G광역시 위생매립장 침출수의 독성평가

신준재,임은채,김성준 한국도시환경학회 2010 한국도시환경학회지 Vol.10 No.3

The study was targeted to evaluate toxicity of leachate from A sanitary landfill located in G city, which have passed 5 years since landfill completion. The raw leachate and the leachate pretreated by a Rotating Biological Contator were examined. The compositions of two leachates were analysized by TOC, ICP etc. examined and Scenedesmus sp. and Daphnia magna as each representative species of micro algae and crustacea were used for the acute biological exposure evaluation. The acute exposure evaluation showed that EC50 of raw and pretreated leachate by Scenedesmus sp. were 15.0% and 22.2%, respectively and the values by Daphnia magna were 1.7% and 2.6%, respectively. On the other hand, the leachate of A sanitary landfill has been currently treated in sewage treatment plant together. In order to examine whether toxicity of the leachate is or not, the inhibition extent on the growth of Bacillus subtillis was examined in various dilution ratio. No growth inhibitions were shown in the dilutions of less 20% in case of raw leachate and less 40% in case of pretreated leachate. 50% of dilution ratio showed that although at the beginning a little toxicity appeared, the toxicity got weak according to elapsed time. From the results, it is concluded that a considerable toxicity will not be occurred in the biological reactor in case of low dilution ratio, which has been presently employed, when the leachate of A sanitary landfill was connected and treated into sewage treatment plant. 본 연구에서는 매립 완료된지 5년이 지난 G도시 A위생매립장의 침출수 독성을 평가하고자 한다. 시험대상은 원수와 회전원판법으로 전처리를 거친 침출수를 검사하였다. 두 침출수의 화학적 조성은 TOC, ICP 등으로 분석하였다. 그리고 침출수의 급성독성평가를 실시하기 위하여 미세조류의 대표종 Scenedesmus sp.와 갑각류 Daphnia magna의 이용하였다. 급성독성평가에서Scenedesmus sp.의 원수와 전처리수의 72시간 EC50은 각각 15%, 22.2%이었고, Daphnia magna 의 EC50 값은 각각 1.7%, 2.6%이었다. 현재 A위생매립장의 침출수는 하수종말처리장에서 연계처리하고 있다. 연계처리에서의 침출수 비율에 따른 영향을 조사하기 위하여 생물학적 처리에서 사용되는 대표종인 Bacillus subtillis의 성장저해도를 다양한 희석비율에서 평가하였다. 성장저해는 원수의 경우 20%보다 낮은 희석배율일 때, 간이처리수의 경우 40%보다 낮을 희석배율일 때 낮게 나타났다. 희석농도 50%에서는 경과시간에 따라 독성이 약해지는 경향이 있었다. 실험 결과로부터 A 위생매립장의 침출수는 하수종말처리장으로 연계처리에 있어서, 독성이 낮은 희석 비율의 경우 현재 사용 중인 생물학적 폭기조에 큰 영향을 미치지 않을 것으로 판단된다.

상위 경추 수질내의 신경절교종

신준재,오성한,윤도흠,김태승,Shin, Jun Jae,Oh, Sung Han,Yoon, Do Heum,Kim, Tae Seung 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2

Gangliogliomas are benign tumors, composed of neoplastic astrocytes and nerve cells. They are rare, account for 0.4-6.25% of all primary central nervous system neoplasms. Gangliogliomas affect predominantly infants or young adults. Gangliogliomas are preferentially encountered supratentorially, predominantly affecting the temporal lobe. Spinal gangliogliomas affect predominantly the cervical spinal cord. We report a case of cervical ganglioglioma which was successfully removed surgically, with a review of literature.

Comparison of Adjacent Segment Degeneration, Cervical Alignment, and Clinical Outcomes After One- and Multilevel Anterior Cervical Discectomy and Fusion

