• Journal of Korean Neurosurgical Society
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• 제61권1호
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• pp.114-119
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• 2018

Objective : The purpose of this study was to determine the feasibility of screw fixation in previously augmented vertebrae with bone cement. We also investigated the influence of cement distribution pattern on the surgical technique. Methods : Fourteen patients who required screw fixation at the level of the previous percutaneous vertebroplasty or balloon kyphoplasty were enrolled in this study. The indications for screw fixation in the previously augmented vertebrae with bone cement included delayed complications, such as cement dislodgement, cement leakage with neurologic deficits, and various degenerative spinal diseases, such as spondylolisthesis or foraminal stenosis. Clinical outcomes, including pain scale scores, cement distribution pattern, and procedure-related complications were assessed. Results : Three patients underwent posterior screw fixation in previously cemented vertebrae due to cement dislodgement or progressive kyphosis. Three patients required posterior screw fixation for cement leakage or displacement of fracture fragments with neurologic deficits. Eight patients underwent posterior screw fixation due to various degenerative spinal diseases. It was possible to insert screws in the previously augmented vertebrae regardless of the cement distribution pattern; however, screw insertion was more difficult and changed directions in the patients with cemented vertebrae exhibiting a solid pattern rather than a trabecular pattern. All patients showed significant improvements in pain compared with the preoperative levels, and no patient experienced neurologic deterioration as seen at the final follow-up. Conclusion : For patients with vertebrae previously augmented with bone cement, posterior screw fixation is not a contraindication, but is a feasible option.

• Journal of Korean Neurosurgical Society
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• 제63권2호
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• pp.248-260
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• 2020

Objective : To investigate the efficiency of diffusion tensor imaging (DTI) fiber-tracking based neuronavigation and assess its usefulness in the preoperative surgical planning, prognostic prediction, intraoperative course and outcome improvement. Methods : Seventeen patients with cerebral masses adjacent to corticospinal tract (CST) were given standard magnetic resonance imaging and DTI examination. By incorporation of DTI data, the relation between tumor and adjacent white matter tracts was reconstructed and assessed in the neuronavigation system. Distance from tumor border to CST was measured. Results : The sub-portion of CST in closest proximity to tumor was found displaced in all patients. The chief disruptive changes were classified as follows : complete interruption, partial interruption, or simple displacement. Partial interruption was evident in seven patients (41.2%) whose lesions were close to cortex. In the other 10 patients (58.8%), delineated CSTs were intact but distorted. No complete CST interruption was identified. Overall, the mean distance from resection border to CST was 6.12 mm (range, 0-21), as opposed to 8.18 mm (range, 2-21) with simple displacement and 2.33 mm (range, 0-5) with partial interruption. The clinical outcomes were analyzed in groups stratified by intervening distances (close, <5 mm; moderated, 5-10 mm; far, >10 mm). For the primary brain tumor patients, the proportion of completely resected tumors increased progressively from close to far grouping (42.9%, 50%, and 100%, respectively). Five patients out of seven (71.4%) experienced new neurologic deficits postoperatively in the close group. At meantime, motor deterioration was found in six cases in the close group. All patients in the far and moderate groups received excellent (modified Rankin Scale [mRS] score, 0-1) or good (mRS score, 2-3) rankings, but only 57.1% of patients in the close group earned good outcome scores. Conclusion : DTI fiber tracking based neuronavigation has merit in assessing the relation between lesions and adjacent white matter tracts, allowing prediction of patient outcomes based on lesion-CST distance. It has also proven beneficial in formulating surgical strategies.

