최씨 훅을 이용한 복강경 버찌씨 수술

김영혜 ( Young Hye Kim ),박준선 ( Jun Seon Park ),최상준 ( Sang Joon Choi ),송창훈 ( Chang Hoon Song ),한세준 ( Sei Jun Han ),정혁 ( Hyuk Jung ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.6

목적: 버찌씨 수술은 복압성 요실금 수술에 효과적인 수술로 여겨져 왔다. 요실금의 원인이 내인성 요도 괄약근의 결손소견 없이 요도의 과운동성으로 인한 경우 버찌씨 수술이 일반적으로 추천되어진다. 본 연구에서는 복강경 버찌씨 수술에서 최씨 훅의 유용성에 대해 알아보고자 하였다. 연구방법: 2000년 10월부터 2005년 3월까지 본원에서 복강경 버찌씨 수술을 시행받은 47명의 환자를 대상으로 하였다. 27명은 고전적 복강경 버찌씨 수술을 시행하였고 20명은 내골반 근막을 Cooper 인대를 부착하는데 유용한 본원에서 고안한 최씨 훅을 이용하여 복강경 버찌씨 수술을 시행하였다. 결과: 고전적 복강경 버찌씨 수술을 시행한 군과 최씨 훅을 이용한 복강경 버찌씨 수술을 시행한 군의 평균 나이, 분만력, 폐경률, BMI는 두 군간에 통계학적으로 유의한 차이를 보이지 않았다 (p>0.05). 수술 시간은 고전적 복강경 버찌씨 수술은 90.52±15.32분, 최씨 훅을 이용한 복강경 버찌씨 수술은 38.50±10.14분으로 최씨 훅을 이용한 경우 수술시간이 통계적으로 유의하게 짧았다 (p<0.05). 두 군간에 재발률 및 합병증 발생은 통계적 유의성을 보이지 않았다 (p>0.05). 결론: 본 연구에서 본원에서 고안한 최씨 훅을 이용하여 복강경 버찌씨 수술을 시행한 결과 수술 시간을 단축시킬 수 있었으며 수술 효과는 기존 방법과 동일하게 관찰되었다. 이에 최씨 훅은 복강경 버찌씨 수술에서 사용할 때 집도자의 봉합 과정을 단순화시켜 수술 시간을 단축시키므로 복강경 버찌씨 수술에 용이한 기구이다. Objective: Burch operation has been effective method for the treatment of stress incontinence. Burch operation is a well-accepted procedure for treating stress urinary incontinence secondary to urethral hypermobility without intrinsic sphincter deficiency and is the reference standard with which other procedures are compared. This study is to evaluate the effectiveness of the Choi`s hook in laparoscopic Burch operation. Methods: This study included 47 patients who had undergone laparoscopic Burch operation from October 2000 through March 2005. Of these 47 patients, 27 patients underwent traditional laparoscopic Burch operation (Group 1) and 20 patients underwent laparoscopic Burch operation with Choi`s Hook on anchoring the endopelvic fascia to the Cooper`s ligament (Group 2). Results: The mean age of patients of Group 1 was 55.6±9.37 years of age and that of Group 2 was 56.0±5.93 years of age. There is no difference in the mean age of patients (P>0.05). The mean operating time was 90.5±15.32 minutes for Group 1 and 38.5±10.14 minute for Group 2. The mean operating time was shorter in Group 2 than Group 1 (P<0.05). There was no difference in recurrence rate and complication rate between Group 1 and Group 2 (P>0.05). Conclusion: We performed laparoscopic Burch operation with the Choi`s Hook on anchoring the endopelvic fascia to the Cooper`s ligament. When we compared traditional laparoscopic Burch operation with laparoscopic Burch operation with Choi`s Hook, we could shorten the operation time using the Choi`s Hook.

분산 데이터 베이스에서 트리구조를 가진 질의어에 대한 최적화 연구

崔宰赫,李相祚 경북대학교 공과대학 1987 工大硏究誌 Vol.16 No.-

The efficient is of great importance in a distributed database management system. For simple query, it is possible to design optimization algorithm that derive optimal distribution strategies. In this paper, a query with tree structure is extension of simple query. To reduce data transmission cost and to fully eliminate relations that is not necessary in result site, efficient algorithm for TSQ-query that considers semijoin operation sequence is presented.

