Systematic Review of Reciprocal Changes after Spinal Reconstruction Surgery : Do Not Miss the Forest for the Trees

Kim, Chang-Wook,Hyun, Seung-Jae,Kim, Ki-Jeong The Korean Neurosurgical Society 2021 Journal of Korean neurosurgical society Vol.64 No.6

The purpose of this review was to synthesize the research on global spinal alignment and reciprocal changes following cervical or thoracolumbar reconstruction surgery. We carried out a search of PubMed, EMBASE, and Cochrane Library for studies through May 2020, and ultimately included 11 articles. The optimal goal of a truly balanced spine is to maintain the head over the femoral heads. When spinal imbalance occurs, the human body reacts through various compensatory mechanisms to maintain the head over the pelvis and to retain a horizontal gaze. Historically, deformity correction has focused on correcting scoliosis and preventing scoliotic curve progression. Following substantial correction of a spinal deformity, reciprocal changes take place in the flexible segments proximal and distal to the area of correction. Restoration of lumbar lordosis following surgery to correct a thoracolumbar deformity induces reciprocal changes in T1 slope, cervical lordosis, pelvic shift, and lower extremity parameters. Patients with cervical kyphosis exhibit different patterns of reciprocal changes depending on whether they have head-balanced or trunk-balanced kyphosis. These reciprocal changes should be considered to in order to prevent secondary spine disorders. We emphasize the importance of evaluating the global spinal alignment to assess postoperative changes.

청소년기 태권도 수련생들의 체격 및 체력 요인별 발달 비교

김동제,권창기,가경환 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.2

This study was intended to investigate changes in the physique and fitness by age in adolescence. For this purpose, it attempted to make the first measurement in June, 2001 and the second measurement in 2002 for a total of 15 persons(seven middle school students aged 13 to 14 years and 8 high school students aged 16 to 17 years) practicing Taekwondo at 'S' and 'C' Drill Centers located in South Kyungsang Province. Both measures were conducted over the 2-day period. An attempt was made to compare and analyze the growth rate of physique and fitness factors by age based on data from measurement. As a result, the following conclusion was drawn: First, it was found that there was a statistically significant difference in the change of height, weight and body fat percent before and after measurement in order to investigate the change of physique(P<.05). Among other things, it was found that there was a statistically significant difference in the change of height, weight between the period of middle school days(13 to 14 years old) and the period of high school days(16 to 17 years old)(P<.05). It was found that Taekwondo trainees grew more over the period of middle school days(13 to 14 years old) than over the period of high school days(16 to 17 years old). But it was found that there was not a statistically significant difference in body fat percent between both groups(P<.05). But body fat percent reduced over the period of middle school days{13 to 14 years old) but did remain almost unchanged. Second, an attempt was made to measure power(high jump test), agility(side step test), muscular endurance(sit-up) and cardiopulmonary endurance(1500-meter run) to investigate the change of physique. It was found that there was not a statistically significant difference in the change of power(high jump test) and muscular endurance(sit-up) before and after measurement(P<.05). But it was found that there was a statistically significant difference on agility(side-step test) and cardiopulmonary(1500-meter run)(P<.05). It was found that there was a statistically significant difference in agility(side-step test), muscular endurance(sit-up) and cardiopulmonary endurance(1500-meter run) except power(high jump test) between he period of middle school days(13 to 14 years old) and the period of high school days(16 to 17 years old)(P<.05). The high jump test was conducted to investigate the change of power. As a result, it was found that power increase the period of middle school days(13 to 14 years old), whereas it decrease over the period of high school days(16 to 17 years old). On the other hand, the side-step test was conducted to investigate the change of agility. It was found that agility increased in Tawekwondo trainees over both the period of middle school days(13 to 14 years old) and the period of high school daysd(16 to 17 years old), the latter of which it was more or less improved. This study conducted the sit-up test to investigate the change of muscular endurance and the 1500-meter run test to investigate the change of cardiopulmonary endurance. In case of the 1500-meter run, cardiopulmonary endurance decreased over the period of middle school days(13 to 14 years old) but increased over the period of high school days(16 to 17 years old).

