• 대한관절경학회지
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• 제7권1호
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• pp.92-95
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• 2003

34세 남자 환자로 등산중 실족으로 발생한 전방십자인대의 완전파열로 자가 슬괵건을 이용한 경핀 고정법으로 전방십자인대 재건술을 시행하였다. 술후 경과는 양호하였으나 술후 3개월째 굴신 신전 운동 시 슬부 후측면의 동통과 지속적인 관절내 부종 소견을 보였으며 수차례의 관절천자와 약물투여에도 반응이 없었다. 컴퓨터 단층 촬영 상후방 피질 골의 천공이 관찰되어 술후 6개월째 이차관절내시경 수술을 시행하였다. 내시경 소견상 경핀고정물의 전방부 1/3에 일치되는 투명한 이물질과 대퇴경골관절면의 연골의 손상이 관찰되었으며 이물 제거 후 증세는 호전되었다. 경핀 터널의 잘못된 위치가 실패의 원인이라고 생각되었으며 경핀고정법을 이용한 전방십자인대 재건술시, 슬관절 과굴곡 상태에서 예각의 대퇴 터널을 만들어 후방 피질 골을 두껍게 남기고, 핀 홀을 만들 때 경핀가이드를 횡상과축보다 $10\~20$도 외회전시켜야 대퇴골 후방피질골의 천공을 방지할 수 있어 조기 실패를 예방할 수 있다고 생각된다.

• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.289-295
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• 2013

Objective : Cerebral vasospasm is a common and potentially devastating complication of aneurysmal subarachnoid hemorrhage (aSAH). Inflammatory processes seem to play a major role in the pathogenesis of vasospasm. C-reactive protein (CRP) constitutes a highly sensitive inflammatory marker. Elevation of serum CRP levels has been demonstrated in patients with aSAH. The purpose of the current study was to evaluate the possible relationship between CRP levels in the serum and transcranial Doppler (TCD) and the development of vasospasm in patients with aSAH. Methods : A total of 61 adult patients in whom aSAH was diagnosed were included in the study from November 2008 to May 2011. The patients' demographics, Hunt and Hess grade, Fisher grade, CT scans, digital subtraction angiography studies, and daily neurological examinations were recorded. Serial serum CRP measurements were obtained on days 1, 3, 5, 7, 9, 11 and 13 and TCD was measured on days 3, 5, 7, 9, 11 and 13. All patients underwent either surgical or endovascular treatment within 24 hours of their hemorrhagic attacks. Results : Serum CRP levels peaked on the 3rd postoperative day. There were significant differences between the vasospasm group and the non-vasospasm group on the 1st, 3rd and 5th day. There were significant differences between the vasospasm group and the non-vasospasm group on the 3rd day in the mean middle cerebral artery velocities on TCD. Conclusion : Patients with high levels of CRP on the 1st postoperative day and high velocity of mean TCD on the 3rd postoperative day may require closer observation to monitor for the development of vasospasm.

• 생물정신의학
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• 제9권2호
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• pp.152-158
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• 2002

Background & Purpose:Neuropsychological disorders after traumatic brain injury(TBI) are poorly correlated with structural lesions detected by structural neuroimaging techniques such as computed tomography(CT) scan or magnetic resonance imaging(MRI). It is well known that patients with TBI have cognitive and behavioral disorders even in the absence of structural lesions of the brain. This study investigated whether there are abnormalities of regional cerebral blood flow(rCBF) in TBI patients without structural abnormality on MRI, using technetium 99m ethyl cysteinate dimer(Tc-99m-ECD) single photon emission computed tomography(SPECT) scans. Materials and Methods:Twenty-eight TBI patients without structural abnormality on MRI(mild, n=13/moderate, n=9/severe, n=6) and fifteen normal controls were scanned by SPECT. A voxel-based analysis using statistical parametric mapping(SPM) was performed to compare the patients with the normal controls. Results:rCBF was reduced in the right uncus and the right lateral orbitofrontal gyrus in the TBI patients. However, no increase of rCBF was noted in the patients in comparison to the normal controls. Conclusions:These results suggest that the TBI patients, even in the absence of structural lesion of the brain, may have dysfunction of the brain, particularly of the orbitofrontal and anterior pole of the temporal cortex. They also suggest that SPECT can be a useful method to identify brain dysfunctions in combination with structural brain imaging and neuropsychological tests.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.44-44
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• 2009

