Adult Patients with Congenital Muscular Torticollis Treated with Bipolar Release : Report of 31 Cases

Lee, Gun Sang,Lee, Myung Ki,Kim, Woo Jae,Kim, Ho Sang,Kim, Jeong Ho,Kim, Yun-Suk The Korean Neurosurgical Society 2017 Journal of Korean neurosurgical society Vol.60 No.1

Objective : We assessed the surgical results of bipolar release in 31 adult patients with uncorrected congenital muscular torticollis (CMT) and more than 12 months of follow-up. Methods : Thirty-one patients underwent a bipolar release of the sternocleidomastoid muscle (SCM) and were retrospectively analyzed. The mean follow-up period was 14.9 months (range, 12-30). The mean age at time of surgery was 30.3 years (range, 20-54). Patients were evaluated with a modified Lee's scoring system, cervicomandibular angle (CMA) measurement, and a global satisfaction rating scale using patient self-reporting. Results : The modified Lee's scoring system indicated excellent results in 4 (12.9%) patients, good in 18 (58.1%), and fair in 9 (29.0%) at the last follow-up after surgery. The improvements in neck movement and head tilt were statistically significant (p<0.05). The preoperative mean CMA was $15.4^{\circ}$ (range, 5.4-29.0), which was reduced to a mean of CMA of $6.3^{\circ}$ (range, 0-25) after surgery (p<0.05). The global satisfaction rating scale was 93.7% (range, 90-100). A transient sensory deficit on the ipsilateral lower ear lobe was noted in three cases. No significant permanent complications occurred. Conclusion : Bipolar release of the SCM is a safe and reliable technique for the treatment of CMT in adults.

조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

제대군인 취업지원 프로그램 구안

정철영,서우석,김성호,이예성,최동선,이종범,이성식,이건남,양안나,김성남 한국직업능력개발원 2007 직업능력개발연구 Vol.10 No.1

이 연구의 목적은 중·장기복무를 마치고 제대하여 재취업하고자 하는 제대군인들의 원활한 전직을 돕기 위한 제대군인 취업지원 프로그램의 개발방향과 개발안을 제시하는 데 있다. 이를 위해 국내·외에서 이루어지고 있는 제대군인 취업지원 프로그램의 실태를 분석하였고, 제대군인 취업지원 프로그램에 대한제대예정군인 및 제대군인과 기업체의 요구를 분석하여 시사점을 도출하였다. 그리고 이를 기초로 제대군인 취업지원 프로그램의 기본방향과 전체 흐름도, 세부 프로그램 개발안을 제시하였다. 이를 위해서 활용된 연구의 방법은 문헌연구, 조사연구, 전문가협의회 등이다. 이 연구를 통해서 제시된 제대군인 취업지원 프로그램의 개발방향과 개발안을 토대로, 일관되고 지속적인 수요자 중심의 제대군인 취업지원 프로그램의 개발이 가능할 것이다. The purpose of this study is to suggest plans and directions for developing. job-seeking support program for military veterans. The study is conducted through literature review, survey and interview. The results of this study are as follows: ⒧ basic development directions and flowchart of job-seeking support program for military veterans are suggested; and ⑵ development plans for sub-programs are suggested.

품종별 쌀의 이화학적 특성과 증편제조 적성과의 관계

우경자,이은아,황홍구,이건순 동아시아식생활학회 1998 동아시아식생활학회지 Vol.8 No.4

This study was carried out in order to investigate the processing adaptability of Jeung-pyun. We used rice materals that were developed domestically for improving the utilization of rice. Six cultivars(Ilpoombyeo, Hwasungbyeo, Dasanbyeo, Daeribbyeo 1, Hyangmibyeo 1, Hyangmibyeo 2) of rice were used for making Jeung-pyun. In physicochemical properties of rice, Hwasungbyeo had the highest amylose content(20.4%) and Hyangmibyeo 2 had the lowest one(14.9%). Lipid content was 0.23%(Daeribbyeo 1)~0.43%(Ilpoombyeo), protein content was 7.94%(Ilpoombyeo)~8.43%(Dasanbyeo), and ash content was 0.15%(Hyangmibyeo 2)~1.24%(Daeribbyeo 1). In volume and specific volume of the 3 hour fermented Jeung-pyuns, Ilpoombyeo, Hwasungbyeo, Hyangmibyeo 2 were higher, but in the 7 hour fermented Jeung-pyuns, Dasanbyeo, Daeribbyeo 1, Hyangmibyeo 1 were higher. In the sensory evaluation of the test Jeung-pyuns, the overall quality of the 3 hour fermented Jeung-pyuns was not significantly different among the rice cultivars, whereas in the 7 hour fermented Jeung-pyuns Hyangmibyeo 2 had the lowest values. When the 7 hour fermented Jeung-pyuns were stored at 20℃, the hardness and brittleness of Jeung-pyuns were respectively increased, the cohesiveness was respectively decreased. The elasticity was not significantly different among the rice cultivars with storage days, and the gumminess was significantly difference between rice cultivars, respectively increasing during storage, but Hyangmibyeo 2 was the lowest, not increased. In instrumental characteristics of Jeung-pyuns, the hardness was correlated with amylose content and the brittleness and gumminess were highly correlated with the hardness.

