• 한국조경학회지
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• 제46권6호
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• pp.17-25
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• 2018

본 연구는 경회루 권역의 경관개선을 위해 원형을 고찰하고, 수목 생장예측모델을 추정하여 개선방안을 제시하기 위해 실시하였다. 식재경관의 개선방안에 대한 검증을 위해 만세산에 식재된 수목에 대한 사진측량을 진행하였다. 만세산 송림의 생장율을 알아보기 위해 Pressler 공식을 이용하고, 시뮬레이션을 제작하여 분석하였다. 연구 결과는 다음과 같다. 첫째, 현장조사 및 경관분석 결과, 경회루 권역의 수목들은 수양벚나무와 감나무를 제외하고 흉고직경 30cm 이상의 대교목으로 특히 경관을 차폐하는 만세산의 송림과 북쪽 화계의 수목들에 대한 전정을 통해 관리하거나, 작은 수목으로 대체할 필요가 있다. 둘째, 수목생장율 측정 결과, 평균 10년을 기준으로 남측 만세산은 근원직경 14%, 수고 5%가 북측 만세산은 근원직경 7%, 수고 2.4% 만큼 생장하였다. 나아가 산출된 수목생장률을 바탕으로 시뮬레이션을 작성했을 때 20년 후에는 경회루 2층에서 경관 또한 만세산의 송림이 인왕산의 스카이라인을 차단함을 확인하였다. 셋째, 경관개선 시뮬레이션을 분석하여 경회루 권역의 경관을 조망하기 위한 수목관리방안을 제시하였다. 본 연구는 경회루 권역의 식재경관을 고증하고 효율적인 정비방안을 도출한 것에 의의가 있다.

• 한국전기전자재료학회논문지
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• 제32권2호
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• pp.165-173
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• 2019

Lithium anodes (13, 15, 17, and 20 wt% Li) were fabricated by mixing molten lithium and iron powder, which was used as a binder to hold the molten lithium, at about $500^{\circ}C$ (discharge temp.). In this study, the effect of applied pressure and lithium content on the discharge properties of a thermal battery's single cell was investigated. A single cell using a Li anode with a lithium content of less than 15 wt% presented reliable performance without any abrupt voltage drop resulting from molten lithium leakage under an applied pressure of less than $6kgf/cm^2$. Furthermore, it was confirmed that even when the solid electrolyte is thinner, the Li anode of the single cell normally discharges well without a deterioration in performance. The Li anode of the single cell presented a significantly improved open-circuit voltage of 2.06 V, compared to that of a Li-Si anode (1.93 V). The cut-off voltage and specific capacity were 1.83 V and $1,380As\;g^{-1}$ (Li anode), and 1.72 V and $1,364As\;g^{-1}$ (Li-Si anode). Additionally, the Li anode exhibited a stable and flat discharge curve until 1.83 V because of the absence of phase change phenomena of Li metal and a subsequent rapid voltage drop below 1.83 V due to the complete depletion of Li at the end state of discharge. On the other hand, the voltage of the Li-Si anode cell decreased in steps, $1.93V{\rightarrow}1.72V(Li_{13}Si_4{\rightarrow}Li_7Si_3){\rightarrow}1.65V(Li_7Si_3{\rightarrow}Li_{12}Si_7)$, according to the Li-Si phase changes during the discharge reaction. The energy density of the Li anode cell was $807.1Wh\;l^{-1}$, which was about 50% higher than that of the Li-Si cell ($522.2Wh\;l^{-1}$).

• Journal of Korean Neurosurgical Society
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• 제62권4호
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• pp.450-457
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• 2019

Objective : Anterior cervical discectomy and fusion (ACDF) is commonly used surgical procedure for cervical degenerative disease. Among the various intervertebral spacers, the use of allografts is increasing due to its advantages such as no harvest site complications and low rate of subsidence. Although subsidence is a rare complication, graft collapse is often observed in the follow-up period. Graft collapse is defined as a significant graft height loss without subsidence, which can lead to clinical deterioration due to foraminal re-stenosis or segmental kyphosis. However, studies about the collapse of allografts are very limited. In this study, we evaluated risk factors associated with graft collapse. Methods : We retrospectively reviewed 33 patients who underwent two level ACDF with anterior plating using allogenous bone graft from January 2013 to June 2017. Various factors related to cervical sagittal alignment were measured preoperatively (PRE), postoperatively (POST), and last follow-up. The collapse was defined as the ratio of decrement from POST disc height to follow-up disc height. We also defined significant collapses as disc heights that were decreased by 30% or more after surgery. The intraoperative distraction was defined as the ratio of increment from PRE disc height to POST disc height. Results : The subsidence rate was 4.5% and graft collapse rate was 28.8%. The pseudarthrosis rate was 16.7% and there was no association between pseudarthrosis and graft collapse. Among the collapse-related risk factors, pre-operative segmental angle (p=0.047) and intra-operative distraction (p=0.003) were significantly related to allograft collapse. The cut-off value of intraoperative distraction ${\geq}37.3%$ was significantly associated with collapse (p=0.009; odds ratio, 4.622; 95% confidence interval, 1.470-14.531). The average time of events were as follows: collapse, $5.8{\pm}5.7months$; subsidence, $0.99{\pm}0.50months$; and instrument failure, $9.13{\pm}0.50months$. Conclusion : We experienced a higher frequency rate of collapse than subsidence in ACDF using an allograft. Of the various preoperative factors, intra-operative distraction was the most predictable factor of the allograft collapse. This was especially true when the intraoperative distraction was more than 37%, in which case the occurrence of graft collapse increased 4.6 times. We also found that instrument failure occurs only after the allograft collapse.