The purpose of this study was to investigate humeral translation relative to the glenoid invivo during loaded and unloaded shoulder abduction. CT scans of 9 healthy shoulders were acquired and 3D models were created. The subject was positioned in front of a fluoroscope and motions were recorded during active abduction. The subjects performed two trials of holding a 3kg weight and unload. 3D motions were determined using model-based 3D-to-2D registration to obtain 6 degrees of freedom kinematics. Glenohumeral translation was determined by finding the location on the humeral head with the smallest separation from the glenoid. Humeral translation was referenced to the glenoid center in the superior/inferior direction. The humerus moved an average of 2 mm, from inferior to central on the glenoid, during arm abduction for both conditions. The humeral head was centered within 1mm from the glenoid center above $70^{\circ}$. There were no statistically significant differences for both conditions. The standard deviation decreased gradually over the motion, with significantly lower variability at the end of abduction compared to the initial unloaded position. We assumed that the humeral translation to the center of the glenoid provides maximum joint congruency for optimal shoulder function and joint longevity. We believe this information will lead to better strategies to prevent shoulder injuries, enhance rehabilitation, and improve surgical treatments.

• Journal of Chest Surgery
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• 제29권6호
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• pp.664-668
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• 1996

미만형 악성 중피세포종은 4∼18개월의 평균생존율을 지닌 치명적인 질환으로 여겨져 왔다. 그러나 종양을 최대한 절제한 후 다양한 접근을 통한 치료방법으로 생존기간을 연장할 수 있다 최근 저자들은 미만형 악성 중피세포종을 가진 49세 남자환자를 치험하였기 에 보고하는 바이다. 환자 는 수개월 동안 혈성객담 및 우측흥통을 호소하였고, 단순흉부사진 및 컴퓨터 단층촬영에서 우측 전흥 강이 진한 음영으로 가리워 져 있었으며 많은 양의 혈성삼출, 미만성 늑막비후와 폐허탈, 파괴 등의 소견 을 보였다. 저자들은 늑막케절제술을 시행하였고, cisplatin과 mitomycin으로 보조적인 항암화학요법을 하였다. 그후 환자는 수 개월간 외래 추적관찰을 받았으며 술후 4개월 현재까지 국소재발의 증거는 없었다.

• 대한기관식도과학회지
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• 제17권1호
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• pp.5-8
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• 2011

The proliferation of new technologies has significantly enhanced the diagnostic capabilities of flexible bronchoscopy compared with traditional methods. Narrow band imaging (NBI), an optical technique in which filtered light enhances superficial neoplasms based on their neoangiogenic patterns, was developed to screen for central intraepithelial moderate or severe dysplasia, carcinoma in situ (CIS), and microinvasive neoplasia in patients at risk for lung cancer. Because angiogenesis occurs preferentially in dysplastic and neoplastic lesions, NBI may identify early dysplastic lesions better than white light bronchoscopy (WLB) currently in use. NBI bronchoscopy can be used not only to detect precancerous lesions, but also to screen for cancerous lesions. We prospectively evaluated 101 patients with suspected lung cancer between July 2009 and June 2010. All were previously scheduled for flexible bronchoscopy CT scans. Abnormal NBI was defined by Shibuya's descriptors (tortuous, dotted, or spiral and screw patterns). Biopsies of 132 lesions in 92 patients showed that 78 lesions (59.1%) were malignant and 54 (40.9%) were benign. The diagnostic sensitivity of bronchoscopy in detecting malignancy was 96.2% (75/78). When assorted by lesion pattern, the sensitivity and specificity of NBI bronchoscopy in detecting malignancies were 69.2% (54/78) and 96.3% (52/54), respectively, for the spiral and screw pattern and 14.1% (11/78) and 96.3% (52/54), respectively, for the dotted pattern. Unexpectedly, additional cancerous lesions were detected in five patients (2 dotted and 3 spiral and screw). As a screening tool for malignant lesions, NBI bronchoscopy should assess combinations of all three lesion. The dotted and spiral and screw patterns may be helpful in determining which lesions should be biopsied. NBI bronchoscopy may be useful not only for the diagnosis of early-stage lung cancer but also for more accurate local staging of lung cancer.

• Journal of Korean Neurosurgical Society
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• 제46권3호
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• pp.181-188
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• 2009

Objective : To evaluate the anatomical parameters that must be considered when performing thoracic transpedicular or extrapedicular screw fixation. Methods : We selected 958 vertebrae (1,916 pedicles) from 98 patients for analysis. Eight parameters were measured from CT scans : the transverse outer pedicular diameter, transverse inner pedicular diameter, length, angle, chord length of the pedicles and the transverse width, angle, and chord length of the pedicle-rib units. Results : The age of the patients ranged from 21 to 82 years (mean: 48.2 years) and there were 57 men and 41 women. The narrowest transverse outer pedicular diameter was at T5 (4.4 mm). The narrowest pedicle length was at T1 (15.9 mm). For pedicle angle, T1 was 31.6 degrees, which was the most convergent angle, and it showed the tendency of the lower the level, the lesser the convergent angle. The chord length showed a horizontal pattern with similar values at all levels. For the PRU width, T5 showed a similar pattern to the pedicle width at 13.4 mm. For the PRU angle, T1 was the largest angle at 46.2 degrees and the tendency was the lower the level. the narrower the angle. For chord length, T1 was the shortest at 46.9 mm and T8 was the longest at 60.1 mm. Conclusion : When transpedicular screw fixations carried out at the mid-thoracic level, special care must be taken because there is a high chance of danger of medial wall violation. In these circumstances, extrapedicular screw fixation may be considered as an alternative treatment.