고양이 소뇌 치상핵 자극에 따른 전경골근의 근전도 변화

성재훈,김문찬,강준기,최창락 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.7

Through the use of stereotactic neurosurgical operation, some authors have employed chronic electrical stimulation of the dentate nucleus reduce spasticity and each trial on spastic patients has show marked clinical improvement. We investigated the eletrophysiological changes of cats after stereotactic electrical stimulation of the dentate nucleus to elucidate the possibility of clinical application and to evaluate the clinical results The M-wave is an initial response and the F-wave is a late response in the electromyography of a muscle, which is stimulated by its original controlling nerve itself. There is evidence that the sue of the F-wave is dependent on motor neuron excitability and its amplitude is increased significantly at spastic condition. If such a relationship exists, procedures which are cam& out to relieve spasticity might be exerted to change the F-wave sue and thus it might be possible to use the F-wave as an objective monitor during electrical stimulation of the dentate nucleus. We investigated this possibility in experiments on 10 cats weighing betHieen 27kg and 4.4kg. We studied the change% of M and F waves, recorded in EMG, after stereotactic stimulation to cerebellar dentate nucleus in cats. The results were as follows 1) The change of mean value of M-wave amplitude was not significant(contro1 group, 3591 ± 1029μV stimulation group, 3424± 927μV, 00.05). 2) The mean value of F-wave amplitude was significantly reduced about 56.7% after the dentate stimulation(contro1 p u p , 443.2± 119μV stimulation p u p , 251.3±99.4μV, P<0.05). 3) The F/M ratio also significantly reduced about 56.8% after the dentate stimulation(contro1 group, 12.5±1.9%, stimulation group, 7.1± 1.2%, P<0.05). Our experimental results demonstrated that the dentate stimulation markedly decreased the sue of F-wave amplitude and F/M ratio in the experimental cats and we concluded that theseelectrophysiological changes can be applied as a parameter of clinical evaluation of electrical dentate stimulation for the spasticity.

복합운동이 비만청소년의 식용조절호르몬과 비만 스트레스에 미치는 영향

김재호(Kim, Jae-Ho),권창기(Kwon, Chang-Ki),이상호(Lee, Sang-Ho) 한국체육과학회 2013 한국체육과학회지 Vol.22 No.2

The purpose of this study proposed an effective method improving obesity of adolescents who attend a combined exercise program during 12 weeks, by obesity stress, changes in blood levels of Appetite control hormone(ghrelin, leptin). The subjects of study were a total of 18 persons each 9 people, allocating combined exercise group (CG), control group(C) that divided by using the simple method conducted obese boys who had more than 25 percent body fat from pre-test. Combined exercise took four days a week, 45 minutes per a day and continued total 12 weeks. Measurement and analysis of all participants were measured after 12 weeks of pre-and post-test. For comparison of each group repeated measurements were performed among groups (repeated measure analysis of variance). The level of statistical significance in all analysis was set at α =. .05. Then that produced through the research process and how conclusions are as follows:1)changes of Ghrelin :CG group showed significant difference(p<.05) in group that ghrelin was decreased from 772.19pg/㎖ at 0 day to 429.77pg/㎖ at 12th week. 2)changes of Leptin : In CG group, the amount of leptin was increased from 12.38ng/㎖ at 0 day to 17.83ng/㎖ at 12th week(p<0.05). 3) Change of obesity stress: In CG group obesity stress was reduced from 109.33 at 0 day to 52.17 at 12th week, respectively. In CG group, obesity stress were significant difference (p<.05). In summary of above results, it showed that ghrelin and leptin hormone concentrations in blood were significantly changed. Therefore, we confirmed that continuous combined combination of exercise were positively effects for obese adolescents as a tool associated with a interventions of obesity.

아시아 지역 폐렴 구균의 항균제 내성 현황 및 변화 양상 : Asian Network for Surveillance of Resistant Pathogens (ANSORP) Study

정숙인,김나영,손준성,기현균,고관수,서지연,장현하,김연숙,오원섭,백경란,이남용,송재훈,항생제 내성 감시를 위한 아시아 연합 (ANSORP) 대한감염학회 2004 감염과 화학요법 Vol.36 No.1

