• Archives of Plastic Surgery
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• 제51권2호
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• pp.212-233
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• 2024

This is a retrospective review of surgical management for primary lymphedema. Data were extracted from 55 articles from PubMed MEDLINE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials between the database inception and December 2022 to evaluate the outcomes of lymphaticovenous anastomosis (LVA) and vascularized lymph node transfer (VLNT), and outcomes of soft tissue extirpative procedures such as suction-assisted lipectomy (SAL) and extensive soft tissue excision. Data from 485 patients were compiled; these were treated with LVA (n = 177), VLNT (n = 82), SAL (n = 102), and excisional procedures (n = 124). Improvement of the lower extremity lymphedema index, the quality of life (QoL), and lymphedema symptoms were reported in most studies. LVA and VLNT led to symptomatic relief and improved QoL, reaching up to 90 and 61% average circumference reduction, respectively. Cellulitis reduction was reported in 25 and 40% of LVA and VLNT papers, respectively. The extirpative procedures, used mainly in patients with advanced disease, also led to clinical improvement from the volume reduction, as well as reduced incidence of cellulitis, although with poor cosmetic results; 87.5% of these reports recommended postoperative compression garments. The overall complication rates were 1% for LVA, 13% for VLNT, 11% for SAL, and 46% for extirpative procedures. Altogether, only one paper lacked some kind of improvement. Primary lymphedema is amenable to surgical treatment; the currently performed procedures have effectively improved symptoms and QoL in this population. Complication rates are related to the invasiveness of the chosen procedure.

• 한국지반공학회:학술대회논문집
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• 한국지반공학회 1999년도 가을 학술발표회 논문집
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• pp.95-102
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• 1999

It is important to estimate the magnitude of settlement and the time of primary consolidation in geotechnical engineering projects. For these purposes, site explorations and laboratory tests are usually performed. However, the mechanical properties determined from laboratory tests on the samples obtained by different sampling techniques show different trends. In this study, three types of consolidation test were carried out on the soil samples obtained by three different sampling techniques (76mm tube, 76mm piston, and block samples), to verify the effect of sample disturbance on consolidation properties. It was found that sampling methods have influence on the $\varepsilon$ - log $\sigma$'$_{v}$ relationship. While insignificant difference of compression indices from the samples obtained by different sampling techniques was observed in compression region, these values showed a different trend in precompression region. The values of $c_{v}$ and k of block samples had a tendency to be larger than those of piston and tube samples. At consolidation pressure larger than $\sigma$'$_{p}$, however, these properties became similar regardless of sampling methods. The block and piston samples gave slightly higher values of $C_{a/}$ $C_{c}$ than tube samples. In the results of I $L_{EOP}$ and CRS test, it was observed that the values of $\sigma$'$_{p measured}$/$\sigma$'$_{p best estimated}$ of Yang-San clay decreases when strain becomes larger than 1.0% and that precompression strain of block samples is in the range of 1.5~2.0% while those of piston and tube samples are 1.75~3.75%. It was also shown that the values of $\sigma$'$_{p}$ of block samples exceed those of piston and tube samples by about 6~10%.6~10%.%.%.%.%.

• Journal of Acupuncture Research
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• 제35권2호
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• pp.75-80
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• 2018

