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허재택 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4
Background : The aim of this study are to detect the radiological findings of decompression sickness that could elucidate the pathogenesis of decompression sickness and to evaluate the results of management of decompression sickness with hyperbaric oxygen therapy. Methods : Forty nine patients(42 men and 7 women; 23-51, mean 32 years) were referred to the Hyperbaric Oxygen Therapy Center of Dong-A University Hospital for diving related injuries. All patients were studied neurologically and radiologically. Forty patients(81.6%) were type 1 decompression sickness who complained pains in various sites. Eight patients(16.3%) were type 2 decompression sickness with spinal cord involvement and underwent MR examination of the spinal cord. One patient(2.0%) was type 2 decompression sickness with chest involvement. Two patients(4.1%) among nine patients of type 2 decompression sickness were combined with type 3 decompression sickness who was suspected of cerebral embolization. All patients of type 1 were treated with therapeutic hyperbaric recompressions of US Navy treatment table 5 and auxiliary therapy. Six patients of type 2 were treated with US Navy treatment table 6 and two patients of type 3 were treated with US Navy treatment table 6A. Results : Magnetic Resonance Image(MRI) demonstrated patchy areas of increased signal intensity in the spinal cord on both T2-weighted and fast SE T2-weighted images in five patients with symptoms of spinal cord injury, corresponding to an area of the cord believed to be clinically involved. Chest X-ray and spiral computed tomogrphy(CT)scan demonstrated patchy area in right middle lobe of lung in type 2 decopmression sickness of chest involvement and disappeared two weeks later with hyperbaric oxygen therapy. All patients of type Ⅰ decompression sickness were improved with hyperbaric oxygen therapy and auxiliary therapy. Motor weakness of extrimities were improved immediately during hyperbaric therapy within hyperbaric chamber in six patients among eight patients of type 2 decompression sickness with spinal cord involvementbut. Two patients who were not improved during first time of hyperbaric oxygen therapy were remained neurological deficit 6 months later. One patient of type 2 decompression sickness with chest involvement were also improved with hyperbaric oxygen therapy and auxiliary therapy. Two patients of type 3 decompression sickness combined with hype 2 were also improved neurologically after hyperbaric oxygen therapy with auxiliary therapy. Conclusion : MRI has proved to be reliable in the detection of spinal cord involvement due to decompression sickness that were previously undetectable by other neuroradiological investigations(such as myelography, CT, angiography, isotopic tests) and its pathologic findings might be corresponded to ischemic injury of spinal cord. Patch area which was demonstrated by chest spiral CT and chest P-A of type 2 decompression sickness might be related to hemorrhage of lung parenchyme due to alveolar rupture which was resolved two weeks later. Therapeutic hyperbaric recompression is very effective in the management of decompresion sickness.
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손홍문,유재원,임만택 朝鮮大學校 附設 醫學硏究所 2004 The Medical Journal of Chosun University Vol.29 No.1
Background and Objectives: Calf spines are commonly used in biomechanical research as a substitute for human cadaveric spines. Despite widespread use, the validity of this model has not been thoroughly investigated. The purpose of this study was to perform biomechanical flexibility tests using identical methods and instrumentation on calf and cadaveric lumbar spines to determine whether significant differences exist between the results from the two models. Materials and Methods: Five fresh calf spines and five cadaver lumbar spines (L2-L5) were used for flexibility testing. The L2 and L5 vertebrae were used to attach the loading and base frames, respectively. Three reflective markers were attached to L3 and L4. Specimens underwent nondestructive biomechanical testing using the VICON 3-D motion analysis system. Maximum moments of 6.4 Nm were achieved in five increments of 1.6 Nm. The rotations of L3 with respect to L4 were measured to determine the stability of the specimens in five cases : 1) intact ; 2) partial discectomy, including partial laminectomy and partial facetomy ; 3) partial discectomy with ISOLA pedicle screw instrumentation ; 4) total discectorny with instrumentation and 5) instrumentation with inter body graft. Rotational angles were normalized to the intact case to determine the overall stabilizing effects. Data were analyzed using ANoVA to determine if significant differences existed. Results: In both models an increase in motion was observed after the partial discectorny, instrumentation reduced motion beyond the intact, and the total discectomy increased motion in all cases. Placement of the inter body graft decreased motion in axial rotation, flexion, and extension, but increased motion in lateral bending. A two-way ANoVA showed no significant differences between the two models during flexion and extension (p)O. 05) however, differences were noted during axial rotation and lateral bending (p<0.05). In all loading cases there were differences between the various testing cases (p<.05). Conclusion: This study demonstrated that calf lumbar spines can serve as a substitute for human cadaveric spines in biomechanical testing. Motion trends were similar for the two models in flexion and extension ; however, significant differences were found in axial rotation and lateral bending. These results suggest that the calf lumber spine can be a good model for in vitro biomechanical evalution of spinal instrumentation. The extrapolation of calf spine data to the in vivo case, especially during axial ratation and lateral bending, should carefully consider the variations between the two models.
