요추부 유합 후 인접분절 각운동의 변화

김홍태,박봉훈,천동욱,김형표,정재호 대한척추외과학회 1995 대한척추외과학회지 Vol.2 No.1

A lumbar fusion may influence biomechanically on the remained unfused segments to take over the lost motions. The adjacent segments to fusion particulatly will experience an additional motional stress following a fusion, and then various late complications can occur. Moreover, the amount of this stress may differ according to the levels and extents of the fusions. The aim of this study is to evalu- ate this motional stress in different levels of fusion. A retrospective review of flexion and extension lateral radiograghs was undertaken for 142 consec- utive patients who had undergone various fusions in the lumbar region. Included in this study were the patients who had performed active daily livings after surgery and followed for minimum of two years. They were 60 males and 82 females, having mean age of 46.7(range 14-72). There were three posterior fusions, 123 lateral fusions, and 16 interbody fusions. The extent of fusions were one seg- ment in 71, two segments in 53, three segments in 16, and four segments in two patients. The follow- up period was 53 months in average(range 2-15 years). The intervertebral angles were measured on the flexion/extension lateral radiographs, and then the calculated intervertebral angular motions at follow-up periods were compared with those of preoperative values. The average increases of angular motion at the adjacent segments to fusions were 2.3˚at L1-2 seg- ment(ranging 0˚to 5˚increase),2.5˚at L2-3 segment(ranging 1˚decrease to 8˚increase), 2.9˚at L3-4 segment (ranging 3˚decrease to 12˚increase), 6.7˚at L4-5 segment(ranging 2˚to 18˚ increase), and 1.5˚at L5-S1 segment(ranging 5˚decrease to 7˚increase). The average increases of the above and below adjacent segments to fusions were 3.3˚(ranging 3˚decrease to 18˚increase) and 1.7˚(ranging 5˚decrease to 12˚increase) respectively. There were no significant differences in the changes of angular motion according to the extents of fusion and during these follow-up periods. In conclusion, the angular motions at the adjacent segment to fusions increased most signficantly at L4-5 segment regardless of the fusion sites whether it is below or above a fusion. Excluding the L4-5 segment, the angular motions at the above adjacent segments to fusion increased significantly compared to those at the below adjacent segments. The late complications at adjacent segments to lumbar fusions are expected to appear preferably at these segments.

만성폐쇄성폐질환의 중증도와 폐고혈압 및 폐성심으로 진행과의 상관관계

김형호,박철진,이준,장광표,하성일,이재록,하재화,권세훈,권용운,윤성호,이승일 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

