• Clinics in Shoulder and Elbow
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• 제25권1호
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• pp.28-35
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• 2022

Background: Given the complications involved in corticosteroid (CS) injections, subacromial platelet-rich plasma (PRP) injections may provide a valid alternative to CS in the treatment of rotator cuff (RC) tendinopathy. Methods: We retrospectively reviewed a total of 98 patients affected by RC tendinopathy who were treated with either subacromial injection of PRP or CS. The PRP group received three injections of autologous PRP at 2 weeks interval, and the CS group received one injection of CS. The Western Ontario Rotator Cuff Index (WORC) was the primary outcome measure, while the secondary outcome measures were the visual analog scale (VAS), range of motion (ROM), and need for cuff repair surgery, which were analyzed at intervals of 6, 12, and 18 months. Results: A total of 75 patients were included in the analysis (PRP, n=35; CS, n=40). The mean follow-up for PRP was 21.1±8.7 months and for CS was 33.6±16.3 months (p<0.001). Both groups showed improvement in WORC, VAS, and ROM. No significant differences were detected between the two groups in any of the primary (WORC) or secondary outcomes over 6, 12, and 18 months (all p>0.05). No adverse events were detected. Conclusions: Both treatments improved patient symptoms, but neither resulted in a significantly better outcome in this series of patients. PRP can be a safe and feasible alternative to CS, even at long-term follow-up, to reduce local and systemic effects involved with CS injections.

• 대한토목학회논문집
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• 제29권5A호
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• pp.503-510
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• 2009

본 연구의 목적은 LMC로 덧씌우기 또는 보수 된 형태의 RC 보의 정적 거동 특성을 파악하는데 있다. 따라서, LMC로 덧씌우기 및 보수된 RC 보를 상대습도 60%, 온도 $20^{\circ}C$의 조건에서 양생을 실시하여 제작하였으며, 제작된 시험체를 4점 휨 실험을 수행하여 균열양상, 파괴거동 및 극한강도 등의 거동을 고찰하였다. 실험결과 전단철근이 보강된 보수형태의 RC보의 경우 100%이상의 내하력을 회복하여 보수 효과가 뛰어난 것을 알 수 있었고, LMC로 압축부에 덧씌우기 된 시험체의 경우 덧씌우기 두께가 증가함에 따라 내하력이 크게 증진되었다. 그러나, 전단철근이 보강되지 않은 보수형태의 시험체와 인장부 덧씌우기된 시험체는 부착계면 파괴양상을 보여주어 보수 및 보강 효과가 거의 없는 것으로 나타났다. 또한 부착계면의 거동특성을 파악하기 위하여 전단흐름 개념을 도입하여 LMC로 압축 덧씌우기된 시험체를 대상으로 하중증가에 따른 전단흐름량을 계산하여 부착계면 특성을 수치적으로 나타내었다.

• 대한족부족관절학회지
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• 제27권1호
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• pp.12-16
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• 2023

Purpose: Postoperative exercise for acute Achilles tendon rupture is important for a patient's return to daily life and sports. On the other hand, the protocol requires considerable effort to educate patients and continuous checking. This study evaluated the outcome of a new simple and delayed rehabilitation protocol after Achilles tendon rupture repair. Materials and Methods: From July 2014 to November 2020, one hundred eighty-three patients were operated on by one surgeon. The exercise protocol was classified into two methods. One group (immediate protocol, control group) started immediate full weight bearing with a 20° plantar flexion range of motion from two days postoperatively. Ankle dorsiflexion was restricted to 0°. The other group (delayed protocol, case group) started full weight bearing with a controlled ankle motion boot from two weeks postoperatively. No range of motion exercise was allowed until six weeks postoperatively. Age, sex, body mass index, ankle range of motion, muscle power, time to return to previous physical activity, functional score, and complication rate were evaluated. The results of the two groups were compared using a Mann-Whitney test. Statistical significance was set as p<0.05. Results: The range of motion, double heel rising, and one-leg standing were achieved faster in the control group (p<0.05). However, single-heel rising, repeated single-heel rising, return to previous activity (work, run, and sport), and functional scores showed no statistical difference (p>0.05). Conclusion: Simple and delayed postoperative rehabilitation of acute Achilles tendon rupture without active range of motion exercises showed satisfactory functional results and a low complication rate.

