• 대한족부족관절학회지
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• 제8권1호
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• pp.31-38
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• 2004

Purpose: The purpose of the study was to identify the subtypes of idiopathic osteoarthritis of the tarsometatarsal joints based on accompanying hindfoot, midfoot, or foot deformities and their corresponding surgical options and also to evaluate the overall clinical results. Materials and Methods: The study included 59 patients (67 feet) with idiopathic tarsometatarsal joint osteoarthritis. Tarsometatarsal fusion was performed for tarsometatarsal joint and accompanied secondary change was divided into subtypes and various bony reconstruction was carried out. The patients were evaluated with the AOFAS midfoot score and FFI. The average patient age was 60.2 years with 40.6 months follow-up. Fifty-four feet (80.6%) had been treated with realignment fusion. Twenty-six feet had first and second tarsometatarsal joint fusion, and 20 feet had first tarsometatarsal fusion only. Six subtypes were identified based on associated foot deformities: 1) in-situ without deformities (18%), 2) pes planovalgus (45%), 3) rockerbottom (15%), 4) cavus foot (1%), 5) hallux valgus (12%), and 6) hallux valgus with pes planovalgus or rockerbottom (9%). Plantar-medial closing-wedge resection was used in 10 feet to correct rockerbottom. For pes planovalgus, a medial sliding calcaneal osteotomy was done. Lateral column lengthening with medial sliding calcaneal osteotomy was done for severe pes planovalgus, and triple arthrodesis was done for rigid pes planovalgus. Hallux valgus was corrected with the Lapidus procedure (85.7%). Results: AOFAS midfoot scores improved from preoperative 34.1 points to postoperative 83.9 points (p<0.05). The Foot Function Index postoperatively also showed significant improvement (p<0.05), with a high satisfaction rate (86.6%). There were 29 complications, most commonly sesamoid pain. Conclusion: Idiopathic tarsometatarsal OA feet can be classified into six categories. Pes planovalgus feet should be treated with medial sliding calcaneal osteotomy, lateral column lengthening, or triple arthrodesis in addition to tarsometatarsal joint realignment fusion. Rockerbottom and hallux valgus deformities should also be addressed.

• Journal of Korean Neurosurgical Society
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• 제55권5호
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• pp.248-254
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• 2014

Objective : According to the recent development of minimally invasive spinal surgery, direct lumbar interbody fusion (DLIF) was introduced as an effective option to treat lumbar degenerative diseases. However, comprehensive results of DLIF have not been reported in Korea yet. The object of this study is to summarize radiological and clinical outcomes of our DLIF experience. Methods : We performed DLIF for 130 patients from May 2011 to June 2013. Among them, 90 patients, who could be followed up for more than 6 months, were analyzed retrospectively. Clinical outcomes were compared using visual analog scale (VAS) score and Oswestry Disability Index (ODI). Bilateral foramen areas, disc height, segmental coronal and sagittal angle, and regional sagittal angle were measured. Additionally, fusion rate was assessed. Results : A total of 90 patients, 116 levels, were underwent DLIF. The VAS and ODI improved statistically significant after surgery. All the approaches for DLIF were done on the left side. The left and right side foramen area changed from $99.5mm^2$ and $102.9mm^2$ to $159.2mm^2$ and $151.2mm^2$ postoperatively (p<0.001). Pre- and postoperative segmental coronal and sagittal angles changed statistically significant from $4.1^{\circ}$ and $9.9^{\circ}$ to $1.1^{\circ}$ and $11.1^{\circ}$. Fusion rates of 6 and 12 months were 60.9% and 87.8%. Complications occurred in 17 patients (18.9%). However, most of the complications were resolved within 2 months. Conclusion : DLIF is not only effective for indirect decompression and deformity correction but also shows satisfactory mechanical stability and fusion rate.

• 한국측량학회지
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• 제38권3호
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• pp.187-196
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• 2020

본 연구에서는 UAV (Unmanned Aerial Vehicle)와 PlanetScope 위성영상을 함께 이용한 붕괴건물 탐지를 수행하여 지표면에 위치한 특정 객체 탐지에 있어 이종 센서의 활용 가능성을 제시하였다. 이를 위해 지난해 4월 산불 피해로 붕괴된 20여 채의 건물들이 있는 곳을 실험장소로 선정하였다. 붕괴건물 탐지를 위해 1차적으로 객체기반 분할을 수행한 고해상도의 UAV 영상을 이용해 ExG (Excess Green), GLCM (Gray-Level Co-occurrence Matrix) 그리고 DSM (Digital Surface Model)과 같은 객체들의 특징(feature) 정보를 생성한 후 이를 붕괴건물 후보군 탐지에 이용하였다. 이 과정에서 탐지정확도 향상을 위해 PlanetScope를 이용한 변화탐지 결과를 함께 사용하였으며 이를 시드 화소(seed pixles)로 사용하여 붕괴건물 후보군에서 오탐지된 영역과 과탐지된 영역을 수정 및 보완하였다. 최종적인 탐지 결과는 참조 영상을 통해 그 성능을 분석하였으며 UAV 영상만을 이용한 붕괴건물 후보군 탐지 결과와 UAV 그리고 PlanetScope 영상을 함께 사용했을 때의 결과의 정확도를 비교, 분석하였다. 그 결과 UAV 영상만을 이용해 탐지한 붕괴건물의 정확도는 0.4867 F1-score를 가지며 UAV와 PlanetScope 영상을 함께 사용했을 때의 결과는 0.8064 F1-score로 그 값이 상승하였다. Kappa 지수 또한 0.3674에서 0.8225로 향상된 것을 확인할 수 있었다.