목적 : 1980년대부터 페니실린을 비롯한 β-lactam 계열과 비 β-lactam 계열 항균제에 대한 폐렴구균의 항생제 내성이 급격하게 증가하여 국내 뿐 아니라 세계적인 문제로 대두되고 있다. ANSORP 에서는 아시아 지역에서 폐렴구균의 항균제 내성과 그 변화 추이, 내성의 기전 및 위험인자를 분석하고자 본 국제 공동 연구를 시행하였다. 재료 및 방법 : 1999년 11월부터 2001년 8월까지 아시아 지역 12개국의 14개 기관에서 폐렴구균 감염증 환자의 임상 검체로 분리된 침습성 폐렴구균을 대상으로 액체배지 미량희석법을 이용하여 16개 항생제의 MIC를 구하였다. 위험인자의 분석을 위하여 폐렴구균 감염증 환자를 대상으로 의무기록지를 조사하였다. Quellung 반응을 통해 혈청형을 결정하였다. 결과 : 총 685균주 중 52.4%가 페니실린에 대하여 비감수성(중등도 내성 22.9%, 내성 29.5%)을 보였고, 그 빈도는 베트남(92.1%), 스리랑카(85.7%), 홍콩(67.9%), 한국(64.5%)의 순이었다. Erythromycin에 대한 비감수성 비율은 베트남(92.1%), 대만(87.7%), 한국(80.6%), 홍콩(76.8%) 등에서 높게 나타났고, 베트남, 대만, 한국, 홍콩 등의 erythromycin의 MIC_(90)이 32㎍/mL를 넘는 고도내성을 보였다. 홍콩, 싱가포르, 대만, 인도에서는 fluoroquinolone에 대한 내성 균주가 출현하였다. 전체 균주 중 다제내성 균주의 비율은 47.7%였다. 혈청형은 19형과 23형이 가장 많았고, 그 외 6형, 14형 등이 있었다. 페니실린 비감수성 감염증의 위험인자로는 5세 미만(OR=1.7; 95%, CI, 1.2-2.4; P=0.002), 기관지폐질환(OR=2.0; 95%, CI, 1.3-3.1; P=0.003), 악성종양(OR=2.3; 95%, CI, 1.2-4.6; P=0.015), 스테로이드의 사용(OR=2.8; 95%, CI, 1.1-7.4; P=0.032)이 확인되었다. 결론 : 침습성 폐렴구균 균주를 대상으로 한 본 연구의 결과 아시아 국가들에서 페니실린, β-lactam 및 macrolide에 대한 폐렴구균의 내성률 및 내성 정도가 급증하고 있음을 확인하였다. Background : Emergence of pneumococcal resistance became a global issue since 1990s. According to the ANSORP studies with clinical isolates and carriage isolates between 1996 and 1999, some Asian countries showed alarmingly high prevalence of resistance to penicillin and other antimicrobial agents. To investigate the changing trends of pneumococcal resistance, ANSORP study group has performed a multinational surveillance study with invasive pneumococcal isolates from Asian countries. Methods : All isolates from various invasive pneumococcal diseases were prospectively collected from 14 centers in 12 countries between November 1999 to August 2001. Broth microdilution tests with 16 antimicrobial agents were performed according to the NCCLS procedures. Serotyping was performed by means of Quelling reaction with use of group-specific antisera. Results : A total of 685 isolates were collected. Overall, 52.4% of invasive isolates from Asian countries were not susceptible to penicillin (intermediate (1), 22.9%, Resistant (R), 29.5%). Vietnam showed the highest prevalence of penicillin non-susceptibility (1 20.6%, R 71.4%) followed by Sri Lanka (1 71.4%, R 14.3%), Hong Kong (1 24.1%, R 76%) and Korea (1 9.7%, R 54.8%). China (I 19.8%, R 23.4%) and Malaysia (1 9.1%, R 29.5%) also showed remarkable increase in penicillin resistance compared with previous ANSORP data, which were less than 10%. Vietnam (92.1%), Taiwan (87.7%), Korea (80.6%), and Hong Kong (76.8%) showed high prevalence of erythromycin resistance. MIG_(90)S for ciprofloxacin were 4 ㎍/mL (Hong Kong) and 2 ㎍/mL (11 Asian countries except Hong Kong), respectively. Conclusion : Compared with previous data from ANSORP studies, antimicrobial resistance among invasive pneumococcal isolates has markedly increased in Vietnam, Sri Lanka, Taiwan, China, and Malaysia. Continuous surveillance of pneumococcal resistance in Asia is strongly warranted.

