슬개골 골절의 수술적 치료

김동휘,김정만,고인준 대한골절학회 2004 대한골절학회지 Vol.17 No.4

목적 : 슬개골 골절 치료의 일반적 치료 지침을 얻고자 하였다. 대상 및 방법 : 평균 2.2년간 추적이 가능하였고 내고정을 시행한 23례를 대상으로 하였다. 주 고정 방법은 금속 나사 7례, Dall-Miles' cable을 이용한 환상 강선 고정 14례, 그리고 이들 두 가지 방법의 겸용이 2례였다. 추가 공정으로는 장력대 강선 고정 9례, 부하배분케이블 고정 3례 그리고 이들 두 가지 겸용이 5례였다. 수술 후 고정은 굴곡위로, 가능하면 90°고정을 7일간 시행하였다. 결과 : 전 예에서 유의한 골편 전위 없는 골유합이 이루어졌다. 일 례를 제외한 전 례에서 완전 운동 범위를 얻을 수 있었다. 결론 : 고정 방법의 선택은 골절의 분쇄 정도, 골의 강도, 골절 부위 및 연부 조직의 손상 정도에 따른 개별화가 필요하다. 강력한 고정, 초기 굴곡위 고정과 조기 관절운동으로 좋은 결과를 얻을 수 있었다. Purpose : To establish general guide line in the treatment of the patellar fracture. Materials and Methods : Twenty three patellar fractures followed for 2.2 years in average, treated with internal fixation were evaluated retrospectively. The primary fixations were the metal screw fixation in 7, the Dall-Mlles' cable circumferential fixation in 14 and combination of both methods in 2 cases. The additional fixations were the tension band wiring in 9, the load sharing cable fixation in 3 and combination of both methods in 5 cases. The initial postoperative immobilazation of the knee joint in flexion, preferably 90°, for 7 days was effective to gain full range of motion. Results : Complete union without displacement was achieved in all cases. Full ROM was achieved in all cases except one. Conclusion : The choice of internal fixation need to be individualized according to the level of comminution, bone strength, fracture site and soft tissue damage. A strong internal fixation, initial immobilization in flexion followed by early ROM exercise were important factors to gain good result.

다양한 진로모색을 위한 치위생학과 학생과 선배 치과위생사의 심층면담

경혜인 ( Hye In Kyung ),김영우 ( Young Woo Kim ),엄제현 ( Jae Hyun Eom ),이지희 ( Ji Hui Lee ),조은정 ( Eun Jung Cho ),박고은 ( Go Eun Park ),김남희 ( Nam Hee Kim ) 한국치위생과학회 2015 치위생과학회지 Vol.15 No.2

The aim of this study was to provide practical information regarding career exploration to dental hygiene students. This study interviewed 15 senior dental hygienists (graduates of Y University Dental Hygiene program) who have worked in non-clinical fields for about three months from January 14, 2014 to April 28. The most frequently mentioned pieces of information that the senior dental hygienists wanted to convey to dental hygiene students were as followed. Contrary to popular belief, clinical experience was also required in non-clinical fields as the importance of clinical experience was quite often and widely emphasized and applied in such fields. High academic excellence and clinical performance were expected of junior dental hygienists and the senior dental hygienists expressed their hope for their juniors to pioneer new fields and areas of work that a dental hygienist can do. Most of the senior dental hygienists pointed out that to develop technical tools for career exploration as early as possible, such as during undergraduate years and to think about which career path to take, whether it is clinical or academic were significantly important factors for desirable career outcomes. Based on the results of this study, undergraduate dental hygiene students should be provided with opportunities to consider and explore various career paths during their undergraduate years and to communicate with their seniors for hands-on experience-based advices. This would in turn broaden each student`s perspective beyond their knowledge or thought about the professional filed of dental hygiene. It was found that the majority of the senior dental hygienists agreed that their clinical experience was the source of their self-competence as a dental hygienist. Our study could be utilized as a valuable resource for future dental hygienists who wish to work in non-clinical fields.

