• Journal of Korean Neurosurgical Society
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• 제64권6호
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• pp.913-921
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• 2021

Objective : Accurate measurement of T1 slope (a component of T1s minus cervical lordosis [CL]) is often constrained by anatomical limitations. In this situation, efforts should be made to find the exact meaning of T1s-CL and whether there are any alternatives to it. Methods : We enrolled 117 patients who received two-level anterior cervical discectomy and fusion (ACDF). Occipital slope, C2 slope (C2s), C7 slope (C7s), T1, O-C2 angle (O-C2A), C2-7 angle (C2-7A), O-C7 angle (O-C7A), T1s-CL, C7-T1 angle (C7-T1A), and C2-7 sagittal vertical axis were measured. We determined 16° (T1s-CL) as the reference point for dividing subjects into the mismatch group and the balance group, and a comparative analysis was performed. Results : The mean value of C7-T1A was constantly maintained within 2.6° peri-operatively. In addition, C2s and T1s-CL showed the same absolute change (Δ|0.8|°). The mean values of T1s-CL of the mismatch and balance groups were 23.0° and 7.6°, respectively. The five factors with the largest differences between the two groups were as follows : C2s (Δ13.3°), T1s-CL (Δ15.4°), O-C2A (Δ8.7°), C2-7A (Δ14.7°), and segmental angle (Δ7.9°) before surgery. Only four factors showed statistically significant change between the two groups after ACDF : T1s-CL (Δ4.0° vs. Δ0.2°), C2s (Δ3.2° vs. Δ0.7°), O-C2A (Δ2.6° vs. Δ1.3°), C2-7A (Δ6.3° vs. Δ1.3°). A very strong correlation between T1s-CL and C2s was also found (r=|0.88-0.96|). Conclusion : C2s itself may be the essential key to represent T1s-CL. The amounts and directions of change of these two factors (T1s-CL and C2s) were also almost identical. The above phenomenon was re-confirmed once again through the correlation analysis.

• 대한통합의학회지
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• 제9권3호
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• pp.165-173
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• 2021

Purpose : Myofascial decompression is frequently mentioned as a method applied to cupping. The purpose of this study is to evaluate and compare active range of motion (AROM), muscle strength, and functional movement by applying myofascial decompression to the hamstrings. Methods : This study evaluated AROM, muscle strength, and functional movement by applying active movement myofascial decompression and static myofascial decompression to the dominant leg, respectively, in a crossover design conducted with normal adults (n=21) in their average 20s enrolled at G University in G city, Gyeongsangbuk-do. Active movement myofascial decompression was implemented for five minutes at a rate of 100 bpm to make the beats in flexion and extension respectively. Static myofascial decompression was only performed for five minutes while at rest. All of these interventions were performed at a cupping depth of two mm. After a one-week washout period, static was applied again to compare the same dependent variables. Results : Regarding AROM and muscle strength, both groups showed significant differences in the before and after results (p<.05). However, in the Functional Reach Aspect and Single Leg Hop test, the active movement myofascial decompression group showed better results. There was no statistical difference between the Active movement myofascial decompression group and Static myofascial decompression group in any dependent variable (p<.05). Conclusion : As a result of this experiment, both active movement myofascial decompression and static myofascial decompression had a positive effect on dependent variable. Therefore this study is meaningful in that it is easier and simpler to see the effect on flexibility, muscle strength, and functional movement just by implementing movement myofascial decompression.

