제 1, 2 경추간 판하철사고정술 없는 후방 경관절 나사못 고정술 및 골유합술

신용환,황정현,성주경,황성규,함인석,박연묵,김승래,Shin, Yong Hwan,Hwang, Jeong Hyun,Sung, Joo Kyung,Hwang, Sung Kyu,Hamm, In Suk,Park, Yeun Mook,Kim, Seung Lae 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.11

Objective : The goal of this study was to evaluate the clinical outcome of the posterior C1-2 transarticular screw fixation without C1-2 sublaminar wiring in atlantoaxial instability. Methods : Between Apr. 1995 and Feb. 2000, we used this technique in treat randomly selected 17 patients (11 men, 6 women) who had atlantoaxial instability. The causes of instability were : type II-A odontoid process fracture(10 cases) ; type II-P odontoid process fracture(1 case) ; Os odontoideum(2 cases) ; transverse ligament laxity due to rheumatoid disease(1 case) ; and, transverse ligament injury without bone fracture(3 cases). All cases were operated with posterior C1-2 transarticular screw fixation with 3.5mm cortical screw and interlaminar iliac graft without sublaminar wire fixation. The mean follow-up period was 28 months(5 to 58 months) and the mean age at the time of operation was 41 years(15 to 68 years). All Patients were allowed to ambulate with Philadelphia neck collar on the first post-operation day. Results : Bony fusion was successfully achieved in all cases demonstrated at 3-month follow-up studies. There was no operative mortality or morbidity. Conclusion : The authors conclude that the posterior transarticular screw fixation without C1-2 sublaminar wiring provide adequate stability with high bony union rate in atlantoaxial instability of various causes.

Insulin 측정용 방사면역측정법 시약의 평가

신용환,김윤현,이일규,김지영,석재동,신숙희,Shin, Yong Hwan,Kim, Yun Hyun,Lee, Il Kyu,Kim, Ji Young,Seok, Jae Dong,Shin, Suk Hee 대한핵의학기술학회 2012 핵의학 기술 Vol.16 No.2

