• Journal of Korean Neurosurgical Society
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• 제60권5호
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• pp.577-583
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• 2017

Objective : Laminoplasty is an effective surgical method for treating cervical degenerative disease. However, postoperative complications such as kyphosis, restriction of neck motion, and instability are often reported. Despite sufficient preoperative lordosis, this procedure often aggravates the lordotic curve of the cervical spine and straightens cervical alignment. Hence, it is important to examine preoperative risk factors associated with postoperative kyphotic alignment changes. Our study aimed to investigate preoperative radiologic parameters associated with kyphotic deformity post laminoplasty. Methods : We retrospectively reviewed the medical records of 49 patients who underwent open door laminoplasty for cervical spondylotic myelopathy (CSM) or ossification of the posterior longitudinal ligament (OPLL) at Pusan National University Yangsan Hospital between January 2011 and December 2015. Inclusion criteria were as follows : 1) preoperative diagnosis of OPLL or CSM, 2) no previous history of cervical spinal surgery, cervical trauma, tumor, or infection, 3) minimum of one-year follow-up post laminoplasty with proper radiologic examinations performed in outpatient clinics, and 4) cases showing C7 and T1 vertebral body in the preoperative cervical sagittal plane. The radiologic parameters examined included C2-C7 Cobb angles, T1 slope, C2-C7 sagittal vertical axis (SVA), range of motion (ROM) from C2-C7, segmental instability, and T2 signal change observed on magnetic resonance imaging (MRI). Clinical factors examined included preoperative modified Japanese Orthopedic Association scores, disease classification, duration of symptoms, and the range of operation levels. Results : Mean preoperative sagittal alignment was $13.01^{\circ}$ lordotic; $6.94^{\circ}$ lordotic postoperatively. Percentage of postoperative kyphosis was 80%. Patients were subdivided into two groups according to postoperative Cobb angle change; a control group (n=22) and kyphotic group (n=27). The kyphotic group consisted of patients with more than $5^{\circ}$ kyphotic angle change postoperatively. There were no differences in age, sex, C2-C7 Cobb angle, T1 slope, C2-C7 SVA, ROM from C2-C7, segmental instability, or T2 signal change. Multiple regression analysis revealed T1 slope had a strong relationship with postoperative cervical kyphosis. Likewise, correlation analysis revealed there was a statistical significance between T1 slope and postoperative Cobb angle change (p=0.035), and that there was a statistically significant relationship between T1 slope and C2-C7 SVA (p=0.001). Patients with higher preoperative T1 slope demonstrated loss of lordotic curvature postoperatively. Conclusion : Laminoplasty has a high probability of aggravating sagittal balance of the cervical spine. T1 slope is a good predictor of postoperative kyphotic changes of the cervical spine. Similarly, T1 slope is strongly correlated with C2-C7 SVA.

• Korean Journal of Radiology
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• 제22권1호
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• pp.106-117
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• 2021

Objective: To explore the value of magnetic resonance imaging (MRI)-based whole tumor texture analysis in differentiating borderline epithelial ovarian tumors (BEOTs) from FIGO stage I/II malignant epithelial ovarian tumors (MEOTs). Materials and Methods: A total of 88 patients with histopathologically confirmed ovarian epithelial tumors after surgical resection, including 30 BEOT and 58 MEOT patients, were divided into a training group (n = 62) and a test group (n = 26). The clinical and conventional MRI features were retrospectively reviewed. The texture features of tumors, based on T2-weighted imaging, diffusion-weighted imaging, and contrast-enhanced T1-weighted imaging, were extracted using MaZda software and the three top weighted texture features were selected by using the Random Forest algorithm. A non-texture logistic regression model in the training group was built to include those clinical and conventional MRI variables with p value < 0.10. Subsequently, a combined model integrating non-texture information and texture features was built for the training group. The model, evaluated using patients in the training group, was then applied to patients in the test group. Finally, receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of the models. Results: The combined model showed superior performance in categorizing BEOTs and MEOTs (sensitivity, 92.5%; specificity, 86.4%; accuracy, 90.3%; area under the ROC curve [AUC], 0.962) than the non-texture model (sensitivity, 78.3%; specificity, 84.6%; accuracy, 82.3%; AUC, 0.818). The AUCs were statistically different (p value = 0.038). In the test group, the AUCs, sensitivity, specificity, and accuracy were 0.840, 73.3%, 90.1%, and 80.8% when the non-texture model was used and 0.896, 75.0%, 94.0%, and 88.5% when the combined model was used. Conclusion: MRI-based texture features combined with clinical and conventional MRI features may assist in differentitating between BEOT and FIGO stage I/II MEOT patients.