• 한국산업보건학회지
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• 제31권4호
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• pp.427-439
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• 2021

Objectives: This study aims to investigate differences in microbial contamination according to the duration and environment of mask wearing. Methods: Forty-five participants were recruited from workers in an offices, multi-purpose facilities, and a schools. After wearing of KF94 mask for two. four, and six hours, the microorganisms adsorbed on the outer and inner layers of the mask were inoculated on BAP(Blood Agar Plate), Chocolate agar, and SDA plates. The bacterial count (CFUs: colony-forming units) cultured in each plate was measured and analyzed for changes in filtration efficiency. Results: The microbial contamination of masks worn in classrooms, offices, and multi-purpose facilities showed a significant difference depending on the environment (p<0.000). The measured CFUs increased significantly according to the time wearing the mask. The difference between the inner and outer layers of the mask was also significant (p<0.05). However, there was no statistical difference in the filtration efficiency of the masks by duration time (p=0.515). Conclusions: Masks worn by workers in the offices, multi-purpose facilities, and schools showed an increase of microbial contamination with the amount of time wearing the mask. The results indicate that the masks used in daily life may have adverse health effects if they are worn for a long time or reused over several days without the realizing that the masks can be contaminated with biological hazards. Guidelines on the safe threshold time for mask use should be established through further research.

• Journal of Breast Cancer
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• 제21권4호
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• pp.425-432
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• 2018

Purpose: Pregnancy-associated breast cancer (PABC) is rare, and its cause and prognosis are not well known. Additionally, treatment is limited with respect to the risk to the fetus. The purpose of this study was to investigate the characteristics and treatment trends of PABC and the survival rate according to the treatment. Methods: In the Korean Breast Cancer Society Registry database, women younger than 50 years and who were diagnosed with breast cancer from 1996 to 2015 were included. PABC was defined as breast cancer diagnosed during pregnancy or within 1 year after delivery. Results: We examined 411 patients with PABC and 83,381 patients with non-PABC. Over time, the proportions of patients undergoing breast-conserving surgery and sentinel lymph node biopsy increased, and neoadjuvant chemotherapy and radiation therapy administration rates also increased. In the past, the overall survival of patients with PABC was poorer than that of patients with non-PABC, but there was no difference in overall survival rates in more recent years. There was no difference in overall survival rates between patients who received neoadjuvant chemotherapy (hazard ratio [HR], 1.28; 95% confidence interval [CI], 0.66-2.49; p=0.459), but PABC conferred poorer prognosis than non-PABC in patients receiving adjuvant chemotherapy (HR, 1.63; 95% CI, 1.27-2.08; p<0.001). Conclusion: There was no difference in the prognosis between patients with PABC and those with non-PABC receiving neoadjuvant chemotherapy. The increase in neoadjuvant chemotherapy according to current treatment guidelines is expected to improve the survival rate of patients with PABC.

• 대한수혈학회지
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• 제29권3호
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• pp.291-300
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• 2018

배경: 적혈구를 폐쇄계에서 동결하고 세척하는 경우 동결해동적혈구의 보존기간을 24시간 이상으로 연장할 수 있다. 본 연구에서는 고농도글리세롤법과 자동화 장비인 Haemonetics ACP 215를 이용한 폐쇄계에서 적혈구의 동결과 세척과정을 평가하였다. 방법: ACP 215를 이용하여 35단위의 적혈구에 글리세롤을 최종농도가 40% (wt/vol)가 되도록 첨가하고 30단위는 즉시 동결하였으며, 나머지 5단위는 잔여 글리세롤을 제거한 다음 동결하였다. 동결한 적혈구는 $-80^{\circ}C$에 보관 후 해동 세척하여 SAG-M 보존액에 부유하고, $4^{\circ}C$에서 보존하면서 안정성 및 품질관리 지표를 분석하였다. 결과: 잔여 글리세롤을 제거하지 않은 동결적 혈구는 잔여 글리세롤을 제거한 동결해동적혈구에 비해 해동 후 보존기간 동안 칼륨 유출이 현저히 낮게 나타났다. 잔여 글리세롤을 제거하지 않은 동결해동적혈구를 해동 후 $4^{\circ}C$에서 7일간 보존하는 동안 측정한 모든 안정성 및 품질지표는 AABB와 유럽연합의 기준에 모두 적합하였다. 결론: ACP 215를 사용하여 동결 전 잔여 글리세롤을 제거하지 않고 바로 적혈구를 동결하는 방법은 동결보존과정이 단순하고 동결해동적혈구의 안정성이 향상되어 향후 수혈을 위한 동결적혈구에 현실적으로 적용가능성이 높은 것으로 생각된다.