Background: The aim of this study was to assess the feasibility of conducting a clinical study of using acupuncture for chronic pain in patients with osteoporotic thoracolumbar vertebral compression fractures (VCFs) in the outpatient setting. Methods: A prospective case-series attempting to recruit 20 participants was performed from February 11, 2016, to December 31, 2016. We provided Manual and electrical acupuncture was provided one 1 to three 3 times a week, for 6 weeks, up to 18 sessions. The primary clinical outcome was the average pain intensity as measured by the visual analog scale (VAS) at 6 weeks. Secondary outcomes included back-specific dysfunction (Oswestry disability index), quality of life (quality of life questionnaire-26), patient-reported improvement, use of other healthcare resources, and adverse events at 6 weeks. Use of healthcare resources and adverse events were additionally followed-up at 12 weeks by telephone. Results: Of 33 patients screened, a total of 7 were enrolled in the study. Manual and electrical acupuncture was provided 1 to 3 times a week, for 6 weeks, up to 18 sessions. We observed reduced pain intensity at 6 weeks in all participants. The change in the quality of life and back-specific dysfunction was inconsistent among participants. Mild, temporary adverse events were observed in three patients. Conclusion: In our clinical setting, it was not feasible to recruit sufficient participants and to assess the efficacy of acupuncture for chronic pain after osteoporotic thoracolumbar VCFs under a year. Strategies to improve recruitment and to identify barriers to participation are required for future clinical trials.

• 한국지반신소재학회논문집
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• 제15권4호
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• pp.1-8
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• 2016

이 연구의 목적은 소다회 생산과정에서 발생한 매립지의 압밀특성을 연구하는데 있다. 소다회를 생산하는 과정에서 발생하는 부산물의 주요성분은 대부분 석회석이다. 이 연구는 우선 폐석회의 압밀특성을 파악하기 위해 시추조사를 통한 불교란 시료를 채취하여 실내실험을 실시하였다. 실험결과 폐석회는 소성이 큰 유기질토로 분류되었으며, 유기물 함유량 시험결과 폐석회에 함유된 유기물 함량은 일반 점토에 비하여 높게 나타났다. 또한, 이론적인 방법과 압밀해석 프로그램에 의하여 폐석회의 압밀침하량과 이차침하량을 산정하였다.

• 한국농공학회지
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• 제31권1호
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• pp.106-116
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• 1989

This study aims at scrutinizing the long4errn consolidation characteristics of peats sampled at three different regions of Chonbuk province. The standard consolidation test and the single load consolidation test were performed about these samples and especially in case of the latter the loading period was 350 days. The main condusions analyzed are as follows. 1. Void ratio showed much greater values than that of the general clay and was decresed greatly according to the increase of the load. 2. In case of the relationship between the sefflement and the long-term settlement time the rate of settlement increment became great according to the increase of the load step and the long4erm settlement became linely proportional to the logarithm of time alter 10 minutes. 3. The linear correlation was showed between the long4erm settlement time and the void ratio and therefore equations by regression analysis were derived in order to estimate the long-term settlement The slope of straight lines increased according th the increase of the load step and secondary consolidation coefficients ranged from 0.04-0.27. 4. The secondary consolidation coeffcient became linealy proportional to the compression index and the ratio of Ca to CC was 0.072. 5. The period required in ending the primary consolidation was about 10 minutes and alter that the secondary consolidation coefficient appeared to have constant value. Therefore the secondary consolidation coefficient was judged to be used as a significant factor in estimating the long4erm settlement. 6. In case of the single load consolidation test the secondary consolidation coefficient showed the tendancy increasing according to the increase of the consolidation pressure.

• 대한약침학회지
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• 제18권1호
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• pp.79-85
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• 2015

