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      • KCI등재후보

        Surgical Results and Risk Factors for Recurrence of Lumbar Disc Herniation

        오정태,박기석,정성삼,정승영,김승민,박문선,김한규 대한척추신경외과학회 2012 Neurospine Vol.9 No.3

        Objective: Recurrent lumbar disc herniation has been defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. The aim of this study is to analyze outcomes and identify the potential risk factors for recurrent lumbar disc herniation. Methods: The authors retrospectively reviewed the cases of 178 patients who underwent open discectomy for single-level lumbar disc herniation. Visual analogue scales and modified Macnab criteria were used to compare the clinical outcomes between the recurrent group and the non-recurrent group. Sex, age, discectomy level, degree of disc degeneration, type of disc herniation, pain-free interval after first-operation, smoking status, and trauma were investigated as potential recurrence risk factors. Results: Of the 178 patients for whom the authors were able to definitely assess symptomatic recurrence status, 18 patients(10.1%) underwent revision surgery for recurrent disc herniation. The most common level involved was L4-L5(61%) and the mean period of time to recurrence was 18.7 months (6-61 months). There were 17 cases of ipsilateral herniation and 1 case of contralateral herniation. The types of herniation for which revision surgery was done were protrusion(3 cases), and transligamentous extrusion (14 cases). There were five excellent, eight good, and two fair results. Conclusion: Repeated discectomy for recurrent disc herniation produced unsatisfactory outcomes. Factors such as sex, type of disc herniation and traumatic events were found to be significant risk factors. Objective: Recurrent lumbar disc herniation has been defined as disc herniation at the same level, regardless of ipsilateral or contralateral herniation, with a pain-free interval greater than 6 months. The aim of this study is to analyze outcomes and identify the potential risk factors for recurrent lumbar disc herniation. Methods: The authors retrospectively reviewed the cases of 178 patients who underwent open discectomy for single-level lumbar disc herniation. Visual analogue scales and modified Macnab criteria were used to compare the clinical outcomes between the recurrent group and the non-recurrent group. Sex, age, discectomy level, degree of disc degeneration, type of disc herniation, pain-free interval after first-operation, smoking status, and trauma were investigated as potential recurrence risk factors. Results: Of the 178 patients for whom the authors were able to definitely assess symptomatic recurrence status, 18 patients(10.1%) underwent revision surgery for recurrent disc herniation. The most common level involved was L4-L5(61%) and the mean period of time to recurrence was 18.7 months (6-61 months). There were 17 cases of ipsilateral herniation and 1 case of contralateral herniation. The types of herniation for which revision surgery was done were protrusion(3 cases), and transligamentous extrusion (14 cases). There were five excellent, eight good, and two fair results. Conclusion: Repeated discectomy for recurrent disc herniation produced unsatisfactory outcomes. Factors such as sex, type of disc herniation and traumatic events were found to be significant risk factors.

      • 뇌하수체 거대선종으로 오인된 안장가로막 뇌수막종과 뇌하수체 선종 1례

        오정태(Jung Tae Oh),정승영(Seung Young Chung),김승민(Seong Min Kim),박문선(Moon Sun Park),정성삼(Sung Sam Jung),박기석(Ki Suk Park) 대한두개저학회 2009 대한두개저학회지 Vol.4 No.1

        The coexistence of a pituitary adenoma and another intracranial tumor is an uncommon finding. We report a rare case of diaphragm sellae meningioma and pituitary adenoma mimicking pituitary macroadenoma in a 41-year-old woman. The patient presented with bitemporal hemianopsia and was pregnant. Magnetic resonance imaging demonstrated a bright, homogeneously enhancing intra- and suprasellar mass, which was interpreted as a pituitary macroadenoma. Transsphenoidal extirpation was used on 1st operation and Orbitozygomatic craniotomy(transcavernous approach) was done on 2nd operarion because of a suspicion of nonsecreting pituitary macroadenoma. Histopathologically, the tumor was diagnosed as a pituitary adnoma and a meningothelial meningioma. Common carotid angiography before the second surgery revealed that the mass was supplied by the left opthalmic artery. The tumor was near-totally removed via a transcranial route, and she had lost her left vision after a second surgical procedure. It is difficult to make a differential diagnosis between nonsecreting pituitary macroadenomas with suprasellar extension and diaphragma sellae meningiomas preoperatively from the viewpoint of neuroimaging. Preoperative differentiation is essential, because the transsphenoidal approach is used for surgical removal of adenomas, while meningiomas are approached via a craniotomy.