하지의 족관절, 족부 3D CT검사에서 보조기구 이용의 유용성 고찰

김민규(Min gyu Kim),함인근(In guen Ham),문일봉(Il bong Moon),범희남(Hui nam Bum),전주섭(Ju seob Jeon) 대한전산화단층기술학회 2013 대한CT영상기술학회지 Vol.15 No.1

목적 : 하지의 족관절, 족부 3D CT검사에서 보조기구 이용이 보조기구를 이용하지 않는 검사군과 비교하여 유용한 검사법임을 알아보고자 하였다. 대상 및 방법 : 뼈 성장판이 융합하고 특별한 외상이 없는 남,녀 60명을 대상으로 보조기구를 사용하는 실험군과 보조기구를 사용하지 않는 대조군 그리고 참조군 (한국 정상 성인의 족관절 각)을 서로 비교하여 실험군과 대조군이 참조군과 비교하여 어떤 의미를 갖는지 분석하였고 실험군과 대조군을 영상의학과 전문의 1인, 정형외과 전문의 1인, 방사선사 1인이 영상의 질을 평가 하였다. 결과 : 보조기구를 이용한 실험군이 보조기구를 이용하지 않는 대조군과 비교하여 Tibial angle은 보조기구 사용 군이 평균 68.41° 보조기구를 사용하지 않는 군이 평균 72.66°로 두 계측각 모두 참조군(63.5~65.2)과 비교하여 범위를 벗어난 수치를 보여주었다. Fibular angle은 보조기구를 사용하는 군이 평균 62.32° 보조기구를 사용하지 않는 군이 67.03°로 참조군 평균값(55.9~56.9)에 포함되지 못하였으나, Talocalcaneal angle 측면에서는 평균 39.9° 참고치 39.9~41.4° Tuber~joint(Bohler’s) angle 평균 32.4° 참고치 30.7~31.6 Calcaneus-tibia angle 평균 83.2° 참고치 81.9~93.0° Calcaneus-floor angle 평균 15.7° 참고치 12.4~13.0°로 4계측각 모두 보조기구를 사용하는 군이 보조기구를 사용하지 않는 군에 비해 참조군 평균 값에 근접 하거나 포함 되었고 대조군은 평균값이 모두 참고치를 벗어났다. 영상의 질 평가 결과 보조기구 사용 군이 그렇지 않는 군과 비교하여 전반적으로 더 뛰어난 평가 결과를 기록하였다. 결론 : 하지의 족관절, 족부 CT에서 실험군과 대조군의 계측 값은 실험군이 참조군의 계측값의 평균값에 포함 되거나 거의 근접한 수치를 보여 주었고 대조군은 실험군의 평균값에 전반적으로 벗어난 수치를 보여주었다. 영상의 질 평가결과 기구를 사용 하는 군이 기구를 사용하지 않는 군과 비교하여 전체적으로 뛰어난 평가 결과 값을 보여 주었다. 결론적으로, 하지의 족관절, 족부 CT검사에서 기구 사용은 영상의 질이 뛰어나고 평균적으로 일정한 형태와 분포도를 보여 주어 기구 사용이 보다 더 유용한 검사법임을 보여주었다. Purpose : To know of usefulness of Lower Extremity Fixation Device(LFD) on ankle, foot 3D CT compare with none use of LFD. Materials and method : To 60 peoples whose tibial growth plate was closed and not injured, we scanned Ankle or Foot 3D CT: A group were used LFD and B group were not used. Then we measured A and B group’ several joints angle compare with reference group(Korean’ standard adult ankle joint angle). Datum and image qualities were analyzed by a Radiologist, a Orthopedist and a Radiation Technologist. Results : At tibial joint, A’ mean angle is 68.41°±5.05 and B’ mean angle is 72.66°±,4.89 they were beyond reference range(63.5°~65.2°). At fibular joint, A’ mean angle is 62.32°±1.76 and B’ mean angle is 67.03°±5.99, they were beyond reference range( 55.9~56.9). However at Talocalcaneal joint, A’ mean lateral angle 39.9° is in reference range(39.9°~41.4°) but B group(34.15) is not in. And also at Tuber joint(Bohler’s), A’ mean angle 32.4° is in reference range(30.7°~32.6°) but B group(28.75) is not in. At Calcaneus-tibia joint, A’ mean angle 83.2° is in reference range(81.9°~93.0°) but B group(95.24) is not in. At Calcaneus-floor, A’ mean angle 15.7° is near to reference range(12.4°~13.0°) but B group(18.71) is far from. The standard deviation of A group showed a more than B constant distribution. The results of measure Image quality, A group is good than B group. Conclusion : On lower extremity ankle, foot CT, A group is in reference range or near but B group is generally beyond to reference range. In image quality measure, A group is good than B group. In conclusion, Use of LFD on lower extremity ankle, foot CT is similar to Korean’ standard adult ankle joint angle and is good in image quality than none use of LFD as well.