후두결핵의 임상적 고찰

이동건,심우영,조재민,박현민,이진춘,왕수건 釜算慶南耳鼻咽喉科學會 1996 임상이비인후과 Vol.7 No.2

Ortho-Chlorobenzylidene Malononitrile(CS) 이 흰쥐 피부조직에 미치는 조직학적 영향에 관한 연구

이우용,최봉근,김잉곤,엄기일,정호삼,정호삼,류재만 한양대학교 의과대학 1998 한양의대 학술지 Vol.18 No.1

This study was undertaken to describe the fine structural changes of cytoplasmic organelles in epidermal cells, and the changes of volume and localization of collagen type Ⅰ in the dermis of rat skin by CS(Ortho-chlorobenzylidene malononitrile) application. The experimental animals, 100∼150gm of body weight rats(Sprague-Dawley strain), were sacrificed at 12 hours, 24 hours, 3 day and 5 day after CS application on the hair-shaved back skin. The specimens were prepared for ultrastructural findings, ultrathin sections were stained with uranyl acetate and lead citrate double stain and observed with Hitachi-600 electron microscrope. The others were incubated with rabbit anti rat type Ⅰ collagen antibody as primary antibody, and Goat anti rabbit IgG antibodies as secondary antibody And advidin-biotin-conjugated(ABC) peroxidase procedure was used. All of specimens for immune reactions were observed with light microscope. The results obtained were as follows. 1 Keratinocytes appeared fully necrotized after 3 days of CS application. The epidermis showed degeneration of basal lamina, enlargement of intercellular spaces and necrotic keratinocytes with vacuole and vesicles. And large keratohyalin granules were seen in the shrunken epidermal cells. 2 At 3 or 5 day after CS treatment, the normal cytoplasmic organelles of keratinocytes began to appear on the basal and prickel cells. 3 At 12 hour an 24 hour after CS treatment. The immune reaction of type Ⅰ collagen showed weak reaction in reticular layer of dermis. But at 3 day and 5 day after CS treatment, moderate immune reaction were seen in throughout the dermis. These results suggest that CS application to rak skin may induce changes of keratinocytes and reductive changes of type Ⅰ collagen in the dermis.

냉기 치료에 따른 둔근에서의 피부 및 근육내 온도 변화

정우성,김미정,박시복,이상건,김영호,양길태,장윤희 大韓再活醫學會 1998 Annals of Rehabilitation Medicine Vol.22 No.2