• Journal of Korean Neurosurgical Society
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• 제30권3호
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• pp.325-333
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• 2001

Objective : To clarify the benefits and therapeutic effects of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm, we analyzed the results of treatment in 32 patients retrospectively. Methods : A total of 510 patients underwent surgical clipping or endovascular intra-aneurysmal treatment for ruptured intracranial aneurysm between May, 1996 and June, 1999. The delayed ischemic deficit(DID) was developed in 90 of 510 patients. Of these 90 patients, 32 developed symptomatic vasospasm inspite of using modest "3H therapy". The brain CT scan was taken before the intra-arterial infusion of papaverine. The 32 patients underwent 42 intra-arterial papaverine infusion. The symptomatic vasospasm was divided into three groups : deterioration of mental status(Group 1), appearance of a focal neurologic deficit(Group 2), or both(Group 3). We measured Glasgow Coma Scale(GCS), arterial diameters, and cerebral circulation time(CCT) at the time of pre- and postangioplasty. Results : The number of patients in group 1, 2 and 3 were 26, 7, 9 respectively. Eighteen cases showed improvement of GCS more than 2 scores, 16 more than 1, and 8 showed no change of GCS. Average cerebral circulation time(CCT) was decreased ranging from 0.0%-67.5%, and arterial diameters were increased in 21 cases ranging from 1 to 4 folds. Conclusion : Intra-arterial papaverine infusion seemed to have therapeutic effects on symptomatic vasospasm by improving the neurological signs and increasing the arterial diameter. We suggest that intra-arterial papaverine infusion would be an useful adjunctive therapeutic modality in symptomatic vasospasm.

• Journal of Korean Neurosurgical Society
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• 제38권2호
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• pp.102-106
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• 2005

Objective : The purposes of this study are to evaluate the efficacy of en bloc open-door laminoplasty and to investigate the validity of various factors as prognotic indicators in patients with multisegmental spondylotic myelopathy and ossification of posterior longitudinal ligament[OPLL]. Methods : The authors reviewed 43 cases in whom laminoplasty were performed for cervical myelopathy between January 2000 and December 2002. Clinical symptoms and results were evaluated using the Japanese Orthopaedic Association[JOA] scale. The recovery rate was calculated and then assessed for prognostic factors such as preoperative JOA scores, ages, history of previous trauma, duration of symptoms and signal change in cord on T2-weighted magnetic resonance Image. Results : In cervical stenosis, canal widening of antero-posterior diameter and dimension after laminoplasty is 4.16mm, $87.43mm^2$ and in OPLL is 6.20mm, $117.61mm^2$. In all cases there wasn't neurologic deterioration, mild postoperative complications developed in seven cases. Four patient had a limitation of range of neck motion and the other one showed kyphotic change and another two showed C5 radiculopathy. The recovery rate of JOA score in cervical stenosis and OPLL was 62% and 68% respectively. Duration of symptoms, the severity[preoperative JOA score], and signal change in cord on T2-weighted magnetic resonance image had close relationship to the clinical outcomes. Conclusion : Unilateral en bloc laminoplasty is simultaneous expansile and decompressive method. And preoperative JOA score, symptom duration and high signal intensity on T2-weighted magnetic resonance image can be used to predict prognosis.

• 대한화장품학회:학술대회논문집
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• 대한화장품학회 2003년도 IFSCC Conference Proceeding Book I
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• pp.448-456
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• 2003

The prime objective of many facial wrinkle-reduction treatments is to achieve visible improvement. Thus the visibility of before/after treatment differences is often part of an efficacy assessment. This paper investigates whether the background knowledge of the people acting as observers in such assessments is of impact on the results: e.g. the subjects themselves are familiar with their faces, skin professionals have much experience in judging skin quality, and thus both might be more sensitive to small changes. In a clinical study 44 Female subjects were regularly treated during a period of 12 weeks with one of three wrinkle-reduction methods: K, Land M (placebo). Photographs were taken before treatment and at 6 and 12 weeks. The photographs were judged by 3 types of observers:ㆍ24 Lay observers were given the 0＆6-week and the 0＆12-week photo pairs of all subjects to indicate the one with the least wrinkles in a two-alternative forced-choice (TAFC) procedure.ㆍThe subjects themselves were given the 0＆6-weel and the 0＆12-week pair of their own photos (8 replications) to indicate the photo with the least wrinkles (TAFC).ㆍA trained panel of skin professionals (N=3) each gave 9-point Fitzpatrick wrinkle-severity scores for all individual 0-week and 12-week photos. We found that the lay observers perceived the same differences as the subjects themselves: significant improvements after 12 weeks for treatment K (p<0.0005 and p=0.005, respectively), no visible effects for treatments Land M, and, most importantly, a significant difference between treatments K and M/placebo (p=0.02 and p=0.04, respectively). Also the trained panel found this difference between K and M (p=0.013), but here it was due to a significant deterioration over time of the 'placebo-treated' wrinkles (M, p=0.03). Thus in conclusion we have found no indications that extra knowledge - in the form of familiarity with the own face or in the form of professional training - results in the identification of more treatments that show significantly visible wrinkle-reduction.

