60세 이상 환자의 척추수술

윤석만,이경석,도재원,배학근,윤일규 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Objective: Advances in surgical technique, anesthesia and perioperative patient management, coupled with the rapid increase in the population of patients reaching their 60s or older, have led to a signiticant rise in spinal precedures. The objective of this study was to evaluate frequency of the disease, surgical results and postoperative complications of the aged patients who underwent spinal surgeries. Methods : We reviewed all spinal procedures for spinal lesions including degenerative diseases, trauma, tumor and others in patients aged 60 years or older between January 1 1994 and October 1 1998(56 men and 26 women), retrospectively. Final outcome was assessed by telephone interview with the patient or the family in 67.1%(55/82). Results : There were 56 male patients and 26 female patients. There were 57 cases of degenerative diseases, 14 cases of trauma, 5 cases of metastaisis, 4 cases of infection and 2 cases of others. According to the level of surgical procedures, there were 20 cases fo cervical spine, 8 cases of thoracic spine, 54 cases of lumbar spine. Postoperaive complications included the following(17/82): 7 dural tears, 2 sepsis, 2 nerve root injury and 6 others. There were no operation-related deaths. During follow up period, ten patients(12.2%) had died, 45 patients(54.9%) were contacted and 27 patients(32.9%) could not be located. Mean follow up period for the 45 patients contacted was 26.1±15.7 months. Of the 45 persons contacted, 34(75.6%) reported improvement, 6(13.3%) no change and 5(11.1%) aggravation of their preoperative symptoms. Conclusion: Spine surgery in patients aged 60 years or older has higher complication rate compare to the younger but it is reasonable to consider the surgical procedures even in the elderly if it is needed. We should give attention not to tear the dura during the surgical procedures, especially in the elderly.

장기입원환자 관리 방해요인

이경석,윤석만,권희,이호,김혜경,조미자,한규남,김명성 순천향의학연구소 2003 Journal of Soonchunhyang Medical Science Vol.9 No.1

Background: Recently the health insurance review agency tried to cut off the cost of unnecessary hospital stay. It is important to reduce the prolonged occupation of the hospital beds. However, there are some obstacles of the management for the prolonged bed occupation. We report our experiences and the problems of bed-control. Methods: To increase the rate of effective bed-usage, a task force was made. This team was consisted of 4 dctors, 2 nurses and 2 personnel of the administrative department. From December 20th 2001 to May 17th 2002, the task force analysed the rate, number and causes of the prolonged (more than 60 days, regardless of the disease entities) bed occupation. We announced and explained the necessity of bed-control and actively pressed to reduce the prolonged bed occupation. Results: The number of the prolonged bed occupation was 71 at the beginning of the management. It was reduced to 46 at best, then turned back to 65 at the end. It seems to be impossible to reduce the prolonged bed occupation until there are sufficient numbers of long-term care facilities. Aggressive bed control makes the sick patients to move every two or three months, it is never desirable. Conclusion: We cannot expect any Quality Improvements without improvement of the wrong system. Prior to the management for the prolonged bed occupation, it is necessary to build a sufficient number of long-term care facilities.

이층지반과 단일지반의 열전달 거동 특성 평가

윤석(Seok Yoon),박스칸(Skan Park),박현구(Hyun-Ku Park),고규현(GyuㅡHyun Go),이승래(Seung-Rae Lee) 한국지열·수열에너지학회 2011 한국지열에너지학회논문집 Vol.7 No.2

This paper presents how to analyze heat transfer characteristics of double-layered soils. Thermal response tests were conducted to measure the ground thermal conductivities of Joomunjm sand and douole layered soils filled in a steel box of which the size is 5m × 1m × 1m. Double-layered soils were composed of Joomunjm sand and Kaoline clay. Each Lhermal conductivity of Joomurym sand and Kaloine clay was measured by using Heat Flow Meter considering different void ratio. The ground thermal conductivity of doubleㅛlayered soils was 15% smaller than that of Joomunjin sand.

