• 대한족부족관절학회지
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• 제11권2호
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• pp.130-134
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• 2007

Purpose: To investigate the relationship between classification based on simple radiographic findings and arthroscopic findings of the cartilage lesions in medial degenerative arthritis of the ankle joint. Materials and Methods: We studied 41 ankles of 36 patients with asymmetrical narrowing of the medial joint space. Degenerative arthritis following fracture and those with generalized arthritic disease were excluded, but those with a history of ankle sprain were included. Standing radiographs of all patients were graded according to the Takakura classification and the Kellgren-Lawrence (K/L) classification. Arthroscopic findings were classified according to the depth, width, and anteroposterior dimension of articular cartilage damage. Results: According to the Takakura classification, 29 ankles were classified as stage II, 7 cases as stage IIIA and 2 cases as stage IIIB. According to our classification of arthroscopic findings of 29 ankles in stage II, 1 ankle was graded as Grade I, 3 ankles as grade II, 10 ankles as grade III, and 15 ankles as grade IV. Spearman correlation coefficient between Takakura classification and arthroscopic classification was 0.342 (P=0.028), and coefficient between K/L classification and arthroscopic classification was 0.480 (P=0.001). Conclusion: Degenerative changes of the articular cartilage are more advanced than radiographic findings in many patients with ankle degenerative arthritis with asymmetrical narrowing of medial joint space. Therefore, we conclude that more aggressive effort should be made for correct diagnosis and treatment of degenerative arthritis.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7371-7375
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• 2014

Background: Concurrent chemo-radiotherapy is the recommended standard treatment modality for patients with locally advanced lung cancer. The purpose of three-dimensional conformal radiotherapy (3DCRT) is to minimize normal tissue damage while a high dose can be delivered to the tumor. The most common dose limiting side effect of thoracic RT is radiation pneumonia (RP). In this study we evaluated the relationship between dose-volume histogram parameters and radiation pneumonitis. This study targeted prediction of the possible development of RP and evaluation of the relationship between dose-volume histogram (DVH) parameters and RP in patients undergoing 3DCRT. Materials and Methods: DVHs of 41 lung cancer patients treated with 3DCRT were evaluated with respect to the development of grade ${\geq}2$ RP by excluding gross tumor volume (GTV) and planned target volume (PTV) from total (TL) and ipsilateral (IPSI) lung volume. Results: Were admitted statistically significant for p<0.05. Conclusions: The cut-off values for V5, V13, V20, V30, V45 and the mean dose of TL-GTV; and V13, V20,V30 and the mean dose of TL-PTV were statistically significant for the development of Grade ${\geq}2$ RP. No statistically significant results related to the development of Grade ${\geq}2$ RP were observed for the ipsilateral lung and the evaluation of PTV volume. A controlled and careful evaluation of the dose-volume histograms is important to assess Grade ${\geq}2$ RP development of the lung cancer patients treated with concurrent chemo-radiotherapy. In the light of the obtained data it can be said that RP development may be avoided by the proper analysis of the dose volume histograms and the application of optimal treatment plans.

• Journal of Korean Neurosurgical Society
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• 제48권6호
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• pp.480-484
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• 2010

Objective : To evaluate the role of lumbar drainage in the prevention of shunt-dependent hydrocephalus after treatment of ruptured intracranial aneurysms by coil embolization in good-grade patients. Methods : One-hundred-thirty consecutive patients with aneurysmal subarachnoid hemorrhage in good-grade patients (Hunt & Hess grades I-III), who were treated by coil embolization between August 2004 and April 2010 were retrospectively evaluated. Poor-grade patients (Hunt & Hess grades IV and V), a history of head trauma preceding the development of headache, negative angiograms, primary subarachnoid hemorrhage (SAH), and loss to follow-up were excluded from the study. We assessed the effects on lumbar drainage on the risk of shunt-dependent hydrocephalus related to coil embolization in patients with ruptured intracranial aneurysms. Results : One-hundred-twenty-six patients (96.9%) did not develop shunt-dependent hydrocephalus. The 2 patients (1.5%) who developed acute hydrocephalus treated with temporary external ventricular drainage did not require permanent shunt diversion. Overall, 4 patients (3.1%) required permanent shunt diversion; acute hydrocephalus developed in 2 patients (50%). There was no morbidity or mortality amongst the patients who underwent a permanent shunt procedure. Conclusion : Coil embolization of ruptured intracranial aneurysms may be associated with a lower risk for developing shunt-dependent hydrocephalus, possibly by active management of lumbar drainage, which may reflect less damage for cisternal anatomy than surgical clipping. Coil embolization might have an effect the long-term outcome and decision-making for ruptured intracranial aneurysms.