• 대한두개안면성형외과학회지
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• 제21권5호
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• pp.283-287
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• 2020

Background: Closed reduction is the standard treatment for nasal bone fractures, which are the most common type of facial bone fractures. We investigated the effect of closed reduction on quality of life. Methods: The 15-dimensional health-related quality of life survey was administered to 120 patients who underwent closed reduction under general anesthesia for nasal bone fractures from February 2018 to December 2019, on both the day after surgery and 3 months after surgery. Three months postoperatively, the presence or absence of five nasal symptoms (nose obstruction, snoring, pain, nasal secretions, and aesthetic dissatisfaction) was also evaluated. Results: The quality of life items that showed significant changes between immediately after surgery and 3 months postoperatively were breathing, sleeping, speech, excretion, and discomfort. Low scores were found at 3 months for breathing, sleeping, and distress. There were 31 patients (25.83%) with nose obstruction, 25 (20.83%) with snoring, 12 (10.00%), with pain, 11 (9.17%) with nasal secretions, and 29 (24.17%) with aesthetic dissatisfaction. Conclusion: Closed reduction affected patients' quality of life, although most aspects improved significantly after 3 months. However, it was not possible to rule out deterioration of quality of life due to complications and dissatisfaction after surgery.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.28-33
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• 2014

Objective : Postoperative delirium is a common complication in the elderly after surgery but few papers have reported after spinal surgery. We analyzed various risk factors for postoperative delirium after spine surgery. Methods : Between May 2012 and September 2013, 70 patients over 60 years of age were examined. The patients were divided into two groups : Group A with delirium and Group B without delirium. Cognitive function was examined with the Mini-Mental State Examination-Korea (MMSE-K), Clinical Dementia Rating (CDR) and Global Deterioration Scale (GDS). Information was also obtained on the patients' education level, underlying diseases, duration of hospital stay and laboratory findings. Intraoperative assessment included Bispectral index (BIS), type of surgery or anesthesia, blood pressure, fluid balance, estimated blood loss and duration of surgery. Results : Postoperative delirium developed in 17 patients. The preoperative scores for the MMSE, CDR, and GDS in Group A were $19.1{\pm}5.4$, $0.9{\pm}0.6$, and $3.3{\pm}1.1$. These were significantly lower than those of Group B ($25.6{\pm}3.4$, $0.5{\pm}0.2$, and $2.1{\pm}0.7$) (p<0.05). BIS was lower in Group A ($30.2{\pm}6.8$ compared to $35.4{\pm}5.6$ in group B) (p<0.05). The number of BIS <40 were $5.1{\pm}3.1$ times in Group A, $2.5{\pm}2.2$ times in Group B (p<0.01). In addition, longer operation time and longer hospital stay were risk factors. Conclusion : Precise analysis of risk factors for postoperative delirium seems to be more important in spinal surgery because the surgery is not usually expected to have an effect on brain function. Although no risk factors specific to spinal surgery were identified, the BIS may represent a valuable new intraoperative predictor of the risk of delirium.

