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李範烈 大韓法醫學會 1981 대한법의학회지 Vol.5 No.1
Current judicial evaluation in medical field has never been satisfiable to medical personnel. In principle, it requires the consent of the patient in medical treatment, especially in invasion upon the body. The author deals with the nature of consent. Valid consent premises the recognition of patient in the nature, meaning, extent of hazard of the medical invasion. Physician should explain the danger attended by surgical operation in principle. It is extremely difficult to establish standards about the scope of explanation. However, objective elements in the standard would be severity of the disease, possibility of recovery, hazard attended by inbasion, depth of invasion, object, etc.; subjective elements would be personality, age, culture, especially attitude, confidence with physician, and occupation of patient.
공동주택의 에너지 절약 및 공기환경개선을 위한 열교환기의 성능평가
김범석,정용호,박병윤,손장열 대한건축학회 2003 대한건축학회 학술발표대회 논문집 - 계획계/구조계 Vol.23 No.1
This study was aimed to suggest the appropriate residential heat and moisture recovery ventilation systems(HRVs) in order to maintain an acceptable indoor air quality for the climatic conditions of Korea. This study was developed from experimental data on HRV Performance specifications and HVAC system. Results show that total heat exchangers of rotary type is applied on HVAC system that is possible to conserve energy and improve indoor air quality.
Park, Yeul-Bum,Kim, Seong-Ho,Kim, Sang-Woo,Chang, Chul-Hoon,Ahn, Sang-Ho,Jang, Sung-Ho The Korean Neurosurgical Society 2006 Journal of Korean neurosurgical society Vol.40 No.3
Objective : Brachial plexus injury can produce a intractable chronic neuropathic pain. This study was undertaken to assess the long term outcome of microsurgical dorsal root entry zonotomy[MDT]. Methods : Between October 1997 and December 2002, 21 patients received MDT because of a intractable pain resulting from brachial plexus injury. Of these, 19 patients were followed for more than 2 years. Fourteen of 19 patients were male and patient ages ranged from 22 to 69 years. Mean pain duration was 36.8 months and all patients had severe pain of $9{\sim}10$ visual analogue scale. To achieve complete destruction of abnormal dorsal horns, thermocoagulation of the posterolateral sulcus were performed and careful gluing was done to prevent postoperative adhesion and pain recurrence. Results : Of the 19 patients, 15 patients had excellent [>75% reduction in pain] and good [$51{\sim}75%$ pain relief] results in a average postoperative period of 4.1 years. One patient had a poor [less than 25% pain relief] result. Three patients were considered to have a fair result [$26{\sim}50%$ pain relief]. Postoperative complications were 2 transient ipsilateral ataxia and 1 CSF fistula that resolved without surgical revision. Conclusion : These results indicate that MDT provides excellent long-term pain relief in medically intractable chronic neuropathic pain following brachial plexus injury without significant complications.
An Intramedullary Neurenteric Cyst in the Conus Medullaris with Recurrent Meningitis
Park, Yeul-Bum,Kim, Seong-Ho,Kim, Sang-Woo,Chang, Chul-Hoon The Korean Neurosurgical Society 2007 Journal of Korean neurosurgical society Vol.41 No.2
Neurenteric cysts are rare congenital lesions of the spine that are lined with endodermal epithelium. Their most common location is the cervico-dorsal region, and the mass usually lies ventral to the spinal cord. However the conus medullaris area location is an uncommon location. Neurenteric cysts are best treated by decompression and as near total excision of cyst membrane as possible. We report a case of a 7 year-old-girl with a neurenteric cyst in the conus medullaris. The patient had a history of meningitis and a gait disturbance. Magnetic resonance imaging [MRI] showed an intramedullary mass lesion in the conus medullaris with syringomyelia. There was no associated bone or soft-tissue anomaly. The mass was subtotally removed through a posterior approach. However 4 months later, meningeal irritation signs developed and MRI showed recurrence of the cyst. At the second operation, the cystic membrane was totally removed and the patient's neurological symptoms improved postoperatively. We reports a case of recurred neurenteric cyst occurred in unusual location with the review of literature.