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고동희,정재면,홍택원,김동욱,전재범,김태환 한양대학교 의과대학 2002 한양의대 학술지 Vol.22 No.2
Myositis ossificans progressiva is rare heritable disorder of connective tissue characterized by congenital malformation of the great toes and by progressive ossification of striated muscle and connective tissue associated with pain and disability. Myositis ossificans progressiva occurs sporadically and is transmitted as a dominant trait with variable expression and complete penetrance. The disease progress from axial to appendicular, cranial to caudal, and proximal to distal sites. We present an 21-year-old man with typical muscle ossification, skeletal malformation and spondylopathy and a review of the pathogenesis, clinical manifestations and treatment options of the rare disease.
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이창민,최택진,김성훈,유재구 漢陽大學校 體育科學硏究所 2003 體育科學 Vol.23 No.23
For the purpose of reinforcing competitive power with foreign enterprises, this study was aimed at offering materials required to establish efficient marketing strategies by analyzing Korean ski consumers' consumptive behaviors. According to this, by using Convenience Sampling Method, 1 selected as the object of the survey 600 among skiers who visited J Skiing Ground and L Skiing Ground located in Gyunggi-do in the 2002-2003 season, distributed questionnaires to them, performed a survey by interview to them, and analyzed521 skiers' behaviors of purchasing goods for skiing, As the result, 1 could obtain the following conclusions. First, for the considerations when sports consumers purchased goods for skiing, there occurred statistically significant differences, in price, in sexes, ages, experiences and dates of using them, in design and color tone, in ages, experiences, dates of using them and skiing levels, in practicality and convenience, in ages, income levels, experiences and dates of using them, in manufacturers and their brands, in ages, income levels, experiences, dates of using them and skiing levels, and, in fashion, in ages, income levels, experiences, dates of using them and skiing levels. Secondly, for the final determinants when they purchased goods for skiing, asa whole, practicality and convenience were shown to be highest. There occurred statistically significant differences in all parts except sexes. Thirdly, for the places when they purchased goods for skiing, it was indicatedthat, as a whole, they purchased them most in an exclusive skiing shop. There occurred statistically significant differences in all parts.
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Choi, Jae-Hyung,Park, Hyun-Seok,Kim, Dae-Hyun,Cha, Jae-Kwan,Huh, Jae-Taeck,Kang, Myongjin The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.54 No.2
Objective : Neurologic complications during carotid artery stenting (CAS) are usually associated with distal embolic event. These embolic incident during CAS are highly associated with the carotid plaque instability. The current study was undertaken to identify the angiographic characteristics of carotid plaque vulnerability, which was represented as filling defect in the cerebral protection filters during CAS. Methods : A total of 107 patients underwent CAS with use of a distal protection filter. Angiographic carotid plaque surface morphology was classified as smooth, irregular, and ulcerated. To determine predictable factors of filling defect in the protection filters, 11 variables were retrospectively analyzed which might influence filling defect in the protection filters during CAS. Results : Filling defects during CAS were presented in the 33 cerebral protection filters. In multivariate analysis, angiographic ulceration [odds ratio (OR), 6.60; 95% confidence interval (CI) : 2.24, 19.4; p=0.001], higher stenosis degree (OR, 1.06; 95% CI : 1.00, 1.12; p=0.039), and coexistent thrombus (OR, 7.58; 95% CI : 1.69, 34.05; p=0.08) were highly associated with filling defect in the cerebral protection devices during CAS. Among several variables, angiographic surface ulceration was the only significant factor associated with flow stagnation during CAS (OR, 4.11; 95% CI : 1.33, 12.72; p=0.014). Conclusion : Plaque surface morphology on carotid angiography can be a highly sensitive marker of plaque instability during CAS. The independent risk factors for filling defect in the filter devices during CAS were plaque ulceration, stenosis degree, and coexistent thrombus.