• Annals of Surgical Treatment and Research
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• 제95권5호
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• pp.278-285
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• 2018

Purpose: We investigated the clinical outcomes of deceased donor kidney transplantation (KT) using kidneys with terminal acute kidney injury (AKI). Methods: Between February 2000 and December 2013, we performed 202 deceased donor renal transplants from 159 brain dead donors. According to the expanded criteria donor (ECD) and AKI network criteria, we divided 202 recipients into 4 groups: Group I: Non-AKI & standard criteria donor (SCD) (n = 97); group II: Non-AKI & ECD (n = 15); group III: AKI & SCD (n = 52); and group IV: AKI & ECD (n = 38). Results: The incidence of delayed graft function (DFG) was significantly higher in patients with AKI than it was in the non-AKI group (P = 0.008). There were no significant differences among the 4 groups in graft survival (P = 0.074) or patient survival (P = 0.090). However, the long-term allograft survival rate was significantly lower in group IV than it was in other groups (P = 0.024). Conclusion: Allografts from deceased donors with terminal AKI had a higher incidence of DGF than did those from donors without AKI. However, there is no significant difference in graft and patient survival rates among the groups. So, the utilization of renal grafts from ECDs with terminal AKI is a feasible approach to address the critical organ shortage.

• Asian Spine Journal
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• 제12권6호
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• pp.973-980
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• 2018

Study Design: Retrospective review. Purpose: To identify the trends in stimulator use, pair those trends with various grafting materials, and determine the influence of stimulators on the risk of revision surgery. Overview of Literature: A large number of studies has reported beneficial effects of electromagnetic energy in healing long bone fractures. However, there are few clinical studies regarding the use of electrical stimulators in spinal fusion. Methods: We used insurance billing codes to identify patients with lumbar disc degeneration who underwent anterior lumbar interbody fusion (ALIF). Comparisons between patients who did and did not receive electrical stimulators following surgery were performed using logistic regression analysis, chi-square test, and odds ratio (OR) analysis. Results: Approximately 19% of the patients (495/2,613) received external stimulators following ALIF surgery. There was a slight increase in stimulator use from 2008 to 2014 (multi-level $R^2=0.08$, single-level $R^2=0.05$). Patients who underwent multi-level procedures were more likely to receive stimulators than patients who underwent single-level procedures (p<0.05; OR, 3.72; 95% confidence interval, 3.02-4.57). Grafting options associated with most frequent stimulator use were bone marrow aspirates (BMA) plus autograft or allograft for single-level and allograft alone for multi-level procedures. In both cohorts, patients treated with bone morphogenetic proteins were least likely to receive electrical stimulators (p<0.05). Patients who received stimulation generally had higher reimbursements. Concurrent posterior lumbar fusion (PLF) (ALIF+PLF) increased the likelihood of receiving stimulators (p<0.05). Patients who received electrical stimulators had similar revision rates as those who did not receive stimulation (p>0.05), except those in the multilevel ALIF+PLF cohort, wherein the patients who underwent stimulation had higher rates of revision surgery. Conclusions: Concurrent PLF or multi-level procedures increased patients' likelihood of receiving stimulators, however, the presence of comorbidities did not. Patients who received BMA plus autograft or allograft were more likely to receive stimulation. Patients with and without bone stimulators had similar rates of revision surgery.