• 대한임상독성학회지
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• 제16권2호
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• pp.61-67
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• 2018

Purpose: To evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and occurrence of aspiration pneumonia in drug intoxication (DI) patients in the emergency department (ED) and to evaluate the relationship between NLR and length of hospital admission/intensive care unit (ICU) admission Methods: A total of 466 patients diagnosed with DI in the ED from January 2016 to December 2017 were included in the analysis. The clinical and laboratory results, including NLR, were evaluated as variables. NLR was calculated as the absolute neutrophil count/absolute lymphocyte count. To evaluate the prognosis of DI, data on the development of aspiration pneumonia were obtained. Also, we evaluated the relationship between NLR and length of hospital admission and between NLR and length of ICU admission. Statistically, multivariate logistic regression analyses, receiver-operating characteristic (ROC) curve analysis, and Pearson's correlation (${\rho}$) were performed. Results: Among the 466 DI patients, 86 (18.5%) developed aspiration pneumonia. Multivariate logistic regression analysis revealed NLR as an independent factor in predicting aspiration pneumonia (odds ratio, 1.7; p=0.001). NLR showed excellent predictive performance for aspiration pneumonia (areas under the ROC curves, 0.815; cut-off value, 3.47; p<0.001) with a sensitivity of 86.0% and a specificity of 72.6%. No correlations between NLR and length of hospital admission (${\rho}=0.195$) and between NLR and length of ICU admission (${\rho}=0.092$) were observed. Conclusion: The NLR is a simple and effective marker for predicting the occurrence of aspiration pneumonia in DI patients. Emergency physicians should be alert for aspiration pneumonia in DI patients with high NLR value (>3.47).

• 대한응급의학회지
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• 제29권5호
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• pp.430-436
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• 2018

Objective: The purpose of this study was to evaluate whether or not the d-dimer level indicating hyperfibrinolysis could be a predictor of early poor outcome (massive transfusion, death within 24 hours) associated with trauma-induced coagulopathy in blunt trauma without significant brain injury. Methods: This study was a retrospective observational study using 516 blunt trauma patients without significant brain injury. The poor outcome group, including patients receiving massive transfusion and those who died within 24 hours, consisted of 33 patients (6.4%). The variables were compared between the poor outcome group and good outcome group, and logistic regression analysis was performed using statistically significant variables. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the poor outcome prediction ability of the initial d-dimer level. Results: The poor outcome group showed more serious anatomical, physiological, and laboratory data than the good outcome group. In the ROC curve analysis for evaluation of the poor outcome prediction of the d-dimer level, the area under the curve value was 0.87 (95% confidence interval [CI], 0.84-0.90) while the cut-off value was 27.35 mg/L. In the logistic regression analysis, the high d-dimer level was shown to be an independent predictor of poor outcome (adjusted odds ratio, 14.87; 95% CI, 2.96-74.67). Conclusion: The high d-dimer level (>27.35 mg/L) can be used as a predictor for the poor outcome of patients with blunt trauma without significant brain injury.