      • KCI등재후보

        반복하중하에서의 강부재에 대한 손상지수 제안

        박연수,최동호,강대흥,오정태,오백만 한국강구조학회 2002 韓國鋼構造學會 論文集 Vol.14 No.5

        본 연구는 강한 반복하중하에서 강부재가 파괴에 이르는 손상과정을 규명하고 , 손상과 관련된 인자들을 이용하여 손상지수를 제시하며, 이와 관련된 해석 기법을 개발하는 것을 목적으로 한다 . 제안된 손상평가 방법은 변형이 가장 심하게 집중된 단면에 있어서 국소 변형율의 이력에 초점을 맞추어 유도되었다 . 해석모델은 좌굴변형의 발생 방향을 가정한 켄틸레버형 강상자형 부재이다 . 파괴에 이르는 중심 압축하중과 일정 압축하중이 가해진 상태에서 반복 제어변위가 작용하는 강부재에 대해 비선형해석을 실시하였다 . 본 해석에 적용된 주요 변수는 하중 재하패턴, 강종이다. 각 변수가 파괴모드, 변형능력, 그리고 손상과정에 미치는 영향을 기술하였고 , 각각 강종에 따른 파괴 과정을 비교하였다. 그 결과 강한 반복하중하에서의 강부재의 파괴는 국부좌굴에 의해서 결정되고 특히 파괴와 직접적으로 연관성이 있는 국 소 소성변형율과 관련되어 있음을 알 수 있었다 . paper aimed to investigate the damage process of steel parts experiencing failure under strong repeatedloading. Likewise, a damage index using various factors related to the damage was proposed. An analysis method for evaluating the damage state was also developed. The damage assessment method focused on the local strain history at the cross-section of the heaviest concentration of deformation. Cantilever-type steel parts were analyzed under uniaxial load combined with a constant axial load, considering horizontal displacement history. Loading patterns and steel types were considered as the main parameters in analyzing the models. The effects of the parameters on the failure modes, deformation capacity, and damage process as seen from the analysis results were also discussed. Each failure proces was compared as steel types. In addition, the failure of steel parts under strong repeated loading was determined according to loading. Results revealed that the state of the failure is closely related to the local plastic strain.

      • KCI등재

        반복하중하에서의 강부재에 대한 손상지수 제안

        박연수,강대흥,오정태,최동호,오백만,Park, Yeon Soo,Kang, Dae Hung,Oh, Jung Tae,Choi, Dong Ho,Oh, Back Man 한국강구조학회 2002 韓國鋼構造學會 論文集 Vol.10 No.3

        본 연구는 강한 반복하중하에서 강부재가 파괴에 이르는 손상과정을 규명하고, 손상과 관련된 인자들을 이용하여 손상지수를 제시하며, 이와 관련된 해석 기법을 개발하는 것을 목적으로 한다. 제안된 손상평가 방법은 변형이 가장 심하게 집중된 단면에 있어서 국소 변형율의 이력에 초점을 맞추어 유도되었다. 해석모델은 좌굴변형의 발생 방향을 가정한 켄틸레버형 강상자형 부재이다. 파괴에 이르는 중심 압축하중과 일정 압축하중이 가해진 상태에서 반복 제어변위가 작용하는 강부재에 대해 비선형해석을 실시하였다. 본 해석에 적용된 주요 변수는 하중 재하패턴, 강종이다. 각 변수가 파괴모드, 변형능력, 그리고 손상과정에 미치는 영향을 기술하였고, 각각 강종에 따른 파괴 과정을 비교하였다. 그 결과 강한 반복하중하에서의 강부재의 파괴는 국부좌굴에 의해서 결정되고 특히 파괴와 직접적으로 연관성이 있는 국소 소성변형율과 관련되어 있음을 알 수 있었다. This paper aimed to investigate the damage process of steel parts experiencing failure under strong repeated loading. Likewise, a damage index using various factors related to the damage was proposed. An analysis method for evaluating the damage state was also developed. The damage assessment method focused on the local strain history at the cross-section of the heaviest concentration of deformation. Cantilever-type steel parts were analyzed under uniaxial load combined with a constant axial load, considering horizontal displacement history, Loading patterns and steel types were considered as the main parameters in analyzing the models. The effects of the parameters on the failure modes, deformation capacity, and damage process as seen from the analysis results were also discussed. Each failure process was compared as steel types. In addition, the failure of steel parts under strong repeated loading was determined according to loading. Results revealed that the state of the failure is closely related to the local plastic strain.

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