• 한국토양비료학회지
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• 제8권2호
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• pp.69-80
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• 1975

수도(水稻)의 수량(收量)과 여러가지 질소효율간, 질소효율 상호간(相互間), 효율과 흡수량간(吸收量間)의 관계(關係)를 설정(設定)하고 3개(個) 연간(年間)의 3요소시험(要素試驗) (30~50개지역(個地域)) 결과자료(結果資料)로 검토(檢討)하였다. 설정(設定)된 상호관계(相互關係)는 고도유의상관(高度有意相關)을 보이므로 실험결과(實驗結果)에 잘 일치(一致)하였다. 시비하(施肥下)에서 다수성(多收性)은 시료(肥料)의 이용율(利用率)(Eu)을 증가(增加)시켜 일차적(一次的)으로 질소흡수(窒素吸收)를 증가(增加)시키고 흡수시료질소吸收肥料窒素(Nf) 효율(Ef) 및 시비효율(Fe)을 증가(增加)시키며 이차적(二次的)으로 질소효율(E)을 증가(增加)시키는데 의존(依存)한다. 흡수(吸收)된 토양질소(土壤窒素)(Ns) 효율(Es)은 Ef보다 E에 대(對)한 기여도(寄與度)가 컸으며 모든 질소효율은 동반질소(同伴窒素)의 흡수량(吸收量) 및 상대(相對)되는 다른 질소효율에 역상관(逆相關)을 보였다. Es와 Ef는 1. 감법(減法) 2. Cs (Cs=Ns/Ns+Nf) 대(對) E plotting 법(法)과 3. 표식비료(標識肥料)를 사용(使用)한 E-Cs 및 Y-Ns Plotting 법(法)이 있으며 Plotting 법(法)은 E-Es Cs+B 식(式) 또는 Y=Es Ns+Ef Nf식(式)을 사용(使用)하며 B=Ef Cf로 Ef Nf와 함께 주어진 조건하(條件下에서 상수(常數)로 본다. Es는 Ef보다 대부분(大部分)의 경우 (80%) 크며 포장간(圃場間)에 Es보다 Ef에 차이가 크며 Ef는 특히 비료(肥料)의 형태(形態)에 의존(依存)한다. 설정검토(設定檢討)된 상호관계(相互關係)는 다음과 같다. 1. Y=$Es{\cdot}Ns+Ef{\cdot}Nf$ (Y는 수량(收量)) 2. E=$Es{\cdot}Cs+Ef{\cdot}Cf(Cf=Nf/Ns/Nf)$ 3. E=b-aN, E=E, Es 또는 Ef이고 N=N, Ns 또는 Nf이다. (E=Y/N, N=Ns+Nf), b는 주어진 조건(條件)에서의 E의 이론적(理論的) 최대치(最大値)이고 a는 Y=EN 곡선(曲線)의 N=0에서의 접선(接線)의 기울기이다. 4. Fe=$Ef{\cdot}Eu$, Se=$Es{\cdot}Eu$ (Se는 토양유효질소의 종조생산효율) 5. E=$Se{\cdot}Cs/Eu+Fe{\cdot}Cf/Eu$ 6. Y=$Es{\cdot}Eu{\cdot}Sf+Ef{\cdot}Eu{\cdot}Fn$ 또는 Y=$Es{\cdot}Eu{\cdot}Ea{\cdot}Sn+Ef{\cdot}Eu{\cdot}Fn(Sf=Ea{\cdot}Sn$, Ea는 비료질소(肥料窒素)와 대등(對等)한 토양유효질소(Sf)를 전토양질소(全土壤窒素)(Sn)로 나눈 유효화율).

• 한국지진공학회논문집
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• 제7권5호
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• pp.19-24
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• 2003

