척추관 협착증에 대한 연구 : 요추관 협착증 환자에서 협착 부위에 따른 수술적 치료의 결과 Results of the Operative Treatments by the Level of Lumbar Spinal Stenosis

이준규,안재성,양준영 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

Spinal stenosis is any type of narrowing of the main spinal canal, nerve canal or foramina from structural abnormality of bony components. Posterior decompression only provide relief of pain and restoration of neurologic function, and simultaneous posterolateral fusion is needed for prevention of spinal instability after wide posterior decompression. The degree of decompression (focal or wide), instrumentation and bone graft is dependent to the level of stenosis and instability. The purpose of this study is to compare the operative results clinically and radiologically by the level of spinal stenosis. We reviewed 73 patients of lumbar spinal stenosis who had undergone operations with posterior decompression or posterolateral fusion with spinal instrumentation at our hospital, From January 1987 to October 1997. We classified the level of stenosis into one level, two level and multi-level(above three level) stenosis, and on the last follow up, radiological bony union, clinical results, and complications were compared. The following results were obtained. I. The one level was 42 cases(57.6%), two level 24 cases(32.9%), and multi-level stenosis 7 cases(9.6%) and the most common stenotic level was at LA-5, 31 cases(42.5%). 2. Posterior decompression only were carried out on 20 patients(27.4%), and simultaneous posterolateral fusion with instrumentation were 53 patients(72.6%), CD 4 cases, CCD 11 cases, PWB 2 cases, and Diapason 36 cases. 3. The radiologic union rate was 41 cases(97.6%) in one level, 22 cases(87.5%) in two level, 6cases(85.7%) in multi-level spinal stenosis. 4. The excellent or good clinical results(by the Kikaldy-Willis criteria) were 40 cases (95.2%) in one level, 22 cases(91.8%) in two level, 6 cases(85.7%) in multi-level spinal stenosis. 5. The postoperative complications such as infection, metal failure, neurologic deficit or death were 6 cases(14.3%) in one level, 4 cases(21%) in two level, 3 cases(44.3%) in multi-level stenosis.

종골 골절의 임상적 고찰

이준규,나상연 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2

Many different methods have been tried for the treatment of fractures of the calcaneus in order to search for better results. But there is no general agreement on the treatment of the fracture of the calcaneus, especially involving the subtalar joint. Calcaneal fractures of 39 feet in 31 patients which were treated at the Dept. of Orthopedic Surgery, Chungnam National University Hospital since 1976 to 1982 were clinically analyzed, and the following results were obtained. 1. Of 31 patients, 25 patients were male and 6 were female. Their ages ranged 9 to 61 years and averaged 33 years. 2. The main cause of fracture of calcaneus was a fall from a height in 77.4% of cases, and the spine fractures were associated in 9 patients with calcaneal fractures. 3. Fractures involving the subtalar joint were 29 feet (74.4%) and Rowe's type 5 were 19 feet(48.7%). 4. Rowe's type 1. 2. 3 and 4 types (20 cases) were treated by only conservative method, and of Rowe's type 5 fractures (19 cases), 15 fractures were treated conservatively and 4 fractures were treated operatively. And then favorable results were obtained. 5. The most common complication after treatment was pain on the heel and around the ankle joint.

슬개골 골절의 임상적 고찰

이준규,안상로,박찬희 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.2

We studies the cases of 30 patients who had fracture of patella, 28 patients were male and 2 patients were female. We treated the patients with operative treatment in 27 patients and with nonoperative treatment in 3 patients. The results are as follows. 1. It was more frequent in male, and average age of patient was 38.5 years old. 2. Most frequent cause of fractures was traffic accident. 3. Open fracture was 76.7%, and transverse or bursting fracture was 66.7%. 4. The end result was dependent on the initial trauma. 5. The associated injuries were frequent nearby the knee joints.

마그네틱 베어링 타입 터보분자펌프 컨트롤러의 제작

이효종,이성준 한국기술교육대학교 2003 論文集 Vol.10 No.1

Turbo Molecular Pump(TMP) is a kind of vacuum pump for high vacuum applications, which is widely used in the semiconductor industry. Since TMP typically requires more than 30,000 rpm of rotational speed, magnetic bearing (MB) shows much better performance compared with the conventional mechanical bearing for TMP systems. MB holds its rotor without any mechanical contacts and it does not require any lubrication method. This makes MB adequate for ultra-high speed or clean environment applications like semiconductor FAB or aerospace industry. MB type TMP controller is organized with three parts, i.e., a MB controller, a motor driver, and a processor for controlling the whole system. We implemented a controller for a commercial TMP and succeeded to run the system up to 30,000 rpm of rotational speed.