Background: From many previous studies, Pulmonary hypertension is the known independent predictive factor of the mortality in COPD. Also pulmonary hypertension is the major cardiovascular complication of COPD and is associated with the progression to cor pulmonale and poor prognosis. Author want to analyze the correlation between pulmonary hypertension and the severity of COPD which are classified by forced expiratory volume in one second, and the extent of progression to corpulmonale. Methods: Retrospectively we investigated the medical records of 118 patients with COPD who had pulmonary function test and echocardiogaphy more than one times during one-year follow-up (from June, 2005 to May, 2006) at respiratory division in chosun university hospital, and then 50 patients were enrolled in this study. We classified the severity from FEVl in pulmonary function test based on the GOLD guideline, also this was comparably analyzed with RVSP, RVIDd, Visual Grading from echocardiography. Results: 16 patients out of 50 were classified as moderate severity, 25 patients were severe, and 9 patients were very severe group. RVSP was higher in more severe groups than less severe groups but when it comes to pulmonary hypertension that RVSP is over 35 mmHg, there was no valid difference lies in those groups. As FEVl decreases RVSP and RVIDd increases, and observed relationship between RVSP which was classified as below 35 mm and above 35 mm groups and visual grading which was classified as normal and dilatated groups revealed valid correlation, Conclusion: As pulmonary function decreases, progression to pulmonary hypertension and cor pulmonale increases but there was no remarkable difference of prevalence in above moderate severity groups. 연구배경 폐고혈압은 이전의 많은 연구에서 만성폐쇄성폐질환에서 독립적인 사망의 예측인자로 알려져 있다. 또한 폐고혈압은 만성폐쇄성폐질환의 주요한 심혈관계 합병증이며, 폐성심으로의 진행 및 불량한 예후와도 관련되어 있다. 이에 저자는 폐고혈압과 1초간 노력성호기량으로 분류되는 만성폐쇄성폐질환의 중증도 및 폐성심으로의 진행 정도를 비교 분석하여 이들의 상관관계를 밝혀보고자 한다. 방법 2005년 6월부터 2006년 5월까지 1년 동안 본 병원 호흡기 내과에서 폐기능검사와 심장초음파 검사를 각각 1회 이상 시행한 적이 있는 118명에 한하여 의무기록을 후향적으로 조사하여 이 중에서 50명을 대상으로 하였다. 폐기능검사 시행 결과 얻은 1초간 노력성호기량을 바탕으로 GOLD guideline에 따라 중증도를 분류하였으며 이를 심초음파 시행 결과 얻은 우심실수축기압, 확장기말 우심실내부간격, 시각등급과 비교분석하였다. 결과 대상 환자 50명중 16명은 중등증, 25명은 중증, 9명은 최고중증 그룹으로 분류되었다. 우심실수축기압은 중증도가 높은 그룹에서 낮은 그룹에 비해 더 높게 나타났으나 폐고혈압에 해당하는 우심실수축기압이 35 mmHg이상인 환자에 있어사는 각 그룹간에 유의한 차이를 보이지 않았으며, 확장기말 우심실내부간격, 시각등급 또한 중증도와 유의한 차이를 보이지 안항ㅆ다. 1초간 노력성호기량이 감소함에 따라서는 우심실수축기압, 시각등급은 증가하였으며 우심실수축기압을 35mmHg 미만과 이상인 그룹으로, 시각등급을 정상과 확장이 있는 그룹으로 분류하여 비교한 결과에서는 유의한 상관관계를 나타냈다. 결론 폐기능이 감소할수록 페고혈압 및 폐성심으로의 진행이 증가하였으나 폐기능검사에서 중등도 이상의 그룹에서 유병률의 차이는 크지 않았다.

응급실로 내원한 장중첩증의증 환아의 진단방법에 대한 임상적 고찰

원형섭,박정배,표창해,김형수,박철완,이근 대한응급의학회 1995 대한응급의학회지 Vol.6 No.2

The purpose of this study is to evaluate the appropriate diagnostic methods for the patients with suspected intussusception. Intrssusception is a state that a portion of alimentary tract is telescoped into a segment just caudad to it, and has a characteristic symptoms of cyclic irritability, vomiting, bloody stools and palpable mass, It is the most common cause of acute or acquired intestinal obstruction in infants and children, and needs early diagnosis and immediate treatment. Authors reviewed retrospectively medical records of 411 infants & children with suspected intussusception from January 1, 1992 to December 31, 1994 and report the results with literature reviews. The results were as followings; 1) 263 cases were definite intussusception(DI) out of 411 suspected intussusception(SI). 2) The male to female ratio was 2.3 : 1 in SI and 2.8 : 1 in DI. 3) The distribution of age revealed that 85% of SI and 84% of DI were under 24 months old, and the most common age was 8 months in SI and 10 months in DI. 4) There were upper respiratory infection in 84 cases(2)%), gastroenteritis in 32 cases(8%) and bronchiolitis in 8 cases(2%) as preceding diseases. 5) The simple X-ray showed gaseous bowel distension in 212 cases(52%). 6) The most common symptoms and signs were cyclic irritability and abdominal pain(94%), bloody stools(72%), palpable abdominal mass(47%), in order. 7) Of 411 patients, 252 cases(61%) were diagnosed and treated by air enema(228 cases) and/or exploration(24 cases). Among 296 cases(72%) who showed bloody stools in digital rectal examination and glycerin enema, 245 cases(83%) were confirmed as intussusception through air enema and/or operative intervention, and that corresponds to 93% of DI. 8) Intestinal perforation as complication occurred in 3 of 393 cases who underwent air and barium enema, but all of them recovered without any sequelae after operation. Conclusively, it is thought that air enema preceded by digital rectal examination and glycerin enema is safe and useful method in diagnosis and treatment of infants and children with SI.