2002년 12월 10일 발생한 철원지진에 의해 기록된 지진파의 파상(phase)분석을 하고, 진원위치, 발생시간, 지진규모 등의 진원요소를 연구하였다. 이 연구에서는 기상청과 한국지질자원연구원의 지진관측망에 의해 기록된 속도 및 가속도 자료를 사용하였다. 이 지진은 휴전선 이북에서 발생한 관계로 휴전선 이남에서 직접파인 Pg가 기록된 관측소는 5곳에 불과하다. 또 굴절파의 초동파인 Pn은 대부분의 관측소에서 구분하기 어렵다. 이러한 이유로 진원 결정에서 기존의 방법으로는 오차가 클 가능성이 있다. 기록된 각 파의 구분을 위하여 Kim et a1. 개발한 파상 분석법과 주시곡선을 사용하여 P 및 S파의 직접파, 반사파 및 굴절파를 구분하였다. 진원위치 및 발생시간을 결정하기 위하여 기존의 방법에서 사용되는 Pg, Pn, Sg, Sn 파 외에 PmP 및 SmS 파를 추가로 사용하여 정확도를 증가시켰다. 진앙거리 200km 미만의 11개 자료로 결정한 철원지진의 진앙은 북위 38.81도, 동경 127.22도, 그리고 진원 깊이는 12.0km이며, 발생시간은 7시 42분 51.4초(한국시간)이다. Richter의 지진규모 정의에 따라 계산된 각 관측소의 평균적 지진규모는 $M_{L}$ 3.6이다. 이 규모는 기상청과 한국지질자원연구원에서 결정한 규모보다는 각각 0.2와 0.5만큼 작다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.871-876
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• 2014

Objective: Desmogleins (DSGs) are major members among the desmosomal cadherins critically involved in cell-cell adhesion and the maintenance of normal tissue architecture in epithelia. Reports exploring links of DSG family member expression with cancers are few and vary. The aim of this study was to investigate the ratio of DSG2 and DSG3 mRNA expression in esophageal squamous cell carcinoma (ESCC) tissue to normal tissue (T/N ratio) and evaluate correlations with clinical parameters. Methods: The mRNA expression of DSGs, as well as ${\gamma}$-catenin and desmoplakin, was detected by real-time quantitative RT-PCR in 85 cases of ESCC tissue specimens. Results: The expression level of DSG3 mRNA was significantly higher than that of DSG2 in ESCC specimens (p=0.000). DSG3 mRNA expression highly correlated with histological grade (p=0.009), whereas that of DSG2 did not significantly relate to any clinicopathologic parameter. Kaplan-Meier survival analysis showed that only DSG3 expression had an impact on the survival curve, with negative DSG3 expression indicating worse survival (p=0.038). Multivariate Cox regression analysis demonstrated DSG3 to be an independent prognostic factor for survival. Furthermore, correlation analysis demonstrated the mRNA level of DSG3 to highly correlate with those of ${\gamma}$-catenin and desmoplakin in ESCC samples (p=0.000), implying that the expression of desmosomal components might be regulated by the same upstream regulatory molecules. Conclusions: Our findings suggest that DSG3 may be involved in the progression of ESCC and serve as a prognostic marker, while expression of DSG2 cannot be used as a predictor of ESCC patient outcome.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권2호
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• pp.145-153
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• 2022

Background: Postoperative analgesia (POA) is an important determinant of successful treatment. Dexmedetomidine (DEX) has recently gained attention as a promising adjuvant to local anesthetics (LA). The present study aimed to evaluate the efficacy and safety of levobupivacaine (LB) as an adjuvant during inferior alveolar nerve block (IANB) in the extraction of lower impacted third molars (LITM). Methods: A prospective, randomized, placebo-controlled, triple-blind, parallel-arm, and clinical study was performed on 50 systemically healthy participants who required removal of an asymptomatic LITM. Using a 1:1 distribution, the participants were randomized into two groups (n = 25). Group L (control group) received 1.8 mL of 0.5% LB and 0.2 mL normal saline (placebo) and Group D (study group) received a blend of 1.8 mL of 0.5% LB and 0.2 mL (20 ㎍) DEX. The primary outcome variable was the duration of POA and hemodynamic stability, and the secondary variable was the total number of analgesics required postoperatively for up to 72 h. The participants were requested to record the time of rescue analgesic use and the total number of rescue analgesics taken. The area under the curve was plotted for the total number of analgesics administered. The pain was evaluated using the visual analog scale. Data analysis was performed using paired students and unpaired t-test, Mann-Whitney U test, Chi-square test, and receiver operating characteristic analysis. Statistical significance was set at P < 0.05. Results: The latency, profoundness of anesthesia, and duration of POA were statistically significant (P < 0.05). The differences between mean pain scores at 6, 12, 24, 48, and 72 h were found to be significant (each P = 0.0001). Fewer analgesics were required by participants in group D (2.12 ± 0.33) than in L (4.04 ± 0.67), with a significant difference (P = 0.0001). Conclusion: Perineurally administered LA with DEX is a safe, effective, and therapeutic approach for improving latency, providing profound POA, and reducing the need for postoperative analgesia.

