뇌수술의 비방수성 경막 봉합

조용운,문재곤,황용순,박인석,전병찬,김한규,Cho, Yong Woon,Moon, Jae Gon,Hwang, Yong Soon,Park, In Suk,Jeon, Byung Chan,Kim, Han Kyu 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.5

Objective : In neurosurgical practice, it has been generally accepted that when the dura is opened, it should be watertightly closed, and traditionally non-watertight closure has not been performed. We clinically tried non-watertight closure, analyzed the frequency of CSF leakage and evaluated the possible clinical application of non-watertight closure. Methods : After classifying our cases with supratentorial and infratentorial approach, we tried non-watertight and watertight closures and compared the results. We also analyzed the cases with or without dural graft. Results : In supratentorial approach, the rate of cerebrospinal fluid leakage noted in non-watertight closure was similar to that of watertight closure. In infratentorial approach, except microvascular decompression(MVD), the rate of cerebrospinal fluid leakage in non-watertight closure was higher than that of watertight closure. Dura graft application did not seemed to influence the cerebrospinal fluid leakage. Conclusion : Since the frequency of cerebrospinal fluid leakage was not higher in non-watertight closure than that of watertight closure, non-watertight closure can be applied in supratentorial approach. In infratentorial approach, non-watertight closure may be applied in surgery with relatively short dural incision, such as MVD. However, non-watertight closure doesn't seem to be appropriate in surgery that requires wide dural incision, such as skull base surgery.

우측 이마에 필러 주입 후 발생한 시력 소실 1예

조용운,정인영,박종문,유지명,김성재,서성욱,한용섭.Yong Wun Cho. MD. In Young Chung. MD. PhD. Jong Moon Park. MD. PhD. Ji Myong Yoo. MD. PhD. Seong Jae Kim. MD. PhD. Seong Wook Seo. MD. PhD. Yong Seop Han. MD. PhD. 대한안과학회 2014 대한안과학회지 Vol.55 No.8

Purpose: We report a case of visual loss after the injection of poly-L-lactic acid filler into the right forehead area for cosmetic purposes. Case summary: A 46-year-old female patient visited our clinic due to sudden visual disturbance and dysesthesia on the right forehead and cheek. Her best corrected visual acuity was no light perception in the right eye and 20/20 in the left eye. Visual acuity in her right eye was not corrected. An afferent papillary defect in the right eye and paralysis of oculomotor muscles were observed. Fundus exam revealed a pale optic nerve and turbid retina on the posterior pole. The retinal vessels were narrowed. A papule 1 cm to the lateral margin of the right eyebrow due to the needle injection was found and no other visible skin abnormalities were observed. She had a cosmetic poly-L-lactic acid filler injection into the right forehead area immediately before the visual disturbance occurred. Fluorescent angiography showed occlusion of the right retinal artery and blood flow defects on the retina and choroid were present. The patient was followed up for 6 months and visual acuity and dysesthesia in her right forehead and cheek did not improve. Conclusions: Several cases of visual loss have occurred after injection of filler on the glabella and forehead for cosmetic purposes. However, most of the complications were observed after the use of hyaluronic fillers and not due to poly-L-lactic acid filler. This is the first case report of visual loss caused by poly-L-lactic acid filler in South Korea in a normal patient. Hence, consideration of complications when using this type of fillers is important. J Korean Ophthalmol Soc 2014;55(8):1253-1256

신경매독과 연관되어 발생한 안매독의 임상 양상

조용운,김체론,한용섭,정인영,박종문,Yong Wun Cho,MD,Che Ron Kim,MD,Yong Seop Han,MD,PhD,In Young Chung,MD,PhD,Jong Moon Park,MD,PhD 대한안과학회 2014 대한안과학회지 Vol.55 No.4

Purpose: To report the manifestation of ocular syphilis combined with neurosyphilis in patients who present with uveitis clinically and are diagnosed initially by an ophthalmologist. Methods: This study is a retrospective, clinical investigation of seven male patients with ocular syphilis from a single tertiary center between 2009 and 2012. Results: The average age of the patients at onset was 44.4 years (range, 33-71 years). Posterior segment involvement was found in all patients. Two patients had papillitis. In serologic testing, all patients had positive responses to Venereal Disease Research Laboratory (VDRL), fluorescent treponemal antibody-absorption test (FTA-ABS) and Treponema pallidum hemagglutination (TPHA). In fluorescein angiography (FAG), retinal vascular and disc leakage was the most common finding. Cerebrospinal fluid (CSF) analysis was performed for six patients and demonstrated positive CSF FTA-ABS and CSF TPHA tests in all patients. CSF VDRL was reactive in 2 patients (33.3%). Conclusions: All patients with ocular syphilis were diagnosed with neurosyphilis based on the analysis of CSF with FTA-ABS and TPHA. Ophthalmologists play an important role in the early diagnosis and treatment of syphilis. J Korean Ophthalmol Soc 2014;55(4):602-607

시상하부 신경절교종 1례 - 증례보고 -

조용운,문재곤,박인석,전병찬,김한규,장희경,Cho, Yong Woon,Moon, Jae Gon,Park, In Suk,Jeon, Byung Chan,Kim, Han Kyu,Chang, Hee Kyung 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.5

The authors report a case of ganglioglioma in unusual site, the hypothalamus. The tumor was completely removed and no recurrence was noted on the follow up. Ganglioglioma usually occurs in the temporal and frontal lobe, but is rarely found on the hypothalamus. We report this case with pertinent literatual reviews.