호중구 감소성 발열환자에게 경험적으로 투여한 Teicoplanin의 효과

이동건,임동석,최수미,박선희,유진홍,최정현,민우성,신완식,김춘추 대한감염학회 2004 감염과 화학요법 Vol.36 No.2

목적 : 호중구감소성 발열 환자에게 경험적으로 teicoplanin을 투여할 때의 효과를 알아보고자 전향적 연구를 시행하였다. 방법 : 2003년 7월부터 12월까지 가톨릭조혈모세포이식센터에 입원하여 항암치료 혹은 조혈모세포이식을 시행하고 호중구감소성 발열이 있는 환자 중 초기 항균요법에 반응이 없어 경험적 teicoplanin 투여가 필요한 49명을 대상으로 A, B 제조회사에서 제공한 teicoplanin을 무작위로 어느 한 쪽 치료군에 배정하여 투여하였다. 용량은 첫날 400㎎ 부하용량을 정맥내 bolus로 투여하고 매 24시간마다 200㎎ 유지용량을 투여하였다. 결과 : A군 27명, B군 22명이 연구에 참여하였고 대부분의 환자가 신독성이 있는 약제를 병용하고 있었다. A군 8명, B군 7명에서 그람양성균이 동정되었고, teicoplanin에 대한 내성률은 A군 22.2%, B군 28.6%로 유의한 차이는 없었다(P=1.00; 0.61<95%CI<1.95). 미생물학적 확인 감염이 있었던 환자 중 평균 53.3%에서 완치 혹은 개선의 반응이 있었고 양 군간 유의한 차이는 없었다(A군 4명 [50.0%], B군 4명 [57.1%], P=1.00; 0.29<95%CI<2.60). 미생물학적 제거율은 평균 62.5% (A군 55.6%, B군 71.4%)이었고 그 외 미생물학적 효과는 A군에서 제거 후 재발 2명(22.2%), 내성 2명(22.2%)이었고 B군에서 각각 0명(0.0%), 2명(28.6%)이었으며 양 군간 유의한 차이는 없었다(P=0.28). 발열기간(P=0.89), teicoplanin 사용기간(P=0.47) 및 전체적인 사망률(P=1.00; 0.78<95%CI<1.24)도 양 군간 유의한 차이는 없었다. 이상반응 중 신독성은 16.3% (A군 18.5%, B군 13.6%)에서 나타났고 양 군에 차이는 없었으며(P=0.72; 0.39<95%CI<3.51), 신기능 이상과 관련있는 약제를 적어도 2개 이상 병용하고 있었다. 피부발진은 A군에서 1명, B군에서 3명 발생하였다(P=0.31; 0.93<95%CI<1.34). 결론 : 호중구감소성 발열환자에게 teicoplanin을 투여하였을 때 임상적 반응률은 평균 53.3%(A군 50.5%, B군 57.1%), 미생물학적 제거율은 평균 62.5%(A군 55.6%, B군 71.4%)이었고 두 제조회사간 차이가 없었고 이상반응도 양 군간 차이가 없었다. 앞으로 국내 호중구감소증 환자에서의 teicoplanin의 적정 용량, 용법 등을 알기 위한 집단 약동학 등의 연구를 시행할 예정이다. Background : This study was done to elucidate the efficacy of teicoplanin as the empirical treatment for febrile neutropenia. Methods : Patients were randomized to two groups according to pharmaceutical company (company A or B). Total of 49 patients (A, 27; B, 22) with neutropenic fever were studied prospectively for 6 months (Jul. 2003-Dec. 2003). Patients received 400 mg i.v. once, then 200 mg i.v. once daily. Results : Groups were matched for all demographic variables. Most of the patients were concurrently receiving nephrotoxic drugs. Gram positive microorganisms were isolated in 8 patients for A and 7 patients for B. Resistance rate against teicoplanin was 22.2% in A and 28.6% in B (P=1.0; 0.61 < 95% confidence interval [Cl] < 1.95). Among the patients with microbiologically documented infection, clinical cure or improvement was seen in 4 (50%) of 8 patients for A and 4 (57.1%) of 7 patients for B (P=1.00; 0.29 <95%CI <2.60). Bacteriologic efficacy was assessed as follows; elimination in 5 (55.6%), elimination with relapse in 2 (22.2%), resistance in 2 (22.2%) out of 9 gram-positive bacteria for A and 5 (51.4%), 0 (0.0%), 2 (28.6%) out of 7 bacteria for B, respectively (P=Q.28). There were no significant differences in duration of fever, duration of use of teicoplanin, and overall mortality. The incidence of nephrotoxicity and ototoxicity was not significant. Conclusion : For using teicoplanin as the empirical therapy for febrile neutropenia, the rate of clinical, microbiological response, and nephrotoxicity was 53.3%, 62.5%, and 16.3% respectively with no significant differences between the 2 preparations of teicoplanin. Supplementary evaluation on the adequate dose and duration of teicoplanin may be required.

자연친화적 하천공사 기법이 적용된 경천에서의 어류상 변화

이승휘,권은호,이건우 호남대학교산업기술연구소 2008 산업기술연구논문집 Vol.14 No.-

자연친화적 하천공법이 적용된 하천의 어류상의 변화를 확인하고자 전라북도 순창군에 위치한 경천을 대상으로 모니터링을 수행한 결과 6목 10과에 속하는 33종 의 담수어류가 확인되었다. 이 중 한국고유종은 13종 이 었 고 멸종위기야생동물 2종까지 확인되었다. 우점종은 R. uyekii(26.37%), Z.platypus(26.14%), 그리고 C auratus (l9.11%) 으로 확인되었다. 각 조사지점별 어류상의 양상은 수제에서는 어식성 어류인 C herzi의 출현이 우세하였고, 도피 및 은신할 수 있는 공간을 제공하는 공법 적용 구간에서는 소형 어류를 용이하게 확인할 수 있었을 뿐 아니라 이들의 번식 양상까지 파악할 수 있는 하천 내 공간이 됨을 확인할 수 있었다. 하중도와 수제구간은 육식성 어종인 C. herzi와 Oplatycephala 등에게 사냥 및 서식에 유리한 조건을 제공하여 하천 내 생태적 안정성을 갖춰나가는 요인으로 작용하고 있음을 추정 할 수 있었다. In induction of close-to-nature streams construction, the prerequisite things of characters were analysis the hydraulic and careful consideration of environmental effects about related stream for least trial and error subsequently. The freshwater fish fauna were measured at eight close-to-nature streams construction as which wing deflectors, riffle, sediment basins, stone we protection, low flow revetment, stepping stones, side stream, and island in the Kyungcheon periodically. In analysing the ichthyofauna in Kyungcheon, suitable target fish species were Coreoperca herzi in wing deflectors, Coreoleuciscus splendidus in riffle, and Oryzias latipes in sediment basins in consideration that divergent construction of close-to-nature stream built Comparative study of attemptεd to divergent eight kinds of construction of close-to-nature streams through analysing the ichthyofauna in Kyungcheon. Suitable fish habitats were diversity index , evenness, richness, number of capture, number of species, stability of egg laying, and the area of rest as criteria significantly. The close-to-nature streams would be succeed with stream diversity in circumstances considerably.

승용차량 추돌에서 후진등 필라멘트의 변형에 관한 연구

이홍석,김태훈,조건우 內務部 國立科學搜査硏究所 2002 國立 科學 搜査 硏究所 年報 Vol.34 No.-