골다공증 환자에서 신허와 골밀도의 상관성에 대한 관찰연구

김윤주 ( Yun Joo Kim ),강재희 ( Jae Hui Kang ),곽규인 ( Kyu In Kwak ),이현 ( Hyun Lee ) 경락경혈학회 2014 Korean Journal of Acupuncture Vol.31 No.3

Objectives : This study was designed to analyze correlation in deficiency syndrome of kidney index and bone mineral density(BMD) in 130 osteoporosis patients. Methods : 130 women who were over 50 years old and visited in Department of Acupuncture & Moxibustion Medicine, Cheonan Oriental Hospital of Daejeon University from January 1, 2012 to December 31, 2013, answered the questionnaire consisting of symptom of deficiency syndrome of kidney, to determine the deficiency syndrome of kidney Index(DSKI). Grade of low back pain were measured in the visual analogue scale(VAS). BMD of the patients were determined by quantitative computerized tomography(QCT). Then, DSKI with BMD, VAS and age were analyzed by correlation analysis, variance analysis and Kruskal-Wallis test. Results : 1. Between DSKI and BMD, patients in total and in-their-50 s group did not show a statistically significant result, but in-their-60`s group and over-70 group showed a statistically significant result by correlation analysis. 2. Between DSKI and VAS, groups in total, in-the-50`s, 60`s, and over-70 groups showed a statistically significant resultby correlation analysis. Conclusions : DSKI and BMD of the patients group who are over 60, DSKI and VAS of the patiens over 50 years old were associated with each other.

The effect of alpha lipoic acid in a porcine in-stent restenosis model

Lim, Sang Yup,Bae, Eun Hui,Jeong, Myung Ho,Kim, Ju Han,Hong, Young Joon,Sim, Doo Sun,Kim, Yong Sook,Park, In Kyu,Ahn, Youngkeun,Song, Sun-Jung,Cho, Dong Lyun,Kim, Kyoung Seok,Kang, Jung Chaee Elsevier 2009 Journal of cardiology Vol.54 No.3

<P><B>Summary</B></P><P><B>Background</B></P><P>The aim of this study was to investigate the effect of alpha lipoic acid (α-LA) on a porcine in-stent restenosis (ISR) model.</P><P><B>Methods</B></P><P>In protocol 1, porcine vascular smooth muscle cells (PVSMC) were stimulated by granulocyte-colony stimulating factor (G-CSF) in the presence or absence of α-LA. MTT (3-[4,5-dimethylthiazole-2-yl] 2,5-diphenyl tetrazolium bromide) assay and western blotting were used to determine the cell growth inhibitory rate and anti-inflammatory effect associated with nuclear factor-κb (NF-κb) and extracellular signal-regulated kinase (ERK). In protocol 2, 28 days after balloon overdilation injuries, 24 bare metal stents were placed in coronary artery of 12 pigs. The pigs were randomly divided to receive control diet with or without α-LA (100mg/kg). In protocol 3, 8 control stents and 8 α-LA coated stents were randomly implanted in 2 coronary arteries of 8 pigs and follow-up coronary angiogram and histopathologic assessment were performed 4 weeks after stenting.</P><P><B>Results</B></P><P>Protocol 1. The proliferation of PVSMC was inhibited and protein expression of NF-κb and ERK were attenuated by α-LA pretreatment. Protocol 2<I>.</I> On histopathologic analysis, the neointimal area (4.0±1.0mm<SUP>2</SUP> vs. 1.5±0.7mm<SUP>2</SUP>, <I>p</I><0.001) and histopathologic area of stenosis (66.7±10.7% vs. 24.2±9.7%, <I>p</I><0.001) were reduced in the α-LA feeding group compared to controls. Protocol 3. On histopathologic analysis, the neointimal area (3.9±0.8mm<SUP>2</SUP> vs. 1.0±0.4mm<SUP>2</SUP>, <I>p</I><0.001), and the histopathologic area of stenosis (67.1±8.8% vs. 17.4±10.0%, <I>p</I><0.001) were reduced in the α-LA coated stent group compared to the control stent group.</P><P><B>Conclusions</B></P><P>α-LA feeding and α-LA coated stents inhibit neointimal hyperplasia in porcine ISR, possibly through inhibiting the activation of NF-κb pathway and proliferation of PVSMC.</P>