空氣壓 변화에 의한 실린더의 最適 位置制御에 관한 硏究

박창언,김일수,김기우,정영재,손준식,송창재 木浦大學校 工業技術硏究所 1999 工業技術硏究誌 Vol.9 No.-

With the increasingly strict demands on accuracy position control of the production line, the modelling and control of the activated process have become a subject of great interest. Much efforts have been made in understanding and modelling of this process in the last decade. This thesis concentrates on the position control of Pneumatic cylinder under parameter variation. An adaptive control is proposed to design the defferent controllers(P, PI, PID, PD controller) in order to choose the best controller based on the fast and accurate control of the system. It is shown that the adaptive control algorithm is robust and effective in attaining the fast and accurate position control of system under time-dependent parameter variation. Experimental results showed that PD controller law is effective to obtain the fast response and to increase the stability of the system. The method is a useful control algorithm which always automatically adjusts the position control in accordance with the error, using carrier wave of triangle type regardless of changes on the operating condition and physical differences between components.

Effect of Microstructure on High Temperature Mechanical Properties of A319 Casting Alloy for Automotive Cylinder Heads

Kim, Ki-Jae,Jeong, Chang-Yeol JAPAN INSTITUTE OF METALS 2016 MATERIALS TRANSACTIONS Vol.57 No.5

<P>A quantitative study has been conducted to evaluate the relationship between microstructural features such as secondary DAS (dendrite arm spacing), eutectic structures and the mechanical behaviors of A319 casting alloys. Depending on the cooling rate affecting the primary and eutectic microstructure, the storage elastic modulus measured by DMA (dynamic mechanical analysis) increased with decreasing DAS, with a concomitant increase in the tensile strength and elongation at RT and also high tempertures. Contrarily, the thermal expansion coefficient increased with increasing temperature, but did not vary with microstructural changes. The hardness of the eutectic phase increased with increasing DAS due to the enlarged size of the eutectic particles, whereas the hardness of the primary phase was similar regardless of DAS, owing to the precipitates that formed during heat treatment. The increase of both of LCF (low cycle fatigue) and HCF (high cycle fatigue) lives with decreasing DAS was observed, mainly due to homogeneous deformation owing to the fine size of eutectic silicon and Fe intermetallic particles. The results of fractography observation showed that finer alpha-Al and eutectic phases were effective to the resistance of fatigue crack initiation and propagation due to the shorter crack path along the secondary particles. The LCF lives increased with increasing test temperature according to the Coffin-Manson relation due to the larger elongation. On the other hand, an analysis of the fatigue lives with the hysteresis loop energy, which consists of both strength and elongation, showed that the fatigue lives were normalized with an alloy of the same strengthening mechanisms regardless of the test temperature. DMA analysis demonstrated that the mechanical properties of the Al2Cu precipitate hardened alloy were maintained at temperatures greater than 250 degrees C, whereas degradation in the mechanical properties of the Mg-containing alloy occurred at 170 degrees C due to coarsening in the precipitation phase of Mg2Si.</P>

Encephalo-duro-arterio-synangiosis(EDAS) using Occipital Artery in Children with Moyamoya Disease

Choi, In-Jae,Hong, Seok-Ho,Cho, Byung-Kyu,Wang, Kyu-Chang,Kim, Seung-Ki The Korean Neurosurgical Society 2005 Journal of Korean neurosurgical society Vol.38 No.6

Objective : Although an encephaloduroarteriosynangiosis procedure using the superficial temporal artery [STA-EDAS] is an effective indirect bypass method in children with moyamoya disease[MMD], there is still a need for an additional bypass operation that can cover the area of the posterior circulation. The goal of this study is to evaluate the efficacy of the EDAS procedure using the occipital arteries [OA-EDAS]. Methods : From August 2003 to April 2004, We performed OA-EDAS in sixteen patients with MMD who have a circulatory insufficiency in the territory of the posterior cerebral artery[PCA]. The medical records were reviewed retrospectively. The surgical outcomes, including the changes in neurological status and imaging studies, with the degree of neovascularization on the cerebral angiogram, and the hemodynamic changes on single-photon emission computed tomography[SPECT], were analyzed. Results : These 16 children consisted of 5 boys and 11 girls aged 2 to 9 years. The clinical outcome of their PCA symptoms, such as visual transient ischemic attacks[TIAs] or visual field defect, was favorable in 14 patients of 16. Nine patients of 11 who underwent follow up magnetic resonance imaging[MRI] showed favorable MRI changes. On angiogram most of the patients exhibited good or fair revascularization of the PCA territory [7 of 8]. The hemodynamic changes on SPECT in the PCA territory after surgery showed improved vascular reserve in 13 of the 16 territories. Conclusion : OA-EDAS is a safe and efficacious revascularization procedure in patients with MMD who have compromised cerebral perfusion in PCA territory, or with visual TIAs.