• 대한족부족관절학회지
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• 제14권2호
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• pp.140-145
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• 2010

Purpose: The diabetic charcot neuroarthropathy of ankle is an infrequent site (around 5%), but is definitely the location that, because of the instability and progressive deformity it involves, cause ulceration in a high percentage of patients, and this can then become a reason for amputation. However, the treatment of this disastrous disease is still challenging. We analyzed the clinical and radiological results of ankle arthrodesis by our fixation method in Charcot neuroarthropathy. Materials and Methods: Seven cases that were diagnosed as charcot neuroarthropathy of ankle arthrodesis were followed for more than 16 months postoperatively. Mean age was 57 years, and the mean follow-up period was 27 months. Anterior approach was used in arthrodesis, and internal fixation by 3 or more cannulated screws and hybrid type external fixation were used. Auto iliac bone for grafting was combined in all cases. External fixator was kept for 3 months without weight-bearing. Then, boots brace was applied for more 3 months allowing partial weight-bearing. Four cases had minor complications such as pin site infection. Preoperative and postoperative AOFAS score, time to fusion and postoperative complications were checked. Results: Postoperative fusion was completed in all cases, and the mean time to fusion was 3.4 months. No postoperative complication was checked. At the last follow-up, the mean AOFAS score had increased from 54 points to 72 points. Patient's satisfaction was over 80%. Conclusion: Satisfactory results were obtained after ankle arthrodesis using internal and hybrid type external fixation combined with auto iliac bone graft in charcot neuroarthropathy with minor complications.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.794-805
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• 2020

Objective : Teriparatide is known as an effective anabolic agent not only for severe osteoporosis but also for bone healing and union. We explored the possibility of teriparatide as an alternative treatment option for osteoporotic thoracolumbar (TL) burst fracture. Methods : This retrospective study enrolled 35 female patients with mean age of 73.77±6.71 years (61-88) diagnosed as osteoporotic TL burst fracture with ≥4 of thoracolumbar injury classification and severity (TLICS) score and no neurological deficits. All patients were treated by teriparatide only (12 of group A), teriparatide plus vertebroplasty (12 of group B), or surgical fixation with fusion (11 of group C), and followed up for 12 months. Radiological outcomes were evaluated using radiological parameters including kyphotic angle (KA), segmental vertebral kyphotic angle (SVKA), compression ratio (CR), and vertebral body height (anterior [AH], middle [MH], posterior [PH]). Functional outcomes were evaluated using visual analog scale (VAS) and Macnab classification (MC). Results : There were no statistical significant differences in age, bone mineral density (-3.36±0.73), and TLICS score (4.34±0.48) among the three groups (p>0.05). Teriparatide was administered during 8.63±2.32 months in group A and B. In 12-month radiological outcomes, there were significant restoration in SVKA, CR, AH, and MH of group B and KA, SVKA, CR, AH, and MH of group C compared to group A with no radiological changes (p<0.05). All groups showed similar significant improvements in 12-month functional outcomes, although group B and C showed a better 1-month VAS, 1-month MC, 3-month MC compared to group A (p<0.05). Conclusion : Non-surgical treatment with teriparatide showed similar 12-month functional outcomes compared to surgical fixation with fusion. The additional vertebroplasty to teriparatide and surgical fixation with fusion were more helpful to improve short-term functional outcomes with structural restoration compared to teriparatide only.

• Journal of Korean Neurosurgical Society
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• 제52권5호
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• pp.452-458
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• 2012

Objective : In the present study, we evaluated the effect, safety and radiological outcomes of cervical hybrid surgery (cervical disc prosthesis replacement at one level, and interbody fusion at the other level) on the multilevel cervical degenerative disc disease (DDD). Methods : Fifty-one patients (mean age 46.7 years) with symptomatic multilevel cervical spondylosis were treated using hybrid surgery (HS). Clinical [neck disability index (NDI) and Visual Analogue Scale (VAS) score] and radiologic outcomes [range of motion (ROM) for cervical spine, adjacent segment and arthroplasty level] were evaluated at routine postoperative intervals of 1, 6, 12, 24 months. Review of other similar studies that examined the HS in multilevel cervical DDD was performed. Results : Out of 51 patients, 41 patients received 2 level hybrid surgery and 10 patients received 3 level hybrid surgery. The NDI and VAS score were significantly decreased during the follow up periods (p<0.05). The cervical ROM was recovered at 6 and 12 month postoperatively and the mean ROM of inferior adjacent segment was significantly larger than that of superior adjacent segments after surgery. The ROM of the arthoplasty level was preserved well during the follow up periods. No surgical and device related complications were observed. Conclusion : Hybrid surgery is a safe and effective alternative to fusion for the management of multilevel cervical spondylosis.

