Mechanisms linking particulate matter exposures and cognitive impairment: epidemiological evidence

조재림,장희선,박현지,노영,손정우,고상백,이승구,김선영,김창수 환경독성보건학회 2022 한국독성학회 심포지움 및 학술발표회 Vol.2022 No.10

요추부 질환에서 시행한 단분절 유합과 장분절 유합간의 임상 결과에 대한 비교

조재림,윤원구,권오재 대한척추외과학회 1995 대한척추외과학회지 Vol.2 No.1

In some of the lumbar sinal disorders, fusion is the method of choice for relieving spinal pain and usually one or two segments fusion is sufficient but somtimes as in degenerative spinal stenosis it is necessary to carry out three or more segments fusion. The purpose of this study is to compare the clinical results between these short and long segment fusion groups. From August 1987 to December 1992, 138 lumbar spinal disorders were operated on and followed for more than one year, the average follow up period was 2 years and 5 months. One or two segments fusion was carried out in 111 patients and three or more segments fusion in 27 patients. 49 patients were male and 89 patients were female. Most prevalent age was from 41 to 60 in both groups. Degenerative spinal stenosis was the most common etiology for operation in both groups. In all cases, pedicle screws were female. Most prevalent age was from 41 to 60 in both groups. Average operation time was 4.75 hours in short segment fusion group and 6.25 hours in long segment fusion group. Under the hypotensive anesthesia, the amount of blood loss during operation was 1520 ㎕ and 2000㎕ respectively, and the amount of postoperative suction drainage was 450㎕ and 730㎕ respectively. On clinical results, 96.4% of good to excellent results were obtained in short segment fusion group while in long segment fusion group is was 85.2% but overall clinical results had no statistical significance between these two groups. In complications, hematoma was the most frequent complication in both groups but it was more frequent in long segment fusion group. Dural tear occured in 5 patients and it was more frequent in long segment fusion group and this was the only statistically significant complication. In this series, we had no deep would infection, no nonunion and no permanant neurologic deficit.

척추측만증(脊椎側彎症)의 개요

조재림 中央醫學社 1999 中央醫學 Vol.64 No.2

임파선을 따라 원격 골화성 전이를 일으킨 골육종 : 증례보고

조재림,김태승,이창우 최신의학사 1995 最新醫學 Vol.38 No.6

요추부에서의 재수술

조재림,박예수,임광민 대한척추외과학회 1996 대한척추외과학회지 Vol.3 No.2

The failed back syndrome refers to unsuccessful back surgery, which means back surgery without improvement. Thus it naturally implies the incorrect or inadequate operation. But in many instances, as in the newly developed herniated nucleus pulposus in a adjacent disk, reoperation is necessary after a long period of complete recovery from the initial symptom by successful initial operation. In this case it ti unfair to call it the failed back syndrome. Thus the term 'repeat surgery' is being used by many authors and we also used this terminology in this report. We analyzed 20 cases of repeat surgery, 15 cases of which were operated initially at the other hospital and the results are as follow : 1. The main cause of repeat surgery was a incomplete decompression(47.6%) of the neural tissue in the initial operation and the next one was degenerative changes in the adjacent disks which occured several years after initial operation with fusion. 2. By precise diagnosis and complete removal of offering reasons as well as by solid fusion with firm internal fixation in a repenat surgery overall 80% or more of good to excellent results could be obtained.

Effect modification of the association between long-term exposure to particulate matter and brain cortical thickness by low-grade systemic inflammation

조재림,손정우,노주환,김우진,장희선,노영,김선영,김창수 환경독성보건학회 2020 한국독성학회 심포지움 및 학술발표회 Vol.2020 No.9

정형외과영역에서의 Cefpiramide sodium (Sepatren^(�))의 임상 연구

조재림,박영봉,최태열 최신의학사 1987 最新醫學 Vol.30 No.4

척추 후외방 유합술후의 인접분절의 변화 : 3년 이상 추시 결과 Follow-up more than Three Years after Spinal Fusion