Objectives: A vertebral compression fracture (VCF) is characterized by back pain and fracture of a vertebral body on spinal radiography. VCFs of the thoraco lumbar spine are common in the elderly. In general, appropriate analgesics should be prescribed to reduce pain and, thus, promote early mobilization. The ideal treatment approach for VCFs has not been determined. In Korea, acupuncture and herbal medication have been used to treat VCFs for many years. There is empirical evidence that acupuncture might benefit patients with a VCF. However, no randomized, controlled, clinical trials evaluating the efficacy and the safety of acupuncture for treating a VCF have been published. Therefore, we designed a randomized, controlled, pilot, clinical trial to obtain information for the design of a further full scale trial. Methods: A five week protocol for a randomized, controlled, pilot, clinical trial is presented. Fourteen patients will be recruited and randomly allocated to two groups: a control group receiving interlaminar epidural steroid injections once a week for three weeks, and an experimental group receiving interlaminar epidural steroid injections plus acupuncture treatment (three acupuncture sessions per week for three weeks, nine sessions in total). The primary outcomes will be the pain intensity (visual analogue scale and PainVision$^{TM}$ system). The secondary outcome measurements will be the answers on the short form McGill pain questionnaire and the oswestry disability index. Assessments will be made at baseline and at one, three, and five weeks. The last assessment (week five) will take place two weeks after treatment cessation. This study will provide both an indication of feasibility and a clinical foundation for a future large scale trial. The outcomes will provide additional resources for incorporating acupuncture into existing treatments, such as nonsteroidal anti-inflammatory medications, narcotics and vertebral augmentation. This article describes the protocol.

• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.623-630
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• 2020

Objective : A primary degenerative sagittal imbalance has been considered because of unique lifestyles such as the prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Previous papers have reported that sagittal imbalance disease is often seen distinctly in the farming districts of "oriental" countries such as Korea and Japan. However, this finding was only evaluated with the use of X-ray, and other factors such as magnetic resonance imaging (MRI), muscle volume, compression fracture, and laboratory results were not considered. Thus, using these, we evaluate the agricultural work-associated factors for Korean elderly spinal sagittal imbalance. Methods : We recruited 103 Korean participants who had a sagittal vertical axis (SVA) of >5 cm in this Korean Elderly Sagittal Imbalance Cohort Study. The following were evaluated : radiological parameters, MRI, compression fracture, vitamin D, parathyroid hormone, C-terminal telopeptide, osteocalcin, bone mineral density and muscle fatty change, muscle volume, and health-related quality of life from patients' survey. Moreover, in this survey, the farmers' annual working hours were investigated. Subsequently, we analyzed the associated factors for spinal sagittal imbalance depending on occupation. Results : A total of 46 participants were farmers, and the others were housewives, sellers, and office workers. The farmer group had more SVA (141 vs. 99 mm, p=0.001) and pelvic tilt (31° vs. 24°, p=0.004) and lesser lumbar lordosis (20° vs. 30°, p=0.009) and thoracic kyphosis (24° vs. 33°, p=0.03) than non-farmer group. A significantly positive correlation was noted between the working hour and SVA in the farmer group (p=0.014). The visual analogue scale score for back pain (8.26 vs. 6.96, p=0.008) and Oswestry Disability Index (23.5 vs. 19.1, p=0.003) in the farmer group were higher than that in the non-farmer group, but the Short Form-36 score was not significantly different between the two groups. The Mini-Mental State Exam score was significantly lower in the farmer group than in the non-farmer group (24.85 vs. 26.98, p=0.002). Conclusion : The farmer group had more sagittal imbalance and back pain in proportion to the working hours even though the muscle and bone factors and general laboratory condition were not significantly different between the two groups. These results supported that the long hours spent in the crouched posture while performing agricultural work were a risk factor for severe sagittal imbalance.

• Radiation Oncology Journal
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• 제12권3호
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• pp.393-399
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• 1994