大學卒業定員制의 實施에 따른 學生生活 指導方案에 關한 硏究

崔根爀,張忠根,李相祐,張鎭吉,張大熙 충남대학교 1982 學生生活硏究 Vol.10 No.1

Higher education in Korea is faced with a new situation since 1981 when the government implemented a college graduation quota system designed to broaden the opportunities for higher education, alleviate the problem of the students who fail the entrance examination, and improve the quality of college graduates. The change of the system has brought about several serious problems including how to supply enough faculty members, how to provide enough educational facilities, and how to cope with the huge increase in the number of students, 30% more than graduation quota. The greatest single problem resulting from the implementation of college graduation quota system is the psychological and emotional unease aroused among the students, because 30% of those students with unsatisfying results must be banished from college before their graduation. This study aims to find effective measures for student guidance that each of the colleges can implement to help students adjust to the changed circumstances. After objectively investigating the problems from the various educational environments, from the recent students' views of college, and from the psychological and emotional unease arising in them by the fear of failing to graduate from their college because of implementation of the graduation quota system, a survey was conducted by means of a questionnaire composed of 40 questions and by means of personal interviews, 5,903 students, who are influenced by the graduation quota system, attending 19 public and private universities and colleges selected throughout the country. The data obtained from this survey were statistically processed with the help of the C. N. U. Computer Center, and the ratios of the responses to each of the questions were analyzed and calculated according to the distinctions of the total, sex, region, and major. The conclusions that the interrelations among the variant factors from each of the questions which were surveyed, analyzed and arranged have suggested are as follows : 1. The original purpose of graduation quota system should continually be clarified and communicated to all students and a concrete, specialized guidance system should be established to guide the minority of the students (13%) who don't fully understand the basic properties of higher educational institutions. 2. The institutions should provide enough educational facilities and supply enough faculty memebers to solve the problem of accomodating the large numbers of students. At the same time, they should suggest how students should learn positively and effectively to gain an expert knowledge, and how professors should gain public confidence in grade evaluation. Accompanying those measures, the government should develop a good policy to expand and distribute job opportunities to college graduates. 3. The admission quota should be controlled depending on the rate of naturally failed students, and then the students' unease and suppression caused by excessive competition can be relieved. In addition, it is advisable that the banished students should be allowed to transfer to University of the Air without regard to their grades. 4. An education devised to let students have a sound sense and way of thinking should be accompanied by a guidance system which their seniors, parents and society take part in. 5. An atmosphere conducive to sweet and well-rounded friendship among classmates should be created, sound extra-curricular activities should be encouraged and the number of students and adviser professor is in charge of should be lessened to a reasonable number.

ZMP를 이용한 굴삭기의 안정성에 관한 연구

최종환,엄혁,임태형,김승수,양순용,이병룡,안경관 한국공작기계학회 2003 한국공작기계학회 춘계학술대회논문집 Vol.2003 No.-

The hydraulic excavator has been a popular research object for automation because of its multi-workings and economic efficiency. When it works crane tasks, most of disasters happen. The stability of the excavator having crane function has a close relation with excavator's posture, motion and load. In this paper, the stability of tipping-over has been analysed using Zero Moment Point(ZMP),