생활습관병 사망률 및 유병률 변화 분석

조용운(Yongwoon Cho),최창희(Changhui Choi) 대한미병의학회 2020 대한미병의학회지 Vol.1 No.1

Objectives The life expectancy is extending in South Korea, the healthy life expectancy, however, is shortening. This study examined where this phenomena happened. Methods This study firstly produced the mortality rate of lifestyle diseases from the 1998-2017 death certificate data of National Statistical Office. This study secondly produced the prevalence of main lifestyle diseases such as essential hypertension, dyslipidemia, cerebrovascular disease, heart disease, diabetes mellitus over the age of 40 from Korea Centers for Disease Control & Prevention. Results The mortality rate of lifestyle diseases is rapidly decreasing more than the total mortality rate. But the prevalence is rapidly increasing. Conclusions Findings suggest that preventive health services such as health management services for people with metabolic syndrome should be provided to extend healthy life expectancy.

의료공급자의 유인수요가 환자본인부담금에 미치는 영향

조용운 ( Yong Woon Cho ),김세환 ( Se Hwan Kim ) 한국보건경제정책학회(구 한국보건경제학회) 2005 보건경제와 정책연구 Vol.11 No.2

집단위험모형을 이용한 성장추세에 있는 실손의료보험리스크 측정

조용운 ( Yong Woon Cho ),조재린 ( Jae Rin Cho ) 보험연구원 2013 보험금융연구 Vol.24 No.2

본 연구는 FY2006년부터 FY2010년까지 대형 4개 손해보험회사의 실손의료보험상품 판매 및 보험금지급 실적을 전수 조사한 데이터를 이용하여 리스크 승수를 측정하였다. 집단위험모형을 적용하였고 이 모형에 필요한 불확실성모수를 실적의 연도별 변화를 이용하는 고전적인 방법과 손해율과 인플레이션을 이용하는 국제계리사회가 제안한 방법을 이용하여 추정하였다. 고전적인 방법은 명목값을 적용한 경우와 실질값을 이용한 경우로 나누어 측정하였다. 그리고 이를 이용하여 리스크승수를 측정하였다. 고전적 방법의 실질값을 이용하여 측정한 리스크승수가 가장 크게 산출되었다. 이는 실손의료보험의 보험사고건수와 심도가 추세를 가지고 변화하고 있어서 고전적 방법의 모형이 요구하는 가정을 충족시키지 못하기 때문에 나타난 결과이다. 실질값으로 전환하는 과정에서 그 추세는 더욱 심화되어 리스크승수를 크게 하고 있는 것이다. 일반적으로 물가지수를 이용하여 실질값으로 변환하여 리스크승수를 측정하고 있다. 추세가 있는 경우 고전적 방법을 그대로 이용하는 것은 모형오류리스크에 직면할 수 있는 것이다. 국제계리사회의 방법은 추세의 영향을 직접적으로 받지 않는다는 특징이 있지만 심도리스크가 인플레이션에만 의존한다고 가정하여 보장정책변화를 반영하지 못하는 단점이 있다. 정책변화가 미미하거나 없는 경우 국제계리사회의 방법이 적절할 수 있다. 이러한 실증 결과를 토대로 적절한 모형의 선택이 이루어진다면 자본적정성을 확보하는데 도움이 될 것이다. In this paper, we measure the risk multipliers of health insurance of the four largest casualty insurance companies using their payment data from FY 2006 to FY 2010. To this end, we apply the collective risk model, and estimate the uncertainty of the parameters required for this model using the method proposed by the International Actuarial Association(IAA), along with the conventional method. The conventional method estimates uncertainty parameters with the annual variations of payment data whereas the IAA method adopts loss ratios and inflation rates. As a consequence, we find that the risk multipliers calculated by the conventional method with real value data are larger than those of the IAA method. This is because the trends in the and of health insurance overstate the uncertainty parameters, implying that the trends, if any, might lead the conventional method to encounter model error risk. In the IAA method, on the other hand, the uncertainty parameters are not directly affected by the trends in payment data. Nonetheless, a shortcoming of the IAA method is to assume that the uncertainty parameters in severity depend only on the variation in inflation. As such, this method does not reflect changes in public health insurance policy, and thus might be more appropriate in the absence of such significant changes.

