중증 뇌손상 환자에서 뇌동정맥 산소함유량차이와 지연성 뇌경색 발생과의 관계

윤승환,조준,문창택,장상근,박형천,박현선,김은영,Youn, Seung-Hwan,Cho, Joon,Moon, Chang-Taek,Chang, Sang-Keun,Park, Hyung-Chun,Park, Hyeon-Seon,Kim, Eun-Young 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.4

Objective : This study was performed to evaluate the relationships among intracranial pressure(ICP), cerebral perfusion pressure(CPP), and cerebral arteriovenous oxygen difference($AVDO_2$) which were used as parameters of adequacy of cerebral blood flow to support cerebral metabolism after severe head injury and also to examine the association between delayed cerebral infarction and outcome. Material and Method : The authors studied the ICP, CPP and $AVDO_2$ before and after treatment on 34 head-injured patients from June 1996 to December 1997 and examined the association with the change of an ICP, CPP and $AVDO_2$ following treatment and the development of delayed cerebral infarction. Sixteen patients underwent craniotomy for hematoma evacuation and eighteen patients received mannitol to decrease ICP. Results : The development of delayed cerebral infarction was demonstrated in 3(42.9%) out of 7 patients in no improvement group and 13(48.1%) out of 27 patients in improvement group with an increased ICP following treatment. Also, the development of delayed cerebral infarction was demonstrated in 8(50%) out of 16 patients in no improvement group and 8(44.4%) out of 18 patients in improvement group with a decreased CPP following treatment. The association with changes of ICP and CPP following treatment and development of delayed cerebral infarction was not statistically significant(p>0.01). However, 11(78.6%) out of 14 patients who demonstrated an increase in $AVDO_2$ and 5(25%) out of 20 patients who demonstrated a decrease in $AVDO_2$ following treatment developed delayed cerebral infarction. No improvement(reduction) in $AVDO_2$ following treatment was significantly associated with the development of delayed cerebral infarction(p<0.01). All of 16 patients with delayed cerebral infarction showed poor prognosis. Conlcusion : The change of $AVDO_2$ rather than those of ICP and CPP was considered more important factor for the development of the delayed cerebral infarction and poor outcome.

본태성 수장부 다한증 환자에서 선택적인 T3 교감신경 차단술

윤승환,조준,문창택,장상근,배기만,Youn, Seung-Hwan,Cho, Joon,Moon, Chang-Taek,Chang, Sang-Keun,Bae, Ki-Man 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.11

Objectives : In general, conventional T2, T3 thoracoscopic sympathicotomy must be one of the most effective treatments for the essential palmar hyperhidrosis. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory sweating and Hornor's syndrome. The authors have performed a selective T3 thoracoscopic sympathicotomy to our patients to see whether it provides successful results with less side effects. Its preliminary results were compared with those of conventional T2, T3 thoracoscopic sympathicotomy. Methods : The thoracoscopic sympathicotomy was performed in 54 patients suffering from essential palmar hyperhidrosis. Twenty-four patients underwent a conventional sympathicotmy(group A) from Jan 1997 to Dec 1997 and 30 patients a selective T3 sympathicotmy(group B) from Jan 1998 to Dec 1999. For assessment of postoperative success and of complications all patients charts were reviewed. Patients further received a postal questionnaire regarding long-term effect, satisfaction, and side-effects. Results : No recurrence was observed in both groups. The global rate of compensatory sweating was significantly(p =0.020) different in both groups : 11 patients(45.8%) in group A and 5 patients(16.73%) in group B. The Hornor's syndrome was observed only in 4 patients in group A. The preliminary results of the procedure in group A were considered fully-satisfying by 16 patients(66.6%), 6 patients(25%) were satisfied partially, and only 2 patients(8.3%) were dissatisfied, and those of the procedure in group B satisfying by 26 patients(86.6%), 4 patients(13.3.% ) were satisfied partially, and none dissatisfied. Conclusion : The selective T3 sympathicotomy results in a significant decrease in the rate of disturbing side effects comparing to conventional T2, T3 sympathicotomy and it dose not lead to recurrence. Our results contribute to recommendations of a selective T3 thoracoscopic sympathicotomy as treatment of choice in essential palmar hyperhidrosis.