Cyclosporine과 Ketoconazole의 약물상호작용을 이용한 아토피 피부염 치험 2예

김동원,표형찬,은희철,이유신 大韓臨床藥理學會 1993 臨床藥理學會誌 Vol.1 No.1

Bezier Spline을 이용한 용접 로봇의 새로운 Weaving Motion 궤적 생성 알고리즘

정원지,김대영,서영교,홍형표,홍대선 한국공작기계학회 2004 한국생산제조학회지 Vol.13 No.3

In this paper, we propose a new weaving trajectory algorithm for the are welding of a articulated manipulator. The algorithm uses the theory of Bezier spline. We make a comparison between the conventional algorithms using Catmull-Rom curve and the new algorithms using Bezier spline. The proposed algorithm has been evaluated based on the MATLAB environment in order to illustrate its good performance. Through simulations, the proposed algorithm can result in high-speed and flexible weaving trajectory planning so that it s trajectory cannot penetrate into a base metal compared to the conventional algorithm using Catmull-Rom curve.

사지의 급성동맥 색전증에 대한 응급동맥 색전제거술

박철완,원형섭,박정배,이근,조상훈,표창해,김상일 대한응급의학회 1996 대한응급의학회지 Vol.7 No.2

Acute arterial occlusion of the extremities is often a surgical emergency and is due mostly to arterial embolus. It has infrequently been reported in the emergency department. Cardiac embolism is most commonly the result of atrial fibrillation secondary to valvular heart disease followed by ischemic heart disease. The emergency arterial embolectomy by Fogarty balloon catheter works well when the cause of occlusion is cardiac embolus obstructing normal vessels in a patient with valvular heart disease. Recently we met some patients with acute critical ischemia of the extremities due to arterial emboli in our emergency department. On physical examination, they all had symptoms of 5"P"s(pain, pallor, pulselessness, paresthesia, paralysis). After emergency arterial embolect omy, immediate improvement was observed in all patients. They were discharged within 1 week. We report our experiences with the review of literatures.

A Study on the Characteristics of a Vibrator Using Flat PCB-Coil

Kim, Hyung Sik,Hong, Sang Pyo,Choi, Mi Hyun,Kim, Hyun Joo,Lee, In Hwa,You, Na Rae,Yi, Jeong Han,Chung, Soon Cheol Trans Tech Publications, Ltd. 2013 Applied mechanics and materials Vol.392 No.-

<P>In this study, we developed and evaluateda vibrator using a flat PCB-coil. The flat PCB-coil vibrator was fabricated on a printed circuit board using and etching process. The spiral pattern was etched on a fiberglass cloth with an epoxy resin. To evaluatethe flat PCB-coil vibrator, we generated a sine wave, saw-tooth, and square wave through a custom made wave generator and amplified the waveforms using a power amplifier. A three-axis accelerometer was used to evaluate the performance of the developed vibrator. Even though the developed vibrator is simple, it has a wide range of vibration frequency (50~500 Hz) and vibration amplitude (0~5 V). The vibration amplitude does not change due to frequency change. It is expected that the developed vibrator can be used in a wide variety of applications such as in a tactile stimulator, in elastography, energy harvesting, and in a cooling system.</P>

Myocardial scarring on cardiovascular magnetic resonance in asymptomatic or minimally symptomatic patients with “pure” apical hypertrophic cardiomyopathy

Kim, Kyung-Hee,Kim, Hyung-Kwan,Hwang, In-Chang,Lee, Seung-Pyo,Park, Eun-Ah,Lee, Whal,Kim, Yong-Jin,Park, Jae-Hyung,Sohn, Dae-Won BioMed Central 2012 Journal of cardiovascular magnetic resonance Vol.14 No.-