최근 혈액암에 있어서 적극적인 복합항암요법및 골수이식등으로 장기 생존자의 수가 증가함에 따라 과거에 흔하지 않았던 합병증, 특히 척추 신경의 침범으로 인한 압박증상을 보이는 환자들의 수가 점차 증가하고 있다. 혈액종양과 고형종양간에 방사선 감수성의 현저한 차이가 있음에도 불구하고, 척수압박증상에 관한 대부분의 보고들이 혈액종양을 따로 구분하여 분석하지 않았으며, 충분한 수의 혈액종양환자를 대상으로 한 보고가 드문 실정이다. 이에 저자들은 1988년부터 1993까지 척수압박으로인해 응급방사선치료를 받은 32명의 혈액종양 환자를 대상으로 후향적 분석을 시행하여 치료결과 및 예후인자를 알아보고자하였다. 신경학적 진찰이나 방사선학적 검사 (척수조영술, 전산화단층촬영, 자기공명영상촬영)로 진단된 경우가 27례 이었고, 환자가 호소하는 증상 을 중심으로 'high index of suspicion' 으로 진단한 5례를 포함하였다. 발병당시 조직학적 진단이 없어 수술을 시행한 1례를 제외한 모든 환자가 방사선 단독으로 치료받았으며, 조사량의 범위는 800 cGy 에서 4000 cGy로 중앙값은 2000 cGy 이었다. 혈액종양의 방사선 감수성을 고려하여 200 cGy이하의 분할조사량이 사용되었으며, 신경학적 증상의 진행속도_가 빠른 13례에 있어서는 치료초기 2회 내지 3회에 걸쳐 250 cGy 이상의 고분할선량이 사용되었다. 전체환자의 $50\%$에서 좋은 반응을 보였고, $37.5\%$에서 부분반응을 보였으며, $12.5\%$는 치료에 반응이 없었다. 이러한 반응율은 문헌에 보고된 고형암에 비해 높았으며, 혈액종양만을 대상으로한 다른 보고들과 유사하였다. 진단당시 신경학적증상의 정도가 치료결과에 영향을 미치는 가장 중요한 예후인자였고, 증상의 출현에서 치료시작까지 소요된 기간도 치료결과에 유의한 영향을 미치는 것으로 나타났다. 반면에 조직학적 진단의 종류, 총방사선량, 초기고분할선량의 사용여부등에 따른 치료결과의 차이는 관찰되지 않았다.

• 농업과학연구
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• 제10권1호
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• pp.110-117
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• 1983

본(本) 연구(硏究)는 쌍곡선법(雙曲線法)을 이용(利用)해서 하중(荷重) 증가율(增加率)이 이차압밀(二次壓密)에 마치는 영향(影響)을 구명(究明)하기 위하여, 아산만(牙山灣)의 해성점토(海成粘土)에 대(對)하여 시험(試驗)한 것으로 그의 결과(結果)를 요약(要略)하면 다음과 같다. 1. 쌍곡선법(雙曲線法)에 의(依)한 이차압밀량산정(二次壓密量算定) 값은 Casagrande의 log t 법(法)에 의(依)한 값보다 약간 작았으나, 그 차이(差異)는 미소(微小)하였고 쌍곡선법(雙曲線法)으로는 하중(荷重) 증가율(增加率)이 작을 때에도 쉽게 이차압밀량(二次壓密量)을 산정(算定)할 수 있었다. 2. 하중증가율(荷重增加率)이 작을수록 이차압밀비(二次壓密比)는 크게 나타났으며 하중증가율(荷重增加率)이 작을때 일어나는 심하곡선(沈下曲線)의 creep 현상(現象)은 이차압밀(二次壓密)에 기인(起因)한 것이라 생각된다. 3. 일차압밀중(一次壓密中)에 생기는 이차압밀(二次壓密)는 과압밀영역(過壓密領域)에서는 불규칙(不規則)했으나, 과압밀영역(過壓密領域)에서는 하중증가율(荷重增加率)이 작을수록 증가현상(增加現象)을 보였다. 4. 이차압밀계수(二次壓密係數)는 하중(荷重)의 증가(增加)에 따라 점차 증가(增加)하여 선행하중근처(先行荷重近處)에서 변곡점(變曲点)을 이루었고 하중(荷重)이 $2kg/cm^2$부터는 감소현상(減少現象)을 나타냈으며 이차압밀계수(二次壓密係數)는 하중증가율(荷重增加率)과 무관(無關)함을 보였다. 5. 이차압밀계수(二次壓密係數)와 압축지수(壓縮指數)는 비례관계(比例關係)를 나타냈다.