• 한국수자원학회논문집
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• 제52권1호
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• pp.61-70
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• 2019

실제증발산 자료를 융합하기 위한 Modified Kling-Gupta efficiency Fusion (KGF)방법을 제시하였고, 인공위성 및 재분석 증발산 자료인 Global Land Data Assimilation System (GLDAS), Global Land Evaporation Amsterdam Model (GLEAM), MODIS Global Evapotranspiration Project (MOD16)를 활용하여 Simple Taylor skill's Score (STS)와 비교하였다. 한반도와 중국의 세가지 land cover type(i.e., cropland, grassland, forest)을 가진 flux tower에서 비교 검증을 실시하였다. 실제증발산의 융합 방법인 STS와 KGF로 계산된 가중치의 결과를 확인하면, cropland와 grassland에서 재분석 자료(GLDAS, GLEAM)가 높은 가중치 영향을 나타내지만, forest에서 융합 방법에 따라 가중치 영향이 다르게 나타났다. 전반적으로 실제증발산 융합 방법 적용 결과의 비교에서는 cropland에서는 융합에 사용된 자료에 비하여 높은 개선이 이뤄지지 않았지만, grassland와 forest 에서는 개선이 이뤄졌다. 두 방법 중 KGF의 결과가 STS의 결과에 비하여 약간 개선되는 결과를 나타내었다.

• Journal of Korean Neurosurgical Society
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• 제49권5호
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• pp.267-272
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• 2011

Objective : Although iliac crest autograft is the gold standard for lumbar fusion, the morbidity of donor site leads us to find an alternatives to replace autologous bone graft. Ceramic-based synthetic bone grafts such as hydroxyapatite (HA) and b-tricalcium phosphate (b-TCP) provide scaffolds similar to those of autologous bone, are plentiful and inexpensive, and are not associated with donor morbidity. The present report describes the use of Polybone$^{(R)}$ (Kyungwon Medical, Korea), a beta-tricalcium phosphate, for lumbar posterolateral fusion and assesses clinical and radiological efficacy as a graft material. Methods : This study retrospectively analyzed data from 32 patients (11 men, 21 women) who underwent posterolateral fusion (PLF) using PolyBone$^{(R)}$ from January to August, 2008. Back and leg pain were assessed using a Numeric Rating Scale (NRS), and clinical outcome was assessed using the Oswestry Disability Index (ODI). Serial radiological X-ray follow up were done at 1, 3, 6 12 month. A computed tomography (CT) scan was done in 12 month. Radiological fusion was assessed using simple anterior-posterior (AP) X-rays and computed tomography (CT). The changes of radiodensity of fusion mass showed on the X-ray image were analyzed into 4 stages to assess PLF status. Results : The mean NRS scores for leg pain and back pain decreased over 12 months postoperatively, from 8.0 to 1.0 and from 6.7 to 1.7, respectively. The mean ODI score also decreased from 60.5 to 17.7. X-rays and CT showed that 25 cases had stage IV fusion bridges at 12 months postoperatively (83.3% success). The radiodensity of fusion mass on X-ray AP image significantly changed at 1 and 6 months. Conclusion: The present results indicate that the use of a mixture of local autologous bone and PolyBone$^{(R)}$ results in fusion rates comparable to those using autologous bone and has the advantage of reduced morbidity. In addition, the graft radiodensity ratio significantly changed at postoperative 1 and 6 months, possibly reflecting the inflammatory response and stabilization.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.385-391
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• 2016

Objective : The purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution. Methods : Total 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2-7 global angle, and segmental angle changes)/clinical outcomes (by Odom's criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes. Results : The majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom's criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time. Conclusion : Long-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating.

• 대한수학교육학회지:학교수학
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• 제10권2호
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• pp.259-277
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• 2008

본 연구는 인지 진단 이론을 활용하여 수학 평가 결과를 분석하고 교수 학습에 활용하는 방안을 모색하고자 하였다. $2003{\sim}2006$년에 실시된 국가수준 학업성취도 평가의 중학교 3학년 수학 검사에서 30개의 선다형 문항을 선정하여 검사지를 재구성하고 검사를 실시하였고 인지 진단 이론의 한 모형인 Fusion Model을 적용하여 평가 결과를 분석하였다. 검사 문항을 통해 학생들이 숙달한 수학적 속성을 판별하고, 학생 전체와 성취수준별로 숙달한 속성과 그 속성의 개수를 분석하였다. 그리고 학생 개개인의 수학적 강점과 약점을 분석하여 교사들에게 학생 개개인의 수학적 능력에 대한 정보를 구체적으로 알려줄 수 있었다. 이 결과는 학생들의 수학 학습에 대한 진단과 처방, 추후 학습 지도에 유용한 정보로 활용될 수 있을 것이다.