혈중 Insulin 농도는 췌장 ${\beta}$세포의 인슐린 분비기능을 반영하고 당뇨병의 진단, 병태 파악, 내당능 이상의 원인감별에 유용한 지표이다. 핵의학검사실에서 사용하고 있는 혈중 Insulin 측정용 시약들은 제조회사마다 검사방법 뿐만 아니라 비용효과 측면, 정밀도 등 정도관리 측면에서도 다소 차이를 보이고 있다. 따라서 Insulin 측정용 방사면역측정법 시약들의 제조 회사별 비교를 통해 진단적 성능을 평가하고자 본 연구를 시행하였다. 2009년 8월 59명의 환자 검체를 대상으로 시행된 3개 제조회사(Biosource, Siemens, TFB)의 혈중 Insulin측정치와 2011년 12월 68명의 환자 검체를 대상으로 시행된 4개 제조회사(Immunotech, Izotope, BNIBT, Cisbio)의 혈중 Insulin측정치를 비교 평가하였다. 이들 7개 제조회사별 Insulin측정치에 대하여 정밀도, 회수율, 상관관계를 살펴보았으며 일부 인슐린 고농도 특이검체를 가지고 희석시험을 통해 혈중 Insulin측정치를 상호 비교 평가하였다. 혈중 Insulin 측정은 시약 내 설명서의 권고사항을 준수하여 실시하였으며 결과 검증을 위한 통계 프로그램은 SPSS 12.0을 이용하였다. 측정 내 정밀도는 Biosource, Siemens, TFB, Immunotech, Izotope, BNIBT, Cisbio 7개 제조회사 모두 5.0% 이하의 변이계수를 보였다. 회수율은 저, 중, 고 세가지 농도의 혈청에서 Biosource, Siemens, TFB시약이 각각 94.2~103.7%, 99.0~104.6%, 99.7~107.6% 구간을 보였고 Immunotech, Izotope, BNIBT, Cisbio 시약에서 각각 93.5~99.1%, 91.4~99.1%, 99.2~131.0%, 84.8~102.3% 구간의 회수율을 보였다. Biosource 시약을 기준으로 비교한 상관관계에서 Siemens 시약이 R2=0.96(P<0.01), TFB시약이 R2=0.99(P<0.01)를 보였으며 TFB 시약을 기준으로 비교한 상관관계에서는 BNIBT시약(R2=0.80, P<0.01)을 제외한 대부분의 시약에서 강한 상관관계(R2=0.96 이상, p<0.01)를 보였다. 200 ${\mu}IU/ml$ 이상 고농도 희석시험에서는 당뇨병환자 검체를 대상으로 했을 때 7개 제조회사 시약 모두 고농도값을 정상적으로 측정하였다. 하지만, 인슐린 종양 검체를 대상으로 측정한 검사에서는 TFB, Siemens, Izotope, Cisbio시약들은 고농도값을 정상적으로 측정하였지만 Biosource와 Immunotech 시약에서 각각 47.4 ${\mu}IU/ml$, 72.3 ${\mu}IU/ml$의 측정치를 보였다. 혈중 Insulin 측정용 방사면역측정법 시약들은 전반적으로 성능이 임상 적용 가능한 범위의 측정 정밀도를 보이면서, 우수한 회수율과 양호한 상관관계를 보였지만 일부 시약에서 고농도 특이검체를 대상으로 Insulin을 측정한 검사에서 고농도값을 제대로 측정하지 못했다. 따라서 여러가지 요인을 놓고 볼 때 비용 효과측면과 자동화 장비에 대한 호환성, 검사 반응시간등 각 검사실 환경에 맞는 시약과 진단적 성능이 보다 우수한 시약을 선정하여 사용한다면 정확하고 신속한 결과보고에 있어서 많은 도움이 된다고 사료된다. Purpose : Serum insulin levels are useful indicator which of reflecting the function of insulin secretion in pancreatic ${\beta}$ cell and diagnosis of diabetes, differentiating the cause of impaired glucose tolerance. Insulin measurement kits have shown some differences in many ways such as test methods as well as quality control. The purpose of this study was to evaluate the diagnostic performance of seven manufacturing companies commercial kits. Materials and Methods : The values of insulin measured by three manufacturing companies (Biosource, Siemens, TFB) with 59 samples in August 2009 were compared with those measured by four manufacturing companies (Immunotech, Izotope, BNIBT, Cisbio) with 68 samples in December 2011. We evaluated precision, recovery rate, dilution test and correlation of serum insulin measurement using seven manufacturing company kits. Statistical program SPSS 12.0 was used for the verification of results. Results : The coefficients variation of the precision on all seven different kits were showed within 5.0%. Recovery rate of Biosource, Siemens, TFB kits on three different levels showed 94.2~103.7%, 99.0~104.6%, 99.7~107.6% respectively. Immunotech, Izotope, BNIBT, Cisbio were 93.5~99.1%, 91.4~99.1%, 99.2~131.0%, 84.8~102.3% respectively. There was strong correlation between the measurement of insulin by Biosource kit and that by two commercial kits, Siemens (R2=0.96), TFB (R2=0.99). There was good correlation between the measurement of insulin by TFB kit and that by three commercial kits, Immunotech (R2=0.97), Izotope (R2=0.96), Cisbio (R2=0.97). In the dilution test performed with more than 200 ${\mu}IU/ml$ high concentration samples, samples with diabetes correctly was measured in all seven manufacturing kits. However, as measured with insulinoma samples TFB, Siemens, Izotope, Cisbio kits were correctly measured, but Biosource and Immunotech kits were measured 47.4 ${\mu}IU/ml$, 72.3 ${\mu}IU/ml$, respectively. Conclusion : Serum Insulin radioimmunoassay kits were showed excellent precision, correlation and good recovery rate. However, some kits were not measured correctly in the high concentration insulin values. when selecting a kit should be considered many factors that cost effectiveness, compatible for automation equipment, high performance kit, the environment for each laboratory such as reaction time and reporting time.

뇌동맥류 수술 환자에서 급성 수두증 병발후 단락술이 요하는 만성 수두증 합병의 임상적 및 형태학적 비교

신용환,황정현,함인석,성주경,황성규,박연묵,김승래,Shin, Yong Hwan,Hwang, Jeong Hyun,Hamm, In Suk,Sung, Joo Kyung,Hwang, Sung Kyoo,Park, Yeun Mook,Kim, Seung Lae 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.11

Objectives : The incidence of acute hydrocephalus(AHC) after aneurysmal subarachnoid hemorrhage reported as 13-31%. The AHC resolves spontaneously in some cases(simple AHC), but about 30% of the AHC progresses to shunt-dependent hydrocephalus(SDHC). The aim of this study was to understand clinical predisposing factors causing SDHC with performing differential clinical analyses between 2 subgroups, the simple AHC and the progresed SDHC. Methods : The 250 surgically treated patients with aneurysmal SAH over last two years were evaluated. Forty four patients(17.6%) of them showed the AHC. Of theses 37 cases were retrospectively analyzed, excluding 7 patients who died within 2 weeks after hemorrhage attack. Of the 37 AHC cases, 21 patient(56.8%) were complicated with the simple AHC, and 16 cases(43.2%) were progressed SDHC. Results : The older age(p<0.05), poor clinical grade(p=0.03), larger amount of SAH in perimesencephalic cistern on CT scan(p=0.005) were significantly related to the SDHC. No significant difference was noted in aneurysm location, multiplicity, rebleeding, hypertension and Fisher grade between 2 subgroups. Conclusion : Of the total 37 AHC, the simple AHC was 56.8% and the progressed SDHC 43.2%. The older age, poor clinical grade, large amount of SAH in perimesencephalic cistern were significant predisposing factors causing the SDHC. The large amount of SAH in perimesencephalic cistern is the single most important predisposing factor developing the progressed SDHC.