• Imaging Science in Dentistry
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• 제35권2호
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• pp.77-82
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• 2005

Purpose : To reveal what is the distinct differential diagnostic differences between unicystic ameloblastoma and solid or multicystic ameloblastoma. Materials and Methods : 56 cases of ameloblastoma were retrospectively reviewed and evaluated among the patients who had taken CT scans at the department of Oral & Maxillofacial Radiology in Yonsei University Dental Hospital from January 1996 to December 2003. Results : In 56 cases, 21 cases $(37.5\%)$ were unicystic ameloblastoma, 35 cases $(62.5\%)$ were solid or multicystic ameloblastoma. Only 1 case $(4.8\%)$ of unicystic ameloblastoma and 4 cases $(11.4\%)$ of solid or multicystic ameloblastoma were occurred in maxilla. 13 cases $(61.9\%)$ of unicystic ameloblastoma were observed as unilocular, and 8 cases $(38.1\%)$ as lobulated. 5 cases $(14.3\%)$ of solid or multicystic ameloblastoma were observed as unilocular, 13 cases $(37.1\%)$ as lobulated, and 17 cases $(48.6\%)$ as multilocular. Tn the results from the measurements after correction of the buccolingual widths and heights to the mesiodistal lengths, there is a statistically significant difference between unicystic ameloblastoma and solid or multicystic ameloblastoma in ANCOVA test (p<0.05). Hounsfield units in the lesion were $24.9{\pm}8.8\;HU$ in unicystic ameloblastoma, $31.2{\pm}11.5\;HU$ in solid or multicystic ameloblastoma. There is no statistically significant difference (p>0.05). Conclusion : Characteristic differences between unicystic ameloblastoma and solid or multicystic ameloblastoma is that there is higher prevalence of solid or multicystic ameloblastoma that have lobulated or multilocular patterns. To measure the Hounsfield units in the lesion is helpful, but it is not a differential diagnostic point between unicystic ameloblastoma and solid or multicystic ameloblastoma.

• Imaging Science in Dentistry
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• 제40권4호
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• pp.179-185
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• 2010

Purpose : Cortical bone thickness is one of the important factor in mini-implant stability. This study was performed to investigate the buccal cortical bone thickness at every interdental area as an aid in planning mini-implant placement. Materials and Methods : Two-dimensional slices at every interdental area were selected from the cone-beam computed tomography scans of 20 patients in third decade. Buccal cortical bone thickness was measured at 2, 4, and 6 mm levels from the alveolar crest in the interdental bones of posterior regions of both jaws using the plot profile function of $Ez3D2009^{TM}$ (Vatech, Yongin, Korea). The results were analyzed using by Mann-Whitney test. Results : Buccal cortical bone was thicker in the mandible than in the maxilla. The thickness increased with further distance from the alveolar crest in the maxilla and with coming from the posterior to anterior region in the mandible (p<0.01). The maximum CT value showed an increasing tendency with further distance from the alveolar crest and with coming from posterior to anterior region in both jaws. Conclusion : Interdental buccal cortical bone thickness varied in both jaws, however our study showed a distinct tendency. We expect that these results could be helpful for the selection and preparation of mini-implant sites.

• Imaging Science in Dentistry
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• 제46권1호
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• pp.9-16
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• 2016

Purpose: To evaluate the upper airway dimensions of obstructive sleep apnea (OSA) and control subjects using a cone-beam computed tomography (CBCT) unit commonly applied in clinical practice in order to assess airway dimensions in the same fashion as that routinely employed in a clinical setting. Materials and Methods: This was a retrospective analysis utilizing existing CBCT scans to evaluate the dimensions of the upper airway in OSA and control subjects. The CBCT data of sixteen OSA and sixteen control subjects were compared. The average area, average volume, total volume, and total length of the upper airway were computed. Width and anterior-posterior (AP) measurements were obtained on the smallest axial slice. Results: OSA subjects had a significantly smaller average airway area, average airway volume, total airway volume, and mean airway width. OSA subjects had a significantly larger airway length measurement. The mean A-P distance was not significantly different between groups. Conclusion: OSA subjects have a smaller upper airway compared to controls with the exception of airway length. The lack of a significant difference in the mean A-P distance may indicate that patient position during imaging (upright vs. supine) can affect this measurement. Comparison of this study with a future prospective study design will allow for validation of these results.