• 한국전기전자재료학회논문지
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• 제36권6호
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• pp.598-602
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• 2023

With the purpose of instilling an awareness of the safety of users of electrical equipment and inducing voluntary facility improvement through the safety rating system for general low voltage electrical equipment, simulation and field application of the safety rating of general low voltage electrical equipment were conducted. For the introduction and application of the safety rating system for general low-voltage electrical equipment, data related to domestic safety was investigated and analyzed, cases of introduction in other fields were reviewed, and for design, the 4M risk assessment method of the Korea Occupational Safety and Health Agency and the cases of safety index development in Korea were analyzed and standardized. Safety rating system simulations were conducted for general low-voltage electrical equipment, and problem improvement measures were prepared by analyzing the results through on-site verification and simulation applied to the initial design. Design standards for the introduction of the safety rating system for general low-voltage electrical equipment were prepared, and 394 youth training facilities were applied to the field to see if the design standards were practically applicable to the field. With the application of the safety rating system for low-voltage electrical equipment for general use, youth training facilities that had been classified as 'appropriate' were able to induce an upgrade to a higher level through voluntary facility improvement according to the application of grades (A to E). As a result of inducing voluntary repair projects based on the results of the 1st and 2nd inspection of youth training facilities, it was confirmed that 86 facilities received grade A, 225 facilities received grade B, and only 311 facilities received grade A to B out of a total of 394 facilities, and there was no grade E.

• Asian Pacific Journal of Cancer Prevention
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• 제15권12호
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• pp.5043-5047
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• 2014

Nowadays increasing effectiveness in cancer therapy and investigation of formation of new strategies that enhance antiproliferative activity against target organs has become a subject of interest. Although the molecular mechanisms of apoptosis can not be fully explained, it is known that cell suicide program existing in their memory genetically is activated by pathophysiological conditions and events such as oxidative stress. Low pressure (hypobaric) conditions that create hypoxia promote apoptosis by inhibiting cell cycling. In this study, determination of the effects of fractional hypobaric applications at different times on HeLa cells at cellular and molecular levels were targeted. Experiments were carried out under hypobaric conditions (35.2 kPa) in a specially designed hypobaric cabin including 2% $O_2$ and 98% N. Application of fractional hypobaric conditions was repeated two times for 3 hours with an interval of 24 hours. At the end of the implementation period cells were allowed to incubate for 24 hours for activation of repair mechanisms. Cell kinetic parameters such as growth rate (MTT) and apoptotic index were used in determination of the effect of hypobaric conditions on HeLa cells. Also in our study expression levels of the Bcl-2 gene family that have regulatory roles in apoptosis were determined by the RT-PCR technique to evaluate molecular mechanisms. The results showed that antiproliferative effect of hypobaric conditions on HeLa cells started three hours from the time of application and increased depending on the period of exposure. While there was a significant decrease in growth rate values, there was a significant increase in apoptotic index values (p<0.01). Also molecular studies showed that hypobaric conditions caused a significant increase in expression level of proapoptotic gene Bax and significant decrease in antiapoptotic Bfl-1. Consequently fractional application of hypobaric conditions on HeLa cell cultures increased both antiproliferative and apoptotic effects and these effects were triggered by the Bax gene.

• 콘크리트학회논문집
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• 제14권2호
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• pp.216-222
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• 2002

현재 국내에서는 급속한 근대화 과정 중에서 시공시부터 부실하게 건설된 콘크리트 구조물의 사용기간이 짧아짐에 따라 구조물의 노후화가 심각하게 진행되고 있는 실정이다. 특히, 교량의 경우에는 교통량과 교통하중의 증가 등으로 인한 손상이 가속화되어 교량의 안전성에 심각한 문제가 발생되고 있다. 본 연구에서는 콘크리트의 부재가 균열에 의해 박리ㆍ탈락되었다고 가정한 후, 인장하단에서 8cm까지 폴리머 시멘트 페이스트로 보수한 후 강연선을 이용하여 보강한 시험체, 에폭시 주입공법으로 균열을 보수한 후, 탄소섬유쉬트를 사용하여 보강한 시험체와 표준시험체 등 8개의 보를 제작하였다. 시험체의 제원은 단면 15$\times$25 cm 지간길이 200cm, 총길이 220cm이고, 강연선의 긴장량과 탄소섬유쉬트의 보강겹수을 실험변수를 선택하여 휨 실험을 실시하였다. 실험결과 폴리머 시멘트 페이스트와 포스트 강연선을 이용한 시험체와 탄소섬유쉬트 보강시험체는 표준시험체보다 상당히 큰 보강효과를 보였다. 탄소섬유쉬트 보강시험체는 1겹으로 보강할 경우에 보강재의 지간 중앙의 인장파단이 발생되어 보강효율이 가장 높았으며 보강겹수가 감소할수록 취성적인 파괴가 발생되어 보강성능이 저하되었다. 그러나, 강연선을 이용한 시험체는 긴장량이 증가할수록 보강효과가 선형적으로 증가하여 어느 정도까지는 상당히 큰 보강효과를 나타내었다.