동북아 물류기지화 구축을 위한 최적화 전략에 관한 연구

李相俊,金壹洙 홍익대학교 경영연구소 2004 경영연구 Vol.29 No.-

Since Korea is poor resource and a relatively small country, it has come to depend on international trade. For more than three decades, Korea has experienced remarkable economic growth. Due to this rapid growth, the total volume of port traffic has grown at an average annual rate of 10.2 percent during that period. Korea's major policies have centered on the development of large-scale ports and their improved operation in order to build the North-East Asia logistic hub. The Korean Government has been promoting the development of new port projects. So, the main objective of this paper is to briefly analyze that korea is to establish a construction of logistic center in North-East Asia. Korea has suffered from the shortage of port facilities, because port development has always followed the demaned of the port facilities. The international competitiveness of both the export and import industries has deteriorated remarkably. Korea is now acting positively in promoting the planned port development in order to handle the projected port traffic volume. The conditions of port development has become worse with all the construction cost. Future development plans should be optimized by maximizing the utilization of existing port facilities through specializing the function of each port. Additionally, in order to secure sufficient investment resources, it is necessary to induce private capital and foreign direct investment. And, in order to establish a new construction of logistic hub in North-East Asia, Korea shoud be established the foreign logistic company.

온실에서 동양란인 심비디움 재배에 공생균의 효과에 관한 연구

이상선,이준기,이정우,박소영,백기엽 충북대학교 첨단원예기술개발연구센터 2000 연구보고서 Vol.5 No.-

The orchid symbiotic fungus (Tulsanella repens P-01; OSF) was cultured on the soil materials by solid culture and inoculated in the two varieties of GwanUm and SaGae of Cymbidium hybrids with the barks. The two varieties of the oriental orchid were measured after 12 months' cultivation under the conditions of greenhouse; fresh weight, numbers of bulb, and rate of dead bulb for an individual plant. The fresh weight of plants were measured to be different for the individual plant. The fresh weight of plants were measured to be different for the individual plants treated with the OSF or not, depending on the varieties, but the rates of dead bulb were significant, disregarding with the varieties. The roots of the plants treated were observed to be more health and heavier weight than those not treated. The bulbs of the plants not treated were measured to be dead at the rate of 20% for a year's cultivation. The roots of two varieties were also observed by naked eyes and by microscope; Several peletons were observed to be in the root cells in the individual plants treated with OSF, but not in the individual plants treated without the OSF. Further, the pathogenic fungal hyphae were observed to be in the roots under the dead bulbs of both varieties not treated; appessorium or hasutorium on the epidermal cells of root. The inoculation of OSF was speculated to stimulate the growth of plants by absorption of mineral nutrition and defense the invasions of soil pathogenic fungi for the cultivations of Cymbidium hybrids.

게이트 심근 SPECT를 이용한 좌심실의 국소탄성률 평가방법 개발 및 재현성 평가

이병일,이동수,이재성,강원준,정준기,이명철,최흥국 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.6