• Journal of Korean Neurosurgical Society
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• 제44권5호
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• pp.308-313
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• 2008

Objective: The serum S100 protein has been known to reflect the severity of neuronal damage. The purpose of this study was to assess the prognostic value of the serum S100 protein by Elecsys S100 immunoassay in patients with subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH) and to establish reference value for this new method. Methods: Serum S100 protein value was measured at admission, day 3 and 7 after bleeding in 42 consecutive patients (SAH : 20, ICH : 22) and 74 healthy controls, prospectively. Admission Glasgow coma scale (GCS) score, Hunt & Hess grade and Fisher grade for SAH, presence of intraventricular hemorrhage, ICH volume, and outcome at discharge were evaluated. Degrees of serum S100 elevation and their effect on outcomes were compared between two groups. Results: Median S100 levels in SAH and ICH groups were elevated at admission (0.092 versus $0.283{\mu}g/L$) and at day 3 (0.110 versus $0.099{\mu}g/L$) compared to healthy controls ($0.05{\mu}g/L;$ p<0001). At day 7, however, these levels were normalized in both groups. Time course of S100 level in SAH patient was relatively steady at least during the first 3 days, whereas in ICH patient it showed abrupt S100 surge on admission and then decreased rapidly during the next 7 days, suggesting severe brain damage at the time of bleeding. In ICH patient, S100 level on admission correlated well with GCS score (r=-0.859; p=0.0001) and ICH volume (r=0.663; p=0.001). A baseline S100 level more than $0.199{\mu}g/L$ predicted poor outcome with 92% sensitivity and 90% specificity. Logistic regression analyses showed Ln (S100) on admission as the only independent predictor of poor outcome (odd ratio 36.1; 95% CI, 1.98 to 656.3) Conclusion: Brain damage in ICH patient seems to develop immediately after bleeding, whereas in SAH patients it seems to be sustained for few days. Degree of brain damage is more severe in ICH compared to SAH group based on the S100 level. S100 level is considered an independent predictor of poor outcome in patient with spontaneous ICH, but not in SAH. Further study with large population is required to confirm this result.

• 대한관절경학회지
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• 제13권1호
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• pp.22-27
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• 2009

목적: 슬관절의 퇴행성 관절 연골 손상과 동반된 내측 반월상 연골 파열에서, 관절 연골 손상의 정도를 확인하고 이에 따른 내측 반월상 연골 부분절제술의 임상적 결과를 알아보고자 하였다. 대상 및 방법: 2001년 1월부터 2004년 12월까지 슬관절의 퇴행성 관절염과 동반된 내측 반월상 연골 파열에서 관절경적 부분절제술을 시행 후 3년 이상 추시가 가능하였던 48예를 대상으로 하였다. 남자가 6예, 여자가 42예였으며, 나이는 평균 55.7세(40~78세), 관절경 소견상 Outerbridge 분류 기준으로 두 군으로 나누었으며 제 1군은 grade I과 II를, 제 2군은 grade III와 IV를 포함하였다. 제 1군이 30예였고, 제 2군이 18예였다. 임상 결과는 Tapper & Hoover분류 및 Lysholm knee score를 측정하여 평가하였다. 술전과 최종 추시 양슬관절 기립 전후면 사진에서 내측 관절 간격을 측정하였다. 결과: Tapper & Hoover분류에 따른 평가에서 우수가 28예, 양호 7예, 보통 8예, 불량 5예였다. 제 1군은 우수 25예, 양호 2예, 보통 2예, 불량이 1예다. 반면에 제 2군에서는 우수 3예, 양호 5예, 보통 6예, 불량이 4예였다. 기능적 평가상 Lysholm 점수는 1군에서는 술전 평균 62.4점에서 술후 평균 94.0점으로 향상되었으며, 2군에서는 술전 평균 58.0점에서 술후 평균 77.9점으로 향상되었다. 술후 점수의 비교에서 1군이 2군에 비하여 우수하였다. 기립 전후면 단순 방사선 사진상 관절 간격의 감소는 유의하지 않았다. 결론: 관절염과 동반된 반월상 연골 파열에서 관절경적 반월상연골 부분절제술은 증세 호전을 기대할 수 있는 효과적인 치료법이었다. 그러나 관절 연골의 손상이 Outerbridge III나 IV인 경우에는 만족스런 결과를 얻기가 어려웠다. Outerbridge III 및 IV의 관절연골 손상에서는 반월상 연골 부분절제술이 증세 호전이 만족스럽지는 않았으나 관절연골손상을 악화시키지는 않았다.