신준재 대한척추신경외과학회 2019 Neurospine Vol.16 No.3

Objective: This study aimed to assess the influence of a fused segment on cervical range of motion (ROM) and adjacent segmental kinematics and determine whether increasing number of fusion levels causes accelerated adjacent segment degeneration (ASD) after anterior cervical discectomy and fusion (ACDF). Methods: A total of 165 patients treated with ACDF were recruited for assessment, and they were divided into 3 groups based on the number of fusion levels. Radiological measurements and clinical outcomes included visual analogue scale (VAS) and Neck Disability Index (NDI) assessed preoperatively and at ≥2 years of follow-up. Results: ASD occurred in 41 of 165 patients who underwent ACDF (1-level, 12 of 78 [15.38%]; 2-level, 14 of 49 [28.57%]; 3-level, 15 of 38 [39.47%]; p=0.015) at final follow-up (mean, 31.9 months). Significant differences were found in reduction of global ROM based on the number of fusion levels (p<0.001). The upper adjacent segment ROM increased over time (p=0.004); however, lower segment ROM did not. Three-level ACDF did not obtain greater amounts of lordosis than did 1- or 2-level ACDF (p=0.003). Postoperative neck VAS scores and NDI were significantly higher for 3-level ACDF than for 1- or 2-level ACDF (p=0.033 and p=0.001). Conclusion: ASD occurred predominantly in multilevel cervical fusion, more frequently in the upper segment of the prior fusion and as the number of fusion levels increased. Patients who underwent multilevel fusion had greater reduction of global ROM and increased compensatory motion at the upper adjacent segment. Three-level ACDF did not appear to restore cervical lordosis significantly compared with 1- or 2-level arthrodesis.

Optimal Use of the Halo-Vest Orthosis for Upper Cervical Spine Injuries

신준재,김상진,김태홍,신형식,황용순,박상근 연세대학교의과대학 2010 Yonsei medical journal Vol.51 No.5

Purpose: Upper cervical fractures can heal with conservative treatments such as halo-vest immobilization (HVI) and Minerva jackets without surgery. The most rigid of these, HVI, remains the most frequently used treatment in many centers despite its relatively high frequency of orthosis-related complications. We conducted this study to investigate the clinical outcome, effectiveness, patient satisfaction,and associated complications of HVI. Materials and Methods: From April 1997 to December 2008, we treated 23 patients for upper cervical spinal injuries with HVI. For analysis, we divided high cervical fractures into four groups,including C1 fracture, C2 dens fracture, C2 hangman’s fracture, and C1-2 associated fracture. We evaluated the clinical outcome, complications, and patient satisfaction through chart reviews and a telephone questionnaire. Results: The healing rate for upper cervical fracture using HVI was 60.9%. In most cases, bony healing occurred within 16 weeks. Older patients required longer fusion time. We observed a 39.1% failure rate, and 60.9% of patients experienced complications. The most common complications were frequent pin loosening (34.8%; 8/23) and pin site infection (17.4%; 4/23). The HVI treatment failed in 66.7% of patients with pin site problems. The patient approval rate was 31.6%. Conclusion: The HVI produced frequent complications and low patient satisfaction. Bony fusion succeeded in 60.9% of patients. Pin site complications showed a tendency to influence the outcome of HVI, and would be promptly addressed to prevent treatment failure if they develop. The decision to use HVI requires an explanation to the patient of potential complications and constant vigilance to prevent such complications and unsatisfactory outcomes.

뇌지주막하 출혈 후 뇌혈관 연축에 대한 동맥내 Papaverine 주입의 치료효과

신준재,이재환,신용삼,허승곤,김동익,이규창,Shin, Jun Jae,Lee, Jae Whan,Shin, Yong Sam,Huh, Seung Kon,Kim, Dong Ik,Lee, Kyu Chang 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.3

Objective : To clarify the benefits and therapeutic effects of intra-arterial papaverine infusion on the symptomatic cerebral vasospasm, we analyzed the results of treatment in 32 patients retrospectively. Methods : A total of 510 patients underwent surgical clipping or endovascular intra-aneurysmal treatment for ruptured intracranial aneurysm between May, 1996 and June, 1999. The delayed ischemic deficit(DID) was developed in 90 of 510 patients. Of these 90 patients, 32 developed symptomatic vasospasm inspite of using modest "3H therapy". The brain CT scan was taken before the intra-arterial infusion of papaverine. The 32 patients underwent 42 intra-arterial papaverine infusion. The symptomatic vasospasm was divided into three groups : deterioration of mental status(Group 1), appearance of a focal neurologic deficit(Group 2), or both(Group 3). We measured Glasgow Coma Scale(GCS), arterial diameters, and cerebral circulation time(CCT) at the time of pre- and postangioplasty. Results : The number of patients in group 1, 2 and 3 were 26, 7, 9 respectively. Eighteen cases showed improvement of GCS more than 2 scores, 16 more than 1, and 8 showed no change of GCS. Average cerebral circulation time(CCT) was decreased ranging from 0.0%-67.5%, and arterial diameters were increased in 21 cases ranging from 1 to 4 folds. Conclusion : Intra-arterial papaverine infusion seemed to have therapeutic effects on symptomatic vasospasm by improving the neurological signs and increasing the arterial diameter. We suggest that intra-arterial papaverine infusion would be an useful adjunctive therapeutic modality in symptomatic vasospasm.

