). Chordal lesions were caused by rupture (18), elongation (6), and a combination of two causes (2). Associated lesions included atrial septal defect (2), tricuspid insufficiency (7), aortic insufficiency(4), and a combination of previous two factors (2). The number of mean artificial chordae was 3.6$\pm$1.6. Annuloplasty was per-formed in all cases. The CPB time was 182,1$\pm$63.7 minutes and the ACC time was 133.1$\pm$45.6 minutes. Aver-age follow up period was 49.2$\pm$7.1 months. Result: There was no early death. Early reoperation was performed in bud patients, one patient received mitral valve replacement because of an abnormality of annuloplasty and ano-ther received pericardiostomy due to postoperative pericardial effusion. During the follow up of 49.2$\pm$7.1 moths, there was no late mortality. Postoperative NYHA functional class checked at last OPD visit was class I in 22 patients (88%), class II in 2 (8%), and class III in 1 (4%). Regarding the late echocardiogram MR was absent in 20 patients (78%), 1 in 4 (15%), and II in 1 (4%). The postrepair mitral valve area was 2.2$\pm$0.35 $\textrm{cm}^2$ Conclusion: This study suggests that mitral valve repair using new chordae formation provides good early and mid term survivals and functional improvement. We think that the artificial chorda formation with polytetrafluoroethylene suture might be safe and effective technique for mitral valve repair.