자동화 권선을 위하여 조립형 보빈을 사용한 LED TV용 LLC 공진형 변압기 설계

신용환(Yong-hwan Shin),이형란(Xinlan Li),김종해(Jong-hae Kim),원재선(Jae-Sun Won),오동성(Dong-Sung Oh),신휘범(Hwi-Beom Shin) 전력전자학회 2012 전력전자학술대회 논문집 Vol.2012 No.7

S band 용 DRO 의 설계 및 제작

신용환(Yong Hwan Shin),임영석(Yeong Seog Lim) 전남대학교 전자통신기술연구소 1998 전자통신기술논문지 Vol.1 No.1

N/A

Dual Source CT에서 Coronary검사의 방사선량 비교분석

신용환(Yong Hwan Shin),안병환(Byoung Hwan Ahn),옥승호(Seung Ho Ock),권오성(Oh Sung Kwon),임흥선(Heung Seon IM),김명구(Myeong Goo Kim) 대한CT영상기술학회 2008 대한CT영상기술학회지 Vol.10 No.1

Purpose This Paper compared the Radiation Dose of Dual Source ECG-gating Spiral Scan and ECG-triggered Sequential Scan in coronary CT. and Analysed how much the Radiation dose reduced in sequential scan. Materials and Methods We studied Spiral and Sequential scan in Phantoms and used by Dual source MDCT called Definition. Scan was made as follows;(Spiral scan:Kvp/mAs/Rotation time/Pitch/Scan time/=100/320/0.33/0.28/8.82, Sequential scan: Kvp/mAs/Table feed/Cycle time/Scan time =100/180/20/1.37/8.22). We used ECG Simulator as equipment( NETECH) Contrast media diluted (CM :1, Normal saline:24) An Experimental method compared CIDivol and CIDIDlP with Spiral and Sequential scan and were measured. Qualitive analysis evaluate the CTDIvol, and CTDIDLP, and SNR through ROI analysis. Quantitative analysis evaluate the Uniformity and noise, Preference Results The results obtained as follows; Radiation dose reduced about 28.8% in Sequential scan than Spiral scan. SNR increased in Spiral scan than Sequential scan. The image Qualities with Sequential scan showed better than Spiral scan. Conclusion In conclusion, by comparing the Phantoms image with Spiral scan and Sequential Radiation dose reduced in Sequential scan. If used and selected properly Sequential scan useful clinically applied to the patients with coronary Disease. (Heart Rate <60-65bpm)

화력발전소 과열기 모델링 및 파라미터 추정

신용환(Yong-Hwan Shin),이형란(Xinlan Li),신휘범(Hwi-Beom Shin) 전력전자학회 2010 전력전자학술대회 논문집 Vol.2010 No.7

This paper presents the superheater dynamic modeling and parameter estimation for the thermal plant boiler. The temperature control is closely related to the power plant efficiency and boiler life. The dynamic modeling of the superheater and desuperheater is essentially needed and developed by using the heat balance principle. The simulated model outputs are well matched with the actual ones. It is expected that the proposed model is useful for the temperature controller design.

Active Inductor를 위한 능동대역통과필터의 설계 및 제작

이기훈,신용환,임영석 전남대학교 전자통신기술연구소 2001 전자통신기술논문지 Vol.4 No.1

In this paper, Active Band Pass Filter using AI(Active Inductor) is designed and fabricated. Active Inductor represented 1.74 nH inductance only using Single P-HEMT (Psedomorphic High Electron Mobility : ATF-34143 producted by Agilent) and its characteristies are similiar to ideal 2 nH inductor. The whole circuit was fabricated on the Teflon substrate ( ε_(y)=3.38, T=0.78mm) using a microstrip line and ADS(Advanced Design System) was used in order to design and optimize. The results between simulation and measurement of Active Band Pass Filter have good agreements. The results indicate that Active Band Pass Filter using AI (Active Inductor) adequate for recievers of IMT-2000 User Equipments

X - band 용 전압제어 ARO 의 설계 및 제작

정용훈(Yong Hun Jung),신용환(Yong Hwan Shin),임영석(Yeong Seog Lim) 전남대학교 전자통신기술연구소 2000 전자통신기술논문지 Vol.3 No.1