Clinical, Radiographic, and Genetic Analyses in a Population-Based Cohort of Adult Spinal Deformity in the Older Population

신준재,김병우,강주원,최준정,문봉주,류달성,윤승환,진동규,이정길,김긍년,하윤 대한척추신경외과학회 2021 Neurospine Vol.18 No.3

Objective: This study aimed to identify the sagittal parameters associated with health-related quality of life and genetic variations that increase the risk of adult spinal deformity (ASD) onset in the older population. Methods: We recruited 120 participants who had a sagittal vertical axis >50 mm in a sagittal imbalance study. Sagittal radiographic parameters, cross-sectional area, and intramuscular fatty infiltration using the Goutallier classification in the paraspinal lumbar muscles were evaluated. Functional scales included the self-reported Oswestry Disability Index (ODI), 36-item Short Form Health Survey (SF-36), and visual analogue scales (VAS) for back and leg pain. We performed whole-exome sequencing and an exome-wide association study using the 100 control subjects and 63 individuals with severe phenotypes of sagittal imbalance. Results: Pelvic incidence minus lumbar lordosis (PI–LL) mismatch was negatively associated with the SF-36 and positively correlated with ODI and VAS for back and leg pain. PI–LL was related to the quality and size of the paraspinal muscles, especially the multifidus muscle. We identified common individual variants that reached exome-wide significance using single-variant analysis. The most significant single-nucleotide polymorphism was rs78773460, situated in an exon of the SVIL gene (odds ratio, 9.61; p=1.15×10-9). Conclusion: Older age, higher body mass index, and a more significant PI–LL mismatch were associated with unfavorable results on functional scales. We found a genetic variation in the SVIL gene, which has been associated with the integrity of the cytoskeleton and the development of skeletal muscles, in severe ASD phenotypes. Our results help to elucidate the pathogenesis of ASD.

G 광역시 위생매립장 침출수의 독성평가

신준재,임은채,김성준 한국도시환경학회 2010 한국도시환경학회지 Vol.10 No.2

본 연구에서는 매립 완료된지 5년이 지난 G도시 A위생매립장의 침출수 독성을 평가하고자 한다. 시험대상은 원수와 회전원판법으로 전처리를 거친 침출수를 검사하였다. 두 침출수의 화학적 조성은 TOC, ICP 등으로 분석하였다. 그리고 침출수의 급성독성평가를 실시하기 위하여 미세조류의 대표종 Scenedesmus sp.와 갑각류 Daphnia magna의 이용하였다. 급성독성평가에서 Scenedesmus sp.의 원수와 전처리수의 72시간 EC50은 각각 15%, 22.2%이었고, Daphnia magna 의 EC50 값은 각각 1.7%, 2.6%이었다. 현재 A위생매립장의 침출수는 하수종말처리장에서 연계처리하고 있다. 연계처리에서의 침출수 비율에 따른 영향을 조사하기 위하여 생물학적 처리에서 사용되는 대표종인 Bacillus subtillis의 성장저해도를 다양한 희석비율에서 평가하였다. 성장저해는 원수의 경우 20%보다 낮은 희석배율일 때, 간이처리수의 경우 40%보다 낮을 희석배율일 때 낮게 나타났다. 희석농도 50%에서는 경과시간에 따라 독성이 약해지는 경향이 있었다. 실험 결과로부터 A 위생매립장의 침출수는 하수종말처리장으로 연계처리에 있어서, 독성이 낮은 희석 비율의 경우 현재 사용 중인 생물학적 폭기조에 큰 영향을 미치지 않을 것으로 판단된다.

Surgical Versus Conservative Management for Treating Unstable Atlas Fractures: A Multicenter Study