임시 수복물 중합시 시간과 중합온도가 변연 적합도에 미치는 효과

윤승환,오남식,김일규,오성섭,최진호,김왕식,임영일,Youn Seung-Hwan,Oh Nam-Sik,Kim Il-Kyu,Oh Sung-Seop,Choi Jin-Ho,Kim Wang-Sik,Rim Young-Il 대한치과보철학회 2001 대한치과보철학회지 Vol.39 No.5

The purpose of this study was to compare the marginal fit of provisional restorations by differentiating the removal time and setting temperature during resin polymerization. After mixing autopolymerizing methyl methacrylate resin, the material was placed in a preformed resin shell crown. The crown was seated on a die with 1mm shoulder margin. Crowns were removed after 3, 4, 5, 6 minutes and polymerization was continued under the following conditions : $25^{\circ}C$ air, $30^{\circ}C,\;40^{\circ}C,\;50^{\circ}C,\;60^{\circ}C,\;70^{\circ}C$ water. After polymerization. the crown was sectioned. The marginal & occlusal discrepancies were measured. The mean marginal discrelpancies at 3 minutes, 4 minutes, 5 minutes and 6 minutes of removing time were $96.6{\mu}m.\;84.6{\mu}m,\;86.7{\mu}m$ and $105.6{\mu}m$. The mean occlusal discrepancies at 3 minutes, 4 minutes, 5 minutes and 6 minutes of removing time were $106.7{\mu}m,\;89.3{\mu}m,\;98.6{\mu}m$ and $127.7{\mu}m$. There was significant difference between 4 minutes group and 6 minutes group in occlusal discrepancies. The mean marginal & occlusal discrepancies for crowns polymerized in $25^{\circ}C$ air were $98.2{\mu}m$ and $124.1{\mu}m$. The crowns polymerized in $50^{\circ}C$ water demonstrated the smallest marginal & occlusal. discrepancies. The mean value of marginal & occlusal discrepancies in $50^{\circ}C$ water were $73.1{\mu}m$ and $77.5{\mu}m$. These values were smaller than that of $25^{\circ}C$ air. There were significant differences in the occlusal discrepancies between $25^{\circ}C$ air and water conditions of $50^{\circ}C$ water (${\alpha}=0.05$) but. no significant difference in marginal discrepancies. There was no significant difference in the interaction between time and temperature. 4 minutes waiting time & $50^{\circ}C$ water polymerizing condition produces the best fit at the margin of the provisional crown.

노령인구의 요추질환에 대한 수술적 치료결과의 분석

이세영,윤승환,조준,문창택,장상근,Lee, Sei-Young,Youn, Seung-Hwan,Cho, Joon,Moon, Chang-Taek,Chang, Sang-Keun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.12

Objective : To retrospectively analyse the surgical outcome and efficacy of the lumbar spinal surgery in sixty to older patients who failed to conservative treatments. Methods : Between July 1990 and November 1996, the authors retrospectively investigated the medical records of 46 patients who over 60 years of age at the time of surgery. The clinical severity was assessed with Prolo's grade(economic and functional). Questionnaire was sent to each patient regarding long-term effect, satisfaction, and side effects. Results : In 46 patients, 2 patients(1 case died of lung cancer, 1 case lost in follow-up) were lost. Among 44 patients (28 men, 16 women ; mean age 64 years), 22 patients underwent partial or total laminectomy, 17 spinal fusion with instruments, 2 chemonucleolysis, 2 adhesiolysis for failed back surgery syndrome, and 1 automated percutaneous lumbar discectomy. Although postoperative complications were observed in 5 patients, they were successfully managed. No deaths were documented in the perioperative periods. The average Prolo's economic and functional grade improved from 2.98 to 3.48 and 2.81 to 3.75, respectively. Conclusion : In overall, the favorable surgical outcome was obtained. This results indicated that with appropriate preoperative selections and indications, careful intraoperative monitoring, and attentive postoperative care, the surgical treatment of eldery patients for the lumbar spinal disorders, significant improvement with acceptable levels of morbidity and mortality can be achived.