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Choi, Jae-Hyung,Kang, Myung-Jin,Huh, Jae-Taeck The Korean Neurosurgical Society 2011 Journal of Korean neurosurgical society Vol.50 No.2
Objective : The purpose of this study was to analyze the clinical and anatomic features involved in determining treatment modalities for anterior communicating artery (AcoA) aneurysms. Methods : The authors retrospectively evaluated 112 AcoA aneurysms with pretreatment clinical features including age, Hunt and Hess grade, medical or neurological comorbidity, and anatomical features including aneurysm size, neck size, dome-to-neck ratio, vessel incorporation, multiple lobulation, and morphologic scoring system. Post-treatment clinical results were classified according to the Glasgow Outcome Scale, and anatomic results in coiled patients were classified according to the modified Raymond scale. Using multivariate logistic regression, the probabilities for decision making between surgical clipping and coil embolization were calculated. Results : Sixty-seven patients (60%) were treated with surgical clipping and 45 patients (40%) with endovascular coil embolization. The clinical factor significantly associated with treatment decision was age (${\geq}$65 vs. <65 years) and anatomical factors including aneurysm size (small or large vs. medium), dome-to-neck ratio (<2 vs. ${\geq}$2), presence of vessel incorporation, multiple lobulation, and morphologic score (${\geq}$2 vs. <2). In multivariate analysis, older patients (age, 65 years) had significantly higher odds of being treated with coil embolization relative to clipping (adjusted OR=3.78; 95% CI, 1.39-10.3; p=0.0093) and higher morphological score patients (${\geq}$2) had a higher tendency toward surgical clipping than endovascular coil embolization (OR=0.23; 95% CI, 0.16-0.93; p=0.0039). Conclusion : The optimal decision for treating AcoA aneurysms cannot be determined by any single clinical or anatomic characteristics. All clinical and morphological features need to be considered, and a collaborative neurovascular team approach to AcoA aneurysms is essential.
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Choi, Jae-Hyung,Park, Hyun-Seok,Kim, Dae-Hyun,Cha, Jae-Kwan,Huh, Jae-Taeck,Kang, Myongjin The Korean Neurosurgical Society 2015 Journal of Korean neurosurgical society Vol.57 No.5
Background : Higher reperfusion rates have been established with endovascular treatment for acute ischemic stroke patients. There are limited data on the comparative performance of mechanical thrombectomy devices. This study aimed to analyse the efficacy and safety of the stent retriever device (Solitaire stent) by comparing procedure time, angiographic outcome, complication rate and long term clinical outcome with previous chemical thrombolysis and mechanical thrombectomy using penumbra system. Method : A retrospective single-center analysis was undertaken of all consecutive patients who underwent chemical thrombolysis and mechanical thrombectomy using Penumbra or Solitaire stent retriever from March 2009 to March 2014. Baseline characteristics, rate of successful recanalization (modified Thrombolysis in Cerebral Infarction score 2b-3), symptomatic intracerebral hemorrhage, procedure time, mortality and independent functional outcomes ($mRS{\leq}2$) at 3 month were compared across the three method. Results : Our cohort included 164 patients, mechanical thrombectomy using stent retriever device had a significant impact on recanalization rate and functional independence at 3 months. In unadjusted analysis mechanical thrombectomy using Solitaire stent retriever showed higher recanalization rate than Penumbra system and chemical thrombolysis (75% vs. 64.2% vs. 49.4%, p=0.03) and higher rate of functional independence at 3 month (53.1% vs. 37.7% vs. 35.4%, p=0.213). In view of the interrelationships between all predictors of variables associated with a good clinical outcome, when the chemical thrombolysis was used as a reference, in multiple logistic regression analysis, the use of Solitaire stent retriever showed higher odds of independent functional outcome [odds ratio (OR) 2.62, 95% confidence interval (CI) 0.96-7.17; p=0.061] in comparison with penumbra system (OR 1.57, 95% CI 0.63-3.90; p=0.331). Conclusion : Our initial data suggest that mechanical thrombectomy using stent retriever is superior to the mechanical thrombectomy using penumbra system and conventional chemical thrombolysis in achieving higher rates of reperfusion and better outcomes. Randomized clinical trials are needed to establish the actual benefit to specific patient populations.
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