• 대한응급의학회지
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• 제29권6호
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• pp.679-686
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• 2018

Objective: The aim of this study was to identify the clinical characteristics and risk factors associated with the admission of patients in the emergency department (ED) within 30 days after discharge. Methods: A retrospective, observational study was conducted on adult patients presenting with abdominal pain to the ED of a single, urban, university hospital, between January 2014 and December 2015, who revisited the ED within 30 days after discharge. Data was collected on the emergency severity index level, time to contact doctors, physical examination, laboratory tests, use of computed tomography (CT), and patient disposition on revisitation. The primary outcome was hospital admission following an ED revisit in the 30-day period after the first visit. Results: During the study period, 19,480 patients visited the ED with the chief complaint of abdominal pain, and 13,577 were discharged. A total of 251 patients (1.29%) revisited the ED within 30 days, of which 89 were eligible for the study. The primary outcome was associated with not performing a CT scan on the initial visit and an increased C-reactive protein (CRP) value. Receiver operating characteristic curve analysis showed that a cut-off baseline CRP value of >0.35 mg/dL can predict the primary outcome with a sensitivity and specificity of 75% and 62.1%, respectively (area under the curve, 0.701; 95% confidence interval, 0.569-0.833; P=0.007). Conclusion: An increased CRP value and not performing abdominal CT were associated with a higher rate of admission following ED revisits of patients with abdominal pain. Future prospective studies on the role of abdominal CT imaging in patients presenting to the ED with abdominal pain will be needed.

• Journal of Korean Neurosurgical Society
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• 제64권1호
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• pp.78-87
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• 2021

Objective : Intraoperative neurophysiological monitoring (IONM) has been widely used during spine surgery to reduce or prevent neurologic deficits, however, its application to the surgical management for cervical myelopathy remains controversial. This study aimed to assess the success rate of IONM in patients with cervical myelopathy and to investigate the factors associated with successful baseline monitoring and the effect of increasing the stimulation intensity by focusing on motor evoked potentials (MEPs). Methods : The data of 88 patients who underwent surgery for cervical myelopathy with IONM between January 2016 and June 2018 were retrospectively reviewed. The success rate of baseline MEP monitoring at the initial stimulation of 400 V was investigated. In unmonitorable cases, the stimulation intensity was increased to 999 V, and the success rate final MEP monitoring was reinvestigated. In addition, factors related to the success rate of baseline MEP monitoring were investigated using independent t-test, Wilcoxon rank-sum test, chi-squared test, and Fisher's exact probability test for statistical analysis. The factors included age, sex, body mass index, diabetes mellitus, smoking history, symptom duration, Torg-Pavlov ratio, space available for the cord (SAC), cord compression ratio (CCR), intramedullary increased signal intensity (SI) on magnetic resonance imaging, SI length, SI ratio, the Medical Research Council (MRC) grade, the preoperative modified Nurick grade and Japanese Orthopedic Association (JOA) score. Results : The overall success rate for reliable MEP response was 52.3% after increasing the stimulation intensity. No complications were observed to be associated with increased intensity. The factors related to the success rate of final MEP monitoring were found to be SAC (p<0.001), CCR (p<0.001), MRC grade (p<0.001), preoperative modified Nurick grade (p<0.001), and JOA score (p<0.001). The cut-off score for successful MEP monitoring was 5.67 mm for SAC, 47.33% for the CCR, 3 points for MRC grade, 2 points for the modified Nurick grade, and 12 points for the JOA score. Conclusion : Increasing the stimulation intensity could significantly improve the success rate of baseline MEP monitoring for unmonitorable cases at the initial stimulation in cervical myelopathy. In particular, the SAC, CCR, MRC grade, preoperative Nurick grade and JOA score may be considered as the more important related factors associated with the success rate of MEP monitoring. Therefore, the degree of preoperative neurological functional deficits and the presence of spinal cord compression on imaging could be used as new detailed criteria for the application of IONM in patients with cervical myelopathy.

• Journal of Korean Neurosurgical Society
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• 제64권4호
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• pp.575-584
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• 2021

Objective : Cervical expansive laminoplasty is an effective surgical method to address multilevel cervical spinal stenosis. During surgery, the spinous processes of C2 and C7 are usually preserved to keep the insertion points of the cervical musculature and nuchal ligament intact. In this regard, dome-like laminectomy (undercutting of C7 lamina) instead of laminoplasty is performed on C7 in selected cases. However, resection of the lamina can weaken the C7 lamina, and stress fractures may occur, but this complication has not been characterized in the literature. The objective of the present study was to investigate the incidence and risk factors for C7 laminar fracture after C7 dome-like laminectomy and its impact on clinical and radiological outcomes. Methods : Patients who underwent cervical open-door laminoplasty combined with C7 dome-like laminectomy (n=123) were classified according to the presence of C7 laminar fracture. Clinical parameters (neck/arm pain score and neck disability index) and radiologic parameters (C2-7 angle, C2-7 sagittal vertical axis, and C7-T1 angle) were compared between the groups preoperatively and at postoperatively at 3, 6, 12, and 24 months. Risk factors for complications were evaluated, and a formula estimating C7 fracture risk was suggested. Results : C7 lamina fracture occurred in 32/123 (26%) patients and occurred at the bilateral isthmus in 29 patients and at the spinolaminar junction in three patients. All fractures appeared on X-ray within 3 months postoperatively, but patients did not present any neurological deterioration. The fracture spontaneously healed in 27/32 (84%) patients at 1 year and in 29/32 (91%) at 2 years. During follow-up, clinical outcomes were not significantly different between the groups. However, patients with C7 fractures showed a more lordotic C2-7 angle and kyphotic C7-T1 angle than patients without C7 fractures. C7 fracture was significantly associated with the extent of bone removal. By incorporating significant factors, the probability of C7 laminar fracture could be assessed with the formula 'Risk score = 1.08 × depth (%) + 1.03 × length (%, of the posterior height of C7 vertebral body)', and a cut-off value of 167.9% demonstrated a sensitivity of 90.3% and a specificity of 65.1% (area under the curve, 0.81). Conclusion : C7 laminar fracture can occur after C7 dome-like laminectomy when a substantial amount of lamina is resected. Although C7 fractures may not cause deleterious clinical outcomes, they can lead to an unharmonized cervical curvature. The chance of C7 fracture should be discussed in the shared decision-making process.