전자동 자반건조기 제작에 이용할 Water Jet의 유동해석 모델

김일수,박창언,정영재,손준식,남기우 한국공작기계학회 1998 한국생산제조학회지 Vol.7 No.5

This paper concentrates on the development of a computational design program to determine nozzle size in water jet, combing the numerical optimization technique with the flow analysis code. To achieve the above objective, a two-dimensional model was developed for investigating the fluid flow in water jet and calculating the velocity and pressure distributions. The mathematical formulation as a standard R-ε model was solved employing a general thermofluid-mechanics computer program. PHOENICS code, which is based on the Semi-Implicit Method Pressure Linked Equations (SIMPLE) algorithm. The developed code was applied to water jet design to determine the nozzle size, and investigated the effect of the change of nozzle location. Calculated results showed that the flow pattern is not changed as the change of nozzle location.

한국인 A 형 간염 환자에서 A 형 간염 바이러스의 유전자형에 관한 연구

권오상,송기준,박상훈,송진원,김재선,김종헌,변관수,이창홍,연종은,백락주,박영태 대한간학회 2000 Clinical and Molecular Hepatology(대한간학회지) Vol.6 No.3

$quot;목적: 한국에서 과거 A형 간염은 낙후된 개인위생 및 자연환경으로 유소아기에 불현성 감염으로 앓고 지나가게 되어 청소년 및 성인에서 HAV에 대한 항체 보유율이 매우 높고 성인에서의 급성 A형 간염은 매우 드물게 보고되었다. 그러나 고도의 경제성장과 더불어 식생활, 위생상태의 개선, 상하수도의 보급 등으로 유소아기의 A형 간염 이환율이 현격히 감소하면서 청소년 및 성인에서 HAV 항체가 없는 인구집단 즉 HAV에 감염되면 현증 간염이 발생할 수 있는 인구 집단이 증가되어 최근 수 년 사이에 현증 A형 간염이 폭발적으로 증가하게 되었다. 이에 저자는 HAV의 유전자형을 알아보고 이미 보고된 각국의 HAV와 연관성을 알아보고자 본 연구를 시행하였다. 대상과 방법: 1994년부터 1998년까지 한국에서 산발적으로 발생한 18예의 A형 간염 환자의 혈청에서 HAV RNA를 추출, 역전사-중화효소 연쇄반응법(RT-PCR)으로 증폭하여 직접 염기서열의 분석을 통해 국내 HAV 사이에 염기서열, 아미노산의 차이 등을 알아보고 세계 각국에서 보고되었던 HAV 분리주들과 비교하였다. 결과: HAV 게놈의 특정부위인 VP1/2A 연결부위 168 bp 길이에서 시행한 염기서열 분석 결과 한국에서 분리된 18예의 HA이러스는 최근 해외에서 유입된 바이러스일 가능성은 적으며 따라서 장기간 국내에서 토착화된 바이러스일 것으로 생각된다. $quot;Background/Aims: Studies of genotypes and changes in nucleotide and amino acid sequences of hepatitis A virus (HAV) may provide valuable information on the epidemiological aspects of a particular region. In Korea the prevalence of anti-HAV in the 1 - 20 year age group declined from 60% in 1980 to 9% in 1995. As a result this age group has a high risk of HAV infection. Actually over 1,500 cases of clinically overt hepatitis A occurred in 1998 while few cases of clinical hepatitis A had been reported until the early 1990s. The aims of this study are to determine the genotypes of HAV which have been circulating in Korea and to define the phylogenetic relationships of geographically defined isolates. Method: From 1994 - 1998 a total of 18 serum specimens was obtained from patients in Korea with sporadic form acute hepatitis A. The HAV nucleic acid from serum specimens was subjected to genomic sequence analysis following viral RNA extraction, reverse transcription and amplification of the cDNA by PCR. DNA sequencing was performed in both directions of each PCR product. Results: All isolates clustered within the subgenotype IA irrespective of the geographic locations and timing of the clinical hepatitis. Among 18 Korean isolates, 9 isolates had 2 amino acid sequence changes and 2 isolates had 1 amino acid sequence change. These changes in the amino acid sequences are unique and have never been reported in HAV subgenotype IA. Conclusions: All isolated HAV had genotype (IA). Eleven of 18 isolates had unique changes in amino acid sequences. These data indicate that the endemic HAV has been circulating in Korea over a long period of time.