• 한국산림과학회지
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• 제107권4호
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• pp.344-350
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• 2018

활엽수림의 고부가가치 목재 이용을 고려한 산림관리 방법 개선을 위해 입목형질등급 기준을 마련하였고, 중부지역의 참나무 임분을 대상으로 적용하였다. 입목형질등급의 평가인자는 줄기의 휨, 가지 굵기, 수피상처, 기타 결함 4개이며 수간을 2.1 m 단위로 구분하여 6.3 m까지 3개의 원목이 이용 가능하면 1등급, 2개 원목이 이용 가능하면 2등급, 1개만 이용 가능하면 3등급, 제재목으로 이용할 수 없을 경우 4등급으로 구분하였다. 개발된 입목형질등급을 참나무류 임분에 적용한 결과, 3등급 38.3%, 4등급 27.0%, 2등급은 28.0% 그리고 1등급 6.7% 순으로 조사되었다. 수종별 제재목으로 이용 가능한 3등급 이상의 입목비율은 상수리나무 88.2%, 굴참나무 88.1%, 졸참나무 83.5%로 높았으나, 갈참나무와 신갈나무의 경우 각각 56.0%, 50.3%로 평가 등급이 낮은 것으로 조사되었다. 굴참나무와 신갈나무의 경우 흉고직경이 증가할수록 4등급의 비율이 감소하는 경향을 보였다. 입목형질등급에 영향을 끼치는 주요 결함요인은 수간의 휨>가지 굵기>수피상처>기타 결함 순이었다. 중부지역 참나무림의 임목형질등급과 분포면적을 고려할 경우 상수리나무와 굴참나무에 대한 지속적인 관리가 실행된다면 활엽수 용재생산이 가능할 것으로 판단된다. 또한, 정확하고 실질적인 입목형질등급을 구분하기 위해서는 평가 인자들에 대한 모니터링 연구를 통한 지속적 개선이 필요하다.

• 한국도로학회논문집
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• 제17권4호
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• pp.53-61
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• 2015

PURPOSES : The objective of this study is to evaluate the SDAR (solvent deasphaltene residue), which is obtained from the solvent deasphalting (SDA) process, as a pavement material. METHODS : The physical properties of the SDAR were evaluated based on its chemical composition, and asphalt mixtures with the SDAR were fabricated and used for the evaluation of mechanical properties. Firstly, the chemical composition of SARA (saturate, aromatic, resin and asphaltene) was analyzed using the TLC-FID (thin-layer chromatography-flame ionization detector). Moreover, the basic material properties of the asphalt binder with the SDAR were evaluated by the penetration test, softening point test, ductility test, and PG (performance grade) grade test. The rheological properties of the asphalt binder with the SDAR were evaluated by the dynamic shear modulus ($G^*$) obtained using the time-temperature superposition (TTS) principle. Secondly, the mechanical properties of the asphalt mixtures with the SDAR were evaluated. The compactibility was evaluated using the gyratory compacter. Moreover, the tensile strength ratio (TSR) was used for evaluating the moisture susceptibility of the asphalt mixtures (i.e., susceptibility to pothole damage). The dynamic modulus $E^*$, which is a fundamental property of the asphalt mixture, obtained at different temperatures and loading cycles, was used to evaluate the mechanical properties of the asphalt mixtures. RESULTS AND CONCLUSION : The SDAR shows stiffer and more brittle behavior than the conventional asphalt binder. As the application of the SDAR directly in the field may cause early failures, such as cracks on pavements, it should be applied with modifiers that can favorably modify the brittleness property of the SDAR. Therefore, if appropriate additives are applied on the SDAR, it can be used as a pavement material because of its low cost and strong resistance to rutting.