충북지역 톱다리개미허리노린재의 발생밀도 변동과 이동

신윤호,윤승환,박영욱,안정진,윤창만,윤영남,김길하,Shin, Youn-Ho,Yun, Seung-Hwan,Park, Young-Uk,An, Jeong-Jin,Yoon, Chang-Mann,Youn, Young-Nam,Kim, Gil-Hah 한국응용곤충학회 2012 한국응용곤충학회지 Vol.51 No.2

Seasonal fluctuations of Riptortus pedestris were investigated in four regions including two sites each at Mt. Yangseong (Munui-myeon, Cheongwon-gun), O-chang (Cheongwon-gun), and Jujung-dong (Cheongju) using aggression pheromone traps from April to November in 2010 and 2011. Aggression pheromone and aggression pheromone + soybean traps were set at all investigated sites, and the Mt. Yangseong A and B sites were investigated at a farmland (80 m, asl) and forest (200 and 300 m). The population density of R. pedestris was high in mid June, mid August, and late October in 2010 and in early May, mid June, mid September, and early October in 2011 with trivoltine. O-chang and Jujung-dong populations, which were distinguished in farmlands and forests, were highest from June to August in the farmland and in September in the forest. Similar numbers of R. pedestris were capture in the farmlands and the forest in June-August, September-November, respectively. From the results of the four regions, more R. pedestris adults were captured in the aggression pheromone + soybean trap than that in the pheromone trap. To investigate the migration route by altitude, 500 R. pedestris adults marked with fluorescent paint were released and re-caught insects were counted in traps after 10 and 20 days. The pattern of the re-caught R. pedestris indicated migration from the forest to farmlands during April-June. These results suggest that the insects did not migrate in August because food was plentiful in the forest at 200 m, but they moved to the forest during October due to the scarcity of food and for overwintering. The R. pedestris seasonal fluctuations in 2011 were affected heavily by the environment, particularly rain precipitation. 충북지역 4곳의 농경지 및 산림지를 선정하여 2010년 4월 5일부터 2011년 11월 30일까지 발생밀도를 조사하였다. 농경지(80 m, 산림경계)와 산림지(200 m, 300 m)로 이루어진 양성산 두 지역은 고도별로 집합페로몬트랩과 집합페로몬+대두트랩을 설치하였다. 2010년도에 톱다리개미허리노린재가 6월 중순, 8월 중순, 10월 하순에 높은 발생밀도를 보였고, 2011년도에는 양성산 두 지역에서는 5월 초순, 6월 중순, 9월 중순, 10월 초순에 높은 발생밀도를 보였다. 농경지와 산림지로 구분된 청원군 오창면, 청주시 주중동 두 지역에서는 6월에서 8월까지 농경지에서, 9월에는 산림지에서 많이 포획되었다. 계절별로도 6월부터 8월까지는 농경지 쪽에서, 9월부터 11월까지는 산림지쪽에 존재하였다. 트랩별 유인력의 차이는 4곳의 지역 모두에서 집합페로몬트랩보다 집합페로몬+대두트랩에서 더 많은 수의 성충이 포획되었다. 성충 500마리에 형광페인트를 칠하여 양성산에서 고도별로 방사하고 10일과 20일 후 고도별 이동을 조사한 결과, 4월부터 월동에서 깨어나기 시작하여 6월까지는 산림지에서 농경지로 이동하였다. 8월에는 고도별로 이동하지 않았으나, 9월과 10월에는 다시 농경지에서 산림지로 이동하였다. 톱다리개미허리노린재는 계절별로 적은 수가 이동을 하며 대부분은 주변에서 먹이를 찾는 것으로 보인다. 2011년도의 발생밀도는 환경, 특히 강우량에 영향을 많이 받았다.