N/A

Proinsulin 참고치 설정에 관한 연구

남이문,신용환,김지영,석재동,Nam, Yee Moon,Shin, Yong Hwan,Kim, Ji Young,Seok, Jae Dong 대한핵의학기술학회 2013 핵의학 기술 Vol.17 No.1

검사실에서 사용하는 참고치는 검사결과의 해석에 기준이 되는 것으로 적절치 못한 경우 위양성이나 위음성과 같은 오류를 범할 수 있어 올바른 참고치 설정은 매우 중요하다. Proinsulin은 insulin의 전구체물질로서 당뇨병과 인슐린종의 판단에 중요한 검사로 사용되고 있다. 현재 본원 검사실에서 사용되는 Proinsulin 시약은 미국에서 제조되었고 참고치 또한 제조사에서 제공하는 수치를 검증을 통해 사용하였다. 그러나 통상적인 추천은 각 검사실에서 검사실 집단에 적합한 참고치를 도출하여 사용하는 것을 권고하고 있다. 따라서 본원에 내원하는 수진자를 대상으로 참고치를 재평가하기로 하였다. 2011년 12월 8일부터 21일까지 본원 건강의학센터에 내원한 수진자 737명 중 당뇨병 진단을 받은 환자와 Fasting Glucose, HbA1c, Insulin, C-peptide 검사에서 참고치를 벗어 난 환자를 제외한 563명을 대상으로 하였다. 대상자 563명 (남자 275명, 여자 288명)을 3가지 집단(전체, 남자, 여자)으로 구분하고, SPSS(version 19.0)를 사용하여 정규분포 검증을 실시하였다. 각각의 집단 모두 정규분포를 이루지 않아 비정규분포 시 사용하는 Percentile법으로 하한 2.5%에서 상한 97.5%를 참고치 범위로 설정하였다. 전체 대상의 측정값을 크기 순으로 나열하면 4.5~52.0 pM의 범위로 남자 5.3~51.9 pM, 여자 4.5~52.0 pM의 범위를 보였다. Percentile 법으로 하한 2.5%에서 상한 97.5%로 설정한 경우에는 전체535명(남자 259명, 여자 276명)으로 6.7~26.5 pM의 범위였으며 남자 6.8~26.5 pM, 여자 6.7~26.5 pM의 범위를 보였다.Proinsulin 시약 제조사에서 제공된 참고치는 6.4~9.4 pM이며 본 연구에서 재설정된 참고치는 6.7~26.5 pM이다. 이 차이는 서양인과 한국인의 인종간 특이성 때문인 것으로 추정된다. 따라서 가장 이상적인 참고치는 각자의 병원에 내원하는 정상인들을 대상으로 설정하는 것이다. 본원은 내분비내과와 협의를 통해 2012년 8월 1일부터 재설정된 참고치를 사용하고 있다. Purpose: It is very important to establish the appropriate reference range in the laboratory for preventing mistakes like false positive or false negative. Because the reference range in the laboratory is standard of patient test results interpretation. Proinsulin is precursor hormone of insulin, and the importance is increasing for diagnosing diabetes or insulinoma. Proinsulin reagent used in our laboratory is produced in the USA, and the reference range provided by manufacturer was adapted to our reference range after the validation test. But, it is generally recommend for the every laboratory to establish the their own reference range. So, we decided to re-evaluate the reference range with our patients' test results. Materials and Methods: Among 737 patients who had been to health promotion center in our hospital between Dec. $8^{th}$ 2011 and Dec. $21^{st}$ 2011, 563 patients are chosen with exception of diabetics patients and patients showing abnormal test results in Fasting Glucose, HbA1c, Insulin, and C-peptide. The 563 test results (275 males and 288 females) were classified with three groups(entire, male, female), and analysis of normal distribution was performed with aid of SPSS(version 19.0). Because Each group didn't show normal distribution, the reference range was set from the lowest limit of 2.5% to the highest limit of 97.5% with Percentile method used in non-normal distribution. Results: When evaluation values are sorted in ascending order, the entire range is 4.5~52.0 pM and 5.3~51.9 pM for male and 4.5~52.0 pM for female. The calculated reference range with percentile method shows 6.7~26.5 pM for entire group, 6.8~26.5 pM for male and 6.7~26.5 pM for female, respectively. Conclusion: The reference range provided by reagent manufacturer is 6.4~9.4 pM and the one established in this study is 6.7~26.5 pM. This difference might be caused by racial characteristics between Western people and Koreans. So an ideal reference range can be gotten with normal population visiting to every hospital. Our hospital has been using the newly re-establishing reference range under consultation with the department of endocrinology since Aug. $1^{st}$ 2012.