두부외상환자에서의 예후인자

최성혁,문준동,김수진,문철규,이성우,홍윤식 대한응급의학회 2001 대한응급의학회지 Vol.12 No.2

Background: Predicting outcome after head trauma is of great interest for clinicians, especially in the early stage. It may provide a basis for therapeutic strategies and may be helpful to select different approaches. But, reliable outcome prediction from head trauma is still unresolved. The purpose of this study is to determine which clinical parameters can be used effectively after an event of head trauma. Methods: In our study we studied head trauma patients who came to the Emergency department of Korea University Medical School Anam Hospital from the 1st of June 1998 to 31th of January 2000, looked into medical records, and studied the records in a retrospective manner. The head trauma patients were divied into two group, a) favourable outcome-related and b) unfavourable outcome-related. The two groups were then subdivided according to their sex, age, the mechanism of their injury, the time they came in, alcohol drinking, loss of consciousness, vomiting, pupil change, previous medical illness, associated injuries and were seperately compared and analyzed. And the factors affecting Glasgow Outcome Scale(GOS) were analyzed in the parameters of Injury Severity Score(ISS), Revised Trauma Score(RTS), Glasgow Coma Scale(GCS), motor score of GCS(mGCS), Marshall Computed Tomographic Classification(MCTC). Statistically, t-test and Mann-Whistney rank sum test using Jandel-sigma were used in the study and then were assessed in Chi-square analysis methods. The statistical significance was determined at a level of p less than 0.05. Results: The total of the head trauma patients, added up to 129 people, 99:males and 30:females. Among this sum, 99 patients showed a favourable outcome and 30 patients showed an unfavourable outcome at discharge. The causes of injury included: automobile accident in 42 cases; fallss in 26; assaults in 6; and accidental-slipping injury etc in 55 cases. 12 patients had bilateral unreactive pupils on admission, 2 had unilateral reactive pupils, and 113 had bilateral reactive pupils. Compared to the favourable outcome-related head trauma group, the unfavourable outcome-relared head trauma group had more history of loss of consciousness, unreactive pupils and tended to have previous medical illness. There were no difference in alcohol related, vomiting and associated injuries between two groups(favourable outcome-related head trauma group: unfavourable outcome-related head trauma group). Substantial difference were observed in GCS, mGCS, ISS, RTS, MCTC between two groups. Patients with unfavourable outcome had a significantly higher ISS, lower RTS, lower mGCS. After MCTC, patients with mass lesion had unfavourable outcome than patients with diffuse injury. Conclusion: Age, history of loss of consciousness, previous medical illness and unreactive pupil change are predictives of outcomes of head trauma patients with respect to Glasgow outcome scale. The lower GCS, lower RTS, lower mGCS, higher ISS, mass lesion based on CT scan provide poorer prognostic outcome in patients with head trauma. Use of prognostic factors thorough complete history taking and physical examination would provide useful prognostic information and facilitate improved therapeutic decision-malting in head-injuried patients.

3분 및 4분 상완골근위부 골절에서의 외반형 및 내반형에 따른 임상적 비교

최창혁,권굉우,김신근,이상욱,신동규,이승진 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 수술적으로 치료한 3분, 4분 상완골 근위부 골절을 외반형과 내반형으로 재분류하여 임상적 결과를 비교하고자 하였다. 대상 및 방법 : Neer 분류상 3분, 4분 상완골근위부 골절로 분류된 21례에 대해 수술적 치료를 시행하고 12개월 이상 추시된 증례를 대상으로, 골절부위의 각형성, 상완골두의 방향성, 그리고 우세 전위결절의 양상에 따라 외반형과 내반형으로 재분류하여 UCLA shoulder rating scale에 따른 기능적 평가를 시행하였다. 결 과 : 단순 방사선 소견을 기준으로 Neer의 3, 4분 상완골 근위부골절을 외반형과 내반형 및 각각의 아형(subtype)으로 분류할 수 있었다. 견관절 반치환술을 시술한 2례를 제외하고 분석한 각 그룹의 UCLA 기능적 평가는 외반형에서 양호 이상의 결과가 9례중 8례(89%), 내반형에서 10례중 4례(40%)로 외반형에서 더 우수한 임상적 경과를 보였다. 결 론 : 상완골 근위부 골절에서 골두의 방향성은 골절의 각형성 및 우세 전위결절의 양상과 높은 상관관계를 가졌으며, 내반형의 경우 혈행과 신경장애가 좀더 빈번하고 예후도 불량한 것으로 나타났고, 이러한 경우 수술시 도달 방법, 연부조직 상태에 대한 평가가 더욱 신중하게 고려되어야 할 것으로 생각되었다. Purpose : We reclassified three-and four-part proximal humerus fracture by Neer's classification into valgus & varus type, and compared the results of these groups. Materials & methods : 21 cases classified as three- and four-part fracture in Neer's classifiation were treated surgically and followed for 12 months. We reclassified the 21 cases vlagus and varus type fractures, according to angulation of fractures, facing of humeral head, and dominant displaced tuberosity. Functional evaluation was done by UCLA shoulder rating scale. Results : Neer's three- and four-part proximal humerus fractures could be reclassified based on angulation, facing of humeral head, and dominant tuberosity displacement. The functional results according to UCLA shoulder rating scale were good or excellent in 8 of 9 cases of valgus type(89%), and at 4 in cases of varus type(40%). The clinical result of the valgus type was better than that of the varus type. Conclusion : Based on reclassification system of proximal humerus fractures, clinical results and radiographic findings including angulation, facing of head and domonant tuberosity displacement showed close relationship. Neurovascular complication were more frequent in the varus type. Therefore, careful evaluation including surgical approach and soft tissue status should be considered in the varus type of complex proximal humerus fracture.