<P><B>Background</B></P><P>Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) enables state-of-the-art in vivo evaluations of myocardial fibrosis. Although LGE patterns have been well described in asymmetrical septal hypertrophy, conflicting results have been reported regarding the characteristics of LGE in apical hypertrophic cardiomyopathy (ApHCM). This study was undertaken to determine 1) the frequency and distribution of LGE and 2) its prognostic implication in ApHCM.</P><P><B>Methods</B></P><P>Forty patients with asymptomatic or minimally symptomatic pure ApHCM (age, 60.2 ± 10.4 years, 31 men) were prospectively enrolled. LGE images were acquired using the inversion recovery segmented spoiled-gradient echo and phase-sensitive inversion recovery sequence, and analyzed using a 17-segment model. Summing the planimetered LGE areas in all short axis slices yielded the total volume of late enhancement, which was subsequently presented as a proportion of total LV myocardium (% LGE).</P><P><B>Results</B></P><P>Mean maximal apical wall thickness was 17.9±2.3mm, and mean left ventricular (LV) ejection fraction was 67.7 ± 8.0%. All but one patient presented with electrocardiographic negative T wave inversion in anterolateral leads, with a mean maximum negative T wave of 7.2 ± 4.7mm. Nine patients (22.5%) had giant negative T waves, defined as the amplitude of ≥10mm, in electrocardiogram. LGE was detected in 130 segments of 30 patients (75.0%), occupying 4.9 ± 5.5% of LV myocardium. LGE was mainly detected at the junction between left and right ventricles in 12 (30%) and at the apex in 28 (70%), although LGE-positive areas were widely distributed, and not limited to the apex. Focal LGE at the non-hypertrophic LV segments was found in some ApHCM patients, even without LGE of hypertrophied apical segments. Over the 2-year follow-up, there was no one achieving the study end-point, defined as all-cause death, sudden cardiac death and hospitalization for heart failure.</P><P><B>Conclusions</B></P><P>LGE was frequently observed not only in the thickened apex of the heart but also in other LV segments, irrespective of the presence or absence of hypertrophy. The simple presence of LGE on CMR was not representative of adverse prognosis in this population.</P>

Wire Tension Method for Coefficient of Friction Measurement of Micro Bearing

Kim, Hyung Jin,Park, In Kyum,Seo, Young Ho,Kim, Byeong Hee,Hong, Nam Pyo 한국정밀공학회 2014 International Journal of Precision Engineering and Vol.15 No.2

In this paper, the novel bearing tester was developed by new method using a wire tension to obtain the coefficient of friction (COF) of micro bearings. Because the conventional bearing testers mostly use bulky and friction-nature torque sensors, there is a limitation to measure the minute rotational torques of the micro bearings. In order to overcome the previous limitation and estimate the COFs of very small journal bearings (inner diameter < 10 mm), the bearing was placed freely along the x-axis and the tension of the wire which wrapped the bearing and was connected between the counterweight and the load cell was measured. The COFs were calculated by dividing the radial friction force obtained by the wire tension by the initial vertical load given by the mass of the counterweight and the bearing module. The developed bearing tester could measure the COFs of the micro journal bearing of various shape and size effectively. The validity of the bearing tester was verified by several friction measuring tests. The system also showed very high repeatability and precision.

Spectrum of rhodopsin mutations in Korean patients with retinitis pigmentosa

Kim, Kwang Joong,Kim, Cinoo,Bok, Jeong,Kim, Kyung-Seon,Lee, Eun-Ju,Park, Sung Pyo,Chung, Hum,Han, Bok-Ghee,Kim, Hyung-Lae,Kimm, Kuchan,Yu, Hyeong Gon,Lee, Jong-Young Molecular Vision 2011 Molecular vision Vol.17 No.-

<P><B>Purpose</B></P><P>To determine the spectrum and frequency of rhodopsin gene (<I>RHO</I>) mutations in Korean patients with retinitis pigmentosa (RP) and to characterize genotype–phenotype correlations in patients with mutations.</P><P><B>Methods</B></P><P>The <I>RHO</I> mutations were screened by direct sequencing, and mutation prevalence was measured in patients and controls. The impact of missense mutations to RP was predicted by segregation analysis, peptide sequence alignment, and in silico analysis. The severity of disease in patients with the missense mutations was compared by visual acuity, electroretinography, optical coherence tomography, and kinetic visual field testing.</P><P><B>Results</B></P><P>Five heterozygous mutations were identified in six of 302 probands with RP, including a novel mutation (c.893C>A, p.A298D) and four known mutations (c.50C>T, p.T17M; c.533A>G, p.Y178C; c.888G>T, p.K296N; and c.1040C>T, p.P347L). The allele frequency of missense mutations was measured in 114 ethnically matched controls. p.A298D, newly identified in a sporadic patient, had never been found in controls and was predicted to be pathogenic. Among the patients with the missense mutations, we observed the most severe phenotype in patients with p.P347L, less severe phenotypes in patients with p.Y178C or p.A298D, and a relatively moderate phenotype in a patient with p.T17M.</P><P><B>Conclusions</B></P><P>The results reveal the spectrum of <I>RHO</I> mutations in Korean RP patients and clinical features that vary according to mutations. Our findings will be useful for understanding these genetic spectra and the genotype–phenotype correlations and will therefore help with predicting disease prognosis and facilitating the development of gene therapy.</P>