목적: 게이트 심근 SPECT 영상에서 국소부피변화를 얻으면, 요골동맥 긴장도를 측정하여 얻은 중심 동맥의 압력 곡선으로부터 최대탄성률을 얻을 수 있다. 이 연구에서는 좌심실의 국소탄성률을 평가하기 위한 방법을 개발하고 국소탄성률 측정의 재현성을 평가하였다. 대상 및 방법: 게이트 Tc-99m MIBI 심근 관류 SPECT를 두 번 연속으로 시행한 환자 7명(남:여=5:2, 58±11.9세)을 대상으로 하였다. 국소적 부피변화를 측정하기 위하여 개발한 CSA(Cardiac SPECT Analyzer) 소프트웨어를 이용하여 좌심실의 부피변화를 측정하였으며, 시간-압력 곡선과 국소 시간-부피 곡선을 이용하여 반복연산을 통하여 구한 국소 시간-탄성율 곡선에서 국소탄성률을 얻었다. 같은 SPECT 영상에 대해서 두 번 측정한 국소탄성률의 재현성과, 같은 환자에서 연속하여 두 번 얻은 SPECT 영상에 대해서 측정한 국소탄성률의 재현성을 평가하였다. 결과: 평균 국소탄성률은 15분할모델에서 3.36±3.38 mmHg/mL이었으며, 7분할모델과 5분할모델에서 각각 3.16±2.25 mmHg/mL, 3.11±2.57 mmHg/mL이었다. 국소탄성률의 조화평균은 전체탄성률과 일치하였다. 동일한 데이터에서 두 번 측정한 국소탄성률 값의 상관계수는 모든 모델에서 0.97이상이었고, Bland Altman 도표에서 차이의 2-표준편차는 각각 1.5%, 1.0%, 0.9%였다. 동일 환자에서 두 번 연속 촬영한 SPECT 데이터로부터 측정한 국소탄성률의 상관계수는 모든 모델에서 0.95이상이었으며, Bland Altman 도표에서 차이의 2-표준편차는 각각 2.2%, 1.0%, 1.2%였다. 결론: 게이트 심근 SPECT를 이용한 좌심실의 국소탄성률을 측정하였으며 재현성 있는 결과를 얻었다. 심근 SPECT를 이용하여 얻은 국소탄성률의 평가방법은 향후 임상적인 데이터를 바탕으로 새로운 심기능 분석지표로 활용될 수 있을 것이다. Purpose: Regional contractility can be calculated using the regional volume change of left ventricle measured by gated myocardial SPECT image and curve of central artery pressure obtained from radial artery pressure data. In this study, a program to obtain the regional contractility was developed, and reproducibility of regional contractility measurement was assessed. Materials and Methods: Seven patients )male:female=5:2, 58±11.9 years) with coronary artery diseases underwent gated Tc-99m MIBI myocardial SPECT twice without delay between two scans. Regional volume change of left ventricle was estimated using CSA (Cardiac SPECT Analyzer) software developed in this study. Regional contractility was iteratively estimated from the time-elastance curve obtained using the time-pressure curve and regional time-volume curve. Reproducibility of regional contractility measurement assessed by comparing the contractility values measured twice from the same SPECT data and by comparing those measured from the pair of SPECT data obtained from a same patient. Results: Measured regional contractility was 3.36±3.38 mmHg/mL using 15-segment model, 3.16±2.25 mmHg/mL using 7-segment model, and 3.11±2.57 mmHg/mL using 5-segment model. The harmonic average of regional contractility value was almost identical to the global contractility. Correlation coefficient of regional contractility values measured twice from the same data was greater than 0.97 for all models, and two standard deviations of contractility difference on Bland Altman plot were 1.5%, 1.0%, and 0.9% for 15-, 7-, and 5-segment models, respectively. Correlation coefficient of regional contractility values measured from the pair of SPECT data obtained from a same patient was greater than 0.95 for all models, and two standard deviations on Bland Altman plot were 2.2%, 1.0%, and 1.2%. Conclusion: Regional contractility of left ventricle measured using developed software in this study was reproducible. Regional contractility of left ventricle will be a new useful index for myocardial function after analysis of the clinical data.

노년기 우울성 가성치매 환자군에서의 뇌 단일광자방출 전산화 단층촬영 소견

이동우,이명철,정준기,이동수,곽철은,이재성,조경형,조맹제 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