박열범 ( Yeul Bum Park ),김민수 ( Min Su Kim ),김성호 ( Seong Ho Kim ),김오룡 ( Oh Lyong Kim ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2006 대한뇌종양학회지 Vol.5 No.2
Pituitary adenoma is one of the most common benign intracranial neoplasms. As the tumor enlarges, it compresses the surrounding pituitary gland, ultimately producing a pseudocapsule. We reviewed the clinical advantage and side effect of the extracapsular approach. A 66-year-old female was brought to the hospital due to bitemporal hemianopsia and headache. A brain magnetic resonance image showed a 16×32mm macroadenoma. The second case was a 57-year-old male who was brought to the hospital due to progressive visual loss. Radiologic evaluation showed a 20×32mm macroadenoma. By trans-sphenoidal microsurgery, we approached the outer part of the pseudocapsule between the normal pituitary gland along the tumor and surgically removed the adenoma. Histology showed tumor cell invasion in pseudocapsule. A follow up brain MRI showed total removal of the pituitary macroadenoma. A complication was cerebrospinal fluid leakage. The extracapsular approach for pituitary macroadenoma may be useful for one stage removal as it does not require additional maneuvers to push the tumor downward. However, careful dissection is necessary to avoid cerebrospinal fluid leakage.
Microsurgical Selective Obturator Neurotomy for Spastic Hip Adduction
Park, Yeul-Bum,Kim, Seong-Ho,Kim, Sang-Woo,Chang, Chul-Hoon,Cho, Soo-Ho,Jang, Sung-Ho The Korean Neurosurgical Society 2007 Journal of Korean neurosurgical society Vol.41 No.1
Objective : Cerebral palsy may induce harmful spastic hip adduction. We report the result of microsurgical selective obturator neurotomy, performed on 12 spastic hip adductions of 6 patients, followed clinically for at least 26 months postoperatively. Methods : Microsurgical selective obturator neurotomies, involving microsurgical resection of the anterior obturator nerve branches were performed on 6 patients from January 2000 through June 2003. All patients presented with the inability to sit and 2 patients complained of persistent, intractable pain. We used intraoperative bipolar stimulation to identify selected motor branches. Results : The procedure was performed bilaterally in all patients. In the 3 patients in whom contractures were present, microsurgical selective obturator neurotomies were accompanied by an additional tenotomy of the adductor muscles. Selective tibial neurotomy was performed on three of six patients who originally presented with a spastic ankle. Postoperatively, all spastic hip adductions were corrected more than 60 degrees in passive abduction-adduction amplitude. However, one patient who did not receive active postoperative physiotherapy demonstrated a decreased passive abduction-adduction amplitude upon follow-up. There were no surgical complications. Conclusion : We think microsurgical selective obturator neurotomy may be an effective procedure in the treatment of localized, harmful spastic hip adduction after failure of well conducted conservative treatment. As muscular contractions are often associated with spasticity of the hip adductors, an adjunctive tenotomy may be an option. Comprehensive postoperative physiotherapy is essential to improve long-term results.
ATP-Sensitive Potassium Channel-Deficient Mice Show Hyperphagia but Are Resistant to Obesity
Park, Yeul Bum,Choi, Yun Jung,Park, So Young,Kim, Jong Yeon,Kim, Seong Ho,Song, Dae Kyu,Won, Kyu Chang,Kim, Yong Woon Korean Diabetes Association 2011 Diabetes and Metabolism Journal Vol.35 No.3
<P><B>Background</B></P><P>The hypothalamus, the center for body weight regulation, can sense changes in blood glucose level based on ATP-sensitive potassium (K<SUB>ATP</SUB>) channels in the hypothalamic neurons. We hypothesized that a lack of glucose sensing in the hypothalamus affects the regulations of appetite and body weight.</P><P><B>Methods</B></P><P>To evaluate this hypothesis, the responses to glucose loading and high fat feeding for eight weeks were compared in Kir6.2 knock-out (KO) mice and control C57BL/6 mice, because Kir6.2 is a key component of the K<SUB>ATP</SUB> channel.</P><P><B>Results</B></P><P>The hypothalamic neuropeptide Y (NPY) analyzed one hour after glucose injection was suppressed in C57BL/6 mice, but not in Kir6.2 KO mice, suggesting a blunted hypothalamic response to glucose in Kir6.2 KO mice. The hypothalamic NPY expression at a fed state was elevated in Kir6.2 KO mice and was accompanied with hyperphagia. However, the retroperitoneal fat mass was markedly decreased in Kir6.2 KO mice compared to that in C57BL/6 mice. Moreover, the body weight and visceral fat following eight weeks of high fat feeding in Kir6.2 KO mice were not significantly different from those in control diet-fed Kir6.2 KO mice, while body weight and visceral fat mass were elevated due to high fat feeding in C57BL/6 mice.</P><P><B>Conclusion</B></P><P>These results suggested that Kir6.2 KO mice showed a blunted hypothalamic response to glucose loading and elevated hypothalamic NPY expression accompanied with hyperphagia, while visceral fat mass was decreased, suggesting resistance to diet-induced obesity. Further study is needed to explain this phenomenon.</P>