'형용사+명사1+와/과+명사2'의 수식 관계 모호성 해결을 위한 MODELING 제안

崔宰赫,李相祚 新羅大學校 1992 論文集 Vol.34 No.1

About the phrase of 'Adjective+Noun1+and+Noun2' among the ambiguity of modifying scope to generate in Korean processing, this paper proposes modeling to resolve the ambiguity by adjective and noun group modifying in real world, not by the semantic classification of adjective and noun. Especially, we can dynamically construct the noun and adjective dictionaries in the extension of words.

골수강내 금속정 및 나사못 맞물림을 이용한 경골의 치료

최창혁,권굉우,김신근,이상욱,강창진 대구효성카톨릭대학교 1997 연구논문집 Vol.56 No.2

Fracture of the tibial shaft is the most common among the long bone fractures, and it is difficult to treat because of a high incidence of delayed union, nonunion and malunion. Interlocking Intramedullary mailing is considered to be valuable method in treating long bone fracture such as tibial fracture these days because it enables rigid fixation, early joint motion exercise and weight bearing. Between April 1993 and March 1997, we treated 63 cases of tibia fractures with interlocking intramedullary nailing. The results were as follows: 1. Among the 63 cases, 51 cases were closed fractures and 12 cases were open fractures. 2. Static interlocking nailing was done in all cases and dynamization was done in 7 cases in postoperative 13 weeks. 3. Average union time was 19.9 weeks, 19 weeks with closed tibia fracture and 2.4 weeks with open tibia fracture. According to fracture site, 22 weeks with proximal tibia fracture, 19.2 weeks with mid-tibia fracture and 21.4 weeks with distal tibia fracture. According to the Winquist-Hansen classification, Type I was 19.8 weeks, Type Ⅱ was 20.4 weeks, Type Ⅲ was 22 weeks and Type Ⅳ was 26 weeks. 4. Weight bearing was started at the time of subsidence of pain and tenderness of the fracture site, 11.5 weeks with closed fracture and 12.3 weeks with open fracture. 5. According to the functional result of Klemm and Borner, 44 cases were excellent, 9 cases were good, 7 cases were fair and 3 cases were poor.

영상처리를 위한 범용성과 지능성을 갖는 병렬 처리기 구조

백순흠,박종원,최성혁 공주영상정보대학 2000 논문집 Vol.7 No.-

운용 측면에서 병렬 처리 방법을 SIMD 구조와 Semi-MIMD 구조를 적용할 수 있도록 하여 병렬 처리 프로그램 작성의 용이성과 적용 대상 범위를 증대시켜 사용자로 하여금 병렬 처리 알고리즘을 제안한 병렬 처리기를 이용하여 구현 시에 편의성을 제고하였다. 성능 개선 측면에서 영상 데이터를 처리하는 과정에서 많이 적용되는 Matrix 연산을 적용 예로 하며 일반적인 직렬 처리 계산 과정과 제안한 병렬 처리기 계산 과정을 비교한 결과, 계산 결과가 일치하였고 성능면에서는 2배의 성능 개선 효과를 얻을 수 있었다. 2배의 성능 개선 효과는 병렬 처리기의 처리기가 4개인 경우이므로, 처리기의 개수가 증가하면 증가된 개수에 따라 그 성능 개선 폭은 더욱 증대될 것이다.

수종의 접착제를 사용한 아말감 수복시의 미세 변연 누출에 관한 연구

최상철,박준일,권혁춘 大韓齒科保存學會 1997 Restorative Dentistry & Endodontics Vol.22 No.1