자발성 뇌지주막하 출혈 환자에서 최초 뇌실 크기의 임상적 의의

신일영,윤일규,윤석만,도재원,이경석,배학근,최순관,변박장 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

The purpose of this study is to invesetigate the clinical significance of initial enlargement of ventricle in the patients who had aneurysmal SAH. Of the total 821 patients with aneursmal SAH who were registerd in SAH data bank system between 1989-1999, 307 patients who had been already measured in the size of ventricle at the time of admission, were studied retrospectively. The size of ventricle was calculated by bifrontal index. Normal size of ventricle was defined as 30% or less, mild enlargement was defined as 31 to 39%, and moderate enlargement of vertricle was defined as more than 39% in bifrontal index. The sizes of ventricle using bifrontal index were analysed according to the age, sex, blood pressure, consciousness at admission, medical history of hypertension, location of ruptured aneurysm, Fisher's grade on CT(computerized tomography) scan at the time of admission, cerebral vasospasm, intraventricular hemorrhage (IVH), performance of external ventricular drainage (EVD), and prognosis at discherge. Chi-square test and ANONA were used in the statistical evaluation. The results were as follows : 1) Of the 307 patients, 235(76.5%) had a mild to moderate enlargement of ventricle at the time of admission (more than 30% in bifrontal index). 2) The size of ventricle was enlarged according to the increase of age (p<0.05). 3) In the patients who had ruptured aneurysm on anterior cerebral artery, the size of ventricle significantly increased and showed a higher incidence in mild enlargement compared with moderate enlargement of ventricle (p<0.05). 4) The size of ventricle increased in th patients who had IVH and the EVD was more frequently performed in th patients who had the enlarged ventricle associated with IVH (p<0.05). 5) In the patients who had high Fisher's grade, the size of ventricle had a tendency to increase, but there was no statistical significance. 6) In the patients who had poor prognosis, the size of ventricle had a tendency to increase, but there was no statistical significance. Conclusively, the initial size of ventricle was enlarged in th aged patients, ruptured aneurysm on anterior communicating artery, high FIsher's grade, patients associated with IVH. Considering those factors, prediction for the enlargement of ventricle size may help to treat the patients suffering aneurysmal SAH.

외상후 발작의 위험인자에 대한 조사

이재학,배학근,윤석만,도재원,이경석,윤일규,최순관,변박장 순천향의학연구소 2001 Journal of Soonchunhyang Medical Science Vol.7 No.1

Risk Factors for Posttraumatic Seizure The authors evaluate the risk factors for posttraumatic seizures. this prospective study was performed in a series of 470 head injured patient from January 1996 to Decomber 1998. The patients who were dead within 1 week of injury or children from 3 years old and under were excluded. There were 358 male and 112 female with a mean age of 35.2±22.8 years (range, 4-88 years). The results were as follows : 1). Of the 470 patients, pasttraumatic seizure occurred in 48 patients(10.2%): early seizure in 28(6%) and late seizure in 20 patients(4.2%). 2). The clinical risk factors for posttraumatic seizure were poor consciousness at admission, presence of brainstem herniation signs, poor GCS score, and posttraumatic amnesia more than 24 hours after trauma(p<0.001). 3). The radiological risk factors for posttraumatic seizure were subdural hematoma(p<0.001), intracerebral hematoma (p<0.02), mutiple intracranial CT lesions(p<0.001), or delayed lesions on follow-up CT scans(p<0.001). the incidence of seizure increased according to the severity of diffuse brain lesion(p<0.001), and the seizure rate in mass lesion was higher than that in diffuse lesion(p<0.001). 5). Hypoxia and coagulopathy had a statistically significant influence on posttraumatic seizure(p<0.05). Hypoxia had a infuence on occurrence of late seizure(p<0.05). 6). The incidence of posttraumatic seizure signiticantly increased in surgical group compared with coservative group(p<0.001) and significantly increased in patient who underwent decompressive craniectomy compared with those who underwent craniotomy(p<0.001) 7). Preventive administration of antiepileptic drugs decreased the incidence of early seizure, but did not affect on the reduction of late seizure. 8). Multivariate logistic regression analysis showed the subdural hematoma, GCS score, delayed lesion, and intracerebral hematoma in order of importance for seizure risk. in conclusion, the risk factors affecting on the occurrence of seizure were clinical status at admission, CT lesions, and severity of diffuse brain inJury. Considering that hypoxia affected on the late seizure, it is necessary to detect and treat it immediately after trauma. In addition, the patients who underwent decompressive craniectomy should be carefully followed to evaluate the risk of late seizure. Even though preventive administration of antiepileptic drugs had a tendency to decrease the incidence of early seizure, it is unclear whether administration of antiepileptic drugs can reduce the incidence of posttraumatic seizures. Prospective study will be needed in the selected patients.