조재림,박예수,한주희,이창훈,노원일 대한척추외과학회 1998 대한척추외과학회지 Vol.5 No.2

Study design : A retrospective analysis of 166 patients was undertaken to observe radiologically the changes of adjacent segments at follow-up more than three years after lumbar fusion. Objectives : The purpose of this study is to analyze the changes of adjacent segments and to correlate these changes to the length of using level and to the degree of deviation from physiologic lumbar lordosis. The authors also correlate these radiologic changes to the clinical symptoms. Materials and Methods : In simple x-ray, authors observed traction spur, disc space narrowing, endplate sclerosis and vacuum phenomenon of adjacent segments. Authors used Gelb's criteria in segmental lordosis angle(SLA) and Katz's classification in clinical results. Results : The average age was 49.6 years old and the average follow-up period was 57.2 months(4 years and 9.2 months). We observed radiologically the traction spurs in 35 cases(21.1%), end-plate sclerosis in 32 cases(19.3%), disc space narrowing in 33 cases(19.9%) and the vacuum phenomenon in 10 cases(6.0%). The numbers of fusion segments and the degree of unphysiologic segmental lordosis angle in fusion segments were related with the frequency and degree of changes of adjacent segments (P<0.05). The clinical results showed satisfaction in 142 cases(85.5%), unsatisfaction in 24 cases(14.5%) and low back pain in 24 cases(14.5%), leg pain in 11 cases(6.6%) and extension of fusion level in 4 cases(2.4%). In low back pain patients more than two kinds of radiological changes were frequently observed than the patients without low back pain(P<0.05 ). Conclusions : The radiological changes of adjacent segments were more frequently observed in long fusion and in fusion with unphysiologic lumbar lordosis angle. And these changes are frequently associated with low back pain. Thus long fusion and fusion with unphysiologic lumbar lordosis angle should be avoided if possible.

Kaneda 기기를 이용한 흉요추부 및 요추부 방출성 골절의 수술적 치료

조재림,박예수,김도형 대한척추외과학회 1997 대한척추외과학회지 Vol.4 No.1

Study Design : Burst fracture consists of 15% of all spine fracture and half of them show neurologic deficit because of neural compression by the posteriorly displaced bony fragment of the mid column. Operative treatment is usually indicated for decompression in moderate to severe canal compromise with or without neurologic deficit. To maintain reduction and for early rehabilitation, various instrumentations are recommended and Kaneda instrument is one of the popular device for anterior decompression. Objectives : To confirm the relationship of anterior decompression and recovery of neurological function in burst fracture and the efficacy of the Kaneda instrumentation. Summary of Literature Review : Anterior approach has the advantages that it can directly remove displaced bony fragment to the spinal canal and also effecitvely correct deformity of the kyphotic angle. In this treatment, we generally use Kaneda instrument as an internal device which is biomechanically more rigid, and can fix even the least segment than any other one. Materials and Methods : From Aug. 1989 to Nov. 1994, the authors applied Kaneda instrument after anteriordecompression in 26 cases of burst fracture, which was followed for more than 1 year. We analysed burst fracture with Denis' classification, Cobbs' method, Mumford technique, Bradford and McBride classification, Denis' pain and work scale. Results : The average rate of preoperative canal encroachment was 55.9% and complete decompression was carried out in all cases. And there was no difference of these results in both groups of with or without neurologic deficit. At the time of injury, neurlogic deficit occurred in 12 cases. 3 of which showed complete paraplegia. In cord level injury, neurologic deficit was observed in horse-shoe and crescent type but no correlation was observed in cauda equina level injury. Neurologic status was improved average 1.3 grade in 9 cases except 3 cases of complete paraplegia. According to Denis' pain and work scale, it was 77% above P₂W₂. There was 4 cases of complications including 2 cases of superficial infection, 1 case of deep infection and 1 case of metal failure. Conclusion : We recommend the anterior spinal decompression and Kaneda instrumentation for restoration of spinal canal and optimal recovery of neurological function and for early rehabilitation.

척추경 나사못 기기술을 사용한 요추부 척추관 협착증의 수술적 치료

조재림,이광현,윤원구,이창우 대한척추외과학회 1994 대한척추외과학회지 Vol.1 No.2

The purpose of this study is to report our results for pedicle screw fixation in 161 cases of lumbar spinal stenosis from August,1987 to July,1993. The operation was performed for degenerative spinal stenosis in 72 cases, for stenosis by isth- mic defect in 51 cases, for stenosis combined with herniated lumbar disc in 30 cases, and for iatrogenic stenosis in 8 cases. The age at the time of operation was from 17 to 76, the mean age was 47.1 years. Contrel-Dubousset instrument was applied in 99 cases, compact C-D in 26 cases, Diapason in 30 cases, TSRH in 4 cases, and Steffee and P.W.B. in 1 case respectively. Decompression for 1 segment was carried out in 45 cases, 2 segments in 56 cases, 3 seg- ments in 41 cases, over 4 segments in 19 cases. Wide decompression including facetectomies were necessary to obtain complete decompression. The clinical results were that among the 161 cases followed over 1 year, 151 cases(94%) were good to excellent, 9 cases were fair and I case was poor according to the criteria of Kirkaldy-Willis. We could anticipate the good result in patients who had preoperative symptom duration for less than two years. But, the degree of compression of dural sac in myelogram is not correlated with the good result. Complications were multiple, hematoma(45 cases), meralgia paresthetica(13 ases), treatsient neurologic deficit(16 cases), dural tear(5 cases), urinary tract infection(2 cases), superficial infection(3 cases), screw breakage(5 cases), malposition of screw(1 case), prenetration of anteri- or cortex(2 cases), and dissociation of screw and rod(1 case). But no permanent neurologic deficit, or deep infection was observed and no reoperation was done. To obtain excellent results, complete decompression, firm internal fixation preferably by pedicle screws, and sufficient autogenous bone grafr were necessary.