Is renal replacement therapy necessary in deceased donor liver transplantation candidates with hepatorenal syndrome?: a 2-year experience at a high-volume center

Gil-Chun Park,Shin Hwang,Dong-Hwan Jung,Gi-Won Song,Chul-Soo Ahn,Ki-Hun Kim,Deok-Bog Moon,Tae-Yong Ha,Young-In Yoon,Hui-Dong Cho,Jae-Hyun Kwon,Yong-Kyu Chung,Sang-Hyun Kang,I-Ji Jung,Jin Uk Choi,Sung- 대한외과학회 2020 Annals of Surgical Treatment and Research(ASRT) Vol.98 No.2

Purpose: Hepatorenal syndrome (HRS) is a fatal complication in patients with end-stage liver disease awaiting liver transplantation (LT). HRS often develops in patients with high model for end-stage liver disease (MELD) score. This study investigated the outcomes of peritransplant management of HRS in a high-volume LT center in Korea for 2 years. Methods: A total of 157 recipients that deceased donor liver transplantation (DDLT) from January 2017 to December 2018 were included. In-hospital mortality (IHM) was analyzed in relation to pre- and posttransplant application of renal replacement therapy (RRT). Results: Primary diagnoses for DDLT were alcoholic liver disease (n = 61), HBV-associated liver cirrhosis (n = 48), retransplantation for chronic graft failure (n = 24), and others (n = 24). Mean MELD score was 34.6 ± 6.2 with 72 patients at Korean Network for Organ Sharing MELD status 2 (45.9%), 43 at status 3 (27.4%), 36 at status 4 (22.9%), and 6 at status 5 (3.8%). Pretransplant RRT was performed in 16 patients (10.2%) that did not show IHM. Posttransplant RRT was performed in 69 patients (44.0%), for whom IHM incidence was 15.9%. In 53 patients that had undergone de novo posttransplant RRT, IHM incidence increased to 20.8%. IHM in the 88 patients not requiring RRT was 2.3%. Conclusion: The majority of adult DDLT recipients in Korean MELD score-based allocation system have very high MELD scores, which is often associated with HRS. Pretransplant RRT appears to improve posttransplant survival outcomes. We thereby recommend that, if indicated, pretransplant RRT be performed while awaiting DDLT.