Failed Back Surgery Syndrome에서 만족스러운 치료 결과에 영향을 주는 요인들

이창명,윤승환,조준,문창택,장상근,Lee, Chang-Myung,Youn, Seung-Hwan,Cho, Joon,Moon, Chang-Taek,Chang, Sang-Keun 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.2

Objective : The authors retrospectively analysed the factors affecting the favorable outcomes in the treatment of the Failed Back Surgery Syndrome(FBSS) or six years. Method : From March 1991 to December 1996, seventy-five patients were diagnosed as FBSS and its incidence was 3.4% of admitted patients with back pain in our department. We analysed the demographic data, etiologies, clinical menifestations, outcomes according to methods of operation, numbers of previous surgery, and time intervals between initial operation and final operation. Result : The most common etiology and previous surgical method of FBSS were insufficient surgery(54.7%) and partial laminectomy(53.3%). Patients were managed as followings ; Total laminectomy and spinal fusion with instrument in 41 cases(54.7%), total laminectomy without fusion in 23 cases(30.7%), and only partial laminectomy in 11 cases(14.7%). The overall treatment outcome was satisfactory in 48 cases(64%). Satisfactory results were observed in those patients who were treated by spinal fusion after complete laminectomy(34 cases), who had underwent only one operation previously(45 cases), and when the time interval between the initial operation and reoperation is shorter than 12 months(43 cases). Conclusion : The treatment outcome in FBSS was favorable in cases of the complete total laminectomy and spinal fusion with instrument, only one previous back surgery, and short time interval between initial and final operations.

보철물 수명 연구를 위한 대한치과보철학회 표준 방안: KAP Criteria

윤준호,박영범,윤승환,오남식,Yoon, Joon-Ho,Park, Young-Bum,Youn, Seung-Hwan,Oh, Nam-Sik 대한치과보철학회 2016 대한치과보철학회지 Vol.54 No.4

목적: 보철물 수명 연구에서 가장 중요한 것은 보철물을 객관적이고 일관성 있게 평가하는 것이다. 대한치과보철학회에서는 이 필요성을 충족시키기 위해 보철물 수명연구를 위한 대한치과보철학회의 표준 방안을 마련하기로 하였다. 본 연구의 목적은 보철물 수명 연구의 통일된 표준을 마련하기 위한 보철물 평가 흐름도와 보철물 평가 기록지를 제작하는 데 있다. 재료 및 방법: 기존에 사용되었던 보철물 평가 방법을 문헌 고찰을 통해 알아본 후 직관적이며, 사용하기 쉽고, 보철물의 상태를 객관적으로 구분할 수 있는 평가 기준을 개발한다. 또한 이 기준을 시범 사용하여 문제점과 개선점을 파악한다. 결과: 고정성 보철물 30 증례, 가철성 보철물 25증례, 그리고 임플란트 보철물 13 증례로 시범 사용하여 Kaplan-Meier 생존율 분석을 시행한 결과 고정성 보철물의 평균수명 추정치는 12.82년, 가철성 보철물은 5.96년, 임플란트 보철물은 4.82년의 결과를 얻었다. 또한 조사자들에게 시범 사용 후의 문제점을 수렴하여 수정, 보완한 후 보철물 평가흐름도 및 보철물 평가 기록지를 완성하였다. 결론: 보철물 수명 평가를 위한 대한치과보철학회 표준 방안 마련을 위해 개발된 보철물 평가 흐름도와 보철물 평가 기록지를 통해 보다 객관적이고 통일된 자료 수집이 가능하였다. 향후 본 표준 방안을 이용한 보철물 수명연구가 시행될 것이다. Purpose: The most important factor in longevity studies of dental prostheses is objective and consistent evaluation of the prosthesis. The Korean Academy of Prosthodontics suggested developing a standardized method for longevity studies of dental prostheses. The purpose of this study is to evaluate previously-used criteria and to develop new criteria, in the form of a procedure flowchart and an evaluation sheet. These new criteria may be able to provide a unified standard for future longevity studies of dental prostheses. Materials and methods: A literature review was performed about the evaluation of dental prostheses. Taking into account the strengths and weaknesses of previously used criteria, a novel, intuitive and objective method was developed for assessment of dental prostheses. Then, a pilot survey was performed with the newly developed flowchart and evaluation sheet to determine problems and implement possible improvements. Results: Thirty cases of fixed dental prosthesis (FDP), 25 cases of removable dental prosthesis (RDP), and 13 cases of implant supported prosthesis (ISP) were evaluated. The average life expectancy estimate was 12.82 years for FDP, 5.96 years for RDP, and 4.82 years for ISP with Kaplan-Meier survival analysis. Additionally, possible improvements discovered by the pilot survey were reflected in the flowchart and evaluation sheet. Conclusion: The newly developed KAP criteria, flowchart and evaluation sheet enabled objective and consistent results in trial longevity studies of dental prostheses. It is expected that future studies will not only use the KAP criteria but also further improvement will be made on them.