연구 목적 : 우울성 가성치매 환자군의 Tc-HMPAO SPECT영상 소견을 정상 대조군, 인지기능장애가 없는 우울증 환자군 및 알쯔하이머형 치매 환자군과 비교함으로써 노년기 우울성 가성치매의 병태생리의 일부를 알아 보았다. 연구 방법: 9명의 알쯔하이머형 치매 환자군, 7명의 인지기능장애가 없는 우울증 환자군, 7명의 우울성 가성치매 환자군, 4명의 정상대조군을 대상으로 하였다. 우울증 환자군은 DSM-III-R의 우울증의 진단 기준에 의해 진단되었고, 알쯔하이머형 치매 환자군은 DSM-III-R의 진단기준과 NINCDS-ADRDA의 알쯔하이머형 치매의 진단 기준에 의해 진단되었다. 모든 대상자가 해밀턴 우울증 척도 및 MMSE-K에 의해 평가되었다. 모든 대상자에 대해 99m-HMPAO SPECT를 시행하였고, 각 대상군의 영상을 Friston의 통계적 매개변수 지도 방법을 이용, 매 복셀(voxel) 단위로 비교분석하였다. 결과 : 결과는 아래와 같다. 1) 알쯔하이머형 치매 환자군은 대조군에 비해 우측 전두엽, 우측 측두엽, 양측 두정엽에서 유의한 혈류감소 소견을 보였다.(p<0.05). 2) 우울증 환자군은 대조군에 비해 좌측 전두엽에서 유의한 혈류감소 소견을 보였다.(p<0.05). 3) 우울성 가성치매 환자군은 대조군에 비해 우측 측두엽과 좌측 두정엽에서 유의한 혈류감소 소견을 보였다.(p<0.05). 4) 우울성 가성치매 환자군은 우울증 환자군에 비해 우측 측두엽과 양측 두정엽에서 유의한 혈류감소 소견을 보였다.(p<0.05). 결론 : 우울성 가성치매 환자군은 측두-두정엽의 혈류감소 소견을 보였고, 이는 알쯔하이머형 치매와 유사한 소견이었다. 이러한 결과는 우울성 가성치매가 초기의 원발성 치매 환자군을 포함한다는 가설을 지지해준다. 0bjects : Through comparison of the Tc-HMPAO SPECT image ofdepressive pseudo-dementia group with those of control group(depression group free from cognitive impairment)and DAT(Dementia of Alzheimer's type). we tried to see part of pathophysiology of she depressive pseudodementia of the elderly. Methods : The subjects consisted of 9 patients with dementia of Alzheimer type(DAT group),7 patients with depression free from cognitive impairment(depression group),7 patients with depressive pseudodementia(depressive pseudodementia group), and 4 normal controls. De-pression patients were diagnosed according to DSM 111-R DAT patients were diagnosed by DSM 111-R and N1NCDS-ADRDA criteria of DAT. All were rated with Hamilton Rating Scale for Depression and Mini Mental State Exam. All underwent 99m-HMPAO SPECT scan. The images of each group were analysed using SPM of Friston, which compares the images on voxel-by-voxel basis. Results : The results were as follows : 1) DAT group showed significant decrease in cerebral blood flow (CBF) compared with controls in the right frontal region, the right temporal region, and both temporal regions(p<0.05). 2) Depression group showed significant decrease in CBF in the left frontal region(p<0.05). 3) Depressive pseudodementia group showed significant decrease in CBF compared with controls in the right temporal region and the left parietal region(p <0.05). 4) Depressive pseudodementia group showed significant decrease in CBF compared with depression group in the right temporal region and both parietal regions(p<0.05). Conclusion : Depressive pseudodementia group showed decreased CBF in temporo-parietal region, similar to that of the DAT group. This result supports the hypothesis that depressive psuedodementia includes a subgroup of patients with early-stage primary dementia.