• 한국산학기술학회논문지
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• 제19권9호
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• pp.20-29
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• 2018

최근 기후 및 홍수사상이 변화함에 따라 하천제방 붕괴 및 범람으로 인한 수재해 위험성이 증가하고 있는 추세이기 때문에 각종 수재해 시나리오에 대응 가능한 하천제방 유지관리 기술을 고도화할 필요가 있다. 본 논문에서는 하천제방의 효율적인 유지관리 및 재해 대응성 향상을 위하여 하천제방 안정성에 영향을 주는 주요 요소별 안전도맵 평가체계를 제안하고자 한다. 하천제방 안전도맵은 활동, 파이핑, 육안점검, 세굴, 제체재료 등의 안전도 지표를 GIS맵 상에 지도형태로 표출함으로써 육안으로 신속하게 위험지역을 파악할 수 있고, 피해발생 이후 피해복구를 실시하는 현 국내 제방관리 수준에서 벗어나 선제적인 대응을 통해 하천제방 유지관리의 효율성을 극대화 할 수 있다. 본 논문은 기 제안된 활동, 파이핑, 육안점검 등을 포함한 하천제방 안전도맵 평가체계에 세굴, 제체재료 등을 추가 및 보완한 후속논문으로서, 1)문헌 및 자료 조사를 통한 세굴 및 제체재료 3등급 기준을 제시하였으며, 시범평가를 통해 2)남강지역 좌안 5개소의 홍수위지속시간에 따른 활동 및 파이핑 특성, 3)남강지역 좌/우안 9개소의 세굴 및 제체재료 특성 등을 평가하였다. 본 논문에서 제안하는 하천제방 안전도맵 평가체계는 향후 하천관리자 행동요령, 보수 보강공법 선정, 소요 예산 산정 등을 연계한 연구가 진행된다면 보다 현실적이고, 활용성 높은 연구가 될 것으로 판단된다.

• 대한족부족관절학회지
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• 제20권1호
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• pp.12-18
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• 2016

Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4517-4525
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• 2016

Background: Sperm DNA damage is underlying aetiology of poor implantation and pregnancy rates but also affects health of offspring and may also result in denovo mutations in germ line and post fertilization. This may result in complex diseases, polygenic disorders and childhood cancers. Childhood cancer like retinoblastoma (RB) is more prevalent in developing countries and the incidence of RB has increased more than three fold in India in the last decade. Recent studies have documented increased incidence of cancers in children born to fathers who consume alcohol in excess and tobacco or who were conceived by assisted conception. The aetiology of childhood cancer and increased disease burden in these children is lin ked to oxidative stress (OS) and oxidative DNA damage( ODD) in sperm of their fathers. Though several antioxidants are in use to combat oxidative stress, the effect of majority of these formulations on DNA is not known. Yoga and meditation cause significant decline in OS and ODD and aid in regulating OS levels such that reactive oxygen speues meditated signal transduction, gene expression and several other physiological functions are not disrupted. Thus, this study aimed to analyze sperm ODD as a possible etiological factor in childhood cancer and role of simple life style interventions like yoga and meditation in significantly decreasing seminal oxidative stress and oxidative DNA damage and thereby decreasing incidence of childhood cancers. Materials and Methods: A total of 131 fathers of children with RB (non-familial sporadic heritable) and 50 controls (fathers of healthy children) were recruited at a tertiary center in India. Sperm parameters as per WHO 2010 guidelines and reactive oxygen species (ROS), DNA fragmentation index (DFI), 8-hydroxy-2'-deoxy guanosine (8-OHdG) and telomere length were estimated at day 0, and after 3 and 6 months of intervention. We also examined the compliance with yoga and meditation practice and smoking status at each follow-up. Results: The seminal mean ROS levels (p<0.05), sperm DFI (p<0.001), 8-OHdG (p<0.01) levels were significantly higher in fathers of children with RB, as compared to controls and the relative mean telomere length in the sperm was shorter. Levels of ROS were significantly reduced in tobacco users (p<0.05) as well as in alcoholics (p<0.05) after intervention. DFI reduced significantly (p<0.05) after 6 months of yoga and meditation practice in all groups. The levels of oxidative DNA damage marker 8-OHdG were reduced significantly after 3 months (p<0.05) and 6 months (p<0.05) of practice. Conclusions: Our results suggest that OS and ODD DNA may contribute to the development of childhood cancer. This may be due to accumulation of oxidized mutagenic base 8OHdG, and elevated MDA levels which results in MDA dimers which are also mutagenic, aberrant methylation pattern, altered gene expression which affect cell proliferation and survival through activation of transcription factors. Increased mt DNA mutations and aberrant repair of mt and nuclear DNA due to highly truncatred DNA repair mechanisms all contribute to sperm genome hypermutability and persistant oxidative DNA damage. Oxidative stress is also associated with genome wide hypomethylation, telomere shortening and mitochondrial dysfunction leading to genome hypermutability and instability. To the best of our knowledge, this is the first study to report decline in OS and ODD and improvement in sperm DNA integrity following adoption of meditation and yoga based life style modification.This may reduce disease burden in next generation and reduce incidence of childhood cancers.