• Journal of Korean Neurosurgical Society
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• 제62권5호
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• pp.502-518
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• 2019

Objective : Since less invasive endovascular treatment was introduced to South Korea in 1994, a considerable proportion of endovascular treatments have been performed by neuroradiology doctors, and endovascular treatments by vascular neurosurgeons have recently increased. However, few specific statistics are known regarding how many endovascular treatments are performed by neurosurgeons. Thus, authors compared endovascular treatments collaboratively performed by vascular neurosurgeons with all cases throughout South Korea from 2013 to 2017 to elucidate the role of neurosurgeons in the field of endovascular treatment in South Korea. Methods : The Society of Korean Endovascular Neurosurgeons (SKEN) has issued annual reports every year since 2014. These reports cover statistics on endovascular treatments collaboratively or individually performed by SKEN members from 2013 to 2017. The data was requested and collected from vascular neurosurgeons in various hospitals. The study involved 77 hospitals in its first year, and 100 in its last. National statistics on endovascular treatment from all over South Korea were obtained from the Healthcare Bigdata Hub website of the Health Insurance Review & Assessment Service based on the Electronic Data Interchange (EDI) codes (in the case of intra-arterial (IA) thrombolysis, however, statistics were based on a combination of the EDI and I63 codes, a cerebral infarction disease code) from 2013 to 2017. These two data sets were directly compared and the ratios were obtained. Results : Regionally, during the entire study period, endovascular treatments by SKEN members were most common in Gyeonggido, followed by Seoul and Busan. Among the endovascular treatments, conventional cerebral angiography was the most common, followed by cerebral aneurysmal coiling, endovascular treatments for ischemic stroke, and finally endovascular treatments for vascular malformation and tumor embolization. The number of endovascular treatments performed by SKEN members increased every year. Conclusion : The SKEN members have been responsible for the major role of endovascular treatments in South Korea for the recent 5 years. This was achieved through the perseverance of senior members who started out in the midst of hardship, the establishment of standards for the training/certification of endovascular neurosurgery, and the enthusiasm of current SKEN members who followed. To provide better treatment to patients, we will have to make further progress in SKEN.

• 한국방사선학회논문지
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• 제13권2호
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• pp.283-290
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• 2019

본 연구의 목적은 레이노 현상 의심 환자의 정량적 판독 보조 지표의 가능성을 확인하고자 하는 것이다. 레이노 현상 의심 환자 99명에서 가능성 낮음 48명, 중간 16명, 높음 35명을 대상으로 하였다. 검사는 $15.2{\pm}0.8^{\circ}C$ 얼음물에 10분 간 양 손을 한랭 부하 후 $^{99m}Tc$ 370 MBq(10 mCi)를 정맥 주사하였다. 이 후 5분, 10분, 20분 양측 열 손가락의 온도 변화를 측정하였고, 핵의학 판독의의 판독 결과와 온도 변화를 비교하였다. 판독 결과 레이노 현상의 가능성이 낮은 군은 손가락 온도가 $32.6{\pm}4.9^{\circ}C$로 높게 측정되었고, 가능성이 높은 군은 $22.7{\pm}6.0^{\circ}C$로 낮게 측정되었다(p<0.05). 결론적으로 레이노 현상 의심 증상에 따라 손가락 온도의 차이가 났음을 확인하였고 이를 통해 손가락 온도의 측정이 레이노 진단의 정량적 보조 지표로서의 가능성이 있음을 확인하였다.

• 대한방사선기술학회지:방사선기술과학
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• 제41권6호
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• pp.587-594
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• 2018

The purpose of this study was to develop the indirect dosimetry by calculation (IDC) method for diagnostic X-ray equipment. The experiments were performed with inverter type X-ray tubes: Toshiba (E7252X, Japan) and Varian (RAD-14, USA). For the development method, we first applied the standard quality of X-ray beam shown in the TRS457 document, and second, to produce the constants of trendline for the IDC, the total filtration on X-ray beam was subdivided. Third, in order to increase the precision, the energy region was divided into the high energy region and the low energy region and developed by the IDC. In order to verify the IDC, mean dose (mR) values were measured for three Toshiba X-ray tubes and three Varian X-ray tubes at clinical medical institutions and then compared with the IDC on the 2013. As a result, compared with the previous study, the accuracy of the IDC of this study were improved by 2.71% and 9.91% in Toshiba and Varian X-ray tubes, respectively.