• Journal of Chest Surgery
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• 제56권4호
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• pp.244-251
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• 2023

Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with cardiorespiratory failure. The serum albumin level is an important prognostic marker in critically ill patients. We evaluated the efficacy of using pre-ECMO serum albumin levels to predict 30-day mortality in patients with cardiogenic shock (CS) who underwent venoarterial (VA) ECMO. Methods: We reviewed the medical records of 114 adult patients who underwent VA-ECMO between March 2021 and September 2022. The patients were divided into survivors and non-survivors. Clinical data before and during ECMO were compared. Results: Patients' mean age was 67.8±13.6 years, and 36 (31.6%) were female. The proportion of survival to discharge was 48.6% (n=56). Cox regression analysis showed that the pre-ECMO albumin level independently predicted 30-day mortality (hazard ratio, 0.25; 95% confidence interval [CI], 0.11-0.59; p=0.002). The area under the receiver operating characteristic curve of albumin levels (pre-ECMO) was 0.73 (standard error [SE], 0.05; 95% CI, 0.63-0.81; p<0.001; cut-off value=3.4 g/dL). Kaplan-Meier survival analysis showed that the cumulative 30-day mortality was significantly higher in patients with a pre-ECMO albumin level ≤3.4 g/dL than in those with a level >3.4 g/dL (68.9% vs. 23.8%, p<0.001). As the adjusted amount of albumin infused increased, the possibility of 30-day mortality also increased (coefficient=0.140; SE, 0.037; p<0.001). Conclusion: Hypoalbuminemia during ECMO was associated with higher mortality, even with higher amounts of albumin replacement, in patients with CS who underwent VA-ECMO. Further studies are needed to predict the timing of albumin replacement during ECMO.

• 대한교통학회지
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• 제20권3호
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• pp.149-158
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• 2002

동적 통행배정모형에서 주로 사용되는 링크 통행비용함수가 현실상황을 제대로 표현하지 못함에 따라, 최근 교통류의 특성을 현실적으로 묘사할 수 있는 여러 형태의 교통류모형(Traffic model)들이 제시되고 있다. 현재까지 개발된 모형들을 차량의 동적 움직임을 표현하는 가장 특징적인 요소인 교통류 전파(flow propagation) 과정에 따라 구분하면 교통량-통행시간(Flow-travel time)간의 관계를 명시적인 함수 형태로 사용하는 경우 (Functional approach)와 Cell transmission model이나 개별차량 또는 몇 개의 차량을 1개의 그룹으로 묶은 미시적인 패킷(package)에 기초한 시뮬레이션 형태로 표현하는 경우로(Non-functional approach) 나눌 수 있다. 그러나 함수형태의 비용함수는 여러 연구에서 실제 차량의 행태를 묘사하는 데에는 한계가 있음을 보여주고 있다. 따라서, 본 연구에서는 차량의 통행시간을 패킷기초의 시뮬레이션으로 묘사하는 기법을 개발하는 데, 수직형 대기행렬모형(Vertical queue model 또는 Point Queue model)으로 개발한다. 개발된 모형의 동적 교통류 표현능력을 검토하기 위하여 교통류의 전파를 시간 종속적으로 재현하는 시뮬레이션 부하기법(Simulation loading algorithm)을 개발하고 개발된 모형을 상용 프로그램과 비교한다. 본 연구에서는 교통류의 기본 변수인 교통량-속도-밀도간의 관계와 통행시간간의 관계를 살펴본다. 분석결과, 미시적모형에 비해 상대적으로 간단한 전파규칙(propagation rule)을 사용함에도 불구하고 현실적인 교통류에서 나타나는 중요한 특성들을 모두 확인할 수 있었다.FA비율에 있어서 D$_2$, D$_3$, D$_{6}$이 D$_1$에 비해 유의적으로 높게 나타났지만 D$_1$, D$_4$, D$_{5}$, D$_{7}$, 실험구간 그리고 D$_2$-D$_{7}$, 실험구간 사이에서는 각각 유의적인 차이가 없었다(P<0.05). DHA/EPA의 비율에 있어서 D$_{7}$이 유의적으로 높았으며, D$_{5}$가 유의적으로 낮았다(P<0.05). 상기의 결과를 토대로, 성장과 전어체내 지방산조성에 있어서 뱀장어 치어의 사료내 EPA와 DHA의 첨가효과 미약한 것으로 판단되며, 사료내 LNA (n-3)와 LA(n-6) HUFA을 각각 0.35%, 0.65% 첨가했을 때 WG, SGR, FE, PER이 가장 높았으나, 이전의 실험(Takeuchi, 1980)과 동일한 수준인 n-3와 n-6를 각각 0.5%씩 첨가한 실험구와는 유의적인 차이를 보이지 않았다. 이렇게 볼 때, 뱀장어 치어의 필수지방산은 LNA (n-3), LA (n-6)이고, 그 적정수준은 각각 0.35-0.5%, 0.5-0.65%임을 보여준다.George W, Bush)가 새로운 지도자로 취임하여 얼마 되지 않은 2001년 9월 11일 사상 초유로 본토에서 알 카에다 테러리스트 조직에 의해 공격받게 되었다. 뉴욕의 세계무역센터 빌딩 2개가 완전히 붕괴되고, 펜타곤에 민간 여객기가 충돌하여 많은 사람이 살상 당하고, 전체적으로 세계 80여 개국으로부터의 6천여 명이 살상되었다. 전 세계와 미국은