TCP/IP 상에서 FMS 프로토콜 구현

황인휘,김대주,홍승호 漢陽大學校 工學技術硏究所 2000 工學技術論文集 Vol.9 No.1

필드버스는 자동화 시스템에서 필드 디바이스들간의 실시간 통신을 제공하는 통신망이다. 본 논문에서는 Profibus와 FOUNDATION Fieldbus을 인터넷에 접속시키기 위해 이들의 응용계층인 FMS(Fieldbus Message Specification)를 TCP/IP 상에서 동작하도록 구현하였다. 본 논문에서 FMS 서비스는 서비스 기술 블록과 데이터 블록의 두 부분으로 나누어 구현하고, 이와함께 FMS 프로토콜의 사용자 접속 S/W를 개발하였다. 본 연구에서 구현된 FMS 프로토콜은 두 대의 PC를 Ethernet으로 연결하여 구성한 클라이언트-서버 모델에 탑재하여 그 성능을 검증하였다. Field bus is the network system which provides real-time communication to field devices in the automation system. In order to integrate fieldbus and Internet, this paper presents an implemetation method of FMS(Fieldbus Message Specification) protool, which is the application layer of Profibus and FOUNDATION Fieldbus, on the TCP/IP. In this study, FMS services are implemented in two blocks; Service Description Block and Data Block, and the user interface S/W is developed. The FMS protocol implemented in this paper is verified using two computers, connected with Ethernet card, each of which plays the role of client and server.

연계적 공학해석 교육을 위한 워크플로우 기반 도구 개발 및 활용 시나리오 제안

신정훈(Jung Hun Shin),김한기(Han Gi Kim),채희승(Hui Seung Chae),전인호(In Ho Jeon),이종숙(Jongsuk Ruth Lee) 대한기계학회 2018 대한기계학회 춘추학술대회 Vol.2018 No.6

공학현장에서 소프트웨어의 활용성 및 중요성은 날로 증대되고 있으며, 따라서 공학설계 단계에서 해석 소프트웨어의 활용 및 이해는 공학도의 핵심역량이 되었다. 본 연구에서는 다수의 해석영역 혹은 해석분야를 가진 현장의 복합적 시스템 대상 공학교육을 위한 새로운 전산 환경을 개발하고 활용 시나리오를 제시하였다. KISTI에서는 개별 해석 연구자들이 개발한 in-house 소프트웨어들을 탑재할 수 있는 계산 플랫폼의 하위모듈로서 워크플로우 실행환경을 개발하였으며, 이를 활용하여 유동, 구조, 최적설계 등의 다양한 단위 소프트웨어들을 서로 연계실행할 수 있게 되었다. 그래서 본 연구에서는 이러한 연계해석 실행환경을 공학해석 및 공학설계 융합형 교육에 활용할 수 있는 활용 시나리오를 제시하였고, 이를 적절히 적용하면 실제 현장에서의 공학해석 과정에 대한 큰 그림에 대한 이해 속에서 공학도 각자의 해석분야에 대한 전문성을 높일 수 있을 것으로 기대한다. The importance of software in the engineering field is increasing day by day, so the utilization and understanding of the simulation software in the engineering design stage has become the core competence of the engineer. This study presents a new software education method for multiple systems in the field of mechanical engineering using a workflow execution environment as a sub-module of a computational platform (called EDISON platform) that can incorporate in-house software tools-developed by many simulation tool developers. It can execute not only individual software tools such as fluid flow, structure, optimal design, but also conduct connective executions of multiple software tools. Based on this simulation environment, a methodology was proposed that can be applied to convergence types of engineering educations. By properly using this methodology, it is expected that beginning engineers could encourage their specialties understanding the big pictures of the analysis processes.