• Journal of Chest Surgery
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• 제30권4호
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• pp.363-372
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• 1997

본 연구는 1986년 6월 3일부터 1995년 12월 31일까지 서울대학교 어린이 병원 흉부외과에서 경험한 144례의 대동맥 교약증 환아를 대상으로, 술후 결과에 영향을 미치는 여러 가지 요소들을 분석하였다. 환아의 평균 연령은 15.73+32.43(범 위 0.1-191.0, 중앙값=3.3)개월이 었고, 이중 11)례(78.5%)의 환아는 영아, 25례(17.4%)는 신생아였다. 환아를 대동맥궁 협 착 부위와 동반 심기형에 따라(제 1형:국소 협착, 제2형:대동맥 헙부 협착, 제3형 :대동맥 협부 및 횡대동맥궁 협착, h:심실중격결손증 동반, B:기타 복 잡 심기 형 동반) 9가지로 분류한 결과, 1, IA, IB, I, IIA, IIB, III, IIIA, IIIB형이 각각 25, 9, 6, 24, 35, 15, 4, 19, 7례 였다. 수술방법은 쇄골하동맥편 교약성형술(subclavian-flap coarctoplasty, SFC: 60례), 절단 및 문합술(resection and anastomo sis, R&A: 44례), 확장된 대동맥성형술(extended aortoplasty, Ex-Ao: 26 례), 덮개포편술(onlay patch, Onlay: 14례)이 사용되었다. 총수술 사망률은 16.0%(23/144)였고, 수술 사망률을 높이는 인자로 협착부위(I, II, III형) 동반 심기형(0, A, B), 환아의 연령, 수술방법, 단계수술 \ulcorner부 등이 분석되었는데 이중 횡대동맥궁협착을 동반하는 III형(I형 사망률=2.5%(1/40), II형=17.6% (13/74), III형=30%(9/30); p(0.01), B형(0형 사망률=3.8%(2/53), A형 =15.9%(10/63), B형 =39.3%(11/28); p(0.01) 등이 의미있는 위험 인자였다. 생존환아 121례는 술후 평균 29.1+28.8(범위 0-129.2)개월 외래 추 적되 었으며 이중 술후 협착을 보였던 경우는 18례로 14.9%의 헙착률은 보였다. 생존환자중 77례의 환자 (I형 20명. ll형 42명, 111형 15명)에서 술전, 술후 3개월 이내, 술후 6개월이후의 심에코도상의 대동맥 각 부위 크기에 관한 자료의 입수가 가능하였으며 이를토대로무명동맥 직근위부의 상행대동맥 직경에 대 한 대동맥협부 직경의 비율(대동맥협부지수)및 경동맥부위의 횡대동맥 직경비율(횡대동맥지수)을구하 여 형태 별로 술전, 수술 직후 6개월이상 경과후의 대동맥 크기 변화의 양상을 관찰하였다. 제 I, II, III형 모두에서 술전에 비하여 술후 평균 대동맥협부지수의 의미있는 증가가 관찰되었으며(p<0.01),제 III형에서는 횡대동맥지수의 의미있는 증가도 관찰되었다(p<0.01). 재헙착으로 진단된 I, II형의 수술직후 대 동맥협부지수와 111형의 횡대동맥 지수는 비협착군에 비하여 의미있게 작았는데 이는 아마도수술 당시 협 착 부위의 완전제거가 이루어지지 않은 것이 원인이라고 사료되었다. 본 분석에서는 어린 연령(3개월 이하), 3개월이하에 시행한 쇄골하동맥편 교약성형술이 의미있는 재협착의 위험요소로 밝혀졌다. 결론 적으로 저자등은 본연구를 통하여 대동맥협부지수, 횡대동맥 지수 등이 개개 대동맥교약 환아의 해부학 적, 임상적 특징을 파악하는데 도움이 되는 도구라는 사실을 발견하였고 아울러 교약의 해부학적 특성, 동반 심기 형, 연령, 수술방법 등이 수술사망 및 재협착에 영향한다는 사실을 입증하였다.