신준재,김광렬,신중겸,강지인,이호진,김태우,홍재택,김상우,하윤 대한척추신경외과학회 2022 Neurospine Vol.19 No.4

Objective: This multicenter study compared radiological parameters and clinical outcomes between surgical and nonsurgical management and investigated treatment characteristics associated with the successful management of unstable atlas fractures. Methods: We retrospectively evaluated 53 consecutive patients with unstable atlas fracture who underwent halo-vest immobilization (HVI) or surgical fixation. Clinical outcomes were assessed using neck visual analogue scale and disability index. The radiological assessment included total lateral mass displacement (LMD) and the anterior atlantodental interval (AADI). Results: Thirty-two patients underwent surgical fixation and 21 received HVI (mean follow-up, 24.9 months). In the surgical fixation, but not in the HVI, LMD, and AADI showed statistically significant improvements at the last follow-up. The osseous healing rate and time-to-healing were 100% and 14.3 weeks with surgical fixation, compared with 71.43% and 20.0 weeks with HVI, respectively. Patients treated with HVI showed poorer neck pain and neck disability outcomes than those who received surgical treatment. LMD showed an association with osseous healing outcomes in nonoperative management. Clinical outcomes and osseous healing showed no significant differences according to Dickman’s classification of transverse atlantal ligament injuries. Conclusion: Surgical internal fixation had a higher fusion rate, shorter fracture healing time, more favorable clinical outcomes, and a more significant reduction in LMD and AADI compared to nonoperative management. The pitfalls of external immobilization are inadequate maintenance and a lower probability of reducing fractured lateral masses. Stabilization by surgical reduction with interconnected fixation proved to be a more practical management strategy than nonoperative treatment for unstable atlas fractures.

신규 살조제 Thiazolidindione 유도체 (TD49)의 해양생물에 대한 생물 농축도 조사

신준재(Jun-Jae Shin),김시욱(Si-Wouk Kim),조훈(Hoon Cho),김성준(Seong-Jun Kim) 한국생물공학회 2012 KSBB Journal Vol.27 No.2

In this study, a newly synthesized thiazolidinedione derivative, TD49 with a highly selective algicide to red tide, was examined in order to evaluate the bioconcentration on aquatic organisms of coast. BAF (accumulation of TD49 by aquatic food chain) and BCF (accumulation of TD49 by sea water) were examined employing the shrimp (Fenneropenaeus chinensis) as the feed organism, and the olive flounder Paralichthys olivaceus as a consumer in marine ecosystem. Bioconcentration degree in sea water showed that the order in P. olivaceus was viscera > gill > muscle. The average BCF values of TD49 were 67.70, 63.32 and 20.25 at viscera, gill and muscle, respectively. Bioaccumulation degree using feed showed that the order in the organs of P. olivaceus was viscera > gill > muscle. The average BAF values of TD49 were 175.89, 114.88 and 32.59 at viscera, gill and muscle, respectively. When compared with two results, the accumulation by the food and water was higher than that by water. After the elimination experiment in sea water, the TD49 concentration was 2.81 nmole/g in the viscera and were not found in the gill and the muscle. More than 50% of the accumulated TD49 were eliminated from viscera in 7 days and all the accumulated TD49 were eliminated from gill and muscle in 7 days. On the other hand, the octanol/water partition coefficient (log Kow) was measured to be 3.66 and experimental BCF of this study was 67.7.

Radiological Changes in Adjacent and Index Levels after Cervical Disc Arthroplasty

하윤,신준재,김광렬,손동욱,신동아,이성,김긍년,윤도흠 연세대학교의과대학 2022 Yonsei medical journal Vol.63 No.1

Purpose: The purpose of this retrospective study was to evaluate radiological and clinical outcomes in patients undergoing cervical disc arthroplasty (CDA) for cervical degenerative disc disease. The results may assist in surgical decision-making and enable more effective and safer implementation of cervical arthroplasty. Materials and Methods: A total of 125 patients who were treated with CDA between 2006 and 2019 were assessed. Radiological measurements and clinical outcomes included the visual analogue scale (VAS), the Neck Disability Index (NDI), and the Japanese Orthopaedic Association (JOA) myelopathy score assessment preoperatively and at ≥2 years of follow-up. Results: The mean follow-up period was 38 months (range, 25–114 months). Radiographic data demonstrated mobility at both the index and adjacent levels, with no signs of hypermobility at an adjacent level. There was a non-significant loss of cervical global motion and range of motion (ROM) of the functional spinal unit at the operated level, as well as the upper and lower adjacent disc levels, compared to preoperative status. The cervical global and segmental angle significantly increased. Postoperative neck VAS, NDI, and JOA scores showed meaningful improvements after one- and two-level CDA. We experienced a 29.60% incidence of heterotrophic ossification and a 3.20% reoperation rate due to cervical instability, implant subsidence, or osteolysis. Conclusion: CDA is an effective surgical technique for optimizing clinical outcomes and radiological results. In particular, the preservation of cervical ROM with an artificial prosthesis at adjacent and index levels and improvement in cervical global alignment could reduce revision rates due to adjacent segment degeneration.