1970年度 釜山市 및 慶南地方에서 콜레라流行時 설사患者에서 分離한 V. parahaemolyticus 에 對한 硏究

梁學道,朱進宇,朴鍾修,黃仁壽,金政輝,金載洙,金熙悳,朱炳七 中央醫學社 1972 中央醫學 Vol.22 No.3

The authors made a study on the isolation of V. parahaemolyticus from diarrheal patients when cholera El Tor epidemic in Pusan and Kyungnam province in summer 1970. The authors made an attempt to bacteriological identification, Kanagawa phenomenon (hemolytic activity) on the modified N agatsuma blood agar plates, serotyping with slide agglutination and comparative sensitivity test of V. parahaemolyticus strains isolated to eight different chemotherapeutic agents including Trimethoprim/Sulfamethoxazole (Bactrim). The results were obtained as follows 1. Kanagawa phenomenon to 29 V. parahaemolyticus isolated from diarrhea] patients were all positive. 2. Serotypes were classified as pooling KI anti-serum (3 cases : K3???1 case, K4..?1 case, and K7???1 case), pooling KII anti-serum (15 cases : K9...1 case, K12??.7 cases, K12...2 cases, K13???2 cases, K15???3 cases), pooling KIII anti-serum (2 cases : K19..1 case, K23???1 case), pooling KIV anti-serum (3 cases : K2s??-2 cases, K28??.1 case), and pooling KV anti-serum (6 cases : K33... 3 cases, K38-3 cases). 3. Sensitivity test to colistin containing 1000 units with paper disk method to the 29 strains of V. parahaemolyticus were as follows 25 strains (84. 1%) were showed 16-19 mm, and 4 strains (15. 9%) were showed 12 mm of inhibition zone. 4. Sensitivity test to eight different chemotherapeutic agents with paper disk method to the 29 strains of V. parahaemolyticus were sensitive to Bactrim, tetracycline, and chloramphenicol (100%), but resistant to amphicillin, sulfadiazine, methicillin, and penicillin G (100%).

Non-vitamin K antagonist oral anticoagulants have better efficacy and equivalent safety compared to warfarin in elderly patients with atrial fibrillation: A systematic review and meta-analysis

Kim, In-Soo,Kim, Hyun-Jung,Kim, Tae-Hoon,Uhm, Jae-Sun,Joung, Boyoung,Lee, Moon-Hyoung,Pak, Hui-Nam Elsevier 2018 Journal of cardiology Vol.72 No.2

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>To evaluate the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in elderly patients (aged ≥75 years) with atrial fibrillation (AF), depending on dose and/or renal function.</P> <P><B>Methods</B></P> <P>After systematically searching the databases (Medline, EMBASE, CENTRAL, SCOPUS, and Web of Science), 5 phase III randomized controlled trials and reported data according to subgroups of elderly/non-elderly AF patients, comparing any NOACs and warfarin were included. The primary efficacy and safety outcomes were stroke/systemic thromboembolism and major bleeding.</P> <P><B>Results</B></P> <P>(1) NOACs showed better efficacy than warfarin in elderly patients [RR 0.83 (0.69–1.00), <I>p</I> =0.04, <I>I</I> <SUP>2</SUP> =55%], but equivalent efficacy in non-elderly patients. (2) NOACs reduced major bleeding compared to warfarin in non-elderly (<I>p</I> <0.001) and had comparable safety to warfarin in elderly patients. (3) Even in elderly patients with moderately impaired renal function, NOACs had a safety profile comparable to that of warfarin for major bleeding if dose reduction was reached appropriately [pooled RR 0.82 (0.35–1.88), <I>p</I> =0.63, <I>I</I> <SUP>2</SUP> =63%]. (4) All-cause mortality was lower with NOACs in non-elderly patients [RR 0.89 (0.83–0.95), <I>p</I> =0.001, <I>I</I> <SUP>2</SUP> =0%], and with standard-dose NOAC group of elderly patients [RR 0.93 (0.86–1.00), <I>p</I> =0.04, <I>I</I> <SUP>2</SUP> =0%] compared to warfarin.</P> <P><B>Conclusions</B></P> <P>For elderly patients (aged ≥75 years), NOACs showed better efficacy and equivalent safety compared to warfarin even in those with moderately impaired renal function. All-cause mortality was lower with standard-dose NOACs compared to warfarin in the elderly patient group.</P> <P><B>Systematic review registration</B></P> <P>The protocol of this meta-analysis was registered on PROSPERO under CRD42016047922 (https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016047922).</P> <P><B>Highlights</B></P> <P> <UL> <LI> Standard-dose non-vitamin K antagonist oral anticoagulant (NOACs) had better efficacy than warfarin in elderly patients (aged ≥75 years). </LI> <LI> NOAC reduced major bleeding compared to warfarin in non-elderly patients (aged <75 years). </LI> <LI> NOAC had a comparable safety to warfarin in elderly patients. </LI> <LI> Even in elderly patients with estimated glomerular filtration rate<50mL/min, NOACs had comparable safety to warfarin. </LI> <LI> Mortality was lower with standard-dose NOAC in elderly patients than warfarin. </LI> </UL> </P>