• Fisheries and Aquatic Sciences
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• 제18권2호
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• pp.115-121
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• 2015

This study was conducted to confirm quality properties of sterilized Ganjang-gejang (marinated crab Portunus trituberculatus) with Korean soy sauce using by gamma irradiation and to improve quality of sterilized Ganjang-gejang. The Ganjang-gejang was irradiated at dose of 3, 6, 9, 12, and 15 kGy by gamma irradiation and there was evaluated in microbiological, physicochemical, and sensory properties. Total aerobic bacteria and fungi contents of non-irradiated samples were about 6 and 4 log CFU/g level, respectively. Gamma-irradiated samples at above 9 kGy did not contain aerobic bacteria or fungi at detection limit less than 2 log CFU/g, but sensory scores were significantly decreased depending on the irradiation dose. To improve the sensory qualities of gamma-irradiated Ganjang-gejang, the temperature was adjusted during sample irradiation. When samples were irradiated under freezing temperatures, especially on dry ice, the TBARS and the deterioration of sensory qualities of Ganjan-Gejang were reduced. Different odor patterns were observed among samples, as observed using electronic nose analysis system. The results of this study indicated that treatment with irradiation under low temperatures may help to preparing high-quality Ganjang-gejang.

• 한국식품과학회지
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• 제26권3호
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• pp.250-254
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• 1994

시판되고 있는 동결건조 즉석 청국장찌개를 $25^{\circ}C$, $35^{\circ}C$ 및 $45^{\circ}C$ 항온기에 저장하면서 저장기간 경과에 따른 품질특성의 변화를 살펴보았다. 저장일수가 증가함에 따라 과산화물값이 직선적으로 증가하는 것으로 나타났는데 이러한 결과는 시료내 함유된 유지중 불포화지방산의 함량(약 61%)이 높기 때문으로 사료된다. 갈색도와 표면색도의 변화를 살펴볼 때 즉석 청국장찌개는 저장기간이 경과함에 따라 갈색화반응이 진행되며 그 변색은 주로 적변으로 진행되는 것을 알 수 있었다. 저장중 수분함량의 변화는 거의 없는 것으로 나타났으며 이러한 결과로부터 알미늄 적층 포장재로 인해 수분의 흡습 및 투습이 완전히 차단되었음을 알 수 있었다. 한편, 관능검사 결과 대조구와의 종합적 차이도에서 제품의 색보다는 향이 더 큰 영향을 미치며, 구매의사가 상실되는 시점에서는 제품의 색이 붉고 산패취가 심하였다. 관능검사 결과와 각 품질 특성간의 회귀분석 결과 즉석 청국장찌개의 저장중 품질변화의 주요인자는 과산화물의 형성인 것으로 나타났다.

• PNF and Movement
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• 제18권2호
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• pp.233-244
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• 2020

Purpose: The study investigated pain and falls as psychological factors in Total Knee Replacement patients and examined the relationship between these factors. Methods: Ninety-six total knee replacement patients aged 69.31±7.01 (male: 21, female: 75) participated in the study. Post-surgery pain was assessed on a visual analog scale, and fall risk scores were evaluated on fall fear and fall efficacy scales. Other psychological factors assessed included national anxiety and trail anxiety, fear prevention, Beck depression score, and psychological health measures. The data were analyzed using SPSS version 22.0. Results: A statistically significant correlation was found between pain before surgery and FES fall fear score before surgery (p < 0.05). A statistically significant correlation was found between pain after surgery and PWBS fall fear score after surgery (p < 0.05). A statistically significant correlation was found between state anxiety and PWBS, Trail anxiety (p < 0.05). A statistically significant correlation was also found between trail anxiety and BDI, PWBS (p < 0.05). State anxiety and fear avoidance before surgery were found to affect trail anxiety, and pain before surgery and fall fear score before surgery were found to affect FES. In addition, PWBS was found to affect BDI. Conclusion: The study confirms that increased pain in Total Knee Replacement patients can be a risk factor for falls. In addition, fall fears increase fear avoidance and cause psychological deterioration. This suggests that efforts should be made to reduce pain and to manage psychological factors.