정책계층별 광양만권 물류정책의 요인 중요도 평가

조용운 ( Yong Yun Cho ),박병인 ( Byung In Park ) 한국로지스틱스학회 2010 로지스틱스연구 Vol.18 No.2

본 논문은 광양만권 물류정책의 의결 및 집행과정을 분석하여 지역 물류정책 담당자에게 물류 정책기본법상의 정책방향설정을 위한 전략지침을 제시하는데 목적이 있다. 물류의 중요성이 높은 광양만권의 물류산업 활성화는 지역발전과 직결된다. 이러한 광양만권의 물류산업 발전전략을 실행하기 위해서는 관련된 정책계층인 국회의원, 광역의원, 기초의원과 중앙공무원, 광역공무원, 기초단체 공무원의 정책인식에 대한 사전분석이 필요하다. 계층분석기법(AHP)을 활용한 분석결과 지역물류정책의 의결 및 집행기관 간 물류정책 요소의 중요도 차이를 확인 하였다. 특히 정책계층 수준이 높을수록 물류경쟁력 요인을 중요시 하며, 수준이 낮을수록 지역물류정책 요소간 종합·조정의 중요도가 높았다. 따라서 지역 물류발전을 위해 수준별, 기관별 원활한 소통과 상위계층의 인식을 감안한 지역물류정책의 수립 및 집행이 지역물류산업의 발전에 필수적임을 확인하였다. 추후에는 부산, 인천 등 주요 물류중심지역과의 비교연구가 필요하다. This paper aims to provide a strategic guideline for establishing the direction of logistics policy on the basic logistics policy act to the officers in charge of their regional logistics policy through the analysis of the processes of decision making and implementation of logistics policy of the Gwangyang-bay area. Since the logistics industry of Gwangyang-bay area is very important, the vitalization of its logistics industry is directly related to regional development. To implement the strategy for developing the logistics industry of Gwangyang-bay area, a preliminary study is required on policy perception of region-related lawmakers, members of provincial council and local councils, and the relevant officials of central, provincial and local governments which are related policy hierarchy groups. The research findings using AHP showed the reality difference between the logistics factors of regional logistics policy and executive agencies was confirmed. The higher policy hierarchy level an agency is, it regards logistics competitiveness factors more highly. Furthermore, it showed that the lower the policy hierarchy level is, the importance of comprehensive adjustment among regional logistics policy factors gets higher. Therefore, it was judged that for the development of regional logistics, the establishment and performance of regional logistics policies considering smooth communication both by level and agency, and the perception of higher hierarchy are essential. Later on, it will be necessary to confirm important and essential policy factors through a study comparing with major logistics hubs such as Busan, Incheon, etc.

Antiphospholipid Syndrome of Bilateral Nonarteritic Anterior Ischemic Optic Neuropathy Patient Deteriorating Over Time

조용운(Yong Wun Cho),김병선(Byoung Seon Kim),유웅선(Woong-Sun Yoo),서성욱(Seong-Wook Seo),정인영(In Young Chung) 대한안과학회 2021 Korean Journal of Ophthalmology Vol.35 No.2

자동차보험의 확률론적 통합보험리스크 실증분석

조용운 ( Yong Woon Cho ),조재린 ( Jae Rin Cho ) 보험연구원 2012 보험금융연구 Vol.23 No.1

본 연구는 보험년도 기준으로 2002년부터 2007년까지 9개 자동차보험회사(대형 4개사, 중소형 4개사, 온라인 1개사) 피보험자 중 10%의 가입 및 지급 내역을 표본 추출하여 감독지침에 따라 리스크 계수를 개인용 대인, 비개인용 대인, 기타로 나누어 추정한다. 그리고 세 가지를 통합하여 하나의 리스크 계수를 추정하였다. CRM(Collective Risk Model)에 체계적 리스크와 시스템 리스크를 반영하는 확률론적 시뮬레이션 알고리듬을 적용하여 리스크의 분산효과가 추정 리스크양에 반영되도록 하였다. 산업 전체를 볼 때 분리추정 후 합한 TVaR값이 8,393억 원, 통합 추정한 값이 8,221억원으로 나타나고 있어 172억 원의 차이를 보이고 있다. 이것은 통합 추정을 하면 분산효과(diversification effect)가 반영되어 리스크양이 줄어들기 때문이다. 감독지침과 같이 세 가지로 분리 추정하면 보험회사들은 적정수준을 넘는 요구자본량을 보유하여야 하기 때문에 통합추정방법을 이용하여 하나의 리스크 계수를 제시하여야 할 것이다. This paper measures risks(TVaR) for three auto insurance coverages - individual, non-individual liabilities, and others - depending upon the guidelines of the Korea Financial Supervisory Service(FSS). To do this, we use Heckman and Meyers CRM with a dataset containing insurance policies and claim settlements of 9 auto insurance companies. In addition, we measure an aggregated risks of all coverages using Heckman and Meyers CRM. We show that at the industry level, aggregated risks of all coverages amount to 839.3 billion KRW with the guidelines of the FSS. FSS requires to linearly add the risks for the three insurance coverages in measuring aggregated risks. However, the aggregated risks of the Heckman and Meyers CRM are measured to 822.1 billion KRW, down by 17.2 billion KRW in risks, as a result of a diversification effect. As such, We suggest our method in measuring aggregated risks of all coverages as insurers` optimal level of capital may be lower than the regulatory capital requirements required by the FSS.