• 한국전통조경학회지
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• 제29권2호
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• pp.63-72
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• 2011

본 연구는 전통주거공간 속에서 환경친화적인 설계기법과 원칙을 파악하여 그 원리를 재정립하고자 수행되었다. 이를 위해서 문헌연구를 통해 전통주거공간에 반영된 환경친화성을 자원보전적 측면, 입지적 측면, 공간구성적 측면으로 구분하고, 사례지를 선정하여 현대적 적용방안을 모색하였다. 사례지는 조선시대에 조영된 상류주택 중 비교적 원형이 잘 보존되고 있으며, 양호한 건축년도가 명확한 주택인 독락당을 선정하였다. 입지적 측면에서는 지형의 변경을 최소화하는 건물축조기법을 하고 있었으며, 환경보전적 측면에서는 열환경조절을 위해 실내 온도를 조절한 기법을 볼 수 있었다. 물질순환 측면에서는 자연재료의 재활용을 하고 있었으며, 수순환기법 및 조절을 통해 물을 적극적으로 활용하였다. 또한, 경관조망을 중요시 하여 내부에서 외부로 바라보는 경관의 다양한 조절을 통하여 내부공간을 외부로 확장시키고 끌어들이는 기법을 활용하였다. 현대적 공간에서의 전통성 추구는 단순히 단절된 전통의 복원이나 회복에 있기 보다는 전통 공간 속에 내재하는 구성원리 등을 추출하여 현대의 사회적, 문화적 환경공간에 대한 이해의 바탕위에서 수용 가능하다. 전통주거공간에 있어서 환경친화적 설계기법은 오랜 시간동안 경험에 의해 발전된 것으로 이의 현대적 적용은 지구환경과 에너지 문제를 해결하고 쾌적한 인간의 생활환경을 창출해 낸다는 점에서 중요한 의미를 내포하고 있다.

• 한국운동역학회지
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• 제31권1호
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• pp.1-15
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• 2021

Objective: The aim of this study was to investigate 1) the difference in static lower extremity alignment (SLEA) according to a history of lateral ankle sprain (LAS), 2) to identify SLEA factors affecting LAS, and 3) to present the cut-off value and 4) the usefulness and limitations of the SLEA measurement. Method: This case-control study recruited 88 men (age: 27.78±4.69 yrs) and 39 women (age: 24.62±4.20 yrs) subjects with and without LAS. SLEA measurement protocol included Q angle, tibiofemoral angle, genu recurvatum, rear foot (RF) angle, tibal varum and torsion, navicular drop, ankle dorsiflexion range of motion (DF ROM). Independent t-test, logistic regression and receiver operating characteristic (ROC) curve were used for statistical analysis. Results: Men with a history of LAS had significantly smaller Q angles both in standing and in supine position, while women with a history of LAS had significantly greater DF ROM in non-weight bearing (NWB; p < 0.05). Logistic regression model suggests tibial varum (OR = 0.779, p = 0.021) and WB DF ROM (OR = 1.067, p = 0.045) were associated with LAS in men. In case of women, there were no significant SLEA factors for LAS, however, ROC curve analysis revealed standing RF angle (AUC = 0.647, p = 0.028) and NWB DF ROM (AUC = 0.648, p = 0.026) could be affecting factors for LAS. Conclusion: There are differences in SLEA according to the history of LAS, furthermore, the identified items were different by sex. In case of men, tibial varum and WB DF ROM affect LAS occurrence. Standing RF angle and NWB DF ROM of women could be a predictor for LAS. However, since the sensitivity and specificity in most of the SLEA measurements are low, kinematic in dynamic tasks should be considered together for a more accurate evaluation of LAS risk.