게이트 심근 SPECT 분석 소프트웨어의 개발과 좌심실 수축 기능 평가

이병일,이동수,이재성,정준기,이명철,최흥국 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.2

목적 : 게이트 심근 SPECT 영상 데이터에서 좌심실을 분할하고 단위영상 각각의 심실부피를 계산하는 소프트웨어를 개발하였다. 개발한 소프트웨어에서 얻은 구혈률을 상용 소프트웨어QGS (Quantitative Gated SPECT)에서 산출한 값과 비교하여 검증하였다. 대상 및 방법 : 게이트 심근 SPECT를 시행하여 구혈률 15%-80%, 확장기말 부피는 46 mL-293 mL, 수축기말 부피는 8 mL-250 mL인 40명의 영상데이터를 사용하여 이 연구에서 개발한 CSA (Cardiac SPECT Analyzer)로 구혈률과 부피를 산출하여 QGS로 얻은 결과와 비교하였다. 같은 영상을 CSA로 두 번 분석하여 구혈률과 부피가 같은 값이 나오는지 보고, 26명의 환자에서 같은 자리에서 두 번 이어서 얻은 게이트 SPECT 영상을 CSA로 분석하여 편차를 조사하였다. 결과 : CSA 측정과 QGS측정의 상관성은 상관계수가 구혈률, 확장기만 부피, 수축기말 부피 각각 0.97, 0.92, 0.96이었고 Bland Altman 도표에 치우침 없이 2표준편차가 구혈률의 경우 10.1%이었다. 같은 영상에 대한 CSA 2회 측정 결과의 상관은 0.96, 0.99, 0.99 이었고 구혈률의 2표준편차는 3.4%이었다. 두 번 연속 촬영한 영상으로 CSA 분석한 결과 상관계수는 0.89, 0.97, 0.98, 이었고 변이계수는 8.2%, 5.4mL, 8.5mL, Bland Altman 도표 2표준편차는 구혈률의 경우 10.6%이었다. 결론: 게이트 심근 SPECT에서 얻은 영상으로 구혈률을 측정할 수 있는 소프트웨어를 개발하였다. 이 소프트웨어로 얻은 구혈률, 확장기말 부피, 수축기말 부피는 정확하며 정밀하였다. 구혈률의 2표준편차는 10.6%이었다. Objectives : A new software (cardiac SPECT Analyzer CSA) was developed for quantification of volumes and ejection fraction on gated myocardial SPECT. Volumes and ejection fraction by CSA were validated by comparing with those quantified by Quantitative Gated SPECT (QGS) software. Materials and Methods: Gated myocardial SPECT was performed in 40 patients with ejection fraction from 15% to 85%. In 26 patients, gated myocardial SPECT was acquired again with the patients in situ. A cylinder model was used to eliminate noise semi-automatically and profile data was extracted using Gaussian fitting after smoothing. The boundary points of endo- and epicardium were found using an iterative learning algorithm. Enddiastolic (EDV) and endsystolic volumes (ESV) and ejection fraction (EF) were calculated. These values were compared with those calculated by QGS and the same gated SPECT data was repeatedly quantified by CSA and variation of the values on sequential measurements of the same patients on the repeated acquisition. Results: From the 40 patient data, EF, EDV and ESV by CSA were correlated with those by QGS with the correlation coefficients of 0.97, 0.92, 0.96. Two standard deviation (SD) of EF on Bland Altman plot was 10.1%. Repeated measurements of EF, EDV, and ESV by CSA were correlated with each other with the coefficients of 0.96, 0.99, and 0.99 for EF, EDV and ESV respectively. On repeated acquisition, reproducibility was also excellent with correlation coefficients of 0.89, 0.97, 0.98, and coefficient of variation of 8.2%, 5.4mL, 8.5mL and 2SD of 10.6%, 21.2mL, and 16.4mL on Bland Altman plot for EF, EDV and ESV. Conclusion: We developed the software of CSA for quantification of volumes and ejection fraction on gated myocardial SPECT. Volumes and ejection fraction quantified using this software was found valid for its correctness and precision.

만성 B형 간염 환자의 급성 악화 후 발생한 피부 결절 다발동맥염과 류마티스관절염

이주현,김민,이준성,장선희,윤보영,이윤우 인제대학교 2009 仁濟醫學 Vol.30 No.-

Cutaneous polyarteritis nodosa(CPAN) is a rare vascular disorder that affects small and medium-sized arteries in the reticular dermis and subcutaneous tissue. It has been described as a distinct clinical entity with benign and a chronic prolonged course without systemic involvement. Hepatitis B virus-related polyarteritis nodosa (HBV-related PAN) is typical form of classic PAN. Its pathogenesis is not well known, but considered an immune complex-mediated disease. The patients with HBV-related PAN often present with malignant hypertension, orchitis, and vascular nephropathy. But, HBV-related CPAN has been rarely reported. Rheumatoid vasculitis is a complication of rheumatoid arthritis that can be lead to variety of clinically significant skin and systemic conditions, It has been reported before or at the time of rheumatoid arthritis diagnosis but is usually seen an average of 10 to 14 years after arthritis onset. The histological features of cutaneous vasculitis in rheumatoid arthritis overlapped both the characteristics of cutaneous necrotizing venulitis and cutaneous polyarteritis nodosa. But polyarteritis nodosa-like rheumatoid vasculitis has rarely been reported. We report a case of rheumatoid arthritis and cutaneous polyarteritis nodosa in a chronic hepatitis B with acute exacerbation.