• The Korean Journal of Physiology
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• 제17권2호
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• pp.119-124
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• 1983

The in vivo and in vitro buffer capacities of true plasma and tissue buffer capaciies were compared on dogs. Intracellular pH was determined on skeletal muscle by a modification of the method of Schloerb and Grantham using $C^{14}$ DMO. The in vivo curve for plasma or extracellular fluid has a much lower slope than the in vitro curve. The in vivo slope of skeletal muscle in the dog is approximately 20 sl. The slope for skeletal muscle in vivo falls between the in vitro and in vivo slopes of true plasma. It appears that intracellular hydrogen ion varies linearly with extracellular hydrogen ion when $CO_2$ tension is changed. Both hydrogen ion gradient and Hi/He ratio vary in skeletal muscle, with an increase in $CO_2$ tension. Infusion of 0.3N HCl gave two distinct patterns, the $H_i-H_e$ gradient decreased; and it would appear that very little hydrogen ion as such penetrated to the inside of the cells during the time of observation. Although lactic acid presumably enters the cell and the same of larger load was given as was used for hydrochloric acid, only very mild intracellular acidosis resulted, ostensibly due to metabolism of this substrate. Gluconic acid produced a more severe acidosis, both intracellularly and extracellularly, but with both of these acids the hydrogen ion gradient decreased and the $H_i/H_e$ ratio also decreased. The experiments on the dogs with hemorrhagic shock the hydrogen ion increase producing the acidosis originates inside the cells. Even so, the hydrogen ion gradient increased only very slightly in the acute experiments. This may suggest that even over short intervals of time skeletal muscle cells have a capacity to pump out hydrogen ions at a rate which maintains approximately the normal $H_i/H_e$ gradient when the source of the hydrogen ion is in the interior of the cell.

• Asian Pacific Journal of Cancer Prevention
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• 제15권2호
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• pp.691-694
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• 2014

Background: Tumor length in patients with esophageal cancer (EC) has recently received great attention. However, its prognostic role for EC is controversial. The purpose of our study was to characterize the prognostic value of tumor length in EC patients and offer the optimum cut-off point of tumor length by reliable statistical methods. Materials and Methods: A retrospective analysis was conducted on 71 consecutive patients with EC who underwent surgery. ROC curve analysis was used to determine the optimal cut-off point for tumor length, measured with a handheld ruler after formalin fixation. Correlations between tumor length and other factors were surveyed, and overall survival (OS) rates were compared between the two groups. Potential prognostic factors were evaluated by univariate Kaplan-Meier survival analysis. A P value less than 0.05 was considered significant. Results: There were a total of 71 patients, with a male/female divide of 43/28 and a median age of 59. Characteristics were as follows: squamous/adenocarcinoma, 65/6; median tumor length, 4 (0.9-10); cut-off point for tumor length, 4cm. Univariate analysis prognostic factors were tumor length and modality of therapy. One, three and five year OS rates were 84, 43 and 43% for tumors with ${\leq}4cm$ length, whereas the rates were 75, 9 and 0% for tumors >4 cm. There was a significant association between tumor length and age, sex, weight loss, tumor site, histology, T and N scores, differentiation, stage, modality of therapy and longitudinal margin involvement. Conclusions: Future studies for modification of the EC staging system might consider tumor length too as it is an important prognostic factor. Further assessment with larger prospective datasets and practical methods (such as endoscopy) is needed to establish an optimal cut-off point for tumor length.