• 대한임상검사과학회지
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• 제48권1호
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• pp.41-48
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• 2016

Motor evoked potential of spinal surgery is known to cause damage due to the movement path of the continuous scan operation and surgery can be performed with minimized disability after surgery. However, if it is not at all formed at the wave motion evoked potential can occur during surgery and, in some cases the size of the waveform to be measured is very small and intermittent. In this case, the surgery cannot provide information about whether there is neurological damage. Increased intensity of the wave-induced motion of the dislocation does not occur if it appears in a very small amplitude stimulus, but changing the inspection area that electrical stimulation of the waveform changes could not be found. However, stimulation of a wide area in the cerebral cortex was found to occur with a waveform in the patients who underwent examination. Through this study, we propose a useful motor evoked potential test. From November to December 2015 three spine surgery patients visited Samsung Medical Center as neurosurgery patients with omission discomfort, gait disturbance, and no symptom of strength before surgery. In spine surgery patients with motor grade weakness, when motor evoked potential waveform has not been measured, in examination of the site of electrical stimulation of the cerebral cortex from entering the C3+C5/C4+C6 or C3+C1/C4+C2 if by the activity of more motor neuron unit, it was found that the waveform is better formed.

• 대한장애인치과학회지
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• 제7권1호
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• pp.15-20
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• 2011

뇌병변장애인은 뇌성마비, 외상성 뇌손상, 뇌졸중 등 뇌의 기질적 병변에 기인한 신체적 장애로 보행 또는 일상생활의 동작 등에 상당한 제한을 받는 사람으로 정의된다. 최근에 뇌병변 장애아동의 DMFT는 비 장애아동과 유사하거나 낮다는 연구가 있었다. 그러나, 본 증례는 중증유아기우식증이 나타난 뇌병변장애 1급 아동들을 치료한 것으로, 아동들의 공통점을 통해 중증유아기우식 우식증의 특별한 원인을 찾고자 하였다. 뇌병변으로 인한 일차적인 운동장애와 이차적인 치과치료를 받기 어려울 정도의 쇠약함, 잦은 입원, 당분이 많은 음식과 약물의 섭취, 구강위생관리 소홀, 늦은 치과 내원, 협조도 저하 등이 우식 유발인자를 높이고, 우식 예방인자를 낮추어 치아우식증을 유발할 수 있는 것으로 사료되었다. 뇌병변 장애아동을 치료할 때, 치과의사는 개인적인 우식 위험도 평가를 통해 철저한 우식 예방프로그램을 만들고, 부모와 의학적 주치의는 구강관리의 중요성을 인식하여 조기 치과 내원 및 홈케어에 신경을 써야 할 것이다.

• 한국콘텐츠학회논문지
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• 제16권3호
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• pp.102-115
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• 2016

본 연구는 중학생 청소년의 학대피해경험이 자아탄력성에 미치는 영향과 사회적 지지의 조절효과를 살펴보았다. 이를 위하여 부산시내 중학생 1, 2, 3학년 568명을 대상으로 조사하여 분석하였다. 먼저 청소년의 피학대경험은 자아탄력성에 영향을 미치는 것으로 나타났다. 구체적으로 학년이 낮을수록 그리고 학대피해 경험이 없을수록 자아탄력성은 증가하였다. 두 번째, 청소년의 피학대경험이 자아탄력성에 미치는 영향에서 사회적 지지는 조절효과를 가는 것으로 나타났다. 이상의 결과를 중심으로 학대피해 청소년의 부정적 경험에도 불구하고 자신의 환경과 상황을 이겨낼 수 있는 힘이라고 할 수 있는 자아탄력성을 높이기 위하여 가정, 학교, 지역사회와 국가의 사회적 지지 방안을 제언하였다.