중증 뇌손상 환자에서 고농도 산소치료법

박성호,박한준,윤승환,조준,문창택,장상근,Park, Sung-Ho,Park, Han-Jun,Youn, Seung-Hwan,Cho, Joon,Moon, Chang-Taek,Chang, Sang-Jeun 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1

Object : The rapid and early oxygen delivery to brain tissue was a common therapeutic method in the treatment of severe head injury patients. The purpose of this study was to investigate the effect of increased fraction of inspired oxygen in early stage of severe head injury. Methods : The parameters of research were CSF(cerebral spinal fluid) oxygen pressure($PcsfO_2$), lactate, pH, temperature, and CSF carbon dioxide pressure($PcsfCO_2$). We selected 28 patients with head trauma whose the Glasgow Coma Scale(GCS) score was less than 8 point at admission. All patients were mechanically ventilated and monitored with the commercial ICP monitoring device. Each of parameters was compared as increased fraction of inspired oxygen. In experimental cohort of 14 patients, the mean $PcsfO_2$ level was increased to $314.93{\pm}259.15mmHg$ by raising the $FiO_2$ from 40% to 100% for nine hours(p<0.05). And the mean CSF lactate level was decreased to $2.96{\pm}1.98mmol/L$ on 100% $FiO_2$ as compared with $5.98{\pm}3.25mmol/L$ on 40% $FiO_2$ in control group(p<0.05). The only above two parameters were showed statistically meaningful outcome. Conclusions : Although this study was performed in small cohort and short period, these results supports that increased inspired oxygen therapy in severe head injuried patients was recommended as a modality of treatment in future through the continuous survey.

살충제의 잔효성을 이용한 집합페로몬통발트랩에 유인된 톱다리개미허리노린재의 살충효과

이선우(Seon-Woo Lee),윤승환(Seung-Hwan Yun),구현나(Hyun-Na Koo),김현경(Hyun Kyung Kim),윤영남(Young-Nam Youn),김길하(Gil-Hah Kim) 한국농약과학회 2013 농약과학회지 Vol.17 No.3

종양내 출혈을 동반한 선천성 교모세포종 -증례보고-

김형중 ( Hyoung Joong Kim ),김세혁 ( Se Hyuk Kim ),김순기 ( Soon Ki Kim ),윤승환 ( Seung Hwan Youn ),박현선 ( Hyeon Seon Park ),김은영 ( Eun Young Kim ),박형천 ( Hyung Chun Park ) 대한뇌종양학회 2003 대한뇌종양학회지 Vol.2 No.2

Congenital glioblastomas have been rarely reported in the literatures and known to have a higher propensity to cause intratumoral hemorrhage compared to pediatric brain tumors. We report a case of definite congenital glioblastoma, which was not detected by endovaginal fetal sonography until 35+1 weeks gestation and presented with intratumoral hemorrhage after birth. Brain CT and MRI scan showed a intracranial mass with internal hemorrhage and small portion of contrast enhancement. If the rapid growing intracranial lesion with internal hemorrhage is detected by fetal sonography or MRI late in gestation, a congenital malignant tumor as well as vascular malformations should be considered.