들기자세 유형별 L₄-L?의 근전도 분석 : At the Base Knee Angle 무릎각도를 중심으로

서국웅,노석규,윤양진,정미라,이훈식,박승범 釜山大學校 附設 體育科學硏究所 1998 體育科學硏究所 論文集 Vol.14 No.-

This research is to find out the most suitable lifting posture and to provide fundamental data for preventing usual injuries. To do this, we select five male graduates and five female graduates of P university, analyze their muscular actions in terms of posture types, measure the limit value of weight lifting by comparing each lifting posture type(knee angle 40˚, 80˚, 180˚) with action amplitudes of two parts of erector spinae muscle, and draw our conclusion as follow ; 1. In case of every lifting posture(that is, knee angle 40˚, 80˚, 180˚), females have higher muscular conductivity value in L⁴-L? of right erector spinae muscle than males(p<.001), but in L⁴-L? of left erector spinae males has higher muscular conductivity value than females(p<.001). 2. Males show lower degree of change in muscular conductivity value from 10kg to 25kg weight lifting. 3. Females show gradually increasing degree of change in muscular conductivity value according as weight lifting is heavier. 4. Males show the constant muscular conductivity action of average 50∼110㎶ in the L⁴-L? in case of each lifting posture, knee angle 40˚, 80˚, and 180˚. 5. Females also show the constant muscular conductivity action of average 100∼200㎶ in the L⁴-L? in case of each lifting posture, knee angle 40˚, 80˚, and 180˚. But they show more active muscular conductivity in more than 15kg weight lifting, IOSHIC permission load value. In short, in case of males, weight lifting up to 25kg has little effect on erector spinae muscle but in case of females, weight lifting from more than 15kg has gradual effect on erector spinae muscle. Therefore, the muscular conductivity values of various posture types(by knee angle)are to be identified according to weight lifting steps.

Residual Stress and Optical Properties in a Post-Annealed Ta2O5/SiO2 Multilayer Prepared by Using Dual-Ion-Beam Sputtering

Seok-Gyu Yoon,Dae-Ho Yoon,D. H. Yoon 한국물리학회 2006 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.49 No.1

The residual stress and optical properties of Ta2O5(H)/SiO2(L) single and multilayers were examined as functions of the annealing temperature (200 400 C) using dual ion beam sputtering (DIBS). The residual stress of the annealed SiO2, Ta2O5 single layer was released, and all were found to be in compressive stress when the annealing temperature ranged from 200 to 300 C. The residual stress of the as-deposited (HL) multilayer film increased as the number of layers increased. The residual stress of the (HL)3 and the (HL)4 films was released as the annealing temperature was increased. The transmittance wavelength of the (HL)4 layer shifted to a longer wavelength as the temperature was increased and the rms roughness increased.

화생방 정찰차 운용 속도가 IMS 센서 탐지 성능에 미치는 영향

윤석규(Seok-Gyu Yoon),홍창기(Chang-Ki Hong),김윤제(Youn-Jea Kim) 대한기계학회 2017 대한기계학회 춘추학술대회 Vol.2017 No.11

Comparison of Left Ventricular Hypertrophy, Fibrosis and Dysfunction According to Various Disease Mechanisms such as Hypertension, Diabetes Mellitus and Chronic Renal Failure.

Koh, Yoon-Seok,Jung, Hae-Ok,Park, Mahn-Won,Baek, Joo-Yeoul,Yoon, Sung-Gyu,Kim, Pum-Joon,Ihm, Sang-Hyun,Chang, Kiyuk,Oh, Yong-Seog,Youn, Ho-Joong,Baek, Sang Hong,Chung, Wook-Sung,Seung, Ki-Bae,Kim, Jae Korean Society of Echocardiography 2009 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.17 No.4

<P>Left ventricular hypertrophy (LVH) has been known as an important predictor of prognosis of cardiovascular disease. Carboxy-terminal propeptide of procollagen type I (PIP) is related with myocardial fibrosis. We sought to analyze the differences in the characteristics of LVH, myocardial fibrosis, and LV functions among hypertension (HBP), diabetes mellitus (DM) and chronic renal failure (CRF).</P>

C-pillar 유동 가이드 휜이 자동차 공력성능에 미치는 영향

윤석규(Seok-Gyu Yoon),이지구(Ji-Gu Lee),이종철(Jong-Chul Lee),김윤제(Youn-Jea Kim) 대한기계학회 2017 대한기계학회 춘추학술대회 Vol.2017 No.11